UNASSIGNED: Meniscal root tears are defined as soft-tissue and/or osseous injuries that rip or avulse within one centimeter of the meniscal insertion to the tibial plateau. These injuries impact around 100,000 patients a year and make up 10 % to 21 % of all meniscal tears. Meniscal extrusion frequently happens when there are root rips, and the transmission of circumferential hoop loads is hampered.
METHODS: We present one case of a 28-year-old male who complained of pain and stiffness in his left knee since 2 years after undergoing ACL reconstruction using a hamstring autograft. His examination revealed joint line tenderness on both the medial and lateral sides of the left knee. Further investigations involving X-ray and MRI established the diagnosis of both medial and lateral meniscal root tears, which were surgically managed using the transtibial pullout technique.
CONCLUSIONS: The biomechanical implications of meniscal root tears, such as loss of hoop forces and increased tibiofemoral contact pressures, underscore the importance of timely diagnosis and management. The literature advocates surgical treatment for managing root tears, as leaving them without surgical intervention can lead to functional outcomes similar to those of total meniscectomy.
CONCLUSIONS: This case report presents both menisci posterior root tears with an intact ACL graft which is unique in that they commonly tear in conjuction with ACL. These kind of injuries necessitates prompt diagnosis and surgical intervention to protect the knee from early arthritic changes.

Ophthalmic and many systemic diseases may damage the eyes, resulting in changes in the composition and content of biomolecules in ocular biofluids such as aqueous humor and tear. Therefore, the biomolecules in biofluids are potential biomarkers to reveal pathological processes and diagnose diseases. Raman spectroscopy is a non-invasive, label-free, and cost-effective technique to provide chemical bond information of biomolecules and shows great potential in the detection of ocular biofluids. This review demonstrates the applications of Raman spectroscopy technology in detecting biochemical components in aqueous humor and tear, then summarizes the current problems encountered for clinical applications of Raman spectroscopy and looks forward to possible approaches to overcome technical bottlenecks. This work may provide a reference for wider applications of Raman spectroscopy in biofluid detection and inspire new ideas for the diagnosis of diseases using ocular biofluids.

BACKGROUND: Anterior cruciate ligament (ACL) injuries are common in sports and are critical knee injuries that require prompt diagnosis. Magnetic resonance imaging (MRI) is a strong, noninvasive tool for detecting ACL tears, which requires training to read accurately. Clinicians with different experiences in reading MR images require different information for the diagnosis of ACL tears. Artificial intelligence (AI) image processing could be a promising approach in the diagnosis of ACL tears.
OBJECTIVE: This study sought to use AI to (1) diagnose ACL tears from complete MR images, (2) identify torn-ACL images from complete MR images with a diagnosis of ACL tears, and (3) differentiate intact-ACL and torn-ACL MR images from the selected MR images.
METHODS: The sagittal MR images of torn ACL (n=1205) and intact ACL (n=1018) from 800 cases and the complete knee MR images of 200 cases (100 torn ACL and 100 intact ACL) from patients aged 20-40 years were retrospectively collected. An AI approach using a convolutional neural network was applied to build models for the objective. The MR images of 200 independent cases (100 torn ACL and 100 intact ACL) were used as the test set for the models. The MR images of 40 randomly selected cases from the test set were used to compare the reading accuracy of ACL tears between the trained model and clinicians with different levels of experience.
RESULTS: The first model differentiated between torn-ACL, intact-ACL, and other images from complete MR images with an accuracy of 0.9946, and the sensitivity, specificity, precision, and F1-score were 0.9344, 0.9743, 0.8659, and 0.8980, respectively. The final accuracy for ACL-tear diagnosis was 0.96. The model showed a significantly higher reading accuracy than less experienced clinicians. The second model identified torn-ACL images from complete MR images with a diagnosis of ACL tear with an accuracy of 0.9943, and the sensitivity, specificity, precision, and F1-score were 0.9154, 0.9660, 0.8167, and 0.8632, respectively. The third model differentiated torn- and intact-ACL images with an accuracy of 0.9691, and the sensitivity, specificity, precision, and F1-score were 0.9827, 0.9519, 0.9632, and 0.9728, respectively.
CONCLUSIONS: This study demonstrates the feasibility of using an AI approach to provide information to clinicians who need different information from MRI to diagnose ACL tears.

