Academic literature on the topic 'Cartilage – Wounds and injuries – Treatment'
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Journal articles on the topic "Cartilage – Wounds and injuries – Treatment"
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Cvetanovich, Gregory, Alan Zhang, Brian Feeley, Brian Wolf, Carolyn Hettrich, C. Benjamin Ma, and Drew Lansdown. "Risk Factors for Intra-Articular Bone and Cartilage Lesions in Patients Undergoing Surgical Treatment for Posterior Instability." Orthopaedic Journal of Sports Medicine 8, no. 7_suppl6 (July 1, 2020): 2325967120S0037. http://dx.doi.org/10.1177/2325967120s00376.
Full textAbstract:
Objectives: Patients with posterior shoulder instability often present with significant differences in history of injury and complaints compared to anterior instability that can lead to challenges in diagnosis and treatment. These patients may have bone and cartilage lesions in addition to caspulolabral injuries, though the risk factors for these intra-articular lesions are unclear. The purpose of this study was to describe intraoperative incidence of glenohumeral bone and cartilage lesions in a cohort of patients undergoing primary posterior stabilization using data from a prospectively collected, multicenter shoulder instability cohort. We hypothesized that patients with traumatic posterior instability with greater number of instability events would have higher rate of bone and cartilage injuries compared to those without fewer instability episodes. Methods: Data from the Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Group instability patient cohort was utilized for this study. This is a multi-center study encompassing a prospective evaluation of patients ages 12 to 99 years of age undergoing primary surgical treatment for shoulder instability by 24 orthopedic surgeons at 11 sites in the United States. Demographic data and specifics regarding the patient’s instability history were recorded, including patient age, sex, body mass index (BMI), history of smoking, and Beighton score. The number of instability events was classified as 0, 1, 2 to 5, or more than 5. The duration of symptoms was classified as <1 month, 1-3 months, 4-6 months, 7-12 months, or greater than 1 year. The glenohumeral joint was evaluated by the treating surgeon at the time of surgical treatment for bone and cartilage injuries, and patients were classified as having a bone or cartilage lesion (BCL) if there was any grade 3 or 4 glenoid or humeral cartilage lesion, reverse Hill-Sachs lesion, bony Bankart lesion, or glenoid bone loss. The effects of number of instability events on the presence of BCLs was investigated using Fisher’s exact tests. Multivariate analysis using logistic regression modeling was performed to investigate the independent contributions of demographic variables and injury-specific variables to the likelihood of having a BCL. Significance was defined as p<0.05. Results: There were 271 patients identified for analysis. Bone and cartilage lesions were identified in 59 patients (21.8%) at the time of surgical treatment (Table 1). The most common lesion was a glenoid cartilage injury, which was identified in 28 patients (10.3%). Patients with BCLs were significantly older and had significantly higher BMI relative to patients without BCLs (Table 2). There was a significant difference between the number of instability events and the presence of BCLs (p = 0.035), with the highest rate observed in patients with 2-5 instability events (33.9%) (Figure 1). Through multivariate logistic regression modeling, increasing age (p=0.002), increasing BMI (p=0.012), and 2 to 5 reported instability events (p=0.001) were significant independent predictors of the presence of BCLs. Conclusion: Bone and cartilage lesions are seen significantly more frequently with increasing patient age, increasing BMI, and patients with 2-5 instability events. Early surgical stabilization for posterior instability may be considered to potentially limit the extent of associated intra-articular injury. [Table: see text][Table: see text][Figure: see text]
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Anderson, Devon E., Riley J. Williams, Thomas M. DeBerardino, Dean C. Taylor, C. Benjamin Ma, Marie S. Kane, and Dennis C. Crawford. "Magnetic Resonance Imaging Characterization and Clinical Outcomes After NeoCart Surgical Therapy as a Primary Reparative Treatment for Knee Cartilage Injuries." American Journal of Sports Medicine 45, no. 4 (January 9, 2017): 875–83. http://dx.doi.org/10.1177/0363546516677255.
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Background: Autologous cartilage tissue implants, including the NeoCart implant, are intended to repair focal articular cartilage lesions. Short-term results from United States Food and Drug Administration (FDA) phase I and phase II clinical trials indicated that the NeoCart implant was safe when surgically applied as a cell-based therapy and efficacious compared with microfracture. Hypothesis: Quantitative magnetic resonance imaging (MRI) analysis would reveal NeoCart tissue maturation through to 60-month follow-up. Study Design: Case series; Level of evidence, 4. Methods: Patients with symptomatic full-thickness cartilage lesions of the distal femoral condyle were treated with NeoCart in FDA clinical trials. Safety and efficacy were evaluated prospectively by MRI and clinical patient-reported outcomes (PROs) through to 60-month follow-up. Qualitative MRI metrics were quantified according to modified MOCART (magnetic resonance observation of cartilage repair tissue) criteria, with an independent evaluation of repair tissue signal intensity. Subjective PROs and objective range of motion (ROM) were obtained at baseline and through to 60 months. Results: Twenty-nine patients treated with NeoCart were observed over a mean of 52.0 ± 15.5 months (median, 60 months). MOCART analyses indicated significant improvement ( P < .001) in cartilage quality from 3 to 24 months, with stabilization from 24 to 60 months. Signal intensity of the repair tissue evolved from hyperintense at early follow-up to isointense after 6 months and to hypointense after 24 months. The temporal progression toward hypointense T2 signals at later time points observed here indicated a further reorganization of the repair tissue toward a dense tissue that was less similar to the surrounding native tissue. However, 80% of patients showed evidence of subchondral bone changes on MRI at all time points; 4 patients (14%) showed no improvement of MRI criteria. Compared with baseline values, significant improvement ( P < .001) was seen in PROs (mean [±SD] baseline to mean [±SD] final follow-up), including the International Knee Documentation Committee score (47.9 ± 17.4 to 75.5 ± 22.1), physical component summary of the Short Form–36 (40.5 ± 7.2 to 51.4 ± 8.1), and all 5 domains of the Knee injury and Osteoarthritis Outcome Score (Pain: 64.8 ± 12.1 to 86.1 ± 17.3; Activities of Daily Living: 75.5 ± 14.8 to 91.6 ± 13.8; Quality of Life: 28.6 ± 15.5 to 69.4 ± 28.0; Symptoms: 65.8 ± 13.8 to 86.6 ± 13.4; Sports and Recreation: 41.4 ± 24.3 to 72.4 ± 28.8). Significant ( P < .0001) decreases from baseline scores for the visual analog scale for pain (34.6 ± 22.5) were seen by 6 months and sustained at final follow-up (14.3 ± 18.4). ROM significantly ( P < .0001) improved from baseline (131.5° ± 7.9°) to final follow-up (140.7° ± 6.3°). Conclusion: Longitudinal MRI analysis demonstrated that NeoCart-based repair tissue is durable and evolves over time. For a majority of patients, this progression trended from an initial hyperintense signal to a hypointense signal at later follow-ups. Changes in radiographic measures over time corresponded with improvement in clinical measures, with maximum benefits experienced at 24-month follow-up. Similarly, clinical efficacy for the total cohort, determined by clinical outcome scores, reached a maximum at 24 months without decline to 60 months. Results from safety and exploratory clinical trials indicate that NeoCart is a safe and effective treatment for articular cartilage lesions through to 5-year follow-up. Registration: NCT00548119 ( ClinicalTrials.gov identifier).
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Alepuz, Eduardo Sánchez, Jaime Alonso Pérez-Barquero, Nadia Jover Jorge, Francisco Lucas García, and Vicente Carratalá Baixauli. "Treatment of The Posterior Unstable Shoulder." Open Orthopaedics Journal 11, no. 1 (August 31, 2017): 826–47. http://dx.doi.org/10.2174/1874325001711010826.
