Device for lengthening of a musculotendinous unit by direct continuous traction in the sheep

Background Retraction, atrophy and fatty infiltration are signs subsequent to chronic rotator cuff tendon tears. They are associated with an increased pennation angle and a shortening of the muscle fibers in series. These deleterious changes of the muscular architecture are not reversible with current repair techniques and are the main factors for failed rotator cuff tendon repair. Whereas fast stretching of the retracted musculotendinous unit results in proliferation of non-contractile fibrous tissue, slow stretching may lead to muscle regeneration in terms of sarcomerogenesis. To slowly stretch the retracted musculotendinous unit in a sheep model, two here described tensioning devices have been developed and mounted on the scapular spine of the sheep using an expandable threaded rod, which has been interposed between the retracted tendon end and the original insertion site at the humeral head. Traction is transmitted in line with the musculotendinous unit by sutures knotted on the expandable threaded rod. The threaded rod of the tensioner is driven within the body through a rotating axis, which enters the body on the opposite side. The tendon end, which was previously released (16 weeks prior) from its insertion site with a bone chip, was elongated with a velocity of 1 mm/day. Results After several steps of technical improvements, the tensioner proved to be capable of actively stretching the retracted and degenerated muscle back to the original length and to withstand the external forces acting on it. Conclusion This technical report describes the experimental technique for continuous elongation of the musculotendinous unit and reversion of the length of chronically shortened muscle

Next-Generation Diamond Electrodes for Neurochemical Sensing: Challenges and Opportunities

© 2021 by the authors. Licensee MDPI, Basel, Switzerland. Carbon-based electrodes combined with fast-scan cyclic voltammetry (FSCV) enable neurochemical sensing with high spatiotemporal resolution and sensitivity. While their attractive electrochemical and conductive properties have established a long history of use in the detection of neurotransmitters both in vitro and in vivo, carbon fiber microelectrodes (CFMEs) also have limitations in their fabrication, flexibility, and chronic stability. Diamond is a form of carbon with a more rigid bonding structure (sp3-hybridized) which can become conductive when boron-doped. Boron-doped diamond (BDD) is characterized by an extremely wide potential window, low background current, and good biocompatibility. Additionally, methods for processing and patterning diamond allow for high-throughput batch fabrication and customization of electrode arrays with unique architectures. While tradeoffs in sensitivity can undermine the advantages of BDD as a neurochemical sensor, there are numerous untapped opportunities to further improve performance, including anodic pretreatment, or optimization of the FSCV waveform, instrumentation, sp2 /sp3 character, doping, surface characteristics, and signal processing. Here, we review the state-of-the-art in diamond electrodes for neurochemical sensing and discuss potential opportunities for future advancements of the technology. We highlight our team’s progress with the development of an all-diamond fiber ultramicroelectrode as a novel approach to advance the performance and applications of diamond-based neurochemical sensors

Fabrication and characterization of boron doped diamond microelectrode arrays of varied geometry

Boron doped diamond (BDD) is a well-known electrode material that exhibits an excellent electrochemical potential window with very low background current. With this, microelectrodes and microelectrode arrays (MEAs) have been found to even further lower background currents without compromising sensitivity. As such, BDD MEAs are excellent electrode materials for a variety of electroanalytical applications, capable of multi-mode detection. We fabricated BDD MEAs adapting traditional semiconductor microfabrication processes; the resulting MEAs were patterned in different geometries to find an optimum electrochemical response, depending on the application. This is demonstrated using 4 different MEA geometries of different size and spacing using cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS), where the charge transfer resistance (Rct) increases as the electrodes are farther spaced from one another. Excellent sigmoidal voltammogram shape in CV was obtained for each BDD MEA geometry. BDD MEAs spaced farther from one another were found to give better resolution from the background in fast scan cyclic voltammetric measurements of dopamine due to the decrease in the double layer capacitance (Cdl) as verified with EIS. This work furthers the understanding of BDD MEAs and their pertinence to sensitive electroanalytical techniques. Keywords: Boron doped diamond, Microelectrode arrays, Fabricatio

Harvesting of intraoral autogenous block grafts from the chin and ramus region: preliminary results with a variable square pulse Er:YAG laser

