BACKGROUND Thumb replantation following complete traumatic avulsion requires complex techniques to restore function,especially in cases of avulsion at the level of the metacarpophalangeal joint(MCP I)and avulsion of t...BACKGROUND Thumb replantation following complete traumatic avulsion requires complex techniques to restore function,especially in cases of avulsion at the level of the metacarpophalangeal joint(MCP I)and avulsion of the flexor pollicis longus(FPL)at the musculotendinous junction.Possible treatments include direct tendon suture or tendon transfer,most commonly from the ring finger.To optimize function and avoid donor finger complications,we performed thumb replantation with flexion restoration using brachioradialis(BR)tendon transfer with palmaris longus(PL)tendon graft.CASE SUMMARY A 20-year-old left-handed male was admitted for a complete traumatic left thumb amputation following an accident while sliding from the top of a handrail.The patient presented with skin and bone avulsion at the MCP I,avulsion of the FPL tendon at the musculotendinous junction(zone 5),avulsion of the extensor pollicis longus tendon(zone T3),and avulsion of the thumb’s collateral arteries and nerves.The patient was treated with two stage thumb repair.The first intervention consisted of thumb replantation with MCP I arthrodesis,resection of avulsed FPL tendon and implantation of a silicone tendon prosthesis.The second intervention consisted of PL tendon graft and BR tendon transfer.Follow-up at 10 months showed good outcomes with active interphalangeal flexion of 70°,grip strength of 45 kg,key pinch strength of 15 kg and two-point discrimination threshold of 4 mm.CONCLUSION Flexion restoration after complete thumb amputation with FPL avulsion at the musculotendinous junction can be achieved using BR tendon transfer with PL tendon graft.展开更多
Tendon adhesion,a prevalent complication affecting over 30%of patients after a tendon injury or surgery,results in joint stiffness and impaired mobility.Although current treatments facilitate tendon repair,they are of...Tendon adhesion,a prevalent complication affecting over 30%of patients after a tendon injury or surgery,results in joint stiffness and impaired mobility.Although current treatments facilitate tendon repair,they are often insufficient in preventing adhesions and promoting optimal healing outcomes.To address these challenges,we developed an oriented cryostructured silk fibroin bandage(OCSFB)using the directional freeze-casting methodology.In vitro studies demonstrated that OCSFB provided a favorable microenvironment for cell viability,proliferation,and alignment,concurrently upregulating the expression of tendon-specific genes.In a rat Achilles tendon model,OCSFB significantly reduced adhesion formation and improved tendon healing.RNA-seq analysis further revealed modulation of cell adhesion molecules,substantiating its role in tissue regeneration.The integration of silk fibroin biocompatibility with a unique microstructure that facilitates cellular adhesion and proliferation renders OCSFB a promising approach for mitigating tendon adhesions and improving repair outcomes,establishing it as a robust candidate for clinical application.展开更多
BACKGROUND To treat flexor pollicis longus(FPL)muscle function loss,the 4th flexor digitorum superficialis(FDS)to the FPL tendon transfer is preferred as a reconstruction method.Various complications can occur during ...BACKGROUND To treat flexor pollicis longus(FPL)muscle function loss,the 4th flexor digitorum superficialis(FDS)to the FPL tendon transfer is preferred as a reconstruction method.Various complications can occur during transfer.However,median nerve neuropathy has not been reported yet.We present a case of median nerve neuropathy caused by irritation of suture knots of the 4th FDS to the FPL tendon transfer with a review of the literature.CASE SUMMARY A 52-year-old male patient presented with paresthesia along median nerve distribution of right hand after tendon transfer.He complained of right thumb flexion limitation due to FPL function loss so authors performed the 4th FDS to FPL transfer using Pulvertaft weave technique.FPL function loss was due to adhesion resulting from repeated surgery of radius shaft.He had a history of radius shaft open fracture 9 years ago and nonunion 7 years ago.During surgery,FPL muscle was severely adhered and indistinguishable.However,tendon continuity remained intact.After tendon transfer,he experienced paresthesia along median nerve distribution upon movement of thumb.He was diagnosed with median nerve neuropathy caused by irritation of tendon suture knots.Exploration was then performed.The median nerve was irritated by suture knots of transferred tendon.Thus,knots were removed.Twelve months later,he demonstrated thumb flexion of 80°.Additionally,median nerve neuropathy symptoms fully resolved.CONCLUSION Median nerve neuropathy can occur after tendon transfer from irritation of suture knots.Covering knots using surrounding tissue is recommended.展开更多
Mechanical stress modulates bone formation and organization of the extracellular matrix(ECM),the interaction of which affects heterotopic ossification(HO).However,the mechanically sensitive cell populations in HO and ...Mechanical stress modulates bone formation and organization of the extracellular matrix(ECM),the interaction of which affects heterotopic ossification(HO).However,the mechanically sensitive cell populations in HO and the underlying mechanism remain elusive.Here,we show that the mechanical protein Polysyctin-1(PC1,Pkd1)regulates CTSK lineage tendon-derived mesenchymal stem cell(TDMSC)fate and ECM organization,thus affecting HO progression.First,we revealed that CTSK lineage TDMSCs are the major source of osteoblasts and fibroblasts in HO and are responsive to mechanical cues via single-cell RNA sequencing analysis and experiments with a lineage tracing mouse model.Moreover,we showed that PC1 mediates the mechanosignal transduction of CTSK lineage TDMSCs to regulate osteogenic and fibrogenic differentiation and alters the ECM architecture by facilitating TAZ nuclear translocation.Conditional gene depletion of Pkd1 or Taz in CTSK lineage cells and pharmaceutical intervention in the PC1-TAZ axis disrupt osteogenesis,fibrogenesis and ECM organization,and consequently attenuate HO progression.These findings suggest that mechanically sensitive CTSK-lineage TDMSCs contribute to heterotopic ossification through PC1-TAZ signaling axis mediated cell fate determination and ECM organization.展开更多
This article offers additional clinical and biomechanical insights into using the peroneus longus tendon(PLT)autograft in posterior cruciate ligament recon-struction.While recent studies report favorable knee outcomes...This article offers additional clinical and biomechanical insights into using the peroneus longus tendon(PLT)autograft in posterior cruciate ligament recon-struction.While recent studies report favorable knee outcomes,concerns remain regarding donor site morbidity.The PLT plays a key role in foot biomechanics,and its harvesting may lead to subtle changes,as suggested by imaging and pe-dobarographic studies.Tendon regeneration may limit long-term morbidity,but further studies are needed.We recommend that future research include gait analysis,long-term follow-up,and insights from anterior cruciate ligament li-terature.展开更多
