The purpose of the present study was to investigate the effect of intra-articular injections of autologous conditioned serum on human hip osteoarthritis and to test whether a potential treatment effect might be increased by additional injections of steroids and the recombinant interleukin-1 receptor antagonist protein anakinra. We compared the effects of autologous conditioned serum 46 hip osteoarthritis patients), autologous conditioned serum+cortisone (56 patients), and autologous conditioned serum+cortisone+recombinant interleukin-1 receptor antagonist protein (17 patients) in a retrospective clinical study by means of the Visual Analogue Scale for pain (pre- vs posttreatment). Over 14 months, treatment resulted in a large, statistically significant improvement for patients in all three groups, independent of the severity of osteoarthritis. Neither cortisone nor cortisone+recombinant interleukin-1 receptor antagonist protein increased the beneficial treatment effect over and above the effect of autologous conditioned serum alone. Autologous conditioned serum successfully reduces pain in hip osteoarthritis. In severe hip osteoarthritis, the sole application of autologous conditioned serum can be even more beneficial than the combination of autologous conditioned serum with steroids.

This study investigated the incidence of injury in German Bundesliga football based on the evaluation of two American football teams before and during the season 1995. Certified team physicians and team physiotherapists were the initial medical professionals providing on-site diagnosis, injury documentation and first aid for all injuries. An injury was defined as minor (group I) causing the player to miss practice or game sessions up to 1 week without requiring surgery; as severe (group II) causing the player to miss practice or game sessions for more than 1 week up to 3 months or requiring surgery; and as catastrophic (group III) if the incident led to treatment for more than 3 months, treatment in an intensive care unit or persistent neurological or orthopaedic disability or death. From the data collected it was possible to calculate the risk of injury per time of exposure per athlete. The athlete's function, influence of the weather and mechanisms of the injuries were registered. In total, 242 injuries were documented. The rate of injury was calculated as 16 per 1000 hours of practice and game per athlete. Severe injuries (group II) were found in 94 cases. Catastrophic injuries were not seen during the study. The knee was found to be the most common site of injury, while the ankle ranked second. Our study showed that the risk of injury in American football in German Bundesliga is comparable with soccer or handball.

For the first time, valid data of Achilles tendon diameters in competitive athletes and normal individuals have been presented. The emerging pattern of results clearly contradicts the notion of a physiological training adaptation of the Achilles tendon.

The concept of a "meniscus report" is introduced for documentation of meniscus tissue specimens integrating histological, histochemical and proteomic data, thereby specifying the degree of degeneration and the assessment of acute or non-acute lesions. Mass spectrometry contributes to an objective histopathology report. An advisory opinion should always be based on close correlation of clinical and morphological evaluations.

Although the clinical potential of bone morphogenetic proteins (BMPs) has been known for decades, their use in humans has only been approved for a limited number of orthopaedic conditions. Promising results in animals demonstrate the utility of BMP-2 in regional bone repair without using osteoconductors. To our knowledge, no comparable human case has been described. We report the case of a 50-year-old who suffered a femoral neck fracture. After 9 months of extensive treatment, he was still not pain-free. The following open-wedge osteotomy resulted in a therapy-resistant delayed union. We therefore conducted 4 computer tomography-guided injections of recombinant human (rh) BMP-2 into the bone gap. No osteoconductor was employed. Six weeks later, there was a 55–60% defect filling. Follow-up examination showed a complete union of the bone defect. Our case report shows that in a complicated delayed union rhBMP-2 can be successfully used to induce bone formation without any osteoconductor.

Based on the presented data rehydration time of 0.5 hours seems to have no disadvantage compared to longer time periods concerning breaking strength. Therefore a longer intraoperative time period seems not to be necessary. This is of advantage for a possible secondary contamination while the allograft is rehydrated. Rehydration after lipid extraction is more effective than rehydration after lyophilization alone. However, the question whether lipid extraction alter bone stability has to be proved in further studies.

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Despite the high prevalence of the disease, at present little effective pharmacological treatment of rheumatoid arthritis is available. Novel approaches utilising biological agents have resulted in the development of new antiarthritic and antiinflammatory agents, such as tumour necrosis factor-alpha (TNFalpha)-specific antibodies and interleukin-1 receptor antagonist (IL-1ra). Local gene therapy not only allows the pharmaceutical use of these biologicals, but also allows for continuous drug supply, which is necessary for chronic diseases like rheumatoid arthritis. We discuss the basics of rheumatoid arthritis therapy, candidate genes and possible gene transfer methods. A current clinical gene therapy trial is focusing on the IL-1 system using IL-1ra as a transgene. The transfer system, clinical protocol and preliminary results are described. After treatment of 11 patients we feel that gene therapy will offer potential as a new avenue to treat rheumatoid arthritis.