Assessment of Surrogate Models for Research on Resistance and Deformation of Repairs of the Human Meniscal Roots: Porcine or Older Human Models?

This study provides data and rationales to aid researchers in the selection of surrogate models for in vitro assessments of surgically repaired meniscal roots. The results are potentially applicable in experimental in vitro investigations aimed at evaluating the performance of surgical repair both in existing approaches and emerging techniques. It could also be of interest for studies seeking to adjust material models of the meniscal tissue around the suture area for incorporation into computational modelsThis research was funded by Junta de Andalucía, Spain, grant number UMA20-FEDERJA-116

Age influence on resistance and deformation of the human sutured meniscal horn in the inmediate postoperative period.

To preserve knee function, surgical repair is indicated when a meniscal root disinsertion occurs. However, this surgery has not yet achieved complete recovery of the joint´s natural biomechanics, with the meniscus-suture interface identified as a potentially determining factor. Knowing the deformation and resistance behavior of the sutured meniscal horn and whether these properties are preserved as the patient ages could greatly contribute to improving repair outcomes. Regarding the influence of age on the sutured meniscal horn tissue, in vitro experimentation revealed that meniscal horn specimens older than 75 years old had a more elastic tissue which was less resistant to cut-out than younger menisci at the suture hole area. However, a thickening of the meniscal horns with age, which was also found, leveled out the difference in the force that initiated the tear, as well as in the maximum force borne by the meniscus in the load-to-failure test

Method for assessing the breaking starting strength of meniscal horns from suture retention tests.

Surgical repair of a detached meniscal root is performed via a transtibial or in situ technique, using sutures to fix the meniscus to restore knee biomechanics. A critical aspect to prevent repair failure is the capacity of the tissue to hold the sutures subjected to forces throughout surgery and the postoperative period. Previously, visual inspection of video-monitored suture retention tests of meniscal horns and other soft tissues, allowed the identification of a breaking starting point that initiates tissue damage, better representing its suture retention capacity than the final failure. In this scenario, it is key to quantifying the Breaking Starting Strength (BSS). Some studies have analyzed horn resistance at the tissue-suture interface, but a robust methodology for computing the BSS has not been described. This work proposes a method to identify the BSS directly from the load curves of suture retention tests. The methodology has been validated using meniscal horns in human and porcine models.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech. UMA20-FEDERJA-11

Age influence on cut-out resistance of sutured meniscus: An experimental cadaveric study

Surgical treatment of meniscal root detachment is changing from partial meniscectomy to root reinsertion with sutures due to alterations in the knee joint contact biomechanics and early cartilage loss development. Suture fixation techniques of meniscal roots can be grouped into transtibial and in situ fixations, both techniques pierce the meniscal horn to pass a suture thread through the hole and reconnect meniscus to bone. Despite its importance for the survival of the repair, few works focus on determining the resistance of meniscal tissue cut-out by direct thread traction on the suture hole and, as far as we are aware, the influence of age on this resistance has not been yet studied.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech. Proyecto UMA20-FEDERJA-11

Improved tibiofemoral contact restoration after transtibial reinsertion of the anterior root of the lateral meniscus compared to in situ repair: a biomechanical study

Purpose: To compare biomechanical behaviour of the anterior root of the lateral meniscus (ARLM) after a transtibial repair (TTR) and after an in situ repair (ISR), discussing the reasons for the efficacy of the more advantageous technique. Methods: Eight cadaveric human knees were tested at flexion angles from 0° to 90° in four conditions of their ARLM: intact, detached, reinserted using TTR, and reinserted using ISR. Specimens were subjected to 1000 N of compression, and the contact area (CA), mean pressure (MP), and peak pressure (PP) on the tibial cartilage were computed. For the TTR, traction force on the sutures was registered. Results: ARLM detachment significantly altered contact biomechanics, mainly at shallow flexion. After ISR, differences compared to the healthy group persisted (extension, CA 22% smaller (p = 0.012); at 30°, CA 30% smaller (p = 0.012), MP 21%, and PP 32% higher (both p = 0.017); at 60°, CA 28% smaller (p = 0.012), MP 32%, and PP 49% higher (both p = 0.025). With TTR, alterations significantly decreased compared to the injured group, with no statistical differences from the intact ones observed, except for CA at extension (15% decrease, p = 0.012) and at 30° (12% decrease, p = 0.017). The suture tension after TTR, given as mean(SD), was 36.46(11.75)N, 44.32(11.71)N, 40.38(14.93)N, and 43.18(14.89)N for the four tested flexion angles. Conclusions: Alterations caused by ARLM detachment were partially restored with both ISR and TTR, with TTR showing better results on recovering CA, MP, and PP in the immediate postoperative period. The tensile force was far below the value reported to cause meniscal cut-out in porcine models.Funding for open access charge: Universidad de Málaga / CBUA. Funding for open access publishing: Universidad Málaga/CBUA This work was supported by the Ministerio de Ciencia, Inno vación y Universidades (Spain) under grant agreement RTI2018-094339-B-100 and the Consejería de Economia, Conocimiento, Empresas y Universidades de Andalucia, (Spain) under grant agree ment P20-00294

