Development Of Degenerative Changes Research Articles

Сучасне розуміння етіопатогенезу дегенеративної хвороби дисків поперекового відділу у осіб дитячого віку. Освітлення ключових аспектів і перспектив

Low back pain is the most common complaint among people of any age, and degenerative disc disease (DHD) is the most common cause. Low back pain due to lumbar spondylolysis in adolescent athletes ranges from 8.8% to 47%. Features of the structure of intervertebral discs, a combination of genetic, mechanical, metabolic, and inflammatory factors create conditions for the development of degenerative changes in the vertebral motor segment, especially in intervertebral discs. The results of pathomorphological and magnetic resonance imaging studies show that degenerative changes in discs begin in childhood. Individual publications present data on the formation of a protrusion, even hernias occur in teenagers. Some publications have shown the effectiveness of drugs containing chondrocyte substitutes, indicating that early diagnosis of degenerative changes in the discs will allow timely treatment and secondary preventive measures. Further detailed research is needed to study the features of the development of degenerative changes in the discs in adolescents using imaging methods, taking into account the most common etiopathogenetic factors.

Age-related decline in goblet cell numbers and mucin content of the human colon: Implications for lower bowel functions in the elderly

Background & aimsOlder people experience a greater incidence of lower bowel disorders, including constipation. Causes can include factors associated with growing older, such as use of medications or disease, but compounded by degenerative changes within the bowel wall. It has been suggested that the latter is exacerbated by loss of an effective mucosal barrier to luminal contents. In human colon, little is known about the impact of ageing on key components of this barrier, namely the goblet cells and mucin content. MethodsChanges in the number of goblet cells and density of mucin content were investigated in macroscopically normal human ascending (AC; n = 13) and descending (DC; n = 14) colon from elderly (≥ 67 years) and younger adults (60 years and below). Samples were serially sectioned and stained for haematoxylin and eosin to assess tissue morphology, and alcian blue periodic acid Schiff (ABPAS) and MUC-2 antibody to identify goblet cells producing mucins. New procedures in visualization and identification of goblet cells and mucin contents were employed to ensure unbiased counting and densitometric analysis. ResultsCompared with the younger adults, the numbers of goblet cells per crypt were significantly lower in the elderly AC (72 ± 1.2 vs 51 ± 0.5) and DC (75 ± 2.6 vs. 54 ± 1.9), although this reduction did not reach statistical significance when assessed per mucosal area (AC: P = 0.068; DC: P = 0.096). In both regions from the elderly, numerous empty vesicles (normally containing mucins) were observed, and some areas of epithelium were devoid of goblet cells. Thus, the density of mucin content per unit mucosal area were significantly reduced with age. ConclusionsAgeing could result in a reduced number of goblet cells and development of degenerative changes in mucin production. Together, these have implications for the mucus barrier function in the colon of elderly individuals.

Bosworth ankle fracture-dislocation: current concept review.

Bosworth fracture (BF) is a special type of locked ankle fracture-dislocation, characterized by displacement of a fragment of the fractured fibula from the fibular notch behind the posterior surface of the distal tibia. BF is a complex injury affecting multiple structures of the ankle joint, which is still frequently misjudged even today, potentially leading to severe complications. CT examination, including 3D reconstructions, should be the diagnostic standard in BF, as it provides a complete picture of the fracture pathoanatomy, most prominently the morphology of the frequently associated posterior malleolar fracture. BF requires early reduction of the displaced fibular fragment without repeated attempts on closed reduction. Non-operative treatment of BF almost always fails. The standard treatment procedure is early open reduction internal fixation. Due to the relative severity and paucity of the injury, BF seems to be particularly prone to soft tissue complications, including compartment syndrome. The results of operative treatment are mixed. Many studies report persistent pain even after a short time interval, with limitations of the range of motion or even stiffness of the ankle joint, and development of degenerative changes. Larger studies with long-term results are still missing.

