The purpose of this study was to evaluate the morpho-functional change of the patellar ligament in dogs affected by cranial cruciate ligament rupture. The hypothesis is that it may show increased thickening and stiffness with increasing days from trauma to diagnosis. Understanding this aspect have implications on the choice of timing to treat patients suffering from cranial cruciate ligament rupture, and also in the contextualization of patellar ligament desmitis pictures after surgical treatment with tibial plateau levelling osteotomy or tibial tuberosity advanced. Thirty-three dogs were affected affected by unilateral cranial cruciate rupture were examined and divided into three groups based on the time elapsed from the onset of lameness to diagnosis: Group 1 (from 1 to 15 days), Group 2 (from 16 to 60 days), Group 3 (over 60 days). Conventional B-mode ultrasonographic and elastosonographic examinations of patellar ligament were performed without sedation for each dog. At the ultrasonographic examination, all dogs showed alterations in the echostructure of the patellar ligament. In addition, the patellar ligament tended to become harder and less soft with increasing days after rupture, although there were not significant differences between groups. Our results showed that as time increases between the onset of cranial cruciate ligament rupture and diagnosis and treatment, the patellar ligament progressively thickens and loses its elasticity.

The knowledge on anatomy, function, biomechanics, and role on surgical procedures of the anterolateral ligament (ALL) of the knee is still controversial. Only a few papers have examined the ALL in children. The aim of this review is to analyse all the available literature about ALL in pediatric population. Following the PRISMA criteria, the literature was systematically reviewed, examining all the articles about ALL in pediatric patients. Eight articles were involved in the study. Five cadaveric studies, 2 diagnostic studies and 1 Cross-sectional study were found. The identification of the ALL is not always possible in diagnostic studies using the Magnetic Resonance (MRI) or in dissecting specimens. A high variability in the presence of the ligament, in its origin and insertion were found among the studies. In younger patients is more difficult to identify the ligament than in older children, suggesting that its presence may develop at some point during the growth. Further studies are needed for a detailed knowledge of the ALL.

Osteoarthritis (OA) has become one of the most common disabilities among elders, especially in female. Obesity and mechanical injury causing OA are attributed to joint loading, cartilage disintegration, bone loss and inflammation as well. Several strategies used for treatment OA including non-pharmacological and pharmacological. Fucoidan possesses several bioactivities such as antitumor, antiviral, anticoagulation, anti-obesity, and immunomodulation. This study aims to investigate the effect of fucoidan in surgery-induced OA on diet-induced obesity rats. OA was induced by anterior cruciate ligament transection and partial medial meniscectomy (ACLT+MMx). Male SD rats were fed high-fat diet (HFD) for 4 weeks to induce obesity before ACLT+MMx to induce OA. OA rats were administered with intragastric water or fucoidan in three different concentrations (32 mg/kg, 64 mg/kg, and 320 mg/kg) after the surgeries for 40 days with HFD. We observed that the swelling in knee joint was alleviated and hind paw weight distribution was rectified after feeding fucoidan, with no significant effect on weight gain and feed intake. Fucoidan administration indicated no significant variation on HDL-Cholesterol level, but reduced plasma triglycerides and LDL-Cholesterol level. In addition, weight-bearing tests showed improvement in the fucoidan-treated group. Our results suggested that fucoidan may improve meniscal/ligamentous injury and obesity-induced OA.

Background: Dental avulsion is the most serious dentoalveolar traumas because its management requires immediate reimplantation to maintain the periodontal ligament. The success of the treatment depends largely on the appropriate storage medium that ensures the viability of the periodontal cells. The purpose of this review was to identify the most efficient media to store and transport avulsed permanent teeth, according to the viability of the periodontal ligament cells. Methods: The Scopus, Web of Science and PubMed electronically searched using the keywords “Storage media”; “Avulsed teeth”; and “Periodontal ligament”. The inclusion criteria were in vitro studies and articles published in English. The exclusion criteria were literature reviews, studies in primary teeth, studies in animals, and cell culture studies. Results: Hank’s saline solution and honey were equally effective, maintaining a cell viability rate of 98.89% and 96.43%, respectively, over a period of 3 hours. Ringer’s lactate solution maintained the viability of 906.40 viable cells/mm3 at 1 hour. Propolis maintained the viability of 285,000 cells/mm3 at 45 minutes, and the Neem extract maintained a cell viability rate of 88% at 30 minutes. Conclusions: Hank’s saline solution is the most effective storage medium for maintaining the viability of periodontal cells in avulsed teeth.

