Ultrasound-Guided Perineural Hydrodissection for the Treatment of Lacertus Fibrosus Syndrome in a Baseball Player: A Case Report.

ABSTRACTS: Lacertus fibrosus Syndrome (LFS) is a rare cause of persistent medial elbow pain in baseball players, often not considered in the initial diagnostic considerations. This case report details a 19-year-old collegiate baseball player who presented with insidious left anterior medial elbow pain, initially diagnosed as biceps tendonitis. The patient did not experience pain relief after six months of conservative management. Sonopalpation during diagnostic ultrasound localized the source of pain to the median nerve at the level of the lacertus fibrosus, and the decision was made to perform ultrasound-guided hydrodissection of the median nerve at this level. The procedure resulted in rapid and sustained symptom relief without the scarring that has been associated with traditional surgical techniques. To date, there has been no study investigating the use of ultrasound-guided hydrodissection targeting lacertus fibrosus. This report highlights the importance of considering LFS in throwing athletes with persistent elbow pain, and advocates for considering ultrasound-guided hydrodissection as a management option for patients with clinical suspicion of LFS.

Ultrasound-Guided A1 Pulley Release: A Systematic Review.

The purpose of this review was to summarize the current literature pertaining to ultrasound-guided percutaneous A1 pulley release procedures. We searched PubMed, Cochrane Library, Embase, and Web of Science for clinical studies examining ultrasound-guided percutaneous A1 pulley release. A total of 17 studies involving 749 procedures were included in this review. The overall success rate was 97%. There were 23 minor complications (4 cases of hematomas, 15 cases of persistent pain, and 4 cases of transient numbness) and no major complications reported. Ultrasound-guided A1 pulley release is an effective and safe procedure for the treatment of trigger fingers and thumb.

Lateral epicondylitis: comparing ultrasound-guided tenotomy with or without amniotic membrane allograft injection.

Aim: To evaluate the clinical response to augmenting ultrasound-guided tenotomy (USGT) with an amniotic membrane (AM) allograft injection. Design: Retrospective study. Materials & methods: Subjects underwent either a USGT (N = 16) or a combined USGT plus AM injection (N = 14). Results: Both groups demonstrated a significant reduction in pain from baseline starting after 2 weeks in the USGT plus AM group (p = 0.036) and after 8 weeks in the USGT group (p = 0.021). The reduction in pain was sustained for the entire duration of the study (52 weeks). There was no significant difference in pain levels at 26- or 52-week follow-up or patient satisfaction between the two groups. Conclusion: USGT with or without AM allograft injections results in a significant reduction in pain with high patient satisfaction.

The goal of this study was to determine if a single injection of an amniotic membrane (AM) tissue improves clinical outcomes for patients with chronic tennis elbow treated with ultrasound-guided tenotomy. Ultrasound-guided tenotomy involves using a cutting device to remove degenerative tissue with ultrasound-guidance to help tendon's healing process. An AM injection is thought to reduce inflammation in the surrounding tissue, provide growth factors that help with the tendon's healing process, and minimize painful scar formation. 30 patients were included in this study (16 ultrasound-guided tenotomy [USGT] and 14 USGT plus AM injection). Both groups showed improvement in pain levels compared with their baseline at the short-term follow-up, and this reduction in pain was sustained for 52 weeks. There were no long-term differences between the two groups at the 52 week follow-up in pain levels or satisfaction. Our findings suggest that USGT, with or without AM injection, is an effective method of treatment for chronic tennis elbow.

Basic Science of Allograft Orthobiologics.

Orthobiologic procedures are based on altering the microenvironment of musculoskeletal tissues to induce an anti-inflammatory effect and reduce pain, promote healing of these tissues, or provide mechanical support. Allograft tissues have these inherent qualities and can be used as such. This could provide patients whose own autologous tissues may be compromised or have contraindications to harvesting an alternative to treat their orthopedic conditions. Although these allograft therapies are promising, they lack high-quality clinical studies and regulatory guidelines currently limit their use.

Plantar fasciitis: a comparison of ultrasound-guided fasciotomy with or without amniotic membrane allograft injection.

Aim: The purpose of this study was to evaluate the clinical response to augmenting an ultrasound-guided percutaneous plantar fasciotomy (UGPF) with an amniotic membrane (AM) allograft injection. Design: Retrospective, single-center, matched, case-controlled study. Methods: Patients underwent either an UGPF (n = 15) or a combined UGPF and AM injection (n = 16). Results: The UGPF plus AM group demonstrated a significant reduction in pain (p = 0.02) from baseline at the short-term follow-up, but there was no significant difference in pain or patient satisfaction between groups at the 52-week follow-up. Conclusion: Both groups demonstrated a significant reduction in pain and high level of patient satisfaction, but the combination of UGPF with an AM injection may provide a greater reduction in pain earlier in the post-operative period.

From chemolithoautotrophs to electrolithoautotrophs: CO2 fixation by Fe(II)-oxidizing bacteria coupled with direct uptake of electrons from solid electron sources.

At deep-sea vent systems, hydrothermal emissions rich in reductive chemicals replace solar energy as fuels to support microbial carbon assimilation. Until recently, all the microbial components at vent systems have been assumed to be fostered by the primary production of chemolithoautotrophs; however, both the laboratory and on-site studies demonstrated electrical current generation at vent systems and have suggested that a portion of microbial carbon assimilation is stimulated by the direct uptake of electrons from electrically conductive minerals. Here we show that chemolithoautotrophic Fe(II)-oxidizing bacterium, Acidithiobacillus ferrooxidans, switches the electron source for carbon assimilation from diffusible Fe(2+) ions to an electrode under the condition that electrical current is the only source of energy and electrons. Site-specific marking of a cytochrome aa3 complex (aa3 complex) and a cytochrome bc1 complex (bc1 complex) in viable cells demonstrated that the electrons taken directly from an electrode are used for O2 reduction via a down-hill pathway, which generates proton motive force that is used for pushing the electrons to NAD(+) through a bc1 complex. Activation of carbon dioxide fixation by a direct electron uptake was also confirmed by the clear potential dependency of cell growth. These results reveal a previously unknown bioenergetic versatility of Fe(II)-oxidizing bacteria to use solid electron sources and will help with understanding carbon assimilation of microbial components living in electronically conductive chimney habitats.