Background and Objectives: It was the aim of this pilot study to evaluate the feasibility, benefits and limitations of a variable square pulse (VSP) Er:YAG laser for harvesting intraoral bone grafts from either the chin or ramus region. Materials and Methods: In 12 patients (5 female, 7 male) a VSP Er:YAG laser was used to harvest bone grafts either from the ramus (3) or the symphyseal area (9). For the osteotomies, the Er:YAG laser was applied with a pulse energy of 1,000 mJ, a pulse duration of 300 microseconds, and a frequency of 12 Hz (energy density 157 J/cm2). The spot size was 0.9 mm and the handpiece was kept at a distance of about 10 mm from the bone surface. Results: There was no visible carbonization or osseous debris on the surface of the osteotomy gap. Damage of adjacent soft tissue structures by mechanical or thermal trauma was minimal. Cutting efficiency was excellent and the overall time required for the procedure was not increased. However, due to a free manual positioning of the laser beam in the non-contact mode, it was difficult to get a well defined osteotomy line without irregularities on the surface. Slight deviations of the original angulation of the laser beam led to considerable bone loss which restricted osteotomy of ramus grafts to three cases. Depth control was limited to visual inspection. Conclusion: The bone ablation technique using a (VSP) Er:YAG laser yielded superior clinical results without impairment of wound healing and in comparison to other laser systems, no significant time loss occurred. Yet, the missing depth control and the necessity of carefully handling the laser beam position and its angulation limit the use of a (VSP) Er:YAG laser to regions where a safe and fixed guidance of the laser beam is feasible

Dynamization at the near cortex in locking plate osteosynthesis by means of dynamic locking screws: an experimental study of transverse tibial osteotomies in sheep

BACKGROUND: Locking plates are widely used in fracture fixation, mainly for meta-diaphyseal fractures, comminuted fractures, fractures with a critical-size bone defect, periprosthetic fractures, osteotomies, and fractures in osteoporotic bone. The aim of this animal study was to evaluate the effect on bone-healing of dynamization of locking plate constructs by means of new 5.0-mm dynamic locking screws (in the DLS group), which allow near-cortex micromotion, compared with a more rigid construct utilizing standard bicortical locking-head screws (in the LS group). Use of dynamic locking screws allows modulation of the stiffness of existing locking compression plate systems via parallel interfragmentary micromotion. METHODS: A standardized diaphyseal tibial osteotomy (90°, 3-mm fracture gap) was performed and stabilized with a six-hole large-fragment locking compression plate in twelve female sheep (six in each group). Radiographs were made postoperatively and then weekly from week three until sacrifice at nine weeks. Macroscopic, biomechanical, histologic, and radiographic assessments and microcomputed tomography were performed. RESULTS: The callus in the tested specimens in the DLS group had better biomechanical stability, with a significantly greater maximum failure moment (mean and standard deviation [SD] as a percentage of intact, 55.15 ± 20.65 compared with 26.80 ± 14.96 in the LS group; p = 0.021). The DLS group also had greater periosteal callus volume at the near cortex (mean volume and SD as a percentage of the tibial shaft volume, 36.21% ± 10.08% compared with 18.98% ± 8.61% in the LS group; p = 0.026) and in the intercortical region (mean volume and SD as a percentage of the bone volume of the tibial shaft, 3.56% ± 0.52% compared with 2.64% ± 0.98% in the LS group; p = 0.045), as shown by microcomputed tomography. The DLS group also had significantly greater torsional stiffness (mean and SD as a percentage of intact, 84.88 ± 13.51 compared with 58.89 ± 20.61 in the LS group; p = 0.027). CONCLUSIONS: Controlled micromotion and nearly homogeneous interfragmentary strain at the fracture site, together with the stable bicortical fixation achieved by the new dynamic locking screw, led to more uniform callus formation, significantly more callus formation at the near cortex, and biomechanically more competent bone-healing compared with use of rigid locking plate constructs with locking-head screws

Rotator cuff muscles lose responsiveness to anabolic steroids after tendon tear and musculotendinous retraction: an experimental study in sheep

