Autogenous bone graft is gold standard in treating bone defects, but it might have difficulty in corporation and rejection reaction. This study is to compare the effectiveness among freeze-dried xenograft, freeze-dried allograft, hydroxyapatite xenograft, and demineralized bone matrix xenograft as bone graft to fill bone defect in femoral diaphysis of white rabbit. Thirty male New Zealand white rabbits were distributed into five groups. Bone defect was filled correspondingly with xenograft freeze-dried cortical bovine, allograft freeze-dried cortical New Zealand white rabbit, xenograft hydroxyapatite bovine, and xenograft demineralized bone matrix bovine. No graft was used in control group. VEGF, osteoblast, and woven bone were higher in allograft freeze-dried cortical New Zealand white rabbit (mean 5.6625 (p < 0.05)) and xenograft demineralized bone matrix bovine (mean 5.2475 (p < 0.05)) with calcification of woven bone was already seen in week 2 in the latter group. There was a decrease of woven bone (mean 4.685 (p < 0.05)) fibrous tissue (mean 41.07 (p < 0.05)) in xenograft demineralized bone matrix bovine. The Immunoglobulin-G was elevated in control and all study groups but not significantly (p = 0.07855). Bone healing process in xenograft demineralized bone matrix bovine is more effective than in xenograft hydroxyapatite bovine, allograft freeze-dried New Zealand white rabbit, xenograft freeze-dried cortical bovine, and control.
Background:
Medial Patellofemoral Ligament (MPFL) reconstruction is a popular procedure to repair recurrent patellar dislocation. Many methods of reconstruction describe the use of hamstring tendons as the graft of choice. This study aimed to compare the functional outcome of MPFL reconstruction using quadriceps tendon graft with arthroscopic lateral release and to identify possible risks.
Methods:
This is a retrospective cohort study in patients with a history of recurrent dislocation trauma from 2014 to 2016 that already done MPFL reconstruction using quadriceps tendon grafts with arthroscopic lateral release. Patient reported outcomes were evaluated pre-operative and 2 years post-operatively using IKDC score, Lysholm knee score, Kujala score, KSS Score, thigh circumference size, and kneel down ability. Patellar fracture, redislocation, and other complications were also assessed 2 years post-operative.
Results:
Eight patients included in this study and showed significant improvement in clinical outcomes. The Lysholm score increased from 64.37 ± 8.23 to 90.87 ± 3.23 (p = 0.011), IKDC score increased from 62.93 ± 7.52 to 88.36 ± 3.64 (p < 0.001). Kujala score increased from 60.87 ± 7.94 to 88.37 ± 4.34 (p < 0.001), KSS knee score increased from 83.25 ± 11 to 93.87 ± 1.73 (p = 0.012). KSS function also increased from 57.50 ± 11.65 to 88.13 ± 3.72 (p = 0.011) with decreased in thigh circumference (1–3 cm). Five patients have full ROM, able to kneeling, while 3 patients were able to kneeling with adjustments. There were no postoperative infection, patellar fractures nor redislocations.
Conclusion:
MPFL reconstruction using quadriceps tendon grafts with arthroscopic lateral release can provide improved clinical results without complications of patellar fracture or stiffness of the knee, infection, and redislocation.
Level of evidence:
Level 3, Retrospective Cohort Study.
Highlights:
Background: Badminton is a high-paced and fastest racket sport in the world. The movements include shot in the upper-head, smash, running, and etc. That is why a lot risk of injuries happens in badminton during the training and competition. Most cases is the overuse injury, it is about, 98.5%.
Methods: A systematic review using PubMed and Google Scholar was conducted based on PRISMA guideline. Inclusion criteria were the mean age 14-52 years old, comparing between training and competition that cause incidence of overuse injury. Studies of only one surgical technique modality and case reports were excluded. For the meta-analysis, a total of 4 studies were included and fixed effect model was used to pool the result. In each study, mean difference (MD) with 95% confidence interval (CI) was calculated for continuous data using review manager 5.0.
Results: A total of 361 athletes mean aged 15-52 years old were included in the analysis. Male and female were equally affected, while variable angle plate was more often performed than fixed angle plate. Meta-analysis based on the incidence of overuse injury proved that the odd ratio between variable angle and fixed angle plate is 1,68, indicating higher incidence while training (p value=0.09).
Conclusion: Current systematic review and meta-analysis suggest that the incidence of overuse injury is higher in badminton training compared to badminton competition.
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