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Alhaskawi A, Zhou H, Dong Y, Ezzi SHA, Zou X, Weijie Z, Yi F, Abdalbary SA, Lu H. Extensor tendon rupture and preoperative mri confirmations of suture anchor prolapse: a case report and literature review. BMC Musculoskelet Disord 2024; 25:355. [PMID: 38704523 PMCID: PMC11069161 DOI: 10.1186/s12891-024-07476-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 04/26/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND While suture anchors are widely used in medical procedures for their advantages, they can sometimes lead to complications, including anchor prolapse. This article presents a unique case of suture anchor prolapse at the base of the distal phalanx of the little finger after extensor tendon rupture reconstruction surgery. CASE PRESENTATION A 35-year-old male, underwent extensor tendon rupture reconstruction using a non-absorbable suture anchor. After seven years the patient visited our outpatients complaining of stiffness, pain, and protrusion at the surgical site. Initial X-ray imaging suggested suggesting either a fracture of the distal phalanx or tendon adhesion but lacked a definitive diagnosis. Subsequent magnetic resonance imaging (MRI) revealed bone connectivity between the middle and distal phalanges with irregular signal shadow and unclear boundaries while maintaining a regular finger shape. MRI proved superior in diagnosing prolapsed suture anchors, marking the first reported case of its kind. Surgical intervention confirmed MRI findings. CONCLUSIONS Suture anchor complications, such as prolapse, are a concern in medical practice. This case underscores the significance of MRI for accurate diagnosis and the importance of tailored surgical management in addressing this uncommon complication.
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Affiliation(s)
- Ahmad Alhaskawi
- Department of Orthopedics, The First Affiliated Hospital, Zhejiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province, 310003, P. R. China
| | - Haiying Zhou
- Department of Orthopedics, The First Affiliated Hospital, Zhejiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province, 310003, P. R. China
| | - Yanzhao Dong
- Department of Orthopedics, The First Affiliated Hospital, Zhejiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province, 310003, P. R. China
| | - Sohaib Hasan Abdullah Ezzi
- Department of Orthopedics of the Third Xiangya Hospital, Central South University, Tongzipo Rd, Changsha, Hunan, 410083, China
| | - Xiaodi Zou
- The Second Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Province, 310003, Hangzhou, P. R. China
| | - Zhou Weijie
- Department of Orthopaedics, Joint Service Assurance Force 903 Hospital, Airport Road, Shangcheng District, Hangzhou City, Zhejiang Province, 310053, P.R. China
| | - Fangyu Yi
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, #548 Binwen Road, Hangzhou, Zhejiang Province, 310053, P.R. China
| | - Sahar Ahmed Abdalbary
- Department of Orthopedic Physical Therapy, Faculty of Physical Therapy, Nahda University in Beni Suef, Beni Suef, Egypt.
| | - Hui Lu
- Department of Orthopedics, The First Affiliated Hospital, Zhejiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province, 310003, P. R. China.
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Chen JS, Paksima N, Rocks MC, Lin CC, Catalano LW. Osteolysis Following the Use of Polyetheretherketone Suture Anchors in Hand and Wrist Surgery: A Preliminary Study. J Hand Surg Am 2023:S0363-5023(23)00304-0. [PMID: 37542497 DOI: 10.1016/j.jhsa.2023.05.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 05/14/2023] [Accepted: 05/31/2023] [Indexed: 08/07/2023]
Abstract
PURPOSE The objective of this study was to investigate and describe the presence of osteolysis after implantation of polyetheretherketone (PEEK) suture anchors in the hand and wrist. METHODS Patients who underwent hand or wrist surgery using PEEK suture anchor(s) at a large academic institution from January 2019 to January 2021 were identified. Patients without accessible intraoperative fluoroscopic imaging were excluded. Patient demographics, type of procedure, and suture anchor material were recorded. The suture anchor tunnel size was measured on sequential radiographs and recorded as percentage change. Descriptive statistics were used to summarize findings. RESULTS A total of 26 PEEK suture anchors in 14 patients were included, with an average follow-up of 12.0 months (range, 1.5-24.1 months). Twenty-seven percent of the anchors (7/26) demonstrated osteolysis at final follow-up, as defined by enlargement of tunnel size by >30%. In all anchors, the tunnel size increased by 19.1% on average (range, -7.7% to 56.1%) by final follow-up. CONCLUSIONS Polyetheretherketone suture anchors may be associated with the development of osteolysis in hand and wrist surgery. The clinical implications of osteolysis in the smaller bones of the hand and wrist remain unclear. TYPE OF STUDY/LEVEL OF EVIDENCE Prognostic IV.
