M bejar-chapa, n rossi, n king, d kostyra, m hussey, k mcguire, m randolph, r redmond, j winograd

Peripheral nerve injuries affect 13–23 per 100,000 people annually in the U.S. and often result in motor and sensory deficits. Microsurgical suture repair (SR) is the standard treatment but is technically challenging and associated with complications. Photochemical tissue bonding (PTB), which uses light and a photoactivated dye to bond collagenous tissues, offers a promising alternative. We compared PTB with commercially available collagen membranes for SR and PTB using cryopreserved human amnion (HAM) in a rat sciatic nerve transection model. In total, 75 Lewis rats underwent nerve repair with one of five methods: SR, PTB-HAM, PTB with commercial collagenous membranes (human amnion monolayer (AML), human amnion–chorion–amnion trilayer (ATL), or swine intestinal submucosa (SIS)). Functional recovery was assessed with walking tracks and the Static Sciatic Index (SSI) at days 30, 60, 90, and 120; histological evaluations at days 30 and 120 examined inflammation, axon density, and fascicle structure. No significant differences in SSI scores were found between groups, though PTB-AML and PTB-SIS improved over time. Histology showed inflammation at day 30 that decreased by day 120. Histomorphometry revealed similar axon regeneration across groups. These results suggest that PTB with commercial membranes is a viable alternative to SR.

Bejar-Chapa M, Rossi N, King NC, Kostyra DM, Hussey MR, McGuire KR, Randolph MA, Redmond RW, Winograd JM. Comparison of Photochemically Sealed Commercial Biomembranes for Nerve Regeneration. Journal of Functional Biomaterials. 2025; 16(2):50. https://doi.org/10.3390/jfb16020050

r rossi, j persinger, n hager, s grogan

Abstract accepted for poster presentation at the 2025 Association for Medical Ultrasound Convention in Orlando, Florida.

The current study was initiated to help inform and validate a parallel study being conducted in the same clinical setting. This was done to elucidate the normative values for routine tendon echo-characteristics, presence/absence of plantaris tendon, microvascular flow (MVF), shear-wave elastography (SWE), Power Doppler (PD), & Young’s moduli in the posterior lower leg & Achilles tendon. Both the parallel study and the current one used the Samsung RS-85 Prestige ultrasound and TeleRay Remote for image review/remote exam observation. Additionally, an EZ Exam protocol was standardized across all users and image acquisition was done exclusively by RMSK-certified staff. Imaging was obtained from the gastroc-soleus complex to the Achilles insertion with stop points at the gastrocnemius, soleus, gastroc-soleus junction (GSJ), avascular zone (AVZ), and calcaneal insertion (CI). Our findings confirmed the sensitivity of MVF at detecting flow over PD. We were able to establish normative values for both SWE and in routine Achilles tendon architecture. Additionally, plantaris tendon prevalence in our study population was found to challenge current existing literature. These findings will inform the normal state of the Achilles tendon complex & its related structures with novel ultrasound values in order to improve the diagnosis and treatment progression of musculoskeletal injuries.

l Pham, l gaudette, m funk, k vogel, m bruneau, k silbernagel, j tam, a tenforde

Achilles tendinopathy (AT) is a prevalent running-related injury affecting up to 52% of runners over their lifetime [1]. Tendinopathy represents a failed healing response from an injury to tendon that results in pain, stiffness, loss of function and limits physical activity [2,3]. Patient reported outcome measures (PROMs) are used to understand impairments from injury and monitor healing. AT symptom severity is commonly assessed using the Victorian Institute of Sport Assessment-Achilles questionnaire (VISA-A) [4]. However, experts propose the need to develop more comprehensive models to understand tendinopathy and characterize factors beyond pain, including psychological manifestations, anxiety, depression, pain catastrophizing and kinesiophobia [3]. The University of Wisconsin Running and Recovery Index (UWRI) and Patient Reported Outcomes Measurements Information System (PROMIS-29) have each been described to measure impact of injury on runners and health features in the general population, respectively [5,6]. To date, research has not described the association of VISA-A with UWRI or sub-domains of PROMIS measures to understand interactions or unique features that may help understand overall impairments in populations with AT. We hypothesize that VISA-A will be associated with UWRI and physical function measures from PROMIS-29. We also expect measures from PROMIS-29 such as anxiety and depression will not be associated with VISA-A and may be present in a subset of this population.

