Repair Group Research Articles (Page 1)

With the growing popularity of rhinoplasty, techniques for enhancing functional and aesthetic outcomes are evolving. This study aims to compare 2 methods in rhinoplasty-sutured scroll reconstruction versus no scroll repair-focusing on their effects on nasal breathing, aesthetic results, and patient satisfaction. This randomized controlled study at Taleghani Hospital in Tehran involved female patients aged 18 to 50 years undergoing primary rhinoplasties. Participants were assigned to 2 groups, and only 1 received sutured horizontal scroll ligament repair. Outcomes were assessed using the FACE-Q rhinoplasty module for patient satisfaction and rhinomanometry for nasal function, with independent surgeons evaluating aesthetic results via a Visual Analog Scale. For statistical analyses SPSS version 22.0 was used, with significance set at P < .05. The study involved 164 female patients, with 82 in the sutured scroll ligament group and 82 in the no scroll repair group. The mean age was 26.32 ± 6.86 years (range = 19-46). No significant baseline differences were found. After a mean follow-up of 11.6 months, no patients required revision surgery. Post-operative FACE-Q scores and VAS ratings were higher in the sutured group. The mean postoperative peak inspiratory nasal flow (PNIF) was 116.42 ± 13.78 ml/minute in the sutured group versus 111.08 ± 15.67 ml/minute in the other group (P = .034). This randomized clinical trial emphasizes on the positive effect of ensuring the scroll ligament repair using sutures on the facial aesthetics, quality of life, and functional capacity of patient after the surgery. Which is consistent with the prior studies indicating both cosmetic and functional benefits for scroll preservation/reconstruction.

Background: Rheumatic mitral valve disease remains one of the most prevalent cardiovascular diseases in developing countries, affecting younger patients compared to degenerative valve disease. Evidence regarding optimal surgical strategies for rheumatic mitral valve disease patients under 65 remains limited. We aimed to quantitatively characterize valve pathology using multimodal imaging and compare midterm outcomes between two groups. Methods: This multicenter cohort study enrolled patients aged ≤65 years undergoing surgery between December 2016 and December 2022. All patients underwent attempted standardized SCORES repair techniques by experienced surgeons, including debridement of fibrotic commissures and leaflets, commissurotomy, subvalvular apparatus release, and annuloplasty ring implantation. Cases deemed unsuitable for repair or with suboptimal results underwent posterior leaflet-preserving mechanical valve replacement. Inverse probability weighting was used to adjust baseline differences between repair and replacement groups. Preoperative mitral valve characteristics were quantitatively assessed using multimodal imaging (echocardiography and coronary CTA). Results: Among 799 rheumatic mitral valve disease patients under 65, 527 (66.0%) underwent repair and 272 (34.0%) underwent mechanical replacement. After inverse probability weighting (SMD&lt;0.1 for all variables), multimodal imaging revealed lower Agatston calcium scores (0.00 vs 37.00, P&lt;0.001), smaller left atrial diameters (50.00 vs 51.00 mm, P=0.003), and lower pulmonary artery pressures (40.00 vs 42.00 mmHg, P=0.005) in the repair group. The repair group had lower rates of postoperative respiratory failure (0.1% vs 1.3%, P=0.031) with comparable other complications. At median 43.65-month follow-up, repair demonstrated lower mortality (1.1% vs 4.9%, P=0.004), reduced stroke incidence (0.9% vs 2.8%, P=0.069), and comparable reoperation rates (0.7% vs 0.0%, P=0.167). Kaplan-Meier analysis showed significantly better midterm survival in the repair group (Log-rank P=0.036). Conclusions: For rheumatic mitral valve disease patients under 65, mitral valve repair significantly reduces midterm mortality and stroke risk compared to mechanical replacement, with similar reoperation rates. Future studies should evaluate long-term repair outcomes and feasibility of transcatheter reinterventions to optimize the whole-life cycle management strategies for rheumatic mitral valve disease.

