Surgical and Biological Treatment with a Platelet-Rich Fibrin Matrix for Patellar Tendinopathy: Clinical Outcomes and Return to Sport at 2-Year Follow-Up.

BACKGROUND: Patellar tendinopathy (PT) involves anterior knee pain and functional. Platelet-rich fibrin matrix (PRFM) is a promising biological therapy for tendinopathies. We examined a cohort of PT patients treated with tendon debridement and autologous PRFM at the 24-month follow-up to assess whether the combined treatment facilitated return to sports and yielded satisfactory clinical and functional scores. METHODS: Baseline and 24-month visual analogue scale (VAS), Victorian Institute of Sport Assessment Scale for Patellar Tendinopathy (VISA-P), Tegner Activity Scale (TAS), and Blazina scores were compared to evaluate treatment effectiveness. The Friedman test was used to compare repeated observations of VAS, VISA-P, TAS, and Blazina Score values. Return to sport rate, Tampa Scale of Kinesiophobia (TKS) score and patient satisfaction were collected at 24 months. RESULTS: The postoperative clinical scores demonstrated significant improvement compared with their preoperative values (all p < 0.001). Specifically, the VISA-P score was 80.32 (±20.58), 92.10% of patients had resumed sports activities and patient satisfaction was 9.21 (±1.21) at 24 months. CONCLUSIONS: Surgical debridement and autologous PRFM application in patients with chronic PT resulted in a higher rate of return to sports when compared to solely surgical treatment, significantly improved clinical outcomes and excellent patient satisfaction at 24 months.

How Free Swimming Fosters the Locomotion of a Purely Oscillating Fish-like Body.

The recoil motions in free swimming, given by lateral and angular rigid motions due to the interaction with the surrounding water, are of great importance for a correct evaluation of both the forward locomotion speed and efficiency of a fish-like body. Their contribution is essential for calculating the actual movements of the body rear end whose prominent influence on the generation of the proper body deformation was established a long time ago. In particular, the recoil motions are found here to promote a dramatic improvement of the performance when damaged fishes, namely for a partial functionality of the tail or even for its complete loss, are considered. In fact, the body deformation, which turns out to become oscillating and symmetric in the extreme case, is shown to recover in the water frame a kind of undulation leading to a certain locomotion speed though at the expense of a large energy consumption. There has been a deep interest in the subject since the infancy of swimming studies, and a revival has recently arisen for biomimetic applications to robotic fish-like bodies. We intend here to apply a theoretical impulse model to the oscillating fish in free swimming as a suitable test case to strengthen our belief in the beneficial effects of the recoil motions. At the same time, we intend to exploit the linearity of the model to detect from the numerical simulations the intrinsic physical reasons related to added mass and vorticity release behind the experimental observations.

Traumatic biceps femoris tendon subluxation in a young football player.

Snapping a knee related to a biceps femoris tendon subluxation is an uncommon syndrome that could be disabling in patients with high functional requirements such as athletes. We report a case of a 21-year-old soccer player with a painful left snapping biceps femoris tendon due to a varus trauma. He underwent knee arthroscopy and surgical exploration of the knee: the long head of the biceps femoris tendon was partially detached from his fibular insertion and there was a prominence on the fibular head. Reinsertion of the tendon and osteotomy of the fibular head allowed for resolution of all symptoms and the return to sport.

The performance of a flapping foil for a self-propelled fishlike body.

Several fish species propel by oscillating the tail, while the remaining part of the body essentially contributes to the overall drag. Since in this case thrust and drag are in a way separable, most attention was focused on the study of propulsive efficiency for flapping foils under a prescribed stream. We claim here that the swimming performance should be evaluated, as for undulating fish whose drag and thrust are severely entangled, by turning to self-propelled locomotion to find the proper speed and the cost of transport for a given fishlike body. As a major finding, the minimum value of this quantity corresponds to a locomotion speed in a range markedly different from the one associated with the optimal efficiency of the propulsor. A large value of the feathering parameter characterizes the minimum cost of transport while the optimal efficiency is related to a large effective angle of attack. We adopt here a simple two-dimensional model for both inviscid and viscous flows to proof the above statements in the case of self-propelled axial swimming. We believe that such an easy approach gives a way for a direct extension to fully free swimming and to real-life configurations.