The Effect of Blood Flow Restriction Training on Muscle Atrophy Following Meniscal Repair or Chondral Restoration Surgery in Active Duty Military: A Randomized Controlled Trial.

CONTEXT: Recently, blood flow restriction (BFR) training has gained popularity as an alternative to high-load resistance training for improving muscle strength and hypertrophy. Previous BFR studies have reported positive treatment effects; however, clinical benefits to using BFR following meniscal repair or chondral surgery are unknown. The purpose of this study was to determine the effect of resistance exercises with BFR training versus exercises alone on self-reported knee function, thigh circumference, and knee flexor/extensor strength postmeniscal or cartilage surgery. DESIGN: Single-blinded randomized controlled trial in an outpatient military hospital setting. Twenty participants were randomized into 2 groups: BFR group (n = 11) and control group (n = 9). METHODS: Participants completed 12 weeks of postoperative thigh strengthening. The BFR group performed each exercise with the addition of BFR. Both groups continued with the prescribed exercises without BFR from 12 weeks until discharged from therapy. Thigh circumference and self-reported knee function were measured at 1, 6, 12, and 24 weeks postoperatively along with knee extensor and flexor strength at 12 and 24 weeks. Change scores between time points were calculated for knee function. Limb symmetry indices (LSI) were computed for thigh circumference and knee strength variables. RESULTS: Seventeen participants were included in the final analyses (BFR = 8 and control = 9) due to COVID-19 restrictions. There were no interactions or main effects for group. Time main effects were established for change in knee function scores, thigh circumference LSI, and knee extensor strength LSI. However, knee flexor strength LSI had no main effect for time. CONCLUSION: The outcomes of this trial suggest that resistance exercises with and without BFR training may result in similar changes to function, thigh atrophy, and knee extensor strength postmeniscus repair/chondral restoration, though further study with larger sample sizes is needed.

Modulation of anisotropy in electrospun tissue-engineering scaffolds: Analysis of fiber alignment by the fast Fourier transform.

We describe the use of the fast Fourier transform (FFT) in the measurement of anisotropy in electrospun scaffolds of gelatin as a function of the starting conditions. In electrospinning, fiber alignment and overall scaffold anisotropy can be manipulated by controlling the motion of the collecting mandrel with respect to the source electrospinning solution. By using FFT to assign relative alignment values to an electrospun matrix it is possible to systematically evaluate how different processing variables impact the structure and material properties of a scaffold. Gelatin was suspended at varying concentrations (80, 100, 130, 150 mg/ml) and electrospun from 2,2,2 trifluoroethanol onto rotating mandrels (200-7000 RPM). At each starting concentration, fiber diameter remained constant over a wide range of mandrel RPM. Scaffold anisotropy developed as a function of fiber diameter and mandrel RPM. The induction of varying degrees of anisotropy imparted distinctive material properties to the electrospun scaffolds. The FFT is a rapid method for evaluating fiber alignment in tissue-engineering materials.

Utilizing acid pretreatment and electrospinning to improve biocompatibility of poly(glycolic acid) for tissue engineering.

Poly(glycolic acid) (PGA) has a long history as a bioresorbable polymer. Its biocompatibility is widely accepted, yet PGA is often rejected as a soft-tissue scaffold because of fibrous encapsulation. The goal of this study was to improve the soft-tissue biocompatibility of PGA by producing scaffolds composed of small-diameter fibers through electrospinning and subjecting these scaffolds to a concentrated hydrochloric acid (HCL) pretreatment. The theory is that small-diameter fibers will elicit a reduced immune response and HCl treatment will improve cellular interactions. Scaffolds were characterized in terms of fiber diameter and pore area via image-analysis software. Biocompatibility was assessed through a WST-1 cell-proliferation assay (in vitro) with the use of rat cardiac fibroblasts and rat intramuscular implantations (in vivo). Fibers produced ranged in diameter from 0.22 to 0.88 microm with pore areas from 1.84 to 13.22 microm(2). The untreated scaffold composed of 0.88-microm fibers was encapsulated in vivo and supported the lowest rates of cell proliferation. On the contrary, the acid pretreated scaffold with 0.22-microm fibers was incorporated into the surrounding tissue and exhibited proliferation rates that exceeded the control populations on tissue-culture plastic. In conclusion, this study has shown the ability to improve the biocompatibility of PGA through acid pretreatment of scaffolds comprised of submicron fiber diameters.