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Keywords = traumatology and orthopaedics

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16 pages, 1361 KiB  
Review
Cardiovascular Remodeling and Potential Controversies in Master Endurance Athletes—A Narrative Review
by Othmar Moser, Stefan J. Schunk, Volker Schöffl, Janis Schierbauer and Paul Zimmermann
Life 2025, 15(7), 1095; https://doi.org/10.3390/life15071095 - 12 Jul 2025
Viewed by 550
Abstract
While the interest and participation in general endurance training and recreational sports competitions have continuously increased in recent decades, the number of recreational master-level endurance athletes has additionally multiplied. Athletes, active men and women older than 40 years of age, who participate in [...] Read more.
While the interest and participation in general endurance training and recreational sports competitions have continuously increased in recent decades, the number of recreational master-level endurance athletes has additionally multiplied. Athletes, active men and women older than 40 years of age, who participate in competitive athletics are usually referred to by the term master athletes (MAs). Previous research revealed the significant benefits of regular moderate physical activity, i.e., its positive influence on cardiovascular risk factors and cardiovascular health; however, recent data have raised concerns that long-term endurance exercise participation is associated with cardiac remodeling and potential adverse cardiovascular outcomes. Previous research also indicated potential structural, functional, and electrical remodeling in MAs due to prolonged and repeated exposure to high-intensity endurance exercise—a condition known as athlete’s heart. In this review, we focus on the association between extreme levels of endurance exercise and potential cardiovascular controversies, such as arrhythmogenesis due to new-onset atrial fibrillation, accelerated coronary artery atherosclerosis, and exercise-induced cardiac remodeling. Additionally, the exercise-dependent modulation of immunological response, such as proteomic response and cytokine alterations, is discussed. Furthermore, we discuss the impact of nutritional supplements in MAs and their potential benefits and harmful interactions. We aim to provide sports medicine practitioners with knowledge of these contemporary longevity controversies in sports cardiology and to highlight the importance of shared decision making in situations of clinical uncertainty. Full article
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10 pages, 2177 KiB  
Article
Arthroscopic Arthrolysis of the Knee Joint Following Total Knee Arthroplasty
by Yersin Zhunussov, Yermek Danenov and Galymzhan Alimbek
J. Clin. Med. 2025, 14(14), 4917; https://doi.org/10.3390/jcm14144917 - 11 Jul 2025
Viewed by 407
Abstract
Background: Arthrofibrosis, mixed contracture, and patellofemoral impingement are frequent complications following total knee arthroplasty (TKA), potentially leading to chronic pain and poor recovery of range of motion (ROM). The comprehensive management of these complications remains challenging and controversial. Methods: This study analyzed [...] Read more.
Background: Arthrofibrosis, mixed contracture, and patellofemoral impingement are frequent complications following total knee arthroplasty (TKA), potentially leading to chronic pain and poor recovery of range of motion (ROM). The comprehensive management of these complications remains challenging and controversial. Methods: This study analyzed the outcomes of arthroscopic arthrolysis performed in 27 patients diagnosed with arthrofibrosis, mixed contracture, and patellofemoral impingement post-TKA to evaluate the efficacy of this technique in improving knee function, enhancing ROM, and reducing pain, as assessed by the Knee Society Score (KSS). A total of 27 patients underwent arthroscopic arthrolysis following unsuccessful conservative rehabilitation. The arthroscopic procedure included removal of fibrous adhesions within the suprapatellar pouch, restoration of medial and lateral gutters, and lateral retinacular release of the patella. Intensive physiotherapy and continuous passive motion commenced immediately postoperatively. The mean follow-up period ranged from 24 to 60 months. Pain and functional outcomes were evaluated using KSSs. Results: Clinical improvements were evident in 26 cases, with the Knee Society Score rising from a preoperative average of 48 to 86, and pain scores improving from 30 to 41. Only one patient did not experience positive outcomes following the procedure. Arthroscopic arthrolysis appears beneficial for patients suffering from arthrofibrosis, patellofemoral impingement, and mixed contracture post-TKA, significantly improving clinical pain scores and KSS outcomes. Conclusions: Further research is recommended to refine specialized surgical instruments and enhance arthroscopic arthrolysis techniques. Full article
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12 pages, 2522 KiB  
Article
GDF5 rs143384 Polymorphism Associated with Developmental Dysplasia of the Hip in Brazilian Patients: A Case-Control Study
by Jamila Alessandra Perini, Raphael Wallace Campos Cunha, Marco Bernardo Cury Fernandes, Lourenço Pinto Peixoto, João Antônio Matheus Guimarães, Amanda dos Santos Cavalcanti and Jéssica Vilarinho Cardoso
Int. J. Mol. Sci. 2025, 26(11), 5012; https://doi.org/10.3390/ijms26115012 - 23 May 2025
Viewed by 479
Abstract
Developmental dysplasia of the hip (DDH) is a multifactorial and polygenic abnormal hip joint development, with a prognosis influenced by environmental and genetic factors, potentially leading to complete dislocation. Growth differentiation factor 5 is a signaling molecule, encoded by a polymorphic gene ( [...] Read more.