Necrobiosis lipoidica of the scalp

Necrobiosis lipoidica is a chronic granulomatous skin disease of a vascular-exchange nature from the group of localized skin lipoidosis, accompanied by the development of degenerative changes in the connective tissue.
 The reason for the development of necrobiosis lipoidica is unknown, but the most common theory remains the theory of vascular disorders, including the deposition of immune complexes (IgM, complement component C3), microangiopathic changes (deposition of a glycoprotein in the walls of blood vessels), as well as other combinations of inflammatory and structural changes leading to collagen degeneration and decreased perfusion and oxygenation of the skin. Necrobiosis lipoidica occurs in association with systemic diseases (sarcoidosis, autoimmune thyroiditis, inflammatory bowel disease, such as ulcerative colitis, and rheumatoid arthritis) and can also occur in otherwise healthy individuals. Necrobiosis lipoidica is closely associated with diabetes mellitus.
 The predominant localization of necrobiosis lipoidica is tibial surface of the legs. Atypical localization is: skin of the scalp and face.
 Clinical polymorphism of necrobiosis lipoidica, possibility of transition from one form to another, its combination with other dermatoses can pose difficult diagnostic questions for the doctor.
 The article describes our own clinical observation of a patient with complaints of rashes on the skin of the legs and scarring alopecia in the scalp. The focus on the scalp had a tendency to grow and signs of development of scarring alopecia. According to the results of a biopsy performed at the Rakhmanov Department of Skin and Veneral Diseases, I.M. Sechenov First Moscow State Medical University, was diagnosed with "Necrobiosis Lipoidica". The case was interesting due to the extreme rarity of rashes on the skin of the scalp and the absence of dermatoscopic features of lesions in this area. Due to ongoing therapy for a month, there was a positive effect in the form of a lack of growth of existing plaques and the appearance of new ones, a decrease in the brightness of the color of the rash, a partial regression with an outcome in residual hyperpigmentation.
 Thus, despite the absence of a gold standard in the treatment of necrobiosis lipoidica, the most well-studied group of drugs for the treatment of the disease at the moment are glucocorticoids, which confirms our experience. Therapy of patients with necrobiosis lipoidica should be carried out by an interdisciplinary team (dermatovenereologist, endocrinologist, therapist).

Adipose-Derived Stromal Vascular Fraction in Treatment of Osteoarthritis: Experimental Study

Background Osteoarthritis OA is the commonest musculoskeletal disabling disease in adults. Most of the current available treatments provide only symptomatic relief. Adipose derivedstromal vascular fraction SVF has been recently introduced as potential regenerative therapy for OA. Objective We aimed to study the therapeutic role of adipose – derived SVF in OA. Materials and Methods This work included 42 female Wister rats for induction of osteoarthritis and 6 male Wistar rats acting as donors for the extraction of SVF from adipose tissue which yielded 106 cells/ml. Osteoarthritis was induced by intra-articular injection of collagenase type II in the right knee joint of all female rats and the left knee was considered as healthy controls. Rats were divided into three groups, healthy control Group (group I), induced osteoarthritis control group (Group II) which received no treatment and SVF treatment group (Group III). Group II and III were subdivided into 2 subgroups; IIa, IIb and IIIa, IIIb which were euthanized after 1 and 2 months of OA induction respectively. Modified Manikin score (MS) was used to assess cartilage degeneration. Image Analysis was used to assess chondrocyte count, articular cartilage thickness and optical density in slides stained with Hematoxylin and Eosin and Safranin-O-stain. Results It was observed that MS scored highest in Group II compared to Group III and Group I (P < 0.001). After 1 month, MS in Group IIa and Group IIIa was (10.75 ± 0.50 and 2.50 ± 0.53, P < 0.001). Similarly at 2 months MS was (8.50 ± 0.58, 0.50 ± 0.53, P < 0.001). Also, morphometric analysis revealed Group II contained least chondrocyte cellular count compared to Group III and Group I (P < 0.001). After 2 months, articular cartilage thickness was least in Group II compared to Group IIIb and highest in Group I (P < 0.001). Also, optical density OD measurement using imaging in slides stained with Safranin revealed OD was highest in Group I, followed by Group III and least in Group II (P < 0.001). Conclusion Adipose derived SVF represents potential regenerative therapy for OA. It decreased development of degenerative changes at early stages of induced osteoarthritis in rats and promoted regeneration with increased cartilage thickness and proteoglycan content at later stage.

