We investigated the effect of supplementing extended boar semen with different amounts of hyaluro... more We investigated the effect of supplementing extended boar semen with different amounts of hyaluronan (HA) prior to freezing on post-thaw sperm characteristics. Using a split sample design, the effect of HA at a final concentration of 500 or 1000 microg/ml semen on post-thaw motility parameters, and membrane lipid architecture status assessed by merocyanine-540/YOPRO-1 and flow cytometry were evaluated. HA-supplementation improved motility parameters (P < 0.05 to P < 0.001) and decreased the percentage of hyperactivated spermatozoa (P < 0.05). HA-supplemented samples had more spermatozoa showing high lipid membrane stability as assessed with merocyanine-540. In conclusion, HA appeared to preserve post-thaw spermatozoa viability in vitro and maintained membrane stability after cryopreservation.
Previous studies have shown sperm quality after cryopreservation differs depending on the fractio... more Previous studies have shown sperm quality after cryopreservation differs depending on the fraction of seminal plasma the boar spermatozoa are contained in. Thus, spermatozoa contained in the first 10 ml of the sperm-rich fraction (portion I) withstand handling procedures (extension, handling and freezing/thawing) better than those contained in the latter part of a fractionated ejaculate (second portion of the sperm-rich fraction and the post-spermatic fraction; portion II). The present study evaluated whether an exogenous antioxidant, the water-soluble vitamin E analogue Trolox (6-hydroxy-2,5,7,8-tetramethylchroman-2-carboxylic acid), could, when added to the freezing extender in a split-sample design trial, improve the post-thaw viability and membrane quality of this particular portion of the ejaculate, with particular attention to the status of the plasma membrane. Using a split-sample design, the initial changes in the fluidity status of the sperm plasmalemma after thawing were measured by flow cytometry (FC) after loading with Merocyanine-540 and YO-PRO-1. The FC-derived data revealed a clear ejaculate portion-dependent effect of the antioxidant supplementation. While no beneficial effect of the antioxidant supplementation was visible in spermatozoa from portion I, more spermatozoa with intact membranes were observed in the supplemented samples of portion II, suggesting the protective effect of vitamin E is dependent of the portion of the boar ejaculate considered.
Detection of early changes in the sperm plasma membrane during cryopreservation is of utmost impo... more Detection of early changes in the sperm plasma membrane during cryopreservation is of utmost importance when designing freezing protocols. The present study evaluated the ability of an Annexin-V binding assay to detect early changes in sperm membrane integrity using flow cytometry (FC) in two different portions of the boar ejaculate, in cryopreserved semen. Using a split sample design, sperm motility was evaluated in fresh (controls) and frozen–thawed (FT) samples, both subjectively and by means of a computer-assisted motility assessment (CASA) system, while membrane integrity was assessed using Annexin-V (A) and propidium iodide (PI) staining in spermatozoa derived from the first sperm-rich fraction (Portion I) or the remaining ejaculate (Portion II). The A/PI technique revealed four sperm subpopulations, two PI negative (either A− (alive) or A+ (apoptotic)); and two PI positive (dead cells), either A+ (dead, late apoptotic or early necrotic cells) or A− (dead, late necrotic cells). Significant differences were found between the two portions of the ejaculate in the fresh (control) and FT samples. In the fresh controls, significantly more live, nonapoptotic spermatozoa (A−/PI−) were present in Portion I than in Portion II (P<0.001). Although apoptotic spermatozoa were detected in both semen portions, the frequency of live, early apoptotic (A+/PI−) cells was significantly lower in Portion I than in Portion II (P<0.001). Irrespective of the ejaculate portion considered, freezing and thawing significantly decreased the mean percentages of live spermatozoa (P<0.01), and dramatically increased the percentages of apoptotic or early necrotic cells (P<0.01), but not of early apoptotic cells (N.S.). The latter finding might suggest that apoptotic changes due to cryopreservation using the procedures applied in this trial are transient and lead to cell death. In conclusion, the Annexin-V binding assay was able to detect deleterious changes in the sperm plasma membrane at an earlier point than PI staining, thus representing a novel approach to investigating membrane integrity in this species. The finding that fewer spermatozoa in Portion I of the ejaculate showed early apoptosis post-freezing, suggests boar spermatozoa in this portion of the seminal plasma are less sensitive to the stress induced by cryopreservation.
