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Ligament Repair

S Y Zhu, P L Wang, C S Liao, Y Q Yang, C Y Yuan, S Wang, W L Dissanayaka, B C Heng, C F Zhang
BACKGROUND AND OBJECTIVE: The goal of periodontal therapy is to regenerate/reconstruct the damaged supporting tissues of diseased teeth and to facilitate recovery of their physiological functions. Combination of stem cell transplantation and gene therapy offers a viable method for accelerating periodontal repair and regeneration. In this study, the role of the ephrinB2/EphB4 signaling pathway in regulating osteogenic differentiation of periodontal ligament stem cells (PDLSCs) and crosstalk between PDLSCs and pre-osteoblasts within co-culture was investigated through ephrinB2 transgenic expression in PDLSCs...
October 20, 2016: Journal of Periodontal Research
C-F Hsieh, P Alberton, E Loffredo-Verde, E Volkmer, M Pietschmann, P E Müller, M Schieker, D Docheva
Tendon's natural healing potential is extremely low and inefficient, with significant dysfunction and disability due to hypocellularity and hypovascularity of tendon tissues. The application of stem cells can aid in significantly enhanced repair of tendon rupture; therefore, the main aim of this study is to assess the potential of using periodontal ligament cells (PDL), usually obtained from patients undergoing orthodontic treatment, as a novel cell source for cell-based therapy for tendon injuries in a clinically relevant rat full-size Achilles tendon defect...
October 20, 2016: European Cells & Materials
Xianghua Liang, Lili Zhang, Yanwei Lv
AIM: A complete and non-splice porcine small-intestine submucosa (SIS) patch was used for total pelvic anatomical repair of organ prolapse. METHODS: This study included a total of 17 patients with severe total pelvic organ prolapse, including five patients with combined stress urinary incontinence (SUI). Panhysterectomy was performed, and then a porcine SIS patch was placed on the anterior (posterior) vaginal wall. The top of the vaginal wall was moved to the corresponding side of the vaginal wall, and the patch was sutured to bilateral uterosacral ligaments, the sacrospinous ligament, and arcus tendineus fasciae pelvis...
October 20, 2016: Journal of Obstetrics and Gynaecology Research
Taku Hatta, Shingo Nobuta, Toshitake Aizawa, Koichi Sasajima, Soichi Nakajima, Masahito Honda, Gosuke Oki, Yoshiaki Yamanaka, Eiji Itoi
The aim of our study is to evaluate the clinical and radiologic outcomes in patients with terrible triad injury, who underwent surgical treatment with or without the medial collateral ligament (MCL) repair. Fourteen patients who underwent surgery with a minimum of 12-month follow-up (mean, 17 months) were reviewed. Based on the systematic treatment protocol, radial head fracture, lateral collateral ligament, and coracoid fracture were treated. Subsequently, torn MCL was repaired in 7 patients, whereas in the remaining 7 patients, the MCL was not treated...
September 19, 2016: Orthopedic Reviews
John Morellato, Hakim Louati, Andrew Bodrogi, Andrew Stewart, Steven Papp, Allan Liew, Wade Gofton
BACKGROUND/PURPOSE: There have been no studies assessing the optimal biomechanical tension of suture button constructs. The purpose of this study was to assess optimal tensioning of suture button fixation and its ability to maintain reduction under loaded conditions using a stress computed tomography (CT) model. METHODS: Ten cadaveric lower limbs disarticulated at the knee were used. The limbs were placed in a modified ankle load frame that allowed for the application of sustained torsional axial, or combined torsional/axial loads...
October 13, 2016: Journal of Orthopaedic Trauma
Erica Dos Santos Carvalho, Rogério Hadid Rosa, Flávia de Moura Pereira, Ana Lia Anbinder, Isabel Mello, Sandra Marcia Habitante, Denise Pontes Raldi
The search for effective protocols to reduce the incidence of root resorptions and allow periodontal ligament repair is still challenging, given the unpredictable outcome of late tooth replantation. The aim of this study was to assess the effects of both high-power diode laser irradiation (DL) and basic fibroblast growth factor (FGF) on the periodontal healing of replanted teeth after extended extra-oral dry time METHODS: Maxillary incisors of 50 male rats were extracted and assigned to three experimental and two control groups (n = 10)...
October 17, 2016: Dental Traumatology: Official Publication of International Association for Dental Traumatology
I Naroura, A Zemirline, C Taleb, F Lebailly, S Facca, J J Hidalgo Díaz, S Collon, P Liverneaux
Three direct volar portals for wrist arthroscopy have been described previously: two radiocarpal and one midcarpal. The aim of this study was to systematically describe four volar arthroscopic portals through minimally invasive incisions using an inside-out approach from known dorsal portals. Four volar arthroscopic wrist portals were studied on six hand specimens using an inside-out technique: a radial radiocarpal approach (RRCA), an ulnar radiocarpal approach (URCA), a radial midcarpal approach (RMCA) and an ulnar midcarpal approach (UMCA)...