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Background:It is estimated that approximately 5% of glenohumeral instabilities are posterior. There are a number of controversies regarding therapeutic approaches for these patients.Methods:We analyse the main surgery alternatives for the treatment of the posterior shoulder instability. We did a research of the publications related with posterior glenohumeral instability.Results:There are conservative and surgical treatment options. Conservative treatment has positive results in most patients, with around 65 to 80% of cases showing recurrent posterior dislocation.There are multiple surgical techniques, both open and arthroscopic, for the treatment of posterior glenohumeral instability. There are procedures that aim to repair bone defects and others that aim to repair soft tissues and capsulolabral injuries. The treatment should be planned according to each case on an individual basis according to the patient characteristics and the injury type.Surgical treatment is indicated in patients with functional limitations arising from instability and/or pain that have not improved with rehabilitation treatment.The indications for arthroscopic treatment are recurrent posterior subluxation caused by injury of the labrum or the capsulolabral complex; recurrent posterior subluxation caused by capsuloligamentous laxity or capsular redundancy; and multidirectional instability with posterior instability as a primary component. Arthroscopic assessment will help identify potential injuries associated with posterior instability such as bone lesions or defects and lesions or defects of soft tissues.The main indications for open surgery would be in cases of Hill Sachs lesions or broad reverse Bankart lesions not accessible by arthroscopy.We indicated non-anatomical techniques (McLaughlin or its modifications) for reverse Hill-Sachs lesions with impairment of the articular surface between 20% and 50%. Disimpaction of the fracture and placement of bone graft (allograft or autograft) is a suitable treatment for acute lesions that do not exceed 50% of the articular surface and with articular cartilage in good condition. Reconstruction with allograft may be useful in lesions affecting up to 50% of the humeral surface and should be considered when there is a situation of non-viable cartilage at the fracture site. For defects greater than 50% of the articular surface or in the case of dislocations over 6 months in duration where there is poor bone quality, some authors advocate substitution techniques as a treatment of choice. The main techniques for treating glenoid bone defects are posterior bone block and posterior opening osteotomy of the glenoid.Conclusions:The treatment of the posterior glenohumeral instability has to be individualized based on the patient´s injuries, medical history, clinical exam and goals. The most important complications in the treatment of posterior glenohumeral instability are recurrent instability, avascular necrosis and osteoarthritis.
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Brophy, Robert H., Laura J. Huston, Isaac Briskin, Annunziato Amendola, Charles L. Cox, Warren R. Dunn, David C. Flanigan, et al. "Articular Cartilage and Meniscus Predictors of Patient-Reported Outcomes 10 Years After Anterior Cruciate Ligament Reconstruction: A Multicenter Cohort Study." American Journal of Sports Medicine 49, no. 11 (July 29, 2021): 2878–88. http://dx.doi.org/10.1177/03635465211028247.
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Background: Articular cartilage and meniscal damage are commonly encountered and often treated at the time of anterior cruciate ligament reconstruction (ACLR). Our understanding of how these injuries and their treatment relate to outcomes of ACLR is still evolving. Hypothesis/Purpose: The purpose of this study was to assess whether articular cartilage and meniscal variables are predictive of 10-year outcomes after ACLR. We hypothesized that articular cartilage lesions and meniscal tears and treatment would be predictors of the International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score (KOOS) (all 5 subscales), and Marx activity level outcomes at 10-year follow-up after ACLR. Study Design: Cohort study (prognosis); Level of evidence, 1. Methods: Between 2002 and 2008, individuals with ACLR were prospectively enrolled and followed longitudinally using the IKDC, KOOS, and Marx activity score completed at entry, 2, 6, and 10 years. A proportional odds logistic regression model was built incorporating variables from patient characteristics, surgical technique, articular cartilage injuries, and meniscal tears and treatment to determine the predictors (risk factors) of IKDC, KOOS, and Marx outcomes at 10 years. Results: A total of 3273 patients were enrolled (56% male; median age, 23 years at time of enrollment). Ten-year follow-up was obtained on 79% (2575/3273) of the cohort. Incidence of concomitant pathology at the time of surgery consisted of the following: articular cartilage (medial femoral condyle [MFC], 22%; lateral femoral condyle [LFC], 15%; medial tibial plateau [MTP], 4%; lateral tibial plateau [LTP], 11%; patella, 18%; trochlea, 8%) and meniscal pathology (medial, 37%; lateral, 46%). Variables that were predictive of poorer 10-year outcomes included articular cartilage damage in the patellofemoral ( P < .01) and medial ( P < .05) compartments and previous medial meniscal surgery (7% of knees; P < .04). Compared with no meniscal tear, a meniscal injury was not associated with 10-year outcomes. Medial meniscal repair at the time of ACLR was associated with worse 10-year outcomes for 2 of 5 KOOS subscales, while a medial meniscal repair in knees with grade 2 MFC chondrosis was associated with better outcomes on 2 KOOS subscales. Conclusion: Articular cartilage injury in the patellofemoral and medial compartments at the time of ACLR and a history of medial meniscal surgery before ACLR were associated with poorer 10-year ACLR patient-reported outcomes, but meniscal injury present at the time of ACLR was not. There was limited and conflicting association of medial meniscal repair with these outcomes.
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McIntyre, James Alexander, Ian A. Jones, Alla Danilkovich, and C. Thomas Vangsness. "The Placenta: Applications in Orthopaedic Sports Medicine." American Journal of Sports Medicine 46, no. 1 (April 4, 2017): 234–47. http://dx.doi.org/10.1177/0363546517697682.
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Background: Placenta has a long history of use for treating burns and wounds. It is a rich source of collagen and other extracellular matrix proteins, tissue reparative growth factors, and stem cells, including mesenchymal stem cells (MSCs). Recent data show its therapeutic potential for orthopaedic sports medicine indications. Purpose: To provide orthopaedic surgeons with an anatomic description of the placenta, to characterize its cellular composition, and to review the literature reporting the use of placenta-derived cells and placental tissue allografts for orthopaedic sports medicine indications in animal models and in humans. Study Design: Systematic review. Methods: Using a total of 63 keyword combinations, the PubMed and MEDLINE databases were searched for published articles describing the use of placental cells and/or tissue for orthopaedic sports medicine indications. Information was collected on placental tissue type, indications, animal model, study design, treatment regimen, safety, and efficacy outcomes. Results were categorized by indication and subcategorized by animal model. Results: Outcomes for 29 animal studies and 6 human studies reporting the use of placenta-derived therapeutics were generally positive; however, the placental tissue source, clinical indication, and administration route were highly variable across these studies. Fourteen animal studies described the use of placental tissue for tendon injuries, 13 studies for osteoarthritis or articular cartilage injuries, 3 for ligament injuries, and 1 for synovitis. Both placenta-derived culture-expanded cells (epithelial cells or MSCs) and placental tissue allografts were used in animal studies. In all human studies, commercial placental allografts were used. Five of 6 human studies examined the treatment of foot and ankle pathological conditions, and 1 studied the treatment of knee osteoarthritis. Conclusion: A review of the small number of reported studies revealed a high degree of variability in placental cell types, placental tissue preparation, routes of administration, and treatment regimens, which prohibits making any definitive conclusions. Currently, the clinical use of placenta is limited to only commercial placental tissue allografts, as there are no placenta-derived biological drugs approved for the treatment of orthopaedic sports medicine conditions in the United States. However, this review shows that the application of placental cells or tissue allografts appears to be safe and has potential to improve outcomes for orthopaedic sports medicine indications.
