Experimental study on reconstruction of anterior labrum of shoulder joint by chemical extraction of allogeneic tendon and allogeneic chondrocytes / 中国修复重建外科杂志

Objective: To study the effect of chemical extraction of allogeneic tendon and allogeneic chondrocytes for reconstruction of anterior labrum of shoulder joint in rabbits. Methods: The body weight of 45 adult New Zealand white rabbits ranged from 2.5 to 3.0 kg. The Achilles tendons of 15 rabbits were taken and the allogeneic tendons were prepared by chemical extraction with antigen inactivation. The extracted tendons were compared with untreated tendons by HE and Masson stainings. Chondrocytes were isolated and cultured by trypsin method and identified by immunohistochemical staining of collagen type Ⅱ. The remaining 30 rabbits were used to prepare the model of anterior labrum defect of shoulder joint. After the allogeneic tendon was transplanted to the damaged labrum, the rabbits was randomly divided into two groups (15 in each group). In group A, the allogeneic chondrocytes were injected into the joint immediately after transplantation, while in group B, no treatment was made. At 4, 6, and 8 weeks after operation, 5 transplanted tendons of each group were taken. After general observation, HE staining was used to observe the number of nuclei, Masson staining was used to observe the expression of collagen fibers in muscle fiber tissues, and AB staining was used to detect the glycosaminoglycan level after transplantation, to evaluate the cell growth in the tissues of the two groups of allogeneic tendon. Results: By HE and Masson stainings, the allogeneic tendon antigen prepared by chemical extraction method was inactivated and the fibrous tissue structure was intact; collagen type Ⅱ immunohisto-chemistry staining showed that the cultured cells were chondrocytes. After tendon transplantation, the content of glycosaminoglycan in group A was significantly higher than that in group B ( P<0.05). At 6 weeks after operation, HE staining showed that the nuclear in tendon tissue of group A was significantly more than that of group B ( t=20.043, P=0.000). Masson staining showed that the number of nuclei in tendon tissue of group A was significantly increased, the muscle fibers and collagen fibers were interlaced, the tissue structure was more compact, and the tendon tissue was mainly blue stained; while the number of nuclei in group B was less, mainly collagen fibers of the original graft. Conclusion: The allogeneic tendon inactivated by chemical extraction can be used to reconstruct the defect of anterior labrum of shoulder joint in rabbits, and the combination of allogeneic chondrocytes can promote the healing of tendon transplantation.

Study Of The Variant Origin Of Long Head Of Biceps Brachii

Objectives: The objective of this study is to identify and categorize the variations in origin of tendon of long headof biceps brachii (LHBB).Methods: The study was carried out on 60 upper limbs of cadaver in the Anatomy department, SMBT IMS & RC,Nashik, India. After exposing the glenoid fossa, we find out the origin of tendon of LHBB from the supraglenoidtubercle and the adjoining glenoid labrum. Labrum is divided into anterior and posterior part.Results: In 11 specimens origin of LHBB was seen from supraglenoid tubercle only, Other specimens has dualorigin of LHBB along with Glenoid labrum. We classified it according to Vangsness et al. Type I: The labralattachment is entirely posterior, with no contribution to anterior labrum, seen in 31 specimens. Type II: Thetendon attached mainly to the posterior part of the Glenoid labrum with also extended up to the anterior labrum,seen in 16 specimens. Type III: There are equal contribution to both the anterior and posterior parts of thelabrum, found in only 2 specimens. Type IV: Most of the labral contribution is anterior, with a small contributionto the posterior labrum. No specimen found.Conclusion: Anatomical variation in origin of LHBB help us to explain the correlation of recurrent shoulderdislocation and labral detachment.This knowledge is necessary to avoid errors in shoulder arthroscopy,radiological investigations and surgical repair

Ultrasonic evaluation of the effect of cartilage acetabular ,glenoid labrum and acetabular tissue on closed reduction of developmental dysplasia of hip / 中华超声影像学杂志

Objective To investigate the effect of cartilage acetabular ,glenoid labrum and acetabular tissue on closed reduction of developmental dysplasia of hip ( DDH ) by analyzing the outcomes of the ultrasound measurement on DDH before and after Pavik Harness treatment . Methods Graf method was used in ultrasound measurement before the treatment . Position of cartilaginous acetabulum and glenoid labrum and displacement direction of femoral head in 31 patients with hip dislocations ( type D ,type Ⅲ ,typeⅣ ,36 hips) were recorded . T he follow‐up testing with ultrasound measurement on the inside of the hip were performed after 1 －2 weeks of Pavik Harness treatment . M ediolateral dimension ,anteroposterior dimension and the area of maximum section of acetabular tissue were measured . Reduction effects were evaluated . Results T he success rate of reduction of dislocation hips with cartilaginous acetabulum on the head orientation was obviously higher than that on the foot orientation( P ＜0 .000 1) . T he success rate of reduction of dislocation hips with glenoid labrum on the head orientation was obviously higher than that on the foot orientation ( P ＝ 0 .001 6 ) . T here was a statistically significant difference in the success rate of different types of hip dislocation ( type D , type Ⅲ , type Ⅳ ) ( P＝ 0 .002 7 ) . T here were statistically significant differences in mediolateral dimension ,anteroposterior dimension and the area of maximum section of acetabular tissue between the reduction group and the group without dislocation ,the irreducible group and the group without dislocation ,the irreducible group and the reduction group ( P ＜ 0 .01) . Conclusions Ultrasonography is of great significance in the diagnosis and treatment of children with DDH . T he position of hip cartilaginous acetabulum and glenoid labrum ,types of hip dislocation and the volume of acetabular tissue have important effects on the success of the closed reduction .

