Geoffrey Wilkin - Academia.edu (original) (raw)

Papers by Geoffrey Wilkin

Archives of Orthopaedic and Trauma Surgery, 2015

We sought to evaluate clinical and biomechanical outcomes of dual mini-fragment plate fixation fo... more We sought to evaluate clinical and biomechanical outcomes of dual mini-fragment plate fixation for clavicle fractures. We hypothesized that this technique would produce an anatomical reduction with good clinical outcomes, be well tolerated by patients, and demonstrate equivalent biomechanics to single plating. Dual mini-fragment plating was performed for 17 isolated, displaced midshaft clavicle fractures. Functional outcomes and complications were retrospectively reviewed. A sawbones model compared dual plating biomechanics to a (1) superior 3.5-mm locking reconstruction plate, or (2) antero-inferior 3.5-mm locking reconstruction plate. On biomechanical testing, with anterior loading, dual plating was significantly more rigid than single locked anterior-plating (p = 0.02) but less rigid than single locked superior-plating (p = 0.001). With superior loading, dual plating trended toward higher rigidity versus single locked superior-plating (p = 0.07) but was less rigid than single locked anterior-plating (p = 0.03). No statistically significant differences in axial loading (p = 0.27) or torsion (p = 0.23) were detected. Average patient follow-up was 16.1 months (12-38). Anatomic reduction was achieved and maintained through final healing (average 14.7 weeks). No patient underwent hardware removal. Average 1-year DASH score was 4.0 (completed in 88 %). Displaced midshaft clavicle fractures can be effectively managed with dual mini-fragment plating. This technique results in high union rates and excellent clinical outcomes. Compared to single plating, dual plating is biomechanically equivalent in axial loading and torsion, yet offers better multi-planar bending stiffness despite the use of smaller plates. This technique may decrease the need for secondary surgery due to implant prominence and may aid in fracture reduction by buttressing butterfly fragments in two planes.

The Journal of Physiology, Mar 15, 2010

High-intensity interval training (HIT) induces skeletal muscle metabolic and performance adaptati... more High-intensity interval training (HIT) induces skeletal muscle metabolic and performance adaptations that resemble traditional endurance training despite a low total exercise volume. Most HIT studies have employed 'all out', variable-load exercise interventions (e.g. repeated Wingate tests) that may not be safe, practical and/or well tolerated by certain individuals. Our purpose was to determine the performance, metabolic and molecular adaptations to a more practical model of low-volume HIT. Seven men (21 ± 0.4 years,V O 2 peak = 46 ± 2 ml kg −1 min −1 ) performed six training sessions over 2 weeks. Each session consisted of 8-12 × 60 s intervals at ∼100% of peak power output elicited during a rampV O 2 peak test (355 ± 10 W) separated by 75 s of recovery. Training increased exercise capacity, as assessed by significant improvements on both 50 kJ and 750 kJ cycling time trials (P < 0.05 for both). Skeletal muscle (vastus lateralis) biopsy samples obtained before and after training revealed increased maximal activity of citrate synthase (CS) and cytochrome c oxidase (COX) as well as total protein content of CS, COX subunits II and IV, and the mitochondrial transcription factor A (Tfam) (P < 0.05 for all). Nuclear abundance of peroxisome proliferator-activated receptor γ co-activator 1α (PGC-1α) was ∼25% higher after training (P < 0.05), but total PGC-1α protein content remained unchanged. Total SIRT1 content, a proposed activator of PGC-1α and mitochondrial biogenesis, was increased by ∼56% following training (P < 0.05). Training also increased resting muscle glycogen and total GLUT4 protein content (both P < 0.05). This study demonstrates that a practical model of low volume HIT is a potent stimulus for increasing skeletal muscle mitochondrial capacity and improving exercise performance. The results also suggest that increases in SIRT1, nuclear PGC-1α, and Tfam may be involved in coordinating mitochondrial adaptations in response to HIT in human skeletal muscle.