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Affiliation(s)
- Jeffrey S Chen
- Department of Orthopedic Surgery, New York University Langone Orthopedic Hospital, NYU Langone Health, New York, NY.
| | - Nader Paksima
- Department of Orthopedic Surgery, New York University Langone Orthopedic Hospital, NYU Langone Health, New York, NY
| | - Madeline C Rocks
- Department of Orthopedic Surgery, New York University Langone Orthopedic Hospital, NYU Langone Health, New York, NY
| | - Charles C Lin
- Department of Orthopedic Surgery, New York University Langone Orthopedic Hospital, NYU Langone Health, New York, NY
| | - Louis W Catalano
- Department of Orthopedic Surgery, New York University Langone Orthopedic Hospital, NYU Langone Health, New York, NY; Department of Orthopedic Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO
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Rivera P, Villegas C, Cabezas R, Pérez B, Torres A, de Dicastillo CL, Garrido L, Galvez P, Araya C, Romero J. Development of PLA suture materials by extrusion, electrospinning and supercritical CO2 impregnation of ibuprofen and naproxen. J Supercrit Fluids 2023. [DOI: 10.1016/j.supflu.2023.105854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Li X, Lin Y, Liu M, Meng L, Li C. A review of research and application of polylactic acid composites. J Appl Polym Sci 2022. [DOI: 10.1002/app.53477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Xiangrui Li
- Key Laboratory of Wood Materials Science and Engineering, School of Materials Science and Engineering Beihua University Jilin China
| | - Yu Lin
- Key Laboratory of Wood Materials Science and Engineering, School of Materials Science and Engineering Beihua University Jilin China
| | - Mingli Liu
- Key Laboratory of Wood Materials Science and Engineering, School of Materials Science and Engineering Beihua University Jilin China
| | - Lipeng Meng
- Forestry Resource Utilization Institute Jilin Forestry Scientific Research Institute Jilin China
| | - Chunfeng Li
- Key Laboratory of Wood Materials Science and Engineering, School of Materials Science and Engineering Beihua University Jilin China
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De Vitis R, Passiatore M, Cilli V, Lazzerini A, Marzella L, Taccardo G. Feasibility of Homodigital Flexor Digitorum Superficialis transposition, a new technique for A2-C1 pulleys reconstruction: A kinematic cadaver study. J Orthop 2020; 21:483-486. [PMID: 32982105 PMCID: PMC7498708 DOI: 10.1016/j.jor.2020.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/06/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Homodigital flexor digitorum superficialis transposition (HFT) is proposed as a new technique for A2-C1 pulley reconstruction. Flexor digitorum superficialis is transposed on the proximal phalanx and inserted on the pulley rims, crossing over flexor digitorum profundus and acting as a pulley. MATERIALS AND METHODS The kinematic feasibility was investigated in a cadaveric bowstring model (after A2 and C1 pulley removal) on 22 fingers (thumb excluded). RESULTS HFT was effective in restoring the correct flexion of proximal and distal interphalangeal joints, compared to bowstring model. No adverse events were registered. CONCLUSION HFT is a feasible technique. Clinical application is encouraged.
