Asymmetric Flexion Contracture is Associated With Leg Length Inequality in Patients With Knee Osteoarthritis: Data From the Osteoarthritis Initiative.

Objective: To evaluate whether knee flexion contracture (FC) was associated with leg length inequality (LLI) and/or morbidity in knee osteoarthritis (OA).

Design: We accessed 2 databases: (1) the Osteoarthritis Initiative (OAI) cohort, including participants with, or at-risk of OA, and (2) the Ottawa Knee Osteoarthritis cross-sectional database (OKOA), including participants with primary advanced knee OA. Both included demographics, radiographic data, knee range of motion, leg length, pain, and function scales.

[Cystoscopy in the outpatient clinical routine: things to keep in mind].

Cystoscopy is an important procedure in the diagnostic evaluation of the lower urinary tract. Standard cystoscopy (white light) undergoes permanent improvement. High-end instruments and video systems are available, supported by PDD (photodynamic diagnostic), NBI (narrow band imaging) and digital contrast enhancement to improve the detection rate of bladder cancer.

Baseline knee extension may be associated with volumetric cartilage loss in the anterolateral tibia: data from the Osteoarthritis Initiative.

Objectives: Animal studies suggest regional unloading of the knee due to flexion contracture (FC) results in cartilage loss in the anterior tibia. We looked for an association between the range of knee extension and articular cartilage thickness in the tibia of patients with knee OA, using quantitative MRI data from the OA Initiative.

Methods: Baseline knee extension was measured using a goniometer.

Rotator cuff anchor repair: Histological changes associated with the recovering mechanical properties in a rabbit model.

Rotator cuff anchor repair is an increasingly common surgical procedure but the failure rate remains high. In order to improve surgical outcomes, a better understanding of postrepair histological and cellular responses at the tendon-bone attachment site (enthesis) is needed. We examined operated shoulders from 42 New Zealand female white rabbits.

Preoperative bone marrow stimulation does not improve functional outcomes in arthroscopic cuff repair: a prospective randomized controlled trial.

Aims: Despite recent advances in arthroscopic rotator cuff repair, re-tear rates remain high. New methods to improve healing rates following rotator cuff repair must be sought. Our primary objective was to determine if adjunctive bone marrow stimulation with channelling five to seven days prior to arthroscopic cuff repair would lead to higher Western Ontario Rotator Cuff (WORC) scores at 24 months postoperatively compared with no channelling.

Supraspinatus tendon transosseous vs anchor repair surgery: a comparative study of mechanical recovery in the rabbit.

Background: Supraspinatus (SSP) tendon ruptures requiring surgical repair are common. Arthroscopic suture anchor fixation has gradually replaced transosseous repair in supraspinatus tendon tear. Our objective was to compare mechanical properties between transosseous and anchor supraspinatus repair in the first 6 postoperative weeks in a rabbit model.

Bone replaces unloaded articular cartilage during knee immobilization. A longitudinal study in the rat.

Background: Joint immobility results in deleterious changes such as capsule shortening, bone loss and articular cartilage damage. Immobilization of rat knees in flexion for 32 weeks resulted in the distinctive feature of well-established replacement of articular cartilage by bone. Determining the time of onset of bone replacement is critical for the prevention of this likely irreversible complication of joint immobilization.

Tendon contains more stem cells than bone at the rotator cuff repair site.

Background: The rotator cuff (RC) repair failure rate is high. Tendon and bone represent sources of mesenchymal stem cells (MSCs), but the number of MSCs from each has not been compared. Bone channeling may increase bone-derived MSC numbers participating in enthesis re-formation at the "footprint" repair site.

Adipocyte hyperplasia: the primary mechanism of supraspinatus intramuscular fat accumulation after a complete rotator cuff tendon tear: a study in the rabbit.

Intramuscular fat (IMF) accumulates in muscles of the rotator cuff after tendon tear. The number and cross-sectional area of fat clumps and of adipocytes were quantified on osmium tetroxide stained sections of the proximal, middle and distal quarters of SSP muscles 4, 8 and 12 weeks after SSP tendon division in a rabbit model. Linear mixed-effects models were fitted to the data and statistical significance was evaluated by ANOVA.

Using a Knee Arthrometer to Evaluate Tissue-specific Contributions to Knee Flexion Contracture in the Rat.

Normal knee range of motion (ROM) is critical to well-being and allows one to perform basic activities such as walking, climbing stairs and sitting. Lost ROM is called a joint contracture and results in increased morbidity. Due to the difficulty of reversing established knee contractures, early detection is important, and hence, knowing risk factors for their development is essential.

Range of Extension Correlates with Posterior Capsule Length after Knee Remobilization.

