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BACKGROUND: Rotator cuff tendinopathy (RCT) is a widespread musculoskeletal disorder and a primary cause of shoulder pain and limited function. The resulting pain and limited functionality have a detrimental impact on the overall quality of life. The purpose of this study was to perform a systematic review of the effects of extracorporeal shock wave therapy (ESWT) for RCT. METHODS: The literature search was conducted on the following databases from inception to February 20, 2024: PubMed, Web of Science, the Cochrane Library, Scopus, MEDLINE, EMBASE, EBSCO, and China National Knowledge Infrastructure (CNKI) were checked to identify the potential studies exploring the effect of ESWT for the treatment of Rotator cuff tendinopathy (Calcification or non-calcification), control group for sham, other treatments (including placebo), without restriction of date, language. Two researchers independently screened literature, extracted data, evaluated the risk of bias in the included studies, and performed meta-analysis using RevMan 5.3 software. RESULTS: A total of 16 RCTs with 1093 patients were included. The results showed that compared with the control group, ESWT for pain score Visual Analogue Scale/Score (VAS) (SMD = -1.95, 95% CI -2.47, -1.41, P < 0.00001), function score Constant-Murley score (CMS) (SMD = 1.30, 95% CI 0.67, 1.92, P < 0.00001), University of California Los Angeles score (UCLA) (SMD = 2.69, 95% CI 1.64, 3.74, P < 0.00001), American Shoulder and Elbow Surgeons form (ASES) (SMD = 1.29, 95% CI 0.93, 1.65, P < 0.00001), Range of motion (ROM) External rotation (SMD = 1.00, 95% CI 0.29, 1.72, P = 0.02), Total effective rate (TER) (OR = 3.64, 95% CI 1.85, 7.14, P = 0.0002), the differences in the above results were statistically significant. But ROM-Abduction (SMD = 0.72, 95% CI -0.22, 1.66, P = 0.13), the difference was not statistically significant. CONCLUSION: Currently limited evidence suggests that, compared with the control group, ESWT can provide better pain relief, functional recovery, and maintenance of function in patients with RCT.
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Tratamento por Ondas de Choque Extracorpóreas , Manguito Rotador , Dor de Ombro , Tendinopatia , Humanos , Tratamento por Ondas de Choque Extracorpóreas/métodos , Tendinopatia/terapia , Resultado do Tratamento , Manguito Rotador/fisiopatologia , Dor de Ombro/terapia , Lesões do Manguito Rotador/terapia , Medição da Dor , Ensaios Clínicos Controlados Aleatórios como Assunto , Amplitude de Movimento Articular , Qualidade de VidaRESUMO
PURPOSE: To evaluate the effectiveness and safety of arthroscopic surgery combined with platelet-rich plasma (PRP) compared with arthroscopic surgery alone in the treatment of patients with full-thickness rotator cuff tears. METHODS: The Cochrane Library, PubMed, Embase, Scopus, EBSCO, Web of Science, China National Knowledge Infrastructure, and Wanfang Database were systematically searched from inception to November 2023. Subject words combined with free words were used to collect randomized controlled trials focusing on arthroscopic surgery combined with PRP in the treatment of full-thickness rotator cuff tears. The assessment of evidence quality employed the Cochrane Collaboration risk of bias tool, and data analysis was performed using RevMan 5.3 software. RESULTS: A total of 9 studies with 537 patients were included. The meta-analysis revealed that compared with the arthroscopic surgery alone group, the summary result of University of California Los Angeles score scores in the arthroscopic combined with PRP group was (mean difference [MD] = 1.08, 95% confidence interval [CI] 0.19â¼1.97, P = .02), subgroup analysis of surgical suture method visual analog scale (VAS) single-row (MD = -1.00, 95% CI -1.50 to -0.50, P < .0001), VAS double-row (MD = -0.10, 95% CI -0.17 to -0.02, P = .02), and Constant-Murley score single-row (MD = 3.49, 95% CI 0.32â¼6.66, P = .03), the difference was statistically significant, and the differences in VAS, Constant-Murley score, and Quick Disabilities of the Arm, Shoulder and Hand, complications, and retear rate were not statistically significant. CONCLUSIONS: Patients undergoing arthroscopic repair combined with PRP treatment showed no difference in pain, function, complications, and retear rate compared with those treated with arthroscopic surgery alone. LEVEL OF EVIDENCE: Level II, systematic review and meta-analysis of Level I and II evidence.
