Introduction: This study investigates the impact of liquid nitrogen administration on histology and chondrocyte count in experimental animal cartilage, highlighting the limited benefits of cryosurgery on cartilage, a common treatment in orthopedics and skeletal muscle injuries. Methods: The research design in this study was a random sampling experimental test on white male rats (Rattus norvegicus). Experimental animals that met the inclusion criteria were randomly divided into four groups: the control group and three groups that received different durations of liquid nitrogen administration (one, five, and ten minutes). Furthermore, an evaluation of the histology and the number of chondrocytes of the experimental animals was carried out and analyzed by statistical tests using SPSS 26.0. Results: The One-way ANOVA analysis showed a significant difference in chondrocytes in the liquid nitrogen group compared to the control group. Furthermore, the results of the Tukey test showed that giving liquid nitrogen for 5 minutes and 10 minutes significantly reduced the number of chondrocytes in experimental animals. There was a negative correlation between liquid nitrogen administration and chondrocytes duration. Discussion: Mechanical destruction of cells, including chondrocytes, occurs because the extreme temperature differences of liquid nitrogen can freeze the cells, becoming an ice crystal that can impair the physical structure of cells and membranes. Conclusion: Liquid nitrogen administration significantly impacts chondrocyte levels in Rattus norvegicus strain cartilage, with duration negatively correlated with chondrocyte levels, suggesting a decrease with longer administration. Keywords: cryosurgery, chondrocytes, neoplasm
This study aimed to compare the return to sports, return to competition, Tegner score and anterior cruciate ligament-return to sports injury (ACL-RSI) scores between patients who underwent ACL reconstruction (ACLR) combined with anterolateral ligament reconstruction (ALLR) and those who underwent ACLR alone. Two independent reviewers conducted a literature search in PubMed (MEDLINE), EMBASE, Google Scholar and the Cochrane Library in July 2024, followed by data extraction and quality assessment. This study followed the Preferred Reporting Items for Systematic Reviews and meta-analysis guidelines. The return to sports rate, return to competition rate, Tegner score and ACL-RSI score were compared between patients who underwent primary ACLR with ALLR and those who underwent isolated primary or revision ACLR. The methodological quality of the included studies was assessed via the Cochrane risk-of-bias tool and methodological items for nonrandomized studies. In total, 12,139 studies were screened, and 14 (four randomized controlled trials and 10 nonrandomized studies) studies were ultimately evaluated. Compared with isolated ACLR, ACLR combined with ALLR resulted in a higher rate of return to sports and competition. Nevertheless, no significant differences were found in the Tegner score or ACL-RSI score between the two groups. Patients who underwent ACLR in combination with ALLR had higher rates of return to sports and competition, but their Tegner activity and ACL-RSI scores were similar to those of patients who underwent ACLR alone. This finding may assist surgeons in making decisions when treating patients undergoing ACLR, especially athletes. Level III.
This was underlying data as part of the article "Suspension of Zinc Oxide Nanoparticles (ZnO-NP) as an Intraoperative Wound Irrigation to Prevent Infection After Fracture Fixation"
Background: The Knee injury and Osteoarthritis Outcome Score (KOOS) is a useful diagnostic tool to assess knee ligament injury and osteoarthritis, but no validated Indonesian version of the KOOS was available. Methods: We used the forward-backward translation protocol to develop the Indonesian version of the KOOS. The translated questionnaire was administered twice to 51 subjects diagnosed with a knee ligament injury and osteoarthritis. Validity of the questionnaire was assessed by analyzing the correlation between the score of each subscale and the overall score of the 36-Item Short Form Health Survey (SF-36) using the Pearson correlation coefficient. Reliability was measured by evaluating internal consistency (Cronbach α) and test-retest reliability (intraclass correlation coefficient). Results: For construct validity, moderate Pearson correlation coefficients were found between the KOOS subscales and the SF-36. Cronbach α was 0.84 to 0.97 for all subscales, indicating adequate internal consistency. The test-retest reliability was excellent, with intraclass correlation coefficients ranging from 0.91 to 0.99 for all subscales. No significant differences were found in the KOOS subscale responses between the first administration of the questionnaire and the second administration within 21 days. Conclusion: The Indonesian version of the KOOS was determined to be valid and reliable and is therefore an objective instrument for evaluating knee ligament injury and knee osteoarthritis in the Indonesian population.
