Platelet rich plasma(PRP)is an autologous blood product rich in platelets,showing promise in reducing inflammation and accelerating healing.While extensively utilized in plastic surgery,dermatology,and osteoarthritis ...Platelet rich plasma(PRP)is an autologous blood product rich in platelets,showing promise in reducing inflammation and accelerating healing.While extensively utilized in plastic surgery,dermatology,and osteoarthritis treatment,its application in anterior cruciate ligament(ACL)injuries is limited.This article examines PRP's potential in ACL reconstruction(ACLR),exploring its history,current usage,controversies and future directions.PRP has demonstrated significant early benefits in ligamentisation and vascularisation post-ACLR,though its long-term efficacy is inconsistent.Studies suggest that PRP may serve as both an adjunct therapy in ACLR to enhance initial healing and reduce postoperative complications,and as a non-surgical alternative for small ACL tears.Despite these promising findings,outcome variability necessitates further high-quality research to optimize PRP formulations and determine its most effective applications.The exploration of PRP as a treatment modality in ACLR offers promising but varied outcomes.PRP holds considerable promise as both an adjunct and alternative to traditional ACLR.This article underscores the need for targeted research to fully realize PRP's therapeutic potential in ACL treatment,aiming to inform future studies and clinical practices.By understanding PRP's mechanisms of efficacy and identifying the most beneficial patient populations,PRP could significantly impact orthopaedics and sports medicine,improving recovery pathways and patient outcomes.展开更多
BACKGROUND Bioabsorbable interference screws are a widely used option for graft fixation in anterior cruciate ligament(ACL)reconstruction.Their ability to degrade over time and avoid secondary hardware removal makes t...BACKGROUND Bioabsorbable interference screws are a widely used option for graft fixation in anterior cruciate ligament(ACL)reconstruction.Their ability to degrade over time and avoid secondary hardware removal makes them advantageous.However,complications such as breakage and intra-articular migration of screws can cause significant clinical issues,including joint pain,swelling,and cartilage damage.Early diagnosis and management are critical in such cases.CASE SUMMARY A 26-year-old male presented with knee pain and swelling one year after ACL reconstruction using a hamstring graft and bioabsorbable tibial interference screw.The patient had been engaged in rigorous physical activity as part of military training.Clinical examination revealed mild effusion without instability,and imaging showed screw breakage with intra-articular migration.Therapeutic arthroscopy confirmed intact graft tension,and broken screw fragments were removed successfully.The patient resumed normal activity two weeks after surgery.CONCLUSION This case highlights the potential complications associated with bioabsorbable screws,emphasizing the need for meticulous surgical technique,postoperative monitoring,and timely intervention.A comprehensive review of the literature illustrates the mechanisms,risk factors,and preventive strategies associated with screw-related complications.展开更多
Anterior cruciate ligament(ACL)injuries are frequently caused by sports injuries and trauma.In cases involving complete tears,ACL reconstruction(ACLR)surgery is the only way to restore the ligament’s integrity.When s...Anterior cruciate ligament(ACL)injuries are frequently caused by sports injuries and trauma.In cases involving complete tears,ACL reconstruction(ACLR)surgery is the only way to restore the ligament’s integrity.When selecting a graft,both the potential complications and the mechanical properties and healing efficacies should be considered.Artificial ligaments have been widely applied in clinical ACLR,and most have exhibited satisfactory biocompatibility and short-term follow-up results.Compared with autografts and allografts,however,the lack of bioactivity of currently available artificial ligaments is a major disadvantage.In addition,some long-term follow-up results have revealed other drawbacks of artificial ligaments,such as graft failure and other complications.Here,we summarize attempts to enhance the bioactive performance of artificial ligaments,as such modifications may have good potential for clinical translation and could improve the long-term outcomes of existing products.展开更多
The surgical approach for patellar instability usually refers to reconstruction of the medial patellofemoral ligament associated with an osteotomy of the tibial tuberosity or a trochleoplasty when required.The medial ...The surgical approach for patellar instability usually refers to reconstruction of the medial patellofemoral ligament associated with an osteotomy of the tibial tuberosity or a trochleoplasty when required.The medial patellotibial ligament and the medial patellomeniscal ligament are secondary stabilizers of the patella.Despite this,both the medial patellotibial and patellofemoral ligaments aid in patellar rotation and tilt when the knee is flexed beyond 45°.The medial patellotibial ligament plays a particularly important role in the final stages of stretching in extension and between 40 degrees to 90 degrees of flexion.The clinical relevance and surgical indications for medial patellotibial ligament reconstruction associated with medial patellofemoral ligament reconstruction are still controversial.This editorial explores the surgical indications and clinical results for medial patellotibial ligament reconstruction to improve readers’understanding of this technique,especially because reported clinical outcomes have remained sparse.展开更多
BACKGROUND The posterior cruciate ligament(PCL)is vital for regulating posterior tibial translation in relation to the femur,which is critical for knee stability.PCL tears are infrequently isolated in knee injuries;ho...BACKGROUND The posterior cruciate ligament(PCL)is vital for regulating posterior tibial translation in relation to the femur,which is critical for knee stability.PCL tears are infrequently isolated in knee injuries;however,the absence of the PCL results in abnormal knee kinematics,which may cause injuries to other ligaments.The ideal tendon source for PCL reconstruction is still a subject of debate.AIM To evaluate the results of employing the peroneus longus tendon(PLT)in PCL reconstruction.METHODS A comprehensive search was conducted to identify relevant randomized controlled trials and retrospective observational studies discussing the outcomes of using the PLT for PCL reconstruction.Studies published up to August 2024 were searched across multiple databases,including PubMed,EMBASE,Scopus,Web of Science,Cochrane Library,and Google Scholar.Full texts of the selected articles were retrieved,reviewed,and independently assessed by the investigators.Discrepancies were resolved by consensus,with any remaining disagreements being arbitrated by a third author.RESULTS This meta-analysis included five studies on PLT use for PCL reconstruction:(1)Four prospective studies with 104 patients;and(2)One retrospective study with 18 patients.Most studies followed up participants for 24 months,while one had a shorter follow-up of 18 months.Lysholm and modified cincinnati scores improved by pooled means of 32.2(95%CI:29.3-35.1,I2=0%)and 31.1(95%CI:27.98-34.22,I2=0%),respectively.Postoperative American Orthopaedic Foot and Ankle Society and Foot and Ankle Disability Index scores were 94.5(I2=61.5%)and 94.5(I2=80.09%),respectively.Single-hop and triple-hop test scores averaged 95.5(95%CI:94.5-96.5)and 92.4(95%CI:91.9-92.9)respectively.No significant differences were observed in thigh circumference at 10 cm and 20 cm between the injured and healthy sides.CONCLUSION Evidence supports PLT autografts for PCL reconstruction,improving knee function and patient outcomes.Larger randomized trials are needed to confirm efficacy and compare graft options.展开更多