Experimental study of morphological changes in the heart and blood vessels in the course of chronic fluoride intoxication

Introduction. Clinical studies have shown the development of a complex of non-specific changes in internal organs due to chronic fluoride intoxication. The accumulation of fluorine in the body initiates free radical oxidation, promotes the development of pathological processes in the heart against the background of an imbalance between pro- and antioxidants, and vascular endothelial dysfunction. Pathological activation of intima cells leads to unbalanced production of damaging factors, changes in the hemostasis system, and entails morphological and functional disorders of organs.
 Materials and methods. The experiments were carried out on one hundred twenty white male rats. A morphological study of the heart, blood vessels was performed out at 1, 3, 6, 9 and 12 weeks of chronic fluoride intoxication.
 Results. The 1st-3rd weeks of the experiment are characterized by the preservation of the morphological structure of the cardiac muscle against the background of the previously shown a compensatory activation of the components of the redox-signalling system, which provided a decrease in the intensity of free radical processes. With an increase in the duration of exposure to sodium fluoride (6–9 weeks) these mechanisms failure was noted, which was manifested by the development of degenerative changes in the myocardium, progressing up to the 12th week of the experiment. The described changes correlated with the development of endotheliosis, degenerative and fibroplastic processes, circulatory disorders in the vessels of the heart and other organs.
 Limitations. Histological findings are descriptive.
 Conclusion. The results obtained are of practical importance for the elaboration of effective methods for timely organ-protective prevention and correction of pathomorphological disorders, depending on the organ-specific features and duration of fluoride intoxication.

Prolonged exposure to the herbicide atrazine promotes kidney fibrosis by activating Wnt/β-catenin signaling in rats.

Exposure to atrazine(ATR),awidely-usedherbicide,is a potential harmful to human health due to its long-term environmental persistence and bioaccumulation. The effects of chronic exposure to ATR on renal function in rats were evaluated in this research. Female Sprague-Dawley rats at 4 weeks of age were treated with different concentrations of ATR for 6months. No significant differences intermsofrenalfunctions were observed afterATRtreatment. In histopathological examination of the kidney, Hematoxylin-Eosin staining indicated the development of degenerative changes in a dose-dependent manner. The results revealed that ATR exposure leads to renal fibrosis and that activation of the Wnt/β-catenin pathway plays a potential role in ATR-related renal fibrosis. Levelsof transforming growth factor (TGF)-β and TGF-β1 levels andthereactiveoxygenspecieswere significantly upregulated after ATR treatment. In conclusion, long-term exposure to ATR could cause kidney fibrosis, which is the result of epithelial-mesenchymal transition caused by inflammation and oxidative stress.

Non-specific porins from the outer membrane of <i>Yersinia pseudotuberculosis</i> effect on mice brain cortex tissues

It was found that with a single immunization of OmpF and OmpC mice with Yersinia pseudotuberculosis porins, against the background of an increasing titer of specific antibodies, pathological changes develop in the deep layers of the cerebral cortex, characterized by dystrophic changes in cells. At the same time, an increased level of caspase 3 expression is observed in neurons, which indicates the induction of proapoptotic signaling pathways. The results obtained indicate the potential ability of nonspecific pore-forming proteins of the outer membrane of Gram-negative bacteria to initiate the development of degenerative changes in brain cells.

