Background: Bone-anchored maxillary protraction (BAMP) aims to correct midfacial deficiencies, with proven positive skeletal changes without potential unwanted side effects. However, the influence of BAMP treatment on facial soft tissues, particularly in subjects with complete unilateral cleft lip, alveolus, and palate (CUCLAP), remains unclear. Methods: This single-center longitudinal cohort study examined the effects of 1.5 years of BAMP treatment on facial soft tissues in growing subjects with complete unilateral cleft lip, alveolus, and palate. The sample consisted of 25 patients, age range 9.7 to 12.6 years. Three-dimensional surface models derived from CBCT scans were superimposed on stable structures of the anterior cranial base and on the occipital area posterior of the foramen magnum to assess three-dimensional changes due to growth and BAMP therapy. Results: The results revealed a moderate positive correlation (Pearson\'s correlation coefficient from 0.203 to 0.560) between changes in hard tissue and soft tissue; some correlations were found to be weak (<0.300). Linear changes in soft tissue following BAMP were in the same direction as skeletal changes, showing downward, forward, and outward displacement. The only exception was in the vertical dimension. The lower facial third showed a slight but significant reduction, mainly in lip length (-1.2 mm), whereas the middle facial third showed a small increase (1.1 mm). Conclusions: It was concluded that during BAMP, soft tissue changes occur in the same direction as skeletal changes, although with a larger variability and less pronounced effects.

OBJECTIVE: To compare the biomechanical properties of lateral femoro-fabella ligament suture (FFLS) and lateral suture with a bone anchor suture (BAS) for management of feline cranial cruciate ligament disease.
METHODS: 12 femurs from 6 mature cat cadavers.
METHODS: The samples were collected from April to June 2023. The specimens had an FFLS and, subsequently, BAS placed and were positioned into a biomechanical testing machine, preloaded from 5 N to 15 N for 100 cycles, and subsequently, a load to suture failure was applied. The displacement at 5 N and 15 N, the total precycle displacement (millimeters), the force at 3 mm displacement and at failure (newtons), the displacement at failure (millimeters), and the stiffness to failure (Newton:millimiter) were recorded. Nonparametric Wilcoxon signed-rank tests were used to compare data between the 2 groups.
RESULTS: The displacement at 5 N and 15 N and the total precycle displacement were significantly higher in the FFLS group compared to the BAS group. Additionally, the FFLS group results showed less consistent displacement and marked variability. The force (newtons) at 3 mm displacement was higher in the BAS group. There was no significant difference in force and no significant difference in displacement at failure between the 2 groups. However, the stiffness to failure (N/mm) was significantly higher in the BAS group.
CONCLUSIONS: BAS represented a more stable and reliable femur attachment for extracapsular suture in cats.
CONCLUSIONS: To demonstrate the stability and reliability between BAS and FFLS and influence implant selection in the treatment of cranial cruciate ligament rupture in cats with evaluation of biomechanical properties.

BACKGROUND: While suture anchors are widely used in medical procedures for their advantages, they can sometimes lead to complications, including anchor prolapse. This article presents a unique case of suture anchor prolapse at the base of the distal phalanx of the little finger after extensor tendon rupture reconstruction surgery.
METHODS: A 35-year-old male, underwent extensor tendon rupture reconstruction using a non-absorbable suture anchor. After seven years the patient visited our outpatients complaining of stiffness, pain, and protrusion at the surgical site. Initial X-ray imaging suggested suggesting either a fracture of the distal phalanx or tendon adhesion but lacked a definitive diagnosis. Subsequent magnetic resonance imaging (MRI) revealed bone connectivity between the middle and distal phalanges with irregular signal shadow and unclear boundaries while maintaining a regular finger shape. MRI proved superior in diagnosing prolapsed suture anchors, marking the first reported case of its kind. Surgical intervention confirmed MRI findings.
CONCLUSIONS: Suture anchor complications, such as prolapse, are a concern in medical practice. This case underscores the significance of MRI for accurate diagnosis and the importance of tailored surgical management in addressing this uncommon complication.

BACKGROUND: While the use of bone anchor fixation for abdominal wall reconstruction for supra-pubic incisional hernia is well described (Yee et al., 2008 [1]), we show in this case report, written in line with the SCARE criteria (Agha et al., 2020 [2]), a novel use of this tool as an adjunct in the repair of a ten time recurrent inguinal hernia.
METHODS: A 65 years old multiparous, diabetic non-obese female, with previous abdominoplasty was submitted for left inguinal hernia for ten times, between multiples complications between infection, more than one mesh excision by anterior approach and laparoscopic approach. The wide range of procedures culminated in a destruction of the abdominal wall, making it impossible for a usual fixation of mesh in the region. Therefore, a multidisciplinary approach was planned for the patient with a bone anchor as a mesh fixation method. With a year follow up we did not observe a local hernia recurrence.
UNASSIGNED: Hernia itself is a multifactorial disease. As a anatomical defect, surgery is the only effective treatment. Our report brings a novel approach to a challenging case with many previous unsuccessful applications of conventional surgeries. Hence, we stimulate the multidisciplinary discussion for enhancing post operatory outcomes and a better point of care for the patient.