The present article reviews the emerging role of melatonin(MT)and the Hippo-Yes-associated protein signaling pathway in periodontal regeneration,high-lighting their potential to delay the aging process of periodontal ...The present article reviews the emerging role of melatonin(MT)and the Hippo-Yes-associated protein signaling pathway in periodontal regeneration,high-lighting their potential to delay the aging process of periodontal ligament stem cells(PDLSCs).Oxidative stress and cellular senescence are major obstacles in regenerative therapies,especially in an aging population.MT,a potent antioxidant,restores the morphology,proliferation,and osteogenic differentiation potential of PDLSCs under oxidative stress conditions.Recent research highlights how MT enhances PDLSC stemness by upregulating Yes-associated protein ex-pression,offering a promising therapeutic strategy to antagonize tissue dege-neration.In addition,the article discusses the growing interest in probiotics as a complementary approach to improve oral microbiota and support tissue regeneration.The integration of MT with traditional and novel therapeutic approaches may pave the way for innovative preventive or active treatments in periodontology,aimed at reducing oxidative stress.Future research needs to focus on translating these findings into clinical applications and promoting a deeper understanding of periodontal regeneration and cellular aging.展开更多
BACKGROUND The purpose of this systematic review was to evaluate the clinical and radiological outcomes at short-term follow-up following suture button fixation for the management of ligamentous Lisfranc injuries.AIM ...BACKGROUND The purpose of this systematic review was to evaluate the clinical and radiological outcomes at short-term follow-up following suture button fixation for the management of ligamentous Lisfranc injuries.AIM To assess the effectiveness of suture button fixation in managing ligamentous Lisfranc injuries through a systematic evaluation of short-term clinical and radiological outcomes.METHODS During March 2024,the PubMed,EMBASE,and Cochrane library databases were systematically reviewed to identify clinical studies examining outcomes following suture button fixation for the management of ligamentous Lisfranc injuries.Data regarding patient demographics,pathological characteristics,subjective clinical outcomes,radiological outcomes,complications,and failure rates were extracted and analyzed.RESULTS Eight studies were included.In total,94 patients(94 feet)underwent suture button fixation for the management of ligamentous Lisfranc injuries at a weighted mean follow-up of 27.2±10.2 months.The American Orthopaedic Foot and Ankle Society score improved from a weighted mean pre-operative score of 39.2±11.8 preoperatively to a post-operative score of 82.8±5.4.The weighted mean visual analogue scale score improved from a weighted mean pre-operative score of 7.7±0.6 preoperatively to a post-operative score of 2.0±0.4.In total,100%of patients returned to sport at a mean time of 16.8 weeks.The complication rate was 5%,the most common complication of which was residual midfoot stiffness(3.0%).No failures nor secondary surgical procedures were recorded.CONCLUSION This systematic review demonstrated that suture button fixation for ligamentous Lisfranc injuries produced improved clinical outcomes at short-term follow-up.In addition,there was an excellent return-to-sport rate(100%)at a weighted mean time of 16.8 weeks.This review highlights that suture button fixation is a potent surgical treatment strategy for ligamentous Lisfranc injuries;however,caution should be taken when evaluating this data in light of the lack of high quality,comparative studies,and short-term follow-up.展开更多
BACKGROUND Leiomyomas or fibroids commonly originate from the uterus;extrauterine leiomyomas are rare and most often arise from the broad ligament.Diagnosing broad ligament leiomyomas becomes particularly challenging ...BACKGROUND Leiomyomas or fibroids commonly originate from the uterus;extrauterine leiomyomas are rare and most often arise from the broad ligament.Diagnosing broad ligament leiomyomas becomes particularly challenging when they undergo degenerative changes because their clinical and radiological features often mimic those of ovarian tumors.We report a rare case of a giant broad ligament fibroid with cystic degeneration,which was initially mistaken for an ovarian mass.CASE SUMMARY A 49-year-old woman presented with mild abdominal distension and pain as the only symptoms.Upon abdominal examination,a large mass measuring approximately 30 cm and extending from the pelvic cavity to just below the xiphoid process was identified.Both transvaginal ultrasound and contrast-enhanced computed tomography suggested an ovarian origin of the mass.However,laparotomy confirmed that the mass originated from the right broad ligament.The mass was separated from the uterus and bilateral ovaries,with no involvement of the uterus or ovaries.The mass was completely resected with respecting the patient’s desire to retain her uterus and adnexa.Postoperative histopathological examination confirmed leiomyoma with cystic degeneration.CONCLUSION Broad ligament myomas mimic ovarian tumors;accurate diagnosis and careful operation are critical to avoid complications and ensure safety.展开更多
Anterior cruciate ligament(ACL)injuries are among the most frequent knee pathologies,with athletes—particularly females and those in pivot-heavy sports such as soccer,basketball,volleyball,and skiing—at increased ri...Anterior cruciate ligament(ACL)injuries are among the most frequent knee pathologies,with athletes—particularly females and those in pivot-heavy sports such as soccer,basketball,volleyball,and skiing—at increased risk.The success of ACL reconstruction is multifactorial,relying on individualized graft selection,surgical precision,patient-specific characteristics,and optimized rehabilitation.Despite the availability of various graft options—hamstring tendon,bone-patellar tendon-bone,and quadriceps tendon—no single type has demonstrated clear superiority,reinforcing the need for patient-tailored approaches based on anatomical,functional,and age-related factors.Surgical techniques continue to evolve,with adaptations such as physeal-sparing methods for skeletally immature patients and minimally invasive procedures aimed at reducing morbidity and improving recovery.Rehabilitation is a critical determinant of functional out-comes.Current evidence supports immediate mobilization,early weight-bearing,and initiation of neuromuscular and strength training,while routine use of continuous passive motion and bracing is discouraged,except in multi-ligament injuries.Prehabilitation is recommended,though accelerated rehabilitation remains controversial.Implant choice and fixation strategy are also essential to long-term success.The use of materials that reduce the risk of chronic complic-ations and support biological integration is increasingly favored.Nevertheless,rare mechanical failures emphasize the need for accurate tunnel placement,appropriate implant selection,and vigilant postoperative monitoring.Outcomes are further influenced by patient-specific variables,including bone quality,metabolic status,and physical activity levels.Optimal ACL reconstruction results from a comprehensive,patient-centered strategy that integrates surgical accuracy,individualized rehabilitation,and continuous follow-up to minimize complications and enhance recovery.展开更多