Journal of Bone Joint Surgery British Volume, Jul 1, 2011

Effects of endurance exercise training on muscle glycogen accumulation in humans. J. Appl. Physio... more Effects of endurance exercise training on muscle glycogen accumulation in humans. J. Appl. Physiol. 87(1): 222-226, 1999.-The purpose of this investigation was to determine whether endurance exercise training increases the ability of human skeletal muscle to accumulate glycogen after exercise. Subjects (4 women and 2 men, 31 Ϯ 8 yr old) performed high-intensity stationary cycling 3 days/wk and continuous running 3 days/wk for 10 wk. Muscle glycogen concentration was measured after a glycogen-depleting exercise bout before and after endurance training. Muscle glycogen accumulation rate from 15 min to 6 h after exercise was twofold higher (P Ͻ 0.05) in the trained than in the untrained state: 10.5 Ϯ 0.2 and 4.5 Ϯ 1.3 mmol · kg wet wt Ϫ1 ·h Ϫ1 , respectively. Muscle glycogen concentration was higher (P Ͻ 0.05) in the trained than in the untrained state at 15 min, 6 h, and 48 h after exercise. Muscle GLUT-4 content after exercise was twofold higher (P Ͻ 0.05) in the trained than in the untrained state (10.7 Ϯ 1.2 and 4.7 Ϯ 0.7 optical density units, respectively) and was correlated with muscle glycogen concentration 6 h after exercise (r ϭ 0.64, P Ͻ 0.05). Total glycogen synthase activity and the percentage of glycogen synthase I were not significantly different before and after training at 15 min, 6 h, and 48 h after exercise. We conclude that endurance exercise training enhances the capacity of human skeletal muscle to accumulate glycogen after glycogendepleting exercise.

Journal of Physiology, 2006

Brief, intense exercise training may induce metabolic and performance adaptations comparable to t... more Brief, intense exercise training may induce metabolic and performance adaptations comparable to traditional endurance training. However, no study has directly compared these diverse training strategies in a standardized manner. We therefore examined changes in exercise capacity and molecular and cellular adaptations in skeletal muscle after low volume sprint-interval training (SIT) and high volume endurance training (ET). Sixteen active men (21 ± 1 years,V O 2 peak = 4.0 ± 0.21 min −1 ) were assigned to a SIT or ET group (n = 8 each) and performed six training sessions over 14 days. Each session consisted of either four to six repeats of 30 s 'all out' cycling at ∼250%V O 2 peak with 4 min recovery (SIT) or 90-120 min continuous cycling at ∼65%V O 2 peak (ET). Training time commitment over 2 weeks was ∼2.5 h for SIT and ∼10.5 h for ET, and total training volume was ∼90% lower for SIT versus ET (∼630 versus ∼6500 kJ). Training decreased the time required to complete 50 and 750 kJ cycling time trials, with no difference between groups (main effects, P ≤ 0.05). Biopsy samples obtained before and after training revealed similar increases in muscle oxidative capacity, as reflected by the maximal activity of cytochrome c oxidase (COX) and COX subunits II and IV protein content (main effects, P ≤ 0.05), but COX II and IV mRNAs were unchanged. Training-induced increases in muscle buffering capacity and glycogen content were also similar between groups (main effects, P ≤ 0.05). Given the large difference in training volume, these data demonstrate that SIT is a time-efficient strategy to induce rapid adaptations in skeletal muscle and exercise performance that are comparable to ET in young active men.

Brief, intense exercise training may induce metabolic and performance adaptations comparable to t... more Brief, intense exercise training may induce metabolic and performance adaptations comparable to traditional endurance training. However, no study has directly compared these diverse training strategies in a standardized manner. We therefore examined changes in exercise capacity and molecular and cellular adaptations in skeletal muscle after low volume sprint-interval training (SIT) and high volume endurance training (ET). Sixteen active men (21 ± 1 years,V O 2 peak = 4.0 ± 0.21 min −1 ) were assigned to a SIT or ET group (n = 8 each) and performed six training sessions over 14 days. Each session consisted of either four to six repeats of 30 s 'all out' cycling at ∼250%V O 2 peak with 4 min recovery (SIT) or 90-120 min continuous cycling at ∼65%V O 2 peak (ET). Training time commitment over 2 weeks was ∼2.5 h for SIT and ∼10.5 h for ET, and total training volume was ∼90% lower for SIT versus ET (∼630 versus ∼6500 kJ). Training decreased the time required to complete 50 and 750 kJ cycling time trials, with no difference between groups (main effects, P ≤ 0.05). Biopsy samples obtained before and after training revealed similar increases in muscle oxidative capacity, as reflected by the maximal activity of cytochrome c oxidase (COX) and COX subunits II and IV protein content (main effects, P ≤ 0.05), but COX II and IV mRNAs were unchanged. Training-induced increases in muscle buffering capacity and glycogen content were also similar between groups (main effects, P ≤ 0.05). Given the large difference in training volume, these data demonstrate that SIT is a time-efficient strategy to induce rapid adaptations in skeletal muscle and exercise performance that are comparable to ET in young active men.

