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Damayanthi ED, Kholinne E, Singjie LC, Sakti M, Anesstesia IJ. Combined Anterior Cruciate Ligament Reconstruction (ACLR) and Lateral Extra-articular Tenodesis through the Modified Lemaire Technique versus Isolated ACLR: A Meta-analysis of Clinical Outcomes. Rev Bras Ortop 2024; 59:e180-e188. [PMID: 38606123 PMCID: PMC11006520 DOI: 10.1055/s-0044-1785492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/25/2023] [Indexed: 04/13/2024] Open
Abstract
Objective Lateral extra-articular tenodesis (LET) has been proposed to resolve rotatory instability following anterior cruciate ligament reconstruction (ACLR). The present meta-analysis aimed to compare the clinical outcomes of ACLR and ACLR with LET using the modified Lemaire technique. Materials and Methods We performed a meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) staement. The literature search was performed on the PubMed, EBSCOHost, Scopus, ScienceDirect, and WileyOnline databases. The data extracted from the studies included were the study characteristics, the failure rate (graft or clinical failure) as the primary outcome, and the functional score as the secondary outcome. Comparisons were made between the patients who underwent isolated ACLR (ACLR group) and those submitted to ACLR and LET through the modified Lemaire technique (ACLR + LET group). Results A total of 5 studies including 797 patients were evaluated. The ACLR + LET group presented a lower risk of failure and lower rate of rerupture than the ACLR group (risk ratio [RR] = 0.44; 95% confidence interval [95%CI]: 0.26 to 0.75; I 2 = 9%; p = 0.003). The ACLR + LET group presented higher scores on the Knee Injury and Osteoarthritis Outcome Score (KOOS) regarding the following outcomes: pain, activities of daily living (ADL), sports, and quality of life (QOL), with mean differences of 0.20 (95%CI: 0.10 to 0.30; I 2 = 0%; p < 0.0001), -0.20 (95%CI: -0.26 to -0.13; I 2 = 0%; p < 0.00001), 0.20 (95%CI: 0.02 to 0.38; I 2 = 0%; p = 0.03), and 0.50 (95%CI: 0.29 to 0.71; I 2 = 0%; p < 0.00001) respectively when compared with the ACLR group. Conclusion Adding LET through the modified Lemaire technique to ACLR may improve knee stability because of the lower rate of graft rerupture and the superiority in terms of clinical outcomes. Level of Evidence I.
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Affiliation(s)
- Essy Dwi Damayanthi
- Departamento de Ortopedia e Traumatologia, Ulin General Hospital, Faculty of Medicine, Lambung Mangkurat University, Banjarmasin, Indonésia
| | - Erica Kholinne
- Departamento de Cirurgia Ortopédica, St. Carolus Hospital, Faculty of Medicine, Universitas Trisakti, Jacarta, Indonésia
| | | | - Muhammad Sakti
- Departamento de Cirurgia Ortopédica, Faculty of Medicine, Hasanuddin University, Macáçar, Indonésia
| | - Ira Juliet Anesstesia
- Departamento de Cirurgia Ortopédica, St. Carolus Hospital, Faculty of Medicine, Universitas Trisakti, Jacarta, Indonésia
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Arifin J, Sakti M, Massi N, Bukhari A, Hamid F, Winangun PA. Vertebral destruction in tuberculous spondylitis correlates with Toll-like Receptor 4 (TLR-4) levels: a cross-sectional study. Ann Med Surg (Lond) 2024; 86:800-804. [PMID: 38333260 PMCID: PMC10849308 DOI: 10.1097/ms9.0000000000001707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 12/29/2023] [Indexed: 02/10/2024] Open
Abstract
Background Tuberculous (TB) spondylitis is a hazardous infectious disease causing significant spinal deformity. Increased toll-like receptor-4 (TLR-4) activity promotes more extensive infections in patients with TB spondylitis, so it has the potential to be used as a biomarker to predict the severity. This study aims to determine the relationship between TLR-4 levels and the degree of vertebral destruction in TB spondylitis patients. Materials and methods A cross-sectional study was conducted from May to October 2023. A total of 27 TB spondylitis samples were then measured for TLR-4 serum levels. Vertebral destruction is assessed based on the Spine At Risk Signs (SARS) criteria on X-ray and MRI examinations. Moreover, the degree of sensory and motor impairment was also assessed in this study. The Spearman correlation test assessed the correlation between TLR-4 levels and vertebral destruction. Results Most of the samples in this study were less than 30 years old (10 people, 37%), female (14 people, 51.9%), had spinal destruction at 1 level (11 people, 40.7%), had paraplegia (8 people, 29.6%), and had hypoesthesia (11 people, 40.7%). TLR-4 levels had a mean value of 8254.1±1076.1 ng/ml. TLR-4 levels were positively correlated with the degree of vertebral destruction (r=0.599, P=0.001), motor disorders (r=0.632.x, P=0.000), and sensory disorders (r=0.574, P=0.002). Conclusion TLR-4 levels are associated with the severity of vertebral destruction in TB spondylitis, so it has the potential to be used as a prognostic biomarker.
