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  1 / 417 MEDLINE  
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PMID:28692374
Autor:Mirza YH; Oussedik S
Endereço:Trauma Fellow, Department of Trauma and Orthopaedics, Royal Gwent Hospital, Newport, NP20 2UB.
Título:Is there a role for stem cells in treating articular injury?
Fonte:Br J Hosp Med (Lond); 78(7):372-377, 2017 Jul 02.
ISSN:1750-8460
País de publicação:England
Idioma:eng
Resumo:Articular cartilage is a specialized tissue with a high prevalence of injuries. The complex architecture of articular cartilage means that injuries are difficult to treat. The sequelae of such injuries include post-traumatic osteoarthritis. Current treatments include microfracture, microdrilling, osteochondral transplantation and matrix autologous chondral implantation. However, current surgical therapies have a number of disadvantages. Mesenchymal stem cells have been suggested as a potential alternative therapy, with a theoretical ability to regenerate articular cartilage. Research, although positive, is mainly limited to case series, in which the follow up is short to medium term. Stem cells may hold the answer to the age-old problem of articular cartilage injury but more robust evidence is required.
Tipo de publicação: JOURNAL ARTICLE


  2 / 417 MEDLINE  
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PMID:28538419
Autor:Shirai Y; Wakabayashi K; Wada I; Tsuboi Y; Ha M; Otsuka T
Endereço:aDepartment of Orthopaedic Surgery bDepartment of Rehabilitation Medicine, Nagoya City University Graduate School of Medicine, Nagoya, Aichi, Japan.
Título:Magnetic resonance imaging evaluation of the labrum to predict acetabular development in developmental dysplasia of the hip: A STROBE compliant study.
Fonte:Medicine (Baltimore); 96(21):e7013, 2017 May.
ISSN:1536-5964
País de publicação:United States
Idioma:eng
Resumo:Recently, more attention has been paid to the role of the acetabular labrum. Therefore, we designed a retrospective cohort study of patients with residual hip dysplasia (RHD) who underwent magnetic resonance imaging (MRI). The objective of this study was to investigate an association between the MRI appearance of the labrum before school age and the natural history of RHD.We retrospectively investigated 45 hips of 40 patients who underwent MRI at about 3 and 4 years of age for RHD and were conservatively followed up with until 6 years of age or older. We evaluated the extent of eversion with a new method that measures the ß angle (MRI ß angle) using landmarks of the Graf method on MRI T2*-weighted images. The outcome measure was the Severin classification at the final follow-up. We compared the radiographic and MRI parameters at approximately 3 and 4 years of age between the good and poor outcome groups. The Student t test or one-way analysis of variance was used to compare the quantitative variables between groups. The Chi-square test was used to perform a ratio comparison.Although there was a significant difference in the center-edge (CE) angle, there was no significant difference in the acetabular index and the ratio of the presence of femoral head necrosis and the break in Shenton line between the good and poor groups. The MRI ß angle was significantly greater in the poor outcome group than in the normal and good outcome groups. The cut-off value of the MRI ß angle to differentiate the good and poor outcome groups was 65°, and its specificity and sensitivity were 92% and 53%, respectively.There was labral eversion on MRI scans in patients with RHD. Acetabular development before adolescence was poorer with greater labral eversion on MRI scans. The specificity for poor acetabular development was high when the MRI ß angle was 65° or more. The MRI ß angle has the potential to predict acetabular development.
Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY


  3 / 417 MEDLINE  
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PMID:27887870
Autor:Zong JC; Mosca MJ; Degen RM; Lebaschi A; Carballo C; Carbone A; Cong GT; Ying L; Deng XH; Rodeo SA
Endereço:Department of Orthopaedic Surgery, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
Título:Involvement of Indian hedgehog signaling in mesenchymal stem cell-augmented rotator cuff tendon repair in an athymic rat model.
Fonte:J Shoulder Elbow Surg; 26(4):580-588, 2017 Apr.
ISSN:1532-6500
País de publicação:United States
Idioma:eng
Resumo:BACKGROUND: Bone marrow aspirate has been used in recent years to augment tendon-to-bone healing, including in rotator cuff repair. However, the healing mechanism in cell-based therapy has not been elucidated in detail. METHODS: Sixteen athymic nude rats were randomly allocated to 2 groups: experimental (human mesenchymal stem cells in fibrin glue carrier) and control (fibrin glue only). Animals were sacrificed at 2 and 4 weeks. Immunohistochemical staining was performed to evaluate Indian hedgehog (Ihh) signaling and SOX9 signaling in the healing enthesis. Macrophages were identified using CD68 and CD163 staining, and proliferating cells were identified using proliferating cell nuclear antigen staining. RESULTS: More organized and stronger staining for collagen II and a higher abundance of SOX9 cells were observed at the enthesis in the experimental group at 2 weeks. There was significantly higher Gli1 and Patched1 expression in the experimental group at the enthesis at 2 weeks and higher numbers of Ihh cells in the enthesis of the experimental group vs control at both 2 weeks and 4 weeks postoperatively. There were more CD68 cells localized to the tendon midsubstance at 2 weeks compared with 4 weeks, and there was a higher level of CD163 staining in the tendon midsubstance in the experimental group than in the control group at 4 weeks. CONCLUSION: Stem cell application had a positive effect on fibrocartilage formation at the healing rotator cuff repair site. Both SOX9 and Ihh signaling appear to play an important role in the healing process.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (Antigens, CD); 0 (Antigens, Differentiation, Myelomonocytic); 0 (CD163 antigen); 0 (CD68 protein, rat); 0 (Collagen Type II); 0 (Gli protein, rat); 0 (Hedgehog Proteins); 0 (Patched-1 Receptor); 0 (Ptch1 protein, rat); 0 (Receptors, Cell Surface); 0 (SOX9 Transcription Factor); 0 (Zinc Finger Protein GLI1)


  4 / 417 MEDLINE  
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PMID:27695906
Autor:Shibata KR; Matsuda S; Safran MR
Endereço:Department of Orthopaedic Surgery, Nishi-Kobe Medical Center, 5-3-7 Kojidai Nishiku, Kobe, 651-2273, Japan. k6shibata@gmail.com.
Título:Is there a distinct pattern to the acetabular labrum and articular cartilage damage in the non-dysplastic hip with instability?
Fonte:Knee Surg Sports Traumatol Arthrosc; 25(1):84-93, 2017 Jan.
ISSN:1433-7347
País de publicação:Germany
Idioma:eng
Resumo:PURPOSE: The purpose of this study was to determine whether or not there is a distinct pattern of injury to the acetabular labrum and/or cartilage in the hip with instability without bony dysplasia. METHODS: Surgical records and intra-operative images of consecutive patients who underwent primary hip arthroscopy for femoroacetabular impingement (FAI) and/or hip instability by the senior author from April 2007 to December 2014 were retrospectively reviewed. Pathological changes were documented and charted on a novel diagram of the acetabulum, and classified into eight patterns corresponding to the lesion's location and size. In patients who had acetabular chondroplasty treatment, the width of the cartilage lesion was recorded. RESULTS: A total of 953 hips in 886 patients were included, and patients who met our inclusion/exclusion criterion were grouped into an Instability-Only group (45 hips), an Instability-Dysplasia group (12 hips), as well as Pincer-FAI, Cam-FAI, and Combined-FAI groups consisting of 100, 54, and 269 hips, respectively. In the Instability-Only group, 42.2 % of the chondral and labral lesions demonstrated a "Straight-Anterior" pattern, which proportion was statistically significantly different compared with Pincer-FAI (p < 0.000), Cam-FAI (p = 0.0002), and Combined-FAI (p < 0.000) groups. In Instability-Only patients, only 15.6 % of the lesions had an "Anterior to Lateral" pattern, a significantly lower proportion (p < 0.000) compared with the FAI groups. Also 11.1 % of the lesions demonstrated a "Lateral" pattern, which is a significantly greater proportion compared with Pincer-FAI (p < 0.000) and Combined-FAI (p < 0.000) groups. The mean width of the cartilage lesions for the Instability-Only group was 2.9 mm, which was significantly shallower than for the other FAI groups (p < 0.000). CONCLUSION: A significant predilection of "Straight-Anterior" or "Lateral" location of labral and/or cartilage damage was observed in the hip with instability, while there was shallow width of articular cartilage damage in these patients. These results suggest that there is a distinctive labral and cartilage damage pattern for hips with instability without inherent bony dysplasia. LEVEL OF EVIDENCE: Diagnostic study, Level IV.
Tipo de publicação: JOURNAL ARTICLE


