The use of motion analysis to measure pain-related behaviour in a rat model of degenerative tendon injuries

Chronic tendinopathy is characterized with longstanding activity-related pain with degenerative tendon injuries. An objective tool to measure painful responses in animal models is essential for the development of effective treatment for tendinopathy. Gait analysis has been developed to monitor the inflammatory pain in small animals. We reported the use of motion analysis to monitor gait changes in a rat model of degenerative tendon injury. Intratendinous injection of collagenase into the left patellar tendon of Sprague Dawley rat was used to induce degenerative tendon injury, while an equal volume of saline was injected in the control groups. Motion analyses with a high speed video camera were performed on all rats at pre-injury, 2, 4, 8, 12 or 16 weeks post injection. In the end-point study, the rats were sacrificed to obtain tendon samples for histological examination after motion analyses. In the follow-up study, repeated motion analyses were performed on another group of collagenase-treated and saline-treated rats. The results showed that rats with injured patellar tendon exhibited altered walking gait as compared to the controls. The change in double stance duration in the collagenase-treated rats was reversible by administration of buprenorphrine (p = 0.029), it suggested that the detected gait changes were associated with pain. Comparisons of end-point and follow-up studies revealed the confounding effects of training, which led to higher gait velocities and probably a different adaptive response to tendon pain in the trained rats. The results showed that motion analysis could be used to measure activity-related chronic tendon pain. © 2009 Elsevier B.V. All rights reserved

Knee kinematics of ACL-deficient patients: A development of a portable motion analysis system

This study is to compare the knee kinematic measurements between the novel portable skin marker-based motion analysis system (Opti-Knee®) and a conventional system (Vicon®). Nineteen subjects were recruited and asked to perform stair descent with lower limb placed with skin markers. Knee kinematic data was computed from the trajectories of the skin markers. Pearson’s correlation coefficient and Root-mean-square deviation (RMSD) were used to analyze the data. For the waveform, sagittal plane rotation is strongly positive correlated between systems, while for axial and coronal plane rotation, it was moderately to strongly positive correlated in both normal (ACLN) and ACL-deficient (ACLD) group. Substantial difference between two groups was found in correlation of abduction/adduction in both stance and swing phase, as well as in external/internal rotation in all selected regions of interest. Moreover, the RMSD was larger in ACLN than in ACLD in three planes of rotation. The capability of Opti-Knee® in tracking lower limb sagittal plane rotation was comparable to Vicon®. However, for coronal and axial plane rotation, although the correlation to Vicon® in kinematic waveforms was moderately high, their ROM and peak values substantially deviated from the values in Vicon®.This study is supported by the Innovation and Technology Support Program, Hong Kong (Ref. No.: ITS/289/14FX)

The effect of glucocorticoids on tendon cell viability in human tendon explants

Background and purpose Previous studies on the culture of human tenocytes have shown that dexamethasone and triamcino-lone reduce cell viability, suppress cell proliferation, and reduce collagen synthesis. However, such cell cultures lack the extracellular matrix and three-dimensional structure of normal tendons, which affects their response to stimuli. We established a human tendon explant culture system and tested the effects of dexamethasone and triamcinolone on cell viability

Ranking of orthopaedic journals: A challenge to the citation-based metrics

Citation-based metrics for journal ranking may provide objective measures to quantitate a journal's contribution to scientific progress as reflected by citation, but comparison of journals solely based on citation-metrics is unjustified. There are two major types of citation-based metrics: the count of cites per paper and the count of papers with significant citations, as exemplified by the h-index. Orthopaedic journals are more likely to be underrated by most citation-based metrics, and this is accounted for by the lower citation potentials. Ranking of orthopaedic journals based on different citation metrics demonstrated a reasonably suitable accordance, but numerous orthopaedic journals experienced greater discrepancies in the measures of the journal's popularity and prestige. Citation-based ranking should not be equated with the scholarly performance of a journal; other criteria to evaluate the “impacts” of journals should be explored as well, such as clinical impacts rated by clinicians. Journal rankings and citation metrics are often used by universities, hospitals, research institutions, and granting agencies for performance assessment and resource allocation. The clinical impact and, to a certain extent, the emphasis on the quality of patient care, are not given the deserved recognition and are not priority considerations. This article sets the tone for a comprehensive review of the journal ranking system in orthopaedics

Graft healing after anterior cruciate ligament reconstruction (ACLR)

