Soft Tissue: Composition, Mechanisms of Injury and Repair

182 Pages·2012·3.786 MB·English

by  Antonio J. Chavez Ruiz, Jose M. Alvarez Mendoza

HUMAN ANATOMY AND PHYSIOLOGY

S T
OFT ISSUE

C , M
OMPOSITION ECHANISMS
I R
OF NJURY AND EPAIR
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HUMAN ANATOMY AND PHYSIOLOGY

S T
OFT ISSUE

C , M
OMPOSITION ECHANISMS
I R
OF NJURY AND EPAIR

ANTONIO J. CHAVEZ RUIZ
AND
JOSE M. ALVAREZ MENDOZA
EDITORS

Nova Science Publishers, Inc.
New York
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Contents

Preface vii
Chapter I Soft Tissue Biomechanics of Diabetic Foot Ulcers 1
Chi-Wen Lung and Yih-Kuen Jan
Chapter II Cellular and Physiological Soft Tissue Response
in Hip Arthroplasty and Its Management 33
Shahril R. Shaarani, Tidi M. Hassan, Ann Igoe,
Gavin McHugh, and Denis Collins
Chapter III A Histologic Study of Peri-Implant Soft Tissues:
Orthodontic’s Anchorage Miniscrews 67
Farid Bourzgui, Mourad Sebbar, Samir Diouny,
Zakaria Bentahar, and Farid El Quars
Chapter IV Connecting Tissue Injury, Temperature
and Mechanical Properties 105
Wei-Hsuan Huang and Chee-Kong Chui
Chapter V Soft Tissue: Magnetic Resonance Imaging Findings
of Myopathies 125
Daphne J. Theodorou, Stavroula J. Theodorou,
and Yousuke Kakitsubata
vi Contents
Chapter VI Soft Tissue Behavior After Mandibular Syphysis
Bone Graft Harvesting 147
Claudio Ferreira Nóia, Rafael Ortega Lopes,
Claudinei Ferreira Nóia,
and José Marcelo Vargas Pinto
Index 157
Preface

Soft tissue refers to tissues that connect, support, or surround other
structures and organs of the body, not being bone. Soft tissue includes tendons,
ligaments, fascia, skin, fibrous tissues, fat, and synovial membranes (which are
connective tissue), and muscles, nerves and blood vessels (which are not
connective tissue). In this book, the authors present current research in the
study of the composition, mechanisms of injury and repair of soft tissue.
Topics discussed include the soft tissue biomechanics of diabetic foot ulcers;
cellular and physiological soft tissue response in hip arthroplasty; peri-implant
soft tissues in orthodontic anchorage; connecting tissue injuries and mechan-
ical properties; MRI findings of myopathies in soft tissue; and soft tissue
behavior after mandibular symphysis bone graft harvesting.
Chapter I - Diabetic foot ulcers are among the most significant comp-
lications in people with diabetes mellitus (DM). The number of diabetics is
estimated to double by 2030. It is clear that diabetic foot ulcers are a top public
healthcare issue. Although the etiology of diabetic foot ulcers remains much
unknown, it is widely accepted that repetitive high plantar pressure during
walking may initiate the foot ulcer development. Chapter 1, reviews the effects
of DM on the changes of composition and structure of the soft tissues of the
diabetic foot and how these factors cause abnormally high plantar pressure
during walking. Also reviewed are the research methods used to quantify
alterations of soft tissue mechanical properties of the diabetic foot. The
orthotic devices used in the reduction of peak plantar pressure and healing of
diabetic foot ulcers are introduced.
Chapter II - Metallic and non-metallic orthopaedic prostheses have been
used widely to replace painful, stiff and mechanically disadvantaged hips.
Though the biomaterials used in these implants have been generally
considered as inert, adverse tissue reactions in metal-on-polyethylene and
viii Antonio J. Chavez Ruiz, and Jose M. Alvarez Mendoza
more recently metal-on-metal hip arthroplasties have been described since the
early 1970s. This can result in premature failure of these implants and need for
revision surgery. Recently, a specific implant has been recalled internationally.
There has been a worldwide increase in the rate of revision surgery for hip
resurfacing arthroplasty due to adverse soft tissue reactions. Inflammatory
pseudotumours are a well-described clinical complication of metal-on-metal
and recent evidence has suggested similar complications for non-metal-on-
metal hip implants. Metal hypersensitivity has been characterized by a pre-
dominantly lymphocytic immune response and causes soft-tissue changes such
as effusions, pseudotumours and osteolysis. Radiological and histopatho-
logical studies have characterized this phenomenon with inflammation, with
an emphasis on metal debris as integral to the pathogenesis of this phenom-
enon. Also, the carcinogenic properties of cadmium, chromium, cobalt, beryl-
lium and other metals utilized in orthopaedic devices have been proven in
animal models. This book chapter will discuss the biologic and physical
effects of hip athroplasty on soft tissue including pseudotumours and hip
arthroplasty-related malignancies.
Chapter 3 - For the orthodontist, orthodontic anchorage has always been a
challenge because of tooth movement under the influence of forces applied to
them. The use of conventional anchorage (elastic and removable extraoral
face-bow) has certain drawbacks for the practitioner and the patient, including
full cooperation on the part of that, some degree of discomfort and undesirable
side effects. The minimplant can be used for both horizontal and vertical
orthodontic traction; they are small enough to fit between the mesial and distal
roots of the molars for their intrusion. Placed in the palatal area, these
miniscrews can produce sufficient anchorage for molar distalization. Note that
miniscrews are too small to cause irreversible bone damage. They can be
submitted at any time when the orthodontist or the patient wants and bone
healing after removal is done without any incident. These anchoring devices
have successes but also failures with particular problems of soft tissue
inflammation, problems with patient comfort, the difficulties associated with
the development of mechanics and orthodontic appliance on them (springs,
chains...), stability problems of anchoring device, and removal. Experimental
studies, especially on the animal model, were able to study the various
functional and morphological responses of both implants used for orthodontic
anchorage (surface geometry), as the surrounding tissue (especially bone
surrounding the implant). Various studies have investigated the histological,
histo-morphometric and microscopic bone-implant interface. However, the
different reactions of the peri-implant tissues, especially soft tissue, are not yet