Adduktorkõõluste hematoomi heterotoopne ossifikatsioon sporditrauma järel – haigusjuht ja kirjanduse ülevaade

Heterotoopne ossifikatsioon (HO) on luukoe moodustumine skeletivälisesse piirkonda, mis on oluline tüsistus ortopeediliste operatsioonide ja protseduuride, luumurdude, küünarliigese vigastuste, laialdaste põletuste, suure energiaga pehmekoe-traumade ning traumaatiliste peaaju- ja seljaajuvigastuste puhul. Sõltuvalt etioloogiast võib HO esinemissagedus olla kuni 60%, trauma geneesiga HO moodustab kõikidest juhtumitest ligikaudu 60–75%. Trauma või operatsiooniga kaasnevad põletikulised protsessid loovad keskkonna, milles mesenhümaalsed tüvirakud hakkavad skeletivälises piirkonnas diferentseeruma osteoblastideks. Artiklis on kirjeldatud füüsiliselt aktiivset patsienti, kes vigastas jooksmise käigus parema reie adduktorlihaseid. Aasta jooksul kujunes m. adductor longus’e ja m. adductor brevis’e kõõluste piirkonda HO, mis vajas operatiivset ravi. Sporditraumajärgne reie adduktorlihaste kõõluste heterotoopne ossifikatsioon on väga harva esinev tüsistus

Põlveliigese eesmise ristatisideme taastamise operatsioon – mitte alati õnnestumine

Põlveliigese eesmise ristatisideme (ERS) rebendite esinemissagedus on eri andmetel 37–61 juhtu 100 000 inimese kohta aastas. Eestis esineb see vigastus 300–400 isikul aastas ja järjest sagedamini rakendatakse sel korral operatiivset ravi. Sõltumata rakendatud operatiivse ravi meetodist on eri autorid hinnanud ERSi vigastuse operatiivse ravi tulemusi edukaks 75–97%-l ravitutest. Operatiivse ravi komplikatsioonideks võivad olla liigese süvainfektsiooni kujunemine, operatsioonjärgne artrofibroos ning liigese ebastabiilsus ja operatsioonijärgne valu. Oluline on ka operatsioonitehnika, eelkõige tunneli õige positsiooni valik. Komplikatsioonide ennetamisel on oluline osa patsientide õigel valikul ning kirurgi oskuste õigel hindamisel

Proliferation of Human Primary Myoblasts Is Associated with Altered Energy Metabolism in Dependence on Ageing In Vivo and In Vitro

Background. Ageing is associated with suppressed regenerative potential of muscle precursor cells due to decrease of satellite cells and suppressive intramuscular milieu on their activation, associated with ageing-related low-grade inflammation. The aim of the study was to characterize the function of oxidative phosphorylation (OXPHOS), glycolysis, adenylate kinase (AK), and creatine kinase (CK) mediated systems in young and older individuals. Materials and Methods. Myoblasts were cultivated from biopsies taken by transcutaneous conchotomy from vastus lateralis muscle in young (20–29 yrs, n=7) and older (70–79 yrs, n=7) subjects. Energy metabolism was assessed in passages 2 to 6 by oxygraphy and enzyme analysis. Results. In myoblasts of young and older subjects the rate of OXPHOS decreased during proliferation from passages 2 to 6. The total activities of CK and AK decreased. Myoblasts of passage 2 cultivated from young muscle showed higher rate of OXPHOS and activities of CK and AK compared to myoblasts from older subjects while hexokinase and pyruvate kinase were not affected by ageing. Conclusions. Proliferation of myoblasts in vitro is associated with downregulation of OXPHOS and energy storage and transfer systems. Ageing in vivo exerts an impact on satellite cells which results in altered metabolic profile in favour of the prevalence of glycolytic pathways over mitochondrial OXPHOS of myoblasts

Neither lateral patellar facet nor patellar size are altered in patellofemoral unstable patients: a comparative magnetic resonance imaging analysis

PURPOSE It remains unclear if morphologic patterns of the patella itself predispose to patellar instability. This study examined established patellar landmarks in relation to the femoral condyle width to clarify differences of patellar morphologies in patellofemoral stable and unstable patients. METHODS Magnetic Resonance Imaging of 50 subjects (20.7 ± 4.4 years; 17 males, 33 females) with patellofemoral instability (study group, SG) and 50 subjects (25.3 ± 5.8 years; 31 males, 19 females) with anterior cruciate ligament rupture (control group, CG) were analyzed. Corresponding patellar value indices (PW-I; LPF-I 1; LPF-I 2) in relation to the femoral condyle width (FCW) were evaluated after the measurement of absolute patellar dimension [patellar width (PW); direct length of the lateral patellar facet (LPF-1); projected length of the lateral patellar facet (LPF-2)]. The patellar shape according to Wiberg, trochlear dysplasia, patellar height, and tibial tubercle-trochlear groove (TT-TG) distance were determined. RESULTS The SG showed a significantly longer absolute (LPF 2) (P = 0.041) and relative (LPF-I 1, LPF-I 2) (P < 0.001) lateral facet of the patella. No significant differences were evaluable for the relative patellar width (PW-I) (ns). A patellar shape type 3 (P = 0.001) as well as a higher position of the patella and TT-TG-distance (P < 0.001) were significantly more often present in the SG. CONCLUSION There are several bony alterations associated with patellofemoral instability, but our data did not show a significantly smaller lateral patellar facet or relative patellar width that could facilitate a patellar dislocation. This helps surgeons, that are considering to surgically address the patella in cases of patellofemoral instability, to better understand its morphologic pattern. LEVEL OF EVIDENCE III