201
|
Baudequin T, Tabrizian M. Multilineage Constructs for Scaffold-Based Tissue Engineering: A Review of Tissue-Specific Challenges. Adv Healthc Mater 2018; 7. [PMID: 29193897 DOI: 10.1002/adhm.201700734] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 09/28/2017] [Indexed: 12/11/2022]
Abstract
There is a growing interest in the regeneration of tissue in interfacial regions, where biological, physical, and chemical attributes vary across tissue type. The simultaneous use of distinct cell lineages can help in developing in vitro structures, analogous to native composite tissues. This literature review gathers the recent reports that have investigated multiple cell types of various sources and lineages in a coculture system for tissue-engineered constructs. Such studies aim at mimicking the native organization of tissues and their interfaces, and/or to improve the development of complex tissue substitutes. This paper thus distinguishes itself from those focusing on technical aspects of coculturing for a single specific tissue. The first part of this review is dedicated to variables of cocultured tissue engineering such as scaffold, cells, and in vitro culture environment. Next, tissue-specific coculture methods and approaches are covered for the most studied tissues. Finally, cross-analysis is performed to highlight emerging trends in coculture principles and to discuss how tissue-specific challenges can inspire new approaches for regeneration of different interfaces to improve the outcomes of various tissue engineering strategies.
Collapse
Affiliation(s)
- Timothée Baudequin
- Faculty of Medicine; Biomat'X Laboratory; Department of Biomedical Engineering; McGill University; 740 ave. Dr. Penfield, Room 4300 Montréal QC H3A 0G1 Québec Canada
| | - Maryam Tabrizian
- Faculty of Medicine; Biomat'X Laboratory; Department of Biomedical Engineering; McGill University; 740 ave. Dr. Penfield, Room 4300 Montréal QC H3A 0G1 Québec Canada
- Faculty of Dentistry; McGill University; 3775 rue University, Room 313/308B Montréal QC H3A 2B4 Québec Canada
| |
Collapse
|
202
|
Yammine K. The Relationship Between Digit Independence and Digital Sesamoids in Humans and a Proposal of a New Digital Sesamoid Evolutionary Hypothesis. Anat Rec (Hoboken) 2018; 301:1046-1060. [DOI: 10.1002/ar.23774] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 10/29/2017] [Accepted: 11/06/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Kaissar Yammine
- The Foot & Hand Clinic and The Center for Evidence-based Anatomy, Jdeideh Highway; Beirut Lebanon
- Lebanese American University Medical Center-Rizk Hospital; Achrafieh Lebanon
| |
Collapse
|
203
|
Wang X, Xie L, Crane J, Zhen G, Li F, Yang P, Gao M, Deng R, Wang Y, Jia X, Fan C, Wan M, Cao X. Aberrant TGF-β activation in bone tendon insertion induces enthesopathy-like disease. J Clin Invest 2018; 128:846-860. [PMID: 29355842 DOI: 10.1172/jci96186] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 12/07/2017] [Indexed: 02/05/2023] Open
Abstract
Enthesopathy is a disorder of bone, tendon, or ligament insertion. It represents one-fourth of all tendon-ligament diseases and is one of the most difficult tendon-ligament disorders to treat. Despite its high prevalence, the exact pathogenesis of this condition remains unknown. Here, we show that TGF-β was activated in both a semi-Achilles tendon transection (SMTS) mouse model and in a dorsiflexion immobilization (DI) mouse model of enthesopathy. High concentrations of active TGF-β recruited mesenchymal stromal stem cells (MSCs) and led to excessive vessel formation, bone deterioration, and fibrocartilage calcification. Transgenic expression of active TGF-β1 in bone also induced enthesopathy with a phenotype similar to that observed in SMTS and DI mice. Systemic inhibition of TGF-β activity by injection of 1D11, a TGF-β-neutralizing antibody, but not a vehicle antibody, attenuated the excessive vessel formation and restored uncoupled bone remodeling in SMTS mice. 1D11-treated SMTS fibrocartilage had increased proteoglycan and decreased collagen X and matrix metalloproteinase 13 expression relative to control antibody treatment. Notably, inducible knockout of the TGF-β type II receptor in mouse MSCs preserved the bone microarchitecture and fibrocartilage composition after SMTS relative to the WT littermate controls. Thus, elevated levels of active TGF-β in the enthesis bone marrow induce the initial pathological changes of enthesopathy, indicating that TGF-β inhibition could be a potential therapeutic strategy.
Collapse
Affiliation(s)
- Xiao Wang
- Department of Orthopedic Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Liang Xie
- Department of Orthopedic Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Janet Crane
- Department of Orthopedic Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Gehua Zhen
- Department of Orthopedic Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Fengfeng Li
- Department of Orthopedic Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ping Yang
- Department of Orthopedic Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,Department of Obstetrics and Gynecology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang, China
| | - Manman Gao
- Department of Orthopedic Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,Department of Spinal Surgery/Orthopedic Research Institute, First Affiliated Hospital, Sun Yat-sen University, Guandong, China
| | - Ruoxian Deng
- Department of Orthopedic Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Yiguo Wang
- Department of Orthopedic Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Xiaohua Jia
- Department of Orthopedic Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Cunyi Fan
- Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai, China
| | - Mei Wan
- Department of Orthopedic Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Xu Cao
- Department of Orthopedic Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| |
Collapse
|
204
|
The Entheseal Signature of Erosive Arthritis: Surface Microscopy of Achilles Tendon Insertions Into Bone. J Clin Rheumatol 2018; 24:339-340. [PMID: 29346195 DOI: 10.1097/rhu.0000000000000656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
205
|
Primary and concomitant flexor enthesopathy of the canine elbow. Vet Comp Orthop Traumatol 2018; 26:425-34. [DOI: 10.3415/vcot-12-02-0025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Accepted: 06/30/2013] [Indexed: 11/17/2022]
Abstract
SummaryObjectives: To report the characteristics of two types of flexor enthesopathy, primary and concomitant, based on different diagnostic techniques.Materials and methods: Over a period of three years a prospective study was performed on dogs admitted for the complaint of elbow lameness. Based on the radiographic findings a selection of dogs underwent a complete series of different imaging modalities. With each technique, pathology of the medial epicondyle and the presence of other elbow disorders were recorded. All joints with signs of flexor pathology apparent with at least three techniques were selected. A distinction was made between primary and concomitant flexor enthesopathy based on the absence or presence of other elbow disorders.Results: Primary flexor enthesopathy was diagnosed in 23 joints and concomitant flexor enthesopathy in 20 joints. In 43% of the joints with primary and in 75% of the joints with concomitant flexor enthesopathy, pathology at the medial epicondyle was demonstrated by all techniques. All joints with concomitant flexor enthesopathy had a diagnosis of medial coronoid disease, osteochondritis dissecans, or both.Clinical significance: Pathology at the medial epicondyle is a sign of flexor enthesopathy. It may be present as the only sign in a joint with primary flexor enthesopathy or concomitant with other elbow pathology. In both groups flexor lesions can be demonstrated with different imaging techniques. The distinction between the primary and concomitant form is based on the presence or absence of other elbow pathology, mainly medial coronoid disease. Recognizing both types is important for a correct treatment decision.
Collapse
|
206
|
Baudequin T, Gaut L, Mueller M, Huepkes A, Glasmacher B, Duprez D, Bedoui F, Legallais C. The Osteogenic and Tenogenic Differentiation Potential of C3H10T1/2 (Mesenchymal Stem Cell Model) Cultured on PCL/PLA Electrospun Scaffolds in the Absence of Specific Differentiation Medium. MATERIALS 2017; 10:ma10121387. [PMID: 29207566 PMCID: PMC5744322 DOI: 10.3390/ma10121387] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 11/27/2017] [Accepted: 11/29/2017] [Indexed: 12/21/2022]
Abstract
The differentiation potential of mesenchymal stem cells (MSC) has been extensively tested on electrospun scaffolds. However, this potential is often assessed with lineage-specific medium, making it difficult to interpret the real contribution of the properties of the scaffold in the cell response. In this study, we analyzed the ability of different polycaprolactone/polylactic acid PCL/PLA electrospun scaffolds (pure or blended compositions, random or aligned fibers, various fiber diameters) to drive MSC towards bone or tendon lineages in the absence of specific differentiation medium. C3H10T1/2 cells (a mesenchymal stem cell model) were cultured on scaffolds for 96 h without differentiation factors. We performed a cross-analysis of the cell–scaffold interactions (spreading, organization, and specific gene expression) with mechanical (elasticity), morphological (porosity, fibers diameter and orientation) and surface (wettability) characterizations of the electrospun fibers. We concluded that (1) osteogenic differentiation can be initiated on pure PCL-based electrospun scaffolds without specific culture conditions; (2) fiber alignment modified cell organization in the short term and (3) PLA added to PCL with an increased fiber diameter encouraged the stem cells towards the tendon lineage without additional tenogenic factors. In summary, the differentiation potential of stem cells on adapted electrospun fibers could be achieved in factor-free medium, making possible future applications in clinically relevant situations.
Collapse
Affiliation(s)
- Timothée Baudequin
- CNRS, UMR 7338 Biomechanics and Bioengineering, Sorbonne Universités, Université de Technologie de Compiègne, 60200 Compiègne, France.
| | - Ludovic Gaut
- CNRS UMR 7622 IBPS-Developmental Biology Laboratory, Sorbonne Universités, UPMC Univ Paris 06, F-75005 Paris, France.
- Inserm U1156, F-75005 Paris, France.
| | - Marc Mueller
- Institute for Multiphase Processes, Leibniz Universität Hanover, D-30167 Hanover, Germany.
| | - Angela Huepkes
- CNRS, UMR 7338 Biomechanics and Bioengineering, Sorbonne Universités, Université de Technologie de Compiègne, 60200 Compiègne, France.
- Institute for Multiphase Processes, Leibniz Universität Hanover, D-30167 Hanover, Germany.
| | - Birgit Glasmacher
- Institute for Multiphase Processes, Leibniz Universität Hanover, D-30167 Hanover, Germany.
| | - Delphine Duprez
- CNRS UMR 7622 IBPS-Developmental Biology Laboratory, Sorbonne Universités, UPMC Univ Paris 06, F-75005 Paris, France.
- Inserm U1156, F-75005 Paris, France.
| | - Fahmi Bedoui
- CNRS, UMR 7337 Roberval Laboratory for Mechanics, Sorbonne Universités, Université de Technologie de Compiègne, 60200 Compiègne, France.
| | - Cécile Legallais
- CNRS, UMR 7338 Biomechanics and Bioengineering, Sorbonne Universités, Université de Technologie de Compiègne, 60200 Compiègne, France.
| |
Collapse
|
207
|
Abstract
During embryogenesis, the musculoskeletal system develops while containing within itself a force generator in the form of the musculature. This generator becomes functional relatively early in development, exerting an increasing mechanical load on neighboring tissues as development proceeds. A growing body of evidence indicates that such mechanical forces can be translated into signals that combine with the genetic program of organogenesis. This unique situation presents both a major challenge and an opportunity to the other tissues of the musculoskeletal system, namely bones, joints, tendons, ligaments and the tissues connecting them. Here, we summarize the involvement of muscle-induced mechanical forces in the development of various vertebrate musculoskeletal components and their integration into one functional unit.
