bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Scapular Kinematics and Range of Motion Between Normal and Post-operative Shoulders Following Subpectoral Biceps Tenodesis
Authors: Cairns Mark Andrew , Helms Jonathan R. , Hibberd Elizabeth , Myers Joseph , Kamath Ganesh V. , Spang Jeffrey T. , Creighton Robert Alexander 
Published: July 2017

Objectives: Though many surgeons advocate biceps tenodesis for treatment of intra-articular biceps pathology, little is known about the biomechanical effects this may have on the glenohumeral joint. The purpose of the present study is to describe in detail the effect of biceps tenodesis on shoulder muscle strength, range of motion, and scapular motion. We hypothesized that post-surgical shoulders would not show significant differences in range of motion, strength, and kinematics when compared to the uninvolved shoulder. Methods: 22 patients underwent a subpectoral biceps tenodesis and were evaluated at least 6 months following the procedure. We evaluated range of motion, strength, and scapular kinematics. Measures included glenohumeral abduction, internal and external rotation, elbow flexion and extension, internal and external rotation strength, and scapular kinematics. Subjects also completed the DASH questionnaire. Results: The average DASH score was 5.3 +/- 6.3 following surgery. The post-surgical shoulder showed a significant 8.3 degree decrease (p = 0.003) in glenohumeral abduction external rotation compared to the uninvolved shoulder. However, there were no significant differences in other measurements of glenohumeral motion or strength. Kinematic data revealed significantly increased scapular internal rotation (p = 0.02) and anterior tipping (p = 0.019) while reaching for the contralateral shoulder. Conclusion: The majority of outcome measures were equivalent when comparing the post-surgical and uninvolved shoulder function and biomechanics. Significant findings include a loss of glenohumeral abduction external rotation after surgery as well as anterior scapular tipping and rotation while reaching for the contralateral shoulder. Overall, subjects expressed minimal disability following surgery, as evidenced by their DASH scores. Nonetheless, we recommend a vigilant focus on regaining external rotation following open subpectoral biceps tenodesis in an attempt to limit or prevent loss of shoulder motion.
Elbow Arthroscopy Complications in Pediatrics and Adults
Authors: Intravia Jessica , Mirzayan Raffy 
Published: July 2017

Objectives: The risks of elbow arthroscopy, have been previously described by Kelly et al (2001) with 473 consecutive elbow arthroscopies from 1980-1998. Since that time, the field of elbow arthroscopy has drastically changed and the complexity of procedures increased. Another report by Nelson et al in 2014, shared the results of 417 consecutive elbow arthroscopy performed over a thirteen year period by three orthopedic surgeons who have completed specialized subspecialty training in shoulder and elbow surgery. While this data set highlights the complication rate of three highly trained surgeons, it may fail to capture the true rate of complications observed with elbow arthroscopy in a community practice. We reviewed the complications of elbow arthroscopy in a community practice with multiple surgeons. In addition, we analyzed the difference in complication rate between adult and pediatric patients. Methods: After institutional IRB approval, the database of an integrated healthcare including 13 medical centers with a captured population was reviewed for all elbow arthroscopies that occurred in the eight year period between 2006 and 2014. A chart review was performed on over 349 consecutive elbow arthroscopies in 322 patients performed by 28 board certified orthopedic surgeons. The average length of follow up was 361 days (0-2739 days). Major complications included deep infection, compartment syndrome, vascular injury, re-hospitalization, deep vein thrombosis, and pulmonary embolus. Minor complications include superficial infection, heterotopic ossification and transient nerve palsies. Results: Of the 349 procedures, the most common complications include heterotopic ossification (eleven patients), transient nerve palsies (twenty six patients), and loss of range of motion (sixty six patients). Loss of range of motion was defined as greater than 10 degrees loss of flexion/extension arc from preoperative visit to final followup. There were twenty six transient nerve palsies (fourteen ulnar, six radial, three median, three medial antebrachial cutaneous). There was one deep infection and eight superficial infections. Forty six patients required reoperation. No patients had vascular injury, compartment syndrome, deep vein thrombosis, or pulmonary embolism. One patient required re-hospitalization for a deep infection post operatively. Conclusion: Elbow arthroscopy remains a safe procedure with a 7.4% risk of nerve palsy, with the ulnar nerve being the most frequently nerve injured. These results are comparable to previously published studies. [Table: see text][Table: see text][Table: see text]
Augmentationof a Distal Biceps Repair with an Acellular DermalGraft Restores Native Biomechanical Properties in a Tendon-Deficient Model
Authors: Sethi Paul M. , Conroy Christine , Macken Craig , Franco William Grant , Wei David , Mirzayan Raffy , Pauzenberger Leo , Dyrna Felix , Obopilwe Elifho , Mazzocca Augustus D. 
Published: July 2017