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Affiliation(s)
- Rocco De Vitis
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Del Sacro Cuore, Istituto di Clinica Ortopedica, Roma, Italy
| | - Marco Passiatore
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Istituto di Clinica Ortopedica, Italy
| | - Vitale Cilli
- Chirurgie de La Main, CHIREC Site Delta, Bruxelles, Belgium
| | | | | | - Giuseppe Taccardo
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Del Sacro Cuore, Istituto di Clinica Ortopedica, Roma, Italy
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Liu S, Yu J, Li H, Wang K, Wu G, Wang B, Liu M, Zhang Y, Wang P, Zhang J, Wu J, Jing Y, Li F, Zhang M. Controllable Drug Release Behavior of Polylactic Acid (PLA) Surgical Suture Coating with Ciprofloxacin (CPFX)-Polycaprolactone (PCL)/Polyglycolide (PGA). Polymers (Basel) 2020; 12:E288. [PMID: 32024179 PMCID: PMC7077375 DOI: 10.3390/polym12020288] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 01/28/2020] [Accepted: 01/30/2020] [Indexed: 02/07/2023] Open
Abstract
Polylactic acid (PLA) surgical suture can be absorbed by human body. In order to avoid surgical site infections (SSIs), the drug is usually loaded on the PLA suture, and then the drug can release directly to the wound. Because the different types of wounds heal at different times, it is needed to control the drug release rate of PLA suture to consistent to the wound healing time. Two biopolymers, polyglycolide (PGA) and polycaprolactone (PCL), were selected as the carrier of ciprofloxacin (CPFX) drug, and then the CPFX-PCL/PGA was coated on the PLA suture. The degradation rate of drug-carrier can be controlled by adjusting the proportion of PCL/PGA, which can regulate the rate of CPFX drug release from PLA suture. The results show that the surface of PLA suture, coating with PCL/PGA, was very rough, which led to increased stitching resistance when we were suturing the wound. These materials, such as the PLA suture, the PCL/PGA carriers and the CPFX drug, were just physically mixed rather than chemically reacted, which was very useful for ensuring the original efficacy of CPFX drug. With the increasing of PCL in the carriers, both the breaking strength and elongation of these un-degraded sutures increased. During degradation, the breaking strength of all sutures gradually decreased, and the more PCL in the coating materials, the longer effective strength-time for the suture. With the increasing of PCL in the drug-carrier, the rate of drug releasing became lower. The drug release mechanism of CPFX-PCL/PGA was a synergistic effect of drug diffusion and PCL/PGA carrier dissolution.
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Affiliation(s)
- Shuqiang Liu
- College of Textile Engineering, Taiyuan University of Technology, Taiyuan 030024, China; (J.Y.); (H.L.); (K.W.); (B.W.); (M.L.); (Y.Z.); (P.W.); (J.Z.); (J.W.); (Y.J.); (F.L.); (M.Z.)
- Biomedical Textile Laboratory, Taiyuan University of Technology, Jinzhong 030600, China
| | - Juanjuan Yu
- College of Textile Engineering, Taiyuan University of Technology, Taiyuan 030024, China; (J.Y.); (H.L.); (K.W.); (B.W.); (M.L.); (Y.Z.); (P.W.); (J.Z.); (J.W.); (Y.J.); (F.L.); (M.Z.)
| | - Huimin Li
- College of Textile Engineering, Taiyuan University of Technology, Taiyuan 030024, China; (J.Y.); (H.L.); (K.W.); (B.W.); (M.L.); (Y.Z.); (P.W.); (J.Z.); (J.W.); (Y.J.); (F.L.); (M.Z.)
| | - Kaiwen Wang
- College of Textile Engineering, Taiyuan University of Technology, Taiyuan 030024, China; (J.Y.); (H.L.); (K.W.); (B.W.); (M.L.); (Y.Z.); (P.W.); (J.Z.); (J.W.); (Y.J.); (F.L.); (M.Z.)
| | - Gaihong Wu
- College of Textile Engineering, Taiyuan University of Technology, Taiyuan 030024, China; (J.Y.); (H.L.); (K.W.); (B.W.); (M.L.); (Y.Z.); (P.W.); (J.Z.); (J.W.); (Y.J.); (F.L.); (M.Z.)
| | - Bowen Wang
- College of Textile Engineering, Taiyuan University of Technology, Taiyuan 030024, China; (J.Y.); (H.L.); (K.W.); (B.W.); (M.L.); (Y.Z.); (P.W.); (J.Z.); (J.W.); (Y.J.); (F.L.); (M.Z.)
| | - Mingfang Liu
- College of Textile Engineering, Taiyuan University of Technology, Taiyuan 030024, China; (J.Y.); (H.L.); (K.W.); (B.W.); (M.L.); (Y.Z.); (P.W.); (J.Z.); (J.W.); (Y.J.); (F.L.); (M.Z.)
