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  • SAGE Publications  (10)
  • 1
    Online Resource
    Online Resource
    Mesenchymal Stem Cell Implantation in Osteoarthritic Knees : Is Fibrin Glue Effective as a Scaffold?
    SAGE Publications ; 2015
    In:  The American Journal of Sports Medicine Vol. 43, No. 1 ( 2015-01), p. 176-185
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 43, No. 1 ( 2015-01), p. 176-185
    Abstract: The cell-based tissue engineering approach that uses mesenchymal stem cells (MSCs) has addressed the issue of articular cartilage repair in osteoarthritic (OA) knees. However, to improve outcomes, an advanced surgical procedure with tissue-engineered scaffolds may be needed to treat patients with large cartilage lesions. Purpose: To investigate the clinical and second-look arthroscopic outcomes of the implantation of MSCs loaded in fibrin glue as a scaffold in patients with OA knees and to compare these outcomes with those of MSC implantation without a scaffold. Study Design: Cohort study; Level of evidence, 3. Methods: This study retrospectively evaluated 54 patients (56 knees) who were examined with second-look arthroscopy after MSC implantation for cartilage lesions in their OA knees. Patients were divided into 2 groups: 37 patients (39 knees) were treated with MSC implantation without a scaffold (group 1), and 17 patients (17 knees) underwent implantation of MSCs loaded in fibrin glue as a scaffold (group 2). Clinical outcomes were evaluated according to the International Knee Documentation Committee (IKDC) score and the Tegner activity scale, and cartilage repair was assessed with the International Cartilage Repair Society (ICRS) grade. Statistical analyses were performed to identify various prognostic factors associated with the clinical and second-look arthroscopic outcomes. Results: At final follow-up (mean, 28.6 months; range, 24-34 months), the mean IKDC score and Tegner activity scale in each group significantly improved: group 1, from 38.1 ± 7.7 to 62.0 ± 11.7 (IKDC) and from 2.5 ± 0.9 to 3.5 ± 0.8 (Tegner); group 2, from 36.1 ± 6.2 to 64.4 ± 11.5 (IKDC) and from 2.2 ± 0.8 to 3.8 ± 0.8 (Tegner) ( P 〈 .001 for all). According to the overall ICRS cartilage repair grades, 9 of the 39 lesions (23%) in group 1 and 12 of the 17 lesions (58%) in group 2 achieved a grade of I or II. There was a significant difference in ICRS grades between the groups ( P = .028). Overweight (body mass index ≥ 27.5 kg/m 2 ) and large lesion size (≥5.7 cm 2 ) were significant predictors of poor clinical and arthroscopic outcomes in group 1 ( P 〈 .05 for both). There was a similar trend in group 2, but the differences were not significant, possibly owing to the smaller sample size. Conclusion: Clinical and arthroscopic outcomes of MSC implantation were encouraging for OA knees in both groups, although there were no significant differences in outcome scores between groups. However, at second-look arthroscopy, there were better ICRS grades in group 2.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546514554190
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
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    SSG: 31
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  • 2
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    Simple microwire and microcatheter mechanical thrombolysis with adjuvant intraarterial urokinase for treatment of hyperacute ischemic stroke patients
    SAGE Publications ; 2008
    In:  Acta Radiologica Vol. 49, No. 3 ( 2008-04), p. 351-357
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 49, No. 3 ( 2008-04), p. 351-357
    Abstract: Background: Mechanical thrombolysis may effectively enhance the efficacy of thrombolysis for hyperacute ischemic stroke patients. Purpose: To assess the feasibility and results of simple mechanical-based thrombolysis using microwire and microcatheter with adjuvant low-dose intraarterial (i.a.) urokinase (UK) for the treatment of hyperacute ischemic stroke. Material and Methods: Nineteen consecutive patients with hyperacute proximal middle cerebral artery (MCA) occlusions treated by a standardized protocol using microwire and microcatheter for mechanical thrombus disruption with adjuvant i.a. UK were reviewed. Simple to-and-fro passages through the clot with the microwire and microcatheter followed by disruptions by a J- or pigtail-shaped wire tip with alternating small-dose injections of UK distal, within, and proximal to the clot were performed. The recanalization rates, post-thrombolysis hemorrhage, and clinical