Supraspinatus Tendon to Bone Healing PDF Download
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Author: Stavros Thomopoulos
Publisher:
ISBN:
Category :
Languages : en
Pages : 410
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Book Description
Author: Jonathan A. Gimbel
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Author: Stavros Thomopoulos
Publisher:
ISBN:
Category :
Languages : en
Pages : 410
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Author: Wayne Z. Burkhead
Publisher: Lippincott Williams & Wilkins
ISBN:
Category : Medical
Languages : en
Pages : 456
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Book Description
A text on the rotator cuff, with nine chapters written by Burkhead himself, and the remaining 24 chapters contributed by nationally and internationally recognized physicians and shoulder surgeons. The volume contains seven sections: history of cuff repair (1 chapter); basic science and the rotator cuff (3 chapters); evaluation and classification of cuff lesions (3 chapters); clinical disorders (10 chapters); conservative treatment of cuff defects and impingement syndrome (2 chapters); arthroscopic management of rotator cuff disease (1 chapter); and surgical management of massive cuff tears and degeneration (13 chapters). Thoroughly illustrated in bandw, with extensive chapter references. Annotation copyright by Book News, Inc., Portland, OR
Author: William R. Walsh
Publisher: Springer Science & Business Media
ISBN: 1592599427
Category : Medical
Languages : en
Pages : 332
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Book Description
A comprehensive and authoritative review of the most important scientific and clinically relevant topics today in ligaments, tendons, and capsular biology, including their biomechanics and surgical reconstruction. The authors review the basic science of tendons in the hand and shoulder ligaments, the current clinical status of the shoulder and cruciate ligaments, and the latest advances in research on the healing of ligament and tendon to bone, artificial ligaments, and gene therapy. They also cover the major type 1 collagen soft tissues that are of particular interest to upper extremity surgeons and sports medicine specialists.
Author: Juerg Hodler
Publisher: Springer Nature
ISBN: 3030712818
Category : Musculoskeletal system
Languages : en
Pages : 293
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Book Description
This open access book focuses on imaging of the musculoskeletal diseases. Over the last few years, there have been considerable advances in this area, driven by clinical as well as technological developments. The authors are all internationally renowned experts in their field. They are also excellent teachers, and provide didactically outstanding chapters. The book is disease-oriented and covers all relevant imaging modalities, with particular emphasis on magnetic resonance imaging. Important aspects of pediatric imaging are also included. IDKD books are completely re-written every four years. As a result, they offer a comprehensive review of the state of the art in imaging. The book is clearly structured with learning objectives, abstracts, subheadings, tables and take-home points, supported by design elements to help readers easily navigate through the text. As an IDKD book, it is particularly valuable for general radiologists, radiology residents, and interventional radiologists who want to update their diagnostic knowledge, and for clinicians interested in imaging as it relates to their specialty.
Author:
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Category :
Languages : en
Pages :
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INTRODUCTION: More than 250,000 rotator cuff repairs are performed annually, yet successful healing of tendon-to-bone attachment is rarely achieved [1]. Although low levels of inflammatory cytokines are important in initiating the repair process, excessive inflammation, commonly seen in adult tendinopathy, impairs healing outcomes [2]. The nuclear factor u03baB (NF-u03baB) signaling pathway has been implicated in the early phases of tendon degeneration, and dramatic up regulation of this inflammatory pathway is seen during tendon healing [3,4]. Specifically inhibiting the inflammatory IKKu03b2-dependent mechanisms of NF-u03baB signaling, rather than complete inhibition of the pathway, following repair may improve clinical outcomes. Therefore, the objective of this study was to evaluate the therapeutic potential of IKKu03b2 inhibition for managing the excessive inflammation that persists after rotator cuff repair and thereby enhance tendon-to-bone healing.METHODS: Patient biopsy cell culture: Human study protocol were approved by the Ethics Committee under ACA No.99/101. Full informed consent was obtained from all patients. Primary tendon cells were isolated from hamstring tendons (n=3, ages:22-44y) taken from patients undergoing anterior cruciate ligament autograft surgery. Cells were isolated, passed to P2, plated, expanded for 48h, and treated with 1 ng Interleukin-1u03b2, 50M IKKu03b2 Inhibitor, or both for 4 hours, and compared to vehicle-treated controls. The supernatant was collected to evaluate inflammatory cytokine concentration. One-way ANOVA with Dunnetu2019s post-hoc analysis was performed to compare cytokine production. Rotator cuff animal model: A total of 52 adult Sprague-Dawley rats were used, as approved by the Columbia University Institutional Animal Care and Use Committee. Bilateral surgical supraspinatus tendon injury-and-repair was performed, as previously described [5]. 