BACKGROUND Long head of biceps tendon(LHBT)transposition is a novel technique based on the double-row suture bridge method,utilizing autologous reconstruction to treat massive rotator cuff tears.AIM To evaluate the mi...BACKGROUND Long head of biceps tendon(LHBT)transposition is a novel technique based on the double-row suture bridge method,utilizing autologous reconstruction to treat massive rotator cuff tears.AIM To evaluate the mid-to-long-term clinical outcomes following the double-row repair method for massive rotator cuff tears.METHODS This retrospective analysis included data from 53 patients with massive rotator cuff tears treated at our hospital between 2020 and 2021.The patients were divided into the double-row repair group(conventional group)and the doublerow repair combined with the LHBT transposition group(transposition group).Postoperative pain was assessed using the visual analogue scale at one week,one year,and the final follow-up.Shoulder function was evaluated using the American Shoulder and Elbow Surgeons and Constant-Murley scores at one year and the final follow-up.Rotator cuff healing was assessed postoperatively for one year using the Sugaya classification,which categorizes tendon integrity based on magnetic resonance imaging findings.RESULTS No perioperative complications were observed in any of the patients at any time.There were no significant differences between the groups regarding operative time and intraoperative blood loss.The transposition group had significantly lower visual analogue scale scores than the conventional group at one week postoperatively;however,there were no significant differences between the groups at one year or the final follow-up.At one year postoperatively,the transposition group showed significantly higher American Shoulder and Elbow Surgeons and Constant-Murley scores than the conventional group;no significant differences were observed at the final followup.There were no significant differences in rotator cuff healing between the groups at one year postoperatively.CONCLUSION Compared to double-row repair alone,double-row repair combined with LHBT transposition for treating massive rotator cuff tears more effectively alleviates short-term postoperative pain and improves shoulder function within the first year.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 tension leg platform is a typical compliant platform that is connected to the seabed through tension leg tendons.However,it is hard to characterize tension leg tendons due to the complexity of their force and moti...The tension leg platform is a typical compliant platform that is connected to the seabed through tension leg tendons.However,it is hard to characterize tension leg tendons due to the complexity of their force and motions as well as the lack of full-scale test methods.We performed a finite element analysis and full-scale four-point bending fatigue tests on tension leg tendons and connectors to study the fatigue properties of the tension leg tendons(made using 36in-X70 steel pipes)used in the Gulf of Mexico.The maximum deflection and the maximum stress of samples under complex loading were estimated through finite element simulation to ensure the testing requirements,including load intensity,load method,load path,and frequency.The maximum equivalent strain and the corresponding position were then determined through testing,which were further compared with simulation results to verify their accuracy and applicability.The maximum strain amplitude from simulations was 761.42με,while the equivalent strain amplitude obtained through tests was 734.90με,which is close to the simulation result.In addition,when the number of fatigue cycles reached 1.055 million,sample damage did not occur.It confirms that the fatigue performance of the tendon steel pipe weld is better than the C1 curve value shown in the DNV RP C203 specification.The proposed full-scale approach to study the fatigue properties of tension leg tendons can provide a reference for domestic engineering design and manufacture of tension leg tendons as well as promote the localization of test equipment.展开更多
BACKGROUND Fibro-adipogenic progenitors(FAPs)are a group of mesenchymal stem cells that cause fibro-fatty degeneration in skeletal muscle in various chronic disease mode-ls.FAPs also play a role in preventing muscle d...BACKGROUND Fibro-adipogenic progenitors(FAPs)are a group of mesenchymal stem cells that cause fibro-fatty degeneration in skeletal muscle in various chronic disease mode-ls.FAPs also play a role in preventing muscle degeneration at acute stages during disease progression.However,few studies have reported the changes in and function of FAPs in the acute phase after tendon rupture.AIM To clarify the changes in the number of FAPs and their impact on skeletal muscle soon after tendon rupture to facilitate future studies targeting FAPs to treat muscle degeneration.METHODS We utilized Pdgfra-H2B::eGFP mice to trace and quantify FAPs in a tibialis anterior tenotomy(TAT)model at 0 and 3 days,1 week,2 weeks,3 weeks,4 weeks,5 weeks,and 6 weeks post-injury,and the results were further validated using fluorescence-activated cell sorting analysis with C57BL/6 mice at the same post-injury timepoints.We subsequently used PdgfraCreERT::RosaDTA mice,and evaluated the severity of post-TAT skeletal muscle degeneration with or without FAP-depletion.RESULTS The number of FAPs peaked at 1 week post-TAT before gradually declining to a level comparable to that pre-TAT.The change in the number of FAPs was potentially temporally correlated with the progression of skeletal muscle degeneration after TAT.FAP-depletion led to more severe degeneration early after TAT,indicating that FAPs potentially alleviate muscle degeneration after tendon rupture in the early post-injury phase.CONCLUSION FAPs potentially alleviate the degeneration of skeletal muscle in the acute stage after tendon rupture.展开更多
Bimodal pressure sensors capable of simultaneously detecting static and dynamic forces are essential to medical detection and bio-robotics.However,conventional pressure sensors typically integrate multiple operating m...Bimodal pressure sensors capable of simultaneously detecting static and dynamic forces are essential to medical detection and bio-robotics.However,conventional pressure sensors typically integrate multiple operating mechanisms to achieve bimodal detection,leading to complex device architectures and challenges in signal decoupling.In this work,we address these limitations by leveraging the unique piezotronic effect of Y-ion-doped ZnO to develop a bimodal piezotronic sensor(BPS)with a simplified structure and enhanced sensitivity.Through a combination of finite element simulations and experimental validation,we demonstrate that the BPS can effectively monitor both dynamic and static forces,achieving an on/off ratio of 1029,a gauge factor of 23,439 and a static force response duration of up to 600 s,significantly outperforming the performance of conventional piezoelectric sensors.As a proof-of-concept,the BPS demonstrates the continuous monitoring of Achilles tendon behavior under mixed dynamic and static loading conditions.Aided by deep learning algorithms,the system achieves 96%accuracy in identifying Achilles tendon movement patterns,thus enabling warnings for dangerous movements.This work provides a viable strategy for bimodal force monitoring,highlighting its potential in wearable electronics.展开更多
Background:Tendinopathy alters the compositional properties of the Achilles tendon by increasing fluid and glycosaminoglycan content.It has been speculated that these changes may affect intratendinous pressure,but the...Background:Tendinopathy alters the compositional properties of the Achilles tendon by increasing fluid and glycosaminoglycan content.It has been speculated that these changes may affect intratendinous pressure,but the extent of this relationship remains unclear.Therefore,we aimed to investigate the impact of elevated fluid and glycosaminoglycan content on Achilles tendon intratendinous pressure and to determine whether hyaluronidase(HYAL) therapy can intervene in this potential relationship.Methods:Twenty paired fresh-frozen cadaveric Achilles tendons were mounted in a tensile-testing machine and loaded up to 5% strain.Intratendinous resting(at 0% strain) and dynamic pressure(at 5% strain) were assessed using the microcapillary infusion technique.First,intratendinous pressure was measured under native conditions before and after infusion of 2 mL physiological saline.Next,80 mg of glycosaminoglycans were administered bilaterally to the paired tendons.The right tendons were additionally treated with 1500 units of HYAL.Finally,both groups were retested,and the glycosaminoglycan content was analyzed.Results:It was found that both elevated fluid and glycosaminoglycan content resulted in higher intratendinous resting and dynamic pressures(p <0.001).HYAL treatment induced a 2.3-fold reduction in glycosaminoglycan content(p=0.002) and restored intratendinous pressures.Conclusion:The results of this study demonstrated that elevated fluid and glycosaminoglycan content in Achilles tendinopathy contribute to increased intratendinous re sting and dynamic pressures,which can be explained by the associated increased volume and reduced permeability of the tendon matrix,respectively.HYAL degrades glycosaminoglycans sufficiently to lower intratendinous pressures and may,therefore,serve as a promising treatment.展开更多