Collapse
Affiliation(s)
- Neta Felsenthal
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Elazar Zelzer
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot 76100, Israel
| |
Collapse
|
208
|
Schwartz O, Abdallah S, Kutikov S, Olsen CH, Dudkiewicz I. The Prevalence and Body Site Distribution of Stress Fractures among Female Combat Soldiers in the Israeli Defense Forces: A Cross-Sectional Study. GENDER AND THE GENOME 2017. [DOI: 10.1089/gg.2017.0010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
One of the most troublesome overuse injuries is stress fractures, for which female gender is a major risk factor. In 2015, the Israeli government opened identical combat duties for both genders. The purpose of this study is to provide a detailed report regarding the prevalence and characteristics of stress fractures in females that will serve as an evidence-based platform for future policy planning and implementation regarding female integration in combat units. This is a report of a cross-sectional study of 2223 female soldiers recruited to combat units between 2010 and 2013. Data were collected from the Israeli Defense Force's (IDF's) computerized medical consultation records package. Descriptive and analytic statistics were performed to obtain and analyze results. The overall stress fractures rate was 11.6% (258 soldiers). The most frequent site for stress fracture was the distal tibia (215 cases, 83%). The average lost training days due to a stress fracture were 26.6 days. The risk for developing a stress fracture was 2.15 (215%) times higher in the noninfantry group than in the infantry group, ( p = 0.0232, 95% confidence interval 1.346, 4.536). The rate of stress fractures and the consequent lost training days in the IDF are high and necessitate the planning and implementation of a comprehensive intervention policy to reduce overuse injuries and stress fracture rates among female warriors.
Collapse
Affiliation(s)
| | | | | | - Cara H. Olsen
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Israel Dudkiewicz
- Department of Rehabilitation, Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
209
|
Nasu H, Nimura A, Sugiura S, Fujishiro H, Koga H, Akita K. An anatomic study on the attachment of the joint capsule to the tibia in the lateral side of the knee. Surg Radiol Anat 2017; 40:499-506. [DOI: 10.1007/s00276-017-1942-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 11/02/2017] [Indexed: 12/27/2022]
|
210
|
Snedeker JG, Foolen J. Tendon injury and repair - A perspective on the basic mechanisms of tendon disease and future clinical therapy. Acta Biomater 2017; 63:18-36. [PMID: 28867648 DOI: 10.1016/j.actbio.2017.08.032] [Citation(s) in RCA: 199] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 08/16/2017] [Accepted: 08/25/2017] [Indexed: 12/16/2022]
Abstract
Tendon is an intricately organized connective tissue that efficiently transfers muscle force to the bony skeleton. Its structure, function, and physiology reflect the extreme, repetitive mechanical stresses that tendon tissues bear. These mechanical demands also lie beneath high clinical rates of tendon disorders, and present daunting challenges for clinical treatment of these ailments. This article aims to provide perspective on the most urgent frontiers of tendon research and therapeutic development. We start by broadly introducing essential elements of current understanding about tendon structure, function, physiology, damage, and repair. We then introduce and describe a novel paradigm explaining tendon disease progression from initial accumulation of damage in the tendon core to eventual vascular recruitment from the surrounding synovial tissues. We conclude with a perspective on the important role that biomaterials will play in translating research discoveries to the patient. STATEMENT OF SIGNIFICANCE Tendon and ligament problems represent the most frequent musculoskeletal complaints for which patients seek medical attention. Current therapeutic options for addressing tendon disorders are often ineffective, and the need for improved understanding of tendon physiology is urgent. This perspective article summarizes essential elements of our current knowledge on tendon structure, function, physiology, damage, and repair. It also describes a novel framework to understand tendon physiology and pathophysiology that may be useful in pushing the field forward.
Collapse
|
211
|
Hexter AT, Pendegrass C, Haddad F, Blunn G. Demineralized Bone Matrix to Augment Tendon-Bone Healing: A Systematic Review. Orthop J Sports Med 2017; 5:2325967117734517. [PMID: 29124078 PMCID: PMC5661670 DOI: 10.1177/2325967117734517] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background: Following injury to the rotator cuff and anterior cruciate ligament, a direct enthesis is not regenerated, and healing occurs with biomechanically inferior fibrous tissue. Demineralized bone matrix (DBM) is a collagen scaffold that contains growth factors and is a promising biological material for tendon and ligament repair because it can regenerate a direct fibrocartilaginous insertion via endochondral ossification. Purpose: To provide a comprehensive review of the literature investigating the use of DBM to augment tendon-bone healing in tendon repair and anterior cruciate ligament reconstruction (ACLR). Study Design: Systematic review. Methods: Electronic databases (MEDLINE and EMBASE) were searched for preclinical and clinical studies that evaluated the use of DBM in tendon repair and ACLR. Search terms included the following: (“demineralized bone matrix” OR “demineralized cortical bone”) AND (“tissue scaffold” OR “tissue engineering” OR “ligament” OR “tendon” OR “anterior cruciate ligament” OR “rotator cuff”). Peer-reviewed articles written in English were included, and no date restriction was applied (searches performed February 10, 2017). Methodological quality was assessed with peer-reviewed scoring criteria. Results: The search strategy identified 339 articles. After removal of duplicates and screening according to inclusion criteria, 8 studies were included for full review (tendon repair, n = 4; ACLR, n = 4). No human clinical studies were identified. All 8 studies were preclinical animal studies with good methodological quality. Five studies compared DBM augmentation with non-DBM controls, of which 4 (80%) reported positive findings in terms of histological and biomechanical outcomes. Conclusion: Preclinical evidence indicates that DBM can improve tendon-bone healing, although clinical studies are lacking. A range of animal models of tendon repair and ACLR showed that DBM can re-create a direct fibrocartilaginous enthesis, although the animal models are not without limitations. Before clinical trials are justified, research is required that determines the best source of DBM (allogenic vs xenogenic) and the best form of DBM (demineralized cortical bone vs DBM paste) to be used in them.
Collapse
Affiliation(s)
- Adam T Hexter
- Institute of Orthopaedic and Musculoskeletal Sciences, University College London, Royal National Orthopaedic Hospital, Middlesex, UK
| | - Catherine Pendegrass
- Institute of Orthopaedic and Musculoskeletal Sciences, University College London, Royal National Orthopaedic Hospital, Middlesex, UK
| | | | - Gordon Blunn
- Institute of Orthopaedic and Musculoskeletal Sciences, University College London, Royal National Orthopaedic Hospital, Middlesex, UK
| |
Collapse
|
212
|
Chimenti RL, Cychosz CC, Hall MM, Phisitkul P. Current Concepts Review Update: Insertional Achilles Tendinopathy. Foot Ankle Int 2017; 38:1160-1169. [PMID: 28789557 PMCID: PMC5956523 DOI: 10.1177/1071100717723127] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Ruth L. Chimenti
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA
| | - Chris C. Cychosz
- Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA
| | - Mederic M. Hall
- Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA,Department of Radiology, University of Iowa, Iowa City, IA, USA
| | - Phinit Phisitkul
- Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA
| |
Collapse
|
213
|
Development of Multilayered Chlorogenate-Peptide Based Biocomposite Scaffolds for Potential Applications in Ligament Tissue Engineering - An <i>In Vitro</i> Study. JOURNAL OF BIOMIMETICS BIOMATERIALS AND BIOMEDICAL ENGINEERING 2017. [DOI: 10.4028/www.scientific.net/jbbbe.34.37] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
In this work, for the first time, chlorogenic acid, a natural phytochemical, was conjugated to a lactoferrin derived antimicrobial peptide sequence RRWQWRMKKLG to develop a self-assembled template. To mimic the components of extracellular matrix, we then incorporated Type I Collagen, followed by a sequence of aggrecan peptide (ATEGQVRVNSIYQDKVSL) onto the self-assembled templates for potential applications in ligament tissue regeneration. Mechanical properties and surface roughness were studied and the scaffolds displayed a Young’s Modulus of 169 MP and an average roughness of 72 nm respectively. Thermal phase changes were studied by DSC analysis. Results showed short endothermic peaks due to water loss and an exothermic peak due to crystallization of the scaffold caused by rearrangement of the components. Biodegradability studies indicated a percent weight loss of 27.5 % over a period of 37 days. Furthermore, the scaffolds were found to adhere to fibroblasts, the main cellular component of ligament tissue. The scaffolds promoted cell proliferation and displayed actin stress fibers indicative of cell motility and attachment. Collagen and proteoglycan synthesis were also promoted, demonstrating increased expression and deposition of collagen and proteoglycans. Additionally, the scaffolds exhibited antimicrobial activity against Staphylococcus epidermis bacteria, which is beneficial for minimizing biofilm formation if potentially used as implants. Thus, we have developed a novel biocomposite that may open new avenues to enhance ligament tissue regeneration.
Collapse
|
214
|
Qin S, Dong F, Wang W. [Mechanism research progress of tendon-derived stem cells in reconstruction of fibrocartilage zone at bone-tendon junction]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2017; 31:1006-1009. [PMID: 29806442 DOI: 10.7507/1002-1892.201612078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To summarize the mechanism research progress of tendon-derived stem cells (TDSCs) in the reconstruction of fibrocartilage zone at bone-tendon junction (BTJ). Methods The domestic and abroad related literature about TDSCs in the reconstruction of fibrocartilage zone at BTJ was summarized and analyzed. Results TDSCs can be induced to osteocytes, fibrochondrocytes, and tenocytes in vitro. Therefore, TDSCs have potential to reconstruct fibrocartilage zone at BTJ. Factors, such as mechanical stimulation, bioactive factor, extracelluar matrix, inflammatory factors, and so on, may influence osteogenic or chondrogenic differentiation of TDSCs. Conclusion Because of the specificity of origin and location of TDSCs, TDSCs have the potential to be the seed cells for BTJ fibrocartilage zone repair. By applying external stimuli, TDSCs can be induced to form structures which are similar to fibrocartilage zone.
Collapse
Affiliation(s)
- Shengnan Qin
- Department of Orthopaedics, Guangzhou Red Cross Hospital, Guangzhou Red Cross Hospital Affiliated to Jinan University, Guangzhou Institute of Traumatic Surgery, Guangzhou Guangdong, 510220, P.R.China
| | - Fei Dong
- Department of Orthopaedics, Guangzhou Red Cross Hospital, Guangzhou Red Cross Hospital Affiliated to Jinan University, Guangzhou Institute of Traumatic Surgery, Guangzhou Guangdong, 510220, P.R.China
| | - Wen Wang
- Department of Orthopaedics, Guangzhou Red Cross Hospital, Guangzhou Red Cross Hospital Affiliated to Jinan University, Guangzhou Institute of Traumatic Surgery, Guangzhou Guangdong, 510220,
| |
Collapse
|
215
|
Abstract
Tendons connect muscles to bones, ensuring joint movement. With advanced age, tendons become more prone to degeneration followed by injuries. Tendon repair often requires lengthy periods of rehabilitation, especially in elderly patients. Existing medical and surgical treatments often fail to regain full tendon function. The development of novel treatment methods has been hampered due to limited understanding of basic tendon biology. Recently, it was discovered that tendons, similar to other mesenchymal tissues, contain tendon stem/progenitor cells (TSPCs) which possess the common stem cell properties. The current strategies for enhancing tendon repair consist mainly of applying stem cells, growth factors, natural and artificial biomaterials alone or in combination. In this review, we summarise the basic biology of tendon tissues and provide an update on the latest repair proposals for tendon tears.