Background: The optimisation of this return to athletic activity pass by a better understanding of the behaviour of the muscle involved in knee function.In this study, we focused on the muscular activity of the muscle involved in the flexion of the knee. Preciseley on the relation between the muscular activity of the gastrocnemius and the hamstring among the patient that underwent an anterior cruciate ligament reconstruction with hamstring graft.Objective : The objective of the study is to compare, the muscular activity of the flexor knee muscle in patient that underwent an anterior cruciate ligament reconstruction with hamstring autograft and the individuals that have not undergone surgery.Methods : The participants have been divided into two groups : an healthy group and an experimental group that underwent an anterior cruciate ligament recontruction with hamstring graft. The participants had to performe a strenght test on a isocinetik dynamometer. The activity of the medial gastrocnemius, lateral gastrocnemius, femoral biceps and the semitendinosus were mesured during this test.The muscular activity of the muscle mentioned of the individuals in the first group were compared to the ones in the second group via a statistical analysis. Then, a ratio of the activity of the gastrocnemius muscle on the activity of the hamstring was calculated The results of the experimental group were then compared to the results of the control groupResults : The results showed a significative difference activity of the medial gastrocnemius, the femoral biceps and the semitendinosus muscles : the experimental group results were superior to the control group results However the evaluation of the activity reporting has shown significant differences in the two groupsConclusion : This study has allowed us to show a difference in muscular activity of the gastrocnemius and hamstring muscle between patient that underwent an anterior cruciate ligament reconstruction surgery and the heathy participants. However our approch has not allowed us to identify the relation between a heihtened gastrocnemius activity and a diminished hamstring activity following an anterior cruciate ligament reconstruction with hamstring graft. Quite on the contrary, we observed a higher activity of the two muscle groups. Nevertheless, it seem to be necessary to have a variation in situations during the analysis of the gastrocnemius muscle to fully understans its purpose in the functional activity of the knee of patient that have undergone an anterior cruciate ligament reconstruction.

Background: After the increasingly common anterior cruciate ligament reconstruction (ACLR) procedure in competitive athletes, rehabilitation is crucial for facilitating a timely return to sports (RTS) and preventing re-injury. This pilot study investigates the biomechanical and psychological outcomes of postoperative rehabilitation in competitive athletes, comparing supervised rehabilita-tion (SVR) and home-based rehabilitation (HBR). Methods: After ACLR, 60 (out of 74 screened) athletes were recruited and equally divided into 2 groups using non-probability convenience sam-pling: 30 HBR and 30 SVR (each group comprising 15 males and 15 females). Rehabilitation out-comes in respective groups were evaluated at 8 months using measures (Tegner-Activity-Scale [TAS], International Knee Documentation Committee subjective knee form [IKDC-SKF], ACL Return to Sport after Injury [ACL-RSI]) and objective parameters (isometric muscle strength, hamstring/quadriceps asymmetry). RTS was evaluated at 9 months; with ACL re-injury rates rec-orded approximately 6 months post-RTS. Results: Both groups exhibited decreased TAS scores (HBR: 8 to 6, SVR: 8 to 7), with the SVR group demonstrating superior post-operative IKDC-SKF scores (81.82 vs. 68.43) and lower ACL-RSI scores (49.46 vs. 55.25). Isometric and isokinetic mus-cle strength, along with asymmetry values, favored the SVR group 8 months post-ACLR (p

Rehabilitation following anterior cruciate ligament reconstruction with hamstring graft allows the patient to regain his functional capacities and to support him in the resumption of sports activities. Rehabilitation also aims to minimize the risk of recurrence, which is why it ensures that the patient's muscular capacities develop properly until they return to sport. Isokinetics helps strengthen and assess the strength of muscle groups in the thigh, but controversy exists as to its use by resistance to the open kinetic chain knee extension that would cause the transplant to distend. The objective of this study is to determine the influence of isokinetic muscle strengthening on the possible laxity of the anterior cruciate ligament and to be able to determine risk factors. The study relates to a population having benefited from anterior cruciate ligament reconstruction with hamstring graft from 3 to 6 months after surgery. Two groups are differentiated, one group exposed to isokinetism during rehabilitation, the other group, named unexposed, undergoes rehabilitation without the use of isokinetism. An anterior knee laxity test is performed 6 months postoperatively using the GNRB® machine for all subjects according to the same protocol. The test results were statistically analyzed to determine a relative risk of transplant distension for each group in the study. Comparison of the results of each group by univariate analysis did not reveal any significant result. Multivariate analysis showed interactions in the two strata of the study. It was argued that the use of isokinetics seems to have no effect on the risk of developing distension for the majority of subjects in the exposed group. A tendency towards transplant protection was perceived for each variable except the age under 25 years (RRa = 1.07). The use of isokinetics does not appear to be a cause of transplant distension in patients undergoing an anterior cruciate ligament reconstruction when this method is introduced 3 months postoperatively.

The anterior cruciate ligament (ACL) injury is the most serious injury in judo. Therefore, its prevention is of great importance. The main mechanism of injury is the collapse of the knee in valgus, which usually occurs when there are deficits of strength and neuromuscular control of the core, external rotators and hip abductors, as well as limitations of ankle and hip mobility. In most sports there is a difference in the prevalence of this injury between both sexes, being more common in women. Therefore, in the present study we observed this possible intersexual disparity in the difference of movement patterns among elite judokas according to their sex, in order to identify those athletes with a higher risk of ACL injury. In addition, it was not observed differences between sexes in the performance of the Single Leg Squat test (SLS test); There was worse neuromuscular control of the non-dominant leg in men and women; No differences were observed in in the range of motion of ankle dorsiflexion and hip external rotation between men and women, but there were differences in internal rotation, a movement whose restriction may be related to an increased risk of ACL injury.

