Double Anchor Research Articles

Double anchor footprint fixation for avulsion fracture of the greater tuberosity with dislocation of the shoulder: Report of four cases

Double anchor footprint fixation for avulsion fracture of the greater tuberosity with dislocation of the shoulder: Report of four cases

Effect of three remplissage techniques on tendon coverage and shoulder kinematics: a navigated robotic biomechanical study.

BackgroundIn addition to Bankart repair engaging Hill-Sachs defects in glenohumeral instability have been treated successfully with remplissage procedure. The purpose of this study was to compare three remplissage techniques regarding (I) ability of preventing Hill-Sachs defect from engaging, (II) influence on glenohumeral rotational torque, and (III) resulting tendon coverage over the Hill-Sachs defect.MethodsStandardized engaging Hill-Sachs defects and Bankart lesions were created in n = 7 fresh frozen human shoulder specimens. Besides Bankart repair three remplissage techniques (T) with double anchor position in the valley of the defect zone were studied: T1, knots tied over anchors; T2, knots tied between anchors (double-pulley); T3, knotless anchors with a suture tape.A parallel position-orientation and force-moment controlled navigated roboticsystem was used to compare prevention of Hill-Sachs defect engagement and torque [Nm]. Pressure sensitive film was used to study area of infraspinatus tendon coverage over Hill-Sachs defect [%].ResultsAll remplissage techniques prevented engagement of the Hill-Sachs defect without showing any construct failures. Regarding humeral torque there were significant impairments observed between intact conditions and the three investigated repair techniques in 60° abduction and ≥30° external rotation (p < .04). There was no significant difference in torque between intervention groups (n.s.). With a mean coverage of 26.8 % over the defect zone the knotless suture tape technique (T3) significantly improved area of soft tissue coverage compared to the other techniques (p = .03).ConclusionAll remplissage techniques prevented engagement of the Hill Sachs defect. With high abduction and external rotation ≥30° all techniques showed significant higher humeral torque compared to the intact specimens, while there was not one technique superior over the others. The suture tape technique conferred the largest and most effective area of tendon coverage over the Hill-Sachs defect zone. Long-term success of the remplissage procedure can possibly be enhanced by increasing the interface area of tendon coverage over the Hill-Sachs defect. Clinical studies will be necessary to proof potential benefits for clinical outcome.

Research on the anchorage measures of reinforced concrete beam and wall plane external connection joint

In the external connection of the beam and wall, the anchorage of the end of the longitudinal reinforcement plays an important role in the bearing capacity of the whole node.Relevant information at home and abroad were reviewed in this paper. In this connection the existing anchor improvement measures research progress and application were summarized,which includes the improving and characteristics of visible beam or beam head, double anchor plate and so on. Put forward the problems to be further studied in the future.

Imidazole‐Based Sensitizers Containing Double Anchors for Dye‐Sensitized Solar Cells

AbstractNew imidazole‐based organic dyes with two 2‐cyanoacetic acid acceptors/anchors connected at the C‐4 and C‐5 positions, and a carbazole or arylamine donor connected at the C‐2 position of the imidazole entity were synthesized and used as sensitizers for dye‐sensitized solar cells. The dyes exhibit optical absorption from 300–600 nm with high molar extinction coefficients. The inclusion of a hexyl chain at the nitrogen atom of the imidazole was found to result in a large twist of the C‐4 segment from the imidazole and, hence, to less efficient electron injection. Although dye aggregation results in light harvesting at longer wavelength regions, it also leads to excited‐state quenching and hinders electron injection. Consequently, only moderate conversion efficiencies of DSSCs were achieved. Upon addition of CDCA coadsorbents, up to ca. 30 % improvement of the cell efficiency was achieved. The best cell efficiency reached 4.97 % with addition of 50 mM CDCA.

New triphenylamine-based sensitizers bearing double anchor units for dye-sensitized solar cells

Two organic sensitizers (LI-33 and LI-34) with double anchoring units were synthesized and utilized for dye sensitized solar cells (DSSCs), which contained thiophene or vinyl thiophene as π-bridge. The introduction of double anchoring units can change their absorption spectra and energy levels in a large degree, thus, the better light-harvesting ability and the convenient electron transfer along the whole molecule can be obtained. The solar cell based on LI-34 exhibited a broad incident photon-to-current conversion efficiency (IPCE) spectrum and high conversion efficiency (η=6.05%) with coadsorbent CDCA.

