Background： Partial-thickness rotator cufftears （PTRCTs） are being diagnosed more often because of high-resolution magnetic resonance imaging （MRI）. Compared with articular and bursal side tears, there have been ...Background： Partial-thickness rotator cufftears （PTRCTs） are being diagnosed more often because of high-resolution magnetic resonance imaging （MRI）. Compared with articular and bursal side tears, there have been few studies about evaluating the clinical and structural outcomes after intratendinous tear repair. Methods： From 2008 to 2012, 33 consecutive patients with intratendinous PTRCTs underwent arthroscopic repair. All of them were retrospectively evaluated. The University of California at Los Angeles （UCLA） and constant scores were evaluated before operation and at the final follow-up. Postoperative cuff integrity was determined using MRI according to Sugaya＇s classification. Results： At the 2-year follow-up, the average UCLA score increased from 16.7± 1.9 to 32.5± 3,5, and the constant score increased from 66.2 ± 10.5 to 92.4 ± 6.9 （P 〈 0.001）. Twenty seven patients received follow-up MRI examinations at an average of 15.2 months after surgery. Of these 27 patients, 22 （81.5%） had a healed tendon, and five patients had partial tears. There was no association between functional and anatomic results. Conclusions： For intratendinous PTRCT, clinical outcomes and tendon healing showed good results at a minimum 2-year after arthroscopic repair.展开更多
Background:This study aimed to investigate the difference between ultrasonographic findings of normal skin and those of re-epithelialized skin after partial-thickness burns and to evaluate the relationship between the...Background:This study aimed to investigate the difference between ultrasonographic findings of normal skin and those of re-epithelialized skin after partial-thickness burns and to evaluate the relationship between these findings and clinical outcomes. Methods:This study retrospectively analysed the ultrasound images of re-epithelialized skin after partial-thickness burns and contralateral normal skin from January 2016 to December 2016. A total of 155 lesions from 148 patients were analysed with ultrasound images, and healing time was documented. The scar status of each lesion was evaluated through medical records and photographs. We analysed the difference in ultrasonographic findings between normal skin and re-epithelialized skin after partial-thickness burns and statistically analysed the relationship between healing time, scar status and ultrasonographic findings. Results: The re-epithelialized skin after partial-thickness burns was significantly thicker than the contralateral normal skin, and the echogenicity was significantly lower. The ultrasound images of the re-epithelialized skin after partial-thickness burns showed the characteristic findings of low-echogenic bands (LEB), and the proportion of LEB thickness is strongly correlated with healing time. In the multivariate analysis of scar status, only the proportion of LEB thickness was statistical y significant. Conclusion:In this study, we found that there were ultrasonographic differences between re-epithelialized skin after partial-thickness burns and normal skin and that an LEB of varying thickness was formed after re-epithelialization. The thickness of the LEB in re-epithelialized skin after partial-thickness burns increased with healing time and was related to scar status.展开更多
Objective: To evaluate the diagnostic efficacy of magnetic resonance imaging (MRI) for the detection of partial-thickness rotator cuff tears (PTT) and full-thickness rotator cuff tears(FTT) by comparing its findings w...Objective: To evaluate the diagnostic efficacy of magnetic resonance imaging (MRI) for the detection of partial-thickness rotator cuff tears (PTT) and full-thickness rotator cuff tears(FTT) by comparing its findings with surgical findings as the gold standard and to improve the previous MRI accuracy in diagnosing rotator cuff tears (RCT) considering more variables. Methods: In 45 months, 804 patients underwent MRI shoulder joint. Among them, only 95 cases had undergone both MRI imaging and surgery accordingly. The patient records were evaluated retrospectively if MRI and surgery were performed within 40 days of MRI. MRI findings were categorized into PTT, FTT and no tears which were further divided into different types according to four main nominal data as variables viz. site, size, shape and muscle involvement in RCT and were correlated with surgical findings for statistical calculation by using Kappa coefficient and McNemar Bowker test. Results: 81 patients (86 RCTs) underwent surgery within 40 days. On the basis of site as variable, MRI correctly depicted 100% of full thickness tears(FTT), 85% of bursal partial thickness tears(PTT), 80.4% of articular partial thickness tears(PTT). The consistency in diagnosis of RCT between MRI and surgery was moderate (Kappa coefficient 0.645). Overall sensitivity, specificity and accuracy of MRI for diagnosing PTT was 87.3%, 53.3% and 81.3%;and that for FTT was 100%, 98.7% and 98.8% respectively. Likewise on the basis of size, shape and muscles involved, the consistency between MRI and surgery was poor for size and shape and moderate for muscles involved;and the difference in diagnosing RCT by MRI and surgery was significant for shape (P = 0.002) only, but not significant for size (P = 0.16) and for muscles involved (P = 0.206) respectively. The agreement between MRI and surgery in diagnosing calcific tendinitis and shoulder joint hematoma with Kappa coefficient is (0.577) and (0.556) respectively. Conclusion: MRI has better accuracy for detecting FTT and has high sensitivity and positive predictive value in diagnosing both PTT and FTT. Combining more others variables in addition to RCT, MRI offers a great value in diagnosing RCT.展开更多
