Arthroscopic Linear Chain Fixation for the Treatment of Medial Meniscus Posterior Root Tear: A Case Study.

BACKGROUND: The repair and reconstruction of medial meniscus posterior root tears (MMPRTs) is an important issue in the field of orthopedic sports medicine. This study reports the first application of arthroscopic linear chain fixation for the treatment of MMPRTs. CASE PRESENTATION: A 78-year-old female patient presented with a 1.5-month history of right knee pain accompanied by a locked facet joint. The patient underwent surgery with the new linear chain fixation method. In this method, the suture and the loop part of the buckle-strap titanium plate were combined into a linear chain mechanical complex, and the tension of the posterior root stump was gradually increased by pulling on the two attachment lines at the external mouth of the tibial tunnel. The postoperative Lysholm score was 89, and the visual analogue scale score was 0.9, indicating a significant improvement in knee joint function. At the 7-month and 1-year post-surgery follow-up, physical and MRI examinations confirmed satisfactory healing of the MMPRTs. CONCLUSION: This surgical approach offers several benefits, including a simplified instrumentation setup, preservation of natural anatomical structures, and reliable residual stump fixation. It has the potential for clinical implementation.

Resveratrol improves neurological outcome and neuroinflammation following spinal cord injury through enhancing autophagy involving the AMPK/mTOR pathway.

Resveratrol, a natural phenolic compound, provides neuroprotective effects, however, the specific mechanisms of action remain to be elucidated. The purpose of the present study was to examine the neuroprotective effect of resveratrol on spinal cord injury (SCI) and the potential molecular mechanisms of action. A rat model of SCI was induced using Allen's method, and resveratrol (100 mg/kg) was intraperitoneally injected 1 day following surgery. The recovery of neurological function was assessed using the Basso, Beattie, Bresnahan scoring system and an inclined plane test. The concentrations of pro­ and anti­inflammatory factors were measured using ELISA. The expression and location of autophagy markers were measured using western blot and immunofluorescence analyses. The results suggested that resveratrol administration resulted in functional improvement of locomotor activity and reduced neuroinflammation following the induction of SCI. In addition, autophagy was activated following SCI, as demonstrated by the significantly increased ratio of microtubule­associated protein light chain 3 (LC3)­II/LC3­I and expression of Beclin­1 in the injured spinal cord. Of note, the enhancement of phosphorylated (p)­AMP­activated protein kinase (AMPK) and the reduction of p­mammalian target of rapamycin (mTOR) following SCI indicated that the SCI­induced activation of autophagy was associated with the AMPK/mTOR signaling pathway. Resveratrol treatment further enhanced the activation of autophagy via the AMPK/mTOR pathway following SCI. By contrast, the autophagic inhibitor, 3­methyladenine, partially inhibited the neuroprotective effects of resveratrol treatment. Together, these findings suggested that resveratrol promoted functional recovery and inhibited neuroinflammation through the activation of autophagy mediated by the AMPK/mTOR pathway following SCI.

Promoting spinal fusions by biomineralized silk fibroin films seeded with bone marrow stromal cells: An in vivo animal study.

OBJECTIVES: To prepare a biomineralized nano silk fibroin film seeded with bone marrow stromal cells (BMSCs), and to evaluate its performance in spinal fusion. METHODS: The silk fibroin film was mineralized in a modified, simulated body fluid, seeded with BMSCs, and evaluated in a rat model of posterolateral lumbar fusion, compared with pure silk fibroin, silk fibroin/bone marrow stromal cells, mineralized silk fibroin, mineralized silk fibroin/bone marrow stromal cells, iliac crest bone, and no graft. After 12 weeks, all rats were sacrificed and underwent manual palpation, micro-CT scanning, biomechanical testing, and histology. RESULTS: The infrared spectrum, X-ray diffraction, and scanning electron microscopy demonstrated deposition of mineral layers on the silk fibroin film surface. The fusion rate, bone volume, relative strength and stiffness, and histological score of the mineralized silk fibroin/bone marrow stromal cells were slightly lower than the autograft, but without any significant difference (p > 0.05). In addition, the mineralized silk fibroin was significantly greater in most parameters than the silk fibroin/bone marrow stromal cells (p < 0.05). CONCLUSION: The mineralized silk fibroin resembles natural bone structurally, and the cellular and mineral layers of silk fibroin are both critical to bone regeneration. The ability to promote spinal fusion is enhanced when the mineralized silk fibroin is seeded with bone marrow stromal cells.

Bioactivity of porous biphasic calcium phosphate enhanced by recombinant human bone morphogenetic protein 2/silk fibroin microsphere.

To prepare a bioactive bone substitute, which integrates biphasic calcium phosphate (BCP) and rhBMP-2/silk fibroin (SF) microsphere, and to evaluate its characteristics. Hydroxyapatite and ß-tricalcium phosphate were integrated with a ratio of 60­40%. RhBMP-2/SF (0.5 µg/1 mg) microsphere was prepared, and its rhBMP-2-release kinetics was assed. After joining pore-forming agent (Sodium chloride, NaCl), porous BCP/rhBMP-2/SF were manufactured, and its characteristics and bioactivity in vitro were evaluated. Mean diameter of rhBMP-2/SF microsphere was 398.7 ± 99.86 nm, with a loading rate of 4.53 ± 0.08%. RhBMP-2 was released in a dual-phase pattern, of which fast-release (nearly half of protein released) focused on the initial 3 days, and slow-release sustained more than 28 days. With the increase in concentration of NaCl, greater was porosity and pore size, but smaller mechanical strength of BCP/rhBMP-2/SF. Material with 150% (w/v) NaCl had an optimal performance, with a porosity of 78.83%, pore size of 293.25 ± 42.77µm and mechanical strength of 31.03 MPa. Proliferation of human placenta-derived mesenchymal stem cells (hPMSCs) on leaching extract medium was similar to the normal medium (P = 0.89), which was better than that on control group (P = 0.03). Activity of alkaline phosphatase on BCP/rhBMP-2/SF surface was higher than on pure BCP at each time point except at 1 day (P < 0.05). RhBMP-2 has a burst release on early times and a sustaining release on later times. BCP/rhBMP-2/SF with 150% (w/v) pore-forming agent has excellent porosity, pore size and mechanical strength. The biomaterial induces proliferation and differentiation hPMSCs effectively.