Interventions used to mitigate muscle fatty degeneration following the repair of massive rotator cuff tears. A systematic review of animal studies.

BACKGROUND: Muscle fatty degeneration following rotator cuff tears has been unequivocally associated with poorer functional outcomes and increased risk for retear following rotator cuff repair. Promising results have emerged from animal studies, with the implementation of various interventions for biologic inhibition of this fatty muscle degeneration. The lack of high quality randomized human evidence on this topic, increases the impact of pooled results from animal literature. The aim of the present study was to systematically review the available published literature for animal studies evaluating the ability of several interventions used to mitigate muscle fatty degeneration following the repair of massive rotator cuff tears. PATIENTS AND METHODS: A comprehensive search was conducted on Pubmed, Scopus and Google Scholar, covering the period from conception until 16th April 2022. Datasets were stratified based on the type of intervention performed. SYRCLE risk of bias instrument was implemented for quality assessment of the included studies. RESULTS: Rotator cuff repair augmentation with Adipose derived stem cells (ADSC's), Mesenchymal stem cells (MSC's) and Nandrolone was effective against fatty infiltration, but less effective against muscle atrophy. More beneficial effect was shown by the utilization of Beige adipose tissue - Fibroadipogenic progenitors (BAT-FAP) stimulation, using either Amibregon or BAT-FAPs transplantation. Both provided good results in mitigating muscle atrophy, fatty infiltration and fibrosis. DISCUSSION: ADSC's, MSC's, Nandrolone and BAT-FAP stimulation may have a role in mitigating muscle fatty degeneration following rotator cuff tears. Large scale human studies are required to further elucidate their role in the clinical setting. LEVEL OF EVIDENCE: V; systematic review of pre-clinical studies.

Evolutionary Computing for the Radiative-Convective Heat Transfer of a Wetted Wavy Fin Using a Genetic Algorithm-Based Neural Network.

Evolutionary algorithms are a large class of optimization techniques inspired by the ideas of natural selection, and can be employed to address challenging problems. These algorithms iteratively evolve populations using crossover, which combines genetic information from two parent solutions, and mutation, which adds random changes. This iterative process tends to produce effective solutions. Inspired by this, the current study presents the results of thermal variation on the surface of a wetted wavy fin using a genetic algorithm in the context of parameter estimation for artificial neural network models. The physical features of convective and radiative heat transfer during wet surface conditions are also considered to develop the model. The highly nonlinear governing ordinary differential equation of the proposed fin problem is transmuted into a dimensionless equation. The graphical outcomes of the aspects of the thermal profile are demonstrated for specific non-dimensional variables. The primary observation of the current study is a decrease in temperature profile with a rise in wet parameters and convective-conductive parameters. The implemented genetic algorithm offers a powerful optimization technique that can effectively tune the parameters of the artificial neural network, leading to an enhanced predictive accuracy and convergence with the numerically obtained solution.

Numerical analysis of magnetohydrodynamics in an Eyring-Powell hybrid nanofluid flow on wall jet heat and mass transfer.

The customization of hybrid nanofluids to achieve a particular and controlled growth rate of thermal transport is done to meet the needs of applications in heating and cooling systems, aerospace and automotive industries, etc. Due to the extensive applications, the aim of the current paper is to derive a numerical solution to a wall jet flow problem through a stretching surface. To study the flow problem, authors have considered a non-Newtonian Eyring-Powell hybrid nanofluid with water and CoFe2O4and TiO2nanoparticles. Furthermore, the impact of a magnetic field and irregular heat sink/source are studied. To comply with the applications of the wall jet flow, the authors have presented the numerical solution for two cases; with and without a magnetic field. The numerical solution is derived with a similarity transformation and MATLAB-based bvp4c solver. The value of skin friction for wall jet flow at the surface decreases by more than 50% when the magnetic fieldMA=0.2is present. The stream function value is higher for the wall jet flow without the magnetic field. The temperature of the flow rises with the dominant strength of the heat source parameters. The results of this investigation will be beneficial to various applications that utilize the applications of a wall jet, such as in car defrosters, spray paint drying for vehicles or houses, cooling structures for the CPU of high-processor laptops, sluice gate flows, and cooling jets over turbo-machinery components, etc.

