bluuebunny/crossref_metadata_2025_split huggingface dataset:
STRESS RESPONSE OF ACHILLES TENOCYTES FROM NON-DIABETIC AND DIABETIC RATS EXPOSED TO NORMO- AND HYPERGLYCAEMIA DIFFERS
Authors: Gögele C. L. , Fleischmann Nils , Hofman S. , Frank E. , Werner C. , Kokozidou M. , Tanzil G. S. 
Published: November 2024

IntroductionDiabetes mellitus type 2 (DMT2) patients often develop Achilles tendon (AS) degeneration. The ZDF rat model is often used to study DMT2. Hence, this study investigated whether tenocytes isolated from diabetic and non diabetic ZDF rats respond differentially to normo- (NG) and hyperglycemic (HG) conditions in the presence of tumor necrosis (TNF)α.MethodAS tenocytes isolated from adult diabetic (fa/fa) or lean (fa/+) Zucker Diabetic Fatty (ZDF) rats were treated with 10 ng/mL TNFα either under NG or HG conditions (1 g/L versus 4.5 g/L glucose). Tendons were characterized histopathologically using Movin score. Tenocyte survival, metabolic activity, gene and/or protein expression of the main tendon extracellular matrix (ECM) component collagen type 1, the myofibroblast marker alpha smooth muscle actin (αSMA, Acta2), complement regulatory factors, the antioxidant defense enzyme heme oxygenase-1 (Hmox1), suppressors of cytokine signaling (Socs)1 and Soc3 were analyzed.ResultTendons of diabetic rats showed significantly higher Movin score values suggesting tendon degeneration. Tenocyte vitality remained high, but metabolic activity was impaired by HG conditions, irrespectively of tenocyte origin. Higher amounts of αSMA were visualized in tendons/cells of diabetic rats or those exposed to TNFα. Collagen type 1 protein and gene expression was suppressed by TNFα (NG), but only in cells of non diabetic animals. The anaphylatoxin receptor C3aR was higher expressed in tenocytes from diabetic animals. CD46 was suppressed by TNFα (NG) in cells of diabetic rats. Hmox1, Socs1 and Socs3 were induced by HG, but only in tenocytes of diabetic rats (4 h).ConclusionThe response of tenocytes to TNFα depends on glucose supply and cell origin suggesting their irreversible impairment in DMT2.
A NOVEL PLATE DESIGN FOR ROTATIONAL GUIDED GROWTH: AN EXPERIMENTAL STUDY IN IMMATURE PORCINE FEMURS
Authors: Halloum A. , Rahbek O. , Gholinezhad S. , Kold S. , Rasmussen J. , Rölfing J. D. , Tirta M. , Abood A. A. 
Published: November 2024

IntroductionCurrent treatments of rotational deformities of long bones in children are osteotomies and fixations.In recent years, the use of guided growth for correction of rotational deformities has been reported in several pre-clinical and clinical studies. Various techniques have been used, and different adverse effects, like growth retardation and articular deformities, have been reported. We tested a novel plate concept intended for correction of rotational deformities of long bones by guided growth, with sliding screw holes to allow for longitudinal growth, in a porcine model.MethodTwelve, 12-week-old female porcines were included in the study.Surgery was performed on the left femur. The right femur was used as control. Plates were placed distally to induce external rotation, as longitudinal growth occurred.CT-scans of the femurs were processed to 3-D models and used for measuring rotation.ResultThe plates rotated as intended in all 12 porcines. One porcine was excluded due to congenital deformity of the proximal part of the femurs. Two porcines had cut-out of the proximal screw on the lateral side, observed at the end of the intervention. These two porcines were included in the results.We observed a Δrotation of 5.7° ± 2° in external direction (CI: 3.7°– 7.7°).ΔFemur length was -0.4 cm [-0.7 cm – 0 cm] equal to 1.5% shortening of the operated femur.No significant difference was observed in coronal or sagittal plane.ConclusionSignificant external rotation was achieved with minimal effect on longitudinal growth.While the use of guided growth for correction of rotational deformities is already being used clinically, it is still to be considered an experimental procedure with sparse evidence.This study shows promising results for the feasibility of the method in a large animal model and is an important first step in validating the technique and detecting possible adverse effects, before future clinical studies.
COAXIAL ELECTROHYDRODYNAMIC PRINTING OF CORE-SHELL MICROFIBROUS SCAFFOLDS WITH LAYER-SPECIFIC GROWTH FACTORS RELEASE FOR ENTHESIS REGENERATION
Authors: Bai L. , Yin Z. 
Published: November 2024