Eugenic metal-free sensitizers with double anchors for high performance dye-sensitized solar cells

A series of new phenothiazine-based dyes (HL5-HL7) with double acceptors/anchors have been synthesized and used as the sensitizers for highly efficient dye-sensitized solar cells (DSSCs). Among them, the HL7-based cell exhibits the best efficiency of 8.32% exceeding the N719-based cell (7.35%) by ∼13%.

Novel Near‐Infrared Squaraine Sensitizers for Stable and Efficient Dye‐Sensitized Solar Cells

A new molecular design strategy for tuning the energy levels of cis‐configured squaraine sensitizers for dye‐sensitized solar cells is described. The Hammett substituent constant and the π‐conjugation length are used as quantitative indicators to modify the central squarate moiety of the sensitizer dyes; specifically, novel near‐infrared squaraine dyes HSQ3 and HSQ4 are synthesized by incorporation of an electron‐withdrawing and π‐extending ethyl cyanoacetate unit on the central squarate moiety. The solution absorption maximum of HSQ4 occurs at 703 nm, and the energy levels of the lowest unoccupied molecular orbital and the highest occupied molecular orbital are in the ideal range for energetically efficient electron injection and regeneration of the oxidized dye. A solar cell sensitized with HSQ4 exhibits a broad incident photo­n‐to‐current conversion efficiency spectrum, extending into the near‐infrared region with a maximum value of 80% at 720 nm, which is is the highest value reported for a squaraine dye–based dye‐sensitized solar cell. The HSQ4‐sensitized solar cell also exhibits excellent durability during light soaking, owing to the double anchors attaching the dye to the TiO2 surface and to the long alkyl chains extending outward from the surface.

Microfluidic Fabrication of Polymeric and Biohybrid Fibers with Predesigned Size and Shape

A “sheath” fluid passing through a microfluidic channel at low Reynolds number can be directed around another “core” stream and used to dictate the shape as well as the diameter of a core stream. Grooves in the top and bottom of a microfluidic channel were designed to direct the sheath fluid and shape the core fluid. By matching the viscosity and hydrophilicity of the sheath and core fluids, the interfacial effects are minimized and complex fluid shapes can be formed. Controlling the relative flow rates of the sheath and core fluids determines the cross-sectional area of the core fluid. Fibers have been produced with sizes ranging from 300 nm to ~1 mm, and fiber cross-sections can be round, flat, square, or complex as in the case with double anchor fibers. Polymerization of the core fluid downstream from the shaping region solidifies the fibers. Photoinitiated click chemistries are well suited for rapid polymerization of the core fluid by irradiation with ultraviolet light. Fibers with a wide variety of shapes have been produced from a list of polymers including liquid crystals, poly(methylmethacrylate), thiol-ene and thiol-yne resins, polyethylene glycol, and hydrogel derivatives. Minimal shear during the shaping process and mild polymerization conditions also makes the fabrication process well suited for encapsulation of cells and other biological components.

Microfluidic Fabrication of Polymeric and Biohybrid Fibers with Predesigned Size and Shape

A “sheath” fluid passing through a microfluidic channel at low Reynolds number can be directed around another “core” stream and used to dictate the shape as well as the diameter of a core stream. Grooves in the top and bottom of a microfluidic channel were designed to direct the sheath fluid and shape the core fluid. By matching the viscosity and hydrophilicity of the sheath and core fluids, the interfacial effects are minimized and complex fluid shapes can be formed. Controlling the relative flow rates of the sheath and core fluids determines the cross-sectional area of the core fluid. Fibers have been produced with sizes ranging from 300 nm to ~1 mm, and fiber cross-sections can be round, flat, square, or complex as in the case with double anchor fibers. Polymerization of the core fluid downstream from the shaping region solidifies the fibers. Photoinitiated click chemistries are well suited for rapid polymerization of the core fluid by irradiation with ultraviolet light. Fibers with a wide variety of shapes have been produced from a list of polymers including liquid crystals, poly(methylmethacrylate), thiol-ene and thiol-yne resins, polyethylene glycol, and hydrogel derivatives. Minimal shear during the shaping process and mild polymerization conditions also makes the fabrication process well suited for encapsulation of cells and other biological components.