Developmental dysplasia of the hip (DDH) is a multifactorial and polygenic abnormal hip joint development, with a prognosis influenced by environmental and genetic factors, potentially leading to complete dislocation. Growth differentiation factor 5 is a signaling molecule, encoded by a polymorphic gene (GDF5), promoting the development, repair, and maintenance of bone, cartilage, and other synovial joint tissues. The GDF5 rs143384 G>A polymorphism affects GDF5 expression and may be associated with a susceptibility to DDH. The aim of this study was to determine the frequency of the GDF5 rs143384 polymorphism in Brazilian individuals and its influence on the development of DDH. This case–control study included 50 DDH cases and 150 controls without hip disease. Genotyping was performed by real-time PCR using the TaqMan system. The GDF5 AA variant genotype frequency was significantly higher in DDH cases (32%) compared to controls (14%, p-value = 0.01) and showed a marginal association with disease risk (OR = 1.47; CI 95% = 0.96–2.26). The GDF5 rs143384 polymorphism could be useful in identifying individuals at risk, guiding personalized treatment strategies, and contributing to diagnosis and clinical management. Full article
(This article belongs to the Section Molecular Pathology, Diagnostics, and Therapeutics)
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15 pages, 5463 KiB  
Article
Protective Effect of Obeticholic Acid on Sepsis-Induced Liver Dysfunction via Regulating Bile Acid Homeostasis
by Jiahui Wang, Li Ma, Yuan An, Yan Ge, Dan Xu and Enqiang Mao
Pharmaceuticals 2025, 18(5), 763; https://doi.org/10.3390/ph18050763 - 21 May 2025
Viewed by 661
Abstract
Background/Objectives: Abnormal bile acid (BA) pool may play an important role in inducing liver damage in sepsis. Farnesoid X receptor (FXR) is a main negative feedback regulator of BA metabolism. This study aims to explore the protective effect and mechanism of the FXR [...] Read more.
Background/Objectives: Abnormal bile acid (BA) pool may play an important role in inducing liver damage in sepsis. Farnesoid X receptor (FXR) is a main negative feedback regulator of BA metabolism. This study aims to explore the protective effect and mechanism of the FXR agonist obeticholic acid (OCA) on liver dysfunction when sepsis occurs. Methods: A rat model of sepsis was induced by cecal ligation and puncture (CLP) for 24 h. Systematic inflammation, tissue injury, hepatic FXR, and BA transporter expression were investigated in the CLP rats and sham-operated control rats with and without OCA pre-treatment (10 mg/kg, gavage) at 2 h before operation. Liquid chromatography–tandem mass spectrometry (LC-MS/MS) assay was performed to access BA composition in the rats’ serum and livers. The injury and inflammatory effects of the elevated unconjugated BAs found in the CLP rats was further verified in a hepatic cell line BRL-3A in vitro. Results: Hepatic FXR was repressed in CLP rats, whereas OCA upregulated liver FXR and hepatic BA transporter expression, reduced total serum BA concentration, ameliorated the elevation of serum levels of IL-1β and IL-6, and improved liver and ileal tissue injuries. OCA administration reduced the elevated unconjugated BAs in both serum and liver, and effectively inhibited increases in cholic acid (CA), deoxycholic acid (DCA), and 7-ketoDCA concentrations in CLP rat livers. These BA fractions promoted the release of aspartate aminotransferase (AST) from BRL-3A cells and increased IL-6, CXCL2, and monocyte chemoattractant protein-1 (MCP-1) expression in the cells, along with enhanced transcription factor nuclear factor-κB activation. Conclusions: Liver inflammation and dysfunction during sepsis is attributable to significant changes in bile acid composition in the blood and liver. FXR activation reduces systemic inflammation and liver dysfunction by regulating bile acid homeostasis, especially inflammatory unconjugated bile acid components. Full article
(This article belongs to the Section Pharmacology)
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19 pages, 1003 KiB  
Article
The Influence of an Eight-Week Home Exercise Program on Spatiotemporal and Kinetic Characteristics of Gait and Knee Function in Women with Severe Knee Osteoarthritis Scheduled for Arthroplasty
by Monika Mets, Jelena Sokk, Jaan Ereline, Mati Pääsuke, Tiit Haviko and Helena Gapeyeva
Medicina 2025, 61(5), 774; https://doi.org/10.3390/medicina61050774 - 22 Apr 2025
Viewed by 1731
Abstract
Background and Objectives: The increased prevalence of knee osteoarthritis (OA) and need for total knee arthroplasty (TKA) indicate a growing need for effective prehabilitation. The effect of preoperative home exercise programs (HEPs) on gait in patients with severe knee OA is under-investigated. This [...] Read more.