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Affiliation(s)
- Jainal Arifin
- Department of Orthopedic and Traumatology, Spine Divison
| | - Muhammad Sakti
- Department of Orthopedic and Traumatology, Sports and Injury Division
| | | | | | | | - Putu A.N. Winangun
- Orthopaedic and Traumatology Study Program, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
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Taufik S A, Dirja BT, Utomo DN, Usman MA, Sakti M, Saleh MR, Hatta M, Budu. Double membrane platelet-rich fibrin (PRF) - Synovium succeeds in regenerating cartilage defect at the knee: An experimental study on rabbit. Heliyon 2023; 9:e13139. [PMID: 36747521 PMCID: PMC9898638 DOI: 10.1016/j.heliyon.2023.e13139] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/14/2023] [Accepted: 01/18/2023] [Indexed: 01/23/2023] Open
Abstract
Background This study aims to prove the healing results (regeneration) in cartilage defects using a combination treatment of microfractures and transplantation synovium-platelet rich fibrin (S-PRF). Methods A cartilage defect was made in the trochlear groove of the knee of adult New Zealand white rabbits, and was classified into three treatment groups. The group 1 was cartilage defect without treatment, 2 with microfracture treatment, and 3 with microfracture covered with a synovium-platelet rich fibrin (S-PRF) membrane. Twelve weeks after the intervention, the animals were macroscopically and histologically examined, and evaluated by the International Cartilage Repair Society (ICRS). Additionally, the expression of aggrecan and type 2 collagen was examined by real-time-PCR. Results The ICSR scores for macroscopic were significantly higher in the microfracture and S-PRF transplant group than in the other groups. Also, the ICSR scores for histology were significantly higher in this group. The expression of aggrecan and type 2 collagen was higher in the group that received complete treatment. Conclusions Microfractures and transplantation of synovium-platelet rich fibrin (S-PRF) can regenerate knee cartilage defects which have been shown to increase the expression of mRNA aggrecan and mRNA type 2 collagen resulting in excellent repair.
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Affiliation(s)
- Ahmad Taufik S
- Faculty of Medicine Mataram University, Mataram, Indonesia,Department of Molecular Biology and Immunology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia,Corresponding author. Faculty of Medicine Mataram University, Mataram, Indonesia.
| | | | - Dwikora Novembri Utomo
- Department of Orthopaedic, Faculty of Medicine Airlangga University, Surabaya, Indonesia
| | - Muhammad Andry Usman
- Department of Orthopaedic, Faculty of Medicine Hasanuddin University, Makasar, Indonesia
| | - Muhammad Sakti
- Department of Orthopaedic, Faculty of Medicine Hasanuddin University, Makasar, Indonesia
| | - Muhammad Ruksal Saleh
- Department of Orthopaedic, Faculty of Medicine Hasanuddin University, Makasar, Indonesia
| | - Mochammad Hatta
- Department of Molecular Biology and Immunology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Budu
- Department of Opthalmology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
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Sakti M, Arifin J, Wonggokusuma G, Arden F, Faidzin M. A comparison of functional knee outcomes post-arthroscopic anterior cruciate ligament (ACL) reconstruction using hamstring and peroneus longus (PL) autograft. Bali Med J 2022. [DOI: 10.15562/bmj.v11i2.3233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background: Hamstring autograft (HA) is the most common graft used in ACL reconstruction procedures. However, harvesting HA could weaken the secondary stabilizer of the knee joint. Peroneus longus grafts (PL) is a novel option secondary to hamstring graft with less morbidity at the knee joint. We intended to determine whether peroneus longus autograft (PL) is a comparable alternative to hamstring autograft for ACL Reconstruction.