UNASSIGNED: The study aims to investigate changes in tear function, meibomian glands and corneal endothelium in patients receiving systemic isotretinoin therapy.
UNASSIGNED: This prospective study included 38 eyes from 38 patients (23 females and 15 males) treated with systemic isotretinoin (0.5-1 mg/kg/day) following the diagnosis of acne vulgaris. All patients underwent a comprehensive ophthalmologic examination at baseline, 1st month, and third month of treatment. Subjective complaints were assessed using the Ocular Surface Disease Index (OSDI). Tear functions were evaluated through non-invasive tear break up time (NIBUT) and Schirmer I test. Meibomian gland (MG) changes were examined using meibography. Corneal parameters, including endothelial cell density (ECD), coefficient of variation (CV), the number of cells with a hexagonal shape (6A), average cell area (AVG), and central corneal thickness (CCT) were assessed using non-contact specular microscopy.
UNASSIGNED: The mean age of the patients was 19.29 ± 2.83 years. Ocular surface-related discomfort, measured with OSDI scores, significantly worsened at the third month measurements compared to the pre-treatment values (p < 0.001). In the 1st month of treatment, there was a significant decrease in NIBUT (p < 0.05). No statistically significant difference was found in the Schirmer test results at each visit. According to the 1st and third-month analysis, there was a significant increase in MG loss compared to the pre-treatment period (p < 0.001). ECD, CV, 6 A, AVG measurements at the first and third months showed a significant change compared to the pre-treatment values (p < 0.001). No significant difference was observed in the CCT measurements during the treatment.
UNASSIGNED: Systemic isotretinoin disrupted tear stability, caused MG loss, deterioration in corneal endothelium, and led to symptomatic complaints in patients.

Phthalate plasticizers (PAEs) illegally used in food pose a great threat to human health. A new and efficient sensing platform for the sensitive detection of the PAE residues in biological fluids needs to be designed and developed. Here, we report a simple and reliable surface-enhanced Raman spectroscopy (SERS) active platform with extralong hot spots of Au nanobipyramids@Ag nanorods (Au NBPs@Ag NRs) for the rapid and sensitive detection of PAEs in biological fluids. To achieve high activity, Au NBPs@Ag NRs with different shell lengths were fabricated by controlling the synthesis conditions, and the corresponding SERS properties were investigated by using crystal violet (CryV) and butyl benzyl phthalate (BBP). The experimental results showed that a longer shell length correlated to greater Raman activity, which was confirmed by finite-difference time-domain (FDTD) electromagnetic simulation. More importantly, the extralong hot spots of the Au NBPs@Ag NR SERS-active substrate showed excellent homogeneity and reproducibility for the CryV probe molecules (6.21%), and the detection limit was 10-9 M for both BBP and diethylhexyl phthalate (DEHP). Furthermore, through the standard addition method, an extralong hot spots SERS substrate could achieve highly sensitive detection of BBP and DEHP in serum and tears fluids, and the detection limit was as low as 3.52 × 10-8 M and 2.82 × 10-8 M. Therefore, the Au NBPs@Ag NR substrate with an extraordinarily long surface is efficient and versatile, and can potentially be used for high-efficiency sensing analysis in complex biological fluids.

(1) Background: Full-thickness rotator cuff tears (RCTs) impact 25% of those over 60 and 50% over 80; however, minimal data exists on public understanding; (2) Methods: The primary outcome was to determine the public\'s baseline understanding of RCTs utilizing a 36-question survey regarding anatomy and function, risk factors, diagnosis and treatment options, and expectations. Secondarily, we evaluated the effect of an educational video and informational handout created by the authors to improve understanding. Participants ≥ 18 years were recruited from the senior author\'s clinic and online discussion platforms over a 5-month period; (3) Results: Baseline surveys were completed by 382 individuals: 56% men, 64% Caucasian, 27% with at least a master\'s degree, and 56% with very little or no RCT knowledge. Mean correct answer scores improved from 47% to 68% posteducational intervention (p < 0.001). Males, higher education level, healthcare experience, and a higher self-rated understanding of RCTs were significantly correlated with higher survey performance (p < 0.001); (4) Conclusions: The public\'s knowledge of RCTs at baseline was poor, with demographic factors correlating with survey performance. The educational intervention effectively enhanced participants\' understanding. By focusing on common misconceptions, this data can help clinicians align patient expectations and enhance patient outcomes.

(1) Background: Bone bruises in acute anterior cruciate ligament (ACL) injuries are closely linked to the occurrence of simultaneous meniscal and cartilage damage. Despite the frequent occurrence of associated injuries including bone bruises, meniscus, and cartilage damage in patients with ACL injuries, a systematic review of the relationships between the presence of bone bruises and the extent of meniscus and cartilage injuries has yet to be conducted. (2) Methods: Multiple comprehensive databases, including MEDLINE, EMBASE, and the Cochrane Library, were searched for studies that evaluated the relationship between bone bruises and meniscus or cartilage injuries following ACL injuries. Study selection, data extraction, and meta-analysis were performed. The Methodological Index for Non-Randomized Studies (MINORS) was used for quality assessments, and Review Manager 5.3 was used for data analysis. (3) Results: Data were extracted from 22 studies encompassing a total of 2891 patients with ACL injuries. Among the included studies, six studies investigated the relationships between bone bruises and medial meniscus (MM) or lateral meniscus (LM) injuries, while three studies investigated the relationships between bone bruises and cartilage injuries. There were no significant correlations between the presence of bone bruises and MM injuries (relative risk (RR) = 1.32; p = 0.61). A quantitative analysis indicated that individuals with bone bruises had a 2.71-fold higher likelihood of sustaining LM injuries than those without bone bruises (RR = 2.71; p = 0.0003). The analysis confirmed a significant relationship between bone bruises and cartilage injuries (RR = 6.18; p = 0.003). (4) Conclusions: Bone bruises occur most frequently in the lateral compartment. Bone bruises resulting from ACL injuries are related to accompanying LM injuries and cartilage injuries. Knowing these associations and the frequency of injuries may allow orthopedic surgeons to promptly address ACL-related meniscus and cartilage injuries on MRI results and in future clinical practice.

