STUDY ON IMPLANT STABILITY IN CEMENTLESS TOTAL KNEE ARTHROPLASTY

Objetives: Determine the stability of tibial and femoral components of 20 cementless knee arthroplasties with rotating platform. Methods: The 20 patients (20 knees) underwent an analysis of dynamic radiographs with an image amplifier and maneuvers of varus and valgus which were compared to static frontal and lateral radiographs of the knees and analyzed by two experienced surgeons in a double-blind way. Results: We could observe in this study that both methods showed very similar results for the stability of the tibial and femoral components (p<0.001) using the Kappa method for comparison. Conclusion: The tibial component was more unstable in relation to the femoral component in both static and dynamic studies. Level of Evidence IV, Case Series.

Do blood components affect the production of reactive oxygen species (ROS) by equine synovial cells in vitro?

Brossi P.M., Baccarin R.Y.A. & Massoco C.O. 2012 Do blood components affect the production of reactive oxygen species (ROS) by equine synovial cells in vitro? Pesquisa Veterinaria Brasileira 32(12):1355-1360. Departamento de Clinica Medica, Faculdade de Medicina Veterinaria e Zootecnia, Universidade de Sao Paulo, Av. Prof. Dr. Orlando Marques de Paiva 87, Butanta, Sao Paulo, SP 5508-210, Brazil. E-mail: baccarin@ usp.br Blood-derived products are commonly administered to horses and humans to treat many musculoskeletal diseases, due to their potential antioxidant and anti-inflammatory effects. Nevertheless, antioxidant effects have never been shown upon horse synovial fluid cells in vitro. If proved, this could give a new perspective to justify the clinical application of blood-derived products. The aim of the present study was to investigate the antioxidant effects of two blood-derived products - plasma (unconditioned blood product - UBP) and a commercial blood preparation (conditioned blood product - CBP)(4) - upon stimulated equine synovial fluid cells. Healthy tarsocrural joints (60) were tapped to obtain synovial fluid cells; these cells were pooled, processed, stimulated with lipopolysaccharide (LPS) or phorbol 12-myristate 13-acetate (PMA), and evaluated by flow cytometry for the production of reactive oxygen species (ROS). Upon addition of any blood-derived product here used - UBP and CBP - there was a significant decrease in the oxidative burst of synovial fluid cells (P<0.05). There was no difference between UBP and CBP effects. In conclusion, treatment of stimulated equine synovial cells with either UBP or CBP efficiently restored their redox equilibrium.

Short-term efficacy of physical interventions in osteoarthritic knee pain. A systematic review and meta-analysis of randomised placebo-controlled trials

Abstract Background Treatment efficacy of physical agents in osteoarthritis of the knee (OAK) pain has been largely unknown, and this systematic review was aimed at assessing their short-term efficacies for pain relief. Methods Systematic review with meta-analysis of efficacy within 1���4 weeks and at follow up at 1���12 weeks after the end of treament. Results 36 randomised placebo-controlled trials (RCTs) were identified with 2434 patients where 1391 patients received active treatment. 33 trials satisfied three or more out of five methodological criteria (Jadad scale). The patient sample had a mean age of 65.1 years and mean baseline pain of 62.9 mm on a 100 mm visual analogue scale (VAS). Within 4 weeks of the commencement of treatment manual acupuncture, static magnets and ultrasound therapies did not offer statistically significant short-term pain relief over placebo. Pulsed electromagnetic fields offered a small reduction in pain of 6.9 mm [95% CI: 2.2 to 11.6] (n = 487). Transcutaneous electrical nerve stimulation (TENS, including interferential currents), electro-acupuncture (EA) and low level laser therapy (LLLT) offered clinically relevant pain relieving effects of 18.8 mm [95% CI: 9.6 to 28.1] (n = 414), 21.9 mm [95% CI: 17.3 to 26.5] (n = 73) and 17.7 mm [95% CI: 8.1 to 27.3] (n = 343) on VAS respectively versus placebo control. In a subgroup analysis of trials with assumed optimal doses, short-term efficacy increased to 22.2 mm [95% CI: 18.1 to 26.3] for TENS, and 24.2 mm [95% CI: 17.3 to 31.3] for LLLT on VAS. Follow-up data up to 12 weeks were sparse, but positive effects seemed to persist for at least 4 weeks after the course of LLLT, EA and TENS treatment was stopped. Conclusion TENS, EA and LLLT administered with optimal doses in an intensive 2���4 week treatment regimen, seem to offer clinically relevant short-term pain relief for OAK.