Objectives: The majority of distal biceps tendon injuries can be repaired primarily. In contrast, chronic tears with severe tendon substance deficiency and retraction often require tendon-graft augmentation. In cases with extensive partial tears of the distal biceps, human dermal allograft may be used as an alternative to restore tendon thickness and biomechanical integrity. The objective of this study was to investigate if dermal graft augmentation of an attritionally thinned distal biceps repair improved load to failure and gap formation compared with a non-augmented repair in this same tendon deficient model. Methods: 18 matched specimens were organized into one of four groups - native tendon, native tendon with dermal graft augmentation, attritional defect tendon, and attritional tendon with graft. To mimic a chronic attritional biceps lesion, a defect was created leaving 30% of the tendon width intact. The repair technique in all groups consisted of a cortical button and interference screw fixation. All specimens underwent cyclical loading for 3000 cycles and were then tested to failure; gap formation and peak load at failure were documented. Results: Mean load to failure (320.9N vs. 343.8N, p=0.38) and gap formation (1.6mm vs.1.8mm, p=0.38) did not differ between the native tendon groups with and without graft augmentation. Stiffness for the repairs with the graft was 22.3 N/mm vs.19.6 N/mm (P=0.16). In the tendon deficient model, mean load to failure was significantly improved by graft augmentation (282.1N vs. 199.7N, p=0.004), whereas mean gap formation was significantly reduced (1.2mm vs. 2.7mm, p=0.04). Mean stiffness for the repairs with the graft was 11.8 N/mm vs. 7.7 N/mm (P=0.04). Conclusion: In a tendon deficient distal biceps rupture model, acellular dermal allograft augmentation restored the native tendon’s biomechanical properties. The grafted tissue deficient model demonstrated no significant differences in load to failure and gap formation compared to intact tendon. As expected, dermal augmentation of the attritional tendon repair increased the load to failure and stiffness, as well as decreased displacement compared to an un-grafted tissue deficient model. Intact native tendon showed no statistical difference or negative biomechanical consequences of dermal augmentation.
Concomitant Lumbar Spine Pathology in Patients Undergoing Hip Arthroscopy: A Matched Cohort Analysis
Authors: Mahure Siddharth Ashok , Ryan Michael K. , Buckland Aaron , Hamula Mathew , Begly John , Capogna Brian , Looze Chris , Chenard Kristofer E. , Wolfson Theodore , Youm Thomas 
Published: July 2017