Investigation of Inlet Conditions in The Mixing Process of Nanoparticles and Blood in a T-Shaped Microfluidic Reactor with Small Rectangular Cavities.

During the metastasis of cancer cells, circulating tumor cells (CTCs) are released from the primary tumor, reach the bloodstream, and colonize new organs. A potential reduction of metastasis may be accomplished through the use of nanoparticles in micromixers in order to capture the CTCs that circulates in blood. In the present study, the effective mixing of nanoparticles and the blood that carries the CTCs are investigated. The mixing procedure was studied under various inlet velocity ratios and several T-shaped micromixer geometries with rectangular cavities by using computational fluid dynamics techniques. The Navier-Stokes equations were solved for the blood flow; the discrete motion of particles is evaluated by a Lagrangian method while the diffusion of blood substances is studied by using a scalar transport equation. Results showed that as the velocity ratio between the inlet streams increases, the mixing rate of nanoparticles with the blood flow is increased. Moreover, nanoparticles are uniformly distributed across the mixing channel while their concentration is decreased along the channel. Furthermore, the evolution in time of the blood substances in the mixing channel increases with the increase of the velocity ratio between the two streams. On the other hand, the concentration of both the blood substances and the nanoparticles is decreased in the mixing channel as the velocity ratio increases. Finally, the differences in the dimensions of the rectangular cavities seems to have an insignificant effect both in the evolution in time of the blood substances and the concentration of nanoparticles in the mixing channel.

Investigation on Thermally Radiative Mixed Convective Flow of Carbon Nanotubes/Al2O3 Nanofluid in Water Past a Stretching Plate with Joule Heating and Viscous Dissipation.

The nature of this prevailing inquisition is to scrutinize the repercussion of MHD mixed convective flow of CNTs/Al2O3 nanofluid in water past a heated stretchy plate with injection/suction, heat consumption and radiation. The Joule heating and viscous dissipation are included in our investigation. The Navier-Stokes equations are implemented to frame the governing flow expressions. These flow expressions are non-dimensioned by employing suitable transformations. The converted flow expressions are computed numerically by applying the MATLAB bvp4c procedure and analytically by the HAM scheme. The impacts of relevant flow factors on fluid velocity, fluid temperature, skin friction coefficient, and local Nusselt number are illustrated via graphs, tables and charts. It is unequivocally shown that the fluid speed declines when escalating the size of the magnetic field parameter; however, it is enhanced by strengthening the Richardson number. The fluid warmness shows a rising pattern when enriching the Biot number and heat consumption/generation parameter. The findings conclusively demonstrate that the surface drag force improves for a larger scale of Richardson number and is suppressed when heightening the unsteady parameter. In addition, it is evident from the outcomes that the heat transfer gradient decreases to increase the quantity of the Eckert number in the convective heating case; however, the opposite nature is obtained in the convective cooling case. Our numerical results are novel, unique and applied in microfluid devices such as micro-instruments, sleeve electrodes, nerve growth electrodes, etc.

Viscous coalescence of unequally sized spherical and cylindrical doublets.

A coalescence model is developed for pairs of unequally sized particles, assuming surface tension driven flow opposed by viscosity. The flow field is extensional, biaxial for spheres and planar for cylinders. The balance of surface energy and viscous dissipation results in a system of two ordinary differential equations for each of the two doublet shapes studied. The solution of the differential equations provides growth of neck radius (or width) as well as surface and cross-sectional area evolution. For an infinitely large size ratio, the model describes the coalescence of a sphere or a cylinder with a semi-infinite wall of the same material. The model is compared to some numerical simulations and experimental measurements available in the literature. The comparison to experiments includes PDMS spheres, macromolecule-rich droplets, spherical bitumen particles, and a smectic circular island with a meniscus.

