Binding and inactivation of human coronaviruses, including SARS-CoV-2, onto purified clinoptilolite-tuff.

The current COVID19 pandemic is caused by a positive-sense single-stranded RNA virus, which presents high mutational rates. The development of effective therapeutics and mitigation strategies using vaccination or therapeutic antibodies faces serious challenges because of the regular emergence of immune escape variants of the virus. An efficient approach would involve the use of an agent to non-specifically limit or block viruses contacting the mucosae and therefore entering the body. Here, we investigated the ability of a micronized purified clinoptilolite-tuff to bind and neutralize different viruses from the Coronaviridae family. Using plaque assay, RT-qPCR and immunostaining, the adsorption and inactivation of the seasonal human coronavirus HCoV-229E and of 2 SARS-CoV-2 variants were demonstrated. The resulting data suggest that purified clinoptilolite-tuff could be used as an ingredient in new medical devices and/or pharmaceuticals to prevent or mitigate SARS-CoV-2 dissemination.

Tendon retracts more than muscle in experimental chronic tears of the rotator cuff.

We released the infraspinatus tendons of six sheep, allowed retraction of the musculotendinous unit over a period of 40 weeks and then performed a repair. We studied retraction of the musculotendinous unit 35 weeks later using CT, MRI and macroscopic dissection. The tendon was retracted by a mean of 4.7 cm (3.8 to 5.1) 40 weeks after release and remained at a mean of 4.2 cm (3.3 to 4.7) 35 weeks after the repair. Retraction of the muscle was only a mean of 2.7 cm (2.0 to 3.3) and 1.7 cm (1.1 to 2.2) respectively at these two points. Thus, the musculotendinous junction had shifted distally by a mean of 2.5 cm (2.0 to 2.8) relative to the tendon. Sheep muscle showed an ability to compensate for approximately 60% of the tendon retraction in a hitherto unknown fashion. Such retraction may not be a quantitatively reliable indicator of retraction of the muscle and may overestimate the need for elongation of the musculotendinous unit during repair.

Outcome after primary hemiarthroplasty for fracture of the head of the humerus. A retrospective multicentre study of 167 patients.

We have examined 167 patients who had a hemiarthroplasty for three- and four-part fractures and fracture-dislocations of the head of the humerus in a multicentre study involving 12 Austrian hospitals. All patients were followed for more than a year. Anatomical healing of the tuberosity significantly influenced the outcome as measured by the Constant score and subjective patient satisfaction. With regard to pain, the outcome was generally satisfactory but only 41.9% of patients were able to flex the shoulder above 90 degrees. The age of the patient and the type of prosthesis significantly influenced the healing of the tuberosity, but bone grafting did not. Achievement of healing of the tuberosity was inferior in institutions at which less than 15 hemiarthroplasties had been performed (Mann-Witney U test, p = 0.0001).

[Intra- and perioperative complications in the stabilization of per- and subtrochanteric femoral fractures by means of PFN]. / Intra- und perioperative Komplikationen bei der Stabilisierung von per- und subtrochantären Femurfrakturen mittels PFN.

In the period from 2/98 up to 6/99, fractures of the proximal femur of 70 patients (phi 79.2 a), were treated with a proximal femur nail (PFN((R))). The aim of this retrospective analysis was to evaluate intra- and perioperative complications. The reports of the operation and the anaesthesia documentation sheets have been worked out, all X-rays have been measured, and evaluated along exactly defined parameters. Problems or complications were found in 18 cases (25,7%). In 7 cases (10,0%) these problems could be solved during operation. The "Z-effect" seen in 5 cases (7,1%) and the "cut-out" of the sliding-hip-screw in 6 cases (8,6%) were the most frequent complications. The main reason was a bad primary reposition in varus with a CCD-Angle less than 125 degrees.

Bone tunnel remodeling at the site of biodegradable interference screws used for anterior cruciate ligament reconstruction: 5-year follow-up.