Objectives: Hip arthroscopy for femoroacetabular impingement (FAI) and related hip pathology is increasing in volume. Variable presentations of hip pain often lead to confusion with lumbar spine pathology however. We sought to define the relationship between the lumbar spine and the hip joint. Our hypothesis is that patients with concurrent lumbar spine pathology will experience inferior outcomes after hip arthroscopy when compared to patients without lumbar spine pathology. Methods: Prospectively-collected data from a single-surgeon database from 2010 to 2014 was used to identify patients who had undergone hip arthroscopy and had documented concurrent lumbar spine pathology. Patients with spine pathology were matched by age, gender, and BMI in a 3:1 fashion to patients without spine pathology. Baseline pre-operative modified Harris Hip Scores (mHHS) were compared to scores at two-year follow-up. “Poor outcome” of initial hip arthroscopy was defined as any combination of: requiring a revision procedure, conversion to THA, or mHHS below 70. Results: 167 patients met inclusion criteria: 72.5% were “normal” while 27.5% had spine pathology. Baseline demographics were appropriately matched between cohorts (Table I). Preoperative and two-year mHHS scores were significantly different between cohorts (Figure 1). Both cohorts demonstrated significant within-group improvement at two-year follow-up, however normal patients had greater improvements than those with spine pathology (34.0 vs 31.76, p<0.001). Overall revision/THA conversion rate for entire cohort was 14.97%, with nearly twice as many spine co-pathology patients requiring additional surgery than those in the normal cohort (23.91% vs 11.57%, p=0.045). Patients with spine pathology were significantly more likely to have “poor outcomes” than those without spine pathology (36.96% vs 21.49%, p=0.048). Conclusion: Our results demonstrate that patients undergoing hip arthroscopy with concomitant lumbar spine pathology demonstrate significantly lower total improvement, significantly higher revision/THA conversion rates and significantly higher rates of suboptimal outcomes after hip arthroscopy than patients without spine pathology. [Table: see text][Figure: see text]
Bone Age Assessment Utilizing Knee MRI
Authors: Pennock Andrew T. , Bomar James D. 
Published: July 2017

Objectives: In managing pediatric knee conditions including osteochondritis dissecans, patella instability, and ACL tears, accurate bone age assessment is critical for diagnostic, prognostic, and treatment purposes. Knee MRIs are almost ubiquitously ordered for these conditions. The purpose of this study was to create an atlas of knee MRIs spanning the pediatric and adolescent years that would enable an accurate skeletal age to be assessed and forgo the need for a left hand radiograph. Methods: A retrospective analysis was performed on knee MRIs that were obtained for pain or trauma between 2007 and 2015. Patients with radiographic evidence of tumors, infections, skeletal dysplasia, or systemic processes affecting the physes were excluded. In creating the atlas, the assessment of 20 to 25 MRIs was performed for each age group and each gender. Radiographic features specific to the patella, tibia, fibula, and femur were documented for their presence or absence. From this data, age and gender “standards” were created. A separate cohort of MRIs with 10 patients in each age group and gender was then used to validate the reliability and reproducibility of the atlas. Pearson correlation, intraclass correlation coefficient, and basic descriptive statistics were performed using SPSS (version 12; SPSS, Chicago, Illinois). Results: In the creation of the atlas, a total of 846 MRIs were reviewed including 413 females and 433 males. The gender distribution and age at presentation of key radiographic features are shown in Table 1. The patella, tibia, fibula, and femur were noted to undergo a consistent and reproducible sequence of skeletal maturation and ossification. The patella provided the best age assessment in early childhood. Features specific to tibia particularly ossification of the tibial spines and the tibial tubercle are of particular importance between the ages of 6 and 12 years. MRI features of the fibula and femur, particularly ossification of the fibular styloid, and closure of both physes, serve a more important role with age assessment later in skeletal maturity. A separate cohort of 323 MRIs (156 female and 167 males) was utilized to subsequently validate the atlas showing a strong correlation between chronologic age and bone age and excellent inter-observer and intra-observer reliability. (Figure 1) Conclusion: The predictable ossification and maturation pattern of the patella, tibia, fibula, and femur, enable accurate bone age calculations to be determined from knee MRIs. When treating conditions about the knee that require an MRI, obtaining an additional left hand radiograph for bone age is unnecessary. Using information available on knee MRIs can avoid additional radiation exposure, impart cost savings, and lead to more clinic efficiency. [Figure: see text]
Distal Femoral Morphology is Altered in Skeletally Immature Anterior Cruciate Ligament (ACL)Injured Knees
Authors: Beck Jennifer J. , Ebramzadeh Edward , Lang Pamela J. 
Published: July 2017