The Journal of physiology, Jan 15, 2010

High-intensity interval training (HIT) induces skeletal muscle metabolic and performance adaptati... more High-intensity interval training (HIT) induces skeletal muscle metabolic and performance adaptations that resemble traditional endurance training despite a low total exercise volume. Most HIT studies have employed 'all out', variable-load exercise interventions (e.g. repeated Wingate tests) that may not be safe, practical and/or well tolerated by certain individuals. Our purpose was to determine the performance, metabolic and molecular adaptations to a more practical model of low-volume HIT. Seven men (21 + or - 0.4 years, V(O2peak) = 46 + or - 2 ml kg(-1) min(-1)) performed six training sessions over 2 weeks. Each session consisted of 8-12 x 60 s intervals at approximately 100% of peak power output elicited during a ramp V(O2) peak test (355 + or - 10 W) separated by 75 s of recovery. Training increased exercise capacity, as assessed by significant improvements on both 50 kJ and 750 kJ cycling time trials (P < 0.05 for both). Skeletal muscle (vastus lateralis) biopsy s...

The Journal of Bone and Joint Surgery (American), 2014

Hip arthroscopy is being performed with expanding indications, commonly including symptomatic lab... more Hip arthroscopy is being performed with expanding indications, commonly including symptomatic labral tears. The effects of various patient factors, including patient age, on clinical outcomes are not well understood. The purpose of the present study was to quantify the postoperative functional and quality-of-life outcomes after arthroscopic debridement of symptomatic labral tears in patients forty-five years of age or older. Forty-one patients who were at least forty-five years of age (mean age, 52.7 years [range, 45.5 to 67.0 years]; mean body mass index, 26.1 kg/m² [range, 18.4 to 33.2 kg/m²]; 75.6% female) and who underwent labral debridement at the time of hip arthroscopy were included. Disease-specific clinical outcome measures (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] and modified Harris hip score [mHHS]) and general health-related measures (12-Item Short Form Health Survey [SF-12]) were collected preoperatively and postoperatively. The reoperation rate was 17% (seven of forty-one) at a mean of 21.3 months, and six of the seven reoperations involved conversion to hip arthroplasty or resurfacing. The overall hip arthroscopy cohort had postoperative improvements in the mean WOMAC pain score (from 54.0 [range, 20 to 90] to 69.4 [range, 0 to 100], p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), WOMAC function score (from 60.4 [range, 16.2 to 95.6] to 69.1 [range, 10.3 to 100], p = 0.004), SF-12 physical component summary score (from 33.2 to 39.3, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), and mHHS (from 56.6 [range, 9.9 to 84.6] to 63.9 [range, 29.7 to 100], p = 0.022). The changes in the WOMAC stiffness score (from 54.6 ± 20.8 to 60.1 ± 28.1, p = 0.157) and SF-12 mental component summary score (from 51.3 ± 11.4 to 51.6 ± 12.2, p = 0.870) were not significant. Thirteen patients (32%) had a good or excellent outcome as indicated by the postoperative mHHS. Arthroscopic labral debridement in patients forty-five years of age or older was associated with a relatively high reoperation rate and minimal overall improvement in joint-specific and quality-of-life outcome measures. Although differences in some outcome measures were statistically significant, most did not reach the level of the minimum clinically important difference. Arthroscopic debridement of labral tears in this patient population must be approached with caution as the overall clinical benefit was small.

The Journal of bone and joint surgery. American volume, Jan 20, 2014

Negative-pressure wound therapy (NPWT) can improve fasciotomy wound closure, but its effects on s... more Negative-pressure wound therapy (NPWT) can improve fasciotomy wound closure, but its effects on skeletal muscle are largely unknown. The purpose of this study was to evaluate NPWT effects on skeletal muscle after fasciotomy for compartment syndrome in an animal model and to assess regional variability in muscle fiber regeneration. Compartment syndrome was induced in the hindlimb of twenty-two adult female pigs with use of a continuous intracompartmental serum-infusion model. Fasciotomy was performed after six hours, and animals were randomized to receive either wet-to-dry gauze dressings (control group) or NPWT dressings (-125 mm Hg, continuous suction) for seven days. Delayed primary wound closure was attempted at seven days, and the peroneus tertius was harvested for analysis seven days or twenty-one days after fasciotomy. Muscles were weighed, and hematoxylin and eosin-stained samples from four regions of the muscle (superficial central, deep central, lateral, and proximal) were ...

