Abstract:
BACKGROUND:Outcomes after intrasynovial tendon repair are highly variable. An intense inflammatory cascade followed by a delayed healing response can cause adhesion formation and repair-site failure that severely impair the function of repaired digits. No effective remedies exist to fully address these issues. Cell- and growth factor-based therapies have been shown to modulate inflammation and improve cell proliferation and matrix synthesis and therefore are promising treatment approaches for intrasynovial tendon repair. QUESTIONS/PURPOSES:(1) Can autologous adipose-derived mesenchymal stromal cells (ASCs) and recombinant bone morphogenetic protein-12 (rBMP-12) be effectively delivered to an intrasynovial flexor tendon repair without adverse effects? (2) Do autologous ASCs modulate the inflammatory response after intrasynovial tendon injury and repair? (3) Does the combined application of autologous ASCs and rBMP-12 modulate the proliferative and remodeling responses after intrasynovial tendon injury and repair? METHODS:Sixteen 1- to 2-year-old female canines were used in this study. Autologous ASC sheets, with and without rBMP-12, were applied to the surface of sutured flexor tendons. Fourteen days after repair, the effects of treatment were determined using quantitative PCR (six per group) for the expression of genes related to macrophage phenotype or inflammation (IL-4, CD163, VEGF, NOS2, IL-1B, and IFNG), cell proliferation (CCND1), and tendon formation (SCX, TNMD, COL1A1 and COL3A1). Proteomics analysis (four per group) was performed to examine changes in tendon protein abundances. CD146 immunostaining and hematoxylin and eosin staining (four per group) were used to detect tendon stem or progenitor cells and to semiquantitatively evaluate cellularity at the tendon repair; analyses were done blinded to group. RESULTS:Gross inspection and cell tracing showed that autologous ASCs and rBMP-12 were delivered to the flexor tendon repair site without the deleterious effects of adhesion and repair-site gap formation. Quantitative assessment of gene and protein expression showed effects of treatment: ASC-sheet treatment modulated the postrepair inflammatory response and facilitated healing by increasing regenerative M2 macrophages (M2 marker CD204, twofold of normal, p = 0.030), inflammatory inhibitor (prostaglandin reductase 1 [PTRG1], 1.6-fold of normal, p = 0.026), and proteins involved in tendon formation (periostin [POSTN], 1.9-fold of normal, p = 0.035). Consistently, semiquantitative and qualitative evaluations of repaired tissue showed that ASC-sheet treatment reduced mononuclear cell infiltration (12% less than nontreated tendons, p = 0.021) and introduced CD146+ stem or progenitor cells to the repair site. The combined administration of ASCs and rBMP-12 further stimulated M2 macrophages by increasing IL-4 (116-fold of normal, p = 0.002) and led to the increase of M2 effector matrix metalloproteinase-12 involved in matrix remodeling (twofold of normal, p = 0.016) and reduction of a negative regulator of angiogenesis and cell migration (StAR-related lipid transfer domain protein13 [STARD13]; 84% of normal, p = 0.000), thus facilitating the proliferative stage of tendon repair. CONCLUSIONS:ASCs and BMP-12 accelerated the progression of healing in the proliferative stage of tendon repair. The effects of ASCs and BMP-12 on tendon functional recovery should be evaluated in future studies. CLINICAL RELEVANCE:The cell sheet approach is an effective, biocompatible, and surgeon-friendly approach for cell and growth factor delivery during tendon repair. Combined application of ASCs and BMP-12 may accelerate intrasynovial tendon healing while suppressing the adverse inflammatory response.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Gelberman RH,Linderman SW,Jayaram R,Dikina AD,Sakiyama-Elbert S,Alsberg E,Thomopoulos S,Shen Hdoi
10.1007/s11999-017-5369-7subject
Has Abstractpub_date
2017-09-01 00:00:00pages
2318-2331issue
9eissn
0009-921Xissn
1528-1132pii
10.1007/s11999-017-5369-7journal_volume
475pub_type
杂志文章abstract::In this series of 62 free flap transfers, 48 (80%) have been successful. There have been a significant number of vascular complications, 39% of which the majority were arterial thrombosis. Fifty per cent of those which thrombosed were salvaged on exploration and revision of the vessels. The frequency of complications ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-06-01 00:00:00
abstract::The purpose of this study was to compare the success rate of bony fusion and the clinical results of rigid instrumentation, nonrigid instrumentation, and no instrumentation for a single level lesion for degenerative lumbar spondylolisthesis. Thirty-three patients with degenerative spondylolisthesis of L4 who had under...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:Dislocation after THA continues to be relatively common. Dual mobility sockets have been associated with low dislocation rates, but it remains unclear whether their use in primary THA would not introduce additional complications. QUESTIONS/PURPOSES:We therefore asked whether a current cementless dual mobili...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-012-2395-3
更新日期:2012-11-01 00:00:00
abstract::Despite the clinical success of total knee arthroplasty, little information can be found in the literature about the relationship between certain postoperative physical findings and the outcome. Specifically, is the range of motion related to patient perception of outcome? We performed a cohort prospective study on 48...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/BLO.0b013e318046ccb7
