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1. Introduction
Rotator cuff tears are commonly seen in the orthopedic surgeon clinic, even more in the shoulder and elbow subspecialized professional practice. Different muscles form the rotator cuff: subscapularis, supraspinatus, infraspinatus, teres minor, and some authors also include the teres major due to its role as an internal rotator. The primary role of the rotator cuff is to stabilize the humeral head regarding the glenoid to allow the deltoid to perform the elevation of the arm. In addition, the rotator cuff externally rotates the glenohumeral joint (infraspinatus and teres minor) and contributes to internal rotation (subscapularis, assisted by the pectoralis major, teres major and latissimus dorsi) [1].
Patients with rotator cuff tears mainly complain of pain during daily living activities but also at night, when the pain can likewise interfere with proper resting. Moreover, a significant tear may impair function, limiting the active range of motion and can be the culprit of premature glenohumeral arthritis. Loss of external rotation, sometimes isolated, may appear in the onset of a posterior rotator cuff tear [1, 2].
Rotator cuff tears are expected after 60 years old. They correspond with the Neer type 3 stage and can be identified in about 20–30% of the patients in this age group. Beyond 80 years old, the ratio of patients suffering from cuff tears rises to more than 60%. However, the symptoms do not correlate with the presence of tears or even the size or retraction. Most patients do not seek advice from an orthopedic surgeon and do not demand a surgical intervention. More than half of the patients where a tear is identified will also suffer from a tear in their contralateral shoulder, especially in those older than 60 years [2, 3, 4, 5, 6, 7].
1.1 Risk factors
Several risk factors have been identified concerning cuff tears. Age, as it was aforementioned, is the most significant. However, others such as smoking, hypercholesterolemia, diabetes, hypo or hyperthyroidism, trauma, scapular dyskinesia and kyphosis also play a critical role in the development and progression of cuff tears [7, 8, 9, 10, 11, 12, 13, 14, 15].
1.2 Classification
A plethora of classifications for rotator cuff tears has been described since the pathology became more interesting for the orthopedic community.
Neer described the evolution of rotator cuff disease in three stages. First, in individuals younger than 40 years, one can observe oedema and hemorrhage in the rotator cuff. In a second stage, the disease evolves in individuals between 40 and 60 years old, and fibrotic and tendinosis phenomena might be observed. Finally, in a third stage, usually, in patients older than 60 years, a tendon rupture is observed. Probably a fourth stage would involve rotator cuff arthropathy, with cephalad migration of the humeral head and degenerative osteoarthritis at the level of the glenoid as well as in the humeral head [15, 16].
Some authors have advocated for a classification based on tear size. Cofield in 1982 described four types of tears: small (<1 cm) medium (1–3 cm) large (3–5 cm) massive (>5 cm) [17].
Bateman also described a four-group classification based on the size: Grade 1 (<1 cm after debridement), Grade 2 (1–3 cm, after debridement), Grade 3 (<5 cm) and Grade 4 (global tear with no cuff left) [18].
Harryman described a classification based on the number of injured tendons. It is commonly accepted in Europe that a complete tear of two or more tendons should be considered massive, and concerns about reparability should arise [19].
Ellman and Gartsman introduced in 1993 a classification differentiating partial-thickness and full-thickness tears. Partial tears were classified in grade 1 (<3 mm deep, <25% thickness), grade 2 (3–6 mm, <50%) and grade 3 (>6 mm, >50%). The partial tear classification system is accepted worldwide as it helps in treatment selection, as discussed in the next section. These authors also proposed a full-thickness classification based on tear-shaped, which has been judged useful and is currently used worldwide. Five groups were described: crescent shape, L shape, Reverse L, trapezoidal shape and massive tears [20, 21].
Concerning partial tears, Snyder clarified that a distinction between articular and bursal tears is mandatory as the criteria for surgery are different.
Fox and Romeo described a specific classification for subscapularis tears in 2003. Four types were proposed: Type 1, partial thickness; Type 2, complete tear of the upper 25%; Type 3, a complete tear of the upper 50%; Type 4, complete rupture of the subscapularis tendon [22].