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Mikheev, Mikheev V., and Sergey N. Trushin. "A clinical case of successful treatment of complete abruption of the trachea from the larynx." I.P. Pavlov Russian Medical Biological Herald 29, no. 1 (March 15, 2021): 117–24. http://dx.doi.org/10.23888/pavlovj2021291117-124.
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Tracheobronchial injuries as a consequence of chest blunt trauma are rare. Blunt traumas of the cervical part of the trachea are a rarer pathology presenting a serious diagnostic problem for a clinician. Traumas of the larynx and the trachea account for 40 to 80% of lethality. The tracheas cervical part is vulnerable despite that it is covered with the neck muscles, spine, clavicles, and mandible. In cut/stab wounds, the tracheas cervical part is often damaged together with the adjacent structures. In blunt trauma, under a direct action of a traumatizing agent, the mobile trachea displaces toward the spine, accompanied by damage to the tracheal cartilages, its membranous part, and the soft surrounding tissues with preservation of the integrity of the skin.
Tracheal ruptures along the distance up to 1 cm from the cricoid cartilage account for not more than 4% of all tracheal ruptures. A complete tracheal rupture and its abruption from the larynx are extremely rare pathology. Because of severe respiratory disorders, most victims die at the site where their injury occurred.
This article presents a clinical case of the successful treatment of patient Z., 41 years of age, with complete tracheal abruption from the larynx. The cause of tracheal damage was blunt neck trauma in a traffic accident. A peculiarity of this clinical case was that the victim arrived at a specialized thoracic surgery unit with a functioning tracheostomy two days after the trauma.
Conclusion. Tracheal trauma is a potentially fatal condition. Therefore, early diagnosis of tracheobronchial damage is essential since it permits timely surgical intervention and diminished risk of lethal outcome. When dealing with patients with trauma of the head, neck, and chest with non-corresponding clinical data and the absence of effective recommended standard therapeutic measures, a clinician should become alert and exclude the tracheal and bronchial damage.
X-ray computed tomography and fibrotracheobronchoscopy are strongly recommended as reliable methods to diagnose tracheobronchial damages. In a surgical intervention, it is necessary to perform the primary suture on the trachea, avoid preventive tracheostomy, and delay interventions associated with poorer prognosis and a high complication rate.
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Lansdown, Drew A., Gregory L. Cvetanovich, Alan L. Zhang, Brian T. Feeley, Brian R. Wolf, Carolyn M. Hettrich, Keith M. Baumgarten, et al. "Risk Factors for Intra-articular Bone and Cartilage Lesions in Patients Undergoing Surgical Treatment for Posterior Instability." American Journal of Sports Medicine 48, no. 5 (March 9, 2020): 1207–12. http://dx.doi.org/10.1177/0363546520907916.
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Background: Patients with posterior shoulder instability may have bone and cartilage lesions (BCLs) in addition to capsulolabral injuries, although the risk factors for these intra-articular lesions are unclear. Hypothesis: We hypothesized that patients with posterior instability who had a greater number of instability events would have a higher rate of BCLs compared with patients who had fewer instability episodes. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Data from the Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Group instability patient cohort were analyzed. Patients aged 12 to 99 years undergoing primary surgical treatment for shoulder instability were included. The glenohumeral joint was evaluated by the treating surgeon at the time of surgery, and patients were classified as having a BCL if they had any grade 3 or 4 glenoid or humeral cartilage lesion, reverse Hill-Sachs lesion, bony Bankart lesion, or glenoid bone loss. The effects of the number of instability events on the presence of BCLs was investigated by use of Fisher exact tests. Logistic regression modeling was performed to investigate the independent contributions of demographic variables and injury-specific variables to the likelihood of having a BCL. Significance was defined as P < .05. Results: We identified 271 patients (223 male) for analysis. Bone and cartilage lesions were identified in 54 patients (19.9%) at the time of surgical treatment. A glenoid cartilage injury was most common and was identified in 28 patients (10.3%). A significant difference was noted between the number of instability events and the presence of BCLs ( P = .025), with the highest rate observed in patients with 2 to 5 instability events (32.3%). Multivariate logistic regression modeling indicated that increasing age ( P = .019) and 2 to 5 reported instability events ( P = .001) were significant independent predictors of the presence of BCLs. For bone lesions alone, the number of instability events was the only significant independent predictor; increased risk of bone lesion was present for patients with 1 instability event (OR, 6.1; P = .012), patients with 2 to 5 instability events (OR, 4.2; P = .033), and patients with more than 5 instability events (OR, 6.0; P = .011). Conclusion: Bone and cartilage lesions are seen significantly more frequently with increasing patient age and in patients with 2 to 5 instability events. Early surgical stabilization for posterior instability may be considered to potentially limit the extent of associated intra-articular injury. The group of patients with more than 5 instability events may represent a different pathological condition, as this group showed a decrease in the likelihood of cartilage injury, although not bony injury.
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Bednarski, Piotr, and Karolina Piekarska. "Traumatic Knee Injuries: Analysis of Reporting Data from the Period 2016-2018 Using API Interface of Polish National Health Fund Statistics." Ortopedia Traumatologia Rehabilitacja 22, no. 4 (August 31, 2020): 263–72. http://dx.doi.org/10.5604/01.3001.0014.3462.
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Background. According to WHO statistics, injuries are among the main causes of contemporary health problems. Injury statistics have been showing a continuing upward trend over years. This is due to numerous factors, such as technological progress, increased life expectancy, change of lifestyle, growing popularity of sports and changes in working conditions. The structures affected by injuries within the knee joint include the ligaments, menisci, articular cartilage and patellar retinacula, with the most common injuries being those to the ligamentous apparatus and menisci. The main objective of this paper is to determine the number of patients hospitalised due to a primary knee injury. Material and methods. Determination of the number of patients hospitalised due to a primary knee injury was performed using the API Interface of National Health Fund (NFZ) Statistics-Benefits Version 1.0. The process of acquiring information on the number of patients consisted of four stages: preparation of a list of primary diagnoses according to ICD-10 classification, analysis of the ordinances of the President of NFZ concerning the conclusion and implementation of contracts on hospital treatment to select products that could be used to bill hospitalisation of patients with selected types of diagnosis, generating medical data using the API Interface of National Health Fund Statistics–Benefits and analysis of reporting data obtained. Results. According to data reported to NFZ, a total of 101,773 patients were hospitalised due to traumatic knee injuries over the period of three years (2016–2018), which gives an average of ca. 34,000 patients annually. Conclusions. 1. Knee injuries represent a very serious health problem in Poland. 2. Knee injuries most frequently affect the ligaments and menisci. 3. It seems necessary to develop a complete nation-wide database with up-to-date information on injuries in Poland that would enable providers to adapt medical services to the current needs of the patients.
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Klein, Céline, Plancq Marie-Christine, François Deroussen, Elodie Haraux, and Richard Gouron. "Treatment options for soft tissue defects in severe foot trauma in children." Journal of Wound Care 30, no. 6 (June 2, 2021): 432–38. http://dx.doi.org/10.12968/jowc.2021.30.6.432.