June 2016: Hand Surgery and Rehabilitation
N Harrasser, K Eichelberg, F Pohlig, H Waizy, A Toepfer, R von Eisenhart-Rothe
Because of their frequency, ankle sprains are of major clinical and economic importance. The simple sprain with uneventful healing has to be distinguished from the potentially complicated sprain which is at risk of transition to chronic ankle instability. Conservative treatment is indicated for the acute, simple ankle sprain without accompanying injuries and also in cases of chronic instability. If conservative treatment fails, good results can be achieved by anatomic ligament reconstruction of the lateral ankle ligaments...
October 13, 2016: Der Orthopäde
Jason M Schon, Brady T Williams, Melanie B Venderley, Grant J Dornan, Jonathon D Backus, Travis Lee Turnbull, Robert F LaPrade, Thomas O Clanton
BACKGROUND: Historically, syndesmosis injuries have been repaired with screw fixation; however, some suggest that suture-button constructs may provide a more accurate anatomic and physiologic reduction. The purpose of this study was to compare changes in the volume of the syndesmotic space following screw or suture-button fixation using a preinjury and postoperative 3-D computed tomography (CT) model. The null hypothesis was that no difference would be observed among repair techniques...
October 12, 2016: Foot & Ankle International
Nisa Gul Amuk, Gökmen Kurt, Yusuf Baran, Volkan Seyrantepe, Melis Kartal Yandim, Aysun Adan, Secil Akyildiz Demir, Yagmur Kiraz, Mehmet Fatih Sonmez
AIM: The aim of this study is to evaluate and compare therapeutic effects of mesenchymal stem cell (MSCs) and osteoprotegerin (OPG) gene transfer applications on inhibition and/or repair of orthodontically induced inflammatory root resorption (OIIRR). MATERIALS AND METHODS: Thirty Wistar rats were divided into four groups as untreated group (negative control), treated with orthodontic appliance group (positive control), MSCs injection group, and OPG transfected MSCs [gene therapy (GT) group]...
October 12, 2016: European Journal of Orthodontics
Eleonora Cianci, Oriana Trubiani, Francesca Diomede, Ilaria Merciaro, Ida Meschini, Pantaleone Bruni, Fausto Croce, Mario Romano
Lipoxin (LX)A4 is a lipoxygenase-formed arachidonic acid metabolite with potent anti-inflammatory, pro-resolution properties. Its therapeutic efficacy has been largely demonstrated in a variety of cellular, preclinical and clinical models. Among these, periodontal disease, where LXA4 promotes tissue repair, also by modulating functions of human periodontal ligament stem cells (hPDLSCs). As medicated biomembranes may be particularly useful in clinical settings, where local stimulation of tissue repair is needed, we used electrospinning to embed LXA4 in membranes made of poly(ethylene oxide) (PEO) and poly(d,l-lactide) (PDLLA)...
October 11, 2016: International Journal of Pharmaceutics
William T Wilson, Graeme P Hopper, Paul A Byrne, Gordon M MacKay
BACKGROUND: Anterior cruciate ligament (ACL) reconstruction using tendon or ligament autograft is the gold standard surgical treatment for acute ruptures; however, this is still associated with subsequent problems and variable outcomes. Renewed interest in healing of injured ACL tissue has led to new surgical repair techniques. CASE DESCRIPTION: We report the case of one of the first patients to undergo this novel procedure of ACL repair with internal bracing. An internal brace is a bridging concept using braided suture tape and knotless bone anchors to reinforce ligament strength...