Antioxidant supplementation during cooling was assayed to improve the motility of frozen-thawed (... more Antioxidant supplementation during cooling was assayed to improve the motility of frozen-thawed (FT) boar spermatozoa from two different fractions of the ejaculate, the first component of the sperm-rich fraction (Fraction I) and the rest of the bulk ejaculate (Fraction II). Using a split-sample design, addition of two different concentrations (100 and 200 μM l−1) of the water-soluble Vitamin E analogue Trolox (6-hydroxy –2,5,7,8-tetramethylchroman –2-carboxylic acid) was evaluated for an effect on sperm motility (measured both subjectively and by means of a computer assisted motility assessment (CASA)), and on mitochondrial membrane potential using flow cytometry after cell-loading with JC-1. The effect of the Vitamin E analogue was clearly dose-dependent and varied with the fraction of the ejaculate considered. Motility was significantly higher in Trolox-treated spermatozoa (200 μm), from either ejaculate fraction, albeit the effect was more evident in spermatozoa from Fraction II (P<0.05) for any Trolox-concentration. Antioxidant supplementation resulted, also dose-dependent, in a higher number of spermatozoa showing high mitochondrial activity as assessed by the JC-1 staining, in both ejaculate fractions. In the present trial, exogenous Trolox positively affected post-thaw sperm viability (as motility and mitochondrial membrane potential) in both fractions of the ejaculate. The magnitude of the effect appeared, however, to be dependent of the fraction of the ejaculate considered.
Endogenous oxytocin is released by the sow at the time of mating in response to stimulation by th... more Endogenous oxytocin is released by the sow at the time of mating in response to stimulation by the boar, which may explain, at least partially, the importance of the relationship between the boar's courting activity and the subsequent reproductive performance of the sow. The aim of this study was to determine the effects on reproductive performance of supplementing AI doses with exogenous oxytocin during the low fertility season. At an intensive piggery in northwest Spain 3 experimental groups were randomly formed and observed throughout the year. Group 1 sows were inseminated with semen supplemented with 4 IU oxytocin. Group 2 sows received 4 IU oxytocin injected through the vulvar lips mucosa at the time of insemination. Group 3 sows were inseminated without oxytocin and served as the controls. During the low fertility season the results for each group were as follows: farrowing rate 77.02, 56.25 and 54.39%, and litter size 10.77 ± 0.28, 10.45 ± 0.31 and 8.53 ± 0.34 respectively. It is concluded that the addition of oxytocin to seminal doses just before AI is an easily applicable, effective method for increasing fertility and litter size during the summer months.
Previous studies have shown sperm quality post-cryopreservation differs depending on the fraction... more Previous studies have shown sperm quality post-cryopreservation differs depending on the fraction of the seminal plasma boar spermatozoa are fortuitously contained in. As such, spermatozoa contained in the first 10 mL of the sperm-rich fraction (portion I) have better sustained handling procedures (extension, handling and freezing/thawing) than those contained in the ulterior part of a fractionated ejaculate (second portion of the sperm-rich fraction and the post-spermatic fraction, portion II). However, those studies were performed using pooled samples. In the present study, individual ejaculates were used. Split ejaculates (portions I and II) from five boars were frozen and thawed using a conventional freezing protocol, followed by computer-assisted motility and morphology analysis (CASA and ASMA, respectively), as well as an Annexin-V assay for spermatozoa from each boar and ejaculate portion. Significant differences between portions were observed in all ASMA-derived variables, except in one boar. Also significant differences were observed between boars and ejaculate portions in sperm quality post-thaw. We identified, however, boars showing best results of motility and sperm membrane integrity post-thaw in portion I, while in other boar the best results was observed in portion II. It is concluded that the identification of the ejaculate portion more suitable to sustain cryopreservation in each individual boar may be a readily applicable and easy technique to diminish variation in sperm freezability among boars.
