Bioresorbable Stent in Anterior Cruciate Ligament Reconstruction

The exact causes of failure of anterior cruciate ligament (ACL) reconstruction are still unknown. A key to successful ACL reconstruction is the prevention of bone tunnel enlargement (BTE). In this study, a new strategy to improve the outcome of ACL reconstruction was analyzed using a bioresorbable polylactide (PLA) stent as a catalyst for the healing process. The study included 24 sheep with 12 months of age. The animals were randomized to the PLA group (n = 16) and control group (n = 8), subjected to the ACL reconstruction with and without the implantation of the PLA tube, respectively. The sheep were sacrificed 6 or 12 weeks post-procedure, and their knee joints were evaluated by X-ray microcomputed tomography with a 50 m resolution. While the analysis of tibial and femoral tunnel diameters and volumes demonstrated the presence of BTE in both groups, the enlargement was less evident in the PLA group. Also, the microstructural parameters of the bone adjacent to the tunnels tended to be better in the PLA group. This suggested that the implantation of a bioresorbable PLA tube might facilitate osteointegration of the tendon graft after the ACL reconstruction. The beneficial e ects of the stent were likely associated with osteogenic and osteoconductive properties of polylactide

Stress fractures in uncommon location : six case reports and review of the literature

BACKGROUND: Individuals’ interest in sports activities has been increasing, contributing to more stress fracture occurrences in uncommon locations on the skeleton. In this study, several cases of stress fractures in atypical locations are presented, and the possibility of combining diagnostic methods to make accurate and quick diagnoses is explored. Additionally, different causes of stress fractures, as well as various modalities of treatment, are highlighted. Other potential factors of stress fractures were identified by a literature review.CASE SUMMARY: Six cases of stress fractures in the calcaneus, intermediate cuneiform bone, sacrum, tibia (bilateral), navicular bone and femoral neck are presented, with different types of diagnostic imaging and treatments. All of the cases were associated with an aspect of mobility because all of the patients were physically active in various sport disciplines.CONCLUSION:The type of therapeutic procedure selected should depend on the specific clinical case, i.e., the patient’s condition and level of physical activity

The bone microstructure from anterior cruciate ligament footprintsis similar after ligament reconstruction and does not affect long‑termoutcomes

Purpose The purpose of this study was to assess the quality of the bone tissue microstructure from the footprints of the anterior cruciate ligament (ACL) and its impact on late follow-up outcomes in patients who undergo anterior cruciate ligament reconstruction (ACLR). Methods The records of 26 patients diagnosed with a completely torn ACL who underwent ACLR were collected. During the surgery performed using the Felmet method, bone blocks from the native ACL footprints were collected. The primary measurements of the bone microstructure were made using a microtomographic scanner. In late follow-up examinations, a GNRB arthrometer was used. Results There was no significant difference in the bone microstructure assessed using micro-CT histomorphometric data according to the blood test results, plain radiographs, age or anthropometric data. There was no difference in the bone volume/total volume ratio or trabecular thickness in the area of the native ACL footprints. Routine preoperative examinations werenot relevant to the quality of the bone microstructure. The elapsed time from an ACL injury to surgery had no relevance to the results of arthrometry. Conclusion The similarities in the microstructure of bone blocks from ACL footprints from the femur and tibia allow the variable use of these blocks to stabilize grafts in the Felmet method. The bone microstructure is not dependent on the time from injury to surgery. Histomorphometric values of the structure of the femoral and tibial ACL footprints have no impact on the long-term stability of the operated knee joint. Trial registration The approval of the Bioethics Committee of the Silesian Medical Chamber in Katowice, Poland (resolution 16/2014) was given for this research

The Influence of Bone Bruises on Bone Tunnel Enlargement Regarding ACL Rupture

Purpose: The purpose was to determine the impact of the size of bone bruises (BBs) on bone tunnel enlargement (BTE) occurrence. Materials and methods: Twenty-four (24) patients who underwent anterior cruciate ligament reconstruction (ACLR) were included in this retrospective study. The measurements of BBs based on the initial MRI scan, bone tunnel size based on the control MRI scan, and the spatial determination of BB in relation to the bone tunnel location were evaluated. To analyze the relationship between BBs and BTE in homogeneous groups regarding the time from injury to ACLR (t(I-S)), the largest subgroup B (n = 15), in which t(I-S) was 31 to 60 days, was isolated for further investigation. Results: Based on subgroup B, a weak correlation (r = 0.33) existed between the BB volume and BTE size in the femur and tibia. Considering the relationship between the distance from the BB to the bone tunnel in the femur (f-l) and its enlargement (Δfd), there was a moderate and statistically significant (p < 0.05) negative correlation (r = −0.64). The correlation between those parameters was even stronger (r = −0.77) in subgroup B (time interval between injury and surgery ranged from 31 to 60 days). Conclusions: A retrospective analysis of MRI data in patients after ACL reconstruction surgery showed a relevant association between the distance from the BB to the bone tunnel and BTE in the femur. The relationship was not confirmed in the tibia

