Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology最新文献

{"title":"Longitudinal measurement of serum cartilage oligomeric matrix protein can detect the progression of cartilage degeneration in anterior cruciate ligament reconstruction patients","authors":"Yohei Nishida ,&nbsp;Yusuke Hashimoto ,&nbsp;Kumi Orita ,&nbsp;Kazuya Nishino ,&nbsp;Takuya Kinoshita ,&nbsp;Ken Iida ,&nbsp;Hiroaki Nakamura","doi":"10.1016/j.asmart.2024.06.003","DOIUrl":"https://doi.org/10.1016/j.asmart.2024.06.003","url":null,"abstract":"<div><h3>Background/objective</h3><p>Cartilage oligomeric matrix protein (COMP) has utility as a diagnostic marker for osteoarthritis (OA). Our previous study revealed that the serum COMP level can be used to detect early cartilage change in non-OA patients with anterior cruciate ligament (ACL)-deficiency. However, there are still no studies on detecting the progression of cartilage degeneration in early OA. The aim of present study was to investigate whether serum COMP can detect the progression of cartilage degeneration after ACL reconstruction in non-OA patients.</p></div><div><h3>Methods</h3><p>Patients without cartilage degeneration of early OA at ACL reconstruction and whose serum COMP levels could be measured were included in the study. Cartilage degeneration of early OA were defined as International Cartilage Repair Society (ICRS) grade 1 to 4 in more than 2 compartments or ICRS grade 2 to 4 in 1 compartment. The patients were divided into two groups: those who had cartilage degeneration of early OA at second-look arthroscopy (cartilage degeneration progression group) and those who did not (non-progression group), and the serum COMP values between the two groups were compared.</p></div><div><h3>Results</h3><p>Thirty-one patients were included. There were 8 cases (25.8 %) in progression group and 23 cases (74.2 %) in non-progression group. There were significant differences between the two groups regarding age and change in serum COMP level. In terms of the rate of change in COMP, an increase of more than 1.24-fold was the cut-off value for detecting the progression of cartilage degeneration.</p></div><div><h3>Conclusions</h3><p>In this study, the increase in serum COMP levels was significantly greater in progressed cartilage degeneration group than non-progression group after ACL reconstruction. Longitudinal serum COMP measurement could detect the progression of cartilage degeneration.</p></div><div><h3>Level of evidence</h3><p>Level Ⅲ, retrospective comparative study.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"37 ","pages":"Pages 27-32"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214687324000177/pdfft?md5=ff2dbf6169e37466be5d426743248f93&pid=1-s2.0-S2214687324000177-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141596459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The meniscotibial ligament does exist: An anatomic and histological description","authors":"Shi-Tang Song ,&nbsp;Xin-Jie Wang ,&nbsp;Jing Ye ,&nbsp;Ji-Ying Zhang ,&nbsp;You-Rong Chen ,&nbsp;Yi-Fan Song ,&nbsp;Jia-Kuo Yu ,&nbsp;Bing-Bing Xu","doi":"10.1016/j.asmart.2024.06.004","DOIUrl":"10.1016/j.asmart.2024.06.004","url":null,"abstract":"<div><h3>Purpose</h3><p>To describe the anatomical and histological characteristics of the human MTL (meniscotibial ligament) that keeps the meniscus stable and are rarely discussed.</p></div><div><h3>Study design</h3><p>Descriptive laboratory study.</p></div><div><h3>Methods</h3><p>In total, six fresh-frozen adult cadaver knees were dissected, and the dissection protocol were designed by two experienced anatomy professors. The anatomical morphology of MTL was observed. The main anatomical specimens included meniscus, tibial plateau, MTL. The osteotome was used to excise the portion of the tibial plateau, which could obtain the complex including partial meniscus, MTL, and a tibial fragment. A histopathologic study was performed by two experienced pathologists.