Pham L, Gaudette LW, Funk MM, et al. Association of functional measures to injury severity in runners with Achilles tendinopathy. PM&R. 2025; 17(6): 726-729. doi:10.1002/pmrj.13314

m Crowell, e florkiewicz, j morris, j mason, w pitt, t benedict, k cameron, d goss

Shoulder stabilization surgery is common among military personnel, causing severe acute postoperative pain that may contribute to the development of chronic pain, thereby reducing military readiness. Battlefield Acupuncture (BFA) has shown promise as a non-pharmaceutical intervention for acute postoperative pain. The purpose of this study was to determine the effectiveness of BFA combined with standard physical therapy on pain, self-reported mood, self-reported improvement, and medication use in patients after shoulder stabilization surgery.

The study design was a single-blind, randomized clinical trial, approved by the Naval Medical Center Portsmouth Institutional Review Board and registered with ClinicalTrials.gov (NCT04094246). Ninety-five participants were recruited after shoulder stabilization surgery. Participants were randomized via concealed allocation into a standard physical therapy (PT) group or a group receiving standard PT and BFA. Both groups received standard postoperative pain medication. The BFA intervention followed a standard protocol with the insertion of gold aiguille d’acupuncture emiermanente needles at 5 specific points in the ear. At 4 time points (baseline [24–48 hours], 72 hours, 1 week, and 4 weeks post-surgery), participants reported worst and average pain using a Visual Analog Scale (VAS), self-reported mood using the Profile of Mood States (POMS), self-recorded medication intake between study visits, and self-reported improvement in symptoms using a Global Rating of Change (GROC) Scale. Outcome assessors were blinded to treatment allocation. An alpha level of 0.05 was set a priori. For pain, a mixed-model analysis of variance was used to analyze the interaction effect between group and time. Differences in baseline data, total opioid usage, and pain change scores between groups were analyzed using independent t-tests.

Of the 95 participants enrolled, 7 failed to provide complete study visits after the baseline, leaving 88 patients (43 BFA, 45 control, mean age 21.8 (2.1) years, 23% female). There were no significant group-by-time interactions for VAS worst pain (F = 0.70, P = .54), VAS average pain (F = 0.99, P = .39), the POMS (F = 1.04, P = .37), or GROC (F = 0.43, P = 0.63). There was a significant main effect of time for VAS worst pain (F = 159.7, P < .001), VAS average pain (F = 122.4, P < .001), the POMS (F = 11.4, P < .001), and the GROC (F = 78.5, P < .001). While both groups demonstrated statistically significant and clinically meaningful improvements in pain and self-reported mood over time, BFA did not provide any additional benefit compared to standard physical therapy alone. There was no significant difference in opioid usage between groups at 4 weeks (t = 0.49, P = .63). Finally, both groups also demonstrated statistically significant and clinically meaningful self-reported improvements in function, but again, there was no additional benefit when adding BFA to standard physical therapy.

The results of this study do not support the effectiveness of BFA for postsurgical pain management as there were no significant differences in pain, self-reported mood, self-reported improvement, and medication use between participants who received BFA and those who did not. As this is the only known study of BFA in postsurgical participants, continued research is needed to determine if BFA is effective for pain reduction in that setting.

Michael S Crowell, Erin M Florkiewicz, Jamie B Morris, John S Mason, Will Pitt, Timothy Benedict, Kenneth L Cameron, Donald L Goss, Battlefield Acupuncture Does Not Provide Additional Improvement in Pain When Combined With Standard Physical Therapy After Shoulder Surgery: A Randomized Clinical Trial, Military Medicine, 2025;, usae577, https://doi.org/10.1093/milmed/usae577

n ghag, j tam, r anderson, n cheema

Histological techniques to study muscle are crucial for assessing skeletal muscle health. To preserve tissue morphology, samples are usually fixed in formaldehyde or cryopreserved immediately after excision from the body. Freezing samples in liquid nitrogen, using isopentane as a mediator for efficient cooling, preserves the tissue in its natural state. However, this method is highly susceptible to freeze-fracture artifacts, which alter or destroy tissue architecture. Isopentane is most commonly used in a semi-frozen/liquid state that is visually assessed by the experimenter, which can pose a challenge when freezing multiple tissues at a time or maintaining a consistent temperature. Furthermore, tissue size is also a confounding factor; depending on the size, freezing times can vary. In this study, we compare two different options for using isopentane while cryopreserving tissue. We also present an easy and reproducible method of freezing the soleus tissue of mice using frozen isopentane. This method decreased the occurrence of freeze-fractures by an order of magnitude, to ~4%, whereas the traditional method of cryopreservation resulted in ~56% freeze-fracturing.

Ghag, N., Tam, J., Anderson, R. R. and Cheema, N. (2025). Cryopreservation Method for Preventing Freeze-Fracture of Small Muscle Samples. Bio-protocol 15(1): e5145. DOI: 10.21769/BioProtoc.5145.