Displaying publications 1 - 20 of 74 in total

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  1. Zulkifli A, Ahmad RE, Krishnan S, Kong P, Nam HY, Kamarul T
    Tissue Cell, 2023 Jun;82:102075.
    PMID: 37004269 DOI: 10.1016/j.tice.2023.102075
    Tendon injuries account up to 50% of all musculoskeletal problems and remains a challenge to treat owing to the poor intrinsic reparative ability of tendon tissues. The natural course of tendon healing is very slow and often leads to fibrosis and disorganized tissues with inferior biomechanical properties. Mesenchymal stem cells (MSC) therapy is a promising alternative strategy to augment tendon repair due to its proliferative and multilineage differentiation potential. Hypoxic conditioning of MSC have been shown to enhance their tenogenic differentiation capacity. However, the mechanistic pathway by which this is achieved is yet to be fully defined. A key factor involved in this pathway is hypoxia-inducible factor-1-alpha (HIF-1α). This review aims to discuss the principal mechanism underlying the enhancement of MSC tenogenic differentiation by hypoxic conditioning, particularly the central role of HIF-1α in mediating activation of tenogenic pathways in the MSC. We focus on the interaction between HIF-1α with fibroblast growth factor-2 (FGF-2) and transforming growth factor-beta 1 (TGF-β1) in regulating MSC tenogenic differentiation pathways in hypoxic conditions. Strategies to promote stabilization of HIF-1α either through direct manipulation of oxygen tension or the use of hypoxia mimicking agents are therefore beneficial in increasing the efficacy of MSC therapy for tendon repair.
    Matched MeSH terms: Tendons/metabolism
  2. Zaidi, M., Azuhairy, Chan, C.K.,
    Malays Orthop J, 2008;2(1):8-11.
    MyJurnal
    This study evaluates the outcome of anterior cruciate ligament (ACL) reconstruction with arthroscopy using the bone–patella tendon-bone method. We performed this procedure in 24 patients with the average age of 33.1 years (range: 17-51 years ) between 2004 and 2006. Sixteen of the 24 patients were available for evaluation using the Lysholm Knee Score and International Knee Documentation Committee (IKDC) system. Based on the Lysholm score, there was a statistically significant improvement in knee function when comparing pre- and post-surgical scores (p
    Matched MeSH terms: Tendons
  3. Yong MW, Yusof N, Rampal L, Arumugam M
    J Hand Surg Asian Pac Vol, 2017 Dec;22(4):484-489.
    PMID: 29117832 DOI: 10.1142/S021881041750054X
    BACKGROUND: Palmaris Longus is being widely used in reconstructive, plastic and cosmetic surgeries due to its long tendon. It is the most readily available source for tendon grafting. The objective of this study was to determine the prevalence of absence of Palmaris Longus and its association with gender, hand dominance and absence of FDS (flexor digitorum superficialis) tendon to little finger among Malay population.

    METHODS: An analytical cross sectional study design was used and a self-administered proforma was distributed for data collection. 1239 Malay secondary school children in Putrajaya were tested for absence of Palmaris Longus using Schaffer's test. 4 additional tests namely Thompson's test, Mishra's test I, Mishra's test II and Pushpakumar's 'two-finger sign' method were used to confirm its absence in respondents with negative Schaffer's test. Function of Flexor Digitorum Superficialis tendon to little finger was determined by flexing PIP of little finger while hyperextend the other fingers.

    RESULTS: The prevalence of absence of Palmaris Longus was 11.7%. Left side absence of Palmaris Longus was much common. There was a significant association between absence of Palmaris Longus with gender in which female had higher prevalence of absence of Palmaris Longus than male.

    CONCLUSIONS: In conclusion, the prevalence of absence of Palmaris Longus in Malay population was lower than Indian but higher than Chinese population. Females had higher prevalence of absence of Palmaris Longus and no association can be found with hand dominance and absence of Flexor Digitorum Superficialis tendon to little finger.