Other authors prefer to classify tears about the retraction, as it can help the surgeon assess reparability before the operation. Patte described in 1990 three groups: Stage 1, where the tendon stump is adjacent to its insertion; Stage 2, with a tendon stump at the level of the humeral head; Stage 3, where the tendon is at the glenoid level or even more medial.
Patte also described a classification in the sagittal plane based on six segments: Segment 1, isolated subscapularis tear; Segment 2, isolated rotator interval tear; Segment 3, isolated supraspinatus tear; Segment 4, supraspinatus and upper one-half of the infraspinatus; Segment 5, complete supraspinatus and infraspinatus; and Segment 6, complete cuff rupture [23].
Finally, some authors prefer a classification based on tissue quality and atrophy. Currently, the classification proposed by Goutallier in 1994 is the most accepted and used. The author described stage 0, corresponding with a normal muscle. Stage 1, some fatty streaks; Stage 2, less than 50% of fatty atrophy; Stage 3, more than 50% of fat; Stage 4, fatty atrophy greater than 50% [24].
2. Treatment
The orthopedic surgeon’s community has failed, to the date, to clearly identify which patients would benefit from surgical repair as the primary treatment. Most patients accept an initial attempt of conservative treatment, which is successful in most cases. They undergo a surgical rotator cuff repair if the former fails to provide pain relief and function improvement. Although this strategy is accepted worldwide, it does not provide a definitive solution for the tear, which seldom heals on its own (about 10% of small tears heal, and 10% become smaller). Tear progression is always worrisome as it may lead to non-repairability, arthritis and chronic pain. As a matter of fact, more than 50% of patients with partial tears experience a progression, which is closely correlated with the size of the index tear, and more than half of those with a full-thickness tear will suffer from an increase in the size of the tear, which may be the culprit for an increase in pain and disability. Acute traumatic tears, either in a previously asymptomatic patient or in patients with a previous history of rotator cuff disease yet compensated, with a significant loss of function, are good candidates for surgical repair without unnecessary delays [25, 26, 27].
The objective of the orthopedic surgeon, once the surgery is indicated and agreed upon by the patient, is to achieve sound fixation of the cuff to humeral tuberosities. Thorough attention to avoid gap formation is also a must. If the tendon is well fixed close to the bone, healing tissue will develop [28].
Despite some studies that show few differences in pain relief concerning tendon healing or retear, many others have identified a well-healed cuff as the main factor for improved strength and range of motion [28].
2.1 Open vs. arthroscopic
Open rotator cuff repair has been the gold standard when treating cuff tears. However, some concerns about infection and faster recovery have led shoulder surgeons to investigate the use of minimally invasive and arthroscopic technique.
Neviaser et al. retrospectively reviewed a cohort of patients who underwent anterosuperior rotator cuff repair with subscapularis involvement and found no differences in the outcomes between both modalities [29].
Hasler et al. in a prospective, randomized and long-term outcome study comparing open and arthroscopic rotator cuff repair did not document any difference either clinical or radiological. In addition, they did not find any harmful consequence due to transdeltoid mini-open approach [30].
Nazari et al. studied the effects of arthroscopic and mini-open rotator cuff repairs concerning pain and range of motion and did not find significant differences at 3, 6 and 12 months between both techniques [31].
Bayle et al. studied not only clinical outcomes but rotator cuff integrity at 1-year follow-up and did not find differences in a prospective study [32].
Fink Barnes et al. studied patient satisfaction and rotator cuff integrity in a cohort and found better results concerning integrity in the open surgery group. However, no statistical differences were found between both at the end of the study [33].
To sum up, if cost or time is an issue, open rotator cuff surgery is preferred. However, if short-term results are crucial and the patient seeks a faster return to work or sport, the arthroscopic repair is the technique of choice. The patient needs to be advised that both techniques may lead to excellent results and that the community of orthopedic surgeons cannot recommend one over the other if the factors mentioned above are not taken into account.
2.2 Repair techniques
With the advent of open and mini-open techniques, some classic repair techniques were developed. Transosseous sutures were mainly implemented, where bone tunnels are created, and sutures are placed directly through them, allowing for cuff reinsertion, as depicted in Figure 1.
