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Purpose — to compare the chemical elemental composition of vitreous cavity content taken from cadaveric eyes compared to samples taken from the eyes with terminal stage refractory glaucoma with decompensated intraocular pressure (IOP). Material and methods. The vitreous contents of the eyes from 2 groups were studied. The 1st group included 15 cadaveric eyes; the 2nd group included 15 eyes with refractory glaucoma in the terminal stage of the disease with decompensated IOP in patients with hypertension pain. The vitreal content samples were taken in the course of antiglaucoma surgery aimed at preserving the eye as an organ and involving employment of drainage in the vitreous cavity. The study of virtual contents was carried out on energy dispersive spectrometer Oxford X-Max 50 integrated into scanning electron microscope Zeiss EVO LS10. Results. Increased concentrations of Kalium and Phosphorus were detected in the vitreous content of cadaveric eyes compared with the vitreal content from the eyes with terminal glaucoma with decompensated IOP taken in vivo (K — 0.172/0.093; P — 0.045/0.025 mmol/L). In the vitreous cavity in the eyes with end-stage glaucoma with decompensated IOP, the concentration of Nitrogen was higher in comparison with human cadaver eyes (2.030/1.424 mmol/L). Conclusion. The increased concentrations of Kalium and Phosphorus in the vitreous content of cadaveric eyes is associated with postmortem autolytic processes and with the release of intracellular content in the destruction of cell membranes. The increased Nitrogen concentration in the vitreal contents of the eyes with terminal stage glaucoma with decompensated IOP may be associated with the presence of osmotically active nitrogen-containing compounds in the eyes with increased IOP.
We present an electromechanically coupled Finite Element model for cardiac tissue. It bases on the mechanical model for cardiac tissue of Hunter et al. that we couple to the McAllister-Noble-Tsien electrophysiological model of purkinje fibre cells. The corresponding system of ordinary differential equations is implemented on the level of the constitutive equations in a geometrically and physically nonlinear version of the so-called edge-based smoothed FEM for plates. Mechanical material parameters are determined from our own pressure-deflection experimental setup. The main purpose of the model is to further examine the experimental results not only on mechanical but also on electrophysiological level down to ion channel gates. Moreover, we present first drug treatment simulations and validate the model with respect to the experiments.
We present an electromechanically coupled computational model for the investigation of a thin cardiac tissue construct consisting of human-induced pluripotent stem cell-derived atrial, ventricular and sinoatrial cardiomyocytes. The mechanical and electrophysiological parts of the finite element model, as well as their coupling are explained in detail. The model is implemented in the open source finite element code Code_Aster and is employed for the simulation of a thin circular membrane deflected by a monolayer of autonomously beating, circular, thin cardiac tissue. Two cardio-active drugs, S-Bay K8644 and veratridine, are applied in experiments and simulations and are investigated with respect to their chronotropic effects on the tissue. These results demonstrate the potential of coupled micro- and macroscopic electromechanical models of cardiac tissue to be adapted to experimental results at the cellular level. Further model improvements are discussed taking into account experimentally measurable quantities that can easily be extracted from the obtained experimental results. The goal is to estimate the potential to adapt the presented model to sample specific cell cultures.
Effectiveness of the edge-based smoothed finite element method applied to soft biological tissues
(2012)
Two single-incision mini-slings used for treating urinary incontinence in women are compared with respect to the stresses they produce in their surrounding tissue. In an earlier paper we experimentally observed that these implants produce considerably different stress distributions in a muscle tissue equivalent. Here we perform 2D finite element analyses to compare the shear stresses and normal stresses in the tissue equivalent for the two meshes and to investigate their failure behavior. The results clearly show that the Gynecare TVT fails for increasing loads in a zipper-like manner because it gradually debonds from the surrounding tissue. Contrary to that, the tissue at the ends of the DynaMesh-SIS direct may rupture but only at higher loads. The simulation results are in good agreement with the experimental observations thus the computational model helps to interpret the experimental results and provides a tool for qualitative evaluation of mesh implants.
