Cartilage is a hydrated tissue with no vascular and neural networks.They are divided into three major groups: hyaline, fibrous and elastic cartilages. Hyaline cartilage is the most frequent form and is found in synovial joints, ribs, nose, trachea, bronchi, etc 1 The main roles of this articular hyaline cartilage are to tolerate bone load and forming a lubricant environment to enable joint movement. 2 Extracellular matrix (ECM) synthesized by chondrocytes constitutes the main part of each cartilage. Collagen type II is the most frequent ECM molecule in hyaline cartilage and accounts for 90%-95% of total collagen molecules. 3,4 Collagen II forms filamentous structures with collagen IX, responsible for cartilage tensile and shear stress. Proteoglycans, such as aggrecan, and glycosaminoglycans (GAG), such as chondroitin sulphate, are the other components of the articular cartilage ECM. 5,6 The integrity of ECM is vital for the normal function of cartilage. Therefore, changes in ECM elements and composition are the main feature of cartilage diseases. 7
Background: Single-row (SR) and double-row (DR) techniques are 2 kinds of widely used approaches for the arthroscopic repair of rotator cuff. This retrospective clinical trial was performed to address the question of whether a DR rotator cuff anchor repair gives results superior to a SR anchor repair in clinical outcome scores and complication rates. Methods: This study was performed and reported in accordance with the Strengthening the Reporting of Observational studies in Epidemiology checklist. We retrospectively reviewed our database, which was collected prospectively. From 2014 to 2017, 264 patients underwent arthroscopic rotator cuff repair by an experienced single shoulder surgeon with the SR and DR techniques. This study was approved by the institutional review board in our hospital and was registered in the Research Registry. Outcome measures included Constant-Murley score, muscle strength, patient satisfaction, passive range of motion, and retear rates. Results: The hypothesis was that the DR technique would achieve better functional scores and fewer complications as compared to the SR technique in treatment of rotator cuff tears.
Background Arthroscopic repair is a promising, minimally invasive surgical technique for patients with Palmer type 1B peripheral triangular fibrocartilage complex (TFCC) tears. Although several arthroscopic techniques are effective for repairing Palmer type 1B TFCC tears, some shortcomings remain; thus, better methods are necessary. Methods We performed an arthroscopic intracapsular suture using an outside-in transfer, all-inside repair technique, which is a modified method of the outside-in and all-inside technique using the needle of a 10-mL sterile syringe, for Palmer type 1B TFCC tears. A No. 2 polydioxanone suture was threaded through the needle and entered the wrist joint. Next, the needle was withdrawn carefully along the suture to the proximal tear ulnar surface of the TFCC and penetrated the TFCC, exiting the articular cavity surface of the ulnar side of the torn TFCC. Finally, arthroscopic knotting was performed. Results This new technique was used to treat 17 patients with Palmer type 1B Atzei class 1 TFCC tears. The treatment was as effective as the previously described arthroscopic techniques and had advantages of no additional incision and decreased risk of operation-related complications. Conclusions The outside-in transfer, all-inside repair is a simple, safe, minimally invasive, and economical procedure that confers a lower risk of complications for Palmer type 1B TFCC tears. We recommend this technique as a useful alternative to the conventional methods of repairing Palmer type 1B TFCC tears.
Purpose: The extra-articular proximal tibial fractures continue to have high malunion rates despite development in intramedullary nailing (IMN) technology. Combined plate and IMN fixation can increase mechanical stability. The purpose of this study was to investigate combined plate and IMN for the treatment of extra-articular proximal tibial fracture using a biomechanical model.Methods: A 10-mm defective osteotomy was created in the fourth-generation composite tibia to simulate extra-articular proximal tibial fractures (AO/OTA 41A2). The fractures were stabilized with IMN alone (IMN group), IMN with supplementary medial plate (M-IMN group), and IMN with supplementary lateral plate (L-IMN group). The biomechanical properties of each specimen were tested under axial compression loading, bending stress, and cyclic loading. The maximum displacement of the fragments and implant-bone construct failure was recorded.Results: The maximum displacement of the M-IMN group was significantly less than either the L-IMN or IMN group in both axial compression loading and bending stress (p < 0.05 for both comparisons). All specimens in the three groups survived in 10,000 cyclic loading without hardware deformation. The maximum stiffness of failure was similar between the M-IMN and L-IMN groups, but the IMN group was statistically lower than either the L-IMN or the IMN group (p < 0.05).Conclusion: The results indicated that combined medial plate and IMN fixation could effectively increase the mechanical stability of proximal tibial fractures.
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