Background: While early surgical repair in tetralogy of Fallot (TOF) is increasingly favored, the long-term impact of surgical strategy—particularly on extracardiac organs—remains unclear. This study aimed to compare neurologic, pulmonary, renal, hepatic, and developmental outcomes between initial total correction and staged repair in neonates with TOF. Methods: We analyzed data from the Korean National Health Insurance Service database (2005–2021), including all infants diagnosed with TOF within the first year of life. Patients were grouped by surgical strategy: (1) initial total correction within 30 days of diagnosis and (2) staged repair, defined as PDA stent or shunt followed by total correction. Primary outcomes were extracardiac complications identified by ICD-10 codes. Multivariable Cox regression models were used to estimate adjusted hazard ratios (HRs), with subgroup analyses for patients undergoing intervention within 1 and 3 months of diagnosis. Results: Among 2,496 patients who underwent total correction, the staged repair group had significantly higher risks of neurologic (HR 6.08; 95% CI, 3.43–10.78), renal (HR 9.95; 95% CI, 4.79–20.66), and developmental (HR 1.70; 95% CI, 1.42–2.03) complications compared to the initial correction group. These associations persisted across early intervention subgroups. Pulmonary and hepatic complications showed no significant difference. Independent predictors of adverse outcomes included low birth weight and presence of genetic disorders. Conclusions: In this nationwide study, staged repair in TOF was associated with substantially greater long-term risk of renal, neurologic, and developmental complications, even in infants requiring early intervention. These findings support consideration of extracardiac morbidity—not just cardiac survival—when selecting surgical timing in TOF.

To evaluate the feasibility and safety of total arch replacement with a frozen elephant trunk in patients with Stanford type B aortic dissection and an entry ≤ 10mm distal to the left subclavian artery. We retrospectively reviewed 40 consecutive patients who underwent either total arch replacement with a frozen elephant trunk (n = 30) or thoracic endovascular aortic repair (n = 10). The primary outcome was late all-cause mortality. Secondary outcomes included major complications, planned additional endovascular repair after total arch replacement with a frozen elephant trunk, false lumen thrombosis, and aortic remodeling. In the thoracic endovascular aortic repair group, procedure-related complications occurred, including retrograde type A dissection and one death from aortic rupture. In the total arch replacement with a frozen elephant trunk group, all deaths were unrelated to the index procedure. Planned additional endovascular repair was more frequently performed after total arch replacement with a frozen elephant trunk. Total arch replacement with a frozen elephant trunk is safe for anatomically challenging type B aortic dissection with an entry near the left subclavian artery and represents a viable treatment option in this setting.

Amyand's hernia (AH) is a relatively rare type of inguinal hernia, characterized by the presence of the appendix inside the hernia sac. The aim of this study is to examine the role of prosthetic mesh in AH repair compared to the traditional suture repair techniques regarding safety, efficacy and various postoperative complications. A systematic review of MEDLINE via PubMed, Scopus and Google Scholar was performed, aligned with the PRISMA guidelines. All studies in English language reporting AH repair using mesh or suture techniques in adults including more than 5 patients were included. Twelve studies reported a total of 123 patients with AH, 58 of which were repaired using prosthetic mesh and 71 with traditional suture techniques. The overall presence of an inflamed appendix was 58.5%. Appendicitis was present in 12.7% of the mesh repair group compared to a 95.5% of the suture repair group. Surgical site infections (SSIs) were 3.4% of all complications in the mesh group compared to 6.8% in the suture repair group. Extended hospital stay of more than 10 days was observed in 12.7 in the mesh group compared to 7.3% of the suture repair group. The most technically challenging cases with septic conditions are appropriate for suture repair only, while mesh repair is usually performed in AH cases without appendix inflammation and is more commonly used in conjunction with appendix reduction into the abdominal cavity rather than appendicectomy.

