RESUMO
BACKGROUND: Anatomic anterior talofibular ligament (ATFL) reconstruction with autologous single-bundle tendon has been widely used in the treatment of ATFL injury. However, there are few clinical reports of using the peroneus brevis tendon (PBT) for double-bundle ATFL reconstruction. The aim of this study was to investigate the clinical effect of double-bundle ATFL reconstruction with PBT. METHODS: This was a retrospective review of all patients diagnosed with ATFL injury presenting from August 2019 to December 2021. Fifty-three patients were selected after screening based on the inclusion and exclusion criteria. The following data were compared before and after surgery: Visual Analogue Scale (VAS) score, American Orthopedic Foot and Ankle Society (AOFAS) score, Karlsson Ankle Functional Score (KAFS), the pain interference (PI) and physical function (PF) scores of the Patient-Reported Outcomes Measurement Information System (PROMIS), the diameter and width of PBT in ultrasound and muscle strength. RESULTS: All functional scores (VAS, PI/PF, AO-FAS, KAFS) and muscle strength were significantly improved at the last follow-up (P < 0.05). The diameter and width of the PBT on ultrasound postoperation were smaller than those preoperatively. CONCLUSION: Double-bundle ATFL reconstruction with the partial PBT technique is a feasible, anatomic reconstruction technique for chronic lateral instability of the ankle, which meets the anatomical characteristics of the double bundle of the ligament, and the absence of partial PBT does not affect the peroneal muscle strength. LEVEL OF EVIDENCE: Level IV, retrospective case series.
Assuntos
Instabilidade Articular , Ligamentos Laterais do Tornozelo , Humanos , Estudos Retrospectivos , Ligamentos Laterais do Tornozelo/cirurgia , Ligamentos Laterais do Tornozelo/lesões , Articulação do Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/cirurgia , Tendões/cirurgia , Ligamentos , Instabilidade Articular/cirurgiaRESUMO
Achilles tendon healing (ATH) remains an unanswered question in the field of sports medicine because it does not produce tissue with homology to the previously uninjured tissue. Oestrogen receptor ß (ERß) is involved in the injury and repair processes of tendons. Our previous study confirmed that ERß plays a role in the early stage of ATH by affecting adipogenesis, but its role in extracellular matrix (ECM) remodelling is unknown. We established a 4-week Achilles tendon repair model to investigate the mechanism through which ERß affects ATH at the very beginning of ECM remodelling phase. In vitro studies were performed using tendon-derived stem cells (TDSCs) due to their promising role in tendon healing. Behavioural and biomechanical tests revealed that ERß-deficient mice exhibit weaker mobility and inferior biomechanical properties, and immunofluorescence staining and qRT-PCR showed that these mice exhibited an erroneous ECM composition, as mainly characterized by decreased collagen type I (Col I) deposition. The changes in gene expression profiles between ERß-knockout and WT mice at 1 week were analysed by RNA sequencing to identify factors affecting Col I deposition. The results highlighted the IRF5-CCL3 axis, and this finding was verified with CCL3-treated TDSCs. These findings revealed that ERß regulates Col I deposition during ATH via the IRF5-CCL3 axis.
Assuntos
Quimiocina CCL3/genética , Receptor beta de Estrogênio/genética , Fatores Reguladores de Interferon/genética , Traumatismos dos Tendões/terapia , Tendão do Calcâneo/lesões , Tendão do Calcâneo/metabolismo , Tendão do Calcâneo/patologia , Adipogenia/genética , Animais , Diferenciação Celular/genética , Colágeno Tipo I/genética , Modelos Animais de Doenças , Matriz Extracelular , Humanos , Masculino , Camundongos , Camundongos Knockout , Medicina Esportiva , Transplante de Células-Tronco , Traumatismos dos Tendões/genética , Traumatismos dos Tendões/patologia , Cicatrização/genéticaRESUMO
BACKGROUND: Giant cell tumors (GCT) are most commonly seen in the distal femur. These tumors are uncommon in the small bones of the hand and feet, and a very few cases have been reported. A giant cell tumor of the talus is rarely seen clinically and could be a challenge to physicians. CASE SUMMARY: We report a rare case of GCT of the talus in one patient who underwent a new reconstructive surgery technique using a three-dimensional (3D) printing talar prosthesis. The prosthesis shape was designed by tomographic image processing and segmentation using technology to match the intact side by mirror symmetry with 3D post-processing technologies. The patient recovered nearly full range of motion of the ankle after 6 mo. The visual analogue scale and American Orthopaedic Foot and Ankle Society scores were 1 and 89 points, respectively. CONCLUSION: We demonstrated that 3D printing of a talar prosthesis is a beneficial option for GCT of the talus.