This study showed that significant improvement in healing outcomes could be achieved by the use of BMC containing MSC as an adjunct therapy in standard of care rotator cuff repair. Furthermore, our study showed a substantial improvement in the level of tendon integrity present at the ten-year milestone between the MSC-treated group and the control patients. These results support the use of bone marrow-derived MSC augmentation in rotator cuff repair, especially due to the enhanced rate of healing and the reduced number of re-tears observed over time in the MSC-treated patients.
This study demonstrates that the level of MSCs present in the greater tuberosity of patients with a rotator cuff tear decreases as a function of a number of clinical factors, including lag time from tear onset to treatment, tear size, number of tears and stage of fatty infiltration, among others. This information may help the practices in using biologic augmentation of a rotator cuff repair.
The Limmed® medial opening wedge HTO system represents a novel method of achieving a reliable correction while producing a stable fixation allowing satisfactory stability and bone healing with immediate full weight-bearing.
We report the case of a total hip arthroplasty infection caused by Ruminococcus gnavus in a 62-year-old man with ulcerative colitis. The bacterium was perfectly identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry.
CASE REPORTA 62-year-old man was referred to the orthopedic surgery department of a suburban clinic with suspected prosthetic joint infection (PJI) of the right hip. This patient had undergone total right hip replacement 13 years earlier and had shown no signs of prosthesis dysfunction since surgery.On admission, the patient presented with right hip pain and fever. Biological tests showed elevated white blood cell (18.3 ϫ 10 9 cells/liter) and C-reactive protein (137 mg/liter) levels. No blood culture was collected. Radiological evaluation of the total hip arthroplasty showed a 5-mm subsidence of the femoral stem.Three bone biopsies were performed with a notch needle, and the samples were sent to the microbiology laboratory of the Hôpi-taux Universitaires Paris Ile de France Ouest, Greater Paris, for microbiological analysis. Samples were processed as previously described (1), with continuously monitored broth enrichment. Briefly, samples were topped with 17 ml sterile distilled water and bead milled for 150 s on a Retsch MM300 mixer mill (Verder, France) with 10 to 15 5-mm-diameter stainless steel beads. One hundred microliters of the resulting suspension, plated on 5% sheep blood Columbia agar medium, was incubated for 5 days at 36°C under aerobic and anaerobic conditions, and 6 ml was injected into Bactec Peds Plus and Lytic/10 Anaerobic/F blood culture vials supplemented with a fastidious organism supplement incubated for 14 days in a Bactec FX automated blood culture system (BD Diagnostics, Le Pont de Claies, France). Microscopic examination of the three biopsy samples showed an absence of erythrocytes, numerous polymorphonuclear cells, and Grampositive cocci in short chains. No empirical antibiotic therapy was started after the biopsy. All samples yielded positive cultures on anaerobic medium, with a time to detection of 7 h 7 min for all three Lytic/10 Anaerobic/F vials. On day 1, growth was detected on anaerobic blood agar plates, with numerous translucent small colonies. The diplococci were identified by mass spectrometry (Biotyper version 3.1 on a Microflex LT mass spectrometer, Bruker Daltonics, Bremen, Germany) as Ruminococcus gnavus, with a score of 2.2, and later confirmed by 16S rRNA gene sequencing using previously described primers (2). A 16S rRNA gene fragment of 407 bp was amplified from the bacteria and sequenced on an Applied Biosystems genetic analyzer. GenBank database searches showed the amplified sequences to be 99% (404/ 407 bp) identical to the 16S rRNA gene sequence of the reference strain for R. gnavus ATCC 29149 (GenBank accession no. KP407134). Antimicrobial susceptibility testing by the agar disk diffusion method (Bio-Rad, Marnes-la-Coquette, France) using Comité de l'Antibiogramme de la Société Française de Microbiologie (CA-SFM 20...
Background: The controversy regarding the outcome of total knee arthroplasties after high tibial osteotomy may relate to malalignment secondary to overcorrection after high tibial osteotomy (HTO) [1,2] and to the type of arthroplasty itself (posterior-stabilized arthroplasty or posterior cruciate ligamentretaining prosthesis). Questions/Purpose: We asked two questions: (1) Would a posterior-stabilized arthroplasty provide sufficient constrain and improve pain and function in patients with severe malalignment due to a previous HTO? (2) Will malalignment of the previous HTO jeopardize the long-term results of a total knee reconstruction with a posterior-stabilized implant? Patients and Methods: We retrospectively reviewed 25 posterior-stabilized TKAs in 25 patients with severe valgus deformity after HTO (ranging from 10°to 20°of valgus) and compared the results with a series of matched 25 posteriorstabilized TKAs in 25 patients with normocorrection after HTO ranging from 5°of valgus to 5°of varus. Clinical, operative, and radiographic data were reviewed. Minimum follow-up was 10 years after the arthroplasty (average, 15 years; range, 10-20 years). Results: All the knees had standard posterior-stabilized total knee arthroplasty implants. Patients with an overcorrected HTO were more likely to require a soft tissue release to balance the knee. However, Average Knee Society and Function Score improved, respectively, from 48 to 85 and from 50 to 90 points in the severely overcorrected group, versus, respectively, 50 to 89 and 52 to 97 in the normocorrected group, but the range of mobility was superior for patients with normal alignment. Fifteen-year survivorship after the arthroplasty comparison showed no significant difference between the two groups (one revision in each group). Conclusions: Patients with an overcorrected HTO are more likely to require a soft tissue release to balance the knee. However, both groups show improvements in function and pain. With a posterior-stabilized arthroplasty, the degree of deformity has no impact on the longevity of the TKA.
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