Antibacterial Activity of Copper Nanoparticles against Xanthomonas campestris pv. vesicatoria in Tomato Plants.

Copper-based bactericides have appeared as a new tool in crop protection and offer an effective solution to combat bacterial resistance. In this work, two copper nanoparticle products that were previously synthesized and evaluated against major bacterial and fungal pathogens were tested on their ability to control the bacterial spot disease of tomato. Growth of Xanthomonas campestris pv. vesicatoria, the causal agent of the disease, was significantly suppressed by both nanoparticles, which had superior function compared to conventional commercial formulations of copper. X-ray fluorescence spectrometry measurements in tomato leaves revealed that bioavailability of copper is superior in the case of nanoparticles compared to conventional formulations and is dependent on synthesis rather than size. This is the first report correlating bioavailability of copper to nanoparticle efficacy.

Activation Energy Impact on Flow of AA7072-AA7075/Water-Based Hybrid Nanofluid through a Cone, Wedge and Plate.

The present research investigates the effect of a heat source/sink on nanofluid flow through a cone, wedge, and plate when using a suspension of aluminium alloys (AA7072 and AA7075) as nanoparticles in base fluid water. The activation energy and porous material are also considered in the modelling. Using similarity transformations, the modelling equations were converted into an ordinary differential equation (ODEs) system. The Runge Kutta Fehlberg 45 fourth fifth-order (RKF 45) technique and shooting approach were used to numerically solve these equations. The influence of essential aspects on flow fields, heat, and mass transfer rates was studied and addressed using graphical representations. The outcome reveals that the case of fluid flow past a plate shows improved heat transfer for augmented heat source/sink parameter values than the cases for fluid flow past a cone and wedge does. Furthermore, we observed the least heat transfer for the case of fluid flow past the cone. The mass transfer for the case of fluid flow past the cone increased more slowly for growing activation energy parameter values than in the other cases. Moreover, we observed higher mass transfer rates for the case of fluid flow past the plate. The augmented values of the heat source/sink parameter decayed the heat transfer rate in all three flow cases.

An MHD Fluid Flow over a Porous Stretching/Shrinking Sheet with Slips and Mass Transpiration.

In the present paper, an MHD three-dimensional non-Newtonian fluid flow over a porous stretching/shrinking sheet in the presence of mass transpiration and thermal radiation is examined. This problem mainly focusses on an analytical solution; graphene water is immersed in the flow of a fluid to enhance the thermal efficiency. The given non-linear PDEs are mapped into ODEs via suitable transformations, then the solution is obtained in terms of incomplete gamma function. The momentum equation is analyzed, and to derive the mass transpiration analytically, this mass transpiration is used in the heat transfer analysis and to find the analytical results with a Biot number. Physical significance parameters, including volume fraction, skin friction, mass transpiration, and thermal radiation, can be analyzed with the help of graphical representations. We indicate the unique solution at stretching sheet and multiple solution at shrinking sheet. The physical scenario can be understood with the help of different physical parameters, namely a Biot number, magnetic parameter, inverse Darcy number, Prandtl number, and thermal radiation; these physical parameters control the analytical results. Graphene nanoparticles are used to analyze the present study, and the value of the Prandtl number is fixed to 6.2. The graphical representations help to discuss the results of the present work. This problem is used in many industrial applications such as Polymer extrusion, paper production, metal cooling, glass blowing, etc. At the end of this work, we found that the velocity and temperature profile increases with the increasing values of the viscoelastic parameter and solid volume fraction; additionally, efficiency is increased for higher values of thermal radiation.

Effects of channel size, wall wettability, and electric field strength on ion removal from water in nanochannels.