Variable during practice is widely accepted to be advantageous for motor learning and therefor a valuable strategy to effectively reduce high-risk landing mechanics and prevent primary anterior cruciate ligament (ACL) injury. Few attempts have examined the specific effects of variable train-ing in athletes who have undergone ACL reconstruction. Thereby it is still unclear to what extent the variations in different sensor areas lead to different effects. Accordingly, we compared the effects of versatile movement variations (DL) with variations of movements with emphasis on disrupting visual information (VMT) in athletes who had undergone ACL reconstruction. For-ty-five interceptive sports athletes after ACL reconstruction were randomly allocated to a DL group (n= 15), VT group (n= 15) or control group (n= 15). The primary outcome was functional performance (Triple Hop Test). The secondary outcomes included dynamic balance (Star Excur-sion Balance Test (SEBT)), biomechanics during single-leg drop-landing task hip flexion (HF), knee flexion (KF), ankle dorsiflexion (AD), knee valgus (KV), and vertical ground reaction force (VGRF), and kinesiophobia (Tampa Scale of Kinesiophobia (TSK)) assessed before and after the 8-weeks of interventions. Data were analyzed be means of 3×2 repeated measures ANOVA fol-lowed by post hoc comparison (Bonferroni) at the significance level of p≤0.05. Significant group × time interaction effects, main effect of time and main effect of group were found for triple hop test, all eight directions of SEBT, HF, KF, AD, KV, VGRF and TSK. There was no significant main ef-fect of group in HF and triple hop test. Also, significant differences in triple hop test, seven direc-tions of SEBT, HF, KF, KV, VGRF and TSK were found between control group with the DL and VMT groups. Between group differences in AD and medial direction of SEBT were not signifi-cant. Also, there was no significant differences between VMT and control groups in triple hop test and HF variables. Both motor learning (DL and VMT) programs improved outcomes in patients after ACL reconstruction. Findings suggest that DL and VMT training programs lead to compa-rable improvements in rehabilitation.

Today, rupture of the anterior cruciate ligament is the most common heavy injury in athletes, but it can also occur in sedentary subjects. Its treatment, always adapted to the lifestyle, age and will of the patient, often remains surgical. However, despite its frequency and universality, there are still walking disorders following the operation. These disorders sometimes persist for several months, or even several years after surgery. The present study is therefore interested in determining the risk factors linked to walking disorders following reconstruction of the anterior cruciate ligament. The objective of this study is to determine what risk factors associated with walking disorders are after reconstruction of the anterior cruciate ligament by hamstring graft. This study focused on factors that may exist at 3 and 6 months postoperatively. Two populations participated in this study, a healthy population and a population having benefited from reconstruction of the anterior cruciate ligament. The operated test group is divided into two subgroups, one with a postoperative period of 3 months and the second at 6 months. All subjects were subjected to the same protocol, their gait on the treadmill was analyzed and evaluated with an Optogait® analysis system. A univariate analysis was carried out first. Then, a multivariate analysis by adjustment method was carried out in order to eliminate the potential confounding factors. The comparison of the results between the populations in the univariate analysis shows an absence of significant results however there are trends. The statistical results of the multivariate analysis showed interactions in the two subgroups of the operated population.In fact, it turns out that at 3 months there is a tendency to worse gait disorders in subjects with a high BMI reflecting overweight, when an associated surgical procedure has taken place on the meniscus, in subjects over 35 years of age and males. On the other hand, at 6 months, the tendency to worsening is visible only in the strata represented by subjects with a BMI corresponding to overweight, as well as in subjects having benefited from a meniscal suture associated with ACL reconstruction. .The results of the present study show that there are certain factors which tend to increase the risk of these walking disorders after reconstruction of the anterior cruciate ligament by hamstring graft, these factors are different depending on the time postoperative.

Prosthetic device is designed to function as a replacement for a missing limb and typically consists of suspension, liner, socket, pylon and foot components. The objectives of this research are to design a pylon component of a transtibial prosthetics by implementing auxetic metamaterial and to also validate performance of the designed pylon under quasi-static and dynamic conditions. The design and analysis processes are conducted using the finite element analysis and its effectiveness is validated by experimental testing of the prototype pylon sample. In the design process, the pylon structure is formulated by rearranging 2D re-entrant hexagon model into 3D model. It is identified from the design evaluation that the pylon exhibits the stiffness of the value of 79.24, 2371.6, and 13344 kN/m for the ligament thickness variation of 0.3 mm, 1 mm, and 2 mm, respectively. This directly indicates a capability of the stiffness tuning of the pylon by changing the ligament thickness. It is evaluated that the pylon with the ligament thickness of 0.3 mm causes the deformation of 0.53 cm during a single period of gait cycle, while the ligament thickness of the 1 mm causes the deformation of 0.4 cm. The deformation physically indicates the energy absorption of the pylon structure and hence the thinner ligament, the higher energy absorption provides. It is also found from the deformation transition of the primary and secondary bends, the negative Poisson’s ratio is occurred in 3D model transformed from 2D re-entrant hexagon.