  5 / 417 MEDLINE  
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PMID:26791778
Autor:Sansone M; Ahldén M; Jónasson P; Thomeé C; Swärd L; Öhlin A; Baranto A; Karlsson J; Thomeé R
Endereço:Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
Título:Outcome after hip arthroscopy for femoroacetabular impingement in 289 patients with minimum 2-year follow-up.
Fonte:Scand J Med Sci Sports; 27(2):230-235, 2017 Feb.
ISSN:1600-0838
País de publicação:Denmark
Idioma:eng
Resumo:Femoroacetabular impingement (FAI) is a common cause of hip pain and dysfunction. The purpose of this study was to report outcome 2 years after the arthroscopic treatment of FAI using validated outcome measurements. Two hundred and eighty-nine patients (males = 190, females = 99) with a mean age of 37 years underwent arthroscopic surgery for FAI. Patients were included consecutively in a hip arthroscopy registry. The cohort was evaluated using online web-based validated health-related patient-reported outcomes measurements, including the iHOT-12, HAGOS, EQ-5D, HSAS for physical activity level, VAS for overall hip function and overall satisfaction. The mean follow-up time was 25.4 months. Pre-operative scores compared with those obtained at follow-up revealed statistically and clinically significant improvements (P < 0.05) for all measured outcomes; iHOT-12 (43 vs 66), VAS for global hip function (50 vs 71), HSAS (2.9 vs 3.6), EQ-5D index (0.58 vs 0.75), EQ-VAS (67 vs 75) and HAGOS different subscales (56 vs 76, 51 vs 69, 60 vs 78, 40 vs 65, 29 vs 57, 33 vs 58). At the 2-year follow-up, 236 patients (82%) reported they were satisfied with the outcome of surgery. We conclude that arthroscopic treatment for FAI resulted in statistically and clinically significant improvements in outcome parameters.
Tipo de publicação: JOURNAL ARTICLE


  6 / 417 MEDLINE  
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PMID:26607944
Autor:Lee SY; Yoon J; Cho YS; Son RC; Kim SK; Ahn SH; Lee HK
Endereço:Department of Radiology, The Armed Forces Capital Hospital, 177 Saemael-ro, Bundang-gu, Sungnam, 13574, Republic of Korea. lsyrad@gmail.com.
Título:Various factors contribute to graft extrusion in lateral meniscus allograft transplantation.
Fonte:Knee Surg Sports Traumatol Arthrosc; 25(2):374-382, 2017 Feb.
ISSN:1433-7347
País de publicação:Germany
Idioma:eng
Resumo:PURPOSE: Lateral meniscus allograft transplantation (LMAT) is a feasible surgical option for young meniscus-deficient patients. Although several studies have explored the factors that contribute to graft extrusion, they have not been fully elucidated. The aim of this study was to determine the various factors that contribute to graft extrusion. METHODS: Patients with knees that had received LMAT using a keyhole technique (n = 87 knees in 82 patients) were reviewed. The median age of these patients was 22 years (range 19-54 years), and the median postprocedural follow-up interval was 5 days (range 1-136 days). Twelve magnetic resonance imaging (MRI) measurement parameters (axial and coronal location of the bone block) that could potentially influence graft extrusion were evaluated, along with absolute graft extrusion and relative percentage of extrusion (RPE). RESULTS: A significant correlation was found between 8 of the 12 MRI measurement parameters and both the absolute extrusion and RPE (r = 0.241-0.438, p < 0.05). The absolute middle distance and depth of the bone block were independent predictors of the absolute extrusion (ß = 0.30 and 0.15, respectively; p < 0.05), and the relative middle distance and relative bone-block elevation were found to be predictors of RPE (ß = 2.29 and 1.44, respectively; p < 0.05). CONCLUSION: The rate of graft extrusions after LMAT was high in this study. Both the coronal and axial locations of the bone block were found to influence graft extrusion in LMAT. Therefore, correct positioning of the bone block, including in both the axial and coronal planes, is essential to minimize graft extrusion. Future studies need to investigate the long-term clinical outcome and longevity of extruded menisci after transplantation. LEVEL OF EVIDENCE: Therapeutic case series, Level IV.
Tipo de publicação: JOURNAL ARTICLE