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BACKGROUND: Compared with the Latarjet procedure, the Bristow procedure has a lower screw-related complication rate but poor bone healing. A modified Inlay Bristow procedure has been reported to significantly improve the bone healing rate, but the biomechanical mechanism is unclear. The aim of this study was to evaluate the biomechanical stability of the bone graft between a modified Inlay Bristow procedure and the classic Bristow procedure. METHODS: Sixteen left scapula models (Sawbones, Composite Scapula, and fourth generation) were randomly divided into 2 groups (8:8). The bone graft in the first group was fixed with a 3.5 mm screw using the Inlay structure. The bone graft in the second group was fixed with a 3.5 mm screw via the traditional method. The maximum cyclic displacement, ultimate failure load and stiffness were evaluated biomechanically. The failure type was recorded for each model. RESULTS: Cyclic loading tests demonstrated that the maximum cyclic displacement of the Inlay procedure was significantly smaller (P = .001) than that of the classic procedure. The Inlay Bristow technique resulted in a significantly higher (P = .024) ultimate failure load than the classic Bristow technique. The stiffness of the classic group was 19.17 ± 4.01 N/mm and that of the inlay group was 22.34 ± 5.35 N/mm (P = .232). Failure was mainly due to bone graft fractures through the drill hole or glenoid bone fractures. CONCLUSION: Inlay Bristow fixation of the bone graft in a Sawbones model provides significantly stronger fixation and better time point zero stability than classic Bristow fixation, suggesting a higher likelihood of graft union.
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Instabilidade Articular , Fraturas do Ombro , Articulação do Ombro , Humanos , Articulação do Ombro/cirurgia , Instabilidade Articular/cirurgia , Escápula/cirurgia , Parafusos ÓsseosRESUMO
PURPOSE: To compare clinical and computed tomography outcomes between the arthroscopic Latarjet procedure and the arthroscopic Bristow procedure. METHODS: Patients who underwent arthroscopic Latarjet or Bristow procedures with at least 2 years of follow-up were retrospectively reviewed. Thirty-eight shoulders were included in the Latarjet group, and 34 were included in the Bristow group. Recurrence of dislocation, clinical scores, rate of return to sports (RTS), and computed tomography assessment findings (position of transferred coracoid, graft healing, graft absorption, and glenohumeral degenerative osteoarthritis [OA]) were obtained at final follow-up. RESULTS: No recurrent dislocation occurred in either group, and no significant differences in clinical scores were found between the 2 procedures, with a mean follow-up period of 3.4 years. The operative time in the Bristow group was significantly shorter than that in the Latarjet group (P < .001). The transferred coracoid had healed in 94.7% of the patients in the Latarjet group and 85.3% in the Bristow group at final follow-up (P = .01). No significant difference in graft absorption or the degree of glenohumeral OA was detected between the 2 groups. However, moderate to severe OA only occurred in the Latarjet group at final follow-up (4 of 38 shoulders, 10.5%). The postoperative external rotation angle and level of RTS favored the Latarjet procedure (P = .030 and P = .034, respectively). CONCLUSIONS: Both the arthroscopic Latarjet and arthroscopic Bristow procedures led to good clinical scores with no new dislocation episodes. The Bristow group showed significantly less graft healing than the Latarjet group. However, the arthroscopic Bristow procedure took less operative time and showed a lower rate of early moderate to severe glenohumeral OA, better range of motion, and a higher rate of RTS. LEVEL OF EVIDENCE: Level III, retrospective comparative therapeutic trial.
