Single-Center Study of 83 Horses with Suspensory Injuries Treated with Adipose-Derived Stem and Regenerative Cells

Adipose-derived stem and regenerative cells (ADRCs), concentrated from autologous fat tissue, have the ability to differentiate into various specific cell types including tenocytes. In this retrospective study, clinical data are presented from 83 horses with 176 suspensory ligament injuries, treated with ADRCs, given a strictly enforced standardized rehabilitation program, and followed up for at least one year after returning to work. Assessment for a successful outcome was return to full work (RFW) at a previous or higher level of performance for one year or more without re-injury. RFW numbers were 84.6% for horses with fore-limb ligament injuries and 82.1% for horses with hind-limb injuries. RFW outcomes were slightly better in cases with proximal suspensory ligament desmitis (86.7%) compared to horses with lesions of the body and branches. The ADRC injection procedure was well tolerated;no treatment-related adverse events, including injection flares, were detected in any of the 83 horses. The demonstrated long term stability of healed lesions strongly supports the therapeutic use of regenerative cells extracted from adipose tissue for treatment of acute and chronic, fore- and hind-limb suspensory ligament injuries in horses of various athletic sport disciplines.

Is V-Y plasty necessary for penile lengthening？ Girth enhancement and increased length solely through circumcision： description of a novel technique

Our objective is to describe a novel ligamentolysis approach using a subcoronal incision technique and to determine its safety and efficacy. During the last 7 years, 82 consecutive patients had penile augmentation surgery. Ligamentolysis, through a lower abdominal incision （V-Y plasty） in the first 35 males, was performed （Group A）, followed by circumcision ligamentolysis in the next 47 males （Group B）. The operation time, complications, and the preoperative and postoperative values of penile length and girth along with the self-esteem and relations questionnaire score as well as satisfaction score was calculated before and after the surgery, and a comparison was conducted between the groups. The mean age at presentation was 32 years （range： 18-56 years）. Seventy-nine patients suffered from penile dysmorphophobia, and three patients had micropenises （length 〈7.5 cm）. The mean surgical times were 150.7 and 125.2 rain for Groups A and B, respectively （P=0.005）. Postoperatively, four Group A patients and three Group B patients （11% versus 6%, respectively） experienced penile retraction （P=0.453）. Hypertrophic scars were observed in 18 men （51%） in the former group. In the circumcision group, no major wound complications were recorded. The length and girth improvements between the groups were similar. In terms of satisfaction and SEAR improvement, the resulting difference for both variables favored the circumcision group （P=0.007 and 〈0.001, respectively）. With strict selection criteria, the circumcision ligamentolysis procedure compared to the V-Y plasty demonstrated improved results in terms of safety, operation time, retraction rate and cosmetic appearance without any compromise in the gained penile size.

Acoustic Myography: Its Assessment of Ground Reaction Forces as Measured through Forelimb and Hind Limb of the Horse during Mild Exercise

Background: Fractures in the limbs of racehorses are common, resulting among other factors, as the result of repeated ground reaction forces on bones and joints, leading to catastrophic failure. Aim: To quantify ground impact transmission through the limb bones of un-shod healthy horses using the non-invasive technique of acoustic myography (AMG). Methods: Four sites were selected for AMG measurements at the walk and trot, hoof wall (site 1) and sites 2 - 4, metacarpal 3, carpals and the radius of the left forelimb of two healthy horses. Measurements were on both rubber and concrete. AMG of the equine hind limb suspensory system was made and analyzed (amplitude and timing) for the proximal suspensory ligament (PSL) and the SDFT/DDFT. Results: AMG signal amplitude at site 1 (1.5 ± 0.2 versus 1.1 ± 1.5) was not found to be significantly different at the trot compared to the walk;however, sites 2, 3 and 4 were all significantly different when compared between the two gaits;site 2 P = 0.008;site 3 P = 0.006;site 4 P = 0.005. AMG signals recorded on the rubber surface had smaller amplitude than the equivalent signal and site on the concrete surface. Ground Reaction Force (GRF) transmission in the equine forelimb was 22 m/sec, whilst that of the hind limb suspensory system was 25 m/sec. Conclusion: Findings indicate that GRFs are transmitted proximally along the limb at considerable speeds, that they are dampened by tissues and structures in the limb, and that the GRFs are present and detectable proximal to the fetlock joint.

Accurate Application of the Levator Palpebrae Superioris Anterior Migration and Shortening Technique in Blepharoptosis Correction Surgery

Background Accurate preoperative evaluation of the levator palpebrae superioris(LPS)strength is required for specific calculation of anterior migration or shortening.This information serves as a surgical reference for more accurate correction of ptosis.Methods Between June 2017 and June 2019,155 eyes of 97 patients were studied.Patients were divided into the following 3 groups based on the ptosis degree:mild(28 cases),moderate(53 cases),and severe(16 cases).The LPS strength was evaluated preoperatively and used to calculate LPS anterior migration and shortening.The LPS aponeurosis and Müller’s muscle(L-M)complex was separated from the upper margin of the tarsal plate to the calculated height according to the levator muscle suspension system retention approach.The complex was subsequently fixed to the planned tarsal plate location.The upper eyelid margin(UEM)height,eyelid morphology,eyelid closure,eye symmetry,exposure keratitis status,and patient satisfaction were evaluated at 1 week and at 1 and 6 months postoperatively.Results In all cases,the UEM positions were normal,and only patients with severe ptosis exhibited lagophthalmos in the early posterative period.Six months postoperatively,13%of eyes in the severe group had residual ptosis;all mild and moderate cases exhibited good surgical outcomes.The eyelids closed well with no exposure keratitis.All patients were satisfied with the eyelid contour.Conclusions Accurate LPS anterior migration and aponeurosis shortening can eliminate various factors affecting surgical blepharoptosis treatment.These procedures not only reduce operation time but also enhance the stability of postoperative correction.

Loop changes after knee flexion-extension movement in a cadaveric anterior cruciate reconstruction model

Background:Recently,adjustable-loop devices(ALDs)have been widely used,and their reliability has always been the focus of attention.This study compared loop length changes under pull stress caused by flexion and extension of the cadaver knee between ALDs and fixed-loop devices(FLDs)in terms of femoral fixation after anterior cruciate ligament(ACL)reconstruction.Methods:ACL reconstruction in cadaveric knee joints was performed under arthroscopy with femoral suspension devices and tibial fixation by tying sutures on staples.The knee joint was repeatedly flexed and extended 30 times after fixation.According to the femoral fixation device used(Endobutton or Ultrabutton),the knee joints were divided into two groups:the ALD group(12 specimens)and the FLD group(ten specimens).The length of the loop before and after fixation was measured,and the loop length of the ALD group was re-measured 1 day after reconstruction.Results:There was no significant difference in the length of the loop between the two groups(t=0.579,P=0.569).One day later,the loop length of the ALDs retracted by 0.29±0.33(0–1.1)mm,and there was no retraction in three specimens.Conclusion:There was no significant difference in the loop length under flexion and extension stress after ACL reconstruction between ALDs and FLDs.