42 rats were injured and repaired and 10 rats were used as healthy normal controls (Normal group). Surgical animals were either left untreated (CTRL group) or administered IKKu03b2 small molecule inhibitor (ACHP Hydrochloride) dissolved in 0.5 % sodium carboxymethyl cellulose (Sigma). The IKKu03b2 inhibitor was delivered orally (5 mg/kg) once a day for 7 days after surgery (ACHP group). Following acute injury and repair, all animals were allowed free cage activity and sacrificed after 3 days, 14 days, or 28 days of healing. Gene expression outcomes for the tendon-to-bone attachment site were evaluated at all time points. A subset of samples from each time point were processed for histology to evaluate healing at the repair site. Two-way ANOVAs (for group and time) were performed to compare gene expression levels. p
Author: Nuno Sampaio Gomes
Publisher: Springer Nature
ISBN: 3662611627
Category : Medical
Languages : en
Pages : 377
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Book Description
This book offers a truly comprehensive overview of the understanding and treatment of massive and irreparable rotator cuff tears, a painful and disabling shoulder condition that continues to pose major challenges. A thorough examination of basic science issues and evidence lays the foundation for discussion of key controversies in the field and exposition of a practical approach to treatment in which the role of both conservative and surgical management is explained. Special insights are provided into the new biological and nonoperative approaches that are becoming increasingly popular among practitioners. All potential surgical techniques are described, from partial repair and tendon transfer, to the use of dedicated implants. In addition, the value of anesthesia and regional blocks, both during surgery and in the postoperative phase, is discussed. The concluding section addresses particularly complex scenarios and offers guidance on the management of treatment complications and failures. Written by leading international shoulder experts, the book will be of value for shoulder surgeons, rehabilitators, and other health care practitioners.
Author: Ryuji Yonemitsu
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Book Description
INTRODUCTION: Rotator cuff (RC) tears frequently lead to shoulder pain and dysfunction. In patients who failed nonoperative treatment, surgical RC tendon-to-bone repair is often performed. However, failure of postsurgical repair is not rare. In previous animal studies, it has been demonstrated that FGF-2-soaked gelatin hydrogels (GHs) have the potential to enhance RC tendon-to-bone healing biomechanically and histologically in RC healing rat models, where the supraspinatus tendon insertion site is transected and repaired immediately. In clinical settings, delayed repair of RC tears has become a concern. Whether FGF-2 enhances RC tendon-to-bone healing after surgical repair of chronic tears still remains unclear. We hypothesized that FGF-2 may improve the biomechanical strength and histological status by stimulating the tenogenic healing response in repaired chronic RC tears.METHODS: Adult male Sprague-Dawley rats (n = 108) underwent unilateral surgery to fix the supraspinatus tendon to its insertion site 3 weeks after detachment. Animals were assigned to either the FGF-2 group or control group. The effects of FGF-2 were assessed via biomechanical testing at 6 and 12 weeks postoperatively, and were examined histologically and immunohistochemically for proliferating cell nuclear antigen (PCNA) and mesenchymal stem cell markers at 2, 6, and 12 weeks postoperatively. The expression of enthesis-related markers, including SRY-box 9 (Sox9), scleraxis (Scx), and tenomodulin (Tnmd), was assessed by real-time reverse transcription polymerase chain reaction, in situ hybridization, and immunohistochemistry. All experimental procedures were approved by the Animal Studies Committee and the Institutional Animal Care and Use Committee of Kumamoto University.RESULTS: Results of histological evaluation showed hypervascular reparative tissue at the insertion site in both groups at 2 and 6 weeks postoperatively. At 12 weeks, loose fibrovascular tissue was observed at the insertion site in the control group, whereas dense