首页 > 最新文献

Clinical Orthopaedics and Related Research®最新文献

英文 中文
CORR® Synthesis: To What Degree Does the Direct Anterior Approach Improve Outcomes in THA? A Systematic Evaluation of Meta-analyses. CORR® 综述:前路直接入路在多大程度上改善了 THA 的疗效?Meta分析的系统评估。
IF 4.2 2区 医学 Q1 ORTHOPEDICS Pub Date : 2024-09-25 DOI: 10.1097/corr.0000000000003195
Maio Chen,Babar Kayani,Bassam A Masri
{"title":"CORR® Synthesis: To What Degree Does the Direct Anterior Approach Improve Outcomes in THA? A Systematic Evaluation of Meta-analyses.","authors":"Maio Chen,Babar Kayani,Bassam A Masri","doi":"10.1097/corr.0000000000003195","DOIUrl":"https://doi.org/10.1097/corr.0000000000003195","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142329098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
CORR Insights®: Are There Differences in Performance Among Femoral Stem Brands Utilized in Cementless Hemiarthroplasty for Treatment of Geriatric Femoral Neck Fractures? CORR Insights®:在治疗老年股骨颈骨折的无水泥半关节成形术中,不同品牌的股骨柄性能是否存在差异?
IF 4.2 2区 医学 Q1 ORTHOPEDICS Pub Date : 2024-09-25 DOI: 10.1097/CORR.0000000000003266
James A Keeney
{"title":"CORR Insights®: Are There Differences in Performance Among Femoral Stem Brands Utilized in Cementless Hemiarthroplasty for Treatment of Geriatric Femoral Neck Fractures?","authors":"James A Keeney","doi":"10.1097/CORR.0000000000003266","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003266","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Art in Science: Unclean, Unclean. 科学中的艺术不干净,不干净
IF 4.2 2区 医学 Q1 ORTHOPEDICS Pub Date : 2024-09-24 DOI: 10.1097/CORR.0000000000003260
Stuart A Green
{"title":"Art in Science: Unclean, Unclean.","authors":"Stuart A Green","doi":"10.1097/CORR.0000000000003260","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003260","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Value-based Healthcare: How Can Large Language Model (LLM) Technology be Integrated With Patient-reported Outcomes? 基于价值的医疗保健:大型语言模型 (LLM) 技术如何与患者报告结果相结合?
IF 4.2 2区 医学 Q1 ORTHOPEDICS Pub Date : 2024-09-24 DOI: 10.1097/corr.0000000000003261
Jefferson Hunter,Gregg Nicandri,Kevin J Bozic
{"title":"Value-based Healthcare: How Can Large Language Model (LLM) Technology be Integrated With Patient-reported Outcomes?","authors":"Jefferson Hunter,Gregg Nicandri,Kevin J Bozic","doi":"10.1097/corr.0000000000003261","DOIUrl":"https://doi.org/10.1097/corr.0000000000003261","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
CORR Insights®: Does Cannabis-based Medicine Improve Pain and Sleep Quality in Patients With Traumatic Brachial Plexus Injuries? A Triple-blind, Crossover, Randomized Controlled Trial. CORR Insights®:大麻药物能改善创伤性臂丛神经损伤患者的疼痛和睡眠质量吗?三盲、交叉、随机对照试验。
IF 4.2 2区 医学 Q1 ORTHOPEDICS Pub Date : 2024-09-24 DOI: 10.1097/CORR.0000000000003265
Pierre Hoffmeyer
{"title":"CORR Insights®: Does Cannabis-based Medicine Improve Pain and Sleep Quality in Patients With Traumatic Brachial Plexus Injuries? A Triple-blind, Crossover, Randomized Controlled Trial.","authors":"Pierre Hoffmeyer","doi":"10.1097/CORR.0000000000003265","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003265","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
What Are the Factors Associated With Revision Surgery on the Residual Limb and Functional Results in Patients With Posttraumatic Lower Limb Amputations? 创伤后下肢截肢患者的残肢翻修手术和功能结果与哪些因素有关?
