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Kwon SW, Choi SW, Oh BH, Kim CH, Lee BR, Kim HY, Nam MA, Lee KS, Lee DW. Bidirectional barbed polydioxanone filament insertion in vastus medialis oblique muscle for knee osteoarthritis improvement. Knee 2025; 55:1-11. [PMID: 40186978 DOI: 10.1016/j.knee.2025.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2024] [Revised: 02/11/2025] [Accepted: 03/13/2025] [Indexed: 04/07/2025]
Abstract
BACKGROUND Strengthening the quadriceps muscle in patients with knee osteoarthritis (OA) can effectively alleviate symptoms such as pain and swelling. However, the use of bidirectional barbed polydioxanone filament (BBPF) for this purpose remains underexplored. Therefore, this study aimed to evaluate the impact of a new muscle enhancement and support therapy (MEST) involving the insertion of a BBPF into the vastus medialis obliquus (VMO) to improve the symptoms of knee OA. METHODS In a multicenter, randomized, double-blind study, we evaluated 131 patients over 40 with Kellgren-Lawrence grade II-III medial compartment knee OA. Of these, 88 received BBPF insertion into the VMO (MEST group), and 43 were in the control group. We compared pain levels (via a visual analog scale (VAS) during weight-bearing and walking), quadriceps muscle strength (IMCSQ), Patient Global Impression of Change (PGIC), and Clinical Global Impression of Change (CGIC), assessing outcomes before and after the procedure. RESULTS At four and eight weeks post-procedure, the VAS scores during weight-bearing and walking were significantly lower in the MEST group compared to the control group (P = 0.001). The differences in the IMCSQ at four and eight weeks post-procedure were significantly higher in the MEST group (P = 0.001). The PGIC and CGIC scores improved significantly at four weeks post-procedure (P = 0.001). CONCLUSION By reducing pain, improving function, and increasing muscle strength, MEST shows promise as a valuable addition to current treatment options. The biodegradable nature of the sutures suggests that repeat procedures may be beneficial, warranting further investigation to optimize this technique for wider clinical use.
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Affiliation(s)
- Sai-Won Kwon
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan, Republic of Korea
| | - Sung-Woo Choi
- Department of Orthopaedic Surgery, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Byung-Hak Oh
- Department of Orthopedic Surgery, Konyang University Hospital, Daejeon, Republic of Korea
| | - Chang-Hyun Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan, Republic of Korea
| | - Byung-Ryul Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan, Republic of Korea
| | - Hyoung-Ye Kim
- Department of Regenerative & Reconstructive Medicine, Soonchunhyang University Hospital Cheonan, Cheonan, Republic of Korea
| | - Mi-Ae Nam
- Department of Regenerative & Reconstructive Medicine, Soonchunhyang University Hospital Cheonan, Cheonan, Republic of Korea
| | - Kang-San Lee
- Department of Regenerative & Reconstructive Medicine, Soonchunhyang University Hospital Cheonan, Cheonan, Republic of Korea
| | - Dong-Woo Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan, Republic of Korea.
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Lee EJ, Kim HY, Lee DW, Kwon SW. The Efficacy of Polydioxanone Sutures in Treating Mild-to-Moderate Knee Osteoarthritis: A Systematic Review and Meta-Analysis. MEDICINA (KAUNAS, LITHUANIA) 2025; 61:388. [PMID: 40142199 PMCID: PMC11944242 DOI: 10.3390/medicina61030388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2025] [Revised: 02/15/2025] [Accepted: 02/18/2025] [Indexed: 03/28/2025]
Abstract
Background and Objectives: This meta-analysis aimed to compare the efficacy of polydioxanone (PDO) suture, a non-surgical treatment for knee osteoarthritis, with intra-articular hyaluronic acid (HA) injections. Materials and Methods: A comprehensive literature search was conducted using major databases including MEDLINE, EMBASE, Cochrane Library, KoreaMed, KMBASE, and RISS. Randomized controlled trials (RCTs) published up to 30 April 2024, focusing on knee osteoarthritis, pain, PDO suture, and intra-articular injections, were included. A total of 10 RCTs were analyzed, with participants having Kellgren & Lawrence Grade II-III knee osteoarthritis. This study compared the pain relief effects of PDO suture and HA injections. Results: The meta-analysis results showed that PDO suture demonstrated consistent and significant pain reduction over a 30-week observation period (p < 0.05), while HA injections did not exhibit statistically significant pain relief. Conclusions: PDO sutures offer the potential for long-term pain management in patients with knee osteoarthritis. However, this study has limitations such as the heterogeneity among studies, and given that the efficacy of PDO sutures is based on a single study, further research is needed to establish the long-term safety profile of polydioxanone sutures and to ensure the generalizability of the findings.