Achilles tendon tears(ATT)are commonly encountered in clinical practice although it is the strongest tendon in the body.ATT are reported to occur in 0.04%of the population annually.ATT may result from high impact spor...Achilles tendon tears(ATT)are commonly encountered in clinical practice although it is the strongest tendon in the body.ATT are reported to occur in 0.04%of the population annually.ATT may result from high impact sports trauma such as sudden dorsiflexion while weight bearing or repeated microtrauma to a compromised tendon.Multiple factors can decrease the tensile strength of the tendon predisposing it to rupture.The treatment approach for ATT is multifaceted,dependent on factors such as the degree of tear,distance between the retracted portions,tear location,and also on pa-tient factors such as occupation and underlying predisposing factors.In this pictorial essay,we present the imaging features of normal Achilles tendon and in ATT across different modalities and outline essential reporting criteria for ATT.展开更多
BACKGROUND Real-time shear wave elastography(SWE)is a non-invasive imaging technique used to measure tissue stiffness by generating and tracking shear waves in real time.This advanced ultrasound-based method provides ...BACKGROUND Real-time shear wave elastography(SWE)is a non-invasive imaging technique used to measure tissue stiffness by generating and tracking shear waves in real time.This advanced ultrasound-based method provides quantitative information regarding tissue elasticity,offering valuable insights into the mechanical properties of biological tissues.However,the application of real-time SWE in the musculoskeletal system and sports medicine has not been extensively studied.AIM To explore the practical value of real-time SWE for assessing Achilles tendon hardness in older adults.METHODS A total of 60 participants were enrolled in the present study,and differences in the elastic moduli of the bilateral Achilles tendons were compared among the following categories:(1)Age:55-60,60-65,and 65-70-years-old;(2)Sex:Male and female;(3)Laterality:Left and right sides;(4)Tendon state:Relaxed and tense state;and(5)Tendon segment:Proximal,middle,and distal.RESULTS There were no significant differences in the elastic moduli of the bilateral Achilles tendons when comparing by age or sex(P>0.05).There were,however,significant differences when comparing by tendon side,state,or segment(P<0.05).CONCLUSION Real-time SWE plays a significant role compared to other examination methods in the evaluation of Achilles tendon hardness in older adults.展开更多
A wide open bottom story of a frame building is often expected by owners for use as a garage or shops.However,this leads to weak stories due to abrupt changes in lateral stiffness and often results in unexpected story...A wide open bottom story of a frame building is often expected by owners for use as a garage or shops.However,this leads to weak stories due to abrupt changes in lateral stiffness and often results in unexpected story collapse as observed in many previous earthquakes.To retrofit frame buildings that have experienced weak story damage,a tendon system is proposed in this study,which consists of a set of swaying columns and tendons.The swaying columns are used to uniformly redistribute the lateral deformation along the height,while the tendons provide extra lateral stiffness and renders the entire structural system a re-centering capability.To avoid unnecessary forces to swaying columns,pin-connections are used at the bottom.Tendons are placed over the entire story to gain large elastic displacements.Parametric analysis reveals that the swaying column,with a stiffness of about 0.9 times that of the weak story,and the tendons attached at the roof,with a stiffness of 0.04 times that of the weak story,can provide the optimal performance with a maximum residual story drift angle of less than 0.5%.Online hybrid tests were carried out,which demonstrated that uniformly distributed story drifts and acceptable residual deformation could be achieved by the proposed tendon system.展开更多
Tendon adhesion is a common complication after tendon injury with the development of accumulated fibrotic tissues without effective anti-fibrotic therapies,resulting in severe disability.Macrophages are widely recogni...Tendon adhesion is a common complication after tendon injury with the development of accumulated fibrotic tissues without effective anti-fibrotic therapies,resulting in severe disability.Macrophages are widely recognized as a fibrotic trigger during peritendinous adhesion formation.However,different clusters of macrophages have various functions and receive multiple regulation,which are both still unknown.In our current study,multi-omics analysis including single-cell RNA sequencing and proteomics was performed on both human and mouse tendon adhesion tissue at different stages after tendon injury.The transcriptomes of over 74000 human single cells were profiled.As results,we found that SPP1^(+)macrophages,RGCC^(+)endothelial cells,ACKR1^(+)endothelial cells and ADAM12^(+)fibroblasts participated in tendon adhesion formation.Interestingly,despite specific fibrotic clusters in tendon adhesion,FOLR2^(+)macrophages were identified as an antifibrotic cluster by in vitro experiments using human cells.Furthermore,ACKR1 was verified to regulate FOLR2^(+)macrophages migration at the injured peritendinous site by transplantation of bone marrow from Lysm-Cre;R26R^(tdTomato) mice to lethally irradiated Ackr1^(-/-)mice(Ackr1^(-/-)chimeras;deficient in ACKR1)and control mice(WT chimeras).Compared with WT chimeras,the decline of FOLR2^(+)macrophages was also observed,indicating that ACKR1 was specifically involved in FOLR2^(+)macrophages migration.Taken together,our study not only characterized the fibrosis microenvironment landscape of tendon adhesion by multi-omics analysis,but also uncovered a novel antifibrotic cluster of macrophages and their origin.These results provide potential therapeutic targets against human tendon adhesion.展开更多
Tendon calcification is a common clinical condition that frequently occurs as a complication after tendon injury and surgery,or as an expression of fibrodysplasia ossificans progressiva.This condition can be referred ...Tendon calcification is a common clinical condition that frequently occurs as a complication after tendon injury and surgery,or as an expression of fibrodysplasia ossificans progressiva.This condition can be referred to by various names in clinical practice and literature,including tendon ossification,tendon mineralization,heterotopic ossification,and calcific tendonitis.The exact pathogenesis of tendon calcification remains uncertain,but current mainstream research suggests that calcification is mostly cell mediated.To further elucidate the pathogenesis of tendon calcification and to better simulate the overall process,selecting appropriate experimental animal models is important.Numerous animal models have been utilized in various clinical studies,each with its own set of advantages and limitations.In this review,we have discussed the advancements made in research on animal models of tendon calcification,with a focus on the selection of experimental animals,the sites of injury in these models,and the methods employed for modeling.展开更多
BACKGROUND Hip fractures account for 23.8%of all fractures in patients over the age of 75 years.More than half of these patients are older than 80 years.Bipolar hemiarthroplasty(BHA)was established as an effective man...BACKGROUND Hip fractures account for 23.8%of all fractures in patients over the age of 75 years.More than half of these patients are older than 80 years.Bipolar hemiarthroplasty(BHA)was established as an effective management option for these patients.Various approaches can be used for the BHA procedure.However,there is a high risk of postoperative dislocation.The conjoined tendon-preserving posterior(CPP)lateral approach was introduced to reduce postoperative dislocation rates.AIM To evaluate the effectiveness and safety of the CPP lateral approach for BHA in elderly patients.METHODS We retrospectively analyzed medical data from 80 patients with displaced femoral neck fractures who underwent BHA.The patients were followed up for at least 1 year.Among the 80 patients,57(71.3%)were female.The time to operation averaged 2.3 d(range:1-5 d).The mean age was 80.5 years(range:67-90 years),and the mean body mass index was 24.9 kg/m^(2)(range:17-36 kg/m^(2)).According to the Garden classification,42.5%of patients were typeⅢand 57.5%of patients were typeⅣ.Uncemented