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简介：Thispaperaimstoinvestigatethehydrodynamicbehaviorofatensionlegplatform(TLP)whenthetendonconnectionanglesarevariedat90°,70°,50°,and30°.ThreedifferenttypesofloadingconditionsareappliedtotheTLP.Conditionsinclude100-yearhurricanestormperiod,regularwavesandnoloading.TheTLPdisplayedmajorresponseinthepitchdegreeoffreedom.Amaximumreductionof14%inpitchrotationisachievedwhen100-yearhurricanestormconditionsareappliedtotheTLP.Thisoccurredin0°loadingsat30°tendonconnectionangleascomparedto90°tendonconnectionangle.Reductioninpitchrotationisalsoachievedintheregularwaveloadings.Amaximumof9%inpitchrotationisachievedduring0°waveloadingat30°tendonconnectionangleascomparedto90°.Whenthetendonconnectionangleisreducedfrom90°to30°,thenaturalfrequencyoftheTLPincreasedbothinpitchandyawdegreesoffreedomby2.55%and2.40%,respectively.

简介：AbstractPurpose:Triceps tendon avulsion (TTA) is an uncommon injury, and there are no classifications or treatment guidelines available. This study aims to describe a clinicoradiological classification and treatment algorithm for traumatic TTA in adults. The functional outcome of surgical repair has been evaluated too.Methods:A retrospective analysis of adult patients with traumatic TTA treated in our institution between January 2012 and December 2017 was done. We only included complete TTA injuries. Children below 15 years, with open injuries, associated fractures, or partial TTA were excluded. The data were obtained from hospital records. The intraoperative findings were correlated with the clinicoradiological presentation for classifying TTA. The functional outcome was analyzed using the Mayo Elbow Performance index and Hospital for Special Surgery elbow score. ANOVA test was used to assess the statistical significance.Results:There were 15 patients included, 11 males and 4 females. The mean age was (31.5 ± 9.15) years, and the mean follow-up was (22.4 ± 8.4) months. Fall on outstretched hand was the mode of injury. In 6 patients, diagnosis was missed on the initial visit. TTA were classified as Type I: palpable soft-tissue defect without bony mass; Type II: palpable soft-tissue defect with a wafer-thin/comminuted bony fragment on X-ray; Type III: palpable soft-tissue defect with a bony mass and a large bony fragment on X-ray without extension to the articular surface; and Type IV: an olecranon fracture with less than 25% of the articular surface. An algorithm for treatment was recommended, i.e. transosseous suture repair/suture anchor for Type I, transosseous suture repair for Type II, and tension band wiring or steel wire sutures for Types III and IV. All the patients achieved good to excellent outcome: the mean Mayo Elbow Performance index was 100 and Hospital for Special Surgery score was 98.26 ± 2.60 on final follow-up.Conclusion:Our clinicoradiological classification and treatment algorithm for TTAs is simple. Surgical treatment results in excellent functions of the elbow. Since it is a single-center study involving a very small number of cases, a multicenter study with a larger number of patients is required for external validation of our classification and treatment recommendations.

简介：Objective:Toinvestigatethemorphologicalcharacteristicsofthebridgetendongraftinginnoman'slandtoreconstructthetendondefectandtheeffectofpassivemobilizationonit.Methods:A2cmdefectwasmadeinbilateralflexordigitorumprofundustendonsofthemiddlechickentoes,andwasthentransplantedtotheoppositesitetoserveasasegmentalautografttendon.Postoperatively,passivemobilizationoftheleftandrightmiddletoesbeganat5and21dseparately.Specimenswerestudiedbylight,scanningandtransmissionelectronmicroscopyat5,10,21and35d.Results:Earlyrepairofthetendon-graftoftheleftmiddletoeswasmadebyproliferationandingrowthoftheepitenoncellsintermingledwithnewly-formedcollagenfibers.aglidingsurfaceformedat10and21d.Thetendongraftitselfplayedanactiveroleintherepair.Incontrast,adhesionsobliteratedthesurfaceandoccupiedthespacebetweenthetendongraftandsurroundingtissuesintherightmiddletoes.Conclusions:Itindicatesthattheuseofthesegmentalbridgetendongraftinnoman'slandcoupledwithearlypassivemotionstimulatesanintrisicrepairprocessinboththetendonstumpandtheautogenoustendongraftandresultsinafunctionalhealing.

