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Implant related infection is a serious problem in orthopaedic surgery. An antibacterial and biocompatible copper with a sol–gel derived titania coating (Cu–TiO2) could be an appropriate approach for the treatment of such infections. Before clinical application, the coatings must be sterilised. The effects of autoclaving and gamma irradiation on the antibacterial coating have not yet been fully investigated. Titanium alloy (TiAl4V6) plates with different numbers of Cu–TiO2 coatings applied were analysed after autoclaving or gamma irradiation. Scanning electron microscopy (SEM) was used to investigate the surface structure of the coating and energy dispersive X-ray spectroscopy (EDX) was used to investigate the distribution of copper ions in three different areas. Examinations by SEM and EDX showed more significant changes to the surface of the coating after autoclaving compared to gamma irradiation. Gamma irradiation seems to be the most appropriate method of sterilisation for the tested antibacter...

Summary Objective The objective was to compare patients after matrix-associated autologous chondrocyte transplantation (MACT) and microfracture therapy (MFX) of the talus using diffusion-weighted imaging (DWI), with morphological and clinical scoring. Materials and methods Twenty patients treated with MACT or MFX (10 per group) were examined using 3 T magnetic resonance imaging (MRI) at 48 ± 21.5 and 59.6 ± 23months after surgery, respectively. For comparability, patients from each group were matched by age, body mass index, and follow-up. American Orthopaedic Foot and Ankle Society (AOFAS) score served as clinical assessment tool pre- and postoperatively. DWI was obtained using a partially balanced, steady-state gradient echo pulse sequence, as well as the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score, based on a 2D proton density-weighted turbo spin-echo sequence and a 3D isotropic true fast imaging with steady-state precession sequence. Semi-quantitative diffusion quotients were calculated after region of interest analysis of repair tissue (RT) and healthy control cartilage, and compared among both groups. Results The mean AOFAS score improved significantly ( P = 0.001) for both groups (MACT: 48.8 ± 20.4–83.6 ± 9.7; MFX: 44.3 ± 16.5–77.6 ± 13.2). No differences in the AOFAS ( P = 0.327) and MOCART ( P = 0.720) score were observed between MACT and MFX postoperatively. DWI distinguished between healthy cartilage and cartilage RT in the MFX group ( P = 0.016), but not after MACT treatment ( P = 0.105). Significant correlations were found between MOCART score and DWI index after MFX (Pearson: −0.648; P = 0.043), and between the diffusivity and longer follow-up interval in MACT group (Pearson: −0.647, P = 0.043). Conclusion Whereas conventional scores reveal a similar outcome after MACT or MFX treatment in the ankle joint, DWI was able to distinguish between different RT qualities, as reported histologically for these diverse surgical procedures.

Autologous chondrocyte transplantation/implantation (ACT/ACI) is an established and recognised procedure for the treatment of localised full-thickness cartilage defects of the knee. The present review of the working group "Clinical Tissue Regeneration" of the German Society of Orthopaedics and Traumatology (DGOU) describes the biology and function of healthy articular cartilage, the present state of knowledge concerning potential consequences of primary cartilage lesions and the suitable indication for ACI. Based on current evidence, an indication for ACI is given for symptomatic cartilage defects starting from defect sizes of more than 3-4 cm2; in the case of young and active sports patients at 2.5 cm2. Advanced degenerative joint disease is the single most important contraindication. The review gives a concise overview on important scientific background, the results of clinical studies and discusses advantages and disadvantages of ACI.

Objective The aim of the study was to explore the sensitivity and robustness of T2 mapping in the detection and quantification of early degenerative cartilage changes at the patella. Materials and methods Forty-two patients (22 women, 20 men) with a mean age of 30.3 years and a symptomatic cartilage defect of ICRS grade ≤2 were examined using a 3 T MRI with an 8-channel knee coil. The cartilage lesion was graded based on high-resolution PD TSE and 3D isotropic TrueFISP images. T2 maps were calculated from a standard MESE-sequence, performed at the beginning and at the end of the scan (40 min in-between). Depending on the defect size, a region-of-interest (ROI) analysis was performed on 1–3 consecutive slices. Mean T2 values for the deep, superficial, and global layer as well as the zonal variation were compared among defect grades (ANOVA, post hoc Duncan-test) and over time (Student's t-test). Results T2-measurements directly correlated with the extent of cartilage defect (ICRS grade) at all layers and at both time-points. However, correlations were closer for the second measurement at the end of the scan. In this unloaded state, differences in T2-values became more pronounced and were significant even between cartilage of normal appearance adjacent to the defect and healthy cartilage of control patients (both ICRS grade 0). In contrast, there were no such differences among grades in the zonal variation at any time. Conclusion T2 mapping might be a sensitive method for the detection of early cartilage degeneration at the patella in the unloaded joint.