Arthroscopy-the Journal of Arthroscopic and Related Surgery, 1996
Recently, one-incision drill guides introduced through predilled tibial tunnels have become popul... more Recently, one-incision drill guides introduced through predilled tibial tunnels have become popular in anterior cruciate ligament (ACL) reconstruction. No data are available on the reproducibility of the tunnel placement when this drill guide is used. The primary goal of this study was to compare accuracy of tunnel placement using the one-inciscion (all-inside) and the conventional two-incision drill guide (outside-in) to the location of the center of the normal ACL attachment. Furthermore, our goal was to measure the forces seen by the normal ACL during extension from 90° of flexion, when the tibia is subjected to 100 N anterior load (22.7 lbs), and compare these with the forces measured in the reconstructions performed with the two drill guides. The center of the tunnel on the lateral femoral condyle using the two different drill guides was measured with a three-dimensional pointer and compared with the center of the normal ACL insertion site. Forces in the normal ACL and the reconstructed ligament were measured with a buckle transducer in a loaded and an unloaded state at four different flexion angles. The one-incision drill guide led to a statistically more proximal placement of the graft than both the conventional drill guide and the center of the normal ACL. Both drill guides led to an anterior placement compared with the normal ACL. There was no difference in the graft forces after reconstruction with the two drill guides, but the forces in the loaded grafts were twice those of the normal ACL.
Knee Surgery Sports Traumatology Arthroscopy, 1996
A failure analysis of interference screw fixation was performed to test the hypothesis that bovin... more A failure analysis of interference screw fixation was performed to test the hypothesis that bovine and/or elderly human cadavers are appropriate models for bonepatellar tendon-bone anterior cruciate ligament (ACL) reconstruction fixation studies. Failure mode is an important criterion for validating experimental models. The bovine, young human, and elderly human failure loads were 799±261 N, 655±186 N, and 382±118 N, respectively, and the failure modes were 75%, 69%, and 30% tissue failures, respectively. The similarities between the bovine and young human models in failure loads and failure modes indicate that bovine models are appropriate for ACL reconstruction fixation studies. The statistically significant differences between the young human and elderly human models in failure loads and failure modes indicate that elderly human cadavers are not an appropriate model for ACL reconstruction fixation studies. The differences in failure modes are consistent with previous studies using elderly human cadavers in which the predominant failure mode was bone block pullout. The tissue failures observed in the bovine and young human models contradict previous studies suggesting fixation strength is the weakest link in bone-patellar tendon-bone ACL reconstruction. Results of linear regression modeling showed statistically significant correlations between insertion torque and failure load (R 2=0.44,PR 2=0.18,P=0.003) when data from all models was combined. Results for the bovine model multiple regression showed a statistically significant regression of insertion torque (linear) and interference (quadritic) versus failure load (R 2=0.56,P=0.02). Regression slopes for screw diameter (P=0.52) and gap size (P=1.00) were not statistically significant. These results indicate that insertion torque and interference are independent predictors of failure load and should be included in future interference screw studies in addition to bone block dimensions, tunnel size, gap size, and screw diameter. Clinicians may consider using insertion torque and interference as indicators of postoperative graft fixation regarding rehabilitation decisions.