Effect of the presence of

The aim of the study was to determine the effect of the Actinomycetes proliferation in the activated sludge on the quality of the treated wastewater and the sewage receiver. The river which is the sewage receiver flows near the wastewater treatment plant. The study was performed on the wastewater (raw and treated) and on the river water samples (collected before and after wastewater discharge). The analysis of the research results, such as the content of total organic carbon (TOC), total phosphorus and oxygen consumption in the examined samples, permit the conclusion that the presence of relatively large population of the Actinomycetes in sewage sludge has a negative impact on the quality of the sewage receiver. Determining the effect of the Actinomycetes in the activated sludge on the wastewater treatment process involved the application of specific analyses, such as Sludge Biotic Index (SBI) and the identification of filamentous bacteria in the activated sludge. The analysis of studies indicates that the presence of the Actinomycetes in the activated sludge adversely affects the efficiency of the wastewater treatment process

Effect of the presence of Actinomycetes in the activated sludge on the quality of the treated wastewater

The aim of the study was to determine the effect of the Actinomycetes proliferation in the activated sludge on the quality of the treated wastewater and the sewage receiver. The river which is the sewage receiver flows near the wastewater treatment plant. The study was performed on the wastewater (raw and treated) and on the river water samples (collected before and after wastewater discharge). The analysis of the research results, such as the content of total organic carbon (TOC), total phosphorus and oxygen consumption in the examined samples, permit the conclusion that the presence of relatively large population of the Actinomycetes in sewage sludge has a negative impact on the quality of the sewage receiver. Determining the effect of the Actinomycetes in the activated sludge on the wastewater treatment process involved the application of specific analyses, such as Sludge Biotic Index (SBI) and the identification of filamentous bacteria in the activated sludge. The analysis of studies indicates that the presence of the Actinomycetes in the activated sludge adversely affects the efficiency of the wastewater treatment process

Elektrostymulacja anodowa i katodowa w leczeniu odleżyn u osób z uszkodzeniami centralnego układu nerwowego. Prospektywne, randomizowane badanie kliniczne. Wyniki wstępne

Introduction: Electrical stimulation (ES) is a treatment recommended for pressure injuries (PIs), but an optimal protocol methodology for wound treatment has not yet been established. Objective: Comparing the effectiveness of cathodal and anodal ES in the treatment of category II-IV pressure injuries. Research project: Experimental trial with randomization. Material and methods: 38 individuals with pressure wounds treated at the Rehabilitation Centre in the region of Upper Silesia were randomly divided into the anodal ES group (AG/12 people, mean age 52.83 years), cathodal ES group (CG/13 people, average age 52.00 years) and the ES placebo group (PG/13 people, average age 54.46 years). Standard pressure injury treatment was implemented in all patients. Additionally, in the AG and CG, ES with high-voltage monophasic pulsed current (HVMPC; twin-peak impulses; 154 μs; 100 pps; 0.36 A; 360 μC/s) was applied for 50 minutes a day, fi ve days a week, for 8 weeks. In the AG group, the healing electrode was an anode, while in the CG, cathodes were used. In the PG, sham ES was performed. Both electrodes were placed on moist gauze. The electrode for treatment was placed on the surface of the wound and the return electrode was positioned on healthy skin at least 15 cm from the PI edge. The surface area of the PIs was measured before and after each subsequent week of therapy. Results: In the AG and CG, the surface of the pressure injuries decreased by 73.68% (SD 28.03) and 76.02% (SD 17.51), respectively. These results were statistically signifi cantly higher than in the PG (44.20%, SD 20.86). The results obtained in AG and CG did not signifi cantly differ statistically. Conclusions: High-voltage anodal and cathodal ES cause a decrease in category II-IV pressure injuries to a similar extent.Wstęp: Elektrostymulacja (ES) jest zabiegiem rekomendowanym w leczeniu odleżyn ale metodyka zabiegów zapewniających najlepsze skutki lecznicze wymaga jeszcze ustalenia. Cel: Porównanie skuteczności ES katodowej i anodowej w leczeniu odleżyn II-IV stopnia. Projekt badawczy: Badanie eksperymentalne z randomizacją. Materiał i metody: 38 osób z odleżynami leczonych w Centrum Rehabilitacji na terenie Górnego Śląska zostało losowo podzielonych do grupy elektrostymulacji anodowej (AG/12 osób; średni wiek 52,83 lata), elektrostymulacji katodowej (KG/13 osób; średni wiek 52,00 lata) i elektrostymulacji placebo (PG/13 osób; średni wiek 54,46 lata). U wszystkich chorych stosowano standardowe leczenie odleżyn. Dodatkowo w AG i KG zastosowano elektrostymulację wysokonapięciową prądem pulsującym (high-voltage monophasic pulsed current − HVMPC) (impulsy podwójne szpiczaste, 154 μs; 100 Hz; 0,36 A; 360 μC/s) przez 50 minut dziennie, pięć dni w tygodniu, przez 8 tygodni. W AG elektrodą leczniczą była anoda, a w KG – katoda. W PG wykonywano symulowaną elektrostymulację. Obie elektrody były układane na wilgotnej gazie. Elektrodę leczniczą układano na powierzchni rany a zamykającą obwód na zdrowej skórze w odległości przynajmniej 15 cm od rany. Pole powierzchni odleżyn było mierzone przed leczeniem oraz po zakończeniu każdego kolejnego tygodnia terapii. Wyniki: W grupach AG i KG powierzchnia odleżyn zmniejszyła się odpowiednio o 73,68% (SD 28,03) i 76,02% (SD 17,51). Wyniki te były znamiennie statystycznie większe niż w PG (44,20%; SD 20,86). Wyniki uzyskane w AG i KG nie różniły się znamiennie statystycznie. Wnioski: ES wysokonapięciowa anodowa i katodowa w podobnym stopniu przyczyniają się do zmniejszenia odleżyn II-IV stopnia