Cite this article: EFORT Open Rev 2017;2:332-342. DOI: 10.1302/2058-5241.2.160075
Collapse
Affiliation(s)
- Fan Wu
- Experimental Surgery and Regenerative Medicine, Department of Surgery, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Michael Nerlich
- Department of Trauma Surgery, University Regensburg Medical Center, Regensburg, Germany
| | - Denitsa Docheva
- Experimental Trauma Surgery, Department of Trauma Surgery, University Regensburg Medical Center, Regensburg, Germany and Department of Medical Biology, Medical University-Plovdiv, Plovdiv, Bulgaria
| |
Collapse
|
216
|
Ueno H, Suga T, Takao K, Tanaka T, Misaki J, Miyake Y, Nagano A, Isaka T. Relationship between Achilles tendon length and running performance in well-trained male endurance runners. Scand J Med Sci Sports 2017; 28:446-451. [PMID: 28658509 DOI: 10.1111/sms.12940] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2017] [Indexed: 11/29/2022]
Abstract
This study aimed to determine the relationship between Achilles tendon (AT) length and running performance, including running economy, in well-trained endurance runners. We also examined the reasonable portion of the AT related to running performance among AT lengths measured in three different portions. The AT lengths at three portions and cross-sectional area (CSA) of 30 endurance runners were measured using magnetic resonance imaging. Each AT length was calculated as the distance from the calcaneal tuberosity to the muscle-tendon junction of the soleus, gastrocnemius medialis (GMAT ), and gastrocnemius lateralis, respectively. These AT lengths were normalized with shank length. The AT CSA was calculated as the average of 10, 20, and 30 mm above the distal insertion of the AT and normalized with body mass. Running economy was evaluated by measuring energy cost during three 4-minutes submaximal treadmill running trials at 14, 16, and 18 km/h, respectively. Among three AT lengths, only a GMAT correlated significantly with personal best 5000-m race time (r=-.376, P=.046). Furthermore, GMAT correlated significantly with energy cost during submaximal treadmill running trials at 14 km/h and 18 km/h (r=-.446 and -.429, respectively, P<.05 for both), and a trend toward such significance was observed at 16 km/h (r=-.360, P=.050). In contrast, there was no correlation between AT CSA and running performance. These findings suggest that longer AT, especially GMAT , may be advantageous to achieve superior running performance, with better running economy, in endurance runners.
Collapse
Affiliation(s)
- Hiromasa Ueno
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Tadashi Suga
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Kenji Takao
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Takahiro Tanaka
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Jun Misaki
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Yuto Miyake
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Akinori Nagano
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Tadao Isaka
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| |
Collapse
|
217
|
Abdala V, Vera MC, Ponssa ML. On the Presence of the Patella in Frogs. Anat Rec (Hoboken) 2017; 300:1747-1755. [PMID: 28667673 DOI: 10.1002/ar.23629] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 12/11/2016] [Accepted: 01/06/2017] [Indexed: 01/30/2023]
Abstract
The patella is one of the most studied sesamoids. Historically, the patella is described as a big sesamoid embedded in the tendon of the quadriceps femoris muscle. This sesamoid is studied from developmental, functional, clinical, and anatomical perspectives. The presence of a patella is reported in squamatans, birds, and mammals. Lissamphibians are identified as the major lineage that fail to develop a patella. However, this sesamoid is reported at least once in anurans, but without detailed anatomical discussions. Through anatomical and histological studies we examined the topography and tissue composition of two structures that we identify as the proximal and distal patellae in several anuran species. We explored the evolution of these sesamoids through ancestral state reconstruction, finding that they are ancestral for amphibians and possibly tetrapods as a whole. The presence of these patellae in anurans would roll back their origin to the last common ancestor of tetrapods. From a functional perspective, the overwhelming evidence of fibrocartilage as a clear response to compression suggests that the fibrocartilaginous patellae could also withstand the mechanical stress generated on the knee undergoing compression during limb extension. Anat Rec, 2017. © 2017 Wiley Periodicals, Inc. Anat Rec, 300:1747-1755, 2017. © 2017 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Virginia Abdala
- IBN CONICET-UNT, Horco Molle s/n. Cátedra de Biología General, Facultad de Ciencias Naturales e IML, Instituto de Biodiversidad Neotropical, Miguel Lillo 205, San Miguel de Tucumán, 4000, Argentina
| | - Miriam C Vera
- UEL CONICET-FML, Unidad Ejecutora Lillo, Miguel Lillo 251, San Miguel de Tucumán, 4000, Argentina
| | - María Laura Ponssa
- UEL CONICET-FML, Unidad Ejecutora Lillo, Miguel Lillo 251, San Miguel de Tucumán, 4000, Argentina
| |
Collapse
|
218
|
Pathria MN, Chung CB, Resnick DL. Acute and Stress-related Injuries of Bone and Cartilage: Pertinent Anatomy, Basic Biomechanics, and Imaging Perspective. Radiology 2017; 280:21-38. [PMID: 27322971 DOI: 10.1148/radiol.16142305] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Bone or cartilage, or both, are frequently injured related to either a single episode of trauma or repetitive overuse. The resulting structural damage is varied, governed by the complex macroscopic and microscopic composition of these tissues. Furthermore, the biomechanical properties of both cartilage and bone are not uniform, influenced by the precise age and activity level of the person and the specific anatomic location within the skeleton. Of the various histologic components that are found in cartilage and bone, the collagen fibers and bundles are most influential in transmitting the forces that are applied to them, explaining in large part the location and direction of the resulting internal stresses that develop within these tissues. Therefore, thorough knowledge of the anatomy, physiology, and biomechanics of normal bone and cartilage serves as a prerequisite to a full understanding of both the manner in which these tissues adapt to physiologic stresses and the patterns of tissue failure that develop under abnormal conditions. Such knowledge forms the basis for more accurate assessment of the diverse imaging features that are encountered following acute traumatic and stress-related injuries to the skeleton. (©) RSNA, 2016.
Collapse
Affiliation(s)
- Mini N Pathria
- From the Department of Radiology (M.N.P.) and Radiology Service, VA San Diego Healthcare System (C.B.C.), UC San Diego Medical Center, 200 W Arbor Dr, San Diego, CA 92103; and Department of Radiology, UCSD Teleradiology and Education Center, La Jolla, Calif (D.L.R.)
| | - Christine B Chung
- From the Department of Radiology (M.N.P.) and Radiology Service, VA San Diego Healthcare System (C.B.C.), UC San Diego Medical Center, 200 W Arbor Dr, San Diego, CA 92103; and Department of Radiology, UCSD Teleradiology and Education Center, La Jolla, Calif (D.L.R.)
| | - Donald L Resnick
- From the Department of Radiology (M.N.P.) and Radiology Service, VA San Diego Healthcare System (C.B.C.), UC San Diego Medical Center, 200 W Arbor Dr, San Diego, CA 92103; and Department of Radiology, UCSD Teleradiology and Education Center, La Jolla, Calif (D.L.R.)
| |
Collapse
|
219
|
Engineering mechanical gradients in next generation biomaterials - Lessons learned from medical textile design. Acta Biomater 2017; 56:14-24. [PMID: 28274765 DOI: 10.1016/j.actbio.2017.03.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 03/02/2017] [Accepted: 03/03/2017] [Indexed: 01/28/2023]
Abstract
Nonwoven and textile membranes have been applied both externally and internally to prescribe boundary conditions for medical conditions as diverse as oedema and tissue defects. Incorporation of mechanical gradients in next generation medical membrane design offers great potential to enhance function in a dynamic, physiological context. Yet the gradient properties and resulting mechanical performance of current membranes are not well described. To bridge this knowledge gap, we tested and compared the mechanical properties of bounding membranes used in both external (compression sleeves for oedema, exercise bands) and internal (surgical membranes) physiological contexts. We showed that anisotropic compression garment textiles, isotropic exercise bands and surgical membranes exhibit similar ranges of resistance to tension under physiologic strains. However, their mechanical gradients and resulting stress-strain relationships show differences in work capacity and energy expenditure. Exercise bands' moduli of elasticity and respective thicknesses allow for controlled, incremental increases in loading to facilitate healing as injured tissues return to normal structure and function. In contrast, the gradients intrinsic to compression sleeve design exhibit gaps in the middle range (1-5N) of physiological strains and also inconsistencies along the length of the sleeve, resulting in less than optimal performance of these devices. These current shortcomings in compression textile and garment design may be addressed in the future through implementation of novel approaches. For example, patterns, fibre compositions, and fibre anisotropy can be incorporated into biomaterial design to achieve seamless mechanical gradients in structure and resulting dynamic function, which would be particularly useful in physiological contexts. These concepts can be applied further to biomaterial design to deliver pressure gradients during movement of oedematous limbs (compression garments) and facilitate transport of molecules and cells during tissue genesis within tissue defects (surgical membranes). STATEMENT OF SIGNIFICANCE External and internal biomaterial membranes prescribe boundary conditions for treatment of medical disorders, from oedema to tissue defects. Studies are needed to guide the design of next generation biomaterials and devices that incorporate gradient engineering approaches, which offer great potential to enhance function in a dynamic and physiological context. Mechanical gradients intrinsic to currently implemented biomaterials such as medical textiles and surgical interface membranes are poorly understood. Here we characterise quantitatively the mechanics of textile and nonwoven biomaterial membranes for external and internal use. The lack of seamless gradients in compression medical textiles contrasts with the graded mechanical effects achieved by elastomeric exercise bands, which are designed to deliver controlled, incremental increases in loading to facilitate healing as injured tissues return to normal structure and function. Engineering textiles with a prescient choice of fibre composition/size, type of knit/weave and inlay fibres, and weave density/anisotropy will enable creation of fabrics that can deliver spatially and temporally controlled mechanical gradients to maintain force balances at tissue boundaries, e.g. to treat oedema or tissue defects.
Collapse
|
220
|
Lee-Barthel A, Baar K, West DWD. Treatment of Ligament Constructs with Exercise-conditioned Serum: A Translational Tissue Engineering Model. J Vis Exp 2017. [PMID: 28654031 PMCID: PMC5608388 DOI: 10.3791/55339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
In vitro experiments are essential to understand biological mechanisms; however, the gap between monolayer tissue culture and human physiology is large, and translation of findings is often poor. Thus, there is ample opportunity for alternative experimental approaches. Here we present an approach in which human cells are isolated from human anterior cruciate ligament tissue remnants, expanded in culture, and used to form engineered ligaments. Exercise alters the biochemical milieu in the blood such that the function of many tissues, organs and bodily processes are improved. In this experiment, ligament construct culture media was supplemented with experimental human serum that has been 'conditioned' by exercise. Thus the intervention is more biologically relevant since an experimental tissue is exposed to the full endogenous biochemical milieu, including binding proteins and adjunct compounds that may be altered in tandem with the activity of an unknown agent of interest. After treatment, engineered ligaments can be analyzed for mechanical function, collagen content, morphology, and cellular biochemistry. Overall, there are four major advantages versus traditional monolayer culture and animal models, of the physiological model of ligament tissue that is presented here. First, ligament constructs are three-dimensional, allowing for mechanical properties (i.e., function) such as ultimate tensile stress, maximal tensile load, and modulus, to be quantified. Second, the enthesis, the interface between boney and sinew elements, can be examined in detail and within functional context. Third, preparing media with post-exercise serum allows for the effects of the exercise-induced biochemical milieu, which is responsible for the wide range of health benefits of exercise, to be investigated in an unbiased manner. Finally, this experimental model advances scientific research in a humane and ethical manner by replacing the use of animals, a core mandate of the National Institutes of Health, the Center for Disease Control, and the Food and Drug Administration.
