DOCSLIB.ORG

Treatment of Knee Cartilage Defect in 2010

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Treatment of Knee Cartilage Defect in 2010 Orthopaedics & Traumatology: Surgery & Research (2011) 97, S140—S153 View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector Available online at www.sciencedirect.com REVIEW ARTICLE Treatment of knee cartilage defect in 2010 G. Versier a,∗, F. Dubrana b, the French Arthroscopy Society a Service de chirurgie orthopédique, HIA Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France b Service de chirurgie orthopédique, CHU La-Cavale-Blanche, boulevard Tanguy-Prigent, 29609 Brest, France Accepted: 16 August 2011 KEYWORDS Summary Treatment of knee cartilage defect, a true challenge, should not only reconstruct Knee; hyaline cartilage on a long-term basis, but also be able to prevent osteoarthritis. Osteochon- Cartilage; dral knee lesions occur in either traumatic lesions or in osteochondritis dissecans (OCD). These Osteochondritis; lesions can involve all the articular surfaces of the knee in its three compartments. In princi- Mosaicplasty; ple, this review article covers symptomatic ICRS grade C or D lesions, depth III and IV, excluding Autologous management of superficial lesions, asymptomatic lesions that are often discovered unexpect- chondrocyte culture; edly, and kissing lesions, which arise prior to or during osteoarthritis. For clarity sake, the Allograft international classifications used are reviewed, for both functional assessment (ICRS and func- tional IKDC for osteochondral fractures, Hughston for osteochondritis) and morphological lesion evaluations (the ICRS macroscopic evaluation for fractures, the Bedouelle or SOFCOT for osteo- chondritis, and MOCART for MRI). The therapeutic armamentarium to treat these lesions is vast, but accessibility varies greatly depending on the country and the legislation in effect. Many comparative studies have been conducted, but they are rarely of high scientific quality; the center effect is nearly constant because patients are often referred to certain centers for an expert opinion. The indications defined herein use algorithms that take into account the size of the cartilage defect and the patient’s functional needs for cases of fracture and the vitality, stability, and size of the fragment for cases of osteochondritis dissecans. Fractures measur- ing less than 2 cm2 are treated with either microfracturing or mosaic osteochondral grafting, between 2 and 4 cm2 with microfractures covered with a membrane or a culture of second- or third-generation chondrocytes, and beyond this size, giant lesions are subject to an excep- tional allografting procedure, harvesting from the posterior condyle, or chondrocyte culture on a 3D matrix to restore volume. Cases of stable osteochondritis dissecans with closed articular cartilage can be simply monitored or treated with perforation in cases of questionable vitality. Cases of open joint cartilage are treated with a PLUS fixation if their vitality is preserved; if not, they are treated comparably to osteochondral fractures, with the type of filling depending on the defect size. © 2011 Elsevier Masson SAS. All rights reserved. ∗ Corresponding author. Tel.: +33 1 43 98 52 33. E-mail address: gilbert.versier@free.fr (G. Versier). 1877-0568/$ – see front matter © 2011 Elsevier Masson SAS. All rights reserved. doi:10.1016/j.otsr.2011.09.007 Treatment of knee cartilage defect in 2010 S141 Introduction Table 1 Hughston Score. Cartilage tissue has mechanical properties that allow move- Excellent 4 Normal sports activity ment of the joint surfaces, by combining absorption of No functional symptom stresses, low friction, and high resistance to wear. Despite Normal clinical examination its mechanical performance, cartilage tissue lacks blood and Good 3 Normal sports activity nerve vessels: the cells are supplied by diffusion through Pain on intense activity the extracellular matrix. This all suggests that in a complex Normal clinical examination mechanical context, the low metabolic activity of cartilage Fair 2 Pain and hydrarthrosis if intense tissue protects it from excessive physical stresses. How- activity ever, vascular paucity results in cartilaginous lesions having Sport normal a low spontaneous repair potential. Development of surgi- Normal clinical examination cal techniques is in full expansion with the major challenge Poor 1 Pain and hydrarthrosis if moderate of hyaline cartilage reconstruction on a bone base, the only activity ◦ long-lasting and viable solution