IF 4.2 2区 医学 Q1 ORTHOPEDICS Pub Date : 2024-09-19 DOI: 10.1097/CORR.0000000000003251
Alexia Milaire, Antoine Grosset, Sylvain Rigal, Fabrice Bazile, Laurent Mathieu, James-Charles Murison, Nicolas De L'Escalopier
<p><strong>Background: </strong>Lower limb amputations performed after trauma are associated with a high risk of revision surgery. While the factors influencing revision surgery in the upper limbs have been studied, no studies have analyzed these factors in the lower limbs. Existing explanations for these revision surgeries are unclear, often leaving patients uninformed. Surgeons also lack the tools to explain the factors that influence repeat operations to patients. Therefore, the aim of this study was to provide surgeons with some answers so they can inform their patients undergoing posttraumatic lower limb amputation, whether military or civilian.</p><p><strong>Questions/purposes: </strong>(1) What was the survivorship of the initial amputation free from any revision surgery? (2) What patient- and injury-related factors were associated with revision amputation? (3) Do these factors influence functional outcomes in these patients?</p><p><strong>Methods: </strong>A single-center, retrospective study was conducted between January 2010 and February 2020 on patients who had undergone traumatic lower limb amputation. Between January 2010 and February 2020, 322 patients underwent amputation or were followed up at Percy Military University Hospital. Thirty-one patients had undergone amputation at another center, 178 had undergone amputation for nontraumatic reasons, and 27 patients had only upper limb amputations. Of those remaining, 1 died before 6 months, and 6% (5 of 86) were not fitted with a prosthesis, leaving 99% (85 of 86) for survivorship free from revision analysis and 93% (80 of 86) for functional endpoints analysis in this retrospective study at a median of 6.5 years (IQR 5 to 9) following the index amputation. The median age at the time of amputation was 31 years (IQR 26 to 52), 85% (72 of 85) of patients were men, and 31% (26 of 85) were military personnel. Revision surgery was defined as surgery performed at or after 6 months to ensure that the residual limb was healed and fitted with a prosthesis. Revision procedures performed before 6 months (median 2 [IQR 0 to 7]) were considered as part of the initial residual limb formation surgery. We performed Kaplan-Meier survivorship analysis for the time free from revision amputation from 6 months after amputation. We considered the competitive risk of death using a Fine-Gray model by an ascending stepwise procedure. To answer our third research question, we performed a chart review and assessed patients' use of prostheses and assistive devices and the percentage of patients who returned to work. An ordinal logistic regression was used to analyze the factors influencing functional outcome using an ascending stepwise procedure.</p><p><strong>Results: </strong>A total of 85 patients (94 limbs) were included, of whom 25 (27 limbs) underwent a revision surgery on the residual limb > 6 months after amputation. Kaplan-Meier survival estimates indicated that 5 years after the initial amputation 64% (
