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Orthopaedics & Traumatology, Surgery &... Oct 2023Follow-up care including rehabilitation therapy after isolated meniscal repair remains to be standardized. Thus, no standard criteria are available for the... (Review)
Review
BACKGROUND
Follow-up care including rehabilitation therapy after isolated meniscal repair remains to be standardized. Thus, no standard criteria are available for the return-to-running (RTR) or return-to-sport (RTS). The objective of this study was to identify criteria for RTR and RTS after isolated meniscal repair, based on a review of the literature.
HYPOTHESIS
Return-to-sport criteria after isolated meniscal repair have been published.
METHODS
We performed a scoping review of the literature using the methodology developed by Arksey and O'Malley. The terms "menisc*" and "repair" and "return-to-sport" or "return to play" or "return to run" or "rehabilitation" were used to search the PubMed database on 1st March 2021. All relevant studies were included. All RTR and RTS criteria were identified, analyzed, and classified.
RESULTS
We included 20 studies. Mean RTR and RTS times were 12.9 and 20 weeks, respectively. Clinical, strength, and performance criteria were identified. The clinical criteria included full range-of-motion recovery with no pain, quadriceps wasting, or joint effusion. Strength criteria were a quadriceps and hamstring deficit, no greater than 30% and 15% for RTR and RTS, respectively, compared to the normal side. Performance criteria were successful completion of proprioception, balance, and neuromuscular tests. RTS rates ranged from 80.4% to 100%.
CONCLUSION
Patients must meet clinical, strength, and performance criteria before resuming running and sports. The level of evidence is low, due to the heterogeneity and generally arbitrary choice of criteria. Further large-scale studies are therefore needed to validate and standardize RTR and RTS criteria.
LEVEL OF EVIDENCE
IV.
Topics: Humans; Return to Sport; Running; Quadriceps Muscle; Meniscus; Sutures; Anterior Cruciate Ligament Injuries
PubMed: 36940904
DOI: 10.1016/j.otsr.2023.103604 -
Facial Plastic Surgery : FPS Dec 2023Nasal obstruction is a common sequela of flaccid facial paralysis but one that is often underaddressed surgically. Weakness of nasal musculature on the paralyzed side of...
Nasal obstruction is a common sequela of flaccid facial paralysis but one that is often underaddressed surgically. Weakness of nasal musculature on the paralyzed side of the face leads to nasal valve narrowing through loss of static and dynamic nasal side wall tone as well as inferomedial displacement of the alar base. Standard rhinoplasty techniques such as alar batten grafts or flaring sutures may be used to support the nasal side wall in facial paralysis. However, to address the inferomedial alar displacement, suspension techniques are often required. Suture resuspension and fascia lata resuspension techniques are described, with modifications to each to improve longevity of the suspension.
Topics: Humans; Rhinoplasty; Facial Paralysis; Nose; Nasal Obstruction; Sutures
PubMed: 37433310
DOI: 10.1055/a-2127-3768 -
The American Journal of Sports Medicine Sep 2023Reconstruction techniques for anterior glenoid bone loss have seen a trend from screws to suture-based fixations. However, comparative biomechanical data, including...
BACKGROUND
Reconstruction techniques for anterior glenoid bone loss have seen a trend from screws to suture-based fixations. However, comparative biomechanical data, including primary fixation and glenoid-graft contact pressure mapping, are limited.
HYPOTHESIS
Suture-based bone block cerclage (BBC) and suspensory suture button (SB) techniques provide similar primary fixation and cyclic stability to double-screw fixation but with higher contact loading at the bony interface.
STUDY DESIGN
Controlled laboratory study.
METHODS
In total, 60 cadaveric scapulae were prepared to simulate anterior glenoid bone loss with coracoid autograft reconstruction. Graft fixation was performed with 3 different techniques: (1) an interconnected all-suture BBC, (2) 2 SB suspensions, and (3) 2 screws. Initial compression was analyzed during primary fixation. Cyclic peak loading with 50 N and 100 N over 250 cycles at 1 Hz was performed with a constant valley load of 25 N. Optical recording and pressure foils allowed for spatial bone block tracking and contact pressure mapping at the glenoid-graft interface. Load-to-failure testing was performed at a rate of 1.5 mm/s with ultimate load and stiffness measured.
