Electrospun nanofibers possess unique qualities such as nanodiameter, high surface area to volume ratio, biomimetic architecture, and tunable chemical and electrical properties. Numerous studies have demonstrated the potential of nanofibrous architecture to direct cell morphology, migration, and more complex biological processes such as differentiation and extracellular matrix (ECM) deposition through topographical guidance cues. These advantages have created great interest in electrospun fibers for biomedical applications, including tendon and ligament repair. Electrospun nanofibers, despite their nanoscale size, generally exhibit poor mechanical properties compared to larger conventionally manufactured polymer fiber materials. This invites the question of what role electrospun polymer nanofibers can play in tendon and ligament repair applications that have both biological and mechanical requirements. At first glance, the strength and stiffness of electrospun nanofiber grafts appear to be too low to fill the rigorous loading conditions of these tissues. However, there are a number of strategies to enhance and tune the mechanical properties of electrospun nanofiber grafts. As researchers design the next-generation electrospun tendon and ligament grafts, it is critical to consider numerous physiologically relevant mechanical criteria and to evaluate graft mechanical performance in conditions and loading environments that reflect in vivo conditions and surgical fixation methods.

Shoulder instability is a common occurrence in young, physically active individuals. The majority of shoulders dislocate in an anteroinferior direction, resulting in damage to the anteroinferior labrum and glenohumeral ligament.1,2) Repair of the Bankart lesion by both open and arthroscopic methods has shown favorable outcomes regarding stability and the incidence of recurrence.3-5) However, in the setting of significant glenoid bone loss (> 20%), soft tissue reconstructions are universally associated with poor outcomes and unacceptably high recurrence rates. [6][7][8][9] In 1954, Latarjet 10) described transferring the coracoid process with an intact conjoint tendon to the anterior neck of the glenoid in cases of recalcitrant instability due to glenoid bone loss. The stabilizing mechanism of the Latarjet procedure is thought to be provided by both the "bone block" derived from transfer of the coracoid process, which increases the surface area of the anteroinferior glenoid, and the "sling effect" produced by the conjoint tendon and intact subscapularis.11-13) The "sling effect" is especially important in positions of mid to end-range shoulder abduction. 13)Another possible stabilizing mechanism of the Latarjet includes the capsular repair from the transferred

BackgroundProlonged wound-discharge following total hip arthroplasty (THA) is associated with an increased risk of infection. However, the potential role of hypertension in prolonging the duration of wound healing in this population has not yet been investigated. The aim of the present study was to compare healing in this population that has not yet been investigated. The aim of the present study was to compare hypertensive and normotensive THA patients in terms of the length of time required to achieve a dry wound and the length of stay in the hospital.MethodsOne hundred and twenty primary THA patients were evaluated. Pre-operative clinical history and physical examination revealed that 29 were hypertensive and 91 were normotensive. The two groups were statistically matched using optimal propensity score matching. The outcomes of interest were the number of days until a dry wound was observed and the duration of hospital stay.ResultsThe average systolic blood pressures were 150.1 mmHg and 120.3 mmHg for the hypertensive and normotensive groups, respectively. The mean number of days until the wound was dry was 3.79 for the hypertensive group and 2.03 for the normotensive group. Hypertensive patients required more days for their wounds to dry than normotensive patients (odds ratio  = 1.65, p<0.05). No significant difference in the duration of hospital stay was found between the two groups.ConclusionsHypertensive patients had a higher risk of prolonged wound discharge after THA than their normotensive counterparts. Patients with prolonged wound drainage are at greater risk for infection. Clinicians should pay particular attention to infection-prevention strategies in hypertensive THA patients.

The goal of this retrospective review was to determine whether fluoroscopic guidance improves acetabular cup abduction and anteversion alignment during anterior total hip arthroplasty. The authors retrospectively reviewed 199 patients (fluoroscopy group, 98; nonfluoroscopy group, 101) who underwent anterior total hip arthroplasty at a single center with and without C-arm fluoroscopy guidance. Included in the study were patients of any age who underwent primary anterior approach total hip arthroplasty performed by a single surgeon, with 6-month postoperative anteroposterior pelvis radiographs. Acetabular cup abduction and anteversion angles were measured and compared between groups. Mean acetabular cup abduction and anteversion angles were 43.4° (range, 26.0°-57.4°) and 23.1° (range, 17°-28°), respectively, in the fluoroscopy group. Mean abduction and anteversion angles were 45.9° (range, 29.7°-61.3°) and 23.1° (range, 17°-28°), respectively, after anterior total hip arthroplasty without the use of C-arm guidance (nonfluoroscopy group). The use of fluoroscopy was associated with a statistically significant difference in cup abduction (P=.002) but no statistically significant difference in anteversion angles. In the fluoroscopy group, 80% of implants were within the combined safe zone compared with 63% in the nonfluoroscopy group. A significantly higher percentage of both acetabular cup abduction angles and combined anteversion and abduction angles were in the safe zone in the fluoroscopy group. Fluoroscopy is not required for proper anteversion placement of acetabular components, but it may increase ideal safe zone placement of components.

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