Clinical results of arthroscopic polyglycolic acid sheet patch graft for irreparable rotator cuff tears

AbstractThe high retear rates after surgery for irreparable rotator cuff tears can be explained by the healing capacity potential of tendons and the native rotator cuff enthesis characterised by complex morphological structures, called direct insertion. Many experimental researches have focused on biologically augmenting the rotator cuff reconstruction and improving tendon–bone healing of the rotator cuff. The results of the experimental study showed that the polyglycolic acid sheet scaffold material allows for the regeneration of not only tendon-to-tendon, but also tendon-to-bone interface in an animal model. We performed a clinical study of the arthroscopic polyglycolic acid sheet patch graft used for the repair of irreparable rotator cuff tears. One-year clinical results of the repair of irreparable rotator cuff tears by arthroscopic patch graft with a polyglycolic acid sheet demonstrated improved shoulder function and a significantly lower retear rate, compared with patients treated with a fascia lata patch

Opening Remarks

IPSHU Research Report Series No.33 : The First International symposium 2017 hosted by Institute for Peace Science, Hiroshima University “The Atomic Bombs and War Memories: Heritage of Peace in an Uncertain Age”, Part1: English Version, Editor: Luli van der DOE

巻頭言

IPSHU Research Report Series No.33 : 平成29年度第1回広島大学平和科学研究センター主催国際シンポジウム「原爆体験・戦争記憶の継承〜託す平和遺産」, パートII : 日本語版, Editor: Luli van der DOE

Developing stem cell-based therapeutic strategies in orthopaedic surgery

open5siEDITORIAL - Developing Stem Cell-Based Therapeutic Strategies in Orthopaedic SurgeryopenAtesok, Kivanc; Ochi, Mitsuo; Baldini, Nicola; Schemitsch, Emil; Liebergall, MeirAtesok, Kivanc; Ochi, Mitsuo; Baldini, Nicola; Schemitsch, Emil; Liebergall, Mei

Liposarcoma Arising in the Foot: A Case Report

Liposarcoma is categorized as a soft tissue sarcoma and most commonly appears in the lower extremities and rarely in the foot during adulthood. We present a very rare case report of a primary well-differentiated liposarcoma arising in the foot on a 60-year-old female. Marginal resection of the tumor with metatarsal ray amputation was eventually performed. The patient's postoperative course was uneventful without recurrence 5 years after the original operation. The authors review the literature and also report on the low incidence of this tumor arising in the foot

Comparison of flexion and extension protocol for testing knee joint position sense

新しい固有感覚測定装置使用のための基礎データを得る目的で膝関節の運動方向の違いが位置覚測定の結果に与える影響を調べた.対象は,膝関節疾患および外傷の既往がない大学生8名とした.位置覚測定は設定角度を膝屈曲15°として,設定角度まで膝屈曲30°から伸展させるタスクと,膝完全伸展位から屈曲させるタスクを行った.2つのタスク間で再現角度,定数誤差値および絶対誤差値の平均値に差があるかを確かめたが,いずれも有意差を認めなかった.その結果,運動方向の違いは,位置覚測定では測定結果に影響を与えないことが示唆された.これは,位置覚測定において運動方向を任意に選択しても結果に影響しないことを示している.膝関節構成体は運動方向の違い,即ち屈曲と伸展で異なった刺激を受けていると考えられるが測定結果に有意差を認めなかったことからメカノレセプターの機能を再考する必要があると考えた.今後はACL 損傷者と健常者とを比較することにより,位置覚測定で運動方向の違いがACL 中のメカノレセプターに与える影響を明らかにすることができると考える.It is reported that the anterior cruciate ligament (ACL) has a sensitive function that regulates proprioception. The partial or total rupture of ACL could reduce proprioception. In this study, we investigated whether the direction of joint motion has an affect on proprioceptive sensibility. Eight subjects (5 men and 3 women) who did not have any history of previous injury or surgery to either knee joint participated. Two kinds of tasks for knee joint position sense were examined using a specially made article to record target joint angles and to calculate reproduced angles after limb movement. Task A involved extension from a 30°flexed position and task B involved flexion from a totally extended position. The repositioning angle departed from target angle (15°) within one degree in each task. Mean real error indicated a tendency to underestimate reproduced joint angles in all tasks, although the magnitude of the error was small. Absolute error was around two degrees. No significant difference was found in repositioning angle, real error or absolute error between task A and task B. These data show that direction of joint motion does not affect knee joint position sense. It is suggested that joint direction can be chosen at will in the measurement of knee joint position sense. Further investigations may include measurements of ACL injured patients to clarify the influence of ACL mechanoreceptors by comparison with the present study as a control group