Background and Objectives: The increased prevalence of knee osteoarthritis (OA) and need for total knee arthroplasty (TKA) indicate a growing need for effective prehabilitation. The effect of preoperative home exercise programs (HEPs) on gait in patients with severe knee OA is under-investigated. This study aimed to evaluate the influence of an 8-week preoperative HEP on gait characteristics, leg extensor muscle strength, knee function, and health status in women with severe knee OA scheduled for TKA and to compare them with healthy control data. Material and Methods: Eighteen women with severe knee OA (KOA, aged 61.8 ± 1.6 years) and ten age-matched healthy women (CON) participated in this study. The KOA group performed an HEP with 15 exercises aimed at improving lower limb muscle strength, motion, balance, and coordination. Gait spatiotemporal and kinetic characteristics during the loading response, isometric leg extensor strength, knee active range of motion (AROM), and The Western Ontario and McMaster Universities Arthritis Index (WOMAC) were investigated. Associations between characteristics were analyzed. Results: Improvements in ground reaction force (GRF) during the loading response of gait, leg extensor muscle strength, the knee AROM, and the WOMAC index were found post-HEP. The KOA group demonstrated lower (p < 0.05) spatiotemporal and GRF characteristics than the CON group. Knee extension moment (KEM) was lower pre-HEP (p < 0.05) but did not differ significantly from the CON group post-HEP. Gait characteristics and WOMAC were associated with leg extensor muscle strength and knee AROM and pain in the KOA group. Conclusions: An eight-week preoperative HEP improved GRF and KEM during the loading response of gait, muscle strength, knee function, and self-reported knee OA-related health status in women with severe knee OA. Preoperative HEP before TKA, focusing on leg extensor muscle strength, range of motion, and pain relief, is an effective alternative to supervised exercise therapy in women with severe knee OA. Full article
(This article belongs to the Section Sports Medicine and Sports Traumatology)
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18 pages, 2600 KiB  
Article
Functional Attributes of Synovial Fluid from Osteoarthritic Knee Exacerbate Cellular Inflammation and Metabolic Stress, and Fosters Monocyte to Macrophage Differentiation
by Vanshika Srivastava, Abhay Harsulkar, Shama Aphale, Aare Märtson, Sulev Kõks, Priya Kulkarni and Shantanu Deshpande
Biomedicines 2025, 13(4), 878; https://doi.org/10.3390/biomedicines13040878 - 4 Apr 2025
Cited by 1 | Viewed by 697
Abstract
Background: Besides conventional norms that recognize synovial fluid (SF) as a joint lubricant, nutritional channel, and a diagnostic tool in knee osteoarthritis (kOA), based on the authors previous studies, this study aims to define functional role of SF in kOA. Methods: U937, a [...] Read more.
Background: Besides conventional norms that recognize synovial fluid (SF) as a joint lubricant, nutritional channel, and a diagnostic tool in knee osteoarthritis (kOA), based on the authors previous studies, this study aims to define functional role of SF in kOA. Methods: U937, a monocytic, human myeloid cell line, was induced with progressive grades of kOA SF, and the induction response was assessed on various pro-inflammatory parameters. This ‘SF challenge test model’ was further extended to determine the impact of SF on U937 differentiation using macrophage-specific markers and associated transcription factor genes. Mitochondrial membrane potential changes in SF-treated cells were evaluated with fluorescent JC-1 probe. Results: a significant increase in nitric oxide, matrix metalloproteinase (MMP) 1, 13, and vascular endothelial growth factor (VEGF)-1 was noted in the induced cells. A marked increase was seen in CD68, CD86, and the transcription factors –activator protein (AP)-1, interferon regulatory factor (IRF)-1, and signal transducer and activator of transcription (STAT)-6 in the SF-treated cells indicating active monocytes to macrophage differentiation. Reduced mitochondrial membrane potential was reflected by a reduced red-to-green ratio in JC-1 staining. Conclusions: these results underline the active role of OA SF in stimulating and maintaining inflammation in joint cells, fostering monocyte differentiation into pro-inflammatory macrophages. The decline in the membrane potential suggestive of additional inflammatory pathway in OA via the release of pro-apoptotic factors and damaged associated molecular patterns (DAMPs) within the cells. Overall, biochemical modulation of SF warrants a potential approach to intervene inflammatory cascade in OA and mitigate its progression. Full article
(This article belongs to the Section Cell Biology and Pathology)
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32 pages, 2445 KiB  
Review
Toxicity, Irritation, and Allergy of Metal Implants: Historical Perspective and Modern Solutions
by Grzegorz Szczęsny, Mateusz Kopec and Zbigniew L. Kowalewski
Coatings 2025, 15(3), 361; https://doi.org/10.3390/coatings15030361 - 20 Mar 2025
Cited by 5 | Viewed by 4618
Abstract
The widespread adoption of metal implants in orthopaedics and dentistry has revolutionized medical treatments, but concerns remain regarding their biocompatibility, toxicity, and immunogenicity. This study conducts a comprehensive literature review of traditional biomaterials used in orthopaedic surgery and traumatology, with a particular focus [...] Read more.