Intraarticular Calcaneal fracture treatment nowadays is still up for debate. Surgical plating treatment is favorable because of the rapid healing process and better anatomical reduction despite the invasive intervention. Hence, clinical evaluation is needed to assess the quality-of-life index from foot and ankle by the American orthopaedics Foot and Ankle Society (AOFAS) score postoperatively. Then, the outcome evaluation of reduction in calcaneal plating of intraarticular calcaneal fracture with Böhler angle and Gissane angle to see if the calcaneal plating technique is a recommended treatment for the calcaneal fracture.We treated six patients from December 2020-July 2021 with a calcaneal fracture that underwent surgical plating, mainly by one surgeon. A calcaneal fracture is classified according to sanders classification. In this study, four patients are above the age of 40, and two are under 25. Pre-operative Böhler angle ranged from 8 to 65°, and Gissane angle ranged from 134 to 158°.Surgical plating was performed on all six patients. From clinical evaluation using the AOFAS score, we got satisfactory results on all patients who underwent calcaneal plating surgery. Three patients achieved excellent range outcomes with 95% and 99% of AOFAS Scores, and three patients reported AOFAS score good range outcomes with the lowest score of 88%. From the radiological outcome, most of the patient's Böhler and Gissane angles achieved normal value after surgical plating.The calcaneal plating technique gives better anatomical reduction depending on Bohler and Gissane angle. These results promise that anatomical reduction can improve clinical outcomes based on the AOFAS score. Thus, the plating method can be used effectively to treat an intraarticular calcaneal fracture.
Utilization of stem cells in orthopedics has increased dramatically. Consequently, stem cells were discovered to have many roles. Some researchers have used them for regenerative medicine, while some have discovered them as a natural source of immune modulators. Currently, there are several research teams studying the translational potential of stem cells, while clinicians have begun treating patients with orthopedic problems (1).Over the past fifteen years, orthopedic surgeons have prioritized Mesenchymal Stem Cell (MCSs) treatment. Several animal experiments have had favorable results, and there is rising concern over their use in human trials. In these clinical studies, stem cell operations were intended to promote fracture healing and cure nonunion, regenerate articular cartilage in degenerated joints, repair ligament or tendon injuries, and replace degenerative spinal disks (1,2).In past research, stem cells have been used for bone tissue regeneration. Bone tissue engineering presents an alternative treatment that may produce a micromilieu with osteogenic, osteoinductive, and osteoconductive properties. In recent studies, researchers have devised methods for combining MSCs with three-dimensional biodegradable polymeric scaffolds. In addition, Udehiya et al. found that the use of hydroxyapatite scaffolds in conjunction with Bone Marrow-MSCs (BM-MSC) accelerates and enhances the healing of bone segmental defects in a rabbit model compared to the use of hydroxyapatite scaffolds alone. Muwan Chen and colleagues discovered that human BM-MSC combined with hyaluronic acid and b-Tri calcium phosphate-coated polymeric scaffold stimulated osteogenic differentiation, cellular proliferation, and reorganization of the cellular matrix in vitro (1–3).Since 2010, stem cells have undergone a paradigm shift where previously stem cells can differentiate and heal injured organs. This stem cell misunderstanding has led some practitioners in the United States and around the world to advertise the availability of stem cell treatments, e.g., MSC can heal blindness, make paralyzed people walk, and makes old tissue young again. In further studies, it was found that at the site of disease, MSCs rarely or never differentiated into tissue at that location, but they do secrete bioactive factors such as growth factors and their therapeutic effects can be analyzed as a site-specific clinical outcome parameter (2–4).