IntroductionHerein, a tri-layered core-shell microfibrous scaffold with layer-specific growth factors (GFs) release is developed using coaxial electrohydrodynamic (EHD) printing for in situ cell recruitment and differentiation to facilitate gradient enthesis tissue repair. Our findings suggest that the microfibrous scaffolds with layer-specific GFs release may offer a promising clinical solution for enthesis regeneration.MethodUtilizing coaxial electrohydrodynamic (EHD) printing, we engineered tri-layered core-shell microfibrous scaffolds, each layer tailored with specific growth factors (GFs) for targeted enthesis tissue repair. This configuration aims to sequentially guide cell migration and differentiation, mirroring the natural enthesis’ gradient structure. SDF-1 was strategically loaded into the shell, while bFGF, TGF-β, and BMP-2 were encapsulated in the core, each selected for their roles in stimulating the regeneration of corresponding enthesis tissue layers.ResultThe coaxial EHD-printed microfibrous scaffolds demonstrated a core-shell fiber width of 24.3 ± 6.3 μm, supporting distinct tenogenic, chondrogenic, and osteogenic layers with pore sizes of 81.5 ± 4.6 μm, 173.3 ± 6.9 μm, and 388.9 ± 6.9 μm, respectively. This structure facilitated a targeted and effective release of growth factors, optimizing stem cell recruitment and differentiation. In vivo assessments demonstrated that the scaffolds significantly enhanced biomechanical properties and facilitated the formation of gradient enthesis structures, with improved biomechanical strength approximately 2-3 times that of control groups. These results highlight the scaffold's capability to mimic the native enthesis structure, encouraging a conducive environment for cell-mediated repair and regeneration.ConclusionThe integration of layer-specific growth factors not only fostered a conducive environment for tissue regeneration but also exemplified a leap in the design of scaffolds that closely mimic the native tendon-to-bone interface. The findings illuminate the scaffold's capacity to direct cellular behavior and tissue formation, heralding a new era in regenerative strategies and offering a promising avenue for clinical translation in the treatment of rotator cuff injuries.
CHANGES IN STIFFNESS OF THE EXTRACELLULAR AND PERICELLULAR MATRIX IN THE ANULUS FIBROSUS OF LUMBAR INTERVERTEBRAL DISCS OVER THE COURSE OF DEGENERATION
Authors: Höflsauer S. G. , Bonnaire F. , Danalache M. , Feierabend M. , Hofmann U. 
Published: November 2024

IntroductionAnalogous to articular cartilage, changes in spatial chondrocyte organisation have been proposed to be a strong indicator for local tissue degeneration and destruction in the intervertebral disc (IVD). While a progressive structural and functional degradation of the extracellular (ECM) and pericellular (PCM) matrix occurs in osteoarthritic cartilage, these processes have not yet been biomechanically elucidated in the IVD. We aimed to evaluate the local stiffness of the ECM and PCM in the anulus fibrosus of the IVD on the basis of local cellular spatial organisation.MethodUsing atomic force microscopy, we measured the elastic modulus of the local ECM and PCM in human disc samples using the spatial chondrocyte patterns as an image-based biomarker.ResultBy measuring tissue from 30 patients, we found a significant difference in the elastic moduli of the PCM in clusters when compared to the healthy patterns single cells (p=0.029), pairs (p=0.016), and string formations (p=0.010) whereas the values of the elastic moduli of the ECM only reached statistical significance when clusters were compared with string formations. The ECM/PCM ratio ranged from 0.62 to 0.89. Overall, the reduced elastic moduli in clusters demonstrates that cluster formation is not only a morphological phenomenon describing disc degeneration, but it marks a compromised biomechanical functioning.ConclusionThis study is the first to describe and quantify the differences in the elastic moduli of the ECM in relation to the PCM in the anulus fibrosus of the IVD by means of atomic force microscopy on the basis of spatial chondrocyte organisation. Advanced disc degeneration is accompanied by a biomechanically compromised tissue functioning.
HOW SHOULD FEMORAL ANATOMY FOR SURGICAL CORRECTION BE MEASURED?
Authors: Dhaliwal J. , Harris S. , Logishetty K. , Brkljač M. , Cobb J. 
Published: November 2024

