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ABSTRACT: The ideal artificial ligament graft should have favorable biocompatibility to facilitate cell adhesion, proliferation, and collagen regeneration. In this present study, surface modification was performed on a poly(ethylene terephthalate) (PET) artificial ligament graft by layer-by-layer (LBL) self-assembly coating of hyaluronic acid (HA) and chitosan (CS). The surface characterization of the ligament was examined using scanning electron microscopy, atomic force microscopy, and energy-dispersive X-ray spectroscopy. The results of in vitro culturing of human foreskin fibroblast cells supported the hypothesis that the LBL coating of CS-HA could promote the cell proliferation and adhesion on the sheets. A rabbit medical collateral ligament reconstruction model was used to evaluate the effect of this LBL coating in vivo. The final results proved that this LBL coating could significantly promote and enhance new collagen formation among the graft fibers. On the basis of these results, we conclude that such CS-HA assembly coating could enhance PET graft biocompatibility in vitro and in vivo, and a CS-HA-coated PET graft has considerable potential as a desirable substitute for ligament reconstruction.
Journal of Biomaterials Science Polymer Edition 03/2013; 24(4):431-46. · 1.69 Impact Factor
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ABSTRACT: PURPOSE: Existing patient self-reported shoulder scoring systems fail to express physicians' points of view, and understanding the wording can sometimes lead to confusion in Easterners. We sought to develop a valid, reliable, and responsive shoulder scoring system that combines the points of view of physicians and patients and is easily understood for worldwide applicability. METHODS: Six steps were followed to develop the scale: (1) investigation, identification of a specific population, and patient and physician interviews; (2) item generation, according to existing shoulder scales, a literature review, and patient and physician interviews; (3) item reduction, by combining and adjusting items; (4) formatting of the questionnaire, designed using both subjective and objective scales, with a 100-point score range; (5) pretesting, to eliminate confusion and misunderstanding of items, and (6) preliminary evaluation. Pearson correlation coefficients were calculated to assess validity (compared with American Shoulder and Elbow Surgeons, Constant-Murley, and University of California, Los Angeles scores), intraclass correlation coefficients were calculated to assess reliability (with a 2-week test-retest interval), and the standardized response mean was calculated to assess responsiveness (comparing preoperative and postoperative scores in patients). RESULTS: The final scoring system was designed to have a 100-point score range, with higher scores indicating better function. It consisted of self-report assessment by patients (61 points in total) and objective assessment by physicians (39 points in total). Updated scales, including a night pain subscale, patient-physician satisfaction, and 2-dimensional visual analog scale tool, were incorporated in our system. Compared with the other 3 scoring systems (American Shoulder and Elbow Surgeons, Constant-Murley, and University of California, Los Angeles scores), the new scoring system has shown favorable validity, with a Pearson correlation coefficient greater than 0.7. In addition, the intraclass correlation coefficient was greater than 0.9 during a 2-week test-retest interval, indicating high reliability, and the standardized response mean of the new system was greater than that of the other 3 scoring systems, indicating sensitive responsiveness. CONCLUSIONS: A new shoulder scoring system has been developed based on patients' and physicians' points of view and worldwide applicability and was verified to be valid, reliable, and responsive. The new scoring system includes a 2-dimensional visual analog scale, night pain subscale, and patient-physician satisfaction scale, which are not included in the existing scoring systems. LEVEL OF EVIDENCE: Level III, development of diagnostic criteria.
Arthroscopy The Journal of Arthroscopic and Related Surgery 02/2013; · 3.02 Impact Factor
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ABSTRACT: A novel hydroxyapatite/regenerated silk fibroin scaffold was prepared and investigated for its potential to enhance both osteoinductivity and osteoconductivity of bone marrow-derived mesenchymal stromal cells in vitro. Approx. 12.4 ± 0.06 % (w/w) hydroxyapatite was deposited onto the scaffold, and cell viability and DNA content were significantly increased (18.5 ± 0.6 and 33 ± 1.2 %, respectively) compared with the hydroxyapatite scaffold after 14 days. Furthermore, alkaline phosphatase activity in the novel scaffold increased 41 ± 2.5 % after 14 days compared with the hydroxyapatite scaffold. The data indicate that this novel hydroxyapatite/regenerated silk fibroin scaffold has a positive effect on osteoinductivity and osteoconductivity, and may be useful for bone tissue engineering.
