PRP significantly reduced pain and improved quality of live in patients with low degree of cartilage degeneration. Magnetic resonance imaging did not confirmed any significant cartilage condition improvement.

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Background: The objective of the present study was to determine if platelet rich plasma (PRP) can increase tibiofemoral cartilage regeneration and improve knee function. Methods: Fourty consecutive and strictly selected patients affected by grade II or III chondromalacia underwent 1 yr of treatment (nine injections) with autologous PRP in a liquid form with 2.0 to 2.5-fold platelet concentration (20 cases) or with hyaluronic acid (HA) (20 patients). Outcome measures included the Lysholm, Tegner, International Knee Documentation Committee (IKDC), Western Ontario and McMaster (WOMAC) Osteoarthritis Index, and Short Form (SF)-36 scores. MRI arthroscopic and histologic assessment were used to evaluate cartilage thickness and degree of degeneration before and after treatment (1 yr after the primary arthroscopy). Results: The study demonstrated significant improvement in Lysholm, Tegner, IKDC, WOMAC, and SF-36 scores in both groups. Cartilage assessment revealed no significant macroscopic or microscopic structural regeneration as well as no cartilage height increase in either group. Higher content of chondrocytes and proteoglycans in cartilage was proven in both groups after treatment without a statistically significant difference between the groups. There were no adverse events observed. Conclusions: PRP and HA significantly reduced pain and improved quality of life in patients with a low degree of cartilage degeneration. MRI and arthroscopic assessment did not confirm any significant cartilage structural improvement. The content of chondrocytes and proteoglycans in cartilage was higher in the PRP group than in the HA group after the treatment but did not reach statistical significance.

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Background: The objective of the study was to demonstrate the effect of concentrated bone marrow stem cells (MSCs) to the healing of sutured tendon of the supraspinatus muscle in comparison to the same procedure performed without MSCs. We have postulated the hypothesis that MSCs enhance the healing of the sutured supraspinatus tendon to its humeral footprint. Methods and findings:None of the patients had to be excluded from our prospective randomized study. 50 patients met the indication criteria for isolated supraspinatus surgery. 25 patients (Group I) received MSCs into the supraspinatus footprint. 25 patients (Group II) was treated without the use of MSCs. Patients were examined pre-operatively, 6, 12 and 24 months after the surgery and assessment included physical examination, visual analogue scale (VAS), ASES (American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form) and Constant score. Patients underwent MRI 2 years postoperatively. Findings were compared with the preoperative results.We have found no statistically significant differences between both groups pre-operatively. After a 24-month follow-up period there were significant differences observed in all clinical outcomes. When compared results between both groups two years postoperatively, p-value (p=0.05) for the VAS score was 0.0176 and for the Constant score 0.0355. The only statistically non-significant was p-value for the ASES score comparing results from both groups at two years follow-up (p=0.085). The MRI findings at 2 years showed fully healed tissue of the rotator cuff tendon in 17 patients in the Group I, but only in 9 patients in the Group II. Conclusions:We have accepted the hypothesis that MSCs enhance the healing of the sutured supraspinatus tendon to its humeral footprint.

The biomechanical function of the anteromedial (AM) and posterolateral (PL) bundles of the anterior cruciate ligament (ACL) remains controversial. Some studies report that the AM bundle stabilises the knee joint in anteroposterior (AP) translation and rotational movement (both internal and external) to the same extent as the PL bundle. Others conclude that the PL bundle is more important than the AM in controlling rotational movement. The objective of this randomised cohort study involving 60 patients (39 men and 21 women) with a mean age of 32.9 years (18 to 53) was to evaluate the function of the AM and the PL bundles of the ACL in both AP and rotational movements of the knee joint after single-bundle and double-bundle ACL reconstruction using a computer navigation system. In the double-bundle group the patients were also randomised to have the AM or the PL bundle tensioned first, with knee laxity measured after each stage of reconstruction. All patients had isolated complete ACL tears, and the presence of a meniscal injury was the only supplementary pathology permitted for inclusion in the trial. The KT-1000 arthrometer was used to apply a constant load to evaluate the AP translation and the rolimeter was used to apply a constant rotational force. For the single-bundle group deviation was measured before and after ACL reconstruction. In the double-bundle group deviation was measured for the ACL-deficient, AM- or PL-reconstructed first conditions and for the total reconstruction. We found that the AM bundle in the double-bundle group controlled rotation as much as the single-bundle technique, and to a greater extent than the PL bundle in the double-bundle technique. The double-bundle technique increases AP translation and rotational stability in internal rotation more than the single-bundle technique.

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