Collapse
Affiliation(s)
- Ann Lee-Barthel
- Department of Neurobiology, Physiology, and Behavior, University of California, Davis
| | - Keith Baar
- Department of Neurobiology, Physiology, and Behavior, University of California, Davis; Department of Physiology and Membrane Biology, University of California, Davis;
| | - Daniel W D West
- Department of Neurobiology, Physiology, and Behavior, University of California, Davis; Faculty of Kinesiology and Physical Education, University of Toronto
| |
Collapse
|
221
|
Rossetti L, Kuntz LA, Kunold E, Schock J, Müller KW, Grabmayr H, Stolberg-Stolberg J, Pfeiffer F, Sieber SA, Burgkart R, Bausch AR. The microstructure and micromechanics of the tendon-bone insertion. NATURE MATERIALS 2017; 16:664-670. [PMID: 28250445 DOI: 10.1038/nmat4863] [Citation(s) in RCA: 172] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 01/17/2017] [Indexed: 05/28/2023]
Abstract
The exceptional mechanical properties of the load-bearing connection of tendon to bone rely on an intricate interplay of its biomolecular composition, microstructure and micromechanics. Here we identify that the Achilles tendon-bone insertion is characterized by an interface region of ∼500 μm with a distinct fibre organization and biomolecular composition. Within this region, we identify a heterogeneous mechanical response by micromechanical testing coupled with multiscale confocal microscopy. This leads to localized strains that can be larger than the remotely applied strain. The subset of fibres that sustain the majority of loading in the interface area changes with the angle of force application. Proteomic analysis detects enrichment of 22 proteins in the interfacial region that are predominantly involved in cartilage and skeletal development as well as proteoglycan metabolism. The presented mechanisms mark a guideline for further biomimetic strategies to rationally design hard-soft interfaces.
Collapse
Affiliation(s)
- L Rossetti
- Lehrstuhl für Zellbiophysik, Technische Universität München, D-85748 Garching, Germany
| | - L A Kuntz
- Lehrstuhl für Zellbiophysik, Technische Universität München, D-85748 Garching, Germany
- Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, D-81675 München, Germany
| | - E Kunold
- Center for Integrated Protein Science (CIPSM), Department of Chemistry, Technische Universität München, D-85747 Garching, Germany
| | - J Schock
- Lehrstuhl für Biomedizinische Physik, Physik-Department &Institut für Medizintechnik, Technische Universität München, D-85748 Garching, Germany
| | - K W Müller
- Institute for Computational Mechanics, Technische Universität München, D-85748 Garching, Germany
- Structural and Applied Mechanics Group, Computational Engineering Division, Lawrence Livermore National Laboratory, 7000 East Ave, Livermore, California 94550, USA
| | - H Grabmayr
- Lehrstuhl für Zellbiophysik, Technische Universität München, D-85748 Garching, Germany
- Department of Physics and Center for Nanoscience, Ludwig Maximilian University, D-80539 Munich, Germany
| | - J Stolberg-Stolberg
- Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, D-81675 München, Germany
- University Hospital Münster, Department of Trauma-, Hand- and Reconstructive Surgery, Albert-Schweitzer-Campus 1, Building W1, D-48149 Münster, Germany
| | - F Pfeiffer
- Lehrstuhl für Biomedizinische Physik, Physik-Department &Institut für Medizintechnik, Technische Universität München, D-85748 Garching, Germany
- Institut für diagnostische und interventionelle Radiologie, Klinikum rechts der Isar, Technische Universität München, D-81675 München, Germany
| | - S A Sieber
- Center for Integrated Protein Science (CIPSM), Department of Chemistry, Technische Universität München, D-85747 Garching, Germany
| | - R Burgkart
- Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, D-81675 München, Germany
| | - A R Bausch
- Lehrstuhl für Zellbiophysik, Technische Universität München, D-85748 Garching, Germany
| |
Collapse
|
222
|
Zhao L, Lee PV, Ackland DC, Broom ND, Thambyah A. Microstructure Variations in the Soft-Hard Tissue Junction of the Human Anterior Cruciate Ligament. Anat Rec (Hoboken) 2017; 300:1547-1559. [DOI: 10.1002/ar.23608] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 03/21/2017] [Accepted: 04/06/2017] [Indexed: 01/18/2023]
Affiliation(s)
- Lei Zhao
- Experimental Tissue Mechanics Laboratory; Department of Chemical and Materials Engineering, University of Auckland; Auckland New Zealand
| | - Peter V.S. Lee
- Department of Biomedical Engineering; University of Melbourne; Victoria Australia
| | - David C. Ackland
- Department of Biomedical Engineering; University of Melbourne; Victoria Australia
| | - Neil D. Broom
- Experimental Tissue Mechanics Laboratory; Department of Chemical and Materials Engineering, University of Auckland; Auckland New Zealand
| | - Ashvin Thambyah
- Experimental Tissue Mechanics Laboratory; Department of Chemical and Materials Engineering, University of Auckland; Auckland New Zealand
| |
Collapse
|
223
|
Lin JD, Jang AT, Kurylo MP, Hurng J, Yang F, Yang L, Pal A, Chen L, Ho SP. Periodontal ligament entheses and their adaptive role in the context of dentoalveolar joint function. Dent Mater 2017; 33:650-666. [PMID: 28476202 DOI: 10.1016/j.dental.2017.03.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 03/09/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The dynamic bone-periodontal ligament (PDL)-tooth fibrous joint consists of two adaptive functionally graded interfaces (FGI), the PDL-bone and PDL-cementum that respond to mechanical strain transmitted during mastication. In general, from a materials and mechanics perspective, FGI prevent catastrophic failure during prolonged cyclic loading. This review is a discourse of results gathered from literature to illustrate the dynamic adaptive nature of the fibrous joint in response to physiologic and pathologic simulated functions, and experimental tooth movement. METHODS Historically, studies have investigated soft to hard tissue transitions through analytical techniques that provided insights into structural, biochemical, and mechanical characterization methods. Experimental approaches included two dimensional to three dimensional advanced in situ imaging and analytical techniques. These techniques allowed mapping and correlation of deformations to physicochemical and mechanobiological changes within volumes of the complex subjected to concentric and eccentric loading regimes respectively. RESULTS Tooth movement is facilitated by mechanobiological activity at the interfaces of the fibrous joint and generates elastic discontinuities at these interfaces in response to eccentric loading. Both concentric and eccentric loads mediated cellular responses to strains, and prompted self-regulating mineral forming and resorbing zones that in turn altered the functional space of the joint. SIGNIFICANCE A multiscale biomechanics and mechanobiology approach is important for correlating joint function to tissue-level strain-adaptive properties with overall effects on joint form as related to physiologic and pathologic functions. Elucidating the shift in localization of biomolecules specifically at interfaces during development, function, and therapeutic loading of the joint is critical for developing "functional regeneration and adaptation" strategies with an emphasis on restoring physiologic joint function.
Collapse
Affiliation(s)
- Jeremy D Lin
- Division of Biomaterials and Bioengineering, Department of Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, CA 94143, United States
| | - Andrew T Jang
- Division of Biomaterials and Bioengineering, Department of Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, CA 94143, United States
| | - Michael P Kurylo
- South of Market Health Center, San Francisco, CA 94103, United States
| | - Jonathan Hurng
- Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA 02115, United States
| | - Feifei Yang
- Division of Biomaterials and Bioengineering, Department of Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, CA 94143, United States
| | - Lynn Yang
- Division of Biomaterials and Bioengineering, Department of Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, CA 94143, United States
| | - Arvin Pal
- Division of Biomaterials and Bioengineering, Department of Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, CA 94143, United States
| | - Ling Chen
- Division of Biomaterials and Bioengineering, Department of Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, CA 94143, United States
| | - Sunita P Ho
- Division of Biomaterials and Bioengineering, Department of Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, CA 94143, United States.
| |
Collapse
|
224
|
Zhang J, Yuan T, Zheng N, Zhou Y, Hogan MV, Wang JHC. The combined use of kartogenin and platelet-rich plasma promotes fibrocartilage formation in the wounded rat Achilles tendon entheses. Bone Joint Res 2017; 6:231-244. [PMID: 28450316 PMCID: PMC5415905 DOI: 10.1302/2046-3758.64.bjr-2017-0268.r1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 02/10/2017] [Indexed: 01/01/2023] Open
Abstract
Objectives After an injury, the biological reattachment of tendon to bone is a challenge because healing takes place between a soft (tendon) and a hard (bone) tissue. Even after healing, the transition zone in the enthesis is not completely regenerated, making it susceptible to re-injury. In this study, we aimed to regenerate Achilles tendon entheses (ATEs) in wounded rats using a combination of kartogenin (KGN) and platelet-rich plasma (PRP). Methods Wounds created in rat ATEs were given three different treatments: kartogenin platelet-rich plasma (KGN-PRP); PRP; or saline (control), followed by histological and immunochemical analyses, and mechanical testing of the rat ATEs after three months of healing. Results Histological analysis showed well organised arrangement of collagen fibres and proteoglycan formation in the wounded ATEs in the KGN-PRP group. Furthermore, immunohistochemical analysis revealed fibrocartilage formation in the KGN-PRP-treated ATEs, evidenced by the presence of both collagen I and II in the healed ATE. Larger positively stained collagen III areas were found in both PRP and saline groups than those in the KGN-PRP group. Chondrocyte-related genes, SOX9 and collagen II, and tenocyte-related genes, collagen I and scleraxis (SCX), were also upregulated by KGN-PRP. Moreover, mechanical testing results showed higher ultimate tensile strength in the KGN-PRP group than in the saline control group. In contrast, PRP treatment appeared to have healed the injured ATE but induced no apparent formation of fibrocartilage. The saline-treated group showed poor healing without fibrocartilage tissue formation in the ATEs. Conclusions Our results show that injection of KGN-PRP induces fibrocartilage formation in the wounded rat ATEs. Hence, KGN-PRP may be a clinically relevant, biological approach to regenerate injured enthesis effectively. Cite this article: J. Zhang, T. Yuan, N. Zheng, Y. Zhou, M. V. Hogan, J. H-C. Wang. The combined use of kartogenin and platelet-rich plasma promotes fibrocartilage formation in the wounded rat Achilles tendon entheses. Bone Joint Res 2017;6:231–244. DOI: 10.1302/2046-3758.64.BJR-2017-0268.R1.