Biotechnology Letters 12/2012; · 1.68 Impact Factor
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ABSTRACT: PURPOSE: The aim of this study was to determine whether hydroxypropylcellulose (HPC) coating of polyethylene terephthalate (PET) artificial ligaments enhances graft osseointegration in the bone tunnel. METHODS: Thirty New Zealand white rabbits underwent artificial ligament graft transplantation in the bilateral proximal tibia tunnels. One limb was implanted with an HPC-coated PET graft, and the contralateral limb was implanted with a non-HPC-coated PET graft as a control. The rabbits were then randomly sacrificed at weeks four and eight after surgery for biomechanical testing, histological examination, and histomorphometric and real-time polymerase chain reaction analysis. RESULTS: At week four after surgery, there were no statistically significant differences in the load to failure or stiffness values between the experimental and control limbs (P = 0.328 and P = 0.128, respectively). At week eight after surgery, the mean load to failure and stiffness value of the experimental limbs was higher than that of the control limbs (P < 0.001 and P = 0.018, respectively). At week eight after surgery, some protruding new bone tissue from the host bone to the graft was found in the HPC-coated group, while a thick fibrous tissue band was observed at the interface between the graft and the host bone in the control group. Histomorphometric analysis showed that the graft-bone interface width in the HPC-coated group was significantly narrower than that in the control group at week eight after surgery (P < 0.001). At weeks four and eight after surgery, the mRNA expression level of bone morphogenetic protein-2 in the HPC group was higher than that in the control group (P = 0.001 and P = 0.010, respectively). The mRNA expression level of osteopontin in the HPC group was higher than that in the control group only at week four after surgery (P = 0.032). CONCLUSIONS: Our data show that an HPC coating on the surface of PET artificial ligament grafts may induce artificial ligament graft osseointegration in the bone tunnel.
International Orthopaedics 11/2012; · 2.03 Impact Factor
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ABSTRACT: PURPOSE: The aim of this study was to investigate whether cationised gelatin and hyaluronic acid (CH) coating could induce polyethylene terephthalate (PET) artificial ligament graft osseointegration in the bone tunnel. METHODS: Surface modification of PET artificial ligament graft was performed by layer-by-layer (LBL) self-assembly CH coating. Six pigs underwent anterior cruciate ligament (ACL) reconstruction on the right knees, with three pigs receiving the CH-coated PET grafts and the other three pigs non-CH-coated PET grafts as controls. They were sacrificed at three months after surgery and the graft-bone complexes were acquired for computed tomography (CT) scan and histological examination. RESULTS: CT scans showed a significant difference at the distal femoral site (p = 0.031) or at the distal tibial site (p = 0.0078), but no significant difference in the bone tunnel areas' enlargement at other sites (p > 0.05) between the CH group and the control group. Histologically, application of CH coating induced new bone formation between graft and bone at three months compared with the controls at the distal site. The interface width of the CH group was significantly lower than that of the control group at the distal femoral site (p = 0.0327) and at the distal tibial site (p = 0.0047). CONCLUSIONS: The study has shown that CH coating on the PET artificial ligament surface has a positive biological effect in the induction of artificial ligament osseointegration within the bone tunnel at the distal site of the bone tunnel.
