The treatment of scoliosis has been explored and debated in medicine since the first recorded texts. Scoliosis treatment has shifted over time from external modalities, such as traction and bracing, to internal stabilization techniques that leverage surgical advances. Surgical fixation constructs can generally be separated into two different modalities: dynamic vs. static constructs. For skeletally immature individuals with progressive deformities, surgical options range from traditional or magnetically controlled growing rods to vertebral body staples or tethering. For individuals who have reached skeletal maturity, many devices have been developed that provide static length constructs. Understanding the surgical options available is critical for the appropriate management of this varied patient population. With this article, we sought to provide a summary of past and present techniques and devices used in the treatment of scoliosis.
Category: Ankle; Basic Sciences/Biologics; Other Introduction/Purpose: The purpose of this study was to evaluate the presence of connective tissue progenitor cells within the retrocalcaneal bursa. The study evaluation included an assessment of the viability of connective tissue progenitor cells, their proliferative potential, and their ability to differentiate into osteoblasts, adipocytes, and chondrocytes. Methods: The retrocalcaneal bursa samples were excised from 10 patients (age: 51.5 +- 10.8 years) undergoing Achilles surgery in which the retrocalcaneal bursa is routinely excised. Bursal tissue was processed by digesting cells with collagenase and obtaining nucleated cell counts and cellular concentrations. The cells were cultured, and differentiated into osteoblasts, adipocytes, and chondrocytes. Analysis of bursal derived cells consisted of fluorescent activated cell sorting (FACS) analysis, cellular proliferation and viability assay, and analysis of differentiation into osteoblasts, adipocytes, and chondrocytes. The CTP differentiation was confirmed using histology staining to qualitatively express differentiation, and qPCR to quantify gene expression. Results: Cell migration at 3 weeks on average was found to be 3.84x107 nucleated cells/gram of tissue and nucleated cellular concentration on average was found to be 6.28x105 cells/mL of suspension. The proliferation data showed high levels of proliferation on average of 1.72 +-0.58. The FACS analysis showed a high percentage of positive surface markers for CTPs measuring greater than 96% (CD105, CD90, CD73) and measuring < 1.1% for negative surface markers (CD45 and CD31). Differentiation into osteoblasts, adipocytes, and chondrocytes were stained appropriately displaying differentiation. Conclusion: The retrocalcaneal bursa is a novel source of connective tissue progenitor cells. This is the first study to our knowledge analyzing the retrocalcaneal bursa as a novel source for CTPs, making it a potential augment to expedite the healing process of the Achilles tendon. Overall, it is unclear what the role of the CTPs within the bursa is, however, they may help to reduce the extensive healing time for the Achilles tendon thereby returning patients with Achilles tendon pathology back to functional status more promptly.
The purpose of this study was to investigate proteomic alteration that occurs to whole blood when converted to activated serum (AS) using an autologous thrombin system. This study further sought to evaluate the functional in vitro effect of AS on tenocytes, chondrocytes, subacromial bursal cells, and osteoblasts. The peptide/protein composition of AS was analyzed by liquid chromatography–mass spectrophotometry (LC-MS). The cell lines were treated with AS, and cellular proliferation was quantified 48 h after treatment. Platelet-derived growth factor (PDGF), insulin-like growth factor 1 (IGF-1), vascular endothelial growth factor (VEGF), interleukin-1 beta (IL-1β), and interleukin-1 receptor antagonist (IL-1Ra) were quantified utilizing enzyme-linked immunosorbent assays (ELISAs). LC-MS identified 357 proteins across the AS and whole blood. Fifty-four of the proteins identified had significant differences between the relative protein abundance of the AS samples compared to whole blood. Treatment with AS in all cell lines significantly increased proliferation compared to control cells at 48 h. Increased PDGF, VEGF, and IGF-1 in all cell lines exposed to AS compared to the control (p < 0.05) were observed. These findings suggest that treatment with AS increases in vitro cellular proliferation and the release of growth factors that may play a role in tissue repair.
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