背景:创伤后进行的下肢截肢手术与翻修手术的高风险有关。虽然已经对影响上肢翻修手术的因素进行了研究,但还没有研究对影响下肢翻修手术的因素进行分析。对这些翻修手术的现有解释并不明确,患者往往对此一无所知。外科医生也缺乏向患者解释影响重复手术因素的工具。因此,本研究旨在为外科医生提供一些答案,以便他们能够告知接受创伤后下肢截肢手术的患者,无论是军人还是平民。问题/目的:(1) 首次截肢后未接受任何翻修手术的存活率是多少?(2) 哪些患者和损伤相关因素与翻修截肢有关?(3)这些因素是否会影响这些患者的功能预后?2010年1月至2020年2月期间,对接受过外伤性下肢截肢手术的患者进行了一项单中心回顾性研究。2010年1月至2020年2月期间,共有322名患者在佩西军事大学医院接受了截肢手术或随访。31名患者曾在其他中心接受过截肢手术,178名患者因非创伤性原因接受过截肢手术,27名患者仅接受过上肢截肢手术。在这项回顾性研究中,有99%的患者(86人中有85人)在截肢后6.5年(IQR为5至9年)内无翻修存活,93%的患者(86人中有80人)在截肢后6.5年(IQR为5至9年)内无功能终点分析。截肢时的中位年龄为31岁(IQR为26至52岁),85%的患者(85人中有72人)为男性,31%的患者(85人中有26人)为军人。翻修手术的定义是在6个月时或之后进行的手术,以确保残肢痊愈并安装假肢。6个月前进行的翻修手术(中位数为2 [IQR为0至7])被视为最初残肢形成手术的一部分。我们对截肢后 6 个月内无翻修截肢的时间进行了 Kaplan-Meier 存活率分析。我们使用Fine-Gray模型,通过升序逐步法考虑了死亡的竞争风险。为了回答第三个研究问题,我们进行了病历回顾,评估了患者使用假肢和辅助设备的情况以及重返工作岗位的患者比例。我们采用升序逐步法对影响功能结果的因素进行了序数逻辑回归分析:共纳入85名患者(94条肢体),其中25名患者(27条肢体)在截肢后6个月以上接受了残肢翻修手术。Kaplan-Meier生存率估计表明,初次截肢5年后,64%(95%置信区间为53%至77%)的患者仍未接受残肢翻修手术。吸烟(亚分布 HR 2.6 [95% CI 1.2 至 5.8];P = 0.02)和年龄大于 50 岁(亚分布 HR 0.3 [95% CI 0.1 至 0.8];P = 0.01)是导致翻修截肢几率增加的相关因素。94%的患者(85 例中的 80 例)安装了假肢,40%的患者(80 例中的 32 例)使用材料或人力辅助进行简单的日常生活活动。71%的患者(80 人中有 57 人)已重返工作岗位。序数逻辑回归显示,受伤前的体育活动与日常活动不需要帮助之间存在关联(OR 9 [95% CI 2.9 至 31.8];P < 0.001):吸烟似乎是下肢外伤后残肢翻修手术的一个相关风险因素,而且有可能是可以改变的。至少50岁似乎与较低的翻修手术发生率有关,这可能与超过这个年龄后对肢体的功能要求较低有关。我们的研究显示,假肢装置的安装率很高,如果患者在创伤前是运动健将,其功能效果会更好。这些结果为我们提供了更精确的信息,使我们能够考虑为每位患者制定护理路径。一项样本量更大的研究将有可能对涉及翻修手术的每种并发症发生的风险因素进行评估:证据等级:三级,治疗性研究。
{"title":"What Are the Factors Associated With Revision Surgery on the Residual Limb and Functional Results in Patients With Posttraumatic Lower Limb Amputations?","authors":"Alexia Milaire, Antoine Grosset, Sylvain Rigal, Fabrice Bazile, Laurent Mathieu, James-Charles Murison, Nicolas De L'Escalopier","doi":"10.1097/CORR.0000000000003251","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003251","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Lower limb amputations performed after trauma are associated with a high risk of revision surgery. While the factors influencing revision surgery in the upper limbs have been studied, no studies have analyzed these factors in the lower limbs. Existing explanations for these revision surgeries are unclear, often leaving patients uninformed. Surgeons also lack the tools to explain the factors that influence repeat operations to patients. Therefore, the aim of this study was to provide surgeons with some answers so they can inform their patients undergoing posttraumatic lower limb amputation, whether military or civilian.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Questions/purposes: &lt;/strong&gt;(1) What was the survivorship of the initial amputation free from any revision surgery? (2) What patient- and injury-related factors were associated with revision amputation? (3) Do these factors influence functional outcomes in these patients?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A single-center, retrospective study was conducted between January 2010 and February 2020 on patients who had undergone traumatic lower limb amputation. Between January 2010 and February 2020, 322 patients underwent amputation or were followed up at Percy Military University Hospital. Thirty-one patients had undergone amputation at another center, 178 had undergone amputation for nontraumatic reasons, and 27 patients had only upper limb amputations. Of those remaining, 1 died before 6 months, and 6% (5 of 86) were not fitted with a prosthesis, leaving 99% (85 of 86) for survivorship free from revision analysis and 93% (80 of 86) for functional endpoints analysis in this retrospective study at a median of 6.5 years (IQR 5 to 9) following the index amputation. The median age at the time of amputation was 31 years (IQR 26 to 52), 85% (72 of 85) of patients were men, and 31% (26 of 85) were military personnel. Revision surgery was defined as surgery performed at or after 6 months to ensure that the residual limb was