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PubMedDate not supplied

Chondrocalcinosis following osteochondritis dissecans in the femur condyles.

Chondrocalcinosis, defined as radiopaque deposits in the joint cartilages and in semilunar cartilages of the knee joint, develops frequently in patients in whom osteochondritis dissecans is diagnosed after the epiphyseal line of the distal end of the femur is closed. Chondrocalcinosis occurred in 2/3 of the cases surgically treated for osteochondritis. The incidence was greater than in knees treated by arthrotomy for ruptured semilunar cartilages. However, the latter show chondrocalcinosis much more frequently in patients without history of injury or arthrotomy. Osteochondritis patients with chondrocalcinosis more often may have joint effusion than patients with other conditions. The chondrocalcinosis is not confined to that part of the joint which was the site of the osteochondritis lesion. The presence of chondrocalcinosis can be correlated with a poor prognosis of the knee including severe gonarthrosis.

Chondrocalcinosis↗
PubMedDate not supplied

Morphology and crystal composition of chondrocalcinosis after osteochondritis dissecans.

Three patients, who in their youth had been operated upon for osteochondritis dissecans in the femoral condyles, and who had developed gonarthrosis and chondrocalcinosis 30 years later, were investigated by arthrotomy. Tissue was obtained from the semilunar cartilages, the joint cartilages and the synovialis, for crystal analysis and morphological studies. The calcium deposits were with X-ray diffraction and polarization microscopy, The compound found was mainly calcium pyrophosphate dihydrate. Crystals were seen in all the tissues studies and the deposits could also be seen in micro-radiography. The histological examination demonstrated mainly degenerative, but also regenerative changes in the articular cartilage. On the site of the osteochondritis lesion the fibrous tissue was very rich in crystals. In the semilunar cartilages and the synovialis crystals were also seen.

Adult↗
PubMed1994

[Viable meniscus transplantation].

The integrity of the semilunar cartilages has proved to be the best safeguard against mechanical degenerative changes. One can postulate that restoring normal congruency between the femur and tibia with intact menisci would be the ideal solution to many mechanical knee problems. Several semilunar cartilages have been transplanted with good functional results in medial and lateral compartmental meniscal disease. However, this form of chondroprotection in the load-bearing area of the femur and tibia can only be properly evaluated after 10 to 20 years of follow-up. In order to obtain functional results, meniscal allografts have to be incorporated in the knee joint by intimate meniscofemoral synovial bonding. The synovial fibroblasts must grow into the collagen meshwork of the meniscal allograft. Such ingrowth has been shown in freeze-dried and deep-frozen meniscal allografts. However, in a small number of transplants shrinking has been observed on repeat arthroscopy at 6 months. Satisfactory incorporation of meniscal allografts has been obtained with fresh allografts, but availability remains a problem when this method is used for meniscal substitution. For this reason viable meniscal allograft implantation was initiated in a series of 25 patients and the value of this method studied. The meniscal allograft can be kept in an adequate semisynthetic nutrient medium for approximately 2-3 weeks without apparent loss of viability, during which period the appropriate recipient can be selected and prepared, a thorough laboratory screening can be conducted, and the culture results and disease transmission factors can be evaluated. In this way, live transplant hazards can be avoided, resulting in a higher success rate.

Adult↗
PubMed2000

[History of meniscus surgery. From excision of joint loose bodies to meniscus suture].

In comparison with other operative procedures, the history of meniscal-surgery offers some particular differences. Over a long period of time injuries of the semilunar-cartilages of the knee-joint were not generally recognised. In the 18th century only was the clinical picture roughly outlined. There is evidence, that parts of the meniscus were removed much earlier than we have historic proof of. These meniscal fragments were generally mistaken for "loose bodies" in the joints, not knowing the exact etiology. Operative interference with joints was afflicted with a very high incidence of infections and thus complications. Due to this reliable standards of sterility were imperative to obtain reproductive and satisfactory results in surgery of the knee-joint and this is why the discovery and implementation of antiseptic and aseptic principles play such an important role in joint- and, in particular, in meniscal-surgery. The development of meniscal-surgery is dominated by a lengthy discussion about the way in which the injuries of the semilunar cartilages should be dealt with operatively. Fundamental techniques such as fixation of the cartilage by sutures, limited or total removal of the meniscus were established as early as 1895. Over a long period they existed concurrently and their adequate application remained cause for a highly controversial discussion until the end of the 20th century. Not before more detailed knowledge was gained about the exact morphology of the meniscus and the rising of arthroscopic surgery offered new surgical perspectives, it was possible to establish a widely accepted standard of meniscal surgery.

History, 18th Century↗