Search

Anterior cruciate ligament (ACR) rupture is a frequent injury in professional sports players. We conducted a retrospective cohort study, including 41 professional female handball players, undergoing ACR reconstruction surgery, using a Ligament Advanced Reinforcement System (LARS) graft (n = 12) or a Soft Tissue (ST) graft (n = 29). After return-to-play, the patients were asked to take a survey, reporting subjective and objective performance indexes before the injury and after return-to-play. Time from surgery to first practice and to return-to-play were significantly shorter in the LARS group (3.92 ± 1.14 vs. 6.93 ± 2.19 months, p < 0.001 and 4.71 ± 1.2 vs. 8.81 ± 2.9, respectively). While there was no difference between postoperative mean time on court, number of goals/match, number of matches played at 6 months return-to-play and 50 m, 100 m and gate-to-gate sprint times, there was a significantly greater increase in preoperative times in the ST group than in the LARS group (1.45 ± 1.05 s vs. 0.21 ± 0.58 s slower than preoperatively, p < 0.001 for 50 m; 1.09 ± 0.95 s vs. 0.08 ± 1 s, p = 0.01 for 100 m; 1.66 ± 1 s vs. 0.21 ± 0.66 s for gate-to-gate). In conclusion, LARS grafts provide a faster recovery time and better functional outcome, significantly impacting the performance of professional handball players. [ABSTRACT FROM AUTHOR]

(1) Background: The aim of the study was to investigate the effecs of mofettes and carbonated mineral water baths on bone healing using a rat femoral defect model; (2) Methods: A 2mm diameter unicortical defect in the left femoral diaphysis in 40 Wistar Rats was surgically created. Furthermore, the subjects were divided into 4 treatment-groups: control, mofette therapy, mofette therapy and carbonated mineral water bath, and carbonated mineral water bath. At the end of the 2-week treatment and at 4 and 6 weeks, the animals were evaluated through Micro-CT analysis of the bone defect and histological analysis of bone tissue and skin; (3) Results: The processes of bone consolidation and repair are not completed at 6 weeks in all groups. However, comparing the proliferated bone tissue in the created orifice and the degree of thickening of the femoral wall, it can be affirmed that at 6 weeks, the best results are present in Group 4, treated with carbonated mineral water baths, followed by the combination of mofettes and carbonated water. (4) The use of these treatments could open a new possibility for shortening the healing time in patients with bone defects, as it is non-invasive and accessible. [ABSTRACT FROM AUTHOR]

The biocompatibility of uncoated titanium, Ti, nails and coated with an innovative biocomposite is assessed in a rat model of femoral fracture. The biocomposite is based on multi-substituted hydroxyapatite, ms-HAP containing Mg, Zn and Si, and is used as a coating material deposited on Ti implants, due to the excellent biocompatibility and osteoconductive property of ms-HAP. Specific focus has been given to biocomposite coating made of ms-HAP functionalized with collagen (ms-HAP/COL, core/shell nanoparticles) NPs embedded into poly lactic acid, PLA, matrix and finally covered by COL layer. This coating on Ti implants is noted as ms-HAP/COL@PLA/COL and named HAPc, and is characterized by SEM images and EDX spectra. Twenty-four Wistar albino rats with left femoral fracture, were used and divided in two equal groups, namely the control group, CG, with uncoated Ti implants and HAPc rat group with Ti implants coated with HAPc biocomposite through layer-by-layer, LBL, dip coating technique. After two- and eight-weeks postsurgery, they were evaluated by bone markers serum concentration, micro-CT and histological study. The alkaline phosphatase (ALP) and osteocalcin (OCN) expression, in the HAPc group showed higher values with an osteoblastic activity more intense and a more advanced callus stage. The micro-CT results showed that biocomposite coating significantly increased the bone volume/tissue volume (BV/TV). The most advanced stage of bone remodelling with osseointegration of the Ti implants was observed in HAPc group, where the new formed trabecular bone is almost completely replaced by compact bone. This study provides a novel strategy for the treatment of bone fracture with a superior osseointegration of biocomposite coated Ti implants and potential orthopaedic applications. [ABSTRACT FROM AUTHOR]