BACKGROUND Periodontitis is an inflammatory disease caused by the host’s immune response and various interactions between pathogens,which lead to the loss of connective tissue and bone.In recent years,mesenchymal ste...BACKGROUND Periodontitis is an inflammatory disease caused by the host’s immune response and various interactions between pathogens,which lead to the loss of connective tissue and bone.In recent years,mesenchymal stem cell(SC)transplantation technology has become a research hotspot,which can form periodontal ligament,cementum,and alveolar bone through proliferation and differentiation.AIM To elucidate the regulatory effects of WD repeat-containing protein 36(WDR36)on the senescence,migration,and osteogenic differentiation of periodontal ligament SCs(PDLSCs).METHODS The migration and chemotaxis of PDLSCs were detected by the scratch-wound migration test and transwell chemotaxis test.Alkaline phosphatase(ALP)activity,Alizarin red staining,calcium content,and real-time reverse transcription polymerase chain reaction(RT-qPCR)of key transcription factors were used to detect the osteogenic differentiation function of PDLSCs.Cell senescence was determined by senescence-associatedβ-galactosidase staining.RESULTS The 24-hour and 48-hour scratch-wound migration test and 48-hour transwell chemotaxis test showed that overexpression of WDR36 inhibited the migration/chemotaxis of PDLSCs.Simultaneously,WDR36 depletion promoted the migration/chemotaxis of PDLSCs.The results of ALP activity,Alizarin red staining,calcium content,and RTqPCR showed that overexpression of WDR36 inhibited the osteogenic differentiation of PDLSCs,and WDR36 depletion promoted the osteogenic differentiation of PDLSCs.Senescence-associatedβ-galactosidase staining showed that 0.1μg/mL icariin(ICA)and overexpression of WDR36 inhibited the senescence of PDLSCs,and WDR36 depletion promoted the osteogenic differentiation of PDLSCs.CONCLUSION WDR36 inhibits the migration and chemotaxis,osteogenic differentiation,and senescence of PDLSCs;0.1μg/mL ICA inhibits the senescence of PDLSCs.Therefore,WDR36 might serve as a target for periodontal tissue regeneration and the treatment of periodontitis.展开更多
BACKGROUND A 56-year-old female presented with acute abdominal pain due to a ruptured pseudoaneurysm associated with median arcuate ligament syndrome(MALS),a rare condition caused by the compression of the celiac arte...BACKGROUND A 56-year-old female presented with acute abdominal pain due to a ruptured pseudoaneurysm associated with median arcuate ligament syndrome(MALS),a rare condition caused by the compression of the celiac artery by the median arcuate ligament(MAL),potentially leading to ischemia,aneurysm formation,and rupture.CASE SUMMARY Computed tomography revealed a retroperitoneal hematoma,celiac artery stenosis,and two aneurysms in the inferior pancreaticoduodenal artery.Hemo-stasis was achieved using transcatheter arterial embolization.However,15 days after embolization,the patient developed duodenal stenosis,manifesting as gastric distension and nausea without abdominal pain.Endoscopy revealed mucosal edema and luminal narrowing of the duodenum.Conservative treatment was ineffective,and the patient underwent MAL transection and gastrojejun-ostomy.She recovered uneventfully,and follow-up at 4 months showed complete resolution of duodenal stenosis and no recurrence.CONCLUSION This case highlights the importance of the early diagnosis and multidisciplinary management of MALS.展开更多
BACKGROUND Thoracic ossification of the posterior longitudinal ligament(T-OPLL)is caused by the ossified posterior longitudinal ligament occupying space in the spinal canal,which causes compression of the thoracic spi...BACKGROUND Thoracic ossification of the posterior longitudinal ligament(T-OPLL)is caused by the ossified posterior longitudinal ligament occupying space in the spinal canal,which causes compression of the thoracic spinal cord.Surgical treatment is difficult,risky and complicated;thus,clinical treatment is difficult at present.CASE SUMMARY A case of severe multi-segmental T-OPLL treated with thoracic anterior controllable antedisplacement fusion(TACAF)is reported,including the surgical procedures and analysis of the clinical data.The modified-Japanese Orthopaedic Association score in this patient was 4 before surgery,and it was raised to 9 after the operation.The symptoms of spinal canal compression were subsequently relieved.Three months after surgery,digital radiography showed good healing and recovery of limb sensory function.CONCLUSION This case report suggests that TACAF is feasible for the treatment of long-segment T-OPLL,and has the advantages of low risk and reduced trauma.However,this operation still needs to be verified by clinical research with a larger sample size.展开更多
Background:The anterior talofibular ligament(ATFL)and the calcaneofibular ligament(CFL)are vulnerable to be torn or ruptured during lateral ankle sprain(LAS),especially in people with chronic ankle instability(CAI).Th...Background:The anterior talofibular ligament(ATFL)and the calcaneofibular ligament(CFL)are vulnerable to be torn or ruptured during lateral ankle sprain(LAS),especially in people with chronic ankle instability(CAI).This study aims to determine whether landing with a larger toe-out angle would influence ATFL and CFL strains in people with CAI,aiming to contribute to the development of effective landing strategies to reduce LAS risk.Methods:Thirty participants with CAI(22 males and 8 females,age:21.2±1.2 years,height:176.9±9.0 cm,body mass:70.6±12.1 kg,mean±SD)were recruited.Each participant landed on a specialized trap-door device with their unaffected limbs on a support platform and their affected limbs on a movable platform,which could be flipped 24°inward and 15°forward to mimic LAS conditions.Two landing conditions were tested—i.e.,natural landing(NL,with natural toe-out angle at landing)and toe-out landing(TL,with toe-out angle increased to over 150%of that under the NL conditions).Kinematic data were captured using a 12-camera motion analysis system,and ATFL and CFL strains were calculated using a 3D rigid-body foot model.Paired sample t tests and Pearson's correlations were used to analyze data.Results:Compared to NL conditions,ATFL strain decreased(p<0.001,d=2.42)while CFL strain remained unchanged(p=0.229,d=0.09)under TL conditions.The toe-out angle was negatively and strongly correlated with ATFL strain(r=-0.743,p<0.001)but not with CFL strain(r=0.153,p=0.251).Compared to NL conditions,participants exhibit a lower ankle inversion angle(p<0.001,d=0.494),a higher plantarflexion angle(p<0.001,d=1.101),and no significant difference in external rotation angle(p=0.571,d=0.133)under TL conditions.Conclusion:Toe-out landing may reduce ATFL strain while maintaining CFL strain in people with CAI,thereby reducing the risk of LAS.展开更多
This article provides a discussion and commentary around the recent advances in arthroscopic anterior cruciate ligament reconstruction(ACLR),with a focus on the aspects of lateral femoral tunnel preparation and graft ...This article provides a discussion and commentary around the recent advances in arthroscopic anterior cruciate ligament reconstruction(ACLR),with a focus on the aspects of lateral femoral tunnel preparation and graft fixation techniques.The paper explores and comments on a recently published review by Dai et al,titled"Research progress on preparation of lateral femoral tunnel and graft fixation in ACLR",while providing insight into its relevance within the field of ACLR,and recommendations for future research.展开更多
Anterior cruciate ligament(ACL)injuries of the knee are one of the most common and serious athletic injuries.The widely used cortical suspension fixation buttons for ligament reconstruction are permanent implants,part...Anterior cruciate ligament(ACL)injuries of the knee are one of the most common and serious athletic injuries.The widely used cortical suspension fixation buttons for ligament reconstruction are permanent implants,particularly those made from conventional steel or titanium alloys.In this study,a biodegradable Zn-0.45Mn-0.2Mg(ZMM42)alloy with the yield strength of 300.4 MPa and tensile strength of 329.8 MPa was prepared through hot extrusion.The use of zinc alloys in the preparation of cortical suspension fixation buttons was proposed for the first time.After 35 d of immersion in simulated body fluids,the ZMM42 alloy fixation buttons were degraded at a rate of 44μm/a,and the fixation strength was retained(379.55 N)in the traction loops.Simultaneously,the ZMM42 alloy fixation buttons exhibited an increase in MC3T3-E1 cell viability and high antibacterial activity against Escherichia coli and Staphylococcus aureus.These results reveal the potential of biodegradable zinc alloys for use as ligament reconstruction materials and for developing diverse zinc alloy cortical suspension fixation devices.展开更多
