Radiofrequency energy on cortical bone and soft tissue: a pilot study

Variable Range Hopping in SrTiO3-Ca10(PO4)6(OH)2 Bio-Ceramic Composites

We investigate the electrical properties in ceramics, focusing primarily on the conductivity mechanisms crucial to bio-electrets' service life. A biocompatible ceramic composite of varying concentrations of SrTiO₃ (ST) and Ca₁₀(PO₄)₆(OH)₂ (HAP) is developed. By X-ray diffraction, we establish the microstructural and phase evolution of the bio-composites. The crystallite sizes are found to increase with the increasing concentration of ST in the composites. The composites' micrograph reveals the presence of pores, and the grain sizes calculated from it are found to follow a trend similar to the crystallite size. The conduction mechanisms in the composites are studied to explore the composites' electrical properties from the perspective of biological applications. The conductivity is very low (≃10^-8 S/cm), and the porous structure of the composites revealed from the micrographs is one of the factors for such low conductivity. From a plethora of conduction mechanisms, Motts' variable range hopping (VRH) conduction is projected as the most appropriate mechanism that appropriately describes the conduction process in the composites. Motts' VRH is also related to the polarization mechanism associated with the development of electrets. Our study points toward the practical potential of applying the designed bio-composites in generating bio-electrets or understanding the electrical properties that are at the forefront of research in designing electro-active smart scaffolds for bone tissue engineering applications.

Shoulder Stiffness: Current Concepts and Concerns

Shoulder stiffness can be caused by various etiologies such as immobilization, trauma, or surgical interventions. The Upper Extremity Committee of ISAKOS defined the term "frozen shoulder" as idiopathic stiff shoulder, that is, without a known cause. Secondary stiff shoulder is a term that should be used to describe shoulder stiffness with a known cause. The pathophysiology of frozen shoulder is capsular fibrosis and inflammation with chondrogenesis, but the cause is still unknown. Conservative treatment is the primary choice. Pain control by oral medication, intra-articular injections with or without joint distension, and physical therapy are commonly used. In cases with refractory stiffness, manipulation under anesthesia or arthroscopic capsular release may be indicated. Because of various potential risks of complications with manipulations, arthroscopic capsular release is preferred. After the capsular release, stepwise rehabilitation is mandatory to achieve satisfactory outcome.

LEVEL OF EVIDENCE

Level V, evidence-based review.

Primary Frozen Shoulder Syndrome: Arthroscopic Capsular Release

Idiopathic adhesive capsulitis, or primary frozen shoulder syndrome, is a fairly common orthopaedic problem characterized by shoulder pain and loss of motion. In most cases, conservative treatment (6-month physical therapy program and intra-articular steroid injections) improves symptoms and restores shoulder motion. In refractory cases, arthroscopic capsular release is indicated. This surgical procedure carries several advantages over other treatment modalities. First, it provides precise and controlled release of the capsule and ligaments, reducing the risk of traumatic complications observed after forceful shoulder manipulation. Second, release of the capsule and the involved structures with a radiofrequency device delays healing, which prevents adhesion formation. Third, the technique is straightforward, and an oral postoperative steroid program decreases pain and allows for a pleasant early rehabilitation program. Fourth, the procedure is performed with the patient fully awake under an interscalene block, which boosts the patient's confidence and adherence to the physical therapy protocol. In patients with refractory primary frozen shoulder syndrome, arthroscopic capsular release emerges as a suitable option that leads to a faster and long-lasting recovery.