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Background:. Scaphocapitate arthrodesis (SCA) is a described technique for chronic wrist pathology such as Kienbock disease and carpal instability. The technique aims to preserve motion, while maintaining carpal height, preserving the radioscaphoid articulation, and offloading the lunate. Limited case series evaluate the outcomes of this previously described technique. We aim to determine if the collective, updated literature on outcomes of SCA support its continued application by the wrist surgeon. Furthermore, we investigated if any technical variations offer an advantage in improving patient-reported outcomes after SCA. Methods:. A literature search was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles selected for critical review were examined for patient demographic data, functional outcomes, radiographic outcomes, and complications. A qualitative analysis was then performed to synthesize the available date. Results:. A total of 18 unique articles published between 1991 and 2022 were identified, representing a total of 285 individual cases of SCA. Nonunion rate ranged 0%–22%. Preoperative visual analog scale pain scores ranged from 3.2 to 10, whereas postoperative visual analog scale pain scores ranged from 0 to 4. Patient-reported outcomes are reported by validated instruments, including the Disabilities of the Arm, Shoulder, and Hand, QuickDASH, Patient-rated Wrist Evaluation, and Mayo Wrist Score. Conclusions:. SCA is a viable treatment option for patients with Kienbock disease. SCA offers reliable improvements in patient pain, grip strength, and patient-reported outcomes.

Background. Heart transplantation is always an emergency because the transplant needs to occur within 6 h after procurement to prevent primary graft dysfunction. Static cold storage (SCS) is the gold-standard preservation method. This study describes the outcomes of hearts preserved after prolonged SCS (12 and 24 h); those are then resuscitated with a novel normothermic ex situ heart perfusion (NEHP) system. Methods. Anesthetized piglets (n = 10) were used as heart donors. Hearts were procured and stored at 5 °C CoStorSol following standard SCS protocols. Two groups were studied: SCS-12 h and SCS-24 h. After SCS, 8 h of NEHP (37 °C blood-based perfusate) was performed at 0.7–1.0 mL/min/g of cardiac tissue. NEHP parameters were monitored continuously. Results were corroborated with 3 additional hearts transplanted orthotopically in healthy recipients (n = 3) after SCS (24 h) + NEHP (5 h). Recipients were observed for 90 min after weaning off cardiopulmonary bypass support. Results. All hearts (after 12 and 24 h of SCS) regained normal function and metabolism within 10 min and retained it throughout 8 h of NEHP. No differences were observed in NEHP parameters and histopathology between groups. Three hearts were successfully transplanted after a total ~30 h of preservation (24 h of SCS + 5 h of NEHP + 1 h of second cold ischemia time). The 3 recipients were weaned off cardiopulmonary bypass with mild vasopressor support. Conclusions. NEHP has the potential to routinely resuscitate porcine hearts that have undergone SCS for up to 24 h, restoring them to viable function. By objectively assessing heart function before transplant, NEHP may enhance the success rate of transplants. If these resuscitated hearts can be successfully transplanted, it would support the effectiveness of NEHP in ensuring heart viability.

Background: Several assessment tools have been developed to estimate a patient's likelihood risk of falling. None of these measures estimate the contributions of the visual, vestibular, and somatosensory systems to fall risk, especially in patients with degenerative lumbar spine disease. Methods: Degenerative lumbar spine patients with radiculopathy (LD) and healthy subjects who were 35-70 years old without spine complaints were recruited. Patient reported outcome measures (PROMs) were collected prior to testing. Fall risk assessment was completed using Computer Dynamic Posturography (CDP), a computer-controlled balance machine that allows cone of economy (CoE) and cone of pressure (CoP) measurements. All patients completed Sensory Organization Tests (SOT) which include normal and perturbed stability, both with and without visual cues. Results: In total, 43 spine patients and 12 healthy controls were included, with mean age 57.8 years, 39.5% females, and mean BMI of 29.3 kg/m2. Nearly all CoE and most CoP dimensions were found to be larger in LD patients compared to controls across nearly all subtests (p

ABSTRACT: Spinal alignment analysis play an important role in evaluating patients and planning surgical corrections for adult spinal deformity. The history of these parameters is relatively short with the first parameter, the Cobb angle, introduced in 1948 as part of an effort to improve scoliosis evaluation. New developments in the field were limited for nearly 30 years before better imaging technology encouraged new theories and later data about spinal alignment and the relationship between the spine and pelvis. These efforts would ultimately contribute to the creation of foundational spinal alignment parameters, including pelvic incidence, pelvic tilt, and sacral slope. By the 1990s, spinal alignment had become a sustained area of investigation for spinal surgeons and researchers. Novel alignment parameters have since been introduced as our knowledge has evolved and has allowed for valuable research that demonstrates the clinical and surgical value of alignment measurement. This manuscript will explore the history of spinal alignment analysis over the decades.