IntroductionThe current methods for measuring femoral torsion have limitations, including variability and inaccuracies. Existing 3D methods are not reliable for abnormal femoral anteversion measurement. A new 3D method is needed for accurate measurement and planning of proximal femoral osteotomies. Currently available software for viewing and modelling CT data lacks measurement capabilities. The MSK Hip planner aims to address these limitations by combining measurement, planning, and analysis functionalities into one tool. We aim to answer 5 key questions: Is there a difference between 2D measurement methods? Is there a difference between 3D measurement methods? Is there a difference between 2D and 3D measurement methods? Are any of the measurement methods affected by the presence of osteoarthritis or a CAM deformity?MethodAfter segmentation was carried out on 42 femoral CT scans using Osirix, 3D bone models were landmarked in the MSK lab hip planning software. Murphy's, Reikeras’, McBryde, and the novel MSK lab method were used to measure femoral anteversion.ResultMurphy's method had the lowest mean femoral neck anteversion (FNA) at 24.98°, while the MSK method had the highest at 28.55°. Bland-Altman plots showed systematic errors between 2D (1.201°) and 3D (1.074°) methods. All methods demonstrated good intra- and inter-user reliability. Significant differences were found between measurement methods and between patient groups.ConclusionThe MSK Hip Planner software proved useful and convenient to measure FNA. Statistically significant differences in FNA were observed between the measurement methods, as well as between patient groups when split by presence of osteoarthritis and cam deformity. Complex joint pathology and altered femoral morphology should be considered by clinicians when deciding which method to use when measuring FNA.
DECIPHERING WRIST DYNAMICS: EXPLORING THE IMPACT OF SCAPHOLUNATE LIGAMENT INJURIES ON WRIST STABILITY, KINETICS, AND CARTILAGE STRESS IN ORTHOPAEDIC PRACTICE
Authors: Amirouche F. , Kim S. , Mzeihem M. , Nyaaba W. , Mungalpara N. , Mejia A. , Gonzalez M. 
Published: November 2024

IntroductionThe human wrist is a highly complex joint, offering extensive motion across various planes. This study investigates scapholunate ligament (SLL) injuries’ impact on wrist stability and arthritis risks using cadaveric experiments and the finite element (FE) method. It aims to validate experimental findings with FE analysis results.MethodThe study utilized eight wrist specimens on a custom rig to investigate Scapho-Lunate dissociation. Contact pressure and flexion were measured using sensors. A CT-based 3D geometry reconstruction approach was used to create the geometries needed for the FE analysis. The study used the Friedman test with pairwise comparisons to assess if differences between testing conditions were statistically significant.ResultThe study found significant variations in scaphoid and lunate bone movement based on ligament condition. Full tears increased scapholunate distance in the distal-proximal direction and decreased in the medial-lateral direction. Lunate angles shifted from flexion to extension with fully torn ligaments. Conversely, the scaphoid shifted significantly from extension to flexion with full tears. A proximal movement was observed in the distal-proximal direction in all groups, with significant differences in the partial tear group. Lateral deviation of the scaphoid and lunate occurred with ligament damage, being more pronounced in the partial tear group. All groups exhibited statistically significant movement in the volar direction, with the full tear group showing the least movement. Also, radiocarpal joint and finger contact pressure and contact area were studied. Whereas the differences in contact area were not significant, scapholunate ligament tears resulted in significantly decreased finger contact pressures. FEA confirmed these findings, showing notable peak radiocarpal contact pressure differences between intact and fully torn ligaments.ConclusionOur study found that SLL damage alters wrist stability, potentially leading to early arthritis. The FEA model confirmed these findings, indicating the potential for the clinical use of computer models from CT scans for treatment planning.
TOWARDS ROUTINE, LOW-COST CLINICAL MOVEMENT ANALYSIS TO ASSESS SHOULDER FUNCTION USING COMPUTER VISION AND CONSUMER CAMERAS: A SCOPING REVIEW
Authors: Spoo S. , Garcia F. , Braun B. , Cabri J. , Grimm B. 
Published: November 2024