Few studies have described the efficacy of end-to-side (ETS) nerve transfer for high ulnar nerve injuries. This study aimed to compare the intrinsic functional outcomes of patients who underwent ETS nerve transfer for proximal ulnar nerve transection injuries and those of patients who did not. We retrospectively evaluated 15 patients who underwent primary repair of proximal ulnar nerve injuries. Patients were divided into groups based on whether ETS nerve transfer was performed. Postoperative intrinsic atrophy, clawing, ability cross finger Froment sign, Wartenberg sign, and Disabilities of Arm, Shoulder, and Hand (DASH) scores were evaluated and compared between groups. Additionally, two-point discrimination, grip strength, pinch strength, and intrinsic muscle strength of the hand were evaluated and compared between groups. Nine patients comprised the ulnar nerve repair (UNR) group and six patients comprised the UNR with SETS (UNR+ETS) group. No significant differences in intrinsic atrophy, clawing, ability to cross finger, Froment sign, Wartenberg sign, and DASH scores were observed between groups. No significant differences in the strength of the abductor digiti minimi, grip strength, pinch strength, and two-point discrimination were observed between groups. A statistically significant difference only in the strength of the first dorsal interosseous muscle was observed between groups. Our comparative study showed little or no benefit of ETS-AIN transfer for high ulnar nerve injuries.

BackgroundThis study aimed to compare preperitoneal ventral mesh patch with barbed suture in ventral hernia repair, evaluating recurrence rates and complications, and to assess the safety of preperitoneal patch placement.MethodsIn this randomized clinical trial, adult patients undergoing ventral hernia repair at Karlskoga Hospital between 2020 and 2023 were randomized 1 : 1 to either a ventral mesh patch repair group or a non-absorbable barbed suture repair group, blinded to patients and outcome assessors. The primary outcome was recurrence detected at clinical examination and CT verification 1 year after surgery. Pain (measured on a visual analogue scale and using the Ventral Hernia Pain Questionnaire), nausea, and surgical site events (including wound infection, haematoma and seroma) were assessed 4 h, 1 week, 1 month, and 4 years after operation.ResultsOf 256 eligible patients, 209 were screened, and 205 were randomized to ventral mesh patch repair (103) or barbed suture repair (102). The hernia recurrence rate at 1 year was lower in the ventral patch repair group (1.9 versus 5.9%), although this was not statistically significant (P = 0.14). The surgical site infection rate at 1 month was significantly lower in the ventral patch group (0.9 versus 6.9%; P = 0.02). At 1 month, the ventral patch repair group had higher ‘pain right now’ scores on the Ventral Hernia Pain Questionnaire (P = 0.02), although this difference had disappeared by 1 year.ConclusionPreperitoneal ventral hernia patch repair is a safe and effective technique with a recurrence rate not statistically significant from that after barbed suture repair. Although postoperative pain scores at 1 month were higher after ventral patch repair, this difference had disappeared by 1 year.

Large os subfibulare (LOS; diameter ≥10 mm) is sometimes identified in patients with chronic lateral ankle instability or pain; thus, ossicle excision with lateral ligament stabilization is commonly performed. However, whether ligament repair or reconstruction yields superior outcomes remains controversial, and comparative studies are lacking. To compare clinical outcomes between ligament repair (modified Broström-Gould procedure) and reconstruction after LOS excision and to identify factors influencing ligament repair outcomes. Retrospective cohort study; Level of evidence, 3Methods:The medical records of patients undergoing LOS excision with ligament repair or reconstruction between May 2020 and April 2023 were retrospectively reviewed. After 1:1 propensity score matching by age, sex, side, body mass index, symptom duration, preoperative Tegner score, and Beighton score, 68 patients were included (34 per group). Preoperative imaging parameters, including ossicle diameter, signal-to-noise ratio (SNR) of the anterior talofibular ligament (ATFL), and joint degeneration, were evaluated. Intraoperative lesions, including osteochondral lesion of the talus and calcaneofibular ligament injuries, were recorded. Primary outcomes included patient-reported outcomes (PROs): visual analog scale (VAS) score for pain, Karlsson score, Tegner score, and Foot and Ankle Outcome Score (FAOS). Secondary outcomes included return-to-sport time and overall satisfaction. Complications, such as recurrent sprains and incisional numbness, were also recorded. Univariate analyses were conducted to evaluate the impact of preoperative imaging parameters and intraoperative lesions on ligament repair outcomes. The mean follow-up times were 44.7 ± 9.3 months (repair) and 44.8 ± 7.3 months (reconstruction) (P = .914). Both groups showed significant improvements in VAS, Karlsson, Tegner, and FAOS values (all P < .05). Postoperative PROs showed no intergroup differences between the repair and reconstruction groups (VAS score: 0.8 ± 1.4 and 0.7 ± 0.8; Karlsson score: 87.9 ± 11.8 and 88.5 ± 8.4; Tegner score: 4.7 ± 1.1 and 4.2 ± 1.2; total FAOS: 90.1 ± 7.7 and 91.2 ± 6.7, respectively). Return-to-sport time, incidence of recurrent sprains, incision numbness, and overall satisfaction were comparable. In the repair group, ATFL-SNR negatively correlated with postoperative FAOS values (r = -0.707; P < .001), and patients with ATFL-SNR >11.8 had mean postoperative FAOS values lower than those of the reconstruction group (91.2 ± 6.7). Both procedures yielded satisfactory outcomes after LOS excision. However, ligament reconstruction may offer superior results when there is a high preoperative ATFL-SNR.