healed and fitted with a prosthesis. Revision procedures performed before 6 months (median 2 [IQR 0 to 7]) were considered as part of the initial residual limb formation surgery. We performed Kaplan-Meier survivorship analysis for the time free from revision amputation from 6 months after amputation. We considered the competitive risk of death using a Fine-Gray model by an ascending stepwise procedure. To answer our third research question, we performed a chart review and assessed patients' use of prostheses and assistive devices and the percentage of patients who returned to work. An ordinal logistic regression was used to analyze the factors influencing functional outcome using an ascending stepwise procedure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 85 patients (94 limbs) were included, of whom 25 (27 limbs) underwent a revision surgery on the residual limb &gt; 6 months after amputation. Kaplan-Meier survival estimates indicated that 5 years after the initial amputation 64% (","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Your Best Life: Turning Posttraumatic Stress Into Posttraumatic Growth. 你最好的生活将创伤后压力转化为创伤后成长。
IF 4.2 2区 医学 Q1 ORTHOPEDICS Pub Date : 2024-09-18 DOI: 10.1097/CORR.0000000000003259
John D Kelly
{"title":"Your Best Life: Turning Posttraumatic Stress Into Posttraumatic Growth.","authors":"John D Kelly","doi":"10.1097/CORR.0000000000003259","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003259","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tissue-engineered Bicipital Autologous Tendon Patch Enhances Massive Rotator Cuff Defect Repair in a Rabbit Infraspinatus Tendon Defect Model. 组织工程化肱二头肌自体肌腱补片增强了兔冈下肌腱缺损模型的肩袖大面积缺损修复。
IF 4.2 2区 医学 Q1 ORTHOPEDICS Pub Date : 2024-09-17 DOI: 10.1097/CORR.0000000000003218
Youguo Liao, Hengzi Liu, Jiayun Huang, Zetao Wang, Tao Zhang, Xiangjun Hu, Qiulin He, Zichen Wang, Yang Fei, Yuxiang Zhang, Fangyuan Cai, Dengfeng Ruan, Hong Zhang, Luyong Jiang, Zi Yin, Hongwei Ouyang, Xiao Chen, Weiliang Shen
<p><strong>Background: </strong>Massive rotator cuff defects represent an important source of shoulder pain and functional debilitation, substantially diminishing patients' quality of life. The primary treatment of massive rotator cuff defects includes complete or partial repair and patch augmentation. However, because of the tendon's limited regenerative ability, the tendon retear risk after rotator cuff defect repair is still high. Thus, a new therapy is needed to promote tendon regeneration for repair of massive rotator cuff defects.</p><p><strong>Questions/purposes: </strong>Using an in vitro analysis, we first asked: (1) What is the biocompatibility and collagen synthesis ability of fibrin glue, and what is the cell growth of tissue-engineered bicipital tendon patches, which is comprised of fibrin glue and biceps tendon tissue particles? Then, using an in vivo animal model of full-thickness defects in the infraspinatus tendon in New Zealand White rabbits, we asked: (2) What is the potential of the tissue-engineered bicipital autologous tendon patch to promote tendon regeneration?