Assessing joint effusion and bone changes of the head of the mandible in MR images of symptomatic patients

The aim of the present study was to investigate the relationship between degenerative bone changes of the head of the mandible and the presence of joint effusion (JE). This study was based on sagittal magnetic resonance imaging (MRI) reports of 148 temporomandibular joints (TMJs) of 74 patients complaining of pain and/or dysfunction in the TMJ area. The mandible heads were surveyed for osteoarthritis characteristics, which were classified as osteophytosis, sclerosis or erosion. The presence of JE was checked whenever high signal intensity was observed in the articular space. The results evidenced the presence of bone changes in 30% of the sample. Osteophytes and erosions were the changes most commonly observed. JE was reported in 10% of TMJs. The results from the statistical tests revealed that bone changes in the head of the mandible are associated with the presence of JE.

Viscosuplementa����o

Com o envelhecimento da popula����o mundial, aumenta a cada dia a preval��ncia das doen��as relacionadas �� idade, com destaque para a osteoartrite, forma mais comum de doen��a articular e que, al��m da alta preval��ncia, relaciona-se a altos custos m��dicos e sociais. Dentre as modalidades de tratamento, a viscosuplementa����o, inje����o intra-articular de derivados do ��cido hialur��nico, vem ganhando cada vez mais destaque. Trata-se de um polissacar��deo de alto peso molecular que possui, al��m das fun����es mec��nicas de distribui����o de peso e lubrifica����o, propriedades anti-inflamat��rias e a����o f��sico-qu��mica sobre diversos aspectos da articula����o, sendo que tais efeitos s��o diretamente proporcionais ao peso molecular, concentra����o e presen��a de liga����es cruzadas da droga utilizada. A viscosuplementa����o �� procedimento simples e pode ser realizada ambulatorialmente. Traz benef��cio para dor e fun����o, e tamb��m altera favoravelmente o curso da doen��a, melhorando quantitativamente e qualitativamente a cartilagem articular. Apresenta bom perfil de seguran��a e favor��vel rela����o custo-efetividade, sendo indicada tanto para osteoartrite quanto ap��s um procedimento de artroscopia.

O uso do transplante osteocondral a fresco no tratamento das les��es osteocondrais do joelho

O tratamento das les��es condrais e osteocondrais do joelho em pacientes jovens ainda permanece um desafio para os ortopedistas. As t��cnicas de reparo atualmente dispon��veis no Brasil, como o desbridamento, microfraturas e transplante osteocondral aut��logo s��o insuficientes nos tratamentos de les��es condrais e osteocondrais grandes. O transplante osteocondral hom��logo a fresco (TOF) na articula����o do joelho vem sendo usado nos Estados Unidos com excelentes resultados. Este artigo tem o intuito de revisar a ci��ncia b��sica, indica����es, t��cnicas cir��rgicas, poss��veis complica����es e descrever a t��cnica de transplante osteocondral hom��logo a fresco na articula����o do joelho realizada no Instituto de Ortopedia e Traumatologia do Hospital das Cl��nicas da Universidade de S��o Paulo.

Estudo da estabilidade dos componentes na artroplastia total do joelho sem cimento

OBJETIVO: Comparar dois m��todos de avalia����o da estabilidade dos componentes tibial e femoral nas artroplastias de joelho n��o cimentadas com plataforma rotat��ria. M��TODOS: Para isso foram avaliados 20 pacientes (20 joelhos) atrav��s de uma an��lise de radiografias din��micas com intensificador de imagem e manobras de estresse em varo e valgo, que foram comparadas com radiografias est��ticas em frente e perfil dos joelhos, analisadas por dois cirurgi��es experientes, cegos um em rela����o ao outro. RESULTADOS: Os resultados das an��lises est��ticas e din��micas foram comparados e demonstraram forte correla����o estat��stica (p<0,001), utilizando-se o m��todo Kappa de compara����o. CONCLUS��O: O componente tibial mostrou-se mais inst��vel quando comparado com o componente femoral, tanto na an��lise est��tica, quanto na din��mica. N��vel de evid��ncia IV, S��rie de Casos.

