Objectives To evaluate the main symptoms of knee osteoarthritis (OA) and tissue structure changes after a single dose bone marrow-derived mononuclear cell (BM MNC) intra articular injection. Case series study. Patients with knee OA Kellgren Lawrence (K-L) grade II and III received 1 injection of BM MNC. The clinical results were analyzed with the Knee injury and Osteoarthritis Outcome Score (KOOS) and Knee Society Score (KSS) before, 3, 6, and 12 months after injection. Radiological evaluation was performed with a calibrated x-ray and the magnetic resonance (MR) imaging before and 6 to 7 months postinjection. Results A total of 34 knees were treated with BM MNC injections. Mean (±SD) age of patient group was 53.96 ± 14.15 years; there were 16 males, 16 females, KL grade II, 16; KL grade III, 18. The average injected count of BM MNCs was 45.56 ± 34.94 × 10 cells. At the endpoint of 12 months 65% of patients still had minimal perceptible clinical improvement of the KOOS total score. The mean improvement of KOOS total score was +15.3 and of the KSS knee score was +21.45 and the function subscale +27.08 ( P < 0.05) points. The Whole Organ Magnetic Resonance Imaging Score (WORMS) improved from 44.31 to 42.93 points ( P < 0.05). No adverse effects after the BM-MNC injection were observed. Conclusions The single dose BM MNC partially reduces clinical signs of the knee osteoarthritis stage II/III and in some cases, decreases degenerative changes in the joint building tissue over 12-month period.

The intra-articular injection of bone marrow-derived mononuclear cells is a safe manipulation with no side effects during the 12-month period. This treatment provides statistically significant clinical improvement between the starting point and 1, 3, 6, and 12 months after. When compared to hyaluronic acid treatment, better pain relief in the long-term period of mononuclear cell group was observed.

Traumatic calcanectomy is a complicated rare condition that results in chronic pain and loss of limb function as the calcaneus is crucial for bearing weight. For an adult, possible treatment options are limited to below knee amputation, bone grafts, and 3D prosthesis; however, for the pediatric population, therapeutic data are scarce. In this case report, the authors describe a technique that provides the possibility for hindfoot reconstruction while maintaining growth potential without traumatizing other anatomic regions. A 5‐year‐old patient presented in the emergency department after he accidentally slipped under a lawnmower, which resulted in full calcaneal amputation with large bone and plantar soft tissue defects from the medial to lateral malleoli. Four days later, reconstructive surgery was performed using a composite vascularized pedicle growth plate flap. The flap was based on the retrograde anterior tibial artery and consisted of the peroneus longus muscle and fasciocutaneous perforator flap to maintain soft tissue coverage. The calcaneus was reconstructed by a double barrel fibular transplant localizing the growth plate in the distal part of the neocalcaneus. Full consolidation of the fibular barrels was achieved and the growth plate was still open at the 8‐year follow‐up. The fibular transplant has acquired a similar shape to a calcaneus with symmetric flattening and opposite side angulation. The patient's lower extremity functional score was 78/80 points. Reconstruction of an amputated calcaneal bone is rare and complicated, especially for pediatric patients. Authors demonstrate treatment with a complex vascularized flap for sustained growth and good functional outcome in the long term.

The clinical effects on knee osteoarthritis (OA) symptoms and tissue structure were evaluated after bone marrow-derived mononuclear cell intraarticular injection. A group of 32 patients with 34 knee joints in stage II–III osteoarthritis were treated by intraarticular injection of mononuclear cell suspension. Clinical results were obtained by KOOS (Knee Osteoarthritis Outcome Score) and KSS (Knee Society Score) scores during a 12 months follow-up period. Radiological evaluation was performed using magnetic resonance imaging. A comparison with a control group of 28 patients treated with routinely used three hyaluronic acid intra-articular injections was made. No adverse effects were observed after the bone marrow derived mononuclear cells (BM-MNC) injection. At the end point of the follow up all score results had improved, compared to those at to the starting point. 65% of patients maintained minimal perceptible clinical improvement of the score results. The Whole Organ Magnetic Resonance Imaging Score showed improvement from 44.31 to 42.93 points (p < 0.05) during a 6–7 month period. Comparing score results to the control group, a statistically significant (p < 0.05) improvement in the KOOS pain subscale score at the 6 and 12 months was observed in the mononuclear cell group. BM-MNC injection leads to a decrease of knee OA symptoms and slows changes in structure of the degenerative joint tissue.