</p></div><div><h3>Results</h3><p>Macroscopically, the MTL could be divided into two parts: medial meniscotibial ligament (MMTL)and lateral meniscotibial ligament (LMTL). The MMTL is distributed continuously, whereas the LMTL is discontinuous on the tibial plateau. The average length from the tibial attachment of the LMTL to the articular surface was 19 ± 1.0mm (mean ± SD). The average length from the tibial attachment of the MMTL to the articular surface was 10 ± 1.2 mm (mean ± SD). Microscopy of the MTL showed that the MTL is a ligamentous tissue, composed of a network of oriented collagenous fibers.</p></div><div><h3>Conclusions</h3><p>In all knees, the MTL was inserted on the outer edge of the meniscus, attaching to the tibia below the level of articular cartilage, which was key to maintaining the rotational stability of knee and the meniscus in the physiological position on the tibial plateau. Histological analysis of this ligament demonstrated that the MTL is a veritable ligamentous structure, which is made up of collagen type I–expressing fibroblasts.</p></div><div><h3>Clinical relevance</h3><p>This article contributes to the understanding of the anatomical and histological characteristics of the MTL. It is beneficial to promote the development of relevant surgical techniques for the MTL lesion.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"37 ","pages":"Pages 33-39"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214687324000189/pdfft?md5=5cebfcefea8b4e966bc3d764fb67d7e8&pid=1-s2.0-S2214687324000189-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141623299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative onset lateral hinge fracture is a risk factor for delayed union of the tibial tuberosity in medial opening wedge distal tibial tuberosity osteotomy","authors":"Hiroyasu Ogawa ,&nbsp;Yutaka Nakamura ,&nbsp;Masaya Sengoku ,&nbsp;Tetsuya Shimokawa ,&nbsp;Kazuichiro Ohnishi ,&nbsp;Haruhiko Akiyama","doi":"10.1016/j.asmart.2024.01.005","DOIUrl":"https://doi.org/10.1016/j.asmart.2024.01.005","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to evaluate bone union of the tibial tuberosity in patients undergoing medial opening wedge distal tibial tuberosity osteotomy (OWDTO). It was hypothesized that bone union of the tibial tuberosity could be associated with lateral hinge fractures (LHFs), but not thickness of the tibial tuberosity osteotomy.</p></div><div><h3>Methods</h3><p>Data of 61 consecutive patients who underwent OWDTO were retrospectively reviewed. Radiographic parameters of the lower limb and LHFs were evaluated. Thickness of the tibial tuberosity osteotomy and bone union of the tibial tuberosity were assessed at 1, 2, 3, 4, and 5 cm distal to the most proximal part of the tibial tuberosity on computed tomography. Bone union was assessed. Factors related to bone union of the tibial tuberosity were analyzed.</p></div><div><h3>Results</h3><p>There were 13 postoperative onset LHFs: all healed with conservative treatments within 6 months after surgery. The total score of bone union of the tibial tuberosity was 8.4 ± 2.1 points, which correlated with age, postoperative medial proximal tibial angle (MPTA), correction angle, and postoperative onset LHF (r = 0.307, 0.388, 0.275, and −0.624, respectively; <em>p</em> = 0.016, 0.002, 0.033, and &lt;0.001, respectively). Regression coefficient for postoperative onset LHF, postoperative MPTA, and body mass index were −0.619 (<em>p</em> &lt; 0.001), 0.285 (<em>p</em> = 0.003), and −0.227 (<em>p</em> = 0.021), respectively.</p></div><div><h3>Conclusion</h3><p>Postoperative onset LHFs, but not thickness of the tibial tuberosity osteotomy, were a risk factor for delayed union of the tibial tuberosity following OWDTO. Furthermore, to prevent delayed union of the tibial tuberosity, postoperative onset LHFs should be prevented.</p></div><div><h3>Level of evidence</h3><p>LEVEL III, Case-control study.