Introduction: Knee injuries are common in sports, and postinjury immobilization is often required to protect healing tissues and alleviate pain, but both the injury and the immobilization can lead to a knee contracture. Knee flexion contractures limit performance. Previous research has identified posterior knee capsule fibrosis as a contributor to immobility-induced knee flexion contractures.

Supraspinatus tendon repair using anchors: a biomechanical evaluation in the rabbit.

Background: Arthroscopic rotator cuff repairs are mostly secured with suture anchors and often supplemented by footprint decortication. The objectives of this study were to characterize the strength of bone-tendon healing following anchor repair and assess the effect of channeling the supraspinatus (SSP) humeral footprint 1 week ahead of reattachment surgery.

Methods: One hundred twelve rabbits underwent unilateral detachment of one SSP tendon and were randomly assigned to two groups: channeling the footprint at time of detachment and no channeling.

Hemolysis during and after 21 days of head-down-tilt bed rest.

Hemoconcentration is observed in bed rest studies, descent from altitude, and exposure to microgravity. Hemoconcentration triggers erythrocyte losses to subsequently normalize erythrocyte concentration. The mechanisms of erythrocyte loss may involve enhanced hemolysis, but has never been measured directly in bed rest studies.

Bone replaces articular cartilage in the rat knee joint after prolonged immobilization.

Background: Lost joint range of motion (ROM) is common in chronic osteoarthritis, alters regional weight-bearing across the articular surfaces, and contributes to loss of cartilage and bone alterations. Limited data exist on the regional effects on joints subjected to chronic losses of ROM.

Objective: To characterize the regional replacement by bone as part of articular cartilage degeneration after prolonged immobilization.

The effects of knee immobilization on marrow adipocyte hyperplasia and hypertrophy at the proximal rat tibia epiphysis.

Marrow adipose deposition is observed during aging and in association with extended periods of immobility. The objective of this study was to determine the contribution of adipocyte hypertrophy and hyperplasia to bone marrow fat deposition induced by immobilization of the rat knee joint for 2, 4, 16 or 32 weeks. Histomorphometric analyses compared immobilized to sham-operated proximal tibia from age and gender matched rats to assess the contribution of aging and duration of immobilization on the number and size of marrow adipocytes.

Imaging of the rabbit supraspinatus enthesis at 7 Tesla: a 4-week time course after repair surgery and effect of channeling.

Purpose: To image the supraspinatus enthesis reformation of rabbit shoulders by magnetic resonance at 7 Tesla (T) using T2 mapping after surgical repair and to assess the effects of channeling aimed at enhancing enthesis reformation.

Materials And Methods: In 112 rabbits, the distal supraspinatus (SSP) tendon was unilaterally detached and reattached after 1 week. At the first surgery, channeling was performed at the footprint in 64 rabbits.

Quantitative analysis of the reversibility of knee flexion contractures with time: an experimental study using the rat model.

Background: Knee flexion contractures prevent the full extension of the knee joint and cause disability. The etiology is not well defined. Extended periods of immobilization of joints lead to contractures difficult to completely reverse by rehabilitation treatments.

Quantitative and temporal differential recovery of articular and muscular limitations of knee joint contractures; results in a rat model.

Joint contractures alter the mechanical properties of articular and muscular structures. Reversibility of a contracture depends on the restoration of the elasticity of both structures. We determined the differential contribution of articular and muscular structures to knee flexion contractures during spontaneous recovery.

Effect of timing of surgical SSP tendon repair on muscle alterations.

To investigate the impacts of delayed repairs of a supraspinatus tendon tear on the supraspinatus muscle, we used an animal model data from two previously published studies in which one supraspinatus (SSP) tendon was detached. In one cohort, the rabbits were killed in groups of 10 at 4, 8, and 12 weeks. In the other cohort, a repair was done at these time points, 12 rabbits each, and the animals killed were 12 weeks later.

Intramuscular fat accumulation and muscle atrophy in the absence of muscle retraction.

Objectives: Although many clinical and experimental investigations have shed light on muscle atrophy and intramuscular accumulation of fat after rotator cuff disruption, none have reported on their onset in the absence of muscle retraction.

Methods: In 30 rabbits, we detached one supraspinatus (SSP) tendon and repaired it immediately, thus preventing muscle retraction. The animals were killed in groups of 10 at one, two and six weeks.

[Outpatient specialist medical care: what is possible, what will come?].

The guidelines on outpatient specialist medical treatment (ASV) according to § 116b of the Social Act were published by the Federal Joint Committee on 21 March 2013. The guidelines regulate the framework conditions for the new area of healthcare and the requirements for potential participants. The ASV guidelines are designed to ultimately bridge the sectorial borders for the treatment of rare diseases and those with unusual courses.