We performed arthroscopically assisted coracoclavicular (CC) stabilization using a suture button device for modified Neer type IIb lateral clavicle fractures accompanied by CC ligament injury. The purpose of the present study was to evaluate the radiological and clinical outcomes of this procedure. Six consecutive patients with modified Neer type IIb fractures were treated with the technique and followed for 12 months. Postoperative ranges of motion (ROMs) and X-rays were evaluated every 3 months. Shoulder functional scores (University of California Los Angeles score, Japanese Orthopedics Association score), visual analog scale (VAS) scores for pain at rest, at night, and during motion, and VAS score for satisfaction were analyzed at 12 months after surgery. For the clinical outcomes, early ROM recovery and excellent outcomes were achieved. For the radiological outcomes, all patients accomplished bone union, slight superior displacement was noted in the CC distance and Dog Bone distance, and bone hole dilation was observed in the superior coracoid and inferior clavicle, but there were no critical complications. The present findings indicate that arthroscopically assisted CC stabilization with a suture button device for unstable lateral clavicle fractures can produce satisfactory radiological and clinical results.

Introduction and Problem: With conventional mechanical rotation measurement of joints, only static measurements are possible with the patient at rest. In the future, however, it would be interesting to carry out dynamic rotation measurements, for example when walking or doing sports. Therefore, a measurement method with an elastic capacitive measuring system was developed and validated. Material and Methods: The measurement system consists of a capacitive strain gauge connected to a flexible printed circuit board. The electronics on the printed circuit board are used for data acquisition and transmission. When the sensor strip is stretched, the distance between the fingers of the strain gauge changes and with it the capacitance. Consequently, the strain can be measured via the change in capacitance. The measurement system is taped to the knee with the sensor on the skin in the direction of the anterolateral ligament (ALL). The bottom of the sensor (silicone) and the bottom of the circuit board are in contact with the knee surface. The sensor must be attached to the knee without pre-stretching The system is validated with an in vivo test on 11 patients. For this purpose, the internal rotational laxity of the knee was tested on healthy volunteers and the results compared with the measurements on the static measuring device (Laxitester). The subjects are placed in the supine position. First the left and then the right leg is clinically examined one after the other and documented using an examination form. Exclusion criteria are the presence of a pathological ligament findings in the area of the collateral/cruciate ligaments, previous knee operations or limitations in the range of motion. The distal thigh rests on a support bench on which a knee joint flexion of 30° is set by height adjustment. The femoral condyles are secured against rotation in the positioning aid by posts. This also prevents internal rotation and displacement of the thigh. The foot is strapped into the holding device without shoes. The second toe beam is centered using an adjustable side clamp on the medial and lateral edge of the foot. Dorsiflexion is set at 2 Nm with a torque meter, in accordance with previous studies, to rule out rotational laxity in the ankle. The strain gauge sensor is taped to Gerdii’s tubercle in the course of the antero-lateral ligament below the lateral epicondyle of the thigh. Then, in three repeated measurements, the internal rotation of the foot and thus the lower leg is measured with a torque of 2 Nm. The change in length of the stretch mark is compared with the measured internal rotation angle in the static measuring device (Laxitester). Results: A significant difference between the sexes was found in the internal rotation range of the knee (p=0.003). The range of rotation was greater for female participants than for male participants. Regarding the measured length change values, the measurements presented showed an individual result for each participant, which tended to decrease with increasing internal rotation angle, with no age or gender differences being observed. The stiffness of the strain gauge was in the linear range for all measurements, within the first 20% strain of the sensor. The differences determined do not result from a different stretching of the sensor, but from individual differences between the test persons. The comparison between length change and internal rotation angle of the knee showed a strong positive correlation (r=1, p<0.01). Conclusion: Elastic capacitive strain gauges can be used to reliably measure the internal rotation angle of the knee joint. This will allow dynamic measurements in the future.

The aim of this study was to evaluate the effects of autologous microfragmented adipose tissue (MFAT), obtained by mechanical fragmentation, on radiographic bone healing in dogs subjected to tibial plateau levelling osteotomy (TPLO). Twenty dogs with unilateral cranial cruciate disease were enrolled and randomly assigned to the treatment group (MFAT) or the control group (NT). The MFAT group underwent TPLO and autologous MFAT intra-articular administration while the NT group underwent TPLO alone. The adipose tissue was collected from the thigh region and MFAT was obtained by mechanical fragmentation at the end of the surgery. The patients were subjected to X-ray exam preoperatively, immediately postoperatively (T0) and at 4 (T1) and 8 (T2) weeks postoperatively. Two radiographic scores that had previously been described for the evaluation of bone healing after TPLO were used. A 12-point scoring system (from 0 = no healing to 12= complete remodelling) was used at T0, T1 and T2, while a 5-point scoring system (from 0 = no healing to 4 = 76%–100% of healing) was used at T1 and T2. The median healing scores were significantly higher at T1 and T2 for the MFAT group compared with the NT group for the 12-point (p < 0.05) and 5-point (p < 0.05) scoring systems. The intra-articular injection of autologous microfragmented adipose tissue can accelerate bone healing after TPLO without complications.