Background: Total shoulder arthroplasty (TSA) is a surgical technique commonly used to treat patients with arthritis and rotator cuff deficiency. Its purpose is to reduce pain and improve shoulder function, namely range of motion (ROM) and strength. While shoulder ROM and strength have been studied extensively in patients with various shoulder pathologies, there is a dearth of knowledge with regard to the asymptomatic population. Methods: A cross-sectional study was conducted in the outpatient orthopaedic clinic following institutional review board approval. Patients 18 years of age and older with at least one asymptomatic and healthy shoulder with no prior history of shoulder surgery, injury, or pain were enrolled in the study. Demographic information, ROM, and strength measurements were collected for 256 shoulders, evenly stratified into groups by age and sex. A goniometer was used to measure forward elevation, abduction, and external rotation, and a handheld dynamometer was utilized for measuring strength. Statistical evaluation was conducted using Pearson correlations, analysis of variance, and Bonferroni and Mann–Whitney post hoc tests, with P

Background:. Amputees frequently experience chronic neuroma-related residual limb and phantom limb pain (PLP). Targeted muscle reinnervation (TMR) transfers transected nerves to nearby motor nerves to promote healing and prevent neuroma formation and PLP. The purpose of this study was to report outcomes of TMR in a series of children and young adults treated at a pediatric hospital. Methods:. Patients undergoing major limb amputation with TMR were included with minimum one year follow-up and completed questionnaires. Primary clinical outcomes included incidence of symptomatic neuromas, PLP, residual limb pain, narcotic use, and neuromodulator use. A follow-up phone survey was conducted assessing five pediatric Patient Reported Outcomes Measurement Information System (PROMIS) metrics adapted to assess residual limb and PLP. Results:. Nine patients (seven male and two female patients, avg. age = 16.83 ± 7.16 years) were eligible. Average time between surgery and phone follow-up was 21.3 ± 9.8 months. Average PROMIS Pediatric t-scores for measures of pain behavior, interference, quality—affective, and quality—sensory for both PLP and residual limb pain were nearly 1 standard deviation lower than the United States general pediatric population. One patient developed a symptomatic neuroma 1 year after surgery. Conclusions:. Compared with an adult patient sample reported by Valerio et al, our TMR patients at Nationwide Children’s Hospital (NCH) showed similar PLP PROMIS t-scores in pain behavior (50.1 versus 43.9) and pain interference (40.7 versus 45.6). Both pediatric and adult populations had similar residual limb pain including PROMIS pain behavior (36.7 adult versus 38.6 pediatric) and pain interference (40.7 adult versus 42.7 pediatric). TMR at the time of amputation is feasible, safe, and should be considered in the pediatric population.