Revis��o dos artigos sobre ortopedia recentemente publicados na imprensa cient��fica brasileira

Este estudo faz o levantamento de artigos publicados em peri��dicos cient��ficos brasileiros nos ��ltimos anos. O principal objetivo �� chamar a aten����o do p��blico leitor da Acta Ortop��dica Brasileira para as contribui����es originais recentemente publicadas em peri��dicos n��o especialistas neste tema. Esperamos que isso sirva de atualiza����o cient��fica geral para os leitores. Cobrimos amplamente os artigos publicados em seis peri��dicos n��o-ortop��dicos indexados pelo ISI, atrav��s de pesquisa realizada em 14 desses peri��dicos.

New functional and biomechanical assessments for the improvement of the surgical navigation systems for joint replacement in the human lower limb

In case of severe osteoarthritis at the knee causing pain, deformity, and loss of stability and mobility, the clinicians consider that the substitution of these surfaces by means of joint prostheses. The objectives to be pursued by this surgery are: complete pain elimination, restoration of the normal physiological mobility and joint stability, correction of all deformities and, thus, of limping. The knee surgical navigation systems have bee developed in computer-aided surgery in order to improve the surgical final outcome in total knee arthroplasty. These systems provide the surgeon with quantitative and real-time information about each surgical action, like bone cut executions and prosthesis component alignment, by mean of tracking tools rigidly fixed onto the femur and the tibia. Nevertheless, there is still a margin of error due to the incorrect surgical procedures and to the still limited number of kinematic information provided by the current systems. Particularly, patello-femoral joint kinematics is not considered in knee surgical navigation. It is also unclear and, thus, a source of misunderstanding, what the most appropriate methodology is to study the patellar motion. In addition, also the knee ligamentous apparatus is superficially considered in navigated total knee arthroplasty, without taking into account how their physiological behavior is altered by this surgery. The aim of the present research work was to provide new functional and biomechanical assessments for the improvement of the surgical navigation systems for joint replacement in the human lower limb. This was mainly realized by means of the identification and development of new techniques that allow a thorough comprehension of the functioning of the knee joint, with particular attention to the patello-femoral joint and to the main knee soft tissues. A knee surgical navigation system with active markers was used in all research activities presented in this research work. Particularly, preliminary test were performed in order to assess the system accuracy and the robustness of a number of navigation procedures. Four studies were performed in-vivo on patients requiring total knee arthroplasty and randomly implanted by means of traditional and navigated procedures in order to check for the real efficacy of the latter with respect to the former. In order to cope with assessment of patello-femoral joint kinematics in the intact and replaced knees, twenty in-vitro tests were performed by using a prototypal tracking tool also for the patella. In addition to standard anatomical and articular recommendations, original proposals for defining the patellar anatomical-based reference frame and for studying the patello-femoral joint kinematics were reported and used in these tests. These definitions were applied to two further in-vitro tests in which, for the first time, also the implant of patellar component insert was fully navigated. In addition, an original technique to analyze the main knee soft tissues by means of anatomical-based fiber mappings was also reported and used in the same tests. The preliminary instrumental tests revealed a system accuracy within the millimeter and a good inter- and intra-observer repeatability in defining all anatomical reference frames. In in-vivo studies, the general alignments of femoral and tibial prosthesis components and of the lower limb mechanical axis, as measured on radiographs, was more satisfactory, i.e. within ����3����, in those patient in which total knee arthroplasty was performed by navigated procedures. As for in-vitro tests, consistent patello-femoral joint kinematic patterns were observed over specimens throughout the knee flexion arc. Generally, the physiological intact knee patellar motion was not restored after the implant. This restoration was successfully achieved in the two further tests where all component implants, included the patellar insert, were fully navigated, i.e. by means of intra-operative assessment of also patellar component positioning and general tibio-femoral and patello-femoral joint assessment. The tests for assessing the behavior of the main knee ligaments revealed the complexity of the latter and the different functional roles played by the several sub-bundles compounding each ligament. Also in this case, total knee arthroplasty altered the physiological behavior of these knee soft tissues. These results reveal in-vitro the relevance and the feasibility of the applications of new techniques for accurate knee soft tissues monitoring, patellar tracking assessment and navigated patellar resurfacing intra-operatively in the contest of the most modern operative techniques. This present research work gives a contribution to the much controversial knowledge on the normal and replaced of knee kinematics by testing the reported new methodologies. The consistence of these results provides fundamental information for the comprehension and improvements of knee orthopedic treatments. In the future, the reported new techniques can be safely applied in-vivo and also adopted in other joint replacements.

