Microfragmented Adipose Tissue (M-FATS) for Improved Healing of Surgically Repaired Achilles Tendon Tears: A Preliminary Study

Introduction Tendon healing is a complicated process that results in inferior structural and functional properties when compared with healthy tendon; the purpose of this study was to assess the effects of the adjunct of microfragmented adipose tissue (M-FATS) after the suture of a series of Achilles tendons. Methods After complete Achilles tendon tear, 8 patients underwent open suture repair in conjunction with perilesional application of a preparation of M-FATS rich in mesenchymal stem cells. Results were compared with a similar group of patients treated with conventional open suture. Outcomes were evaluated based on range of motion, functional recovery, and complications according to the American Orthopedic Foot and Ankle Society (AOFAS) score and Foot and Ankle Disability Index (FADI). Achilles tendons were examined by ultrasound (US) at 3 months. Results The AOFAS and FADI scores showed no differences between the 2 groups. US evaluation showed quicker tendon remodeling in the M-FATS group. Adverse events were not documented for both procedures. Conclusions The combined application of derived M-FATS for tendon rupture is safe and presents new possibilities for enhanced healing. Levels of Evidence Level IIIb: Case control study

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Stimulation of Tendon Healing With Delayed Dexamethasone Treatment Is Modified by the Microbiome

The American Journal of Sports Medicine ◽

10.1177/0363546518799442 ◽

2018 ◽

Vol 46 (13) ◽

pp. 3281-3287 ◽

Cited By ~ 1

Author(s):

Franciele Dietrich-Zagonel ◽

Malin Hammerman ◽

Love Tätting ◽

Fabrícia Dietrich ◽

Monika Kozak Ljunggren ◽

...

Keyword(s):

Immune System ◽

Elastic Modulus ◽

Achilles Tendon ◽

Bacterial Flora ◽

Tendon Healing ◽

Peak Stress ◽

Female Rats ◽

Dexamethasone Treatment ◽

Positive Effects ◽

Tendon Remodeling

Background: The immune system reflects the microbiome (microbiota). Modulation of the immune system during early tendon remodeling by dexamethasone treatment can improve rat Achilles tendon healing. The authors tested whether changes in the microbiota could influence the effect of dexamethasone treatment. Hypothesis: A change in microbiome would influence the response to dexamethasone on regenerate remodeling, specifically tendon material properties (peak stress). Study Design: Controlled laboratory study. Methods: Specific opportunist and pathogen-free female rats were housed separately (n = 41) or together with specific pathogen-free rats carrying opportunistic microbes such as Staphylococcus aureus (n = 41). After 6 weeks, all co-housed rats appeared healthy but now carried S aureus. Changes in the gut bacterial flora were tested by API and RapID biochemical tests. All rats (clean and contaminated) underwent Achilles tendon transection under aseptic conditions. Flow cytometry was performed 8 days postoperatively on tendon tissue. Sixty rats received subcutaneous dexamethasone or saline injections on days 5 through 9 after transection. The tendons were tested mechanically on day 12. The predetermined primary outcome was the interaction between contamination and dexamethasone regarding peak stress, tested by 2-way analysis of variance. Results: Dexamethasone increased peak stress in all groups but more in contaminated rats (105%) than in clean rats (53%) (interaction, P = .018). A similar interaction was found for an estimate of elastic modulus ( P = .021). Furthermore, dexamethasone treatment reduced transverse area but had small effects on peak force and stiffness. In rats treated with saline only, contamination reduced peak stress by 16% ( P = .04) and elastic modulus by 35% ( P = .004). Contamination led to changes in the gut bacterial flora and higher levels of T cells (CD3+CD4+) in the healing tendon ( P < .05). Conclusion: Changes in the microbiome influence tendon healing and enhance the positive effects of dexamethasone treatment during the early remodeling phase of tendon healing. Clinical Relevance: The positive effect of dexamethasone on early tendon remodeling in rats is strikingly strong. If similar effects could be shown in humans, immune modulation by a few days of systemic corticosteroids, or more specific compounds, could open new approaches to rehabilitation after tendon injury.

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Accelerated Achilles tendon healing with interleukin-1 receptor antagonist protein in rabbits

TURKISH JOURNAL OF VETERINARY AND ANIMAL SCIENCES ◽

10.3906/vet-1604-32 ◽

2017 ◽

Vol 41 ◽

pp. 118-126

Author(s):

Marko PECIN ◽

Mario KRESZINGER ◽

Snjezana VUKOVIC ◽

Marija LIPAR ◽

Ozren SMOLEC ◽

...