Collapse
Affiliation(s)
- J Zhang
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 200 Lothrop Street, Pittsburgh, Pennsylvania 15213, USA
| | - T Yuan
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 200 Lothrop Street, Pittsburgh, Pennsylvania 15213, USA
| | - N Zheng
- Department of Mechanical Engineering, University of North Carolina, 9201 University City Blvd, Mechanical Engineering, Duke 201, Charlotte, North Carolina, USA
| | - Y Zhou
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 200 Lothrop Street, Pittsburgh, Pennsylvania 15213, USA
| | - M V Hogan
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 200 Lothrop Street, Pittsburgh, Pennsylvania 15213, USA
| | - J H-C Wang
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 200 Lothrop Street, Pittsburgh, Pennsylvania 15213, USA
| |
Collapse
|
225
|
Kirkpatrick J, Yassaie O, Mirjalili SA. The plantar calcaneal spur: a review of anatomy, histology, etiology and key associations. J Anat 2017; 230:743-751. [PMID: 28369929 DOI: 10.1111/joa.12607] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2017] [Indexed: 12/15/2022] Open
Abstract
The plantar calcaneal spur (PCS) is a bony outgrowth from the calcaneal tuberosity and has been studied using various methods including cadavers, radiography, histology and surgery. However, there are currently a number of discrepancies in the literature regarding the anatomical relations, histological descriptions and clinical associations of PCS. Historically, authors have described the intrinsic muscles of the foot and/or the plantar fascia as attaching to the PCS. In this article we review the relationship between the PCS and surrounding soft tissues as well as examining the histology of the PCS. We identify a number of key associations with PCS, including age, weight, gender, arthritides, plantar fasciitis and foot position; these factors may function as risk factors in PCS formation. The etiology of these spurs is a contentious issue and it has been explained through a number of theories including the degenerative, inflammatory, traction, repetitive trauma, bone-formers and vertical compression theories. We review these and finish by looking clinically at the evidence that PCS causes heel pain.
Collapse
Affiliation(s)
- Joshua Kirkpatrick
- Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand
| | - Omid Yassaie
- Department of Orthopedic Surgery, Wellington Hospital, Wellington, New Zealand
| | - Seyed Ali Mirjalili
- Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand
| |
Collapse
|
226
|
Samuels ME, Regnault S, Hutchinson JR. Evolution of the patellar sesamoid bone in mammals. PeerJ 2017; 5:e3103. [PMID: 28344905 PMCID: PMC5363259 DOI: 10.7717/peerj.3103] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 02/17/2017] [Indexed: 12/22/2022] Open
Abstract
The patella is a sesamoid bone located in the major extensor tendon of the knee joint, in the hindlimb of many tetrapods. Although numerous aspects of knee morphology are ancient and conserved among most tetrapods, the evolutionary occurrence of an ossified patella is highly variable. Among extant (crown clade) groups it is found in most birds, most lizards, the monotreme mammals and almost all placental mammals, but it is absent in most marsupial mammals as well as many reptiles. Here, we integrate data from the literature and first-hand studies of fossil and recent skeletal remains to reconstruct the evolution of the mammalian patella. We infer that bony patellae most likely evolved between four and six times in crown group Mammalia: in monotremes, in the extinct multituberculates, in one or more stem-mammal genera outside of therian or eutherian mammals and up to three times in therian mammals. Furthermore, an ossified patella was lost several times in mammals, not including those with absent hindlimbs: once or more in marsupials (with some re-acquisition) and at least once in bats. Our inferences about patellar evolution in mammals are reciprocally informed by the existence of several human genetic conditions in which the patella is either absent or severely reduced. Clearly, development of the patella is under close genomic control, although its responsiveness to its mechanical environment is also important (and perhaps variable among taxa). Where a bony patella is present it plays an important role in hindlimb function, especially in resisting gravity by providing an enhanced lever system for the knee joint. Yet the evolutionary origins, persistence and modifications of a patella in diverse groups with widely varying habits and habitats-from digging to running to aquatic, small or large body sizes, bipeds or quadrupeds-remain complex and perplexing, impeding a conclusive synthesis of form, function, development and genetics across mammalian evolution. This meta-analysis takes an initial step toward such a synthesis by collating available data and elucidating areas of promising future inquiry.
Collapse
Affiliation(s)
- Mark E. Samuels
- Department of Medicine, University of Montreal, Montreal, QC, Canada
- Centre de Recherche du CHU Ste-Justine, Montreal, QC, Canada
| | - Sophie Regnault
- Department of Comparative Biomedical Sciences, Structure and Motion Laboratory, The Royal Veterinary College, London Hertfordshire, UK
| | - John R. Hutchinson
- Department of Comparative Biomedical Sciences, Structure and Motion Laboratory, The Royal Veterinary College, London Hertfordshire, UK
| |
Collapse
|
227
|
Rothrauff BB, Pauyo T, Debski RE, Rodosky MW, Tuan RS, Musahl V. The Rotator Cuff Organ: Integrating Developmental Biology, Tissue Engineering, and Surgical Considerations to Treat Chronic Massive Rotator Cuff Tears. TISSUE ENGINEERING PART B-REVIEWS 2017; 23:318-335. [PMID: 28084902 DOI: 10.1089/ten.teb.2016.0446] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The torn rotator cuff remains a persistent orthopedic challenge, with poor outcomes disproportionately associated with chronic, massive tears. Degenerative changes in the tissues that comprise the rotator cuff organ, including muscle, tendon, and bone, contribute to the poor healing capacity of chronic tears, resulting in poor function and an increased risk for repair failure. Tissue engineering strategies to augment rotator cuff repair have been developed in an effort to improve rotator cuff healing and have focused on three principal aims: (1) immediate mechanical augmentation of the surgical repair, (2) restoration of muscle quality and contractility, and (3) regeneration of native enthesis structure. Work in these areas will be reviewed in sequence, highlighting the relevant pathophysiology, developmental biology, and biomechanics, which must be considered when designing therapeutic applications. While the independent use of these strategies has shown promise, synergistic benefits may emerge from their combined application given the interdependence of the tissues that constitute the rotator cuff organ. Furthermore, controlled mobilization of augmented rotator cuff repairs during postoperative rehabilitation may provide mechanotransductive cues capable of guiding tissue regeneration and restoration of rotator cuff function. Present challenges and future possibilities will be identified, which if realized, may provide solutions to the vexing condition of chronic massive rotator cuff tears.
Collapse
Affiliation(s)
- Benjamin B Rothrauff
- 1 Department of Orthopaedic Surgery, Center for Cellular and Molecular Engineering, University of Pittsburgh , Pittsburgh, Pennsylvania.,2 McGowan Institute for Regenerative Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Thierry Pauyo
- 3 Division of Sports Medicine, Department of Orthopaedic Surgery, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Richard E Debski
- 2 McGowan Institute for Regenerative Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Mark W Rodosky
- 3 Division of Sports Medicine, Department of Orthopaedic Surgery, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Rocky S Tuan
- 1 Department of Orthopaedic Surgery, Center for Cellular and Molecular Engineering, University of Pittsburgh , Pittsburgh, Pennsylvania.,2 McGowan Institute for Regenerative Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Volker Musahl
- 2 McGowan Institute for Regenerative Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania.,3 Division of Sports Medicine, Department of Orthopaedic Surgery, University of Pittsburgh , Pittsburgh, Pennsylvania.,4 Orthopaedic Robotics Laboratory, Department of Orthopaedic Surgery, University of Pittsburgh , Pittsburgh, Pennsylvania
| |
Collapse
|
228
|
Xu K, Kuntz LA, Foehr P, Kuempel K, Wagner A, Tuebel J, Deimling CV, Burgkart RH. Efficient decellularization for tissue engineering of the tendon-bone interface with preservation of biomechanics. PLoS One 2017; 12:e0171577. [PMID: 28170430 PMCID: PMC5295703 DOI: 10.1371/journal.pone.0171577] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 01/22/2017] [Indexed: 02/07/2023] Open
Abstract
Interfaces between tendon/ligament and bone (“entheses”) are highly specialized tissues that allow for stress transfer between mechanically dissimilar materials. Entheses show very low regenerative capacity resulting in high incidences of failure after surgical repair. Tissue engineering is a promising approach to recover functionality of entheses. Here, we established a protocol to decellularize porcine entheses as scaffolds for enthesis tissue engineering. Chemical detergents as well as physical treatments were investigated with regard to their efficiency to decellularize 2 mm thick porcine Achilles tendon entheses. A two-phase approach was employed: study 1 investigated the effect of various concentrations of sodium dodecyl sulfate (SDS) and t-octylphenoxypolyethoxy-ethanol (Triton X-100) as decellularization agents. The most efficient combination of SDS and Triton was then carried forward into study 2, where different physical methods, including freeze-thaw cycles, ultrasound, perfusion, and hydrostatic washing were used to enhance the decellularization effect. Cell counts, DNA quantification, and histology showed that washing with 0.5% SDS + 1% Triton X-100 for 72 h at room temperature could remove ~ 98% cells from the interface. Further investigation of physical methods proved that washing under 200 mmHg hydrostatic pressure shortened the detergent exposing time from 72 h to 48 h. Biomechanical tensile testing showed that the biomechanical features of treated samples were preserved. Washing under 200 mmHg hydrostatic pressure with 0.5% SDS + 1% Triton X-100 for 48 h efficiently decellularized entheses with preservation of matrix structure and biomechanical features. This protocol can be used to efficiently decellularize entheses as scaffolds for tissue engineering.
Collapse
Affiliation(s)
- Kai Xu
- Department of Orthopaedics and Sportsorthopaedics, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany.,Department of Orthopedics, Tongji Hospital, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Lara A Kuntz
- Department of Orthopaedics and Sportsorthopaedics, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Peter Foehr
- Department of Orthopaedics and Sportsorthopaedics, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Katharina Kuempel
- Department of Orthopaedics and Sportsorthopaedics, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Alexandra Wagner
- Department of Orthopaedics and Sportsorthopaedics, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Jutta Tuebel
- Department of Orthopaedics and Sportsorthopaedics, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Constantin V Deimling
- Department of Orthopaedics and Sportsorthopaedics, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Rainer H Burgkart
- Department of Orthopaedics and Sportsorthopaedics, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| |
Collapse
|
229
|
Belcastro MG, Mariotti V. A muscular imprint on the anterolateral surface of the proximal femurs of the Krapina Neandertal collection. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2017; 162:583-588. [PMID: 28102010 DOI: 10.1002/ajpa.23140] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 11/15/2016] [Accepted: 11/21/2016] [Indexed: 01/19/2023]
Abstract
OBJECTIVES The purpose of this study is to report and interpret a feature on the anterolateral surface of the proximal femurs of the Krapina hominid collection that we briefly described in 2006 (Periodicum Biologorum, 108, 319-329). MATERIALS AND METHODS We recorded the presence or absence of the feature in all the proximal femurs of the Krapina collection (six specimens recordable) and in 622 modern human adult femurs. RESULTS The feature consists in a series of crests delimitating three raised or depressed areas. This feature has been found in three out of four adult Neandertal femurs observable. The two observable subadult Neandertal femurs do not show this character. None of the modern femurs displayed the feature. CONCLUSION We interpret this feature as a muscular imprint, probably representing the m. vastus intermedius origin and discuss a possible interpretation. We did not find any other references for such imprint in the existing literature regarding the Neandertal femurs.