tendon-like tissue was observed in the FGF-2 group. The histological score at 12 weeks was significantly higher in the FGF-2 group than in the control group (FGF-2: 9.3; control: 7.2). With respect to biomechanical testing, significantly higher ultimate load to failure (FGF-2: 18.4, control: 11.8; and FGF-2: 24.0, control: 14.1 [N]), stiffness (FGF-2: 9.0, control: 6.2; and FGF-2: 12.8, control: 7.0 [N/mm]), and ultimate stress to failure (FGF-2: 3.5, control: 2.5; and FGF-2: 5.1, control: 3.0 [N/mm2]) were demonstrated at 6 and 12 weeks, respectively, in the FGF-2 group than in the control group. The cross-sectional area was significantly larger in the FGF-2 group than in the control group at 6 weeks (FGF-2: 5.44, control: 4.62 [mm2]), but no significant differences were observed between the two groups at 12 weeks (FGF-2: 4.76, control: 4.79 [mm2]). At 2 weeks, the percentages of PCNA-positive cells (FGF-2: 36.3, control: 19.8 [%]) and CD73-positive cells (FGF-2: 11.6, control: 7.5 [%]) within the reparative tissue were significantly higher in the FGF-2 group than in the control group. Scx and Tnmd mRNA expressions increased significantly in the FGF-2 group at 12 weeks postoperatively (Scx: FGF-2: 2.0, control: 1.0; Tnmd: FGF-2 group: 1.0, control group: 0.7). Scx and Tnmd mRNAs were mainly detected in the spindle-shaped cells of the tendon mid-substance in both groups, but showed greater expansion into reparative tissues in the FGF-2 group at 12 weeks. Scx mRNA was detected in the reparative tissue around bone surfaces, while Tnmd mRNA was detected in the reparative tissue aligned with collagen fibers.DISCUSSION: Our findings suggested that FGF-2 enhances the RC tendon-to-bone healing process histologically and biomechanically for surgical repaired chronic RC tears by promoting the increase of undifferentiated mesenchymal cells during the early phase, subsequently facilitating growth of tenogenic cells during later phase of repair. However, the mechanism by which FGF-2 enhances healing response at the reparative tissue remains unclear. Further investigations of the healing responses in chronic RC tears may provide essential clues to help develop clinical strategies to improve healing after surgical repair of RC.
Author: Gianezio Paribelli
Publisher: Springer
ISBN: 3319619462
Category : Medical
Languages : en
Pages : 203
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Book Description
This book is exceptional in providing detailed state of the art guidance on all aspects of transfer of the latissimus dorsi tendon for indications including irreparable posterosuperior rotator cuff tears, irreparable subscapularis tears, and shoulder replacement. In addition to clear, well-illustrated descriptions of arthroscopically assisted surgical technique, readers will find helpful information on biomechanics, surgical indications, post-transfer rehabilitation, and complications and their management. Outcomes from individual studies and meta-analyses are evaluated, and a feature of special interest is the presentation of experiences and results in a series of more than 430 patients using the surgical technique first described by Enrico Gervasi more than 10 years ago. This technique involves modifications in both preparation of the footprint for the latissimus dorsi tendon and the biomechanical features of the tendon transfer and is very different from the procedure proposed by Christian Gerber. The book will be of high value for all orthopedic surgeons who perform this complex shoulder surgery, as well as for residents and fellows-in-training.
Author: Nicola Maffulli
Publisher: Karger Medical and Scientific Publishers
ISBN: 3805598149
Category : Medical
Languages : en
Pages : 198
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Book Description
A valuable collection of up-to-date information by leading international experts The history of rotator cuff tendinopathy started more than 150 years ago, when some types of shoulder pain were attributed to rupture of the rotator cuff tendon'. In the third millennium, the pathogenetic mechanisms leading to rotator cuff problems are still debated. Although conservative measures are the first-line therapy, poor spontaneous tendon healing and progression from partial- thickness to full-thickness tears may mandate surgery. Biological, biomechanical and clinical studies have been conducted to establish the superiority of one technique over the other, but no clinical differences have been found. Although we know more about the pathogenesis, diagnosis and management of rotator cuff pathology, our efforts should be directed at trying to find the treatment that best fits the specific needs of each patient. This book collects current reviews on rotator cuff problems, with regard to both biological and clinical aspects, and provides practical hints on management and rehabilitation for sports physicians, surgeons, physiotherapists and athletic trainers.