Archives of Orthopaedic and Trauma Surgery, 2015

We sought to evaluate clinical and biomechanical outcomes of dual mini-fragment plate fixation fo... more We sought to evaluate clinical and biomechanical outcomes of dual mini-fragment plate fixation for clavicle fractures. We hypothesized that this technique would produce an anatomical reduction with good clinical outcomes, be well tolerated by patients, and demonstrate equivalent biomechanics to single plating. Dual mini-fragment plating was performed for 17 isolated, displaced midshaft clavicle fractures. Functional outcomes and complications were retrospectively reviewed. A sawbones model compared dual plating biomechanics to a (1) superior 3.5-mm locking reconstruction plate, or (2) antero-inferior 3.5-mm locking reconstruction plate. On biomechanical testing, with anterior loading, dual plating was significantly more rigid than single locked anterior-plating (p = 0.02) but less rigid than single locked superior-plating (p = 0.001). With superior loading, dual plating trended toward higher rigidity versus single locked superior-plating (p = 0.07) but was less rigid than single locked anterior-plating (p = 0.03). No statistically significant differences in axial loading (p = 0.27) or torsion (p = 0.23) were detected. Average patient follow-up was 16.1 months (12-38). Anatomic reduction was achieved and maintained through final healing (average 14.7 weeks). No patient underwent hardware removal. Average 1-year DASH score was 4.0 (completed in 88 %). Displaced midshaft clavicle fractures can be effectively managed with dual mini-fragment plating. This technique results in high union rates and excellent clinical outcomes. Compared to single plating, dual plating is biomechanically equivalent in axial loading and torsion, yet offers better multi-planar bending stiffness despite the use of smaller plates. This technique may decrease the need for secondary surgery due to implant prominence and may aid in fracture reduction by buttressing butterfly fragments in two planes.

The Journal of Physiology, Mar 15, 2010

High-intensity interval training (HIT) induces skeletal muscle metabolic and performance adaptati... more High-intensity interval training (HIT) induces skeletal muscle metabolic and performance adaptations that resemble traditional endurance training despite a low total exercise volume. Most HIT studies have employed 'all out', variable-load exercise interventions (e.g. repeated Wingate tests) that may not be safe, practical and/or well tolerated by certain individuals. Our purpose was to determine the performance, metabolic and molecular adaptations to a more practical model of low-volume HIT. Seven men (21 ± 0.4 years,V O 2 peak = 46 ± 2 ml kg −1 min −1 ) performed six training sessions over 2 weeks. Each session consisted of 8-12 × 60 s intervals at ∼100% of peak power output elicited during a rampV O 2 peak test (355 ± 10 W) separated by 75 s of recovery. Training increased exercise capacity, as assessed by significant improvements on both 50 kJ and 750 kJ cycling time trials (P < 0.05 for both). Skeletal muscle (vastus lateralis) biopsy samples obtained before and after training revealed increased maximal activity of citrate synthase (CS) and cytochrome c oxidase (COX) as well as total protein content of CS, COX subunits II and IV, and the mitochondrial transcription factor A (Tfam) (P < 0.05 for all). Nuclear abundance of peroxisome proliferator-activated receptor γ co-activator 1α (PGC-1α) was ∼25% higher after training (P < 0.05), but total PGC-1α protein content remained unchanged. Total SIRT1 content, a proposed activator of PGC-1α and mitochondrial biogenesis, was increased by ∼56% following training (P < 0.05). Training also increased resting muscle glycogen and total GLUT4 protein content (both P < 0.05). This study demonstrates that a practical model of low volume HIT is a potent stimulus for increasing skeletal muscle mitochondrial capacity and improving exercise performance. The results also suggest that increases in SIRT1, nuclear PGC-1α, and Tfam may be involved in coordinating mitochondrial adaptations in response to HIT in human skeletal muscle.