The foot's tarsal bones primarily consist of four joints: the subtalar joint, talonavicular joint, calcaneocuboid joint, and naviculocuboid joint. These tarsal joints are associated with each other and exhibit complex kinematic features. The kinematic characteristics of these tarsal bones following injury and the repair of the lateral ankle ligaments throughout the normal gait cycle are still not fully understood. The aim of the study was to analyze the effect of lateral ankle ligament injury on the four midfoot and hindfoot joints using specimen models of different lateral ankle ligament injuries and repairs, and to perform biomechanical experiments with axial loading on each model. The biomechanical properties of the four midfoot and hindfoot joints were compared under different conditions of lateral ankle ligament injury and repair. This study provides a reference for future clinical research and treatment strategies. Biomechanical analysis under multiple loading conditions revealed that anterior talofibular ligament (ATFL) and Calcaneofibular ligament (CFL) cut reduced peak stress in subtalar joint (neutral: P=0.01 vs normal, eversion: P=0.01 vs normal), talonavicular (neutral: P < 0.01 vs normal), calcaneocuboid joints (eversion: P<0.05 vs normal), and naviculocuboid joint (plantarflexion: P=0.03 vs normal). Only the group that underwent ATFL repair and the group receiving repairs to both ATFL and CFL can notably restore the peak stress across the four joints, particularly in the subtalar and talonavicular joints. The stress recovery effect of ATFL and CFL repair group was relatively better than only ATFL repair group. This biomechanical study demonstrates that combined ATFL and CFL repair effectively restores near-normal stress distributions across midfoot and hindfoot joints, particularly optimizing load transfer in the subtalar and talonavicular joints. The findings integrate biomechanical evidence with clinical relevance, providing a foundation for refining ligament repair protocols in ankle instability treatment.

Background: Open thoracoabdominal aortic aneurysm (TAAA) repair for Crawford extent II aneurysms carries substantial risks. This study compares outcomes of open TAAA repair following prior thoracic endovascular aortic repair (TEVAR) with conventional open extent II repair. Patients and methods: A retrospective analysis of 91 patients (2006-2024) divided into prior TEVAR (n=29) and conventional repair Crawford extent II repair without previous TEVAR (n=62). Primary endpoints included mortality and complications; secondary endpoints assessed survival and reinterventions. This study was designed according to STROBE criteria. Results: The prior TEVAR group (n=29) had a mean age of 61.5±10.7 years and 72.4% were male, while the conventional extent II repair group (n=62) had a mean age of 63.2±9.8 years and 69.4% were male. Prior TEVAR patients underwent open repair for extent II (13.8%), III (58.6%), or IV (27.6%) aneurysms. In-hospital mortality was lower in the prior TEVAR group (6.9% vs. 25.8%, p =.07), as were rates of spinal cord ischemia (3.4% vs. 8.1%, p =.55), acute kidney injury (24.1% vs. 35.5%, p =.28), and massive transfusion (24.1% vs. 30.6%, p =.54). Pulmonary complications occurred less frequently after TEVAR (69.0% vs. 82.3%, p =.25). Kaplan-Meier analysis revealed no significant survival difference (log-rankp=.05), with 5-year survival rates of 94% (prior TEVAR) and 61% (conventional). Aortic reintervention rates were also similar (10.5% vs. 18.8%, p=.69). Conclusions: Open TAAA repair following prior TEVAR may offer clinically meaningful advantages over conventional open type II repair with acceptable survival rates; however, these findings should be interpreted cautiously given the study's retrospective design and small sample size.Staged hybrid approach could be a viable strategy for managing complex aortic pathologies.