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Objective: Severe foot trauma in children is a therapeutic challenge, with presence of devitalised and soiled distal tissues. Several reconstruction and covering procedures can be applied, including artificial dermis (AD), negative pressure wound therapy (NPWT), fasciocutaneous flaps and free flaps. Here, we have developed and evaluated an algorithm for treating severe foot injuries with skin defects in children Method: Paediatric cases of severe foot injury treated over a 16-year period were retrospectively reviewed. Characteristics of the injuries, surgical procedures, complications and the modified Kitaoka score (clinical and functional rating score of the ankle and foot) were recorded. Results: A total of 18 children were included. The mean age at the time of injury was four years and 10 months (range: 1–11 years). The mean follow-up period was 6.2 years. Of the children, 13 presented with an amputation (12 partial foot amputations and one whole ankle and foot). The skin defect was combined with tendon exposure in nine cases, and/or bone and cartilage in seven cases, and heel damage in two cases. A flap was implemented in eight cases, of which one failed. NPWT was used in 13 patients (for an average of 21 days) and was combined with AD in six patients. The mean modified Kitaoka score was 68 (range: 55–80). Additional surgery during the follow-up period was required in seven patients (dorsal skin retraction, a thick flap, osteoma, trophic ulcer or ankle deviation). Conclusion: Our algorithm suggests different therapeutic strategies for skin coverage and healing, depending on the size of the lesion and the exposed structures, and seems to offer good results. These procedures should be combined with NPWT to optimise these results (improved healing, reduced infections, decreased skin defects and enhanced granulation tissue) and so should be used more frequently.
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Westermann, Robert W., Kurt P. Spindler, Carolyn M. Hettrich, and Brian R. Wolf. "Outcomes Following ACL and Grade III MCL Injuries." Orthopaedic Journal of Sports Medicine 5, no. 3_suppl3 (March 1, 2017): 2325967117S0012. http://dx.doi.org/10.1177/2325967117s00126.
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Objectives: Complete disruptions of the medial collateral ligament (MCL) are rare, but do occur with anterior cruciate ligament (ACL) tears. Complete ACL/MCL injuries may be managed with ACL reconstruction and either conservative or operative treatment of the MCL. MCL tear location has also been associated with outcome. We hypothesized that outcomes would be best with acute surgery and worse with proximal MCL tears.We also hypothesized that operative management of MCL injuries would not influence outcome. Methods: Patients enrolled in a multicenter prospective longitudinal cohort who underwent unilateral primary ACL reconstruction between 2002-2008 and who had 2-year follow-up were evaluated. Patients with concomitant grade III MCL injuries treated either operatively or non-operatively were identified. Concurrent injuries (to meniscus or articular cartilage) and subsequent surgeries were documented. Comparisons of surgical chronicity (before and after 30 days from injury) and MCL tear location (femoral or tibial) were performed. Patient reported outcomes (KOOS, IKDC and Marx activity scores) were measured at the time of ACL reconstruction and at 2-year follow-up. Results: Initially, 3028 patients were identified to have undergone primary ACL reconstruction in the cohort during the identified time frame, with 2586 patients completing 2-year follow-up (85%). Complete MCL tears were documented in 1.1% (27/2586) of the cohort: 16 operatively managed patients and 11 conservatively treated MCLs during ACL reconstruction. Concurrent articular pathology was similar between groups. Clinically important differences were seen in baseline KOOS (all subscales) and IKDC scores, with lower scores seen in patients who underwent operative MCL treatment. Reoperation for arthrofibrosis was higher after operative repair of the MCL (19%) versus nonoperative treatment (9%). At 2 years the non-operative MCL cohort maintained significantly better KOOS Sports Rec (88.2 versus 74.4), KOOS QOL (81.3 versus 68.4), and IKDC (87.6 versus 76.0) scores compared to the MCL surgery group. Marx activity scores were equal between groups at the time of study enrollment, however patients who underwent operative MCL management had lower activity scores at 2 years (6.5 versus 10.7). Tibial-sided MCL injuries were associated with worse baseline outcomes compared with femoral-sided MCL injuries in terms of KOOS ADL, Sports Rec, and QOL subscales, but these differences were resolved by 2 years. Surgical chronicity did not influence 2-year outcome. Conclusion: Complete and combined ACL/MCL injuries are rare. Both operative and nonoperative management of MCL tears in our cohort demonstrated clinical improvements between study enrollment and 2-year follow-up. MCL surgery during ACL reconstruction was associated with more frequent stiffness, worse patient-reported outcomes and lower activity at 2 years. There may be a subset of patients with severe combined ACL and medial knee injuries that may benefit from operative management, however, that patient population has yet to be defined.
Dissertations / Theses on the topic "Cartilage – Wounds and injuries – Treatment"
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Lin, Zhen. "Chondrocyte : a target for the treatment of osteoarthritis." University of Western Australia. Orthopaedics Unit, 2007. http://theses.library.uwa.edu.au/adt-WU2007.0203.
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[Truncated abstract] Osteoarthritis (OA) is the most common form of arthritis, characterized by progressively degeneration of articular cartilage. Chondrocyte is the only cell type in articular cartilage tissue and responsible for cartilage matrix turnover. This thesis focuses on the biological and genetic behaviors of human chondrocyte and potential therapeutic strategies that target on chondrocyte. Chondrocytes have been used for the tissue-engineered cartilage construction, especially in articular cartilage repair. The technique of chondrocyte-base tissue engineering utilizes in vitro propagated chondrocytes combined with several manufactured biomaterials to regenerate cartilage tissue. Although these technologies have been successfully applied in clinic, the biological characteristics of chondrocyte during in vitro propagation and after implantation remain unclear. This thesis reviewed the present studies of chondrocyte biology and its potential uses in tissue engineering. Particularly, chondrocytes have been shown to de-differentiate into fibroblastic-cells when they are exposed to inflammatory conditions or cultured on monolayer in vitro. This thesis investigated the gene expression profile of chondrocytes when they are cultured and serially passaged on monolayer in vitro. Human chondrocytes obtained from OA patients were cultured up to passage 6. Twenty-eight chondrocyte associated genes were measured by Real-time PCR. The results showed that a number of genes were changed in expression levels at various stages of passage as indications of chondrocyte de-differentiation. Chondrocytes derived from OA patients or normal donors exhibited a very similar gene expression pattern. Interestingly, transcription factor Sox-9, which plays a key role in chondrogenesis remained unchanged with increasing passage number, indicating that the de-differentiation process of chondrocyte is reversible. This thesis also focused on the development of novel pharmacological approaches for OA that target on articular chondrocyte. The clinical feature, etiology, pathogenesis, diagnostic approaches, conventional and potential future treatments for OA were briefly reviewed in this thesis. ... The effects of natural compounds on chondrocyte gene expression, proteoglycan degradation and nitric oxide production were measured. The results showed that parthenolide, a NF-kB inhibitor, regulated chondrocyte function by suppressing the up-regulation of gene expression of inflammatory factors and matrix proteinases induced by lipopolysaccharide, and down-regulating COX-2 expression. Parthenolide was able to reduce proteoglycan degradation in human chondrocytes, but had no effect on nitric oxide production. These results suggest that parthenolide mediates inflammatory-activated NF-kB pathway, and subsequently reduces inflammatory response, prevents cartilage destruction and relieves pain, and hence may be useful for OA treatment.
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Robertson, William Brett. "Functional and radiological evaluation of autologous chondrocyte implantation using a type I/III collagen membrane: from single defect treatment to early osteoarthritis." University of Western Australia. Orthopaedics Unit, 2007. http://theses.library.uwa.edu.au/adt-WU2007.0172.