High‐Performance Dye‐Sensitized Solar Cells Based on Phenothiazine Dyes Containing Double Anchors and Thiophene Spacers

A series of new push-pull phenothiazine-based dyes (HL1-HL4) featuring various π spacers (thiophene, 3-hexylthiophene, 4-hexyl-2,2'-bithiophene) and double acceptors/anchors have been synthesized, characterized, and used as sensitizers for dye-sensitized solar cells (DSSCs). Among them, the best conversion efficiency (7.31%) reaches approximately 99% of the N719-based (7.38%) DSSCs fabricated and measured under similar conditions. The dyes with two anchors have more efficient interfacial charge generation and transport compared with their congeners with only single anchor. Incorporation of hexyl chains into the π-conjugated spacer of these double-anchoring dyes can efficiently suppress dye aggregation and reduce charge recombination.

Design and fabrication of uniquely shaped thiol–ene microfibers using a two-stage hydrodynamic focusing design

Microfluidic systems have advantages that are just starting to be realized for materials fabrication. In addition to the more common use for fabrication of particles, hydrodynamic focusing has been used to fabricate continuous polymer fibers. We have previously described such a microfluidics system which has the ability to generate fibers with controlled cross-sectional shapes locked in place by in situ photopolymerization. The previous fiber fabrication studies produced relatively simple round or ribbon shapes, demonstrated the use of a variety of polymers, and described the interaction between sheath-core flow-rate ratios used to control the fiber diameter and the impact on possible shapes. These papers documented the fact that no matter what the intended shape, higher flow-rate ratios produced rounder fibers, even in the absence of interfacial tension between the core and sheath fluids. This work describes how to fabricate the next generation of fibers predesigned to have a much more complex geometry, as exemplified by the "double anchor" shape. Critical to production of the pre-specified fibers with complex features was independent control over both the shape and the size of the fabricated microfibers using a two-stage hydrodynamic focusing system. Design and optimization of the channels was performed using finite element simulations and confocal imaging to characterize each of the two stages theoretically and experimentally. The resulting device design was then used to generate thiol-ene fibers with a unique double anchor shape. Finally, proof-of-principle functional experiments demonstrated the ability of the fibers to transport fluids and to interlock laterally.

Outcomes of the Modified Brostrom Procedure Using Suture Anchors for Chronic Lateral Ankle Instability—A Prospective, Randomized Comparison between Single and Double Suture Anchors

The present prospective, randomized study was conducted to compare the clinical outcomes of the modified Brostrom procedure using single and double suture anchors for chronic lateral ankle instability. A total of 50 patients were followed up for more than 2 years after undergoing the modified Brostrom procedure. Of the 50 procedures, 25 each were performed using single and double suture anchors by 1 surgeon. The Karlsson scale had improved significantly to 89.8 points and 90.6 points in the single and double anchor groups, respectively. Using the Sefton grading system, 23 cases (92%) in the single anchor group and 22 (88%) in the double anchor group achieved satisfactory results. The talar tilt angle and anterior talar translation on stress radiographs using the Telos device had improved significantly to an average of 5.7° and 4.6 mm in the single anchor group and 4.5° and 4.3 mm in the double anchor group, respectively. The double anchor technique was superior with respect to the postoperative talar tilt. The single and double suture anchor techniques produced similar clinical and functional outcomes, with the exception of talar tilt as a reference of mechanical stability. The modified Brostrom procedure using both single and double suture anchors appears to be an effective treatment method for chronic lateral ankle instability.