outcome (baseline and discharge National Institute of Health Stroke Scale [NIHSS], mortality, 3-month modified Rankin scale [mRS] ) were evaluated. Results: Recanalization was achieved in 18 of 19 patients (94.7%). The mean UK dose was 375,789 IU (range 130,000–580,000 IU). Two patients (10.5%) developed symptomatic hemorrhage. One of the hemorrhages included a patient who developed subarachnoid hemorrhage. Mortality rate was 15.8% ( n = 3). The median baseline NIHSS scores showed improvement from 17 to 10 at presentation and discharge, respectively. At three months, good outcome was noted in 11 of 19 patients (57.9%, mRS 0–2). Conclusion: Simple mechanical-based thrombolysis using microwire and microcatheter with adjuvant low-dose i.a. UK is safe and effective in achieving recanalization with good long-term outcome.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1080/02841850701819143
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2008
    detail.hit.zdb_id: 105-3
    detail.hit.zdb_id: 2024579-8
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  • 3
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    Comparative Matched-Pair Analysis of the Injection Versus Implantation of Mesenchymal Stem Cells for Knee Osteoarthritis
    SAGE Publications ; 2015
    In:  The American Journal of Sports Medicine Vol. 43, No. 11 ( 2015-11), p. 2738-2746
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 43, No. 11 ( 2015-11), p. 2738-2746
    Abstract: The mesenchymal stem cell (MSC)–based tissue engineering approach has been developed to address the problem of articular cartilage repair in knee osteoarthritis (OA). However, the most effective method of MSC application has not yet been established. Purpose: To compare the injection and implantation of MSCs in patients with knee OA in terms of clinical and second-look arthroscopic outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: Among 182 patients treated with arthroscopic surgery using MSCs for knee OA from October 2010 to August 2012, patients treated with an injection of MSCs in combination with platelet-rich plasma (injection group; n = 20) were pair-matched with patients who underwent MSC implantation on a fibrin glue scaffold (implantation group; n = 20) based on sex, age, and lesion size. Clinical outcomes were evaluated using the International Knee Documentation Committee (IKDC) score and Tegner activity scale, and cartilage repair was assessed arthroscopically with the International Cartilage Repair Society (ICRS) grading system. Results: The mean (±SD) IKDC and Tegner activity scores significantly improved from 38.5 ± 9.2 to 55.2 ± 15.0 and from 2.5 ± 1.2 to 3.5 ± 1.2, respectively, in the injection group and from 36.6 ± 4.9 to 62.7 ± 14.1 and from 2.3 ± 0.9 to 3.6 ± 1.1, respectively, in the implantation group at the time of second-look arthroscopic surgery (mean, 12.6 months postoperatively) ( P 〈 .001 in all cases). At final follow-up (mean, 28.6 months postoperatively), the mean IKDC and Tegner activity scores in the implantation group had improved further to 64.8 ± 13.4 and 3.9 ± 1.0, respectively ( P 〈 .001 and P = .035, respectively), while no significant improvements were found in the injection group ( P = .130 and P = .655, respectively). At final follow-up, there was a significant difference in the mean IKDC score between groups ( P = .049). Significant correlations between the number of administered MSCs and the postoperative clinical outcomes were found only in the injection group. Significant correlations between the clinical outcomes and the ICRS grades were found in both groups. The ICRS grades were significantly better in the implantation group ( P = .041). In the injection group, 2 of the 20 lesions (10%) were grade I (normal), 5 (25%) were grade II (near normal), 8 (40%) were grade III (abnormal), and 5 (25%) were grade IV (severely abnormal). In the implantation group, 6 of the 20 lesions (30%) were grade I, 7 (35%) were grade II, 4 (20%) were grade III, and 3 (15%) were grade IV. Conclusion: Utilizing the described method, MSC implantation for knee OA resulted in better clinical and second-look arthroscopic outcomes than an MSC injection.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546515599632
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
    detail.hit.zdb_id: 197482-8
    detail.hit.zdb_id: 2063945-4
    SSG: 31
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  • 4
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    Predictive Factors for Lateral Hinge Fracture in Medial Closing Wedge Distal Femoral Osteotomy