Keyword(s):

Achilles Tendon ◽

Receptor Antagonist ◽

Interleukin 1 ◽

Tendon Healing ◽

Interleukin 1 Receptor Antagonist

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Adipose tissue fatty acid composition and colon cancer: a case–control study

European Journal of Nutrition ◽

10.1007/s00394-013-0605-8 ◽

2013 ◽

Vol 53 (4) ◽

pp. 1029-1037 ◽

Cited By ~ 11

Author(s):

A. Giuliani ◽

F. Ferrara ◽

M. Scimò ◽

F. Angelico ◽

L. Olivieri ◽

...

Keyword(s):

Colon Cancer ◽

Adipose Tissue ◽

Fatty Acid Composition ◽

Fatty Acid ◽

Acid Composition ◽

Case Control Study ◽

Case Control ◽

Tissue Fatty Acid Composition ◽

Adipose Tissue Fatty Acid ◽

Control Study

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VIABILITY AND DISTRIBUTION EVALUATION OF MESENCHYMAL STEM CELLS DERIVED FROM ADIPOSE TISSUE MARKED BY NANOCRYSTALS IN HORSES WITH CHRONIC LAMINITIS 24 HOURS AFTER REGIONAL INFUSION - PRELIMINARY STUDY

Cytotherapy ◽

10.1016/j.jcyt.2021.02.113 ◽

2021 ◽

Vol 23 (4) ◽

pp. 39

Author(s):

APL Oliveira ◽

BS Monteiro ◽

BS Leise ◽

AM Carvalho ◽

RR Faleiros

Keyword(s):

Stem Cells ◽

Mesenchymal Stem Cells ◽

Adipose Tissue ◽

Preliminary Study ◽

Regional Infusion

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Distal Tibiofibular Syndesmotic Widening in Progressive Collapsing Foot Deformity

Foot & Ankle International ◽

10.1177/1071100720982907 ◽

2021 ◽

pp. 107110072098290

Author(s):

Elijah Auch ◽

Nacime Salomao Barbachan Mansur ◽

Thiago Alexandre Alves ◽

Christopher Cychosz ◽

Francois Lintz ◽

...

Keyword(s):

Case Control Study ◽

Mean Difference ◽

Foot And Ankle ◽

Spearman Correlation ◽

Foot Deformity ◽

Weak Correlation ◽

Level Of Evidence ◽

Valgus Instability ◽

Retrospective Comparative Study ◽

Control Study

Background: Lateral overload in progressive collapsing foot deformity (PCFD) takes place as hindfoot valgus, peritalar subluxation, and valgus instability of the ankle increase. Fibular strain due to chronic lateral impingement may lead to distraction forces over the distal tibiofibular syndesmosis (DTFS). This study aimed to assess and correlate the severity of the foot and ankle offset (FAO) as a marker of progressive PCFD with the amount of DTFS widening and to compare it to controls. Methods: In this case-control study, 62 symptomatic patients with PCFD and 29 controls who underwent standing weightbearing computed tomography (WBCT) examination were included. Two fellowship-trained blinded orthopedic foot and ankle surgeons performed FAO (%) and DTFS area measurements (mm2). DTFS was assessed semiautomatically on axial-plane WBCT images, 1 cm proximal to the apex of the tibial plafond. Values were compared between patients with PCFD and controls, and Spearman correlation between FAO and DTFS area measurements was assessed. P values of less than .05 were considered significant. Results: Patients with PCFD demonstrated significantly increased FAO and DTFS measurements in comparison to controls. A mean difference of 6.9% ( P < .001) in FAO and 10.4 mm2 ( P = .026) in DTFS was observed. A significant but weak correlation was identified between the variables, with a Þ of 0.22 ( P = .03). A partition predictive model demonstrated that DTFS area measurements were highest when FAO values were between 7% and 9.3%, with mean (SD) values of 92.7 (22.4) mm2. Conclusion: To our knowledge, this was the first study to assess syndesmotic widening in patients with PCFD. We found patients with PCFD to demonstrate increased DTFS area measurements compared to controls, with a mean difference of approximately 10 mm2. A significantly weak positive correlation was found between FAO and DTFS area measurements, with the highest syndesmotic widening occurring when FAO values were between 7% and 9.3%. Our study findings suggest that chronic lateral impingement in patients with PCFD can result in a negative biomechanical impact on syndesmotic alignment, with increased DTFS stress and subsequent widening. Level of Evidence: Level III, retrospective comparative study.