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Instabilidade Articular , Luxação do Ombro , Articulação do Ombro , Humanos , Artroscopia/métodos , Seguimentos , Instabilidade Articular/cirurgia , Recidiva , Estudos Retrospectivos , Volta ao Esporte , Luxação do Ombro/cirurgia , Articulação do Ombro/cirurgiaRESUMO
PURPOSE: To investigate the clinical characteristics of intratendinous subscapularis (inSSC) tears. METHODS: Retrospectively, 69 patients with arthroscopically confirmed inSSC tears were identified from 2018 to 2019. Preoperatively and at final follow-up, thorough physical examination was performed and clinical outcomes (American Shoulder and Elbow Surgeons [ASES] score; University of California, Los Angeles [UCLA] score; visual analogue scale [VAS] for pain; and Simple Shoulder Test [SST]) were recorded. Features of pre-operative magnetic resonance image (MRI) such as high signalling within the tendon substance, communication to the bicipital groove and long head of biceps tendon (LHBT) lesions were investigated. Characteristics of arthroscopic view were investigated. Bear-hug and internal rotation resistance test at 90° abduction and external rotation (IRRT90°) test were used to assess the SSC strength. RESULTS: The mean follow-up was 2.4 (2-3) years. The prevalence of arthroscopically confirmed inSSC tears was 69/675 (10.2%) among arthroscopic rotator cuff repairs. Pre-operative physical examination found positive IRRT90° and bear-hug test in 41/60 (68.3%) and 42/69 (60.8%) patients, respectively. The Cohen kappa coefficient was interpreted to be substantial for the evaluation of all MRI parameters. According to the conditions of LHBT, inSSC tears were classified into 3 types: type I: without LHBT subluxation and tear; type II: with LHBT subluxation or tears and type III: with LHBT dislocation. At final follow-up, mean ASES, UCLA, VAS, and SST scores improved significantly from mean of 50.6 ± 14.7, 19.4 ± 3.07, 6.2 ± 2.0, and 6.1 ± 2.5 to mean of 90.7 ± 9.5, 32.2 ± 1.8, 1.4 ± 1.2 and 9.8 ± 2.2, respectively (P < 0.001). Bilateral symmetric strength was found by bear-hug and IRRT90° test in all patients postoperatively. CONCLUSION: Understanding features of pre-operative MRI, physical examination and arthroscopic view is helpful to identify inSSC tears. Arthroscopic repair yielded satisfactory clinical outcomes in patients with inSSC tears. LEVEL OF EVIDENCE: Level IV.
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Lesões do Manguito Rotador , Ursidae , Humanos , Animais , Manguito Rotador/cirurgia , Lesões do Manguito Rotador/cirurgia , Prevalência , Estudos RetrospectivosRESUMO
PURPOSE: This study aims to determine the rate of different levels of return to sports (RTS) in athletes undergoing the modified arthroscopic Bristow procedure and the factors associated with the level of RTS. METHODS: The study was performed retrospectively on patients with traumatic anterior shoulder instability who underwent the modified arthroscopic Bristow procedure with a minimum follow-up of 2 years. The RTS rate, the level of return and the timing of return were assessed. Additionally, factors such as preoperative basic information, clinical outcomes, graft position, graft healing and graft absorption were analysed to investigate their correlation with the level of RTS. Multivariate regression models were used to evaluate the factors affecting the level of RTS. RESULTS: In total, this study included 182 shoulders of 177 athletes undergoing the modified arthroscopic Bristow procedure. Of these patients, 142 (78.0%) shoulders of 137 athletes were enrolled, with a mean of 3.3-year follow-up. At the final follow-up, 134 (94.4%) shoulders were able to RTS, 123 (86.6%) shoulders were able to RTS to the pre-injury level, 52 (36.6%) shoulders could be completely "forgotten" without any psychological barrier during exercise. The multivariate logistic regression analysis identified the variable associated with RTS at the pre-injury level as previously failed arthroscopic Bankart repair (p < 0.001). As for the "forgetting" operated shoulder, the duration from first dislocation to surgery was a significant independent predictor (p = 0.034). CONCLUSION: Although a large majority of athletes were able to RTS at the pre-injury level after the modified arthroscopic Bristow procedure, about two-thirds of the athletes felt difference in shoulders on both sides and could not completely "forget" the operated shoulder during exercise. Previously failed Bankart repair and the duration from first dislocation to surgery were the risk factors associated with the level of RTS after the modified arthroscopic Bristow procedure. LEVEL OF EVIDENCE: IV.
