Calcification of the patellar tendon after ACL reconstruction - A case report with long-term follow-up

(E)xtensive calcification of the patellar tendon following ACL reconstruction with central-third bone-patellar tendon-bone autograft is a rarely seen complication. A 45-year-old male patient underwent combined intraarticular reconstruction of ACL with 1/3 central patellar bone-tendon-bone graft and extraarticular reconstruction with modified MacIntosh technique. Two cm of calcification of the patellar tendon was observed incidentally when he underwent a high tibial osteotomy due to medial compartment degeneration, secondary to varus malalignment, 18 months after the ACL surgery. The calcification, being painless, was left untouched during the surgery. At the final examination, 136 months postoperatively, the patient still had no complaint relating to the patellar tendon

Acromion's morphological role in impingement syndrome: a prospective radiologic study

Aim. The purpose of this prospective study was to evaluate the acromion's morphology, which is one of the extrinsic reasons of impingement syndrome, and to examine its role on this syndrome

Medial meniscus anterior horn cyst: Arthroscopic decompression

Meniscus cysts are mostly seen with meniscus tears, and arthroscopic decompression of cysts is gaining great importance in their treatment. In this study, we present a medial meniscus anterior horn cyst without an accompanying tear in the meniscus. A 33-year-old male patient was seen with pain and a palpable mass in his right knee. He complained that the severity of the pain had increased over the previous year. After the clinical and radiologic examinations, a painless, fixed soft tissue mass averaging 4 X 5 cm was located just medial to tuberositas tibia. The cyst was decompressed arthroscopically. In the 18th month of follow up, the mass had totally disappeared and the patient had no pain. Medial meniscus cysts are seen nine times fewer than lateral meniscus cysts. They are mostly accompanied with meniscal tears. Total meniscectomy with arthrotomy, isolated cyst excision, cyst excision, and partial meniscectomy with arthrotomy,and arthroscopic partial meniscectomy with cyst decompression are treatment modalities. Arthroscopic meniscal cyst decompression is an important treatment choice and should always be taken into consideration with low morbidity, short recovery period, low recurrence rate, preservation of range of motion, and permission for early mobilization and rehabilitation of the joint

Evaluation of patellar height and measurement methods after valgus high tibial osteotomy

Several controversies exist regarding the surgical difficulties and the results of total knee arthroplasty performed after failed valgus high tibial osteotomy (HTO), and the main subject is the change in patellar height that results as patella baja or infera. The purpose of this retrospective study was to evaluate patellar height after valgus HTO and the measurement methods that were actually used. Eighty-five knees that were subjected to valgus HTO were evaluated both preoperatively and postoperatively according to the Insall-Salvati Index (ISI), Blackburne-Peel Index (BPI), and Caton Index (CI) to assess any alteration of patellar tendon height that was present. All cases underwent closing wedge osteotomy with three staples or plate internal fixation and were allowed early range of motion. Significant decrease in mean patellar height ratios was detected according to all three indexes at 85 months of mean follow-up. The percentages of the decrease were 8.26% in ISI, 9.08% in BPI, and 6.34% in CI. Two knees showed patella infera according to ISI, one according to BPI and three according to CI. There were no significant correlations between the indexes and clinical status of the patients. Elevation of patella relative to the femur in closing wedge valgus HTO procedure due to the shortening of the segment between tibial tuberosity and joint line is normally expected. A significant decrease in patellar height according to ISI suggests that there should be patellar tendon shortening as patellar height cannot be changed. BPI and CI for determining patellar height in valgus HTO do not accurately measure the alteration of patella because they may affect the tibial inclination and antero-posterior translation of the proximal fragment. Another measuring system based on femoral reference points should be proposed to determine the exact change of patellar height in the valgus HTO procedure

Sponge-derived natural bioactive glass microspheres with self-assembled surface channel arrays opening into a hollow core for bone tissue and controlled drug release applications