Evaluation of bone strength: microtomographic tecniques

This thesis is a part of a larger study about the characterization of mechanical and histomorphometrical properties of bone. The main objects of this study were the bone tissue properties and its resistance to mechanical loads. Moreover, the knowledge about the equipment selected to carry out the analyses, the micro-computed tomography (micro-CT), was improved. Particular attention was given to the reliability over time of the measuring instrument. In order to understand the main characteristics of bone mechanical properties a study of the skeletal, the bones of which it is composed and biological principles that drive their formation and remodelling, was necessary. This study has led to the definition of two macro-classes describing the main components responsible for the resistance to fracture of bone: quantity and quality of bone. The study of bone quantity is the current clinical standard measure for so-called bone densitometry, and research studies have amply demonstrated that the amount of tissue is correlated with its mechanical properties of elasticity and fracture. However, the models presented in the literature, including information on the mere quantity of tissue, have often been limited in describing the mechanical behaviour. Recent investigations have underlined that also the bone-structure and the tissue-mineralization play an important role in the mechanical characterization of bone tissue. For this reason in this thesis the class defined as bone quality was mainly studied, splitting it into two sub-classes of bone structure and tissue quality. A study on bone structure was designed to identify which structural parameters, among the several presented in the literature, could be integrated with the information about quantity, in order to better describe the mechanical properties of bone. In this way, it was also possible to analyse the iteration between structure and function. It has been known for long that bone tissue is capable of remodeling and changing its internal structure according to loads, but the dynamics of these changes are still being analysed. This part of the study was aimed to identify the parameters that could quantify the structural changes of bone tissue during the development of a given disease: osteoarthritis. A study on tissue quality would have to be divided into different classes, which would require a scale of analysis not suitable for the micro-CT. For this reason the study was focused only on the mineralization of the tissue, highlighting the difference between bone density and tissue density, working in a context where there is still an ongoing scientific debate.

Campi elettromagnetici pulsanti nella terapia dell'artrosi del cane

The aim of this study is to evaluate the effects of the pulsed electromagnetic fields (PEMFS) on pain relief and functional capacity of dogs with osteoarthritis by which a single centre study prospective clinical trial. PEMFs are non ionized, athermic and time varying electromagnetic fields that has been successfully used for the treatment of osteoarthritis in human thanks to their chondroprotective, antinflammatory and analgesic property. 20 dogs were treated with PEMFs , 3 times per week for a total of 20 sessions.We found beneficial effects on pain relief and lameness in the absence of adverse effect. The decrease of pain impacted positively on the health-dogs related quality of life and the grade of satisfaction of their owner was very high. The benefits were obvious at half therapy and lasted for a medium long time. This is the first published report concerning PEMFs treatment on canine osteoarthtitis. The result of this study proves that PEMFs is a non ���invasive remedy, lacking in adverse effect , easy to employ and useful for controlling pain and inflammation associated with osteoarthritis.