RESULTS
Initial graft compression was higher with screw fixation (141 ± 5 N) compared with suture-based fixations ( < .001), with BBC fixation providing significantly higher compression than SB fixation (116 ± 7 N vs. 91 ± 5 N; < .001). Spatial bone block migration and ultimate failure load were similar between the BBC and screw groups. The SB group showed significantly increased bone block translation (3.1 ± 1.0 mm; ≤ .014) and rotation (2.5°± 1.4°; ≤ .025) and significantly lower ultimate failure load (180 ± 53 N) compared with the BBC ( = .046) and screw ( = .002) groups. Both suture-based fixations provided significantly increased graft-glenoid contact loading with higher pressure amplitudes (≤ .032) and contact pressure after cyclic loading (+13%; SB: = .007; BBC: = .004) compared with screw fixation.
CONCLUSION
Both SB and interconnected cerclage fixation improved dynamic contact loading compared with screw fixation in a biomechanical glenoid bone loss model. Cerclage fixation was biomechanically comparable with screw fixation but with a greater variability. SB fixation showed significantly lower primary fixation strength and greater bone block rotation and migration.
CLINICAL RELEVANCE
Suture-based bone block fixations improved graft-glenoid contact loading, but the overall clinical consequence on healing remains unclear.
Topics: Humans; Scapula; Sutures; Orthopedic Procedures; Bone Screws; Histological Techniques
PubMed: 37656204
DOI: 10.1177/03635465231188976 -
International Journal of Legal Medicine Jul 2023This study sought to develop an age-estimation formula to evaluate the extent of median palatine suture (MP) closure using postmortem computed tomographic (PMCT) images....
This study sought to develop an age-estimation formula to evaluate the extent of median palatine suture (MP) closure using postmortem computed tomographic (PMCT) images. The PMCT images of 634 Japanese subjects (mean age, 54.5 years; standard deviation [SD], 23.2 years) with known age and sex were examined. The degree of suture closure of the MP, anterior median palatine suture (AMP), and posterior median palatine suture (PMP) was measured and scored (suture closure score, SCS), and a single linear regression analysis was conducted with age at death. On the analysis, SCS of MP, AMP, and PMP showed a significant correlation with age (p < 0.001). The correlation coefficient of MP was higher (0.760, male; 0.803, female; and 0.779, total) than that of AMP (0.726, male; 0.745, female; and 0.735, total) or PMP (0.457, male; 0.630, female; and 0.549, total). The regression formula and standard error of estimation (SEE) of MP were calculated as Age = 100.95 × SCS + 20.51 (SEE 14.87 years) for male subjects, Age = 91.93 × SCS + 26.65 (SEE 14.12 years) for female subjects, and Age = 95.17 × SCS + 24.09 (SEE 14.59 years) for the total, respectively. In addition, another 50 Japanese subjects were randomly selected to validate the age-estimation formula. In this validation, the actual age of 36 subjects (72%) was within the estimated age ± SEE. This study showed that the age estimation formula using PMCT images of MPs was potentially useful for estimating the age of unidentified corpses.
Topics: Humans; Male; Female; Middle Aged; Aged, 80 and over; Forensic Anthropology; Tomography, X-Ray Computed; Regression Analysis; Autopsy; Sutures
PubMed: 37074412
DOI: 10.1007/s00414-023-02994-3 -
Techniques in Hand & Upper Extremity... Sep 2023Scapulothoracic arthrodesis has been proposed for the treatment of painful scapular winging in patients with facioscapulohumeral muscular dystrophy. It was introduced to...
ABSTRACT
Scapulothoracic arthrodesis has been proposed for the treatment of painful scapular winging in patients with facioscapulohumeral muscular dystrophy. It was introduced to improve shoulder function. Several methods of fixation have been proposed to obtain the union of the scapula to the ribs. These include plates, screws, cables, or wires with or without bone grafting. The purpose of this manuscript is to describe the surgical technique of scapulothoracic arthrodesis using plate and cerclage suture tapes.