简介：ObjectiveTo评估未耕作的脂肪质导出stromal的潜在的效果腱healing.MethodsTwenty上的脉管的部分称2.5-3.0kg的五只成年雄的新西兰白兔子被使用。当脂肪质的组织和剩余的施主被划分成控制和治疗组，五只兔子被使用。损害模型被单方的腱切断术通过中间完成三分之一深数字的屈肌腱。立即在缝术以后修理，也新鲜的stromal从脂肪质的织物或安慰剂的酶的消化的脉管的部分intratendinously分别地在治疗和控制组在腱树桩被注射。有演员组的固定在外科以后被继续二个星期。动物在外科以后在八个星期被牺牲，腱经历了组织学，immunohistochemical，和机械评估。量、质的数据的统计分析用变化和Mann-Whitney的单程的分析被估计[/-test，表明的优异纤丝状的线性和连续性，和在处理的减少的由脉管形成组织的respectively.ResultsHistological评估显示了改进组织并且neotendons改变。Immunohistochemistry在骨胶原表明了重要增加我在处理的表示组。最终的负担和精力吸收能力显著地两个都与学习显示出的在场的controls.ConclusionThe相比在对待房间的修理被增加未耕作的脂肪质导出stromal的那intratendinous注射脉管的部分结果在改进了腱修理和它的结构、机械的性质能是为对待腱损害的一种有效形式。

简介：AbstractPurpose:The purpose of this study was to assess and compare elbow range of motion, triceps extension strength and functional results of type C (AO/OTA) distal humerus fractures treated with bilateral triceps tendon (BTT) approach and olecranon osteotomy (OO). At the same time, we are also trying to know whether BTT approach can provide sufficient vision for comminuted intra-articular fractures of the distal humerus, and whether it is convenient to convert to the treatment to total elbow arthroplasty (TEA) or OO.Methods:Patients treated with OO and BTT approaches for type C distal humerus fractures between July 2014 and December 2017 were retrospectively reviewed. Inclusion criteria include: (1) patients' age were more than 18 years old, (2) follow-up was no less than 6 months, and (3) patients were diagnosed with type C fractures (based on the AO/OTA classification). Exclusion criteria include: (1) open fractures (Gustillo type 2 or type 3), (2) treated by other approaches, and (3) presented with combined injuries of ipsilateral upper extremities, such as ulnar nerve. Elbow range of motion and triceps extension strength testing were completely valuated, when the fractures had healed. Assessment of functional results using the Mayo elbow performance score and complications were conducted in final follow-up. The data were compared using the two tailed Student's t-test. All data were presented as mean ± standard deviation.Results:Eighty-six patients of type C distal humerus fractures, treated by OO and BTT approach were retrospectively reviewed between July 2014 and December 2017. Fifty-five distal humerus fractures (23 males and 32 females, mean age 52.7 years) treated by BTT approach or OO were included in this study. There were 10 fractures of type C1, 16 type C2 and 29 type C3 according to the AO/OTA classification. Patients were divided into two surgical approach groups chosen by the operators: BTT group (28 patients) and OO group (27 patients). And the mean follow-up time of all patients was 15.6 months (range, 6-36 months). Three cases in BTT group were converted to TEA, and one converted to OO. Only one case in BTT group presented poor articular reduction with a step more than 2 mm. There were not significantly different in functional outcomes according to the Mayo elbow performance score, operation time and extension flexion motion are values between BTT group and OO group (p > 0.05). Complications and reoperation rate were also similar in the two groups. Triceps manual muscle testing were no significant difference in the two groups, even subdivided in elder patients (aged >60 years old).Conclusion:BTT is a safe approach to achieve similar functional result comparing with OO. BTT were not suitable for every case with severe comminuted pattern, but it avoids the potential complications related to OO, and has no complications concerning with triceps tendon. It is convenient for open reduction internal fixation and flexible to be converted to OO, as well as available to be converted to TEA in elder patients.

