Novel nano-composite multi-layered biomaterial for the treatment of multifocal degenerative cartilage lesions

We report on a 46-year-old athletic patient, previously treated with anterior cruciate ligament reconstruction, with large degenerative chondral lesions of the medial femoral condyle, trochlea and patella, which was successfully treated with a closing-wedge high tibial osteotomy and the implant of a newly developed biomimetic nanostructured osteochondral bioactive scaffold. After 1 year of follow-up the patient was pain-free, had full knee range of motion, and had returned to his pre-operation level of athletic activity. MRI evaluation at 6 months showed that the implant gave a hyaline-like signal as well as a good restoration of the articular surface, with minimal subchondral bone oedema. Subchondral oedema was almost non-visible at 12 months

Fibrin glue improves osteochondral scaffold fixation: study on the human cadaveric knee exposed to continuous passive motion

SummaryObjectiveTo evaluate stability and integrity of bi-layer and three-layer collagen-hydroxyapatite (C-HA) osteochondral scaffolds in a human cadaveric knee exposed to continuous passive motion (CPM) with and without loading and the role of added fibrin glue to improve the press-fit fixation of C-HA scaffolds.DesignOsteochondral lesions (2.0 × 1.5 cm) were chiseled out on both condyles and trochlea in eight human cadaveric knees. A total of 24 bi-layer (5 mm, four in each condyle) or three-layer C-HA scaffolds (8 mm, eight in the trochlea, four in each condyle) were first press-fit implanted and underwent testing with CPM, 90 cycles, 0°–90°. The second set of 24 scaffolds was implanted in cleaned lesions with the addition of fibrin glue. Two knees with fibrin glue fixation were additionally exposed to 15 kg loading, with 30 cycles of CPM, 0°–30°. Then, the knees were reopened and the scaffolds were evaluated using semi-quantitative Drobnic and modified Bekkers scores.ResultsAll but two scaffolds remained in the lesions site throughout CPM. Two implants failed: both were bi-layer osteochondral scaffolds, press-fit implanted at the lateral femoral condyle (LFC). A statistically significant difference was obtained between press-fit and fibrin glue implants with both Drobnic (2.9 ± 0.7 vs 4.3 ± 0.1, P < 0.0005) and Bekkers (3.3 ± 1.0 vs 5.0 ± 0.1, P < 0.0005) scores. Additional knee loading did not affect fibrin glue scaffold fixation or integrity.ConclusionThis cadaveric study showed fibrin glue notably improved bi-layer or three-layer C-HA scaffold press-fit fixation regardless of lesion location. It is therefore recommended that fibrin glue be used during surgery to improve early post-operative C-HA scaffold stability and integrity

A PRELIMINARY STUDY TO MODEL CARRYING ANGLE VARIATIONS DURING FLEXION-EXTENSION OF THE ELBOW

The aim of this work was to identify an accurate method to evaluate the variability of the carrying angle during the flexion extension of the elbow and to define a mathematical description of this movement applicable in sport and rehabilitation field. In order to develop this objective, we marked the arm and the forearm by six reflective markers of six healthy subjects performing the flexion extension movement and acquired the coordinates using six infrared cameras (VICON Motion System). Five repeated measures were performed for each subject in order to verify the reliability of the measures. Our results demonstrated that this movement can be easily modelled as a linear variation of the carrying angle in function of the flexion angle. The reliability between repeated measures was high and adopting a linear fit the accuracy was more than 94% in all cases. This is the first study to compute the flexion-extension movement by a carrying angle evaluation

INFLUENCE OF AGE AND HAND GRIP STRENGTH ON FREESTYLE PERFORMANCES IN MASTER SWIMMERS

The aim of our work was to examine whether age and hand grip strength are correlated with 50m, 100m, 200m, 400m, 800m swimming performance times in Master swimmers and how correlation varies considering short, middle or long distances. The main finding of this work was that hand grip strength and age correlated significantly at each distance. Hand grip strength showed a relevant influence on performance time and explained 52% of variance of performance time in 50m race freestyle and only 15% in 800m race. Increasing age was a disadvantageous factor for performance time, and explained 45% of variance of performance time in 800m race freestyle and only 20% in 50 m race