BACKGROUND Human periodontal ligament stem cells(PDLSCs)regenerate oral tissue.In vitro expansion causes replicative senescence in stem cells.This causes intracellular reactive oxygen species(ROS)accumulation,which ca...BACKGROUND Human periodontal ligament stem cells(PDLSCs)regenerate oral tissue.In vitro expansion causes replicative senescence in stem cells.This causes intracellular reactive oxygen species(ROS)accumulation,which can impair stem cell function.Tissue engineering efficiency is reduced by exogenous ROS stimulation,which causes premature senescence under oxidative stress.Melatonin(MT),a powerful free radical scavenger,can delay PDLSCs senescence but may not maintain stemness under oxidative stress.This experiment examined the effects of hydrogen peroxide-induced oxidative stress on PDLSCs’apoptosis,senescence,and stemness.AIM To determine if MT can reverse the above effects along with the underlying molecular mechanisms involved.METHODS PDLSCs were isolated from human premolars and cultured in different conditions.Flow cytometry was used to characterize the cell surface markers of BACKGROUND Human periodontal ligament stem cells(PDLSCs)regenerate oral tissue.In vitro expansion causes replicative senescence in stem cells.This causes intracellular reactive oxygen species(ROS)accumulation,which can impair stem cell function.Tissue engineering efficiency is reduced by exogenous ROS stimulation,which causes premature senescence under oxidative stress.Melatonin(MT),a powerful free radical scavenger,can delay PDLSCs senescence but may not maintain stemness under oxidative stress.This experiment examined the effects of hydrogen peroxide-induced oxidative stress on PDLSCs’apoptosis,senescence,and stemness.AIM To determine if MT can reverse the above effects along with the underlying molecular mechanisms involved.METHODS PDLSCs were isolated from human premolars and cultured in different conditions.Flow cytometry was used to characterize the cell surface markers of differentiation,ROS,and senescence-associatedβ-galactosidase activity were assessed by various assays.Reverse transcription-polymerase chain reaction and western blot were used to measure the expression of genes and proteins related to stemness and senescence.RESULTS MT increases Yes-associated protein expression and maintains cell stemness in an induced inflammatory microenvironment,which may explain its therapeutic effects.We examined how MT affects PDLSCs aging and stemness and its biological mechanisms.CONCLUSION Our study reveals MT’s role in regulating oxidative stress in PDLSCs and Yes-associated protein-mediated activity,providing insights into cellular functions and new therapeutic targets for tissue regeneration.展开更多
BACKGROUND Tibial avulsion fractures of the posterior cruciate ligament(PCL)are challenging to treat and compromise knee stability and function.Traditional open surgery often requires extensive soft tissue dissection,...BACKGROUND Tibial avulsion fractures of the posterior cruciate ligament(PCL)are challenging to treat and compromise knee stability and function.Traditional open surgery often requires extensive soft tissue dissection,which may increase the risk of morbidity.In response to these concerns,arthroscopic techniques have been evolving.The aim of this study was to introduce a modified arthroscopic tech-nique utilizing an M-shaped suture fixation method for the treatment of tibial avulsion fractures of the PCL and to evaluate its outcomes through a case series.AIM To evaluate the effects of arthroscopic M-shaped suture fixation on treating tibia avulsion fractures of the PCL.METHODS We developed a modified arthroscopic M-shaped suture fixation technique for tibia avulsion fractures of the PCL.This case series included 18 patients who underwent the procedure between January 2021 and December 2022.The patients were assessed for range of motion(ROM),Lysholm score and International knee documentation committee(IKDC)score.Postoperative complications were also recorded.RESULTS The patients were followed for a mean of 13.83±2.33 months.All patients showed radiographic union.At the final follow-up,all patients had full ROM and a negative posterior drawer test.The mean Lysholm score significantly improved from 45.28±8.92 preoperatively to 91.83±4.18 at the final follow-up(P<0.001),and the mean IKDC score improved from 41.98±6.06 preoperatively to 90.89±5.32 at the final follow-up(P<0.001).CONCLUSION The modified arthroscopic M-shaped suture fixation technique is a reliable and effective treatment for tibia avulsion fractures of the PCL,with excellent fracture healing and functional recovery.展开更多
BACKGROUND Extragastric lesions are typically not misdiagnosed as gastric submucosal tumor(SMT).However,we encountered two rare cases where extrinsic lesions were misdiagnosed as gastric SMTs.CASE SUMMARY We describe ...BACKGROUND Extragastric lesions are typically not misdiagnosed as gastric submucosal tumor(SMT).However,we encountered two rare cases where extrinsic lesions were misdiagnosed as gastric SMTs.CASE SUMMARY We describe two cases of gastric SMT-like protrusions initially misdiagnosed as gastric SMTs by the abdominal contrast-enhanced computed tomography(CT)and endoscopic ultrasound(EUS).Based on the CT and EUS findings,the patients underwent gastroscopy;however,no tumor was identified after incising the gastric wall.Subsequent surgical exploration revealed no gastric lesions in both patients,but a mass was found in the left triangular ligament of the liver.The patients underwent laparoscopic tumor resection,and the postoperative diagnosis was hepatic hemangiomas.CONCLUSION During EUS procedures,scanning across different layers and at varying degrees of gastric cavity distension,coupled with meticulous image analysis,has the potential to mitigate the likelihood of such misdiagnoses.展开更多
Ligament cryopreservation enables a prolonged shelf life of allogeneic ligament grafts,which is fundamentally important to ligament reconstruction.However,conventional cryopreservation techniques fail to eliminate the...Ligament cryopreservation enables a prolonged shelf life of allogeneic ligament grafts,which is fundamentally important to ligament reconstruction.However,conventional cryopreservation techniques fail to eliminate the damage caused by ice crystal growth and the toxicity of cryopreservation agents(CPAs).Here,we report a novel CPA vitrification formulation primarily composed of betaine for ligament cryopreservation.Comprehensive optimization was conducted on the methods for vitrification and rewarming,as well as the loading and unloading conditions,based on the critical cooling rate(CCR),critical warming rate(CWR),and permeation properties of the CPA.Using biomechanical and histological level tests,we demonstrate the superior performance of our method in ligament cryopreservation.After 30 days of vitrification cryopreservation,parameters such as the Young's modulus,tensile stress,denaturation temperature,and glycosaminoglycans content of the ligament remained essentially unchanged.This work pioneers the application of ice-free cryopreservation for ligament and holds great potential for improving the long-term storage of ligament,providing valuable insights for future cryopreservation technique development.展开更多
