1
|
Aljasim O, Vahabi A, Biçer MEK, Taşkıran E. Synovectomy induced patellar tendon ossification in patient with rheumatoid arthritis: A case report and review of the literature. Int J Surg Case Rep 2023; 110:108574. [PMID: 37574628 PMCID: PMC10448270 DOI: 10.1016/j.ijscr.2023.108574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/19/2023] [Accepted: 07/23/2023] [Indexed: 08/15/2023] Open
Abstract
INTRODUCTION Patellar tendon ossification is a rare complication that primarily occurs following a knee injury. This article aims to describe, for the first time, a case of patellar tendon ossification following synovectomy. CASE PRESENTATION A 48-year-old male with a diagnosis of rheumatoid arthritis presented with swelling in his left knee following a synovectomy procedure. After a thorough physical examination, radiographic assessment, and computed tomography, the patient was diagnosed with total patellar tendon ossification. Subsequently, the patient underwent excision of the ossified mass and tendon reconstruction using an Achilles allograft. DISCUSSION The primary causes of patellar tendon ossification are iatrogenic and traumatic injuries. The presence of rheumatoid arthritis, which negatively affects tissue healing, may exacerbate this condition. Smaller lesions can be managed conservatively or through resection and repair. In cases of extensive ossification, resection and reconstruction are necessary. A comprehensive literature review is also provided. CONCLUSION The occurrence of patellar tendon swelling following trauma or surgery should raise suspicion of patellar tendon ossification. Rheumatoid arthritis is a risk factor for the development of patellar tendon ossification. In cases of extensive ossification, successful treatment can be achieved through reconstruction using an Achilles allograft.
Collapse
Affiliation(s)
- Omar Aljasim
- Department of Orthopedic Surgery, Gebze Medikal Park Hospital, Kocaeli, Turkey.
| | - Arman Vahabi
- Department of Orthopedic Surgery, Ege University Faculty of Medicine, Izmir, Turkey
| | | | - Emin Taşkıran
- Department of Orthopedic Surgery, Ege University Faculty of Medicine, Izmir, Turkey
| |
Collapse
|
2
|
Zhang H, Dai Y, Long H, Cao R, Shi L, Zhao J, Ma L, Diao N, Yin H, Guo A. Tendon Stem/Progenitor Cell-Laden Nanofiber Hydrogel Enhanced Functional Repair of Patellar Tendon. Tissue Eng Part A 2023; 29:150-160. [PMID: 36424823 DOI: 10.1089/ten.tea.2022.0183] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Functional repair of tendons remains a challenge to be overcome for both clinicians and scientists. We have previously reported a three-dimensional RADA peptide hydrogel that provides a suitable microenvironment for human tendon stem/progenitor cells (TSPCs) survival and tenogenesis. In this study, we explore the potential of in vivo patellar tendon repair by human TSPC-laden RADA hydrogel in rats, which were sacrificed at 4 and 8 weeks after operation. Hind limb function test, macroscopical and histological examination, tendon cell amount and alignment analysis, and radiographic assessments were performed at several time points. Our results demonstrated that human TSPC-laden RADA hydrogel (RADA+TSPC group) boosted in vivo patellar tendon repair with better ambulatory function recovery compared with the control groups, in which tendon defects were untreated (Defect group) or treated with RADA hydrogel alone (RADA group). In addition, better macroscopic appearance and improved matrix organization in the repaired tendon with less cell amount and reduced adipocyte accumulation and blood vessel formation were observed in the RADA+TSPC group. Moreover, tendon defect treated with TSPC-laden RADA hydrogel resulted in diminished heterotopic ossification (HO) at 8 weeks postoperation, which was indicated by both X-ray examination and micro-computed tomography scan. Taken together, the combination of TSPC and nanofiber hydrogel provide an optimistic alternative method to accelerate functional tendon repair with reduced HO. Impact statement Our study clearly demonstrates the combination of tendon stem/progenitor cell and nanofiber hydrogel provide a new and optimistic tissue engineering strategy to treat tendon injury by accelerating functional tendon repair with reduced heterotopic ossification. The clinical translation is also very promising, which can provide a minimally invasive, nonsurgical, or complementary treatment methods to treat human tendon injury.