Diagnostic Procedures and Surgical Treatment of Craniodorsal Coxofemoral Luxation in a dwarf rabbit

To our knowledge, there are no sufficient reports on the full management of hip luxation in rabbits, including descriptions of the diagnostics procedure with the use of computed tomography, surgical procedure, and postoperative management with a measurable assessment of the results. The objective of this study was to report on a computed tomography examination of a coxofemoral joint in a rabbit, a surgical technique for the repair of craniodorsal coxofemoral dislocation, as well as short- and long-term postoperative outcomes. Craniodorsal coxofemoral luxation was diagnosed by physical examination and radiographic examination. A craniodorsal luxation of the femoral head and the presence of an intact femoral neck were confirmed by computed tomography. An ostectomy of the femoral head and neck was performed using a craniolateral open approach. The coxofemoral luxation was successfully reduced, and reluxation did not occur. At short- and long-term follow-ups, in parallel with clinical examination, an extensive pain assessment protocol was applied. CT proved to be a simple and effective technique and should be considered as an alternative to radiographic examination for diagnosis of coxofemoral luxation in rabbits. An immediate surgical intervention in hip dislocation in rabbits is necessary to alleviate pain associated with the movement of the injured joint and to avoid development of degenerative changes. In follow-up examinations after the procedure, a reliable assessment of postoperative pain and the effectiveness of perioperative analgesia should be made by introducing a postoperative pain assessment protocol. It could simplify an objective comparison between outcomes of different orthopaedic procedures in rabbits.

CHANGES IN THE CELLULAR COMPOSITION OF SYNOVIAL FLUID IN EXPERIMENTAL OSTEOARTHRITIS OF THE KNEE JOINT IN RABBITS

Pathology of the locomotion system in animals of various species is one of the key issues. Osteoarthritis is common among large breed dogs and accounts for up to 85% of the total number of examined animals with "chronic" lameness. German and Eastern European Shepherds are most susceptible to osteoarthritis, accounting for 25% and 15% of the total number of dogs examined, respectively. At the age of 4 to 8 years, 90 % of dogs with osteoarthritis were found. The prevalence of pathology in males was found to be 4 times higher than in females. The study presents the peculiarities of changes in the cellular composition of synovial fluid taken from the knee joint of rabbits with experimentally modelled osteoarthritis of the knee joint in laboratory conditions of the joint using intra-articular Yellow peel 2*5 ml (manufacturer Medicare, Germany). The studies showed that synovial fluid plays an important role in the metabolic process inside the joint and contains many nutrients, and changes in the indicators on the 7th day were significantly different from those of the control group of animals that were intra-articularly injected with an isotonic 0.9% NaCl solution. It was noted that on the 7th day there was a clouding of the synovial fluid, the appearance of a pinkish tint and a more liquid character of the fluid. We found an increase in the level of eosinophils, macrophages, neutrophils and other cells compared to the control group of animals. The number of synovial cells decreased by 1.2 times compared to the control group. In animals of the experimental group on the 14th day of the study, the level of lymphocytes and macrophages increased, and the level of neutrophils remained constant, while the level of eosinophils decreased. In the experimental group of animals, on the 21st day of the experimental study, the pink tint of the punctured synovial fluid disappears, the colour becomes straw, the fluid becomes more viscous and remains cloudy. The level of macrophages and neutrophils decreases, but remains above the level of the control group of animals. We also noted the appearance of Tuton cells in the cytological samples, indicating the development of degenerative changes in the cartilage tissue in the joint. It was noted that in the animals of the experimental group on the 28th day of the study, the colour of the synovial fluid disappeared, but it remained cloudy. The level of neutrophils, eosinophils, lymphocytes and macrophages remained almost unchanged.

Age-related changes of myofibrils in white laboratory rats of different ages

The study of isolated preparations of experimental white rats of 14 months and older reveals that the longitudinal orientation of cardiomyocytes is replaced by an angular orientation in older mice. The number and structural integrity of myofibrils occupy one of the leading places in the regulation of the contraction-relaxation cycle and the implementation of the adaptive capabilities of the myocardium in the normal functioning of cardiomyocytes. Our experimental studies aim at describing the quantitative and morphological characteristics of myofibrils in rats of two age groups and analyzing the morphological and functional results. Isolated heart preparations were examined in two age groups of white rats (middle - 8-14 years; elderly - 14 months and more. The number of rats in each group amounted to six) using different histological staining methods. The results obtained show that, compared with middle-aged rats, the development of degenerative changes in myofibrils is observed in old rats, which is manifested in structural inferiority and quantitative reduction. Degenerative changes revealed with age at the intracellular level can be considered an important morphological basis for the formation of functional heart failure and the depletion of adaptive capabilities.