International Orthopaedics 11/2012; · 2.03 Impact Factor
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ABSTRACT: Background
Anterior talofibular ligament (ATFL) injury is a commonly seen sports-related injury and a major underlying pathology of chronic ankle instability. However, it is difficult to accurately identify chronic injury of the ATFL.PurposeTo investigate the value of ultrasound (US) examination in identifying chronic ATFL injury.Material and Methods
We evaluated 83 consecutive patients who underwent US examination for diagnosis of the ATFL injury and subsequent ankle arthroscopy. The arthroscopic findings were used as the reference standard.ResultsForty-four patients were found to have ATFL injury on arthroscopy. The accuracy of US examination for the detection of ATFL injury was 95.2%, with sensitivity of 97.7%, specificity of 92.3%, positive predictive value of 93.5%, negative predictive value of 97.3%, positive likelihood ratio of 12.7, and negative likelihood ratio of 0.025.ConclusionUS examination is a reliable and accurate method to evaluate chronic ATFL injury.
Acta Radiologica 10/2012; · 1.37 Impact Factor
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ABSTRACT: Carbonic anhydrase III (CAIII) is remarkably abundant in slow skeletal muscles. It has multiple biological activities which could dissipate or resist some fatigue-related substances. In this study, we purified trans-activating transcriptional activator (TAT) fused CAIII protein and investigated its effect on C2C12 cell apoptosis induced by hypoxia/reoxygenation.
The CAIII and TAT-CAIII genes were constructed, cloned into plasmid pET28a and expressed in Escherichia coli BL21 (DE3). The fusion proteins were purified with a nickel-nitrilotriacetic acid affinity chromatography column and then verified by Western blot and phosphatase activity staining subsequently. The C2C12 cells were treated respectively with serum-free medium containing 1 μM TAT-CAIII or 1 μM CAIII for 1 h and the intracellular distributions of fusion proteins were observed by indirect immunofluorescence. The effect of TAT-CAIII on C2C12 cell apoptosis induced by hypoxia/reoxygenation was detected by flow cytometry.
The CAIII and TAT-CAIII fusion proteins were expressed and purified successfully. After being cultured for 1 h, green fluorescence was visible in TAT-CAIII group cells under the fluorescence microscope, while no fluorescence was found in the CAIII group. Compared with the oxygen-glucose deprivation group, the apoptosis rate of C2C12 cells induced by hypoxia/reoxygenation in the TAT-CAIII group decreased significantly (p < 0.001).
The purified TAT-CAIII could be transferred into cells efficiently and clearly decreased the apoptosis rate of C2C12 cells induced by hypoxia/reoxygenation, which indicated that it had antioxidative activity. This study lays an experimental basis for future research on the relationship between CAIII and muscle fatigue.
Archives of medical science : AMS. 09/2012; 8(4):711-8.
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ABSTRACT: In this study layer by layer (LBL) self-assembled coatings of hyaluronic acid (HA) and cationized gelatin (CG) were used to modify polyethylene terephthalate (PET) artificial ligament grafts. Changes in the surface properties were characterized by scanning electron microscopy, attenuated total reflection Fourier transform infrared spectroscopy, energy-dispersive X-ray spectroscopy, and contact angle and biomechanical measurements. The cell compatibility of this HA-CG coating was investigated in vitro on PET films seeded with human foreskin dermal fibroblasts over 7days. The results of our in vitro studies demonstrated that the HA-CG coating significantly enhanced cell adhesion, facilitated cell growth, and suppressed the expression of inflammation-related genes relative to a pure PET graft. Furthermore, rabbit and porcine anterior cruciate ligament reconstruction models were used to evaluate the effect of this LBL coating in vivo. The animal experiment results proved that this LBL coating significantly inhibited inflammatory cell infiltration and promoted new ligament tissue regeneration among the graft fibers. In addition, the formation of type I collagen in the HA-CG coating group was much higher than in the control group. Based on these results we conclude that PET grafts coated with HA-CG have considerable potential as substitutes for ligament reconstruction.
Acta biomaterialia 07/2012; 8(11):4007-19. · 3.98 Impact Factor
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ABSTRACT: Cancellous osteoid osteoma of the talus near the subtalar joint is rare, and the treatment is very challenging. We present the first case of arthroscopic excision of juxtaarticular cancellous osteoid osteoma in the talar neck near the subtalar joint. After confirming the nidus of the osteoid osteoma with computer tomography, the lesion was completely removed with a motorized bur under arthroscopy, and the patient's pain disappeared immediately after surgery. This case report demonstrates that a cancellous osteoid osteoma in the talar neck near the subtalar joint can be treated by arthroscopic excision and good results could be obtained. Level of evidence IV.