Collapse
Affiliation(s)
- Hongrui Zhang
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yike Dai
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Huibin Long
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ruiqi Cao
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Lin Shi
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jiaming Zhao
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Lifeng Ma
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Naicheng Diao
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Heyong Yin
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ai Guo
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
3
|
Bragg JT, Hayes-Lattin M, Shields MV, Salzler MJ. Heterotopic Ossification After Anterior Cruciate Ligament Reconstruction With Quadriceps Tendon Autograft: A Case Report. JBJS Case Connect 2022; 12:01709767-202212000-00035. [PMID: 36820843 DOI: 10.2106/jbjs.cc.22.00445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 10/10/2022] [Indexed: 02/24/2023]
Abstract
CASE A 32-year-old healthy woman tore her right anterior cruciate ligament (ACL) and underwent reconstruction with quadriceps tendon autograft. Twelve weeks postoperatively, she had anterior thigh pain limiting knee flexion and a palpable mass in the anterior thigh. Imaging revealed a calcified mass near the graft site, concerning for heterotopic ossification (HO). After maturation of the heterotopic bone, she underwent debridement and HO removal. CONCLUSION This is a case of HO at the quadriceps tendon autograft site after ACL reconstruction. When counseling patients, clinicians should be mindful of this possible complication and its treatment.
Collapse
Affiliation(s)
- Jack T Bragg
- Department of Orthopaedic Surgery, Tufts Medical Center, Boston, Massachusetts
| | | | - Margaret V Shields
- Department of Orthopaedic Surgery, Tufts Medical Center, Boston, Massachusetts
| | - Matthew J Salzler
- Department of Orthopaedic Surgery, Tufts Medical Center, Boston, Massachusetts
| |
Collapse
|
4
|
Liu Q, Tang D, Zhu W, Chen Y. Patellar Tendon Reconstruction Using Autologous Hamstring Tendons for the Treatment of Extensive Patellar Tendon Ossification. Orthop Surg 2022; 14:3119-3124. [PMID: 36000539 PMCID: PMC9627062 DOI: 10.1111/os.13435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/21/2022] [Accepted: 06/23/2022] [Indexed: 11/21/2022] Open
Abstract
Background Extensive patellar tendon ossification is very uncommon and requires surgical intervention when ossification significantly affects knee function. While various approaches and grafts are available for reconstructing ruptured patellar tendons, there is a paucity of literature regarding the management of joint ankylosis due to severely ossified patellar tendons. Case Presentation This is a case involving an extensively ossified patellar tendon after patellar and tibial tuberosity fracture fixation. Reconstruction of the patellar tendon was performed using ipsilateral semitendinosus and gracilis autografts. At the latest follow‐up of 12 months, the patient achieved knee flexion up to 120° with a slight extension lag and resumed daily activities. Conclusions Autograft hamstring reconstruction of the patellar tendon is suitable for extensive heterotopic ossification of the patellar tendon, resulting in significant improvement in postoperative knee function. Similar patients may be referred for this reconstruction technique.