Introduction: Vaccination rates may be improved through culturally tailored messages, but little is known about them among disaggregated Asian American subgroups. We assessed the vaccination rates for key vaccines among these subgroups. Methods: Using the National Health Interview Survey, we analyzed recent vaccination rates (2015–2018, n=188,250) and trends (2006–2018) among Asians (Chinese [n=3,165], Asian Indian [n=3,525], Filipino [n=3,656], other Asian [n=5,819]) and non-Hispanic White adults (n=172,085) for 6 vaccines (the human papillomavirus, hepatitis B, pneumococcal, influenza, tetanus-diphtheria [tetanus], and shingles vaccines). We controlled demographic, socioeconomic, and health-related variables in multivariable logistic regression and predicted marginal modeling analyses. We also computed vaccination rates among Asian American subgroups on the 2015–2018 National Health Interview Survey data stratified by foreign-born and U.S.-born status. We used Joinpoint regression to analyze trends in vaccination rates. All analyses were conducted in 2021 and 2022. Results: Among Asians, shingles (29.2%; 95% CI=26.6, 32.0), tetanus (53.7%; 95% CI=51.8, 55.6), and pneumococcal (53.8%; 95% CI=50.1, 57.4) vaccination rates were lower than among non-Hispanic Whites. Influenza (47.9%; 95% CI=46.2, 49.6) and hepatitis B (40.5%; 95% CI=39.0, 42.7) vaccination rates were similar or higher than among non-Hispanic Whites (48.4%; 95% CI=47.9, 48.9 and 30.7%; 95% CI=30.1, 31.3, respectively). Among Asians, we found substantial variations in vaccination rates and trends. For example, Asian Indian women had lower human papillomavirus vaccination rates (12.9%; 95% CI=9.1, 18.0) than all other Asian subgroups (Chinese: 37.9%; 95% CI=31.1, 45.2; Filipinos: 38.7%; 95% CI=29.9, 48.3; other Asians: 30.4%; 95% CI=24.8, 36.7) and non-Hispanic Whites (36.1%; 95% CI=34.8, 37.5). Being male, having lower educational attainment and income, having no health insurance or covered by public health insurance only, and lower frequency of doctor visits were generally associated with lower vaccine uptakes. Foreign-born Asian aggregate had lower vaccination rates than U.S.-born Asian aggregate for all vaccines except for influenza. We also found subgroup-level differences in vaccination rates between foreign-born and U.S.-born Asians. We found that (1) foreign-born Chinese, Asian Indians, and other Asians had lower human papillomavirus and hepatitis B vaccination rates; (2) foreign-born Chinese and Filipinos had lower pneumococcal vaccination rates; (3) foreign-born Chinese and Asian Indians had lower influenza vaccination rates; and (4) all foreign-born Asian subgroups had lower tetanus vaccination rates. Conclusions: Vaccination rates and trends differed among Asian American subgroups. Culturally tailored messaging and interventions may improve vaccine uptakes.

Background: Scapular winging is a rare and often misdiagnosed disorder, which can be painful and functionally limited. Medial scapular winging is often due to serratus anterior dysfunction in the setting of a long thoracic nerve palsy. While nonoperative management can be successful, transfer of the pectoralis major with autograft hamstring augmentation to the inferior scapula is an effective operative means of relieving pain and restoring shoulder function in those who fail conservative management. Indications: The patient is a 16-year-old woman with symptomatic medial scapular winging who had a complete workup and 6-month course of conservative treatment, including physical therapy. Thus, we elected to proceed with a 2-incision transfer of the sternal head of pectoralis major transfer with autograft hamstring augmentation to the inferior scapular angle. Technique Description: A 2-incision transfer of the sternal head of pectoralis major with autograft hamstring to the inferior scapular angle is a strong and reliable method of operatively treating medial scapular winging. In addition, performing this operation in the lateral position allows for ease of access to both the anterior and posterior incisions. Results: At 1-year follow-up, the patient had full, painless range of motion of the shoulder with 5/5 strength in all tested planes. She also had returned to all activities, including softball, without restrictions. Discussion/Conclusions: A 2-incision transfer of the sternal head of the pectoralis major with autograft hamstring augmentation to the inferior scapular angle is an effective means of operatively treating medial scapular winging. Multiple studies have shown that this operation improves motion, pain, and function for those who have failed an appropriate course of conservative treatment. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Background: A distal biceps repair is performed after a rupture of the distal biceps tendon, an injury that typically affects the dominant arm of middle-aged men, resulting in weakness in supination and elbow flexion. A volar 2-incision technique minimizes skin incision length while optimizing exposure to anatomical structures through proper incision placement for acute repair and chronic reconstruction with graft. Indications: Retraction of the distal biceps away from its insertion on the proximal radius in the chronic setting can require a more extensile incision. Two transverse incisions are strategically placed on either side of the antecubital fossa to optimize exposure of the radial insertion site and proximally to retrieve the retracted tendon for either acute or chronic retracted distal biceps tears with or without graft reconstruction. Technique Description: A transverse incision is made in the forearm directly over the radial tuberosity. This facilitates direct exposure and drilling of a socket for placement of the distal biceps’ tendon with suture button and interference screw construct. A second proximal transverse incision is made to identify and retrieve the retracted tendon. The tendon is retrieved and prepared or reconstructed with graft for chronic cases with suture. The tendon and graft are tunneled under the skin bridge between the 2 incisions. The sutures are then loaded onto a titanium button, which is deployed onto the far cortex. The tendon is advanced into the tunnel, an interference screw is placed, and the sutures are tied. Results: Restoration of anatomy and correct placement of the 2 incisions is facilitated with this approach, restoring distal biceps function without requiring extensile volar exposure of the entirety of the length of the distal biceps tendon. Discussion/Conclusion: This technique mitigates the need for extensive dissection. It also facilitates improved visualization of relevant structures for cases with substantial tendon retraction, even in the case of chronic retracted tears requiring allograft reconstruction. The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Background: Implantable cardioverter-defibrillators (ICDs) are an effective treatment in some patients with inherited heart disease, including inherited channelopathies, yet they have also been shown to impact patients’ psychological health. Objective: We sought to improve understanding of the level of anxiety and depression as well as device acceptance among inherited channelopathy patients with an ICD. Methods: Eligible patients seen at Johns Hopkins Hospital were sent a survey, which included the Hospital Anxiety and Depression Scale (HADS), Cardiac Anxiety Questionnaire (CAQ), and the Florida Patient Acceptance Survey (FPAS). Student t tests and χ2 tests were used to identify associations with abnormal anxiety and depression scores. Results: Among eligible patients (n = 65), 32 individuals (49%) completed the survey. The rate of device-related complications was 34%, and 41% of patients experienced 1 or more ICD shocks. Twelve patients (38%) had an abnormal HADS anxiety subscore and 5 patients (16%) had an abnormal HADS depression subscore (score ≥ 8). Secondary-prevention ICDs were associated with an abnormal HADS anxiety subscore (P = .03). Experiencing ICD shock(s), device complications, age, sex, and family history of sudden cardiac death were not statistically associated with anxiety or depression. Overall, respondents demonstrated high device acceptance by FPAS (79.9 ± 2.9, maximum total score 100) and moderately high cardiac-specific anxiety by CAQ total score (1.53 ± 0.12). Conclusion: A high prevalence of generalized anxiety was identified among inherited channelopathy patients with ICDs. High device acceptance and lack of association with ICD shocks or complications indicate that further research is necessary to understand this increased incidence.