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"37 ","pages":"Pages 21-26"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214687324000050/pdfft?md5=cabe0b2245d5593cc4e49c352f39bacd&pid=1-s2.0-S2214687324000050-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141543792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time course of biomechanics during jump landing before and after two different fatigue tasks","authors":"Makoto Asaeda ,&nbsp;Kazuhiko Hirata ,&nbsp;Tomoya Ohnishi ,&nbsp;Hideyuki Ito ,&nbsp;So Miyahara ,&nbsp;Koki Fukuhara ,&nbsp;Yuki Nakashima ,&nbsp;Yoshitaka Iwamoto ,&nbsp;Kai Ushio ,&nbsp;Yukio Mikami ,&nbsp;Nobuo Adachi","doi":"10.1016/j.asmart.2024.06.002","DOIUrl":"10.1016/j.asmart.2024.06.002","url":null,"abstract":"<div><h3>Objective</h3><p>Muscle fatigue contributes to anterior cruciate ligament (ACL) injuries, with increased knee and hip abduction observed during fatigue. However, there have been no reports revealing the differences between fatigue tasks or the duration of these changes. In this study, we conducted single-leg drop landings before and after hip and knee fatigue tasks to elucidate the changes in lower limb biomechanics over time.</p></div><div><h3>Methods</h3><p>Twenty-two male participants performed single-leg drop landings before, immediately after, and 5, 10, and 15 min after fatigue tasks involving isokinetic hip abduction/adduction (hip fatigue task [HFT]) and knee extension/flexion (knee fatigue task [KFT]). Hip and knee kinematic and kinetic data were collected using a three-dimensional motion analysis device and two force plates. A two-way ANOVA was performed with both the fatigue task (HFT and KFT) and time point (Time 1 to Time 4) as factors, and the main effects and interactions were calculated.</p></div><div><h3>Results</h3><p>The knee adduction angle after the HFT was significantly greater than that after KFT immediately following the fatigue task. The knee flexion moment was significantly lower in the KFT, whereas the knee adduction and internal rotation moments were significantly higher in the HFT immediately after the fatigue task.</p></div><div><h3>Conclusion</h3><p>This study revealed distinct kinematic and kinetic changes specific to each fatigue task, particularly in the frontal plane for hip joint tasks and the sagittal plane for knee joint tasks. These findings could assist in the development of ACL injury prevention programs tailored to the functional improvement and exercise capacity of each joint.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"37 ","pages":"Pages 40-46"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214687324000165/pdfft?md5=9b639b4e97b999f233f73bf85dfdd6f2&pid=1-s2.0-S2214687324000165-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141623300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periarticular cocktail injection is more useful than nerve blocks for pain management after anterior cruciate ligament reconstruction","authors":"Tomoyuki Kanayama ,&nbsp;Junsuke Nakase ,&nbsp;Rikuto Yoshimizu ,&nbsp;Yoshihiro Ishida ,&nbsp;Yusuke Yanatori ,&nbsp;Yu Arima ,&nbsp;Naoki Takemoto","doi":"10.1016/j.asmart.2024.03.001","DOIUrl":"https://doi.org/10.1016/j.asmart.2024.03.001","url":null,"abstract":"<div><h3>Background</h3><p>Anterior cruciate ligament (ACL) reconstruction is commonly associated with moderate-to-severe postoperative pain. Notably, various pain control strategies, a femoral nerve block (FNB) with a lateral femoral cutaneous nerve block (LFCNB), adductor canal block (ACB) with LFCNB, or periarticular cocktail injection (PI), have been investigated. However, no studies compare the effects of FNB with LFCNB, ACB with LFCNB, and PI for pain control after ACL reconstruction. This study aimed to evaluate the impact of FNB with LFCNB, ACB with LFCNB, and PI for pain relief in the early postoperative period after ACL reconstruction.</p></div><div><h3>Methods</h3><p>This retrospective controlled clinical trial enrolled 299 patients who underwent primary ACL reconstruction at our hospital between April 2016 and October 2022. We categorized these cases into groups based on the use of PI (PI group), FNB with LFCNB (FNB group), and ACB with LFCNB (ACB group) for pain management. We selected 40 cases each, with matched age, sex, and body mass index (BMI) from each group, resulting in 120 cases for analysis. In the FNB and ACB groups, 0.75% ropivacaine 15 ml was injected under ultrasound guidance preoperatively. In the PI group, a mixture of 0.75% ropivacaine 20 ml, normal saline 20 ml, and dexamethasone 6.6 mg was injected half at the start of surgery and the rest just before wound closure. Patient demographics (age, sex, height, body weight, and BMI) and surgical data (the requirement for meniscal repair, operative time, and tourniquet inflation time) were analyzed. After ACL reconstruction, patients' numerical rating scale pain scores (NRS) (0-10) were recorded at 30 min and 4, 8, 12, 24, 48, and 72 h postoperatively. NRS were then compared among the three groups using analysis of variance. In addition, within each group, these data were compared between the NRS ≥7 and NRS ≤6 groups using a <em>t</em>-test.