    Matched MeSH terms: Tendons/abnormalities*
  4. Yong CK
    Med J Malaysia, 2006 Dec;61 Suppl B:45-7.
    PMID: 17605180
    This is a report of a case of peroneal subluxation caused by peroneus quartus, a supernumerary muscle in the peroneal muscle group. Peroneus quartus' anatomy and its clinical relevance in lateral ankle pain, swelling and peroneal subluxation are described. It may be accurately diagnosed by peroneal tendoscopy. The technical note of this procedure is also described.
    Matched MeSH terms: Tendons/pathology; Tendons/surgery*
  5. Yeap JS, Birch R, Singh D
    Int Orthop, 2001;25(2):114-8.
    PMID: 11409449
    Twelve patients with drop-foot secondary to sciatic or common peroneal nerve palsy treated with transfer of the tibialis posterior tendon were followed-up for a mean of 90 (24-300) months. In 10 patients the results were 'excellent' or 'good'. In 11 patients grade 4 or 5 power of dorsiflexion was achieved, although the torque, as measured with a Cybex II dynamometer, and generated by the transferred tendon, was only about 30% of the normal side. Seven patients were able to dorsiflex their foot to the neutral position and beyond. The results appeared to be better in men under 30 years of age with common peroneal palsies. A painful flatfoot acquired in adulthood does not appear to be a significant long-term complication despite the loss of a functioning tibialis posterior tendon.
    Matched MeSH terms: Tendons/transplantation*
  6. Yammine K, Erić M
    Surg Radiol Anat, 2020 Mar;42(3):259-267.
    PMID: 31741040 DOI: 10.1007/s00276-019-02381-x
    INTRODUCTION: The tendon of the palmaris longus is commonly used as a tendon graft in many reconstructive surgeries. Easy to access and at proximity to the hand, the palmaris longus tendon is considered as the optimal tendon source for hand reconstructive surgery. However, and besides its inconsistency, the size of the palmaris longus tendon is reported to show variability. The aim of this study is to look for the surgical adequacy of the palmaris longus tendon by conducting a quantitative synthesis on its length and width in human populations and its correlation with the forearm length.

    METHODS: Twenty-four studies met the inclusion criteria including 1761 cadaveric limbs.

    RESULTS: The results were as following: (a) the mean palmaris longus tendon length was of 13.9 ± 2.6 cm, (b) the mean ratio palmaris longus tendon length/forearm length was of 0.545 ± 0.06, (c) the weighted correlation value was of 0.686, and (d) the mean palmaris longus tendon width was of 4.0 ± 1.7 mm. Only five studies reported a palmaris longus tendon length of more than 15 cm. The palmaris longus tendon length was shown to vary between ancestries; the Japanese had the shortest while Malaysian the longest palmaris longus tendons. All studies but one reported a palmaris longus tendon mean width of more than 3 mm where the minimal mean palmaris longus tendon width was of 2.5 mm.

    CONCLUSION: While the requested length depends on the recipient site and/or type of reconstructive surgery, the palmaris longus tendon often met the required diameter for grafting. Our review demonstrated that while palmaris longus length varies between ancestries, its width is often adequate for grafting. In addition, the forearm length could be a good predictor of palmaris longus tendon length; such correlation could assist surgeons when planning to use palmaris longus tendon as a graft source.