Molecular dynamics simulations are employed to estimate the effect of nanopore size, wall wettability, and the external field strength on successful ion removal from water solutions. It is demonstrated that the presence of ions, along with the additive effect of an external electric field, constitute a multivariate environment that affect fluidic interactions and facilitate, or block, ion drift to the walls. The potential energy is calculated across every channel case investigated, indicating possible ion localization, while electric field lines are presented, to reveal ion routing throughout the channel. The electric field strength is the dominant ion separation factor, while wall wettability strength, which characterizes if the walls are hydrophobic or hydrophilic has not been found to affect ion movement significantly at the scale studied here. Moreover, the diffusion coefficient values along the three dimensions are reported. Diffusion coefficients have shown a decreasing tendency as the external electric field increases, and do not seem to be affected by the degree of wall wettability at the scale investigated here.

Anterior femoral notching ≥ 3 mm is associated with increased risk for supracondylar periprosthetic femoral fracture after total knee arthroplasty: a systematic review and meta-analysis.

PURPOSE: Anterior femoral notching (AFN) may be associated with a higher risk for supracondylar periprosthetic fracture (sPPF) after total knee arthroplasty (TKA), although studies have yielded inconclusive results. We aimed to systematically investigate and meta-analyze the best available evidence regarding the association between AFN and the risk of sPPF after TKA. METHODS: A comprehensive search of PubMed, Scopus, Mendeley, Google Scholar and Cochrane databases was performed, from conception to February 29, 2020. Data were expressed as odds ratio (OR) with 95% confidence intervals (CI). I2-index was employed for heterogeneity. Newcastle-Ottawa scale was implemented for quality assessment of the included studies. RESULTS: Nine studies fulfilled the eligibility criteria, including a total of 3264 patients subjected to TKA. Among them, there were 150 patients who sustained a sPPF. Overall, patients exposed to AFN (AFN group) demonstrated an increased risk for sPPF compared to those not exposed (control group) (OR 3.91, 95% CI 1.22-12.58, p = 0.02; I2 68.52%). Subgroup analysis based on AFN depth with a cut-off value of 3 mm further clarified this association. Patients with AFN ≥ 3mm were at higher risk for sPPF compared to patients with AFN < 3 mm and control group (OR 4.85, 95% CI 2.08-11.33, p = 0.00; I2 0.0%). On the contrary, fracture risk was not significant for patients with AFN < 3 mm compared to the control group (OR 5.0, 95% CI 0.44-56.82, p = 0.19; I2 42.99%). CONCLUSION: Patients, exposed to AFN ≥ 3 mm in depth, are at higher risk for sustaining a sPPF.

Study of Non-Newtonian biomagnetic blood flow in a stenosed bifurcated artery having elastic walls.

Fluid structure interaction (FSI) gained attention of researchers and scientist due to its applications in science fields like biomedical engineering, mechanical engineering etc. One of the major application in FSI is to study elastic wall behavior of stenotic arteries. In this paper we discussed an incompressible Non-Newtonian blood flow analysis in an elastic bifurcated artery. A magnetic field is applied along [Formula: see text] direction. For coupling of the problem an Arbitrary Lagrangian-Eulerian formulation is used by two-way fluid structure interaction. To discretize the problem, we employed [Formula: see text] finite element technique to approximate the velocity, displacement and pressure and then linearized system of equations is solved using Newton iteration method. Analysis is carried out for power law index, Reynolds number and Hartmann number. Hemodynamic effects on elastic walls, stenotic artery and bifurcated region are evaluated by using velocity profile, pressure and loads on the walls. Study shows there is significant increase in wall shear stresses with an increase in Power law index and Hartmann number. While as expected increase in Reynolds number decreases the wall shear stresses. Also load on the upper wall is calculated against Hartmann number for different values of power law index. Results show load increases as the Hartmann number and power law index increases. From hemodynamic point of view, the load on the walls is minimum for shear thinning case but when power law index increased i.e. for shear thickening case load on the walls increased.

Heavy Metal Adsorption Using Magnetic Nanoparticles for Water Purification: A Critical Review.