Objectives: The number of publications on the outcomes of treatment of ductal-dependent pulmonary atresia-ventricular septal defect in developing countries is limited. This study examines the results of surgical repair of this complex congenital heart disease at a high-volume center in Vietnam. Methods: This retrospective study included 144 patients with primary biventricular repair (group p-BVR, n = 70, 48.6%) or staged repair (group SR, n = 74, 51.4%) from April 2014 to March 2023. Concomitant augmentation of individual pulmonary arteries with autologous pericardial patches was performed in most patients who underwent the Rastelli operation (115/120 patients). Results: The overall rates of freedom from right ventricular outflow tract (RVOT) reintervention after the Rastelli operation at 1 year and 6 years were 94% (95% confidence interval [CI], 90%-99%) and 79% (95% CI, 69%-91%), respectively, with a median of 1.9 years (IQR, 0.9-5.0 years) from the Rastelli operation to the first reintervention. Fine and Gray's model for cumulative incidence across groups revealed that being in the p-BVR group was a high-risk factor for RVOT reintervention but not significant relative to being in the SR group (P = .12, SHR = 2.22, 95% CI, 0.82-6.03). The overall survival rate at 6 years was 89% (95% CI, 82%-97%) in the p-BVR group and 76% (95% CI, 66%-87%) in the SR group (P = .048). Conclusions: Concomitant pulmonary arterioplasty may contribute to or be associated with favorable reintervention rates and should be considered in patients with ductal-dependent pulmonary atresia with ventricular septal defect who undergo the primary Rastelli operation.

Comparison of the healing rate with meniscal repair concomitant with anterior cruciate ligament reconstruction and isolated meniscal repair based on magnetic resonance imaging signal intensity

Chronic ankle instability (CAI) commonly follows ankle sprains and significantly affects walking patterns and daily activities. Two main surgical treatments exist: Broström repair and anatomic allograft reconstruction. It remains unclear which technique better restores normal ankle movement. This study compared how these 2 surgeries affect ankle function during walking. We conducted a prospective study with 30 CAI patients. Fifteen received Broström repair and 15 received anatomic allograft reconstruction. We also included 16 healthy controls. We analyzed ankle joint kinematics (range of motion in dorsi/plantar flexion and inversion/eversion), and kinetics (joint moments, power, and ground reaction force [GRF]) during the gait cycle using 3D motion capture and force plate measurements. Assessments were performed before and 8 months after surgery. Both surgical techniques altered ankle biomechanics compared with controls. However, the Broström repair group demonstrated gait patterns more similar to healthy controls in most parameters. The reconstruction group showed greater deviation from normal, with increased plantarflexion and eversion throughout the gait cycle. Kinetic analysis revealed that Broström repair better preserved normal ankle moment patterns, while reconstruction resulted in significant alterations in ankle power generation. Both surgical techniques alter ankle mechanics, but Broström repair more effectively restores normal ankle biomechanics compared with allograft reconstruction in CAI patients during walking. These findings can guide surgeons in selecting the most appropriate surgical technique for restoring natural gait patterns. II.