Background: Runners have high incidence of repetitive load injuries, and habitual runners often use smartwatches with embedded IMU sensors to track their performance and training. If accelerometer information from such IMUs can provide information about individual tissue loads, then running watches may be used to prevent injuries. Methods: We investigate a combined physics-based simulation and data-based method. 285 running trials from 76 real runners are subjected to physics-based simulation to recover forces in the Achilles tendon and patella ligament, and the collected data are used to train and test a data-based model using elastic net and gradient boosting methods. Results: Correlations up to 0.95 and 0.71 for the patella ligament and Achilles tendon forces, respectively, are obtained, but no single best predictive algorithm can be identified. Conclusions: Prediction of tissues loads based on body-mounted IMUs appears promising but requires further investigation before deployment as a general option for users of running watches to reduce running-related injuries.

Abstract: Periodontal disease is the main reason for tooth loss in adults. Tissue engineering and regenerative medicine are the advanced technologies used to manage soft and hard tissue defects caused by periodontal disease. We developed a transforming growth factor-β3 chitosan sponge (TGF-β3/CS) to repair periodontal soft and hard tissue defects. We investigated the proliferation and osteogenic differentiation behaviors of primary human periodontal ligament stem cells (hPDLSCs) to discuss the bioactivity and application of TGF-β3 in periodontal disease. We separately used Calcein-AM/PI double-labeling or CM-Dil-labeling coupled with fluorescence microscopy to trace the survival and function of the cells after implantation in vitro or in vivo. The mineralization of osteogenic differentiated hPDLSCs was confirmed by measuring ALP activity and calcium content. The levels of COL I, ALPL, TGF-βRI, TGF-βRII, and Pp38/t-p38 were tested using Western blot to explore the mechanism of bone repair prompted by TGF-β3. When hPDLSCs were inoculated with different concentrations of TGF-β3/CS (62.5–500 ng/mL), ALP activity was the highest in TGF-β3 (250 ng/mL) group after seven days (P < 0.05 vs. control); the calcium content in each group increased significantly after 21 and 28 days (P < 0.001 vs. control). The best result was achieved in the TGF-β3 (500 ng/mL) group. All results showed that TGF-β3/CS can promote osteogenic differentiation of hPDLSC and may be involved in the p38 MAPK signaling pathway. TGF-β3/CS has the potential for application in the repair of incomplete alveolar bone defects.

Different bone bruise patterns observed on magnetic resonance imaging (MRI) after non-contact anterior cruciate ligament (ACL) rupture and lateral patellar dislocation may indicate different injury mechanism of knee. In order to investigate the typical bone bruising patterns after ACL rupture and patellar dislocation. In this study, 77 ACL rupture and 77 patellar dislocation patients’ knee MR images with bone bruises between August 2020 and March 2022at our institution were selected and analyzed, respectively. Sagittal and transverse planes images were used to determine the bone bruise location in the lateral-medial and superior-inferior directions of the MR images. The presence, location, and intensity of the bone bruises within specific compartments of the femur and tibial after ACL rupture and patellar dislocation were recorded. Relative bone bruise patterns of the ACL rupture and patellar dislocation were classified and analyzed. Results showed that there were 4 kinds of bone bruise (1-,2-,3-,4- bone bruises) patterns after ACL rupture. The most common two patterns after ACL rupture were 3- bone bruises (including lateral side of femur and both lateral and medial side of tibia, LF+BT; both lateral and medial side of femur and lateral side of tibia, BF+LT, medial side of femur and both lateral and medial side of tibia, MF+BT) followed by 4- bone bruises (both lateral and medial side of femur and tibia, BF+BT), 2- bone bruises (LF+LT, lateral side of femur and tibia; MF+LT, medial side of femur and lateral side of tibia; LF+MT, lateral side of femur and medial side of tibia; MF+MT, medial side of femur and tibia; 0+BT, both lateral and medial side of tibia;), and 1- bone bruise (0+LT, only lateral side of tibia). There was only 1 pattern bone bruise (latera femur and medial patella bone bruise) of patellar dislocation, the most common pattern of patellar dislocation was in the inferior medial patella and lateral anterior inferior femur. The results suggest that the pattern of bone bruise after ACL rupture and patellar dislocation is completely different. There were 4 kinds of bone bruise patterns after non-contact ACL rupture while there was only 1 kind of bone bruise pattern after patellar dislocation bone bruise patients which was in the inferior medial patella and lateral anterior inferior femur.

Background: The objective of the present study was to evaluate the formation of biofilm in bone patellar tendon bone grafts (BPTB grafts) and to compare it to the formation of biofilm formation in quadrupled hamstring anterior cruciate ligament grafts (4xHt graft). Methods: A descriptive in vitro study was conducted. One 4xHt graft and one BPTB graft were prepared. They were then contaminated with a strain of S. epidermidis. Later, a quantitative analysis was carried out by means of microcalorimetry and sonication with plating. Additionally, a qualitative analysis was carried out by means of electron microscopy. Results: No significant differences were found between the bacterial growth profiles of 4xHt graft and BPTB graft in microcalorimetry and colony counting. In the samples analyzed with electron microscopy, no specific biofilm growth pattern was identified upon comparing BPTB graft to 4xHt graft. Conclusions: There were no significant differences at either the quantitative or qualitative level when comparing bacterial growth in BPTB graft to that in 4xHt graft. Therefore, the presence of sutures in 4xHt graft cannot be established as a predisposing factor for increased biofilm growth in this in vitro study.

