To assess clinical results in patients undergoing implantation of expanded polytetrafluoroethylene (Softform) for perioral enhancement (melolabial fold, melomental fold, upper lip, and lower lip). Design: Fifty patients had undergone Softform implantation by a single surgeon. A retrospective telephone survey (25 questions) was conducted. Of 50 patients, 38 (76%) were contacted. The mean interval between the procedure and survey was 22.7 months (range, 2-40 months). Responses were submitted for statistical analysis. A pathological review was performed on specimens removed from 2 patients. Results: Two patients (4%) developed postoperative infections that resolved with use of oral antibiotics; 5 patients (10%) requested repositioning owing to dissatisfaction with placement; and 5 patients (10%) requested implant removal. Composite scores indicated that patients were "slightly" satisfied with the procedure outcome. Of the 38 patients contacted, 24 (63%) would undergo additional implants and 20 (53%) would recommend the procedure to others. Results were not significantly influenced by site, size, or history of prior augmentation procedures. Histologic review indicated that implants elicit a chronic inflammatory reaction and that blood vessels infiltrate the porous walls of the implant. Conclusion: With proper patient selection, Softform represents a potential option for those individuals considering perioral enhancement.
Activities of daily living (ADLs) generate complex, multidirectional forces in the anterior cruciate ligament (ACL). While calibration problems preclude direct measurement in patients, ACL forces can conceivably be measured in animals after technical challenges are overcome. For example, motion and force sensors can be implanted in the animal but investigators must determine the extent to which these sensors and surgery affect normal gait. Our objectives in this study were to determine (1) if surgically implanting knee motion sensors and an ACL force sensor significantly alter normal ovine gait and (2) how increasing gait speed and grade on a treadmill affect ovine gait before and after surgery. Ten skeletally mature, female sheep were used to test four hypotheses: (1) surgical implantation of sensors would significantly decrease average and peak vertical ground reaction forces (VGRFs) in the operated limb, (2) surgical implantation would significantly decrease single limb stance duration for the operated limb, (3) increasing treadmill speed would increase VGRFs pre- and post operatively, and (4) increasing treadmill grade would increase the hind limb VGRFs pre- and post operatively. An instrumented treadmill with two force plates was used to record fore and hind limb VGRFs during four combinations of two speeds (1.0 m/s and 1.3 m/s) and two grades (0 deg and 6 deg). Sensor implantation decreased average and peak VGRFs less than 10% and 20%, respectively, across all combinations of speed and grade. Sensor implantation significantly decreased the single limb stance duration in the operated hind limb during inclined walking at 1.3 m/s but had no effect on single limb stance duration in the operated limb during other activities. Increasing treadmill speed increased hind limb peak (but not average) VGRFs before surgery and peak VGRF only in the unoperated hind limb during level walking after surgery. Increasing treadmill grade (at 1 m/s) significantly increased hind limb average and peak VGRFs before surgery but increasing treadmill grade post op did not significantly affect any response measure. Since VGRF values exceeded 80% of presurgery levels, we conclude that animal gait post op is near normal. Thus, we can assume normal gait when conducting experiments following sensor implantation. Ultimately, we seek to measure ACL forces for ADLs to provide design criteria and evaluation benchmarks for traditional and tissue engineered ACL repairs and reconstructions.
Complications following abdominal hernia repair include infection, mechanical failure, adhesion, and hernia recurrence [1,2]. Mesh materials require less revision surgery and reduce patient morbidity compared to when fascia is harvested [1,3]. Biologic meshes have lower infection rates and less adhesion than synthetic materials, but are more expensive [1]. In order to determine how these materials will function in vivo, it is important to simulate aspects of the actual conditions to which the material might be subjected after surgery. Previous studies have examined how different types of fascia, synthetic materials, and extracellular matrix materials responded to tests that mimic the in vivo state [3–6]. Suture retention testing has been used to compare the performance of human fascia versus possible substitutes [4]. Ball burst testing has been instrumental in understanding the biomechanical properties of different soft tissues and replacement materials by simulating biaxial forces associated with physiological loading conditions [5–7]. This objective of this was to determine which material might be most optimal for use in hernia repair. We hypothesize that biologic mesh materials will exhibit more optimal mechanical properties than synthetic materials when exposed to these test procedures.
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