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Affiliation(s)
- Eun-Ju Lee
- Department of Public Health, Graduate School, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea;
| | - Hyoung-Ye Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan 31151, Republic of Korea; (H.-Y.K.); (D.-W.L.)
| | - Dong-Woo Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan 31151, Republic of Korea; (H.-Y.K.); (D.-W.L.)
| | - Sai-Won Kwon
- Department of Orthopaedic Surgery, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Dongam-gu, Cheonan 31151, Republic of Korea; (H.-Y.K.); (D.-W.L.)
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Wu H, Feng E, Yin H, Zhang Y, Chen G, Zhu B, Yue X, Zhang H, Liu Q, Xiong L. Biomaterials for neuroengineering: applications and challenges. Regen Biomater 2025; 12:rbae137. [PMID: 40007617 PMCID: PMC11855295 DOI: 10.1093/rb/rbae137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2024] [Revised: 10/19/2024] [Accepted: 11/03/2024] [Indexed: 02/27/2025] Open
Abstract
Neurological injuries and diseases are a leading cause of disability worldwide, underscoring the urgent need for effective therapies. Neural regaining and enhancement therapies are seen as the most promising strategies for restoring neural function, offering hope for individuals affected by these conditions. Despite their promise, the path from animal research to clinical application is fraught with challenges. Neuroengineering, particularly through the use of biomaterials, has emerged as a key field that is paving the way for innovative solutions to these challenges. It seeks to understand and treat neurological disorders, unravel the nature of consciousness, and explore the mechanisms of memory and the brain's relationship with behavior, offering solutions for neural tissue engineering, neural interfaces and targeted drug delivery systems. These biomaterials, including both natural and synthetic types, are designed to replicate the cellular environment of the brain, thereby facilitating neural repair. This review aims to provide a comprehensive overview for biomaterials in neuroengineering, highlighting their application in neural functional regaining and enhancement across both basic research and clinical practice. It covers recent developments in biomaterial-based products, including 2D to 3D bioprinted scaffolds for cell and organoid culture, brain-on-a-chip systems, biomimetic electrodes and brain-computer interfaces. It also explores artificial synapses and neural networks, discussing their applications in modeling neural microenvironments for repair and regeneration, neural modulation and manipulation and the integration of traditional Chinese medicine. This review serves as a comprehensive guide to the role of biomaterials in advancing neuroengineering solutions, providing insights into the ongoing efforts to bridge the gap between innovation and clinical application.
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Affiliation(s)
- Huanghui Wu
- Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai 200434, China
| | - Enduo Feng
- Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai 200434, China
| | - Huanxin Yin
- Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai 200434, China
| | - Yuxin Zhang
- Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai 200434, China
| | - Guozhong Chen
- Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai 200434, China
| | - Beier Zhu
- Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai 200434, China
| | - Xuezheng Yue
- School of Materials and Chemistry, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Haiguang Zhang
- Rapid Manufacturing Engineering Center, School of Mechatronical Engineering and Automation, Shanghai University, Shanghai 200444, China
- Shanghai Key Laboratory of Intelligent Manufacturing and Robotics, Shanghai University, Shanghai 200072, China
| | - Qiong Liu
- Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai 200434, China
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| | - Lize Xiong
- Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai 200434, China
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