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Luxações Articulares , Instabilidade Articular , Luxação do Ombro , Articulação do Ombro , Humanos , Luxação do Ombro/cirurgia , Articulação do Ombro/cirurgia , Volta ao Esporte , Instabilidade Articular/cirurgia , Instabilidade Articular/etiologia , Estudos Retrospectivos , Luxações Articulares/complicações , Artroscopia/métodos , Fatores de Risco , RecidivaRESUMO
GLYCOGEN SYNTHASE KINASE 3 physically interacts with VRN1 and regulates its accumulation to mediate flowering in wheat.
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Flores , Triticum , Flores/fisiologia , Triticum/genética , Triticum/metabolismo , Quinase 3 da Glicogênio Sintase , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Regulação da Expressão Gênica de Plantas/genéticaRESUMO
PURPOSE: To investigate the clinical outcomes and radiologic evaluation of an all-arthroscopic Latarjet procedure with modified button fixation. METHODS: Patients who received all-arthroscopic Latarjet procedure with modified suture button fixation between September 2015 to September 2016 were retrospectively reviewed. Indications for surgery were recurrent anterior shoulder dislocation with any 1 of these 3 conditions: glenoid defect >15%, contact-sport athlete, or failure after Bankart repair. Inclusion criteria included cases who received this surgery. Clinical outcomes were evaluated by University of California Los Angeles, ASES and Rowe score with a minimal follow-up of 3 years. Radiologic assessment on 3D computed tomography scan was performed preoperatively and postoperatively at different time points. Complications were also recorded. RESULTS: A total of 30 patients were eventually included in this study. The mean follow-up time was 38.0 ± 2.5 months. There were 25 patients who performed contact sports. Of them, 10 patients were without glenoid defect >15% or failed Bankart repair. The remaining 20 patients had glenoid defect >15%, including 2 failed Bankart cases. Ten patients had glenoid defect < 13.5%, and the rest 20 patients had > 13.5%. UCLA, American Shoulder and Elbow Surgeons, and Rowe score significantly improved during follow-up, and the improvement exceeded MCID for all patients. No severe complications were noted. In total, 86.7% of the graft positioning was measured as flush and 13.3% as medial. The bone union rate was 96.7% at 3 months postoperatively and at final follow-up. The remodeling process for the restoration of the normal anatomy of the lower part of glenoid was noted. CONCLUSIONS: All-arthroscopic Latarjet with modified suture button fixation can achieve stable fixation of the coracoid, good clinical outcomes (all patients with improvement exceeding MCID), low complications rate. Furthermore, the bone remodeling process contributes to the recovery of the normal anatomy of anteroinferior glenoid. STUDY DESIGN: Case series; Level of evidence, 4.