Porous, bioactive microspheres have always been a dream material to biomedical scientists for bone regeneration and drug delivery applications due to their interconnectivity, unique pore geometry, encapsulation ability and porosity spanning macroscopic, microscopic and nanoscopic length scales. Extensive efforts have been made to produce such materials synthetically at a great cost of money, time and labor. Herein, naturally-assembled multifunctional, open-channeled and hollow bioactive micro silica spheres (diameter 209.4 ± 38.5 µm) were discovered in a marine sponge (Geodia macandrewii), by peeling the outer surface of the sterrasters using hydrogen fluoride. The obtained micro silica spheres exhibited valuable characteristics such as homogeneously distributed pores, a cavity in the center of the sphere, and channels (approx. 3000) opening from each pore into the central cavity. Simulated body fluid analysis demonstrated the bioactivity of the micro silica spheres; whereas, no bioactivity was recorded for the original untreated sterrasters. The non-cytotoxicity and osteogenic ability of the isolated microspheres were confirmed through osteoblast cell culture. Finally, these silica based porous microspheres were tested for controlled drug release capacity. The spheres showed excellent loading and release abilities for an anti-cancer drug, carboplatin, in simulated solutions and in human cancer cell culture, HeLa, through a real time cell analyzer system. The drug loading capacity of the porous beads was determined as 10.59%. Considering the unique biological and physicochemical properties, these novel bioactive silica spheres, which we name as giant macroporous silica (GMS), are promising materials for a range of applications including bone tissue engineering and drug delivery

Sponge-derived natural bioactive glass microspheres with self-assembled surface channel arrays opening into a hollow core for bone tissue and controlled drug release applications

Porous, bioactive microspheres have always been a dream material to biomedical scientists for bone regeneration and drug delivery applications due to their interconnectivity, unique pore geometry, encapsulation ability and porosity spanning macroscopic, microscopic and nanoscopic length scales. Extensive efforts have been made to produce such materials synthetically at a great cost of money, time and labor. Herein, naturally-assembled multifunctional, open-channeled and hollow bioactive micro silica spheres (diameter 209.4 +/- 38.5 mu m) were discovered in a marine sponge (Geodia macandrewii), by peeling the outer surface of the sterrasters using hydrogen fluoride. The obtained micro silica spheres exhibited valuable characteristics such as homogeneously distributed pores, a cavity in the center of the sphere, and channels (approx. 3000) opening from each pore into the central cavity. Simulated body fluid analysis demonstrated the bioactivity of the micro silica spheres; whereas, no bioactivity was recorded for the original untreated sterrasters. The non-cytotoxicity and osteogenic ability of the isolated microspheres were confirmed through osteoblast cell culture. Finally, these silica based porous microspheres were tested for controlled drug release capacity. The spheres showed excellent loading and release abilities for an anti-cancer drug, carboplatin, in simulated solutions and in human cancer cell culture, HeLa, through a real time cell analyzer system. The drug loading capacity of the porous beads was determined as 10.59%. Considering the unique biological and physicochemical properties, these novel bioactive silica spheres, which we name as giant macroporous silica (GMS), are promising materials for a range of applications including bone tissue engineering and drug delivery

Sponge-derived natural bioactive glass microspheres with self-assembled surface channel arrays opening into a hollow core for bone tissue and controlled drug release applications

Abstract Porous, bioactive microspheres have always been a dream material to biomedical scientists for bone regeneration and drug delivery applications due to their interconnectivity, unique pore geometry, encapsulation ability and porosity spanning macroscopic, microscopic and nanoscopic length scales. Extensive efforts have been made to produce such materials synthetically at a great cost of money, time and labor. Herein, naturally-assembled multifunctional, open-channeled and hollow bioactive micro silica spheres (diameter 209.4 ± 38.5 µm) were discovered in a marine sponge (Geodia macandrewii), by peeling the outer surface of the sterrasters using hydrogen fluoride. The obtained micro silica spheres exhibited valuable characteristics such as homogeneously distributed pores, a cavity in the center of the sphere, and channels (approx. 3000) opening from each pore into the central cavity. Simulated body fluid analysis demonstrated the bioactivity of the micro silica spheres; whereas, no bioactivity was recorded for the original untreated sterrasters. The non-cytotoxicity and osteogenic ability of the isolated microspheres were confirmed through osteoblast cell culture. Finally, these silica based porous microspheres were tested for controlled drug release capacity. The spheres showed excellent loading and release abilities for an anti-cancer drug, carboplatin, in simulated solutions and in human cancer cell culture, HeLa, through a real time cell analyzer system. The drug loading capacity of the porous beads was determined as 10.59%. Considering the unique biological and physicochemical properties, these novel bioactive silica spheres, which we name as giant macroporous silica (GMS), are promising materials for a range of applications including bone tissue engineering and drug delivery