Knee Surgery Sports Traumatology Arthroscopy 06/2012; · 2.21 Impact Factor
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ABSTRACT: The purpose of our study is to evaluate the clinical results of anatomical reconstruction of the lateral ligaments with semitendinosus allograft.
Thirty-six patients with chronic lateral instability underwent anatomical reconstruction of the lateral ligaments of the ankle with semitendinosus allograft. The American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale score (AOFAS score) and the Karlsson score were used to evaluate the clinical results before and after surgery.
A total of 35 patients (97.2 %) (36 ankles) were followed up for a mean of 37.9 months. The mean AOFAS score improved from 42.3 ± 4.9 points preoperatively to 90.4 ± 6.7 postoperatively. The mean Karlsson score improved from 38.5 ± 3.2 preoperatively to 90.1 ± 7.8 postoperatively.
Anatomical reconstruction of the lateral ligaments with semitendinosus allograft achieves a satisfactory surgical outcome for chronic ankle instability.
International Orthopaedics 06/2012; 36(10):2027-31. · 2.03 Impact Factor
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ABSTRACT: Currently, there is an ongoing debate regarding the optimal graft choice between autograft and allograft tendons in reconstruction of the anterior cruciate ligament (ACL). It has been reported that allograft tendons have a slower onset and rate of revascularization compared with autograft tendons.
Allograft tendons might have inferior graft maturity compared with autograft tendons in ACL reconstruction at 2 years postoperatively.
Cohort study; Level of evidence, 3.
A total of 52 participants with ACL reconstruction were recruited in this study, including 30 using allograft tendons and 22 using autograft tendons. All of them had unilateral ACL reconstruction and were followed up using 3.0-T magnetic resonance imaging (MRI) at least 2 years postoperatively. Clinical examination was performed on the same day when the MRI examination was performed, including subjective functional examinations (International Knee Documentation Committee [IKDC] and Tegner Lysholm Knee Scoring Scale [TLKS]) and physical examinations (anterior drawer test and Lachman test). Four measurements based on MRI were focused on graft orientation (including tibial tunnel position and graft angles), the edematous condition of the graft, intra-articular graft width at different sites, and signal intensity of the ACL graft using the signal/noise quotient (SNQ) from a region of interest analysis. Differences in each measurement were compared between the allograft group and the autograft group.
All the participants returned to normal sports activities at the follow-up time point, as all of them acquired full functional strength and stability. There was no significant difference between the autograft and the allograft group with respect to IKDC or TLKS score. The knees in both of the groups were confirmed stable by physical examination before MRI. On MRI measurements, the allograft group displayed no significant difference in graft orientation compared with the autograft group (P > .05). Moreover, there was also no significant difference between allograft group and autograft group in graft width of the distal site (P > .05), middle site (P > .05), and proximal site (P > .05). However, the mean SNQ value of the allograft group was significantly higher than that of the autograft group in the distal site (6.54 ± 6.58 vs 2.98 ± 5.48; P = .0173), the middle site (7.21 ± 6.31 vs 3.56 ± 4.62; P = .0149), and the proximal site (6.61 ± 8.08 vs 2.45 ± 8.12; P = .0018).
The allograft group had a significantly higher SNQ value compared with the autograft group in this study, indicating that allograft tendons might have inferior graft maturity than autograft tendons in ACL reconstruction at 2 years postoperatively.
The American journal of sports medicine 04/2012; 40(7):1519-26. · 3.61 Impact Factor
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ABSTRACT: The purpose of our study is to make a retrospective evaluation of endoscopic treatment of Haglund's syndrome using a new three portal technique.
All 23 patients (25 heels) with a mean age of 27.7 years were evaluated pre-operatively and postoperatively with parallel pitch lines, the American Orthopaedic Foot and Ankle Society (AOFAS) score and the Ogilvie Harris score.
