35 research outputs found
Biological augmentation strategies in rotator cuff repair
Rotator cuff tears (RCT) are a common problem encountered
by orthopaedic surgeons. The incidence of re-tears (up to 94%)
following surgical repair of RCTs renders the management of
RCTs challenging. This higher re-tear rate has been attributed
to the failure of healing at the tendon-bone junction. Biological
augmentation methods such as growth factors, stem cell thera pies, and biomaterials have been developed to promote the he aling at the tendon-bone junction. Growth factors and stem cell
therapies have been intensively studied in mid to large RCTs.
Biomaterials have been generally utilized for large or massive
RCTs. However, these newly generated biological augmentation
strategies are mostly studied in animal models. The efficacy and
safety of the biological augmentation methods in humans need
further investigation. In this review, we aimed to highlight the
most recent advancements in RCT surgical repair with biologi cal augmentati
Cadaver versus simulator based arthroscopic training in shoulder surgery
Introduction: There are few studies that compare the cadaver dissections with the medical simulators in means of talent improvement.
Therefore, the aim of this study is to find out if using cadaver dissections is still the golden standard for surgical training or using the
medical simulators in surgery could replace cadaver dissections.
Materials and methods: The study is conducted during the European Orthopaedics & Traumatology Education Platform accredited
Shoulder Club International Cadaver Course including a number of 34 orthopedics trainees. The participants were randomly divided
into two groups to be trained with the simulator (Group 1) and on cadavers (Group 2), followed by a test performed on shoulder
arthroscopy simulator (Virtamed ArthroS, Switzerland). There was no conflict of interest before, during, or after the study. Informed
consent was obtained from all individual participants included in the study.
Results: Group 2 had statistically significant higher simulation overview procedure time values than Group 1 (p < 0.05), the meaning
of which is participants trained with the simulator completed the given tasks in a shorter period of time. Group 2 had statistically
significant higher scratching of humerus cartilage values than Group 1 (p < 0.05), which means that participants trained with simulation
have less scratching done on the humerus cartilage than the participants trained on a cadaver.
Conclusion: To the best of our knowledge, this study is the first one to compare virtual reality (VR) simulators with cadavers for surgical
education in an objective manner, while using qualitative and quantitative data. According to this study, it is possible to state that VR
simulators are just as effective as cadavers in means of training subjects. As medical education will face a total change all around the
world after the COVID-19 pandemic, this study has the potential to be an important guide during and after this period
Epidermal growth factor stimulates rabbit achilles tendon histologically and biomechanically healing
Background. Epidermal Growth Factor (EGF) stimulates epidermis cell growth, proliferation and differentiation in skin regeneration. The aim of this study was to pre-clinically
investigation of the role of EGF in tendon healing.
Methods. One cm defects were created at the right Achilles tendons of 30 New Zealand
White rabbits. Ten rabbits were allocated to one of three groups: Group-1-(Sham) tendon
defect with a gap that was splinted with a non-absorbable suture; Group-2-(EGF +)
tendon defect with a gap that was splinted with a non-absorbable suture and a 25 µg/kg
EGF injection into the defect; Group-3-(Scaffold + EGF) tendon defect was grafted with
a biodegradable, porous Polycaprolactone (PCL) scaffold loaded with 25 µg/kg EGF and
stabilized with a non-absorbable suture. Animals were sacrificed at 8 weeks post-surgery
and Achilles tendon repair and healing status was investigated using histopathologic and
biomechanical analysis methods.
Results. Group-2-(EGF +) had greater adipocyte development (moderate) than Group1-(Sham) and Group-3-(Scaffold + EGF). Group-2-(EGF +) and Group-3-(Scaffold +
EGF) had greater peripheral nerve development (weak) than Group-1-(Sham). Group-2-
(EGF +) had greater vascularization (moderate) than Group-1-(Sham) and Group-3-(Scaffold + EGF). Group-2-(EGF +) had greater collagen Type-III development (moderate) than Group-1-(Sham) and Group-3-(Scaffold + EGF). Group-3-(Scaffold + EGF)
had greater collagen Type-I development (moderate) than Group-1-(Sham) and Group2-(EGF +). Groups did not display statistically significant differences for load to failure
or elongation at failure. Group-2-(EGF +) and Group-3-(Scaffold + EGF) displayed less
stiffness that the control (healthy contralateral Achilles tendon) (p 0.05).