Helping athletes return to sports participation is a primary goal of anterior cruciate ligament(ACL)reconstruction rehabilitation.To facilitate the achievement of this goal,decades of research studies have sought to i...Helping athletes return to sports participation is a primary goal of anterior cruciate ligament(ACL)reconstruction rehabilitation.To facilitate the achievement of this goal,decades of research studies have sought to identify knee impairments that reduce knee function as well as interventions to resolve them.1Yet,over the past 10 years,research pertaining to psychological responses(i.e.,cognitions and emotions)after ACL reconstruction has grown exponentially—a phenomenon that can be visualized by entering the search terms"psychological"and"anterior cruciate ligament reconstruction"into the PubMed search engine.展开更多
文摘Platelet rich plasma(PRP)is an autologous blood product rich in platelets,showing promise in reducing inflammation and accelerating healing.While extensively utilized in plastic surgery,dermatology,and osteoarthritis treatment,its application in anterior cruciate ligament(ACL)injuries is limited.This article examines PRP's potential in ACL reconstruction(ACLR),exploring its history,current usage,controversies and future directions.PRP has demonstrated significant early benefits in ligamentisation and vascularisation post-ACLR,though its long-term efficacy is inconsistent.Studies suggest that PRP may serve as both an adjunct therapy in ACLR to enhance initial healing and reduce postoperative complications,and as a non-surgical alternative for small ACL tears.Despite these promising findings,outcome variability necessitates further high-quality research to optimize PRP formulations and determine its most effective applications.The exploration of PRP as a treatment modality in ACLR offers promising but varied outcomes.PRP holds considerable promise as both an adjunct and alternative to traditional ACLR.This article underscores the need for targeted research to fully realize PRP's therapeutic potential in ACL treatment,aiming to inform future studies and clinical practices.By understanding PRP's mechanisms of efficacy and identifying the most beneficial patient populations,PRP could significantly impact orthopaedics and sports medicine,improving recovery pathways and patient outcomes.
文摘BACKGROUND Bioabsorbable interference screws are a widely used option for graft fixation in anterior cruciate ligament(ACL)reconstruction.Their ability to degrade over time and avoid secondary hardware removal makes them advantageous.However,complications such as breakage and intra-articular migration of screws can cause significant clinical issues,including joint pain,swelling,and cartilage damage.Early diagnosis and management are critical in such cases.CASE SUMMARY A 26-year-old male presented with knee pain and swelling one year after ACL reconstruction using a hamstring graft and bioabsorbable tibial interference screw.The patient had been engaged in rigorous physical activity as part of military training.Clinical examination revealed mild effusion without instability,and imaging showed screw breakage with intra-articular migration.Therapeutic arthroscopy confirmed intact graft tension,and broken screw fragments were removed successfully.The patient resumed normal activity two weeks after surgery.CONCLUSION This case highlights the potential complications associated with bioabsorbable screws,emphasizing the need for meticulous surgical technique,postoperative monitoring,and timely intervention.A comprehensive review of the literature illustrates the mechanisms,risk factors,and preventive strategies associated with screw-related complications.
基金supported by the Areas of Excellence Scheme(AoE/M402/20)the Knowledge Transfer Project Fund(KPF24GWP05)+2 种基金the IdeaBooster Fund(IDBF24MED12)the HKSTP Ideation Fund(Ideation 23-0698)the ITC Technology Startup Support Scheme for Universities(TSU24MED05).
文摘Anterior cruciate ligament(ACL)injuries are frequently caused by sports injuries and trauma.In cases involving complete tears,ACL reconstruction(ACLR)surgery is the only way to restore the ligament’s integrity.When selecting a graft,both the potential complications and the mechanical properties and healing efficacies should be considered.Artificial ligaments have been widely applied in clinical ACLR,and most have exhibited satisfactory biocompatibility and short-term follow-up results.Compared with autografts and allografts,however,the lack of bioactivity of currently available artificial ligaments is a major disadvantage.In addition,some long-term follow-up results have revealed other drawbacks of artificial ligaments,such as graft failure and other complications.Here,we summarize attempts to enhance the bioactive performance of artificial ligaments,as such modifications may have good potential for clinical translation and could improve the long-term outcomes of existing products.
文摘The surgical approach for patellar instability usually refers to reconstruction of the medial patellofemoral ligament associated with an osteotomy of the tibial tuberosity or a trochleoplasty when required.The medial patellotibial ligament and the medial patellomeniscal ligament are secondary stabilizers of the patella.Despite this,both the medial patellotibial and patellofemoral ligaments aid in patellar rotation and tilt when the knee is flexed beyond 45°.The medial patellotibial ligament plays a particularly important role in the final stages of stretching in extension and between 40 degrees to 90 degrees of flexion.The clinical relevance and surgical indications for medial patellotibial ligament reconstruction associated with medial patellofemoral ligament reconstruction are still controversial.This editorial explores the surgical indications and clinical results for medial patellotibial ligament reconstruction to improve readers’understanding of this technique,especially because reported clinical outcomes have remained sparse.
文摘BACKGROUND The posterior cruciate ligament(PCL)is vital for regulating posterior tibial translation in relation to the femur,which is critical for knee stability.PCL tears are infrequently isolated in knee injuries;however,the absence of the PCL results in abnormal knee kinematics,which may cause injuries to other ligaments.The ideal tendon source for PCL reconstruction is still a subject of debate.AIM To evaluate the results of employing the peroneus longus tendon(PLT)in PCL reconstruction.METHODS A comprehensive search was conducted to identify relevant randomized controlled trials and retrospective observational studies discussing the outcomes of using the PLT for PCL reconstruction.Studies published up to August 2024 were searched across multiple databases,including PubMed,EMBASE,Scopus,Web of Science,Cochrane Library,and Google Scholar.Full texts of the selected articles were retrieved,reviewed,and independently assessed by the investigators.Discrepancies were resolved by consensus,with any remaining disagreements being arbitrated by a third author.RESULTS This meta-analysis included five studies on PLT use for PCL reconstruction:(1)Four prospective studies with 104 patients;and(2)One retrospective study with 18 patients.Most studies followed up participants for 24 months,while one had a shorter follow-up of 18 months.Lysholm and modified cincinnati scores improved by pooled means of 32.2(95%CI:29.3-35.1,I2=0%)and 31.1(95%CI:27.98-34.22,I2=0%),respectively.Postoperative American Orthopaedic Foot and Ankle Society and Foot and Ankle Disability Index scores were 94.5(I2=61.5%)and 94.5(I2=80.09%),respectively.Single-hop and triple-hop test scores averaged 95.5(95%CI:94.5-96.5)and 92.4(95%CI:91.9-92.9)respectively.No significant differences were observed in thigh circumference at 10 cm and 20 cm between the injured and healthy sides.CONCLUSION Evidence supports PLT autografts for PCL reconstruction,improving knee function and patient outcomes.Larger randomized trials are needed to confirm efficacy and compare graft options.