Development of newly conceived biomimetic nano-structured biomaterials as scaffolds for bone and osteochondral regeneration

The present research thesis was focused on the development of new biomaterials and devices for application in regenerative medicine, particularly in the repair/regeneration of bone and osteochondral regions affected by degenerative diseases such as Osteoarthritis and Osteoporosis or serious traumas. More specifically, the work was focused on the synthesis and physico-chemical-morphological characterization of: i) a new superparamagnetic apatite phase; ii) new biomimetic superparamagnetic bone and osteochondral scaffolds; iii) new bioactive bone cements for regenerative vertebroplasty. The new bio-devices were designed to exhibit high biomimicry with hard human tissues and with functionality promoting faster tissue repair and improved texturing. In particular, recent trends in tissue regeneration indicate magnetism as a new tool to stimulate cells towards tissue formation and organization; in this perspective a new superparamagnetic apatite was synthesized by doping apatite lattice with di-and trivalent iron ions during synthesis. This finding was the pin to synthesize newly conceived superparamagnetic bone and osteochondral scaffolds by reproducing in laboratory the biological processes yielding the formation of new bone, i.e. the self-assembly/organization of collagen fibrils and heterogeneous nucleation of nanosized, ionically substituted apatite mimicking the mineral part of bone. The new scaffolds can be magnetically switched on/off and function as workstations guiding fast tissue regeneration by minimally invasive and more efficient approaches. Moreover, in the view of specific treatments for patients affected by osteoporosis or traumas involving vertebrae weakening or fracture, the present work was also dedicated to the development of new self-setting injectable pastes based on strontium-substituted calcium phosphates, able to harden in vivo and transform into strontium-substituted hydroxyapatite. The addition of strontium may provide an anti-osteoporotic effect, aiding to restore the physiologic bone turnover. The ceramic-based paste was also added with bio-polymers, able to be progressively resorbed thus creating additional porosity in the cement body that favour cell colonization and osseointegration.

Synthese und Testung von COX-1-, COX-2- und 5-LOX-Inhibitoren zur topischen Anwendung

Das Ziel der Dissertation war die Synthese und pharmakologische Charakterisierung von COX-1-, COX-2- und 5-LOX-Inhibitoren, die zur Behandlung entz��ndlicher Dermatosen f��r die topische Anwendung geeignet sein sollten. Hierf��r wurden zwei Strukturklassen - die sogenannten Imidazothiazole und die Chalcone-Derivate - entworfen und synthetisiert sowie in verschiedenen in vitro-Testsystemen auf ihre pharmakologische Wirksamkeit untersucht. rnDie Leitsubstanz der ersten Strukturklasse wurde in Anlehnung an die Struktur von Licofelon entworfen. Licofelon ist ein dualer COX/LOX-Inhibitor, der f��r die Indikation Osteoarthritis eingesetzt werden soll. Durch den Austausch einzelner Substituenten an den Phenylringen wurde die Leitstruktur schrittweise ver��ndert, um die Wirksamkeit zu optimieren. Die Substituentenvariation erfolgte anhand des sogenannten Topliss-Schemas. Bei der zweiten Substanzklasse wurde durch Kombination zweier antiinflammatorisch wirksamer Molek��lgruppen - mit dem Ziel eines synergistischen Effekts - eine Grundstruktur entwickelt, die zur Optimierung der Wirksamkeit derivatisiert wurde. Als Komponenten dienten 4,5-Bis(4-methoxyphenyl)-1H-imidazol-2-thiol (Z11) und ein Chalcon. Z11 ist sowohl in der Literatur als auch in vorangegangen Arbeiten des Arbeitskreises als dualer COX/LOX-Inhibitor beschrieben. Chalcone besitzen eine 1,3-Diphenylpropenon-Partialstruktur und k��nnen ��ber einen der beiden Phenylringe mit Z11 verkn��pft werden. In der Literatur wurde vielfach ��ber die vielf��ltigen pharmakologischen Eigenschaften der Chalcone berichtet; im Rahmen dieser Arbeit stand deren antiinflammatorische Eigenschaft im Vordergrund. rnZur Beurteilung der Effektivit��t und Toxizit��t der Substanzen wurden diese anschlie��end pharmakologisch charakterisiert werden. Hierf��r standen verschiedene in vitro-Testsysteme zur Verf��gung, die Aufschluss ��ber die COX-1-, COX-2- und 5-LOX-Inhibition der synthetisierten Substanzen gaben. Des Weiteren wurden die Substanzen auf eine m��gliche inhibitorische Aktivit��t gegen��ber TNF-��� untersucht. Da die Entwicklung der Testverbindungen mit dem Ziel der topischen Anwendung erfolgte, wurde eine log P-Wert-Bestimmung durchgef��hrt, um eine Aussage ��ber die Lipophilie der Verbindungen treffen zu k��nnen.rn