Objectives: With an increased incidence of anterior cruciate ligament (ACL) injuries and high rates of re-injury among skeletally immature individuals, investigators have attempted to identify factors that may help risk stratify patients and provide families with prognostic data concerning the risk of re-injury. Osseous morphology of the tibia as described by posterior tibial slope has received attention as a possible risk factor for ACL injury. The purpose of this study is to describe distal femoral morphology in skeletally immature, ACL-injured patients and compare that to age-matched, uninjured individuals. The authors hypothesize that the distal femoral morphology in ACL injured knees differs significantly from that of age-matched normal knees. Methods: A retrospective radiographic review of 58 skeletally immature patients treated at a single institution was conducted. Patients were grouped by age with Group A =>12 years and Group B =13+ years. The Blumensaat Epiphyseal Containment of the Knee (BECK) Angle, which assesses the flexion of Blumensaat’s line relative to the distal femoral physis, was measured on the involved knee for each patient on standard lateral knee radiographs. Posterior tibial slope was also measured on lateral radiographs. (Figure 1) Roof angle and posterior tibial slope of the lateral plateau were measured on sagittal T1 magnetic resonance imaging sequences of the involved knee. Paired T-tests compared distal femoral morphology in ACL injured knees to the morphology of uninjured knees. Results: Patients in Group A had a significantly decreased mean BECK Angle compared to Group B patients (48° ± 1.87° vs 53.4° ± 6.69°; p=0.045). When comparing Group B to age-matched patients without ACL injuries, there was a significant increase in BECK Angle values found in those with ACL injuries. (53.4° ± 6.69° compared to 48.8° ± 5.9°; p=0.009). Group A patients also tended to have higher BECK Angles compared to their uninjured counterparts, though this did not reach statistical significance (48° ± 1.87° compared to 45.8° ± 5.3°; p=0.38). Conversely, Notch Roof Angle showed significantly increased values in Group A compared to Group B (44 ± 1.581° vs. 41.85° ± 6.347°; p=0.01). Females with ACL injuries showed significantly higher BECK Angle measurements compared to males across both groups (54.56° ± 6.599° vs. 50.84° ± 6.074°; p=0.002). Posterior tibial slope of the lateral plateau on MRI showed a significantly decreased mean value in females compared to males (5.57° ± 3.532° vs 6° ± 3.536°; p=0.051). Conclusion: Distal femoral morphology appears to change with age and differ between females and males. Skeletally immature individuals, who have sustained an ACL injury, have significantly different morphology of the distal femur when compared to age-matched patients without ACL injuries. When risk stratifying patients for first time or repeat ACL injury, assessment of the distal femoral BECK Angle can add valuable information.
Stem Cell Yield after Bone Marrow Concentration
Authors: Dragoo Jason L. , DeBaun Malcolm R. 
Published: July 2017

Objectives: The number of Mesenchymal Stem/Stromal Cells (MSCs) in the human bone marrow (BM) is small compared to other cell types, estimated at 0.01-0.02%. Bone marrow aspirate concentration (BMAC) may be used to increase numbers of MSCs, but the efficacy of BMAC, as well as the composition of MSC subpopulations after processing, is currently unknown. The purpose of this descriptive laboratory study is to assess the enrichment of MSC subpopulations in bone marrow aspirate by two different BMAC devices versus standard BM aspiration from single donors. Methods: 120 mL of BM was aspirated from multiple punctures of the iliac crest in 9 human male donors. Each sample was divided into 3 partitions and processed by 2 different commercially available systems Harvest BMAC or Emcyte PureBMC, and compared to untreated BM aspirate as an internal control. Samples were quantitatively analyzed with multicolor flow cytometry for cellular viability and expression of hematopoietic and MSC subpopulation markers. Colony-forming unit-fibroblasts (CFU-F) assays were performed to estimate the number of functional progenitor cells. Results: Cell viability after processing was over 90% in all groups without significant differences, and hematopoietic cell content was lower in BMAC where, in contrast, non-hematopoietic stem cell subpopulations were significantly enriched. Specifically, BMAC from Harvest BMAC contained more CD45-CD73+CD90+ (11.44 fold vs control, p = 0.01), CD45-CD10+ (3.68 fold vs control, p = 0.01), CD45-CD29+ (1.54 fold vs control, p = 0.03), and CD45-CD119+ (5.52 fold vs control, p = 0.02) cells, whereas Emcyte PureBMC concentrated more CD45-CD73+ cells (13.90 fold vs control, p = 0.04). Both BMAC devices mainly enriched the CD45-CD90+CD271+ MSC subpopulation (Harvest BMAC: 13,011.84 fold vs control, p = 0.001; Emcyte PureBMC: 10,669.11 fold vs control, p = 0.02) compared to other MSC subpopulations. Both BMAC systems significantly increased progenitor colonies (Harvest BMAC: 2692 CFU-F/mL; Emcyte PureBMC: 4336 CFU-F/mL) verses control BM aspiration (183 CFU-F/mL), p<0.05. Conclusion: BMAC devices lead to: 1) enrichment of functional mesenchymal stem cell subpopulations with distinct phenotypes, 2) no increase in hematopoietic stem cell concentration, and 3) no significant loss of cell viability.
The use of tracheal sounds for the diagnosis of sleep apnoea
Authors: Penzel Thomas , Sabil AbdelKebir 
Published: July 2017