简介：electrospun(lactide-co-glycolide)(PLGA)poly，膜被准备并且过去常执行跟腱的反粘附。在整个实验，膜显示出适当降级率，并且降级媒介的pH价值在约7.4点被维持。同时，在vitro并且在vivo的膜的优秀biocompatibility被实时/死了、组织病理学说的分析证实。同时，膜能显著地减少腱粘附并且有效地支持功能的恢复。令人鼓舞的结果被hematoxylin和曙红(H&E)进一步表明，并且Massons三色的染色，和类型我骨胶原immunohistochemical分析。没有处理，与electrospunPLGA膜对待的模型比那关于粘附预防和织物修理显著地更好，这被结束。就降级和粘附预防功效的结果而言，electrospunPLGA膜将是手术后的腱粘附的预防的一个大候选人。

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简介：跟腱的客观外科的修理(在)破裂应该被活跃的腱动员立即跟随。动员什么时候应该开始的最佳的时间还是重要的争论。早kinesitherapy导致减少的康复时期。然而，进这个过程的详细机制的卓见没被获得。Proteomic技术能被用来由与不同蛋白质的函数有关的微分表达式侧面分开并且净化蛋白质，但是在proteomic分析的区域研究在3点，在修理以后的天到目前为止没被学习。47只新西兰白兔子被使随机化进3个组的方法。组A(固定组，n=16)收到的手术后的演员组固定；组B(早运动组，n=16)立即跟随修理的收到的早活跃的运动处理在从腱切断术另外一个的破裂，15只兔子担任了控制组(组C)。AT样品被准备3天列在后面microsurgery。蛋白质被分开采用二维的polyacrylamide胶化电气泳动(2D页)。PDQuest软件版本8.0被用来鉴别差别表示了蛋白质，由肽团指纹(PMF)和双人脚踏车团光谱分析列在后面，用生物工学信息(NCBI)蛋白质数据库检索然后为生物信息学分析的国家中心。446.33，436.33和462.67蛋白质吝啬的结果A在组在组A，在组B的14只兔子和13只兔子在13只兔子的跟腱样品上看到C成功地被检测在2D页。分别地在组A，B和C有40，36和79唯一的蛋白质。一些差别表示了蛋白质是有胶化的酶，帮助矩阵的laser-desorption/ionizationtime-of-flight团spectrometry(MALDI-TOFMS)。我们成功地在组A和B识别了9和11不同蛋白质，例如GAPDH，phosphoglyceratekinase1，pro-alpha-1类型1骨胶原，peroxiredoxin1，alpha-1-antiproteinaseEa-1和MAD2L1绑定蛋白质，等等。并且有分子的女伴的一些，氧化应力，精力新陈代谢，信号transduction，结合了腱房间表达式和蛋白质合成，增殖，区分并且仔细与AT有关正在愈合。GAPDH蛋白质进一步通过西方的弄污被验证。一