</p></div><div><h3>Results</h3><p>There were no significant differences in patient demographics and surgical data. Pain scores were significantly higher in the PI group than in the FCB and ACB groups 30 min postoperatively, but they were lower at 12, 24, 48, and 72 h postoperatively. In the FNB group, there were no significant differences in the demographic and surgical data by NRS pain score. In the ACB group, the number of men was significantly higher in the NRS ≥7 group than in the NRS ≤6 group (p = 0.015). In the PI group, tourniquet inflation time was significantly longer in the NRS ≥7 group than in the NRS ≤6 group (p = 0.008).</p></div><div><h3>Conclusions</h3><p>Following ACL reconstruction using a hamstring autograft, periarticular cocktail significantly reduced early postoperative pain compared with nerve block combinations.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"36 ","pages":"Pages 45-49"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214687324000086/pdfft?md5=3b7acfad299c4c4112a8d48722f6563b&pid=1-s2.0-S2214687324000086-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140342540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of inside-out meniscal repair on meniscal dimension in meniscal tear patients","authors":"Takuya Kinoshita ,&nbsp;Yusuke Hashimoto ,&nbsp;Kazuya Nishino ,&nbsp;Ken Iida ,&nbsp;Hiroaki Nakamura","doi":"10.1016/j.asmart.2024.03.002","DOIUrl":"https://doi.org/10.1016/j.asmart.2024.03.002","url":null,"abstract":"<div><h3>Background</h3><p>It remains controversial whether meniscal repair causes meniscal extrusion. This study aimed to investigate the effect of inside-out meniscal repair on meniscal dimensions in patients with meniscal tear of the mid-body–posterior horn.</p></div><div><h3>Methods</h3><p>This retrospective study included 75 patients who underwent meniscal repair followed by MRI within 2 weeks after surgery between 2020 and 2022. Patients with a discoid lateral meniscus, pull-out repair, concomitant osteotomy, all-inside repair only, and revision surgery were excluded. Thirty-three meniscal tear treated using an inside-out arthroscopic repair technique were included in the lateral meniscus (LM, n = 19) and medial meniscus (MM, n = 14) tear groups. Thirty-six participants with intact meniscus were included as controls. Meniscal extrusion and posterior shift were measured on coronal and sagittal MRI pre-operatively and within 2 weeks postoperatively.</p></div><div><h3>Results</h3><p>Preoperative coronal extrusion was significantly greater in the LM tear group than in the control group (P = 0.001). Coronal extrusion and posterior shift were significantly smaller postoperatively than preoperatively in the LM tear group (P &lt; 0.001 and, P = 0.008, respectively). Pre- and postoperative coronal extrusion in the MM tear group were not significantly different (P = 0.291). Postoperative coronal extrusion in both LM and MM tear groups were not significantly correlated with the number of sutures required for repair (LM: P = 0.765, R = −0.076, MM: P = 0.1, R = 0.497).</p></div><div><h3>Conclusions</h3><p>The torn meniscus of the mid-body - posterior horn before surgery was extruded and shifted posteriorly in both LM and MM tears, and repair using an inside-out arthroscopic technique was effective in reducing meniscal extrusion and posteriors shift in the LM tear immediately after surgery.