文摘The present article reviews the emerging role of melatonin(MT)and the Hippo-Yes-associated protein signaling pathway in periodontal regeneration,high-lighting their potential to delay the aging process of periodontal ligament stem cells(PDLSCs).Oxidative stress and cellular senescence are major obstacles in regenerative therapies,especially in an aging population.MT,a potent antioxidant,restores the morphology,proliferation,and osteogenic differentiation potential of PDLSCs under oxidative stress conditions.Recent research highlights how MT enhances PDLSC stemness by upregulating Yes-associated protein ex-pression,offering a promising therapeutic strategy to antagonize tissue dege-neration.In addition,the article discusses the growing interest in probiotics as a complementary approach to improve oral microbiota and support tissue regeneration.The integration of MT with traditional and novel therapeutic approaches may pave the way for innovative preventive or active treatments in periodontology,aimed at reducing oxidative stress.Future research needs to focus on translating these findings into clinical applications and promoting a deeper understanding of periodontal regeneration and cellular aging.
文摘BACKGROUND The purpose of this systematic review was to evaluate the clinical and radiological outcomes at short-term follow-up following suture button fixation for the management of ligamentous Lisfranc injuries.AIM To assess the effectiveness of suture button fixation in managing ligamentous Lisfranc injuries through a systematic evaluation of short-term clinical and radiological outcomes.METHODS During March 2024,the PubMed,EMBASE,and Cochrane library databases were systematically reviewed to identify clinical studies examining outcomes following suture button fixation for the management of ligamentous Lisfranc injuries.Data regarding patient demographics,pathological characteristics,subjective clinical outcomes,radiological outcomes,complications,and failure rates were extracted and analyzed.RESULTS Eight studies were included.In total,94 patients(94 feet)underwent suture button fixation for the management of ligamentous Lisfranc injuries at a weighted mean follow-up of 27.2±10.2 months.The American Orthopaedic Foot and Ankle Society score improved from a weighted mean pre-operative score of 39.2±11.8 preoperatively to a post-operative score of 82.8±5.4.The weighted mean visual analogue scale score improved from a weighted mean pre-operative score of 7.7±0.6 preoperatively to a post-operative score of 2.0±0.4.In total,100%of patients returned to sport at a mean time of 16.8 weeks.The complication rate was 5%,the most common complication of which was residual midfoot stiffness(3.0%).No failures nor secondary surgical procedures were recorded.CONCLUSION This systematic review demonstrated that suture button fixation for ligamentous Lisfranc injuries produced improved clinical outcomes at short-term follow-up.In addition,there was an excellent return-to-sport rate(100%)at a weighted mean time of 16.8 weeks.This review highlights that suture button fixation is a potent surgical treatment strategy for ligamentous Lisfranc injuries;however,caution should be taken when evaluating this data in light of the lack of high quality,comparative studies,and short-term follow-up.
文摘BACKGROUND Leiomyomas or fibroids commonly originate from the uterus;extrauterine leiomyomas are rare and most often arise from the broad ligament.Diagnosing broad ligament leiomyomas becomes particularly challenging when they undergo degenerative changes because their clinical and radiological features often mimic those of ovarian tumors.We report a rare case of a giant broad ligament fibroid with cystic degeneration,which was initially mistaken for an ovarian mass.CASE SUMMARY A 49-year-old woman presented with mild abdominal distension and pain as the only symptoms.Upon abdominal examination,a large mass measuring approximately 30 cm and extending from the pelvic cavity to just below the xiphoid process was identified.Both transvaginal ultrasound and contrast-enhanced computed tomography suggested an ovarian origin of the mass.However,laparotomy confirmed that the mass originated from the right broad ligament.The mass was separated from the uterus and bilateral ovaries,with no involvement of the uterus or ovaries.The mass was completely resected with respecting the patient’s desire to retain her uterus and adnexa.Postoperative histopathological examination confirmed leiomyoma with cystic degeneration.CONCLUSION Broad ligament myomas mimic ovarian tumors;accurate diagnosis and careful operation are critical to avoid complications and ensure safety.
文摘Anterior cruciate ligament(ACL)injuries are among the most frequent knee pathologies,with athletes—particularly females and those in pivot-heavy sports such as soccer,basketball,volleyball,and skiing—at increased risk.The success of ACL reconstruction is multifactorial,relying on individualized graft selection,surgical precision,patient-specific characteristics,and optimized rehabilitation.Despite the availability of various graft options—hamstring tendon,bone-patellar tendon-bone,and quadriceps tendon—no single type has demonstrated clear superiority,reinforcing the need for patient-tailored approaches based on anatomical,functional,and age-related factors.Surgical techniques continue to evolve,with adaptations such as physeal-sparing methods for skeletally immature patients and minimally invasive procedures aimed at reducing morbidity and improving recovery.Rehabilitation is a critical determinant of functional out-comes.Current evidence supports immediate mobilization,early weight-bearing,and initiation of neuromuscular and strength training,while routine use of continuous passive motion and bracing is discouraged,except in multi-ligament injuries.Prehabilitation is recommended,though accelerated rehabilitation remains controversial.Implant choice and fixation strategy are also essential to long-term success.The use of materials that reduce the risk of chronic complic-ations and support biological integration is increasingly favored.Nevertheless,rare mechanical failures emphasize the need for accurate tunnel placement,appropriate implant selection,and vigilant postoperative monitoring.Outcomes are further influenced by patient-specific variables,including bone quality,metabolic status,and physical activity levels.Optimal ACL reconstruction results from a comprehensive,patient-centered strategy that integrates surgical accuracy,individualized rehabilitation,and continuous follow-up to minimize complications and enhance recovery.