The widespread adoption of metal implants in orthopaedics and dentistry has revolutionized medical treatments, but concerns remain regarding their biocompatibility, toxicity, and immunogenicity. This study conducts a comprehensive literature review of traditional biomaterials used in orthopaedic surgery and traumatology, with a particular focus on their historical development and biological interactions. Research articles were gathered from PubMed and Web of Science databases using keyword combinations such as “toxicity, irritation, allergy, biomaterials, corrosion, implants, orthopaedic surgery, biocompatible materials, steel, alloys, material properties, applications, implantology, and surface modification”. An initial pool of 400 articles was screened by independent reviewers based on predefined inclusion and exclusion criteria, resulting in 160 relevant articles covering research from 1950 to 2025. This paper explores the electrochemical processes of metals like iron, titanium, aluminium, cobalt, molybdenum, nickel, and chromium post-implantation, which cause ion release and wear debris formation. These metal ions interact with biological molecules, triggering localized irritation, inflammatory responses, and immune-mediated hypersensitivity. Unlike existing reviews, this paper highlights how metal–protein interactions can form antigenic complexes, contributing to delayed hypersensitivity and complications such as peri-implant osteolysis and implant failure. While titanium is traditionally considered bioinert, emerging evidence suggests that under certain conditions, even inert metals can induce adverse biological effects. Furthermore, this review emphasizes the role of oxidative stress, illustrating how metal ion release and systemic toxicity contribute to long-term health risks. It also uncovers the underappreciated genotoxic and cytotoxic effects of metal ions on cellular metabolism, shedding light on potential long-term repercussions. By integrating a rigorous methodological approach with an in-depth exploration of metal-induced biological responses, this paper offers a more nuanced perspective on the complex interplay between metal implants and human biology, advancing the discourse on implant safety and material innovation. Full article
(This article belongs to the Collection Review Papers Collection for Bioactive Coatings)
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22 pages, 1631 KiB  
Systematic Review
A Systematic Review and Meta-Analysis on Aerobic Fitness Dynamics in Post-COVID-19 Athletes: Implications in the Return-to-Play Performance
by Lucas Rafael Lopes, Rui Medeiros, Valéria Tavares, Francisca Dias, Marcus Vinícius Galvão Amaral, Rodrigo Araújo Goes, João Antonio Matheus Guimarães and Jamila Alessandra Perini
Sports 2025, 13(2), 40; https://doi.org/10.3390/sports13020040 - 5 Feb 2025
Viewed by 1006
Abstract
Maximal oxygen uptake (V.O2max) assesses athletic performance; however, its values are inconsistent in post-COVID-19 athletes. This study aimed to analyze the dynamics of V.O2max in post-COVID-19 athletes. Observational studies were identified by screening the [...] Read more.