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Instabilidade Articular , Luxação do Ombro , Articulação do Ombro , Artroscopia/métodos , Humanos , Instabilidade Articular/cirurgia , Recidiva , Estudos Retrospectivos , Luxação do Ombro/etiologia , Luxação do Ombro/cirurgia , Articulação do Ombro/diagnóstico por imagem , Articulação do Ombro/cirurgia , SuturasRESUMO
The development of efficient electrocatalysts for the CO2 reduction reaction (CO2 RR) remains a challenge. Demonstrated here is a NiSn atomic-pair electrocatalyst (NiSn-APC) on a hierarchical integrated electrode, which exhibits a synergistic effect in simultaneously promoting the activity and selectivity of the CO2 RR to formate. The NiSn atomic pair consists of adjacent Ni and Sn, each coordinated with four nitrogen atoms (N4 -Ni-Sn-N4 ). The as-prepared NiSn-APC displays exceptional activity for the CO2 RR to formate with a turnover frequency of 4752â h-1 , a formate productivity of 36.7â mol h-1 gSn -1 and an utilization degree of active sites (57.9 %), which are superior to previously reported single-atomic catalysts. Both experimental data and density-functional theory calculations verify the electron redistribution of Sn imposed by adjacent Ni, which reduces the energy barrier of the *OCHO intermediate and makes this potential-determining step thermodynamically spontaneous. This synergistic catalysis provides a successful paradigm for rational design and preparation of atomic-pair electrocatalysts with enhanced performance.
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PURPOSE: To investigate the accuracy of preoperative 1.5 T magnetic resonance imaging (MRI) interpreted with standardized procedure for diagnosing subscapularis (SSC) tears identified by arthroscopy. The diagnostic accuracy of MRI for different types of SSC lesions was also evaluated. METHODS: Two-hundred and seventy-two consecutive patients with rotator cuff tears identified by arthroscopy were included into this study. All patients had preoperative MRI scans with 1.5 T strength. Totally, seven different signs of SSC tears were evaluated on MRI scans. The diagnostic value of MRI was evaluated, respectively, according to two classifications of SSC lesions. The definitive diagnosis for SSC lesions was based on the arthroscopic findings. RESULTS: Among the 272 patients in this study, 107 (39 %) had SSC tears confirmed by arthroscopy. The surgeons correctly diagnosed 88 of 107 patients with SSC tears. The overall sensitivity was 82.2 %. The sensitivity of MRI for types I, II, III, IV and V was 70, 82.4, 96, 100 and 100 %, respectively, based on the classification by Lafosse. The sensitivity of MRI for partial-thickness and partial-width, full-thickness and partial-width, full-thickness and full-width tear was 75.3, 96.2, 100 %, respectively, according to the classification by Kim. CONCLUSIONS: The sensitivity of MRI in predicting SSC tears preoperatively was improved with the current procedure. Understanding of certain MRI characteristics of SSC tears could increase the accuracy for diagnosing SSC lesions. 1.5 T MRI of the SSC was not reliable for predicting partial thickness and especially less than 1/3 width tears. LEVEL OF EVIDENCE: III.
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Artroscopia , Imageamento por Ressonância Magnética , Cuidados Pré-Operatórios , Lesões do Manguito Rotador/diagnóstico por imagem , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Lesões do Manguito Rotador/cirurgia , Sensibilidade e EspecificidadeRESUMO
PURPOSE: A new clinical test for evaluating subscapularis (SSC) integrity was described, and its diagnostic value was compared with the present SSC tests (the lift-off, belly-press, IRLS and bear-hug tests). The new test is called internal rotation resistance test at abduction and external rotation (IRRT). The test is performed at maximal 90° of abduction and maximal external rotation. METHODS: Two hundred and thirty-five consecutive patients suffering from rotator cuff injury were evaluated preoperatively. Six tests were performed to assess the function of the SSC: the lift-off, belly-press, IRLS, the bear-hug, IRRT at 0° abduction and 0° external rotation (IRRT0°) and IRRT at maximal 90° abduction and maximal external rotation (IRRTM). Arthroscopic findings were the reference for diagnosing of SSC lesions. RESULTS: The IRRTM test showed the greatest sensitivity (76.5 %), and IRLS (31.6 %) test had the lowest sensitivity. The IRRTM had the highest accuracy (79.0 %), and lift-off had the lowest accuracy (65.3 %). Positive IRRTM, bear-hug, belly-press, IRRT0° tests indicate that about one-third of the SSC is torn, and a positive lift-off and IRLS tests predict a severe tear at least two-thirds of the SSC. CONCLUSIONS: The IRRTM represents a sensitive diagnostic test for SSC lesions and improves the chance of finding the upper part of the SSC tears. When the IRRTM is positive, the surgeon should pay particular attention to detecting the SSC tendon during arthroscopy. LEVEL OF EVIDENCE: Diagnostic study, Level I.