ObjectivesThis study aimed to evaluate the effectiveness of medial meniscus posterior root tear (MMPRT) repair during open-wedge high tibial osteotomy (OWHTO) by investigating MMPRT healing and clinical outcomes. It also aimed to explore the impact of lower limb alignment correction on MMPRT healing in unrepaired cases.MethodsA total of 157 patients (68 males and 89 females) were included, with an average age of 57.0 ± 6.66 years and an average postoperative follow-up duration of 22.1 ± 2.92 months, who underwent OWHTO followed by second-look arthroscopy. Patients were divided into two groups: the OWHTO with MMPRT repair group (n = 82) and the OWHTO-only group (n = 75). Each group was further divided into Fujisawa subgroup and neutral subgroups to assess the healing of MMPRT and clinical outcomes.ResultsThe overall MMPRT healing outcomes in the OWHTO with MMPRT repair group were similar to the OWHTO-only group. Cartilage damage showed no intergroup differences. Functional improvements were equivalent between groups. Subgroup analyses revealed differential outcomes: Fujisawa subgroup exhibits superior healing in isolated OWHTO, but not in combined procedures.ConclusionMid-term clinical outcomes were comparable between OWHTO combined with MMPRT pull-out repair and isolated OWHTO. For patients undergoing isolated OWHTO, mechanical axis correction targeting the Fujisawa point is significantly more conducive to MMPRT healing than neutral alignment. Consider prioritizing MMPRT repair for young patients or those with high activity demands. When MMPRT repair is not performed, it is recommended to target the correction of knee alignment to the Fujisawa point.

Data on aortic valve outcomes following surgical repair of doubly committed subarterial ventricular septal defect remain limited. This retrospective study included doubly committed subarterial ventricular septal defect patients who underwent surgical repair at our centre from 2013 to 2023. The primary outcome was the incidence of new-onset aortic regurgitation during follow-up. A total of 320 patients were included, with a median age of 2.0 (0.9-7.2) years. Among them, 289 patients underwent surgical repair alone (repair group), and 31 received additional aortic valve surgery (repair + aortic valve surgery group). Preoperatively, 58 (18.1%) patients exhibited aortic regurgitation ≥ mild (10.7% in the repair group vs 87.1% in the repair + aortic valve surgery group, P < 0.001). The overall median follow-up was 40.5 (16.0-72.0) months. At the last follow-up, 23 (7.4%) patients had aortic regurgitation ≥ mild (3.8 vs 52.2%, P < 0.001), and 6 (1.9%) had aortic regurgitation > mild (0.3vs 21.7%, P < 0.001). Sixteen (5.1%) patients developed new-onset aortic regurgitation during follow-up (1.7 vs 47.8%, log-rank P< 0.001), and 6 (1.9%) of them developed new-onset aortic regurgitation > mild (0.3 vs 21.7%, log-rank P < 0.001). Age, ventricular septal defect size, preoperative aortic regurgitation > mild, and maximum aortic valve flow velocity (AVmax) were related to concurrent aortic valve surgery and new-onset aortic regurgitation. Based on our retrospective data, the mid-term aortic valve outcomes after doubly committed subarterial ventricular septal defect repair were relatively satisfactory, with a low incidence of new-onset aortic regurgitation during follow-up. However, aortic valve outcomes for patients who received concurrent aortic valve surgery were less satisfactory.

Elbow Range of Motion Is Stable or Improves Following Ulnar Collateral Ligament Repairs and Reconstructions.

