Quadriceps recovery and pain relief in knee osteoarthritis rats by cog polydioxanone filament insertion

Bidirectional barbed polydioxanone filament insertion in vastus medialis oblique muscle for knee osteoarthritis improvement

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.

The Efficacy of Polydioxanone Sutures in Treating Mild-to-Moderate Knee Osteoarthritis: A Systematic Review and Meta-Analysis

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.

Biomaterials for neuroengineering: applications and challenges

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.