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   2007| July-September  | Volume 1 | Issue 3  
 
 
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REVIEW ARTICLE
Shoulder surgeon and autologous cellular regeneration - From bench to bed: Part one- the link between the human fibroblast, connective tissue disorders and shoulder
Don F Du Toit, Wayne G Kleintjes, Erick J Mazyala, Deepak N Bhatia, Joe F De Beer, Benedict J Page
July-September 2007, 1(3):87-95
DOI:10.4103/0973-6042.34516  
The process of autologous cell regeneration (ACR) is a facet of cell therapy and regenerative medicine. It is initiated when activated autologous platelet rich plasma alone (PRP), containing cytokines or growth factors, is injected into the dermis or other structure in order to initiate a regenerative or antiaging process. The recipients resident cells at the target zone are activated by biologically active growth factors, derived from the activated platelets in the PRP through a paracrine effect. The platelet gel that contains the fibrin and clumped platelets, releases growth factors that influences activation of macrophages and stem cells in the recipient site. Tissue regeneration is facilitated by stem cell proliferation and differentiation. The PRP that has sealant and wound healing properties, may shift the wound healing cascade to the left, thereby speeding up tissue regeneration and remodelling by the use of the recipients own plasma. Both the fibroblast and myofibroblast play key roles in the wound healing cascade. The fibroblast, of mesenchymal origin, plays a pivotal role in the formation of the extracellular matrix and deposition of collagen. A failure of organised fibroblast function results in important and disabling disease processes and conditions such as chronic ischaemic heart disease and remodelling of the heart, lung fibrosis, fibromatosis, solar aged-face, keloids, hypertrophic scar formation, nodular fasciitis, inguinal hernia, Dupuytren's disease and scleroderma. More recent additions include frozen shoulder and the captured shoulder. In aesthetic medicine, one of the prime functions of fractional photothermolysis with lasers, intense pulsed light and radiofrequency devices, is to stimulate dermal fibroblast proliferation, by thermal energy thereby increasing collagen deposition which enhances facial rejuvenation. Platelet -rich plasma (REGENLAB PRP, REGENLAB-ACR) possesses unique growth factors that stimulate, fibroblast, keratinocyte and myoblasts ex vivo in tissue culture, allowing three-dimensional cell proliferation within the fibrin gel. PRP can be used as a cell carrier (i.e., keratinocytes, fibroblasts), may enhance cell retention at the point of treatment. REGENKIT is authorized for human use, ISO and CE marked. In this overview fibroblast morphology, tissue culture and cell biology relevant to the shoulder surgeon is reviewed.
  10,300 513 -
CASE REPORTS
Arthroscopy-assisted percutaneous fixation of glenoid fossa fracture
Rahikiran Yallapragada, Kuntal Patel, Pardhasaradhi Davuluri, Andy Sloan, Hans Marynissen
July-September 2007, 1(3):96-99
DOI:10.4103/0973-6042.34515  
We are reporting an interesting case of glenoid fracture in a 46-year-old male which was fixed with the help of arthroscopy. At present, anterior or posterior glenoid rim fractures and some greater tuberosity fractures are widely treated arthroscopically. We report the arthroscopically assisted fixation of a transverse articular glenoid fracture. Arthroscopic reduction and percutaneous fixation of glenoid fractures not only allows anatomic reduction with minimal surgical trauma but provides a valid diagnostic and treatment alternative for associated capsular, ligamentous, labral or tendon injuries as well as joint irrigation. The principle portals are discussed. We suggest fixation with cannulated screws for better stability of fracture fragments and advise K-wires for fractures that are comminuted and not amenable to cannulated screw fixation. However, arthroscopic fixation of shoulder fractures is associated with a learning curve depending on surgeon's experience in shoulder arthroscopy.
  7,560 201 2
ORIGINAL ARTICLE
Risk factors for the development of rotator cuff disease
JR Northover, P Lunn, DI Clark, M Phillipson
July-September 2007, 1(3):82-86
DOI:10.4103/0973-6042.34025  
We have undertaken a case control study of 300 patients to ascertain some of the etiological variables in the development of rotator cuff disease. Materials and Methods: The results of 300 questionnaires of two groups of 150 people were compared. The first group with symptoms of impingement and ultrasound appearances of rotator cuff pathology (mean age 59.0, range 24-86) were compared to a second group of asymptomatic controls (mean age 60.6, range 35-90). Results: Activities that increase the risk of developing rotator cuff pathology include occupations that involve manual (odds ratio 3.81) and/or overhead work (3.83), weight training (2.32) and swimming (1.98). Patient factors that increase the risk include diabetes (3.34) and general osteoarthritis (2.39).
  5,606 431 -
CASE REPORTS
Luxatio erecta: Inferior glenohumeral dislocation
Asif Nazir Baba, Javid A Bhat, SD Paljor, Naseer A Mir, Suhail Majid
July-September 2007, 1(3):100-102
DOI:10.4103/0973-6042.34026  
Inferior dislocation of the shoulder, also called luxatio erecta, is a rare form of the otherwise common shoulder dislocation. It accounts for less than 0.5% of all shoulder dislocations. A case involving the inferior dislocation of the shoulder is reported. A brief review of the presentation and management of the condition is described.
  5,649 367 -
EDITORIAL
Biological trends in shoulder surgery
Deepak N Bhatia, Joe F de Beer
July-September 2007, 1(3):81-81
DOI:10.4103/0973-6042.34755  
  2,196 212 -