LEVEL OF EVIDENCE
Level IV, treatment study (case series).
Topics: Humans; Shoulder Joint; Range of Motion, Articular; Retrospective Studies; Muscular Dystrophy, Facioscapulohumeral; Scapula; Sutures
PubMed: 37073680
DOI: 10.1097/BTH.0000000000000434 -
Nederlands Tijdschrift Voor... Jun 2024This article highlights the importance of proper suturing of mucosa, gingiva, and skin after surgical procedures and trauma. Several factors play a role in promoting... (Review)
Review
This article highlights the importance of proper suturing of mucosa, gingiva, and skin after surgical procedures and trauma. Several factors play a role in promoting good healing, including optimal tension on the sutured wound, adequate blood flow, and careful selection of suture materials. The selected suture material depends on various factors, such as type of tissue, location of the wound, and healing time. Different suture techniques are discussed, including interrupted sutures, continuous sutures, horizontal and vertical mattress sutures, each with their own specific applications and benefits. Skillfulness in suture techniques and appropriate material selection contribute to effective wound healing and optimal outcomes.
Topics: Humans; Suture Techniques; Oral Surgical Procedures; Sutures; Wound Healing; Gingiva; Mouth Mucosa
PubMed: 38860657
DOI: 10.5177/ntvt.2024.06.23090 -
Forensic Science International Jul 2023The present study aimed to investigate the correlation between palatal suture obliteration and age in modern Japanese and to develop an age estimation equation by...
The present study aimed to investigate the correlation between palatal suture obliteration and age in modern Japanese and to develop an age estimation equation by modifying Kamijo's (1949) method. The subjects were 195 Japanese skeletal remains (155 males and 40 females) whose age and sex were known. First, obliteration score (OS) was obtained by measuring palatal suture obliteration from photographic images taken at the time of forensic autopsy, and the correlation with age was examined; no significant correlation was found in females. Second, the palatal sutures were divided into 14 sections, and each section was scored from 0 to 4 points according to the degree of the suture obliteration. Suture scores (SS) were then calculated for each of the four sutures, and the sum of the 14 scores (TSS: total suture score) was used to perform regression analysis for age. For male and all subjects (male and female), age significantly increased (p < 0.001) according to increment of SSs for all sutures. TSS has the highest regression coefficient (r = 0.540), and the lowest standard error of estimation (13.54 years) for all of the patients. The intra- and inter-observer agreement scoring showed high reliability. Validation study using the formulae showed a high percentage of correct responses (80 %). In conclusion, age estimation regression formula by palatal suture using modified Kamijo's method was established for Japanese population, and the study showed the formula might be valid for age estimation.
Topics: Humans; Male; Female; Reproducibility of Results; Maxilla; Cranial Sutures; Regression Analysis; Sutures; Forensic Anthropology
PubMed: 37137211
DOI: 10.1016/j.forsciint.2023.111706 -
Plastic and Reconstructive Surgery Feb 2024The goal of every rhinoplasty surgeon is to create a functional and aesthetically pleasing nose. The lateral crura resting angle, a recently described key concept,...
The goal of every rhinoplasty surgeon is to create a functional and aesthetically pleasing nose. The lateral crura resting angle, a recently described key concept, should be taken into consideration to achieve a satisfactory result. In this article, the authors describe the resting-angle suture, a novel technique derived from the inversion suture used to correct ectropion deformity in lower eyelid surgery.
Topics: Humans; Nose; Rhinoplasty; Sutures; Ectropion; Eyelids; Suture Techniques
PubMed: 36995193
DOI: 10.1097/PRS.0000000000010482 -
Surgical Endoscopy May 2024Robotic technology is an important tool in surgical innovation, with robots increasingly being used in the clinical setting. Robots can be used to enhance accuracy,... (Review)
Review
BACKGROUND
Robotic technology is an important tool in surgical innovation, with robots increasingly being used in the clinical setting. Robots can be used to enhance accuracy, perform remote actions, or to automate tasks. One such surgical task is suturing, a repetitive, fundamental component of surgery that can be tedious and time consuming. Suturing is a promising automation target because of its ubiquity, repetitive nature, and defined constraints. This systematic review examines research to date on autonomous suturing.
