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Bone & Joint Research
Vol. 8, Issue 8 | Pages 357 - 366
1 Aug 2019
Lädermann A Tay E Collin P Piotton S Chiu C Michelet A Charbonnier C

Objectives

To date, no study has considered the impact of acromial morphology on shoulder range of movement (ROM). The purpose of our study was to evaluate the effects of lateralization of the centre of rotation (COR) and neck-shaft angle (NSA) on shoulder ROM after reverse shoulder arthroplasty (RSA) in patients with different scapular morphologies.

Methods

3D computer models were constructed from CT scans of 12 patients with a critical shoulder angle (CSA) of 25°, 30°, 35°, and 40°. For each model, shoulder ROM was evaluated at a NSA of 135° and 145°, and lateralization of 0 mm, 5 mm, and 10 mm for seven standardized movements: glenohumeral abduction, adduction, forward flexion, extension, internal rotation with the arm at 90° of abduction, as well as external rotation with the arm at 10° and 90° of abduction.


Objectives

Platelet-rich fibrin matrix (PRFM) has been proved to enhance tenocyte proliferation but has mixed results when used during rotator cuff repair. The optimal PRFM preparation protocol should be determined before clinical application. To screen the best PRFM to each individual’s tenocytes effectively, small-diameter culture wells should be used to increase variables. The gelling effect of PRFM will occur when small-diameter culture wells are used. A co-culture device should be designed to avoid this effect.

Methods

Tenocytes harvested during rotator cuff repair and blood from a healthy volunteer were used. Tenocytes were seeded in 96-, 24-, 12-, and six-well plates and co-culture devices. Appropriate volumes of PRFM, according to the surface area of each culture well, were treated with tenocytes for seven days. The co-culture device was designed to avoid the gelling effect that occurred in the small-diameter culture well. Cell proliferation was analyzed by water soluble tetrazolium-1 (WST-1) bioassay.


Orthopaedic Proceedings
Vol. 84-B, Issue SUPP_II | Pages 134 - 134
1 Jul 2002
Clatworthy M Chiu R Chiu C Minas T
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Introduction: We report one surgeon’s experience with autologous chondrocyte implantation (ACI) for the treatment of large chondral knee defects

Method: Over a five-year period, 295 chondral knee defects in 169 patients were treated with ACI. Most patients were complex having failed other treatments. Only 4% of patients had simple condylar lesions. Patients were followed prospectively. Patients were independently evaluated by an history, clinical examination, WOMAC score, Cincinnati Knee Score (CKS), IKDC, SF-36 and patient satisfaction scores administered pre-operatively and at 12, 24, 36 and 48 months post-operatively.

Results: Two hundred and sixty seven grafts (89%) were functioning well. The common causes for graft failure were poor graft incorporation and delamination, non-compliant rehabilitation and progressive osteoarthritis. Periosteal hypertrophy was present in 20% requiring arthroscopic debridement. All outcome measures improved significantly with time.

Conclusion: In a complex group of patients ACI showed encouraging results in the short term.