The mean follow-up was 41 months (range, 30-59 months). There were no obvious complications in our study. In 22 heels, postoperative lateral radiographs showed the achievement of negative parallel pitch lines. The average AOFAS score improved from 63.3 ± 11.9 points pre-operatively to 86.8 ± 10.1 points at final follow-up. There were 14 excellent results, seven good results, two fair results and two poor results. For the Ogilvie Harris score, there were 15 excellent, seven good, one fair, and two poor results.
An endoscopic procedure using the three portal technique seemed to be a safe and efficacious option for surgical treatment of Haglund's syndrome.
International Orthopaedics 03/2012; 36(8):1623-7. · 2.03 Impact Factor
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ABSTRACT: Tendon-bone healing is a progressive and complex pathophysiological process after tendon graft transplantation into a bone tunnel. A fibrous scar tissue layer forms at the graft-bone interface, which means a weak bonding of the graft in the bone tunnel. Periosteum, a favourable autologous tissue, was confirmed to be effective in promoting tendon-bone healing in the human body. The advantages of a periosteum patch for tendon-bone repair include the fact that this tissue meets the three primary requirements for tissue engineering: a source of progenitor cells, a scaffold for recruiting cells and growth factors, and a source of local growth factors. Furthermore, the periosteum can prevent graft micromotion, alleviate inflammation and deter bone resorption. In this review, we highlight the role of progenitor cells in the periosteum, which contribute to the regeneration of new bone and/or fibrocartilage at the tendon-bone interface. In summary, the periosteum has shown significant potential for use in the enhancement of graft-bone healing. Our investigations may provoke further studies on the management of allograft-bone healing and artificial ligament graft healing using a periosteum patch in future.
International Orthopaedics 03/2012; 36(3):665-9. · 2.03 Impact Factor
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ABSTRACT: A ligament advanced reinforcement system (LARS) artificial ligament has been proposed for use in anterior cruciate ligament reconstruction in some cases, and an emerging body of reports has shown its success in the short term. However, there are great concerns about the potential risks of complications, which might prevent its extensive use. We report a rare case of serious synovitis 3 years postoperatively in a 26-year-old man who underwent LARS artificial ligament reconstruction. During revision arthroscopy, we observed a large amount of synovial hyperplasia in the knee joint, containing a large amount of hemosiderin deposition. In addition, the femoral tunnel was placed too anteriorly, and the ligament was ruptured near the tibial tunnel. Histologically, there was thick fibrous scar tissue around the graft, and poorly organized fibrous scar tissue infiltrated into the graft fibers, which could cause loss of structural integrity of the ligament and eventual graft failure. Collectively, our findings might arouse further in-depth research on the development of artificial ligament.
Arthroscopy The Journal of Arthroscopic and Related Surgery 02/2012; 28(4):583-6. · 3.02 Impact Factor
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ABSTRACT: At present, due to the growing attention focused on the issue of tendon-bone healing, we carried out an animal study of the use of genetic intervention combined with cell transplantation for the promotion of this process. Here, the efficacy of bone marrow stromal cells infected with bone morphogenetic protein-2 (BMP-2) on tendon-bone healing was determined. A eukaryotic expression vector containing the BMP-2 gene was constructed and bone marrow-derived mesenchymal stem cells (bMSCs) were infected with a lentivirus. Next, we examined the viability of the infected cells and the mRNA and protein levels of BMP-2-infected bMSCs. Gastrocnemius tendons, gastrocnemius tendons wrapped by bMSCs infected with the control virus (bMSCs+Lv-Control), and gastrocnemius tendons wrapped by bMSCs infected with the recombinant BMP-2 virus (bMSCs+Lv-BMP-2) were used to reconstruct the anterior cruciate ligament (ACL) in New Zealand white rabbits. Specimens from each group were harvested four and eight weeks postoperatively and evaluated using biomechanical and histological methods. The bMSCs were infected with the lentivirus at an efficiency close to 