PURPOSE: The purpose of this prospective study was to review, using expanded clinical-assessment tools, the long-term results of the local effects of a bioabsorbable interference screw (copolymer 85/15 D,L lactide/glycolide) in anterior cruciate ligament (ACL) reconstruction. TYPE OF STUDY: This prospective study was initiated in May 1993. The inclusion criteria for patient selection included rupture of the ACL in athletic patients without involvement of the collateral ligaments, arthroscopic ACL reconstruction using middle third of the ligamentum patella, and magnetic resonance imaging (MRI) and plain radiographic examinations of the knee joint during follow-up. MATERIALS: Between May 1993 and October 1994, 32 patients were enlisted in the study; 48 patients did not fit the inclusion criteria. There were 25 men 7 women. The average age was 29.1 years (range, 19 to 50 years). There were 21 right knees and 11 left knees. The follow-up examinations were performed by an independent examiner. There were 28 patients available for follow-up at a medium of 5.2 years (range, 4.1 to 6.4 years). The evaluation included various testing systems (i.e., OAK, IKDC, Lysholm) as well as MRI and plain radiographic studies to investigate the longevity of the implant and potential adverse effects of this new bioabsorbable material. RESULTS: The clinical results were good. The OAK score (Orthopädische Arbeitsgruppe Knie) showed 93% excellent and good results, and 7% fair results. The IKDC and Lysholm scores were 92% and 96% good and excellent results, respectively. MRI showed bone remodeling and new bone formations at the site of the implant in the femoral as well as in the tibial bone tunnel at follow-up. No cystic or osteolytic changes where seen on MRI or plain radiographs. CONCLUSIONS: This study showed the correlation between histology and MRI: there was minimal surgical-site edema, minimal reaction to this material, and complete replacement by new bone formation of the previous site of this implant. At 5 years, this bioabsorbable interference screw appeared clinically safe and effective for fixation of bone blocks during ACL reconstruction and MRI showed complete absorption and replacement with new bone.

Half pipe cannula for shoulder arthroscopy.

Shoulder arthroscopy makes it possible to diagnose and to reconstruct different pathologies. This article describes the use of a half pipe cannula for changing instruments in shoulder arthroscopy without using a closed cannula system. The use of this new device is not an alternative to standard cannula systems, but it is very helpful for changing different arthroscopic instruments without altering the soft tissues, thus minimizing postoperative swelling.

[Diagnostic value of conventional roentgen image, computerized and magnetic resonance tomography in acute sprains of the foot. A prospective clinical study]. / Diagnostische Wertigkeit von Nativröntgen, Computer- und Magnetresonanztomographie beim akuten Hyperflexionstrauma des Fusses. Eine prospektive klinische Studie.

In order to gain satisfying results in the treatment of acute hyperflexion trauma to the foot, it is absolutely necessary to achieve an exact primary diagnosis because injuries to the tarsometatarsal joint are frequently missed primarily. Aim of this prospective clinical study was to evaluate the diagnostic reliability of conventional radiography, CT and MRI compared to each other. 75 consecutive patients after hyperflexion trauma to the foot were included. There were 47 males and 28 females with a mean age of 38 years. After admittance, pa-, lateral and 45 degrees oblique radiographs were taken as well as stress views in comparison to the contralateral foot. Furthermore, CT and MRI were performed in any patient. By conventional radiography, 48 metatarsal and 24 tarsal fractures were diagnosed as well as 17 cases of malalignment of the Lisfranc joint. Stress radiographies were not able to provide a more accurate diagnosis. By CT scans, however, 86 metatarsal and 74 tarsal fractures were detected. Moreover, we found malalignment in 31 and bony avulsions of Lisfranc's ligament in 4 patients. By MRI, finally, 85 metatarsal, 100 tarsal fractures and 31 cases of malalignment were diagnosed. Additionally, partial or complete tears of Lisfranc's ligament were depicted in 22 patients. The present study could clearly show the superiority of CT and MRI to conventional radiography in diagnosis of bony and ligamentous disorders of the Lisfranc joint. Therefore, extended diagnosis has to be demanded in all cases of hyperflexion trauma to the foot.