bipolar hip prostheses were used for all patients.Torn conjoined tendons,dislocations,and adverse complications during and after surgery were recorded.RESULTS The mean postoperative follow-up time was 15.3 months(range:12-18 months).The average surgery time was 52 min(range:40-70 min)with an average blood loss of 120 mL(range:80-320 mL).The transfusion rate was 10%(8 of 80 patients).The gemellus inferior was torn in 4 patients(5%),while it was difficult to identify in 2 patients(2.5%)during surgery.The posterior capsule was punctured by the fractured femoral neck in 3 patients,but the conjoined tendon and the piriformis tendon remained intact.No patients had stem varus greater than 3 degrees or femoral fracture.There were no patients with stem subsidence more than 5 mm at the last follow-up.No postoperative dislocations were observed throughout the follow-up period.No significance was found between preoperative and postoperative mean Health Service System scores(87.30±2.98 vs 86.10±6.10,t=1.89,P=0.063).CONCLUSION The CPP lateral approach can effectively reduce the incidence of postoperative dislocation without increasing perioperative complications.For surgeons familiar with the posterior lateral approach,there is no need for additional surgical instruments,and it does not increase surgical difficulty.展开更多
The effectiveness of platelet-rich plasma(PRP)for the treatment of Achilles tendon disorders still needs to be evaluated through a series of prospective studies,but genomic analysis can reveal the existence of complem...The effectiveness of platelet-rich plasma(PRP)for the treatment of Achilles tendon disorders still needs to be evaluated through a series of prospective studies,but genomic analysis can reveal the existence of complementary PRP treatment options.Based on the 96 platelet activation-related genes in the Kyoto Encyclopedia of Genes and Genomes(KEGG)database,we performed Gene Ontology functional enrichment analysis and KEGG enrichment analysis,pathway correlation analysis,and enrichment mapping to determine the enrichment results of the gene set enrichment analysis and found that the cAMP signalling pathway may be the key to enhancing the effectiveness of PRP treatment.The cAMP signalling pathway interacts with the Rap1 signalling pathway and cGMPPKG signalling pathway to mediate the entire pathophy-siological process of Achilles tendon disease.Moreover,ADCY1-9 may be the key to the activation of the cAMP signalling network.Further based on the data in the Gene Expression Omnibus database,it was found that ADCY4 and ADCY7 may be the players that play a major role,associated with the STAT4-ADCY4-LAMA5 axis and the GRbeta-ADCY7-SEMA3C axis,which is expected to be a complementary target for enhancing the efficacy of PRP in the treatment of Achilles tendon disease.展开更多
This letter addresses the recent study by Zhu et al on the predictive factors for coronal and sagittal graft extrusion length following medial meniscus reconstruction using tendon autografts.The study provides valuabl...This letter addresses the recent study by Zhu et al on the predictive factors for coronal and sagittal graft extrusion length following medial meniscus reconstruction using tendon autografts.The study provides valuable insights into the importance of preoperative joint space width and tunnel positioning as predictors of graft extrusion.Specifically,it found strong correlations between preoperative joint space width and medial,posterior,and mean graft extrusion at both 1 week and 8 months post-operation.Additionally,tunnel edge distance at 1 week postoperation correlated with anterior and posterior graft extrusion.These findings offer critical guidance for improving surgical outcomes.However,the letter highlights the need for further research with larger sample sizes and comparative studies involving different graft types to strengthen these findings and broaden their applicability in clinical settings.The study's contributions to understanding meniscus reconstruction using tendon autografts are acknowledged,along with suggestions for future research directions.展开更多
BACKGROUND Achilles tendon rupture is a common orthopedic injury,with an annual incidence of 11-37 per 100000 people,significantly impacting daily life.Minimally invasive surgery,increasingly favored for its reduced r...BACKGROUND Achilles tendon rupture is a common orthopedic injury,with an annual incidence of 11-37 per 100000 people,significantly impacting daily life.Minimally invasive surgery,increasingly favored for its reduced risks and comparable fixation strength to open surgery,addresses these challenges.Despite advantages like accelerated recovery,perioperative care poses emotional support,pain management,and rehabilitation challenges,impacting treatment efficacy and patient experience.To address these gaps,this study investigated the efficacy of a rapid rehabilitation protocol in enhancing recovery outcomes for minimally invasive Achilles tendon surgery,aiming to develop personalized,standardized care guidelines for broader implementation.AIM To evaluate a nursing-led rapid rehabilitation program for minimally invasive Achilles tendon repair surgery,providing evidence-based early recovery indicators.METHODS This study enrolled 160 patients undergoing channel-assisted minimally invasive Achilles tendon repair randomized into experimental and control groups.The experimental group received perioperative rapid rehabilitation nursing care,while the control group received standard care.The primary outcome measure was the Oswestry disability index score,with secondary outcomes including quality of life,Barthel index,patient satisfaction with nursing,incidence of complications,and rehabilitation adherence.Statistical analysis included appropriate methods to compare outcomes between groups.The study was conducted in a specific setting,utilizing a randomized controlled trial design.RESULTS All 160 patients completed the follow-up.The experimental group showed significantly greater improvements in key efficacy indicators:Postoperative Oswestry disability index score(8.688 vs 18.88,P<0.0001),quality of life score(53.25 vs 38.99,P<0.0001),and Barthel index(70.44 vs 51.63,P<0.0001).The experimental group had a lower incidence of deep vein thrombosis(1.25%vs 10.00%,P=0.0339)with a relative risk of 0.1250(95%confidence interval:0.02050-0.7421).Infection rates were lower in the experimental group(2.50%vs 11.25%,P=0.0564).Hospital stay(5.40 days vs 7.26 days,P<0.0001)and postoperative bed rest(3.34 days vs 5.42 days,P<0.0001)were significantly shorter.Patient satisfaction was 100%in the experimental group vs 87.50%in the control group(P=0.0031).CONCLUSION The rapid rehabilitation intervention significantly reduced pain,shortened hospital stays,and lowered complication rates,improving joint function and patient satisfaction.展开更多
文摘BACKGROUND Thumb replantation following complete traumatic avulsion requires complex techniques to restore function,especially in cases of avulsion at the level of the metacarpophalangeal joint(MCP I)and avulsion of the flexor pollicis longus(FPL)at the musculotendinous junction.Possible treatments include direct tendon suture or tendon transfer,most commonly from the ring finger.To optimize function and avoid donor finger complications,we performed thumb replantation with flexion restoration using brachioradialis(BR)tendon transfer with palmaris longus(PL)tendon graft.CASE SUMMARY A 20-year-old left-handed male was admitted for a complete traumatic left thumb amputation following an accident while sliding from the top of a handrail.The patient presented with skin and bone avulsion at the MCP I,avulsion of the FPL tendon at the musculotendinous junction(zone 5),avulsion of the extensor pollicis longus tendon(zone T3),and avulsion of the thumb’s collateral arteries and nerves.The patient was treated with two stage thumb repair.The first intervention consisted of thumb replantation with MCP I arthrodesis,resection of avulsed FPL tendon and implantation of a silicone tendon prosthesis.The second intervention consisted of PL tendon graft and BR tendon transfer.Follow-up at 10 months showed good outcomes with active interphalangeal flexion of 70°,grip strength of 45 kg,key pinch strength of 15 kg and two-point discrimination threshold of 4 mm.CONCLUSION Flexion restoration after complete thumb amputation with FPL avulsion at the musculotendinous junction can be achieved using BR tendon transfer with PL tendon graft.
