Assessment of the proficiency level of novices in distal intramedullary nail interlocking achieved through training with Digitally Enhanced Hands-on Surgical Training (DEHST).

Background: Digitally Enhanced Hands-on Surgical Training (DEHST) platform was introduced to overcome the lack of training capabilities for the challenging task of freehand distal interlocking of intramedullary nails. It demonstrates high perceived realism for surgeons, and novices perform significantly better after DEHST training. However, characterization of how performance improves remained unexplored.

In Vitro Induction of Hypertrophic Chondrocyte Differentiation of Naïve MSCs by Strain.

In the context of bone fractures, the influence of the mechanical environment on the healing outcome is widely accepted, while its influence at the cellular level is still poorly understood. This study explores the influence of mechanical load on naïve mesenchymal stem cell (MSC) differentiation, focusing on hypertrophic chondrocyte differentiation. Unlike primary bone healing, which involves the direct differentiation of MSCs into bone-forming cells, endochondral ossification uses an intermediate cartilage template that remodels into bone.

Unraveling the Atomistic Mechanism of Electrostatic Lateral Association of Peptide β-Sheet Structures and Its Role in Nanofiber Growth and Hydrogelation.

Guiding molecular assembly of peptides into rationally engineered nanostructures remains a major hurdle against the development of functional peptide-based nanomaterials. Various non-covalent interactions come into play to drive the formation and stabilization of these assemblies, of which electrostatic interactions are key. Here, the atomistic mechanisms by which electrostatic interactions contribute toward controlling self-assembly and lateral association of ultrashort β-sheet forming peptides are deciphered.

Biofabrication of anisotropic articular cartilage based on decellularized extracellular matrix.

Tissue-engineered grafts that mimic articular cartilage show promise for treating cartilage injuries. However, engineering cartilage cell-based therapies to match zonal architecture and biochemical composition remains challenging. Decellularized articular cartilage extracellular matrix (dECM) has gained attention for its chondro-inductive properties, yet dECM-based bioinks have limitations in mechanical stability and printability.

Spatial transcriptomics in bone mechanomics: Exploring the mechanoregulation of fracture healing in the era of spatial omics.

In recent decades, the field of bone mechanobiology has sought experimental techniques to unravel the molecular mechanisms governing the phenomenon of mechanically regulated fracture healing. Each cell within a fracture site resides within different local microenvironments characterized by different levels of mechanical strain; thus, preserving the spatial location of each cell is critical in relating cellular responses to mechanical stimuli. Our spatial transcriptomics-based "mechanomics" platform facilitates spatially resolved analysis of the molecular profiles of cells with respect to their local in vivo mechanical environment by integrating time-lapsed in vivo micro-computed tomography, spatial transcriptomics, and micro-finite element analysis.

Preoperative skin asepsis in bovine surgery: an outcome-blinded 3-arm randomized clinical trial under non-sterile operating room conditions.

Background: Surgical site infections (SSI) following clean abdominal surgery in cattle pose significant economic and welfare concerns. Preoperative skin asepsis aims to minimize microbial load over the surgical field before and throughout surgery to minimize its risk. While chlorhexidine (CHX) and povidone-iodine (PVI) are commonly used antiseptics for this purpose, our study introduces the so far unexplored use of octenidine (OCT) in veterinary surgery.

How many knots are necessary to achieve knot security of two high strength suture tapes? A biomechanical comparative analysis.

Introduction: According to current clinical practice, a minimum of 7 knots are required to provide secure hold in high-strength sutures. A new technology featuring a suture tape with a salt-infused silicon core has been recently developed, potentially reducing the number of needed knots.

Aims: to (1) assess the influence of number of knots on tape security, (2) evaluate the effect of different ambient conditions on knot security, and (3) compare the biomechanical competence of the novel versus a conventional suture tape.

Fixation of Takeuchi Type II/III lateral hinge fractures provides favourable stability of a medial open wedge high tibial osteotomy-A biomechanical study.

Purpose: To investigate the biomechanical consequences of osteosynthesis of lateral hinge fractures (LHFs) in medial open wedge high tibial osteotomy (MOWHTO).

Methods: Sixteen fresh-frozen human cadaveric proximal tibiae underwent MOWHTO fixed with an ipsilateral locking compression plate. The specimens were assigned to two clusters simulating LHFs according to the Takeuchi classification: (1) Type II fracture; and (2) Type III fracture.

Effects of proline substitution/inclusion on the nanostructure of a self-assembling β-sheet-forming peptide.

Self-assembling peptides remain persistently interesting objects for building nanostructures and further assemble into macroscopic structures, hydrogels, at sufficiently high concentrations. The modulation of self-assembling β-sheet-forming peptide sequences, with a selection from the full library of amino acids, offers unique possibility for rational tuning of the resulting nanostructured morphology and topology of the formed hydrogel networks. In the present work, we explored how a known β-sheet-disassembling amino acid, proline (P), affects the self-assembly and gelation properties of amphipathic peptides.

45° helical plates are a valid alternative to straight plates for treatment of proximal humeral shaft fractures.

Helical plates used for proximal humeral shaft fracture fixation avoid the radial nerve distally as compared to straight plates. To investigate in a human cadaveric model the biomechanical competence of straight lateral plates versus 45° helical plates used for fixation of proximal comminuted humeral shaft fractures, eight pairs of human cadaveric humeri were instrumented using either a long straight PHILOS plate (Group 1) or a 45° helical plate (Group 2) for treatment of an unstable proximal humeral shaft fracture. All specimens were tested under non-destructive quasi-static loading in axial compression, internal and external rotation, and bending in four directions.

