Revistas
Autores:
Gil-Melgosa, L.; Grasa, J.; Urbiola, A.; et al.
Revista:
BIOMEDICINES
ISSN:
2227-9059
Año:
2022
Vol.:
10
N°:
1
Págs.:
19
Achilles tendon rupture is a frequent injury with an increasing incidence. After clinical surgical repair, aimed at suturing the tendon stumps back into their original position, the repaired Achilles tendon is often plastically deformed and mechanically less strong than the pre-injured tissue, with muscle fatty degeneration contributing to function loss. Despite clinical outcomes, pre-clinical research has mainly focused on tendon structural repair, with a lack of knowledge regarding injury progression from tendon to muscle and its consequences on muscle degenerative/regenerative processes and function. Here, we characterize the morphological changes in the tendon, the myotendinous junction and muscle belly in a mouse model of Achilles tendon complete rupture, finding cellular and fatty infiltration, fibrotic tissue accumulation, muscle stem cell decline and collagen fiber disorganization. We use novel imaging technologies to accurately relate structural alterations in tendon fibers to pathological changes, which further explain the loss of muscle mechanical function after tendon rupture. The treatment of tendon injuries remains a challenge for orthopedics. Thus, the main goal of this study is to bridge the gap between clinicians' knowledge and research to address the underlying pathophysiology of ruptured Achilles tendon and its consequences in the gastrocnemius. Such studies are necessary if current practices in regenerative medicine for Achilles tendon ruptures are to be improved.
Revista:
MATERIALS
ISSN:
1996-1944
Año:
2019
Vol.:
12
N°:
19
Págs.:
3105
In the treatment of bone non-unions, an alternative to bone autografts is the use of bone morphogenetic proteins (BMPs), e.g., BMP-2, BMP-7, with powerful osteoinductive and osteogenic properties. In clinical settings, these osteogenic factors are applied using absorbable collagen sponges for local controlled delivery. Major side effects of this strategy are derived from the supraphysiological doses of BMPs needed, which may induce ectopic bone formation, chronic inflammation, and excessive bone resorption. In order to increase the efficiency of the delivered BMPs, we designed cryostructured collagen scaffolds functionalized with hydroxyapatite, mimicking the structure of cortical bone (aligned porosity, anisotropic) or trabecular bone (random distributed porosity, isotropic). We hypothesize that an anisotropic structure would enhance the osteoconductive properties of the scaffolds by increasing the regenerative performance of the provided rhBMP-2. In vitro, both scaffolds presented similar mechanical properties, rhBMP-2 retention and delivery capacity, as well as scaffold degradation time. In vivo, anisotropic scaffolds demonstrated better bone regeneration capabilities in a rat femoral critical-size defect model by increasing the defect bridging. In conclusion, anisotropic cryostructured collagen scaffolds improve bone regeneration by increasing the efficiency of rhBMP-2 mediated bone healing.
Revista:
JOURNAL OF PEDIATRIC ORTHOPAEDICS-PART B
ISSN:
1060-152X
Año:
2019
Vol.:
28
N°:
6
Págs.:
553 - 554
Buckle or torus fractures in the distal forearm are characterized by a bulging of the cortical bone. They are a frequent reason for consultation in pediatric emergencies. The treatment and follow-up of this type of fractures varies from soft immobilizations to a plaster cast. The purpose of this study is to assess the stability of buckle fractures of the distal radius. We reviewed 106 pediatric patients with buckle fractures and analyzed the radiographs at the time of initial consultation and at the last follow-up. None of these fractures displaced further, regardless of the treatment given. Buckle or torus fractures do not need follow-up radiographs. As they are stable, the simpler immobilization treatment is sufficient.
Revista:
M.L.T.J. MUSCLES, LIGAMENTS AND TENDONS JOURNAL
ISSN:
2240-4554
Año:
2018
Vol.:
8
N°:
2
Págs.:
261-275
Conclusion: Animal models for muscular degeneration after rotator cuff tears have been well established and described. The next challenge is the achievement of a therapeutic target that could be transferred to the clinical setting.
Revista:
ATENCION PRIMARIA
ISSN:
0212-6567
Año:
2016
Vol.:
48
N°:
7
Págs.:
501 - 502
Revista:
JOURNAL OF FOOT AND ANKLE SURGERY
ISSN:
1067-2516
Año:
2016
Vol.:
55
N°:
3
Págs.:
461-4
We used coronal computed tomography to determine the normal sesamoid position in 20 healthy volunteers. The sample involved 40 feet (20 left [50%] and 20 right [50%]) in 20 volunteers, including 11 females (55%) and 9 males (45%). The relationship between the first metatarsal head and the sesamoid complex was categorized as Yildirim grade 0 in every case (100%). The mean width of the foot was 77.7 ± 5.8 mm, and the ratio of the foot width to the distance from the second metatarsal head to the tibial sesamoid was 39.6% ± 2.02%. Based on our findings, we consider Yildirim grade 0 to be the normal sesamoid alignment.