基金sponsored by the National Natural Science Foundation of China(Nos.52235007,T2121004,and 52325504)the Key R&D Program of Zhejiang(No.2024SSYS0027)+1 种基金the National Key Research and Development Program of China(Nos.2024YFB4607700 and 2024YFB4607703)the China National Postdoctoral Program for Innovative Talents(No.BX20240312)。
文摘Tendon adhesion,a prevalent complication affecting over 30%of patients after a tendon injury or surgery,results in joint stiffness and impaired mobility.Although current treatments facilitate tendon repair,they are often insufficient in preventing adhesions and promoting optimal healing outcomes.To address these challenges,we developed an oriented cryostructured silk fibroin bandage(OCSFB)using the directional freeze-casting methodology.In vitro studies demonstrated that OCSFB provided a favorable microenvironment for cell viability,proliferation,and alignment,concurrently upregulating the expression of tendon-specific genes.In a rat Achilles tendon model,OCSFB significantly reduced adhesion formation and improved tendon healing.RNA-seq analysis further revealed modulation of cell adhesion molecules,substantiating its role in tissue regeneration.The integration of silk fibroin biocompatibility with a unique microstructure that facilitates cellular adhesion and proliferation renders OCSFB a promising approach for mitigating tendon adhesions and improving repair outcomes,establishing it as a robust candidate for clinical application.
文摘BACKGROUND To treat flexor pollicis longus(FPL)muscle function loss,the 4th flexor digitorum superficialis(FDS)to the FPL tendon transfer is preferred as a reconstruction method.Various complications can occur during transfer.However,median nerve neuropathy has not been reported yet.We present a case of median nerve neuropathy caused by irritation of suture knots of the 4th FDS to the FPL tendon transfer with a review of the literature.CASE SUMMARY A 52-year-old male patient presented with paresthesia along median nerve distribution of right hand after tendon transfer.He complained of right thumb flexion limitation due to FPL function loss so authors performed the 4th FDS to FPL transfer using Pulvertaft weave technique.FPL function loss was due to adhesion resulting from repeated surgery of radius shaft.He had a history of radius shaft open fracture 9 years ago and nonunion 7 years ago.During surgery,FPL muscle was severely adhered and indistinguishable.However,tendon continuity remained intact.After tendon transfer,he experienced paresthesia along median nerve distribution upon movement of thumb.He was diagnosed with median nerve neuropathy caused by irritation of tendon suture knots.Exploration was then performed.The median nerve was irritated by suture knots of transferred tendon.Thus,knots were removed.Twelve months later,he demonstrated thumb flexion of 80°.Additionally,median nerve neuropathy symptoms fully resolved.CONCLUSION Median nerve neuropathy can occur after tendon transfer from irritation of suture knots.Covering knots using surrounding tissue is recommended.
基金National Natural Science Foundation of China(Grant Nos.82261160397,82272560)Central South University Research Programme of Advanced Interdisciplinary Studies(2023QYJC011)+4 种基金National Natural Science Foundation of China(Grant Nos.82472521,81922017)Hunan Provincial Science and Technology Department(2023JJ30896)Key Research and Development Program of Hunan Province(2022SK2023)Science and Technology Innovation Program of Hunan Province(2023RC1027)Major Basic Research Projects in Hunan Province(No.2024JC0004)。
文摘Mechanical stress modulates bone formation and organization of the extracellular matrix(ECM),the interaction of which affects heterotopic ossification(HO).However,the mechanically sensitive cell populations in HO and the underlying mechanism remain elusive.Here,we show that the mechanical protein Polysyctin-1(PC1,Pkd1)regulates CTSK lineage tendon-derived mesenchymal stem cell(TDMSC)fate and ECM organization,thus affecting HO progression.First,we revealed that CTSK lineage TDMSCs are the major source of osteoblasts and fibroblasts in HO and are responsive to mechanical cues via single-cell RNA sequencing analysis and experiments with a lineage tracing mouse model.Moreover,we showed that PC1 mediates the mechanosignal transduction of CTSK lineage TDMSCs to regulate osteogenic and fibrogenic differentiation and alters the ECM architecture by facilitating TAZ nuclear translocation.Conditional gene depletion of Pkd1 or Taz in CTSK lineage cells and pharmaceutical intervention in the PC1-TAZ axis disrupt osteogenesis,fibrogenesis and ECM organization,and consequently attenuate HO progression.These findings suggest that mechanically sensitive CTSK-lineage TDMSCs contribute to heterotopic ossification through PC1-TAZ signaling axis mediated cell fate determination and ECM organization.
文摘This article offers additional clinical and biomechanical insights into using the peroneus longus tendon(PLT)autograft in posterior cruciate ligament recon-struction.While recent studies report favorable knee outcomes,concerns remain regarding donor site morbidity.The PLT plays a key role in foot biomechanics,and its harvesting may lead to subtle changes,as suggested by imaging and pe-dobarographic studies.Tendon regeneration may limit long-term morbidity,but further studies are needed.We recommend that future research include gait analysis,long-term follow-up,and insights from anterior cruciate ligament li-terature.