</p><p><strong>Methods: </strong>In vitro experiments were conducted to assess the survival, proliferation, and collagen synthesis ability of tendon stem/progenitor cells cultured in fibrin glue. This was achieved through an assay of live/dead cell viability, cell counting kit-8 (CCK-8) assay, and Sirius red staining, respectively. The in vivo animal study was conducted using 8- to 12-week-old New Zealand White rabbits. The left shoulder of each animal was operated on, with equal numbers of males and females. There were 12 rabbits in the control group and 15 rabbits each in the gel and patch groups. Six rabbits were allocated to each of the three groups at the 1- and 3-month time points and three rabbits each were in the gel and patch groups at 2-month time point. Through an infraspinatus tendon defect model, the effectiveness of tissue-engineered bicipital autologous tendon patches (patch group) in tendon repair was assessed compared with untreated (control group) and fibrin glue (gel group) treatments in vivo. This assessment included histological evaluation of repaired tissue morphology, transmission electron microscopy (TEM) evaluation of regenerated collagen fibrils, and RNA sequencing to explore the potential mechanisms of tissue-engineered bicipital autologous tendon patches in tendon regeneration.</p><p><strong>Results: </strong>In vitro experiments demonstrated that fibrin glue enhanced the collagen synthesis ability of tendon stem/progenitor cells (0.38 ± 0.02) compared with standard cell culture alone (0.27 ± 0.02, mean difference 0.11 [95% CI 0.07 to 0.14]; p < 0.001). With prolonged cultivation, the cell growth area of tissue-engineered bicipital tendon patches showed a notable increase after culturing for 14 days (78.13% ± 3.68%) compared with 11 days (13.05% ± 8.78%, mean difference -65.08% [95% CI -77.99% to -52.15%]; p<0.001), 7 days (2.67% ± 2.62%,
背景:肩袖大块缺损是肩部疼痛和功能障碍的重要原因,严重降低了患者的生活质量。肩袖大面积缺损的主要治疗方法包括完全或部分修复和补片增量。然而,由于肌腱的再生能力有限,肩袖缺损修复后肌腱再撕裂的风险仍然很高。因此,需要一种新疗法来促进肌腱再生,以修复大面积肩袖缺损:通过体外分析,我们首先提出了以下问题:(1)纤维蛋白胶的生物相容性和胶原合成能力如何,由纤维蛋白胶和肱二头肌肌腱组织颗粒组成的组织工程肱二头肌肌腱补片的细胞生长情况如何?然后,利用新西兰白兔冈下肌腱全厚缺损的体内动物模型,我们提出了以下问题:(2)组织工程双腱鞘自体肌腱补片促进肌腱再生的潜力如何?我们进行了体外实验,以评估在纤维蛋白胶中培养的肌腱干/祖细胞的存活、增殖和胶原合成能力。分别通过活/死细胞存活率检测、细胞计数试剂盒-8(CCK-8)检测和天狼星红染色来实现。体内动物研究使用的是 8 至 12 周大的新西兰白兔。每只兔子的左肩都接受了手术,雌雄数量相等。对照组有 12 只兔子,凝胶组和贴片组各有 15 只兔子。在 1 个月和 3 个月的时间点,三组各分配 6 只兔子,在 2 个月的时间点,凝胶组和贴片组各分配 3 只兔子。通过冈下肌腱缺损模型,评估了组织工程双膝自体肌腱贴片(贴片组)与未处理组(对照组)和纤维蛋白胶(凝胶组)的肌腱修复效果。评估包括修复组织形态的组织学评估、再生胶原纤维的透射电子显微镜(TEM)评估以及 RNA 测序,以探索组织工程双腱鞘自体肌腱贴片在肌腱再生中的潜在机制:体外实验表明,与单独的标准细胞培养(0.27 ± 0.02,平均差 0.11 [95% CI 0.07 至 0.14];p < 0.001)相比,纤维蛋白胶增强了肌腱干细胞/祖细胞的胶原合成能力(0.38 ± 0.02)。随着培养时间的延长,培养 14 天后(78.13%±3.68%)与培养 11 天(13.05%±8.78%,平均差-65.08%[95%CI-77.99%至-52.15%];p<0.001)、7天(2.67%±2.62%,平均差异-75.46%[95%CI-88.37%至-62.53%];p<0.001)和1天(0.33%±0.30%,平均差异-77.80%[95%CI-90.71%至-64.87%];p<0.001)。移植后 3 个月的体内实验显示,与对照组和凝胶组相比,贴片组的修复效果更好。与凝胶组(10.67 ± 0.58,平均差 6.84 [95% CI 3.67 至 10.00];p = 0.001)和对照组(10.75 ± 0.66,平均差 6.92 [95% CI 3.75 to 10.08]; p = 0.001),以及补片组(77.52 ± 44.41 nm)与对照组(53.34 ± 6.64 nm,平均差 24.18 [95% CI 22.24 to 26.11]; p < 0.001)相比,新形成的胶原纤维排列规则且直径更大。RNA 测序分析表明,组织工程双腱鞘自体肌腱补片通过调节免疫反应、促进胶原纤维组织和减轻血管收缩促进了肌腱再生:这项动物研究表明,组织工程双腱鞘自体肌腱补片可有效调节免疫反应和胶原纤维组织,从而促进肌腱再生:组织工程双腱鞘自体肌腱补片是一种很有前景的肌腱再生策略,在临床肩袖手术中修复肩袖大面积缺损方面具有潜力。后续研究可侧重于使用组织工程双腱鞘自体肌腱补片进行大型动物实验,以探索其临床转化的可行性。
{"title":"Tissue-engineered Bicipital Autologous Tendon Patch Enhances Massive Rotator Cuff Defect Repair in a Rabbit Infraspinatus Tendon Defect Model.","authors":"Youguo Liao, Hengzi Liu, Jiayun Huang, Zetao Wang, Tao Zhang, Xiangjun Hu, Qiulin He, Zichen Wang, Yang Fei, Yuxiang Zhang, Fangyuan Cai, Dengfeng Ruan, Hong Zhang, Luyong Jiang, Zi Yin, Hongwei Ouyang, Xiao Chen, Weiliang Shen","doi":"10.1097/CORR.0000000000003218","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003218","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Massive rotator cuff defects represent an important source of shoulder pain and functional debilitation, substantially