| | - Yao Zhang
- College of Textile Engineering, Taiyuan University of Technology, Taiyuan 030024, China; (J.Y.); (H.L.); (K.W.); (B.W.); (M.L.); (Y.Z.); (P.W.); (J.Z.); (J.W.); (Y.J.); (F.L.); (M.Z.)
| | - Peng Wang
- College of Textile Engineering, Taiyuan University of Technology, Taiyuan 030024, China; (J.Y.); (H.L.); (K.W.); (B.W.); (M.L.); (Y.Z.); (P.W.); (J.Z.); (J.W.); (Y.J.); (F.L.); (M.Z.)
| | - Jie Zhang
- College of Textile Engineering, Taiyuan University of Technology, Taiyuan 030024, China; (J.Y.); (H.L.); (K.W.); (B.W.); (M.L.); (Y.Z.); (P.W.); (J.Z.); (J.W.); (Y.J.); (F.L.); (M.Z.)
| | - Jie Wu
- College of Textile Engineering, Taiyuan University of Technology, Taiyuan 030024, China; (J.Y.); (H.L.); (K.W.); (B.W.); (M.L.); (Y.Z.); (P.W.); (J.Z.); (J.W.); (Y.J.); (F.L.); (M.Z.)
| | - Yifan Jing
- College of Textile Engineering, Taiyuan University of Technology, Taiyuan 030024, China; (J.Y.); (H.L.); (K.W.); (B.W.); (M.L.); (Y.Z.); (P.W.); (J.Z.); (J.W.); (Y.J.); (F.L.); (M.Z.)
| | - Fu Li
- College of Textile Engineering, Taiyuan University of Technology, Taiyuan 030024, China; (J.Y.); (H.L.); (K.W.); (B.W.); (M.L.); (Y.Z.); (P.W.); (J.Z.); (J.W.); (Y.J.); (F.L.); (M.Z.)
- Biomedical Textile Laboratory, Taiyuan University of Technology, Jinzhong 030600, China
| | - Man Zhang
- College of Textile Engineering, Taiyuan University of Technology, Taiyuan 030024, China; (J.Y.); (H.L.); (K.W.); (B.W.); (M.L.); (Y.Z.); (P.W.); (J.Z.); (J.W.); (Y.J.); (F.L.); (M.Z.)
- Biomedical Textile Laboratory, Taiyuan University of Technology, Jinzhong 030600, China
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Abstract
Bone tissue engineering is currently a mature methodology from a research perspective. Moreover, modeling and simulation of involved processes and phenomena in BTE have been proved in a number of papers to be an excellent assessment tool in the stages of design and proof of concept through in-vivo or in-vitro experimentation. In this paper, a review of the most relevant contributions in modeling and simulation, in silico, in BTE applications is conducted. The most popular in silico simulations in BTE are classified into: (i) Mechanics modeling and scaffold design, (ii) transport and flow modeling, and (iii) modeling of physical phenomena. The paper is restricted to the review of the numerical implementation and simulation of continuum theories applied to different processes in BTE, such that molecular dynamics or discrete approaches are out of the scope of the paper. Two main conclusions are drawn at the end of the paper: First, the great potential and advantages that in silico simulation offers in BTE, and second, the need for interdisciplinary collaboration to further validate numerical models developed in BTE.
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Liu S, Wu G, Chen X, Zhang X, Yu J, Liu M, Zhang Y, Wang P. Degradation Behavior In Vitro of Carbon Nanotubes (CNTs)/Poly(lactic acid) (PLA) Composite Suture. Polymers (Basel) 2019; 11:polym11061015. [PMID: 31181799 PMCID: PMC6630379 DOI: 10.3390/polym11061015] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/05/2019] [Accepted: 06/05/2019] [Indexed: 12/20/2022] Open
Abstract
Poly(lactic acid) (PLA) suture can be absorbed by the human body, and so have wide applications in modern surgery operations. The degradation period of PLA suture is expected to meet with the healing time of different types of wounds. In order to control the degradation period of the PLA suture, the carbon nanotubes (CNTs) were composited with PLA suture, and the degradation experiment in vitro was performed on sutures. The structure and properties of sutures during degradation, such as surface morphology, breaking strength, elongation, mass and chemical structure, were tracked and analyzed. The results indicated that the degradation brought about surface defects and resulted in 13.5 weeks for the strength valid time of the original PLA suture. By contrast, the strength valid time of the CNTs/PLA suture was increased to 26.6 weeks. Whilst the toughness of both the pure PLA and CNTs/PLA sutures decreased rapidly and almost disappeared after 3 to 4 weeks of degradation. The mass loss demonstrated that the time required for complete degradation of the two sutures was obviously different, the pure PLA suture 49 weeks, while CNTs/PLA sutures 63 to 73 weeks. The research proved that CNTs delayed PLA degradation and prolonged its strength valid time in degradation.
