Arthroscopic treatment of ankle impingement syndrome.

Arthroscopic treatment of ankle impingement syndrome (AIS) is a minimally invasive surgical procedure used to address symptoms caused by impingement in the ankle joint. This syndrome occurs when there is abnormal contact between certain bones or soft tissues in the ankle, leading to pain, swelling, or limited range of motion. Traditionally, open surgery was the standard approach for treating AIS. However, with advancements in technology and surgical techniques, arthroscopic treatment has become a preferred method for many patients and surgeons. With improved visualization and precise treatment of the arthroscopy, patients can experience reduced pain and improved functionality, allowing them to return to their daily activities sooner. In this paper, we reviewed the application and clinical efficacy the of arthroscopic approach for treating AIS, hoping to provide a reference for its future promotion.

Effectiveness and safety of arthroscopy combined with radial extracorporeal shockwave therapy for osteochondritis of the talus: a prospective, single-centre, randomized, double-blind study.

Aims: Arthroscopic microfracture is a conventional form of treatment for patients with osteochondritis of the talus, involving an area of < 1.5 cm2. However, some patients have persistent pain and limitation of movement in the early postoperative period. No studies have investigated the combined treatment of microfracture and shortwave treatment in these patients. The aim of this prospective single-centre, randomized, double-blind, placebo-controlled trial was to compare the outcome in patients treated with arthroscopic microfracture combined with radial extracorporeal shockwave therapy (rESWT) and arthroscopic microfracture alone, in patients with ostechondritis of the talus. Methods: Patients were randomly enrolled into two groups. At three weeks postoperatively, the rESWT group was given shockwave treatment, once every other day, for five treatments. In the control group the head of the device which delivered the treatment had no energy output. The two groups were evaluated before surgery and at six weeks and three, six and 12 months postoperatively. The primary outcome measure was the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale. Secondary outcome measures included a visual analogue scale (VAS) score for pain and the area of bone marrow oedema of the talus as identified on sagittal fat suppression sequence MRI scans. Results: A total of 40 patients were enrolled and randomly divided into the two groups, with 20 in each. There was no statistically significant difference in the baseline characteristics of the groups. No complications, such as wound infection or neurovascular injury, were found during follow-up of 12 months. The mean AOFAS scores in the rESWT group were significantly higher than those in the control group at three, six, and 12 months postoperatively (p < 0.05). The mean VAS pain scores in the rESWT group were also significantly lower than those in the control group at these times (p < 0.05). The mean area of bone marrow oedema in the rESWT group was significantly smaller at six and 12 months than in the control group at these times (p < 0.05). Conclusion: Local shockwave therapy was safe and effective in patients with osteochondiritis of the talus who were treated with a combination of arthroscopic surgery and rESWT. Preliminary results showed that, compared with arthroscopic microfracture alone, those treated with arthroscopic microfracture combined with rESWT had better relief of pain at three months postoperatively and improved weightbearing and motor function of the ankle.

3D Hollow Xerogels with Ordered Cellulose Nanocrystals for Tailored Mechanical Properties.

Advanced materials with aligned cellulose nanocrystals (CNCs) have attracted much attention due to their remarkable mechanical and optical properties, but most of them still focus on 1D or 2D architectures. Herein, complex 3D architectures as pseudo catenoid hollow xerogels with aligned CNCs are prepared from dynamic hydrogels by mechanical stretching and air-drying process. Aligned CNCs endow the pseudo catenoids with distinct birefringence in addition to reinforcement. The mechanical properties of pseudo catenoid architecture are revealed for the first time to be controlled at two stages on diverse length scales. Both the aligned CNCs on the nanoscale and the geometry of the xerogels affect the mechanical properties. The inwardly curved surface of the pseudo catenoid xerogel makes the structure conducive to energy dissipation. These both stages of controls on the mechanical properties can be adjusted by changing the morphology of the initial hydrogels and the mechanical stretching ratios. These results will provide a new perspective for the design and manufacture advanced materials with tailored mechanical properties and functions.

Bone Marrow Edema Syndrome of the Foot Treated with Extracorporeal Shock Wave Therapy: A Retrospective Case Series.