At the end of 2019, we faced a new variant of the coronavirus that can cause pneumonia and acute respiratory distress syndrome-like symptoms. It started in Wuhan, Hubei Province, China, and spread quickly to the whole world.This new virus is called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and can manifest as a disease called coronavirus disease 2019 (COVID-19). On March 13th, 2020 World Health Organization (WHO) declared COVID-19 as a global pandemic, and the story of frightening pandemic begin.
BACKGROUND: Many countries report decreasing on the number of hospital visit even on the emergency cases.
AIM: This study aims to reveal the important data on how big the impact of coronavirus-19 pandemic on orthopedic services in two Government’s tertiary-referral hospitals.
METHODS: This research is a comparison study to measure the trend of orthopedic services, the monthly orthopedic surgical load and outpatient visit were examined during the period of March to May 2020 (the early pandemic period) then compared to the same period in the 2019.
RESULTS: The lowest number of outpatient visits occurred during May 2020 with 715 total number of outpatient visit. The lowest number of orthopedic surgery occurred during May 2020 with 167 total number of orthopedic surgery. Significant decrease of outpatient visits is recorded in 3 months of early pandemic period compared to the same period in 2019 (p < 0.005). Regarding the orthopedic surgical loads, the data show significant decrease in number of orthopedic surgeries in early pandemic period compared to those months in 2019 (p < 0.005). The largest declines were in visits for post-operative control patient (–179), spinal problem (–127,33), and osteoarthritis (–91,33).
CONCLUSION: There was a significant difference in outpatient visit and orthopedic surgery number in the early pandemic period compared to the period before the pandemic occur.
The largest drops in outpatient visit were in visits for post–operative control patient and spinal problem.
Anterior Cruciate Ligament (ACL) is the most common ligament injury during sports activities that was treated with ACL reconstruction. Nowadays, peroneus longus is used in ACL reconstruction. However, it is difficult to predict the peroneus longus graft diameter for ACL reconstruction. Thus, preoperative measurements are very important to predict peroneus longus autograft for ACL reconstruction. A cohort retrospective study was conducted using consecutive sampling method from February 2016 until October 2017 in our center. We recorded patients' characteristics include gender, age, body weight, height, and Body Mass Index (BMI) preoperatively. We measured peroneus longus graft diameter intraoperatively, and analysed data using Spearman correlation. Thirty-nine patients met inclusion criteria. There were 28 males and 11 females in the peroneus group. From the patients' mean characteristics, age was 25.10 ± 9.16, body weight 71.23 ± 14.17, height 169.13 ± 8.81, and BMI 20.96 ± 3.44. Intraoperative peroneus longus diameter measurement was 8.56 ± 0.82. Spearman correlation showed significant correlation between intraoperative peroneus longus diameter with patient's height, body weight, and BMI with p < 0.05. Patients' characteristics including gender, height, weight, and BMI in preoperative measurements can predict peoneus longus graft diameter intraoperatively.
Abstract
Objective: Osteoarthritis (OA) is a degenerative joint disease characterized by changes in the structure of the subchondral articular cartilage. Chondrocytes are responsible for the synthesis and integrity of the extracellular matrix of articular cartilage. Hyaluronic acid (HA) is believed to have a potential protective effect on joint cartilage through chondroprotective.
Materials and methods: This study is experimental research (pre and post-test control group design) with 20 samples divided into five groups, each consisting of four samples. Four different dosages of HA have been given to the treatment group: 0.1 mg/ml, 1 mg/ml, 2 mg/ml, and 3 mg/ml. Subsequently, collagen type II (COL2) and type X (COL10) were examined using the ELISA method, and data were analyzed with SPSS 20.0
Result: Our study revealed that COL2 expression was not significantly different between the control group and 0.1 mg/ml. Interestingly, with 1 mg/ml of HA, there was a markedly significant increase in the expression of COL2 (p < 0,05), and a further increase in dosage did not give an incremental effect. Conversely, treatment of HA significantly suppressed the expression of COL10, but no enhanced suppression was found with increasing dose.
Conclusion: The administration of HA results in an increased number of COL2 and reduced number of COL10 and has the potential function of inhibiting the degeneration process in joint cartilage.