Experimental study of the specificity of morphological changes development in internal organs with prolonged exposure to coal-rock dust and sodium fluoride to the body

Introduction. Occupational diseases detected at occupational examinations - pneumoconiosis and fluorosis - are, as a rule, chronic, the initial stages of development are almost asymptomatic. Industrial dust affects only the respiratory organs. Specific sign of fluoride intoxication is a lesion of the musculoskeletal system. The information available in the literature on the systemic manifestations of these diseases is not numerous. In this regard, it is relevant to study the early morphological changes, the timing of their occurrence and the features of development, depending on the specificity of the production factor. The study aims to experimentally identify the specificity of the development of morphological changes in organs and tissues under prolonged exposure to harmful production factors: coal-rock dust and sodium fluoride. Materials and methods. The authors conducted studies on adult white male laboratory rats. Scientists studied the features of the development of morphological changes in the bronchopulmonary system, heart, liver and kidneys in the dynamics of the impact of production factors on experimental models of anthracosilicosis and chronic fluoride intoxication. For histological examination, specialists carried out organ sampling in animals after 1, 3, 6, 9, 12 weeks of the experime Results. Chronic exposure to coal-rock dust, as well as sodium fluoride, leads to the development of compensatory and adaptive changes in the internal organs in the early stages of the experiment before the formation of degenerative and fibroplastic disorders of the stromal and parenchymal components in the later stages. Inhalation of coal-rock dust creates in experimental animals by an early breakdown of the adaptive mechanisms of the respiratory system and heart muscle. There is a formation from the 6th week of the experiment of pneumosclerosis with the spread to the air-conducting structures, atrophy of the bronchial mucosa, degenerative changes in cardiomyocytes. Despite the early formation of stroma fibrosis, reparative processes restrain dystrophic cell changes in the liver and kidneys. All this develops by the 9th week of the experiment. The accumulation of sodium fluoride leads to the early formation of pronounced protein dystrophy of the liver and kidney parenchyma with the development of necrotic changes by the 6-9 weeks of the experiment. Disorders in the bronchopulmonary system before the 9th week of exposure are of the nature of immune inflammation with the subsequent development of degenerative changes in the air-conducting structures. The heart has moderate dystrophy throughout the experiment. Regardless of the influencing factor, changes in the vessels of the studied organs at the initial stages of the experiment lead to hypertrophy of smooth muscle cells of the media and intima, followed by the development of endotheliosis and hyalinosis. Limitations. The results of the histological examination are descriptive of pathomorphological changes in the bronchopulmonary system, heart muscle, liver and kidneys. We did not conduct a morphometry of various structures of the studied organs has not been carried out with subsequent statistical processing of the results obtained. In this regard, when studying the specifics of the development of morphological changes depending on the influencing harmful production factor, the compared indicators were the first morphological changes and the timing of their formation. Conclusions. The obtained results have theoretical and practical significance for the development of recommendations for timely preventive and organ-specific therapeutic measures in the premorbid period of the development of occupational diseases. Ethics. The researchers conducted maintenance, feeding and removal of animals from the experiment in accordance with the requirements of the Order of the Ministry of Health of the Russian Federation "On approval of the Rules of Good Laboratory Practice" (No. 199n of 01.04.2016), as well as the Guide for the Maintenance and Use of Laboratory Animals (Guide for the Care and Use of Laboratory Animals, 1996). Scientists received permission from the Bioethical Committee of the Research Institute of Complex Problems of Hygiene and Occupational Diseases to conduct the study.