Open reduction and internal fixation versus minimally invasive plate osteosynthesis of unstable proximal humerus fractures treated with locking plate and intramedullary allograft: A retrospective study.

Background: This retrospective clinical study aims to compare the functional and radiological outcomes after open reduction and internal fixation versus minimally invasive plate osteosynthesis of unstable proximal humerus fractures treated with both locking plate and intramedullary graft.

Methods: Forty-seven patients with proximal humerus fractures were treated with either open reduction and internal fixation (25 cases) or minimally invasive plate osteosynthesis (22 cases) and evaluated retrospectively with a minimum follow-up of 12 months. Thirty-one fresh-frozen fibulae and 16 lyophilized tibia allografts were used for augmentation.

Exploring the potential of naturally occurring antimicrobials for managing orthopedic-device-related infections.

Orthopedic-device-related infections (ODRIs) are challenging clinical complications that are often exacerbated by antibiotic resistance and biofilm formation. This review explores the efficacy of naturally occurring antimicrobials - including agents sourced from bacteria, fungi, viruses, animals, plants and minerals - against pathogens common in ODRIs. The limitations of traditional antibiotic agents are presented, and innovative naturally occurring antimicrobials, such as bacteriophage therapy and antimicrobial peptides, are evaluated with respect to their interaction with conventional antibiotics and antibiofilm efficacy.

Civilian ballistic spinal cord injuries versus blunt trauma: comparative analysis of clinical characteristics, management, and outcomes.

Background Context: There are no current guidelines for the management of civilian gunshot wound injuries (GSW) to the spine and patient management often relies on algorithms derived from blunt trauma (BT). However, spinal cord injury due to GSW or blunt trauma mechanism may have significantly different clinical presentation, management, and outcomes. To ensure improved and evidence-based treatment, we need to understand the outcome determining characteristics of civilian GSW to the spine and identify the differences to the well-studied BT.

Prognostic bone fracture healing simulations in an ovine tibia model validated with in vivo sensors.

Bone fracture healing is a complex physiological process influenced by biomechanical and biomolecular factors. Mechanical stability is crucial for successful healing, and disruptions can lead to delayed healing or nonunion. Bone commonly heals itself through secondary fracture healing, which is governed by the mechanical strain at the fracture site.

The Role of the Bone Morphogenetic Protein Antagonist Noggin in Nucleus Pulposus Intervertebral Disc Cells.

Low back pain (LBP) is a significant global health issue, contributing to disability and socioeconomic burdens worldwide. The degeneration of the human intervertebral disc (IVD) is a critical factor in the pathogenesis of LBP. Recent studies have emphasized the significance of a specific set of genes and extracellular matrix (ECM) in IVD health.

The most responsive foot position for non-invasive detection of isolated unstable syndesmotic injuries - a 3D analysis.

Background: The aim of this study was to identify the most responsive foot position for detection of isolated unstable syndesmotic injury.

Methods: Fourteen paired human cadaveric lower legs were positioned in a pressure-controlled radiolucent frame and loaded under 700 N. Computed tomography scans were performed in neutral position, 15° internal / external rotation, and 20° dorsal / plantar flexion of the foot before and after cutting all syndesmotic ligaments.

Phage therapy: A primer for orthopaedic trauma surgeons.

Phage therapy (PT) continues to attract interest in the fight against fracture-related infection (FRI), particularly for recurring infections that have not been resolved using conventional therapeutic approaches. The journey PT has taken from early clinical application in the pre-antibiotic era to its recent reintroduction to western clinical practice has been accelerated by the increased prevalence of multi-drug resistant (MDR) pathogens in the clinic. This review will present PT's potential as a precise, adaptable, and effective treatment modality, with a focus on patient and phage selection, as well as the various administration protocols currently applied to patients.

Drug retention after intradiscal administration.

Intradiscal drug delivery is a promising strategy for treating intervertebral disk degeneration (IVDD). Local degenerative processes and intrinsically low fluid exchange are likely to influence drug retention. Understanding their connection will enable the optimization of IVDD therapeutics.

Preparation and Characterization of Photo-Cross-Linkable Methacrylated Silk Fibroin and Methacrylated Hyaluronic Acid Composite Hydrogels.

Composite biomaterials with excellent biocompatibility and biodegradability are crucial in tissue engineering. In this work, a composite protein and polysaccharide photo-cross-linkable hydrogel was prepared using silk fibroin methacrylate (SFMA) and hyaluronic acid methacrylate (HAMA). SFMA was obtained by the methacrylation of degummed SF with glycidyl methacrylate (GMA), while HA was methacrylated by 2-aminoethyl methacrylate hydrochloride (AEMA).

Accuracy of pelvic bone segmentation for 3d printing: a study of segmentation accuracy based on anatomic landmarks to evaluate the influence of the observer.

Background: 3D printing has a wide range of applications and has brought significant change to many medical fields. However, ensuring quality assurance (QA) is essential for patient safety and requires a QA program that encompasses the entire production process. This process begins with imaging and continues on with segmentation, which is the conversion of Digital Imaging and Communications in Medicine (DICOM) data into virtual 3D-models.