Rotator cuff tears are common, with failure rates of up to 94% for large and massive tears Optimisation samples of 15×10×5mm3, trialled as separate cancellous and cortical bone samples, were cut from porcine femoral condyles and shafts, respectively. Samples underwent 1-week progressive stepwise decellularisation and a partial demineralisation process of half wax embedding and acid bathing. Characterisations were performed histologically for the presence/absence of cellular staining in both peripheral and central tissue areas (n=3 for each cortical/cancellous, test/PBS control and peripheral/central group), and with BioDent reference point indentation (RPI) for pre- and post-processing mechanical properties. Histology revealed absent cellular staining in peripheral and central cancellous samples, whilst reduced in cortical samples compared to controls. Cancellous samples decreased in wet mass after decellularisation by 45.3% (p<0.001). RPI measurements associated with toughness (total indentation depth, indentation depth increase) and elasticity (1st cycle unloading slope) showed no consistent changes after decellularisation. X-rays confirmed half wax embedding provided predictable control of the mineralised-demineralised interface position. Initial optimisation trials show proof-of-concept of a soft-hard hybrid scaffold as an immune compatible xenograft for irreparable rotator cuff tears. Decellularisation did not appreciably affect mechanical properties, and further biological, structural and chemical characterisations are underway to assess validity before
Idiopathic Toe-walking (ITW) is a condition where children persistently walk on their toes in the absence of neurological or orthopaedic structural abnormalities. ITW affects 2% of children at the age of 5.5yr. This may eventually result in fixed ankle equinus. There is a paucity of long-term natural history studies in untreated ITW however persisting equinus contractures are implicated in common adult foot conditions. The Aim of this study is to show if the percentage of contact pressure through the hindfoot during standing and walking improve following surgical tendoachilles lengthening one year after surgery in children with ITW when compared to a normative cohort 23 patients (46 feet) diagnosed with ITW between 2017-2022; were treated with open zone III Achilles lengthening. We reported patient demographics, clinical resolution, or revision. Passive dorsiflexion range and hindfoot pressure percentage when standing and walking were measured on a baropodometric walkway and compared pre-operatively and at 12-18months postoperatively. We compared this to data from a previously studied normative cohort 87% of children had compete resolution of toe-walking. 3 had recurrence with 1 patient having a revision surgery. Mean pre-operative static heel pressure percentage was 15.7%, this improved to 54.7% (p<0.001). This neared normative average of 70.6%. Mean pre-operative dynamic heel pressure percentage was 5.5%, this improved to 44.6% (p<0.001). This neared the normative mean of 52.0%. Mean Passive dorsiflexion in extension and 90˚ knee flexion was −5.8˚ and 0.5˚ respectively. This improved on average by 17.4˚ and 14.5˚ to a new mean of 11.6˚ and 15.0˚ (p<0.001). Open Zone III Achilles lengthening for ITW has high resolution rates. Hindfoot contact pressures and passive ankle dorsiflexion show improvement at 1 year post operatively.
The scapholunate interosseous ligament (SLIL) has a unique C-shape following the arc of the scaphoid and lunate surfaces from distal dorsal around to distal volar. This ligament comprises of three subregions: dorsal, proximal and volar. The SLIL enthesis, a specialized region where this ligament attaches to the scaphoid and lunate, has not previously been studied despite its important mechanical function in the biomechanics of the wrist joint. This study therefore aims to compare the histomorphological differences between the SLIL subregions, including at their entheses. This study will examine the qualitative and quantitative differences between the three subregions, as well as between the scaphoid and lunate attachments. Twelve fresh-frozen human cadaveric wrists were dissected and the gross dimensions of each SLIL subregion measured. Subregions were then histologically processed for qualitative and quantitative morphological and compositional analyses, including quantification of enthesis calcified fibrocartilage (CF) area.Abstract
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To examine the effect of lateral spine curvature on somatosensory evoked potentials (SSEP) in patients with adolescent idiopathic scoliosis (AIS) compared to normal controls. We hypothesise that patients with AIS will show increased latency in their SSEPs when bending into their curve suggesting that their spinal cord is more sensitive to this increased lateral curvature. Patients were recruited from the paediatric scoliosis clinic in a single centre. Inclusion criteria were: diagnosis of AIS, age 10–18 years, major thoracic curve measuring greater than 10 degrees on Cobb measurement, and undergoing nonoperative management. Exclusion criteria were: any detectable neurologic deficit, and previous surgery on the brain or spine. SSEP recordings were obtained via stimulation of the posterior tibial nerve with surface electrode and measurement of the cortical response over the scalp. All recordings were performed three times: with the patient in neutral standing and maximum right and left side bending. SSEP recordings show that when AIS subjects bend into their curve, latency slows by an average of 0.5ms. However there was a bimodal distribution with most subjects showing minimal change (3ms). This subset was statistically different from both a control group, and the larger AIS group. There appears to be a subset of patients with AIS who have subclinical spinal cord dysfunction demonstrated by abnormal SSEPs. This may place these patients at slightly higher risk of neurologic injury at the time of surgery.