The purpose of this study was to assess the incidence of iatrogenic articular cartilage injuries ... more The purpose of this study was to assess the incidence of iatrogenic articular cartilage injuries during ankle arthroscopy and to determine the factors that caused them. The hypothesis of this study was that the incidence of iatrogenic cartilage injuries produced during ankle arthroscopic procedures is high and directly related to the arthroscopic technique. All consecutive records from ankle arthroscopies performed between 2008 and 2010 were reviewed. Arthroscopic arthrodesis of the ankle was excluded from the study. Iatrogenic articular cartilage injury was defined as any cartilage injury that occurred during the arthroscopic procedure. The final number of ankle arthroscopic procedures reviewed was 74. There were a total of 23 iatrogenic lesions of the cartilage, for an overall complication rate of 31 %. The two most common injury locations were the anterolateral and central area of the talus. The cartilage lesion was superficial in 78.2 % of injuries (24.3 % of all patients), and deep in 21.8 % of injuries (6.7 % of all patients). Of the 23 injuries found, 65 % of them were sustained during the therapeutic portion of the arthroscopic procedure and the remaining 35 % occurred during the portal creation portion of the procedure. The incidence of cartilage injury during ankle arthroscopy is high. However, severe damage was found in only 6.7 % of ankle arthroscopies. Retrospective case series, Level IV.
Knee Surgery Sports Traumatology Arthroscopy, 1998
The aims of this study were to measure the forces in the anterior talofibular ligament (ATFL) and... more The aims of this study were to measure the forces in the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) and the motion in the tibiotalar and subtalar joints during simulated weight-bearing in eight cadaver ankle specimens. An MTS test machine was used to apply compressive loads to specimens held in a specially designed testing apparatus in which the ankle position (dorsiflexion-plantarflexion and supination-pronation) could be varied in a controlled manner. The forces in the ATFL and CFL were measured with buckle transducers. Tibiotalar motion and total ankle joint motion were measured with an instrumented spatial linkage. The specimens were positioned sequentially at 10° dorsiflexion, neutral, and 10° and 20° plantarflexion, and this sequence was repeated at 15° supination, neutral pronation/supination, and 15° pronation. Force and motion measurements were recorded in each of these positions with and without a 375 N compressive load simulating weight-bearing. From 10° dorsiflexion to 20° plantarflexion, all motion occurred in the tibiotalar joint. In contrast, the ratio of subtalar motion to tibiotalar motion was 3:1 for supination-pronation and 4:1 for internal-external rotation. Inverse loading patterns were observed for the ATFL and CFL from plantarflexion to dorsiflexion. Compressive loading did not affect CFL tension, but it magnified the pattern of increasing ATFL tension with plantarflexion. The largest increase in ATFL force was observed in supination and plantarflexion with a compressive load (76 ± 23 N), whereas CFL tension mainly increased in supination and dorsiflexion with a compressive load (109 ± 28 N). In conclusion, the results showed that the ATFL acted as a primary restraint in inversion, where injuries typically occur (combined plantarflexion, supination and internal rotation). Also, the subtalar joint was of primary importance for normal supination-pronation and internal-external rotation.
We wanted to use biomechanical testing in a cadaveric model to compare the Broström repair, the W... more We wanted to use biomechanical testing in a cadaveric model to compare the Broström repair, the Watson-Jones reconstruction, and a new anatomic reconstruction method. Eight specimens were held in a specially designed testing apparatus in which the ankle position (dorsiflexion-plantar flexion and supination-pronation) could be varied in a controlled manner. Testing was done with intact ligaments and was repeated after sectioning of the anterior talofibular ligament and the calcaneofibular ligament and after a Broström repair, a Watson-Jones reconstruction, and a new anatomic reconstruction were performed. An anterior drawer test was performed using an anterior translating force of 10 to 50 N, and a talar tilt test was performed using a supination torque of 1.1 to 3.4 N-m. The forces in the anterior talofibular ligament and calcaneofibular ligament were measured with buckle transducers, and tibiotalar motion and total ankle joint motion were measured with an instrumented spatial linkage. The increase in ankle joint laxity observed after sectioning of both the anterior talofibular and calcaneofibular ligaments was significantly reduced by the three reconstructive techniques, although not always to the level of the intact ankle. Joint motion was restricted after the Watson-Jones procedure compared with that in the intact ankle. Unlike the Watson-Jones procedure, the ligament or graft force patterns observed during loading after the Broström repair and the new anatomic technique resembled those observed in the intact ankle.