Revista:
JOURNAL OF FOOT AND ANKLE SURGERY
ISSN:
1067-2516
Año:
2015
Vol.:
54
N°:
6
Págs.:
1111-1115
Some investigators have emphasized restoring the relationship between the sesamoid complex and the first metatarsal head to reduce the risk of hallux valgus recurring after surgical reconstruction. In a prospective study, we analyzed whether the first metatarsophalangeal joint could be realigned after scarf-Akin bunionectomy without lateral soft tissue release. A total of 25 feet, in 22 patients, were prospectively enrolled and analyzed using anteroposterior radiographs and coronal computed tomography scans obtained before and 3 months after surgery. The Yildirim sesamoid position decreased from a preoperative of 2 (range 1 to 3) to a postoperative position of 0 (range 0 to 1; p < .001), the mean first intermetatarsal angle decreased from 12.6° ± 2.4° to 5.8° ± 2.1° (p < .001), and the mean distance between the second metatarsal and the tibial sesamoid changed from 25.7 ± 4.6 to 25.9 ± 4.6 (p = .59). Our findings suggest that dislocation of the sesamoid complex is actually caused by displacement of the first metatarsal. In conclusion, the scarf-Akin bunionectomy adequately restores the alignment of the first metatarsophalangeal joint, including restoration of the sesamoid apparatus, without direct plantar-lateral soft tissue release
Autores:
Neyton; Noël; Walch; et al.
Revista:
JOURNAL OF SHOULDER AND ELBOW SURGERY
ISSN:
1058-2746
Año:
2014
Vol.:
23
N°:
10
Págs.:
e261-265
Revista:
INTERNATIONAL ORTHOPAEDICS
ISSN:
0341-2695
Año:
2014
Vol.:
38
N°:
7
Págs.:
1407-1413
Reverse arthroplasty leads to high satisfaction rates for patients with osteoarthritis and rotator cuff deficiency who had undergone previous shoulder stabilisation procedures. The improvements in clinical outcome as well as the radiographic results seem to be comparable with those of other studies reporting on the outcome of reverse shoulder arthroplasty for other conditions
Revista:
MUSCULOSKELETAL SURGERY
ISSN:
2035-5106
Año:
2013
Vol.:
97
N°:
1
Págs.:
31-37
With the development of hip prosthesis, younger patients may need more than one revision surgery, with less bone stock available in each subsequent surgery. We retrospectively reviewed the hip revision surgeries in which a Burch-Schneider device has been used. Patients were classified according to the Paprosky score. Functional and clinical evaluation was assessed by the Merlé-Daubigné score. Radiolucencies were assessed by Gill's criteria. Sixteen patients with a mean age of 66.1 years were reviewed at a mean follow-up of 60.7 months. According to Paprosky classification, 18.7% were grade IIb, 56.3% grade IIIa and 25% grade IIIb. The mean Merlé-Daubigné score improved from 10 to 15 points. Radiologically, 12 patients had no radiolucencies, two had grade I radiolucencies and two had grade III radiolucencies. In greater than 50% of acetabular defects, the Burch-Schneider seems to be useful providing clinical and functional improvement. Immediately, non-progressive radiolucencies are not associated with implant loosening at the end of follow-up. The ischial flap should be inserted inside the ischial portion of the acetabulum.
Autores:
Kidder; Rouleau; DeFranco; et al.
Revista:
SHOULDER AND ELBOW
ISSN:
1758-5732
Año:
2012
Vol.:
4
N°:
1
Págs.:
11-5
We report the first study on the Walch classification to use a large number of patients
and challenge its reliability. According to the results obtained, there is no advantage in changing the
classification. Therefore, surgeons must be aware of higher risk ofmistake for glenoid type B. The superiority
of a classification in terms of the prediction of surgical decisions and outcome has to be determined.
Revista:
J TRAUMA
ISSN:
0022-5282
Año:
2011
Vol.:
70
N°:
5
Págs.:
1072 - 1077
Background: Despite the prevailing notion than injury victims are healthy subjects, there is scarce evidence on their preinjury health status, particularly for motor vehicle crash (MVC) victims, where changes between their preinjury health status (or age- and sex-adjusted standards) have seldom been compared with their postinjury status.
Methods: This longitudinal study recorded pre-event self-reported health status (as measured by Short Form-36 scores) of cohort participants who were followed up for 4 years. Differences at the beginning and the end of follow-up as well as differences in Short Form-36 scores changes over time were compared according to the occurrence of a MVC during that time.
Results: From 3,361 participants included for analysis, 64 had an incident MVC. At baseline, those participants who would not have subsequently a MVC had better health than those who would have it. In addition, those who reported being in a crash lost more health after the crash than their noncrash counterparts, although these differences were only seen in adjusted analyses. Adjusted analyses showed a significantly greater worsening of health in MVC victims, particularly in regards to role physical (adjusted difference in 4 years change, -7.7; 95% CI, -13.6 to -1.9), bodily pain (-5.9; 95% CI, -11.4 to -0.3), and role emotional (-6.2; 95% CI, -12.5 to -0.02).