Percutaneous radiological gastrostomy: single-puncture double-anchor technique

We evaluated technical success, safety and effectiveness of percutaneous radiological gastrostomy (PRG) with a modified technique: single puncture and double anchor. From January 2008 to June 2011, 163 patients underwent PRG with a single-puncture double-anchor technique. The stomach was punctured with a 17-gauge Chiba needle, and gastropexy was performed by placing two anchors in the gastric lumen. Finally, a 12-F Wills-Oglesby percutaneous gastrostomy catheter was inserted. Technical success and complications at 30 days were evaluated on the basis of imaging and patients' medical records. PRG was successfully completed in all 163 patients. Only a single puncture was required in all patients. The average PRG procedure time was 9 min. Three patients had major complications: haemorrhage (n=2) and pneumoperitoneum (n=1). Ten patients had minor complications: tube malfunction/breakage (n=9), and leakage through the insertion site (n=1). Two patients died 30 days after the procedure. Single-puncture double-anchor PRG is a fast, safe and effective technique.

Paper 34: Functional and MR Arthrography Imaging Evaluation After Arthroscopic Single Row and Double Row Suture Anchor Repair

Paper 34: Functional and MR Arthrography Imaging Evaluation After Arthroscopic Single Row and Double Row Suture Anchor Repair

Evaluation of the association of mercury(II) with some dicysteinyl tripeptides

The present study was undertaken to gain insight into the associations of mercury(II) with dicysteinyl tripeptides in buffered media at pH 7.4. We investigated the effects of increasing the distance between cysteinyl residues on mercury(II) associations and complex formations. The peptide–mercury(II) formation constants and their associated thermodynamic parameters in 3-(N-morpholino)propanesulfonic acid (MOPS) buffered solutions were evaluated by isothermal titration calorimetry. Complexes formed in different relative ratios of mercury(II) to cysteinyl peptides in ammonium formate buffered solutions were characterized by LTQ Orbitrap mass spectrometry. The results from these studies show that n-alkyl dicysteinyl peptides (CP 1–4), and an aryl dicysteinyl peptide (CP 5) can serve as effective “double anchors” to accommodate the coordination sites of mercury(II) to form predominantly one-to-one Hg(peptide) complexes. The aryl dicysteinyl peptide (CP 5) also forms the two-to-two Hg2(peptide)2 complex. In the presence of excess peptide, Hg(peptide)2 complexes are also detected. Notably, increasing the distance between the ligating groups or “anchor points” in CP 1–5 does not significantly affect their affinity for mercury(II). However, the enthalpy change (ΔH) values (ΔH1∼−91kJmol−1 and ΔH2∼−66kJmol−1) for complex formation between CP 4 and 5 with mercury(II) are about one and a half times larger than the related values for CP 1, 2 and 3 (ΔH1∼−66kJmol−1 and ΔH2∼46kJmol−1). The corresponding entropy change (ΔS) values (ΔS1∼−129JK−1mol−1 and ΔS2∼−116JK−1mol−1) of the structurally larger dicysteinyl peptides CP 4 and 5 are less entropically favorable than for CP 1, 2 and 3 (ΔS1∼−48JK−1mol−1 and ΔS2∼−44JK−1mol−1). Generally, these associations result in a decrease in entropy, indicating that these peptide–mercury complexes potentially form highly ordered structures. The results from this study show that dicysteinyl tripeptides are effective in binding mercury(II) and they are promising motifs for the design of multi-cysteinyl peptides for binding more than one mercury(II) ion per peptide.

A new technique of arthroscopic fixation using double anchors for SLAP lesions

The aim of this study was to evaluate the clinical and structural outcome of the new fixation technique of type-II SLAP repair using double anchors compared with conventional method. Twenty-eight patients with 29 shoulders, who were followed up for at least 1 year after surgery, were enrolled. Fourteen shoulders were treated using the new technique (group 1), and 15 shoulders using the conventional technique (group 2). The clinical outcomes were evaluated using two different functional scores, the pain VAS and range of motion. The postoperative labral integrity was determined by magnetic resonance imaging at 1 year after surgery. At postoperative 6 months, all functional scores of group 1 were superior to group 2, particularly in pain VAS and Constant Scoring System. All ranges of motion in group 1 showed a better result than in group 2, particularly in forward flexion and external rotation at 90° abduction (88° ± 4.8 in group 1 and 84° ± 9.2 in group 2, P = 0.03). At postoperative 12 months and the last visit, all functional scores in group 1 were superior to those in group 2 and all external rotations at 90° of abduction in group 1 showed significantly better results than those of group 2. All patients in group 1 showed complete healing of the repaired SLAP lesion but one patient in group 2 showed partial detachments on the MRI. This new technique provides anatomical restoration of a SLAP lesion and yields successful clinical and structural outcomes at a short-term follow-up. Randomized controlled trials, level II.

