Tissue engineering (TE) combines cells, scaffolds, and growth factors to assemble functional tissues for repair or replacement of tissues and organs. Cardiac TE is focused on developing cardiac cells, tissues, and structures—most notably the heart. This review presents the requirements, challenges, and research surrounding electrospun scaffolds and induced pluripotent stem cell (iPSC)-derived cardiomyocytes (CMs) towards applications to TE hearts. Electrospinning is an attractive fabrication method for cardiac TE scaffolds because it produces fibers that demonstrate the optimal potential for mimicking the complex structure of the cardiac extracellular matrix (ECM). iPSCs theoretically offer the capacity to generate limitless numbers of CMs for use in TE hearts, however these iPSC-CMs are electrophysiologically, morphologically, mechanically, and metabolically immature compared to adult CMs. This presents a functional limitation to their use in cardiac TE, and research aiming to address this limitation is presented in this review.

Patellofemoral instability is a common condition in children, with an annual incidence of approximately 50 cases per 100,000 children. Instability of the patella involves a number of structures, such as the medial patellofemoral ligament and the vastus medialis obliquus, which can be used for patellar realignment in soft tissue, physeal-sparing procedures. In this rapid review, we aim to review the surgical interventions, post-operative outcomes, and associated surgical complications of global soft tissue procedures in the management of patellofemoral instability. A search of the Medline database was conducted to identify studies evaluating the treatment and outcomes of global treatment of pediatric patellofemoral instability. The included studies analyzed the surgical management of patellofemoral instability in pediatric patients, utilizing soft tissue global procedures and reported functional outcomes, return to sport or play, and post-operative complications. A total of eight studies were included, comprising a cohort of 270 pediatric and adolescent patients and 334 knees. The average patient age was 10.6 years, with 60.4% (163/270) patients being female, and the mean follow-up duration was 58.4 months. Of the eight studies, two examined the three-in-one procedure, three examined the four-in-one procedure, one examined a combination of medial and lateral release, and two examined the Galeazzi procedure. This review underscores the variety of global physeal-sparing surgical procedures available for treating patellofemoral instability. While outcomes are generally favorable, with high rates of return to sport, recurrent residual instability and recurrent dislocation remain significant challenges, with residual instability affecting nearly half of patients. Future research should focus on exploring long-term outcomes, optimizing patient selection, and identifying the causes of recurrent instability to further enhance patient outcomes and reduce complication rates.

Distal clavicle autograft (DCA) has garnered increasing popularity as a cost-effective and safe autograft for glenoid reconstruction in shoulder instability. The purpose of this study is to report the clinical outcomes of a single-surgeon case series of patients managed with arthroscopic DCA for glenoid bone loss with suture button fixation at minimum follow-up of 1 year. All cases of recurrent anterior glenohumeral instability treated with DCA by a single surgeon between January 2020 and December 2023 were reviewed. Patients were included if DCA was performed arthroscopically with 2 suture buttons for fixation, with minimum clinical follow-up of 1 year. Patients were evaluated post-operatively for recurrent instability or complications. Glenoid bone loss was measured using 3-dimensional reconstruction and best-fit circle methods on pre-operative computed tomography scans. Coracoclavicular (CC) distances were measured pre-operatively and post-operatively to assess for acromioclavicular joint instability and change in preoperative to post-operative CC distance was assessed with dependent t-test. Eight patients were included. Average age was 32.6 years. There were 7 males and 1 female. At surgery, mean glenoid bone loss was 23.3% (range: 17.8%-30.8%). At harvest, the average length, thickness, and width of the DCA were 22.8 mm, 11.6 mm, and 11.3 mm, respectively. After preparation, the graft averaged 22.8 mm in length with a width and depth of 10 mm, respectively. At a mean follow-up of 2.6 years (range: 1.5-4.0 years), no patients had recurrent subluxation or dislocation. No evidence of CC ligament damage was noted; average preoperative and post-operative CC distances were 11.5 mm and 11.3 mm, respectively, with mean change of −0.7 mm (95% confidence interval: −4.8 to +3.4 mm, P = .69). One patient was noted to have one loose posterior extracapsular button without clinical complication. No other complications were noted. In this case series of patients who underwent arthroscopic glenoid reconstruction with DCA, we noted low complication rates and no evidence of recurrent instability.

This study aims to compare the short-term outcomes of reverse total shoulder arthroplasty (rTSA) in patients with proximal humerus fractures stratified by age into young and elderly cohorts. This retrospective review analyzed patients with a minimum 1-year follow-up who underwent RTSA for proximal humerus fractures, categorizing patients <70 years as young and ≥70 as elderly. The operative and postoperative courses were recorded, including discharge location, range of motion (ROM), and need for revision surgery. Patient-reported outcomes such as Single Assessment Numeric Evaluation (SANE) and Preoperative Patient-Reported Outcomes Measurement Information System (PROMIS) scores were collected. A P value ≤.05 was statistically significant. The study consisted of 52 patients (<70 years, n = 22; ≥70 years, n = 30). The <70 group had a higher ROM in forward flexion (141° ± 26° vs. 123° ± 35°; P = .05). ROM in external rotation (34° ± 14° vs. 35° ± 22°; P = .86) and abduction (102° ± 29° vs. 107° ± 46°; P = .79) were similar between the groups. The revision rate was similar between the 2 groups, at 9.1% in the under-70 cohort and 13.3% in the 70 and over cohort (P = .73). Postoperative PROMIS - upper extremity scores were similar between age groups, with mean scores of 35.0 ± 5.7 for the <70 group and 35.3 ± 8.7 for the ≥70 group (P = .96). There was no statistically significant difference in postoperative PROMIS - Physical Function scores, with mean values of 44.8 ± 10.2 in the <70 group and 37.6 ± 9.3 in the ≥70 group (P = .06). In addition, there was no statistically significant difference in postoperative PROMIS - pain interference scores, with mean values of 55.2 ± 9.6 in the <70 group and 54.2 ± 7.7 in the ≥70 group (P = .78). Postoperative SANE scores demonstrated no significant difference between the younger and older cohorts, with mean scores of 73.7 ± 24.4 and 80.0 ± 11.4, respectively (P = .58). There was no difference in short-term postoperative PROMIS - upper extremity, PROMIS - Physical Function, SANE, ROM in external rotation or abduction, pain, and revision rates between patients <70 and ≥70 undergoing RTSA. However, the <70 RTSA group had higher short-term ROM in forward flexion.