• Title/Summary/Keyword: Bio-absorbable

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Factors Affecting the Extent of Graft Tendon Synovialization after Double-Bundle Anterior Cruciate Ligament Reconstruction: Based on Second-Look Arthroscopic Findings

  • Ahn, Gil Yeong;Nam, Il Hyun;Lee, Yeong Hyeon;Lee, Yong Sik;Choi, Young Duk;Lee, Hee Hyung;Hwang, Sung Hyun
    • Clinics in Orthopedic Surgery
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    • v.10 no.4
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    • pp.413-419
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    • 2018
  • Background: We aimed to examine the factors that influence synovialization of the grafted tendon after double-bundle anterior cruciate ligament (ACL) reconstruction based on second-look arthroscopic findings. Methods: Out of 205 knees that were treated between August 2008 and May 2016 with double-bundle ACL reconstruction using bio-absorbable cross-pins and Endobuttons for femoral tunnel fixation, we enrolled 65 knees (64 patients) that underwent second-look arthroscopy with hardware removal at 1 year postoperatively. Measured clinical outcomes included the Lysholm score and Tegner activity score that were evaluated preoperatively and during the final follow-up. We analyzed the relationship between synovial coverage and patient age, length of the preserved remnant tissue on the tibial side, type of bundle (anteromedial or posterolateral), type of graft (autograft or allograft), and time from injury to surgery. Results: The area of synovial coverage showed a significant statistical correlation with patient age and the length of the preserved remnant tissue on the tibial side. The average synovial coverage was significantly better for the anteromedial bundle than for the posterolateral bundle, better for the autograft than for the allograft reconstruction, and better when treated in the acute stage than in the chronic stage. However, synovialization of grafted tendon did not correlate to clinical outcomes. Conclusions: While we were able to identify several factors influencing synovialization of the grafted tendon after double-bundle ACL reconstruction, including patient age, length of preserved remnant tissue of the torn ACL, type of bundle, type of graft, and time from injury to surgery, we found no evidence that increased synovialization improves clinical outcomes at 1 year postoperatively.

One Anchor Double Fixation (OADF) Technique for Arthroscopic Bony Bankart Repair (두가닥의 봉합사를 가진 봉합나사못을 이용한 새로운 관절경적 골성 방카르트 병변 봉합술)

  • Choi, Eui-Sung;Park, Kyoung-Jin;Kim, Yong-Min;Kim, Dong-Soo;Shon, Hyun-Chul;Cho, Byung-Ki;Bae, Seung-Hwan
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.40-46
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    • 2010
  • Purpose: The aim of this study was to evaluate the usefulness of arthroscopic Bony Bankart repair using a One Anchor Double Fixation Technique. Materials and Method: Seventeen patients with a Bony Bankart lesion were treated using the One Anchor Double Fixation Technique (OADF Technique). There were 13 males and 4 females. The average age was 24 years (range 17-42). The average follow-up period was 22.3 months. One 3.0 mm suture anchor with doubly loaded sutures was inserted into the glenoid rim. One suture strand was passed the around the small bony fragment and tied first. Another suture strand was passed through the capsule and tied over the bony fragment. The result was measured using Rowe's evaluation index & KSS score. The glenoid defect & bony fragment were measured by 3D-CT scan. Results: Rowe's evaluation index on the final follow-up showed an overall improvement from an average of 54 (range, 23-71) to 83.4 (range 71-90). Of the 17 cases, 13 were excellent, 3 were good, and 1 was fair. KSS scores showed improvement from an average of 71 (range 49-82) to 92.5 (range 82-94). There were no cases where pain continued to the final follow-up, and no cases being re-dislocated during the follow-up period. For six cases, we confirmed the bony healing of the bony Bankart lesion by CT. Conclusion: Bony Bankart lesion repair using this new method achieves excellent clinical results with low recurrence rates and is considered another choice for bony Bankart lesions.