基金Supported by the General Program of the Hubei Provincial Natural Science Foundation of China Key Project,No.2021CFB520.
文摘BACKGROUND Long head of biceps tendon(LHBT)transposition is a novel technique based on the double-row suture bridge method,utilizing autologous reconstruction to treat massive rotator cuff tears.AIM To evaluate the mid-to-long-term clinical outcomes following the double-row repair method for massive rotator cuff tears.METHODS This retrospective analysis included data from 53 patients with massive rotator cuff tears treated at our hospital between 2020 and 2021.The patients were divided into the double-row repair group(conventional group)and the doublerow repair combined with the LHBT transposition group(transposition group).Postoperative pain was assessed using the visual analogue scale at one week,one year,and the final follow-up.Shoulder function was evaluated using the American Shoulder and Elbow Surgeons and Constant-Murley scores at one year and the final follow-up.Rotator cuff healing was assessed postoperatively for one year using the Sugaya classification,which categorizes tendon integrity based on magnetic resonance imaging findings.RESULTS No perioperative complications were observed in any of the patients at any time.There were no significant differences between the groups regarding operative time and intraoperative blood loss.The transposition group had significantly lower visual analogue scale scores than the conventional group at one week postoperatively;however,there were no significant differences between the groups at one year or the final follow-up.At one year postoperatively,the transposition group showed significantly higher American Shoulder and Elbow Surgeons and Constant-Murley scores than the conventional group;no significant differences were observed at the final followup.There were no significant differences in rotator cuff healing between the groups at one year postoperatively.CONCLUSION Compared to double-row repair alone,double-row repair combined with LHBT transposition for treating massive rotator cuff tears more effectively alleviates short-term postoperative pain and improves shoulder function within the first year.
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.
基金supported by the Innovation Capability Improvement Project of Scientific and Technological Small and Medium-sized Enterprises in Shandong Province,China(2021TSGC1415).
文摘The tension leg platform is a typical compliant platform that is connected to the seabed through tension leg tendons.However,it is hard to characterize tension leg tendons due to the complexity of their force and motions as well as the lack of full-scale test methods.We performed a finite element analysis and full-scale four-point bending fatigue tests on tension leg tendons and connectors to study the fatigue properties of the tension leg tendons(made using 36in-X70 steel pipes)used in the Gulf of Mexico.The maximum deflection and the maximum stress of samples under complex loading were estimated through finite element simulation to ensure the testing requirements,including load intensity,load method,load path,and frequency.The maximum equivalent strain and the corresponding position were then determined through testing,which were further compared with simulation results to verify their accuracy and applicability.The maximum strain amplitude from simulations was 761.42με,while the equivalent strain amplitude obtained through tests was 734.90με,which is close to the simulation result.In addition,when the number of fatigue cycles reached 1.055 million,sample damage did not occur.It confirms that the fatigue performance of the tendon steel pipe weld is better than the C1 curve value shown in the DNV RP C203 specification.The proposed full-scale approach to study the fatigue properties of tension leg tendons can provide a reference for domestic engineering design and manufacture of tension leg tendons as well as promote the localization of test equipment.
基金Supported by National Natural Science Foundation of China,No.82172509.
文摘BACKGROUND Fibro-adipogenic progenitors(FAPs)are a group of mesenchymal stem cells that cause fibro-fatty degeneration in skeletal muscle in various chronic disease mode-ls.FAPs also play a role in preventing muscle degeneration at acute stages during disease progression.However,few studies have reported the changes in and function of FAPs in the acute phase after tendon rupture.AIM To clarify the changes in the number of FAPs and their impact on skeletal muscle soon after tendon rupture to facilitate future studies targeting FAPs to treat muscle degeneration.METHODS We utilized Pdgfra-H2B::eGFP mice to trace and quantify FAPs in a tibialis anterior tenotomy(TAT)model at 0 and 3 days,1 week,2 weeks,3 weeks,4 weeks,5 weeks,and 6 weeks post-injury,and the results were further validated using fluorescence-activated cell sorting analysis with C57BL/6 mice at the same post-injury timepoints.We subsequently used PdgfraCreERT::RosaDTA mice,and evaluated the severity of post-TAT skeletal muscle degeneration with or without FAP-depletion.RESULTS The number of FAPs peaked at 1 week post-TAT before gradually declining to a level comparable to that pre-TAT.The change in the number of FAPs was potentially temporally correlated with the progression of skeletal muscle degeneration after TAT.FAP-depletion led to more severe degeneration early after TAT,indicating that FAPs potentially alleviate muscle degeneration after tendon rupture in the early post-injury phase.CONCLUSION FAPs potentially alleviate the degeneration of skeletal muscle in the acute stage after tendon rupture.
基金financially supported by the National Natural Science Foundation of China(No.U2330120)the Natural Science Foundation of Sichuan Province of China(No.2023NSFSC0313)the Basic Research Cultivation Project of Southwest Jiaotong University(No.2682023KJ024)。
文摘Bimodal pressure sensors capable of simultaneously detecting static and dynamic forces are essential to medical detection and bio-robotics.However,conventional pressure sensors typically integrate multiple operating mechanisms to achieve bimodal detection,leading to complex device architectures and challenges in signal decoupling.In this work,we address these limitations by leveraging the unique piezotronic effect of Y-ion-doped ZnO to develop a bimodal piezotronic sensor(BPS)with a simplified structure and enhanced sensitivity.Through a combination of finite element simulations and experimental validation,we demonstrate that the BPS can effectively monitor both dynamic and static forces,achieving an on/off ratio of 1029,a gauge factor of 23,439 and a static force response duration of up to 600 s,significantly outperforming the performance of conventional piezoelectric sensors.As a proof-of-concept,the BPS demonstrates the continuous monitoring of Achilles tendon behavior under mixed dynamic and static loading conditions.Aided by deep learning algorithms,the system achieves 96%accuracy in identifying Achilles tendon movement patterns,thus enabling warnings for dangerous movements.This work provides a viable strategy for bimodal force monitoring,highlighting its potential in wearable electronics.
