A delayed bone-tendon junction healing model established for potential treatment of related sports injuries.

BACKGROUND: Animal models for the study of tendinopathy and bone-tendon (B-T) junction repair have been established in the past for sports medicine research. As healing at the B-T junction is difficult and sometimes delayed, establishing a delayed B-T healing experimental model is therefore essential to study the efficacy of potential biophysical and biological interventions for treatment of B-T junction healing. OBJECTIVE: To test the hypothesis that a delay in B-T healing could be modelled by shielding the B-T healing interface for the initial few weeks. METHODS: Using an established partial patellectomy model in rabbits, the B-T healing interface was shielded with a latex slice for the first 4 postoperative weeks in mature female rabbits. The characteristics of delay in B-T repair (n = 10) compared with controls (n = 10) were evaluated at 8 and 12 postoperative weeks. RESULTS: Radiology showed consistent delay in osteogenesis at the healing interface in all samples in the delayed healing group; growth of new bone was only 25.8% and 50.1% of that in the control group at weeks 8 and 12, respectively. Bone mineral density was 56.0% lower in the delayed healing group at week 8, but this difference diminished at week 12. The quality of B-T healing was poor in the delayed healing group, with 22.9% and 24.2% lower failure load than the control group at weeks 8 and 12, respectively. The healing quality was also reflected by histological findings. CONCLUSIONS: A delayed B-T healing experimental model was established for the first time for future sports medicine research.

Factors associated with back pain symptoms in pregnancy and the persistence of pain 2 years after pregnancy.

BACKGROUND: Factors associated with back pain symptoms in pregnancy and the persistence of pain 2 years after pregnancy. AIMS: To determine the prevalence of back pain during pregnancy and to delineate the factors associated with the development and persistence of such symptoms 2 years after delivery. MATERIALS AND METHODS: Prospective observational cohort. Consecutive patients in a low-risk obstetric population with singleton pregnancies were surveyed for back pain symptoms during pregnancy in the early postpartum period by a structured questionnaire. Data from this survey were then correlated with the details of labor and pregnancy outcome, as well as epidemiological, occupation and work data. A follow-up questionnaire survey was administered 24 months after delivery to the group who reported back pain symptoms in the first survey. The absence/presence of persistent symptoms at 24 months was correlated with the characteristics of their pregnancy, as well as their daily life activities at the time of the survey. RESULTS: A total 326 patients with complete data were recruited. Two hundred and fifty (76.6%) reported one or more significant episodes of back pain during their pregnancy. Significantly more patients with presence of pain in pregnancy had history of previous back pain episodes when not pregnant (48% vs. 19.7%, p < 0.001), as well as during previous pregnancies (66% vs. 40%, p < 0.025), or in the postpartum period (40% vs. 6.6%, p < 0.001). There was no significant difference between those with or without pain in their pregnancy outcome. Complete data on 189 of the 250 study patients (75.6%) were available for analysis at 24 months after delivery. The incidence of persistent back pain symptoms was 21.1% (n = 40). Those with persistent pain were older, had significantly earlier onset of pain symptoms in the index pregnancy compared with those without pain at 24 months, and they also had their worse symptoms at an earlier gestation during the index pregnancy. Moreover, those with persistent pain had a higher weight gain at 24 months compared with their preindex pregnancy weight (6.8 kg, SD3.0) compared with those without further pain (4.0 kg, SD2.8) (p < 0.01), as well as less weight loss compared with their early postpartum weight (8.1 kg, SD4.8 vs. 1.1.5 kg, SD5.6) (p < 0.01). CONCLUSION: The main factors associated with development of back pain were previous episodes of back pain while non-pregnant or pregnant. The occurrence of back pain during pregnancy did not affect the pregnancy outcome. The main risk factors associated with persistent back pain at 24 months appeared to be the onset of severe pain at an early gestation in the index pregnancy, as well as the inability to reduce weight to their pre-pregnant level.

Hand surgery - past, present and future.

Although new techniques and innovative approaches in hand surgery are increasing in number and popularity, the ultimate aim of achieving improved functions may not be fulfilled. On the other hand, perfect functional results are not achieved, not because of inability to use recent technology, but because of deficient skills, e.g. on basic incisions, tendon repair, or nerve repair.

A critical analysis of professional and academic publications on traditional Chinese medicine in China.

An open competition for scientific reports on Chinese medicine invited enthusiastic subscriptions of over 10,000 manuscripts. Three categories were separated viz, clinical studies, literature review and laboratory studies. Reports of very high quality were found among the literature review group. Clinical studies appeared to be generally weak; very few follow the evidence-based approach or pass the test of biometa-analysis.