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[Truncated abstract] Hyaline articular cartilage is a highly specialised tissue consisting of chondrocytes embedded in a matrix of proteoglycan and collagens. Hyaline articular cartilage withstands high levels of mechanical stress and continuously renews its extracellular matrix. Despite this durability, mature articular cartilage is vulnerable to injury and disease processes that cause irreparable tissue damage. Native hyaline articular cartilage has poor regenerative capacity following injury, largely due to the tissue's lack of blood and lymphatic supply, as well as the inability of native chondrocytes to migrate through the dense extracellular matrix into the defect site. Articular cartilage injuries that fail to penetrate the subchondral bone plate evoke only a short-lived metabolic and enzymatic response, which fails to provide sufficient new cells or matrix to repair even minimal damage. Clinically, it has previously been accepted that treatment of such defects does not result in the restoration of normal hyaline articular cartilage, which is able to withstand the mechanical demands that are placed on the joint during every day activities of daily living. ... Historically, rehabilitation following ACI has not kept pace with the advances in cell culture and surgical technique. Subsequently, there exists a significant gap in knowledge regarding `best practice' in post operative rehabilitation following ACI. The importance of structured rehabilitation in ACI should not be underestimated when evaluating the clinical success of this chondral treatment. Patients should not be left to their own devices following ACI surgery, as the risk of damage to their implant (via delamination) is high if immediate postoperative movement is not controlled. Furthermore, the biological longevity and clinical success of the graft is dependent on a controlled and graduated return to ambulation and physical activity, and the biomechanical stimulation of the implanted chondrocytes.
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Ebert, Jay Robert. "Post-operative load bearing rehabilitation following autologous chondrocyte implantation." University of Western Australia. School of Sport Science, Exercise and Health, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0196.
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[Truncated abstract] Autologous Chondrocyte Implantation (ACI) has shown early clinical success as a repair procedure to address focal articular cartilage defects in the knee, and involves isolating and culturing a patient's own chondrocytes in vitro and re-implantation of those cells into the cartilage defect. Over time, repair tissue can develop and remodel into hyaline-like cartilage. A progressive partial weight bearing (PWB) program becomes the critical factor in applying protection and progressive stimulation of the implanted cells, to promote best chondrocyte differentiation and development, without overloading the graft. The aim of this thesis was to investigate whether patients could replicate this theoretical load bearing model to possibly render the best quality tissue development. In addition, this proposed external load progression is only a means to loading the articular surface. Several factors, including those that may result from pathology, have the potential to influence gait patterns, and therefore, articular loading. The association between increasing external loads (ground reaction forces - GRF) and knee joint kinetics during partial and full weight bearing gait was, therefore, investigated in the ACI patient group, as was the contribution of other gait variables to these knee joint kinetics which may be modified by the clinician. Finally, current weight bearing (WB) protocols have been based on early ACI surgical techniques. With advancement in the surgical procedure and ongoing clinical experience, we employed a randomised controlled clinical trial to assess the effectiveness of an 'accelerated' load bearing program, compared with the traditionally 'conservative' post-operative protocol. ... Although similar spatio-temporal, knee kinematic and external loading parameters were observed between the traditional and accelerated rehabilitation groups, the accelerated group was 'more comparable' to the controls in their external knee adduction and flexion moments, where the traditional group had lower knee moments. Knee moments greatly affect knee articular loading, and large adduction moments have been related to poor clinical outcomes after surgery. Therefore, the return of normal levels may be ideal for graft stimulation, however, may overload the immature chondrocytes. Acceleration of the intensive rehabilitation program will enable the patient to return to normal activities earlier, whilst reducing time and expenses associated with the rehabilitative process, and may enhance long-term tissue development. However, continued follow-up is required to determine if there are any detrimental effects that may emerge as a result of the accelerated load bearing program, and assess the recovery of normal gait patterns and whether longer term graft outcomes are affected by the recovery time course of normal gait function, and/or abnormal loading mechanics in gait. Furthermore, analysis at all levels of PWB is needed to identify a more complete set of variables attributing to the magnitude of external knee joint kinetics and, therefore, knee articular loading, while the influence muscle activation patterns may have on articular loading needs to be investigated. This becomes critical when you consider loads experienced by the articular surface throughout the early post-operative period following ACI may be important to short- and long-term graft development.
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Watts, Russell Edward. "Evaluation of DETA as a surface treatment to enhance neuronal attachment to a silicone-based substrate." Thesis, Georgia Institute of Technology, 2001. http://hdl.handle.net/1853/16905.
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Granger, Nicolas. "Effects of intraspinal transplantation of mucosal olfactory ensheathing cells in chronic spinal cord injury in domestic dogs." Thesis, University of Cambridge, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.608161.
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Leung, Ka-kit Gilberto, and 梁嘉傑. "Applications of self-assembling peptide nanofibre scaffold and mesenchymal stem cell graft in surgery-induced brain injury." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206347.
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Surgery-induced brain injury (SBI) refers to trauma caused by routine neurosurgical procedures that may result in post-operative complications and neurological deficits. Unlike accidental trauma, SBI is potentially subject to preemptive interventions at the time of surgery. SBI can cause bleeding, inflammation and the formation of tissue gaps. Conventional haemostatic techniques, though effective, are not necessarily conducive to healing. Inflammation and the absence of extracellular matrix in tissue gaps also hinder regeneration after SBI. This study investigated the applications of RADA16-I, a type I self-assembling peptide nanofibre scaffold (SAPNS), and mesenchymal stem cells (MSCs) in the treatment of SBI. Using animal SBI models, treatments were applied immediately and locally onto the operative fields, taking advantages of the haemostatic and cell-carrying properties of RADA16-I, the immune- modulatory effects of MSCs, and the earliest available therapeutic window for SBI.
There were three objectives. Objective 1 was to compare RADA16-I with conventional haemostatic methods, including electrocautery and fibrin sealant, in their effects on the brain’s acute cellular inflammatory response. The hypothesis was that RADA16-I would cause the same or a lesser degree of inflammation. This study showed that RADA16-I was superior to electrocautery, and was noninferior to conventional topical haemostats.
Objective 2 was to study the in vitro expansion of MSCs within RADA16-I in preparation for in vivo transplantation. The hypothesis was that the in vitro survival of MSCs would vary between different RADA16-I concentrations and culturing methods. This study showed that plating MSCs onto pre-buffered RADA16-I would protect the cells against RADA16-I’s intrinsic acidity and result in better initial survival. Subsequent integration with the RADA16-I hydrogel, however, was poor. Mixing the cells directly with RADA16-I caused initial cell loss but allowed better integration. RADA16-I at lower concentrations resulted in better survival but also more fragile hydrogels that were mechanically unfit for transplantation. Mixing MSCs with 0.5% RADA16-I for seven days represented a compromise between these competing factors.
Objective 3 was to study the in vivo effects of a MSC-RADA16-I implant on tissue reactions after SBI. The hypothesis was that the combinatorial therapy would result in less cellular inflammatory response than MSC alone or RADA16-I alone. Implants of pre-buffered 0.5% RADA16-I hydrogel, with or without cells, were found to cause less inflammation than control. MSCs in free suspension resulted in significantly more pronounced inflammation than when carried in RADA16-I. Supplementing RADA16-I with MSCs, however, did not confer additional benefit over RADA16-I alone.
The present study provided new preclinical evidence to support future clinical testing of RADA16-I as a novel surgical haemostat. It also demonstrated the feasibility of early intracerebral transplantation of RADA16-I hydrogel in the treatment of SBI. Whether RADA16-I and/or transplanted MSCs could modulate the brain’s inflammatory response after SBI require further investigations, which may include the search for the optimal ex vivo expansion technique and specifically tailored nanofibre scaffold. The translational applications of these findings would include the treatment of SBI over critical brain regions where trauma would cause severe functional deficits and where better healing would facilitate patient recovery.published_or_final_version
Anatomy
Doctoral
Doctor of Philosophy
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Basey, Adriana L. "Effects of a traditional and modified straight straight leg raise on EMG characteristics." Virtual Press, 1997. http://liblink.bsu.edu/uhtbin/catkey/1048378.
