This study aimed to investigate time-dependent gene expression
of injured human anterior cruciate ligament (ACL), and to evaluate
the histological changes of the ACL remnant in terms of cellular
characterisation. Injured human ACL tissues were harvested from 105 patients undergoing
primary ACL reconstruction and divided into four phases based on
the period from injury to surgery. Phase I was <
three weeks,
phase II was three to eight weeks, phase III was eight to 20 weeks,
and phase IV was ≥ 21 weeks. Gene expressions of these tissues were
analysed in each phase by quantitative real-time polymerase chain
reaction using selected markers (collagen types 1 and 3, biglycan,
decorin, α-smooth muscle actin, IL-6, TGF-β1, MMP-1, MMP-2 and TIMP-1).
Immunohistochemical staining was also performed using primary antibodies
against CD68, CD55, Stat3 and phosphorylated-Stat3 (P-Stat3). Objectives
Methods
Although good to excellent short-term results
of arthroscopic partial limbectomy of the hip have been reported, there
is little information on the long-term outcome of the procedure.
We report a case with a 16-year follow-up. A 34-year old woman presented with a three-month history of severe
pain and limitation of movement of the hip. Plain radiographs and
arthrography showed no abnormality. MRI showed an effusion and a
deformity of the anterosuperior part of the labrum. This was confirmed
as an inverted labral tear that was debrided arthroscopically. At 16 years post-operatively, she remained symptom-free. Plain
radiographs showed no abnormality and MRI suggested that the sealing
effect of the scar tissue prevented articular damage and degeneration.
We investigated the effect of locally administered bisphosphonate on distraction osteogenesis in a rabbit model and evaluated its systemic effect. An osteotomy on the right tibia followed by distraction for four weeks was performed on 47 immature rabbits. They were divided into seven equal groups, with each group receiving a different treatment regime. Saline and three types of dosage of alendronate (low, 0.75 μg/kg; mid, 7.5 μg/kg and high 75 μg/kg) were given by systemic injection in four groups, and saline and two dosages (low and mild) were delivered by local injection to the distraction gap in the remaining three groups. The injections were performed five times weekly during the period of distraction. After nine weeks the animals were killed and image analysis and mechanical testing were performed on the distracted right tibiae and the left tibiae which served as a control group. The local low-dose alendronate group showed a mean increase in bone mineral density of 124.3 mg/cm3 over the local saline group (analysis of variance, p <
0.05) without any adverse effect on the left control tibiae. The findings indicate that the administration of local low-dose alendronate could be an effective pharmacological means of improving bone formation in distraction osteogenesis.
There have been few descriptions of the site of attachment onto the triquetrum, the so-called meniscal homologue, of the triangular fibrocartilage complex (TFCC). We have investigated the sites of attachment onto the triquetrum of 87 TFCCs collected from embalmed cadavers. All TFCCs were smoothly attached to the triquetrum. In 79 (46 cases, 90%) they were attached to the triquetrum and fifth metacarpal bone, and in eight (5 cases, 10%) they were attached widely on the articular surface of the triquetrum. It is necessary to have accurate positional information about the normal triquetrum and TFCC in order to perform arthroscopy. The meniscal homologue attached to the triquetrum is smooth in almost all cases. In about 10% of joints the TFCC is attached to the lunotriquetral ligament, either partly or completely obscuring the articular surface of the triquetrum.
The clinical results of 26 digits (18 patients) lengthened by distraction callotasis were evaluated and the factors which influenced healing were analysed. There were 14 men and four women, with a mean age of 39 years. All digits had suffered traumatic amputation. There were eight thumbs and 18 fingers. The level of the site of the osteotomy was at the proximal metaphysis in ten, the middle diaphysis in 13 and the distal metaphysis in three. Although the proposed length was achieved in 23 of the 26 digits, five required additional bone grafts. The rate of healing was 96 days/cm in the digits without complications such as callus fracture or poor callus formation, and 158 days/cm in those with complications. Lengthening at the proximal metaphysis gave a better result than at the diaphysis or distal metaphysis.