Background:Rotator cuff tears (RCTs) represent a significant challenge in orthopaedic care, particularly in chronic cases where tendon healing is suboptimal. Novel biological therapies such as concentrated growth factor (CGF) and stromal vascular fraction (SVF) offer promising solutions for enhanced tendon repair.Hypothesis:This study hypothesized that a fibrin scaffold enriched with CGF and SVF would improve tendon healing by reducing fatty degeneration, increasing vascularization, and enhancing biomechanical properties in a chronic RCT rabbit model.Study Design:Controlled laboratory study.Methods:A chronic RCT model was developed in the subscapularis tendon of 28 male New Zealand rabbits. In the first phase (week 0), the chronic injury model was created surgically. At week 6, in addition to the transosseous repair technique, biological materials were applied into the bone tunnel in each group as follows: hydrogel (group 1), fibrin gel with CGF (group 2), CGF+SVF–enriched fibrin scaffold (group 3), and no repair (group 4). At week 12, animals were euthanized, and samples were collected for macroscopic, histological, immunohistochemical, and biomechanical analysis.Results:Group 3 demonstrated a superior result. Fatty degeneration was significantly lower in group 3 compared with group 1 (P = .045). Vascularization and cellularity scores were highest in group 3 (3.7 ± 0.5 and 3.6 ± 0.5, respectively), significantly greater than group 1 (1.4 ± 0.5 and 1.3 ± 0.5, respectively) (P = .024 and P = .004, respectively). Collagen fiber continuity and regularity scores were 3.7 ± 0.5 and 3.6 ± 0.5 in group 3, respectively, significantly better than group 1 (1.4 ± 0.5 and 1.3 ± 0.5, respectively) (P = .006 and P = .003, respectively). Biomechanical testing revealed the highest tensile strength in group 3 (116.14 ± 8.49 N; P < .001). Midsubstance tears, indicating robust healing, were observed in 85.7% of tendons in group 3 compared with 28.6% in group 1 (P = .002). Notably, group 3 also demonstrated superior outcomes compared with group 2, with significantly greater tensile strength (116.14 ± 8.49 N vs 100 ± 6.85 N; P < .001) and improved histological parameters including reduced fatty degeneration, and increased vascularization and collagen fiber regularity.Conclusion:The inclusion of CGF and SVF in fibrin scaffolds significantly enhances tendon healing in chronic RCTs, outperforming the use of CGF alone. This combined biological approach offers a promising therapeutic strategy to optimize tendon repair outcomes.Clinical Relevance:These findings support the clinical potential of CGF and SVF in improving repair outcomes in chronic RCT cases in sports medicine.

Enthesis-related progenitors recruited from the subacromial bursa contribute to rotator cuff healing in rats.

Biomechanical Comparison of Volar Plate Repair Versus Volar Plate Repair With Suture Tape Augmentation at the Finger Proximal Interphalangeal Joint.

Background: More than 20 million hernias are repaired annually. This study aimed to compare two techniques, Shouldice hernia repair and transabdominal preperitoneal (TAPP) laparoscopic hernia repair, in terms of various measures, such as recurrence rates, intraoperative and postoperative complications, and length of postoperative stay.Methods: A single-center, prospective, comparative study was conducted among patients admitted to a tertiary care hospital with a diagnosis of primary inguinal hernia (direct or indirect). A total of 125 patients underwent surgery. Among these patients, 53 had bilateral inguinal hernias, and 72 had unilateral inguinal hernias. The patients were alternatively allocated (based on their outpatient department visits) to either TAPP laparoscopic hernia repair or Shouldice hernia repair. All patients were followed up both in the short term (on postoperative days 1, 3, and 15) and in the long term (at 6 and 12 months) on an outpatient basis. Follow-up included a clinical examination and ultrasonography to assess recurrence and complications, such as postoperative pain, seroma formation, testicular atrophy, inguinodynia, foreign body sensation, and recurrence.Results: The mean operative durations of the Shouldice and laparoscopic TAPP groups were 82.7 ± 12.9 minutes and 107.6 ± 13.8 minutes, respectively, indicating that significantly less time was needed for Shouldice repair (p = 0.001). Postoperative pain was measured on days 1, 3, and 15, and visual analog scale scores were compared. Comparing the two procedures for pain on days 1, 3, and 15, there was less pain associated with the Shouldice repair than with the TAPP repair. However, this difference was not statistically significant (p = 0.2199). Seroma formation and testicular atrophy were significantly greater in the TAPP group than in the Shouldice group (p = 0.047 and p = 0.0194, respectively). Inguinodynia was significantly greater in the laparoscopic group than in the Shouldice repair group (p = 0.029). At the 12-month follow-up, there was one case of recurrence after Shouldice hernia repair (1.1%) and two cases of recurrence after TAPP laparoscopic hernia repair (2.2%). This difference was not statistically significant (p > 0.05).Conclusion: The operative time was significantly shorter for Shouldice than for laparoscopic TAPP. Postoperative pain and recurrence rates were comparable in both groups, whereas the seroma and testicular atrophy rates were higher in the laparoscopic TAPP group.