Methods: 84 patients were grouped into "hamstring" (n = 51) and "peroneus longus" (n = 33) groups, with a mean age of 26.2 ± 5.9 in the Hamstring group and a mean age of 26.4 ± 6.6 in peroneus group. We obtain secondary data from the medical records of several hospitals in Makassar.
Results: There was a significant difference in Lysholm score (p<0.05) in the hamstring group with peroneus at 6 months and 12 months postoperatively for IKDC score, anterior translation, Power Grading Flexi-Extension, ROM on flexion, and extension. In addition, in muscle atrophy, the Hamstring group compared to the peroneus group also showed a significant difference (p=0.001).
Conclusion: The study's results did not show significant differences between the hamstring and peroneus groups other than atrophy of thigh muscles in the hamstring group. Based on the results of this study, we conclude peroneus longus graft is one of the graft options in ACL reconstruction surgery.
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Arief A, Budu, Usman MA, Sakti M, Lubis AMT, Bukhari A. Treatment of grade III knee osteoarthritis with bone marrow stimulation and intraarticular injection of triamcinolone and hyaluronic acid combination; three case report and literature review. Int J Surg Case Rep 2022; 95:107177. [PMID: 35623121 PMCID: PMC9136340 DOI: 10.1016/j.ijscr.2022.107177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/07/2022] [Accepted: 05/07/2022] [Indexed: 01/29/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Osteoarthritis is a severe joint disease that affects more than 60% of the elderly and more common an idiopathic disease or unknown cause although there is also a secondary cause such as trauma, infection, neurological or metabolic disorders. The usual complaints that perceived by osteoarthritis patients is pain in the affected joint. Many patients and providers think of arthroplasty as the only surgical option for the treatment of osteoarthritis of the knee. However, there are several other surgical options for osteoarthritis which can be therapeutic alternatives. The role of bone marrow stimulation and intraarticular injection with triamcinolone and Hyaluronic acid combination on grade III knee osteoarthritis patient has not been reported. CASE PRESENTATION Three patients who presented to orthopedic department with complaints of bilateral knee pain were identified with grade III osteoarthritis (Kellgren and Lawrence) receiving some kind of analgetic treatment for more than 1 year which provided pain relief for some time but not permanent. They underwent arthroscopic procedure (bone marrow stimulation) and then injected with triamcinolone and hyaluronic acid combination. Pre and post operation outcome scores (WOMAC score, Interleukin 15 and MRI) were assessed. At six-month follow-up, all patients reported improvement in pain and stiffness. WOMAC score and Interleukin 15 serum level decreases, MRI with Amadeus score showed improvement of cartilage defect. CLINICAL DISCUSSION This case report showed that our three patients were successfully treated with bone marrow stimulation and intraarticular injection with triamcinolone and hyaluronic acid combination. All three patients have improved in their functional outcome, IL 15 and cartilage defect. CONCLUSION Bone marrow stimulation and intraarticular injection with triamcinolone and hyaluronic acid combination can be a valuable treatment option for moderate active patients with grade III knee osteoarthritis.
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Affiliation(s)
- Ariyanto Arief
- Medical and Health Science Faculty of State Islamic Alauddin University Makassar, Indonesia; Department of Orthopedic and Traumatology, Hasri Ainun Habibie Hospital Parepare, Indonesia.
