Eng-Hin Lee

Open reduction and annular ligament reconstruction with fascia of the forearm in chronic monteggia lesions in children.

Fifteen children with chronic Monteggia lesions were treated with open reduction, annular ligament reconstruction with fascia of the forearm, and ulnar osteotomy. Mean age was 8 years 3 months (range 3-16 years). The chronicity of missed Monteggia was from 6 weeks to 2 years (mean 12 weeks). All patients were classified as Bado type I, except one with Bado type III. Mean follow-up was 4 years 3 months after surgery. There was a loss of pronation in six cases with the mean of 16 degrees. However, only four cases had rotational loss; the others had a mean rotational arch increase of 5 degrees. The flexion arches improved in all patients, with a mean of 27.7 degrees. The functional result was excellent in 11 patients, good in 3 patients, and poor in 1 patient. This one-incision approach is safe in treating chronic Monteggia lesions in children.

Characterization of anterior cruciate ligament cells and bone marrow stromal cells on various biodegradable polymeric films

In this study, the adhesion, proliferation and morphology of rabbit anterior cruciate ligament (ACL) cells and bone marrow stromal cells (bMSCs) on synthetic biodegradable polymeric films were investigated. Tissue culture polystyrene (TCP) was used as control. Seven biodegradable polymers were used; they are as follows: poly(e-caprolactone) (PCL), poly(DL-lactide) (D-PLA), poly(L-lactide) (L-PLA), PLA/PCL (50:50), PLA/PCL (75:25), high molecular weight (HMW) poly(DL-lactide-co-glycolide (PLGA50:50) and HMW PLGA75:25. Polymeric film substrates were manufactured using solvent spin-casting technique. After 8 h of cell culture, a high percentage of ACL cells was found attached to PLGA50:50 (38.6 ± 8.4%) and TCP (39.3 ± 6.1%) as compared to the other six polymeric films (p ≤ 0.001). As for bMSCs, 76.4 ± 10%, 76.3 ± 16% and 76.1 ± 19% of seeded bMSCs were adhered to TCP, PLGA50:50 and PLGA75:25, respectively. These were significantly more than those of the other five polymeric films (p<0.001). At Day 5, bMSCs were found to proliferate faster on TCP (by 7 ± 0.8-fold of initial cell seeding number), D-PLA (by 5.6 ± 1.6-fold), PLGA50:50 (by 9.3 ± 1.3-fold) and PLGA75:25 (by 5.8 ± 1.3-fold) than on PCL, PLLA and PCL/PLA (50:50, 25:75) (p<0.001). ACL cells had a greater fold expansion on TCP (by 3.5 ± 0.2-fold), PLGA50:50 (by 3.1 ± 0.4-fold) and PLGA75:25 (by 3.9 ± 0.4-fold) than on the other five polymer substrates (p <0.001). From these results, HMW PLGA (50:50, 75:25) was shown more likely to allow bMSCs and ACL cells to attach and proliferate, and bMSCs attached and proliferated faster than ACL cells.