简介：AbstractPurpose:To observe the changes of gait behavior and the expression of wound healing factors of transforming growth factor-β1 (TGF-β1), TGF-β3 and cAMP response element binding protein-1 (CREB-1) during the healing of Achilles tendon in a rat model, and to investigate whether gait analysis can be used to evaluate the tendon healing.Methods:Achilles tendon of 40 healthy male Sprague-Dawley rats were transected and sutured to establish the Achilles tendon injury (ATI) model. They were randomly divided into 4 groups based on the observational time point at 1, 2, 4 and 6 weeks after injury (n= 10 for each group). Before modeling, 9 rats were randomly selected for CatWalk gait analysis, which contained step cycle, single stance time and average speed. Data were recorded as the normal controls. After then, ATI models were established in the left hind limbs of the all 40 rats (ATI group), while the right hind limbs were only cut and sutured without injury of the Achilles tendon (sham operation group). At 1, 2, 4 and 6 weeks after injury, the gait behavior of the corresponding group of rats (n= 9) as observed and recorded by CatWalk platform. After then, the rats were sacrificed and Achilles tendon of both limbs was harvested. The tendon healing was observed by gross anatomy and histological examination, and the protein and mRNA expression of TGF-β1, TGF-β3, CREB-1 were observed by immunohistochemistry and qPCR. The results of tendon gross grading were analyzed by Wilcoxon rank sum test, and other data were analyzed by one-way analysis of variance among multiple groups.Results:Compared with normal controls, all gait indexes (step cycle, single stance time and average speed) were greatly affected following ATI, which however improved with time. The step cycle was significantly lower at 1, 2 and 4 weeks after ATI (compared with normal controls, all p < 0.05), but almost returned to the normal level at 6 weeks ((0.694 ± 0.102) vs. (0.503 ± 0.094) s, p > 0.05). The single stance time of the ATI group was significantly shorter at 1 and 2 weeks after operation ((0.078 ± 0.010) s at 1 week, (0.078 ± 0.020) s at 2 weeks, all p < 0.001) and revealed no significant difference at 4 weeks (p= 0.120). The average speed of ATI group at 1, 2, 4, 6 weeks was significantly lower than that in the normal control group (all p < 0.001).Gross observation showed that the grade of local scar adhesion in ATI group increased significantly at 2, 4 and 6 weeks, compared with the sham operation group (all p < 0.001). Extensive adhesion was formed at 6 weeks after ATI. The results of HE staining showed that the number of fibroblast increased gradually and arranged more orderly in ATI group at 1, 2 and 4 weeks (all p < 0.001), and decreased at 6 weeks, but it was still significantly higher than that of the sham operation group (p < 0.001). Immunohistochemistry showed that the positive expression of TGF-β1, TGF-β3, CREB-1 in ATI group was higher than that in the sham operation group at 4 time points (all p < 0.05), which reached the peak at 2 weeks after operation and decreased at 4 weeks (p= 0.002, p < 0.001, p= 0.041, respectively). The results of qPCR suggested that the mRNA expression of TGF-β1, TGF-β3, CREB-1 in ATI group was higher than that in the sham operation group at all-time points (all p < 0.05), which reached the peak at 2 weeks after operation, decreased at 4 weeks, and significantly decreased at 6 weeks (all p < 0.001).Conclusion:Gait behavior indexes are associated with Achilles tendon healing. The study gives an insight of TGF-β1, TGF-β3, CREB-1 changes in the coursing of Achilles tendon healing and these cytokines may be able to be used to regulate the Achilles tendon healing.

简介：AbstractPurpose:To assess the clinical efficacy of converting partial articular supraspinatus tendon avulsion (PASTA) lesions to full-thickness tears through a small local incision of the bursal-side supraspinatus tendon followed by repair.Methods:We retrospectively analyzed 41 patients with Ellman grade 3 PASTA lesions and an average age of (54.7 ± 11.4) years from March 2013 to July 2017. Patients without regular conservative treatment and concomitant with other shoulder pathologies or previous shoulder surgery were excluded from the study. The tears were confirmed via arthroscopy, and a polydioxanone suture was placed to indicate the position of each tear. A small incision of approximately 6 mm was made using a plasma scalpel on the bursal-side supraspinatus tendon around the positioned suture to convert the partial tear into a full-thickness tear. The torn rotator cuff was sutured through the full thickness using a suture passer after inserting a 4.5-mm double-loaded suture anchor. Data were analyzed using a paired Student’s t-test with statistical significance defined as p <0.05.Results:At the final follow-up of 2 years, the pain-free shoulder joint range of motion and visual analog scale score were significantly improved compared to those before surgery (p < 0.001). The postoperative American Shoulder and Elbow Surgeons shoulder score was (90.6 ± 6.2), which was significantly higher than the preoperative score of (47.9 ± 8.3) (p < 0.001). The University of California at Los Angeles shoulder rating scale score increased from (14.7 ± 4.1) prior to surgery to (32.6 ± 3.4) points after surgery (p < 0.001). No patient had joint stiffness.Conclusion:This modified tear completion repair, by conversion to full-thickness tears through a small incision, has less damage to the supraspinatus tendon on the side of the bursa compared to traditional tear completion repair in the treatment of PASTA lesions. This surgical method is a simple and effective treatment that can effectively alleviate pain and improve shoulder joint function.