We investigated the effect of supplementing extended boar semen with different amounts of hyaluro... more We investigated the effect of supplementing extended boar semen with different amounts of hyaluronan (HA) prior to freezing on post-thaw sperm characteristics. Using a split sample design, the effect of HA at a final concentration of 500 or 1000 microg/ml semen on post-thaw motility parameters, and membrane lipid architecture status assessed by merocyanine-540/YOPRO-1 and flow cytometry were evaluated. HA-supplementation improved motility parameters (P &amp;amp;amp;amp;amp;amp;lt; 0.05 to P &amp;amp;amp;amp;amp;amp;lt; 0.001) and decreased the percentage of hyperactivated spermatozoa (P &amp;amp;amp;amp;amp;amp;lt; 0.05). HA-supplemented samples had more spermatozoa showing high lipid membrane stability as assessed with merocyanine-540. In conclusion, HA appeared to preserve post-thaw spermatozoa viability in vitro and maintained membrane stability after cryopreservation.
Previous studies have shown sperm quality after cryopreservation differs depending on the fractio... more Previous studies have shown sperm quality after cryopreservation differs depending on the fraction of seminal plasma the boar spermatozoa are contained in. Thus, spermatozoa contained in the first 10 ml of the sperm-rich fraction (portion I) withstand handling procedures (extension, handling and freezing/thawing) better than those contained in the latter part of a fractionated ejaculate (second portion of the sperm-rich fraction and the post-spermatic fraction; portion II). The present study evaluated whether an exogenous antioxidant, the water-soluble vitamin E analogue Trolox (6-hydroxy-2,5,7,8-tetramethylchroman-2-carboxylic acid), could, when added to the freezing extender in a split-sample design trial, improve the post-thaw viability and membrane quality of this particular portion of the ejaculate, with particular attention to the status of the plasma membrane. Using a split-sample design, the initial changes in the fluidity status of the sperm plasmalemma after thawing were measured by flow cytometry (FC) after loading with Merocyanine-540 and YO-PRO-1. The FC-derived data revealed a clear ejaculate portion-dependent effect of the antioxidant supplementation. While no beneficial effect of the antioxidant supplementation was visible in spermatozoa from portion I, more spermatozoa with intact membranes were observed in the supplemented samples of portion II, suggesting the protective effect of vitamin E is dependent of the portion of the boar ejaculate considered.
Detection of early changes in the sperm plasma membrane during cryopreservation is of utmost impo... more Detection of early changes in the sperm plasma membrane during cryopreservation is of utmost importance when designing freezing protocols. The present study evaluated the ability of an Annexin-V binding assay to detect early changes in sperm membrane integrity using flow cytometry (FC) in two different portions of the boar ejaculate, in cryopreserved semen. Using a split sample design, sperm motility was evaluated in fresh (controls) and frozen–thawed (FT) samples, both subjectively and by means of a computer-assisted motility assessment (CASA) system, while membrane integrity was assessed using Annexin-V (A) and propidium iodide (PI) staining in spermatozoa derived from the first sperm-rich fraction (Portion I) or the remaining ejaculate (Portion II). The A/PI technique revealed four sperm subpopulations, two PI negative (either A− (alive) or A+ (apoptotic)); and two PI positive (dead cells), either A+ (dead, late apoptotic or early necrotic cells) or A− (dead, late necrotic cells). Significant differences were found between the two portions of the ejaculate in the fresh (control) and FT samples. In the fresh controls, significantly more live, nonapoptotic spermatozoa (A−/PI−) were present in Portion I than in Portion II (P<0.001). Although apoptotic spermatozoa were detected in both semen portions, the frequency of live, early apoptotic (A+/PI−) cells was significantly lower in Portion I than in Portion II (P<0.001). Irrespective of the ejaculate portion considered, freezing and thawing significantly decreased the mean percentages of live spermatozoa (P<0.01), and dramatically increased the percentages of apoptotic or early necrotic cells (P<0.01), but not of early apoptotic cells (N.S.). The latter finding might suggest that apoptotic changes due to cryopreservation using the procedures applied in this trial are transient and lead to cell death. In conclusion, the Annexin-V binding assay was able to detect deleterious changes in the sperm plasma membrane at an earlier point than PI staining, thus representing a novel approach to investigating membrane integrity in this species. The finding that fewer spermatozoa in Portion I of the ejaculate showed early apoptosis post-freezing, suggests boar spermatozoa in this portion of the seminal plasma are less sensitive to the stress induced by cryopreservation.