IntroductionThe objective assessment of shoulder function is important for personalized diagnosis, therapies and evidence-based practice but has been limited by specialized equipment and dedicated movement laboratories. Advances in AI-driven computer vision (CV) using consumer RGB cameras (red-blue-green) and open-source CV models offer the potential for routine clinical use. However, key concepts, evidence, and research gaps have not yet been synthesized to drive clinical translation. This scoping review aims to map related literature.MethodFollowing the JBI Manual for Evidence Synthesis, a scoping review was conducted on PubMed and Scholar using search terms including “shoulder,” “pose estimation,” “camera”, and others. From 146 initial results, 27 papers focusing on clinical applicability and using consumer cameras were included. Analysis employed a Grounded Theory approach guided iterative refinement.ResultStudies primarily used Microsoft Kinect (infrared-based depth sensing, RGB camera; discontinued) or monocular consumer cameras with open-source CV-models, sometimes supplemented by LiDAR (laser-based depth sensing), wearables or markers. Technical validation studies against gold standards were scarce and too inconsistent for comparison. Larger range of motion (RoM) movements were accurately recorded, but smaller movements, rotations and scapula tracking remained challenging. For instance, one larger validation study comparing shoulder angles during arm raises to a marker-based gold-standard reported Pearson's R = 0.98 and a standard error of 2.4deg. OpenPose and Mediapipe were the most used CV-models. Recent efforts try to improve model performance by training with shoulder specific movements.ConclusionLow-cost, routine clinical movement analysis to assess shoulder function using consumer cameras and CV seems feasible. It can provide acceptable accuracy for certain movement tasks and larger RoM. Capturing small, hidden or the entirety of shoulder movement requires improvements such as via training models with shoulder specific data or using dual cameras. Technical validation studies require methodological standardization, and clinical validation against established constructs is needed for translation into practice.
A NEUROANGIOGENIC SCAFFOLD WITH SPATIOTEMPORAL CONTROL FOR TISSUE REGENERATION IN MEDICATION-RELATED OSTEONECROSIS OF THE JAW, EMPLOYING BIOACTIVE ELASTIN-LIKE RECOMBINAMERS (ELRS)
Authors: Torre I.G. D , Redondo L. M. , Sierra C. G. , Cabello J. C. R. , Bsarcia A.l J. A. 
Published: November 2024

IntroductionThe objective of the work is construction of a multi-bioactive scaffold based on that allows a space/time control over the regeneration of damaged bones by Medication-Related Osteonecrosis of the Jaw using a minimal invasive approach based on the injection of the fast-degrading pro neuro and angiogenic ELR (Elastin-Like Recombinamers) based hydrogels.MethodChemical crosslinking facilitated the creation of multi-bioactive scaffolds using ELRs with reactive groups. Cell-loaded multi-bioactive scaffolds, prepared and incubated, underwent evaluation for adhesion, proliferation, angiogenic, and neurogenic potential. In vitro assessments utilized immunofluorescence staining and ELISA assays, while live-recorded monitoring and live-dead analysis ensured cytocompatibility. In rat and rabbit models, preformed scaffolds were subcutaneously implanted, and the regenerative process was evaluated over time. Rabbit models with MRONJ underwent traditional or percutaneous implantation, with histological evaluation following established bone histological techniques.ResultA 3D scaffold using ELR that combines various peptides with different degradation rates to guide both angiogenesis and neurogenesis has been developed. Notably, scaffolds with different degradation rates promoted distinct patterns of vascularization and innervation, facilitating integration with host tissue. This work demonstrates the potential for tailored tissue engineering, where the scaffold's bioactivities and degradation rates can control angiogenesis and neurogenesis. In an animal model of medication-related osteonecrosis of the jaw (MRONJ), the scaffold showed promising results in promoting bone regeneration in a necrotic environment, as confirmed by histological and imaging analyses. This study opens avenues for novel tissue-engineering strategies where precise control over vascularization and nerve growth is crucial.ConclusionA groundbreaking dual approach, simultaneously targeting angiogenesis and innervation, addresses the necrotic bone in MRONJ syndrome. Vascularization and nerve formation play pivotal roles in driving reparative elements for bone regeneration. The scaffold achieves effective time/space control over necrotic bone regeneration.The authors are grateful for funding from the Spanish Government (PID2020-118669RA-I00)
WALKING AND RUNNING IN CHILDREN WITH DECREASED FEMORAL TORSION
Authors: Tsagkaris C. , Hamberg M. E. , Villefort C. , Dreher T. , Krautwurst B. K. 
Published: November 2024

