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Arthroscopic revision of failed rotator cuff reconstruction
Published in Andreas B. Imhoff, Jonathan B. Ticker, Augustus D. Mazzocca, Andreas Voss, Atlas of Advanced Shoulder Arthroscopy, 2017
The reticulated structure of the scaffold should allow for cellular ingrowth. The synthetic patch from poly-4-hydroxybutyrate (P4HB) is subject to slow degradation in the Krebs cycle. The material has been successfully used in general (abdominal wall) and cosmetic breast surgery, however, few results are available in the orthopedic literature. Of course, patch material from other sources can be used in the same fashion. If the cuff is retorn at its lateral attachment with an EFP36 of more than 2 cm, we use two double-loaded medial anchors and proceed with an otherwise identical technique.
Mechanical and Histological Characteristics of Phasix™ ST Mesh in a Porcine Model of Hernia Repair
Published in Journal of Investigative Surgery, 2022
Corey R. Deeken, Darcy H. Gagne, Amit Badhwar
A unique, fully-resorbable composite mesh design launched in 2015 (Phasix™ ST Mesh, Becton, Dickinson and Company (BD), Franklin Lakes, NJ) and is depicted in Figure 1. Phasix™ ST Mesh is comprised of fully resorbable, biologically-derived, poly-4-hydroxybutyrate (P4HB) monofilament that is co-knitted with polyglycolic acid (PGA) and coated with a resorbable hydrogel layer on the visceral side of the mesh [6]. The hydrogel layer is comprised of sodium hyaluronate (HA), carboxymethylcellulose (CMC), and polyethylene glycol (PEG). The hydrogel provides a barrier to minimize visceral tissue attachment and resorbs in approximately 30 days, while the underlying P4HB mesh serves as a scaffold for tissue ingrowth and mechanical support for the repair, resorbing gradually over a period of 12–18 months [6].
The Transition from Experimental Data to Clinical Practice Using P4HB Mesh in Ventral Hernia Repair
Published in Journal of Investigative Surgery, 2022
Despite early success with synthetic permanent mesh in ventral hernia repair due to its tensile strength and durability, it has been associated with long-term complications like mesh infection, erosion and chronic pain.1 In an attempt to address the limitations of synthetic mesh first biologic meshes were developed as acellular matrices that better resisted infection, promoted revascularization and minimized longterm foreign body reaction.2 However, this type of mesh is extremely expensive and has demonstrated increased recurrence rates without really affecting complications.3 Therefore, Poly-4-hydroxybuturate (P4HB) was designed as a type of biosynthetic mesh implant in an attempt to combine the strength of a synthetic mesh with an increased bacterial resistance due to its biocompatible byproducts.4,5
Glimpses into the molecular pathogenesis of Peyronie’s disease
Published in The Aging Male, 2020
Evert-Jan P. M. ten Dam, Mels F. van Driel, Igle Jan de Jong, Paul M. N. Werker, Ruud A. Bank
There is a large number of other post-translational modifications of collagen catalyzed by enzymes, such as 4-prolyl hydroxylation (catalyzed by P4HA1, P4HA3, P4HB, and P4HA2 was not measurable), 3-prolyl hydroxylation (catalyzed by LEPRE1, LEPREL1, and LEPREL2), and the amount and type of cross-linking (catalyzed by FKBP10, PLOD2, LOX, LOXL1, LOXL2, LOXL3, and LOXL4). None of mentioned enzymes shows a consistent up- or downregulation in plaques compared to the samples out of normal tunica. The same applied for the collagen receptors DDR1, DDR2 and MRC2 (= Endo180), for the enzymes involved in the processing of the propeptides of procollagen (ADAMTS2, BMP1, PCOLCE1, PCOLCE2; ADAMTS3, and ADAMTS14 were not measurable), and for the extracellular matrix proteins, elastin, decorin, biglycan, and fibromodulin. A significantly decreased expression of fibronectin was seen in plaques. As the main constituents in fibrotic tissues are collagen and fibronectin, the decreased expression of fibronectin will contribute to a different composition of the extracellular matrix in plaque. Differences in fibronectin mRNA expression have also been observed between the cord and the nodule in DD [29], whereas no differences were seen in mRNA levels among elastin, decorin, biglycan, and fibromodulin, which is similar to what we observed in PD.