Antioxidant supplementation during cooling was assayed to improve the motility of frozen-thawed (... more Antioxidant supplementation during cooling was assayed to improve the motility of frozen-thawed (FT) boar spermatozoa from two different fractions of the ejaculate, the first component of the sperm-rich fraction (Fraction I) and the rest of the bulk ejaculate (Fraction II). Using a split-sample design, addition of two different concentrations (100 and 200 μM l−1) of the water-soluble Vitamin E analogue Trolox (6-hydroxy –2,5,7,8-tetramethylchroman –2-carboxylic acid) was evaluated for an effect on sperm motility (measured both subjectively and by means of a computer assisted motility assessment (CASA)), and on mitochondrial membrane potential using flow cytometry after cell-loading with JC-1. The effect of the Vitamin E analogue was clearly dose-dependent and varied with the fraction of the ejaculate considered. Motility was significantly higher in Trolox-treated spermatozoa (200 μm), from either ejaculate fraction, albeit the effect was more evident in spermatozoa from Fraction II (P<0.05) for any Trolox-concentration. Antioxidant supplementation resulted, also dose-dependent, in a higher number of spermatozoa showing high mitochondrial activity as assessed by the JC-1 staining, in both ejaculate fractions. In the present trial, exogenous Trolox positively affected post-thaw sperm viability (as motility and mitochondrial membrane potential) in both fractions of the ejaculate. The magnitude of the effect appeared, however, to be dependent of the fraction of the ejaculate considered.
Endogenous oxytocin is released by the sow at the time of mating in response to stimulation by th... more Endogenous oxytocin is released by the sow at the time of mating in response to stimulation by the boar, which may explain, at least partially, the importance of the relationship between the boar's courting activity and the subsequent reproductive performance of the sow. The aim of this study was to determine the effects on reproductive performance of supplementing AI doses with exogenous oxytocin during the low fertility season. At an intensive piggery in northwest Spain 3 experimental groups were randomly formed and observed throughout the year. Group 1 sows were inseminated with semen supplemented with 4 IU oxytocin. Group 2 sows received 4 IU oxytocin injected through the vulvar lips mucosa at the time of insemination. Group 3 sows were inseminated without oxytocin and served as the controls. During the low fertility season the results for each group were as follows: farrowing rate 77.02, 56.25 and 54.39%, and litter size 10.77 ± 0.28, 10.45 ± 0.31 and 8.53 ± 0.34 respectively. It is concluded that the addition of oxytocin to seminal doses just before AI is an easily applicable, effective method for increasing fertility and litter size during the summer months.
Previous studies have shown sperm quality post-cryopreservation differs depending on the fraction... more Previous studies have shown sperm quality post-cryopreservation differs depending on the fraction of the seminal plasma boar spermatozoa are fortuitously contained in. As such, spermatozoa contained in the first 10 mL of the sperm-rich fraction (portion I) have better sustained handling procedures (extension, handling and freezing/thawing) than those contained in the ulterior part of a fractionated ejaculate (second portion of the sperm-rich fraction and the post-spermatic fraction, portion II). However, those studies were performed using pooled samples. In the present study, individual ejaculates were used. Split ejaculates (portions I and II) from five boars were frozen and thawed using a conventional freezing protocol, followed by computer-assisted motility and morphology analysis (CASA and ASMA, respectively), as well as an Annexin-V assay for spermatozoa from each boar and ejaculate portion. Significant differences between portions were observed in all ASMA-derived variables, except in one boar. Also significant differences were observed between boars and ejaculate portions in sperm quality post-thaw. We identified, however, boars showing best results of motility and sperm membrane integrity post-thaw in portion I, while in other boar the best results was observed in portion II. It is concluded that the identification of the ejaculate portion more suitable to sustain cryopreservation in each individual boar may be a readily applicable and easy technique to diminish variation in sperm freezability among boars.