A 47-year-old female with poorly differentiated carcinoma of urothelial origin on pembrolizumab, presented to the hospital with fever, dysuria, pruritus, diffuse erythema, and skin desquamation 11 days after starting immunotherapy with enfortumab vedotin (EV). The desquamation covered about 25% of her body surface area and she subsequently developed a positive Nikolsky sign, bullae, and oral erosions. Labs were significant for elevated LFTs: 121 u/L (AST), 129 u/L (ALT), 147 u/L (ALP), CBC, and BMP were within normal limits.Histopathology demonstrated a vacuolar interface dermatitis consistent with an adverse drug reaction.EV was immediately stopped, and two doses of Etanercept 50 mg were administered subcutaneously followed by a three-day course of 200 mg IVIG, resulting in dramatic improvement of her rash. The patient required an ICU stay for worsening respiratory status and was discharged after five days of admission.According to a phase II trial, 48% of individuals receiving EV therapy developed treatment-related rashes. Post-marketing analysis data presented eight cases of serious skin reactions defined as either Stevens-Johnson Syndrome (SJS) or Toxic Epidermal Necrolysis (TEN) after EV therapy. The majority of reports are from singular cases or case series. Further research is necessary to establish the real-world incidence of SJS/TEN in post market analysis from EV and management of the same.

Background: Superior labrum anterior posterior (SLAP) lesions are prevalent in athletes and the elderly. Therefore, acquiring accurate diagnoses is beneficial for improvement in return to play for athletes and quality of life. A well-done clinical examination can help detect these lesions leading to an early and accurate diagnosis. Indications: Being able to perform a clinical examination for diagnosing SLAP lesions is an important tool for a doctor to know. Currently, there is not a centralized location with published videos that show how to perform these examinations and describe their attributes. This video helps clinicians quickly ascertain how to perform these examinations and learn about the statistical measures associated with them. Technique Description: The 7 exams shown are as follows: modified dynamic labral shear (DLS) test, speed’s test, active compression test (O’Brien test), anterior slide test, crank test, Kim test, and the Jerk test. Results: These tests have a wide variety of statistical measures making different ones useful for specific results such as ruling in or ruling out labral lesions. The tests with the highest sensitivity are the modified dynamic labral shear test (72%) and Kim test (61%-92%). The tests with the highest specificity are the modified dynamic labral shear test (98%), anterior slide test (81%-89%), Kim test (88%-99%), and the Jerk test (94%-99%). All of these have a 95% confidence interval except DLS test. Discussion/Conclusions: Some of these tests are more reliable than others when diagnosing labral lesions. Since the dynamic labral shear test and Kim test have the highest sensitivity, they are the most useful tests at ruling out labral lesions. These tests along with the anterior slide test and the Jerk test are the most useful for ruling in labral lesions due to their high specificity. Even though these tests have been proven to be more reliable than others, it still matters which tests the doctors feel comfortable performing accurately for them to use in the clinical setting.