Maximal oxygen uptake (V.O2max) assesses athletic performance; however, its values are inconsistent in post-COVID-19 athletes. This study aimed to analyze the dynamics of V.O2max in post-COVID-19 athletes. Observational studies were identified by screening the PubMed database published up to 17 July 2023. The initial electronic search found 320 studies. Of these, 26 employing the cardiopulmonary exercise test (CPET) to assess aerobic fitness were selected. Of the 2625 pooled athletes, 1464 were infected and considered as the post-COVID-19 group, either asymptomatic or symptomatic, while the remaining 1161, who were uninfected or had V.O2max results prior to infection, were defined as the infection-free group. Age and V.O2max were differently distributed between post-COVID-19 athletes and those without infection (p = 0.03 in both). Persistent symptoms athletes had 8 mL/Kg/min lower V.O2max than those without infection (p = 0.04). In addition, post-infected athletes who underwent CPET after 12 weeks showed a significant reduction of 2.9 mL/Kg/min in V.O2max according to the increase in body mass index (BMI). The pooled analysis showed that aerobic fitness was reduced in athletes post-COVID-19. V.O2max was negatively correlated with BMI in those who underwent CPET at 12 weeks, suggesting that symptoms persist beyond 12 weeks, affecting return-to-play. Full article
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23 pages, 8575 KiB  
Article
Total and Free Zinc Dynamics as Biomarkers for Neurological Impairment in Traumatic Spinal Cord Injury
by Raban Arved Heller, Maria Maares, Thilo Samson Chillon, Hanno Witte, Obada T. Al-Halabi, Stefan Heene, Alexander Younsi, Patrick Haubruck, Lutz Schomburg, Arash Moghaddam, Bahram Biglari and Hajo Haase
Nutrients 2025, 17(3), 496; https://doi.org/10.3390/nu17030496 - 29 Jan 2025
Viewed by 1044
Abstract
Background/Objectives: Traumatic spinal cord injury (TSCI) profoundly impacts patients by precipitating a loss of motor and sensory capabilities, largely due to oxidative stress and inflammation during the secondary injury phase. Methods: This investigation explores the diagnostic potential of zinc (Zn) and free zinc [...] Read more.
Background/Objectives: Traumatic spinal cord injury (TSCI) profoundly impacts patients by precipitating a loss of motor and sensory capabilities, largely due to oxidative stress and inflammation during the secondary injury phase. Methods: This investigation explores the diagnostic potential of zinc (Zn) and free zinc (fZn) as biomarkers by analyzing their serum concentration dynamics in 48 TSCI individuals with TSCI, with the aim of correlating these levels with neurological impairment. Serum samples collected at admission, 4 h, 9 h, 12 h, 24 h, and 3 days post-injury were analyzed for total serum Zn and fZn concentrations. The patients were compared to a control group comprised of individuals with vertebral fractures but no neurological deficits. Results: The study revealed injury-specific fluctuations in Zn and fZn levels following TSCI, with significantly lower Zn levels observed post-TSCI compared to controls (p = 0.016). The American Spinal Injury Association (ASIA) Impairment scale (AIS) assessments at admission and three months post-injury showed Zn level differences are linked to neurological recovery (AIS+:1 > AIS+:2, 0 h: p = 0.008; AIS+:0 < AIS+:1, 4 h: p = 0.016), highlighting the critical role of Zn and trace elements in the early remission process after TSCI. Notably, significant differences in fZn levels were detected between the control and TSCI groups (TSCI < Control; 12 h: p = 0.045; 24 h: p = 0.001; 3 d: p = 0.016), with the peak diagnostic performance of fZn at 24 h post-injury, as indicated by an Area Under the ROC Curve (AUC) of 83.84% (CI: 0.698–0.978). Conclusions: These findings underscore the potential of fZn as a biomarker to guide early diagnostic and therapeutic interventions aimed at mitigating secondary injury and enhancing recovery outcomes. This study contributes insights into the dynamics of serum Zn and its importance, holding specific diagnostic properties that could be critically relevant in the early phase of biomarker signature development for TSCI diagnostics and prognosis. Full article
(This article belongs to the Section Micronutrients and Human Health)
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14 pages, 2103 KiB  
Review
Management of Acute Lateral Humeral Condyle Fractures in Children
by Mónica Álvarez Muñoz, Juan Carlos García de la Blanca, Myriam Vidart Anchía, Rafael Martí Ciruelos, Sara Calvo Calvo and María Teresa Menéndez Crespo
Children 2024, 11(12), 1421; https://doi.org/10.3390/children11121421 - 25 Nov 2024
Viewed by 1891
Abstract
Pediatric elbow fractures are quite common, accounting for up to 34% of bone fractures in children. Among these, acute lateral humeral condyle (LHC) fractures represent up to 22%. The accurate diagnosis and early treatment of LHC fractures are crucial due to the potential [...] Read more.
