Osteoarthritis Development Following Meniscectomy vs. Meniscal Repair for Posterior Medial Meniscus Injuries: A Systematic Review.

This systematic review aims to evaluate critically and synthesize the existing literature on the outcomes of meniscectomy versus meniscal repair for posterior medial meniscus injuries, with a focus on osteoarthritis (OA) development. We sought to assess the incidence of OA following both treatment modalities, compare functional outcomes post-treatment, and identify factors influencing treatment choice, providing evidence-based recommendations for clinical decision-making. A comprehensive search strategy was employed across PubMed, Scopus, and Embase up until December 2023, adhering to PRISMA guidelines. The primary outcomes included OA development, functional knee outcomes, and quality of life measures. Six studies met the inclusion criteria, encompassing 298 patients. The systematic review revealed a significant association between meniscal repair and decreased progression of OA compared to meniscectomy. Meniscectomy patients demonstrated a 51.42% progression rate towards OA, significantly higher than the 21.28% observed in meniscal repair patients. Functional outcomes, as measured by the International Knee Documentation Committee (IKDC) and Lysholm scores, were notably better in the repair group, with average scores of 74.68 (IKDC) and 83.78 (Lysholm) compared to 67.55 (IKDC) and 74.56 (Lysholm) in the meniscectomy group. Furthermore, the rate of complete healing in the repair group was reported at 71.4%, as one study reported, indicating a favorable prognosis for meniscal preservation. However, these pooled data should be interpreted with consideration to the heterogeneity of the analyzed studies. Meniscal repair for posterior medial meniscus injuries is superior to meniscectomy in preventing OA development and achieving better functional outcomes and quality of life post-treatment. These findings strongly suggest the adoption of meniscal repair as the preferred treatment modality for such injuries, emphasizing the need for a paradigm shift in clinical practice towards preserving meniscal integrity to optimize patient outcomes.

An Insight into the Structural Diversity and Clinical Applicability of Polyurethanes in Biomedicine.

Due to their mechanical properties, ranging from flexible to hard materials, polyurethanes (PUs) have been widely used in many industrial and biomedical applications. PUs' characteristics, along with their biocompatibility, make them successful biomaterials for short and medium-duration applications. The morphology of PUs includes two structural phases: hard and soft segments. Their high mechanical resistance featuresare determined by the hard segment, while the elastomeric behaviour is established by the soft segment. The most important biomedical applications of PUs include antibacterial surfaces and catheters, blood oxygenators, dialysis devices, stents, cardiac valves, vascular prostheses, bioadhesives/surgical dressings/pressure-sensitive adhesives, drug delivery systems, tissue engineering scaffolds and electrospinning, nerve generation, pacemaker lead insulation and coatings for breast implants. The diversity of polyurethane properties, due to the ease of bulk and surface modification, plays a vital role in their applications.

Are Zirconia Bioceramics and Ceramics Intended to Come in Contact with Skin Inert?

Generally speaking, ceramic materials are insensitive to corrosion, compared to most other materials. The present study questions the fact that ceramics are inert. Two major aspects are to be considered: the stability of zirconia over time, the stable tetragonal phase transforming into an unstable monoclinic form; the multitude of manufacturing methods, using various additives, sintering additives, oxides mixing, impurities, grain boundaries, and porosities which strongly influence the corrosion behavior and chemical degradation. In case of the investigated ceramics two paths were pursued:a) Dissolutions of ceramics in a mixture of HNO3 60% and HF 40% ultrapure medium.b) Release of cations from ceramics in various mediums:dental bioceramics in a 0.07 M HCl medium and a 0.1% NaF+0.1% KF medium; ceramics used in jewelry and watchmaking applications in a HCl 0.07 M medium and an artificial sweat medium. By inductively coupled plasma-optical emission spectrometry/mass spectrometry (ICP-OES/MS), traces of significant chemical elements were assessed: Hf, Cr, Y, As, Pb, Al, Fe, Cu, Se, Sb, La, Ni, Co, Sb, Ta, Te, Ba, Sm, Nb, Hg, Cd, Sr, As and Se. In ceramics used in jewelry and watchmaking applications the concentrations found vary from one ceramic to another, including toxic elements such as Te, Ba, As, Pb, Sm, Hg and Cd, therefore being technical zirconia ceramics which are not intended for the medical field. For ceramics used in jewelry and watchmaking applications a screening identification test for Ni, Co, Cu and Fe with strips of type Merckoquant® (Merck, Kenilworth, NJ, USA) was also performed. The obtained data prove that the zirconia ceramics in question are far from being "inert".