Journal Article10.1111/JMI.12260
The development of confocal arthroscopy as optical histology for rotator cuff tendinopathy.
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TL;DR: The development of confocal arthroscopy for optical histological assessment without biopsy has the potential for surgeons to gain in real time the histological information of rotator cuff tendons, which may assist planning repair strategies and potentially improve intervention outcomes.
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Abstract: MRI, ultrasound and video arthroscopy are traditional imaging technologies for noninvasive or minimal invasive assessment of the rotator cuff tendon pathology. However, these imaging modalities do not have sufficient resolution to demonstrate the pathology of rotator cuff tendons at a microstructural level. Therefore, they are insensitive to low-level tendon diseases. Although traditional histology can be used to analyze the physiology of rotator cuff tendons, it requires biopsy that traumatizes the rotator cuff, thus, potentially comprising the mechanical properties of tendons. Besides, it cannot offer real-time histological information. Confocal endoscopy offers a way to assess the microstructural disorder in tissues without biopsy. However, the application of this useful technique for detecting low-level tendon diseases has been restricted by using clinical grade fluorescent contrast agent to acquire high-resolution microstructural images of tendons. In this study, using a clinical grade sodium fluorescein contrast agent, we have reported the development of confocal arthroscopy for optical histological assessment without biopsy. The confocal arthroscopic technique was able to demonstrate rotator cuff tendinopathy in human cadavers, which appeared macroscopically normal under video arthroscopic examinations. The tendinopathy status of the rotator cuff tendons was confirmed by corresponding traditional histology. The development of confocal arthroscopy may provide a minimally invasive imaging technique for real-time histology of rotator cuff without the need for tissue biopsy. This technique has the potential for surgeons to gain in real time the histological information of rotator cuff tendons, which may assist planning repair strategies and potentially improve intervention outcomes.
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Citations
Three dimensional microstructural network of elastin, collagen, and cells in Achilles tendons
Xin Pang,Jianping Wu,Garry T. Allison,Jiake Xu,Jonas Rubenson,Minghao Zheng,David Lloyd,Bruce S. Gardiner,Allan Wang,Thomas Brett Kirk +9 more
TL;DR: In this article, the hierarchical system of the spatial microstructure of tendon, including the mapping of collagen, elastin and tenocytes, with 3-dimensional confocal images was investigated.
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Probe-based three-dimensional confocal laser endomicroscopy of brain tumors: technical note.
Evgenii Belykh,Arpan A. Patel,Eric J. Miller,Baran Bozkurt,Kaan Yağmurlu,Eric C. Woolf,Adrienne C. Scheck,Jennifer M. Eschbacher,Peter Nakaji,Mark C. Preul +9 more
TL;DR: 3D and Z-stack CLE imaging is a unique new option for live intraoperative endomicroscopy of brain tumors that afford an increased spatial understanding of tumor cellular architecture and visualization of related structures compared with two-dimensional images.
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High-resolution study of the 3D collagen fibrillary matrix of Achilles tendons without tissue labelling and dehydrating
Jianping Wu,Jianping Wu,Benjamin Swift,Thomas Becker,Andrew Squelch,Allan Wang,Yong Chang Zheng,Xuelin Zhao,Jiake Xu,Wei Xue,Minghao Zheng,David Lloyd,Thomas Brett Kirk +12 more
TL;DR: A novel 3D microscopic method has been developed to examine the 3D collagen microstructure of tendons without tissue dehydrating and labelling, which enables understanding of the function of the tissue and may be important for applying surgical and tissue engineering techniques to tendon reconstruction.
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A multiscale study of morphological changes in tendons following repeated cyclic loading.
TL;DR: In this article, the response of white New Zealand rabbit Achilles tendons to load was assessed using mechanical measures and confocal arthroscopy (CA) using the same non-viable intact tendon in response to prolonged cyclic and static loading.
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Rethinking Acute Sports Injuries: Evidence for an Overuse Mechanism in Hamstring and <scp>ACL</scp> Injuries
Bas Van Hooren
Abstract: ABSTRACT Sports injuries have traditionally been classified as acute or overuse based on their onset and associated circumstances. Hamstring strain injuries and anterior cruciate ligament (ACL) injuries are two common sports injuries that are typically implicitly considered to represent acute injuries. This brief review, however, argues that hamstring and ACL injuries may at least partly present as overuse injuries resulting from a mechanical fatigue phenomenon, rather than acute injuries. Human, animal, and cadaveric studies are discussed to support this view. For example, human studies show no kinematic deviation in the stride during which the hamstring injury occurs as compared to the preceding strides. Further, the location of injury and ultrastructural damage of hamstring injuries is largely comparable to that seen in repetitive muscle–tendon unit lengthening experiments in animals. For the ACL, repetitive simulated jump landings have been shown to lead to ACL failure despite the ACL load being well below its ultimate strength. Furthermore, analyses of ACL explants obtained from noncontact ACL‐injured patients during reconstruction surgery indicate similar damage to cadaveric studies that repetitively loaded the ACL. In summary, studies with diverse methodological approaches support the view that mechanical fatigue may predispose hamstring and ACL tissues to failure at submaximal loads during seemingly normal movements. Although further research is needed to substantiate these hypotheses, recognizing mechanical fatigue as a factor in these injuries can inform training and rehabilitation protocols and open opportunities to use modeling approaches and wearable sensors to monitor tissue load and damage, ultimately reducing injury rates.
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