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The "fascial system" has been defined as a fascial network involved in functional aspects such as force transmission. The fascial system comprises the superficial and deep fasciae which are connected through skin ligaments, also known as retinacula, providing a continuity from the skin to the muscular plane (See Figure). Indeed, superficial and deep fascia roles in clinical disorders have been shown to reflect their structures. Specifically, the superficial fascia has been described anatomically as an irregular multilamellar structure of interconnected substrates with islets of fat cells. Meanwhile, for example, the deep aponeurotic fascia consists of multilayered structures of dense and loose connective tissues, where collagen fibers follow specific directions. Since the properties of superficial and deep fasciae mimic their structural organization, the biomechanical characterization of these tissues is key to understanding how they influence each other. Despite the clinical impact of these arguments, to date, the literature is still poor in data comparing different substrates of the fascial system through mechanical tests. Therefore, the aim of this work is to investigate this open topic by presenting the biomechanical properties of both superficial and deep fasciae. The study highlights how these tissues have different biomechanical properties in relation to their specific structures and functions. These results have a direct impact in the medical field such as in the surgical treatment of soft tissue repair or reconstruction, as well as in rehabilitation intervention (e.g., manual treatment). [ABSTRACT FROM AUTHOR]

The article focuses on histotopographic characterization of the suprapatellar fat pad (SFP) in the anterior knee and its comparison to the infrapatellar fat pad (IFP) in the absence of osteoarthritis (OA), providing insights into their morphological differences.

A constitutive framework is provided for the characterization of the mechanical behavior of colonic tissues, as a fundamental tool for the development of numerical models of the colonic structures. The constitutive analysis is performed by a multidisciplinary approach that requires the cooperation between experimental and computational competences. The preliminary investigation pertains to the review of the tissues histology. The complex structural configuration of the tissues and the specific distributions of fibrous elements entail the nonlinear mechanical behavior and the anisotropic response. The identification of the mechanical properties requires to perform mechanical tests according to different loading situations, as different loading directions. Because of the typical functionality of colon structures, the tissues mechanics is investigated by tensile tests, which are performed on taenia coli and haustra specimens from fresh pig colons. Accounting for the histological investigation and the results from the mechanical tests, a specific hyperelastic framework is provided within the theory of fiber-reinforced composite materials. Preliminary analytical formulations are defined to identify the constitutive parameters by the inverse analysis of the experimental tests. Finite element models of the specimens are developed accounting for the actual configuration of the colon structures to verify the quality of the results. The good agreement between experimental and numerical model results suggests the reliability of the constitutive formulations and parameters. Finally, the developed constitutive analysis makes it possible to identify the mechanical behavior and properties of the different colonic tissues. © 2013 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 102A: 1243-1254, 2014. [ABSTRACT FROM AUTHOR]

The article informs that osteoarthritis (OA) is a degenerative disorder and a major cause of pain and disability worldwide. For long time it has been considered a cartilage disease and currently it is best recognized as a whole joint disease whose pathogenesis is not fully understood. Study evidence shows that age affects the infrapatellar pad tissue causing a variation in extracellular matrix proteins' content and specific cells' morphometry.

Osteoarthritis (OA) is one of the most common joint disorders. Evidence suggests that the infrapatellar fat pad (IFP) is directly involved in OA pathology. However, a comparison between OA versus non-OA IFP is still missing. Thus, the aim of this study was to compare IFP molecular, adipocytes and extracellular matrix characteristics of patients affected by OA, and patients undergoing anterior cruciate ligament (ACL) reconstruction. We hypothesized that not only inflammation but also changes in adipocytes and extracellular matrix (ECM) composition might be involved in OA pathogenesis. Fifty-three patients were enrolled. IFP biopsies were obtained, evaluating: (a) lymphocytic infiltration and vascularization; (b) adipocytes area and number; (c) adipo-cytokines and extracellular matrix gene expression levels; (d) IL-6 and VEGF protein production; (e) collagen fibers distribution. OA IFP was more inflamed and vascularized compared to ACL IFP. OA IFP adipocytes were larger and numerically lower (1.3-fold) than ACL IFP adipocytes. An increase of gene expression of typical white adipose tissue genes was observed in OA compared to ACL IFP. Collagen-types distribution was different in the OA IFP group compared to controls, possibly explaining the change of the biomechanical characteristics found in OA IFP. Statistical linear models revealed that the adipocyte area correlated with BMI in the OA group. In conclusion, inflammation and fibrotic changes of OA IFP could represent novel therapeutic targets to counteract OA. [ABSTRACT FROM AUTHOR]

