Biomedical subjects

Michael Jagodzinski

Publications and source records attributed to Michael Jagodzinski.

8 recordsLinked to original sources

PubMed2006

Changes of Achilles midportion tendon microcirculation after repetitive simultaneous cryotherapy and compression using a Cryo/Cuff.

BACKGROUND: Cryotherapy and compression have been shown to decrease pain and improve function. The dosage and timing of these options remain unclear. PURPOSE: To examine the effects of a standardized compression and cryotherapy device (Cryo/Cuff) on midportion Achilles tendon microcirculation during intermittent administration. STUDY DESIGN: Descriptive laboratory study. METHODS: Twenty-six subjects were included (13 men and 13 women; age, 32.3 +/- 12 years; body mass index, 25.4 +/- 5 kg/m(2)). Each underwent three 10-minute applications of the device, followed by a 10-minute recovery period. A continuous real-time assessment of parameters of Achilles tendon midportion microcirculation was performed with a laser Doppler spectrophotometry system. RESULTS: Superficial tendon oxygen saturation dropped significantly from 35.9 +/- 21 arbitrary units (AU) to 13.5 +/- 15, 15.9 +/- 16, and 11.1 +/- 11 AU (P = .0001) during each period of cryo-compression, respectively. There was significant increase during the recovery period (55.4 +/- 29, 65.2 +/- 26, and 65.7 +/- 27 AU; P = .003), up to +83% of the baseline level. At 8-mm tendon depth, cryo-compression preserved local oxygen with -4% (P = .001) of the baseline level and small but significant increased oxygen saturation of up to +13% (P = .0001). Relative postcapillary venous tendon filling pressures were favorably reduced both superficially (57% +/- 34%, 67% +/- 27%, and 64% +/- 38%, respectively; P = .0004) and deep (76% +/- 13%, 79% +/- 11%, and 78% +/- 18%, respectively; P = .0002). Superficial capillary blood flow was reduced from 48.4 +/- 48 to 5 +/- 7, 4 +/- 5, and 3 +/- 4 AU at each period, respectively (-94%, P = .0003), with increased flow during recovery periods of up to 58 +/- 64, 58 +/- 79, and 47 +/- 71 AU, respectively (+20%, P = .265). Deep flow was reduced from 197 +/- 147 to 66.7 +/- 64, 55 +/- 46, and 43 +/- 39 AU, respectively (-78%, P = .0002) without increase during recovery periods. CONCLUSION: Cryo/Cuff exerts beneficial effects on the microcirculatory level of the midportion Achilles tendon with decreased capillary blood flow, preserved deep tendon oxygen saturation, and facilitated venous capillary outflow.

Achilles Tendon↗

PubMed2006

Rapid rehabilitation programme following sacral stress fracture in a long-distance running female athlete.

Stress fractures occur in normal bone due to mechanical overload by cyclic stress increasing the osteoclastic activity, thus facilitating weakening leading to fracture of bones. Long-distance running may lead to stress fractures of the mid- and distal tibia and of the metatarsal bones. Stress fractures to the sacrum are rare. Certain factors for stress fractures in runners have been identified, such as leg-length inequality, a high longitudinal arch of the foot, forefoot varus, and menstrual irregularities in case of female athlete triad. We report on a 22-year-old female runner (usually training 140 km/week) suffering a sacral fatigue-type fracture. The female athlete triad with eating disorders, dysmenorrhea, and osteopenia was ruled out. Sexual hormone blood samples proofed normal values. The diagnosis was performed using magnetic resonance imaging 2 weeks after the onset of buttock pain. A conservative treatment regimen was initiated with strict physical rest for the first 2 weeks, and then gradual increase of physical activity with 60-90 min of daily cycling and moderate 2 x 60 min cross-training. After another 2 weeks time, daily 60-90 min of walking, Nordic pole walking, and moderate strength training two times a week was performed. At 7 weeks running was started, gradually increased to 90 km/week without any pain. A rapid rehabilitation programme after sacral stress fractures involving low impact physical activity, such as Walking and Nordic pole walking, is applicable to female athletes after ruling out the female athlete triad.

Adult↗

PubMed2006

Recurrent shoulder instability among athletes: changes in quality of life, sports activity, and muscle function following open repair.