Collapse
Affiliation(s)
- Qian Liu
- Department of Orthopaedics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Dezhou Tang
- Department of Orthopaedics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Weihong Zhu
- Department of Orthopaedics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yueming Chen
- Department of Orthopaedics, The Second Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
5
|
No Difference in Outcome of Anterior Cruciate Ligament Reconstruction with "Bone-patellar Tendon-bone versus Semitendinosus-gracilis Graft with Preserved Insertion": A Randomized Clinical Trial. Indian J Orthop 2020; 54:665-671. [PMID: 32850031 PMCID: PMC7429638 DOI: 10.1007/s43465-020-00073-y] [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] [Indexed: 02/04/2023]
Abstract
BACKGROUND The type of graft for anterior cruciate ligament (ACL) reconstruction is still a topic of debate and there is still no clear consensus on the ideal graft for ACL reconstruction. PURPOSE This study was conducted to compare the outcome of ACL reconstruction surgery between hamstring tendon graft and bone-patellar tendon-bone (BPTB) graft. MATERIALS AND METHODS One hundred and sixty professional athletes were enrolled in the study. They were divided into two groups by computerized randomization. In Group I, ACL reconstruction was done using BPTB graft, and in Group II, ACL reconstruction was done using semitendinosus gracilis graft with preserved tibial insertion (STGPI). Postoperatively, patients were assessed for knee stability, Lysholm score, and WOMAC score. RESULTS Mean KT-1000 side-to-side difference at 1 year was 2.31 ± 1.68 mm in BPTB cohort and 2.52 ± 1.6 mm in STGPI cohort (P = 0.4); and at 2 years, it was 1.98 ± 1.62 mm in BPTB cohort and 2.23 ± 1.6 mm in STGPI cohort (P = 0.4). Mean Lysholm score at 2 years was 96.1 ± 5.81 in STGPI cohort and 97.3 ± 4.62 in BPTB cohort (P = 0.15). Mean WOMAC score at 2 years was 3.3 ± 2.76 in STGPI cohort and 2.84 ± 2.21 in BPTB cohort (P = 0.25). Graft rupture rate was 3.75%; 3 patients in each group had graft rupture. Kneeling pain was present in 15% (12/80) of patients with BPTB graft whereas none of the patients in STGPI cohort had kneeling pain. CONCLUSION There was no difference between two grafts in term of knee stability, visual analog scale score and functional outcome. However, hamstring tendon graft is associated with less donor site morbidity.
Collapse
|
6
|
Sarzaeem MM, Razi M, Omrani FA, Azimi F, Aghaalikhani M. Modified patellar side harvest technique for bone-patella, tendon-bone autograft anterior cruciate ligament reconstruction; a three-year prospective cohort. J Orthop 2020; 18:95-98. [PMID: 32189892 DOI: 10.1016/j.jor.2019.10.011] [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: 10/09/2019] [Accepted: 10/23/2019] [Indexed: 01/10/2023] Open
Abstract
Purpose To introduce and discuss the outcome of a modified patellar side harvest technique. Methods This prospective cohort was conducted on patients with torn ACL who were eligible candidates for surgical intervention. Demographics and baseline characteristics were gathered for each patient. Results In total, 1024 patients with a mean age of 30.6 ± 3.6 were enrolled in this cohort. Results of modified IKDC scores reported with good and excellent outcome in 75% of patients. Conclusion Most of the patients who underwent BPTB-ACL reconstruction surgery with modified patellar side harvest technique, experienced acceptable clinical outcome.
