MicroRNAs (miRNAs) are a class of small non-coding RNAs that have emerged as potential predictive, prognostic, and therapeutic biomarkers, relevant to many pathophysiological conditions including limb immobilization, osteoarthritis, sarcopenia, and cachexia. Impaired musculoskeletal homeostasis leads to distinct muscle atrophies. Understanding miRNA involvement in the molecular mechanisms underpinning conditions such as muscle wasting may be critical to developing new strategies to improve patient management. MicroRNAs are powerful post-transcriptional regulators of gene expression in
Objectives. The most prevalent disorders of the shoulder are related to the
muscles of rotator cuff. In order to develop a mechanical method
for the evaluation of the rotator cuff
Objectives. Lower limb
Introduction and Objective. Clinically, it is considered that spastic
Background. Spastic
The inability to replace human
Aims. Sarcopenia is characterized by a generalized progressive loss of skeletal muscle mass, strength, and physical performance. This systematic review primarily evaluated the effects of sarcopenia on postoperative functional recovery and mortality in patients undergoing orthopaedic surgery, and secondarily assessed the methods used to diagnose and define sarcopenia in the orthopaedic literature. Methods. A systematic search was conducted in MEDLINE, EMBASE, and Google Scholar databases according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Studies involving sarcopenic patients who underwent defined orthopaedic surgery and recorded postoperative outcomes were included. The quality of the criteria by which a diagnosis of sarcopenia was made was evaluated. The quality of the publication was assessed using Newcastle-Ottawa Scale. Results. A total of 365 studies were identified and screened, 26 full-texts were reviewed, and 19 studies were included in the review. A total of 3,009 patients were included, of whom 2,146 (71%) were female and 863 (29%) were male. The mean age of the patients was 75.1 years (SD 7.1). Five studies included patients who underwent spinal surgery, 13 included hip or knee surgery, and one involved patients who underwent fixation of a distal radial fixation. The mean follow-up was 1.9 years (SD 1.9; 5 days to 5.6 years). There was wide heterogeneity in the measurement tools which were used and the parameters for the diagnosis of sarcopenia in the studies. Sarcopenia was associated with at least one deleterious effect on surgical outcomes in all 19 studies. The postoperative rate of mortality was reported in 11 studies (57.9%) and sarcopenia was associated with poorer survival in 73% (8/11) of these. The outcome was most commonly assessed using the Barthel Index (4/19), and sarcopenic patients recorded lower scores in 75% (3/4) of these. Sarcopenia was defined using the gold-standard three parameters (muscle strength,
Summary Statement. Paraspinal
Aims. Internal hemipelvectomy without reconstruction of the pelvis is a viable treatment for pelvic sarcoma; however, the time it takes to return to excellent function is quite variable. Some patients require greater time and rehabilitation than others. To determine if psoas
Introduction. Intra-articular injury has been described as primary cause of pain in hip dysplasia. At this point it is unknown whether external muscle-tendon related pain coexists with intra-articular pathology. The primary aim was to identify muscle-tendon related pain in 100 dysplasia patients. The secondary aim was to test if muscle-tendon related pain is linearly associated to self-reported hip disability and
Purpose of study and background. Spinal
Patients demonstrate distinct trajectories of recovery after THA. The purpose of this study was to assess the impact of adjacent
The nervous system is known to be involved in inflammation and repair. We aimed to determine the effect of physical activity on the healing of a
Aims. The aim of this study was to describe a quantitative 3D CT method to measure rotator cuff
Aims. Rotator cuff (RC) injuries are characterized by tendon rupture, muscle atrophy, retraction, and fatty infiltration, which increase injury severity and jeopardize adequate tendon repair. Epigenetic drugs, such as histone deacetylase inhibitors (HDACis), possess the capacity to redefine the molecular signature of cells, and they may have the potential to inhibit the transformation of the fibro-adipogenic progenitors (FAPs) within the skeletal muscle into adipocyte-like cells, concurrently enhancing the myogenic potential of the satellite cells. Methods. HDACis were added to FAPs and satellite cell cultures isolated from mice. The HDACi vorinostat was additionally administered into a RC injury animal model. Histological analysis was carried out on the isolated supra- and infraspinatus