for cartilage lesions. This is Loss of flexion less than 20 the therapeutic challenge for the coming decades. Failure 0 Cessation of sports activity Pain and hydrarthrosis in daily activities Lesion assessment Loss of flexion greater than 20◦ Three factors are used to assess the initial cartilage lesion: the patient’s clinical status and the lesion’s size and type. The indication for management is based on the deteriora- arc described by Robert. Directly visualizing the lesion, tion of the functional status measured by pain and functional arthroscopy can appreciate the depth of the lesion using limitation; these criteria are validated by a number of clin- the ICRS grades: ical scores [1]. The most frequently used functional scores are the International Cartilage Repair Society (ICRS) score, • grade 1: nearly normal (superficial lesions): softening, fib- the International Knee Documentation Committee (IKDC) rillations, lacerations, fissures; functional score, and the Hughston score. The ICRS is a • grade 2: abnormal (less than 50% of cartilage depth); validated score used to evaluate the repair of cartilage • grade 3: severely abnormal (cartilage defects extending lesions, to evaluate the functional status (normal, nearly down to more than 50% of cartilage depth); normal, abnormal, and severely abnormal), to compare the • grade 4: severely abnormal (lesion extending past sub- injured side with the healthy side (as a percentage of the chondral plate, bone exposed). healthy side), to evaluate pain using an analogic pain scale, and to classify the sports level from normal to severely According to the ICRS guidelines, the seat of the lesion abnormal [2]. The functional IKDC has not been specifi- is represented by identifying the location of the cartilage cally validated for cartilage lesions, but it is a frequently involvement on drawings of the articular surfaces: a lateral used score. It evaluates, from 0 to 100, the level of activ- view of the knee, an AP view in perspective of the femur, a ity with no pain, stiffness, effusion, locking, the patient’s superior view of the tibia in perspective, and an inferior view sports activities, and the knee’s optimal functioning. The of the patella in perspective. There are four specific radio- functional IKDC is completed by the physical IKDC, which graphic classifications for osteochondritis lesions in children assesses intra-articular effusion, loss of range of motion, (OCD). Two locate the lesions on the AP and lateral images ligament laxity, joint cracking (crepitus), disease related of the knee: the Cahill and Berg [7],(Fig. 1) and Harding [8], to grafting sites, and hopping on one foot. It is also used (Fig. 2) classifications. The two other classifications evalu- to analyze radiographic images. Each group of clinical and ate the radiological signs of OCD, classifying lesions into four radiographic criteria is classified in grades: normal, nearly pathological stages: the Bedouelle [9] and Hughston et al. normal, abnormal, and severely abnormal. A final grade is classifications [6]. given to the patient corresponding to the lowest grade [3,4]. Bedouelle classification: The Hughston score is more specifically used by pediatric orthopaedic physicians and was designed to assess the treat- • stage 1: clearly incomplete well-defined image (Ia) with ment of osteochondritis lesions in children [5,6]. It classifies more or fewer calcifications within (Ib); patients into five clinical categories from failure to an excel- • stage 2: presence of a nodule (IIa) with more or less shrink- lent clinical result (Table 1). age of the nodule in relation to the condyle (IIb); The lesion size can be measured in different ways. The • stage 3: sleigh-bell aspect; standard radiological work-up can be used to estimate the • stage 4: free fragment in the joint with an empty with an width on the AP view of the knee and the length on the empty bed. lateral knee image. However, the CT arthrogram, MRI, and arthro-MRI provide a more precise appreciation of the width on AP slices and length on sagittal slices; this measurement Hughston et al. classification: makes it possible to calculate the surfaces. Arthroscopy directly measures the size of the lesion using either a probe, • stage 0: osteoarthritis, or impingement of the joint space cylindrical gauges, or the measurement of the lesional greater than 50%; S142 G. Versier, F. Dubrana Figure 1 Diagram: Cahill and Berg classification. Zone 1: medial condyle (internal half). Zone 2: medial condyle (external Figure 2 Diagram: Harding classification. Zone A: in front of half). Zone 3: femoral notch. Zone 4: lateral condyle (internal the Blumensaat line. Zone B: between zone A and C. Zone C: half). Zone 5: lateral condyle (external half). behind the tangential line to the posterior cortex of the femoral diaphysis. • stage 1: condyle irregularities, impingement of the joint space less than 50%; fibrous scar (microfracturing, Pridie drilling, and abrasion), • stage 2: condyle flattening; reconstruction methods contributing mature cartilage to • stage 3: healing zone with defect or sclerosis; the