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"36 ","pages":"Pages 50-57"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214687324000098/pdfft?md5=0cb1d51220f9497152a0ce6b7fb2a606&pid=1-s2.0-S2214687324000098-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140536479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of knee bracing on clinical outcomes following anterior cruciate ligament reconstruction: A prospective randomised controlled study","authors":"Ukris Gunadham ,&nbsp;Patarawan Woratanarat","doi":"10.1016/j.asmart.2024.01.006","DOIUrl":"https://doi.org/10.1016/j.asmart.2024.01.006","url":null,"abstract":"<div><h3>Objectives</h3><p>While there is a consensus against bracing after anterior cruciate ligament (ACL) reconstruction, the question of its potential benefits, especially in cases involving meniscus repair, as well as its routine use by the majority of clinicians, remains a topic of debate. This study aims to assess the effectiveness of bracing in relation to clinical scores after ACL reconstruction, regardless of meniscus surgery.</p></div><div><h3>Methods</h3><p>This randomised controlled study involved patients aged 15–55 years who underwent arthroscopic ACL reconstruction surgery. All eligible patients were assigned into two groups: one group received an adjustable frame with a four-point fixation knee brace for a four-week period, while the other did not.</p><p>A single experienced surgeon performed standard anatomical single-bundle ACL reconstruction. All patients, irrespective of whether they underwent meniscus repair, followed the same rehabilitation protocol. Knee functional questionnaires, including the International Knee Documentation Committee (IKDC) score, Lysholm score, Tegner Activity Scale, Visual Analogue Scale (VAS), and examinations, were collected preoperatively, at six months, one year, and two years postoperatively. The study employed an intention-to-treat analysis and multilevel mixed-effects generalised linear models to compare continuous outcomes between the groups, adjusting for the times of follow-up.</p></div><div><h3>Results</h3><p>A total of 84 patients (42 patients per group) comprised of 75 males (89 %) and average age of 30 ± 9.4 years old. Patient-reported function, physical examination findings, and surgical characteristics were comparable between the two groups. (P-value &gt;0.05) Both groups demonstrated significant improvement in IKDC and Lysholm scores at the end of the two-year follow-up period. (P-value &lt;0.0001) In multivariate analysis, bracing was significantly associated with lower Tegner activity scale than the non-brace group after adjustment for VAS and time (coefficient −0.49, 95 % confidence interval −0.87, −0.10, P-value = 0.013). None of the graft ruptures were reported, and there was no significant difference of return to sports between the groups at the end of the follow-up.</p></div><div><h3>Conclusion</h3><p>The study suggests that knee bracing after ACL reconstruction, regardless of any additional meniscus procedures, fails to enhance subjective or objective outcomes and could potentially have a negative impact on the Tegner activity scale, although the difference is not clinically significant. The routine use of a postoperative brace should be discontinued.</p></div><div><h3>Level of evidence</h3><p>Level I, Randomised controlled trial with no negative criteria.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"36 ","pages":"Pages 18-23"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214687324000062/pdfft?md5=35e2fc92d7adae9624dd01499742e933&pid=1-s2.0-S2214687324000062-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139907961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histologic and biomechanical comparison of fascia lata autograft, acellular dermal xenograft, and synthetic patch for bridging massive rotator cuff tear in a rabbit model","authors":"Yuyan Na ,&nbsp;Hao Jue ,&nbsp;Tian Xia ,&nbsp;Xiaoao Xue,&nbsp;Luyi Sun,&nbsp;Jun Chen,&nbsp;Yinghui Hua","doi":"10.1016/j.asmart.2024.01.007","DOIUrl":"https://doi.org/10.1016/j.asmart.2024.01.007","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Bridging repair has emerged as a promising and reliable treatment strategy for the massive rotator cuff tears (MRCTs). However, there remains a lack of evidence on which bridging graft provides the better repair results, and a dearth of animal studies comparing bridging repairs with different grafts. The purpose of this study was to evaluate the histological and biomechanical outcomes of commonly used grafts (autologous fascia lata (FL), acellular dermal matrix graft (ADM), and polyethylene terephthalate (PET) patch).