To determine the validity and safety of extracorporeal shock wave therapy (ESWT) in the treatment of bone marrow edema syndrome (BMES) of the foot. Twenty patients diagnosed as foot BMES in our Center were followed and treated by ESWT for 1 to 2 courses. The target of the ESWT treatment was the most obvious foot tenderness, or the most obvious part of bone edema on magnetic resonance imaging (MRI). One course of ESWT was 1 time/week, 5 times in total, with the shock wave energy flow density 0.18 mJ/mm2. The visual analog scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) scores of the foot were recorded before treatment, at 3 months after treatment and the last follow-up; the areas of BME before treatment and at the last follow-up were measured by the fat suppression MRI. Complications during treatment were also recorded. Twenty follow-up patients were obtained. Compared with the pretreatment, the patients had significant improvement in various indicators at 3 months after treatment (p < 0.01). The sagittal MRI at the last follow-up showed that the BME area decreased significantly (p < 0.01). Two patients developed transient erythema on their skin after treatment and alleviated after 2 days of rest. No serious complications were found during treatment. Our findings show that for patients with foot BMES, the use of ESWT treatment can effectively relieve local pain, improve the motor function of the foot and ankle. Two courses of treatment may be required for some patients.

Temperature-Responsive, Manipulable Cavitary Hydrogel Containers by Macroscopic Spatial Surface-Interior Separation.

Synthetic macroscopic materials transforming from bulk solid or semisolid to a closed structure with inner cavities and distinct outer and inner microstructures are rarely reported. Here, we report an in situ method for directing spatial surface-interior separation from bulk dynamic hydrogels to closed three-dimensional (3D) hydrogel containers with inner cavities via constructing a competitively cross-linking gradient within dynamic hydrogels. The initial cross-linking of phenylboronic acid/catechol complexes is disrupted by stronger ferric ions/catechol associations, generating gradually weakened cross-linking from the outside to the inside. Both stronger cross-linking in the outer shells and sequentially weaker cross-linked interior generated during swelling closed the hydrogel container with a tunable dense outer shell, fluffy inner layer, and cavities in the core. Cellulose nanocrystals could be used to significantly improve the spatial distinction of gradient cross-linking within hydrogels, leading to an even denser outer shell with tunable shell thickness. Moreover, cavitary hydrogel containers with diverse shapes can be programmed by designing the initial shapes of dynamic hydrogels and macroscopic assembly of individual dynamic hydrogels based on their self-healing capability after subsequent surface-interior separation. These cavitary hydrogel containers demonstrate thermal-responsive gate systems with unique sustained release at higher temperature and potential reaction containers for oxygen generation on demand. This facile spatial surface-interior separation strategy for fabricating closed cavity systems has great potential for various applications.

Structural Colors by Synergistic Birefringence and Surface Plasmon Resonance.

One-dimensional nanomaterials including cellulose nanocrystals (CNCs) and gold nanorods (GNRs) are widely used in optical materials due to their respective inherent features: birefringence with accompanying light retardation and surface plasmon resonance (SPR). Herein, we successfully combine these properties of both nanorods to generate synergistic and readily tunable structural colors in hybrid composite polymer films. CNCs and GNRs are embedded either in the same or in separate films after unidirectional alignment in dynamic hydrogels. By synergistically leveraging CNCs and GNRs with diverse amounts in hybrid films or stacked separate films, wide-ranging structural colors are obtained, far beyond those from films solely with aligned CNCs or GNRs. Higher GNR contents enhance light absorption at 520 nm with promoted magenta colors, while more CNCs affect the overall phase retardation with light absorption between 400 and 700 nm between crossed polarizers. Moreover, adjusting the angles between films solely with CNCs or GNRs via a stacking/rotating technique successively manipulates colors with flexible film combinations. By rotating the films with aligned GNRs (0-180°), light absorption can traverse from ∼500 to 650 nm. Thus, tuning the adjustable synergism of birefringence of CNCs and SPR of GNRs provides great potential for structural colors, which enlightens inspirations for designing functional optical materials.

Extracorporeal Shock Wave Therapy for Pain Relief After Arthroscopic Treatment of Osteochondral Lesions of Talus.

Arthroscopic treatment is an effective technique for osteochondral lesion of talus (OLT); however, some patients still suffer pain and limitation of activities after surgery. The purpose of this study was to evaluate the efficacy of extracorporeal shock wave therapy (ESWT) after ankle arthroscopy for OLT. We reviewed the clinical history of a series of 78 patients with OLT who underwent arthroscopic microfracture. ESWT was prescribed for 15 patients who complained of ankle pain and restriction of weightbearing activities 3 months postoperatively. The parameters assessed were visual analog scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale scores (before ESWT, at 6 and 12 weeks, and at last follow-up after ESWT) and magnetic resonance imaging (MRI) before and 1 year after ESWT. Follow-up was 27.8 ± 15.2 months. VAS and AOFAS scores showed a significant improvement at 12 weeks after ESWT and a progressive trend at last follow-up. Areas of lesions in sagittal plane in MRI were distinctly reduced at last follow-up. ESWT for osteochondral lesions of talus after arthroscopy results in good clinical outcomes.

Thermoresponsive Water Transportation in Dually Electrostatically Crosslinked Nanocomposite Hydrogels.