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The purpose of this study was to determine the vastus medialis oblique muscular electromyographical (EMG) activity during two therapeutic exercises: the modified straight leg raise and the traditional straight leg raise. Two subject groups of 10 subjects each, one with anterior knee pain (PHY) and the other group with no history of patellofemoral pathology (NORM), performed the traditional straight leg raise (SLR) and a modified straight leg raise with external hip rotation (MOD). Each subject performed an isometric maximum voluntary contraction and three trials of each of the two therapeutic exercises. The EMG variables analyzed were the percent of the maximum voluntary contraction for each muscle, vastus medialis oblique, vastus lateralis, and rectus femoris: the percent of the maximum voluntary contraction of the ratio between the vastus medialis oblique and the vastus lateralis; the percent of the maximum voluntary contraction for the integrated EMG for each muscle; and the percent of the maximum voluntary contraction for the root mean square for each muscle. The statistical analysis was conducted with two-way analysis of variance procedures. The statistical analysis revealed no significant differences; however, the data appeared to illustrate a trend toward more electromyographical activity in the vastus medialis oblique in the PHY subject group during the MOD therapeutic exercise. This suggests that the MOD therapeutic exercise may be able to isolate the vastus medialis oblique muscle in persons with anterior knee pain and allow them to regain strength and normal function earlier than with the use of the SLR therapeutic exercise.School of Physical Education
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Rodling, Wahlström Marie. "Severe cerebral emergency aspects of treatment and outcome in the intensive care patient /." Umeå Umeå universitet, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-21065.
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Aderem, Jodi. "The biomechanical risk factors associated with preventing and managing iliotibial band syndrome in runners : a systematic review." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/96803.
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Thesis (MScPhysio)--Stellenbosch University, 2015.ENGLISH ABSTRACT: Introduction: Iliotibial band syndrome (ITBS), an overuse injury, is the second most common running injury and the main cause of lateral knee pain in runners. Due to the increasing number of runners worldwide there has been an increase in its occurrence. Runners with ITBS typically experience symptoms just after heel strike at approximately 20°-30° of knee flexion (impingement zone) during the stance phase of running. A variety of intrinsic and extrinsic risk factors may be responsible for why some runners are more prone to developing symptoms during the impingement zone as opposed to others. Abnormalities in running biomechanics is an intrinsic risk factor which has been most extensively described in literature but little is known about its exact relationship to ITBS. Objectives: The purpose of this systematic review was to provide an up to date evidence synthesis of the biomechanical risk factors associated with ITBS. These risk factors may need to be considered in the prevention or management of ITBS in runners. A clinical algorithm is also presented. Methods: A systematic review with meta-analysis was conducted. An electronic search was performed in PubMed, PEDro, SPORTSDisc and Scopus of literature published up-until May 2014. Cross-sectional and cohort studies were eligible for inclusion if they evaluated the lower limb biomechanics of runners with ITBS or those who went onto developing it. All studies included in the review were methodologically appraised. Evidence was graded according to the level of evidence, consistency of evidence and the clinical impact. Data was described narratively using tables or narrative summaries where appropriate. A meta-analysis was conducted for biomechanical risk factors which were reported in at least two studies, provided that homogeneity in the outcomes and samples were present. Results: A total of 11 studies were included (1 prospective and 10 cross-sectional). Overall the methodological score of the studies was moderate. Increased peak hip adduction and knee internal rotation during the stance phase may predict the development of ITBS in female runners. These biomechanical risk factors may need to be screened for ITBS prevention, despite the evidence base being limited to a single study. Currently there is no conclusive evidence that any of the biomechanical parameters need to be considered when managing runners with ITBS. Stellenbosch University https://scholar.sun.ac.za iii Conclusion: Biomechanical differences may exist between runners with ITBS and those who may develop ITBS compared to healthy runners. Although a large variety of biomechanical risk factors were evaluated, the evidence base for screening or managing these risk factors for runners with ITBS is limited. This is due to a small evidence base, small clinical effect and heterogeneity between study outcomes and findings. Further prospective and cross-sectional research is required to ascertain if abnormalities in running biomechanics may be related to why runners develop ITBS or to ascertain which risk factors may be involved when managing these runners.
AFRIKAANSE OPSOMMING: Inleiding: Iliotibiale-band-sindroom (ITBS), ’n besering vanweë oormatige gebruik, is die tweede algemeenste hardloopbesering en die hoofoorsaak van laterale kniepyn by hardlopers. Namate die getal hardlopers wêreldwyd toeneem, neem die voorkoms van hierdie toestand ook toe. Hardlopers met ITBS ervaar tipies simptome ná die hakslag met die knie ongeveer 20-30° gebuig (die wrywingsone of “impingement zone”) gedurende die staanfase van hardloop. Verskeie intrinsieke en ekstrinsieke risikofaktore kan ’n rol speel in waarom sommige hardlopers meer geneig is as ander om gedurende die wrywingsone simptome te ervaar. Abnormaliteite in hardloopbiomeganika is ’n intrinsieke risikofaktor wat reeds omvattend in die literatuur beskryf is. Tog is weinig bekend oor presies hoe dit met ITBS verband hou. Oogmerke: Die doel van hierdie stelselmatige ondersoek was om ’n sintese te bied van die jongste bewyse van die biomeganiese risikofaktore van ITBS. Hierdie risikofaktore kan dalk oorweeg word om ITBS by hardlopers te voorkom of te bestuur. ’n Kliniese algoritme word ook aangebied. Metodes: ’n Stelselmatige ondersoek is met behulp van meta-ontleding onderneem. PubMed, PEDro, SPORTSDisc en Scopus is elektronies deurgesoek vir literatuur wat tot en met Mei 2014 verskyn het. Deursnee en kohortstudies is ingesluit indien dit gehandel het oor die biomeganika in die onderste ledemate van hardlopers wat ITBS het of later ontwikkel het. Alle studies wat deel was van die ondersoek is metodologies geëvalueer. Bewyse is aan die hand van bewysvlak, bewyskonsekwentheid en kliniese impak beoordeel. Data is narratief beskryf met behulp van tabelle of narratiewe opsommings waar dit toepaslik was. ’n Meta-ontleding is onderneem waar biomeganiese risikofaktore in minstens twee studies aangemeld is, mits daar homogeniteit in die uitkomste sowel as die steekproewe was. Resultate: Altesaam 11 studies is ingesluit (een prospektief en tien deursnee). Die metodologiese telling van die studies was oorwegend gemiddeld. Verhoogde spitsheupadduksie en interne knierotasie gedurende die staanfase kan op die ontwikkeling van ITBS by vrouehardlopers dui. Hierdie biomeganiese risikofaktore kan dalk nagegaan word vir ITBS-voorkoming, al was die bewysbasis beperk tot ’n enkele studie. Daar is tans geen afdoende bewys dat enige van die biomeganiese parameters oorweeg behoort te word in die bestuur van langafstandatlete met ITBS nie. Gevolgtrekking: Daar bestaan dalk biomeganiese verskille tussen hardlopers wat ITBS het of kan ontwikkel en gesonde hardlopers. Hoewel ’n groot verskeidenheid biomeganiese risikofaktore beoordeel is, is die bewysbasis vir die toets of bestuur daarvan by atlete met ITBS beperk. Dít is vanweë die klein hoeveelheid bewyse, die klein kliniese impak, en heterogeniteit tussen studie-uitkomste en bevindinge. Verdere prospektiewe en deursneenavorsing word vereis om te bepaal of abnormaliteite in hardloopbiomeganika ’n rol kan speel in waarom langafstandhardlopers ITBS ontwikkel, of om vas te stel watter risikofaktore ter sprake kan wees in die bestuur van hierdie hardlopers.