Research on contamination of groundwater and drinking water is of major importance. Due to the rapid and significant progress in the last decade in nanotechnology and its potential applications to water purification, such as adsorption of heavy metal ion from contaminated water, a wide number of articles have been published. An evaluating frame of the main findings of recent research on heavy metal removal using magnetic nanoparticles, with emphasis on water quality and method applicability, is presented. A large number of articles have been studied with a focus on the synthesis and characterization procedures for bare and modified magnetic nanoparticles as well as on their adsorption capacity and the corresponding desorption process of the methods are presented. The present review analysis shows that the experimental procedures demonstrate high adsorption capacity for pollutants from aquatic solutions. Moreover, reuse of the employed nanoparticles up to five times leads to an efficiency up to 90%. We must mention also that in some rare occasions, nanoparticles have been reused up to 22 times.

Influence of Thermophoretic Particle Deposition on the 3D Flow of Sodium Alginate-Based Casson Nanofluid over a Stretching Sheet.

The wide range of industrial applications of flow across moving or static solid surfaces has aroused the curiosity of researchers. In order to generate a more exact estimate of flow and heat transfer properties, three-dimensional modelling must be addressed. This plays a vital role in metalworking operations, producing plastic and rubber films, and the continuous cooling of fibre. In view of the above scope, an incompressible, laminar three-dimensional flow of a Casson nanoliquid in the occurrence of thermophoretic particle deposition over a non-linearly extending sheet is examined. To convert the collection of partial differential equations into ordinary differential equations, the governing equations are framed with sufficient assumptions, and appropriate similarity transformations are employed. The reduced equations are solved by implementing Runge Kutta Fehlberg 4th 5th order technique with the aid of a shooting scheme. The numerical results are obtained for linear and non-linear cases, and graphs are drawn for various dimensionless constraints. The present study shows that improvement in the Casson parameter values will diminish the axial velocities, but improvement is seen in thermal distribution. The escalation in the thermophoretic parameter will decline the concentration profiles. The rate of mass transfer, surface drag force will reduce with the improved values of the power law index. The non-linear stretching case shows greater impact in all of the profiles compared to the linear stretching case.

Simulation of magnetic nanoparticles crossing through a simplified blood-brain barrier model for Glioblastoma multiforme treatment.

BACKGROUND AND OBJECTIVES: Glioblastoma multiforme is considered as one of the most aggressive types of cancer, while various treatment techniques have been proposed. Magnetic nanoparticles (MNPs) loaded with drug and magnetically controlled and targeted to tissues affected by disease, is considered as a possible treatment. However, MNPs are difficult to penetrate the central nervous system and approach the unhealthy tissue, because of the blood-brain barrier (BBB). This study investigates numerically the delivery of magnetic nanoparticles through the barrier driven by normal pressure drop and external gradient magnetic fields, employing a simplified geometrical model, computational fluid dynamics and discrete element method. The goal of the study is to provide information regarding the permeability of the BBB under various conditions like the imposed forces and the shape of the domain, as a preliminary predictive tool. METHODS: To achieve that, the three-dimensional Navier-Stokes equations are solved in the margin of a blood vessel along with a discrete model for the MNPs with various acting forces. The numerical results are compared with experimental measurements showing that the model can predict acceptably the flow behavior. RESULTS: The effect of nanoparticles' size, external magnetic field and blood flow in the vessel, on the brain-barrier's permeability are investigated. Three different cases of available area among the endothelial cells per the MNPs' size ratio are also examined, showing that the MNPs' size and available area is not the dominant parameter affecting the permeability of the BBB. The results indicate that the applied magnetic field enhances the drug delivery into the central nervous system (CNS). When larger MNPs (∼100 nm) are exposed to an external magnetic field, the permeability can be improved up to 30%, while it is shown that smaller MNPs (∼10 nm) cannot be driven by the applied magnetic field and in this case the permeability remains relatively unchanged. Finally, the blood flow increase leads to a permeability improvement up to 15%. CONCLUSIONS: The applied magnetic field improves up to 45% the permeability of the BBB for MNPs of 100 nm. The geometric characteristics of the endothelial cells, the nanoparticles' size and the blood flow are not so decisive parameters for the drug delivery into the CNS, compared to the external magnetic force.