Tenotomy of the iliopsoas tendon has been described as an effective procedure to treat refractive groin pain induced by iliopsoas tendinitis. However, the procedure forces the rectus femoris to act as the primary hip flexor and little is known about the long-term effects of this procedure on the peri-articular
Both intrinsic and extrinsic hand
Falls in adults are a major problem and can lead to injuries and death. In order to better understand falls and successful recoveries, identifying kinematics, kinetics, and
The direct anterior approach (DAA) is a popular minimally invasive approach for total hip arthroplasty (THA). It usually involves ligation of the lateral femoral circumflex artery's ascending branch (a-LFCA), which contributes to the perfusion of the tensor fasciae latae (TFL)
Aims. Dystrophic calcification (DC) is the abnormal appearance of calcified deposits in degenerating tissue, often associated with injury. Extensive DC can lead to heterotopic ossification (HO), a pathological condition of ectopic bone formation. The highest rate of HO was found in combat-related blast injuries, a polytrauma condition with severe
Abstract. Objectives. Acute compartment syndrome (ACS) is a progressive form of
Introduction. A 6cm femoral gain requires 5-Y during normal growth, but only 6–8-W surgically (x30–40 faster). In lengthening surgery, losses of
Background. Trunk
Study design: To investigate the effects of muscle atrophy on back
Purpose: Several variables related to tourniquet (TQ) inflation contribute to ischemic
Although interlaminar endoscopic lumbar discectomy (IELD) is considered to be less invasive than microscopic lumbar discectomy (MLD) in treatment of lumbar herniated nucleus pulposus, the radiologic change of multifidus
The lower limbs of five cadavers were dissected and the lengths of the
Aims. Rotational acetabular osteotomy (RAO) is an effective joint-preserving surgical treatment for acetabular dysplasia. The purpose of this study was to investigate changes in
Abstract. Background. Progressive
Aims. Improvements in the evaluation of outcomes following peripheral nerve injury are needed. Recent studies have identified
Aims. The aticularis genu (AG) is the least substantial and deepest
Sarcopenia is an age-related geriatric syndrome which is associated with subsequent disability and morbidity. Currently there is no promising therapy approved for the treatment of sarcopenia. The receptor activator of nuclear factor NF-κB ligand (RANKL) and its receptor (RANK) are expressed in bone and skeletal muscle. Activation of the NF-κB pathway mainly inhibits myogenic differentiation, which leads to skeletal muscle dysfunction and loss. LYVE1 and CD206 positive macrophage has been reported to be associated with progressive impairment of skeletal muscle function with aging. The study aims to investigate the effects of an anti-RANKL treatment on sarcopenic skeletal muscle and explore the related mechanisms on
Aim. To assess the relationship between mRNA expression of genetic markers of inflammation (tumour necrosis factor-alpha (TNFα)) and interleukin-6 (IL-6) in the vastus lateralis (VL) of the operated leg, and the strength of the operated leg quadriceps, in patients following THR. Methods. Following ethical approval, 10 patients were recruited prospectively. Distal VL (5cm proximal to lateral supra-patellar pouch) biopsies were obtained intraoperatively and at 6 weeks post-operatively, with maximal voluntary contraction of the operated leg quadriceps (MVCOLQ) in Newtons(N), assessed preoperatively and at 6 weeks post-op. mRNA expression in the biopsies was assessed using the reverse transcriptase polymerase chain reaction (RT-PCR). Relationships were assessed using Spearman's correlation coefficient (data not normally distributed). Results. mRNA RQ (comparison of 6 week VL samples to intraoperative samples) was (mean (SD)) 6.23(12.85) for TNFα and 17.10(47.46) for IL-6. Preoperatively mean MVCOLQ was 188.90(76.84) N and at 6 weeks it was 217.00(53.91) N. There was no significant relationship between TNFα or IL-6 RQ and absolute MVCOLQ at 6 weeks. A trend to significance was noted between TNFα and the improvement (%) in MVCOLQ at 6 weeks (R = −0.552, p=0.098) with no such relationship observed for IL-6 (R = 0.127, p=0.726). Conclusions. In patients with hip osteoarthritis, reduced strength (MVCOLQ) appears to be mediated by
The HIPGEN study funded under EU Horizon 2020 (Grant 7792939) has the aim to investigate the potential of the first regenerative cell therapy for the improvement of recovery after