Human-induced pluripotent stem cell-derived cardiomyocytes (hiPS-CM) today are widely used for the investigation of normal electromechanical cardiac function, of cardiac medication and of mutations. Computational models are thus established that simulate the behavior of this kind of cells. This section first motivates the modeling of hiPS-CM and then presents and discusses several modeling approaches of microscopic and macroscopic constituents of human-induced pluripotent stem cell-derived and mature human cardiac tissue. The focus is led on the mapping of the computational results one can achieve with these models onto mature human cardiomyocyte models, the latter being the real matter of interest. Model adaptivity is the key feature that is discussed because it opens the way for modeling various biological effects like biological variability, medication, mutation and phenotypical expression. We compare the computational with experimental results with respect to normal cardiac function and with respect to inotropic and chronotropic drug effects. The section closes with a discussion on the status quo of the specificity of computational models and on what challenges have to be solved to reach patient-specificity.
The present article describes a standard instrument for the continuous online determination of retinal vessel diameters, the commercially available retinal vessel analyzer. This report is intended to provide informed guidelines for measuring ocular blood flow with this system. The report describes the principles underlying the method and the instruments currently available, and discusses clinical protocol and the specific parameters measured by the system. Unresolved questions and the possible limitations of the technique are also discussed.
Prolonged operations close to small solar system bodies require a sophisticated control logic to minimize propellant mass and maximize operational efficiency. A control logic based on Discrete Mechanics and Optimal Control (DMOC) is proposed and applied to both conventionally propelled and solar sail spacecraft operating at an arbitrarily shaped asteroid in the class of Itokawa. As an example, stand-off inertial hovering is considered, recently identified as a challenging part of the Marco Polo mission. The approach is easily extended to stand-off orbits. We show that DMOC is applicable to spacecraft control at small objects, in particular with regard to the fact that the changes in gravity are exploited by the algorithm to optimally control the spacecraft position. Furthermore, we provide some remarks on promising developments.
Geochemical characterisation of hypersaline waters is difficult as high concentrations of salts hinder the analysis of constituents at low concentrations, such as trace metals, and the collection of samples for trace metal analysis in natural waters can be easily contaminated. This is particularly the case if samples are collected by non-conventional techniques such as those required for aquatic subglacial environments. In this paper we present the first analysis of a subglacial brine from Taylor Valley, (~ 78°S), Antarctica for the trace metals: Ba, Co, Mo, Rb, Sr, V, and U. Samples were collected englacially using an electrothermal melting probe called the IceMole. This probe uses differential heating of a copper head as well as the probe’s sidewalls and an ice screw at the melting head to move through glacier ice. Detailed blanks, meltwater, and subglacial brine samples were collected to evaluate the impact of the IceMole and the borehole pump, the melting and collection process, filtration, and storage on the geochemistry of the samples collected by this device. Comparisons between melt water profiles through the glacier ice and blank analysis, with published studies on ice geochemistry, suggest the potential for minor contributions of some species Rb, As, Co, Mn, Ni, NH4+, and NO2−+NO3− from the IceMole. The ability to conduct detailed chemical analyses of subglacial fluids collected with melting probes is critical for the future exploration of the hundreds of deep subglacial lakes in Antarctica.
The connective tissues such as tendons contain an extracellular matrix (ECM) comprising collagen fibrils scattered within the ground substance. These fibrils are instrumental in lending mechanical stability to tissues. Unfortunately, our understanding of how collagen fibrils reinforce the ECM remains limited, with no direct experimental evidence substantiating current theories. Earlier theoretical studies on collagen fibril reinforcement in the ECM have relied predominantly on the assumption of uniform cylindrical fibers, which is inadequate for modelling collagen fibrils, which possessed tapered ends. Recently, Topçu and colleagues published a paper in the International Journal of Solids and Structures, presenting a generalized shear-lag theory for the transfer of elastic stress between the matrix and fibers with tapered ends. This paper is a positive step towards comprehending the mechanics of the ECM and makes a valuable contribution to formulating a complete theory of collagen fibril reinforcement in the ECM.