Generierung und Charakterisierung von in-vitro- und in- vivo-Modellsystemen zur Untersuchung des Skelettsystems

Die Entstehung und Aufrechterhaltung von Knorpel- und Knochengewebe wird durch eine Vielzahl von hemmenden oder f��rdernden Faktoren hoch komplex reguliert, wobei die dabei involvierten physiologischen Prozesse bisher nur teilweise verstanden werden. Auch die Ursachen sowohl degenerativer Erkrankungen, aber auch durch Mutationen im FGFR3-Gen verursachter Chondrodysplasien sind in ihrer ��tiopathogenese noch nicht vollst��ndig erforscht. In dieser Arbeit wurden verschiedene experimentelle Ans��tze verfolgt, die zur weiteren Aufkl��rung der Pathophysiologie zweier unterschiedlicher Skeletterkrankungen beitragen sollten.rnEin relevantes Charakteristikum der degenerativen Gelenkserkrankung Osteoarthrose ist der Verlust an Aggrekan, hauptverantwortlich verursacht durch die Aggrekanase ADAMTS5. Es wurde ein Tiermodell generiert, bei dem gezielt mittels des Tet-ON-Systems die Aggrekanase mAdamts-5 ��berexprimiert werden kann. Nach Konstruktherstellung und Generierung als auch Charakterisierung des in vitro-Modells wurde das Tiermodell hergestellt, um die Folgen der ��berexpression im Hinblick auf einen verst��rkten Aggrekanabbau im Knorpel der M��use zu analysieren. Nach initialer Charakterisierung auf Induzierbarkeit zeigte eine Gr��nderlinie eine induzierbare transgene mAdamts5-Expression. Die ��berpr��fung auf Knorpelspezifit��t zeigte, sowohl embryonal als auch im adulten Tier, dass sich der verwendete, zusammengesetzte Kollagen-Typ II Promotor wie der endogene verhielt und somit funktional war. Nach Doxyzyklininduktion wurde bei der optimalen Dosis von 1 mg/ml im Vergleich zum induzierten Wildtyp-Tier eine 15%ige Abnahme des Gesamt-Glykosamino-glykan(GAG)-Gehaltes und eine um 120% erh��hte GAG-Abgabe ins Medium detektiert, was eine verst��rkte Spaltung von Aggrekan bedeutete. Die transgene Aggrekanase wurde ��berexprimiert und spaltete verst��rkt Aggrekan. Da aufgrund der histologischen Untersuchungen jedoch keine Knorpelerosionen feststellbar waren, konnte im Umkehrschluss gefolgert werden, dass der Knorpel einen Verlust an Glykosaminoglykanen bis zu einer gewissen Grenze tolerieren kann. Mit dem generierten und charakterisierten Tiermodell konnte mit dem Verlust an GAG eine Osteoarthrose-��hnliche Situation simuliert werden, insbesondere im Hinblick auf fr��he Stadien der Erkrankung, bei denen noch keine makroskopisch eindeutig sichtbare Knorpelerosionen vorliegen. rnIm zweiten Teil der Arbeit wurden Zellkulturexperimente zur weiteren Aufkl��rung FGFR3-regulierter Prozesse durchgef��hrt. Nach Generierung und Verifizierung der stabilen Zelllinien, die mittels des Tet-ON-Systems das FGFR3-Gen mit jeweils einer Chondrodysplasie-assoziierten Mutation (Achondroplasie-Mutation G380R, Thanatophore Dysplasie Typ II-Mutation K650E) induzierbar ��berexprimieren, wurden die Auswirkungen der zwei verschiedenen Mutationen anhand bereits beschriebener Signalwege untersucht. ��ber die Rekrutierung des ERK-Signalweges konnte bei beiden Zelllinien die Funktionalit��t nachgewiesen werden, wobei die Zelllinie mit der einen schwereren Ph��notyp beim Menschen verursachenden TDII-Mutation eine st��rkere Aktivierung zeigte. Bei der Aktivierung von STAT1 wies nur die TDII-Zelllinie eine Phosphorylierung auf, nicht jedoch die ACH-Zelllinie; dies deckte sich mit bereits publizierten Untersuchungen. Beide Kaskaden zeigten eine unterschiedliche Signalantwort aufgrund der verschiedenen Mutationen. Des Weiteren konnte eine unterschiedliche MMP13-Zielgenexpression nachgewiesen werden, wobei lediglich die ACH-Zelllinie eine erh��hte MMP13-Expression (6-fach) zeigte. Zur Identifizierung neuer involvierter FGFR3-Zielgene wurde die differentielle Genexpression der TDII-Zelllinie im Vergleich induziert/nicht induziert mittels Microarray-Hybridisierung untersucht. Als interessantes Zielgen fiel STC1 auf, welches ebenfalls eine Rolle in der Chondrogenese spielt und bislang nicht mit FGFR3 in Verbindung gebracht wurde. Es konnte jedoch nur auf RNA-Ebene eine Regulation nachgewiesen werden. Nachfolgend durchgef��hrte transiente Experimente zeigten, dass die Wildtyp-Variante von FGFR3 m��glicherweise eine Funktion in der Sekretion des Proteins STC1 hat und dass durch die beiden eingef��gten Mutationen (ACH, TDII) diese aufgehoben ist. Der Einfluss von FGFR3 auf die Sekretion von STC1 stellt ein neues Ergebnis dar, insbesondere auch die Auswirkungen der beiden f��r die unterschiedlichen Krankheitsbilder stehenden Mutationen. Welche Relevanz allerdings die STC1-Sekretion im Rahmen FGFR3-assoziierter Erkrankungen hat, kann nicht eindeutig beurteilt werden. Weitere Faktoren aus dem hoch komplexen Zusammenspiel w��hrend der Knorpel/Knochenentwicklung m��ssen untersucht werden, um eine definitive Einordnung zu erm��glichen.

