The inhibition of MMPs at the optimal stage of the repair process may accelerate Achilles tendon repair and improve biomechanical properties, especially when paired with surgical management.

BackgroundIn light of poor outcomes with nonoperative management of hip fractures, orthopedic surgeons are faced with difficult decisions about which patients are too ill or too old for surgical treatment.Questions/PurposesThis study sought to investigate if patients over 90 years had different preoperative laboratory, clinical, and injury characteristics than younger patients with the same injury. We compared our cohort with previously published data. We wished to identify if there were pre-injury risk factors associated with 30-day mortality, which could be modified to enhance postoperative outcomes.MethodsThis is a retrospective review of 198 operatively managed hip fractures in patients 75 years or older. We collected data on demographics, select preoperative laboratory values, injury type, comorbidities, and 30-day mortality.ResultsEleven (5.6%) of the cohort died within 30 days of surgery, 6.3% in the younger group, and 3.7% in the older group; the difference was not statistically significant. For baseline characteristics, there was no difference between the age groups for pre-injury comorbidities, hemoglobin, serum albumin, BUN, prevalence of UTI, or fracture type. A total of 67 (35.8%) patients had evidence of UTI on admission.ConclusionsThese findings reveal that in our dichotomized cohort, pre-injury characteristics were similar and age alone was not an independent predictor of mortality. These data may inform decision-making for orthopedic surgeons and the medical providers who consult to optimize these patients for surgery. We identified high rates of UTI in both age groups, a potentially remediable factor to optimize outcomes in hip fracture surgery in elderly patients.Electronic supplementary materialThe online version of this article (doi:10.1007/s11420-015-9435-y) contains supplementary material, which is available to authorized users.

Tissue engineering has been at the forefront of medical research for more than 20 years. One of the most promising applications of tissue engineering is its use in cartilage repair. A successful cartilage repair model relies on the intricate interplay between cells, scaffolds, and the environment. Dedication to this field has resulted in a wide variety of materials available for use as scaffolds, each with advantages and disadvantages. In this article, we explore these materials and provide concise descriptions of the major scaffold subtypes. Included in this review are synthetic scaffolds, hydrogels, nanofibers, biologic scaffolds derived from fibrin, collagen, hyaluronic acid, alginate, and PRP, as well as intact extracellular matrix (ECM) scaffolds. Scaffolds represent a cornerstone of the tissue-engineering model for cartilage repair. This promising technology offers new hope in the continuing effort to repair cartilage defects and improve the quality of life for patients worldwide.

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