Background/Aims: Common systems for the quantification of cellular contraction rely on animal-based models, complex experimental setups or indirect approaches. The herein presented CellDrum technology for testing mechanical tension of cellular monolayers and thin tissue constructs has the potential to scale-up mechanical testing towards medium-throughput analyses. Using hiPS-Cardiac Myocytes (hiPS-CMs) it represents a new perspective of drug testing and brings us closer to personalized drug medication. Methods: In the present study, monolayers of self-beating hiPS-CMs were grown on ultra-thin circular silicone membranes and deflect under the weight of the culture medium. Rhythmic contractions of the hiPS-CMs induced variations of the membrane deflection. The recorded contraction-relaxation-cycles were analyzed with respect to their amplitudes, durations, time integrals and frequencies. Besides unstimulated force and tensile stress, we investigated the effects of agonists and antagonists acting on Ca²⁺ channels (S-Bay K8644/verapamil) and Na⁺ channels (veratridine/lidocaine). Results: The measured data and simulations for pharmacologically unstimulated contraction resembled findings in native human heart tissue, while the pharmacological dose-response curves were highly accurate and consistent with reference data. Conclusion: We conclude that the combination of the CellDrum with hiPS-CMs offers a fast, facile and precise system for pharmacological, toxicological studies and offers new preclinical basic research potential.
Physical interaction with small solar system bodies (SSSB) is the next step in planetary science, planetary in-situ resource utilization (ISRU), and planetary defense (PD). It requires a broader understanding of the surface properties of the target objects, with particular interest focused on those near Earth. Knowledge of composition, multi-scale surface structure, thermal response, and interior structure is required to design, validate and operate missions addressing these three fields. The current level of understanding is occasionally simplified into the phrase, ”If you’ve seen one asteroid, you’ve seen one asteroid”, meaning that the in-situ characterization of SSSBs has yet to cross the threshold towards a robust and stable scheme of classification. This would enable generic features in spacecraft design, particularly for ISRU and science missions. Currently, it is necessary to characterize any potential target object sufficiently by a dedicated pre-cursor mission to design the mission which then interacts with the object in a complex fashion. To open up strategic approaches, much broader in-depth characterization of potential target objects would be highly desirable. In SSSB science missions, MASCOT-like nano-landers and instrument carriers which integrate at the instrument level to their mothership have met interest. By its size, MASCOT is compatible with small interplanetary missions. The DLR-ESTEC Gossamer Roadmap Science Working Groups‘ studies identified Multiple Near-Earth asteroid (NEA) Rendezvous (MNR) as one of the space science missions only feasible with solar sail propulsion. The Solar Polar Orbiter (SPO) study showed the ability to access any inclination, theDisplaced-L1 (DL1) mission operates close to Earth, where objects of interest to PD and for ISRU reside. Other studies outline the unique capability of solar sails to provide access to all SSSB, at least within the orbit of Jupiter, and significant progress has been made to explore the performance envelope of near-term solar sails for MNR. However, it is difficult for
sailcraft to interact physically with a SSSB. We expand and extend the philosophy of the recently qualified DLR Gossamer solar sail deployment technology using efficient multiple sub-spacecraft integration to also include landers for one-way in-situ investigations and sample-return missions by synergetic integration and operation of sail and lander. The MASCOT design concept and its characteristic features have created an ideal counterpart for thisand has already been adapted to the needs of the AIM spacecraft, former part of the NASA-ESA AIDA missionDesigning the 69th International Astronautical Congress (IAC), Bremen, Germany, 1-5 October 2018. IAC-18-F1.2.3 Page 2 of 17 combined spacecraft for piggy-back launch accommodation enables low-cost massively parallel access to the NEA population.
Physical interaction with small solar system bodies (SSSB) is key for in-situ resource utilization (ISRU). The design of mining missions requires good understanding of SSSB properties, including composition, surface and interior structure, and thermal environment. But as the saying goes "If you've seen one asteroid, you've seen one Asteroid": Although some patterns may begin to appear, a stable and reliable scheme of SSSB classification still has to be evolved. Identified commonalities would enable generic ISRU technology and spacecraft design approaches with a high degree of re-use. Strategic approaches require much broader in-depth characterization of the SSSB populations of interest to the ISRU community. The DLR-ESTEC GOSSAMER Roadmap Science Working Groups identified target-flexible Multiple Near-Earth asteroid (NEA) Rendezvous (MNR) as one of the missions only feasible with solar sail propulsion, showed the ability to access any inclination and a wide range of heliocentric distances as well as continuous operation close to Earth's orbit where low delta-v objects reside.
