Outcomes of tenodesis of the long head of the biceps tendon more than three months after rupture

AIM: To demonstrate that long head of the biceps tendon (LHBT) tenodesis is possible more than 3 mo after rupture.

METHODS: From September 2009 to January 2012 we performed tenodesis of the LHBT in 11 individuals (average age 56.9 years, range 42 to 73) more than 3 mo after rupture. All patients were evaluated by Disabilites of the Arm Shoulder and Hand (DASH) and Mayo outcome scores at an average follow-up of 19.1 mo. We similarly evaluated 5 patients (average age 58.2 years, range 45 to 64) over the same time treated within 3 mo of rupture with an average follow-up of 22.5 mo.

RESULTS: Tenodesis with an interference screw was possible in all patients more than 3 mo after rupture and 90% had good to excellent outcomes but two had recurrent rupture. All of those who had tenodesis less than 3 mo after rupture had good to excellent outcomes and none had recurrent rupture. No statistical difference was found for DASH and Mayo outcome scores between the two groups (P <0.05).

CONCLUSION: Tenodesis of LHBT more than 3 mo following rupture had outcomes similar to tenodesis done within 3 mo of rupture but recurrent rupture occurred in 20%.

Intranasal spray of cubosomal Tizanidine Hydrochloride for brain targeting: In-vitro and in-vivo characterization

Tizanidine HCl (TH) is used as first-line therapy for the treatment of muscular spasm. The intranasal cubosomal delivery system of TH for site-specific delivery i.e. CNS was developed. Cubosomes of TH were prepared using Glyceryl monooleate (GMO) as a lipid, poloxamer 407 as stabilizer, and ethanol and polyethylene glycol 200 as co-solvent. Optimized cubosomes of TH were characterized for vesicle size, zeta potential, % drug entrapment, mucin binding efficiency, which found to be 50.22 nm, -6.39 mV, 69.28%, 42.12%. It is also evaluated for CRYO-FESEM, CRYO-TEM, SAXS, residual solvent content, and in-vitro drug release. Ex-vivo permeation was also conducted at 7.4 and it indicates that almost 93.66% drug was diffused from a formulation in 6 hrs. Histopathological study of the optimized TH cubosomes suggests that the prepared formulation is non-toxic to the nasal mucosa. Pharmacokinetic and brain distribution study indicates targeted action of the formulated TH cubosomes.