    Matched MeSH terms: Tendons/anatomy & histology*; Tendons/transplantation
  7. Yahya S, Moghavvemi M, Almurib HA
    Sensors (Basel), 2012;12(6):6869-92.
    PMID: 22969326 DOI: 10.3390/s120606869
    Research on joint torque reduction in robot manipulators has received considerable attention in recent years. Minimizing the computational complexity of torque optimization and the ability to calculate the magnitude of the joint torque accurately will result in a safe operation without overloading the joint actuators. This paper presents a mechanical design for a three dimensional planar redundant manipulator with the advantage of the reduction in the number of motors needed to control the joint angle, leading to a decrease in the weight of the manipulator. Many efforts have been focused on decreasing the weight of manipulators, such as using lightweight joints design or setting the actuators at the base of the manipulator and using tendons for the transmission of power to these joints. By using the design of this paper, only three motors are needed to control any n degrees of freedom in a three dimensional planar redundant manipulator instead of n motors. Therefore this design is very effective to decrease the weight of the manipulator as well as the number of motors needed to control the manipulator. In this paper, the torque of all the joints are calculated for the proposed manipulator (with three motors) and the conventional three dimensional planar manipulator (with one motor for each degree of freedom) to show the effectiveness of the proposed manipulator for decreasing the weight of the manipulator and minimizing driving joint torques.
    Matched MeSH terms: Tendons
  8. Wazir NN, Kareem BA
    Singapore Med J, 2011 Jan;52(1):47-9.
    PMID: 21298241
    Cervical spondylotic myelopathy (CSM) represents a spectrum of pathologies with progressive compression of the spinal cord. The clinical signs and symptoms play a key role in diagnosis. The characteristic hand myelopathy signs are of significant clinical importance. The aim of this descriptive study was to report a relatively easy to elicit new hand myelopathy sign. The basis for this is finger and wrist flexor disinhibition, which is used for the spinal specificity of cord compression at or above the C5/6 level.
    Matched MeSH terms: Tendons/pathology
  9. Vosoughi AR, Erfani MA
    Malays Orthop J, 2018 Mar;12(1):57-59.
    PMID: 29725517 DOI: 10.5704/MOJ.1803.014
    Peroneal tendon dislocation in association with medial malleolus fracture is a very rare traumatic injury to the ankle. A 19-year old male patient was referred after injury sustained in a motorcycle accident with car, with concomitant traumatic peroneal tendon dislocation and medial malleolus fracture. The possible mechanism of this unusual injury could have been sudden external rotation force to the pronated foot in full dorsiflexed position of the ankle. Diagnosis of peroneal tendon subluxation or dislocation should be carefully evaluated in patients with single medial malleolus fracture.
    Matched MeSH terms: Tendons
  10. Vollala VR, Nagabhooshana S, Bhat SM, Potu BK, Rodrigues V, Pamidi N
    Rom J Morphol Embryol, 2009;50(1):129-35.
    PMID: 19221659
    During routine dissection classes to undergraduate medical students, we have observed some important anatomic variations in the right upper limb of a 45-year-old cadaver. The anomalies were superficial ulnar artery, persistent median artery, variant superficial palmar arch, third head for biceps brachii, accessory head for flexor pollicis longus, variant insertion of pectoralis major, absence of musculocutaneous nerve, coracobrachialis muscle supplied by lateral root of median nerve and anomalous branching of median nerve in arm and forearm. Although there are individual reports about these variations, the combination of these variations in one cadaver has not previously been described in the literature consulted. Awareness of these variations is necessary to avoid complications during radiodiagnostic procedures or surgeries in the upper limb.
    Matched MeSH terms: Tendons/abnormalities; Tendons/pathology
  11. Thwin SS, Fazlin F, Than M
    Singapore Med J, 2014 Jan;55(1):37-40.
    PMID: 24452976
    Multiple tendons of the abductor pollicis longus (APL) in the anatomical snuffbox of the wrist can lead to the development of de Quervain's syndrome, which is caused by stenosing tenosynovitis. A cadaveric study was performed to establish the variations present in the tendons of the anatomical snuffbox in a Malaysian population, in the hope that this knowledge would aid clinical investigation and surgical treatment of de Quervain's tenosynovitis.
    Matched MeSH terms: Tendons/anatomy & histology*
  12. Tan, S.L., Selvaratnam, L., Ahmad, T.S.
    JUMMEC, 2015;18(2):1-14.
    MyJurnal
    Tendon is a dense connective tissue that connects muscle to bone. Tendon can adapt to mechanical forces passing across it, through a reciprocal relationship between its cellular components (tenocytes and tenoblasts) and the extracellular matrix (ECM). In early development, the formation of scleraxis-expressing tendon progenitor population in the sclerotome is induced by a fibroblast growth factor signal secreted by the myotome. Tendon injury has been defined as a loss of cells or ECM caused by trauma. It represents a failure of cells and matrix adaptation to mechanical loading. Injury initiates attempts of tendon to repair itself, which has been defined as replacement of damaged or lost cells and ECM by new cells or new matrices. Tendon healing generally consists of four different phases: the inflammatory, proliferation, differentiation and remodelling phases. Clinically, tendons are repaired with a variety of surgical techniques, which show various degrees of success. In order to improve the conventional tendon repair methods, current tendon tissue engineering aims to investigate a repair method which can restore tissue defects with living cells, or cell based therapy. Advances in tissue engineering techniques would potentially yield to a cell-based product that could regenerate functional tendon tissue.
    Matched MeSH terms: Tendons
  13. Tan SL, Ahmad TS, Ng WM, Azlina AA, Azhar MM, Selvaratnam L, et al.
    PLoS One, 2015;10(11):e0140869.
    PMID: 26528540 DOI: 10.1371/journal.pone.0140869