BACKGROUND: Recurrent anterior shoulder instability is a disabling condition in young athletes with possibly underestimated impact on quality of life and sports activity. Commonly used clinical scoring systems do not reflect the impairment of quality of life and sports activity. It was our aim to assess the return to preinjury levels of quality of life and sports activity as well as the changes in muscle function among competitive and recreational athletes. HYPOTHESIS: Patients suffering from post-traumatic recurrent shoulder instability have to adopt their participation in sports and therefore discover a reduction in quality of life. Open stabilization procedures are able to improve shoulder function and to reduce recurrence rates. However, return to preinjury shoulder function is not guaranteed. STUDY DESIGN: Retrospective longitudinal cohort study on 19 consecutive athletes with recurrent, post-traumatic shoulder instability. All patients were treated with an open, capsulo-labral repair. The minimum follow-up was 24 months. METHODS: Life quality (SF12) and sports activity data (Athletic Shoulder Outcome Scoring System) were retrospectively collected for the time before injury (time 1) and for the time with recurrent instability (time 2). Two years after surgical stabilization (time 3), we followed our patients with different clinical outcome scores, rotator surface EMG measurement, isokinetic muscle strength testing, and a radiological evaluation. This design of a three-step follow-up allowed for calculating the impact on quality of life and sports activity following the injury. RESULTS: Two years after surgery, the clinical scoring systems revealed good-to-excellent results in all patients. Quality of life physical component summary remained diminished by 9.2% despite the surgical procedure and was therefore significantly lower as compared to preinjury levels (p < 0.05). Sports activity was also significantly lower at the time of follow-up (p < 0.05). In this specific procedure, external rotation was not impaired postoperatively. EMG testing showed an overall reduction of muscle activity, however not significant. Isokinetic muscle strength was significantly diminished for external rotation and shoulder abduction. CONCLUSIONS: Open reconstruction procedures for recurrent shoulder instability can restore shoulder function and stability to near-normal values. Despite good-to-excellent clinical results, there is a significant impairment of quality of life and sports activity 2 years after surgery. Muscle activity and muscle strength are diminished. Recurrent shoulder instability remains a disabling condition to the young athlete. Future strategies have to emphasize restoration of quality of life, sports activity, and muscle function.

Adolescent↗

PubMed2006

Hinged external fixation and closed reduction for distal humerus fracture.

Elbow fractures are relatively rare in extremity injuries. Functional deficits often comprise the outcome. We report of a 77-year-old diabetic lady with a distal humerus fracture. She was treated with external fixation and closed reduction. Special emphasis was directed to early motion exercises. Follow-up after 1 year demonstrated a range of motion of 0-30-130 degrees for extension and flexion of the elbow joint. No neurovascular deficits were seen. The use of a hinged device was successful in re-establishing a good function. Although there are no earlier reports using this technique in acute treatment, we consider this strategy as an alternative option in carefully selected cases.

Accidental Falls↗

PubMed2006

[Arthroscopic partial meniscectomy].

OBJECTIVE: Excision of damaged meniscal tissue whereby the mechanical obstacles to joint movement are eliminated. As much functional, intact meniscal tissue should be retained as possible. Resection of only the bare minimum. INDICATIONS: Symptomatic, irreparable lesions of the meniscus due to trauma or degeneration. CONTRAINDICATIONS: Reparable lesions of the meniscus. Local skin affections. SURGICAL TECHNIQUE: Introduction of the arthroscope through an anterolateral or central portal. The instrument portal is positioned in accordance with the situation of the meniscal lesion to be treated. The tissue to be excised is either broken into fragments with different punches or resected en bloc. POSTOPERATIVE MANAGEMENT: Functional postoperative management without immobilization. Full loading on the leg. RESULTS: Very good and good clinical results can be achieved in the short and long term after arthroscopic partial meniscectomy. In a study by Burks et al., 88% of 146 patients with stable knee joints had a very good or good result 14.7 years after partial meniscectomy. 95% of 57 patients were satisfied or very satisfied with the result 12 years after partial medial meniscectomy. A degenerative meniscal tear, axial deformity, higher age, and anterior cruciate ligament insufficiency are factors associated with an increased rate of arthrosis in the long term.

Ambulatory Surgical Procedures↗

PubMed2005

Achilles tendon and paratendon microcirculation in midportion and insertional tendinopathy in athletes.

BACKGROUND: Neovascularisation can be detected qualitatively by Power Doppler in Achilles tendinopathy. Quantitative data regarding tendon microcirculation have not been established and may be substantial. PURPOSE: To assess the microcirculation of the Achilles tendon and the paratendon in healthy volunteers as well as in athletes with either midportion or insertional tendinopathy. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: In 66 physically active volunteers, parameters of Achilles tendon and paratendon microcirculation, such as tissue oxygen saturation, relative postcapillary venous filling pressures, and microcirculatory blood flow, were determined at rest at 2-mm and 8-mm tissue depths. Forty-one patients never had Achilles pain (25 men, 27 +/- 8 years), 14 patients had insertional pain (7 men, 29 +/- 8 years), and 11 patients had midportion tendinopathy (7 men, 38 +/- 13 years, not significant). RESULTS: Achilles tendon diameter 2 cm and 6 cm proximal to the insertion was increased in symptomatic tendons. Compared with the uninvolved opposite tendon, deep microcirculatory blood flow was significantly elevated at insertional (160 +/- 79 vs 132 +/- 42, P < .05) as well as in midportion tendinopathy (150 +/- 74 vs 119 +/- 34, P < .05). The microcirculation in the uninvolved opposite tendon and the normal athlete controls were not significantly different from each other (132 +/- 42 insertional asymptomatic vs 119 +/- 34 mid-portion vs 120 +/- 48 healthy tendon). Insertional paratendon deep microcirculatory flow was elevated in all groups, whereas tissue oxygen saturation and relative postcapillary venous filling pressures were not significantly different. CONCLUSION: Microcirculatory blood flow is significantly elevated at the point of pain in insertional and midportion tendinopathy. Postcapillary venous filling pressures are increased at both the midportion Achilles tendon and the midportion paratendon, whereas tissue oxygen saturation is not different among the studied groups. We found no evidence of an abnormal microcirculation of the asymptomatic limb in Achilles tendinopathy.

