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Annals of The Royal College of Surgeons of England logoLink to Annals of The Royal College of Surgeons of England
. 2006 Jul;88(4):421–422. doi: 10.1308/003588406X114794

Publication of Abstracts from the Best Regional Presentations

Editor: Linda de Cossart
PMCID: PMC1964652
Ann R Coll Surg Engl. 2006 Jul;88(4):421. doi: 10.1308/003588406X114794

Effect of Chemically Modified Glucosamine Derivatives on Aggrecanase-Generated Aggrecan Catabolites

AM Thomas, Clare Hughes, Bruce Caterson, Richard Evans, Colin Dent

Osteoarthritis is a degenerative disease affecting a large proportion of the population. Recently, there has been renewed interest in the use of neutraceuticals (such as glucosamine) for the treatment of symptomatic pain and pathology in arthritic joints. However, little research has been carried out to assess the biochemical mechanisms by which glucosamine imparts its effects on the disease process. Biochemically, an early change in cartilage metabolism is a loss of the large aggregating proteoglycan, named aggrecan. Functionally, this loss results in a decreased capacity for the tissue to sustain mechanical loading and eventually leads to cartilage destruction and a painful joint. The enzymes responsible for the loss of aggrecan from the tissue are commonly referred to as the aggrecanases and are members of the A Disintegrin And Metalloproteinase with ThromboSpondin motifs (ADAMTS) family of enzymes. Degradation of aggrecan by the aggrecanases can be detected using a specific neo-epitope monoclonal antibody BC-3.1 Model systems using cartilage explant cultures that mimic the degradative processes seen in osteoarthritis have been developed in which cytokines such as IL-1 are used to initiate the catabolic processes leading to cartilage degradation. In this study, we have investigated the effects of pretreatment of articular cartilage explant cultures with preparations of chemically modified glucosamine on their ability to inhibit the release of aggrecan following treatment with IL-1. Initial experiments have shown that glucosamine hydrochloride was unable to inhibit the release of aggrecan from explant cultures; however, a modified glucosamine was able to inhibit the release of aggrecan to that of control culture levels that were not treated with either glucosamine or IL-1. These data suggest a role for chemically modified glucosamine in the treatment of arthritic disease and help explain the potential role of the dietary ingestion of glucosamine and its beneficial effects with arthritis patients.

Reference

  • 1.Hughes CE. Monoclonal antibodies that specifically recognise neoepitope sequences generated by aggrecanase and matrix metalloproteinase cleavage of aggrecan: application to catabolism in situ and in vitro. Biochem J. 1995;305:799–804. doi: 10.1042/bj3050799. [DOI] [PMC free article] [PubMed] [Google Scholar]
Ann R Coll Surg Engl. 2006 Jul;88(4):421–422. doi: 10.1308/003588406X114794

Winter Wonderland: An Audit of Injuries Sustained at the Outdoor Ice Rink

PD Hodgson 1, S Walsh 1, K Mohanty 1

For the last 3 years, for a 6-week period over Christmas, City Hall Lawn in Cardiff has been transformed into an open-air ice rink, together with other attractions forming Winter Wonderland. A retrospective audit of injuries sustained as a result of this temporary ice rink has demonstrated a significant burden on the orthopaedic department at the University Hospital of Wales, both in terms of increased numbers of patients seen in clinics, and financial cost. Injuries sustained ranged from simple soft tissue injuries like ankle sprains, to comminuted ankle and wrist fractures requiring surgical intervention. This year (2004/2005), over 68,000 people used the ice rink at a cost of £4.50–£6.50 per person. This has generated a significant profit for Cardiff City Council, but the hospital does not receive any financial compensation for increased costs accrued. Our audit showed that some of those injured had travelled from elsewhere in Wales and England and, therefore, chose to have their treatment nearer their homes. However, there are currently plans to establish similar temporary ice rinks in Swansea, Newport and Bridgend over the Christmas period later this year, which is likely to lead to an increased workload in these areas too.

Ann R Coll Surg Engl. 2006 Jul;88(4):422. doi: 10.1308/003588406X114794

High-Frequency Impaction of Morsellised Cancellous Bone

Marck Van Liefland 1

Revision hip arthroplasty surgeons often have to deal with a weakened femur. An increasingly popular method of dealing with bony defects is impaction grafting with cancellous allograft. Vigorous hammer blows are needed to obtain compaction. The two most frequent complications are femoral fracture and subsidence. Strategies to reinforce the femur prior to impaction and to optimise the graft strength have been described. The mechanism to achieve impaction itself has not been altered. We studied the efficiency of high-frequency impaction of cancellous bone graft and the stiffness obtained. Morsellised porcine cancellous bone (6 g) was placed in a cylinder. This sample was impacted with a pneumatic axial impactor at a frequency of 70 Hz with increasing loads. The resultant axial loads and displacement were recorded. To simulate ambulation, the compacted specimen was then placed in a testing machine and cyclically loaded with 90 N at a rate of 1 Hz. Axial force and displacement were recorded. High-frequency impaction achieved high compaction at low load. Compared to traditional impaction, the same amount of compaction was achieved at a 10–20% of the load. Inversely, compaction almost doubled at the same load. Cyclical loading showed that simulated subsidence was almost halved. The results were promising. High-frequency impaction lowered the required loads for compaction and also increased the total compaction. Simulated subsidence had decreased. Vibration-induced thixotrophy might explain some of the findings. The scope for practical application is evaluated.

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