    SAGE Publications ; 2022
    In:  The American Journal of Sports Medicine Vol. 50, No. 14 ( 2022-12), p. 3819-3826
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 50, No. 14 ( 2022-12), p. 3819-3826
    Abstract: Recent studies have reported that lateral hinge fracture (LHF) has a negative effect on bone healing at the osteotomy site after medial closing wedge distal femoral osteotomy (MCDFO). However, limited evidence exists in the literature regarding the predictive factors for LHF in MCDFO. Hypothesis: A large medial closing gap and a lateral hinge position in the supracondylar area would increase plain radiography–based and/or computed tomography (CT)–based LHF in MCDFO. Study Design: Case control study; Level of evidence, 3. Methods: We retrospectively evaluated 67 knees of 53 patients (mean age, 37.4 ± 16.9 years) who underwent MCDFO between May 2009 and June 2021. The surgical indications for MCDFO were genu valgum deformity combined with either lateral compartment osteoarthritis or recurrent patellar dislocation. The presence of LHF was evaluated based on immediate postoperative plain radiography and CT scans. The predictive factors for LHF in MCDFO were investigated using multivariate logistic regression analysis. Results: LHFs were identified in 21 knees (31.3%) through plain radiography and in 40 knees (59.7%) through CT. Multivariate logistic regression analysis showed that the medial closing gap and lateral hinge position were predictive factors for plain radiography– and CT-based LHF after MCDFO. Controlling for other variables, we found that an increase in the medial opening gap by 1 mm increased the likelihood of plain radiography–based LHF by a factor of 1.805 (95% CI, 1.291-2.525; P = .001) and CT-based LHF by 1.333 (95% CI, 1.003-1.772; P = .048). Moreover, a lateral hinge position in the supracondylar area increased the likelihood of plain radiography–based LHF by a factor of 9.870 (95% CI, 2.179-44.720; P = .003) and CT-based LHF by 5.686 (95% CI, 1.124-28.754; P = .036). Conclusion: A large medial closing gap and lateral hinge position in the supracondylar area are associated with LHF in MCDFO. Care should be taken to prevent LHF in MCDFO with a large medial closing gap. Moreover, a lateral hinge position in the supracondylar area should be avoided to decrease the incidence of LHF in MCDFO.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/03635465221131527
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 197482-8
    detail.hit.zdb_id: 2063945-4
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  • 5
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    Remnant preservation with tensioning can improve the clinical outcome after anterior cruciate ligament reconstruction
    SAGE Publications ; 2022
    In:  Journal of Orthopaedic Surgery Vol. 30, No. 1 ( 2022-01), p. 230949902110733-
    Details
    In: Journal of Orthopaedic Surgery, SAGE Publications, Vol. 30, No. 1 ( 2022-01), p. 230949902110733-
    Abstract: Many studies exist about remnant preservation in anterior cruciate ligament (ACL) reconstruction. However, concern remains for development of a cyclops lesion during remnant preservation. To prevent this, a tensioning method has been suggested. Current study evaluated the clinical and radiologic results of remnant preservation in ACL reconstruction with tensioning compared to classical ACL reconstruction. Methods From January 2016 to June 2017, ACL reconstruction patients who underwent magnetic resonance imaging (MRI) 2 years postoperatively were enrolled. For comparison, all participants were divided in two groups: remnant preservation with tensioning (group R) and controls (group C). Clinically, Hospital for Special Surgery (HSS), International Knee Documentation Committee (IKDC), Lysholm scores, and incidence of symptomatic cyclops lesions were evaluated. Radiologically, signal-to-noise quotient (SNQ) and size of the synovium on MRI as well as anterior instability in Telos stress radiographs were evaluated. Results A total of 64 patients were enrolled (42 in group R and 22 in group C). The IKDC score in group R (70) was better than that in group C (62; p 〈 0.05). One patient in group R had a cyclops lesion with clinical symptoms and arthroscopic excision was recommended. Radiologically, the SNQ, synovium area, and anterior instability on Telos radiography showed no difference between the two groups. Conclusion Remnant preservation with tensioning is a good option for ACL reconstruction without the development of a cyclops lesion.