Achilles Tendon↗

PubMedDate not supplied

Modulation of proliferation and differentiation of human bone marrow stromal cells by fibroblast growth factor 2: potential implications for tissue engineering of tendons and ligaments.

Bone marrow stromal cells (BMSCs) play a central role in the repair and regeneration of mesenchymal tissues. For tissue engineering of ligaments and tendons, both stimulation of cell proliferation and differentiation with increased expression of essential extracellular matrix proteins and cytoskeletal elements are desirable. This study analyzes the effect of low-dose (3 ng/mL) fibroblast growth factor 2 (FGF-2) and high-dose FGF-2 (30 ng/mL) on proliferation (bromodeoxyuridine content, spectrophotometry), differentiation (transcription of collagen I, collagen III, fibronectin, elastin, alpha-smooth muscle actin, and vimentin, reverse transcription-polymerase chain reaction, and cell density and apoptosis (annexin V, fluorescence-activated cell sorting) of human BMSCs, and compares the results with those of a control group without FGF-2. Low-dose FGF-2 triggered a biphasic BMSC response: on day 7, cell proliferation reached its maximum and was significantly higher compared with the other groups. On days 14 or 28, collagen I, collagen III, fibronectin, and alpha- smooth muscle actin mRNA expression was significantly enhanced in the presence of low-dose FGF-2. In contrast, high-dose FGF-2 did not stimulate differentiation or proliferation. Vimentin mRNA was expressed only in cultures with low-dose and high-dose FGF-2 after 14 and 28 days. Cell density was significantly higher in cultures with low-dose FGF-2 compared with the group with high-dose FGF-2 on days 7, 14, and 28. The apoptosis rate remained stable, at a rather high level, in all groups. Microscopic investigation of the cell cultures with low-dose FGF-2 showed more homogeneous, dense, fibroblast-like, spindle-shaped cells with long cell processes compared with cultures with high-dose, or no FGF-2. Low-dose FGF-2 may be useful for tissue engineering of ligaments and tendons by increasing BMSC proliferation and stimulating mRNA expression of specific extracellular matrix proteins and cytoskeletal elements.

Bone Marrow Cells↗

PubMedDate not supplied

Femoral press-fit fixation of the hamstring tendons for anterior cruciate ligament reconstruction.

BACKGROUND: Press-fit fixation of patellar tendon-bone anterior cruciate ligament autografts is an interesting technique because no hardware is necessary. For hamstring tendon grafts, no biomechanical data exist of a press-fit procedure. HYPOTHESIS: Press-fit femoral fixation of hamstring tendons is mechanically equivalent to press-fit patellar tendon-bone fixation. STUDY DESIGN: Controlled laboratory study. METHODS: Patellar and hamstring tendons of 30 human cadavers (age, 53.8 +/- 18.0 years) were used. An outside-in press-fit fixation with a knot in the semitendinosus and gracilis tendons and an inside-out and outside-in fixation with the tendons wrapped around a bone block were compared with patellar tendon-bone press-fit fixation in 30 ovine femora. Constructs were cyclically strained and then loaded until failure. Maximum load to failure, stiffness, and elongation during failure testing and cyclical loading were investigated. RESULTS: The maximum load to failure was 561 +/- 309 N for the patellar tendon, 599 +/- 234 N for the semitendinosus/gracilis tendons knot construct, 678 +/- 231 for the semitendinosus/gracilis tendons bone construct inserted outside in, and 339 +/- 236 for the semitendinosus/gracilis tendons bone construct inserted inside out (inferior to the others; analysis of variance, Dunn test, P < .01). Stiffness of the constructs averaged 134 +/- 32 N/mm for the patellar tendon, 124 +/- 21 N/mm for the knot construct, 118 +/- 27 N/mm for the outside-in fixation, and 117 +/- 23 N/mm for inside-out fixation. Elongation during initial cyclical loading was 0.7 +/- 0.6 mm for the patellar tendon, 1.6 +/- 0.5 mm for the knot construct, 1.9 +/- 1.2 mm for the outside-in fixation, and 1.9 +/- 0.9 mm for the inside-out fixation (significantly larger for all semitendinosus/gracilis tendon techniques, P < .05). CONCLUSIONS: Failure loads for the semitendinosus/gracilis tendons bone construct inserted outside in and the semitendinosus/ gracilis tendons knot construct were within the confidence interval of the patellar tendon press-fit fixation. All semitendinosus/ gracilis tendon graft techniques exhibited larger elongation during initial cyclical loading than the patellar tendon graft. There was no difference in stiffness between all techniques. CLINICAL RELEVANCE: Two of the 3 hamstring press-fit fixation techniques showed loads to failure similar to the patellar tendon fixation. Preconditioning of the constructs is critical. These results must be interpreted with care because of high standard deviations.

Adolescent↗