Savio Woo

..The research summarized here is multidisciplinary and cutting edge that will ultimately help improve the treatment of ligament injuries. The material presented should serve as an inspiration to future investigators...

..We hypothesized that current reconstruction techniques, which are designed mainly to provide resistance to anterior tibial loads, are less effective in limiting knee instability in response to combined rotational loads...

..To conclude, new technology, including imaging and robotics as well as functional tissue engineering, that could form novel treatment strategies to enhance healing of ligament and tendon are presented...

..This will facilitate a better understanding of the function of the anterior cruciate ligament and a scientifically based design of surgical procedures and postoperative rehabilitation protocols that will lead to better patient outcomes...

..Yet, solving new and more complex problems must still follow the stepwise methods of approach as taught by Professor Fung...

..05). These improvements in the morphological characteristics and biochemical constituents of healing MCLs following SIS treatment are the likely reasons for improved mechanical properties...

..The challenging areas are listed in the future direction that suggests where collection of energy could be placed in order to restore the injured ligaments and tendons structurally and functionally...

..Finally, the future role of biomechanics to facilitate in vivo data for further improvement of ACL reconstruction will be discussed...

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..SIS treatment increased the quantity of healing tissue, improved the histological appearance and biomechanical properties of the neo-PT, and prevented adhesion formation between the PT and fat pad...

..Nonaffine structural models will be necessary to fully predict the fiber kinematics under large uniaxial strains in SIS...

..This validated model will enable the analysis of force and stress distribution in the ACL in response to more complex loading conditions and has the potential to help design improved surgical procedures following ACL injuries...

..However, the same is not true when the knee is at high flexion angles. CLINICAL RELEVANCE: To reproduce the complex function of the anterior cruciate ligament, reproducing both bundles of the anterior cruciate ligament may be necessary...

..05). The findings extend the shorter term 12-week results, and support the potential of porcine SIS as a bioscaffold to enhance ligament healing...

..These findings suggest that greater post-injury activity levels may render the goat to be a better animal model for studying the healing process of the MCL...

..05). Such significant reduction in the gene expressions are closely related to the improved morphological characteristics, which are known to be coupled with better mechanical properties, as previously reported in longer term studies...

..These results demonstrate that while the high initial graft tension could better replicate the normal knee kinematics at time-zero, these effects may diminish during the early graft healing process...

..68). These results suggest that careful refreezing of the specimens had little or no effect on the biomechanical properties measured...

..This model can be used to show surgeons how different fibers are taut in different forearm rotation positions-this information is important for understanding the biomechanical role of the IOL and for planning an IOL reconstruction...

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..For anterior cruciate ligament reconstruction with a double-bundle procedure, one of the major concerns is to not predispose either one of the grafts to risk of failure by overloading...

..Clinical Relevance: The study suggests that either technique may be performed with similar biomechanical results at initial fixation under these loading conditions...

..As PGE(2) is a known inflammatory mediator of tendinitis, the contribution of COX-1 and COX-2 to PGE(2) production and their roles in tendon inflammation are clearly indicated...

..As a result, the healing MCL may have been required to take on excessive loads and was unable to heal sufficiently as compared to an isolated MCL injury...

..The purpose of this study was to biomechanically evaluate the motor function of the index finger based on multi-directional strengths...

..This may enhance the mechanical properties of healing ligaments and tendons...

..These findings provide a better understanding of the function of the two bundles of the ACL and could serve as a basis for future considerations of surgical reconstruction in the replacement of the ACL...

..7 N, which is equal to other devices published in the literature. CLINICAL RELEVANCE: The experiment suggests that the knot/press-fit technique may be a reliable alternative for the femoral fixation of hamstring tendon grafts...

..These results provide the basis for future studies involving the time course of healing of these two procedures using the goat model...

..CONCLUSIONS: These data will help to provide a basis for planning and performing IOL reconstruction in cases of longitudinal radioulnar dissociation...

..Thus, an estimate of the in situ forces in the ACL during in vivo activities might be obtainable using this novel methodology...

..CONCLUSIONS: This study showed that a minimal amount of internal torque in combination with valgus torque may be a suitable way to elicit a pivot shift from an ACL-deficient knee...

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..In terms of force distribution, the ACL replacement graft in both fixations still functioned as a primary restraint to an anterior tibial load close to the intact ACL...

..Additionally, the action of the ITB as an ACL agonist suggests that its use as an ACL graft might hinder knee stability in response to rotatory load...

..CONCLUSIONS: Anatomic reconstruction may produce a better biomechanical outcome, especially during rotatory loads. CLINICAL RELEVANCE: Results may lead to the use of a two-bundle technique...

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..This work is important in understanding one load component needed for the pivot shift examination; further studies quantifying other load components are essential for better comprehension of the in vivo pivot shift examination...

..Clinical Relevance: The measurement of total anterior-posterior translation may be a more accurate way to assess kinematics of the reconstructed knee...

..Therefore, this approach offers the potential to explore the effect of the reduction of type III collagen in healing ligaments and tendons as a means to improve their mechanical properties...

..Thus, the CCD laser reflectance system is an improved method for measuring the cross-sectional shape and area of soft tissues since it can detect and account for concavities without physically contacting the specimen...

..CLINICAL RELEVANCE: Modifications of anterior cruciate ligament reconstruction procedures to reduce posterolateral graft force may be needed for valgus knees after a high tibial osteotomy...

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..CLINICAL RELEVANCE: Combined tibial fixation may provide a more stable reconstruction at initial fixation...

..7 degrees at 30 degrees of knee flexion with the two-thirds and entire PMM resected, respectively. These results suggest that resecting more than two-thirds of the PMM will have a significant effect on the kinematics of the knee...

..However, accuracy values in this study were found to be below the values for precision of repeated tunnel placements reported in the literature...

..The purpose of this study was to investigate the rat as a model for evaluating the structural properties of the vagina and its supportive tissues...

..Therefore, it was demonstrated that there is a potential for nucleated cells from bone marrow to serve as a vehicle for therapeutic molecules as well as to be a source in enhancing healing of ligaments...

..Even though these early results are encouraging, more work is required regarding the response of the recipient site to donor cells or vectors...

..Control algorithms used during the biomechanical testing of cadaveric knees and computational knee models might need to be gender specific...

..As a result, sagittal osteotomies that alter slope have recently been proposed for treatment of posterior cruciate ligament (PCL) injuries...

..b>Savio Woo discussed a list of functional tissue engineering approaches designed to restore the biochemical and ..

..The knowledge gained from this study will increase our understanding of the mechanisms of MCL healing, which could be applied to other ligaments. ..

..Thus, the in situ forces and force distribution in the ACL and replacement grafts during the activities of daily living and sports could be indirectly determined. ..

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..These findings will provide improved rationale for the selection of ACL replacement grafts, for the determination of appropriate reconstructive techniques, and for improvement of established rehabilitation protocols...

..The specific goals are to study effects of graft placement (anatomical position vs. "over-the-top") and the amount of graft pretension of joint motion...

..We anticipate that such knowledge will ultimately lead to improved treatment for patients with combined MCL+ACL injuries...

..The knowledge gained from this study will enhance the understanding of the mechanisms of ligament healing, which in turn, could be applied to aid in the healing of other ligaments (ACL) and tendons (flexor tendon). ..