FRACTURES ARE A COMMON FINDING IN TRAUMA DEPARTMENTS WORLDWIDE AND THEY CAN BE TREATED CONSERVATIVELY OR SURGICALLY. IN BOTH TYPES OF FRACTURE TREATMENT, DEEP VEIN THROMBOSIS (DVT) AND PULMONARY EMBOLISM (PE) ARE LIFETHREATENING COMPLICATIONS. AN ANIMAL MODEL WAS USED TO STUDY THE INFLUENCE OF TREATMENT TYPE ON DVT AND PE INCIDENCE. THIRTY RATS WERE EQUALLY DIVIDED INTO THREE GROUPS AS FOLLOWING: GROUP I (BILATERAL FEMORAL VEIN THROMBOSIS), GROUP II (BILATERAL VEIN THROMBOSIS AND UNILATERAL TIBIA FRACTURE TREATED SURGICALLY) AND GROUP III (BILATERAL VEIN THROMBOSIS AND UNILATERAL TIBIA FRACTURE TREATED CONSERVATIVELY). THE TOTAL OBSTRUCTION OF THE FEMORAL VEIN IPSILATERAL TO THE FRACTURE WAS FOUND IN 60% OF CASES IN GROUP I, 50% OF CASE IN GROUP II AND 100% OF CASES IN GROUP III. REGARDING THE FEMORAL VEIN THROMBOSIS IN THE NON-FRACTURED LIMB, THE TOTAL OBSTRUCTION OF THE FEMORAL VEIN WAS OBSERVED IN 50% FOR GROUP I, 60% FOR GROUP II AND 11% FOR GROUP III. COMPLETE OBSTRUCTION OF THE PULMONARY ARTERIES WAS 50% IN GROUP I, 10% IN GROUP II AND 9% IN GROUP III. FAT PULMONARY EMBOLISM OCCURRED IN 6 OUT OF 10 CASES IN GROUP II. CONSERVATIVE TREATMENT HAS A HIGHER RISK OF DEEP VEIN THROMBOSIS COMPARED TO SURGICAL TREATMENT. FURTHERMORE, PULMONARY FAT EMBOLISM IN THE INTRAMEDULLARY NAIL TREATED GROUP IS FOUND IN MOST CASES, WITHOUT CLINICAL SYMPTOMS. [ABSTRACT FROM AUTHOR]

Introduction: Delay in bone consolidation and nonunion occur in 5-10% of the total number of fractures and are often hard to treat in order to obtain an optimum morphologic and functional result. Regarding the bone consolidation and spinal fusion, pulsed electromagnetic field (PEMF) stimulators are the most commonly noninvasive method used. The limitations of the studies that evaluated the potential of these treatments are represented by the proper moment when to start the PEMF therapy or which spectral characteristics and energy output would be the most effective. Materials and methods: The experiment was performed on 20 murine models. After an open fracture of the left femoral diaphysis was made, there were introduced titanium nails in order to reduce and stabilize the fracture. After the second day of the intervention, ten murine models were treated with pulsed electromagnetic short - waves (PEMSW group) provide by DIAPULSE machine, ten minutes per day at 4/400 pulses/sec, for two weeks. The bone consolidation was evaluated by optical microscopy of the histological sections, micro- CT and the mechanical resistance of the bone by tree-point bonding test. Furthermore, alkaline phosphatase and osteocalcin were analyzed before the intervention, after two weeks and after eight weeks post-surgery. Results: Histological images, at two weeks, showed in the PEMSW group a more extensive and mineralized callus and micro-CT scan revealed a higher bone volume per total tissue volume (BV/TV) in the callus area: 34.23% in the PEMSW group vs. 29.87% in the control group (CG) (p=0.028). Moreover, alkaline phosphatases (AP) (p=0.023) and osteocalcin (OC) (p=0.016) serum levels were higher in the PEMSW group. Tree-point bonding test showed a higher mechanical resistance in the PEMSW group compared to CG (p=0.03). At eight weeks histology and micro-CT revealed a more advanced stage of bone remodeling, CG had a TV of 110.72% (p<0.001) compared to PEMSW group. Furthermore, the AP (p=0.19) and OC (p=0.15) serum levels showed higher values in the CG but without statistical differences. Conclusions: Pulsed electromagnetic short-waves, applied from the second day post-operative, showed an improvement in the bone consolidation process, reducing the total period of fracture healing. [ABSTRACT FROM AUTHOR]