Asteroid mining has the potential to greatly reduce the cost of in-space manufacturing, production of propellant for space transportation and consumables for crewed spacecraft, compared to launching the required resources from Earth’s deep gravity well. This paper discusses the top-level mission architecture and trajectory design for these resource-return missions, comparing high-thrust trajectories with continuous low-thrust solar-sail trajectories. This work focuses on maximizing the economic Net Present Value, which takes the time-cost of finance into account and therefore balances the returned resource mass and mission duration. The different propulsion methods will then be compared in terms of maximum economic return, sets of attainable target asteroids, and mission flexibility. This paper provides one more step towards making commercial asteroid mining an economically viable reality by integrating trajectory design, propulsion technology and economic modelling.
In parallel to the evolution of the Planetary Defense Conference, the exploration of small solar system bodies has advanced from fast fly-bys on the sidelines of missions to the planets to the implementation of dedicated sample-return and in-situ analysis missions. Spacecraft of all sizes have landed, touch-and-go sampled, been gently beached, or impacted at hypervelocity on asteroid and comet surfaces. More have flown by close enough to image their surfaces in detail or sample their immediate environment, often as part of an extended or re-purposed mission. And finally, full-scale planetary defense experiment missions are in the making. Highly efficient low-thrust propulsion is increasingly applied beyond commercial use also in mainstream and flagship science missions, in combination with gravity assist propulsion. Another development in the same years is the growth of small spacecraft solutions, not in size but in numbers and individual capabilities. The on-going NASA OSIRIS-REx and JAXA HAYABUSA2 missions exemplify the trend as well as the upcoming NEA SCOUT mission or the landers MINERVA-II and MASCOT recently deployed on Ryugu. We outline likely as well as possible and efficient routes of continuation of all these developments towards a propellant-less and highly efficient class of spacecraft for small solar system body exploration: small spacecraft solar sails designed for carefree handling and equipped with carried landers and application modules, for all asteroid user communities –planetary science, planetary defence, and in-situ resource utilization. This projection builds on the experience gained in the development of deployable membrane structures leading up to the successful ground deployment test of a (20 m)² solar sail at DLR Cologne and in the 20 years since. It draws on the background of extensive trajectory optimization studies, the qualified technology of the DLR GOSSAMER-1 deployment demonstrator, and the MASCOT asteroid lander. These enable ‘now-term’ as well as near-term hardware solutions, and thus responsive fast-paced development. Mission types directly applicable to planetary defense include: single and Multiple NEA Rendezvous ((M)NR) for mitigation precursor, target monitoring and deflection follow-up tasks; sail-propelled head-on retrograde kinetic impactors (RKI) for mitigation; and deployable membrane based methods to modify the asteroid’s properties or interact with it. The DLR-ESTEC GOSSAMER Roadmap initiated studies of missions uniquely feasible with solar sails such as Displaced L1 (DL1) space weather advance warning and monitoring and Solar Polar Orbiter (SPO) delivery which demonstrate the capability of near-term solar sails to achieve NEA rendezvous in any kind of orbit, from Earth-coorbital to extremely inclined and even retrograde orbits. For those mission types using separable payloads, such as SPO, (M)NR and RKI, design concepts can be derived from the separable Boom Sail Deployment Units characteristic of DLR GOSSAMER solar sail technology, nanolanders like MASCOT, or microlanders like the JAXA-DLR Jupiter Trojan Asteroid Lander for the OKEANOS mission which can shuttle from the sail to the asteroids visited and enable multiple NEA sample-return missions. These are an ideal match for solar sails in micro-spacecraft format whose launch configurations are compatible with ESPA and ASAP secondary payload platforms.