BACKGROUND Current clinical treatment options for symptomatic,partial-thickness rotator cuff tear(sPTRCT)offer only limited potential for true tissue healing and improvement of clinical results.In animal models,inject...BACKGROUND Current clinical treatment options for symptomatic,partial-thickness rotator cuff tear(sPTRCT)offer only limited potential for true tissue healing and improvement of clinical results.In animal models,injections of adult stem cells isolated from adipose tissue into tendon injuries evidenced histological regeneration of tendon tissue.However,it is unclear whether such beneficial effects could also be observed in a human tendon treated with fresh,uncultured,autologous,adipose derived regenerative cells(UA-ADRCs).A specific challenge in this regard is that UA-ADRCs cannot be labeled and,thus,not unequivocally identified in the host tissue.Therefore,histological regeneration of injured human tendons after injection of UA-ADRCs must be assessed using comprehensive,immunohistochemical and microscopic analysis of biopsies taken from the treated tendon a few weeks after injection of UA-ADRCs.CASE SUMMARY A 66-year-old patient suffered from sPTRCT affecting the right supraspinatus and infraspinatus tendon,caused by a bicycle accident.On day 18 post injury[day 16 post magnetic resonance imaging(MRI)examination]approximately 100 g of abdominal adipose tissue was harvested by liposuction,from which approximately 75×10^(6) UA-ADRCs were isolated within 2 h.Then,UA-ADRCs were injected(controlled by biplanar X-ray imaging)adjacent to the injured supraspinatus tendon immediately after isolation.Despite fast clinical recovery,a follow-up MRI examination 2.5 mo post treatment indicated the need for open revision of the injured infraspinatus tendon,which had not been treated with UAADRCs.During this operation,a biopsy was taken from the supraspinatus tendon at the position of the injury.A comprehensive,immunohistochemical and microscopic analysis of the biopsy(comprising 13 antibodies)was indicative of newly formed tendon tissue.CONCLUSION Injection of UA-ADRCs can result in regeneration of injured human tendons by formation of new tendon tissue.展开更多
文摘Background： Partial-thickness rotator cufftears （PTRCTs） are being diagnosed more often because of high-resolution magnetic resonance imaging （MRI）. Compared with articular and bursal side tears, there have been few studies about evaluating the clinical and structural outcomes after intratendinous tear repair. Methods： From 2008 to 2012, 33 consecutive patients with intratendinous PTRCTs underwent arthroscopic repair. All of them were retrospectively evaluated. The University of California at Los Angeles （UCLA） and constant scores were evaluated before operation and at the final follow-up. Postoperative cuff integrity was determined using MRI according to Sugaya＇s classification. Results： At the 2-year follow-up, the average UCLA score increased from 16.7± 1.9 to 32.5± 3,5, and the constant score increased from 66.2 ± 10.5 to 92.4 ± 6.9 （P 〈 0.001）. Twenty seven patients received follow-up MRI examinations at an average of 15.2 months after surgery. Of these 27 patients, 22 （81.5%） had a healed tendon, and five patients had partial tears. There was no association between functional and anatomic results. Conclusions： For intratendinous PTRCT, clinical outcomes and tendon healing showed good results at a minimum 2-year after arthroscopic repair.
文摘Background:This study aimed to investigate the difference between ultrasonographic findings of normal skin and those of re-epithelialized skin after partial-thickness burns and to evaluate the relationship between these findings and clinical outcomes. Methods:This study retrospectively analysed the ultrasound images of re-epithelialized skin after partial-thickness burns and contralateral normal skin from January 2016 to December 2016. A total of 155 lesions from 148 patients were analysed with ultrasound images, and healing time was documented. The scar status of each lesion was evaluated through medical records and photographs. We analysed the difference in ultrasonographic findings between normal skin and re-epithelialized skin after partial-thickness burns and statistically analysed the relationship between healing time, scar status and ultrasonographic findings. Results: The re-epithelialized skin after partial-thickness burns was significantly thicker than the contralateral normal skin, and the echogenicity was significantly lower. The ultrasound images of the re-epithelialized skin after partial-thickness burns showed the characteristic findings of low-echogenic bands (LEB), and the proportion of LEB thickness is strongly correlated with healing time. In the multivariate analysis of scar status, only the proportion of LEB thickness was statistical y significant. Conclusion:In this study, we found that there were ultrasonographic differences between re-epithelialized skin after partial-thickness burns and normal skin and that an LEB of varying thickness was formed after re-epithelialization. The thickness of the LEB in re-epithelialized skin after partial-thickness burns increased with healing time and was related to scar status.
