Autophagy in Osteoarthritis: A Double-Edged Sword in Cartilage Aging and Mechanical Stress Response: A Systematic Review.

: Although osteoarthritis (OA) development is epidemiologically multifactorial, a primary underlying mechanism is still under debate. Understanding the pathophysiology of OA remains challenging. Recently, experts have focused on autophagy as a contributor to OA development.

Dual Growth Factor Delivery Using Photo-Cross-Linkable Gelatin Hydrogels for Effectively Reinforced Regeneration of the Rotator Cuff Tendon.

Rotator cuff tears are currently treated with drugs (steroids and nonsteroidal anti-inflammatory drugs) and surgery. However, the damaged rotator cuff requires a considerable amount of time to regenerate, and the regenerated tissue cannot restore the same level of function as that before the damage. Although growth factors can accelerate regeneration, they are difficult to be used alone because of the risk of degradation and the difficulties in ensuring their sustained release.

Effect of structural design on the pullout strength of suture anchors for rotator cuff repair.

Various types of suture anchor designs are currently available for rotator cuff repair. The purpose of our study was to investigate the pullout strength of such anchors based on their structural design and the predominant geometric design factors affecting the pullout strength using finite element analysis. Finite element models were constructed using five cadaveric humeri and ten suture anchors with different designs.

Primary stability of inferior tilt fixation of the glenoid component in reverse total shoulder arthroplasty: A finite element study.

Glenoid component fixation with inferior tilt has been suggested as one of the surgical methods to decrease scapular notching and improve stability, but its clinically beneficial effect remains a concern. We evaluated the influence of inferior tilt fixation of the glenoid component on primary stability in reverse total shoulder arthroplasty by finite element analysis. Finite element models were constructed from cadaveric scapulae of females over the age of 60 years and glenoid components from reverse total shoulder arthroplasty.

Effect of baseplate size on primary glenoid stability and impingement-free range of motion in reverse shoulder arthroplasty.

Background: Use of a baseplate with a smaller diameter in reverse shoulder arthroplasty is increasing, especially in patients with a small glenoid or glenoid wear. However, the effect of a smaller baseplate on stability of the glenoid component has not been evaluated. Thus, the purpose of this study was to determine whether a smaller baseplate (25 mm) is beneficial to the initial stability of the glenoid component compared to that with a baseplate of a commonly used size (29 mm).

Effect of Poloxamer 407 as a carrier vehicle on rotator cuff healing in a rat model.

Background: In vivo studies showing the effects of biologic healing-promoting factors on tendon-to-bone healing after rotator cuff repair have focused only on biologic healing-promoting factors and have not taken into consideration the effect of the carrier vehicle. Moreover, most studies have evaluated the healing process using different carrier vehicles, each of which may have specific effects on tendon healing. This may explain the large variability seen in outcomes in research studies.

Modified tension band fixation for unstable distal clavicle fractures.

Background: Optimal surgical treatment of unstable distal clavicle fractures is controversial, and various fixation options are available. The objective of this study was to evaluate a new modified tension band fixation technique for unstable distal clavicle fractures.

Methods: Forty-two patients with acute unstable distal clavicle fractures were managed with open reduction and internal fixation using modified tension band fixation.

Effect of anterior supraspinatus tendon partial-thickness tears on infraspinatus tendon strain through a range of joint rotation angles.

Background: Rotator cuff tears are common shoulder problems whose propagation is difficult to predict because of the structural and mechanical inhomogeneity of the supraspinatus tendon. We have previously shown that the supraspinatus and infraspinatus tendons interact mechanically when the supraspinatus tendon is intact or exhibits a full-thickness tear, so that an increase in supraspinatus tendon strain is paralleled by an increase in infraspinatus tendon strain. Such interaction is critical and suggests that an increase in infraspinatus tendon strain that accompanies an increase in supraspinatus tendon strain may shield the supraspinatus tendon from further injury, but increase the risk of injury to the infraspinatus tendon.

Transient decreases in forelimb gait and ground reaction forces following rotator cuff injury and repair in a rat model.

Due to inadequate healing, surgical repairs of torn rotator cuff tendons often fail, limiting the recovery of upper extremity function. The rat is frequently used to study rotator cuff healing; however, there are few systems capable of quantifying forelimb function necessary to interpret the clinical significance of tissue level healing. We constructed a device to capture images, ground reaction forces and torques, as animals ambulated in a confined walkway, and used it to evaluate forelimb function in uninjured control and surgically injured/repaired animals.

The effect of postoperative passive motion on rotator cuff healing in a rat model.

Background: Surgical repairs of torn rotator cuff tendons frequently fail. Immobilization has been shown to improve tissue mechanical properties in an animal model of rotator cuff repair, and passive motion has been shown to improve joint mechanics in animal models of flexor tendon repair. Our objective was to determine if daily passive motion would improve joint mechanics in comparison with continuous immobilization in a rat rotator cuff repair model.

The development and validation of an appraisal method for rotator cuff disorders: the Korean Shoulder Scoring System.

Hypothesis: The purpose of this study was to develop and validate a disease-specific appraisal method for patients with rotator cuff disorders. The Korean Shoulder Scoring System (KSS) includes 5 domains totalling 100 points: function, 30 points; pain, 20; satisfaction, 10; range of motion, 20; and muscle power, consisting of strength, 10; and endurance, 10.

Method: The KSS was used to evaluate clinical outcomes of 430 patients with rotator cuff disorder for a period of 6 months postoperatively.

Arthroscopically assisted mini-deltopectoral rotator cuff repair.

This study examined the technique and outcome of arthroscopically assisted mini-deltopectoral rotator cuff repair. The mini-deltopectoral approach enables the repair of large or massive rotator cuff tears while preventing injury to the deltoid muscle and axillary nerve often caused by splitting and excessive traction during conventional mini-open repair. This technique also is useful in the repair of subscapularis tears and thus could extend the indications for mini-open repair.