Figure 1.
a. and b. Transosseous repair, usually used in open surgery.
A single-row repair is performed by means of anchors, usually one or two, with sutures integrated into them that permit cuff repair, as depicted in Figure 2. Single-row techniques are easier to perform arthroscopically, as well as in an open fashion.
Figure 2.
a. and b. classic single-row repair with two lateral anchors.
Double-row repairs use one or two anchors in a medial row, suturing far from the tendon stump border area and a lateral row, again with one or two anchors, closer to the end of the ruptured tendon and the lateral border of the cuff footprint along the tuberosity, as it can be seen in Figure 3.
Figure 3.
a. and b. classic double-row configurations. Two anchors medial and two anchors lateral to the footprint with mattress sutures.
More recent are transosseous equivalent techniques, similar to double-row techniques yet requiring only a medial row and knotless implants laterally (without sutures passing through the tendon laterally but applying those from the medial row against the tendon)(see Figures 4 and 5) [28].
Figure 4.
On the left, a classic double row with independent sutures and anchors. On the right, the medial row sutures have been passed through the cuff, very close to the musculotendinous junction.
Figure 5.
The medial row mattress sutures, tied, are inserted into the bone, lateral to the footprint, by means of a knotless anchor.
2.3 Single vs. double row
Single- and double-row techniques have been compared about their failure loads and gap formation. In an experimental study, Kim et al. and Ma et al. reported significant more load to failure and less gap formation in favor of double row. They also confirmed in vitro that the strain using a double row was a third of that of a single row. However, other studies, such as the one performed by Mazzoca et al., compared both without finding any difference. Finally, a meta-analysis by Hohmann et al. revealed a possible superiority in vitro regarding gap formation and load to failure yet not observed clinically in vivo. Therefore, a superiority of a technique versus the other has not been demonstrated, and the final decision belongs to the orthopedic surgeon who should analyze factors such as simplicity, skill, cost and time consumption when choosing the right technique for the patient [28, 34, 35, 36].
Deveci et al. and Maasse et al. reported that most studies comparing single- and double-row techniques were comparing different constructs and suture configurations, and thus the results obtained are not valid. Most studies used lateral single-row configurations either in vitro or in vivo, and very few a more medial single row avoiding unnecessary tension at the level of the repair (which is a must, especially in large and retracted tears) When a proper, more medial, single-row configuration was used, the results become similar. It is not fair to compare single-row configurations performed poorly and too lateral to modern double-row techniques, and despite that, clinically relevant results have failed to be obtained [37, 38].
2.4 Transsosseous vs. single row
Transosseous repairs are of everyday use during open rotator cuff repair. The use of bony tunnels avoids anchors, which is a significant advantage concerning cost and ease of revision surgery. The former is performed either by employing guides and Kirschner wires or bone needles in the osteoporotic bone. Ahmad et al. and Park et al.compared micromotion in vitro at the footprint interface and concluded that transosseous repair minimizes strain and, therefore, would be advantageous concerning tendon to bone healing. Apreleva et al., in another experimental study, demonstrated that footprint anatomy restoration was superior when using transosseous techniques [39, 40, 41, 42].
On the contrary, other authors such as Randelly et al. in a clinical study concluded that single-row and transosseous hardware-free repairs led to the same results concerning pain, function and retear rate at 15 months. However, transosseous repairs might be more cost-effective because they avoid the use of anchors [43].
Same principles apply to partial repairs when comparing transtendon single-row techniques versus double-row suture bridges. Zafra et al. demonstrated that partial tears might be treated with similar results using both techniques [44].
2.5 Transosseous vs. double row
Traditional transosseous repair focuses on restoring cuff footprint and applying pressure on the enthesis (against tuberosity bone). On the contrary, the traditional double row focuses on suturing the tendon medial and lateral in the footprint. Waltrip et al. compared both and demonstrated that a higher stress concentration was found in the latter at the medial anchors and suturing areas, while the former had more significant stress at the tendon to bone interface level. Forces through the tendon to bone enthesis can be beneficial, and on the contrary, forces around the anchors may explain the high recurrence rate and pull-out observed in double-row repairs [28, 45].