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Affiliation(s)
- Shuqiang Liu
- College of Textile Engineering, Taiyuan University of Technology, Taiyuan 030024, China.
| | - Gaihong Wu
- College of Textile Engineering, Taiyuan University of Technology, Taiyuan 030024, China.
| | - Xiaogang Chen
- School of Materials, The University of Manchester, Manchester M13 9PL, UK.
| | - Xiaofang Zhang
- College of Textile Engineering, Taiyuan University of Technology, Taiyuan 030024, China.
| | - Juanjuan Yu
- College of Textile Engineering, Taiyuan University of Technology, Taiyuan 030024, China.
| | - Mingfang Liu
- College of Textile Engineering, Taiyuan University of Technology, Taiyuan 030024, China.
| | - Yao Zhang
- College of Textile Engineering, Taiyuan University of Technology, Taiyuan 030024, China.
| | - Peng Wang
- College of Textile Engineering, Taiyuan University of Technology, Taiyuan 030024, China.
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Ling Z, Wu L, Shi G, Chen L, Dong Q. Increased Runx2 expression associated with enhanced Wnt signaling in PDLLA internal fixation for fracture treatment. Exp Ther Med 2017; 13:2085-2093. [PMID: 28565812 DOI: 10.3892/etm.2017.4216] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 11/10/2016] [Indexed: 01/19/2023] Open
Abstract
Poly-D-L lactide (PDLLA) biodegradable implants to heal fractures are widely applied in orthopedic surgeries. However, whether the process of fracture healing is regulated differently when PDLLA is used compared with traditional metal materials remains unclear. Runt-related transcription factor 2 (Runx2) and canonical Wnt signaling are essential and may interact reciprocally in the regulation of osteogenesis during bone repair. In the present study, a rat femoral open osteotomy model was used to compare the curative efficacy of a PDLLA rod and Kirschner wire under intramedullary fixation for fracture treatment. The dynamic expression of Runx2 and key components of the canonical Wnt signaling in callus tissue during fracture healing was also investigated. The results of the current study indicate that at weeks 4 and 6 following fixation, the callus bone structural parameters of microCT were significantly improved by PDLLA rod compared to that of Kirschner wire. In addition, at weeks 4 and 6 after fixation, the protein and mRNA expression of Runx2 and the positive regulators of canonical Wnt signaling, such as Wnts and β-catenin, were significantly increased. However, the protein and mRNA expression levels of the negative regulators of canonical Wnt signaling, such as glycogen synthase kinase-3β, were significantly decreased in callus tissue when treated with PDLLA rod compared with Kirschner wire. Collectively, these data indicate that compared to the traditional metal material, using PDLLA internal fixation for fracture treatment may further improve bone formation, which is associated with the increased expression of Runx2 and the enhancement of canonical Wnt signaling.