    Type of Medium: Online Resource
    ISSN: 1022-5536 , 2309-4990
    URL: Article
    DOI: 10.1177/23094990211073378
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
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    detail.hit.zdb_id: 1493368-8
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  • 6
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    Atelocollagen Enhances the Healing of Rotator Cuff Tendon in Rabbit Model
    SAGE Publications ; 2017
    In:  The American Journal of Sports Medicine Vol. 45, No. 9 ( 2017-07), p. 2019-2027
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 45, No. 9 ( 2017-07), p. 2019-2027
    Abstract: Failure of rotator cuff healing is a common complication despite the rapid development of surgical repair techniques for the torn rotator cuff. Purpose: To verify the effect of atelocollagen on tendon-to-bone healing in the rabbit supraspinatus tendon compared with conventional cuff repair. Study Design: Controlled laboratory study. Methods: A tear of the supraspinatus tendon was created and repaired in 46 New Zealand White rabbits. They were then randomly allocated into 2 groups (23 rabbits per group; 15 for histological and 8 for biomechanical test). In the experimental group, patch-type atelocollagen was implanted between bone and tendon during repair; in the control group, the torn tendon was repaired without atelocollagen. Each opposite shoulder served as a sham (tendon was exposed only). Histological evaluation was performed at 4, 8, and 12 weeks. Biomechanical tensile strength was tested 12 weeks after surgery. Results: Histological evaluation scores of the experimental group (4.0 ± 1.0) were significantly superior to those of the control group (7.7 ± 2.7) at 12 weeks ( P = .005). The load to failure was significantly higher in the experimental group (51.4 ± 3.9 N) than in the control group (36.4 ± 5.9 N) ( P = .001). Conclusion: Histological and biomechanical studies demonstrated better results in the experimental group using atelocollagen in a rabbit model of the supraspinatus tendon tear. Clinical Relevance: Atelocollagen patch could be used in the cuff repair site to enhance healing.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546517703336
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
    detail.hit.zdb_id: 197482-8
    detail.hit.zdb_id: 2063945-4
    SSG: 31
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  • 7
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    Mesenchymal Stem Cell Implantation in Knee Osteoarthritis: Midterm Outcomes and Survival Analysis in 467 Patients
    SAGE Publications ; 2020
    In:  Orthopaedic Journal of Sports Medicine Vol. 8, No. 12 ( 2020-12-01), p. 232596712096918-
    Details
    In: Orthopaedic Journal of Sports Medicine, SAGE Publications, Vol. 8, No. 12 ( 2020-12-01), p. 232596712096918-
    Abstract: A cell-based tissue engineering approach that uses mesenchymal stem cells (MSCs) has addressed the issue of articular cartilage repair in knees with osteoarthritis (OA). Purpose: To evaluate the midterm outcomes, analyze the survival rates, and identify the factors affecting the survival rate of MSC implantation to treat knee OA. Study Design: Case series; Level of evidence, 4. Methods: We retrospectively evaluated 467 patients (483 knees) who underwent MSC implantation on a fibrin glue scaffold for knee OA with a minimum 5-year follow-up. Clinical outcomes were determined based on the International Knee Documentation Committee (IKDC) and Tegner activity scale results measured preoperatively and during follow-up. Standard radiographs were evaluated using Kellgren-Lawrence grading. Statistical analyses were