20 years after the successful ground deployment test of a (20 m) 2 solar sail at DLR Cologne, and in the light of the upcoming U.S. NEAscout mission, we provide an overview of the progress made since in our mission and hardware design studies as well as the hardware built in the course of our solar sail technology development. We outline the most likely and most efficient routes to develop solar sails for useful missions in science and applications, based on our developed `now-term' and near-term hardware as well as the many practical and managerial lessons learned from the DLR-ESTEC Gossamer Roadmap. Mission types directly applicable to planetary defense include single and Multiple NEA Rendezvous ((M)NR) for precursor, monitoring and follow-up scenarios as well as sail-propelled head-on retrograde kinetic impactors (RKI) for mitigation. Other mission types such as the Displaced L1 (DL1) space weather advance warning and monitoring or Solar Polar Orbiter (SPO) types demonstrate the capability of near-term solar sails to achieve asteroid rendezvous in any kind of orbit, from Earth-coorbital to extremely inclined and even retrograde orbits. Some of these mission types such as SPO, (M)NR and RKI include separable payloads. For one-way access to the asteroid surface, nanolanders like MASCOT are an ideal match for solar sails in micro-spacecraft format, i.e. in launch configurations compatible with ESPA and ASAP secondary payload platforms. Larger landers similar to the JAXA-DLR study of a Jupiter Trojan asteroid lander for the OKEANOS mission can shuttle from the sail to the asteroids visited and enable multiple NEA sample-return missions. The high impact velocities and re-try capability achieved by the RKI mission type on a final orbit identical to the target asteroid's but retrograde to its motion enables small spacecraft size impactors to carry sufficient kinetic energy for deflection.
Following the successful PHILAE landing with ESA's ROSETTA probe and the launch of the MINERVA rovers and the Mobile Asteroid Surface Scout, MASCOT, aboard the JAXA space probe, HAYABUSA2, to asteroid (162173) Ryugu, small landers have found increasing interest. Integrated at the instrument level in their mothership they support small solar system body studies. With efficient capabilities, resource-friendly design and inherent robustness they are an attractive exploration mission element. We discuss advantages and constraints of small sub-spacecraft, focusing on emerging areas of activity such as asteroid diversity studies, planetary defence, and asteroid mining, on the background of our projects PHILAE, MASCOT, MASCOT2, the JAXA-DLR Solar Power Sail Lander Design Study, and others. The GOSSAMER-1 solar sail deployment concept also involves independent separable sub-spacecraft operating synchronized to deploy the sail. Small spacecraft require big changes in the way we do things and occasionally a little more effort than would be anticipated based on a traditional large spacecraft approach. In a Constraints-Driven Engineering environment we apply Concurrent Design and Engineering (CD/CE), Concurrent Assembly, Integration and Verification (CAIV) and Model-Based Systems Engineering (MBSE). Near-term solar sails will likely be small spacecraft which we expect to harmonize well with nano-scale separable instrument payload packages.
Following the recent successful landings and occasional re-awakenings of PHILAE, the lander carried aboard ROSETTA to comet 67P/Churyumov-Gerasimenko, and the launch of the Mobile Asteroid Surface Scout, MASCOT, aboard the HAYABUSA2 space probe to asteroid (162173) Ryugu we present an overview of the characteristics and peculiarities of small spacecraft missions to small solar system bodies (SSSB). Their main purpose is planetary science which is transitioning from a ‘pure’ science of observation of the distant to one also supporting in-situ applications relevant for life on Earth. Here we focus on missions at the interface of SSSB science and planetary defence applications. We provide a brief overview of small spacecraft SSSB missions and on this background present recent missions, projects and related studies at the German Aerospace Center, DLR, that contribute to the worldwide planetary defence community. These range from Earth orbit technology demonstrators to active science missions in interplanetary space. We provide a summary of experience from recently flown missions with DLR participation as well as a number of studies. These include PHILAE, the lander of ESA’s ROSETTA comet rendezvous mission now on the surface of comet 67P/Churyumov-Gerasimenko, and the Mobile Asteroid Surface Scout, MASCOT, now in cruise to the ~1 km diameter C-type near-Earth asteroid (162173) Ryugu aboard the Japanese sample-return probe HAYABUSA2. We introduce the differences between the conventional methods employed in the design, integration and testing of large spacecraft and the new approaches developed by small spacecraft projects. We expect that the practical experience that can be gained from projects on extremely compressed timelines or with high-intensity operation phases on a newly explored small solar system body can contribute significantly to the study, preparation and realization of future planetary defence related missions. One is AIDA (Asteroid Impact & Deflection Assessment), a joint effort of ESA, JHU/APL, NASA, OCA and DLR, combining JHU/APL’s DART (Double Asteroid Redirection Test) and ESA’s AIM (Asteroid Impact Monitor) spacecraft in a mission towards near-Earth binary asteroid system (65803) Didymos. DLR is currently applying MASCOT heritage and lessons learned to the design of MASCOT2, a lander for the AIM mission to support a bistatic low frequency radar experiment with PHILAE/ROSETTA CONSERT heritage to explore the inner structure of Didymoon which is the designated impact target for DART.