Controlling water transportation within hydrogels makes hydrogels attractive for diverse applications, but it is still a very challenging task. Herein, a novel type of dually electrostatically crosslinked nanocomposite hydrogel showing thermoresponsive water absorption, distribution, and dehydration processes are developed. The nanocomposite hydrogels are stabilized via electrostatic interactions between negatively charged poly(acrylic acid) and positively charged layered double hydroxide (LDH) nanosheets as well as poly(3-acrylamidopropyltrimethylammonium chloride). Both LDH nanosheets as crosslinkers and the surrounding temperatures played pivotal roles in tuning the water transportation within these nanocomposite hydrogels. By changing the surrounding temperature from 60 to 4 °C, these hydrogels showed widely adjustable swelling times between 2 and 45 days, while the dehydration process lasted between 7 and 27 days. A swift temperature decrease, for example, from 60 to 25 °C, generated supersaturation within these nanocomposite hydrogels, which further retarded the water transportation and distribution in hydrogel networks. Benefiting from modified water transportation and rapidly alternating water uptake capability during temperature change, pre-loaded compounds can be used to track and visualize these processes within nanocomposite hydrogels. At the same time, the discharge of water and loaded compounds from the interior of hydrogels demonstrates a thermoresponsive sustained release process.

Liquid-Behaviors-Assisted Fabrication of Multidimensional Birefringent Materials from Dynamic Hybrid Hydrogels.

Liquid-solid transition is a widely used strategy to shape polymeric materials and encode their microstructures. However, it is still challenging to fully exploit liquid behaviors of material precursors. In particular, the dynamic and static liquid behaviors naturally conflict with each other, which makes it difficult to integrate their advantages in the same materials. Here, by utilizing a shear-thinning phenomenon in the dynamic hybrid hydrogels, we achieve a hydrodynamic alignment of cellulose nanocrystals (CNC) and preserve it in the relaxed hydrogel networks due to the much faster relaxation of polymer networks (within 500 s) than CNC after the unloading of external force. During the following drying process, the surface tension of hydrogels further enhances the orientation index of CNC up to 0.872 in confined geometry, and these anisotropic microstructures demonstrate highly tunable birefringence (up to 0.004 14). Due to the presence of the boundaries of dynamic hydrogels, diverse xerogels including fibers, films, and even complex three-dimensional structures with variable anisotropic microstructures can be fabricated without any external molds.

Robust Heterogeneous Hydrogels with Dynamic Nanocrystal-Polymer Interface.

A kind of novel heterogeneous composite hydrogel with dynamic nanocrosslinkers is designed, which is built via the preorganized host-guest interaction on the surface of cellulose nanocrystals. The reversible ß-cyclodextrin/adamantane conjunctions and their gradual dissociation on the nanocrystal-polymer interface guarantee the compressibility and stretchability of the composite hydrogels. While the sacrificed toughening mechanism can be rebuilt in the as-prepared hydrogels, it fails to be regenerated in the swollen hydrogels. This fact is originally due to the extreme mechanical contrast between rigid nanocrystals and the flexible polymer phase. This heterogeneity is largely amplified by the swelling process: polymer chains are prestretched between nanocrosslinkers and generate residual stress on the dynamic nanocrystal-polymer interface. Thus, this swelling-induced heterogeneity resists the reassociation of the sacrificed ß-cyclodextrin/adamantane complexes. Furthermore, the unstable nanocrystal-polymer interface induces the crack propagate along the nanocrosslinker surface, which remarkably retards the crack propagation during the stretch.

Sulfated hyaluronic acid hydrogels with retarded degradation and enhanced growth factor retention promote hMSC chondrogenesis and articular cartilage integrity with reduced hypertrophy.