performed to determine the survival rate and the effect of different factors on the clinical outcomes. Results: The mean IKDC scores (baseline, 39.2 ± 7.2; 1 year, 66.6 ± 9.6; 3 years, 67.2 ± 9.9; 5 years, 66.1 ± 9.7; 9 years, 62.8 ± 8.5) and Tegner scores (baseline, 2.3 ± 1.0; 1 year, 3.4 ± 0.9; 3 years, 3.5 ± 0.9; 5 years, 3.4 ± 0.9; 9 years, 3.2 ± 0.9) were significantly improved until 3 years postoperatively and gradually decreased from 3- to 9-year follow-up ( P 〈 .05 for all, except for Tegner score at 5 years vs 1 year [ P = .237]). Gradual deterioration of radiological outcomes according to the Kellgren-Lawrence grade was found during follow-up. Survival rates based on either a decrease in IKDC or an advancement of radiographic OA with Kellgren-Lawrence scores were 99.8%, 94.5%, and 74.5% at 5, 7, and 9 years, respectively. Based on multivariate analyses, older age and the presence of bipolar kissing lesion were associated with significantly worse outcomes ( P = .002 and .013, respectively), and a larger number of MSCs was associated with significantly better outcomes ( P 〈 .001) after MSC implantation. Conclusion: MSC implantation provided encouraging outcomes with acceptable duration of symptom relief at midterm follow-up in patients with early knee OA. Patient age, presence of bipolar kissing lesion, and number of MSCs were independent factors associated with failure of MSC implantation.
    Type of Medium: Online Resource
    ISSN: 2325-9671 , 2325-9671
    URL: Article
    DOI: 10.1177/2325967120969189
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2706251-X
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  • 8
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    Risk factors for adjacent segment degeneration after iliac screw fixation in lumbar degenerative kyphoscoliosis
    SAGE Publications ; 2017
    In:  Journal of Orthopaedic Surgery Vol. 25, No. 1 ( 2017-01-01), p. 230949901668472-
    Details
    In: Journal of Orthopaedic Surgery, SAGE Publications, Vol. 25, No. 1 ( 2017-01-01), p. 230949901668472-
    Abstract: To analyze pre- and postoperative spinopelvic parameters and sagittal profiles in lumbar degenerative kyphoscoliosis (LDK) patients who underwent surgery using iliac screw (IS) and the incidence and risk factor of radiological adjacent segment degeneration (ASD). Methods: A total of 32 patients, who had undergone surgical correction and lumbar/thoracolumbar fusion with pedicle screws and IS instrumentation for LDK with a minimum 2-year follow-up, were included. Ten cases with ASD (group 1) and 22 cases without ASD (group 2) were compared to see pre- and postoperative change in sagittal view of spine and adjacent segment. Parameters of both groups were analyzed before and after surgery with each parameters being tested on correlativity. All deformity types of patients were classified using Scoliosis Research Society (SRS)-Schwab classification. Risk factors of ASD were evaluated using variables of SRS-Schwab classification. Results: Group 1, rather than group 2, showed significant increment in pelvic incidence (PI). Curve types, classified using SRS-Schwab classification, were all corrected using IS; and after correction, coronal curve type was N curve and PI minus lumbar lordosis (LL) and pelvic tilt showed tendency to decrease. Cases with preoperative sagittal vertical axis (SVA) more than 10 cm and with postoperative PI minus LL more than 20° were at higher risk of developing ASD. Conclusion: For those with high PI, it might be a risk to cause ASD. Maintaining normal thoracic and lumbar angle, correction of SVA less than 4 cm, and PI minus LL below 20° are proper ways to avoid ASD after surgery.