Collapse
Affiliation(s)
- Maria Giovanna Belcastro
- Laboratorio di Bioarcheologia e Osteologia Forense, Dipartimento di Scienze Biologiche, Geologiche e Ambientali, Alma Mater Studiorum Università di Bologna, Via Selmi 3, Bologna, 40126, Italy.,UMR 7268 ADES Anthropologie Bioculturelle, Droit, Ethique Et Santé CNRS/Université d'Aix-Marseille/EFS-Faculté De Médecine-Secteur Nord, CS80011, Marseille Cedex 15, Boulevard Pierre Dramard, 13344, France.,Centro Fermi, Piazza Del Viminale 1, Roma, 00184, Italy
| | - Valentina Mariotti
- Laboratorio di Bioarcheologia e Osteologia Forense, Dipartimento di Scienze Biologiche, Geologiche e Ambientali, Alma Mater Studiorum Università di Bologna, Via Selmi 3, Bologna, 40126, Italy.,UMR 7268 ADES Anthropologie Bioculturelle, Droit, Ethique Et Santé CNRS/Université d'Aix-Marseille/EFS-Faculté De Médecine-Secteur Nord, CS80011, Marseille Cedex 15, Boulevard Pierre Dramard, 13344, France
| |
Collapse
|
230
|
UTE-T2 ⁎ Analysis of Diseased and Healthy Achilles Tendons and Correlation with Clinical Score: An In Vivo Preliminary Study. BIOMED RESEARCH INTERNATIONAL 2017; 2017:2729807. [PMID: 28154823 PMCID: PMC5244000 DOI: 10.1155/2017/2729807] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 11/24/2016] [Indexed: 01/20/2023]
Abstract
Objective. To compare T2⁎ value of healthy and diseased Achilles tendons (AT) with a recently introduced three-dimensional ultrashort echo time (3D-UTE) sequence and analyze the correlation between T2⁎ value and clinical scores. Methods. Ten patients with symptomatic Achilles tendon and ten healthy volunteers were investigated with 3D-UTE sequence on a 3T magnetic resonance (MR) scanner. T2⁎ values of four regions in Achilles tendons were calculated. The clinical outcomes of patients were evaluated according to the American Orthopaedic Foot and Ankle Society (AOFAS) score and Achilles Tendon Rupture Score (ATRS). An independent sample t-test was used to compare the differences of T2⁎ value and clinical scores between two groups. The Pearson correlation coefficient between clinical scores and T2⁎ values was assessed. Results. The T2⁎ values of Achilles tendon were statistically significantly different between patients and volunteers. The Pearson correlation coefficients between T2⁎ and AOFAS or ATRS scores of patients were r = −0.733 and r = −0.634, respectively. Conclusion. The variability of T2⁎ in healthy and pathologic AT can be quantified by UTE-T2⁎. T2⁎ may be a promising marker to detect and diagnose AT tendinopathy. UTE-T2⁎ could give a precise guidance to clinical outcome.
Collapse
|
231
|
Kwon BC, Kim JY, Park KT. The Nirschl procedure versus arthroscopic extensor carpi radialis brevis débridement for lateral epicondylitis. J Shoulder Elbow Surg 2017; 26:118-124. [PMID: 27810264 DOI: 10.1016/j.jse.2016.09.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 08/01/2016] [Accepted: 09/07/2016] [Indexed: 02/01/2023]
Abstract
BACKGROUND The Nirschl technique and arthroscopic débridement are common surgical procedures for chronic lateral elbow tendinopathy. The purpose of this study was to compare outcomes following the use of these techniques to treat chronic lateral elbow tendinopathy. METHODS We retrospectively reviewed 59 elbows of 55 patients who did not improve after conservative treatment. Twenty-nine elbows of 26 patients were treated with the Nirschl procedure (Nirschl group), and 30 elbows of 29 patients were treated with arthroscopic débridement (arthroscopy group). Outcomes were assessed subjectively with the quick Disabilities of the Arm, Shoulder and Hand questionnaire and the visual analog scale (VAS) for pain in 3 domains (overall pain, pain at rest, and pain during hard work) and objectively with pain-free grip strength. RESULTS The Nirschl and arthroscopy groups showed significant improvements in subjective and objective outcomes at a mean of 28.5 months and 31 months, respectively (P <.05). No significant between-group differences were found in postoperative outcomes, including quick Disabilities of the Arm, Shoulder and Hand questionnaire scores; pain-free grip strength; and VAS scores for overall pain and pain at rest (P > .05). However, a small but significant difference was found in the postoperative VAS score for pain during hard work (1.6 ± 1.3 for Nirschl group vs 2.2 ± 2.0 for arthroscopy group, P = .042). CONCLUSIONS Both techniques are comparable and highly effective for treating chronic recalcitrant lateral elbow tendinopathy. Although the Nirschl technique provides slightly superior pain relief during hard work, the effect size is very small and the difference does not appear to be clinically important.
Collapse
Affiliation(s)
- Bong Cheol Kwon
- Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Anyang-si, Gyeonggi-do, Republic of Korea.
| | - Jin Young Kim
- Department of Orthopedic Surgery, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Kun-Tae Park
- Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Anyang-si, Gyeonggi-do, Republic of Korea
| |
Collapse
|
232
|
Simpson M, Rio E, Cook J. At What Age Do Children and Adolescents Develop Lower Limb Tendon Pathology or Tendinopathy? A Systematic Review and Meta-analysis. Sports Med 2016; 46:545-57. [PMID: 26626072 DOI: 10.1007/s40279-015-0438-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Tendon pathology and tendinopathy have been reported in children and adolescents; however, the age at onset and prevalence of the conditions have not been examined systematically. OBJECTIVE To examine the prevalence of lower limb tendon pathology and tendinopathy in children and adolescents, and the factors associated with these conditions in this population. METHODS Six databases were searched (MEDLINE, the Cochrane Central Register of Controlled Trials, Embase, Scopus, the Web of Science and the Allied and Complementary Medicine Database). Studies were included if the prevalence of lower limb tendon pathology and/or tendinopathy were reported in humans under the age of 18 years. Studies were divided according to the method of diagnosis (physical examination, ultrasound or a questionnaire) and further divided into studies that reported prevalence data by tendon [reported two data points (right and left) for each participant] and those that reported prevalence data for each participant [reporting one data point (right or left) per participant]. RESULTS Seventeen studies met the inclusion criteria. Lower limb tendinopathy prevalence (presence of pain and dysfunction) ranged between 8.2 and 33.3%, and increased in prevalence as age increased up to 18 years. The odds ratio for studies reporting tendinopathy by tendon was 0.37 (95% confidence interval 0.20-0.69) in favour of boys presenting with tendinopathy. Study aims and reporting methods were heterogeneous. CONCLUSIONS The age at onset of lower limb tendinopathy in children and adolescents has not been widely studied. This systematic review found that tendinopathy is present in children and adolescents, and increases in prevalence with age up to 18 years. Male sex is significantly associated with tendinopathy in studies that report tendinopathy by tendon.
Collapse
Affiliation(s)
- Mitchell Simpson
- Department of Physiotherapy, Monash University Peninsula, Building G, McMahons Road, Frankston, Melbourne, VIC, 3199, Australia.
| | - Ebonie Rio
- Department of Physiotherapy, Monash University Peninsula, Building G, McMahons Road, Frankston, Melbourne, VIC, 3199, Australia
| | - Jill Cook
- Department of Physiotherapy, Monash University Peninsula, Building G, McMahons Road, Frankston, Melbourne, VIC, 3199, Australia
| |
Collapse
|
233
|
Locke RC, Abraham AC, Killian ML. Orthopedic Interface Repair Strategies Based on Native Structural and Mechanical Features of the Multiscale Enthesis. ACS Biomater Sci Eng 2016; 3:2633-2643. [PMID: 32832593 DOI: 10.1021/acsbiomaterials.6b00599] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The enthesis is an organ that connects a soft, aligned tissue (tendon/ligament) to a hard, amorphous tissue (bone) via a fibrocartilage interface. Mechanically, the enthesis sustains a dynamic loading environment that includes tensile, compressive, and shear forces. The structural components of the enthesis act to minimize stress concentrations and control stretch at the interface. Current surgical repair of the enthesis, such as in rotator cuff repair and anterior cruciate ligament reconstruction, aim to bridge the gap between the injured ends via reattachment of soft-to-hard tissues or graft replacement. In this review, we discuss the multiscale, morphological, and mechanical characteristics of the fibrocartilage attachment. Additionally, we review historical and recent clinical approaches to treating enthesis injury. Lastly, we explore new technological advancements in tissue-engineered biomaterials that have shown promise in preclinical studies.
Collapse
Affiliation(s)
- Ryan C Locke
- Department of Biomedical Engineering, University of Delaware, Newark, Delaware 19716, United States
| | - Adam C Abraham
- Department of Orthopedic Surgery, Columbia University Medical Center, New York, New York 10032, United States
| | - Megan L Killian
- Department of Biomedical Engineering, University of Delaware, Newark, Delaware 19716, United States
| |
Collapse
|
234
|
Quental C, Folgado J, Monteiro J, Sarmento M. Full-thickness tears of the supraspinatus tendon: A three-dimensional finite element analysis. J Biomech 2016; 49:3962-3970. [DOI: 10.1016/j.jbiomech.2016.11.049] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 11/09/2016] [Accepted: 11/11/2016] [Indexed: 11/30/2022]
|
235
|
Mengsteab PY, Nair LS, Laurencin CT. The past, present and future of ligament regenerative engineering. Regen Med 2016; 11:871-881. [PMID: 27879170 DOI: 10.2217/rme-2016-0125] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Regenerative engineering has been defined as the convergence of Advanced Materials Sciences, Stem Cell Sciences, Physics, Developmental Biology and Clinical Translation for the regeneration of complex tissues and organ systems. Anterior cruciate ligament (ACL) reconstruction necessitates the regeneration of bone, ligament and their interface to achieve superior clinical results. In the past, the ACL has been repaired with the use of autologous and allogeneic grafts, which have their respective drawbacks. Currently, investigations on the use of biodegradable matrices to achieve knee stability and permit tissue regeneration are making promising advancements. In the future, utilizing regenerative biology cues to induce an endogenous regenerative response may aid the enhancement of clinical ACL reconstruction outcomes.
Collapse
Affiliation(s)
- Paulos Y Mengsteab
- Institute for Regenerative Engineering, University of Connecticut Health, Farmington, CT 06030, USA.,Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA.,Raymond & Beverly Sackler Center for Biomedical, Biological, Physical & Engineering Sciences, University of Connecticut Health, Farmington, CT 06030, USA.,Department of Orthopaedic Surgery, University of Connecticut Health, Farmington, CT 06030, USA
| | - Lakshmi S Nair
- Institute for Regenerative Engineering, University of Connecticut Health, Farmington, CT 06030, USA.,Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA.,Raymond & Beverly Sackler Center for Biomedical, Biological, Physical & Engineering Sciences, University of Connecticut Health, Farmington, CT 06030, USA.,Department of Orthopaedic Surgery, University of Connecticut Health, Farmington, CT 06030, USA.,Department of Materials Science & Engineering, University of Connecticut, Storrs, CT 06269, USA.,Department of Chemical & Biomolecular Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - Cato T Laurencin
- Institute for Regenerative Engineering, University of Connecticut Health, Farmington, CT 06030, USA.,Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA.,Raymond & Beverly Sackler Center for Biomedical, Biological, Physical & Engineering Sciences, University of Connecticut Health, Farmington, CT 06030, USA.,Department of Orthopaedic Surgery, University of Connecticut Health, Farmington, CT 06030, USA.,Department of Materials Science & Engineering, University of Connecticut, Storrs, CT 06269, USA.,Department of Chemical & Biomolecular Engineering, University of Connecticut, Storrs, CT 06269, USA.,Department of Craniofacial Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA
| |
Collapse
|
236
|
Lu H, Chen C, Qu J, Chen H, Chen Y, Zheng C, Wang Z, Xu D, Zhou J, Zhang T, Qin L, Hu J. Initiation Timing of Low-Intensity Pulsed Ultrasound Stimulation for Tendon-Bone Healing in a Rabbit Model. Am J Sports Med 2016; 44:2706-2715. [PMID: 27358283 DOI: 10.1177/0363546516651863] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Low-intensity pulsed ultrasound stimulation (LIPUS) has been proven to be a beneficial biophysical therapy for tendon-bone (T-B) healing. However, the optimal time to initiate LIPUS treatment has not been determined yet. LIPUS initiated at different stages of the inflammatory phase may profoundly affect T-B healing. PURPOSE An established rabbit model was used to preliminarily investigate the effect of LIPUS initiation timing on T-B healing. STUDY DESIGN Controlled laboratory study. METHODS A total of 112 mature rabbits that underwent partial patellectomy were randomly assigned to 4 groups: daily mock sonication (control group) and daily ultrasonication started immediately postoperatively (immediate group), on postoperative day 7 (7-day delayed group), or on postoperative day 14 (14-day delayed group). Peripheral leukocyte counts at the inflammatory phase were used to assess postoperative inflammation. The rabbits were sacrificed at 8 or 16 weeks postoperatively for microarchitectural, histological, and mechanical evaluations of the patella-patellar tendon (PPT) junction. RESULTS The biomechanical properties of the PPT junction were significantly improved in the LIPUS-treated groups. Significantly higher ultimate strength and stiffness were seen in the 7-day delayed group compared with the other groups at 8 weeks postoperatively (P < .05 for all). Newly formed bone expansion from the remaining patella in the ultrasonic treatment groups was significantly increased and remodeled compared with the control group. Micro-computed tomography analysis showed that the 7-day delayed group had significantly more bone volume and bone mineral content at the interface as compared with the other groups at 8 weeks postoperatively (P < .05 for all). Histologically, the ultrasonic treatment groups exhibited a significantly better PPT junction, as shown by more formation and remodeling of the fibrocartilage layer and newly formed bone. Additionally, peripheral leukocyte counts displayed a significant increase from postoperative day 1 to day 3 in the immediate group as compared with the other groups. Furthermore, postoperative hydrarthrosis was more likely in the immediate group. CONCLUSION LIPUS started at postoperative day 7 had a more prominent effect on T-B healing compared with the other treatment regimens in this study. CLINICAL RELEVANCE The findings of the study may help optimize the initiation timing of LIPUS for T-B healing.