Massive posterosuperior cuff tears (mRCT) retracted to the glenoid are surgically challenging and often associated with high retear rates. Primary repair is a less-favourable option and other salvage procedures such as SCR and tendon transfers are used. This study presents clinical and radiological outcomes of
To investigate changes in quadriceps and hamstrings
Abstract. Source of Study: London, United Kingdom. This intervention study was conducted to assess two developing protocols for quadriceps and hamstring rehabilitation: Blood Flow Restriction (BFR) and Neuromuscular Electrical Stimulation Training (NMES). BFR involves the application of an external compression cuff to the proximal thigh. In NMES training a portable electrical stimulation unit is connected to the limb via 4 electrodes. In both training modalities, following device application, a standardised set of exercises were performed by all participants. BFR and NMES have been developed to assist with rehabilitation following lower limb trauma and surgery. They offer an alternative for individuals who are unable to tolerate the high mechanical stresses associated with traditional rehabilitation programmes. The use of BFR and NMES in this study was compared across a total of 20 participants. Following allocation into one of the training programmes, the individuals completed training programmes across a 4-week period. Post-intervention outcomes were assessed using Surface Electromyography (EMG) which recorded EMG amplitude values for the following
Objectives. Regenerative medicine is an emerging field aimed at the repair and regeneration of various tissues. To this end, cytokines (CKs), growth factors (GFs), and stem/progenitor cells have been applied in this field. However, obtaining and preparing these candidates requires invasive, costly, and time-consuming procedures. We hypothesised that skeletal muscle could be a favorable candidate tissue for the concept of a point-of-care approach. The purpose of this study was to characterize and confirm the biological potential of skeletal muscle supernatant for use in regenerative medicine. Methods. Semitendinosus
Many patients who undergo a total knee arthroplasty (TKA) wish to return to a more active lifestyle. The implant must be able to restore adequate
Acute Compartment Syndrome (ACS) is an orthopaedic emergency that can develop after a wide array of etiologies. In this pilot study the MY01 device was used to assess its ease of use and its ability to continuously reflect the intracompartmental pressure (ICP) and transmit this data to a mobile device in real time. This preliminary data is from the lead site which is presently expanding data collection to five other sites as part of a multi-center study. Patients with long bone trauma of the lower or upper extremity posing a possibility of developing compartment syndrome were enrolled in the study. Informed consent was obtained from the patients. A Health Canada licensed continuous compartmental pressure monitor (MY01) was used to measure ICP. The device was inserted in the compartment that was deemed most likely to develop ACS and ICP was continuously measured for up to 18 hours. Fractures were classified according to the AO/OTA classification. Patient clinical signs and pain levels were recorded by healthcare staff during routine in-patient monitoring and were compared to the ICP from the device. Important treatment information was pulled from the patient's chart to help correlate all of the patient's data and symptoms. The study period was conducted from November 2020 through December 2021. Twenty-six patients were enrolled. There were 17 males, and nine females. The mean age was 38 years (range, 17–76). Seventeen patients received the device post-operatively and nine received it pre-operatively. Preliminary results show that post-operative ICPs tend to be significantly higher than pre-operative ICPs but tend to trend downwards very quickly. The trend in this measurement appears to be more significant than absolute numbers which is a real change from the previous literature. One patient pre-operatively illustrated a steep trend upwards with minimal clinical symptoms but required compartment release at the time of surgery that exhibited no
Musculoskeletal modeling techniques simulate reverse total shoulder arthroplasty (RTSA) shoulders and how implant placement affects
Aims. The aim of this study was to analyse human
Background. Revision total knee arthroplasties (rTKA) are performed with increasing frequency due to the increasing numbers of primary arthroplasties, but very little is known regarding the influence of
Introduction. The direct anterior approach (DAA) and the posterior approach (PA) are 2 common total hip arthroplasty (THA) exposures. This prospective study quantitatively compared changes in periarticular