Load more

Recommended publications
  • Applications of Chondrocyte-Based Cartilage Engineering: an Overview
    Hindawi Publishing Corporation BioMed Research International Volume 2016, Article ID 1879837, 17 pages http://dx.doi.org/10.1155/2016/1879837 Review Article Applications of Chondrocyte-Based Cartilage Engineering: An Overview Abdul-Rehman Phull,1 Seong-Hui Eo,1 Qamar Abbas,1 Madiha Ahmed,2 and Song Ja Kim1 1 Department of Biological Sciences, College of Natural Sciences, Kongju National University, Gongjudaehakro 56, Gongju 32588, Republic of Korea 2Department of Pharmacy, Quaid-i-Azam University, Islamabad 45320, Pakistan Correspondence should be addressed to Song Ja Kim; ksj85@kongju.ac.kr Received 14 May 2016; Revised 24 June 2016; Accepted 26 June 2016 Academic Editor: Magali Cucchiarini Copyright © 2016 Abdul-Rehman Phull et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Chondrocytes are the exclusive cells residing in cartilage and maintain the functionality of cartilage tissue. Series of biocomponents such as different growth factors, cytokines, and transcriptional factors regulate the mesenchymal stem cells (MSCs) differentiation to chondrocytes. The number of chondrocytes and dedifferentiation are the key limitations in subsequent clinical application of the chondrocytes. Different culture methods are being developed to overcome such issues. Using tissue engineering and cell based approaches, chondrocytes offer prominent therapeutic option specifically in orthopedics for cartilage repair and to treat ailments such as tracheal defects, facial reconstruction, and urinary incontinence. Matrix-assisted autologous chondrocyte transplantation/implantation is an improved version of traditional autologous chondrocyte transplantation (ACT) method. An increasing number of studies show the clinical significance of this technique for the chondral lesions treatment.
    [Show full text]
  • The Epiphyseal Plate: Physiology, Anatomy, and Trauma*
    3 CE CREDITS CE Article The Epiphyseal Plate: Physiology, Anatomy, and Trauma* ❯❯ Dirsko J. F. von Pfeil, Abstract: This article reviews the development of long bones, the microanatomy and physiology Dr.med.vet, DVM, DACVS, of the growth plate, the closure times and contribution of different growth plates to overall growth, DECVS and the effect of, and prognosis for, traumatic injuries to the growth plate. Details on surgical Veterinary Specialists of Alaska Anchorage, Alaska treatment of growth plate fractures are beyond the scope of this article. ❯❯ Charles E. DeCamp, DVM, MS, DACVS athologic conditions affecting epi­ foramen. Growth factors and multipotent Michigan State University physeal (growth) plates in imma­ stem cells support the formation of neo­ ture animals may result in severe natal bone consisting of a central marrow P 2 orthopedic problems such as limb short­ cavity surrounded by a thin periosteum. ening, angular limb deformity, or joint The epiphysis is a secondary ossifica­ incongruity. Understanding growth plate tion center in the hyaline cartilage forming anatomy and physiology enables practic­ the joint surfaces at the proximal and distal At a Glance ing veterinarians to provide a prognosis ends of the bones. Secondary ossification Bone Formation and assess indications for surgery. Injured centers can appear in the fetus as early Page E1 animals should be closely observed dur­ as 28 days after conception1 (TABLE 1). Anatomy of the Growth ing the period of rapid growth. Growth of the epiphysis arises from two Plate areas: (1) the vascular reserve zone car­ Page E2 Bone Formation tilage, which is responsible for growth of Physiology of the Growth Bone is formed by transformation of con­ the epiphysis toward the joint, and (2) the Plate nective tissue (intramembranous ossifica­ epiphyseal plate, which is responsible for Page E4 tion) and replacement of a cartilaginous growth in bone length.3 The epiphyseal 1 Growth Plate Closure model (endochondral ossification).