PAIN MANAGEMENT IN DOGS WITH OSTEOARTHROSIS: A CASE REPORT

Degenerative joint disease (DAD) or osteoarthrosis (OA) is a common disease among dogs and is characterized by being progressive, minimally inflammatory and with non-neoplastic neoproliferative alterations, which causes considerable dysfunction in all joint structures with its subsequent failure. Affected animals present lameness, reluctance to move after rest and difficulty in performing certain activities, these being the earliest common signs. The outcome of these diseases can be aggravated by: obesity, genetic predisposition, age or trauma. Its diagnosis is based on anamnesis, patient history, physical and radiographic examination. OA treatments can be surgical or conservative depending on the case, and aim to relieve discomfort and delay the development of degenerative changes and it is impossible to revert to existing pathological changes.

Radiological and Functional Assessment of Treatment Outcomes in Patients after Open Reduction with Internal Fixation (ORIF) of Acetabular Fractures.

(1) Fracture of the pelvis usually happens in young men and results from high-energy trauma. It generates high social and economic costs and results in further health problems. It is therefore important to assess long-term treatment results. (2) The study (NCT04902209) involved 31 patients (mean age 43.6 ± 14.8 years). We conducted fixation assessment on the basis of radiographs and CT scans and functional assessment based on functional scales. (3) We observed more degenerative changes in the less precise reconstruction of the acetabulum (p = 0.075). We did not find statistically significant relationships between the area of surgical approach, the gravity of fracture, and the development of degenerative changes. We did not find statistically significant relationships between patients’ functional states and the type of surgical approach or the complexity of the fracture. We found a positive correlation between the time of surgical treatment and patients’ functional state (p = 0.04). Patients whose joint surfaces were reconstructed anatomically had significantly higher scores in functional scales (HHS p = 0.05, Merle p = 0.03). (4) Patients after surgical fixation of the acetabulum have low functional abilities. The quality of reconstruction of the loaded surface as well as the length of time post-surgery seems to be essential for the patients’ functional state.

Myopic choroidal neovascularization: management issues remain

In the modern world, myopia continues to be one of the most common refractive errors and is considered a socially signifi cant problem, since it is a common cause of decreased vision. In connection with the growth of myopia, the risk of developing complications in the fundus increases, leading to the development of degenerative changes in the retina and an irreversible decrease in visual functions in young and middle-aged people. One of these complications is myopic choroidal neovascularization, which leads to a progressive, irreversible decrease in visual acuity and poor prognosis, and the process is often bilateral in nature. The tactics of managing patients with such complications has been determined: antiangiogenic therapy is used – intravitreal therapy with anti-VEGF drugs, which is currently the fi rst choice therapy for this pathology. But in some cases, antiangiogenic therapy is contraindicated, and the question arises about the tactics of managing such patients. The aim: to study treatment options for myopic choroidal neovascularization in patients with myopia in different situations.Material and methods. The paper presents two clinical observations of patients with mChNV, considers the tactics of their management. The patients underwent standard ophthalmological examination, optical coherence tomography (OCT) and OCT-Angio (OPTOPOL Technology, Poland).Conclusions. Women with myopia planning pregnancy need a thorough examination not only by a clinician, but also by an ophthalmologist, since it is necessary to take into account not only the degree of myopia and choose the optimal delivery method, but also to study the state of the retina for the timely diagnosis of degenerative changes in the fundus.

Ultrastructural characteristics of the rats laryngeal mucosa and cartilage on the 7 and 14 days of the experimental opioid effect