  7 / 417 MEDLINE  
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PMID:26572634
Autor:Signorelli C; Bonanzinga T; Lopomo N; Zaffagnini S; Marcacci M; Safran M
Endereço:Laboratorio di Biomeccanica ed Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, Bologna, BO, Italy. c.signorelli@biomec.ior.it.
Título:Evaluation of the sealing function of the acetabular labrum: an in vitro biomechanical study.
Fonte:Knee Surg Sports Traumatol Arthrosc; 25(1):62-71, 2017 Jan.
ISSN:1433-7347
País de publicação:Germany
Idioma:eng
Resumo:PURPOSE: To quantitatively evaluate the biomechanical sealing function of an intact labrum and the effect of labral-chondral separation, cerclage suture labral repair, vertical mattress suture repair and partial labrectomy on distraction load and hip joint centre (HJC) displacement. METHODS: Eight fresh-frozen cadaveric hips were tested using a navigation system for intra-operative kinematic analysis. A six-axis load cell was used to measure the manually applied force when performing the tests: hip pivoting movement and distraction. The HJC displacement that occurred during the distraction test has been evaluated in correspondence of seven different values of applied force. During the pivoting motion, the maximum value of HJC displacement was evaluated. Five different conditions were tested: labrum intact, labral-chondral separation, vertical mattress suture repair, cerclage suture repair, and partial labrectomy. RESULTS: With regard to HJC displacement using at fixed value of force, the paired sample t test underscored the statistically significant differences (p < 0.05) for each of the five tested conditions among themselves. Only the comparison of intact versus labral-chondral separation was not significantly different. During pivoting motion, a statistically significantly greater displacement was identified after labrectomy when compared with the cerclage suture repair (p = 0.03) and vertical mattress repair (p < 0.01) in medial-lateral direction. Along proximal-distal direction, a significant lower displacement after labrectomy was identified when compared to the cerclage suture repair (p = 0.03). Performing the pivoting motion at the extreme ranges of motion demonstrated a higher value of displacement after labrectomy when compared with all the previously tested conditions. CONCLUSIONS: These results suggest that labral repair is important in the function of the hip and that the vertical mattress suture technique may be better than the cerclage suture repair.
Tipo de publicação: EVALUATION STUDIES; JOURNAL ARTICLE


  8 / 417 MEDLINE  
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PMID:27744000
Autor:Dangin A; Tardy N; Wettstein M; May O; Bonin N
Endereço:CHU Nord Saint-Étienne, chirurgie orthopédique et de traumatologie, avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, France. Electronic address: antoine.dangin@gmail.com.
Título:Microinstability of the hip: A review.
Fonte:Orthop Traumatol Surg Res; 102(8S):S301-S309, 2016 Dec.
ISSN:1877-0568
País de publicação:France
Idioma:eng
Resumo:With the development of conservative hip surgery techniques, new entities such as microinstability have been identified. Microinstability is a painful supra-physiological mobility of the hip. It results from the association of architectural and functional abnormalities impairing joint stability. These risk factors concern hip joint bone architecture or peri-articular soft tissues. Bone abnormalities are identified on hip assessment parameters. Soft tissues also play a key role in the static and dynamic stability of the hip: the joint capsule, labrum, ligamentum teres and adjacent myotendinous structures affect joint coaptation; any abnormality or iatrogenic lesion concerning these structures may constitute a risk factor for microinstability. Diagnosis is based on interview, clinical examination and imaging. Findings of labral lesions or femoro-acetabular impingement do not rule out microinstability; they may be associated. Treatment is based first on physiotherapy for muscle reinforcement to improve joint coaptation. In case of failure, arthroscopic surgery is indicated for femoro-acetabular impingement and capsular plicature which is being evaluated. Periacetabular osteotomy or shelf acetabuloplasty may be indicated, according to the severity of joint bone architecture abnormality. Microinstability is a multifactorial entity. Lesions induced by microinstability may in turn become risk factors for aggravation. Diagnosis and indications for surgery are thus difficult to establish. Only full clinical examination and exhaustive imaging assessment allow microinstability and associated lesions to be identified.
Tipo de publicação: JOURNAL ARTICLE; REVIEW