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Affiliation(s)
- Zhuoyan Ling
- Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Lei Wu
- Centers for Disease Control and Prevention of Suzhou Industrial Park, Suzhou, Jiangsu 215021, P.R. China.,School of Biology and Basic Medical Sciences, Soochow University, Suzhou, Jiangsu 215123, P.R. China
| | - Gaolong Shi
- Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Li Chen
- Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Qirong Dong
- Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
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Tucker JJ, Gordon JA, Zanes RC, Zuskov A, Vinciguerra JD, Bloebaum RD, Soslowsky LJ. P 2 porous titanium implants improve tendon healing in an acute rat supraspinatus repair model. J Shoulder Elbow Surg 2017; 26:529-535. [PMID: 27751717 DOI: 10.1016/j.jse.2016.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 08/01/2016] [Accepted: 09/07/2016] [Indexed: 02/01/2023]
Abstract
BACKGROUND Current techniques in rotator cuff repair often lack structural integrity. P2 porous titanium-coated constructs (DJO Surgical, Austin, TX, USA) promote osseointegration and soft tissue ingrowth. This study examined the ability of this material to improve the structural integrity of supraspinatus tendon repair in a rat model. We hypothesized that P2 implants placed at the tendon-to-bone interface would improve mechanical and histologic measures of supraspinatus healing. METHODS Forty rats underwent supraspinatus repairs with P2 implants in 1 shoulder and standard repair in the other. Rats were humanely killed at time 0 (n = 3), 2 weeks (n = 8), 4 weeks (n = 15), and 12 weeks (n = 14). Tendon-to-bone composite specimens were harvested and evaluated mechanically and histologically. RESULTS Tendon cross-sectional area was decreased in the P2 implant group at 4 weeks, percentage of relaxation was increased at 2 weeks, elastic modulus was increased at 4 weeks, and maximum load and maximum stress were both increased at 2 and 4 weeks. Histologic analysis revealed no foreign body reactions within or around the P2 implant, and healthy viable bone was visible within the P2 implant. CONCLUSION The results support our hypothesis, specifically in early healing, in this randomized controlled animal study. These data support the use of P2 porous titanium implants to improve tendon-to-bone healing.
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Affiliation(s)
- Jennica J Tucker
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA
| | - Joshua A Gordon
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA
| | - Robert C Zanes
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA
| | - Andrey Zuskov
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Roy D Bloebaum
- Departments of Bioengeering, Biology, and Orthopaedics, University of Utah, Salt Lake City, UT, USA; Bone and Joint Research Laboratory, Department of Veterans Affairs, Salt Lake City, UT, USA
| | - Louis J Soslowsky
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA.
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Zaidenberg EE, Roitman P, Gallucci GL, Boretto JG, De Carli P. Foreign-Body Reaction and Osteolysis in Dorsal Lunate Dislocation Repair With Bioabsorbable Suture Anchor. Hand (N Y) 2016; 11:368-371. [PMID: 27698643 PMCID: PMC5030865 DOI: 10.1177/1558944715627632] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: In recent years the use of biodegradable suture anchors for treating tendon and ligament pathology in hand surgery became popular. These materials are biocompatible, radiolucent, and load sharing, as they incrementally transfer load to surrounding bone during the resorption process. Despite these numerous advantages, polyglycolic (PGA) and poly-L-lactic acid (PLLA) have become a problem because of the potential risk for foreign body reactions. Methods: This article presents a case of an intraosseous foreign body reaction and massive osteolysis of the proximal carpal after dorsal lunate dislocation repair with bioabsorbable suture anchors. Results: Because of the persistent pain and the decreased strength, a proximal row carpectomy was performed 12-months after the initial trauma. Conclusions: Hand surgeons should be aware of the possibility of a late foreign body reaction, that could be especially severe in carpal bones.
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Affiliation(s)
- Ezequiel Ernesto Zaidenberg
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina,Ezequiel Ernesto Zaidenberg, Instituto de Ortopedia y Traumatología “Carlos E. Ottolenghi,” Hospital Italiano de Buenos Aires, Potosí 4215 (C1199ACK), Buenos Aires, Argentina.
| | - Pablo Roitman
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | | | - Pablo De Carli
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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12
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The Second Look after Fights: Why Wounds Might Not Only Be Superficial. Case Rep Emerg Med 2016; 2016:9063621. [PMID: 27073703 PMCID: PMC4814675 DOI: 10.1155/2016/9063621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 02/29/2016] [Indexed: 11/20/2022] Open
Abstract
Introduction. We present a case of intraosseous foreign body penetration due to knife attack and its emergency service management. Case. Seventeen-year-old patient was admitted to the emergency department with a knife cut over the right knee. In the local wound exploration during the extension position of the knee, deep tissue penetration was not observed. Therefore, the patient was discharged after a primary wound saturation without any radiographic evaluation. During the second admission, the detailed anamnesis revealed that the injury occurred while the knee was in the flexion and the radiographic examination displayed a broken knifepoint in the sagittal plane of the femur's medial patellar region penetrated in the intraosseous tissue. Conclusion. Intraosseous foreign body cases due to the knife attacks are quite rare. There is no algorithm, indicating the necessity of radiographic examination in the stab wounds. Local wound exploration of stab wounds should be done in accordance with the mechanism of injury.