Arthroscopy-the Journal of Arthroscopic and Related Surgery, 1996
Recently, one-incision drill guides introduced through predilled tibial tunnels have become popul... more Recently, one-incision drill guides introduced through predilled tibial tunnels have become popular in anterior cruciate ligament (ACL) reconstruction. No data are available on the reproducibility of the tunnel placement when this drill guide is used. The primary goal of this study was to compare accuracy of tunnel placement using the one-inciscion (all-inside) and the conventional two-incision drill guide (outside-in) to the location of the center of the normal ACL attachment. Furthermore, our goal was to measure the forces seen by the normal ACL during extension from 90° of flexion, when the tibia is subjected to 100 N anterior load (22.7 lbs), and compare these with the forces measured in the reconstructions performed with the two drill guides. The center of the tunnel on the lateral femoral condyle using the two different drill guides was measured with a three-dimensional pointer and compared with the center of the normal ACL insertion site. Forces in the normal ACL and the reconstructed ligament were measured with a buckle transducer in a loaded and an unloaded state at four different flexion angles. The one-incision drill guide led to a statistically more proximal placement of the graft than both the conventional drill guide and the center of the normal ACL. Both drill guides led to an anterior placement compared with the normal ACL. There was no difference in the graft forces after reconstruction with the two drill guides, but the forces in the loaded grafts were twice those of the normal ACL.
Knee Surgery Sports Traumatology Arthroscopy, 1996
A failure analysis of interference screw fixation was performed to test the hypothesis that bovin... more A failure analysis of interference screw fixation was performed to test the hypothesis that bovine and/or elderly human cadavers are appropriate models for bonepatellar tendon-bone anterior cruciate ligament (ACL) reconstruction fixation studies. Failure mode is an important criterion for validating experimental models. The bovine, young human, and elderly human failure loads were 799±261 N, 655±186 N, and 382±118 N, respectively, and the failure modes were 75%, 69%, and 30% tissue failures, respectively. The similarities between the bovine and young human models in failure loads and failure modes indicate that bovine models are appropriate for ACL reconstruction fixation studies. The statistically significant differences between the young human and elderly human models in failure loads and failure modes indicate that elderly human cadavers are not an appropriate model for ACL reconstruction fixation studies. The differences in failure modes are consistent with previous studies using elderly human cadavers in which the predominant failure mode was bone block pullout. The tissue failures observed in the bovine and young human models contradict previous studies suggesting fixation strength is the weakest link in bone-patellar tendon-bone ACL reconstruction. Results of linear regression modeling showed statistically significant correlations between insertion torque and failure load (R 2=0.44,PR 2=0.18,P=0.003) when data from all models was combined. Results for the bovine model multiple regression showed a statistically significant regression of insertion torque (linear) and interference (quadritic) versus failure load (R 2=0.56,P=0.02). Regression slopes for screw diameter (P=0.52) and gap size (P=1.00) were not statistically significant. These results indicate that insertion torque and interference are independent predictors of failure load and should be included in future interference screw studies in addition to bone block dimensions, tunnel size, gap size, and screw diameter. Clinicians may consider using insertion torque and interference as indicators of postoperative graft fixation regarding rehabilitation decisions.