Conclusions: In this cohort, participants who eventually suffered a crash had a worse health status before their MVC than those who did not suffer a MVC. They lost even further health after the injurious event. These findings bear particular relevance when assessing the burden of disease, or when conducting effectiveness evaluation studies at the individual and population level.
Revista:
MUSCULOSKELETAL SURGERY
ISSN:
2035-5106
Año:
2011
Vol.:
95
N°:
1
Págs.:
53-7
We report a case of a 15-year-old girl who presented with pain and swelling in the right shoulder. Imaging studies showed an inflammatory process well limited at the rotator interval. Open biopsy showed an osteogenic process that was evident in the postoperative X-rays. Two-year follow-up showed a mature ossification at the rotator interval.
Revista:
MUSCULOSKELETAL SURGERY
ISSN:
2035-5106
Año:
2010
Vol.:
94
N°:
3
Págs.:
137-139
cute compartment syndrome of the forearm requires immediate treatment to avoid damage of the soft tissues and a poor functional outcome for the forearm. Muscular and bone lesions are the main causes of acute compartment syndromes. We report a case of acute compartment syndrome of the forearm caused by a calcific tendinitis of the distal biceps.
Revista:
MUSCULOSKELETAL SURGERY
ISSN:
2035-5106
Año:
2010
Vol.:
94
N°:
2
Págs.:
93-97
We report the case of a young boy who presented a dorsal defect of the patella (DDP) with fracture after a small sport trauma. The patient's parents (professional of health care) had been warned on a possible tumoral disease in a previous consultation and claimed for an accurate diagnosis. Although fracture is rarely reported in DDP, the radiographic image strongly suggested this condition; nevertheless, the diagnosis accuracy requested by the parents lead to indicate a biopsy that showed irregular fragments of laminar bone and hyaline cartilage islands similar to articular cartilage compatible with a non-specific developmental ossification defect. The lytic defect was filled with morselized cancellous bone graft, the fracture having a normal consolidation. With a follow-up of 4 years, the patient is asymptomatic, and the radiological morphology of the patella is normal. Although DDP is accepted to be a radiologically well-defined condition, images may perhaps not get accuracy enough for diagnosis and biopsy may be indicated by clinical and radiological features different than the typical ones. Although fracture is rarely reported in case of DDP, it has not to be considered as indicative of tumor or malignancy.
Revista:
Journal of Shoulder and Elbow Surgery
ISSN:
1058-2746
Año:
2010
Vol.:
19
N°:
8
Págs.:
1230 - 1237
Revista:
Techniques in Shoulder and Elbow Surgery
ISSN:
1523-9896
Año:
2010
Vol.:
11
N°:
3
Págs.:
72 - 76
Revista:
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
ISSN:
0300-5771
Año:
2010
Vol.:
39
N°:
2
Págs.:
580 - 587
Background: Physical activity is generally accepted as a healthy habit. Nevertheless, its associated risk to cause injuries has not been sufficiently evaluated. Measuring this risk more precisely would contribute to giving more accurate health advice to the general population.
Methods: Data are from participants (60% women, mean age 38 years) in a cohort of university graduates in Spain (1999-2008). Among other exposures and outcomes, they self report on frequency of participation in several physical activities over 1 year, and on incidence of sports-related injuries after 2, 4 or 6 years follow-up. Participation in 17 physical activities was categorized as a dichotomous variable (yes/no) and also according to average time per week spent in each one. Proportional hazards regression was used to estimate the adjusted relative risks [hazard ratios (HRs)] of incident injury associated with each specific physical activity or with total weekly energy expenditure in leisure-time activity [metabolic equivalents (METs)-h/week]. Statistical analyses were stratified by sex.
Results: We identified 1658 incident sports-related injuries among 14 356 participants after a median follow-up of 4.6 years. When we adjusted for overall energy expenditure (METs-h/week) in other activities, age and body mass index (BMI), a higher risk of injury was associated with participation in soccer, other team sports, skiing, tennis, running and athletics (HRs ranging from 1.50 to 1.86) among men. With the exception of soccer (rarely practiced by women in Spain), similar results were found for women (HRs ranging from 1.61 to 2.04). Walking, gymnastics, swimming, mountain hiking and gardening were associated with a low injury risk.
Conclusions: Despite the healthy effects of physical activity, we consider that the higher risk for injuries related to soccer, team sports, skiing, tennis, running or athletics should be taken into consideration when advice for more physical activity is given to the general population. Daily routine physical activities such as walking or gardening should be encouraged.
Revista:
INTERNATIONAL JOURNAL OF INJURY CONTROL AND SAFETY PROMOTION
ISSN:
1745-7300
Año:
2010
Vol.:
17
N°:
4
Págs.:
223 - 230