Kee Jeong Bae

Aging, linked to reduced tendon healing and higher injury susceptibility, is associated to the high incidence of rotator cuff (RC) tears in the elderly. Even after RC repair, disordered neofibrovascular scar tissue often occurs, lowering mechanical strength, and tendon‐derived cell (TDC) senescence has been suggested as one of the causes. Age reduces the efficacy of mesenchymal stem cell (MSC) therapy for tendon regeneration. However, certain biomaterial exposure may increase MSC differentiation and paracrine effects. We aimed to develop and evaluate an optimal tenon–MSC complex (TSC) for tendon regeneration and investigate its efficacy and antisenescence mechanisms in aged and degenerated TDCs. We proposed a novel method to isolate a maximum quantity of tenon with col6‐rich pericellular matrix (PCM) per gram of tendon, utilizing 2% collagenase. In a fibrin 3D gel culture system, rejuvenated METn (TSC) had higher tenogenic marker expression, collagen fiber quantity, and quality than MSC‐only or METc (TDC–MSC complex). METn could repair DNA damage and improve cellular metabolism in senescent TDCs by releasing antisenescence factors. TDCs, which overcomes senescence by the METn_CM treatment, also produced a higher quality tendon matrix. In conclusion, this study demonstrates that rejuvenated and functional TSC significantly enhances tendon regeneration by countering senescence in aged and degenerated TDCs, offering a safe approach to enhance the therapeutic potential of autologous senescent MSCs from the elderly.

Park J, et al. Clin Orthop Surg. 2025 Jun;17(3):408-416. https://doi.org/10.4055/cios24250

Kim KW, et al. Clin Orthop Surg. 2024 Apr;16(2):313-321. https://doi.org/10.4055/cios23266

Bae KJ, et al. Clin Orthop Surg. 2022 Aug;14:e65. https://doi.org/10.4055/cios22099

Joint Diseases and Related Surgery (JDRS), the official journal of the Turkish Joint Diseases Foundation, is an international, peer-reviewed, immediate open access journal. All published articles in JDRS has been free for everyone, without embargo, since 1990.

Purpose: An ankylosed elbow should be released with consideration of the nature of the stiffness and location of the pathologic structures, and care should be taken to avoid damage to the surrounding musculature and neurovascular structures. We report the clinical results of a combined anterior and posterior approach, which allowed safe access with good visibility, for severe elbow stiffness.Methods: We retrospectively reviewed patients who underwent surgical release for elbow ankylosis from August 2014 to May 2020. All operations were performed by the same surgeon at a single institution. The final outcomes were assessed by measuring the range of motion, calculating the Mayo Elbow Performance Score (MEPS), and reading radiologic images. Results: Eight patients with a mean age of 43 years (range, 21–65 years) were included in the study, and the mean follow-up period was 22 months. The average range of motion was 13° of flexion contracture (range, 0°–40°) and 123° of further flexion (range, 100°–140°) at the last follow-up. The average net improvement in the total arc compared to patients’ preoperative status was 68° (range, –10°–130°). The mean postoperative MEPS was 89 points (range, 70–100 points). The development of heterotopic ossification and recalcitrant rheumatoid arthritis caused relatively poor outcomes.Conclusion: The combined anterior and posterior approach allows safe access with good visibility for elbow ankylosis, while minimizing the risk of neurovascular injury and preserving the medial and lateral muscles.

Purpose: Hamate coronal body fracture is a rare injury and often associated with dislocation of the carpometacarpal joint. For preserving the carpometacarpal joint, open reduction and rigid internal fixation is needed to displaced fracture. The purpose of this study was to evaluate the outcome of treating hamate coronal fracture with the screw fixation method through a temporary Kirschner wire (K-wire) fixation hole.Methods: From August 2016 to January 2021, eight patients who had displaced coronal hamate body fractures were enrolled. All patients were performed open reduction and multiple K-wires fixations. After that, the cortical screws were then inserted directly into the holes made by removing the K-wires one by one. The outcome measures were Disabilities of the Arm, Shoulder and Hand (DASH) scores and visual analogue scale (VAS) scores.Results: The average follow-up period was 11.5 months (range, 5–8 months) after surgery, and the bone union was observed at the 8 weeks after surgery. We confirmed that bone union had been completed for all the patients, and functional tests showed that the average DASH score was 3.95 (range, 0–8.3) and VAS score was 0.8 (range, 0–3).Conclusion: In coronal hamate body fractures, open reduction and screw fixation method through temporary K-wire fixation hole is simple and effective treatment technique.

Objective: This study aims to investigate compensatory rotational movements of the wrist joint in patients with proximal congenital radioulnar synostosis (CRUS), using a valid and reliable three-dimensional (3D) motion analysis technique. Methods: A total of 26 patients (6 females, 14 males; mean age=15.3 years; and age range=6-32 years) who were diagnosed with unilateral proximal CRUS but were not operated were enrolled in this study. Patients were then categorized into 2 groups: Group I included 5 patients younger than 10 years, and Group II included 15 patients older than 10 years. Eighteen light-reflective skin markers were placed on the bony landmarks of both upper limbs, and both distal forearms were fixed using a U-shaped device to minimize forearm rotation. Each patient grasped the handle of an instrument that used a goniometer to measure wrist rotation; maximal passive pronation and supination angles of the wrist were measured in this manner and also using 3D motion analysis. Results: There was a significant correlation between measurements by the goniometer and 3D motion analysis (r=0.985, p<0.001). The test-retest reliability of the 3D motion analysis was acceptable for both the affected side (ICC=0.992) and the contralateral normal side (ICC=0.997) with low standard measurement errors (1.3° and 0.8°, respectively). Although no significant difference was observed in the range of the wrist rotation between the affected and contralateral sides in Group I (p=0.686), there was a significant difference in the wrist rotation between the affected and contralateral sides in Group II (p=0.001). Further, the pronation angle of the wrist joint was significantly larger in the affected side than that in the contralateral normal side in Group II (p=0.001). Conclusion: The 3D motion analysis technique seems to be a valid and reliable method to measure the rotation of the wrist joint. Unilateral proximal CRUS patients older than 10 years of age may develop rotational hypermobility of the wrist joint compared to the contralateral normal side as a compensatory phenomenon. Level of Evidence: Level III, Diagnostic Study Cite this article as: Li Q, Park JH, Lee Y, Kim J, Bae KJ, Baek GH. Measurement of compensatory wrist joint rotation using three-dimensional motion analysis in patients with unilateral proximal congenital radioulnar synostosis. Acta Orthop Traumatol Turc 2021; 55(2): 107-11.