100%. The BMP-2 mRNA and protein levels in bMSCs were significantly increased after lentiviral infection. The bMSCs and BMP-2-infected bMSCs on the gastrocnemius tendon improved the biomechanical properties of the graft in the bone tunnel; specifically, bMSCs infected with BMP-2 had a positive effect on tendon-bone healing. In the four-week and eight-week groups, bMSCs+Lv-BMP-2 group exhibited significantly higher maximum loads of 29.3 ± 7.4 N and 45.5 ± 11.9 N, respectively, compared with the control group (19.9 ± 6.4 N and 21.9 ± 4.9 N) (P = 0.041 and P = 0.001, respectively). In the eight-week groups, the stiffness of the bMSCs+Lv-BMP-2 group (32.5 ± 7.3) was significantly higher than that of the bMSCs+Lv-Control group (22.8 ± 7.4) or control groups (12.4 ± 6.0) (p = 0.036 and 0.001, respectively). Based on the histological findings, there was an increased amount of perpendicular collagen fibers formed between the tendon and bone in the bMSCs+Lv-Control and bMSCs+Lv-BMP-2 group, compared with the gastrocnemius tendons. The proliferation of cartilage-like cells and the formation of fibrocartilage-like tissue were highest within the bone tunnels in the bMSCs+Lv-BMP-2 group. These results suggest that this lentivirus can be used to efficiently infect bMSCs with BMP-2. Furthermore, tendons wrapped by bMSCs+Lv-BMP-2 improved tendon-bone healing.
International Journal of Molecular Sciences 01/2012; 13(10):13605-20. · 2.60 Impact Factor
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ABSTRACT: To compare the effectiveness of anatomical single-bundle (ASB) and over-the-top single-bundle (OSB) reconstruction of the anterior cruciate ligament (ACL).
Between January 2008 and June 2008, 64 patients with ACL injury underwent arthroscopic ACL reconstruction. ASB ACL reconstruction was performed in 28 cases (ASB group) and OSB ACL reconstruction in 36 cases (OSB group). There was no significant difference in gender, age, disease duration, International Knee Documentation Committee (IKDC) score, Lysholm score, and side-to-side difference between 2 groups (P > 0.05).
All incisions healed by first intention; no infection or other complications occurred. All cases were followed up 20-24 months (mean, 21.5 months). There were significant differences in the IKDC score, Lysholm score, and the side-to-side difference between last follow-up and preoperation in 2 groups (P < 0.05), but there was no significant difference between 2 groups at last follow-up (P > 0.05). Significant differences were found in negative rate of the pivot shift test between last follow-up and preoperation in ASB group and between 2 groups at last follow-up (P < 0.05), but there was no significant difference between last follow-up and preoperation in OSB group (P > 0.05).
The effectiveness of arthroscopic ASB ACL reconstruction is better than that of arthroscopic OSB ACL reconstruction, especially in controlling rotational stability.
Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery 08/2011; 25(8):912-5.
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ABSTRACT: The aim of the study was to investigate whether a bioactive glass (BG) coating on the polyethylene terephthalate (PET) artificial ligament could enhance graft osseointegration by promoting bone regeneration at the interface between PET graft and bone tunnel.
Thirty New Zealand white rabbits underwent artificial ligament graft transplantation in proximal tibial tunnels bilaterally. One limb was implanted with a 58S BG-coated PET graft, and the contralateral limb was implanted with a non-BG-coated PET graft as a control. The rabbits were randomly sacrificed at three, six and 12 weeks after surgery for biomechanical and histological examinations.
The maximum load to failures of the BG-coated experimental group were significantly higher than those of the control group at 12 weeks (p = 0.0051). Histologically, at 12 weeks, the BG-coated PET graft induced great new bone formation between graft and host bone, and the average graft-bone interface width of the BG group became significantly lower than that of the control group. Furthermore, the BG coating on the ligament graft surface also stimulated greater expression of bone morphogenetic protein 2 (BMP-2) and vascular endothelial growth factor (VEGF) around the graft in vivo compared to the control group at three weeks (p < 0.05).
This study has shown that a BG coating on the PET artificial ligament surface has a positive effect in the induction of artificial ligament osseointegration within the bone tunnel.