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An Unusual Metallic Foreign Body inside the Knee Medial Femoral Condyle. Case Rep Orthop 2014; 2014:849020. [PMID: 25506452 PMCID: PMC4259144 DOI: 10.1155/2014/849020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 11/12/2014] [Indexed: 11/18/2022] Open
Abstract
Foreign bodies in the knee joint are uncommon, particularly those not related to surgical procedures. In this paper, we present a case of an intraosseous metallic foreign body situated in the medial femoral condyle for one year, causing pain, which was removed with complete resolution of the symptoms.
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Trindade R, Albrektsson T, Tengvall P, Wennerberg A. Foreign Body Reaction to Biomaterials: On Mechanisms for Buildup and Breakdown of Osseointegration. Clin Implant Dent Relat Res 2014; 18:192-203. [DOI: 10.1111/cid.12274] [Citation(s) in RCA: 238] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Ricardo Trindade
- Department of Prosthodontics; Faculty of Odontology; Malmö University; Malmö Sweden
| | - Tomas Albrektsson
- Department of Biomaterials; Institute of Clinical Sciences; Göteborg University; Göteborg Sweden
- Department of Prosthodontics; Faculty of Odontology; Malmö University; Malmö Sweden
| | - Pentti Tengvall
- Department of Biomaterials; Institute of Clinical Sciences; Göteborg University; Göteborg Sweden
| | - Ann Wennerberg
- Head of Department of Prosthodontics; Faculty of Odontology; Malmö University; Malmö Sweden
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Forli A, Corcella D, Semere A, Mesquida V, Moutet F. [Management of zone 1 flexor digitorum profundus tendon injuries]. ACTA ACUST UNITED AC 2014; 33 Suppl:S13-27. [PMID: 24837520 DOI: 10.1016/j.main.2014.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 02/28/2014] [Accepted: 03/06/2014] [Indexed: 11/27/2022]
Abstract
Flexor tendons repair in zone 1 is classically considered providing good results with an overall satisfactory finger function. However, the objective functional results after surgical repair of flexor digitorum profundus are sometimes disappointing. The authors describe the different surgical repair techniques available to the operator from so-called "traditional" sutures to newer methods of internal fixation using miniaturized anchor sutures. The management of postoperative procedures, that of failures and old cases are reported.
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Affiliation(s)
- A Forli
- Clinique de chirurgie de la main et des brûlés, hôpital Albert-Michallon, CHU de Grenoble, 38243 Grenoble cedex 9, France.
| | - D Corcella
- Clinique de chirurgie de la main et des brûlés, hôpital Albert-Michallon, CHU de Grenoble, 38243 Grenoble cedex 9, France
| | - A Semere
- Clinique de chirurgie de la main et des brûlés, hôpital Albert-Michallon, CHU de Grenoble, 38243 Grenoble cedex 9, France
| | - V Mesquida
- Clinique de chirurgie de la main et des brûlés, hôpital Albert-Michallon, CHU de Grenoble, 38243 Grenoble cedex 9, France
| | - F Moutet
- Clinique de chirurgie de la main et des brûlés, hôpital Albert-Michallon, CHU de Grenoble, 38243 Grenoble cedex 9, France
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Induction of bone ingrowth with a micropore bioabsorbable suture anchor in rotator cuff tear: an experimental study in a rabbit model. J Shoulder Elbow Surg 2013; 22:1558-66. [PMID: 23571082 DOI: 10.1016/j.jse.2013.01.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 01/17/2013] [Accepted: 01/30/2013] [Indexed: 02/01/2023]
Abstract
BACKGROUND The bioabsorbable suture anchor is probably one of the most commonly used tools in arthroscopic shoulder operations. However, there is controversy about whether the bioabsorbable anchor is replaced by bone. The object of this study is to evaluate bone ingrowth into the micropore bioabsorbable suture anchor and the differences in the biomechanical properties of a micropore anchor and a nonpore anchor. MATERIALS AND METHODS A total of 16 microsized holes (diameter, 250 ± 50 μm; depth, 0.2 mm) were made on the bioabsorbable anchors with a microdrill. Twelve adult New Zealand White rabbits were randomly divided into two groups: group A (n = 6), the nonpore bioabsorbable suture anchor group, and group pA (n = 6), the micropore bioabsorbable suture anchor group. Microcomputed tomography was used at 4 and 8 weeks postoperatively to evaluate ingrowth by bone volume fraction (BVF), which was measured by calculating the ratio of the total volume of bone ingrowth to that of the region of interest. For pullout strength testing, 3 additional rabbits (6 limbs) were used for mechanical testing. RESULTS The mean BVF was higher in group pA (0.288 ± 0.054) than in group A (0.097 ± 0.006). The micropore anchor had a higher pullout strength (0.520 ± 0.294 N) than the nonpore anchor (0.275 ± 0.064 N). CONCLUSION Micropore bioabsorbable suture anchors induced bone ingrowth and showed higher pullout strength, despite processing.