[Arthroscopy of the upper ankle joint. A retrospective analysis of complications]. / Arthroskopie des oberen Sprunggelenks. Eine retrospektive Analyse der Komplikationen.

The purpose of this retrospective study was to analyse the complications of our arthroscopic procedures at the ankle joint. In all patients we evaluated the treatment protocols and in 111 patients (79.3%) we also evaluated the clinical and radiologic results. All in all we have found complications in 14 patients. In 4 cases we have seen a delayed wound healing, in 2 cases a superficial infection, in 3 cases a deep infection, in 3 cases a neural damage and in 2 cases a phlebothrombosis. Our study show, that the complication rate could be minimized by detailed knowledge of the anatomy, exact preoperative diagnostic and planing of the operation and careful preparation of the portals. The use of a laser also shows a tendency to a lower complication rate.

Conventional radiography, CT, and MR imaging in patients with hyperflexion injuries of the foot: diagnostic accuracy in the detection of bony and ligamentous changes.

OBJECTIVE: The goal of this study was to compare the capabilities of conventional radiography, CT, and MR imaging in revealing ligamentous and bony changes in patients after hyperflexion injuries. SUBJECTS AND METHODS: Forty-nine patients with hyperflexion injuries of the foot were included in our study. Conventional radiography, weight-bearing radiography, CT, and MR imaging were performed. All images were reviewed with respect to ligamentous and bony abnormalities and alignment alterations. Eleven patients with joint malalignment underwent surgery, which is considered the gold standard in these patients. Five patients with joint malalignment refused surgery. RESULTS: For all 49 patients, conventional radiographs revealed 33 metatarsal and 20 tarsal fractures. Eight patients presented with tarsometatarsal joint (Lisfranc's joint) malalignment. Weight-bearing radiographs showed joint malalignment in the same eight patients only. CT showed 41 tarsal fractures and 53 metatarsal fractures. Joint malalignment was evident in 16 patients. MR imaging revealed 41 metatarsal fractures and 18 metatarsal bone bruises. Tarsal bones were fractured at 39 sites and there were nine tarsal bone bruises. Metatarsal fractures were mostly localized in the second metatarsal bone; tarsal fractures, in the cuboid. Joint malalignment was evident in 16 patients; in 11 of these 16 patients, Lisfranc's ligament was disrupted. Surgery confirmed bony and ligamentous changes and joint malalignment in 11 patients. CONCLUSION: Conventional radiographs including weight-bearing images are not sufficient for routine diagnostic workup of patients with acute hyperflexion injuries of the foot. CT should serve as the primary imaging technique for such patients.

Serial magnetic resonance imaging evaluation of operative site after fixation of patellar tendon graft with bioabsorbable interference screws in anterior cruciate ligament reconstruction.

Magnetic resonance imaging (MRI) is accepted as the imaging procedure of choice for showing internal derangement of the knee. In contrast to metal implants, bioabsorbable interference screws do not produce an artifact and provide an opportunity to expand the evaluation of the postoperative anterior cruciate ligament (ACL) ligament repair. There is the potential to evaluate the implant, the graft, the adjacent tissue, and the surgically created bone tunnels. The purpose of this study was to evaluate with MRI the postoperative site of ACL patellar tendon autografts in which bioabsorbable screws were used for fixation. It was hypothesized that a time line of bone tissue changes resulting from this type of surgery could be developed based on the expanded evaluation of MRI. From January 1993 through October 1997, 270 patients underwent surgical repair of a disrupted native ACL. There were 173 men 97 women; the average age was 25.1 years, (range, 17 to 50 years). There were 155 right knees and 115 left knees. In addition to the conventional postoperative clinical assessment and plain film radiographs, opportunistic MRIs were obtained with the patient's permission. The examinations were performed at different postoperative intervals from the third postoperative day to 4 years postoperatively. A total 206 MRIs from various time intervals were available for study. The study protocol was designed to look for loss of integrity of the screws, adjacent fluid collection, tunnel widening, and tunnel healing or narrowing. The hypothesis was substantiated in this study. The use of MRI provided observations not available by other imaging methods. The absence of metal implants for fixation provided an opportunity to examine the adjacent tissue in detail and to form a time line of the tissue response in this type of surgery.

