845 research outputs found

    Unique myological changes associated with ossified fabellae: a femorofabellar ligament and systematic review of the double-headed popliteus

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    The fabella is a sesamoid bone embedded in the tendon of the lateral head of the gastrocnemius. It is the only bone in the human body to increase in prevalence in the last 100 years. As the fabella can serve as an origin/insertion for muscles, tendons, and/or ligaments (e.g., the oblique popliteal and fabellofibular ligaments), temporal changes in fabella prevalence could lead to temporal changes in “standard” knee anatomy. The aim of this study was to investigate unique myological changes to the posterolateral corner knee associated with ossified fabella presence and perform a systematic review to contextualize our results. Methods Thirty-three fresh frozen cadaveric knees were considered. As the knees were all used for previous experimentation, the knees were in variable levels of preservation. Those with adequate preservation were used to determine ossified fabella presence/absence. When ossified fabellae were present, unique myologies associated with the fabella were recorded. A systematic review was performed on the double-headed popliteus to investigate possible correlations between this anatomical variant and the fabella. Results Of the 33 knees, 30 preserved enough soft tissue to determine fabella presence/absence: 16/30 knees had fabellae (five cartilaginous and 11 ossified). Eight of the eleven knees with ossified fabellae retained enough soft tissue to investigate the posterolateral knee anatomy. Of these, 4/8 exhibited unique myological changes. One knee had a double-headed popliteus muscle where one head originated from the medial side of a large, bulbous fabella. A systematic review revealed double-headed popliteus muscles are rare, but individuals are 3.7 times more likely to have a fabella if they have a double-headed popliteus. Another knee had a large, thick ligament stretching from the lateral edge of the fabella to the inferoposterior edge of the lateral femoral epicondyle, deep to the lateral collateral ligament (LCL) and near the popliteal sulcus. We found no mention of such a ligament in the literature and refer to it here as the “femorofabellar ligament”. In all four knees, the plantaris and lateral gastrocnemius appeared to share a common tendinous origin, and the fabella was located at/near the junction of these muscles. In the case of the double-headed popliteus, the fabella clearly served as an origin for the plantaris. Conclusions Despite being found in an average of 36.80% of human knees, most standard anatomical models fail to account for the fabella and/or the unique myological changes associated with fabella presence. Although our sample is small, these data highlight aspects of human biological variability generally not considered when creating generalized anatomical models. Further work is needed to identify additional changes associated with ossified fabellae and the functional consequences of omitting these changes from models

    Effects of arthroscopic vs. mini-open rotator cuff repair on function, pain & range of motion. A systematic review and meta-analysis

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    Objective To assess the effectiveness of arthroscopic versus mini-open rotator cuff repair on function, pain and range of motion at 3-, 6- and 12-month follow ups. Design Systematic review and meta-analysis of randomized controlled trials. Setting Clinical setting. Participants Patients 18 years and older with a rotator cuff tear. Intervention/Comparison Arthroscopic/mini-open rotator cuff repair surgery followed by post operative rehabilitation. Main outcome measures Function and pain. Results Six RCTs (n = 670) were included. The pooled results, demonstrated no significant difference between arthroscopic and mini open approach to rotator cuff repair on function (very low quality, 4 RCTs, 495 patients, SMD 0.00, 3-month; very low quality, 4 RCTs, 495 patients, SMD -0.01, 6-month; very low quality, 3 RCTs, 462 patients, SMD -0.09, 12-months). For pain, the pooled results, were not statistically different between groups (very low quality, 3 RCTs, 254 patients, MD -0.21, 3-month; very low quality, 3 RCTs, 254 patients, MD -0.03, 6-month; very low quality, 2 RCTs, 194 patients, MD -0.35, 12-months). Conclusion The effects of arthroscopic compared to mini-open rotator cuff repair, on function, pain and range of motion are too small to be clinically important at 3-, 6- and 12-month follow ups

    SOX9 predicts progression towards cirrhosis in patients while its loss protects against liver fibrosis