Pediatric elbow fractures are quite common, accounting for up to 34% of bone fractures in children. Among these, acute lateral humeral condyle (LHC) fractures represent up to 22%. The accurate diagnosis and early treatment of LHC fractures are crucial due to the potential for abnormal growth and significant long-term impacts on joint motion. With the aim of enhancing the understanding of pediatric LHC fracture management among pediatric healthcare practitioners, we present a literature review combined with our technical recommendations based on our experience. Imaging through AP, lateral, and internal oblique X-rays remains the gold standard for diagnosis, although there is increasing focus on non-irradiating techniques, considering the skeletally immature nature of the patients. Several classification systems aid in fracture assessment, each varying in their simplicity, reproducibility, and inter- and intra-observer correlations. The treatment approaches for LHC fractures include conservative management with immobilization for minimally displaced fractures and surgical intervention for displaced fractures. The surgical options encompass closed and open reductions, using Kirschner wires or cannulated screws for fixation. While both methods show favorable outcomes, recent years have seen a growing interest in expanding the traditional indications for closed approaches. After a period of post-surgical immobilization of the limb, rehabilitation care is recommended to assist in the recovery of the range of motion. During the postoperative period, the most frequent complications are bony overgrowth, malunion, and infection, although with highly variable rates, which typically do not result in functional impairment if managed properly. Regular follow-up and monitoring are essential for optimal recovery and minimizing long-term complications. Full article
(This article belongs to the Special Issue Pediatric Trauma and Rehabilitation)
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17 pages, 68807 KiB  
Article
Structural and Viscoelastic Properties of Bacterial Cellulose Composites: Implications for Prosthetics
by Natalia Pogorelova, Daniil Parshin, Anna Lipovka, Alexey Besov, Ilya Digel and Pyotr Larionov
Polymers 2024, 16(22), 3200; https://doi.org/10.3390/polym16223200 - 18 Nov 2024
Viewed by 1520
Abstract
This study investigates the morphological, mechanical, and viscoelastic properties of bacterial cellulose (BC) hydrogels synthesized by the microbial consortium Medusomyces gisevii. BC gel films were produced under static (S) or bioreactor (BioR) conditions. Additionally, an anisotropic sandwich-like composite BC film was developed [...] Read more.
This study investigates the morphological, mechanical, and viscoelastic properties of bacterial cellulose (BC) hydrogels synthesized by the microbial consortium Medusomyces gisevii. BC gel films were produced under static (S) or bioreactor (BioR) conditions. Additionally, an anisotropic sandwich-like composite BC film was developed and tested, consisting of a rehydrated (S-RDH) BC film synthesized under static conditions, placed between two BioR-derived BC layers. Sample characterization was performed using scanning electron microscopy (SEM), atomic force microscopy (AFM), rheometry, and uniaxial stretching tests. To our knowledge, this is the first study to combine uniaxial and rheological tests for BC gels. AFM and SEM revealed that the organization of BC fibrils (80±20 nm in diameter) was similar to that of collagen fibers (96±31 nm) found in human dura mater, suggesting potential implications for neurosurgical practice. Stretching tests demonstrated that the drying and rehydration of BC films resulted in a 2- to 8-fold increase in rigidity compared to other samples. This trend was consistent across both small and large deformations, regardless of direction. Mechanically, the composite (BioR+S-RDH) outperformed BC hydrogels synthesized under static and bioreactor conditions by approx. 26%. The composite material (BioR+S-RDH) exhibited greater anisotropy in the stretching tests compared to S-RDH, but less than the BioR-derived hydrogels, which had anisotropy coefficients ranging from 1.29 to 2.03. BioR+S-RDH also demonstrated the most consistent viscoelastic behavior, indicating its suitability for withstanding shear stress and potential use in prosthetic applications. These findings should provide opportunities for further research and medical applications. Full article
(This article belongs to the Special Issue Advances in Cellulose-Based Polymers and Composites, 2nd Edition)
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14 pages, 1535 KiB  
Article
Tenascin-C-Matrix Metalloproteinase-3 Phenotype and the Risk of Tendinopathy in High-Performance Athletes: A Case–Control Study
by Lucas Rafael Lopes, Marcus Vinícius Galvão Amaral, Rodrigo Araujo Goes, Valéria Tavares, Francisca Dias, Rui Medeiros, Daniel Escorsim Machado and Jamila Alessandra Perini
Diagnostics 2024, 14(22), 2469; https://doi.org/10.3390/diagnostics14222469 - 5 Nov 2024
Cited by 1 | Viewed by 1447
Abstract
Background/Objectives: Tendon structure is predominantly composed of the extracellular matrix (ECM), and genetic variants in non-collagenous ECM components may influence susceptibility to tendinopathy. We investigated the potential influence of single nucleotide polymorphisms (SNPs) in fibrillin-2 (FBN2), tenascin-C (TNC), and [...] Read more.