    [Show full text]
  • Musculo-Skeletal System
    Musculo-Skeletal System (Trunk, Limbs, and Head) somite: ectoderm dermatome General Statements: myotome Bilaterally, paraxial mesoderm become sclerotome neural crest somites and somitomeres. (Somitomeres develop ros- intermediate tral to the notochord in the head. They are like somites, but mesoderm neural tube smaller and less distinctly organized.) The mesoderm somatic mesoderm comprising each somite differentiates into three notochord regions: endoderm aorta — dermatome (lateral) which migrates to form dermis of the skin coelom — sclerotome (medial) forms most of the splanchnic mesoderm axial skeleton (vertebrae, ribs, and base of the skull). Mesoderm Regions — myotome (middle) forms skeletal mus- culature. Individual adult muscles are produced by merger of adjacent myotomes. Note: Nerves make early connections with adjacent myotomes and dermatomes, establishing a segmental innervation pattern. As myotome/dermatome cells migrate to assume adult positions, the segmental nerve supply must follow along to maintain its connection to the innervation target. (Recurrent laryngeal & phrenic nerves travel long distances because their targets migrated far away.) Skin. Consists of dermis and epidermis. Epidermis, including hair follicles & glands, is derived from ectoderm. Neural crest cells migrate into epidermis and become melanocytes. (Other neural crest cells become tactile disc receptors.) Dermis arises from mesoderm (dermatomes of somites). Each dermatome forms a continu- ous area of skin innervated by one spinal nerve. Because adjacent dermatomes overlap, a locus of adult skin is formed by 2 or 3 dermatomes, and innervated by 2 or 3 spinal nerves. Muscle. Muscles develop from mesoderm, except for muscles of the iris which arise from optic cup ectoderm. Cardiac and smooth muscles originate from splanchnic mesoderm.
    [Show full text]
  • Nomina Histologica Veterinaria, First Edition
    NOMINA HISTOLOGICA VETERINARIA Submitted by the International Committee on Veterinary Histological Nomenclature (ICVHN) to the World Association of Veterinary Anatomists Published on the website of the World Association of Veterinary Anatomists www.wava-amav.org 2017 CONTENTS Introduction i Principles of term construction in N.H.V. iii Cytologia – Cytology 1 Textus epithelialis – Epithelial tissue 10 Textus connectivus – Connective tissue 13 Sanguis et Lympha – Blood and Lymph 17 Textus muscularis – Muscle tissue 19 Textus nervosus – Nerve tissue 20 Splanchnologia – Viscera 23 Systema digestorium – Digestive system 24 Systema respiratorium – Respiratory system 32 Systema urinarium – Urinary system 35 Organa genitalia masculina – Male genital system 38 Organa genitalia feminina – Female genital system 42 Systema endocrinum – Endocrine system 45 Systema cardiovasculare et lymphaticum [Angiologia] – Cardiovascular and lymphatic system 47 Systema nervosum – Nervous system 52 Receptores sensorii et Organa sensuum – Sensory receptors and Sense organs 58 Integumentum – Integument 64 INTRODUCTION The preparations leading to the publication of the present first edition of the Nomina Histologica Veterinaria has a long history spanning more than 50 years. Under the auspices of the World Association of Veterinary Anatomists (W.A.V.A.), the International Committee on Veterinary Anatomical Nomenclature (I.C.V.A.N.) appointed in Giessen, 1965, a Subcommittee on Histology and Embryology which started a working relation with the Subcommittee on Histology of the former International Anatomical Nomenclature Committee. In Mexico City, 1971, this Subcommittee presented a document entitled Nomina Histologica Veterinaria: A Working Draft as a basis for the continued work of the newly-appointed Subcommittee on Histological Nomenclature. This resulted in the editing of the Nomina Histologica Veterinaria: A Working Draft II (Toulouse, 1974), followed by preparations for publication of a Nomina Histologica Veterinaria.