Background and objective. Our main task was to study the ultrastructural organization of the laryngeal mucosa and cartilage on the seventh and fourteenth day of opioid exposure. Methods. The material for the study were mature, outbred male rats in the number of 32 animals, weighing 80g, aged 4.5 months. Animals were injected intramuscularly with Nalbuphine once a day at the same time (10-11 hours in the morning) for 14 days. The initial dose of Nalbuphine was 8 mg / kg during the first week, 15 mg / kg during the second week of the experimental study. Thus, we created the conditions for chronic opioid exposure. Animals were divided into 3 experimental groups: 1 – control group; 2 - animals that received the drug for 7 days; 3 - animals that received the drug for 14 days). All animals were kept in a vivarium. Animal care, labeling and all other manipulations were carried out taking into account the issues of bioethical norms. Before collecting necropsy material, the animal was removed from the experiment with diethyl ether. The the larynx mucosa and rats cartilage were used as the material for ultrastructural examination. Ultrastructural capsule was prepared according to conventional methods. Results. As a result of experimental opioid exposure at the end of 7 days we found alternative changes in the epithelial cells of different parts of the larynx, dyscirculatory changes in blood vessels of lamina propria and submucosa, as well as the destruction of chondrocytes of hyaline and elastic cartilages. The hemocapillaries of lamina propria and submucosa, especially in the ventricles of the larynx and in the subchondral region, were dilated, overflowing with erythrocytes. In the laryngeal mucosa and submucosal base of the laryngeal ventricles, in addition to the overflow of hemocapillaries with erythrocytes, a moderate accumulation of perivascular transudate was noted. At the end of the 14th day of the experimental opioid effect, a pronounced hemocapillaries injury was found, which was accompanied by an increase in the permeability of the vascular wall. In addition to blood plasma, erythrocytes were visualized in the enlarged lumens of hemocapillaries. The development of degenerative changes of endothelial cells, which were accompanied by inhomogeneous dilation of the tubules of the smooth and granular endoplasmic reticulum, was noted. The main substance of the connective tissue of the mucous membrane and submucosal base, especially around the vessels was impregnated with transudate.

Increased Glenohumeral Joint Loads Due to a Supraspinatus Tear Can Be Reversed With Rotator Cuff Repair: A Biomechanical Investigation

To evaluate the effect of an isolated full-thickness supraspinatus (SSP) tear on glenohumeral kinematics and contact mechanics, as well as to quantify improvement following rotator cuff repair (RCR). Ten fresh-frozen cadaveric shoulders (mean age: 63.1 ± 4.6 years) were tested using a dynamic shoulder simulator. A pressure-mapping sensor was placed between the humeral head and the glenoid. Each specimen underwent the following three conditions: 1) native, 2) isolated full-thickness SSP tear, and 3) RCR. Maximum abduction angle (MAA) and superior humeral head migration (SHM) were measured using 3D motion tracking software. Cumulative deltoid force (CDF) and glenohumeral contact mechanics, including contact area (GCA) and contact pressure (GCP), were assessed at the resting position, as well as at 15°, 30°, 45°, and 60° of glenohumeral abduction. Compared to native, the SSP tear resulted in a significant decrease in MAA (Δ-8.3°; P < .001) along with a SHM of 6.4 ± 3.8 mm, while significantly increasing CDF (Δ20.5 N; P=.008), GCP (Δ63.1 kPa; P < .001), and peak GCP (Δ278.6 kPa; P < .001), as well as decreasing GCA (Δ-45.8 mm2; P<.001) at each degree of abduction. RCR reduced SHM to 1.2 ± 2.5 mm, while restoring native MAA, CDF (Δ1.8 N), GCA (Δ4.5 mm2), GCP (Δ-4.5 kPa) and peak GCP (Δ19.9 kPa) at each degree of abduction (P > .999, respectively). In a dynamic biomechanical cadaveric model, increased glenohumeral joint loads due to a full-thickness SSP tear can be reversed with RCR. More specifically, RCR restored native glenohumeral contact area and contact pressure, while preventing superior humeral head migration and decreasing compensatory deltoid forces. These time 0 observations indicate that undergoing rotator cuff repair may prevent the development of degenerative changes by significantly reducing glenohumeral joint loads and ensuring sufficiently stable joint kinematics.

Risk factors for the development of degenerative changes among patients undergoing rotator cuff repair: A systematic review.