IntroductionUnderstanding the implications of decreased femoral torsion on gait and running in children and adolescents might help orthopaedic surgeons to optimize treatment decisions. To date, there is limited evidence regarding the kinematic gait deviations between children with decreased femoral torsion and typically developing children as well as regarding the implications of the same on the adaptation of walking to running.MethodA three dimensional gait analysis study was undertaken to compare gait deviations during running and walking among patients with decreased femoral torsion (n=15) and typically developing children (n=11). Linear mixed models were utilized to establish comparisons within and between the two groups and investigate the relation between clinical examination, spatial parameters and the difference in hip rotation between running and walking.ResultPatients exhibited increased external hip rotation during walking in comparison to controls accompanied by higher peaks for the same as well as for, knee valgus and external foot progression angle. A similar kinematic gait pattern was observed during running with significant differences noted in peak knee valgus. In terms of variations from running to walking, patients internally rotated their initially external rotated hip by 4°, whereas controls maintained the same internal hip rotation. Patients and controls displayed comparable kinematic gait deviations during running compared to walking. The passive hip range of motion, torsions and velocity did not notably influence the variation between mean hip rotation from running to walking.ConclusionThis study underlines the potential of 3D gait kinematics to elucidate the functional implications of decreased FT and hence may contribute to clinical decision making.
COMPLICATIONS FOLLOWING INTRAMEDULLARY NAILING OF DIAPHYSEAL FEMUR FRACTURES IN A LEVEL I TRAUMA CENTRE IN FINLAND
Authors: Lähdesmäki M. , Ylitalo A. , Liukkonen R. , Suominen V. , Karjalainen L. , Mattila V. M. , Repo J. 
Published: November 2024

IntroductionWe aimed to study the rates of both surgical and medical complications associated with femoral diaphysis fracture fixation with intramedullary nailing including all fracture mechanisms. Additionally, we investigated whether the trauma energy has an impact on the complication risk.MethodIn this retrospective cohort study, the health records of 491 patients with 503 femoral fractures, who underwent surgery between May 2007 and May 2022 in Tampere University Hospital, were reviewed. Patients who underwent a primary operation with a reamed rigid intramedullary nail for a diaphyseal femoral fracture and whose follow-ups were organized at the same hospital district, were included. Based on those criteria, 57.5% were included for analysis (279 patients with 289 fractures). The complications were then recorded by chart review. To investigate the impact of trauma energy on complication risk, we compared complication proportions in high- and low-energy groups and calculated odds ratios.ResultThe crude percentage of 30-day mortality was 2.1% (6 of 289) based on information obtained from the patients’ records. The overall proportion of complications was 22.5%. The risk of any medical complication was 2.8%, whereas the risk of surgical complication was 19.8%. The risk of complications was nearly twice as high in high-energy fractures compared to low-energy fractures, with an odds ratio (OR) of 1.92, 95% CI 1.03-3.75. The risk of reoperations was significantly increased in high-energy traumas (OR 2.46, CI 1.25-5.24).ConclusionThis study reveals a 2.1% risk of thirdy-day mortality and a 22.5% risk of overall complications, predominantly of a surgical type. The complication risk, especially the risk of surgical complications, is higher among the patients with fractures caused by high-energy injury compared to low-energy fractures, highlighting the importance of timely identification of those complications for providing better postoperative care.