The suprapatellar fat pad (SFP) is located above the patella and behind the suprapatellar joint recess with the function of increasing the congruency of the extensor mechanism. Osteoarthritis SFP has been demonstrated to produce high amount of inflammatory molecules and to be more fibrous than subcutaneous adipose tissue in osteoarthritis (OA) patients. The aim of this study was to analyze 1. the morphological characteristics of the SFP compared to that of the infrapatellar fat pad (IFP) in normal subjects; 2. the magnetic resonance (MR) volumetric characteristics of the IFP and the SFP in non-OA controls compared to moderate and endstage OA patients. Five specimens of SFP were sampled from bodies of the donation program of the University of Padova without history of OA. The SFP consisted of white adipose tissue, of lobular type, with lobules delimited by thin connective septa. Forty-four MR images were collected: a) 17 control; b) 15 patients with moderate OA ; and c) 12 patients with end-stage OA. Volume, depth, femoral and tibial arch lengths of IFP were quantified. The SFP volume, oblique, antero-posterior and, cranio-caudal lengths were determined. A decrease of IFP volume, depth, femoral, and tibial arch lengths in moderate and end-stage OA compared to controls were observed. A difference in IFP hypointense signal was found between groups. No differences were found in SFP characteristics between the groups. In controls and moderate OA patients, correlations were found among the different MRI characteristics of both IFP and SFP, while in the end-stage OA group correlations were found only in SFP. Differences of the IFP MRI morphometric characteristics between the groups analyzed supports an important role of IFP in OA pathology and progression. On the contrary, no differences were highlighted in SFP analysis suggesting that this fat pad is not clearly involved in OA, probably due to its peculiar localization and different function. [ABSTRACT FROM AUTHOR]

The infrapatellar fat pad (IFP) is an intracapsular, but extrasynovial structure, located between the patellar tendon, femoral condyles and tibial plateau. We have recently described the microscopic orgnisation of the IFP, which consists of white adipose tissue (fibroadipose, lobular type), organised in lobuli delimited by thin connective septa. The aim of the study is to describe the sonoanatomical features of IFP in subjects without knee pathology during flexo-extension movements. Twentyfour volunteers subjects with no history of knee diseases (5M, 19F, mean age: 45yo)were analysed. Examinations was performed using high-resolution grey-scale ultrasound. The mean area of the deepest recognisable adipose chamber in extension were 0,12 and in flexion 0,19 mm2, and the circumference were in extension 1,36 and in flexion 1,19 mm. The area of the closest adipose chamber to the patellar tendon were in extension 0,29 and flexion 0,12 mm2(p<0.01), whereas the circumference were in extension 2,67 and in flexion 1,56 mm(p<0.01). Our study demonstrated that the normal IFP is constituted by largest lobuli in the superficial part(p<0.01) that become flattened in flexion movement. The deep lobuli are smaller and do not change their morphology. Our study demonstrated that ultrasound is useful to analyse the dynamic changes of the IFP. [ABSTRACT FROM AUTHOR]

Plantar adipose tissue is a connective tissue whose structural configuration changes according to the foot region (rare or forefoot) and is related to its mechanical role, providing a damping system able to adsorb foot impact and bear the body weight. Considering this, the present work aims at fully describing the plantar adipose tissue's behaviour and developing a proper constitutive formulation. Unconfined compression tests and indentation tests have been performed on samples harvested from human donors and cadavers. Experimental results provided the initial/final elastic modulus for each specimen and assessed the non-linear and time-dependent behaviour of the tissue. The different foot regions were investigated, and the main differences were observed when comparing the elastic moduli, especially the final elastic ones. It resulted in a higher level for the medial region (89 ± 77 MPa) compared to the others (from 51 ± 29 MPa for the heel pad to 11 ± 7 for the metatarsal). Finally, results have been used to define a visco-hyperelastic constitutive model, whose hyperelastic component, which describes tissue non-linear behaviour, was described using an Ogden formulation. The identified and validated tissue constitutive parameters could serve, in the early future, for the computational model of the healthy foot.

Urinary incontinence is still an underestimated problem due to its anatomical complexity and social taboo. Most of the time, it is believed to affect predominantly the elderly female population, and the literature still lacks data on its presence in the younger and male populations. Its relationship with other pelvic floor dysfunctions (PFDs) and sport activity remains an open topic. Thus, the present study surveyed 342 subjects of both genders, ranging from 18 to 39 y/o and with different sport activity levels, to understand the prevalence of PFDs (such as haemorrhoids, anal fissures, involuntary urinary/faecal leakage, and urgency). The results also showed a significative prevalence in younger, sporty, and male people. Approximately one third of the population had urinary incontinence mostly during stress activities (sport activity: 17%, cough/sneeze: 13%). The statistical analysis confirmed a higher prevalence in the cases of a light (32%) and intense (41%) sport activity level and a protective role of sport if practiced between 5 and 10 h/week, with bodybuilding/CrossFit and running seeming to be the riskiest sports. The relationship with the other PFDs showed a statistically significant dependence with most of them, confirming that urinary incontinence cannot be considered a separate problem from the other PFDs.

Introduction: This work reports a set of results on the mechanical response of foot plantar tissues in healthy and degenerative conditions during the gait cycle, by means of a computational approach., Methods: A three dimensional finite element model of the foot was developed starting from the analysis of biomedical images. Different constitutive models were defined to interpret the mechanical response of the biological tissues. In particular, a specific visco-hyperelastic constitutive formulation was provided for foot plantar soft tissue considering the general features of tissue mechanics. Degenerative phenomena induce histomorphological alterations and modification of the mechanical properties, as stiffening and lower damping capabilities. Different constitutive parameters for healthy and degenerative conditions were identified by the inverse analysis of experimental data from mechanical tests., Results: The three dimensional numerical model interprets the capability of the plantar soft tissue to act under mechanical actions in different conditions during the phases of the gait cycle., Conclusion: Numerical results highlight aspects of the different stress and strain distributions at the heel strike and the midstance of the healthy and degenerative conditions., Level of Evidence: V.