  9 / 417 MEDLINE  
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PMID:27358283
Autor:Lu H; Chen C; Qu J; Chen H; Chen Y; Zheng C; Wang Z; Xu D; Zhou J; Zhang T; Qin L; Hu J
Endereço:Department of Sports Medicine, Research Center of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China.
Título:Initiation Timing of Low-Intensity Pulsed Ultrasound Stimulation for Tendon-Bone Healing in a Rabbit Model.
Fonte:Am J Sports Med; 44(10):2706-2715, 2016 Oct.
ISSN:1552-3365
País de publicação:United States
Idioma:eng
Resumo:BACKGROUND: Low-intensity pulsed ultrasound stimulation (LIPUS) has been proven to be a beneficial biophysical therapy for tendon-bone (T-B) healing. However, the optimal time to initiate LIPUS treatment has not been determined yet. LIPUS initiated at different stages of the inflammatory phase may profoundly affect T-B healing. PURPOSE: An established rabbit model was used to preliminarily investigate the effect of LIPUS initiation timing on T-B healing. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 112 mature rabbits that underwent partial patellectomy were randomly assigned to 4 groups: daily mock sonication (control group) and daily ultrasonication started immediately postoperatively (immediate group), on postoperative day 7 (7-day delayed group), or on postoperative day 14 (14-day delayed group). Peripheral leukocyte counts at the inflammatory phase were used to assess postoperative inflammation. The rabbits were sacrificed at 8 or 16 weeks postoperatively for microarchitectural, histological, and mechanical evaluations of the patella-patellar tendon (PPT) junction. RESULTS: The biomechanical properties of the PPT junction were significantly improved in the LIPUS-treated groups. Significantly higher ultimate strength and stiffness were seen in the 7-day delayed group compared with the other groups at 8 weeks postoperatively (P < .05 for all). Newly formed bone expansion from the remaining patella in the ultrasonic treatment groups was significantly increased and remodeled compared with the control group. Micro-computed tomography analysis showed that the 7-day delayed group had significantly more bone volume and bone mineral content at the interface as compared with the other groups at 8 weeks postoperatively (P < .05 for all). Histologically, the ultrasonic treatment groups exhibited a significantly better PPT junction, as shown by more formation and remodeling of the fibrocartilage layer and newly formed bone. Additionally, peripheral leukocyte counts displayed a significant increase from postoperative day 1 to day 3 in the immediate group as compared with the other groups. Furthermore, postoperative hydrarthrosis was more likely in the immediate group. CONCLUSION: LIPUS started at postoperative day 7 had a more prominent effect on T-B healing compared with the other treatment regimens in this study. CLINICAL RELEVANCE: The findings of the study may help optimize the initiation timing of LIPUS for T-B healing.
Tipo de publicação: JOURNAL ARTICLE


  10 / 417 MEDLINE  
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PMID:27329049
Autor:O'Reilly A; Kelly DJ
Endereço:Trinity Centre for Bioengineering, Trinity Biomedical Sciences, Trinity College Dublin, Dublin, Ireland.
Título:Unravelling the Role of Mechanical Stimuli in Regulating Cell Fate During Osteochondral Defect Repair.
Fonte:Ann Biomed Eng; 44(12):3446-3459, 2016 Dec.
ISSN:1573-9686
País de publicação:United States
Idioma:eng
Resumo:We have previously developed a computational mechanobiological model to explore the role of substrate stiffness and oxygen availability in regulating stem cell fate during spontaneous osteochondral defect repair. This model successfully simulated many aspects of the regenerative process, however it was unable to predict the spatial patterns of endochondral bone and fibrocartilaginous tissue formation observed during the latter stages of the repair process. It is hypothesised that this was because the mechanobiological model did not consider the role of tissue strain in regulating specific aspects of chondrocyte differentiation. To test this, our mechanobiological model was updated to include rules whereby intermediate levels of octahedral shear strain inhibited chondrocyte hypertrophy, while excessively high octahedral shear strains resulted in the formation of fibrocartilage. This model was used to simulate spontaneous osteochondral defect repair, where it correctly predicted the experimentally observed patterns of bone formation. Overall the results suggest that oxygen availability regulates chondrogenesis and endochondral ossification during the early phases of osteochondral defect repair, while direct mechanical cues play a greater role in regulating chondrocyte differentiation during the latter stages of this process. In particular, these results suggest that an appropriate loading regime can assist in promoting the development of stable hyaline cartilage during osteochondral defect repair.
Tipo de publicação: JOURNAL ARTICLE



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