UNASSIGNED: A 7-year-old male castrated Ragdoll cat was presented for chronic shoulder instability after a previous medial luxation of the right shoulder. Upon examination, there was palpable instability of the glenohumeral joint and an increased abduction angle. Surgical stabilisation was elected due to lameness and instability after closed reduction, rest and medical management. A low-profile bone-anchor and a ligament prosthesis were used to stabilise the glenohumeral joint with minimal disruption to the cat\'s natural shoulder stabilisers. Clinical signs resolved after surgery and the cat remained non-symptomatic at the 12-month follow-up.
UNASSIGNED: Feline shoulder luxation is rarely described in the veterinary literature. To the authors\' knowledge, this is the first report describing stabilisation of the glenohumeral joint in a cat using a bone anchor and a ligament prosthesis.

This review provides an overview of the patent literature on posteriorly placed intrapedicular bone anchors. Conventional pedicle screws are the gold standard to create a fixation in the vertebra for spinal fusion surgery but may lack fixation strength, especially in osteoporotic bone. The ageing population demands new bone anchors that have an increased fixation strength, that can be placed safely, and, if necessary, can be removed without damaging the surrounding tissue.
The patent search was conducted using a classification search in the Espacenet patent database. Only patents with a Cooperative Patent Classification of A61B17/70 or A61B17/7001 concerning spinal positioners and stabilizers were eligible for inclusion. The search query resulted in the identification of 731 patents. Based on preset inclusion criteria, a total of 56 unique patents on different anchoring methods were included, reviewed and categorized in this study.
Five unique fixation methods were identified; (1) anchors that use threading, (2) anchors that utilize a curved path through the vertebra, (3) anchors that (partly) expand, (4) anchors that use cement and (5) anchors that are designed to initiate bone ingrowth. Of the anchor designs included in this study, eight had a corresponding commercial product, six of which were evaluated in clinical trials.
This review provides insights into worldwide patented intrapedicular bone anchors that aim to increase the fixation strength compared to the conventional pedicle screw. The identified anchoring methods and their working principles can be used for clinical decision-making and as a source of inspiration when designing novel bone anchors.

Background: The repair of zone 1 flexor tendon injury often relies on re-inserting the flexor digitorum profundus (FDP) tendon to the distal phalanx. The aim of this retrospective study is to compare outcomes at 12 weeks following traditional button-over-nail (BON) versus bone anchor (BA) repair of zone I FDP injury. Methods: Patients undergoing zone 1 FDP repair between April 2007 and September 2018 using a BON or a BA were included in the study. Patient demographics, complications, arc of flexion of distal (distal interphalangeal joint [DIPJ]) and proximal interphalangeal joint (PIPJ) and patient-rated outcomes were analysed. Results: Forty-three patients were included in the study: 21 in the BA group and 22 in the BON group. Good function was achieved by 20 patients in BA versus nine in BON. Complications occurred in five BA patients versus 10 BON patients. Patients achieved a mean active DIPJ flexion of 49° and 31° and PIPJ flexion of 92° and 57° in the BA and BON groups, respectively. Conclusion: Our study demonstrates better arc of motion, patient-rated outcomes and lower complications at 12 weeks after surgery in patients undergoing zone 1 FDP repair using a BA. Level of Evidence: Level III (Therapeutic).

Localization of features and structures in images is an important task in medical image-processing. Characteristic structures and features are used in diagnostics and surgery planning for spatial adjustments of the volumetric data, including image registration or localization of bone-anchors and fiducials. Since this task is highly recurrent, a fast, reliable and automated approach without human interaction and parameter adjustment is of high interest. In this paper we propose and compare four image processing pipelines, including algorithms for automatic detection and localization of spherical features within 3D MRI data. We developed a convolution based method as well as algorithms based on connected-components labeling and analysis and the circular Hough-transform. A blob detection related approach, analyzing the Hessian determinant, was examined. Furthermore, we introduce a novel spherical MRI-marker design. In combination with the proposed algorithms and pipelines, this allows the detection and spatial localization, including the direction, of fiducials and bone-anchors.