Conclusions. The application of EGF and scaffold displayed superior histological tendon
healing evidence, but there was no significant difference in terms of biomechanics
An Atypical Metastasis Of Follicular-Type Adenocarcinoma Of The Thyroid Gland To Thumb
Bone metastasis in the hand is rare. The etiology of metastatic hand cancers is different from other bones. Bronchogenic carcinoma is the most common primary tumor metastasis to hand. In this paper a rare case of thumb metastasis from “follicular-type carcinoma” of the thyroid is presented.PubMe
Patellar Instability in Pediatric Patients: Review of the Literature
Patellar instability is a common pathology of the knee in pediatric patients. The management of this condition can be a challenge for the orthopedic surgeon, and a comprehensive understanding of the anatomy and biomechanics of the structures around the knee is of utmost importance in formulating a treatment plan. Predisposing factors can be related to: trochlear and patellar morphological abnormalities, ligamentous stabilizers, limb geometries in the axial plane, and patellar height abnormalities. Traditionally, first-time dislocators have been treated non-operatively; however, recent evidence suggests that certain factors are related to recurrent instability, and surgical treatment may be considered even after the first dislocation. It is important to keep in mind that younger children with open physes are not suitable candidates for certain surgical techniques. In this comprehensive review, we aimed to focus on the most up-to-date information on this topic and emphasize the importance of individualizing the treatment of pediatric patients
Tissue Engineering Strategies in Ligament Regeneration
Ligaments are dense fibrous connective tissues that connect bones to other bones and their injuries are frequently encountered in the clinic. The current clinical approaches in ligament repair and regeneration are limited to autografts, as the gold standard, and allografts. Both of these techniques have their own drawbacks that limit the success in clinical setting; therefore, new strategies are being developed in order to be able to solve the current problems of ligament grafting. Tissue engineering is a novel promising technique that aims to solve these problems, by producing viable artificial ligament substitutes in the laboratory conditions with the potential of transplantation to the patients with a high success rate. Direct cell and/or growth factor injection to the defect site is another current approach aiming to enhance the repair process of the native tissue. This review summarizes the current approaches in ligament tissue engineering strategies including the use of scaffolds, their modification techniques, as well as the use of bioreactors to achieve enhanced regeneration rates, while also discussing the advances in growth factor and cell therapy applications towards obtaining enhanced ligament regeneration
Comment on: Functional outcomes of minimal invasive percutaneous plate osteosynthesis (MIPPO) in humerus shaft fractures: a clinical study reply
WOS: 000363025000021PubMed ID: 26422358
Unusual Cause of Knee Locking
We report a case of partial intrasubstance tear of popliteus tendon as an unusual cause of pseudolocking of the knee. A 13-year-old semiprofessional soccer player applied to our clinic with a locked right knee in spite of the therapy applied (cold pack, NSAID, and immobilization) in another institution 20 days after the injury. Significant extension loss was observed in his right knee with 30∘–90∘ ROM. Magnetic resonance imaging (MRI) and arthroscopy confirmed the intrasubstance tear of popliteus tendon and synovitis. The ruptured part of the tendon was debrided, and the inflammatory tissue around the tendon, which may lead to pseudolocking, was gently removed with a shaver in order to regain the normal ROM. The patient was discharged with full ROM and weight bearing first day after the surgery. To our knowledge, this is the first case demonstrating intrasubstance tear of popliteus tendon causing pseudolocking of the knee
Patellar Instability in Pediatric Patients: Review of the Literature
Patellar instability is a common pathology of the knee in pediatric patients. The management of this condition can be a challenge for the orthopedic surgeon, and a comprehensive understanding of the anatomy and biomechanics of the structures around the knee is of utmost importance in formulating a treatment plan. Predisposing factors can be related to: trochlear and patellar morphological abnormalities, ligamentous stabilizers, limb geometries in the axial plane, and patellar height abnormalities. Traditionally, first-time dislocators have been treated non-operatively; however, recent evidence suggests that certain factors are related to recurrent instability, and surgical treatment may be considered even after the first dislocation. It is important to keep in mind that younger children with open physes are not suitable candidates for certain surgical techniques. In this comprehensive review, we aimed to focus on the most up-to-date information on this topic and emphasize the importance of individualizing the treatment of pediatric patients