Aortic Endovascular Stent IIIb Endoleak Combined With Sealed Aneurysm Rupture Mimicking a Paravertebral Retroperitoneal Tumor.

The aim of this paper is to present the unique case of a sealed ruptured abdominal aortic aneurysm (AAA) with simultaneous type IIIb endoleak of an endovascular stent, mimicking a paravertebral retroperitoneal tumor. A 75-year-old male was referred to the tumor service of our tertiary orthopaedic department suffering from intractable low back pain with an onset of six months. He had undergone repair of an infrarenal AAA with an endovascular stent 5 years ago. Imaging studies depicted a large retroperitoneal mass adjacent to L2 and L3 vertebrae. The stent's metal cage had no signs of wear or migration. The pathology report of a CT-guided core-needle biopsy he had undergone before his referral raised suspicion about possible AAA rupture. CT-angiography confirmed the existence of a ruptured AAA, accompanied by retroperitoneal blood loss and a (possibly) failed stent. The IIIb eroded stent was openly removed and a Y-type allograft was used to repair the defect. The patient reported immediate relief and was uneventfully discharged. He demised 4 years later due to reasons unrelated to the hereby reported condition. Increased awareness is warranted when dealing with anterior lumbar spine or retroperitoneal lesions. A close cooperation between a vascular and an orthopaedic/spine surgeon must always be sought.

Analysis of magnetohydrodynamic channel flow through complex network analysis.

Velocity time series of hydrodynamic and magnetohydrodynamic (MHD) turbulent flow are analyzed by means of complex network analysis in order to understand the mechanism of fluid patterns modification due to the external magnetic field. Direct numerical simulations of two cases are used, one for the plane hydrodynamic turbulent channel flow at the low Reynolds number of 180, based on the friction velocity, and the corresponding MHD flow with an external streamwise magnetic field with a magnetic interaction number of 0.1. By applying the visibility graph algorithm, we first transformed the time series into networks and then we evaluated the network topological properties. Results show that the proposed network analysis is not only able to identify and detect dynamical transitions in the system's behavior that identifies three distinct fluid areas in accordance with turbulent flow theory but also can quantify the effect of the magnetic field on the time series transitions. Moreover, we find that the topological measures of networks without a magnetic field and as compared to the one with a magnetic field are statistically different within a 95% confidence interval. These results provide a way to discriminate and characterize the influence of the magnetic field on the turbulent flows.

Outcomes of Arthroscopic Nerve Release in Patients Treated for Large or Massive Rotator Cuff Tears and Associated Suprascapular Neuropathy: A Prospective, Randomized, Double-Blinded Clinical Trial.