    [Show full text]
  • Inability of Low Oxygen Tension to Induce Chondrogenesis in Human Infrapatellar Fat Pad Mesenchymal Stem Cells
    fcell-09-703038 July 20, 2021 Time: 15:26 # 1 ORIGINAL RESEARCH published: 26 July 2021 doi: 10.3389/fcell.2021.703038 Inability of Low Oxygen Tension to Induce Chondrogenesis in Human Infrapatellar Fat Pad Mesenchymal Stem Cells Samia Rahman1, Alexander R. A. Szojka1, Yan Liang1, Melanie Kunze1, Victoria Goncalves1, Aillette Mulet-Sierra1, Nadr M. Jomha1 and Adetola B. Adesida1,2* 1 Laboratory of Stem Cell Biology and Orthopedic Tissue Engineering, Division of Orthopedic Surgery and Surgical Research, Department of Surgery, University of Alberta, Edmonton, AB, Canada, 2 Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta Hospital, Edmonton, AB, Canada Objective: Articular cartilage of the knee joint is avascular, exists under a low oxygen tension microenvironment, and does not self-heal when injured. Human infrapatellar fat pad-sourced mesenchymal stem cells (IFP-MSC) are an arthroscopically accessible source of mesenchymal stem cells (MSC) for the repair of articular cartilage defects. Human IFP-MSC exists physiologically under a low oxygen tension (i.e., 1–5%) Edited by: microenvironment. Human bone marrow mesenchymal stem cells (BM-MSC) exist Yi Zhang, physiologically within a similar range of oxygen tension. A low oxygen tension of Central South University, China 2% spontaneously induced chondrogenesis in micromass pellets of human BM-MSC. Reviewed by: Dimitrios Kouroupis, However, this is yet to be demonstrated in human IFP-MSC or other adipose tissue- University of Miami, United States sourced MSC. In this study, we explored the potential of low oxygen tension at 2% to Dhirendra Katti, Indian Institute of Technology Kanpur, drive the in vitro chondrogenesis of IFP-MSC.
    [Show full text]
  • Bone Cartilage Dense Fibrous CT (Tendons & Nonelastic Ligaments) Dense Elastic CT (Elastic Ligaments)
    Chapter 6 Content Review Questions 1-8 1. The skeletal system consists of what connective tissues? Bone Cartilage Dense fibrous CT (tendons & nonelastic ligaments) Dense elastic CT (elastic ligaments) List the functions of these tissues. Bone: supports the body, protects internal organs, provides levers on which muscles act, store minerals, and produce blood cells. Cartilage provides a model for bone formation and growth, provides a smooth cushion between adjacent bones, and provides firm, flexible support. Tendons attach muscles to bones and ligaments attach bone to bone. 2. Name the major types of fibers and molecules found in the extracellular matrix of the skeletal system. Collagen Proteoglycans Hydroxyapatite Water Minerals How do they contribute to the functions of tendons, ligaments, cartilage and bones? The collagen fibers of tendons and ligaments make these structures very tough, like ropes or cables. Collagen makes cartilage tough, whereas the water-filled proteoglycans make it smooth and resistant. As a result, cartilage is relatively rigid, but springs back to its original shape if it is bent or slightly compressed, and it is an excellent shock absorber. The extracellular matrix of bone contains collagen and minerals, including calcium and phosphate. Collagen is a tough, ropelike protein, which lends flexible strength to the bone. The mineral component gives the bone compression (weight-bearing) strength. Most of the mineral in the bone is in the form of hydroxyapatite. 3. Define the terms diaphysis, epiphysis, epiphyseal plate, medullary cavity, articular cartilage, periosteum, and endosteum. Diaphysis – the central shaft of a long bone. Epiphysis – the ends of a long bone. Epiphyseal plate – the site of growth in bone length, found between each epiphysis and diaphysis of a long bone and composed of cartilage.