更新日期:2007-07-01 00:00:00
abstract::We hypothesized the extent of involvement of the proximal femoral growth plate in Perthes disease determined the final radiographic outcome after containment by shelf acetabuloplasty. We retrospectively evaluated the extent of growth plate involvement using a modified version of the method described by Yasuda and Tamu...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/BLO.0b013e3180380ef2
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:The ability of injection of corticosteroids into the subacromial space to relieve pain ascribed to rotator cuff tendinosis is debated. The number of patients who have an injection before one gets relief beyond what a placebo provides is uncertain. QUESTIONS/PURPOSES:We asked: (1) Do corticosteroid injection...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s11999-016-5002-1
更新日期:2017-01-01 00:00:00
abstract::Musculoskeletal medicine is not taught adequately in American medical schools and the predictable consequences are seen. Students cannot show cognitive mastery of the subject and lack confidence in this topic. To address this, the Academic Orthopaedic Society held a symposium on medical school education at its annual ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000093922.26658.3c
更新日期:2003-10-01 00:00:00
abstract::Two hundred and eight skin knives and 374 deep knives were evaluated in 153 clean orthopedic cases with and without a horizontal wall-less laminar air-flow system. There was no statistical difference in contamination frequency between the skin and the deep knives with and without the laminar air-flow. However, the kni...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-197505000-00024
更新日期:1975-05-01 00:00:00
abstract::Sixty patients were treated with Harris-Galante prosthesis for failed, nonseptic, cemented total hip arthroplasties. The minimum follow-up period was 12 months, although 23 patients were followed for two or more years. Acetabular bone grafting was done in 86% and femoral bone grafting in 57% of the patients. The avera...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1988-10-01 00:00:00
abstract::Fibrodysplasia ossificans progressiva is a disabling genetic disorder characterized by congenital skeletal malformations and progressive heterotopic ossification. New episodes of ossification are heralded by preosseous inflammatory lesions replete with B and T lymphocytes that overexpress bone morphogenetic protein-4....
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000030075.92399.11
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Hip preservation surgery has become more commonplace, yet when it fails, it is unclear why it does so. Understanding failed procedures should lead to improved surgical results. QUESTIONS/PURPOSES:The purposes of this study were to (1) characterize patients undergoing hip preservation surgery after prior pro...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,多中心研究
doi:10.1007/s11999-013-3218-x
更新日期:2013-12-01 00:00:00
abstract::Augmented reality is a display technique that combines supplemental information with the real world environment. Augmented reality systems are on the verge of being used everyday in medical training, preoperative planning, preoperative and intraoperative data visualization, and intraoperative tool guidance. The basic ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199809000-00014
更新日期:1998-09-01 00:00:00
abstract::Fifty-two patients with subtalar joint involvement secondary to os calcis fractures have been treated with a surgical technique designed by George F. Pennal. There were 23 tongue-type fractures and 33 joint depression fractures in this series. All were treated by open reduction and internal fixation, and occasionally ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1985-10-01 00:00:00
abstract::Use of the lowest possible cuff inflation pressure should minimize the pathogenic effects of compression beneath the pneumatic tourniquet. Curved tourniquets (designed to fit conically shaped limbs) and wider tourniquets were associated with significantly lower arterial occlusion pressure (AOP) than standard, straight...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-02-01 00:00:00
abstract:BACKGROUND:While the primary objective of joint arthroplasty is to improve patient quality of life, pain, and function, younger active patients often demand a return to higher function that includes sporting activity. Knowledge of rates and predictors of return to sports will help inform expectations in patients antici...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2198-y
更新日期:2012-02-01 00:00:00
abstract::The age- and sex-specific incidence of hip fractures is central Norway is reported for the periods of 1972-1973 and 1983-1984. The incidence of hip fracture for women had increased by approximately 22% in the intervening period. The region under investigation was subdivided into urban, semirural, and rural areas. The ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-05-01 00:00:00
abstract::The design features of an implant system can be crucial to the success of cementless total knee arthroplasty (TKA). The implant system described in this study incorporates anatomic features including an asymmetric tibial tray that is smaller laterally than medially, and a deep trochlear-grooved femoral component. Two ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1991-08-01 00:00:00
