The treatment of chondral and osteochondral defects of the knee with autologous matrix-induced chondrogenesis (AMIC): method description and recent developments

Purpose: Articular resurfacing by treatment of chondral defects may include chondral abrasion, autologous chondrocyte Implantation (ACI), matrix-induced chondrocyte transplantation (MACT) or osteochondral autologous transplantation (OATS). This technical note describes the method of autologous matrix-induced chondrogenesis (AMIC), a one-step procedure combining subchondral microfracture with the fixation of a collagen I/III membrane with fibrin glue or sutures. Methods: This is a technical note on the AMIC procedure and its further development. Results and conclusion: This method is applied primarily in chondral or osteochondral lesions of the knee. Indications and contraindications are provided; the technique is described. The further development of AMIC is described with an increased focus on the subchondral zone and the complex of cartilage and bone, the osteochondral unit, which receives increased attention in cartilage research. Level of evidence: I

A symptomatic sesamoid bone in the popliteus muscle (cyamella)

Sesamoid bones of the popliteus muscle, also called cyamellae, are common in primates but rare in humans. They reside as accessory bones in the tendon itself or in the intersection between tendon and bone. They should be clearly distinguished from osteochondral flakes, periosseuos calcifications, osteophytes and the fabella, a common sesamoid bone of the knee. In this case, we report a 25-year-old male with posterior lateral knee pain related to the popliteus tendon where a corresponding cyamella could be demonstrated on X-rays and MRI scans. The clinical findings may be related to the cyamella. Diagnosis and treatment of this rare pathology are discusse

We do not have evidence based methods for the treatment of cartilage defects in the knee

Purpose: The aim of this study was to perform a systematic review of studies concerning current treatment of chondral defects of the knee. Methods: The relevance for evidence based data and for successful surgical treatment of cartilage defects was evaluated. From 56,098 evaluated studies, 133 studies could be further pursued. These supplied data concerning microfracturing, the osteochondral autograft transplantation system (OATS), the autologous chondrocyte implantation (ACI) and the matrix induced chondrocyte implantation (MACI). The modified Coleman Methodical Score (CMS) and the Level of Evidence (LOE) were applied to evaluate the quality. Results: In these studies, a total of 6,920 patients were reviewed with a median of 32 patients per study and a mean follow-up of 24months. The mean CMS was 58 of 100 points. No study reached 100 points in the CMS. Three studies reached a level above 90. Ten studies were Level I, five studies reached Level II. Seven studies reached Level III, 111 studies Level IV. MRI scans to verify the clinical data were used by only 72 studies. The means in the modified CMS were for the different procedures as follows: ACI 58 points, MACI 57 points, microfracturing 68 points and OATS 50 points. 24 studies applied the Lysholm Score (LS) for clinical evaluation of cartilage surgery. All operative procedures yielded comparable improvements of the LS (n.s.) meaning that no operative procedure proved superior. Conclusion: As the majority of studies evaluated by this review is insufficient for EBM purposes more coherent studies with LOE of I or II are needed. Co-relating the systems of CMS and LOE and validating the applied scores seems desirabl

Early failure of a non-cemented femoral stem after minimal-invasive total hip arthroplasty: cause analysis and classification

In this paper, we present a 77-year-old female patient with an early failure of a non-cemented femoral stem 6months after implantation. We evaluate possible reasons for the implant failure in our case against the literature. Risk factors for stem failure include a BMI >30, varus implantation, a high femoral canal cortex ratio, and a small implant. It should be distinguished between modular and non-modular stems as well as cemented and non-cemented. Early failure would be 1year postoperatively. A classification of stem failure differentiating time and cause is suggested as this seems to be missing in the literature

Study abroad, L2 motivation and English language acquisition: A longitudinal study of the experience of Japanese university students studying English abroad and at home

This portfolio of individual exploratory studies reports on the English language learning experiences of a cohort of Japanese university students who studied English abroad as a group during their first year at university. The studies focus on the students' English language learning experiences in three successive environments and time periods: the pre-study abroad period in Japan during the years of schooling, the study abroad period in the United Kingdom during the students' first year at university, and finally the post-study abroad period in Japan during the students' second and third years at university. Each study explores L2 motivation from different perspectives in order to capture the dynamic trajectory of L2 motivation in Japanese university students whose program of study includes studying English abroad. The portfolio draws on dynamic systems theory (DST) and L2 motivation theories to conceptualise the participants' learning journeys, and to identify diverse possible cognitive, social and environmental factors acting on the learning of an additional language and on motivation to learn an additional language. Applying the DST approach to the study participants' language learning has made it possible to trace their L2 journeys as multi-dimensional experiences, non-linear in nature and sensitive to the effect of temporal factors

Influence of temperature on the δ13C values and distribution of methanotroph‐related hopanoids in Sphagnum‐dominated peat bogs