Serial magnetic resonance imaging evaluation of a bioabsorbable interference screw and the adjacent bone.

The purpose of this prospective study was to review, using expanded clinical assessment tools, the initial use of a bioabsorbable interference screw (copolymer 85/15 D, L lactide/glycolide) in anterior cruciate ligament (ACL) reconstruction at the Wels Hospital, Austria. The study enlisted 32 patients of whom 28 were available for follow-up at minimum of 2.5 years. Since the implant material was new and the screw would not show on plain film radiographs, the clinical assessment was expanded beyond the usual historical and physical findings. The evaluation included opportunistic knee joint aspiration and repeat magnetic resonance imaging (MRI) studies to investigate the longevity of the implant and potential adverse effects of this new bioabsorbable material. The knee joint aspirations showed no infection. Serial MRIs showed the physical presence of the screw to remain intact for 4 months and disappear in 6 months. The MRIs showed minimal collection of edema around the bone tunnels that resolved by 12 months. There were no symptoms or adverse clinical result correlated with the MRI evidence of edema. There was temporary bone tunnel expansion. The clinical results were good. The OAK-score (Orthopädische Arbeitsgruppe Knie) showed 89.5% excellent and good results, 7% fair results and 3.5% poor results. The average score was 90.7 points (range, 63 to 100 points). The knee joint stability measured with the KT-1000 arthrometer showed 93% to have a 3-mm or less difference compared with the unoperated knee. This bioabsorbable interference screw appeared safe and effective for fixation of bone blocks during ACL reconstruction while producing no occult infection or adverse clinical response during the degradation process.

[Results of reconstruction of anterior cruciate ligament ruptures. Use of resorbable interference screws (minimum follow-up of 2.5 years)]. / Ergebnisse nach Rekonstruktion vorderer Kreuzbandrupturen. Verwendung resorbierbarer Interferenzschrauben (minimum Follow-up 2.5 Jahre).

The purpose of this study was to assess the effects of biodegradable interference screw use in ACL reconstruction beyond the usual clinical historical and physical findings. The use of this material for interference screws has potential benefits if the problems of inflammation are minimal and the fixation properties are sufficient. There is no need for a second operation for removal and no complicating factor if revision surgery is necessary. A prospective study was initiated in May, 1993 to evaluate the use of biodegradable interference screws (Instrument Makar). Our patients were evaluated with the aid of the common OAK-score. The overall evaluation showed 89.5% excellent and good results, 7% fair results and 3.5% poor results. The average score was 90.7 points (63-100 points). The measurement with the arthrometer (KT 1000) showed a difference of up to 3 mm as compared to the knee joint not operated on in 24 (93%) of the patients. Four patients showed a 3 to 6 mm difference. A tibia translation of more than 4 mm was not measured in any case. The biodegradable interference screw is a safe and effective interference screw for fixation of the bone blocks for ACL reconstruction.

[Resorbable interference screws. Histologic study 4.5 years postoperative]. / Resorbierbare Interferenzschrauben. Histologische Untersuchung 4,5 Jahre postoperativ.

The use of degradable implants in recent years has brought not only good results. Foreign body reactions to implantation of degradable polymers clearly curtailed the initial expectations. Bioabsorbable polymers have been used for sutures, vascular clips, and fixation implants for both intra-articular fractures and malleolar fractures. In the literature these implants are controversial. Potential benefits remain for the use of this material for interference screws if the problems of inflammation are minimal and the fixation properties are sufficient. There is no need for a second operation for removal. In one patient, 4,5 years after to implantation of an degradable interference screw (Copolymer 85/15 D,L lactide glycolide; Biologically Quiet, Instrument Makar, Inc. Mount Hope, MI 48864, USA) we took an biopsy and made histological examinations. No foreign body reaction or inflammation signs could be detected.