Tracheal sounds have been the subject of many research studies. In this review, we describe the state of the art, original work relevant to upper airways obstruction during sleep, and ongoing research concerning the methods used when analysing tracheal sounds. Tracheal sound sensors are a simple and noninvasive means of measurement and are more reliable than other breathing sensors. Developments in acoustic processing techniques and enhancements in tracheal sound signals over the past decade have led to improvements in the accuracy and clinical relevance of diagnoses based on this technology. Past and current research suggests that they may have a significant role in the diagnosis of obstructive sleep apnoea.Key pointsTracheal sounds are currently a topic of significant interest but are not yet used in most routine sleep study systems.Measured at the suprasternal notch, tracheal sounds can provide reliable information on breathing sounds, snoring sounds and respiratory efforts.Tracheal sounds may be used as a noninvasive method of studying abnormalities of the upper airways during wakefulness.Educational aimsTo understand the principles of tracheal sound measurement and analysis.To highlight the importance of tracheal sounds for the diagnosis of sleep apnoea–hypopnoea syndrome.To present the most relevant clinical studies that have validated the use of tracheal sound sensors and to make future clinical validation studies possible.
The three-dimensional genome organization of Drosophila melanogaster through data integration
Authors: Li Qingjiao , Tjong Harianto , Li Xiao , Gong Ke , Zhou Xianghong Jasmine , Chiolo Irene , Alber Frank 
Published: July 2017

AbstractBackgroundGenome structures are dynamic and non-randomly organized in the nucleus of higher eukaryotes. To maximize the accuracy and coverage of three-dimensional genome structural models, it is important to integrate all available sources of experimental information about a genome’s organization. It remains a major challenge to integrate such data from various complementary experimental methods. Here, we present an approach for data integration to determine a population of complete three-dimensional genome structures that are statistically consistent with data from both genome-wide chromosome conformation capture (Hi-C) and lamina-DamID experiments.ResultsOur structures resolve the genome at the resolution of topological domains, and reproduce simultaneously both sets of experimental data. Importantly, this data deconvolution framework allows for structural heterogeneity between cells, and hence accounts for the expected plasticity of genome structures. As a case study we chooseDrosophila melanogasterembryonic cells, for which both data types are available. Our three-dimensional genome structures have strong predictive power for structural features not directly visible in the initial data sets, and reproduce experimental hallmarks of theD. melanogastergenome organization from independent and our own imaging experiments. Also they reveal a number of new insights about genome organization and its functional relevance, including the preferred locations of heterochromatic satellites of different chromosomes, and observations about homologous pairing that cannot be directly observed in the original Hi-C or lamina-DamID data.ConclusionsOur approach allows systematic integration of Hi-C and lamina-DamID data for complete three-dimensional genome structure calculation, while also explicitly considering genome structural variability.