ABSTRACT
Objetivo: El objetivo de este estudio es investigar los resultados clínicos y los hallazgos radiográficos tras la reconstrucción de la cápsula superior (RCS) en las roturas irreparables posterosuperiores sintomáticas (RIPS) del manguito de los rotadores mediante una nueva técnica de RCS utilizando injerto autógeno de isquiotibiales. Material y métodos: Desde 2014 hasta 2016, 8 hombros en 8 pacientes (edad media de 59,6 años) con RIPS fueron tratados con la RCS utilizando injerto autógeno de isquiotibiales. El examen físico, Rx y RM fueron realizados antes de la cirugía y a los 12 meses. Se ha realizado un análisis descriptivo de las variables y se ha utilizado test no paramétrico de los signos para comparar las medidas tomadas antes de la cirugía y a los 12 meses. Resultados: Encontramos una mejoría en el test de Costant: de 49 antes de ser intervenido a 77,25 al año de la RCS. La media de flexión activa aumentó de forma significativa de 99,3° a 142,5°. La distancia media HA preoperatoria aumentó de 5,25mm (rango de 3 a 7mm) antes de la cirugía a 8,18mm (rango de 6 a 10,5) tras la RCS. No hubo roturas del injerto durante el seguimiento Conclusión: La RCS con injerto de isquiotibiales mejora la función del hombro en las RIPS. Es una técnica alternativa al tratamiento de dichas lesiones sin cerrar las puertas a otras cirugías
Objective: The aim of this study was to investigate the clinical results and radiographic findings after superior capsular reconstruction (SCR) of postero-superior symptomatic irreparable rotator cuff tears (PSIRCT) using a new SCR technique using autologous hamstring graft Material and methods: From 2014 to 2016, 8 shoulders of 8 patients (mean age 59.6 years) with PSIRCT underwent SCR using autologous hamstring graft. Physical examination, X-ray and MRI were performed before the surgery and 12 months after it. A descriptive analysis was performed of the variables, and the non-parametric test of signs comparing the measurements taken before the operation and 12 months after it. Results: We found an improvement in the Constant test from 49 before the SCR to 77.25 one year after the operation. The mean active flexion significantly increased from 99.3° to 142.5°. The mean preoperative AH distance increased from 5.25 (range from 3 to 7) before surgery to 8.18 (range from 6 to 10.5) after the SCR. There were no tears of the graft during follow-up. Conclusion: SCR with a hamstring graft improves the function of the shoulder in PSIRCT, and is an alternative technique for treating these injuries without closing the door to other types of surgery
Subject(s)
Humans , Male , Female , Middle Aged , Rotator Cuff Injuries/surgery , Surgical Flaps/transplantation , Hamstring Tendons/transplantation , Plastic Surgery Procedures/methods , Recovery of Function , Treatment Outcome , Prospective StudiesABSTRACT
OBJECTIVE: The aim of this study was to investigate the clinical results and radiographic findings after superior capsular reconstruction (SCR) of postero-superior symptomatic irreparable rotator cuff tears (PSIRCT) using a new SCR technique using autologous hamstring graft MATERIAL AND METHODS: From 2014 to 2016, 8 shoulders of 8 patients (mean age 59.6 years) with PSIRCT underwent SCR using autologous hamstring graft. Physical examination, X-ray and MRI were performed before the surgery and 12 months after it. A descriptive analysis was performed of the variables, and the non-parametric test of signs comparing the measurements taken before the operation and 12 months after it. RESULTS: We found an improvement in the Constant test from 49 before the SCR to 77.25 one year after the operation. The mean active flexion significantly increased from 99.3° to 142.5°. The mean preoperative AH distance increased from 5.25 (range from 3 to 7) before surgery to 8.18 (range from 6 to 10.5) after the SCR. There were no tears of the graft during follow-up. CONCLUSION: SCR with a hamstring graft improves the function of the shoulder in PSIRCT, and is an alternative technique for treating these injuries without closing the door to other types of surgery.
Subject(s)
Hamstring Tendons/transplantation , Joint Capsule/surgery , Orthopedic Procedures/methods , Rotator Cuff Injuries/surgery , Shoulder Joint/surgery , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pilot Projects , Prospective Studies , Shoulder Injuries , Transplantation, Autologous , Treatment OutcomeABSTRACT
OBJECTIVE: To analyze whether women who sustain obstetric anal sphincter injury (OASI) in their first vaginal delivery have a higher incidence of levator ani muscle (LAM) avulsion than do women without OASI. METHODS: We conducted a prospective observational cohort study of 80 primiparous women who gave birth at our tertiary obstetric unit between September 2011 and July 2013. The women were divided into two groups: women diagnosed with OASI during vaginal delivery (n = 40) and women without OASI (n = 40), matched by mode of delivery and newborn birth weight. Four-dimensional (4D) transperineal ultrasound was performed in all participants at 6-12 months after delivery to assess for integrity or avulsion of the LAM. Ultrasound images were evaluated by two observers who were blinded to group assignment and clinical data. Interobserver agreement was assessed to determine the reproducibility of 4D transperineal ultrasound for diagnosing LAM avulsion. RESULTS: We found no statistically significant differences between the two groups. The incidence of LAM avulsion was 24.3% in the OASI group and 34.2% in the control group (P = 0.448). Interobserver agreement in the diagnosis of LAM avulsion in the study population using 4D transperineal ultrasound was 89.5%, with a kappa index of 0.76. CONCLUSIONS: Our findings do not support OASI as a risk factor for LAM avulsion. Prospective studies in larger populations are needed to establish the biomechanical relationships of the pelvic floor structures involved in vaginal delivery. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
Subject(s)
Anal Canal/injuries , Muscle, Skeletal/diagnostic imaging , Pelvic Floor/injuries , Adult , Delivery, Obstetric/methods , Female , Humans , Muscle, Skeletal/injuries , Observer Variation , Pregnancy , Prospective Studies , Risk Factors , Tertiary Care Centers , Ultrasonography/methodsABSTRACT
The purpose of this study was to compare the effects of five different cryopreservation protocols on the histology of bioengineered tissues. Although several artificial tissues have been developed to the date by tissue engineering, classical histological analysis methods and techniques must be optimized for these new tissues with special properties. The results of this study showed that the use of volatile solutions (formaldehyde, glutaraldehyde, glacial acetic acid and acetone) was not able to prevent the formation of large ice crystals that, in turn, can alter the structure of the artificial tissues. However, preincubation of the tissues in different concentrations of a carbon hydrate (glucose, maltose or trehalose) resulted in a better preservation of the tissue structure. We conclude that the best protocol that allows for an efficient analysis of the bioengineered tissues with very few artifacts is preincubation of the tissues in 0.300M or 0.400M trehalose for 30 or 120 min prior to OCT (optimal cutting temperature) embedding and cryosectioning. For all those reasons, we recommend the use of a cryoprotective agent before OCT embedding of human artificial tissues.