L4 fixation is not necessary in L5-Iliac spinopelvic fixation after trauma, but coadjutant transilio-transsacral fixation is

Spinopelvic dissociation (SPD) is a severe injury characterized by a discontinuity between the spine and the bony pelvis consisting of a bilateral longitudinal sacral fracture, most of the times through sacral neuroforamen, and a horizontal fracture, usually through the S1 or S2 body.. Since SPD results after high energy injuries, like a fall from height, traffic accidents or blast injuries , most of the times it is found in a polytraumatized patient, associated with other life-threatening injuries Conservative treatment is chosen only in patients who are not fit for surgery or have concomitant injuries that will require a period of immobilization longer than three months and in those presenting mild displacement at the fracture sites]. Otherwise, SPD lesions are best treated by surgical procedures.Funding for open Access charge: Universidad de Málaga / CBUA. King Fahd bin Abdulaziz al-Saud Foundation at the Hospital Universitario Costa del Sol in Marbella (Malaga

Compressive relaxation properties of human meniscus increase under combined traction and compression.

Physiologically, the meniscal horns are subjected to a complex loading combination of compressive axial forces and internal circumferential tensile loading. However, while the compressive properties of human menisci have been extensively studied, the impact of tensile loading on the compressive properties is unknown. Therefore, the aim of this study was to analyze the changes in the compressive relaxation properties of the meniscal horn under combined axial compression and circumferential traction.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech Ministerio de Universidades del Gobierno de España con ayuda FPU20/0544

Análisis de la progresión del daño macroscópico en la interfase menisco-sutura tras reparación de la raíz: estudio biomecánico en modelo porcino

En un modelo porcino de la reparación de la raíz posterior del menisco medial sometido a cargas cíclicas representativas de protocolos de rehabilitación habituales en el post-operatorio temprano, no se observa daño macroscópico en la interfase tejido-sutura generada por el orificio de sutura. El desgarro meniscal en ensayo de tracción a rotura se inicia a valores de carga muy superiores a los esperables en el posoperatorio.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Sensorised child walker for the assessment of rehabilitation therapies

The balance and corporal position of people with movement disorders improve when walkers or devices for the mobility aid are used [1]. The ability to walk and interact with the environment causes improvements in the gait, the muscle strength, the endurance, and the muscle innervation. In addition, the use of gait support systems promotes user participation and interaction, giving them greater autonomy and a better life quality. There are many works that offer solutions adapted to the patient's condition and their pathology and allow doctors to personalize rehabilitation therapies based on patient’s evolution [2, 3]. However, many static training platforms, pediatric exoskeletons and smart walkers can be unfeasible for most rehabilitation centers. This project addresses the development of an affordable sensorised walker capable of detecting and storing parameters induced by the patient in a passive posterior walker prototype. The walker is designed for training the gait and monitoring of the patient’s progress. In this way, professionals in the rehabilitation field such as orthopedists, doctors and physiotherapists will be able to use the electronic instrumentation of the walker to complement the obtained information through observational assessment scales and personalize recovery therapies taking into account the data provided by each user in the performed tests.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Situaciones de vulnerabilidad relacionadas con un trato inadecuado: Los malos tratos a las personas mayores

En la actualidad, la calidad de vida de las personas mayores se presenta como la esencia de las actuaciones desde las distintas ciencias humanas y sociales dirigidas a este colectivo de la población. Colectivo cada vez más numeroso y presente en los distintos escenarios sociales. Uno de los principales problemas que están deteriorando las condiciones vitales de los mayores lo constituye el maltrato que reciben por parte de otras personas. Con este artículo pretendemos avanzar en la comprensión, la etiología, los factores de riesgo así como la detección de los malos tratos a las personas mayores