The purpose of this study was to assess the incidence of iatrogenic articular cartilage injuries ... more The purpose of this study was to assess the incidence of iatrogenic articular cartilage injuries during ankle arthroscopy and to determine the factors that caused them. The hypothesis of this study was that the incidence of iatrogenic cartilage injuries produced during ankle arthroscopic procedures is high and directly related to the arthroscopic technique. All consecutive records from ankle arthroscopies performed between 2008 and 2010 were reviewed. Arthroscopic arthrodesis of the ankle was excluded from the study. Iatrogenic articular cartilage injury was defined as any cartilage injury that occurred during the arthroscopic procedure. The final number of ankle arthroscopic procedures reviewed was 74. There were a total of 23 iatrogenic lesions of the cartilage, for an overall complication rate of 31 %. The two most common injury locations were the anterolateral and central area of the talus. The cartilage lesion was superficial in 78.2 % of injuries (24.3 % of all patients), and deep in 21.8 % of injuries (6.7 % of all patients). Of the 23 injuries found, 65 % of them were sustained during the therapeutic portion of the arthroscopic procedure and the remaining 35 % occurred during the portal creation portion of the procedure. The incidence of cartilage injury during ankle arthroscopy is high. However, severe damage was found in only 6.7 % of ankle arthroscopies. Retrospective case series, Level IV.
Knee Surgery Sports Traumatology Arthroscopy, 1998
The aims of this study were to measure the forces in the anterior talofibular ligament (ATFL) and... more The aims of this study were to measure the forces in the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) and the motion in the tibiotalar and subtalar joints during simulated weight-bearing in eight cadaver ankle specimens. An MTS test machine was used to apply compressive loads to specimens held in a specially designed testing apparatus in which the ankle position (dorsiflexion-plantarflexion and supination-pronation) could be varied in a controlled manner. The forces in the ATFL and CFL were measured with buckle transducers. Tibiotalar motion and total ankle joint motion were measured with an instrumented spatial linkage. The specimens were positioned sequentially at 10° dorsiflexion, neutral, and 10° and 20° plantarflexion, and this sequence was repeated at 15° supination, neutral pronation/supination, and 15° pronation. Force and motion measurements were recorded in each of these positions with and without a 375 N compressive load simulating weight-bearing. From 10° dorsiflexion to 20° plantarflexion, all motion occurred in the tibiotalar joint. In contrast, the ratio of subtalar motion to tibiotalar motion was 3:1 for supination-pronation and 4:1 for internal-external rotation. Inverse loading patterns were observed for the ATFL and CFL from plantarflexion to dorsiflexion. Compressive loading did not affect CFL tension, but it magnified the pattern of increasing ATFL tension with plantarflexion. The largest increase in ATFL force was observed in supination and plantarflexion with a compressive load (76 ± 23 N), whereas CFL tension mainly increased in supination and dorsiflexion with a compressive load (109 ± 28 N). In conclusion, the results showed that the ATFL acted as a primary restraint in inversion, where injuries typically occur (combined plantarflexion, supination and internal rotation). Also, the subtalar joint was of primary importance for normal supination-pronation and internal-external rotation.
We wanted to use biomechanical testing in a cadaveric model to compare the Broström repair, the W... more We wanted to use biomechanical testing in a cadaveric model to compare the Broström repair, the Watson-Jones reconstruction, and a new anatomic reconstruction method. Eight specimens were held in a specially designed testing apparatus in which the ankle position (dorsiflexion-plantar flexion and supination-pronation) could be varied in a controlled manner. Testing was done with intact ligaments and was repeated after sectioning of the anterior talofibular ligament and the calcaneofibular ligament and after a Broström repair, a Watson-Jones reconstruction, and a new anatomic reconstruction were performed. An anterior drawer test was performed using an anterior translating force of 10 to 50 N, and a talar tilt test was performed using a supination torque of 1.1 to 3.4 N-m. The forces in the anterior talofibular ligament and calcaneofibular ligament were measured with buckle transducers, and tibiotalar motion and total ankle joint motion were measured with an instrumented spatial linkage. The increase in ankle joint laxity observed after sectioning of both the anterior talofibular and calcaneofibular ligaments was significantly reduced by the three reconstructive techniques, although not always to the level of the intact ankle. Joint motion was restricted after the Watson-Jones procedure compared with that in the intact ankle. Unlike the Watson-Jones procedure, the ligament or graft force patterns observed during loading after the Broström repair and the new anatomic technique resembled those observed in the intact ankle.
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