Collapse
Affiliation(s)
- Mohammad Mahdi Sarzaeem
- Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid BeheshtiUniversity of Medical Sciences, Tehran, Iran
| | - Mohammad Razi
- Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid BeheshtiUniversity of Medical Sciences, Tehran, Iran
| | - Farzad Amuzade Omrani
- Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid BeheshtiUniversity of Medical Sciences, Tehran, Iran
| | - Farya Azimi
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Aghaalikhani
- Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid BeheshtiUniversity of Medical Sciences, Tehran, Iran
| |
Collapse
|
7
|
Gupta R, Kapoor A, Soni A, Khatri S, Masih GD, Raghav M. No Difference in Outcome of Anterior Cruciate Ligament Reconstruction with "Bone-patellar Tendon-bone versus Semitendinosus-gracilis Graft with Preserved Insertion:" A Randomized Clinical Trial. Indian J Orthop 2019; 53:721-726. [PMID: 31673172 PMCID: PMC6804384 DOI: 10.4103/ortho.ijortho_214_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The type of graft for anterior cruciate ligament (ACL) reconstruction is still a topic of debate and there is still no clear consensus on the ideal graft for ACL reconstruction. PURPOSE This study was conducted to compare the outcome of ACL reconstruction surgery between hamstring tendon graft and bone-patellar tendon-bone (BPTB) graft. MATERIALS AND METHODS One hundred and sixty professional athletes were enrolled in the study. They were divided into two groups by computerized randomization. In Group I, ACL reconstruction was done using BPTB graft, and in Group II, ACL reconstruction was done using semitendinosus gracilis graft with preserved tibial insertion (STGPI). Postoperatively, patients were assessed for knee stability, Lysholm score, and WOMAC score. RESULTS Mean KT-1000 side-to-side difference at 1 year was 2.31 ± 1.68 mm in BPTB cohort and 2.52 ± 1.6 mm in STGPI cohort (P = 0.4); and at 2 years, it was 1.98 ± 1.62 mm in BPTB cohort and 2.23 ± 1.6 mm in STGPI cohort (P = 0.4). Mean Lysholm score at 2 years was 96.1 ± 5.81 in STGPI cohort and 97.3 ± 4.62 in BPTB cohort (P = 0.15). Mean WOMAC score at 2 years was 3.3 ± 2.76 in STGPI cohort and 2.84 ± 2.21 in BPTB cohort (P = 0.25). Graft rupture rate was 3.75%; 3 patients in each group had graft rupture. Kneeling pain was present in 15% (12/80) of patients with BPTB graft whereas none of the patients in STGPI cohort had kneeling pain. CONCLUSION There was no difference between two grafts in term of knee stability, visual analog scale score and functional outcome. However, hamstring tendon graft is associated with less donor site morbidity.
Collapse
Affiliation(s)
- Ravi Gupta
- Sports Injury Centre and Medical Superintendent, Government Medical College Hospital, Chandigarh, India
| | - Anil Kapoor
- Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India,Address for correspondence: Dr. Anil Kapoor, Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India. E-mail:
| | - Ashwani Soni
- Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India
| | - Sourabh Khatri
- Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India
| | - Gladson David Masih
- Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India
| | - Mukta Raghav
- Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India
| |
Collapse
|
8
|
Frank RM, Mascarenhas R, Haro M, Verma NN, Cole BJ, Bush-Joseph CA, Bach BR. Closure of patellar tendon defect in anterior cruciate ligament reconstruction with bone-patellar tendon-bone autograft: systematic review of randomized controlled trials. Arthroscopy 2015; 31:329-38. [PMID: 25442654 DOI: 10.1016/j.arthro.2014.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 09/08/2014] [Indexed: 02/02/2023]
Abstract
PURPOSE This study aimed to systematically review the highest level of evidence on anterior cruciate ligament (ACL) reconstruction with bone-patellar tendon-bone (BPTB) autografts with patellar tendon defect closure versus no closure after surgery. METHODS We performed a systematic review of multiple medical databases using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Level I and Level II randomized controlled trials comparing patellar tendon defect closure to no closure during ACL reconstruction with BPTB autografts were included. Two independent reviewers analyzed all studies. Descriptive statistics were calculated. Study methodological quality was analyzed using the Modified Coleman Methodology Score (MCMS) and Jadad scale. RESULTS Four studies with a combined 221 patients (154 male patients and 67 female patients) with an average age of 26.6 ± 2.4 years (range, 17 to 54 years) were included. All studies randomized patients before surgery into ACLR with BPTB autografts either with patellar tendon defect closure or without closure. There were no differences in clinical outcomes (Lysholm score, Tegner scale, International Knee Documentation Committee [IKDC] classification, modified Larsen score, and Lauridsen rating) between groups. There were no significant differences in knee pain between groups. All studies reported imaging findings of the patellar tendon defect, with 2 studies showing no difference in appearance between groups, one study showing excessive scar formation with defect repair, and one study showing improved restoration of normal tendon appearance with defect repair. The overall quality of the studies was poor, with all studies scoring less than 46 (average, 40.5 ± 4.7) on the MCMS and scoring 1 on the Jadad scale. CONCLUSIONS Based on this systematic review of 4 randomized trials, there are no statistically significant or clinically relevant differences in outcomes between patients who have the patellar tendon defect closed and those who have it left open after ACLR with BPTB autografts. The methodology of the included studies limits the interpretation of the data, as evidenced by low MCMS and Jadad scores. LEVEL OF EVIDENCE Level II, systematic review of Level I and Level II studies.