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;A total of 66 male New Zealand White Rabbits were used to mimic a model of unilateral chronic MRCTs. The rabbits were randomly divided into three groups: (1) FL group, which underwent bridging repair with autologous FL; (2) ADM group, which underwent bridging with ADM; and (3) PET group, which underwent bridging with PET patch. Tissue samples were collected and subjected to histological analysis using Hematoxylin and eosin, Picrosirius red, Safranin O/Fast green staining, and Immunostaining. Collagen diameter and fibril density in the regenerated tendon was analyzed with transmission electron microscopy (TEM). Additionally, biomechanical tests were performed at 6 and 12 weeks after repair.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;The regenerated tendon successfully reattached to the footprint in all experimental groups. At 6 weeks after repair, the FL group had a significantly higher Modified Tendon Histological Evaluation (MTHE) score at the regenerated tendon than the PET group (13.2 ± 1.64 vs 9.6 ± 1.95, respectively; &lt;em&gt;P&lt;/em&gt; = 0.038). The picrosirius red staining results showed that the FL group had a significantly higher type I collagen content than the ADM and PET groups at 6 weeks, and this difference was sustained with the PET group at 12 weeks (&lt;em&gt;P&lt;/em&gt; &lt; 0.05). Immunofluorescence analysis against CD68 indicated that the number of macrophage infiltrates was significantly lower in the FL group than in the ADM and PET groups (&lt;em&gt;P&lt;/em&gt; &lt; 0.05). At 12 weeks after repair, the area of Safranin O metachromasia was significant greater in ADM group than that in the PET group (&lt;em&gt;P&lt;/em&gt; = 0.01). The FL group showed a significantly larger collagen diameter in the regenerated tendon than the PET group (&lt;em&gt;P&lt;/em&gt; &lt; 0.05), as indicated by TEM results. Furthermore, the FL group resulted in a greater failure load (at 6 weeks; 118.40 ± 16.70 N vs 93.75 ± 9.06 N, respectively; &lt;em&gt;P&lt;/em&gt; = 0.019) and elastic modulus (at 6 weeks; 12.28 ± 1.94 MPa vs 9.58 ± 0.79 MPa, respectively; &lt;em&gt;P&lt;/em&gt; = 0.024; at 12 weeks; 15.02 ± 2.36 MPa vs 11.63 ± 1.20 MPa, respectively; &lt;em&gt;P&lt;/em&gt; = 0.032) than the ADM group.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;This study demonstrated that all three grafts could successfully bridging chronic MRCTs in a rabbit model. However, autologous FL promoted tendon regeneration and maturation, and enhanced the tensile properties of the tendon-to-bone comple","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"36 ","pages":"Pages 28-39"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214687324000074/pdfft?md5=a86699757fb555004f732e078ced6e8c&pid=1-s2.0-S2214687324000074-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140320634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of continuous interscalene brachial plexus block for arthroscopic rotator cuff repair","authors":"Tomohiro Uno ,&nbsp;Nariyuki Mura ,&nbsp;Issei Yuki ,&nbsp;Ryuta Oishi ,&nbsp;Michiaki Takagi","doi":"10.1016/j.asmart.2024.01.004","DOIUrl":"https://doi.org/10.1016/j.asmart.2024.01.004","url":null,"abstract":"<div><h3>Background</h3><p>Arthroscopic rotator cuff repair (ARCR) is a minimally invasive surgical technique. However, it is challenging to control postoperative pain. This study aimed to investigate the difference between a single-shot interscalene block and a combined continuous block for ARCR.</p></div><div><h3>Methods</h3><p>Ninety-four patients who underwent ARCR were included in this study. In the preceding period, 43 patients received a single-shot interscalene block and continuous postoperative intravenous opioid infusion (Single group). In the posterior period, 51 patients received a single-shot interscalene block preoperatively and a continuous block postoperatively (Continuous group). Their mean age at surgery was 64.9 years (range, 43–83 years). The mean follow-up period was 25.4 months (range, 24–54 months). The numerical rating scale (NRS) of pain was evaluated immediately after the surgery, at rest, and at night for 1–4 days after the surgery. One day postoperatively, the amount of food taken was assessed from 0 % (no food intake) to 100 % (all food taken). The University of California at Los Angeles (UCLA) shoulder score, range of motion (ROM), and isometric shoulder strength were evaluated.