Cam-type femoroacetabular impingement (FAI) is a common cause for athletic hip injury and early hip osteoarthritis. Although corrective cam FAI surgery can improve patient reported outcome measures (PROMs), it is not clear how surgery affects
Introduction. Current modeling techniques have been used to model the Reverse Total Shoulder Arthroplasty (RTSA) to account for the geometric changes implemented after RTSA [2,3]. Though these models have provided insight into the effects of geometric changes from RTSA these is still a limitation of understanding
Objectives. Although many clinical and experimental investigations have shed
light on muscle atrophy and intramuscular accumulation of fat after
rotator cuff disruption, none have reported on their onset in the
absence of
Current modeling techniques have been used to model the Reverse Total Shoulder Arthroplasty (RTSA) to account for the geometric changes implemented after RTSA. Though these models have provided insight into the effects of geometric changes from RTSA these is still a limitation of understanding
Modern musculoskeletal modeling techniques have been used to simulate shoulders with reverse total shoulder arthroplasty and study how geometric changes resulting from implant placement affect shoulder
The iliocapsularis
Objectives. The aim of this study was to systematically review the literature on measurement of
We retrospectively studied the possibility that direct trauma to the biceps
The gluteus minimus (GMin) and gluteus medius (GMed) have unique structural and functional segments that may be affected to varying degrees, by end-stage osteoarthritis (OA) and normal ageing. We used data from patients with end-stage OA and matched healthy controls to 1) quantify the atrophy of the GMin and GMed in the two groups and 2) describe the distinct patterns of the fatty infiltration in the different segments of the GMin and GMed in the two groups. A total of 39 patients with end-stage OA and 12 age- and sex frequency-matched healthy controls were prospectively enrolled in the study. Fatty infiltration within the different segments of the GMin and the GMed was assessed on MRI according to the semiquantitative classification system of Goutallier and normalized cross-sectional areas were measured.Aims
Methods
Objectives. We have observed clinical cases where bone is formed in the overlaying
Last decade, a shift towards operative treatment of midshaft clavicle fractures has been observed [T. Huttunen et al., Injury, 2013]. Current fracture fixation plates are however suboptimal, leading to reoperation rates up to 53% [J. G. Wijdicks et al., Arch. Orthop. Trauma Surg, 2012]. Plate irritation, potentially caused by a bad geometric fit and plate prominence, has been found to be the most important factor for reoperation [B. D. Ashman et a.l, Injury, 2014]. Therefore, thin plate implants that do not interfere with
Objectives. Rotator cuff tears are among the most frequent upper extremity injuries. Current treatment strategies do not address the poor quality of the
After total hip replacement, force generating capacity of gluteal
Background: Muscle tears and injuries are a huge problem throughout the world. Ways of reducing these injuries are welcome, with warm-up and stretching of
1. The results of a three-year study of recovery in 3,033 lower limb
Aims. We wished to quantify the extent of soft-tissue damage sustained
during minimally invasive total hip arthroplasty through the direct
anterior (DA) and direct superior (DS) approaches. Materials and Methods. In eight cadavers, the DA approach was performed on one side,
and the DS approach on the other, a single brand of uncemented hip
prosthesis was implanted by two surgeons, considered expert in their
surgical approaches. Subsequent reflection of the gluteus maximus
allowed the extent of
Background. Previous work has identified differential kinematics and
Purpose. Even though various factors have been associated with neck pain, skeletal muscle mechanical properties have been cited among the leading causes of neck pain. Changes in skeletal muscle stiffness may be related to chronic neck pain and these changes may be associated with the severity of pain and disability in patients with chronic neck pain. The purpose of the present study was to investigate differences in neck
Purpose of the study. To assess the ability of magnetic resonance spectroscopy (MRS) to detect changes in spinal
Breast and other cancers commonly metastasize to bone to cause bone destruction, pain, fractures hypercalcemia and muscle weakness. Recently, we described a specific molecular mechanism by which bone-derived transforming growth factor (TGF)-beta, released as a consequence of tumor-induced bone destruction causes