International Orthopaedics 05/2011; 36(1):191-7. · 2.03 Impact Factor
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ABSTRACT: Surface coating with an organic layer-by-layer self-assembled template of chitosan and hyaluronic acid on a poly(ethylene terephthalate) (PET) artificial ligament was designed for the promotion and enhancement of graft-to-bone healing after artificial ligament implantation in a bone tunnel. The results of in vitro culturing of MC3T3-E1 mouse osteoblastic cells supported the hypothesis that the layer-by-layer coating of chitosan and hyaluronic acid could promote the cell compatibility of grafts and could promote osteoblast proliferation. A rabbit extra-articular tendon-to-bone healing model was used to evaluate the effect of this kind of surface-modified stainless artificial ligament in vivo. The final results proved that this organic compound coating could significantly promote and enhance new bone formation at the graft-bone interface histologically and, correspondingly, the experimental group with coating had significantly higher biomechanical properties compared with controls at 8 weeks (P < 0.05).
Journal of Biomaterials Science Polymer Edition 01/2011; 23(1-4):425-38. · 1.69 Impact Factor
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ABSTRACT: To observe the outcome of arthroscopic meniscal plasty and suture repair to treat torn discoid lateral meniscus involving popliteal hiatus.
Between January 2008 and May 2009, 21 cases of torn discoid lateral meniscus involving popliteal hiatus were treated by arthroscopic surgery. There were 9 males and 12 females with an average age of 22.5 years (range, 12-45 years), including 12 left knees and 9 right knees. Seven cases had the history of injury and other 14 cases had uncertain trauma. The average disease duration was 6.4 months (range, 3 months to 2 years). All patients complained knee pain or locking with positive McMurray test and milling test before surgery. All cases had torn discoid lateral meniscus, and the tear extended to the popliteal hiatus, including 17 cases of complete type and 4 cases of incomplete type according to the Watanabe classification. After meniscal plasty, suture repair of torn popliteal lateral hiatus was performed. The anterior part to hiatus was repaired by the outside-in technique, and the posterior part underwent repair of all inside technique by FasT-Fix.
All wounds healed by first intention with no complications such as infection, stiffness of knee, or injury of common peroneal nerve. All patients were followed up 12-28 months with an average of 18 months. The symptoms of knee pain or locking disappeared postoperatively with negative McMurray test and milling test in all patients. The Lysholm score was improved from 54.0 +/- 13.4 to 90.0 +/- 6.6 at 12 months postoperatively, showing significant difference (t = -12.00, P = 0.00). Based on the improved Lysholm classification standard, the results were excellent in 14 cases, good in 5, and fair in 2; the excellent and good rate was 90.5%.
For torn discoid lateral meniscus involving popliteal hiatus, based on meniscal plasty, suture repair of the popliteal hiatus would contribute to preserve the peripheral part and restore its stability.
Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery 01/2011; 25(1):13-6.
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ABSTRACT: The purpose of this study was to investigate whether hydroxyapatite (HAp) coating could induce polyethylene terephthalate (PET) artificial ligament graft osseointegration in the bone tunnel. Twenty-four New Zealand white rabbits underwent artificial ligament graft transplantation in bilateral proximal tibia tunnels. One limb was implanted with HAp-coated PET graft, and the contralateral limb was implanted with non-HAp-coated PET graft as control. The rabbits were randomly sacrificed at four and eight weeks after surgery. The loads to failure of the experimental group at eight weeks were significantly higher than those of the control group (p = 0.0057). Histologically, application of HAp coating induced new bone formation between graft and bone at eight weeks compared with the controls. Real-time polymerase chain reaction examination revealed significantly elevated messenger ribonucleic acid expression levels of osteopontin and collagen I in the grafts of the HAp group compared with the controls at four weeks (p < 0.05). The study has shown that HAp coating on the PET artificial ligament surface has a positive effect in the induction of artificial ligament osseointegration within the bone tunnel.
International Orthopaedics 11/2010; 35(10):1561-7. · 2.03 Impact Factor