Acceleration of healing of the medial collateral ligament of the knee by local administration of synthetic microRNA-210 in a rat model

AbstractBackgroundInjury to the medial collateral ligament (MCL) of the knee joint is the most common ligament injury of the knee. Ligament healing generally takes a long time. Micro-ribonucleic acid (miRNA) is one of the noncoding RNAs and plays a crucial role in physiological function; miRNA (miR)-210 is known as a potent factor of angiogenesis, which is an important initiator of ligament healing. The purpose of this study is to examine the effect of local injection of double-stranded (ds) miR-210 on the healing of the MCL of rat knee joint.MethodsMCLs of Sprague-Dawley rats were cut transversely. After the fascia and skin were sutured, dsmiR-210 or control dsRNA was injected into the injured site of MCL. At 2 weeks and 4 weeks, histological analysis and immunofluorescence staining of vascular endothelial growth factor, isolectin B4, collagen type 1, and Ki67 as well as a mechanical test were performed. Analysis of complementary deoxyribonucleic acid (cDNA) microarray data was performed at 1 week.ResultsHistological analysis showed that parallel fibres in the injured site were organised at 2 weeks and became thicker at 4 weeks in the miR-210-treated group, whereas the injured site in controls was filled with loose fibrous tissues and was thinner than that in the miR-210-treated group. The number of blood vessels in the miR-210-treated group was significantly higher than that in controls (p < 0.05), and vascular endothelial growth factor, Ki67, and collagen type 1 in the miR-210-treated group were intensely expressed in the repaired site as compared to the control group. The mechanical test indicated that the ultimate failure load in the miR-210-treated group was significantly higher than that in the control group at 2 weeks. The cDNA microarray analysis showed significant upregulation of genes related to cell proliferation and cell differentiation, and genes involved in negative regulation of apoptosis.ConclusionThis study showed that local injection of dsmiR-210 could accelerate MCL healing in rat, which is likely due to stimulation of angiogenesis at the healing site

Evaluation of Single-Bundle versus Double-Bundle PCL Reconstructions with More Than 10-Year Follow-Up

Background. Posterior cruciate ligament (PCL) injuries are not rare in acute knee injuries, and several recent anatomical studies of the PCL and reconstructive surgical techniques have generated improved patient results. Now, we have evaluated PCL reconstructions performed by either the single-bundle or double-bundle technique in a patient group followed up retrospectively for more than 10 years. Methods. PCL reconstructions were conducted using the single-bundle (27 cases) or double-bundle (13 cases) method from 1999 to 2002. The mean age at surgery was 34 years in the single-bundle group and 32 years in the double-bundle group. The mean follow-up period was 12.5 years. Patients were evaluated by Lysholm scoring, the gravity sag view, and knee arthrometry. Results. The Lysholm score after surgery was 89.1±5.6 points for the single-bundle group and 91.9±4.5 points for the double-bundle group. There was no significant difference between the methods in the side-to-side differences by gravity sag view or knee arthrometer evaluation, although several cases in both groups showed a side-to-side difference exceeding 5 mm by the latter evaluation method. Conclusions. We found no significant difference between single- and double-bundle PCL reconstructions during more than 10 years of follow-up

Double bundle arthroscopic Anterior Cruciate Ligament reconstruction with remnant preserving technique using a hamstring autograft

<p>Abstract</p> <p>Background</p> <p>Preservation of the Anterior Cruciate Ligament (ACL) remnant is important from the biological point of view as it enhances revascularization, and preserves the proprioceptive function of the graft construct. Additionally, it may have a useful biomechanical function. Double bundle ACL reconstruction has been shown to better replicate the native ACL anatomy and results in better restoration of the rotational stability than single bundle reconstruction.</p> <p>Methods</p> <p>We used the far anteromedial (FAM) portal for creation of the femoral tunnels, with a special technique for its preoperative localization using three dimensional (3D) CT. The central anteromedial (AM) portal was used to make a longitudinal slit in the ACL remnant to allow visualization of the tips of the guide pins during anatomical creation of the tibial tunnels within the native ACL tibial foot print. The use of curved hemostat allow retrieval of the wire loop from the apertures of the femoral tunnels through the longitudinal slit in the ACL remnant thereby, guarding against impingement of the reconstruction graft against the ACL remnant as well as the roof of the intercondylar notch.</p> <p>Conclusion</p> <p>Our technique allows for anatomical double bundle reconstruction of the ACL while maximally preserving the ACL remnant without the use of intra-operative image intensifier.</p