Periodontal ligament fibroblasts (PdLFs) exert important functions in oral tissue and bone remodeling following mechanical forces, which are specifically applied during orthodontic tooth movement (OTM). Located between the teeth and the alveolar bone, mechanical stress activates the mechanomodulatory functions of PdLFs including the regulation of local inflammation and activation of further bone-remodeling cells. Previous studies suggested the growth differentiation factor 15 (GDF15) as important pro-inflammatory regulator during the PdLFs mechanoresponse. However, the precise mechanism remains to be clarified, as GDF15 may act both intracrine and by receptor binding, potentially also in an autocrine manner. The extent to which PdLFs are susceptible to extracellular GDF15 has not yet been investigated. Thus, our study aims to examine the influence of GDF15 exposure on cellular properties of PdLFs and their mechanoresponse, which seems particularly relevant regarding disease- and aging-associated elevated GDF15 serum levels. Therefore, in addition to investigating potential GDF15 receptors, we analyzed its impact on proliferation, survival, senescence, and differentiation of human PdLFs, demonstrating a pro-osteogenic effect upon long-term stimulation. Furthermore, we detected an altered force-related inflammation and impaired osteoclast differentiation. Overall, our data suggest a major impact of extracellular GDF15 on PdLFs differentiation and their mechanoresponse.

Background and Objectives: This study aimed to evaluate the effects of subtalar joint axis-based balance exercises on the anterior talofibular ligament (ATFL) thickness, ankle strength, and ankle stability after an arthroscopic modified Broström operation (AMBO) for chronic ankle instability (CAI). Materials and Methods: The study included 47 patients diagnosed with CAI who underwent AMBO and were randomly divided into three groups: control (n=11), general balance exercise (n=17), and subtalar joint axis balance exercise (n=19), regardless of the affected area. Participants in the exercise rehabilitation group performed exercises for 60 min twice a week for 6 weeks, starting 6 weeks after AMBO. ATFL thickness, ankle strength, and ankle dynamic stability were measured using musculoskeletal ultrasonography, Biodex, and Y-balance test, respectively, before and after treatment. Results: Compared with the remaining groups, the subtalar joint axis balance exercise group had reduced ATFL thickness (p = 0.000), improved ankle strength for eversion (p = 0.000) and inversion (p = 0.000), and enhanced ankle stability (p = 0.000). Conclusions: The study results suggests that subtalar joint axis-based balance exercises may contribute to the early recovery of the ankle joint after AMBO.

Transarterial embolization (TAE) for high-flow pancreaticoduodenal artery (PDA) aneurysms in patients with celiac-trunk stenosis by the median arcuate ligament (MAL) has been found effective both after rupturing and to prevent rupture. The objective was to describe the TAE techniques used and their effectiveness in excluding PDA aneurysms due to MAL syndrome. This single-center retrospective study done at the Dijon-Bourgogne University Hospital included all patients treated by TAE in 2010–2022 for ruptured or unruptured high-flow PDA aneurysms caused by MAL syndrome. We identified 14 patients (7 women and 7 men; mean age, 64 years). Packing and trapping techniques were used alone or together. Occlusion was with microcoils, co-polymer, or cyanoacrylate glue, used separately or combined. Technical success was achieved in 13 (93%) patients. Clinical success was achieved in 12 (86%) patients. One major and two minor complications were recorded within the first 30 days. No complications occurred after 30 days. Follow-up ranged from 1 to 84 months. No cases of aneurysm recanalization were recorded to date. TAE had high technical and clinical success rates in our patients with unruptured or ruptured PDA aneurysms due to MAL syndrome.

A tricalcium silicate nanoparticle-containing cement (NPC) was developed to overcome the disadvantages of existing mineral trioxide aggregate (MTA) dental materials. This study aimed at evaluating the effects of NPC on the osteogenic differentiation of human periodontal ligament fibroblasts (HPLFs) in vitro, and on the healing of furcal perforations created experimentally in rat molars in vivo, in comparison to MTA. The in vitro studies performed the following assays; pH measurement using a pH meter, the release of calcium ions using a calcium assay kit, cell attachment and morphology using SEM, cell proliferation using a coulter counter, marker expression using quantitative reverse transcription polymerase chain reaction (qRT-PCR) and cell mineralized deposit formation using Alizarin Red S (ARS) staining. In the in vivo studies, MTA and NPC were used to fill the rat molar perforations. Rat molars were processed at 7, 14 and 28 days for analysis of inflammatory processes using hematoxylin and eosin (HE) staining, immunohistochemical staining of Runx2 and tartrate-resistant acid phosphate (TRAP) staining. The results demonstrate that the nanoparticle size distribution of NPC is critical for osteogenic potential at an earlier stage compared to MTA. Further studies are required to elucidate the mechanism of action of NPC in osteogenic differentiation.