A dropped appendicolith is a well-known complication of laparoscopic appendectomy that may occur because of stone expulsion from the appendix, before or during surgery, and typically manifests as a focal, subcentimeter area of high attenuation with or without associated abscess. Dropped appendicoliths may act as niduses for infection and may result in the future development of abscess formation. We report the case of a 10-year-old pediatric patient who developed 2 perihepatic abscesses caused by 2 appendicoliths that were inadvertently dropped during laparoscopic surgery. Keywords: Appendicitis, CT, Dropped appendicolith, Abscess

On May 11, 2020, the Association of American Medical Colleges released recommendations discouraging in-person activities for away rotations and mandating virtual-only residency recruitment interviews. This paper focuses on how residency programs have attempted to adjust to this vastly different application cycle by using social media to reach their applicants. A total of 138 programs were identified through the Electronic Residency Application Services. The presence of Departmental/Residency program Twitter, Instagram, and Facebook as well as web pages offering virtual opportunities was recorded for each program on October 30, 2020. A total of 132 social media accounts were found; the majority of which were on Twitter, while fewer were on Instagram and Facebook. All 138 pathology residency programs had websites. Sixteen (11.5%) of those advertised virtual open houses and 2 (1.4%) advertised virtual subinternships; social media were more often used for advertisement of these virtual experiences. A total of 58 open house opportunities were advertised on Twitter, 21 on Instagram, and 20 on Facebook. Innovative virtual subinternships ranging from 2 to 4 weeks were developed, but only represented 6% of the usual 126 away rotations available. Pathology programs across the country utilized websites and social media as a method of communication to interact with applicants as part of the #Path2Path in 2020 and to provide virtual opportunities in preparation for a drastically different recruitment cycle.

A 36-year-old African American man presented to the emergency department with 2 days of left-sided perineal pain after sexual activity. He was found to have induration in the left perineum overlying the proximal left corporal body. Clinical picture was suspicious for traumatic corporal rupture; however, advanced imaging showed a proximal segmental thrombosis of the left corpus cavernosum. The patient underwent perineal exploration with evacuation of an intracorporal penile hematoma. In spite of disrupting a fibrous membrane in the proximal corpora and drainage of the corpora, we observed repeat tumescence during the procedure because of an observed arterial high-flow state in the corpora cavernosum. This was resolved with administration of phenylephrine into the cavernosum. The patient had return of normal erectile function 2 days after the procedure with resolution of pain at the site.Singh D, Larson T, Campbell K, et al. Surgical Management of Idiopathic Partial Thrombosis of the Corpus Cavernosum. Sex Med 2021;9:100273.