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Comparison of in vitro motion and stability between techniques for index metacarpophalangeal joint radial collateral ligament reconstruction. J Hand Surg Am 2013; 38:1324-30. [PMID: 23747165 PMCID: PMC3755456 DOI: 10.1016/j.jhsa.2013.03.048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 03/25/2013] [Accepted: 03/25/2013] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate a technique using interference screws to secure a tendon graft for reconstruction of the radial collateral ligament (RCL) of the index finger metacarpophalangeal (MCP) joint. We hypothesized that this technique would provide equivalent stability and flexion as a 4-tunnel reconstruction. METHODS We isolated the RCL in 17 cadaveric index fingers. A cyclic load was applied to the intact RCL across the MCP joint to assess flexion, ulnar deviation at neutral (UD 0), and ulnar deviation at 90° of MCP joint flexion (UD 90). The RCL was excised from its bony origin and insertion. We performed each reconstruction (4-tunnel and interference screw) sequentially on each specimen in a randomized order using a palmaris longus tendon graft. We repeated testing after each reconstruction and compared differences from the intact state between techniques using paired t-tests for all joint positions (flexion/UD 0/UD 90). RESULTS There was no statistically significant difference in UD 0 or UD 90 between the intact state and after interference screw reconstruction. Compared with the intact state, there was significantly less UD 0 and significantly more UD 90 after 4-tunnel reconstruction. There was no statistically significant difference between techniques when we compared changes in -UD 0 or UD 90. Change in flexion was statistically significantly different, which indicates that the interference screw technique better replicated intact MCP joint flexion compared with the 4-tunnel technique. CONCLUSIONS Interference screw reconstruction of the index RCL provides stability comparable to 4-tunnel reconstruction and is less technically challenging. These results substantiate our clinical experience that the interference screw technique provides an optimal combination of stability and flexion at the index MCP joint. CLINICAL RELEVANCE Using an interference screw to reconstruct the index RCL is less challenging than 4-tunnel reconstruction and provides stability and range of motion that closely resemble the native MCP joint.
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Semere A, Forli A, Corcella D, Mesquida V, Loret M, Moutet F. Réaction à corps étranger dans les rhizarthroses traitées par trapézectomie et interposition d’un « anchois » en acide L-polylactique (Arex®615R). À propos de huit cas. ACTA ACUST UNITED AC 2013; 32:161-8. [DOI: 10.1016/j.main.2013.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 03/18/2013] [Accepted: 03/23/2013] [Indexed: 11/26/2022]
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Abstract
Flexor pulley reconstruction is a challenging surgery. Injuries often occur after traumatic lacerations or forceful extension applied to an acutely flexed finger. Surgical treatment is reserved for patients with multiple closed pulley ruptures, persistent pain, or dysfunction after attempted nonoperative management of a single pulley rupture, or during concurrent or staged flexor tendon repair or reconstruction. If the pulley cannot be repaired primarily, pulley reconstruction can be performed using graft woven into remnant pulley rim or looping graft around the phalanx. Regardless of the reconstructive technique, the surgeon should emulate the length, tension, and glide of the native pulley.
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Affiliation(s)
- Christopher J Dy
- Division of Hand and Upper Extremity Surgery, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY 10021, USA
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