Journal of Bone Joint Surgery British Volume, Jul 1, 2011

Effects of endurance exercise training on muscle glycogen accumulation in humans. J. Appl. Physio... more Effects of endurance exercise training on muscle glycogen accumulation in humans. J. Appl. Physiol. 87(1): 222-226, 1999.-The purpose of this investigation was to determine whether endurance exercise training increases the ability of human skeletal muscle to accumulate glycogen after exercise. Subjects (4 women and 2 men, 31 Ϯ 8 yr old) performed high-intensity stationary cycling 3 days/wk and continuous running 3 days/wk for 10 wk. Muscle glycogen concentration was measured after a glycogen-depleting exercise bout before and after endurance training. Muscle glycogen accumulation rate from 15 min to 6 h after exercise was twofold higher (P Ͻ 0.05) in the trained than in the untrained state: 10.5 Ϯ 0.2 and 4.5 Ϯ 1.3 mmol · kg wet wt Ϫ1 ·h Ϫ1 , respectively. Muscle glycogen concentration was higher (P Ͻ 0.05) in the trained than in the untrained state at 15 min, 6 h, and 48 h after exercise. Muscle GLUT-4 content after exercise was twofold higher (P Ͻ 0.05) in the trained than in the untrained state (10.7 Ϯ 1.2 and 4.7 Ϯ 0.7 optical density units, respectively) and was correlated with muscle glycogen concentration 6 h after exercise (r ϭ 0.64, P Ͻ 0.05). Total glycogen synthase activity and the percentage of glycogen synthase I were not significantly different before and after training at 15 min, 6 h, and 48 h after exercise. We conclude that endurance exercise training enhances the capacity of human skeletal muscle to accumulate glycogen after glycogendepleting exercise.

Journal of Physiology, 2006

Brief, intense exercise training may induce metabolic and performance adaptations comparable to t... more Brief, intense exercise training may induce metabolic and performance adaptations comparable to traditional endurance training. However, no study has directly compared these diverse training strategies in a standardized manner. We therefore examined changes in exercise capacity and molecular and cellular adaptations in skeletal muscle after low volume sprint-interval training (SIT) and high volume endurance training (ET). Sixteen active men (21 ± 1 years,V O 2 peak = 4.0 ± 0.21 min −1 ) were assigned to a SIT or ET group (n = 8 each) and performed six training sessions over 14 days. Each session consisted of either four to six repeats of 30 s 'all out' cycling at ∼250%V O 2 peak with 4 min recovery (SIT) or 90-120 min continuous cycling at ∼65%V O 2 peak (ET). Training time commitment over 2 weeks was ∼2.5 h for SIT and ∼10.5 h for ET, and total training volume was ∼90% lower for SIT versus ET (∼630 versus ∼6500 kJ). Training decreased the time required to complete 50 and 750 kJ cycling time trials, with no difference between groups (main effects, P ≤ 0.05). Biopsy samples obtained before and after training revealed similar increases in muscle oxidative capacity, as reflected by the maximal activity of cytochrome c oxidase (COX) and COX subunits II and IV protein content (main effects, P ≤ 0.05), but COX II and IV mRNAs were unchanged. Training-induced increases in muscle buffering capacity and glycogen content were also similar between groups (main effects, P ≤ 0.05). Given the large difference in training volume, these data demonstrate that SIT is a time-efficient strategy to induce rapid adaptations in skeletal muscle and exercise performance that are comparable to ET in young active men.

Brief, intense exercise training may induce metabolic and performance adaptations comparable to t... more Brief, intense exercise training may induce metabolic and performance adaptations comparable to traditional endurance training. However, no study has directly compared these diverse training strategies in a standardized manner. We therefore examined changes in exercise capacity and molecular and cellular adaptations in skeletal muscle after low volume sprint-interval training (SIT) and high volume endurance training (ET). Sixteen active men (21 ± 1 years,V O 2 peak = 4.0 ± 0.21 min −1 ) were assigned to a SIT or ET group (n = 8 each) and performed six training sessions over 14 days. Each session consisted of either four to six repeats of 30 s 'all out' cycling at ∼250%V O 2 peak with 4 min recovery (SIT) or 90-120 min continuous cycling at ∼65%V O 2 peak (ET). Training time commitment over 2 weeks was ∼2.5 h for SIT and ∼10.5 h for ET, and total training volume was ∼90% lower for SIT versus ET (∼630 versus ∼6500 kJ). Training decreased the time required to complete 50 and 750 kJ cycling time trials, with no difference between groups (main effects, P ≤ 0.05). Biopsy samples obtained before and after training revealed similar increases in muscle oxidative capacity, as reflected by the maximal activity of cytochrome c oxidase (COX) and COX subunits II and IV protein content (main effects, P ≤ 0.05), but COX II and IV mRNAs were unchanged. Training-induced increases in muscle buffering capacity and glycogen content were also similar between groups (main effects, P ≤ 0.05). Given the large difference in training volume, these data demonstrate that SIT is a time-efficient strategy to induce rapid adaptations in skeletal muscle and exercise performance that are comparable to ET in young active men.