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Myer, Gregory D. "The effect of three selected exercises on electromyographic root mean square values and vastus medialis oblique to vastus lateralis ratio." Virtual Press, 1998. http://liblink.bsu.edu/uhtbin/catkey/1101588.
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The primary purpose of this study was to determine the ratio of activation between the VMO and VL while performing three selected knee exercises (drop squat, modified lateral squat, Muncie Method). Additionally, the data was analyzed to determine if a correlation existed between the muscle's activation rate per set and whether or not the rates are affected by Q-angle or gender. Twenty Ball State University subjects (10 male, 10 female) who were asymptomatic to Patellofemoral Syndrome (PFS), provided electroymyographic (EMG) data while performing the three selected exercises. A one-way ANOVA found no statistical significance (p=0.500) on any of the tested variables except the Drop Squat VL Root Mean Square (RMS). Significant correlations were found between: VL RMS to set number during drop squat, and VMO and VL RMS to set number during Muncie Method performance. Based on the results of this study, each of these exercises could be used to selectively strengthen the VMO in treatment of PFS.School of Physical Education
Books on the topic "Cartilage – Wounds and injuries – Treatment"
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Scott, W. Norman. Dr. Scott's knee book: Symptoms, diagnosis, and treatment of knee problems, including--torn cartilage, ligament damage, arthritis, tendinitis, arthroscopic surgery, and total knee replacement. New York: Simon & Schuster, 1996.
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Consensus Development Conference on the Treatment of Radiation Injuries (1st 1989 Washington, D.C.). Treatment of radiation injuries. New York: Plenum Press, 1990.
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Garde, Louis Anatole Le. Gunshot injuries: How they are inflicted, their complications and treatment. 2nd ed. Mt. Ida, Ark: Lancer Militaria, 1991.
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1970-, Aksenov Igor V., and Miller Stuart S, eds. MasterMinding wounds. [Flagstaff, AZ]: Best Publishing Company, 2010.
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Homutov, Viktor. Challenges in treating combat injuries. Bloomington, Indiana]: Xlibris Corporation, 2012.
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Shoulder injuries in sport: Evaluation, treatment, and rehabilitation. Champaign, Ill: Human Kinetics, 1996.
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Trauma. Oxford: Oxford University Press, 1986.
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Moserová, Jara. The healing and treatment of skin defects. Basel: Karger, 1989.
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Gunshot wounds. Rosemont, IL: American Academy Of Orthopaedic Surgeons, 2011.
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Principles and techniques of minor wound care. New Hyde Park, N.Y: Medical Examination Pub. Co., 1985.
Find full textBook chapters on the topic "Cartilage – Wounds and injuries – Treatment"
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Brittberg, Mats. "Cartilage Injury Treatment." In Arthroscopy and Sport Injuries, 323–29. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-14815-1_39.
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Orgill, Dennis P. "Operative Management of Pressure Injuries." In Interventional Treatment of Wounds, 75–84. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-66990-8_5.
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Kon, Elizaveta, Berardo Di Matteo, Francesco Iacono, Filippo Vandenbulcke, Nicolò Danilo Vitale, and Maurilio Marcacci. "Biological Treatment in Cartilage Injuries." In The Sports Medicine Physician, 599–614. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-10433-7_44.
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Brittberg, M. "Surgical Treatment of the Cartilage Injuries." In Osteoarthritis, 431–52. Berlin, Heidelberg: Springer Berlin Heidelberg, 1999. http://dx.doi.org/10.1007/978-3-642-60026-5_23.
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Brittberg, Mats. "Arthroscopic Autologous Chondrocyte Implantation for the Treatment of Cartilage Defects." In Sports Injuries, 1857–66. Berlin, Heidelberg: Springer Berlin Heidelberg, 2015. http://dx.doi.org/10.1007/978-3-642-36569-0_152.
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Hanson, R. Reid, and Amelia S. Munsterman. "Treatment of Burn Injuries, Gunshot Wounds, and Dog-Bite Wounds." In Equine Wound Management, 476–89. Hoboken, NJ, USA: John Wiley & Sons, Inc., 2016. http://dx.doi.org/10.1002/9781118999219.ch20.
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Brittberg, Mats, Anders Lindahl, Anders Nilsson, and Claes Ohlsson. "Cellular Aspects on Treatment of Cartilage Injuries." In Joint Destruction in Arthritis and Osteoarthritis, 237–41. Basel: Birkhäuser Basel, 1993. http://dx.doi.org/10.1007/978-3-0348-7442-7_28.
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Brittberg, Mats. "The History of the Treatment of Cartilage Injuries." In Techniques in Cartilage Repair Surgery, 3–16. Berlin, Heidelberg: Springer Berlin Heidelberg, 2014. http://dx.doi.org/10.1007/978-3-642-41921-8_1.
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LaPrade, Christopher M., Clayton W. Nuelle, Taylor Ray, and Seth L. Sherman. "Osteochondral Autograft for Treatment of Small Cartilage Injuries." In Cartilage Injury of the Knee, 253–60. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-78051-7_22.
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Gobbi, Alberto, Georgios Karnatzikos, and Dnyanesh G. Lad. "PRP in the Treatment of Cartilage Defects and Early Osteoarthritis of the Knee." In Sports Injuries, 1–12. Berlin, Heidelberg: Springer Berlin Heidelberg, 2014. http://dx.doi.org/10.1007/978-3-642-36801-1_157-1.
Full textConference papers on the topic "Cartilage – Wounds and injuries – Treatment"
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Chen, Chih-Hui, Jing-Sheng Li, Ali Hosseini, Hemanth Reddy Gadikota, Michal Kozanek, Thomas J. Gill, and Guoan Li. "Tibiofemoral Kinematics of the Knee During the Stance Phase of Gait After ACL Deficiency." In ASME 2011 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2011. http://dx.doi.org/10.1115/sbc2011-53904.
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Numerous studies have demonstrated that ACL deficiency could lead to further meniscus tear and cartilage degeneration. The post-injury joint degeneration has been mainly attributed to altered joint kinematics caused by ACL deficiency. Therefore, understanding of the effect of ACL injuries on knee joint motion is critical for development of conservative treatment or surgical reconstruction of the ACL injured knees. However, few data have been reported on the influence of ACL deficiency on knee joint motion during gait [1,2] — the most commonly performed daily activities. The objective of this study was to determine the 6DOF kinematics of the knee after ACL injuries during gait on a treadmill and to compare the kinematics data to those measured from the intact contralateral side using a combined dual fluoroscopic imaging system (DFIS) and MR image technique [3,4]. We hypothesized that the 6DOF tibiofemoral kinematics of ACL-deficient knees would be altered even under low demand activities such as walking.
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Wanich, Tony. "Treatment of Articular Cartilage Injuries in the Knee." In ASME 2009 4th Frontiers in Biomedical Devices Conference. ASMEDC, 2009. http://dx.doi.org/10.1115/biomed2009-83083.
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Articular cartilage is a unique biphasic tissue composed of chondrocytes surrounded by extracellular matrix (ECM). This thin layer of tissue covers the articular surface of diarthroidal joints and provides a durable, low friction interface which also helps to reduce the load transmitted to the underlying subchondral bone.
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Lima, Eric G., Liming Bian, Francis B. Gonzales, Gerard A. Ateshian, and Clark T. Hung. "Influence of Interleukin Treatment on Engineered and Native Articular Cartilage." In ASME 2007 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2007. http://dx.doi.org/10.1115/sbc2007-176220.