BACKGROUND: Suprascapular neuropathy has been observed in the setting of rotator cuff tears (RCTs), but its association with these tears and their treatment are unclear. HYPOTHESIS: Arthroscopic suprascapular nerve release during rotator cuff repair will not alter the outcomes of neuropathy. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: A total of 42 patients with large/massive reparable RCTs and suprascapular neuropathy were recruited and followed up at 6 and 12 months. Electrophysiological results as well as Disabilities of the Arm, Shoulder and Hand (DASH), American Shoulder and Elbow Surgeons (ASES), and Constant scores were evaluated at selected time periods. Patients were randomly assigned to 2 groups. Patients in the control group underwent arthroscopic repair of the rotator cuff without combined arthroscopic release of the superior transverse scapular ligament; in the second group, the superior transverse ligament was released. The primary outcome was to examine full suprascapular nerve recovery through electrophysiological changes between groups. The secondary/tertiary outcomes were analysis of clinical outcomes and assessment of the relation between RCT size and the degree of suprascapular nerve recovery. Patients, clinical staff members, and the neurologist were blinded to the type of surgical procedure. RESULTS: Of 42 patients, 37 completed the follow-up at 12 months (median age, 64 years [range, 50-75 years]). Overall, 17 of 19 (89.5%) patients in the control group and 15 of 18 (83.3%) patients in the nerve release group had full nerve recovery, with no significant difference between the 2 groups. Clinically, all patients in both groups showed a significant improvement (P < .001), but no significant difference was observed between the 2 groups in terms of 12-month postoperative scores (control group: DASH: median, 5 [range, 0-21]; ASES: median, 88 [range, 83-98]; Constant: median, 86 [range, 70-98]) (nerve release group: DASH: median, 6 [range, 0-25]; ASES: median, 90 [range, 83-98]; Constant: median, 88 [range, 75-98]). Also, no significant difference was found between the 2 groups regarding other secondary and tertiary outcomes. CONCLUSION: Combined arthroscopic release of the superior transverse scapular ligament and rotator cuff repair in patients with large/massive RCTs and suprascapular neuropathy did not produce statistically significant improved outcomes compared with repair of the rotator cuff alone. REGISTRATION: NCT02318381 (ClinicalTrials.gov identifier).

Large eddy simulation of dispersion of hazardous materials released from a fire accident around a cubical building.

The turbulent smoke dispersion from a pool fire around a cubical building is studied using large eddy simulation at a high Reynolds number, corresponding to existing experimental measurements both in laboratory and field test scales. Emphasis of this work is on the smoke dispersion due to two different fuel pool fire accident scenarios, initiated behind the building. For the setup of fire in the first case, crude oil was used with a heat release rate of 7.8 MW, and in the second, diesel oil with a heat release rate of 13.5 MW. It is found that in both fire scenarios, the downstream extent of the toxic zone is approximately the same. This is explained in terms of the fact that the smoke concentration and dispersion are influenced mainly by the convective buoyant forces and the strong turbulence mixing processes within the wake zone of the building. It is suggested that wind is the dominating factor in these accident scenarios, which represent the conditions resulting in the highest toxicity levels.

Evaluation of Femoral Bone Fracture Healing in Rats by the Modal Damping Factor and Its Correlation With Peripheral Quantitative Computed Tomography.

Introduction Monitoring the progress of fracture healing is essential in order to establish the appropriate timing that ensures adequate bone strength for weight-bearing. In the present experimental study on a rat model of femoral fracture healing, the measurement of bone density and strength by peripheral quantitative computerized tomography (pQCT) was correlated with the modal damping factor (MDF) method. Methods Four groups of 12 male six-month-old Wistar rats each were anesthetized and submitted to baseline femoral pQCT and MDF scanning, followed by aseptic midshaft osteotomy of the right femur which was fixed by a locking intramedullary nail technique. The animals were left to recover and re-scanned following euthanasia of each group after six, eight, 10, and 12 weeks, respectively. The parameters measured by the pQCT method were total bone mineral density (BMD) and polar strength strain index (SSIp). Results Fracture healing progressed over time and at 12 weeks post-osteotomy there was no statistically significant difference between the osteotomized right and the control left femurs regarding MDF, BMD, and SSIp measurements. The highest correlations for the osteotomized femurs were observed between MDF and BMD (r = -0.647, P = 0.043), and between MDF and SSIp (r = -0.350, P = 0.321), at 10 weeks postoperatively. The high to moderate correlations between MDF and BMD, and between MDF and SSIp respectively, support the validity of MDF in assessing fracture healing. Conclusions Based on our findings in this fracture healing animal model, the results from the MDF method are reliable and correlate highly with the total BMD and moderately with the SSI polar values obtained by the pQCT method of bone quality measurement. Further studies are needed which may additionally support that the MDF method can be an attractive portable alternative to monitor fracture healing in the community.