Collapse
Affiliation(s)
- Hongbin Lu
- Department of Sports Medicine, Research Center of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Can Chen
- Department of Sports Medicine, Research Center of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Jin Qu
- Department of Sports Medicine, Research Center of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Huabin Chen
- Department of Sports Medicine, Research Center of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Yong Chen
- Department of Sports Medicine, Research Center of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China Department of Pediatric Orthopaedics, Yongchuan Hospital, Chongqing Medical University, Chongqing, China
| | - Cheng Zheng
- Department of Sports Medicine, Research Center of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China Department of Orthopaedics, Hospital of Wuhan Sports University, Wuhan Sports University, Wuhan, China
| | - Zhanwen Wang
- Department of Sports Medicine, Research Center of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Daqi Xu
- Department of Sports Medicine, Research Center of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Jingyong Zhou
- Department of Sports Medicine, Research Center of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Tao Zhang
- Department of Sports Medicine, Research Center of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Ling Qin
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Jianzhong Hu
- Department of Sports Medicine, Research Center of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China Department of Spine Surgery, Research Center of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
237
|
Popkov VA, Plotnikov EY, Silachev DN, Zorova LD, Pevzner IB, Jankauskas SS, Zorov SD, Babenko VA, Zorov DB. Diseases and Aging: Gender Matters. BIOCHEMISTRY (MOSCOW) 2016; 80:1560-70. [PMID: 26638680 DOI: 10.1134/s0006297915120032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
At first glance, biological differences between male and female sex seem obvious, but, in fact, they affect a vast number of deeper levels apart from reproductive function and related physiological features. Such differences affect all organizational levels including features of cell physiology and even functioning of separate organelles, which, among other things, account for such global processes as resistance to diseases and aging. Understanding of mechanisms underlying resistance of one of the sexes to pathological processes and aging will allow taking into consideration gender differences while developing drugs and therapeutic approaches, and it will provide an opportunity to reproduce and enhance such resistance in the more vulnerable gender. Here we review physiological as well as cellular and biological features of disease course including aging that are affected by gender and discuss potential mechanisms behind these processes. Such mechanisms include features of oxidative metabolism and mitochondrial functioning.
Collapse
Affiliation(s)
- V A Popkov
- Lomonosov Moscow State University, Belozersky Institute of Physico-Chemical Biology, Moscow, 119991, Russia.
| | | | | | | | | | | | | | | | | |
Collapse
|
238
|
Śmigielski R, Zdanowicz U, Drwięga M, Ciszek B, Williams A. The anatomy of the anterior cruciate ligament and its relevance to the technique of reconstruction. Bone Joint J 2016; 98-B:1020-6. [DOI: 10.1302/0301-620x.98b8.37117] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 11/26/2015] [Indexed: 01/14/2023]
Abstract
Anterior cruciate ligament (ACL) reconstruction is commonly performed and has been for many years. Despite this, the technical details related to ACL anatomy, such as tunnel placement, are still a topic for debate. In this paper, we introduce the flat ribbon concept of the anatomy of the ACL, and its relevance to clinical practice. Cite this article: Bone Joint J 2016;98-B:1020–6.
Collapse
Affiliation(s)
- R. Śmigielski
- Carolina Medical Center, Pory
78, 02-757 Warsaw, Poland
| | - U. Zdanowicz
- Carolina Medical Center, Pory
78, 02-757 Warsaw, Poland
| | - M. Drwięga
- Carolina Medical Center, Pory
78, 02-757 Warsaw, Poland
| | - B. Ciszek
- Medical University of Warsaw, Chalbinskiego
5, 02-004 Warsaw, Poland
| | - A. Williams
- Fortius Clinic, 17
Fitzhardinge Street, London, W1h
6EQ, UK
| |
Collapse
|
239
|
A Review of Natural Joint Systems and Numerical Investigation of Bio-Inspired GFRP-to-Steel Joints. MATERIALS 2016; 9:ma9070566. [PMID: 28773688 PMCID: PMC5456843 DOI: 10.3390/ma9070566] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 06/20/2016] [Accepted: 07/01/2016] [Indexed: 11/16/2022]
Abstract
There are a great variety of joint types used in nature which can inspire engineering joints. In order to design such biomimetic joints, it is at first important to understand how biological joints work. A comprehensive literature review, considering natural joints from a mechanical point of view, was undertaken. This was used to develop a taxonomy based on the different methods/functions that nature successfully uses to attach dissimilar tissues. One of the key methods that nature uses to join dissimilar materials is a transitional zone of stiffness at the insertion site. This method was used to propose bio-inspired solutions with a transitional zone of stiffness at the joint site for several glass fibre reinforced plastic (GFRP) to steel adhesively bonded joint configurations. The transition zone was used to reduce the material stiffness mismatch of the joint parts. A numerical finite element model was used to identify the optimum variation in material stiffness that minimises potential failure of the joint. The best bio-inspired joints showed a 118% increase of joint strength compared to the standard joints.
Collapse
|
240
|
Wezenbeek E, Mahieu N, Willems TM, Van Tiggelen D, De Muynck M, De Clercq D, Witvrouw E. What does normal tendon structure look like? New insights into tissue characterization in the Achilles tendon. Scand J Med Sci Sports 2016; 27:746-753. [PMID: 27367438 DOI: 10.1111/sms.12706] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2016] [Indexed: 12/27/2022]
Abstract
Recently, ultrasound tissue characterization (UTC) was introduced as a reliable method for quantification of tendon structure. Despite increasing publications on the use of UTC, it is striking that there is a lack of normative data in active adolescents. Therefore, the aim of this study was to provide normative values of the Achilles tendon as quantified by UTC. Seventy physiotherapy students (26 male and 44 female students) with no history of Achilles tendon injuries were recruited. The Achilles tendons were scanned with UTC to characterize tendon structure. This study demonstrated that Achilles tendons of active, healthy adolescents contained 54.6% echo type I, 42.8% echo type II, 2.2% echo type III, and 0.3% echo type IV at midportion. The comparison between insertion and midportion of the tendon showed more echo type II at insertion (P < 0.001). Furthermore, female tendons contained significantly more echo type II, in both insertion and midportion compared with male tendons (P = 0.004 and P = 0.003, respectively). The results of this study, with respect to the MDC (minimum detectable change), highlight differences in the UTC echopattern in the normal population (sex and regional location), which are important considerations for future studies.
Collapse
Affiliation(s)
- E Wezenbeek
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - N Mahieu
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - T M Willems
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.,Department of Physical Therapy and Orthopedics, Ghent University, Ghent, Belgium
| | - D Van Tiggelen
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.,Department of Physical Medicine & Rehabilitation, Military Hospital of Base Queen Astrid, Belgian Defence, Brussels, Belgium
| | - M De Muynck
- Department of Physical Medicine and Rehabilitation, Ghent University Hospital, Ghent, Belgium
| | - D De Clercq
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - E Witvrouw
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.,Department of Physiotherapy, Aspetar, Doha, Qatar
| |
Collapse
|
241
|
Williams-Hatala EM, Hatala KG, Hiles S, Rabey KN. Morphology of muscle attachment sites in the modern human hand does not reflect muscle architecture. Sci Rep 2016; 6:28353. [PMID: 27334440 PMCID: PMC4917838 DOI: 10.1038/srep28353] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 05/12/2016] [Indexed: 11/24/2022] Open
Abstract
Muscle attachment sites (entheses) on dry bones are regularly used by paleontologists to infer soft tissue anatomy and to reconstruct behaviors of extinct organisms. This method is commonly applied to fossil hominin hand bones to assess their abilities to participate in Paleolithic stone tool behaviors. Little is known, however, about how or even whether muscle anatomy and activity regimes influence the morphologies of their entheses, especially in the hand. Using the opponens muscles from a sample of modern humans, we tested the hypothesis that aspects of hand muscle architecture that are known to be influenced by behavior correlate with the size and shape of their associated entheses. Results show no consistent relationships between these behaviorally-influenced aspects of muscle architecture and entheseal morphology. Consequently, it is likely premature to infer patterns of behavior, such as stone tool making in fossil hominins, from these same entheses.
Collapse
Affiliation(s)
- E M Williams-Hatala
- Department of Biology, Chatham University, Woodland Road, Pittsburgh, PA 15232, USA.,Center for the Advanced Study of Human Paleobiology, The George Washington University, 800 22nd St., NW, Suite 6000, Washington, DC 20052, USA
| | - K G Hatala
- Center for the Advanced Study of Human Paleobiology, The George Washington University, 800 22nd St., NW, Suite 6000, Washington, DC 20052, USA.,Department of Human Evolution, Max Planck Institute for Evolutionary Anthropology, Deutscher Platz 6, D-04103 Leipzig, Germany
| | - S Hiles
- Department of Biology, Chatham University, Woodland Road, Pittsburgh, PA 15232, USA
| | - K N Rabey
- Department of Anatomy, Midwestern University, 555 31st St., Downers Grove, IL 60515, USA.,Department of Evolutionary Anthropology, Duke University, 104 Biological Sciences Building, Durham, NC 27708, USA
| |
Collapse
|
242
|
Miyakoshi D, Senba H, Shikichi M, Maeda M, Shibata R, Misumi K. A retrospective study of radiographic abnormalities in the repositories of 2-year-old Thoroughbred in-training sales in Japan. J Equine Sci 2016; 27:67-76. [PMID: 27330400 PMCID: PMC4914399 DOI: 10.1294/jes.27.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 04/23/2016] [Indexed: 11/29/2022] Open
Abstract
This study aimed to evaluate the influence of radiographic abnormalities of 2-year-old Thoroughbred horses
that were listed at in-training sales in Japan, on whether they started to race or not at 2–3 years of age.