文摘BACKGROUND Periodontitis is an inflammatory disease caused by the host’s immune response and various interactions between pathogens,which lead to the loss of connective tissue and bone.In recent years,mesenchymal stem cell(SC)transplantation technology has become a research hotspot,which can form periodontal ligament,cementum,and alveolar bone through proliferation and differentiation.AIM To elucidate the regulatory effects of WD repeat-containing protein 36(WDR36)on the senescence,migration,and osteogenic differentiation of periodontal ligament SCs(PDLSCs).METHODS The migration and chemotaxis of PDLSCs were detected by the scratch-wound migration test and transwell chemotaxis test.Alkaline phosphatase(ALP)activity,Alizarin red staining,calcium content,and real-time reverse transcription polymerase chain reaction(RT-qPCR)of key transcription factors were used to detect the osteogenic differentiation function of PDLSCs.Cell senescence was determined by senescence-associatedβ-galactosidase staining.RESULTS The 24-hour and 48-hour scratch-wound migration test and 48-hour transwell chemotaxis test showed that overexpression of WDR36 inhibited the migration/chemotaxis of PDLSCs.Simultaneously,WDR36 depletion promoted the migration/chemotaxis of PDLSCs.The results of ALP activity,Alizarin red staining,calcium content,and RTqPCR showed that overexpression of WDR36 inhibited the osteogenic differentiation of PDLSCs,and WDR36 depletion promoted the osteogenic differentiation of PDLSCs.Senescence-associatedβ-galactosidase staining showed that 0.1μg/mL icariin(ICA)and overexpression of WDR36 inhibited the senescence of PDLSCs,and WDR36 depletion promoted the osteogenic differentiation of PDLSCs.CONCLUSION WDR36 inhibits the migration and chemotaxis,osteogenic differentiation,and senescence of PDLSCs;0.1μg/mL ICA inhibits the senescence of PDLSCs.Therefore,WDR36 might serve as a target for periodontal tissue regeneration and the treatment of periodontitis.
文摘BACKGROUND A 56-year-old female presented with acute abdominal pain due to a ruptured pseudoaneurysm associated with median arcuate ligament syndrome(MALS),a rare condition caused by the compression of the celiac artery by the median arcuate ligament(MAL),potentially leading to ischemia,aneurysm formation,and rupture.CASE SUMMARY Computed tomography revealed a retroperitoneal hematoma,celiac artery stenosis,and two aneurysms in the inferior pancreaticoduodenal artery.Hemo-stasis was achieved using transcatheter arterial embolization.However,15 days after embolization,the patient developed duodenal stenosis,manifesting as gastric distension and nausea without abdominal pain.Endoscopy revealed mucosal edema and luminal narrowing of the duodenum.Conservative treatment was ineffective,and the patient underwent MAL transection and gastrojejun-ostomy.She recovered uneventfully,and follow-up at 4 months showed complete resolution of duodenal stenosis and no recurrence.CONCLUSION This case highlights the importance of the early diagnosis and multidisciplinary management of MALS.
文摘BACKGROUND Thoracic ossification of the posterior longitudinal ligament(T-OPLL)is caused by the ossified posterior longitudinal ligament occupying space in the spinal canal,which causes compression of the thoracic spinal cord.Surgical treatment is difficult,risky and complicated;thus,clinical treatment is difficult at present.CASE SUMMARY A case of severe multi-segmental T-OPLL treated with thoracic anterior controllable antedisplacement fusion(TACAF)is reported,including the surgical procedures and analysis of the clinical data.The modified-Japanese Orthopaedic Association score in this patient was 4 before surgery,and it was raised to 9 after the operation.The symptoms of spinal canal compression were subsequently relieved.Three months after surgery,digital radiography showed good healing and recovery of limb sensory function.CONCLUSION This case report suggests that TACAF is feasible for the treatment of long-segment T-OPLL,and has the advantages of low risk and reduced trauma.However,this operation still needs to be verified by clinical research with a larger sample size.
基金supported by the General Administration of Sport of China(23QN009)the National Natural Science Foundation of China(12102235)。
文摘Background:The anterior talofibular ligament(ATFL)and the calcaneofibular ligament(CFL)are vulnerable to be torn or ruptured during lateral ankle sprain(LAS),especially in people with chronic ankle instability(CAI).This study aims to determine whether landing with a larger toe-out angle would influence ATFL and CFL strains in people with CAI,aiming to contribute to the development of effective landing strategies to reduce LAS risk.Methods:Thirty participants with CAI(22 males and 8 females,age:21.2±1.2 years,height:176.9±9.0 cm,body mass:70.6±12.1 kg,mean±SD)were recruited.Each participant landed on a specialized trap-door device with their unaffected limbs on a support platform and their affected limbs on a movable platform,which could be flipped 24°inward and 15°forward to mimic LAS conditions.Two landing conditions were tested—i.e.,natural landing(NL,with natural toe-out angle at landing)and toe-out landing(TL,with toe-out angle increased to over 150%of that under the NL conditions).Kinematic data were captured using a 12-camera motion analysis system,and ATFL and CFL strains were calculated using a 3D rigid-body foot model.Paired sample t tests and Pearson's correlations were used to analyze data.Results:Compared to NL conditions,ATFL strain decreased(p<0.001,d=2.42)while CFL strain remained unchanged(p=0.229,d=0.09)under TL conditions.The toe-out angle was negatively and strongly correlated with ATFL strain(r=-0.743,p<0.001)but not with CFL strain(r=0.153,p=0.251).Compared to NL conditions,participants exhibit a lower ankle inversion angle(p<0.001,d=0.494),a higher plantarflexion angle(p<0.001,d=1.101),and no significant difference in external rotation angle(p=0.571,d=0.133)under TL conditions.Conclusion:Toe-out landing may reduce ATFL strain while maintaining CFL strain in people with CAI,thereby reducing the risk of LAS.
文摘This article provides a discussion and commentary around the recent advances in arthroscopic anterior cruciate ligament reconstruction(ACLR),with a focus on the aspects of lateral femoral tunnel preparation and graft fixation techniques.The paper explores and comments on a recently published review by Dai et al,titled"Research progress on preparation of lateral femoral tunnel and graft fixation in ACLR",while providing insight into its relevance within the field of ACLR,and recommendations for future research.
基金financially supported by the Xiongan New Area Science and Technology Innovation Project,China(No.2022XACX0600)the Beijing Nova Program Cross Cooperation Program,China(No.20220484178)。
文摘Anterior cruciate ligament(ACL)injuries of the knee are one of the most common and serious athletic injuries.The widely used cortical suspension fixation buttons for ligament reconstruction are permanent implants,particularly those made from conventional steel or titanium alloys.In this study,a biodegradable Zn-0.45Mn-0.2Mg(ZMM42)alloy with the yield strength of 300.4 MPa and tensile strength of 329.8 MPa was prepared through hot extrusion.The use of zinc alloys in the preparation of cortical suspension fixation buttons was proposed for the first time.After 35 d of immersion in simulated body fluids,the ZMM42 alloy fixation buttons were degraded at a rate of 44μm/a,and the fixation strength was retained(379.55 N)in the traction loops.Simultaneously,the ZMM42 alloy fixation buttons exhibited an increase in MC3T3-E1 cell viability and high antibacterial activity against Escherichia coli and Staphylococcus aureus.These results reveal the potential of biodegradable zinc alloys for use as ligament reconstruction materials and for developing diverse zinc alloy cortical suspension fixation devices.