文摘Objective: To evaluate the diagnostic efficacy of magnetic resonance imaging (MRI) for the detection of partial-thickness rotator cuff tears (PTT) and full-thickness rotator cuff tears(FTT) by comparing its findings with surgical findings as the gold standard and to improve the previous MRI accuracy in diagnosing rotator cuff tears (RCT) considering more variables. Methods: In 45 months, 804 patients underwent MRI shoulder joint. Among them, only 95 cases had undergone both MRI imaging and surgery accordingly. The patient records were evaluated retrospectively if MRI and surgery were performed within 40 days of MRI. MRI findings were categorized into PTT, FTT and no tears which were further divided into different types according to four main nominal data as variables viz. site, size, shape and muscle involvement in RCT and were correlated with surgical findings for statistical calculation by using Kappa coefficient and McNemar Bowker test. Results: 81 patients (86 RCTs) underwent surgery within 40 days. On the basis of site as variable, MRI correctly depicted 100% of full thickness tears(FTT), 85% of bursal partial thickness tears(PTT), 80.4% of articular partial thickness tears(PTT). The consistency in diagnosis of RCT between MRI and surgery was moderate (Kappa coefficient 0.645). Overall sensitivity, specificity and accuracy of MRI for diagnosing PTT was 87.3%, 53.3% and 81.3%;and that for FTT was 100%, 98.7% and 98.8% respectively. Likewise on the basis of size, shape and muscles involved, the consistency between MRI and surgery was poor for size and shape and moderate for muscles involved;and the difference in diagnosing RCT by MRI and surgery was significant for shape (P = 0.002) only, but not significant for size (P = 0.16) and for muscles involved (P = 0.206) respectively. The agreement between MRI and surgery in diagnosing calcific tendinitis and shoulder joint hematoma with Kappa coefficient is (0.577) and (0.556) respectively. Conclusion: MRI has better accuracy for detecting FTT and has high sensitivity and positive predictive value in diagnosing both PTT and FTT. Combining more others variables in addition to RCT, MRI offers a great value in diagnosing RCT.
文摘BACKGROUND Current clinical treatment options for symptomatic,partial-thickness rotator cuff tear(sPTRCT)offer only limited potential for true tissue healing and improvement of clinical results.In animal models,injections of adult stem cells isolated from adipose tissue into tendon injuries evidenced histological regeneration of tendon tissue.However,it is unclear whether such beneficial effects could also be observed in a human tendon treated with fresh,uncultured,autologous,adipose derived regenerative cells(UA-ADRCs).A specific challenge in this regard is that UA-ADRCs cannot be labeled and,thus,not unequivocally identified in the host tissue.Therefore,histological regeneration of injured human tendons after injection of UA-ADRCs must be assessed using comprehensive,immunohistochemical and microscopic analysis of biopsies taken from the treated tendon a few weeks after injection of UA-ADRCs.CASE SUMMARY A 66-year-old patient suffered from sPTRCT affecting the right supraspinatus and infraspinatus tendon,caused by a bicycle accident.On day 18 post injury[day 16 post magnetic resonance imaging(MRI)examination]approximately 100 g of abdominal adipose tissue was harvested by liposuction,from which approximately 75×10^(6) UA-ADRCs were isolated within 2 h.Then,UA-ADRCs were injected(controlled by biplanar X-ray imaging)adjacent to the injured supraspinatus tendon immediately after isolation.Despite fast clinical recovery,a follow-up MRI examination 2.5 mo post treatment indicated the need for open revision of the injured infraspinatus tendon,which had not been treated with UAADRCs.During this operation,a biopsy was taken from the supraspinatus tendon at the position of the injury.A comprehensive,immunohistochemical and microscopic analysis of the biopsy(comprising 13 antibodies)was indicative of newly formed tendon tissue.CONCLUSION Injection of UA-ADRCs can result in regeneration of injured human tendons by formation of new tendon tissue.