</p></div><div><h3>Results</h3><p>NRS at rest in the Continuous group on the day of surgery was 3.7 ± 2.5. This was significantly lower than in the Single group (5.2 ± 1.8) (<em>P</em> = 0.002). NRS at rest in the Continuous group on the second day after surgery was 3.0 ± 2.1, significantly lower than in the Single group (3.9 ± 1.8) (<em>P</em> = 0.04). The amount of food taken in the morning in the Continuous group was 61 % ± 37 %, which was significantly greater than in the Single group (35 % ± 41 %) (<em>P</em> = 0.004). The ROM of extension at 6 months postoperatively in the Continuous group was 47 ± 7°, which was significantly greater than in the Single group (43 ± 6°) (<em>P =</em> 0.02). The postoperative strength of the external rotator at 6 months in the Continuous group was 95 ± 33 N, significantly greater than in the Single group (78 ± 28 N) (<em>P</em> = 0.01). There was no significant difference in UCLA score at any time.</p></div><div><h3>Conclusion</h3><p>The continuous interscalene block with ultrasound guidance in ARCR effectively relieved pain. The recovery of ROM for extension and the strength of the external rotator was better in the Continuous group.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"36 ","pages":"Pages 6-12"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214687324000049/pdfft?md5=8baa9211d10237229461c1aeefddff57&pid=1-s2.0-S2214687324000049-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139674140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Injuries to both anterolateral ligament and Kaplan fiber of the iliotibial band do not increase preoperative pivot-shift phenomenon in ACL injury","authors":"Takeo Tokura,&nbsp;Kanto Nagai,&nbsp;Yuichi Hoshino,&nbsp;Shu Watanabe,&nbsp;Noriyuki Kanzaki,&nbsp;Kyohei Nishida,&nbsp;Takehiko Matsushita,&nbsp;Ryosuke Kuroda","doi":"10.1016/j.asmart.2024.03.004","DOIUrl":"https://doi.org/10.1016/j.asmart.2024.03.004","url":null,"abstract":"<div><h3>Background</h3><p>To assess the incidence of anterolateral ligament (ALL) and Kaplan fiber of the iliotibial band (KF) injuries in patients with acute anterior cruciate ligament (ACL) injury on magnetic resonance imaging (MRI), and to investigate the association between these injuries and the magnitude of preoperative pivot-shift test.</p></div><div><h3>Method</h3><p>One-hundred and five patients with primary ACL injury were retrospectively reviewed. ALL injury and KF injury were assessed by preoperative MRI, and subjects were allocated into four groups: Group A, neither injury; Group B, only ALL injury; Group C, only KF injury; Group D, simultaneous ALL and KF injuries. Before ACL reconstruction, tibial acceleration during the pivot-shift test was measured by an electromagnetic measurement system, and manual grading was recorded according to the International Knee Documentation Committee (IKDC) guideline.</p></div><div><h3>Results</h3><p>In MRI, the ALL was identified in 104 patients (99.1%) and KF in 99 patients (94.3%). ALL and KF injuries were observed in 43 patients (43.9%) and 23 patients (23.5%), respectively. Patient distribution to each group was as follows; Group A: 43 patients (43.9%), Group B: 32 patients (32.7%), Group C: 12 patients (12.2%), Group D: 11 patients (11.2%). No significant differences were observed in tibial acceleration, and manual grading among the four groups.</p></div><div><h3>Conclusion</h3><p>Simultaneous injury to both ALL and KF was uncommon, and preoperative pivot-shift phenomenon did not increase even in those patients. The finding suggests that the role of ALL and KF in controlling anterolateral rotatory knee laxity may be less evident in the clinical setting compared to a biomechanical test setting.</p></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"36 ","pages":"Pages 40-44"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214687324000116/pdfft?md5=00836a5c56443bb75c159bc5fc9804f8&pid=1-s2.0-S2214687324000116-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140339656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}