For now, the Planetary Defense Conference Exercise 2021's incoming fictitious(!), asteroid, 2021 PDC, seems headed for impact on October 20th, 2021, exactly 6 months after its discovery. Today (April 26th, 2021), the impact probability is 5%, in a steep rise from 1 in 2500 upon discovery six days ago. We all know how these things end. Or do we? Unless somebody kicked off another headline-grabbing media scare or wants to keep civil defense very idle very soon, chances are that it will hit (note: this is an exercise!). Taking stock, it is barely 6 months to impact, a steadily rising likelihood that it will actually happen, and a huge uncertainty of possible impact energies: First estimates range from 1.2 MtTNT to 13 GtTNT, and this is not even the worst-worst case: a 700 m diameter massive NiFe asteroid (covered by a thin veneer of Ryugu-black rubble to match size and brightness), would come in at 70 GtTNT. In down to Earth terms, this could be all between smashing fireworks over some remote area of the globe and a 7.5 km crater downtown somewhere. Considering the deliberate and sedate ways of development of interplanetary missions it seems we can only stand and stare until we know well enough where to tell people to pack up all that can be moved at all and save themselves. But then, it could just as well be a smaller bright rock. The best estimate is 120 m diameter from optical observation alone, by 13% standard albedo. NASA's upcoming DART mission to binary asteroid (65803) Didymos is designed to hit such a small target, its moonlet Dimorphos. The Deep Impact mission's impactor in 2005 successfully guided itself to the brightest spot on comet 9P/Tempel 1, a relatively small feature on the 6 km nucleus. And 'space' has changed: By the end of this decade, one satellite communication network plans to have launched over 11000 satellites at a pace of 60 per launch every other week. This level of series production is comparable in numbers to the most prolific commercial airliners. Launch vehicle production has not simply increased correspondingly – they can be reused, although in a trade for performance. Optical and radio astronomy as well as planetary radar have made great strides in the past decade, and so has the design and production capability for everyday 'high-tech' products. 60 years ago, spaceflight was invented from scratch within two years, and there are recent examples of fast-paced space projects as well as a drive towards 'responsive space'. It seems it is not quite yet time to abandon all hope. We present what could be done and what is too close to call once thinking is shoved out of the box by a clear and present danger, to show where a little more preparedness or routine would come in handy – or become decisive. And if we fail, let's stand and stare safely and well instrumented anywhere on Earth together in the greatest adventure of science.