Anterior cruciate ligament reconstruction (ACLR) is a commonly performed procedure in Orthopaedic sports medicine. With advances in surgical techniques providing better positioning and fixation of the graft, subsequent graft failure to certain extent should be accounted by poor graft healing. Although different biological modulations for enhancement of graft healing have been tried in different clinical and animal studies, complete graft incorporation into bone tunnels and the “ligamentization” of the intra-articular part have not been fully achieved yet. Based on the understanding of graft healing process and its failure mechanism, the purpose of this review is to combine both the known basic science & clinical evidence, to provide a much clearer picture of the obstacle encountered in graft healing, so as to facilitate researchers on subsequent work on the enhancement of ACL graft healing

Skilled reaching test for shoulder function assessment in a rat model of rotator cuff tear: a pilot study

Abstract Background Functional assessments are crucial to evaluate treatment outcomes in clinical and animal studies on rotator cuff injuries. While gait analysis is commonly used to assess animal models of rotator cuff tears, it is less relevant for human patients as the human shoulder is typically assessed in a non-weight-bearing condition. The present study introduces the skilled reaching test as a shoulder functional assessment tool for rats, which allows for evaluation without weight bearing. Methods In the control group, 8 male Sprague–Dawley rats received rotator cuff tear surgery without repair. In the rotator cuff repair group, 20 rats received rotator cuff repair at 4 weeks post rotator cuff tear. For the skilled reaching test, rats were trained to extend their forelimbs to fetch food pellets, and the number of trials, number of attempts and the success rate were recorded. The gait analysis and skilled reaching test were performed at baseline, 4 weeks post-tear, 1, 2, 4, and 8 weeks post-repair. The repeated measures analysis of variance was used to evaluate the effects of time on the shoulder function. The significance level was set at 0.05. Results The skilled reaching test required 216 h to conduct, while the gait analysis took 44 h. In the rotator cuff repair group, gait performance significantly deteriorated at 1 week post-repair and restored to 4 weeks post-tear levels at 4 weeks post-repair. Regarding the skilled reaching test, the number of attempts, number of trials and the success rate decreased at 1 week post-repair. Subsequently, there was a brief rebound in performance observed at 2 weeks post-repair, followed by a continued decline in the number of attempts and trials. By 8 weeks post-repair, only the success rate had restored to levels similar to those observed at 4 weeks post-tear. Conclusion The skilled reaching test can detect functional deficiencies following rotator cuff tear and repair, while it requires high time and labour costs

Local administration of Trolox, a vitamin E analog, reduced tendon adhesion in a chicken model of flexor digitorum profundus tendon injury

Background: Hand flexor tendon injuries are compromised with tendon adhesion. Tendon adhesion forms between flexor tendon and tendon sheath, reduces the range of motion of fingers, and affects their function. Oxidative stress is increased in flexor tendon after injury and might play a role in tendon adhesion formation. Trolox (6-hydroxy-2,5,7,8-tetramethylchroman-2-carboxylic acid), a water-soluble analog of vitamin E, is antioxidative. Trolox reduced oxidative stress and the expression of fibrotic cytokines in the bile gut ligation animal model. Vitamin C and Trolox are strong antioxidants, but they might also have prooxidant properties. The prooxidant properties of vitamin C and Trolox are different. In this study, our aim was to determine the effect of Trolox in reducing tendon adhesion formation. Methods: Flexor digitorum profundus tendon injury was induced in 54 Kai-Mei Chicken according to a well-established protocol. After wound closure, an injection of 50 μL saline, 10mM Trolox, or 100mM Trolox was administered into the wound area. At 2 weeks or 6 weeks after the surgery, chicken feet were harvested for gliding test, high-resolution ultrasound measurement on a fibrotic area, and histology. Results: At Week 2 after the surgery, Trolox has no effect on the flexion angle and gliding resistance, whereas a significant improvement was observed in the flexion angle and gliding resistance in the Trolox-treated groups at Week 6. However, no dose response was observed. In the ultrasound measurement, there was no significant difference in the fibrotic mass in the Trolox-treated group as compared to the saline group at Week 2. At Week 6, fibrotic mass was significantly reduced in both Trolox-treated groups. From the histological examination, the Trolox-treated groups presented a higher cellularity at Week 2 as compared to the saline group, and reduced fibrosis and adhesion at Week 6. Conclusion: Our results suggest that local administration of Trolox can reduce tendon adhesion, and a higher dose of Trolox did not have negative effects. Clinical Significance: Trolox solution might be feasible to reduce tendon adhesion via intraoperative injection at the wound area during tendon repair