These results suggest that PRP could be a potential therapeutic tool for the treatment of OA.
Introduction Soft tissue mass following total hip arthroplasty raises several differential diagnoses not limited to infection, hematoma, wear debris, malignancy, and bursitis. Rice body formation in the hip region is an uncommon process denoting a chronic inflammation. We report here the second case of its kind in the medical literature of a wide symptomatic rice-like body cyst complicating a total hip arthroplasty. Case Presentation This is the case of an 82-year-old white female, presenting with a warm, red, and inflated groin five years after revision of right total hip arthroplasty. Surgical intervention reveals a large well circumscribed cyst containing well-organized rice-like bodies. This eventuality was never reported in differential diagnosis of hip periprosthetic soft tissue masses before. Conclusion This case report helps widening the array of the differential diagnosis in patients presenting with a slow growing soft tissue mass following total hip arthroplasty, making rice-like bodies cyst a valid one to consider.
Femoral head fractures in adults are known to be frequently associated with femoral neck fractures, acetabular fractures and sciatic nerve neurapraxia. Here, we report for the first time in the English medical literature the case of a 30-year-old patient having a Pipkin Type II comminuted femoral head fracture associated to an isolated acetabular labral osteochondral avulsion. This entity was diagnosed preoperatively through the presence of the acetabular ‘fleck’ sign recently described in adolescents with hip dislocation. This was of paramount importance knowing the key role of the acetabular labrum in physiological hip functioning. Therefore, a high index of suspicion of complete posterior acetabular labrum avulsion should be raised in front of a hip computed tomography scan showing the acetabular fleck sign even in an adult patient. This finding is important in posing the surgical indication and in completing the preoperative surgical planning in cases of femoral head fractures and dislocations.
BackgroundOsteoarthritis is a chronic debilitating disease characterised by degeneration of cartilage, synovitis and osteophytes formation.1 This disease does not only affect aged people but it afflicts also young athletes where until today no medications has proven efficacy in stopping the progression of the disease and/or regenerate the loss of cartilage.2 Recently cell therapy has attracted attention in many medical fields and especially in rheumatology and orthopaedic specialty. Stem cells due to their differentiation capacity, trophic and paracrine effects have been shown to serve as promising new modality in treating osteoarthritis.3,4 ObjectivesOur objective in this study is to investigate the effect and mechanism of action of the three sources of stem cells; bone marrow derived stem cells (B-MSC), adipose derived stem cells (A-MSC) and umbilical cord stem cells (U-MSC) on osteoarthritic chondrocytes.MethodsMesenchymal stem cells were isolated from bone marrow, adipose tissue and umbilical cord from 5 different donors respectively and cocultured with human osteoarthritic chondrocytes obtained from 5 patients undergoing total knee arthroplasty. The effect autophagy was determined using flow cytometry analysis. Quantitative polymerase chain reaction (qPCR) and ELISA were used to measure the changes in the major factors playing a role in OA such as(a disintegrin and metalloproteinase with thrombospondin motifs-5(ADAMDTS-5), Metalloproteinases (MMP-3, MMP13), tissue inhibitor of metalloproteinases (TIMP-1–2–3), Collagen, Cox-2, Il-6, the regulators of autophahy FOXO1, FOXO3, and LC3II and Beclin I in the tissues and cocultured media.ResultsIn our study we found that the three stem cells sources increased significantly the proliferation of chondrocytes, and increased autophagy via increasing Beclin 1 and LC3II, along with its regulators FOXO1, FOXO3 in human osteoarthritic chondrocytes with p<0.05. Furthermore, the three sources of stem cells caused a dose dependent significant decrease in MMP-3, MMP-13, ADAMTS-5, IL-6, CCL20 and COX-2 with p<0.05. Aggregan, collagen, TIMPs were also significantly increased by the co-culture of A-MSC, B-MSC, U-MSC.ConclusionsThese results suggest that stem cells could be a promising therapeutic target for the treatment of osteoarthritis.References[1] Soler R, et al. Final results of a phase I-II trial using ex vivo expanded autologous mesenchymal stromal cells for the treatment of osteoarthritis of the knee confirming safety and suggesting cartilage regeneration. Knee2016;23(4):647–6541.[2] Lagorce T, Buxeraud J, Guillot X. Comprendre l’arthrose. Actual Pharm2016Apr;55(555):18–22.[3] Martel-Pelletier J, Wildi LM, Pelletier J-P. Future therapeutics for osteoarthritis. Bone2012Aug;51(2):297–311.[4] Orozco L, Munar A, Soler R, Alberca M, Soler F, Huguet M, et al. Treatment of knee osteoarthritis with autologous mesenchymal stem cells: A pilot study. Transplantation2013Jun 27;95(12):1535–41.[5] Soler R, et al. Final results of a phase I-II trial using ex vivo expanded autologous mes...
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