Osteoarthritis (OA) of the glenohumeral joint results in significant pain and functional limitations. It is unclear which risk factors increase the risk of developing glenohumeral OA amongst Rotator Cuff Repair (RCR) patients. The purpose of this systematic review was to examine the risk factors which may contribute to the development of osteoarthritic changes post-operatively. MEDLINE, Embase, and PubMed databases were searched to identify studies reporting on demographics of patients who develop OA following RCR. Seventeen articles were identified investigating a total of 1292 patients. The overall quality of evidence was low. Pooled assessment of OA incidence following RCR at minimum 5 years follow-up found 26% of patients developed OA. Patients requiring revision surgery following retears developed OA at a rate of 29%. Surgical technique and patient demographics may also contribute to degenerative changes. This review found correlations between the aforementioned risk factors and glenohumeral joint degeneration at long-term follow-up after RCR. These findings suggest that future long-term studies should aim to identify prognostic factors that may place a patient at increased risk of developing OA. Such data can be used to counsel patients with respect to long-term outcomes following surgical intervention.

Relationship between structural changes in paravertebral muscles and the development of spine degenerative diseases

Based on the systematic approach to the diagnosis of spinal patho­logy, there are no fundamental differences in the etiology of spine degenerative disease, facet joints arthritis, and other diseases. These diseases are considered multifactorial: age (aging), systemic regulatory factors (hormones, peptides, cytokines), genetic predisposition, inadequate physical activity, unfavorable environmental factors, and others lead to pathological changes in the structure of the spinal motor segment components. Recently, much attention has been paid to the paravertebral muscles changes, in which over time, as a result of injuries or degenerative processes, inevitably lead to dysfunction, which can lead to the occurrence of chronic lumbar pain. Objective. To assess the relationship between structural changes in paravertebral muscles and the development of degenerative diseases of the spine on the basis of scientific literature review. It was found that degenerative changes in paravertebral muscles, as components of spinal motor segments, develop with aging. In particular, muscle fibers are replaced by fat tissue, which is more pronounced in women compared to men. A direct correlation between chronic lumbar pain and paravertebral muscle atrophy has been reported. Systemic factors, in particular low levels of vitamin D, also can cause the development of degenerative changes in paravertebral muscles, especially in women. Obesity provokes systemic inflammation, increases fatty infiltration of skeletal muscles and increases sensitivity to pain. Reduced levels of physical activity lead to weakness and atrophy of the paravertebral muscles, which can cause degeneration of the intervertebral disc. At the same time, exercise prior to spinal surgery for degenerative disea­ses improves functional outcomes and reduces pain. Conversely, damage to the paravertebral muscles increase the load on the adjacent to spinal fusion segments. In general, the role of paravertebral muscles in the development of degenerative spinal diseases has not been definitively studied.

Modelling of degenerative changes in paravertebral muscles for studying of its influence on spine diseases

An important component of the development of degenerative changes in the spine is damage and disruption of the vital acti­vity of the paravertebral muscles. Objective. Based on the analysis of biochemical parameters of laboratory rats serum we evaluated the suitability of the studied models of dystrophic muscle tissue lesions for further study of the development of degenerative-dystrophic disorders in the spinal motor segments. Methods. Simulated: group I (5 female rats) — alimentary obesity by keeping for 3 months. on a high-calorie diet (hyperlipidemic diet); group II (5) — ischemia by ligation for 45 days of large back rectus muscles the with suture material that is not absorbed. Control — 5 intact animals of the same age and sex, which were kept on a standard diet. Serum levels of glycoproteins, haptoglobin, total chondroitin sulfates (CHS), glucose, cholesterol, low-density lipoproteins, triglycerides, total lipids, activity of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline and acid phosphatases, creatine phosphokinase were defined, thymol test was determined. Parameters were processed by the Fisher–Student method. Results. In the I group of rats, the content of glycoproteins, total cholesterol and lipids, low-density lipoproteins, triglycerides, glucose, CHS, ALT and AST activity, thymol test va­lues were increased and the level of creatine phosphokinase activi­ty was decreased. In animals of group II, an increase in serum activity of creatine phosphokinase, glycoproteins and CHS was recorded. Conclusions. Changes in the serum biochemical parameters of white rats recorded on a hyperlipidemic diet indicate the development of fatty degeneration, including in muscle tissue. Biochemical signs of degenerative processes in muscle tissue have been identified as a result of simulation of paravertebral muscle ischemia. Key words. Muscle, disorders, degeneration, spine, mo­deling, hyperlipidemia, ligation, biochemistry.