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    Fibrosis and organ failure is a common endpoint for many chronic liver diseases. Much is known about the upstream inflammatory mechanisms provoking fibrosis and downstream potential for tissue remodeling. However, less is known about the transcriptional regulation in vivo governing fibrotic matrix deposition by liver myofibroblasts. This gap in understanding has hampered molecular predictions of disease severity and clinical progression and restricted targets for antifibrotic drug development. In this study we show the prevalence of SOX9 in biopsies from patients with chronic liver disease correlated with fibrosis severity and accurately predicted disease progression towards cirrhosis. Inactivation of Sox9 in mice protected against both parenchymal and biliary fibrosis, improved liver function and ameliorated chronic inflammation. SOX9 was downstream of mechanosignaling factor, YAP1. These data demonstrate a role for SOX9 in liver fibrosis and open the way for the transcription factor and its dependent pathways as new diagnostic, prognostic and therapeutic targets in patients with liver fibrosis

    The allure of luxury brands’ social media activities: a uses and gratifications perspective

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    Purpose The purpose of this paper is to explore the social media marketing activities of luxury brands, guided by uses and gratifications theory (UGT). It examines the gratifications sought by millennials, a new core luxury consumer group, and the gratifications obtained when following and connecting with luxury brands. Design/methodology/approach Online data are gathered from Facebook, Instagram and Twitter accounts of five top luxury brands. In addition, 30 in-depth interviews with millennials, the new generation of luxury consumers, were conducted. Thematic analysis strategy was followed to analyze the data and present the findings. Findings Luxury brands remain distant and aloof, which helps them to maintain a sense of exclusivity. User activity, ranging from observations to commenting on and liking luxury brand content, leads to the gratification of two types of need: affective and cognitive. Two affective needs that are satisfied by luxury brands’ social media marketing activities are aesthetic appreciation and entertainment. Cognitive needs are satisfied through the functional use of social media as an information source. Originality/value Several studies have investigated social media from the perspective of UGT, but this study is the first to investigate the implications of luxury brands’ social media usage with the lenses of UGT

    Automatic Detection of User Abilities through the SmartAbility Framework

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    This paper presents a proposed smartphone application for the unique SmartAbility Framework that supports interaction with technology for people with reduced physical ability, through focusing on the actions that they can perform independently. The Framework is a culmination of knowledge obtained through previously conducted technology feasibility trials and controlled usability evaluations involving the user community. The Framework is an example of ability-based design that focuses on the abilities of users instead of their disabilities. The paper includes a summary of Versions 1 and 2 of the Framework, including the results of a two-phased validation approach, conducted at the UK Mobility Roadshow and via a focus group of domain experts. A holistic model developed by adapting the House of Quality (HoQ) matrix of the Quality Function Deployment (QFD) approach is also described. A systematic literature review of sensor technologies built into smart devices establishes the capabilities of sensors in the Android and iOS operating systems. The review defines a set of inclusion and exclusion criteria, as well as search terms used to elicit literature from online repositories. The key contribution is the mapping of ability-based sensor technologies onto the Framework, to enable the future implementation of a smartphone application. Through the exploitation of the SmartAbility application, the Framework will increase technology amongst people with reduced physical ability and provide a promotional tool for assistive technology manufacturers

    An In Vitro Study Comparing Limited to Full Cementation of Polyethylene Glenoid Components

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    BACKGROUND: Glenoid component survival is critical to good long-term outcomes in total shoulder arthroplasty. Optimizing the fixation environment is paramount. The purpose of this study was to compare two glenoid cementing techniques for fixation in total shoulder arthroplasty. METHODS: Sixteen cadaveric specimens were randomized to receive peg-only cementation (CPEG) or full back-side cementation (CBACK). Physiological cyclic loading was performed and implant displacement was recorded using an optical tracking system. The cement mantle was examined with micro-computed tomography before and after cyclic loading. RESULTS: Significantly greater implant displacement away from the inferior portion of the glenoid was observed in the peg cementation group when compared to the fully cemented group during the physiological loading. The displacement was greatest at the beginning of the loading protocol and persisted at a diminished rate during the remainder of the loading protocol. Micro-CT scanning demonstrated that the cement mantle remained intact in both groups and that three specimens in the CBACK group demonstrated microfracturing in one area only. DISCUSSION: Displacement of the CPEG implants away from the inferior subchondral bone may represent a suboptimal condition for long-term implant survival. Cement around the back of the implant is suggested to improve initial stability of all polyethylene glenoid implants. CLINICAL RELEVANCE: Full cementation provides greater implant stability when compared to limited cementation techniques for insertion of glenoid implants. Loading characteristics are more favorable when cement is placed along the entire back of the implant contacting the subchondral bone
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