基金funded by Ghent University Hospital(FIKO21/TYPE2/013)。
文摘Background:Tendinopathy alters the compositional properties of the Achilles tendon by increasing fluid and glycosaminoglycan content.It has been speculated that these changes may affect intratendinous pressure,but the extent of this relationship remains unclear.Therefore,we aimed to investigate the impact of elevated fluid and glycosaminoglycan content on Achilles tendon intratendinous pressure and to determine whether hyaluronidase(HYAL) therapy can intervene in this potential relationship.Methods:Twenty paired fresh-frozen cadaveric Achilles tendons were mounted in a tensile-testing machine and loaded up to 5% strain.Intratendinous resting(at 0% strain) and dynamic pressure(at 5% strain) were assessed using the microcapillary infusion technique.First,intratendinous pressure was measured under native conditions before and after infusion of 2 mL physiological saline.Next,80 mg of glycosaminoglycans were administered bilaterally to the paired tendons.The right tendons were additionally treated with 1500 units of HYAL.Finally,both groups were retested,and the glycosaminoglycan content was analyzed.Results:It was found that both elevated fluid and glycosaminoglycan content resulted in higher intratendinous resting and dynamic pressures(p <0.001).HYAL treatment induced a 2.3-fold reduction in glycosaminoglycan content(p=0.002) and restored intratendinous pressures.Conclusion:The results of this study demonstrated that elevated fluid and glycosaminoglycan content in Achilles tendinopathy contribute to increased intratendinous re sting and dynamic pressures,which can be explained by the associated increased volume and reduced permeability of the tendon matrix,respectively.HYAL degrades glycosaminoglycans sufficiently to lower intratendinous pressures and may,therefore,serve as a promising treatment.
文摘Achilles tendon tears(ATT)are commonly encountered in clinical practice although it is the strongest tendon in the body.ATT are reported to occur in 0.04%of the population annually.ATT may result from high impact sports trauma such as sudden dorsiflexion while weight bearing or repeated microtrauma to a compromised tendon.Multiple factors can decrease the tensile strength of the tendon predisposing it to rupture.The treatment approach for ATT is multifaceted,dependent on factors such as the degree of tear,distance between the retracted portions,tear location,and also on pa-tient factors such as occupation and underlying predisposing factors.In this pictorial essay,we present the imaging features of normal Achilles tendon and in ATT across different modalities and outline essential reporting criteria for ATT.
基金Supported by Sichuan Orthopaedic Hospital Research Project,No.2019MS02.
文摘BACKGROUND Real-time shear wave elastography(SWE)is a non-invasive imaging technique used to measure tissue stiffness by generating and tracking shear waves in real time.This advanced ultrasound-based method provides quantitative information regarding tissue elasticity,offering valuable insights into the mechanical properties of biological tissues.However,the application of real-time SWE in the musculoskeletal system and sports medicine has not been extensively studied.AIM To explore the practical value of real-time SWE for assessing Achilles tendon hardness in older adults.METHODS A total of 60 participants were enrolled in the present study,and differences in the elastic moduli of the bilateral Achilles tendons were compared among the following categories:(1)Age:55-60,60-65,and 65-70-years-old;(2)Sex:Male and female;(3)Laterality:Left and right sides;(4)Tendon state:Relaxed and tense state;and(5)Tendon segment:Proximal,middle,and distal.RESULTS There were no significant differences in the elastic moduli of the bilateral Achilles tendons when comparing by age or sex(P>0.05).There were,however,significant differences when comparing by tendon side,state,or segment(P<0.05).CONCLUSION Real-time SWE plays a significant role compared to other examination methods in the evaluation of Achilles tendon hardness in older adults.
基金National Science Foundation for Distinguished Young Scholars under Grant No.52125806the Heilongjiang Touyan Innovation Team Program under Grant No.3016。
文摘A wide open bottom story of a frame building is often expected by owners for use as a garage or shops.However,this leads to weak stories due to abrupt changes in lateral stiffness and often results in unexpected story collapse as observed in many previous earthquakes.To retrofit frame buildings that have experienced weak story damage,a tendon system is proposed in this study,which consists of a set of swaying columns and tendons.The swaying columns are used to uniformly redistribute the lateral deformation along the height,while the tendons provide extra lateral stiffness and renders the entire structural system a re-centering capability.To avoid unnecessary forces to swaying columns,pin-connections are used at the bottom.Tendons are placed over the entire story to gain large elastic displacements.Parametric analysis reveals that the swaying column,with a stiffness of about 0.9 times that of the weak story,and the tendons attached at the roof,with a stiffness of 0.04 times that of the weak story,can provide the optimal performance with a maximum residual story drift angle of less than 0.5%.Online hybrid tests were carried out,which demonstrated that uniformly distributed story drifts and acceptable residual deformation could be achieved by the proposed tendon system.
基金supported by the National Natural Science Foundation of China(No.82172408)Shanghai Jiao Tong University Medical College“Two-hundred Talent”Program(No.20191829)+1 种基金The Second Three-Year Action Plan for Promoting Clinical Skills and Clinical Innovation in Municipal Hospitals of Shanghai Shenkang(No.SHDC2020CR4032)Shanghai Engineering Research Center for Orthopaedic Material Innovation and Tissue Regeneration(No.20DZ2254100).
文摘Tendon adhesion is a common complication after tendon injury with the development of accumulated fibrotic tissues without effective anti-fibrotic therapies,resulting in severe disability.Macrophages are widely recognized as a fibrotic trigger during peritendinous adhesion formation.However,different clusters of macrophages have various functions and receive multiple regulation,which are both still unknown.In our current study,multi-omics analysis including single-cell RNA sequencing and proteomics was performed on both human and mouse tendon adhesion tissue at different stages after tendon injury.The transcriptomes of over 74000 human single cells were profiled.As results,we found that SPP1^(+)macrophages,RGCC^(+)endothelial cells,ACKR1^(+)endothelial cells and ADAM12^(+)fibroblasts participated in tendon adhesion formation.Interestingly,despite specific fibrotic clusters in tendon adhesion,FOLR2^(+)macrophages were identified as an antifibrotic cluster by in vitro experiments using human cells.Furthermore,ACKR1 was verified to regulate FOLR2^(+)macrophages migration at the injured peritendinous site by transplantation of bone marrow from Lysm-Cre;R26R^(tdTomato) mice to lethally irradiated Ackr1^(-/-)mice(Ackr1^(-/-)chimeras;deficient in ACKR1)and control mice(WT chimeras).Compared with WT chimeras,the decline of FOLR2^(+)macrophages was also observed,indicating that ACKR1 was specifically involved in FOLR2^(+)macrophages migration.Taken together,our study not only characterized the fibrosis microenvironment landscape of tendon adhesion by multi-omics analysis,but also uncovered a novel antifibrotic cluster of macrophages and their origin.These results provide potential therapeutic targets against human tendon adhesion.
基金the Science and Technology Innovation Cooperation Special Programme of Sichuan Province,Grant/Award Number:2022YFS0609-C1Industry-University-Research Cooperation Foundation,Grant/Award Number:2021CXYZ01+2 种基金Luzhou Science and Technology Plan Project,Grant/Award Number:2021-SYF-25China Postdoctoral Science Foundation,Grant/Award Number:2023M732927Scientific Research Project of Southwest Medical University,Grant/Award Number:2021ZKMS051 and 2022QN018。
文摘Tendon calcification is a common clinical condition that frequently occurs as a complication after tendon injury and surgery,or as an expression of fibrodysplasia ossificans progressiva.This condition can be referred to by various names in clinical practice and literature,including tendon ossification,tendon mineralization,heterotopic ossification,and calcific tendonitis.The exact pathogenesis of tendon calcification remains uncertain,but current mainstream research suggests that calcification is mostly cell mediated.To further elucidate the pathogenesis of tendon calcification and to better simulate the overall process,selecting appropriate experimental animal models is important.Numerous animal models have been utilized in various clinical studies,each with its own set of advantages and limitations.In this review,we have discussed the advancements made in research on animal models of tendon calcification,with a focus on the selection of experimental animals,the sites of injury in these models,and the methods employed for modeling.
