Anatomic reconstruction for acromioclavicular joint injuries: a pilot study of a cost-effective new technique

Background: The treatment for acromioclavicular joint injuries (ACJI) ranges from a conservative approach to extensive surgical reconstruction, and the decision on how to manage these injuries depends on the grade of acromioclavicular (AC) joint separation, resources, and skill availability. After a thorough review of the literature, the researchers adopted a simple cost-effective technique of AC joint reconstruction for acute ACJI requiring surgery.Methods: This was a prospective single-center study conducted between April 2017 and April 2018. For patients with acute ACJI more than Rockwood grade 3, the researchers performed open corococlavicular ligament reconstruction using synthetic sutures along with an Endobutton and a figure of 8 button plate. This was followed by AC ligament repair augmenting it with temporary percutaneous AC K-wires. Clinical outcomes were evaluated using the Constant Murley shoulder score. Results: Seventeen patients underwent surgery. The immediate postoperative radiograph showed an anatomical reduction of the AC joint dislocation in all patients. During follow-up, one patient developed subluxation but was asymptomatic. The mean follow-up period was 30 months (range, 24–35 months). The mean Constant score at 24 months was 95. No AC joint degeneration was noted in follow-up X-rays. The follow-up X-rays showed significant infra-clavicular calcification in 11 of the 17 patients, which was an evidence of a healed coracoclavicular ligament post-surgeryConclusions: This study presents a simple cost-effective technique with a short learning curve for anatomic reconstruction of acute ACJI. The preliminary results have been very encouraging.

3D Printed Multiphasic Scaffolds for Osteochondral Repair: Challenges and Opportunities

Osteochondral (OC) defects are debilitating joint injuries characterized by the loss of full thickness articular cartilage along with the underlying calcified cartilage through to the subchondral bone. While current surgical treatments can provide some relief from pain, none can fully repair all the components of the OC unit and restore its native function. Engineering OC tissue is challenging due to the presence of the three distinct tissue regions. Recent advances in additive manufacturing provide unprecedented control over the internal microstructure of bioscaffolds, the patterning of growth factors and the encapsulation of potentially regenerative cells. These developments are ushering in a new paradigm of ‘multiphasic’ scaffold designs in which the optimal micro-environment for each tissue region is individually crafted. Although the adoption of these techniques provides new opportunities in OC research, it also introduces challenges, such as creating tissue interfaces, integrating multiple fabrication techniques and co-culturing different cells within the same construct. This review captures the considerations and capabilities in developing 3D printed OC scaffolds, including materials, fabrication techniques, mechanical function, biological components and design.

Evaluation of the Load Reduction Performance via a Suspended Backpack with Adjustable Stiffness

Backpacks are essential for travel but carrying a load during a long journey can easily cause muscle fatigue and joint injuries. Previous studies have suggested that suspended backpacks can effectively reduce the energy cost while carrying loads. Researchers have found that adjusting the stiffness of a suspended backpack can optimize its performance. Therefore, this paper proposes a stiffness-adjustable suspended backpack; the system stiffness can be adjusted to suitable values at different speeds. The stiffness of the suspended backpack with a 5-kg load was designed to be 690 N/m for a speed of 4.5 km/h, and it was adjusted to 870 and 1050 N/m at speeds of 5.5 and 6.5 km/h, respectively. The goal of this study was to determine how carrying a stiffness-adjustable suspended backpack affected performance while carrying a load. Six healthy participants participated in experiments where they wore two backpacks under three conditions: the adjustable-stiffness suspended backpack condition (S_A), the unadjustable-stiffness suspended backpack condition (S_UA), and the ordinary backpack condition (ORB). Our results showed that the peak accelerations, muscle activities, and peak ground reaction forces in the S_A condition were reduced effectively by adjusting the stiffness to adapt to different walking speeds; this adjustment decreased the metabolic cost by 4.21 ± 1.21% and 2.68 ± 0.88% at 5.5 km/h and 4.27 ± 1.35% and 3.38± 1.31% at 6.5 km/h compared to the ORB and S_UA, respectively.

12 Months of Balance Training Decreases Ankle-Joint Injury Frequency in Young Girl Basketball Players

Summary Aim: Balance training can help reduce the frequency of ankle joint injuries in adults, but data on young girls is relatively scant. Methods: Out of 91 female basketball players (7-16 years), 40 players were assigned to an experimental balance training group, and 51 players were assigned to a control group. Both groups performed their typical basketball training but the experimental group performed additional balance-focused exercises during the warm-up of their basketball training sessions. Results: A total of 47 girls (52 %) reported at least one ankle joint injury in their entire basketball history (52.5 % in the experimental, 50.9% in the control group). There was a positive correlation between the number of ankle joint injuries and age before the experiment (r = 0.34, p < 0.001). During the 12-month study period, girls who participated in balance training suffered significantly fewer ankle joint injuries than the control group (χ2 = 3.8423, df = 1, p-value < 0.05). Increased risk for ankle joint injury in the future was confirmed according to logistic regression for girls with previous ankle joint injury in history (4.33 times) and girls who did not participate in the balance training program (3.97 times). Conclusions: A progressive, barefoot balance training program that is simple and short enough to be performed during normal warm-ups can reduce the likelihood of suffering an ankle joint injury in young girls basketball players, which may be useful for athletes in other sports as well.

BANDHANA WITH MANJISHTADI LEPA IN THE MANAGEMENT OF ANKLE SPRAIN – A CASE REPORT

The ankle joint is the most common site for a ligament injury in the body. Some ankle joint injuries are minor and heal with some rest from activities, but some are serious and require immediate medical attention. An ankle sprain refers to ligament injuries of the ankle. In classics, there is no direct reference regarding sprain and its manage- ment. In Susrutha Samhitha Chikitsa Sthana 3rdchapter, Bhagna Chikitsitham, Acharya Susruta has mentioned the application of Manjishtadi Lepa for traumatic joint injuries. In the present case study, a 22 years old male pa- tient visited the OPD with severe pain and swelling of the right ankle following a twisting injury of the foot. He was diagnosed with a grade 1 ankle sprain and was bandaged with Manjishtadi Lepa. Management with Man- jishtadi Lepa has shown significant relief in pain and swelling as well as in the restoration of normal movements. Keywords: Ankle sprain, Manjishtadi Lepa