| | - Budu
- Medical Faculty of Hasanuddin University Makassar, Indonesia
| | - Muhammad Andry Usman
- Medical Faculty of Hasanuddin University Makassar, Indonesia; Department of Orthopedic and Traumatology, Wahidin Sudirohusodo Hospital, Makassar, Indonesia
| | - Muhammad Sakti
- Medical Faculty of Hasanuddin University Makassar, Indonesia; Department of Orthopedic and Traumatology, Wahidin Sudirohusodo Hospital, Makassar, Indonesia
| | - Andri Maruli Tua Lubis
- Department of Orthopedic and Traumatology, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusomo Hospital Jakarta, Indonesia
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Sakti M, Saleh R, Yudha K, Akbar T. Predicting factors for walking ability of postoperative patients with hemiarthroplasty at Wahidin Sudirohusodo Hospital in Makassar. BALI MEDICAL JOURNAL 2021. [DOI: 10.15562/bmj.v10i1.2256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Sakti M, Biakto KT, Usman MA, Tedjajuwana MJ, Pasallo P, Subagio ES. Predicting the peroneus longus tendon autograft size in ACL reconstruction by using anthropometric parameters: A study in South Sulawesi population. J Orthop 2020; 22:1-4. [PMID: 32273665 PMCID: PMC7132115 DOI: 10.1016/j.jor.2020.03.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 03/23/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction Some literature use peroneus longus tendon (PLT) as the alternative to anterior cruciate ligament (ACL) reconstruction to overcome inadequate autograft size potential risk by using hamstring tendon (HT) autograft. Among the available methods to predict PLT measurements, anthropometric parameters are one of the most accessible and feasible methods. The objective of this prospective study was to predict the PLT autograft sizes in single bundle ACL reconstruction by using preoperative anthropometric measurement. Method Anthropometric parameters, including age, gender, height, weight, body mass index (BMI), true leg length (TLL), shank circumference and shank length of 20 patients with primary ACL reconstruction was measured before surgery. Univariate analysis, independent-sample t-test, Pearson correlation test, and logistic regression to evaluate the influence of these anthropometric variables on the diameter and length of the PLT autograft obtained. Result Pearson correlation test has shown that body weight and height correlates to PLT length and diameter also autograft's length and diameter significantly (p < 0.05). The linear regression analysis showed that height, weight, TLL and shank length were signifcantly related to autograft diameter. While height and TLL were significantly related to autograft length. Conclusion Height, weight, TLL and shank length can use to predict PLT autograft diameter. While height and TLL can use to predict PLT autograft length. It is important to estimate tendon graft size prior to ACL reconstruction surgery. Preoperative anthropometric measurement is a good method to predict PLT autograft size. Height is a good predictor of the PLT autograft diameter and length. Patient less than 153 cm in height, high risk for having in adequate graft size.
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Affiliation(s)
- M Sakti
- Orthopaedy and Traumatology Department, Hasanuddin University School of Medicine, Indonesia
| | - K T Biakto
- Orthopaedy and Traumatology Department, Hasanuddin University School of Medicine, Indonesia
| | - M A Usman
- Orthopaedy and Traumatology Department, Hasanuddin University School of Medicine, Indonesia
| | - M J Tedjajuwana
- Orthopaedy and Traumatology Department, Hasanuddin University School of Medicine, Indonesia
| | - P Pasallo
- Resident of Orthopaedy and Traumatology Department, Hasanuddin University School of Medicine, Indonesia
| | - E S Subagio
- Resident of Orthopaedy and Traumatology Department, Hasanuddin University School of Medicine, Indonesia
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Kitta MI, Ismiarto YD, Saleh MR, Sakti M, Abidin MA, Putra LT. Analysis of radiological alignment and functional outcomes of pediatric patients after surgery with displaced supracondylar humerus fracture: A cross-sectional study. International Journal of Surgery Open 2020. [DOI: 10.1016/j.ijso.2020.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
Deposition of tophus is a common feature in chronic gout; however, signs and symptoms are not always well-pronounced in cases of uncommon sites. We report a case series of three patients, one with an acute locked knee suspected to be meniscus tear or intra-articular loose body, a second case with a lump on the dorsal hand suspected to be a benign lesion, and a third case with a finger flexion deformity with carpal tunnel syndrome; all three cases were later on found out to be tophaceous gout. White chalky monosodium urate crystal deposition was found to be the culprit of the symptoms of the patients.
