ATT may be a useful treatment of chronic Achilles tendinopathy.

This study indicates that autophagic cell death, apoptosis and myofibroblast cell differentiation occur in ruptured rotator cuff tissue. These cellular events are closely related to the extent of damage to the ECM structure.

Background Reconstruction of hemiglossectomy defects requires careful flap design to avoid adverse functional and aesthetic outcomes. Methods Hemitongue specimens were obtained from minipigs to study the three‐dimensional anatomy and to define anatomic landmarks for precise measurements of flap requirement. The concept developed in animal models was then applied to hemiglossectomy reconstruction in clinical practice. Sixty‐one patients were randomly enrolled into the following two groups: a “five‐point eight‐line segment” (FIPELS) flap design group (28 patients) and a conventional group (33 patients). Functional and aesthetic outcomes were compared between the two groups. Results All flaps designed with the FIPELS technique matched the hemiglossectomy defects without the need for flap trimming, thus reducing the operating time (P = .03). Swallowing functions, speech intelligibility, and aesthetic outcomes were superior in the FIPELS group than that in the conventional group (P < .05). Conclusions The FIPELS flap design for hemiglossectomy reconstruction yields improved functional and aesthetic outcomes compared to a conventional flap design.

Fibrovascular scar healing of bone-tendon interface (BTI) instead of functional fibrocartilage regeneration is the main concern associated with unsatisfactory prognosis in rotator cuff repair. Mesenchymal stem cells exosomes have been reported to be a new promising cell-free approach for rotator cuff healing. Whereas, controvercies abound in whether exosomes of native MSCs alone can effectively induce chondrogenesis. In this study, we aimed to explore the effect of Exosomes derived from low-intensity pulsed ultrasound stimulation (LIPUS)-preconditioned bone marrow mesenchymal stem cells (LIPUS-BMSC-Exos) or un-preconditioned BMSCs (BMSC-Exos) on rotator cuff healing and the underlying mechanism. Specifically, C57BL/6 mice underwent unilateral supraspinatus tendon detachment and repair were randomly assigned to saline, BMSCs-Exos or LIPUS-BMSC-Exos injection therapy. The results indicated that the biomechanical properties of the supraspinatus tendon-humeral junction were significantly improved in the LIPUS-BMSC-Exos group than that of the BMSCs-Exos group. The LIPUS-BMSC-Exos group also exhibited a higher histological score and more newly regenerated fibrocartilage at the repair site at postoperative 2 and 4 weeks and less fatty infiltration at 4 weeks than the BMSCs-Exos group. In vitro, co-culture of BMSCs with LIPUS-BMSC-Exos could significantly promote BMSCs chondrogenic differentiation and inhibit adipogenic differentiation than the BMSCs and BMSC-Exos co-cultured group did. Subsequently, quantitative real-time polymerase chain reaction revealed significantly higher enrichment of chondrogenic miRNAs and less enrichment of adipogenic miRNAs in LIPUS-BMSC-Exos compared with BMSC-Exos. Moreover, we demonstrated that this chondrogenesis-inducing potential was primarily attributed to miR-140, one of the most abundant miRNAs in LIPUS-BMSC-Exos. Collectively, our results highlight the regenerative potential of LIPUS-BMSC-Exos to promote BTI fibrocartilage regeneration and ameliorate supraspinatus fatty infiltration by positive regulation of pro-chondrogenetic and anti-adipogenetic of BMSCs differentiation which was primarily through delivering miR-140.

Background: Injuries on tendon-to-bone attachment (TBA) are common clinical dilemmas. Bone Morphogenetic Proteins-4 (BMP-4) has been found the potency in chondrogenesis. But there is rare studies focusing the influence of BMP-4 on the TBA healing. Thus, the objective of this study was to explore the effect of BMP-4 on the healing of TBA in murine model of rotator cuff tear.Methods: 120 mature C57BL/6 mice (12 weeks old) were randomly divided into BMP-4 group, noggin (an inhibitor of all BMP activities) group and control group after being established an injury model of supraspinatus tendon insertion. At week 2 and 4 after surgery, the supraspinatus tendon- humerus complex (SSTHC) were harvested for microradiographic, histologic, immunofluorescent and biomechanical evaluations.Results: Radiographic data showed that BMP-4 was able to improve the quality of subchondral bone, manifested as higher BV/TV, Tb.N, TB.Th, and lower Tb.Sp. Histologically, the BMP-4 group at week-2 and -4 showed better BTA healing interface, characterized by better organizational integration and remodeling, thicker fibrocartilage layer and more fibrocartilage cells. Immunoflorescence evaluation demonstrated the number of SOX 9 positive cells in the BMP-4 group was significantly more than that in the control or noggin group at postoperative weeks 2 and 4 (p<0.05 for all). Mechanical testing results demonstrated the failure load and stiffness in the BMP-4 group were significantly higher (p<0.05 for both), while in the noggin group were lower (p<0.05 for both), compared to the control group at postoperative weeks 4.Conclusion: BMP-4 might enhance the TBA healing by promoting the regeneration of fibrocartilaginous enthesis and mineralization, while noggin inhibited this process.Clinical Relevance: BMP-4 may be a potential therapy to augment TBA healing, and finally lead to more rapid rehabilitation and reduce risk of recurrent repair.

The present study aimed to investigate the effect of a new method of abdominal skin care on patients with ankylosing spondylitis (AS) undergoing orthopedic surgery. A total of 90 patients with AS and thoracolumbar kyphosis undergoing orthopedic surgery were randomly divided into two groups. Patients in the control group received routine care while those in experimental group received the following new treatment regimen: i) Vaseline cream was applied to the abdominal skin for 3-5 min every 6 h; ii) preoperative stretch exercises were encouraged and iii) 24 h after surgery, the patient was placed in a lateral decubitus position. The difference in abdominal pain levels and the size of tension blisters was the compared between the two groups. There was no difference in age, gender, disease course and kyphosis angle between two groups (P>0.05). Compared with the patients in the control group, those in test group experienced milder pain when evaluated by visual analogue score at 6, 18 and 30 h after surgery (3.6±1.2 vs. 4.5±1.8; 4.4±2.3 vs. 6.1±2.7; 4.1±2.1 vs. 4.1±2.1, P<0.05). Moreover, tension vesicles in the abdominal skin were significantly smaller in the treatment group than the control group (P<0.05). Optimal nursing may be the key to the reduction of the level of pain and occurrence of tension vacuoles in the abdominal skin.