Category: Midfoot/Forefoot Introduction/Purpose: Clinical decisions are often made based on the measurements of foot radiographs. Orthopaedic patients who have had lower extremity trauma or surgery are often given different weight bearing conditions including non-weight bearing, touch-down weight bearing, partial weight bearing (of various percent of body weight), and weight bearing as tolerated. However, it is largely unknown how these various weight bearing conditions alter specific parameters of foot radiographs. As such, the purpose of this study was to determine whether percent weight bearing influences radiographic measurements of the foot on anteroposterior (AP) and lateral radiographs? Methods: A total of 20 healthy subjects had AP and lateral radiographs of the foot under five weight bearing conditions (non-weight bearing, 10% body weight, 25% body weight, 50% body weight, and 100% body weight). Measurements were then made of hallux valgus angle (HVA), 1-2 intermetatarsal angle (IMA), talonavicular coverage angle (TNCA), talo-calcaneal angle (TCA), forefoot width, LisFranc distance, cuboid height to ground (CHG), and talo-1st metatarsal angle (TMA) of each weight bearing condition. Statistical differences of each measurement for each weight bearing condition were then determined. Measurements were made by a radiologist and orthopaedic surgeon and inter-observer reliability determined for each measurement. For each radiographic measurement, a single factor ANOVA determined whether measurements were different between non-weight bearing, touchdown weight bearing, 25% weight bearing, 50% weight bearing, and 100% weight bearing. When a significant difference was detected, a post-hoc Tukey’s determined which categories of weight bearing were different. Results: The inter-observer reliability determined by the intraclass correlation coefficient was excellent to good in all measurements except for the TCA which was fair. For measurements made on the AP radiographs of the foot, the measurements that changed with percent weight bearing were the TNCA (p = 0.0009) and TCA (p = 0.0446) (Table 1). Weight bearing did not change the HVA (p = 0.2564, IMA (p = 0.1698), forefoot width (p = 0.2431), or LisFranc distance (p = 0.9854). For measurements made on the lateral radiographs of the foot, the measurement that changed with percent weight bearing was the CHG (p = 0.006). Weight bearing did not change the TMA (p = 0.9889). Conclusion: This study demonstrates a flattening of the medial arch with increasing percent body weight applied to a foot. This results in an increase in the TNCA as well as a decrease in the CHG. In addition, increasing percent body weight to the foot increases the hindfoot alignment. However, percent body weight does not alter measurements of the forefoot. Percentage body weight increase may not influence clinical preoperative/non-operative treatment as much as we expect; however, our findings do show that certain parameters increase with increasing weight bearing.

Category: Ankle, Arthroscopy, Sports Introduction/Purpose: A promising new technique in the treatment of osteochondral lesions of the talus (OLT) involves the use of an acellular micronized cartilage matrix (MCM), BioCartilage, to fill the lesions. The micronized cartilage matrix is thought to improve the production of hyaline-like cartilage by resident cells in a cartilage defect, but its effect on bone marrow cells remains untested. Here we hypothesized that adding bone-marrow derived stem cells to the BioCartilage would result in the chondrogenic differentiation of the stem cells. We designed an in-vitro model to mimic the clinical situation to determine if the combination of MCM and human bone marrow derived mesenchymal stem cells (MSCs) would produce a hyaline-like cartilage in- vitro to ultimately provide a reliable, one-step treatment for osteochondral lesions in the talus. Methods: Human bone marrow-derived stem cells were obtained from consented patients and expanded in monolayer culture using standard protocols, to a maximum passage of 4. Viability was measured using Live/Dead cell viability assays (Thermofisher), and imaged on a Nikon TE2000 inverted fluorescent microscope. A custom-manufactured polysulfone device was created with four 6 mm diameter 3 mm deep indentations in agarose within each well of standard 6-well culture plates (Figure 1A-C). In each well, we placed chrondrogenic media with cells+micronized matrix to a depth of 2 mm and covered with a 1 mm layer of TISSEEL fibrin glue as is done clinically. Control groups had either no cells, or no MCM. At the end of 3 weeks, cartilage constructs were extracted and divided to perform viability, histology, and gene expression analysis (Figure 1D). Experiments were performed with 4 technical replicates, and repeated at least 3 times. Statistical analysis was performed using ANOVA with Dunnett’s test. Results: We found that stem cells were almost immediately killed when added directly to the dry micronized cartilage powder. Rehydrating the micronized cartilage prior to addition of cells was required to maintain the viability of the added stem cells, with no statistically significant difference between rehydration with serum or saline. After 3 weeks of culture in chondrogenic media, we observed that the combination of stem cells and micronized cartilage produced a cohesive structures that were easily handled, suggesting chondrogenic differentiation of the stem cells. Without the micronized matrix, the stem cells did not form viable constructs. In constructs that contained both cells and micronized cartilage, the 3-week cell viability was over 98%, with no dead cells visible in many constructs. Conclusion: Our study demonstrates that the micronized cartilage matrix is a suitable scaffold for the chondrogenic differentiation of bone marrow-derived stem cells, given that the matrix is first rehydrated before adding cells. Technical observations include that the MCM itself generated a “dead cell” signal initially, therefore the normalized total number of live cells in each condition was used for statistical comparisons. After 3 weeks of culturing under chondrogenic media conditions, we observed robust cell survival with nearly 100% viability. Preliminary results suggest cartilage matrix deposition occurred surrounding the cells after 3 weeks of chondrogenic culture.