Collapse
Affiliation(s)
- Rachel M Frank
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A..
| | - Randy Mascarenhas
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Marc Haro
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Nikhil N Verma
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Brian J Cole
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Charles A Bush-Joseph
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Bernard R Bach
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| |
Collapse
|
9
|
Wu CL, Jain D, McNeill JN, Little D, Anderson JA, Huebner JL, Kraus VB, Rodriguiz RM, Wetsel WC, Guilak F. Dietary fatty acid content regulates wound repair and the pathogenesis of osteoarthritis following joint injury. Ann Rheum Dis 2014; 74:2076-83. [PMID: 25015373 DOI: 10.1136/annrheumdis-2014-205601] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 06/01/2014] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The mechanisms linking obesity and osteoarthritis (OA) are not fully understood and have been generally attributed to increased weight, rather than metabolic or inflammatory factors. Here, we examined the influence of fatty acids, adipokines, and body weight on OA following joint injury in an obese mouse model. METHODS Mice were fed high-fat diets rich in various fatty acids (FA) including saturated FAs (SFAs), ω-6 polyunsaturated FAs (PUFAs), and ω-3 PUFAs. OA was induced by destabilising the medial meniscus. Wound healing was evaluated using an ear punch. OA, synovitis and wound healing were determined histologically, while bone changes were measured using microCT. Activity levels and serum cytokines were measured at various time-points. Multivariate models were performed to elucidate the associations of dietary, metabolic and mechanical factors with OA and wound healing. RESULTS Using weight-matched mice and multivariate models, we found that OA was significantly associated with dietary fatty acid content and serum adipokine levels, but not with body weight. Furthermore, spontaneous activity of the mice was independent of OA development. Small amounts of ω-3 PUFAs (8% by kcal) in a high-fat diet were sufficient to mitigate injury-induced OA, decreasing leptin and resistin levels. ω-3 PUFAs significantly enhanced wound repair, SFAs or ω-6 PUFAs independently increased OA severity, heterotopic ossification and scar tissue formation. CONCLUSIONS Our results indicate that with obesity, dietary FA content regulates wound healing and OA severity following joint injury, independent of body weight, supporting the need for further studies of dietary FA supplements as a potential therapeutic approach for OA.
Collapse
Affiliation(s)
- Chia-Lung Wu
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA Department of Biomedical Engineering, Duke University Medical Center, Durham, North Carolina, USA
| | - Deeptee Jain
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Jenna N McNeill
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Dianne Little
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - John A Anderson
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA Rothman Institute Cartilage Center, Rothman Institute, Philadelphia, Pennsylvania, USA
| | - Janet L Huebner
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Virginia B Kraus
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Ramona M Rodriguiz
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA Department of Neurobiology, Duke University Medical Center, Durham, North Carolina, USA Department of Mouse Behavioral and Neuroendocrine Analysis Core Facility, Duke University Medical Center, Durham, North Carolina, USA
| | - William C Wetsel
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA Department of Neurobiology, Duke University Medical Center, Durham, North Carolina, USA Department of Mouse Behavioral and Neuroendocrine Analysis Core Facility, Duke University Medical Center, Durham, North Carolina, USA Department of Cell Biology, Duke University Medical Center, Durham, North Carolina, USA
| | - Farshid Guilak
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA Department of Biomedical Engineering, Duke University Medical Center, Durham, North Carolina, USA Department of Cell Biology, Duke University Medical Center, Durham, North Carolina, USA
| |
Collapse
|