ABSTRACT
Objective:To compare the effects of glenosphere offset positions on the impingement-free range of motion (ROM) in reverse total shoulder arthroplasty (RTSA).Methods:Shoulder joint models were reconstructed using shoulder CT scans of 6 patients with primary osteoarthritis. RTSA was performed virtually according to standard surgical procedures, and shoulder movements were simulated. Reverse shoulder models were constructed with 2 lateral offsets (0 and 4 mm) and 6 positional offsets (center, inferior, posterior, anterior, anterior-inferior, and posterior-inferior). The impingement-free ROM and impingement sites for abduction-adduction, flexion-extension, total rotation (sum of internal and external rotation), and total ROM (sum of ROM in all movement modes) were evaluated.Results:All the 12 combinations of different glenosphere offsets achieved 50% of the original shoulder ROM in all movements. In the abduction-adduction motion with 0 and 4 mm lateral offsets, the anterior-inferior offset provided the largest ROM (94.4°±8.7° and 105.3°±6.9°, respectively), but there was no significant difference between the positions ( P>0.05). In the flexion-extension motion with 0 and 4 mm lateral offsets, the posterior-inferior offset showed the largest ROM (194.1°±6.9° and 196.9°±9.7°, respectively), but there was no significant difference between the positions ( P>0.05). In the total rotation motion with 0 and 4 mm lateral offsets, the anterior-inferior offset had the largest ROM (141.5°±5.9° and 160.6°±8.5°, respectively), showing significant advantages over the center, anterior, and posterior offsets ( P<0.05), but insignificant advantages over the inferior and posterior-inferior offsets ( P>0.05). In total ROM, the anterior-inferior offset provided the largest ROM. When the lateral offset was 0 mm, the anterior-inferior offset provided a ROM of 421.8°±16.4°, showing significant advantages over the center and posterior offsets ( P<0.05). Compared with the lateral glenosphere offset of 0 mm, the lateral glenosphere offset of 4 mm significantly improved total shoulder ROM (122.8°±10.6° versus 145.8°±4.8°) and total ROM (390.9°±11.6° versus 428.4°±19.8°) ( P<0.05). Conclusions:The anterior-inferior, inferior, and posterior-inferior glenosphere offsets can improve ROM in all movement patterns. The position and lateral offset of the glenosphere significantly affect the total rotation and total ROM of the shoulder joint. Specifically, the anterior-inferior and inferior offsets show significant advantages over the center position in total rotation and total ROM of the shoulder joint.
ABSTRACT
Salivary gland (SG) dysfunction, due to radiotherapy, disease, or aging, is a clinical manifestation that has the potential to cause severe oral and/or systemic diseases and compromise quality of life. Currently, the standard-of-care for this condition remains palliative. A variety of approaches have been employed to restore saliva production, but they have largely failed due to damage to both secretory cells and the extracellular matrix (niche). Transplantation of allogeneic cells from healthy donors has been suggested as a potential solution, but no definitive population of SG stem cells, capable of regenerating the gland, has been identified. Alternatively, mesenchymal stem cells (MSCs) are abundant, well characterized, and during SG development/homeostasis engage in signaling crosstalk with the SG epithelium. Further, the trans-differentiation potential of these cells and their ability to regenerate SG tissues have been demonstrated. However, recent findings suggest that the "immuno-privileged" status of allogeneic adult MSCs may not reflect their status post-transplantation. In contrast, autologous MSCs can be recovered from healthy tissues and do not present a challenge to the recipient's immune system. With recent advances in our ability to expand MSCs in vitro on tissue-specific matrices, autologous MSCs may offer a new therapeutic paradigm for restoration of SG function.
Subject(s)
Mesenchymal Stem Cell Transplantation , Mesenchymal Stem Cells , Quality of Life , Regeneration , Salivary Glands , Stem CellsABSTRACT
Objective To evaluate the schistosomiasis control effect of the comprehensive measures that focused on beach?land smoothing and tillage cultivation in Tieban Marshland,Wuhan Section of the Yangtze River. Methods From 2011 to 2015, before and after the comprehensive control,the Oncomelania hupensis snail situations in Tieban Marshland were investigated in spring annually,and the residents aged 6-65 years in Huayuan Community which was next to the marshland were examined to un?derstand their schistosome infection status. In late July,2014,the sentinel mouse surveillance was carried out. Moreover,the eco?nomic effectiveness of comprehensive development was evaluated. Results The schistosome infection rates of residents in 2011 (before the comprehensive control),2012(after the comprehensive control),and 2013 were 0.72%(3/414),0.37%(2/536)and 0.31%(1/326),respectively,and no schistosomiasis patients were found in 2014 and 2015. The snail area,the occurrence rate of frames with snails,and the average density of living snails in Tieban Marshland in 2005 decreased by 22.18%,97.83% and 98.25%,respectively compared to those in 2011,and no schistosome infected snails were found. No positive mice were found in the sentinel mouse surveillance. The annual net income of Tieban Marshland increased by 233.33%compared to that before the comprehensive development. Conclusion The endemic situation of schistosomiasis and snail situation declined significantly af?ter the comprehensive development in Tieban Marshland,and the economic and social benefits are significant.