    [Show full text]
  • Humeral Condylar Fractures and Incomplete Ossification of the Humeral Condyle in Dogs ANDY MOORES
    A five-year old springer PRACTICE ANIMAL COMPANION spaniel that was treated for an intercondylar Y fracture Humeral condylar fractures and incomplete ossification of the humeral condyle in dogs ANDY MOORES HUMERAL condylar fractures are among the most common fractures seen in dogs and account for approximately 20 per cent of the author’s canine fracture caseload, although this is a referral population and probably does not represent the true incidence of these injuries. It has long been recognised that spaniels are predisposed to humeral condylar fractures. It is now recognised that many of these dogs have a condition known as incomplete ossification of the humeral condyle (IOHC) that predisposes them to condylar fractures, often occurring during normal activity or associated with only minor trauma. This article discusses the management of humeral condylar fractures and IOHC. HUMERAL CONDYLAR FRACTURES the force from sudden impacts is primarily directed lat- Andy Moores erally. Secondly, the lateral epicondylar ridge is smaller graduated from Bristol in 1996. He CLASSIFICATION and weaker than its medial counterpart. Lateral condylar spent five years in Humeral condylar fractures can be divided into lateral fractures are most prevalent in skeletally immature dogs. small animal practice condylar, medial condylar and intercondylar fractures. In one retrospective review, 67 per cent of cases were before returning to Bristol to complete Lateral and medial humeral condylar fractures involve less than one year of age, the most common age being a residency in small only one epicondylar ridge of the condyle. Intercondylar four months (Denny 1983). Lateral and medial condylar animal surgery. In 2004, he joined the fractures involve both the medial and lateral epicondylar fractures are often associated with a minor fall, although Royal Veterinary ridges and are commonly described as ʻYʼ or ʻTʼ frac- in some dogs with IOHC they can occur during relative- College as a lecturer in small animal tures depending on the orientation of the fracture lines ly normal activity.
    [Show full text]
  • Aandp1ch07lecture.Pdf
    Chapter 07 Lecture Outline See separate PowerPoint slides for all figures and tables pre- inserted into PowerPoint without notes. Copyright © McGraw-Hill Education. Permission required for reproduction or display. 1 Introduction • In this chapter we will cover: – Bone tissue composition – How bone functions, develops, and grows – How bone metabolism is regulated and some of its disorders 7-2 Introduction • Bones and teeth are the most durable remains of a once-living body • Living skeleton is made of dynamic tissues, full of cells, permeated with nerves and blood vessels • Continually remodels itself and interacts with other organ systems of the body • Osteology is the study of bone 7-3 Tissues and Organs of the Skeletal System • Expected Learning Outcomes – Name the tissues and organs that compose the skeletal system. – State several functions of the skeletal system. – Distinguish between bones as a tissue and as an organ. – Describe the four types of bones classified by shape. – Describe the general features of a long bone and a flat bone. 7-4 Tissues and Organs of the Skeletal System • Skeletal system—composed of bones, cartilages, and ligaments – Cartilage—forerunner of most bones • Covers many joint surfaces of mature bone – Ligaments—hold bones together at joints – Tendons—attach muscle to bone 7-5 Functions of the Skeleton • Support—limb bones and vertebrae support body; jaw bones support teeth; some bones support viscera • Protection—of brain, spinal cord, heart, lungs, and more • Movement—limb movements, breathing, and other