Double Anchor Footprint Fixation 法を用いた鏡視下腱板修復術の MRI 評価：Double Row 法との比較

Double Anchor Footprint Fixation 法を用いた鏡視下腱板修復術の MRI 評価：Double Row 法との比較

Arthroscopic repair of rotator cuff tear with anchor and transosseous suture

Objective To discuss the surgical methods and techniques of rotator cuff tear repair with anchor and transosseous suture and evaluate the clinical outcomes. Methods From February 2007 to February 2009, 32 cases of various types of rotator cuff tear were treated arthroscopically. The rotator cuff was repaired with suture anchor and transosseous suture. Twenty-five cases had full thickness tear, 5 had partial bursa-side tear,and 2 had partial articular-side tear. Sixteen lesions were on the dominant side. Preoperatively X-rays of the shoulder at the anteroposterior and supraspinatus outlet projection were obtained in all cases. Eleven patients had undergone MRI examinations and 21 cases had MRA. All the patients underwent acromioplasty. Eighteen cases were treated by single roll suture anchor and 1 or 2 transosseous tunnel suture, while 14 cases were treated by double roll suture anchor and 1 or 2 transosseous tunnel suture. UCLA scoring system was adopted to evaluate shoulder function before the operation and at the final postoperative follow up. Results All 32 cases were followed up for 3 to 23 months, with a mean interval of 13.4 months. The average UCLA score was 13.3 preoperatively and 33. 1 postoperatively. Twenty-three cases were rated as good and 9 cases as fair. Pain disappeared in 21 cases, while occasional and mild pain and discomfort still existed in 5 cases. In 6 cases pain was triggered by massive movement or special maneuvers. Normal shoulder movement was achieved in 24 cases. Active forward flexion and abduction reached > 150° in 26 cases and 90° to 120° in 6 cases. Muscle power of forward flexion and abduction was M5 in 25 cases and M4 in 7 cases. All the patients were satisfied with the surgical outcomes. Conclusion Arthroscopic repair using anchor and transosseous suture is a good method for repairing rotator cuff tear. This technique leads to secure fixation and hence ensures rotator cuff to bone healing. It is especially suitable for patients with osteoporosis or for revision cases. Key words: Shoulder joint; Reconstructive surgical procedures; Arthroscopes

Structural Studies of Soybean Calmodulin Isoform 4 Bound to the Calmodulin-binding Domain of Tobacco Mitogen-activated Protein Kinase Phosphatase-1 Provide Insights into a Sequential Target Binding Mode

The calcium regulatory protein calmodulin (CaM) binds in a calcium-dependent manner to numerous target proteins. The calmodulin-binding domain (CaMBD) region of Nicotiana tabacum MAPK phosphatase has an amino acid sequence that does not resemble the CaMBD of any other known Ca(2+)-CaM-binding proteins. Using a unique fusion protein strategy, we have been able to obtain a high resolution solution structure of the complex of soybean Ca(2+)-CaM4 (SCaM4) and this CaMBD. Complete isotope labeling of both parts of the complex in the fusion protein greatly facilitated the structure determination by NMR. The 12-residue CaMBD region was found to bind exclusively to the C-lobe of SCaM4. A specific Trp and Leu side chain are utilized to facilitate strong binding through a novel "double anchor" motif. Moreover, the orientation of the helical peptide on the surface of Ca(2+)-SCaM4 is distinct from other known complexes. The N-lobe of Ca(2+)-SCaM4 in the complex remains free for additional interactions and could possibly act as a calcium-dependent adapter protein. Signaling through the MAPK pathway and increases in intracellular Ca(2+) are both hallmarks of the plant stress response, and our data support the notion that coordination of these responses may occur through the formation of a unique CaM-MAPK phosphatase multiprotein complex.

Prospective Randomized Clinical Trial of Single versus Double Row Suture Anchor Repair in Medium to Large Rotator Cuff Tears (SS-07)

Prospective Randomized Clinical Trial of Single versus Double Row Suture Anchor Repair in Medium to Large Rotator Cuff Tears (SS-07)