Radiographs of 850 2-year-old Thoroughbreds in the in-training sales repository from 2007 to 2010 were
reviewed, and 26 categories of radiographic abnormalities were found. Forty-three horses (5.1%, 43/850) did
not start a race at 2–3 years of age. In accordance with the racing results for this age category, as
determined by Fisher’s exact test and multiple logistic regression analysis, none of the radiographic
abnormalities were significantly related to failure to start a race. At 2 years of age, 198 horses (23.3%,
198/850) did not start a race. Horses with enlargement of the proximal sesamoid bones in the fore (9 of 19
horses) and hind limbs (5 of 9 horses) did not start a race at the age of 2 years, and fewer of these horses
(fore, P=0.021; hind, P=0.030) started a race at the age of 2 years compared with the population of horses
without these radiographic abnormalities. These results suggest that identification of radiographic
enlargement of the proximal sesamoid bones during training sales could derail the racing debut of horses at
the age of 2 years. However, this might not necessarily indicate a poor prognosis and resulting in retirement
from racing at 2–3 years of age.
Collapse
Affiliation(s)
| | - Hiroyuki Senba
- The Japan Bloodhorse Breeders' Association, Hokkaido 056-0144, Japan
| | | | - Masaya Maeda
- Hidaka Horse Breeders Association, Hokkaido 056-0002, Japan
| | - Ryo Shibata
- Hidaka Horse Breeders Association, Hokkaido 056-0002, Japan
| | - Kazuhiro Misumi
- Faculty of Veterinary Medicine, Kagoshima University, Kagoshima 890-0065, Japan
| |
Collapse
|
243
|
Huh J, Easley ME, Nunley JA. Characterization and Surgical Management of Achilles Tendon Sleeve Avulsions. Foot Ankle Int 2016; 37:596-604. [PMID: 26843543 DOI: 10.1177/1071100716629778] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND An Achilles sleeve avulsion occurs when the tendon ruptures distally from its calcaneal insertion as a continuous "sleeve." This relatively rare injury pattern may not be appreciated until the time of surgery and can be challenging to treat because, unlike a midsubstance rupture, insufficient tendon remains on the calcaneus to allow for end-to-end repair, and unlike a tuberosity avulsion fracture, any bony element avulsed with the tendon is inadequate for internal fixation. This study aimed to highlight the characteristics of Achilles sleeve avulsions and present the outcomes of operative repair using suture anchor fixation. METHODS A retrospective analysis was conducted on 11 consecutive Achilles tendon sleeve avulsions (10 males, 1 female; mean age 44 years) that underwent operative repair between 2008 and 2014. Patient demographics, injury presentation, and operative details were reviewed. Postoperative outcomes were collected at a mean follow-up of 38.4 (range, 12-83.5) months, including the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot score, visual analog scale (VAS) for pain, plantarflexion strength, patient satisfaction, and complications. RESULTS Eight patients (72.7%) had preexisting symptoms of insertional Achilles disease. Ten of 11 (90.9%) injuries were sustained during recreational athletic activity. An Achilles sleeve avulsion was recognized preoperatively in 7 of 11 (64%) cases, where lateral ankle radiographs demonstrated a small radiodensity several centimeters proximal to the calcaneal insertion. Intraoperatively, 90.9% of sleeve avulsions had a concomitant Haglund deformity and macroscopic evidence of insertional tendinopathy. All patients healed after suture anchor repair. The average AOFAS score was 92.8 and VAS score was 0.9. Ten patients (90.9%) were completely satisfied. One complication occurred, consisting of delayed wound healing. CONCLUSIONS Achilles tendon sleeve avulsions predominantly occurred in middle-aged men with preexisting insertional disease, while engaged in athletic activity. Suture anchor fixation, combined with addressing concomitant insertional pathology, was a reliable and safe technique for the operative management of Achilles tendon sleeve avulsions. The majority of patients returned to their preinjury levels of work and recreational activity. LEVEL OF EVIDENCE Level IV, retrospective case series.
Collapse
Affiliation(s)
- Jeannie Huh
- Department of Orthopaedic Surgery, Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA, USA
| | - Mark E Easley
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - James A Nunley
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| |
Collapse
|
244
|
Borges MCD, Errero TK, Rosa CT, Bernardino GR, Brancalhão RMC, Ribeiro LDFC, Bertolini GRF. Avaliação dos ligamentos longitudinais da coluna de ratos Wistar em modelo experimental da terapia Suit. FISIOTERAPIA E PESQUISA 2016. [DOI: 10.1590/1809-2950/14542923022016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Ligamentos adaptam-se de acordo com a intensidade da atividade física e carga mecânica a que são submetidos. Na última década, na área da fisioterapia neurofuncional infantil, têm surgido métodos e protocolos que possuem em comum o termo suit para caracterizar a existência de vestimentas com bandas elásticas ajustáveis e a possibilidade da aplicação de carga sobre o esqueleto humano. Visto que a carga mecânica pode produzir alterações fibrocartilaginosas sobre os ligamentos e que não foram encontrados estudos avaliando o efeito da terapia suit sobre os ligamentos da coluna, justificam-se pesquisas com métodos experimentais de carga. O objetivo deste trabalho foi analisar as espessuras e morfologia dos ligamentos longitudinais da coluna de ratos Wistar quando submetidos à carga mecânica por compressão vertebral. Trinta animais foram separados em cinco grupos (G1 - controle; G2 - simulação do uso de suit; G3, G4 e G5 - manutenção da vestimenta). Ao modelo experimental do suit, em G4 e G5, foram adaptados pesos ou elásticos dispostos em "X" para sobrecarga vertebral de 50% do peso do animal, que permaneceram com a vestimenta por 40 horas ao longo de 4 semanas de experimento, 5 dias por semana. Não houve diferenças significativas para a espessura, assim como não foram observadas mudanças morfológicas nos ligamentos longitudinais. Conclui-se que não houve alterações nos ligamentos longitudinais da coluna em animais submetidos ao modelo experimental de suit terapia.
Collapse
|
245
|
Johansson K, Lempainen L, Sarimo J, Laitala-Leinonen T, Orava S. Different distributions of operative diagnoses for Achilles tendon overuse injuries in Italian and Finnish athletes. Muscles Ligaments Tendons J 2016; 6:111-5. [PMID: 27331038 DOI: 10.11138/mltj/2016.6.1.111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND the origin of chronic Achilles tendinopathy (AT) is currently unclear and epidemiological factors, such as ethnicity, may be associated. METHODS intraoperative findings from the treatment of 865 Finnish and 156 Italian athletic patients with chronic Achilles tendon related pain were evaluated, retrospectively. The mean age was 34 years (range, 18 to 65 years) in the Finnish and 29 years (range, 17-63 years) in the Italian patients. In total, 786 patients were males and 226 females of which 84 and 87% Finnish, respectively. Data were collected, retrospectively from patient records. The differences in the frequencies of operative findings were assessed for statistical significance. RESULTS retrocalcaneal bursitis, partial tear and chronic paratenonitis were the most prevalent findings in patients with chronic AT undergoing surgery. Tendinosis and chronic paratenonitis were significantly (p=0.011) more common in Finnish athletes. Italian patients exhibited significantly (p<0.001) more insertional calcific tendinopathy (heel spurs) and prominent posterosuperior calcaneal corners (Haglund's heel). CONCLUSION ethnicity appears to be associated with specific characteristics of overuse-related Achilles tendon pathology. This is an issue that should be considered in the planning of genetic research on AT.
Collapse
Affiliation(s)
| | | | | | - Tiina Laitala-Leinonen
- Skeletal Biology Consortium, Department of Cell Biology and Anatomy, University of Turku, Turku, Finland
| | | |
Collapse
|
246
|
Abstract
Groin pain encompasses a number of conditions from the lower abdomen, inguinal region, proximal adductors, hip joint, upper anterior thigh and perineum. The complexity of the anatomy, the heterogeneous terminology and the overlapping symptoms of different conditions that may co-exist epitomise the challenges in diagnosis and treatment. Inguinal-related and adductor-related pain is the most common cause of groin pain and will be discussed in this article.
Collapse
|
247
|
Nelson BB, Kawcak CE, Goodrich LR, Werpy NM, Valdés-Martínez A, McIlwraith CW. COMPARISON BETWEEN COMPUTED TOMOGRAPHIC ARTHROGRAPHY, RADIOGRAPHY, ULTRASONOGRAPHY, AND ARTHROSCOPY FOR THE DIAGNOSIS OF FEMOROTIBIAL JOINT DISEASE IN WESTERN PERFORMANCE HORSES. Vet Radiol Ultrasound 2016; 57:387-402. [DOI: 10.1111/vru.12366] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 01/23/2016] [Accepted: 02/14/2016] [Indexed: 11/26/2022] Open
Affiliation(s)
- Brad B. Nelson
- Gail Holmes Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins CO 80523
| | - Chris E. Kawcak
- Gail Holmes Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins CO 80523
| | - Laurie R. Goodrich
- Gail Holmes Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins CO 80523
| | - Natasha M. Werpy
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville FL 32608
| | - Alejandro Valdés-Martínez
- Department of Environmental and Radiological Health Sciences; Colorado State University; Fort Collins CO 80523
| | - C. Wayne McIlwraith
- Gail Holmes Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins CO 80523
| |
Collapse
|
248
|
Karakostis FA, Lorenzo C. Morphometric patterns among the 3D surface areas of human hand entheses. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2016; 160:694-707. [DOI: 10.1002/ajpa.22999] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 03/20/2016] [Accepted: 04/09/2016] [Indexed: 02/06/2023]
Affiliation(s)
- Fotios Alexandros Karakostis
- Senckenberg Center for Human Evolution and Palaeoenvironments; Eberhard Karls University at Tübingen; Rumelinstrasse 23 Tübingen 72070 Germany
| | - Carlos Lorenzo
- Area de Prehistoria; Universitat Rovira i Virgili; Av. Catalunya 35 Tarragona 43002 Spain
- Institut de Paleoecologia Humana i Evolució Social (IPHES); Campus Sescelades (Edifici W3) Tarragona 43007 Spain
| |
Collapse
|
249
|
Deffontaines JB, Lussier B, Bolliger C, Bédard A, Doré M, Blevins WE. Chronic desmitis and enthesiophytosis of the radio-ulnar interosseous ligament in a dog. THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2016; 57:487-491. [PMID: 27152034 PMCID: PMC4827737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A 10-year-old golden retriever dog was presented for chronic right forelimb lameness associated with a painful swelling at the lateral aspect of the proximal ulna. Proximal ulnar ostectomy and stabilization resulted in a good clinical outcome. The proposed diagnosis is chronic desmitis and enthesiophytosis of the radio-ulnar interosseous ligament.
Collapse
|
250
|
Abstract
Athletic pubalgia, or "sports hernia", represents a constellation of pathologic conditions occurring at and around the pubic symphysis. These injuries are primarily seen in athletes or those involved in athletic activity. In this article, we review the sonographic appearance of the relevant complex anatomy, scanning technique for ultrasound evaluation of athletic pubalgia, and the sonographic appearances of associated pathologic conditions.
Collapse
|