UNASSIGNED: Subscapularis repair has recently garnered significant interest. A thorough understanding of the tendon\'s anatomy is essential for precise and safe repair. Our objectives were to describe the anatomy of the subscapularis insertion, define its landmarks, and analyze nearby structures to guide arthroscopic repair.
UNASSIGNED: We conducted an anatomical study, dissecting 12 shoulders. We evaluated the distance from the footprint to the axillary nerve, the dimensions, and shape of the footprint, and its relationship with the humeral cartilage.
UNASSIGNED: The distance to the axillary nerve was 32 mm (standard deviation [SD], 3.7 mm). The craniocaudal length of the footprint was 37.3 mm (SD, 4.6 mm). Its largest mediolateral thickness was 16 mm (SD, 2.2 mm), wider at the top and narrower distally. The distance between the footprint and the cartilage varied, being 3.2 mm (SD, 1.2 mm) in the upper part, 5.4 mm (SD, 1.8 mm) in the medium, and 15.9 mm (SD, 2.9 mm) in the lower part.
UNASSIGNED: When performing a repair of the subscapularis tendon, the distance to the cartilage should be carefully evaluated as it varies proximally to distally, and the shape of the footprint (wider proximally, tapered distally) should be considered for implant positioning. The distance to the axillary nerve is approximately 30 mm. Anterior visualization guarantees direct control of all landmarks and allows accurate implant positioning with safe tendon release.

Arabinoxylan (AX)-based films can improve the mechanical characteristics of biodegradable materials when utilized for food packaging. However, the mechanical properties of AX films for food packaging applications require thorough investigation to establish their viability. In this study, AX was extracted from corn bran coproducts of dry-milling (DCB), wet-milling (WCB), and dried distiller\'s grains with solubles (DDGS) using an acid-alkali method. Packaging materials were produced using these AX extracts, each combined with laccase and sorbitol, forming the basis for three different films. These films were then modified by immersing the surface in a lipase-acetate solution. We evaluated their mechanical characteristics, including thickness, tensile properties, tear resistance, and puncture resistance. The thickness and tensile properties of the modified AX films derived from DCB and DDGS showed significant improvements (p < 0.05) compared to the unmodified AX films. In contrast, the modified AX films from WCB showed no significant changes (p > 0.05) in thickness and tensile properties compared to the unmodified WCB AX films. A significant increase in tear resistance (p < 0.05) was observed in all modified AX films after immersion in the lipase-acetate mixture. While puncture resistance was enhanced in the modified AX films, the improvement was not statistically significant (p > 0.05) compared to the unmodified films. The presence of hydroxyl (OH) and carbonyl (CO) groups on the surfaces of AX films from DCB and DDGS, modified by the lipase-acetate solution, suggests excellent biodegradability properties. The modification process positively affected the AX films, rendering them more bendable, flexible, and resistant to deformation when stretched, compared to the unmodified AX films.

BACKGROUND: Distal biceps tendon repair is usually performed via a double-incision or single-incision bicortical drilling technique. However, these techniques are associated with specific complications and usually do not allow for anatomical footprint restoration. It was the aim of this study to report the clinical results of a double intracortical button anatomical footprint repair technique for distal biceps tendon tears. We hypothesized that this technique would result in supination strength comparable to the uninjured side with a low re-rupture rate and minimal bony or neurological complications.
METHODS: This was a retrospective, single-surgeon cohort study of a consecutive series of 22 patients with a mean (SD) age of 50.7 (9.4) years and at least 1-year follow-up after distal biceps tendon repair. At final follow-up, complications, range of motion (ROM), the Patient-rated Elbow Evaluation (PREE), Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, visual analog scale (VAS) for pain, patient satisfaction and supination strength in neutral as well as 60° of supination were analyzed. Radiographic evaluation was performed on a CT scan.
RESULTS: One patient (4.5%) experienced slight paresthesia in the area of the lateral antebrachial cutaneous nerve. Heterotopic ossification was seen in one patient (4.5%). All patients recovered full ROM except for one who had 10° of loss of flexion and extension. Median PREE score was 4.6 (0-39.6), median MEP was 100 (70-100) and median DASH was 1.4 (0-16.7). All but one patient were very satisfied with the outcome. The affected arm had a mean of 98% (± 13) of neutral supination strength (p=0.633) and 94% (± 12) of supination strength in 60° (p=0.054) compared to the contralateral, unaffected side. There were four cases (18.2%) of cortical thinning due to at least one button and one case of button pull-out (4.5%).
CONCLUSIONS: The double intracortical button anatomical footprint repair technique seems to provide reliable restoration of supination strength, excellent patient satisfaction while minimizing complications, particularly nerve damage and heterotopic ossification.