文摘BACKGROUND Hip fractures account for 23.8%of all fractures in patients over the age of 75 years.More than half of these patients are older than 80 years.Bipolar hemiarthroplasty(BHA)was established as an effective management option for these patients.Various approaches can be used for the BHA procedure.However,there is a high risk of postoperative dislocation.The conjoined tendon-preserving posterior(CPP)lateral approach was introduced to reduce postoperative dislocation rates.AIM To evaluate the effectiveness and safety of the CPP lateral approach for BHA in elderly patients.METHODS We retrospectively analyzed medical data from 80 patients with displaced femoral neck fractures who underwent BHA.The patients were followed up for at least 1 year.Among the 80 patients,57(71.3%)were female.The time to operation averaged 2.3 d(range:1-5 d).The mean age was 80.5 years(range:67-90 years),and the mean body mass index was 24.9 kg/m^(2)(range:17-36 kg/m^(2)).According to the Garden classification,42.5%of patients were typeⅢand 57.5%of patients were typeⅣ.Uncemented bipolar hip prostheses were used for all patients.Torn conjoined tendons,dislocations,and adverse complications during and after surgery were recorded.RESULTS The mean postoperative follow-up time was 15.3 months(range:12-18 months).The average surgery time was 52 min(range:40-70 min)with an average blood loss of 120 mL(range:80-320 mL).The transfusion rate was 10%(8 of 80 patients).The gemellus inferior was torn in 4 patients(5%),while it was difficult to identify in 2 patients(2.5%)during surgery.The posterior capsule was punctured by the fractured femoral neck in 3 patients,but the conjoined tendon and the piriformis tendon remained intact.No patients had stem varus greater than 3 degrees or femoral fracture.There were no patients with stem subsidence more than 5 mm at the last follow-up.No postoperative dislocations were observed throughout the follow-up period.No significance was found between preoperative and postoperative mean Health Service System scores(87.30±2.98 vs 86.10±6.10,t=1.89,P=0.063).CONCLUSION The CPP lateral approach can effectively reduce the incidence of postoperative dislocation without increasing perioperative complications.For surgeons familiar with the posterior lateral approach,there is no need for additional surgical instruments,and it does not increase surgical difficulty.
文摘The effectiveness of platelet-rich plasma(PRP)for the treatment of Achilles tendon disorders still needs to be evaluated through a series of prospective studies,but genomic analysis can reveal the existence of complementary PRP treatment options.Based on the 96 platelet activation-related genes in the Kyoto Encyclopedia of Genes and Genomes(KEGG)database,we performed Gene Ontology functional enrichment analysis and KEGG enrichment analysis,pathway correlation analysis,and enrichment mapping to determine the enrichment results of the gene set enrichment analysis and found that the cAMP signalling pathway may be the key to enhancing the effectiveness of PRP treatment.The cAMP signalling pathway interacts with the Rap1 signalling pathway and cGMPPKG signalling pathway to mediate the entire pathophy-siological process of Achilles tendon disease.Moreover,ADCY1-9 may be the key to the activation of the cAMP signalling network.Further based on the data in the Gene Expression Omnibus database,it was found that ADCY4 and ADCY7 may be the players that play a major role,associated with the STAT4-ADCY4-LAMA5 axis and the GRbeta-ADCY7-SEMA3C axis,which is expected to be a complementary target for enhancing the efficacy of PRP in the treatment of Achilles tendon disease.
文摘This letter addresses the recent study by Zhu et al on the predictive factors for coronal and sagittal graft extrusion length following medial meniscus reconstruction using tendon autografts.The study provides valuable insights into the importance of preoperative joint space width and tunnel positioning as predictors of graft extrusion.Specifically,it found strong correlations between preoperative joint space width and medial,posterior,and mean graft extrusion at both 1 week and 8 months post-operation.Additionally,tunnel edge distance at 1 week postoperation correlated with anterior and posterior graft extrusion.These findings offer critical guidance for improving surgical outcomes.However,the letter highlights the need for further research with larger sample sizes and comparative studies involving different graft types to strengthen these findings and broaden their applicability in clinical settings.The study's contributions to understanding meniscus reconstruction using tendon autografts are acknowledged,along with suggestions for future research directions.
文摘BACKGROUND Achilles tendon rupture is a common orthopedic injury,with an annual incidence of 11-37 per 100000 people,significantly impacting daily life.Minimally invasive surgery,increasingly favored for its reduced risks and comparable fixation strength to open surgery,addresses these challenges.Despite advantages like accelerated recovery,perioperative care poses emotional support,pain management,and rehabilitation challenges,impacting treatment efficacy and patient experience.To address these gaps,this study investigated the efficacy of a rapid rehabilitation protocol in enhancing recovery outcomes for minimally invasive Achilles tendon surgery,aiming to develop personalized,standardized care guidelines for broader implementation.AIM To evaluate a nursing-led rapid rehabilitation program for minimally invasive Achilles tendon repair surgery,providing evidence-based early recovery indicators.METHODS This study enrolled 160 patients undergoing channel-assisted minimally invasive Achilles tendon repair randomized into experimental and control groups.The experimental group received perioperative rapid rehabilitation nursing care,while the control group received standard care.The primary outcome measure was the Oswestry disability index score,with secondary outcomes including quality of life,Barthel index,patient satisfaction with nursing,incidence of complications,and rehabilitation adherence.Statistical analysis included appropriate methods to compare outcomes between groups.The study was conducted in a specific setting,utilizing a randomized controlled trial design.RESULTS All 160 patients completed the follow-up.The experimental group showed significantly greater improvements in key efficacy indicators:Postoperative Oswestry disability index score(8.688 vs 18.88,P<0.0001),quality of life score(53.25 vs 38.99,P<0.0001),and Barthel index(70.44 vs 51.63,P<0.0001).The experimental group had a lower incidence of deep vein thrombosis(1.25%vs 10.00%,P=0.0339)with a relative risk of 0.1250(95%confidence interval:0.02050-0.7421).Infection rates were lower in the experimental group(2.50%vs 11.25%,P=0.0564).Hospital stay(5.40 days vs 7.26 days,P<0.0001)and postoperative bed rest(3.34 days vs 5.42 days,P<0.0001)were significantly shorter.Patient satisfaction was 100%in the experimental group vs 87.50%in the control group(P=0.0031).CONCLUSION The rapid rehabilitation intervention significantly reduced pain,shortened hospital stays,and lowered complication rates,improving joint function and patient satisfaction.