    [Show full text]
  • 26 April 2010 TE Prepublication Page 1 Nomina Generalia General Terms
    26 April 2010 TE PrePublication Page 1 Nomina generalia General terms E1.0.0.0.0.0.1 Modus reproductionis Reproductive mode E1.0.0.0.0.0.2 Reproductio sexualis Sexual reproduction E1.0.0.0.0.0.3 Viviparitas Viviparity E1.0.0.0.0.0.4 Heterogamia Heterogamy E1.0.0.0.0.0.5 Endogamia Endogamy E1.0.0.0.0.0.6 Sequentia reproductionis Reproductive sequence E1.0.0.0.0.0.7 Ovulatio Ovulation E1.0.0.0.0.0.8 Erectio Erection E1.0.0.0.0.0.9 Coitus Coitus; Sexual intercourse E1.0.0.0.0.0.10 Ejaculatio1 Ejaculation E1.0.0.0.0.0.11 Emissio Emission E1.0.0.0.0.0.12 Ejaculatio vera Ejaculation proper E1.0.0.0.0.0.13 Semen Semen; Ejaculate E1.0.0.0.0.0.14 Inseminatio Insemination E1.0.0.0.0.0.15 Fertilisatio Fertilization E1.0.0.0.0.0.16 Fecundatio Fecundation; Impregnation E1.0.0.0.0.0.17 Superfecundatio Superfecundation E1.0.0.0.0.0.18 Superimpregnatio Superimpregnation E1.0.0.0.0.0.19 Superfetatio Superfetation E1.0.0.0.0.0.20 Ontogenesis Ontogeny E1.0.0.0.0.0.21 Ontogenesis praenatalis Prenatal ontogeny E1.0.0.0.0.0.22 Tempus praenatale; Tempus gestationis Prenatal period; Gestation period E1.0.0.0.0.0.23 Vita praenatalis Prenatal life E1.0.0.0.0.0.24 Vita intrauterina Intra-uterine life E1.0.0.0.0.0.25 Embryogenesis2 Embryogenesis; Embryogeny E1.0.0.0.0.0.26 Fetogenesis3 Fetogenesis E1.0.0.0.0.0.27 Tempus natale Birth period E1.0.0.0.0.0.28 Ontogenesis postnatalis Postnatal ontogeny E1.0.0.0.0.0.29 Vita postnatalis Postnatal life E1.0.1.0.0.0.1 Mensurae embryonicae et fetales4 Embryonic and fetal measurements E1.0.1.0.0.0.2 Aetas a fecundatione5 Fertilization
    [Show full text]
  • Musculoskeletal System
    4 Musculoskeletal System Learning Objectives Upon completion of this chapter, you will be able to • Identify and define the combining forms, prefixes, and suffixes introduced in this chapter. • Correctly spell and pronounce medical terms and major anatomical structures relating to the musculoskeletal system. • Locate and describe the major organs of the musculoskeletal system and their functions. • Correctly place bones in either the axial or the appendicular skeleton. • List and describe the components of a long bone. • Identify bony projections and depressions. • Identify the parts of a synovial joint. • Describe the characteristics of the three types of muscle tissue. • Use movement terminology correctly. • Identify and define musculoskeletal system anatomical terms. • Identify and define selected musculoskeletal system pathology terms. • Identify and define selected musculoskeletal system diagnostic procedures. • Identify and define selected musculoskeletal system therapeutic procedures. • Identify and define selected medications relating to the musculoskeletal system. • Define selected abbreviations associated with the musculoskeletal system. 83 M04_FREM0254_06_SE_C04.indd 83 18/12/14 10:12 pm Section I: Skeletal System at a Glance Function The skeletal system consists of 206 bones that make up the internal framework of the body, called the skeleton. The skeleton supports the body, protects internal organs, serves as a point of attachment for skeletal muscles for body movement, produces blood cells, and stores minerals. Organs Here
    [Show full text]
  • Clinicopathological Comparison of Fibrous Dysplasia and Ossifying Fibroma