Arthroscopic Treatment of a Type II Superior Labrum Anterior to Posterior (SLAP) Lesion Combined with a Bankart Lesion: Comparative Study between Debridement and Repair of Type II SLAP Lesion by the Status of Lesion

BACKGROUND: The purpose of this study is to evaluate results of superior labrum anterior to posterior (SLAP) repairs and debridement of type II SLAP lesions combined with Bankart lesions. METHODS: Between 2010 and 2014, total 58 patients with anterior shoulder instability due to a Bankart lesion combined with a type II SLAP lesion were enrolled. Patients were divided into two groups: group C consisted of 30 patients, each with a communicated Bankart and type II SLAP lesion and group NC consisted of 28 patients, each with a non-communicated Bankart and type II SLAP lesion. Bankart repairs were performed for all patients. SLAP lesions were repaired in group C and debrided in group NC. Clinical results were analysed to compare groups C and NC by using the visual analogue scale pain score, American Shoulder and Elbow Surgeons score, Constant scores, Rowe score for instability and range of motion assessments. RESULTS: The clinical scores were improved in both groups at final follow-up. Also, there were no differences between two groups. No significant difference was found in terms of the range of motion measured at the last follow-up. The number of suture anchors used was significantly higher in group C than in group NC (5.6 vs. 3.8; p=0.021). CONCLUSIONS: In this study, it is considered that Bankart repair and SLAP debridement could be a treatment option in patients with a non-communicated type II SLAP lesion combined with a Bankart lesion (study design: IV, therapeutic study, case series).

Clinical application of glenohumeral ligament combined with articular capsule in the repair of anterior and infe-rior labrum complete defect / 局解手术学杂志

Objective To investigate the method and effect of arthroscopic repair of recurrent anterior shoulder dislocation caused by anterior and inferior labrum complete defect.Methods Retrospective analyzed the clinical data of 23 patients with anterior and inferior la-brum complete defect who were admitted into hospital from June 2014 to October 2016 and recieved arthroscopic repair opreation with gleno-humeral ligament combined with articular capsule.Intraoperative arthroscopy was used to suture the lower glenohumeral ligament and articular capsule at the missing part of the glenoid labrum.The Rowe score,ASES score and UCLA score were compared before and after operation. Results There was no postoperative complications such as dislocation or infection occurred.All the 23 cases were followed up for 12~42 months,with an average of(19.6 ±3.4)months.The average lost angle of shoulder external rotation was(17.3 ±3.9)°.And the postopera-tive Rowe score,ASES score and UCLA score were significantly better than those before operation.Conclusion Arthroscopic repair opreation with glenohumeral ligament combined with articular capsule can effectively restore the stability of front shoulder joint,and it can be a good method for the treatment of recurrent anterior shoulder dislocation caused by anterior and inferior labrum complete defect.

Origin of the tendon of the long head of the biceps brachii muscle and its relationship with glenoid labrum in human foetuses / Origen del tendón de la cabeza larga del bíceps braquial y sus relaciones con el labro glenoideo en fetos humanos

We dissected the shoulders of 20 human foetuses to anatomical study. The purpose of this study was to characterize the anatomical origin of the long head tendon of the muscle biceps brachii (LHBBT) in human foetuses and its relationships with the glenoid labrum of the scapula. The results had shown that in approximately 95 percent of the cases the tendon of the long head of the biceps brachii inserts in the region of the glenoid labrum. This origin seems to form, together with the glenoid labrum, an anatomical complex. We conclude that the almost totality of the LHBBT was originated in the glenoidal labrum. For us, this furthermore reinforce the importance and necessity of better clarifying the anatomical and clinical implications of the biceps/labrum complex.

Fueron disecados los hombros de 20 fetos humanos con el propósito de hacer un estudio anatómico. El objetivo de este estudio fue cdeterminar el origen del tendón de la cabeza larga del músculo bíceps braquial en fetos humanos y sus relaciones con el labro glenoideo. Los resultados demostraron que, en cerca del 95 por ciento de los casos, el tendón de la cabeza larga del músculo bíceps braquial estaba originándose en la región del labro glenoideo. Este origen parece formar junto, con el labro glenoideo, un complejo anatómico. Concluimos que casi todos de los tendones del músculo bíceps braquial están insertados en el labro glenoideo. Esto es importante conocer para una mejor clarificación de las implicaciones clínico-anatómicas del complejo del bíceps/labro.