Purpose & Background. The ability to jump higher is a key factor for athletic performance and relies on many factors including spinal movement and trunk
It has been shown that the bone, nerve, tendon, and
The purpose of this study was to compare lower limb
1. The effects of heavy training on a skeletal muscle have been studied in the rat. After denervation of the triceps surae
Purpose. Investigating the effects of femoral stem length on hip and knee
The response of the
Introduction. The inferior/medial shift in the center of rotation (CoR) associated with reverse shoulder arthroplasty (rTSA) shortens the anterior and posterior shoulder
We present the use of dynamic electromyographic analysis (DEMG) in the diagnosis of
We used an experimental rabbit model of leg lengthening to study the morphology and function of
Introduction: Neck pain often arises without any evident trauma suggesting that everyday loading may cause fatigue damage to spinal tissues. However, little is known about the forces acting on the cervical spine in everyday life. The purpose of this study was to determine spinal compressive forces using an electromyo-graphic (EMG) technique. Methods: Eight subjects performed a number of tasks while cervical flexion/extension and surface EMG activity of upper trapezius and sternocleidomastoid were measured. Dynamic EMG signals were corrected for contraction speed, using a correction factor obtained from lumbar
Dual mobility (DM) bearing implants reduce the incidence of dislocation following total hip arthroplasty (THA) and as such they are used for the treatment of hip instability in both primary and revision cases. The aim of this study was to compare lower limb
A histochemical analysis was made of 103
Background. Trunk
Summary. This study describes the use of a quasi-static, 6DOF knee loading simulator using cadaveric specimens.
Osteochondroplasty procedure for cam deformity provides excellent outcomes on alleviating pain, improving quality of life and clinical function in femoroacetabular impingement syndrome (FAIS) patients. Although medium-term outcomes on gait biomechanics have been reported, it is unclear how it would translate to better hip
Background. Loss of
Intact abductors of the hip play a crucial role
in preventing limping and are known to be damaged through the direct lateral
approach. The extent of trauma to the abductors after revision total
hip replacement (THR) is unknown. The aim of this prospective study
was to compare the pre- and post-operative status of the gluteus
medius
Physical outcome following total knee arthroplasty is variable. Satellite cells are undifferentiated myogenic precursors considered to be
Whilst a few studies have associated various symptoms with the presence of a peroneus quartus
Background:. The balance between the subscapularis
After big loos of substances of peripheral nerves, in order to connect proximal with distal stump, it is possible to use, in alternative to autologous grafting, different kind of conduits. The chitosan conduit and the
1. Direct injury to skeletal muscle results in fragmentation and necrosis of
Change in forearm
To compare the complication profile of a
Introduction. Reverse shoulder arthroplasty (rTSA) increases the deltoid abductor moment arm length to facilitate the restoration of arm elevation; however, rTSA is less effective at restoring external rotation. This analysis compares the
Background and Aim. Spinal stability is associated with low back pain and affects the spines ability to support loads. Stability can be achieved if the applied force follows the curvature of the spine, passing close to the vertebral centroids. Previously we showed that calculated
Physiological studies have revealed that the central nervous system controls groups of
To compare strength and recruitment of periarticular knee
Injury to
Purpose: Echinococciasis or hydatid disease is a cosmopolite anthropozoonosis common to many mammalian species including humans. The disease is caused by development of the larval form of a canine tenia called Echinococcus granulosus.
The Stanford Upper Extremity Model (SUEM) (Holzbauer, Murray, Delp 2005, Ann Biomed Eng) includes the major
Introduction. Total knee arthroplasty (TKA) is a well proven surgical procedure. Squat and gait motions are common activities in daily life. However, squat motion is known as most dissatisfying motion in activities in daily life after total knee arthroplasty (TKA). Dissatisfaction after TKA might refer to
To demonstrate the role of an antibiotic containing bone substitute, native bone active proteins and
This study examined the role of vitamin D as a factor accounting for fatty degeneration and
Aim. Simultaneous use of Ilizarov techniques with transfer of free
The dorsal interosseous