October 6, 2016: Surgical Technology International
Andrew R Palisch, Ronald R Winters, Marc H Willis, Collin D Bray, Theodore B Shybut
The menisci play an important biomechanical role in axial load distribution of the knees by means of hoop strength, which is contingent on intact circumferentially oriented collagen fibers and meniscal root attachments. Disruption of the meniscal root attachments leads to altered biomechanics, resulting in progressive cartilage loss, osteoarthritis, and subchondral edema, with the potential for development of a subchondral insufficiency fracture. Identification of meniscal root tears at magnetic resonance (MR) imaging is crucial because new arthroscopic surgical techniques (transtibial pullout repair) have been developed to repair meniscal root tears and preserve the tibiofemoral cartilage of the knee...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Gary M LiMarzi, Kurt F Scherer, Michael L Richardson, David R Warden, Christopher W Wasyliw, Jack A Porrino, Christopher R Pettis, Gideon Lewis, Christopher C Mason, Laura W Bancroft
A variety of surgical procedures exist for repair of both traumatic and degenerative osseous and soft-tissue pathologic conditions involving the foot and ankle. It is necessary for the radiologist to be familiar with these surgical procedures, so as to assess structural integrity, evaluate for complicating features, and avoid diagnostic pitfalls. Adequate interpretation of postoperative changes often requires access to surgical documentation to evaluate not only the surgery itself but the expected timeline for resolution of normal postoperative changes versus progressive disease...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Jelle P van der List, Gregory S DiFelice
Over the last century, many surgical treatments have been developed in the orthopedic field, including treatments of anterior cruciate ligament (ACL) injuries. These treatments ideally evolve in a process of trial and error with prospective comparison of new treatments to the current treatment standard. However, these evolutions are sometimes not linear and periodically undergo paradigm shifts. In this article, we review the evolution of ACL treatment and explain how it underwent a paradigm shift. Open primary ACL repair was the most common treatment in the 1970s and 1980s, but because multiple studies noted deterioration of outcomes at mid-term follow-up, in addition to several randomized clinical trials (RCTs) that noted better outcomes following ACL reconstruction, the open primary repair technique was abandoned...
October 6, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
N Lefevre, S Klouche, O de Pamphilis, S Herman, A Gerometta, Y Bohu
INTRODUCTION: Femoral nerve block (FNB) is considered as a major advance in anterior cruciate ligament (ACL) reconstruction as it reduces the need for parenteral opioids. However, the incidence of transient or even permanent neurological deficits due to the FNB is estimated at 1.94% after knee surgery. The primary objective of this study was to compare local infiltration analgesia (LIA) to FNB during ACL reconstruction procedures. The study hypothesis was that LIA was not less effective than FNB on early postoperative pain...
October 3, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
David Wasylynko
OBJECTIVE: To present a case of chronic elbow pain as a result of a hidden underlying osteochondral defect. CLINICAL FEATURES: A 17-year old baseball player presented with chronic lateral elbow pain. Examination revealed swelling of the elbow with signs of possible ligament, muscle, and tendon injury. DIAGNOSIS AND TREATMENT: Although there was apparent soft-tissue injury, the elbow swelling created immediate suspicion of a more serious underlying condition...
September 2016: Journal of the Canadian Chiropractic Association
Miten Rajendra Sheth, Sachin Ramchandra Tapasvi, Shantanu Sudhakar Patil
Lesions of the anterior cruciate ligament (ACL) are common; the current gold standard of treatment for such lesions is ACL reconstruction. Tibial-sided soft-tissue avulsion is a rare subtype of ACL injuries. Unlike femoral-sided ACL repair, surgery for acute tibial-sided ACL ruptures has been neither reported nor described. This technical note presents a method for primary anatomic ACL reinsertion for an acute distal soft-tissue avulsion-type ACL injury, using a transosseous pull-out repair technique. Our technique, as an alternative to reconstruction, has the potential to enhance healing due to marrow stimulation (tibial tunneling)...
August 2016: Arthroscopy Techniques
Andrea M Spiker, Christopher L Camp, Brian T Barlow, Shawn G Anthony, Struan H Coleman
This article describes the use of sutures to enhance visualization while protecting the capsule in both the central and peripheral compartments during hip arthroscopy. We describe first a technique to preserve the proximal capsule cuff while working in the central compartment and then an alternative to the T-capsulotomy while maintaining excellent visualization of the peripheral compartment during femoroplasty of cam-type femoroacetabular impingement. By use of suture suspension of the capsule, multiple goals are achieved: The integrity of the proximal capsule cuff is maintained while aiding in visualization of the central compartment; the iliofemoral ligament is spared, which plays a critical role in preventing microinstability; the necessary space is created to obtain adequate visualization of the peripheral compartment for complete femoroplasty; and operative time is reduced because creation and subsequent repair of the T-capsulotomy can be avoided...
August 2016: Arthroscopy Techniques
Mathieu Thaunat, Jean Marie Fayard, Tales M Guimaraes, Nicolas Jan, Colin G Murphy, Bertrand Sonnery-Cottet
Ramp lesions of the medial meniscus are commonly associated with anterior cruciate ligament ruptures and consist of longitudinal peripheral tears of the posterior horn of the medial meniscus. Given the frequency of partial-thickness tears, they can be difficult to diagnose arthroscopically from the anterior compartment. We describe a classification of the different types of ramp lesions depending on both tear pattern (partial- or full-thickness tear) and associated meniscotibial ligament disruption. An original technique of arthroscopic suture placement through a single posteromedial portal with a 25° curved suture hook device is described...
August 2016: Arthroscopy Techniques
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