    Clinicopathological comparision of fibrous dysplasia & ossifting fibroma Seta A Sarkis & Sami Kh Jabba Basrah Journal Of Surgery Bas J Surg, June, 23, 2017 CLINICOPATHOLOGICAL COMPARISON OF FIBROUS DYSPLASIA AND OSSIFYING FIBROMA Seta A Sarkis* & Sami Kh Jabba# *Department of Oral Pathology, College of Dentistry, Baghdad University. #Department of Oral Pathology, College of Dentistry, Maysan University, Maysan, IRAQ. Abstract Fibrous dysplasia and Ossifying fibroma of jawbones share the conduct of similar clinicopathological characteristics and this can be a challenge for the histopathologists. The purpose of this study was to evaluate the differences in clinicohistopathological features in fibrous dysplasia cells compared with ossifying fibroma of jaws bones. The study included 30 formalin-fixed, paraffin embedded tissue blocks; of which fifteen for patients with fibrous dysplasia and fifteen sample of ossifying fibroma of jaws. The histopathological examination was conducted on 4µm thick of H & E tissue sections. Results: showed where most cases were females; 11 cases (73.3%) for fibrous dysplasia, as well as ossifying fibroma. Most of FD cases presented in the maxilla (66.76%) while for OF most ofthe cases presented in the mandible (73.33%). FD cases were more predominant in molar area (60%) whereas OF cases were more predominant in premolar & molar area(33.33%). Regarding the histopathological components, in all cases of FD (100%) the presence of bone trabecule with large osteocytes within the lacunae was found, while OF featured more irregular osteoid or cementoid masses( 80%) compared to ( 33.3%) osteoid observed in FD. Remarkable, (80%) of the OF cases had osteoblastic rimming , while it is presented in only two cases ( 13.3%) of total FD sample.
    [Show full text]
  • Applications of Chondrocyte-Based Cartilage Engineering: an Overview
    Hindawi Publishing Corporation BioMed Research International Volume 2016, Article ID 1879837, 17 pages http://dx.doi.org/10.1155/2016/1879837 Review Article Applications of Chondrocyte-Based Cartilage Engineering: An Overview Abdul-Rehman Phull,1 Seong-Hui Eo,1 Qamar Abbas,1 Madiha Ahmed,2 and Song Ja Kim1 1 Department of Biological Sciences, College of Natural Sciences, Kongju National University, Gongjudaehakro 56, Gongju 32588, Republic of Korea 2Department of Pharmacy, Quaid-i-Azam University, Islamabad 45320, Pakistan Correspondence should be addressed to Song Ja Kim; ksj85@kongju.ac.kr Received 14 May 2016; Revised 24 June 2016; Accepted 26 June 2016 Academic Editor: Magali Cucchiarini Copyright © 2016 Abdul-Rehman Phull et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Chondrocytes are the exclusive cells residing in cartilage and maintain the functionality of cartilage tissue. Series of biocomponents such as different growth factors, cytokines, and transcriptional factors regulate the mesenchymal stem cells (MSCs) differentiation to chondrocytes. The number of chondrocytes and dedifferentiation are the key limitations in subsequent clinical application of the chondrocytes. Different culture methods are being developed to overcome such issues. Using tissue engineering and cell based approaches, chondrocytes offer prominent therapeutic option specifically in orthopedics for cartilage repair and to treat ailments such as tracheal defects, facial reconstruction, and urinary incontinence. Matrix-assisted autologous chondrocyte transplantation/implantation is an improved version of traditional autologous chondrocyte transplantation (ACT) method. An increasing number of studies show the clinical significance of this technique for the chondral lesions treatment.
    [Show full text]