The Journal of physiology, Jan 15, 2010

High-intensity interval training (HIT) induces skeletal muscle metabolic and performance adaptati... more High-intensity interval training (HIT) induces skeletal muscle metabolic and performance adaptations that resemble traditional endurance training despite a low total exercise volume. Most HIT studies have employed 'all out', variable-load exercise interventions (e.g. repeated Wingate tests) that may not be safe, practical and/or well tolerated by certain individuals. Our purpose was to determine the performance, metabolic and molecular adaptations to a more practical model of low-volume HIT. Seven men (21 + or - 0.4 years, V(O2peak) = 46 + or - 2 ml kg(-1) min(-1)) performed six training sessions over 2 weeks. Each session consisted of 8-12 x 60 s intervals at approximately 100% of peak power output elicited during a ramp V(O2) peak test (355 + or - 10 W) separated by 75 s of recovery. Training increased exercise capacity, as assessed by significant improvements on both 50 kJ and 750 kJ cycling time trials (P < 0.05 for both). Skeletal muscle (vastus lateralis) biopsy s...

The Journal of Bone and Joint Surgery (American), 2014

Hip arthroscopy is being performed with expanding indications, commonly including symptomatic lab... more Hip arthroscopy is being performed with expanding indications, commonly including symptomatic labral tears. The effects of various patient factors, including patient age, on clinical outcomes are not well understood. The purpose of the present study was to quantify the postoperative functional and quality-of-life outcomes after arthroscopic debridement of symptomatic labral tears in patients forty-five years of age or older. Forty-one patients who were at least forty-five years of age (mean age, 52.7 years [range, 45.5 to 67.0 years]; mean body mass index, 26.1 kg/m² [range, 18.4 to 33.2 kg/m²]; 75.6% female) and who underwent labral debridement at the time of hip arthroscopy were included. Disease-specific clinical outcome measures (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] and modified Harris hip score [mHHS]) and general health-related measures (12-Item Short Form Health Survey [SF-12]) were collected preoperatively and postoperatively. The reoperation rate was 17% (seven of forty-one) at a mean of 21.3 months, and six of the seven reoperations involved conversion to hip arthroplasty or resurfacing. The overall hip arthroscopy cohort had postoperative improvements in the mean WOMAC pain score (from 54.0 [range, 20 to 90] to 69.4 [range, 0 to 100], p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), WOMAC function score (from 60.4 [range, 16.2 to 95.6] to 69.1 [range, 10.3 to 100], p = 0.004), SF-12 physical component summary score (from 33.2 to 39.3, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), and mHHS (from 56.6 [range, 9.9 to 84.6] to 63.9 [range, 29.7 to 100], p = 0.022). The changes in the WOMAC stiffness score (from 54.6 ± 20.8 to 60.1 ± 28.1, p = 0.157) and SF-12 mental component summary score (from 51.3 ± 11.4 to 51.6 ± 12.2, p = 0.870) were not significant. Thirteen patients (32%) had a good or excellent outcome as indicated by the postoperative mHHS. Arthroscopic labral debridement in patients forty-five years of age or older was associated with a relatively high reoperation rate and minimal overall improvement in joint-specific and quality-of-life outcome measures. Although differences in some outcome measures were statistically significant, most did not reach the level of the minimum clinically important difference. Arthroscopic debridement of labral tears in this patient population must be approached with caution as the overall clinical benefit was small.

The Journal of bone and joint surgery. American volume, Jan 20, 2014

Negative-pressure wound therapy (NPWT) can improve fasciotomy wound closure, but its effects on s... more Negative-pressure wound therapy (NPWT) can improve fasciotomy wound closure, but its effects on skeletal muscle are largely unknown. The purpose of this study was to evaluate NPWT effects on skeletal muscle after fasciotomy for compartment syndrome in an animal model and to assess regional variability in muscle fiber regeneration. Compartment syndrome was induced in the hindlimb of twenty-two adult female pigs with use of a continuous intracompartmental serum-infusion model. Fasciotomy was performed after six hours, and animals were randomized to receive either wet-to-dry gauze dressings (control group) or NPWT dressings (-125 mm Hg, continuous suction) for seven days. Delayed primary wound closure was attempted at seven days, and the peroneus tertius was harvested for analysis seven days or twenty-one days after fasciotomy. Muscles were weighed, and hematoxylin and eosin-stained samples from four regions of the muscle (superficial central, deep central, lateral, and proximal) were ...