Objective: The purpose of this study is to assess the effect and correlation of gender, body mass index (BMI) and quadriceps femoris (QF) muscle strength on patellar tendon (PT) thickness and stiffness in healthy sedentary individuals. Methods: This study was carried out with 67 (36 female, 31 male) healthy sedentary individuals between the ages of 18e44 (28.0 ± 7.5 years). The individuals included in the study were divided into two groups according to their gender and BMI (18.5 < BMI < 25 and 25 < BMI). The body composition was determined with Tanita Body Composition Analyser. PT thickness and stiffness was measured with ACUSON S3000 Ultrasonography Device using 9L4 ultrasonography probe. QF concentric muscle strength of the individuals was measured with Biodex® System 4 Dynamometer at 60/sec angular speed. Results: It was found that PT stiffness was higher in males compared to females (p < 0.001). It was found that PT stiffness was lower in obese individuals compared to individuals with normal weight (p ¼ 0.017). A negative and weak correlation was found between BMI and PT stiffness (r ¼ 0.26, p ¼ 0.032), whereas a negative and moderate correlation was found between fat percentage and PT stiffness (r ¼ 0.50, p < 0.001). A moderate correlation was found between BMI and PT thickness (r ¼ 0.54, p < 0.001). It was found that peak torque at 60/sec angular speed had a moderate correlation with PT stiffness (r ¼ 0.44, p < 0.001) and PT thickness (r ¼ 0.45, p < 0.001). Conclusions: PT stiffness is correlated and affected by gender, BMI and QF muscle strength whereas PT thickness is correlated and affected only to BMI and QF muscle strength.

Adipose tissue contains adult mesenchymal stem cells that may modulate the metabolism when applied to other tissues. Stromal vascular fraction (SVF) can be isolated from adipose tissue mechanically and/or enzymatically. SVF was recently used to decrease the pain and improve the function of knee osteoarthritis (OA) patients. Primary and/or secondary OA causes inflammation and degeneration in joints, and regenerative approaches that may modify the natural course of the disease are limited. SVF may modulate inflammation and initiate regeneration in joint tissues by initiating a paracrine effect. Chemokines released from SVF may slow down degeneration and stimulate regeneration in joints. In this review, we overviewed articular joint cartilage structures and functions, OA, and macro-, micro-, and nano-fat isolation techniques. Mechanic and enzymatic SVF processing techniques were summarized. Clinical outcomes of adipose tissue derived tissue SVF (AD-tSVF) were evaluated. Medical devices that can mechanically isolate AD-tSVF were listed, and publications referring to such devices were summarized. Recent review manuscripts were also systematically evaluated and included. Transferring adipose tissues and cells has its roots in plastic, reconstructive, and aesthetic surgery. Micro- and nano-fat is also transferred to other organs and tissues to stimulate regeneration as it contains regenerative cells. Minimal manipulation of the adipose tissue is recently preferred to isolate the regenerative cells without disrupting them from their natural environment. The number of patients in the follow-up studies are recently increasing. The duration of follow up is also increasing with favorable outcomes from the short- to mid-term. There are however variations for mean age and the severity of knee OA patients between studies. Positive outcomes are related to the higher number of cells in the AD-tSVF. Repetition of injections and concomitant treatments such as combining the AD-tSVF with platelet rich plasma or hyaluronan are not solidified. Good results were obtained when combined with arthroscopic debridement and micro- or nano-fracture techniques for small-sized cartilage defects. The optimum pressure applied to the tissues and cells during filtration and purification of the AD-tSVF is not specified yet. Quantitative monitoring of articular joint cartilage regeneration by ultrasound, MR, and synovial fluid analysis as well as with second-look arthroscopy could improve our current knowledge on AD-tSVF treatment in knee OA. AD-tSVF isolation techniques and technologies have the potential to improve knee OA treatment. The duration of centrifugation, filtration, washing, and purification should however be standardized. Using gravity-only for isolation and filtration could be a reasonable approach to avoid possible complications of other methodologies.

Achieving the stable osteointegration of prosthetic implants is one of the great challenges of modern orthopedic surgery. The fixation of ceramic acetabular cups of hip joint prostheses is usually achieved using a metal shell provided with screws or pegs that penetrate into the host pelvic bone. The deposition of bioactive coatings on the implant surface to be put in contact with bone could be a valuable strategy to promote a more “physiological” osteointegration. In this work, bioactive glass porous coatings were manufactured on the top of alumina/zirconia composite implants by two different methods, i.e., sponge replication and laser cladding. The coated samples underwent immersion studies in Kokubo’s simulated body fluid (SBF) to assess in vitro bioactivity and were found to exhibit an excellent hydroxyapatite-forming ability, which is key to allow bonding to bone. Biological tests using mesenchymal stem and osteoblast-like cells revealed the good biocompatibility of both types of materials. Furthermore, a higher level of mineralization was induced by the sponge-replicated coatings at 10 days. Overall, these results are highly promising and encourage further research on these materials.

A fracture that does not unite in nine months is defined as nonunion. Nonunion is common in fragmented fractures and large bone defects where vascularization is impaired. The distal third of the tibia, the scaphoid bone or the talus fractures are furthermore prone to nonunion. Open fractures and spinal fusion cases also need special monitoring for healing. Bone tissue regeneration can be attained by autografts, allografts, xenografts and synthetic materials, however their limited availability and the increased surgical time as well as the donor site morbidity of autograft use, and lower probability of success, increased costs and disease transmission and immunological reaction probability of allografts oblige us to find better solutions and new grafts to overcome the cons. A proper biomaterial for regeneration should be osteoinductive, osteoconductive, biocompatible and mechanically suitable. Cytokine therapy, where growth factors are introduced either exogenously or triggered endogenously, is one of the commonly used method in bone tissue engineering. Transforming growth factor beta (TGF beta) superfamily, which can be divided structurally into two groups as bone morphogenetic proteins (IIMPs), growth differentiation factors (GUI's) and TGF beta, activin, Nodal branch, Mullerian hormone, are known to be produced by osteoblasts and other bone cells and present already in bone matrix abundantly, to take roles in bone homeostasis. BMP family, as the biggest subfamily of TGF beta superfamily, is also reported to be the most effective growth factors in bone and development, which makes them one of the most popular cytokines used in bone regeneration. Complications depending on the excess use of growth factors, and pleiotropic functions of BMPs are however the main reasons of why they should be approached with care. In this review, the Smad dependent signaling pathways of TGF beta and BMP families and their relations and the applications in preclinical and clinical studies will be briefly summarized.

Objective: To investigate the effects of eccentric hamstring training on strength measures and vertical jumping performance. Methods: 26 male basketball players aged 10–12 were divided into Nordic Hamstring Strength Training group (N=15) and control group (N=11). Training was conducted over a 5-week period during which both groups participated in basketball training. All participants underwent pre- and post-training testing comprising isokinetic concentric and eccentric knee extension and flexion strength and vertical jump performance. Results: The NHST group exhibited significant increase in eccentric hamstring strength (p< 0.05) and vertical jumping ability (p< 0.01) whereas the performance of the control group remained unchanged during that period. Conclusion: Including eccentric exercises into entire training program improve muscular strength and can help athletes to reach their highest potential so they produce greater muscular forces.