基金Supported by Open Foundation of Shandong Key Laboratory of Oral Tissue Regeneration,No.SDDX202001Shandong Provincial Natural Science Foundation,No.ZR2021MH075Clinical Research Center of Shandong University,No.2020SDUCRCC006.
文摘BACKGROUND Human periodontal ligament stem cells(PDLSCs)regenerate oral tissue.In vitro expansion causes replicative senescence in stem cells.This causes intracellular reactive oxygen species(ROS)accumulation,which can impair stem cell function.Tissue engineering efficiency is reduced by exogenous ROS stimulation,which causes premature senescence under oxidative stress.Melatonin(MT),a powerful free radical scavenger,can delay PDLSCs senescence but may not maintain stemness under oxidative stress.This experiment examined the effects of hydrogen peroxide-induced oxidative stress on PDLSCs’apoptosis,senescence,and stemness.AIM To determine if MT can reverse the above effects along with the underlying molecular mechanisms involved.METHODS PDLSCs were isolated from human premolars and cultured in different conditions.Flow cytometry was used to characterize the cell surface markers of BACKGROUND Human periodontal ligament stem cells(PDLSCs)regenerate oral tissue.In vitro expansion causes replicative senescence in stem cells.This causes intracellular reactive oxygen species(ROS)accumulation,which can impair stem cell function.Tissue engineering efficiency is reduced by exogenous ROS stimulation,which causes premature senescence under oxidative stress.Melatonin(MT),a powerful free radical scavenger,can delay PDLSCs senescence but may not maintain stemness under oxidative stress.This experiment examined the effects of hydrogen peroxide-induced oxidative stress on PDLSCs’apoptosis,senescence,and stemness.AIM To determine if MT can reverse the above effects along with the underlying molecular mechanisms involved.METHODS PDLSCs were isolated from human premolars and cultured in different conditions.Flow cytometry was used to characterize the cell surface markers of differentiation,ROS,and senescence-associatedβ-galactosidase activity were assessed by various assays.Reverse transcription-polymerase chain reaction and western blot were used to measure the expression of genes and proteins related to stemness and senescence.RESULTS MT increases Yes-associated protein expression and maintains cell stemness in an induced inflammatory microenvironment,which may explain its therapeutic effects.We examined how MT affects PDLSCs aging and stemness and its biological mechanisms.CONCLUSION Our study reveals MT’s role in regulating oxidative stress in PDLSCs and Yes-associated protein-mediated activity,providing insights into cellular functions and new therapeutic targets for tissue regeneration.
文摘BACKGROUND Tibial avulsion fractures of the posterior cruciate ligament(PCL)are challenging to treat and compromise knee stability and function.Traditional open surgery often requires extensive soft tissue dissection,which may increase the risk of morbidity.In response to these concerns,arthroscopic techniques have been evolving.The aim of this study was to introduce a modified arthroscopic tech-nique utilizing an M-shaped suture fixation method for the treatment of tibial avulsion fractures of the PCL and to evaluate its outcomes through a case series.AIM To evaluate the effects of arthroscopic M-shaped suture fixation on treating tibia avulsion fractures of the PCL.METHODS We developed a modified arthroscopic M-shaped suture fixation technique for tibia avulsion fractures of the PCL.This case series included 18 patients who underwent the procedure between January 2021 and December 2022.The patients were assessed for range of motion(ROM),Lysholm score and International knee documentation committee(IKDC)score.Postoperative complications were also recorded.RESULTS The patients were followed for a mean of 13.83±2.33 months.All patients showed radiographic union.At the final follow-up,all patients had full ROM and a negative posterior drawer test.The mean Lysholm score significantly improved from 45.28±8.92 preoperatively to 91.83±4.18 at the final follow-up(P<0.001),and the mean IKDC score improved from 41.98±6.06 preoperatively to 90.89±5.32 at the final follow-up(P<0.001).CONCLUSION The modified arthroscopic M-shaped suture fixation technique is a reliable and effective treatment for tibia avulsion fractures of the PCL,with excellent fracture healing and functional recovery.
基金Supported by the Natural Science Foundation of Zhejiang Province,No.LQ20H030007 and No.LY20H030010the Zhejiang Medical Health Technology Project,No.2019KY393.
文摘BACKGROUND Extragastric lesions are typically not misdiagnosed as gastric submucosal tumor(SMT).However,we encountered two rare cases where extrinsic lesions were misdiagnosed as gastric SMTs.CASE SUMMARY We describe two cases of gastric SMT-like protrusions initially misdiagnosed as gastric SMTs by the abdominal contrast-enhanced computed tomography(CT)and endoscopic ultrasound(EUS).Based on the CT and EUS findings,the patients underwent gastroscopy;however,no tumor was identified after incising the gastric wall.Subsequent surgical exploration revealed no gastric lesions in both patients,but a mass was found in the left triangular ligament of the liver.The patients underwent laparoscopic tumor resection,and the postoperative diagnosis was hepatic hemangiomas.CONCLUSION During EUS procedures,scanning across different layers and at varying degrees of gastric cavity distension,coupled with meticulous image analysis,has the potential to mitigate the likelihood of such misdiagnoses.
基金supported by the National Natural Science Foundation of China(22078238,U23B20121)。
文摘Ligament cryopreservation enables a prolonged shelf life of allogeneic ligament grafts,which is fundamentally important to ligament reconstruction.However,conventional cryopreservation techniques fail to eliminate the damage caused by ice crystal growth and the toxicity of cryopreservation agents(CPAs).Here,we report a novel CPA vitrification formulation primarily composed of betaine for ligament cryopreservation.Comprehensive optimization was conducted on the methods for vitrification and rewarming,as well as the loading and unloading conditions,based on the critical cooling rate(CCR),critical warming rate(CWR),and permeation properties of the CPA.Using biomechanical and histological level tests,we demonstrate the superior performance of our method in ligament cryopreservation.After 30 days of vitrification cryopreservation,parameters such as the Young's modulus,tensile stress,denaturation temperature,and glycosaminoglycans content of the ligament remained essentially unchanged.This work pioneers the application of ice-free cryopreservation for ligament and holds great potential for improving the long-term storage of ligament,providing valuable insights for future cryopreservation technique development.
文摘Helping athletes return to sports participation is a primary goal of anterior cruciate ligament(ACL)reconstruction rehabilitation.To facilitate the achievement of this goal,decades of research studies have sought to identify knee impairments that reduce knee function as well as interventions to resolve them.1Yet,over the past 10 years,research pertaining to psychological responses(i.e.,cognitions and emotions)after ACL reconstruction has grown exponentially—a phenomenon that can be visualized by entering the search terms"psychological"and"anterior cruciate ligament reconstruction"into the PubMed search engine.