diminishing patients' quality of life. The primary treatment of massive rotator cuff defects includes complete or partial repair and patch augmentation. However, because of the tendon's limited regenerative ability, the tendon retear risk after rotator cuff defect repair is still high. Thus, a new therapy is needed to promote tendon regeneration for repair of massive rotator cuff defects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Questions/purposes: &lt;/strong&gt;Using an in vitro analysis, we first asked: (1) What is the biocompatibility and collagen synthesis ability of fibrin glue, and what is the cell growth of tissue-engineered bicipital tendon patches, which is comprised of fibrin glue and biceps tendon tissue particles? Then, using an in vivo animal model of full-thickness defects in the infraspinatus tendon in New Zealand White rabbits, we asked: (2) What is the potential of the tissue-engineered bicipital autologous tendon patch to promote tendon regeneration?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In vitro experiments were conducted to assess the survival, proliferation, and collagen synthesis ability of tendon stem/progenitor cells cultured in fibrin glue. This was achieved through an assay of live/dead cell viability, cell counting kit-8 (CCK-8) assay, and Sirius red staining, respectively. The in vivo animal study was conducted using 8- to 12-week-old New Zealand White rabbits. The left shoulder of each animal was operated on, with equal numbers of males and females. There were 12 rabbits in the control group and 15 rabbits each in the gel and patch groups. Six rabbits were allocated to each of the three groups at the 1- and 3-month time points and three rabbits each were in the gel and patch groups at 2-month time point. Through an infraspinatus tendon defect model, the effectiveness of tissue-engineered bicipital autologous tendon patches (patch group) in tendon repair was assessed compared with untreated (control group) and fibrin glue (gel group) treatments in vivo. This assessment included histological evaluation of repaired tissue morphology, transmission electron microscopy (TEM) evaluation of regenerated collagen fibrils, and RNA sequencing to explore the potential mechanisms of tissue-engineered bicipital autologous tendon patches in tendon regeneration.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In vitro experiments demonstrated that fibrin glue enhanced the collagen synthesis ability of tendon stem/progenitor cells (0.38 ± 0.02) compared with standard cell culture alone (0.27 ± 0.02, mean difference 0.11 [95% CI 0.07 to 0.14]; p &lt; 0.001). With prolonged cultivation, the cell growth area of tissue-engineered bicipital tendon patches showed a notable increase after culturing for 14 days (78.13% ± 3.68%) compared with 11 days (13.05% ± 8.78%, mean difference -65.08% [95% CI -77.99% to -52.15%]; p<0.001), 7 days (2.67% ± 2.62%, ","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Does Integration of Graded Motor Imagery Training Augment the Efficacy of a Multimodal Physiotherapy Program for Patients With Frozen Shoulder? A Randomized Controlled Trial. 分级运动想象训练是否能增强肩周炎患者多模式物理治疗计划的疗效?随机对照试验
IF 4.2 2区 医学 Q1 ORTHOPEDICS Pub Date : 2024-09-17 DOI: 10.1097/CORR.0000000000003252
Zeynal Yasaci, Derya Celik