    To date, the molecular signalling mechanisms which regulate growth factors-induced MSCs tenogenic differentiation remain largely unknown. Therefore, a study to determine the global gene expression profile of tenogenic differentiation in human bone marrow stromal cells (hMSCs) using growth differentiation factor 5 (GDF5) was conducted. Microarray analyses were conducted on hMSCs cultures supplemented with 100 ng/ml of GDF5 and compared to undifferentiated hMSCs and adult tenocytes. Results of QuantiGene® Plex assay support the use and interpretation of the inferred gene expression profiles and pathways information. From the 27,216 genes assessed, 873 genes (3.21% of the overall human transcriptome) were significantly altered during the tenogenic differentiation process (corrected p<0.05). The genes identified as potentially associated with tenogenic differentiation were ARHGAP29, CCL2, integrin alpha 8 and neurofilament medium polypeptides. These genes, were mainly associated with cytoskeleton reorganization (stress fibers formation) signaling. Pathway analysis demonstrated the potential molecular pathways involved in tenogenic differentiation were: cytoskeleton reorganization related i.e. keratin filament signaling and activin A signaling; cell adhesion related i.e. chemokine and adhesion signaling; and extracellular matrix related i.e. arachidonic acid production signaling. Further investigation using atomic force microscopy and confocal laser scanning microscopy demonstrated apparent cytoskeleton reorganization in GDF5-induced hMSCs suggesting that cytoskeleton reorganization signaling is an important event involved in tenogenic differentiation. Besides, a reduced nucleostemin expression observed suggested a lower cell proliferation rate in hMSCs undergoing tenogenic differentiation. Understanding and elucidating the tenogenic differentiation signalling pathways are important for future optimization of tenogenic hMSCs for functional tendon cell-based therapy and tissue engineering.
    Matched MeSH terms: Tendons/cytology; Tendons/metabolism*
  14. Sinnasamy, Shankari, B Mohd Shakir, Vijayashingam, Naveen, Mustaqim Afifi @ Apipi, Prakash, Doddaballapur Ramaiah
    MyJurnal
    Reconstruction of hand injury is the challenge for the surgeon especially in rural settings. This case report is about a 10-year-old boy, who sustained large degloving wound of dorsum of right hand with extensor tendon injury following a road traffic accident. We performed a staged abdominal flap with tensor fascia lata graft for tendon reconstruction as microsurgery facilities was not available. Post-operatively he was subjected to physiotherapy and he has a functional right hand. This case report aimed to highlight abdominal flap as reconstructive option as compared to skin grafting which is reproducible with limited resources. Besides that, overall exposure to all surgical options is of paramount importance in the training of trainees to equip them with skills to serve in rural setting.
    Matched MeSH terms: Tendons
  15. Singh, S., Choon, S.K., Tai, C.C.
    Malays Orthop J, 2008;2(2):34-36.
    MyJurnal
    We describe herein a modified technique for reconstruction of chronic rupture of the quadriceps tendon in a patient with bilateral total knee replacement and distal realignment of the patella. The surgery involved the application of a Dacron graft and the ‘double eights’ technique. The patient achieved satisfactory results after surgery and we believe that this technique of reconstruction offers advantages over other methods.
    Matched MeSH terms: Tendons
  16. Singh PKM, Noor MIM, Jaafar R, Ahmad A, Mohamad I
    Medeni Med J, 2021;36(1):75-79.
    PMID: 33828894 DOI: 10.5222/MMJ.2021.37539
    Retropharyngeal calcific tendonitis (RCT) is an aseptic inflammatory process of the superior oblique tendons of the longus colli muscle caused by the deposition of calcium hydroxyapatite crystals. We reported a 23-year-old woman who presented with a sudden onset of neck pain with odynophagia after waking up from sleep. Physical examination showed paracervical point tenderness with limited neck movement in all directions. Prior to surgery, further imaging was requested to aid in diagnosis, which in turn revealed RCT. It is important to be aware that RCT presentation may mimic other severe conditions such as retropharyngeal space abscess or meningitis.
    Matched MeSH terms: Tendons
  17. Shipra P, Srijit D
    Acta Medica (Hradec Kralove), 2007;50(3):213-215.
    PMID: 28795947 DOI: 10.14712/18059694.2017.85
    Abductor pollicis longus (APL) muscle is known to exhibit different variations with respect to its attachments. Various studies have reported the splitting of the APL muscle. Comparative anatomical findings of split insertion of APL is commonly found in chimpanzees, gorillas and gibbons. In the present study, we describe an anomalous APL muscle, which originated from the posterior surface of the shaft of the radius and ulna and traversed a course deep to the extensor retinaculum. Interestingly, immediately after emerging form the deeper aspect of extensor retinaculum, the thin tendon of the APL muscle continued again as a muscular belly in relation to the dorsolateral part of the 1st metacarpal bone, to end as a tendon with its attachment to the base of the proximal phalanx. Such an unusual variation of APL with its attachment into proximal phalanx is a rare finding and may be of importance in altering the mechanics of the thumb during abduction. The clinical significance of such an anatomical variation of APL may be important during reconstructive surgeries involving thumb and also of academic interest.
    Matched MeSH terms: Tendons
  18. Shalimar, A., Jamari, S., Abdul Halim, A.R., Roohi, S.A., Naicker, A.S., Sharaf, I.
    Malays Orthop J, 2007;1(1):34-38.
    MyJurnal
    Domestic paediatric hand injuries make up the bulk of overall paediatric hand injuries. This is a retrospective study of domestic paediatric hand injuries admitted into an urban hospital that required surgical intervention. The most common injuries sustained were tendon injuries (24%), total amputations (20%) and lacerations wounds (16%). Accordingly the most common surgical interventions were tendon repairs (28%), toilet suturing (24%) and refashioning (20%). Parents and care providers need to be more vigilant and careful when supervising children including ensuring the safe storage of dangerous items. Sharp items may require additional safety features and warning labels.
    Matched MeSH terms: Tendons
  19. Shalimar A, Nor-Hazla MH, Arifaizad A, Jamari S
    Malays Orthop J, 2015 Jul;9(2):41-46.
    PMID: 28435609 MyJurnal DOI: 10.5704/MOJ.1507.011
    Splinting of the wrist after carpal tunnel release (CTR) has been practised by many surgeons especially in North America. The main reason was to prevent possible adverse events of bowstringing of flexor tendons and the median nerve, pillar pain, entrapment of the median nerve in scar tissue and wound dehiscence. Studies on the effect of splinting after standard CTR have had dismal results. The duration of splinting in standard CTR has been either too long (for 2-4 weeks) or too short (48 hours only). The aim of our study was to compare the effects of post-operative splinting for a duration of one week with no splinting.