abstract::International Classification of Diseases coding of patient charts is used by hospitals to allow for billing of patients. Coding information also is used for assessing physician effectiveness. The purpose of the current study was to examine hospital coding for patients having total hip arthroplasty. One hundred consecu...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200209000-00014
更新日期:2002-09-01 00:00:00
abstract:UNLABELLED:Long-term results of periacetabular osteotomy for advanced-stage osteoarthritis secondary to developmental dysplasia of the hip are reportedly unsatisfactory compared with results for early-stage osteoarthritis. Other preoperative information that can be used to determine indications for periacetabular osteo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-008-0443-9
更新日期:2009-04-01 00:00:00
abstract:UNLABELLED:Acetabular component orientation during total hip arthroplasty affects dislocation, range of motion, polyethylene wear, pelvic osteolysis, and component migration. New total hip arthroplasty navigation systems have been introduced to avoid the errors reported after acetabular component orientation using a ma...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000201165.82690.f8
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:A porous Ti6Al4V implant that is manufactured using selective laser melting (SLM) has broad potential applications in the field of orthopaedic implants. The pore structure of the SLM porous Ti6Al4V implant allows for cell migration and osteogenic differentiation, which is favorable for bone ingrowth and osse...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000000954
更新日期:2019-12-01 00:00:00
abstract::Since 1941, distal clavicle excision has been a reliable technique for alleviating pain caused by acromioclavicular joint arthritis. Disadvantages of the procedure include permanent shoulder weakness, a lengthy recovery time ranging from weeks to months before useful function of the extremity returns, and lack of cosm...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1994-04-01 00:00:00
abstract::The authors report the results of a prospective randomized clinical trial using continuous passive motion after total knee arthroplasty. One hundred twenty patients were assigned randomly to one treatment group: No continuous passive motion (Group I), continuous passive motion from 0 degrees to 50 degrees and increase...
journal_title:Clinical orthopaedics and related research
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003086-200011000-00005
更新日期:2000-11-01 00:00:00
abstract::Osteonecrosis of the femoral head developed in three patients during pregnancy. There were no demonstrable predisposing factors. The symptoms were first noted during the last trimester and persisted following delivery. Results of examination, radiography, and scanning were consistent with a diagnosis of osteonecrosis,...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-05-01 00:00:00
abstract::Symptomatic (Stage II) impingement of the rotator cuff against the coracoacromial arch has been treated with anterior acromioplasty in 60 shoulders in 56 patients. Patient selection is crucial. Arthrography of the shoulder was routinely included in the preoperative diagnostic tools to rule out a tear of the rotator cu...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract::Removal of broken femoral stems continues to be a difficult technical procedure in hip replacement surgery, despite the development of metal drilling devices and special extractors placed into the drill hole. The window technique for the removal of broken femoral stems is technically easier than the metal drilling tec...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-11-01 00:00:00
abstract::Femoroacetabular impingement due to metaphyseal prominence is associated with the slippage in patients with slipped capital femoral epiphysis (SCFE), but it is unclear whether the changes in femoral metaphysis morphology are associated with range of motion (ROM) changes or type of impingement. We asked whether the fem...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-008-0477-z
更新日期:2009-03-01 00:00:00
abstract::Records of sales revealed that 6172 Ortholoc II cementless total knee femoral components with double bead layers were sold between January 1986 and December 1987. Sixteen thousand two hundred thirty Ortholoc II femoral implants with single bead layers were sold between December 1986 and January 1990. Fractures of the ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::This biographical sketch on John Caffey corresponds to the historic text, The Classic: Multiple Fractures in the Long Bones of Infants Suffering From Chronic Subdural Hematoma (1946), available at DOI 10.1007/s11999-010-1666-0 . ...
journal_title:Clinical orthopaedics and related research
pub_type: 传,历史文章
doi:10.1007/s11999-010-1665-1
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Improved patient care is related to validated outcome measures requiring the collection of three distinct data types: (1) demographics; (2) patient outcome measures; and (3) physician treatment. Previous impediments to widespread data collection have been: cost, office disruption, personnel requirements, phy...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1397-2
更新日期:2010-10-01 00:00:00