<p><strong>Background: </strong>Despite the availability of numerous treatment modalities for frozen shoulder, spanning from nonsurgical approaches to surgical interventions, a consensus regarding the most effective treatment remains elusive. Current studies emphasize that pain in frozen shoulder affects central nervous system activity and leads to changes in cortical structures, which are responsible for processing sensory information (like pain) and controlling motor functions (like movement). These cortical changes highlight the importance of including the central nervous system in the management of frozen shoulder. It is therefore recommended that treatment should provide more effective management by focusing not only on the shoulder region but also on the cortical areas thought to be affected.</p><p><strong>Questions/purposes: </strong>Among patients treated nonsurgically for frozen shoulder, is graded motor imagery added to a multimodal physical therapy program more effective than multimodal physical therapy alone in terms of (1) Shoulder Pain and Disability Index (SPADI) scores, (2) pain with activities and QuickDASH (Q-DASH) scores, and (3) ROM after 8 weeks of treatment?</p><p><strong>Methods: </strong>In this randomized clinical trial, we considered the following as eligible for inclusion: (1) ROM < 50% compared with the unaffected shoulder, (2) clinically and radiologically confirmed primary frozen shoulder, and (3) 30% loss of joint ROM in at least two planes compared with the unaffected shoulder. Diagnosis of patients was based on patient history, symptoms, clinical examination, and exclusion of other conditions. A total of 38 patients with frozen shoulder were randomly assigned to either the graded motor imagery group (n = 19) or the multimodal physiotherapy group (n = 19). The groups did not differ in age, height, weight, gender, and dominant and affected side. In both groups, there were no losses to follow-up during the study period, and there was no crossover between groups. The multimodal physiotherapy program encompassed a variety of treatments, including stretching exercises, ROM exercises, joint-oriented mobilization techniques, scapular mobilization, strengthening exercises, and the application of cold agents. The graded motor imagery program, as an addition to the multimodal physiotherapy program, included the following steps: (1) left-right discrimination (identifying left and right body parts), (2) motor imagery (mentally visualizing movements), and (3) mirror therapy training (using mirrors to trick the brain into thinking the affected part is moving). Both groups of patients participated in a program of 12 sessions, each lasting approximately 45 minutes, twice a week for 6 weeks. Participants were assessed at baseline, after 6 weeks, and at 8 weeks. The primary outcome was the SPADI score, which ranges from 0 to 100, with higher values denoting greater disability. The minimum clinically important difference (MCID) for S
虽然增加分级运动想象在许多评分方面具有优势,而且不需要高预算的设备,但其缺点也不容忽视,例如某些评分低于 MCID 的差异以及对专业知识和经验的需求。因此,尽管分级运动图像疗法前景广阔,但仍建议进行更长时间的后续研究,以充分了解其在治疗肩周炎方面的优势和局限性:证据等级:I级,治疗性研究。
{"title":"Does Integration of Graded Motor Imagery Training Augment the Efficacy of a Multimodal Physiotherapy Program for Patients With Frozen Shoulder? A Randomized Controlled Trial.","authors":"Zeynal Yasaci, Derya Celik","doi":"10.1097/CORR.0000000000003252","DOIUrl":"10.1097/CORR.0000000000003252","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Despite the availability of numerous treatment modalities for frozen shoulder, spanning from nonsurgical approaches to surgical interventions, a consensus regarding the most effective treatment remains elusive. Current studies emphasize that pain in frozen shoulder affects central nervous system activity and leads to changes in cortical structures, which are responsible for processing sensory information (like pain) and controlling motor functions (like movement). These cortical changes highlight the importance of including the central nervous system in the management of frozen shoulder. It is therefore recommended that treatment should provide more effective management by focusing not only on the shoulder region but also on the cortical areas thought to be affected.