Small Spacecraft in Planetary Defence Related Applications–Capabilities, Constraints, Challenges
(2015)
In this paper we present an overview of the characteristics and peculiarities of small spacecraft missions related to planetary defence applications. We provide a brief overview of small spacecraft missions to small solar system bodies. On this background we present recent missions and selected projects and related studies at the German Aerospace Center, DLR, that contribute to planetary defence related activities. These range from Earth orbit technology demonstrators to active science missions in interplanetary space. We provide a summary of experience from recently flown missions with DLR participation as well as a number of studies. These include PHILAE, the lander recently arrived on comet 67P/Churyumov-Gerasimenko aboard ESA’s ROSETTA comet rendezvous mission, and the Mobile Asteroid Surface Scout, MASCOT, now underway to near-Earth asteroid (162173) 1999 JU3 aboard the Japanese sample-return probe HAYABUSA-2. We introduce the differences between the conventional methods employed in the design, integration and testing of large spacecraft and the new approaches developed by small spacecraft projects. We expect that the practical experience that can be gained from projects on extremely
compressed timelines or with high-intensity operation phases on a newly explored small solar system body can contribute significantly to the study, preparation and realization of future planetary defence related missions. One is AIDA (Asteroid Impact & Deflection Assessment), a joint effort of ESA,JHU/APL, NASA, OCA and DLR, combining JHU/APL’s DART (Double Asteroid Redirection Test) and ESA’s AIM (Asteroid Impact Monitor) spacecraft in a mission towards
near-Eath binary asteroid (65803) Didymos.
Background:
Additional stabilization of the “comma sign” in anterosuperior rotator cuff repair has been proposed to provide biomechanical benefits regarding stability of the repair.
Purpose:
This in vitro investigation aimed to investigate the influence of a comma sign–directed reconstruction technique for anterosuperior rotator cuff tears on the primary stability of the subscapularis tendon repair.
Study Design:
Controlled laboratory study.
Methods:
A total of 18 fresh-frozen cadaveric shoulders were used in this study. Anterosuperior rotator cuff tears (complete full-thickness tear of the supraspinatus and subscapularis tendons) were created, and supraspinatus repair was performed with a standard suture bridge technique. The subscapularis was repaired with either a (1) single-row or (2) comma sign technique. A high-resolution 3D camera system was used to analyze 3-mm and 5-mm gap formation at the subscapularis tendon-bone interface upon incremental cyclic loading. Moreover, the ultimate failure load of the repair was recorded. A Mann-Whitney test was used to assess significant differences between the 2 groups.
Results:
The comma sign repair withstood significantly more loading cycles than the single-row repair until 3-mm and 5-mm gap formation occurred (P≤ .047). The ultimate failure load did not reveal any significant differences when the 2 techniques were compared (P = .596).
Conclusion:
The results of this study show that additional stabilization of the comma sign enhanced the primary stability of subscapularis tendon repair in anterosuperior rotator cuff tears. Although this stabilization did not seem to influence the ultimate failure load, it effectively decreased the micromotion at the tendon-bone interface during cyclic loading.
Clinical Relevance:
The proposed technique for stabilization of the comma sign has shown superior biomechanical properties in comparison with a single-row repair and might thus improve tendon healing. Further clinical research will be necessary to determine its influence on the functional outcome.
Treatment of posttraumatic osteoarthritis of the radial column of the elbow joint remains a challenging yet common issue.
While partial joint replacement leads to high revision rates, radial head excision has shown to severely increase joint instability. Shortening osteotomy of the radius could be an option to decrease the contact pressure of the radiohumeral joint and thereby pain levels without causing valgus instability. Hence, the aim of this biomechanical study was to evaluate the effects of radial shortening on axial load distribution and valgus stability of the elbow joint.
Surgical reconstruction of the interosseous membrane (IOM) could restore longitudinal forearm stability to avoid persisting disability due to capituloradial and ulnocarpal impingement in Essex Lopresti lesions. This biomechanical study aimed to assess longitudinal forearm stability of intact specimens, after sectioning of the IOM and after reconstruction with a TightRope construct using either a single or double bundle technique.
Plate osteosynthesis of displaced proximal phalangeal neck fractures of the hand allows early mobilization due to a stable internal fixation. Nevertheless, joint stiffness—because of soft tissue irritation—represents a common complication leading to high complication rates. Del Pinal et al. recently reported promising clinical results for a new, minimally invasive fixation technique with a cannulated headless intramedullary compression screw. Hence, the aim of this study was to compare plate fixation of proximal phalangeal neck fractures to less two less invasive techniques: Crossed k-wire fixation and intramedullary screw fixation. We hypothesized that these fixation techniques provide inferior stability when compared to plate osteosynthesis.