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Affiliation(s)
- Muhammad Sakti
- Department of Orthopaedic and Traumatology, Hasanuddin University Teaching Hospital, Makassar, Indonesia,
| | - Muhammad Andry Usman
- Department of Orthopaedic and Traumatology, Hasanuddin University Teaching Hospital, Makassar, Indonesia,
| | - Jansen Lee
- Department of Orthopaedic and Traumatology, Hasanuddin University Teaching Hospital, Makassar, Indonesia,
| | - Michael Benjamin
- Department of Orthopaedic and Traumatology, Hasanuddin University Teaching Hospital, Makassar, Indonesia,
| | - Qariah Maulidiah
- Department of Orthopaedic and Traumatology, Hasanuddin University Teaching Hospital, Makassar, Indonesia,
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Sakti M, Yurianto H, Pasallo P, Hidayatullah S, Faisal A, Subagio ES. Anthropometric parameters measurement to predict 4-strand hamstring autograft size in single bundle anterior cruciate ligament reconstruction of South Sulawesi population. International Journal of Surgery Open 2019. [DOI: 10.1016/j.ijso.2019.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Saleh R, Paturusi I, Sakti M, Pasallo P, Maulidiah Q, Guatama A. Evaluation of elbow function following bipolar latissimus dorsi flap in late partial brachial plexus injury: A case report. International Journal of Surgery Open 2019. [DOI: 10.1016/j.ijso.2019.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hutabarat A, Saleh R, Sakti M, Toban Layu Y, Rizan Hend A. Morphology Study of the Acetabulum Values of Indonesian Deutero Malay Sub-race Population in South Sulawesi. J of Medical Sciences 2018. [DOI: 10.3923/jms.2018.69.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Sakti M, Nakasa T, Shoji T, Usman MA, Kawanishi Y, Hamanishi M, Yusuf I, Ochi M. Acceleration of healing of the medial collateral ligament of the knee by local administration of synthetic microRNA-210 in a rat model. Asia Pac J Sports Med Arthrosc Rehabil Technol 2015; 2:129-136. [PMID: 29264252 PMCID: PMC5730664 DOI: 10.1016/j.asmart.2015.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 08/10/2015] [Accepted: 08/21/2015] [Indexed: 11/29/2022]
Abstract
Background Injury to the medial collateral ligament (MCL) of the knee joint is the most common ligament injury of the knee. Ligament healing generally takes a long time. Micro-ribonucleic acid (miRNA) is one of the noncoding RNAs and plays a crucial role in physiological function; miRNA (miR)-210 is known as a potent factor of angiogenesis, which is an important initiator of ligament healing. The purpose of this study is to examine the effect of local injection of double-stranded (ds) miR-210 on the healing of the MCL of rat knee joint. Methods MCLs of Sprague-Dawley rats were cut transversely. After the fascia and skin were sutured, dsmiR-210 or control dsRNA was injected into the injured site of MCL. At 2 weeks and 4 weeks, histological analysis and immunofluorescence staining of vascular endothelial growth factor, isolectin B4, collagen type 1, and Ki67 as well as a mechanical test were performed. Analysis of complementary deoxyribonucleic acid (cDNA) microarray data was performed at 1 week. Results Histological analysis showed that parallel fibres in the injured site were organised at 2 weeks and became thicker at 4 weeks in the miR-210-treated group, whereas the injured site in controls was filled with loose fibrous tissues and was thinner than that in the miR-210-treated group. The number of blood vessels in the miR-210-treated group was significantly higher than that in controls (p < 0.05), and vascular endothelial growth factor, Ki67, and collagen type 1 in the miR-210-treated group were intensely expressed in the repaired site as compared to the control group. The mechanical test indicated that the ultimate failure load in the miR-210-treated group was significantly higher than that in the control group at 2 weeks. The cDNA microarray analysis showed significant upregulation of genes related to cell proliferation and cell differentiation, and genes involved in negative regulation of apoptosis. Conclusion This study showed that local injection of dsmiR-210 could accelerate MCL healing in rat, which is likely due to stimulation of angiogenesis at the healing site.
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Affiliation(s)
- Muhammad Sakti
- University of Hasanuddin, Makassar, South Sulawesi, Indonesia
- Corresponding author. Faculty of Medicine, University of Hasanuddin, Makassar. Jln. Perintis Kemerdekaan, Tamalanrea, 90000, South Sulawesi, Indonesia.
| | | | | | | | | | | | - Irawan Yusuf
- University of Hasanuddin, Makassar, South Sulawesi, Indonesia
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