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Questions/purposes: &lt;/strong&gt;Among patients treated nonsurgically for frozen shoulder, is graded motor imagery added to a multimodal physical therapy program more effective than multimodal physical therapy alone in terms of (1) Shoulder Pain and Disability Index (SPADI) scores, (2) pain with activities and QuickDASH (Q-DASH) scores, and (3) ROM after 8 weeks of treatment?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this randomized clinical trial, we considered the following as eligible for inclusion: (1) ROM &lt; 50% compared with the unaffected shoulder, (2) clinically and radiologically confirmed primary frozen shoulder, and (3) 30% loss of joint ROM in at least two planes compared with the unaffected shoulder. Diagnosis of patients was based on patient history, symptoms, clinical examination, and exclusion of other conditions. A total of 38 patients with frozen shoulder were randomly assigned to either the graded motor imagery group (n = 19) or the multimodal physiotherapy group (n = 19). The groups did not differ in age, height, weight, gender, and dominant and affected side. In both groups, there were no losses to follow-up during the study period, and there was no crossover between groups. The multimodal physiotherapy program encompassed a variety of treatments, including stretching exercises, ROM exercises, joint-oriented mobilization techniques, scapular mobilization, strengthening exercises, and the application of cold agents. The graded motor imagery program, as an addition to the multimodal physiotherapy program, included the following steps: (1) left-right discrimination (identifying left and right body parts), (2) motor imagery (mentally visualizing movements), and (3) mirror therapy training (using mirrors to trick the brain into thinking the affected part is moving). Both groups of patients participated in a program of 12 sessions, each lasting approximately 45 minutes, twice a week for 6 weeks. Participants were assessed at baseline, after 6 weeks, and at 8 weeks. The primary outcome was the SPADI score, which ranges from 0 to 100, with higher values denoting greater disability. The minimum clinically important difference (MCID) for S","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
CORR Insights®: Can Repetition-based Training in a High-fidelity Model Enhance Critical Trauma Surgical Skills Among Trainees and Attending Surgeons Equally? CORR Insights®:高仿真模型中的重复训练能否同样提高受训者和主治外科医生的关键创伤外科技能?
IF 4.2 2区 医学 Q1 ORTHOPEDICS Pub Date : 2024-09-17 DOI: 10.1097/CORR.0000000000003258
Peter N Mittwede
{"title":"CORR Insights®: Can Repetition-based Training in a High-fidelity Model Enhance Critical Trauma Surgical Skills Among Trainees and Attending Surgeons Equally?","authors":"Peter N Mittwede","doi":"10.1097/CORR.0000000000003258","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003258","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Clinical Orthopaedics and Related Research®
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1