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Amplitude de Movimento Articular , Lesões do Manguito Rotador , Articulação do Ombro/fisiopatologia , Traumatismos dos Tendões/fisiopatologia , Adulto , Idoso , Artroscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Exame Físico , Estudos Prospectivos , Rotação , Manguito Rotador/fisiopatologia , Ruptura , Lesões do Ombro , Articulação do Ombro/cirurgia , Traumatismos dos Tendões/diagnóstico , Traumatismos dos Tendões/cirurgiaRESUMO
BACKGROUND: There have been few studies using magnetic resonance imaging (MRI) to evaluate the clinical outcomes and structural results after arthroscopic repair of bursal-side partial-thickness rotator cuff tears (PTRCTs). METHODS: From 2009 to 2012, 73 consecutive patients with bursal-side PTRCTs underwent arthroscopic repair. Fifty-nine of them were retrospectively evaluated as Ellman classification grade 2 (group A, n = 11) or grade 3 (group B, n = 48). All repairs were performed with a technique that preserved the intact articular fibers and repaired the avulsed bursal flap. The University of California-Los Angeles (UCLA) score and Constant score were assessed before the operation and at the final follow-up. Postoperative cuff integrity was determined with MRI following Sugaya's classification. RESULTS: At the 2-year follow-up, the average UCLA score increased from 17.3 ± 3.7 to 33.3 ± 2.2, and the Constant score increased from 65.3 ± 12.9 to 93.9 ± 5.1 (P < .001). Forty-nine patients received follow-up MRI examinations at an average of 10.3 months after surgery. Of these 49 patients, 41 patients (83.7%) had a healed tendon and 8 patients had partial tears. Neither the clinical scores nor the retear rates on follow-up MRI were significantly different between the 2 groups. CONCLUSIONS: Arthroscopic repair of bursal-side PTRCTs achieved good functional and structural outcomes at a minimum of 2 years after surgery.
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Artroscopia/métodos , Imageamento por Ressonância Magnética , Lesões do Manguito Rotador , Manguito Rotador/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Bolsa Sinovial/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Ruptura/cirurgia , Resultado do Tratamento , CicatrizaçãoRESUMO
PURPOSE: The purposes of our study were to determine normative C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) values from a retrospective review of patients with and without infection after anterior cruciate ligament (ACL) reconstruction and to determine CRP and ESR threshold levels that can serve as diagnostic indicators of infection. We also tried to draw a curve of CRP and ESR value changes after treatment of ACL infection to evaluate the response to treatment of the infection. METHODS: A retrospective chart review was performed of arthroscopic ACL reconstruction patients from 2007 to 2008 (noninfection group) and all patients with postoperative intra-articular infection from 1997 to 2010 (infection group). We collected the CRP and ESR values on the third and fifth postoperative days in the noninfection group and before infection treatment and on the first, third, fifth, seventh, 10th, 14th, 21st, 28th, and 35th days after infection treatment in the infection group. Sensitivity, specificity, and Youden's index were calculated for different threshold values of CRP and ESR as predictors of infection. Receiver operator curves were obtained for CRP and ESR on the fifth postoperative day. RESULTS: Of 122 patients, 83 had normal joints and 39 had septic joints. The mean CRP and ESR values in patients with septic joints were 101.9 mg/L and 57.1 mm/h, respectively, which were significantly higher than those in the noninfection group (P < .01). A CRP value of 41 mg/L and ESR value of 32 mm/h were the optimal thresholds to predict an infection, which had the highest Youden's index of all calculated values and had sensitivity values of 94.1% and 91.2%, respectively, and specificity values of 97.6% and 80.5%, respectively. The peak CRP level after infection treatment occurred earlier than the peak ESR level (first day v third day) and returned to normal more quickly (21st day v 28th day). CONCLUSIONS: Both CRP and ESR were helpful in determining the presence of a normal or septic joint. The threshold values of 41 mg/L for CRP and 32 mm/h for ESR had the most optimal sensitivity and specificity. The peak CRP level occurred earlier than the peak ESR level after treatment of postoperative infection and returned to normal more quickly. In this study CRP was more useful than ESR to evaluate the response of infection to treatment. LEVEL OF EVIDENCE: Level IV, diagnostic study.