THE EFFECT OF RESORBABLE MEMBRANE ON BONE REGENERATION IN CALVARIAL DEFECTS OF RATS (백서의 두개골 결손부에서 탈단백우골 이식 시 흡수성악의 효과)

  • Park, Young-Jun;Choi, Guen-Ho;Jang, Jung-Rok;Jung, Seung-Gon;Kim, Young-Joon;Yu, Min-Gi;Kook, Min-Suk;Oh, Hee-Kyun;Ryu, Sun-Youl;Park, Hong-Ju
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.5
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    • pp.365-374
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    • 2009
  • Purpose : This research evaluates the effect of the use of absorbable membrane barrier with deproteinized bovine bone (Bio-$Oss^{(R)}$, Switzerland) on bone healing in surgically created critical-sized defects in rat calvaria. Materials and Methods : Two standardized transosseous circular calvarial defects (5 mm in diameter) are made in each calvarium of 30 rats. These rats are divided into negative control group(n=15), positive control group(n=15) and two experimental groups(n=15). In the negative control group, defects are only filled with blood clots. In the positive control group, defects are filled with autogenous bone obtained from calvarium; in the experimental group 1, defects are filled with deproteinized bovine bone; and in the experimental group 2, defects are filled with deproteinized bovine bone with absorbable membrane. At the postoperative 1 week, 3 weeks. and 6 weeks, clinical. histologic and histomorphometric evaluations of the defects are performed. Results : 1. The grafted bone without membrane in the calvarial bone defect was scattered but, the grafted bone with membrane was stable. 2. $BioMesh^{(R)}$ membrane was absorbed beginning at 3 weeks, and was absorbed considerably at 6 weeks while maintaining the structural form of the membrane. 3. The use of membrane blocked soft tissue invasion. 4. In histomorphometric analysis. it showed the greatest amount of new bone formation in the positive control group. The amount of new bone formation was greater in the experimental group 2 than experimental group 1. At 6 weeks. the amount of new bone formation was greater in the positive control group than experimental group l(p<0.005). Conclusion : These results suggest that membrane increase the stability of grafted bone and protects from soft tissue invasion, and the use of the membrane may promote new bone formation in deproteinized bovine bone graft area.

Concurrent Innate Immunity Activation and Anti-inflammation effects of Dialyzed Coffee Extract in RAW 264.7 Cells, Murine Macrophage Lineage (RAW 264.7 세포에서 투석시킨 커피 추출액의 선천면역활성화와 항염증의 동시발생)

  • Yoon, Cheol Soo;Lee, Suk Keun
    • The Korean Journal of Oral and Maxillofacial Pathology
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    • v.41 no.3
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    • pp.121-129
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    • 2017
  • Coffee (Coffea spp.) is one of the most important agricultural commodities, being widely consumed in the world. Various beneficial health effects of coffee have been extensively investigated, but data on habitual coffee consumption and its bio-physiological effect have not been clearly explained as well as it is not proved the cause and effect between drinking coffee and its bio-physiological reactions. We made the dialyzed coffee extract (DCE), which is absorbable through gastrointestinal tract, in order to elucidate the cellular effect of whole small coffee molecules. RAW 264.7 cells, a murine macrophage lineage, were directly treated with DCE, i.e., DCE-2.5 (equivalent to 2.5 cups of coffee a day), DCE-5, and DCE-10, for 12 hours, and their protein extracts were examined by immunoprecipitation high performance liquid chromatography (IP-HPLC). RAW 264.7 cells differently expressed the inflammation-related proteins depending on the doses of DCE. RAW 264.7 cells treated with DCE showed marked increase of cathepsin C, cathepsin G, CD20, CD28, CD31, CD68, indicating the activation of innate immunity. Particularly, the macrophage biomarkers, cathepsin G, cathepsin C, CD31, and CD68 were markedly increased after DCE-5 and DCE-10 treatments, and the lymphocyte biomarkers, CD20 and CD28 were consistently increased and became marked after DCE-10 treatment. On the other hand, RAW 264.7 cells treated with DCE showed consistent increase of IL-10, an anti-inflammatory factor, but gradual decreases of different pro-inflammatory proteins including $TNF{\alpha}$, COX-2, lysozyme, MMP-2, and MMP-3. In particular, the cellular signaling of inflammation was gradually mitigated by the reduction of $TNF{\alpha}$, COX-2, IL-12, and M-CSF, and also the matrix inflammatory reaction was reduced by marked deceases of MMP-2, MMP-3, and lysozyme. These anti-inflammatory expressions were consistently found until DCE-10 treatment. Therefore, it is presumed that DCE may have dynamic effects of innate immunity activation and pro-inflammation suppression on RAW264.7 cells simultaneously. These effects were consistently found in the highest dose of coffee, DCE-10 (equivalent to 10 cups of coffee a day in man), that might imply the small coffee molecules were accumulated in RAW 264.7 cells after DCE-10 treatment and produce synergistic cytokine effects for innate immunity activation and anti-inflammatory reaction concurrently.