Allograft Bone: What Is the Role of Platelet-Derived Growth Factor in Hindfoot and Ankle Fusions

The Posttraumatic Tarsometatarsal Joints

Tarsometatarsal joint injuries can be painful and debilitating and are most commonly due to direct or indirect trauma. Posttraumatic arthritis is a well-known long-term complication, with incidence as high as 58%. Conservative treatment options include shoe modifications, orthotic inserts, topical or oral anti-inflammatories, and intra-articular corticosteroid injections. There are various joint prep and fixation techniques reported in the literature, many with positive clinical and radiographic outcomes. This article discusses nonoperative and operative management of posttraumatic tarsometatarsal joint arthritis, reviews available literature, and includes the authors' tips and techniques.

An Update on the Clinical Efficacy and Safety of Collagen Injectables for Aesthetic and Regenerative Medicine Applications

Soft tissues diseases significantly affect patients quality of life and usually require targeted, costly and sometimes constant interventions. With the average lifetime increase, a proportional increase of age-related soft tissues diseases has been witnessed. Due to this, the last two decades have seen a tremendous demand for minimally invasive one-step resolutive procedures. Intensive scientific and industrial research has led to the recognition of injectable formulations as a new advantageous approach in the management of complex diseases that are challenging to treat with conventional strategies. Among them, collagen-based products are revealed to be one of the most promising among bioactive biomaterials-based formulations. Collagen is the most abundant structural protein of vertebrate connective tissues and, because of its structural and non-structural role, is one of the most widely used multifunctional biomaterials in the health-related sectors, including medical care and cosmetics. Indeed, collagen-based formulations are historically considered as the "gold standard" and from 1981 have been paving the way for the development of a new generation of fillers. A huge number of collagen-based injectable products have been approved worldwide for clinical use and have routinely been introduced in many clinical settings for both aesthetic and regenerative surgery. In this context, this review article aims to be an update on the clinical outcomes of approved collagen-based injectables for both aesthetic and regenerative medicine of the last 20 years with an in-depth focus on their safety and effectiveness for the treatment of diseases of the integumental, gastrointestinal, musculoskeletal, and urogenital apparatus.

Serum Levels of PDGF, EGF, and sFlt-1 in Patients with Polycystic Ovary Syndrome and Their Predictive Effects on Pregnancy Outcomes

Polycystic ovary syndrome (PCOS) is a neuroendocrine disease with complex etiology characterized by infrequent menstruation, follicular developmental disorders, insulin resistance, and hyperandrogenism. PCOS patients often suffer from anovulatory infertility, and even after successful pregnancy promotion, spontaneous abortion is easy to occur. At present, PCOS is mainly diagnosed by auxiliary examinations such as sex hormones and B ultrasonography, and there is a lack of specific serological markers for the diagnosis of diseases. Similarly, there is a lack of effective evaluation methods for the risk of abortion in PCOS patients. Therefore, it is extremely important to explore the factors that affect the occurrence of abortion in PCOS patients and to find specific indicators that can guide the pregnancy outcome of PCOS patients. The purpose of this study was to investigate the serum levels of platelet-derived growth factor (PDGF), epidermal growth factor (EGF), and soluble fms-like tyrosine kinase-1 (sFlt-1) in PCOS patients and analyze their predictive effects on the pregnancy outcomes of PCOS patients. The results showed that serum PDGF, EGF, and sFlt-1 levels were secreted abnormally in PCOS patients with abortion and were closely related to the pregnancy outcome of PCOS patients. The combination of the three levels has the highest value in predicting the pregnancy outcome of PCOS patients, which is worth promoting.

Epidemiology, Clinical Assessments, and Current Treatments of Nonunions

PURPOSE OF REVIEW

The failure of bony union following a fracture, termed a fracture nonunion, has severe patient morbidity and economic consequences. This review describes current consensuses and future directions of investigation for determining why, detecting when, and effective treatment if this complication occurs.

RECENT FINDINGS

Current nonunion investigation is emphasizing an expanded understanding of the biology of healing. This has led to assessments of the immune environment, multiple cytokines and morphogenetic factors, and the role of skeletogenic stem cells in the development of nonunion. Detecting biological markers and other objective diagnostic criteria is also a current objective of nonunion research. Treatment approaches in the near future will likely be dominated by the development of specific adjunct therapies to the nonunion surgical management, which will be informed by an expanded mechanistic understanding of nonunion biology. Current consensus among orthopedists is that improved diagnosis and treatment of nonunion hinges first on discoveries at the bench side with later translation to the clinic.

The role of biologic in foot and ankle trauma-a review of the literature

PURPOSE OF REVIEW

The use of biologics in orthopedics is becoming increasingly popular as an adjuvant in healing musculoskeletal injuries. Though many biologics involved in the management of foot and ankle injuries are used based on physician preference, reports of improved outcomes when combined with standard operative treatment has led to further clinical interest especially in foot and ankle trauma.

RECENT FINDINGS

The most recent studies have shown benefits for biologic use in patients predisposed to poor bone and soft tissue healing. Biologics have shown benefit in treating soft tissue injuries such as Achilles ruptures as well as the complications of trauma such as non-unions and osteoarthritis. Biologics have shown some benefit in improving functional and pain scores, as well as reducing time to heal in foot and ankle traumatic injuries, with particular success shown with patients that have risk factors for poor healing. As the use of biologics continues to increase, there is a need for high-level studies to confirm early findings of lower level reports.