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Reconstrução do Ligamento Cruzado Anterior , Artrite Infecciosa/diagnóstico , Sedimentação Sanguínea , Proteína C-Reativa/análise , Complicações Pós-Operatórias/sangue , Adolescente , Adulto , Artrite Infecciosa/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Período Pós-Operatório , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
PURPOSE: To determine if anatomic double-bundle anterior cruciate ligament (ACL) reconstruction is superior to anatomic single-bundle reconstruction in restoring the stabilities and functions of the knee joint. METHODS: A prospective randomized clinical study was done to compare the results of 32 cases of anatomic single-bundle ACL reconstruction and 34 cases of anatomic double-bundle ACL reconstruction with average follow-up of 16.3 ± 3.1 months. Tunnel placements of all the cases were measured on 3D CT. Clinical results were collected after reconstruction; graft's appearance, meniscus status and cartilage state under arthroscopy were compared and analysed too. RESULTS: Tunnel placements, confirmed with 3D CT, were in the anatomic positions as described in literature both in SB and DB group. No differences were found between SB and DB groups in clinical outcome scores, pivot shift test and KT 1000 measurements (average side-to-side difference for anterior tibial translation was 0.7 mm in SB group and 1.0 mm in DB group). More than 70 % of the single-bundle graft and AM bundle graft in DB group appeared excellent, but only 44.1 % of PL bundle grafts in DB group were excellent and 11.8 % were in poor state. No new menisci tear was found either in SB or DB group, however, in DB group cartilage damages in medial patella-femoral joint occurred in 38.2 % cases. This rate was significantly higher than in the SB group which is only 9.3 %. CONCLUSION: Both single- and double-bundle anatomic ACL reconstruction can restore the knee's stability and functions very well. However, more incidences of poor PL status and medial patellar-femoral cartilage damage may occur in double-bundle ACL reconstruction.
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Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior/métodos , Traumatismos do Joelho/cirurgia , Adulto , Ligamento Cruzado Anterior/anatomia & histologia , Ligamento Cruzado Anterior/cirurgia , Artroscopia , Feminino , Seguimentos , Humanos , Traumatismos do Joelho/fisiopatologia , Articulação do Joelho/fisiologia , Articulação do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do TratamentoRESUMO
Objective: To explore the research progress of the coracoid transfer surgery using suture button fixation, particularly focusing on the technique known as Chinese unique Inlay Bristow (Cuistow surgery). Methods: Extensive literature review was conducted to summarize and analyze the utilization of suture button fixation in the Cuistow surgery, comparing its biomechanical and clinical outcomes with those of traditional screw fixation. Results: Utilizing suture button fixation in coracoid transfer surgery helps circumvent certain metal-related complications associated with traditional screw fixation. While its biomechanical stability and effectiveness have been preliminarily confirmed, debates persist regarding its graft healing rate and postoperative recurrence rate compared to traditional screw fixation. The Cuistow surgery based on the Inlay structure is a solution to improve the healing rate of graft after suture button fixation. Conclusion: Suture button fixation, as a novel approach in coracoid transfer surgery, remains to have its advantages and disadvantages compared to traditional screw fixation not entirely elucidated, underscoring the need for further in-depth clinical and fundamental research. Cuistow surgery is the Chinese experience of coracoid transfer surgery, and its biomechanical stability and clinical advantages have been preliminarily confirmed.