The selection of biomaterials for biomedical application is a significant challenge. In the last few decades, various bioabsorbable and stable biopolymers have been applied for use as biomedical devices in orthopedic applications. Ultra-high molecular weight polyethylene (UHMWPE) has been extensively used in medical implants, notably in the bearings of hip, knee, and other joint prostheses, owing to its biocompatibility and high wear resistance. For the ACL graft, synthetic UHMWPE is an ideal candidate due to its biocompatibility and its extremely high tensile strength. Despite the appeal of new advanced materials such as carbon fiber, poly-ether-ether ketone, and other load-bearing materials, UHMWPE remains a primary load-bearing candidate material for ACL reconstructions because of its extremely high strength, the simplicity of the fabrication process, its biocompatibility, and low friction. However, some significant problems are observed in UHMWPE based implants, such as wear debris, and oxidative degradation due to the generation of free radicals when exposed to irradiation with gamma rays for grafting or sterilization. Various innovative methodologies have been developed to resolve those problems and enhance the properties of UHMWPE. In this review, we will explore in detail the methods for surface functionalization of UHMWPE and will apply these findings to the case study of UHMWPE for Anterior Cruciate Ligament repair.

The present study aimed to analyze novel mechanisms underlying Nrf2-mediated anti-apoptosis in periodontal ligament stem cells (PDLSCs) in the periodontitis oxidative microenvironment. We created an oxidative stress model with H2O2-treated PDLSCs. Herein, we used real-time PCR, western blotting, TUNEL staining, fluorogenic assay and transfer genetics to confirm the degree of oxidative stress and apoptosis as well as the Nrf2 function. Surprisingly, we demonstrated that with up-regulated ROS and MDA levels, the effect of oxidative stress was obvious under H2O2 treatment. Anti-oxidative molecules were changed after the H2O2 exposure, whereby the anti-oxidative signaling of Nrf2 was activated with the increase of its downstream effectors, HO-1, NQO1 and γ-GCS. Additionally, the apoptosis levels gradually increased with oxidative stress and changes in the caspase-9, caspase-3, Bax and c-Fos levels, but not with caspase-8 and down-regulated Bcl-2. The enhanced antioxidant effect could not resist the occurrence of apoptosis. Furthermore, Nrf2 overexpression effectively improved the anti-oxidative levels and increased cell proliferation. At the same time, overexpression effectively restrained TUNEL staining and decreased the molecular levels of caspase-9, caspase-3, et al, but not that of caspase-8. By contrast, silencing the expression Nrf2 levels had the opposite effect. Collectively, Nrf2 alleviates PDLSCs via its effects on anti-oxidative and anti-intrinsic apoptosis by the activation of anti-oxidative enzymes.

Tendons and ligaments injuries are frequent in sport horses and humans, representing a great therapeutic challenge. Tissue regeneration and function recovery are the paramount of tendon and ligament lesions management. Nowadays, several regenerative treatments are being developed, based on the use of stem cell and stem cell-based therapies. In the present study, the preparation of equine synovial membrane mesenchymal stem cells (eSM-MSCs) for clinical use - collection, transport, isolation, differentiation, characterization, and application is described. These cells are fibroblast-like and grow in clusters. They retain an osteogenic, chondrogenic and adipogenic differentiation potential. 16 clinical cases of tendonitis and desmitis, treated with allogenic eSM-MSCs and autologous serum are also presented, including their evaluation, treatment and follow-up. The use of autologous serum as a vehicle concern to a decreased immunogenic response after the administration of this combination and to its healing properties, due to the presence of growth factors and immunoglobulins. Most of the cases (14/16), healed in 30 days and presented a good outcome. Treatment of tendon and ligament lesions with the mixture of eSM-MSCs and autologous serum appears to be a promising clinical option for this category of lesions in equine patients.

Background: Osteoclastic bone resorption in the compression zone of periodontal ligament (PDL) plays a role in orthodontic tooth movement, and is regulated by the balance of RANKL and OPG. Compression downregulates OPG, conversely, tension upregulates OPG in PDL cells. However, the regulatory mechanism of OPG expression in PDL cells under different mechanical stresses remains unclear. Methods: To study microRNA (miRNA) expression profiles, compression (2g/cm²) or tension (15%-elongation) was applied to immortalized human PDL (HPL) cells, and miRNA was extracted. The miRNA expression was analyzed using a human miRNA microarray, and the changes of the miRNA expression were confirmed by real-time RT-PCR. In addition, miR-3198-mimic and -inhibitor were transfected into HPL cells to understand the resulting OPG expression and production. Results: Certain miRNAs were expressed differentially under compression and tension. Some miRNAs including miR-3198 were upregulated only by compression. Real-time RT-PCR confirmed that compression induced miR-3198, but tension reduced it, in HPL cells. miR-3198-inhibitor upregulated and miR-3198-mimic reduced OPG in HPL cells. miR-3198-inhibitor rescued the compression-mediated downregulation of OPG. On the other hand, miR-3198-mimic reduced OPG expression under tension. Conclusion: We conclude that miR-3198 is upregulated by compression and is downregulated by tension, suggesting that miR-3198 downregulates OPG in response to mechanical stress.