    METHODS: All 30 of our patients underwent a standardized limited open CTR by a designated surgeon. Post operatively, they were randomized into a splinted (n=16) and a nonsplinted (n=14) group. The splint was kept for a week. Patients were reviewed at regular intervals of one week, two months and six months. At each follow up, these patients were clinically assessed for the following outcome measures: VAS (visual analogue score), 2PD (two-point discrimination), pinch grip, grip, Abductor Pollicis Brevis (APB)) power and completion of the Boston questionnaire.

    RESULTS: All patients presented with significant improvement in the postoperative evaluation in the analyzed parameters within each group. However, there was no significant difference between the two groups for any of the outcome measurements at sequential and at final follow-up.

    CONCLUSION: We conclude that wrist splinting in the immediate post-operative period has no advantage when compared with the unsplinted wrist after a limited open carpal tunnel release.

    Matched MeSH terms: Tendons
  20. Sem SH, Omar MF, Muhammad Nawawi RF
    Cureus, 2019 May 02;11(5):e4588.
    PMID: 31309013 DOI: 10.7759/cureus.4588
    Irreducible closed dorsal dislocation of distal interphalangeal (DIP) joint of the finger is a rare injury. The causes of irreducibility of the DIP joint are volar plate interposition, entrapment of flexor digitorum profundus tendon behind the head of middle phalanx, and buttonholing of the middle phalanx head through the volar plate or flexor tendon. Open reduction with a volar approach is recommended with the advantages of better wound healing, ease of releasing entrapped structures, and possibilities of a volar plate, collateral ligaments, and/or flexor tendon repair. We report a case of irreducible dorsal dislocation of left ring finger DIP joint secondary to volar plate interposition treated successfully with open reduction.
    Matched MeSH terms: Tendons
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