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Técnicas de Sutura , Humanos , Fenômenos Biomecânicos , Processo Coracoide/cirurgia , Parafusos Ósseos , Suturas , Transplante Ósseo/métodosRESUMO
This study aims to prevent ice accumulation on the surface of drilling tools by investigating the effectiveness of hydrophobic coatings, which is one of the most promising methods to solve drilling difficulties in warm ice. Herein, four types of hydrophobic organic coatings that can be used on metal surfaces were tested to evaluate their anti-icing performance, service durability, and friction properties. All of them possess rough surfaces with microstructure characteristics such as pores, stripes, or micropapillae. They also exhibit hydrophobicity, with water contact angles of 101.6°, 100.0°, 103.1°, and 108.5°. They can significantly prolong the required freezing time of water droplets on their surfaces, effectively reduce ice adhesion, and decrease the friction between ice and their surface. The ice adhesion in the axial, tensile, and tangential directions can be reduced by 65.64 %, 56.31 %, and 72.11 %, respectively, for the coating with silicon (Si)-based and fluorine (F)-containin compounds (coating-C) at -30 °C; while it can be reduced by 85.05 %, 73.9 %, and 94.2 %, respectively, for the coatings with Si-based and polytetrafluoroethylene (PTFE) compounds (coating-D). The two coatings mentioned above lose their anti-icing performance after 20 icing and de-icing cycles, and their hydrophobicity after 120 abrasion cycles under a load of 6 N.
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BACKGROUND: Rotator cuff injury (RCI) is a common musculoskeletal ailment and a major cause of shoulder pain and limited functionality. The ensuing pain and restricted movement significantly impact overall quality of life. This study aims to systematically review the effects of extracorporeal shock wave therapy (ESWT) on RCI. METHODS: This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. A literature search, spanning inception to November 1, 2023, will include databases such as PubMed, Web of Science, the Cochrane Library, Scopus, MEDLINE, EMBASE, EBSCO, and China National Knowledge Infrastructure (CNKI) to identify ESWT studies for RCI treatment. Excluding retrospectives, bias risk will be assessed with the Cochrane tool. Two researchers will independently screen, extract data, and evaluate bias risk. Revman 5.3 software will be used for data analysis. RESULTS: This study aims to objectively and comprehensively evaluate the effectiveness and safety of randomized controlled trials of ESWT in the treatment of RCI, and analyze in detail the effect of ESWT in the treatment of RCI. Results will be analyzed using the Pain Visual Analogue Scale (VAS), Constant-Murley score, University of California Los Angeles score (UCLA), and American Shoulder and Elbow Surgeons form (ASES). If applicable, subgroup analysis will also be performed to divide patients into groups according to the energy level of ESWT, the time of intervention, and the degree of tearing of RCI. Finally, the results are submitted for publication in a peer-reviewed journal. DISCUSSION AND CONCLUSION: There is existing evidence suggesting that ESWT may contribute to the amelioration of pain and functional limitations associated with Rotator Cuff Injury (RCI). This systematic review aims to update, consolidate, and critically evaluate relevant evidence on the effects of ESWT for RCI. The anticipated outcomes may serve as a valuable reference for clinical ESWT practices, covering treatment methods, timing, and intensity. Moreover, this review aspires to provide high-quality evidence addressing the impact of ESWT on RCI-related pain. Simultaneously, the findings of this systematic review are poised to offer guidance to clinicians and rehabilitation therapists. This guidance is intended to enhance the management of pain and functional impairments experienced by individuals with RCI, ultimately leading to improvements in their physical well-being. TRIAL REGISTRATION: Protocol registration number CRD42023441407. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023441407.