Background/Objectives: Tendon structure is predominantly composed of the extracellular matrix (ECM), and genetic variants in non-collagenous ECM components may influence susceptibility to tendinopathy. We investigated the potential influence of single nucleotide polymorphisms (SNPs) in fibrillin-2 (FBN2), tenascin-C (TNC), and matrix metalloproteinase-3 (MMP3) on the tendon regeneration failure phenotype and impact on the susceptibility to tendinopathy in Brazilian high-performance athletes. Methods: This case–control study was conducted with 397 high-performance athletes from different sports modalities (197 tendinopathy cases and 200 controls), and they were analyzed by validated TaqManTM SNP genotyping assays of the SNPs FBN2 (rs331079), TNC (rs2104772), and MMP3 (rs591058). Results: Out of the 197 tendinopathy cases, 63% suffered from chronic tendon pain and 22% experienced more than three episodes of disease manifestation. The TNC-rs2104772-A allele was significantly associated with tendinopathy (OR: 1.4; 95% CI: 1.1–1.8), while athletes carrying the MMP3-rs591058-T allele were linked to an increased risk of more episodes of disease manifestation (OR: 1.7; 95% CI: 1.1–2.8). The TNC-MMP3 tendon regeneration failure phenotype (TNC-A/MMP3-T) was associated with an increased risk of tendinopathy (OR: 1.4; 95% CI: 1.1–2.0) and episodes of disease manifestation (OR: 2.0; 95% CI: 1.2–3.5). Athletes with tendinopathy who had the TNC-A/MMP3-T interaction were more prone to experiencing more than three disease exacerbations (OR: 4.3; 95% CI: 1.8–10.5) compared to TNC-A/TNC-C. Conclusions: This study suggests that rs2104772 and rs591058 SNPs could be involved in the tendon regeneration failure phenotype and may influence the molecular mechanism related to the regulation of the tendon ECM during training workload. Full article
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10 pages, 943 KiB  
Article
Open vs. Percutaneous Achilles Tendon Repair: Experience of Single Orthopedic Institute with Long-Term Follow-Up
by Gaetano Caruso, Edoardo Gambuti, Achille Saracco, Elisa Spadoni, Elena Corso, Ilaria Pinotti, Alessandro Pisano and Leo Massari
Medicina 2024, 60(9), 1382; https://doi.org/10.3390/medicina60091382 - 23 Aug 2024
Cited by 2 | Viewed by 1393
Abstract
Background and Objectives: There are numerous techniques for the surgical treatment of Achilles tendon lesions described in the literature, and it is possible to distinguish repair techniques as either open surgery or percutaneous repair techniques. Both approaches have advantages and disadvantages. With [...] Read more.
Background and Objectives: There are numerous techniques for the surgical treatment of Achilles tendon lesions described in the literature, and it is possible to distinguish repair techniques as either open surgery or percutaneous repair techniques. Both approaches have advantages and disadvantages. With this retrospective study, we aim to analyze the incidence of re-ruptures and other complications, return to sport and overall quality of life at a long-term follow-up in the treatment of acute ATRs, comparing the results of percutaneous repair with those of open repair. Materials and Methods: This is a retrospective study on a consecutive series of patients with complete tear of the AT who were managed through a surgical approach by the Operative Unit of Orthopaedics and Traumatology of Sant’Anna University Hospital (Ferrara, Emilia-Romagna, Italy) between April 2014 and December 2021. Patients were treated with a percutaneous or an open technique according to the surgeon’s preference without randomization. Results: We considered 155 patients who met the established inclusion criteria. Of these, 103 (66.45%) patients underwent percutaneous treatment with the Tenolig® system, and 52 (33.55%) underwent open surgery, with an average ATRS in the first group of 92.5 compared to an average ATRS value of 82 in patients treated with the open technique. Conclusions: In our experience, following overlapping rehabilitation protocols in all patients included, we observed that the Tenolig® repair system led to a better ATRS at long-term follow-up, with comparable complication rates to open surgery. Full article
(This article belongs to the Section Orthopedics)
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8 pages, 622 KiB  
Case Report
Case Report: High-Dose Ferric Carboxymaltose as an Antianaemic Agent to Avoid Haemotransfusions after Total Hip Replacement
by Maiya Konkayeva, Assiya Kadralinova, Nazerke Zhanarystan, Nurlan Akhatov and Aidos Konkayev
Medicina 2024, 60(8), 1274; https://doi.org/10.3390/medicina60081274 - 7 Aug 2024
Viewed by 2332
Abstract
This article highlights a case of high-dose ferric carboxymaltose (Ferinject®) for the treatment of perioperative iron deficiency anaemia in a 39-year-old patient with dysplastic coxarthrosis. The patient was admitted routinely for a total hip replacement of the left hip joint. She [...] Read more.