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High serum concentration of dipeptidyl peptidase 4 at early stage of obesity – preliminary study

Diagnostyka Laboratoryjna ◽

10.5604/01.3001.0013.7752 ◽

2019 ◽

Vol 54 (4) ◽

pp. 233-240

Author(s):

Agnieszka Olejnik ◽

Iwona Bil-Lula ◽

Anna Krzywonos-Zawadzka ◽

Łukasz Kozera

Keyword(s):

Adipose Tissue ◽

Serum Concentration ◽

Body Mass ◽

Early Stage ◽

Density Lipoprotein ◽

Dipeptidyl Peptidase ◽

Tnf Alpha ◽

Serum Concentrations ◽

Dipeptidyl Peptidase 4 ◽

Preliminary Study

Background: Adipose tissue has been recognized as an endocrine organ of considerable complexity, able to secrete adipose-derived factors named adipokines. The secretion of adipokines depends greatly on the volume of body fat, which in turn significantly changes their activity towards a diabetogenic, proinflammatory, and atherogenic pattern. One of the discovered adipokines is dipeptidyl peptidase 4 (DPP4).<br>Objectives: The aim of this preliminary study was to establish an association between serum concentration of DPP4 and obesity at early stage.<br>Material and methods: A total of 32 obese adult volunteers and 40 lean controls were studied. Total cholesterol, triglycerides, HDL (high-density lipoprotein), LDL (low-density lipoprotein) and glucose concentrations were assessed in serum/plasma samples by using commercial tests. Body mass index (BMI) and waist-hip ratio (WHR) were determined. Serum concentrations of DPP4, leptin, visfatin, CRP (C-reactive protein), and TNF-alpha (tumor necrosis factor alpha) were measured using commercial ELISA immunoassay tests.<br>Results: Serum concentrations of DPP4, leptin and visfatin were significantly higher in obese than in lean subjects. The concentration of DPP4 positively correlated with BMI and body mass. Serum CRP and TNF-alpha were increased in obese compared to non-obese, and had a positive correlation with BMI, WHR and body mass.<br>Conclusions: We showed that there is an association between the DPP4, leptin and visfatin concentration in serum and elevated body weight and BMI even at early stage of obesity (I stage of obesity). It suggest the importance of adipose tissue reduction to prevent rise of adipokines levels and further negative metabolic and inflammatory changes.

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The Influence of Diabetes on Acute Achilles Tendon Rupture Repair

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00282 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0028

Author(s):

Jonathan Kaplan ◽

Jeffery Hillam ◽

Amiethab Aiyer ◽

Niall Smyth

Keyword(s):

Diabetes Mellitus ◽

Postoperative Complications ◽

Achilles Tendon ◽

Power Analysis ◽

Tendon Rupture ◽

Surgical Repair ◽

Achilles Tendon Rupture ◽

The United States ◽

Foot And Ankle ◽

Tendon Ruptures

Category: Sports Introduction/Purpose: Diabetes Mellitus (DM) is an epidemic affecting millions of individuals in the United States. Multiple studies have demonstrated an increase in complications in foot and ankle surgery in patients with DM, including wound healing complications, surgical site infections (SSI), or surgical failure. The goal of this study was to retrospectively review outcomes data from the National Surgical Quality Improvement Program (NSQIP) to determine the impact of DM on operative treatment of achilles tendon ruptures. Methods: Using the NSQIP from 2006-2015, patients were identified using common procedure terminology (CPT) for Achilles tendon ruptures. Diabetic and non-diabetic cohorts were evaluated to compare demographics, comorbidities, perioperative details and 30-day outcomes. Statistical evaluation included a power analysis for the primary outcome measure of wound disruption as well as univariate analysis was performed using chi-squared or Fisher’s exact and Wilcoxon signed-rank tests. Results: A total of 2,014 patients were identified having sustained an Achilles tendon rupture. There were 1,981 patients without DM and 33 patients with DM. There were no significant differences in postoperative complications, including SSI, medical complications, and 30-day outcomes between patients with DM and non-DM patients undergoing surgical repair of acute Achilles tendon ruptures. The power analysis for wound disruption showed a P=0.9 with an alpha of 0.05, sample size of n=2014, and Pearson correlation coefficient of r=0.0721 Conclusion: While DM has been shown to have an increase in complications in various foot and ankle procedures, this study demonstrates that there is no significant difference in postoperative complications and 30-day outcomes between patients with DM and non-DM patients undergoing surgical repair of acute Achilles tendon ruptures using the NSQIP database from 2006-2015. Based on this data, patients with diabetes mellitus can be considered adequate surgical candidates for acute Achilles tendon rupture repair.

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