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Background Adhesion band formation is a common cause of morbidity for patients undergoing surgeries. Anti-inflammatory and anti-fibrotic properties of curcumin, a pharmacologically active component of Curcuma longa, have been investigated in several studies. The aim of this study is to explore the therapeutic potential of curcumin in attenuating post-operative adhesion band (PSAB) formation in both peritoneal and peritendinous surgeries in animal models. Methods Bio-mechanical, histological and quantitative evaluation of inflammation, and total fibrosis scores were graded and measured in the presence and absence of phytosomal curcumin. Results Results showed that phytosomal curcumin significantly decreased severity, length, density and tolerance of mobility of peritendinous adhesions as well as incidence and severity of abdominal fibrotic bands post-surgery. Curcumin may decrease inflammation by attenuating recruitment of inflammatory cells and regulating oxidant/anti-oxidant balance in post-operative tissue samples. Moreover, markedly lower fibrosis scores were obtained in the adhesive tissues of phytosomal curcumin-treated groups which correlated with a significant decrease in quantity, quality and grading of fibers, and collagen deposition in animal models. Conclusion These results suggest that protective effects of phytosomal curcumin against PSAB formation is partially mediated by decreasing inflammation and fibrosis at site of surgery. Further studies are needed to investigate the therapeutic potential of this molecule in preventing PSAB.

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Background In this study we investigated the therapeutic potential of the phytosomal form of pharmacologically active component of Curcuma longa, curcumin, in attenuating Post-operative adhesion bands (PSAB) formation in both peritoneal and peritendinous surgeries in animal models. Methods Bio-mechanical, Histological and quantitative evaluation of inflammation, and total fibrosis scores were graded and measured in the presence and absence of phytosomal curcumin. Results Our results showed that phytosomal curcumin significantly decreased severity, length, density and tolerance of mobility of peritendinous adhesions as well as incidence and severity of abdominal fibrotic bands post-surgery. We showed that curcumin could decrease inflammation by attenuating recruitment of inflammatory cells and regulating oxidant/anti-oxidant balance in post-operative tissue samples. Moreover, markedly lower fibrosis scores were obtained in the adhesive tissues of phytosomal curcumin-treated groups which correlated with a significant decrease in quantity, quality and grading of fibers, and collagen deposition in animal models. Conclusion These results suggest that the anti-inflammatory and anti-fibrotic properties of phytosomal curcumin, has therapeutic potential for preventing PSAB formation.”

Objective To compare the effects of ankle integral and conventional physiotherapy on pain, range of motion, balance, disability, and treatment effectiveness in patients with chronic ankle instability (CAI). Design Two-arm, parallel-group, randomized, double-blind, controlled trial. Participants 60 patients with unilateral CAI. Intervention integral physiotherapy (n = 30) or conventional physiotherapy (n = 30). Outcomes Visual Analog Scale (VAS), dorsiflexion and plantarflexion range of motion, Star Excursion Balance Test (SEBT), Single Leg Hop (SLH) test, Foot and Ankle Outcome Score (FAOS), Lower Extremity Functional Score (LEFS), global rating of change, were gathered pre and post-intervention. Results The ANOVA results revealed statistically significant interaction for FAOS, and LEFS outcome measures ( P < 0.05) and the mean change results showed there were a favorable clinical difference incline toward the integral group (meanintegral = 20.14 (14.95–25.37), meanConventional = 29.46 (24.09–34.83)). There were no interactions between group and time among other outcome measures ( P > 0.05). The group main effect did not show any statistical significance ( P > 0.05). Conclusion Hip strengthening and balance exercises added to ankle rehabilitation could be more favorable on improving the patients’ functional ability.

Talus fracture is often associated with debilitating complications, including osteonecrosis, non-union, malunion, and osteoarthritis. This study aimed to evaluate the clinical and radiographic outcomes of different types of surgically treated talus fractures and factors affecting outcomes. A total of 38 patients with talus fractures from April 2014 to April 2019 were included. Radiological evaluations, including standard ankle radiographs and ankle CT scans, were performed pre-and post-operatively to assess union, malunion, osteonecrosis, and osteoarthritis of adjacent joints. Functional evaluation was performed using the American Orthopedic Foot and Ankle Society (AOFAS), visual analogue scale (VAS), and Manchester Oxford Foot Questionnaire (MOXFQ) questionnaires. Talar fractures included talar neck (52.6%), talar body (28.9%), body fractures extend to neck (15.7%), lateral and posterior process fracture (2.6%). Osteoarthritis was the most common complication (52.6%), followed by osteonecrosis (47.3%). The mean AOFAS, MOXFQ, and VAS scores were 60.3 (SD=+/-18.6), 67.6 (SD=+/-20.7), and 4.9 (SD=+/-2.1), respectively. There was no significant difference in VAS, MOXFQ, and AOFAS scores between different types of talar fractures (p > 0.05). There was no correlation between the time of surgery and the rate of osteonecrosis (p > 0.05). In conclusion, talus fracture was associated with many complications that adversely affected the clinical outcome of the patients. Delay in surgical fixation did not appear to affect the outcome or prevalence of osteonecrosis. Level of Clinical Evidence (LOCE):4

Background Hyperlipidemia is associated with tendon disorders and biomechanical changes through tissue deposition. In the present study, we seek the relation of plantar fasciitis (PF) with lipid profile parameters and fasting blood sugar (FBS) levels. Methods In a case-control study, we enrolled 68 patients with a clinical diagnosis of PF in the case group and 136 individuals without PF in the control group. Patients’ height, weight, body mass index (BMI), FBS, lipid profile including low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol, and triglyceride (TG) laboratory tests were also checked as the main study variables to be compared between the two groups. The mean difference of each variable between the two case and control groups was tested using an independent t-test. Correlation coefficient analyses were used to calculate the correlation of patients’ BMI with lipid profile and FBS levels to evaluate the BMI variable as a confounder. Results Patients with PF had higher levels of total cholesterol (p=0.001), LDL (P= 0.004), and TG (P=0.02). HDL (P=0.13) and FBS (P=0.24) levels did not differ between two groups. Odds ratio calculation showed that patients with serum levels of LDL >130 mg/dl and total cholesterol > 200 mg/dl were 3.7 and 1.8 times more likely to develop PF, respectively. We found no association between lipid profile parameters and BMI in either of the two groups. Conclusions Our findings show higher levels of serum lipid profile parameters in patients with PF. Thus, it supports the modification of LDL, TC, TG, and glucose levels when managing PF. Trial Registration: The study does not include intervention.