BACKGROUND: Long-standing rotator cuff tendon tearing is associated with retraction, loss of work capacity, irreversible fatty infiltration, and atrophy of the rotator cuff muscles. Although continuous musculotendinous relengthening can experimentally restore muscular architecture, restoration of atrophy and fatty infiltration is hitherto impossible. HYPOTHESIS: Continuous relengthening with pharmacological stimulation of muscle growth using an anabolic steroid or insulin-like growth factor (IGF) can reverse atrophy and fatty infiltration as well as improve the work capacity of chronically retracted rotator cuff muscles in sheep. STUDY DESIGN: Controlled laboratory study. METHODS: Sixteen weeks after tenotomy of the infraspinatus (ISP) tendon, atrophy and fatty infiltration had developed in the retracted ISP muscle. The musculotendinous unit was continuously relengthened in 14 sheep during 6 weeks: Four sheep were treated without pharmacological stimulation, 4 with intramuscular administration of an anabolic steroid, and 6 with IGF before final repair and rehabilitation (12 weeks). Changes were documented by intraoperative measurements of muscle work capacity, histology, and computed tomography/magnetic resonance imaging. RESULTS: Musculotendinous relengthening by continuous traction resulted in gains of length ranging from 0.7 cm in the IGF group to 1.3 cm in the control group. Fatty infiltration progressed in all groups, and the muscle's cross-sectional area ranged from 71% to 74% of the contralateral side at sacrifice and did not show any differences between groups in weight, volume, histological composition, or work capability of the muscle. The contralateral muscles in the anabolic steroid group, however, showed significantly higher (mean ± standard deviation) muscle work capacity of 10 ± 0.9 N·m than the contralateral muscles of the control group (6.8 ± 2.4 N·m) (P < .05). This was accompanied by an increased mean muscle fiber area as well as by an unusual gain in the animals' weight after injection of the anabolic steroid. CONCLUSION: Subcutaneous continuous relengthening of a chronically retracted musculotendinous unit is feasible and advances the retracted musculotendinous junction toward its original position. This does not change the muscle work capacity. Whereas anabolic steroids have been shown to be effective in preventing classic degenerative muscle changes after tendon tears, neither an anabolic steroid nor IGF contributes to regeneration of the muscle once degenerative changes are established. CLINICAL RELEVANCE: The findings demonstrate that muscle cells lose reactiveness to an anabolic steroid and IGF once retraction has led to fatty infiltration and atrophy of the muscle. Retraction of the muscle after tendon tears must be avoided by early repair, particularly in an athlete, as no regeneration can be achieved by mechanical or pharmacological means at this time

Computer-guided CO2-laser osteotomy of the sheep tibia : technical prerequisites and first results

The purpose of this study was to examine for the first time the feasibility of performing complete osteotomy of sheep tibia using a computer-guided CO2-laser osteotome, and to examine bone healing under functional loading

Bone healing of the sheep tibia shaft after carbon dioxide laser osteotomy : histological results

The aim of the study was to compare the histological results after complete osteotomies of the sheep tibia using either the prototype carbon dioxide (CO(2)) laser osteotome 'OsteoLAS' (n = 12) or an oscillating saw (n = 12). The laser parameters were as follows: wavelength 10.6 microm; energy of laser pulses 75-85 mJ; pulse duration 80 mus; pulse repetition rate 200 Hz; spot diameter 460 mum (1/e(2) level); radiant exposure 45-51 J/cm(2); peak irradiance 0.56-0.64 MW/cm(2). Both groups were divided into two subgroups (n = 6), and the animals were killed after 4 weeks or 12 weeks, respectively. Light and fluorescence microscopy with semiquantitative analysis and histomorphometry were performed to compare bone healing. Charring-free laser osteotomies were possible up to a depth of 20 mm with the short-pulsed CO(2) laser. The laser, however, required a significantly longer time to perform, and a wedge-shaped gap was present on the cis-cortex. After 4 weeks the osteotomy gaps were almost unchanged in both groups and filled with connective tissue. After 12 weeks the gaps were filled with newly formed bone in both groups. Primary gap healing was predominant in the laser group and longitudinal cortical remodelling in the control group. On a cellular level, no fundamental differences were observed for early and late stages of bone healing. Further research has to be focussed on improving the CO(2) laser ostetome in order to reduce the long duration of the laser osteotomy and the necessity of creating a wedge-shaped cut in thick bones