Characterized in biomedical terms, stretching exercises have been defined as movements applied by external and/or internal forces – to increase muscle and joint flexibility, decrease muscle stiffness, to elevate joint range of motion (ROM), to increase the length of the morpho-functional unit “muscle-tendon”, to improve joint, muscle and tendon movements, contraction and relaxa-tion. The present review examines and summarizes the initial and recent literature data related to the biomechanical, physiological and therapeutic effects of static stretching (SS) on flexibility and other physiological characteristics of the main structural and functional unit “joint-ligaments-tendon-muscle”. The healing and therapeutic effects of SS, soon combined with other rehabilitation techniques (massage, foam rolling – with and without vibrations; hot/cold therapy, etc.) are discussed in relationship to creation of individual (patient-specific) or group programs for treatment and prevention of joint injuries as well as for improving performance in sports. From a theoretical point of view, the role of SS as positively affecting the composition of the connective tissue matrix is pointed out: type I-III collagen synthesis, hyaluronic acid and glucosaminoglycans (GAGs) turnover – under influence of the transforming growth factor beta-1 (TGF-β-1). Different variables as collagen type, biochemistry, elongation and elasticity are used as molecular biomarkers. Recent studies evaluated that the static progressive stretching therapy could prevent/reduce the development of arthrogenic contractures, joint capsule fibrosis, muscle stiffness and need new clinical applications. Combined stretch techniques are proposed and ap-plied in medicine and sports, depending on their long- and short-term effects on variables such as ROM, EMG activity, muscle stiffness, etc. The results obtained are of theoretical and practical interest for development of new experimental, mathematical and computational models and creation of efficient therapeutic programs. The healing SS effects on the main structural and functional unit – “joint-ligament-tendon-muscle” need further investigations, which could clarify and evaluate benefits of SS in prophylaxis and treatment of joint injuries - in healthy and ill in-dividuals, in older adults, as compared to young, active and well-trained persons, as well as to professional athletes.

Horses are high performance athletes prone to sportive injuries such as tendonitis and desmitis. The formation of fibrous tissue in tendon repair becomes a therapeutic challenge to overcome. This impels regenerative medicine to develop innovative therapies that enhance tissue regenera-tion retrieving original tissue properties. Multipotent Mesenchymal Stem/ Stromal Cells (MSCs) have been successfully used to develop therapeutic products, as they secrete a variety of bioac-tive molecules that play a pivotal role in tissue regeneration. These factors are released in cul-ture media producing conditioned media (CM). The aforementioned assumptions led to the formulation of equine synovial membrane MSCs (eSM-MSCs) – the cellular pool that naturally regenerates joint tissue, combined with medium enriched in immunomodulatory factors (among other bioactive factors) produced by umbilical cord stroma-derived MSCs (eUC-MSCs), that nat-urally contribute to suppress the immune rejection in the maternal-fetal barrier. A clinical case of an equine acute desmitis, treated with this formulation is presented. Ultrasonographic ligament regeneration occurred in a reduced time frame, reducing stoppage time and allowing return to unrestricted competition after completion of a physical rehabilitation program. This study fo-cused on the determination of the formulation therapeutic potential and the evaluation of its synergistic effect in an equine desmitis treatment, utilizing the cells themselves and its secretome.

Horses are high performance athletes prone to sportive injuries such as tendonitis and desmitis. Fibrous tissue formation with loss of mechanical properties occurs in tendon repair, becoming a therapeutic challenge to overcome. This impels regenerative medicine to develop innovative therapies that enhance tissue regeneration retrieving original tissue properties. Mesenchymal stem cells (MSCs) have been successfully used to develop therapeutic products. They secrete a variety of bioactive molecules that play a pivotal role in tissue regeneration. These factors are released in culture media producing conditioned media (CM). The aforementioned assumptions impelled us to formulate equine synovial membrane stem cells (eSM-MSCs) – the cellular pool that naturally regenerates joint tissue, combined with medium enriched in immunomodulatory factors produced by umbilical cord stroma-derived MSCs (eUC-MSCs), that naturally contribute to suppress the immune rejection in the maternal-fetal frontier. A clinical case of an equine acute desmitis, treated with the abovementioned formulation is presented. Ligament regeneration occurred in a reduced time frame, reducing stoppage time, allowing return to unrestricted competition after completion of a physical rehabilitation program. This study focus was determination of the formulation therapeutic potential and the evaluation of its synergistic effect in an equine desmitis treatment, utilizing the cells themselves and its secretome.

Segmental bone defects caused by trauma, infection, tumor resection or osteoporotic fractures present significant surgical treatment challenges. Host bone autograft is considered the gold standard to restore function but comes with the cost of harvest site comorbidity. Allograft bone is a secondary option but has its own limitations in incorporation with host bone as well as cost. Therefore, developing new bone tissue engineering strategies to treat bone defects is critically needed. In the past three decades, the use of stem cells delivered with different scaffolds or growth factors for bone tissue engineering has made tremendous progress. Many varieties of stem cells have been isolated from different tissues for use in bone tissue engineering. This review summarizes the progress in using different postnatal stem cells including bone marrow mesenchymal stem cells, muscle-derived stem cells, adipose-derived stem cells, dental pulp stem cells/periodontal ligament stem cells, periosteum stem cells, umbilical cord-derived stem cells, peripheral blood stem cells and urine-derived stem cells for bone tissue engineering and repair. This review also summarizes the progress using exosomes or extracellular vesicles delivered with various scaffolds for bone repair. The advantages and disadvantages of each type of stem cell are also discussed and explained in detail. It is hopeful in the future that these preclinical results will translate into new therapies for bone defect repair.