Efficacia clinica dello stanozololo intrarticolare nella terapia dell'osteoartrosi di gomito nel cane

Il trattamento dell���osteoartrosi (OA) del cane �� una sfida nella pratica clinica veterinaria. Molti trattamenti sono stati proposti, tuttavia la risposta clinica agli stessi non �� sempre soddisfacente. Molti farmaci sono utilizzati per il trattamento dell���OA, tra cui farmaci anti-infiammatori non steroidei, corticosteroidi, ed inibitori della produzione dell���ossido nitrico. Lo stanozololo �� un derivato sintetico del testosterone; oltre alle sue propriet�� anaboliche/androgeniche , a basse dosi lo stanozololo ha un affinit�� per i recettori glucocorticoidi. Per questa attivit�� antinfiammatoria e rigenerativa sui tessuti articolari danneggiati viene utilizzato nella degenerative joint desease del cavallo. Lo scopo di questo studio �� stato di valutare l���efficacia clinica dello stanozololo intra-articolare a 15, 30, 45 e 60 giorni dal trattamento di gomiti con OA di cane. E��� stato eseguito uno studio cieco, multicentrico e randomizzato. Previo consenso informato, sono stati arruolati 48 cani, suddivisi in 3 gruppi e trattati con stanozololo, mavacoxib e con entrambi i farmaci. Sono state valutate zoppia, tollerabilit�� del trattamento, range of motion, e punteggio radiografico. Inoltre sono state stabilite e annoverate quantit�� e qualit�� del liquido sinoviale. Ai dati ottenuti sono stati applicati i test di Kruskal-Wallis, Chi-quadro e Fischer, i quali hanno dimostrato l���efficacia della terapia nei singoli gruppi e tra i diversi gruppi di studio. I risultati ottenuti hanno mostrato la riduzione di almeno un grado di zoppia e la riduzione della progressione dell���OA nei casi trattati con stanozololo. Si pu�� quindi affermare che tale molecola per via intra-articolare pu�� essere una valida alternativa per il trattamento dell���OA di gomito nel cane.