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Injury to the diarthrodial joint is often associated with elevated levels of cytokines and other inflammatory molecules. While the influence of interleukin on articular cartilage has been well-studied, its effects on engineered cartilage are not. The presence of inflammatory factors in the injured joint would be expected to affect the performance of implanted engineered cartilage repair tissue [1] and this effect may be especially pronounced in underdeveloped tissues [2]. The current study addresses this issue by examining the influence of interleukin (IL-1α and IL-1β) on engineered cartilage mechanical and biochemical properties at sequential stages of development. Furthermore, dexamethasone, an anti-inflammatory steroid that has been shown in some cases to suppress interleukin-induced degradation of native cartilage [3], was examined in the context of engineered constructs.
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Chappell, Isaac D., Phil Lee, Terence E. McIff, E. Bruce Toby, and Kenneth J. Fischer. "In Vivo Evaluation of Wrist Cartilage Integrity Using T2 Relaxation Time After Scapholunate Ligament Injury and Surgical Repair." In ASME 2012 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/sbc2012-80278.
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Osteoarthritis (OA) is a serious and frequently occuring outcome of untreated scapholunate dissocation, the most common form of carpal instability in the wrist [1]. As cartilage degenerates, the water content of surrounding tissue becomes less bound. Magnetic resonance imaging (MRI) T2 relaxation time is longer when water content is less bound [2]. MRI offers the advantageous combination of detailed images of soft tissues such as cartilage with the ability to evaluate free water content. Contrasting the various T2 relaxation times found in the cartilage of healthy wrist surfaces with those of injured wrists is thereby proposed as a method of evaluating cartilage degeneration. We hypothesized that T2 values obtained would be longer for the cartilage of the injured wrists. Though surgical treatment may relieve pain and restore some function to the wrist, it is hypothesized that T2 relaxation time will remain increased after surgery as cartilage regeneration is a very slow process, if it happens at all. The goal of this research is to provide a method to evaluate the biochemical and infer the biomechanical integrity of cartilage for various cartilage surfaces in a wrist after injury.
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Limpisvasti, Orr. "Arthroscopy and Ligament Reconstruction in the Knee." In ASME 2009 4th Frontiers in Biomedical Devices Conference. ASMEDC, 2009. http://dx.doi.org/10.1115/biomed2009-83081.
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Ligament injuries in the knee are a common cause of disability in the active population. The advent of arthroscopy and arthroscopic surgical techniques has changed our ability to diagnose and treat these injuries. Arthroscopy has become the gold standard for diagnosis of intra-articular ligament injuries, as well as meniscal and articular cartilage pathology. It combines optimal visualization and the ability to manipulate tissue under anesthesia to best understand the degree of ligament injury and knee instability. Arthroscopy has also evolved into the primary means for the surgical treatment of injuries to intra-articular ligaments, articular cartilage, and meniscus.
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Frybarger, Michelle R., and Karim H. Muci-Küchler. "Distribution of Bacterial Contamination in Partial Penetration Surrogate Ballistic Wounds." In ASME 2020 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2020. http://dx.doi.org/10.1115/imece2020-23897.
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Abstract With the rise in use of IEDs during armed conflicts, there has been an increase in the number of injuries to the extremities. Shrapnel and debris ejected during the explosion become high-speed projectiles capable of penetrating soft tissues, bringing bacterial contamination into the wound. If not properly treated, that contamination could lead to infection. Studies aimed at understanding the distribution of bacterial contamination along the permanent cavity could provide useful information to improve treatment protocols for these types of injuries. In this paper, a lower extremity surrogate model was used to investigate bacterial distribution in partial penetration ballistic wounds. The targets used were ballistic gelatin blocks that had an Escherichia coli-laden filter paper placed on their front face. Spherical projectiles were fired into the targets adjusting their speed to obtain three different partial penetration depths. After each shot, a gelatin strip containing the permanent cavity was extracted and segmented. The permanent cavity was removed from each segment, placed in a test tube with buffer solution, and heated in a water bath to melt the gelatin. Standard microbiology protocols were followed to determine the number of colony forming units (CFUs) in each segment. The bacteria distribution was represented by percent of total CFU in the permanent cavity versus segment number. In addition, bacterial contamination as a function of projectile penetration depth was explored. For the cases considered, most of the bacterial contamination occurred in the segments closer to the projectile entry point.
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Sturgeon, Dannica L., Sang-Pil Lee, Terence E. McIff, E. Bruce Toby, and Kenneth J. Fischer. "Evaluation of Wrist Cartilage With and Without Scapholunate Ligament Injury in Pre and Post Operation Subjects." In ASME 2011 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2011. http://dx.doi.org/10.1115/sbc2011-53718.
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Hand and wrist injuries commonly occur and can be debilitating. Scapholunate dissociation generally requires surgery, and if left untreated, can lead to scapholunate advanced collapse (SLAC wrist) and associated osteoarthritis [1]. The overall goal of this research is to make a positive impact on the assessment and treatment of wrist injuries and on prevention of osteoarthritis as a result of injury.
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Izmailov, Sergey, Julia Perevezentseva, Andrey Rotkov, Vladimir Beschastnov, Evgeniy Popov, and Egor Lukoyanychev. "Mathematical Justification of the Wound suturing by Wound Contractors of new Generation." In International Conference "Computing for Physics and Technology - CPT2020". Bryansk State Technical University, 2020. http://dx.doi.org/10.30987/conferencearticle_5fce2772128d09.10616351.
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Frequent cases of man-made disasters, terrorist attacks and military conflicts lead to an increase in the number of victims. Significant soft tissue defects are known to result from gunshot wounds. So, as a result of mine-blasting injuries, defects in the skin and underlying tissues more than 10 cm in diameter are formed in 71.1% of cases. The prerequisite for the uncomplicated course of the wound process is to achieve an adequate comparison of the edges of the wound without excessive tension. To close such extensive wounds, various technical means are used: sutures on pads, various types of dermatotension. We have developed various models of wound contractors (RC) for treatment of wounds. With the help of the RC, a complete reposition and good adaptation of the edges of the wound is created. The wound closure method using these RC almost completely eliminates tissue cutting and limits the sawing effect to a minimum. This is explained by the effects of elastic forces reducing to zero when matching soft tissues and suturing. The use of hardware methods for suturing wounds requires the development of mathematical models of various types of wounds and surgical sutures. These models should provide a simulation of living tissues of the wound edges behavior to achieve the best results in the treatment of wounds by RC advanced technologies. The purpose of this study is to mathematically justify RC with the parallel holding of spokes. Another purpose is to develop a mathematical model of the wounds suturing by hardware technology.
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CHIRVA, Y. V., and M. I. BABICH. "TREATMENT OF DEFECTS IN BONES AND SOFT TISSUE WOUNDS IN VICTIMS WITH INJURIES OF THE LOWER EXTREMITIES BY THE METHOD OF SEQUENTIAL OSTEOSYNTHESIS." In Проблемы и вопросы современной науки. Научно-Издательский Центр Международной Объединенной Академии Наук (НИЦ МОАН), 2018. http://dx.doi.org/10.18411/pivsn-18.
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Blum, Michelle M., and Timothy C. Ovaert. "Synthesis and Characterization of Boundary Lubricant-Functionalized PVA Gels for Biotribological Applications." In ASME 2010 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2010. http://dx.doi.org/10.1115/sbc2010-19281.
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Hyaline cartilage is a material which exhibits ideal tribological properties by maintaining naturally low friction, leading to high wear resistance in articulating joints. When damage to hyaline cartilage occurs, due to diseases such as osteoarthritis or traumatic tissue injuries, tissue regeneration is limited due to cartilage’s avascular and aneural nature. The resulting bone-on-bone contact causes serious pain and limited mobility. Current treatment options are limited to total or partial joint replacements, which are not ideal procedures due to long term failure of components and osteolysis. A vastly improved material is desirable, which better mimics the structure and excellent tribological behavior of natural cartilage.