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We have performed a prospective, single-surgeon study analysing the histological results of autologous chondrocyte implantation. Fourteen patients underwent autologous chondrocyte implantation of the knee and were evaluated at one year by clinical assessment and arthroscopy. Standard staining was used to examine the sections. In addition, in situ hybridisation was used to establish type-IIa and type-IIb collagen mRNA expression and immunolocalisation techniques demonstrated the positions of type-II and type-X collagen. Eight patients regenerated hyaline cartilage and also contained type-X collagen in the deepest layers and type-II collagen in the deep layers. Three demonstrated fibrocartilage and had type-I collagen in the deep layers. In situ hybridisation revealed that all 14 samples had the potential to express both type-IIa and type-IIb collagen. We have shown that one year after the initial implantation chondrocytes are capable of producing type-II collagen and that they continue to proliferate and mature.

We followed up seven patients with histologically confirmed diffuse pigmented villonodular synovitis in a prospective study between 1992 and 2001. The mean age at diagnosis was 30.7 years. The patients underwent synovectomy, followed by radiotherapy with a total dose of 35 Gy in 20 fractions. In all cases, the excision was considered incomplete when examined histologically. At an average follow up of 24 (18-36) months, six patients reported better function and reduced levels of pain. One patient remained symptomatic but did not have a recurrence. We conclude that a combined approach to a primary pigmented villonodular synovitis of the foot and ankle may reduce the risk of recurrence without functional impairment.Résumé Nous avons suivi sept malades avec une synovite villonodulaire pigmentée diffuse confirmé histologiquement dans une étude prospective entre 1992 et 2001. L'âge moyen au diagnostic était de 30,7 ans. Les malades ont subi une synovectomie suivie d'une radiothérapie avec une dose totale de 35 Gy en 20 fractions. Dans tous les cas, la résection a été considérée incomplète à l'examen histologique. À une moyenne de suivi de 24 (18-36) mois, six malades ont une meilleure fonction et un niveau réduit de douleur. Un malade est resté symptomatique, mais sans récidive. Nous concluons qu'un traitement combiné d'une synovite villonodulaire pigmenté du pied et de la cheville peut réduire le risque de récidive sans dégrada-tion fonctionnelle.

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