Tendons are anatomical structure that connects muscle to bone to allow the force to be transmitted from the muscle to the bone, allowing movement of fingers. The main objective of this study is to present the recent data from animal experimental studies where pharmacological topical agents are used after tendon repair in prevention of adhesion formation. Some of the most commonly used topical agents are: Hyaluronic Acid (HA) and its derivatives, 5-Fluorouracil (5-FU), lubricin, alginate solution and topical application of growth factors. These studies have shown that the above mentioned substances reduce adhesion formation through different mechanisms. The successes of the tendon healing after tendon repair in experimental studies using topical agents, can be evaluated using a variety of methods such as: biomechanical evaluation, macroscopic and microscopic evaluation, cell isolation and analysis of growth factors. However, most authors agree that despite good tendon repair and topical application of these substances, creation of adhesion formation continues to be a great problem for hand surgeons.

Purpose: This study was done to determine whether a) there is a correlation between the Notch Width Index (NWI) and notch volume, as measured by Magnetic Resonance Imaging (MRI), in patients with ACL-injured and non-ACL injured knees, b) there is a difference in NWI between patients with and without anterior cruciate ligaments tear, c) there is a relationship between ACL diameter, angle of ACL inclination and ACL injury and d) there are differences in distal femur morphology between the ACL-injured and non-ACL injured knees.

Materials and methods: In this study, 59 ACL-injured patients and 59 match-control ACL-intact patients were enrolled. MRI was used to measure the notch width, notch height and condylar widths. The thickness of ACL and ACL angle of inclination were also measured.

Results: Statistically, Notch Width Index (NWI) (0.47 +/- 0.07 vs 0.43+/-0.05, p <0.05) and Medial-condyle to-lateral condyle ratio (M:L ratio) ( 1.07 +/- 0.11 vs 1.02 +/- 0.09, p = 0.023) were all significantly greater in the ACL-ruptured group compared to the ACL-intact group. However the ACL angle of inclination from the vertical axis is statistically significantly smaller in the ACL-injured group compared to the ACL-intact group( 30.729 +/- 6.147 deg vs 43.339 +/- 12.950 deg, p<0.0001).

In both the ACL-injured and ACL-intact groups, the Notch Width (NW), Notch Height (NH) and Notch Volume (NV) measurements were all statistically significantly greater in males compared to females.In both ACL-injured and ACL-intact groups, Notch width indices showed no statistical significant difference between the sexes.

Conclusion: In this MRI study, a high femoral notch width indices and high medial condyle-to-lateral condyle ratio (M:L ratio) serve as accurate predictors in subjects prone to ACL injury. The MRI findings can guide future routine radiological or ultrasound screening of ACL-injury prone knees.

Patellofemoral Pain Syndrome (PFPS) is the most common type of knee pain. It is estimated that PFPS accounts for 25-30% of all knee pathologies. The condition can be very painful and the symptoms can take a long time to settle. There is general consensus that effective treatment strategies should be based on a thorough understanding of pathological changes of PFPS. This mini review briefly outlines biomechanical aspects of pathophysiology of the structures involved and describes current treatment strategies available in the literature, in particular it looks at muscle tightness and provides an insight into stretching techniques as an effective physiotherapy choice for the condition.

Background: C-Terminal Telopeptide of type I collagen (CTX-I) is a bone marker of resorption. We study levels and compare levels in hip and wrist fractures.

Material and methods: Our study population included 82 men and postmenopausal women with hip fractures and 27 with radius fractures. CTX-I serum concentrations (measured in nanograms/milliliter) in the blood were measured using immunoassay. Levels above 0.60 ng/ml and 0.30 ng/ml were considered to be abnormal for women and men, respectively. Statistics: descriptive, t-test, and linear regression statistics were performed. The significance level was set at p <0.05.

Results: The mean ages were 83.3 years and 74.1 years for patients with hip and radius fractures, respectively. The mean CTX-I serum concentrations were 0.74 ng/ml in patients with hip fractures and 0.64 ng/ ml in patients with radius fractures. Above normal CTX-I concentrations were seen in 62% of the women with hip fractures and all of the men and 50% of all patients with radius fractures. Neither age nor sex influenced the CTX-I levels in patients with hip or wrist fractures. Trochanteric fractures had higher β-crosslaps than did cervical fractures. Serum CTX-I levels were significantly higher in hip fractures than in radius fractures independently of age (p<0.001).

Conclusion: Resorption bone markers are higher in patients with hip fractures than in patients with radius fractures. In our study, patients with trochanteric hip fractures had greater CTX-I levels than did patients with cervical fractures. All males and most women with fractures had high CTX-I levels, regardless of age.

Level of Evidence: Level 4.

Intra-articular calcaneal fractures make up 2% of all fractures [1]. The management of displaced intra-articular calcaneal fractures remains controversial.