    Type of Medium: Online Resource
    ISSN: 2309-4990 , 2309-4990
    URL: Article
    DOI: 10.1177/2309499016684727
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
    detail.hit.zdb_id: 2128854-9
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  • 9
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    Influence of initial microstructures on intercritical annealing behaviour in a medium Mn steel
    SAGE Publications ; 2019
    In:  Materials Science and Technology Vol. 35, No. 17 ( 2019-11), p. 2092-2100
    Details
    In: Materials Science and Technology, SAGE Publications, Vol. 35, No. 17 ( 2019-11), p. 2092-2100
    Abstract: The present work reports the effect of different initial microstructures on reverse transformation kinetics and morphologies of austenite formed during intercritical annealing in Fe-0.14C-7Mn-1Si (wt-%) medium Mn steel. Three different initial microstructures were produced by cold-rolling and cold-rolling followed by austenitisation at 820°C and 900°C. The specimen austenitised at higher temperature shows lath-type austenite after intercritical annealing. The difference in austenitisation temperature leads to different Mn distribution in martensitic initial microstructures, thereby leading to a difference in morphology of austenite. The inhomogeneous Mn profiles in initial microstructures also affect reverse transformation kinetics of austenite upon intercritical annealing. The presence of Mn-enriched regions accelerates austenite growth at an early stage of intercritical annealing but retards the transformation kinetics afterwards. This paper is part of a Thematic Issue on Medium Manganese Steels.
    Type of Medium: Online Resource
    ISSN: 0267-0836 , 1743-2847
    URL: Article
    DOI: 10.1080/02670836.2018.1475445
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 226723-8
    detail.hit.zdb_id: 2037367-3
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  • 10
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    Factors Influencing Clinical and MRI Outcomes of Mesenchymal Stem Cell Implantation With Concomitant High Tibial Osteotomy for Varus Knee Osteoarthritis
    SAGE Publications ; 2021
    In:  Orthopaedic Journal of Sports Medicine Vol. 9, No. 2 ( 2021-02-01), p. 232596712097998-
    Details
    In: Orthopaedic Journal of Sports Medicine, SAGE Publications, Vol. 9, No. 2 ( 2021-02-01), p. 232596712097998-
    Abstract: Cartilage repair procedures using mesenchymal stem cells (MSCs) can provide superior cartilage regeneration in the medial compartment of the knee joint when high tibial osteotomy (HTO) is performed for varus knee osteoarthritis (OA). However, few studies have reported the factors influencing the outcomes of MSC implantation with concomitant HTO. Purpose: To investigate the outcomes of MSC implantation with concomitant HTO and to identify the prognostic factors that are associated with the outcomes. Study Design: Case series; Level of evidence, 4. Methods: A total of 71 patients (75 knees) were retrospectively evaluated after MSC implantation with concomitant HTO. Clinical and radiological outcomes were evaluated, and magnetic resonance imaging (MRI) was used to assess cartilage regeneration. Statistical analyses were performed to determine the effect of different factors on clinical, radiographic, and MRI outcomes. Results: Clinical and radiographic outcomes improved significantly from preoperatively to final follow-up ( P 〈 .001 for all), and overall cartilage regeneration was encouraging. Significant correlations were found between clinical and MRI outcomes. However, radiographic outcomes were not significantly correlated with clinical or MRI outcomes. Patient age and number of MSCs showed significant correlations with clinical and MRI outcomes. On multivariate analyses, patient age and number of MSCs showed high prognostic significance with poor clinical outcomes. Conclusion: MSC implantation with concomitant HTO provided feasible cartilage regeneration and satisfactory clinical outcomes for patients with varus knee OA. Patient age and number of MSCs were important factors that influenced the clinical and MRI outcomes of MSC implantation with concomitant HTO for varus knee OA.
    Type of Medium: Online Resource
    ISSN: 2325-9671 , 2325-9671
    URL: Article
    DOI: 10.1177/2325967120979987
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2706251-X
    SSG: 31
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