Avulsion injuries of the tendon-bone junction of the adductor longus are rare. Avulsions of the iliopsoas tendon insertion on the lesser trochanter are even rarer. Avulsion injuries of the adductor insertion occur predominantly in active athletes. Iliopsoas tendon avulsions are described mainly in nonathletes, in old age and frequently with no triggering event. In these cases possible underlying pathologies (e.g. tumor or metastases in the lesser trochanter) must be ruled out. In the literature no generally accepted recommendations for treatment of these injuries can be found because only a few retrospective anecdotal case reports and case studies have been published. For this reason, it is mostly unclear if and when a conservative or operative approach is indicated.A PubMed/Medline literature search resulted in 86 articles for iliopsoas avulsions and 155 hits for adductor tendon avulsions. Accordingly, both injuries can basically be treated conservatively. A surgical treatment is recommended only occasionally when conservative treatment fails and when the adductor insertion or the apophysis of the lesser trochanter is dislocated more than 2 cm after avulsion. Reinsertion for adductor longus tendon avulsion injuries is usually performed by open repair using various anchor systems, while extensive avulsion injuries or non-unions of the apophysis of the lesser trochanter are treated by refixation by cannulated screw systems or resection and anchor refixation of the tendon. The postoperative outcome in most cases is described as good or very good (excellent). No major complications were reported in both groups.
UNASSIGNED: Abrissverletzungen am Sehnen-Knochen-Übergang (Avulsionen) des Adductor longus sind selten. Noch seltener kommen Avulsion an der Iliopsoassehne am Trochanter minor vor. Avulsionsverletzungen der Adduktorenursprünge treten überwiegend bei aktiven Sportlern auf. Avulsionen der Iliopsoassehne sind vorwiegend bei Nichtsportlern, im höheren Alter und häufig ohne auslösendes Ereignis zu verzeichnen. Bei einer Iliopsoasavulsion muss eine möglicherweise zugrunde liegende Pathologie (z. B. Tumor oder Metastase im Trochanter minor) ausgeschlossen werden. In der Literatur sind keine allgemeingültigen Empfehlungen zur Behandlung dieser Verletzungen zu finden, weil nur wenige retrospektive anekdotische Fallbeschreibungen und Fallserien publiziert sind. Deshalb ist noch weitgehend unklar, ob und wann eine konservative oder operative Therapie indiziert ist.Im Rahmen einer Literaturanalyse (PubMed/Medline) wurden 86 und 155 Arbeiten für Iliopsoas- bzw. Sehnenavulsionen des Adductor longus gefunden. Danach können sowohl Avulsionen des Iliopsoas als auch des Adductor longus grundsätzlich konservativ behandelt werden. Lediglich bei Nichtansprechen auf konservative Therapie, wenn die Adduktorenursprünge oder die Trochanter-minor-Apophyse nach Avulsion eine Dehiszenz von mehr als 2 cm aufweisen, wird gelegentlich eine operative Therapie empfohlen. Für die Sehnenavulsionen des Adductor longus werden Reinsertionen grundsätzlich über verschiedene Knochenanker durchgeführt, während ausgedehnte Avulsionsverletzungen der Trochanter-minor-Apophyse mit Resektion oder Refixation über kanülierte Schraubensysteme verankert werden. Das postoperative Ergebnis wird in den meisten Fällen als gut und sehr gut (exzellent) beschrieben. Wesentliche Komplikationen wurden in beiden Gruppen nicht berichtet.

BACKGROUND: Although distal tibialis anterior tendinopathy is a common condition, it has rarely been described in literature. It is often a condition in overweight women around 50-70 years old with pain that worsens at night. The purpose of this retrospective study is to describe the specific clinical signs and postoperative results of distal tibialis anterior tendinopathy.
METHODS: Between 2013 and 2017 we operated 9 patients (10ft) who failed a conservative treatment of distal tibialis anterior tendinopathy. Surgery consisted of debridement of the diseased tendon and reinsertion with a bone anchor. There was a minimum follow-up of 12 months. All patients were clinically evaluated postoperative (range 14-57 months after surgery) with the use of the American Orthopaedic Foot and Ankle Society (AOFAS) score and Visual Analog Scale (VAS) RESULTS: The mean AOFAS score postoperative was 99 (range 94-100). The mean VAS score postoperative was 1 (range 0-3). In all 10 cases the patient was completely satisfied with the result following surgery. There was no recurrence or rupture of tendon after debridement.
CONCLUSIONS: Distal tibialis anterior tendinopathy is mainly a clinical diagnosis where conservative treatment should always be the first choice. However, our results show that when conservative treatment fails, surgical treatment can lead to very good long term results with a high level of patient satisfaction.