This article highlights a case of high-dose ferric carboxymaltose (Ferinject®) for the treatment of perioperative iron deficiency anaemia in a 39-year-old patient with dysplastic coxarthrosis. The patient was admitted routinely for a total hip replacement of the left hip joint. She had been suffering from pain, lameness, and restriction of movement in her left hip joint for the past several years. The patient was admitted with initial iron deficiency anaemia of a medium severity (Hgb—96.5 g/L, RBC—3.97 × 1012/L). Laboratory tests were taken to determine the iron deficiency, and transfusion readiness was submitted. The patient received ferric carboxymaltose infusion before surgery. The intraoperative blood loss was—100 mL with an operation duration of 50 min. On the first postoperative day, haemoglobin decreased to 86 g/L. No haemoglobin decrease was observed in the postoperative period, and 92 g/L was the amount of haemoglobin at the time of hospital discharge. The optimal dose for the treatment of perioperative anaemia has not been established; some studies recommend ferric carboxymaltose at a dose of 15 to 20 mg/kg and a maximum of 1000 mg once on the first day after surgery. The uniqueness of this case report is that a high dose of ferric carboxymaltose (1340 mg) during the preoperative period was applied. No side effects such as hypophosphatemia were reported. We believe that, in this clinical case, the patient managed to avoid large intraoperative blood loss and transfusions by using high doses of ferric carboxymaltose. Full article
(This article belongs to the Section Surgery)
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Article
Concentrations of Bioelements (Zn, Cu, Fe, Cr, Mg, Mn) in Serum and Bone Tissue of Aging Men Undergoing Hip Arthroplasty: Implications for Erectile Dysfunction
by Aleksandra Rył, Żaneta Ciosek, Aleksandra Szylińska, Alina Jurewicz, Andrzej Bohatyrewicz and Iwona Rotter
Biomolecules 2024, 14(5), 565; https://doi.org/10.3390/biom14050565 - 9 May 2024
Cited by 4 | Viewed by 2214
Abstract
Background: Erectile dysfunction (ED) stands out as one of the most prevalent sexual disorders in men, with its incidence progressively escalating with age. As delineated by the International Consultation Committee for Sexual Medicine on Definitions/Epidemiology/Risk Factors for Sexual Dysfunction, the prevalence of ED [...] Read more.
Background: Erectile dysfunction (ED) stands out as one of the most prevalent sexual disorders in men, with its incidence progressively escalating with age. As delineated by the International Consultation Committee for Sexual Medicine on Definitions/Epidemiology/Risk Factors for Sexual Dysfunction, the prevalence of ED among men under 40 years is estimated to be within the range of 1–10%. The aim of this study was to determine the relationship between the concentration of bioelements (Zn, Cu, Fe, Cr, Mg, and Mn) in the serum and bone tissue and the concentration of selected hormones in men with and without erectile dysfunction. Materials and methods: The retrospective cohort study included 152 men who underwent total hip arthroplasty for hip osteoarthritis at the Department of Orthopaedic Traumatology and Musculoskeletal Oncology at the Pomeranian Medical University in Szczecin. Certain exclusion criteria were applied to ensure the integrity of the study. These included individuals with diabetes, a history of cancer, alcohol abuse, liver or kidney failure, New York Heart Association (NYHA) class III or IV heart failure, and those taking medications that affect bone metabolism, such as mineral supplements, neuroleptics, chemotherapeutic agents, immunosuppressants, corticosteroids, or antidepressants. Patients with hypogonadism or infertility were excluded from the study. Results: The study showed an association between bioT concentrations and Cu concentrations in both patients with and without erectile dysfunction. A correlation between bioactive testosterone and Cr concentrations was also observed in both groups. Patients with erectile dysfunction showed a relationship between bioT concentration and Zn concentration, TT concentration and Mn concentration, FT concentration and Zn concentration, and E2 concentration and Cr concentration. An analysis of elemental concentrations in bone tissue showed an association between FT and Mg and Mn concentrations, but only in patients with erectile dysfunction. In patients without erectile dysfunction, a correlation was observed between FT and Cu concentrations. A correlation was also observed between bioT concentrations and Mg, Mn, and Zn concentrations, but only in patients with erectile dysfunction. In patients without erectile dysfunction, a correlation was observed between bioT and Cu concentrations. Conclusions: Studying the relationship between the concentration of bioelements (Zn, Cu, Fe, Cr, Mg, and Mn) in the serum and bone tissue and the concentration of selected hormones in men may be important in explaining the etiology of the problem. The study of the concentration of Zn and Cu in bone tissue and serum showed that these two elements, regardless of the place of accumulation, may be related to the concentration of androgens in men. Full article
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