Methane emissions from peat bogs are mitigated by methanotrophs, which live in symbiosis with peat moss (e.g. Sphagnum ). Here, we investigate the influence of temperature and resultant changes in methane fluxes on Sphagnum and methanotroph‐related biomarkers, evaluating their potential as proxies in ancient bogs. A pulse‐chase experiment using 13C‐labelled methane in the field clearly showed label uptake in diploptene, a biomarker for methanotrophs, demonstrating in situ methanotrophic activity in Sphagnum under natural conditions. Peat cores containing live Sphagnum were incubated at 5, 10, 15, 20 and 25°C for two months, causing differences in net methane fluxes. The natural δ13C values of diploptene extracted from Sphagnum showed a strong correlation with temperature and methane production. The δ13C values ranged from −34‰ at 5°C to −41‰ at 25°C. These results are best explained by enhanced expression of the methanotrophic enzymatic isotope effect at higher methane concentrations. Hence, δ13C values of diploptene, or its diagenetic products, potentially provide a useful tool to assess methanotrophic activity in past environments. Increased methane fluxes towards Sphagnum did not affect δ13C values of bulk Sphagnum and its specific marker, the C23 n ‐alkane. The concentration of methanotroph‐specific bacteriohopanepolyols (BHPs), aminobacteriohopanetetrol (aminotetrol, characteristic for type II and to a lesser extent type I methanotrophs) and aminobacteriohopanepentol (aminopentol, a marker for type I methanotrophs) showed a non‐linear response to increased methane fluxes, with relatively high abundances at 25°C compared to those at 20°C or below. Aminotetrol was more abundant than aminopentol, in contrast to similar abundances of aminotetrol and aminopentol in fresh Sphagnum . This probably indicates that type II methanotrophs became prevalent under the experimental conditions relative to type I methanotrophs. Even though BHP concentrations may not directly reflect bacterial activity, they may provide insight into the presence of different types of methanotrophs

Temperature-Induced Increase in Methane Release from Peat Bogs: A Mesocosm Experiment

Peat bogs are primarily situated at mid to high latitudes and future climatic change projections indicate that these areas may become increasingly wetter and warmer. Methane emissions from peat bogs are reduced by symbiotic methane oxidizing bacteria (methanotrophs). Higher temperatures and increasing water levels will enhance methane production, but also methane oxidation. To unravel the temperature effect on methane and carbon cycling, a set of mesocosm experiments were executed, where intact peat cores containing actively growing Sphagnum were incubated at 5, 10, 15, 20, and 25°C. After two months of incubation, methane flux measurements indicated that, at increasing temperatures, methanotrophs are not able to fully compensate for the increasing methane production by methanogens. Net methane fluxes showed a strong temperature-dependence, with higher methane fluxes at higher temperatures. After removal of Sphagnum, methane fluxes were higher, increasing with increasing temperature. This indicates that the methanotrophs associated with Sphagnum plants play an important role in limiting the net methane flux from peat. Methanotrophs appear to consume almost all methane transported through diffusion between 5 and 15°C. Still, even though methane consumption increased with increasing temperature, the higher fluxes from the methane producing microbes could not be balanced by methanotrophic activity. The efficiency of the Sphagnum-methanotroph consortium as a filter for methane escape thus decreases with increasing temperature. Whereas 98% of the produced methane is retained at 5°C, this drops to approximately 50% at 25°C. This implies that warming at the mid to high latitudes may be enhanced through increased methane release from peat bogs

Specific Dimensional Change Behavior of Laminated Beech Veneer Lumber (BauBuche) in Terms of Moisture Absorption and Desorption

Replacing greenhouse gas-intensive building materials with wood products from sustainable forestry contributes to the implementation of current climate conventions such as the Paris Agreement. Hardwood products, such as laminated veneer lumber made of beech (e.g., BauBuche), are an alternative to conventional building materials. For the application of wood products in the construction sector, a precise knowledge of the mechanical and physical properties is essential. Therefore, the aim of the present study was to investigate the sorption behavior and associated dimensional changes of the product BauBuche. This was done by applying a manual testing procedure (climatic chamber, balance and caliper) as well as a dynamic vapor sorption analyzer equipped with a camera. During initial moistening after production, due to the irreversible spring back (approximately 2 mm at 50 mm; i.e., 4%), Baubuche shows an extremely strong swelling in the radial direction. Once the maximum spring back is reached, Baubuche shows sorption behavior in the radial and tangential direction, which is comparable to that of solid beech wood in the radial direction. Consequently, the dimensional changes caused by moisture changes must be taken into account in the dimensioning of Baubuche components in order to avoid damage to building structures

A symptomatic sesamoid bone in the popliteus muscle (cyamella)

Sesamoid bones of the popliteus muscle, also called cyamellae, are common in primates but rare in humans. They reside as accessory bones in the tendon itself or in the intersection between tendon and bone. They should be clearly distinguished from osteochondral flakes, periosseuos calcifications, osteophytes and the fabella, a common sesamoid bone of the knee. In this case, we report a 25-year-old male with posterior lateral knee pain related to the popliteus tendon where a corresponding cyamella could be demonstrated on X-rays and MRI scans. The clinical findings may be related to the cyamella. Diagnosis and treatment of this rare pathology are discussed