Resorbable screws versus pins for optimal transplant fixation (SPOT) in anterior cruciate ligament replacement with autologous hamstring grafts: rationale and design of a randomized, controlled, patient and investigator blinded trial [ISRCTN17384369]

BACKGROUND: Ruptures of the anterior cruciate ligament (ACL) are common injuries to the knee joint. Arthroscopic ACL replacement by autologous tendon grafts has established itself as a standard of care. Data from both experimental and observational studies suggest that surgical reconstruction does not fully restore knee stability. Persisting anterior laxity may lead to recurrent episodes of giving-way and cartilage damage. This might at least in part depend on the method of graft fixation in the bony tunnels. Whereas resorbable screws are easy to handle, pins may better preserve graft tension. The objective of this study is to determine whether pinning of ACL grafts reduces residual anterior laxity six months after surgery as compared to screw fixation. DESIGN/ METHODS: SPOT is a randomised, controlled, patient and investigator blinded trial conducted at a single academic institution. Eligible patients are scheduled to arthroscopic ACL repair with triple-stranded hamstring grafts, conducted by a single, experienced surgeon. Intraoperatively, subjects willing to engage in this study will be randomised to transplant tethering with either resorbable screws or resorbable pins. No other changes apply to locally established treatment protocols. Patients and clinical investigators will remain blinded to the assigned fixation method until the six-month follow-up examination. The primary outcome is the side-to-side (repaired to healthy knee) difference in anterior translation as measured by the KT-1000 arthrometer at a defined load (89 N) six months after surgery. A sample size of 54 patients will yield a power of 80% to detect a difference of 1.0 mm ± standard deviation 1.2 mm at a two-sided alpha of 5% with a t-test for independent samples. Secondary outcomes (generic and disease-specific measures of quality of life, magnetic resonance imaging morphology of transplants and devices) will be handled in an exploratory fashion. CONCLUSION: SPOT aims at showing a reduction in anterior knee laxity after fixing ACL grafts by pins compared to screws

Osteointegration of soft tissue grafts within the bone tunnels in anterior cruciate ligament reconstruction can be enhanced

Anterior cruciate ligament reconstruction with a soft tissue autograft (hamstring autograft) has grown in popularity in the last 10 years. However, the issues of a relatively long healing time and an inferior histological healing result in terms of Sharpey-like fibers connection in soft tissue grafts are still unsolved. To obtain a promising outcome in the long run, prompt osteointegration of the tendon graft within the bone tunnel is essential. In recent decades, numerous methods have been reported to enhance osteointegration of soft tissue graft in the bone tunnel. In this article, we review the current literature in this research area, mainly focusing on strategies applied to the local bone tunnel environment. Biological strategies such as stem cell and gene transfer technology, as well as the local application of specific growth factors have been reported to yield exciting results. The use of biological bone substitute and physical stimulation also obtained promising results. Artificially engineered tissue has promise as a solution to the problem of donor site morbidity. Despite these encouraging results, the current available evidence is still experimental. Further clinical studies in terms of randomized control trial in the future should be conducted to extrapolate these basic science study findings into clinical practice. © 2009 Springer-Verlag.postprin

Finding Clauses In Unrestricted Text' By Finitary And Stochastic Methods

This paper is a report of an attempt to provide a better foundation for parsing text by the use of simple finitary and stochastic computational methods. These simple methods have not figured prominently in the theory and practice of natural language parsing, with some exceptions (Langendoen 1975, Church 1982, Ejerhed & Church 1983). For an experimental, and more complicated method to derive all prosodic units in the text-to-speech system, i.e. not just tonal minor and major phrases but every type of prosodic unit, from the syntactic structure and length of constituents, see Wright, Bacbenko & Fitzpatrick (1986

Public-private riskkapital : en självmotsägelse? Att starta biotechföretag i Mecklenburg Vorpommern

The purpose of this Master's Thesis is to investigate the outlooks for a seed stage venture capital fund investing in biotechnology-related spinouts from public research to be established in Mecklenburg-Western Pomerania, Germany. Recommendations on how to improve any discovered deficits of the fund's prerequisites are also to be presented. Analyses showed that the spinout potential of the research in the region is weak. The entrepreneurial prerequisites of the researchers, in terms of previous experience, business knowledge and a track record that would vouch for them being suitable entrepreneurs, are generally poor. Nor is there sufficient industry in the region to facilitate the establishment of and subsequent businesses for the spinouts. The seed fund must therefore provide any future portfolio ventures with a substantial amount of Hands-on Management. To improve the prerequisites for the seed fund, PVA-MV must influence the researchers'attitude towards spinouts and make the monetary gains more visible. The researchers must be imbued with a business approach in their research and PVA-MV must market its services as being the intermediary of government, universities and industry and as being able to create opportunities for researchers as well as for industry. PVA-MV should also focus on the few institutes and individual researchers that do have some favourable entrepreneurial characteristics, in order to evoke professional entrepreneurs with a forming track record. To cope with the deficient prerequisites of the fund, PVA-MV must expand the competence of its own work force and focus on the rate of return rather than on building regional infrastructure pro bono as a governmental agency