Recently, hyaluronic acid (HA) hydrogels have been extensively researched for delivering cells and drugs to repair damaged tissues, particularly articular cartilage. However, the in vivo degradation of HA is fast, thus limiting the clinical translation of HA hydrogels. Furthermore, HA cannot bind proteins with high affinity because of the lack of negatively charged sulfate groups. In this study, we conjugated tunable amount of sulfate groups to HA. The sulfated HA exhibits significantly slower degradation by hyaluronidase compared to the wild type HA. We hypothesize that the sulfation reduces the available HA octasaccharide substrate needed for the effective catalytic action of hyaluronidase. Moreover, the sulfated HA hydrogels significantly improve the protein sequestration, thereby effectively extending the availability of the proteinaceous drugs in the hydrogels. In the following in vitro study, we demonstrate that the HA hydrogel sulfation exerts no negative effect on the viability of encapsulated human mesenchymal stem cells (hMSCs). Furthermore, the sulfated HA hydrogels promote the chondrogenesis and suppresses the hypertrophy of encapsulated hMSCs both in vitro and in vivo. Moreover, intra-articular injections of the sulfated HA hydrogels avert the cartilage abrasion and hypertrophy in the animal osteoarthritic joints. Collectively, our findings demonstrate that the sulfated HA is a promising biomaterial for the delivery of therapeutic agents to aid the regeneration of injured or diseased tissues and organs. STATEMENT OF SIGNIFICANCE: In this paper, we conjugated sulfate groups to hyaluronic acid (HA) and demonstrated the slow degradation and growth factor delivery of sulfated HA. Furthermore, the in vitro and in vivo culture of hMSCs laden HA hydrogels proved that the sulfation of HA hydrogels not only promotes the chondrogenesis of hMSCs but also suppresses hypertrophic differentiation of the chondrogenically induced hMSCs. The animal OA model study showed that the injected sulfated HA hydrogels significantly reduced the cartilage abrasion and hypertrophy in the animal OA joints. We believe that this study will provide important insights into the design and optimization of the HA-based hydrogels as the scaffold materials for cartilage regeneration and OA treatment in clinical setting.

Bioactive Nanocomposite Poly (Ethylene Glycol) Hydrogels Crosslinked by Multifunctional Layered Double Hydroxides Nanocrosslinkers.

Poly (ethylene glycol) (PEG) based hydrogels have been widely used in many biomedical applications such as regenerative medicine due to their good biocompatibility and negligible immunogenicity. However, bioactivation of PEG hydrogels, such as conjugation of bioactive biomolecules, is usually necessary for cell-related applications. Such biofunctionalization of PEG hydrogels generally involves complicated and time-consuming bioconjugation procedures. Herein, we describe the facile preparation of bioactive nanocomposite PEG hydrogel crosslinked by the novel multifunctional nanocrosslinkers, namely polydopamine-coated layered double hydroxides (PD-LDHs). The catechol-rich PD-LDH nanosheets not only act as effective nanocrosslinkers reinforcing the mechanical strength of the hydrogel, but also afford the hydrogels with robust bioactivity and bioadhesion via the cortical-mediated couplings. The obtained nanocomposite PEG hydrogels with the multifunctional PD-LDH crosslinking domains show tunable mechanical properties, self-healing ability, and bioadhesion to biological tissues. Furthermore, these hydrogels also promote the sequestration of proteins and support the osteogenic differentiation of human mesenchymal stem cells without any further bio-functionalization. Such facile preparation of bioactive and bioadhesive PEG hydrogels have rarely been achieved and may open up a new avenue for the design of nanocomposite PEG hydrogels for biomedical applications.

Graphitic carbon nitride solid nanofilms for selective and recyclable sensing of Cu2+ and Ag+ in water and serum.

Herein we report the fabrication of g-C3N4 nanofilms and their application as a solid fluorescence sensor. The as-prepared films are capable of convenient, sensitive, selective, rapid and recyclable sensing of Cu(2+) and Ag(+) in water and serum, indicating the sensor's potential application in disease diagnosis. Attractively, our sensor is able to differentiate Cu(2+) and Ag(+) by making use of their different adsorption and desorption kinetics during the interaction with g-C3N4 nanofilms.

Observations on a cucullanid nematode of marine fishes from Taiwan Strait, Dichelyne (Cucullanellus) jialaris n. sp.

During a helminthological examination of marine fishes from south of the Minnan-Taiwan Bank Fishing Ground, Taiwan Strait, Fujian, China, a new cucullanid nematode, Dichelyne (Cucullanellus) jialaris n. sp., was removed from the intestine of the red seabream, Pagrus major (Temminck & Schlegel, 1834). The new species differs from its congeners mainly in the following characters: body size medium but with relative long spicules of 1.01 mm (0.97-1.06) in length or 20.0% (18.21-21.8%) of the body length; proximal end of spicules somewhat expanded and distal end rounded; gubernaculum I-shaped, slightly narrow in the middle part, both ends rounded; both anterior and posterior cloaca lips round or oval, prominent and unequal in size. The anterior cloaca lip is at least 2 times larger than the posterior one. There is a conspicuous papilliform structure within the central of anterior and posterior cloacal lip. Vulva of female is not prominent, slightly postequatorial; distance from vulva to anterior end of body is 4.3 (3.0-5.5) mm or 58.0% (54.0-62.0%) of the body length. Considering the result of comparing the structure of so-called unpaired median papilla with the 10 pairs of caudal petiolated papillae in the body of the same individual. the papilliform structures are just a backstop for the cloacal lips, this new species represents the first record of a nematode of the Dichelyne, subgenus Cucullanellus in marine fishes of China Sea.