METHODS
A systematic review of the literature focused on autonomous suturing was conducted in accordance with PRISMA guidelines.
RESULTS
6850 articles were identified by searching PubMed, Embase, Compendex, and Inspec. Duplicates and non-English articles were removed. 4389 articles were screened and 4305 were excluded. Of the 84 remaining, 43 articles did not meet criteria, leaving 41 articles for final review. Among these, 34 (81%) were published after 2014. 31 (76%) were published in an engineering journal9 in a robotics journal, and 1 in a medical journal. The great majority of articles (33, 80%) did not have a specific clinical specialty focus, whereas 6 (15%) were focused on applications in MIS/laparoscopic surgery and 2 (5%) on applications in ophthalmology. Several suturing subtasks were identified, including knot tying, suture passing/needle insertion, needle passing, needle and suture grasping, needle tracking/kinesthesia, suture thread detection, suture needle shape production, instrument assignment, and suture accuracy. 14 articles were considered multi-component because they referred to several previously mentioned subtasks.
CONCLUSION
In this systematic review exploring research to date on autonomous suturing, 41 articles demonstrated significant progress in robotic suturing. This summary revealed significant heterogeneity of work, with authors focused on different aspects of suturing and a multitude of engineering problems. The review demonstrates increasing academic and commercial interest in surgical automation, with significant technological advances toward feasibility.
Topics: Suture Techniques; Humans; Robotic Surgical Procedures; Laparoscopy; Sutures
PubMed: 38553597
DOI: 10.1007/s00464-024-10788-w -
Minerva Dental and Oral Science Aug 2023Several types of suture materials are available for oral surgery. However, the most used non-resorbable suture in oral surgery is 3/0 silk. The aim of the present study...
BACKGROUND
Several types of suture materials are available for oral surgery. However, the most used non-resorbable suture in oral surgery is 3/0 silk. The aim of the present study was to compare the effectiveness of knotless/barbed sutures with silk sutures during the postoperative period after the third molar surgery in terms of clinical and microbiological parameters.
METHODS
The study comprised 38 patients who underwent surgical extraction of a mandibular impacted third molar. The patients were divided into two groups. The mucoperiosteal flap was closed using 3/0 knotless/barbed sutures for the test group and 3/0 silk sutures for the control group. The duration of suturing was recorded during surgery. Pain level, postoperative edema, and trismus were measured at 3 and 7 days after surgery. The status of plaque formation on the sutures was scored using the Plaque Index at 3 and 7 days after the surgery. At 7 days, the suture materials were removed and submitted to the laboratory for microbiological analysis. The level of pain during suture removal was also recorded by a Visual Analog Scale.
RESULTS
The duration of suturing in the barbed sutures group was found significantly lower than in silk sutures (P<0.05). There was no significant difference between the suture types in terms of trismus and edema at 3 and 7 days after surgery (P>0.05). On the third day after surgery and during suture, removal pain scores were statistically significantly lower in the barbed suture group than in the silk suture group (P<0.05). The Plaque Index values of the barbed sutures were statistically significantly lower than that of the silk sutures at 3 and 7 days after surgery (P<0.05). Aerobic, anaerobic, and aerobic/anaerobic mean colony forming units (CFUs) were statistically significantly lower in the barbed suture group than in the silk suture group (P<0.05).
CONCLUSIONS
Barbed sutures increase the ease of operation and patient comfort with less postoperative pain than silk sutures. Additionally, less plaque accumulation and lower bacterial colonization were found on the barbed/knotless sutures than on the silk sutures.
Topics: Humans; Trismus; Molar, Third; Suture Techniques; Sutures; Tooth, Impacted; Silk; Pain, Postoperative; Edema
PubMed: 36951010
DOI: 10.23736/S2724-6329.23.04764-2