2.6 Transosseous equivalent vs. double row
Transosseous equivalent techniques mimic the effect created by traditional transosseous techniques utilizing lateral knotless anchors, which insert the sutures used in the medial row into the lateral cortex of the tuberosity. Hence, this technique mimics the effect of the classic techniques as it adds pressure forces that apply the tendon stump against the bone.
Siskoksy et al., in a cadaveric study, compared load to failure and gap formation using transosseous equivalent and double-row techniques. They concluded that load to failure was higher when using a transosseous equivalent construct. However, gap formation was similar between both [46]. The same conclusion was obtained by Costic et al. in a similar study in cadavers where cyclic loading was applied on the footprint [47].
Park et al. demonstrated in vitro that the pressure exerted by a transosseous equivalent is significantly higher than that observed in double rows. Nevertheless, it remains difficult to know the right amount of pressure or the ischemic effect of an excessive force on the tendon stump [48].
3. The art of the single-row technique
Not all single-row techniques are created equal. Arthroscopic rotator cuff repair emerged in the 1990s, and logically single-row constructs were the first used by shoulder and sports medicine surgeons. Initially, a unique row formed by one or two anchors (placed in the centre of the footprint or lateral to it) was used.
Not all single-row techniques are created equal. Arthroscopic rotator cuff repair emerged in the 1990s, and logically single-row constructs were the first used by shoulder and sports medicine surgeons. Initially, a unique row formed by one or two anchors (placed in the centre of the footprint or lateral to it) was used. Despite initial promising outcomes, the retear rate was undoubtedly worrisome, which explains the subsequent interest in developing double rows or transosseous equivalent techniques.
Complex and more robust suture configurations (such as the Mason-Allen technique) are complicated to replicate arthroscopically.
Simple or mattress sutures, often used arthroscopically, may not be sufficient to hold a rotator cuff with poor-quality tissue to the bone long enough to allow for proper healing. These statements led to a quest to find a better technique by adding anchors and complexity to the repairs. However, it was not until later that some surgeons started to question if a well-performed single row would be sufficient. To do so, a more medial single row started to be used with the rationale behind it that less tension on the rotator cuff would result. This is very useful in the onset of chronic and massive tears where even after proper slide liberation, tendon retraction impedes proper footprint anatomical restoration, as depicted in Figures 6–9 [49].
Figure 6.
Classic single row is performed with anchors in a more central or even lateral position in the footprint. Modern single row uses anchors closer to the cartilage, in a more medial position in the footprint (red area).
Figure 7.
The number of anchors varies between one and three depending on the size of the tear.
Figure 8.
A modern single-row construct uses sutures that pass about 1 cm medial to the border of the tendon stump. Thus, reducing the tension and minimizing retear rates due to excessive tension or damage to the musculotendinous junction.
Figure 9.
Final modern single-row construct. Sutures are passed through the tendon far from the musculotendinous junction and far from the border. Less footprint is covered by the cuff when using this technique; however, bone marrow vents, lateral to the footprint, may provide stem cells which will develop a neotendon.
Several factors may contribute to the final healing of the rotator cuff tendons to the bone. Among them, mechanical factors such as gap formation, stiffness and strength of the repair, load to failure, repair tension have already been discussed in previous sections of this chapter. However, other factors such as tendon vascularity, footprint coverage and respecting the proper biology of tendon healing are sometimes forgotten [49].
Suture bridge techniques have demonstrated in vitro superior strength, stiffness, less gap formation and more load to failure. However, this comes at the cost of vascularity disruption, high tension at the muscle to tendon junction (which may lead to a tear at this level). Transosseous equivalent techniques enhance the resistance and stability of the repair at the tendon to bone interface; nevertheless, they neglect biology as they create an ischemic environment. As a matter of fact, in vivo studies have failed to demonstrate the superiority of transosseous rotator cuff repair over single-row repair [49, 50].
In the context of a single-row repair, a more medial row may enhance biology as it adds less loading forces and respects vascularity. However, footprint non-anatomic restoration may arise as a concern. By medializing the anchors in the footprint (not medial to it), a part of the surface may stay uncovered by the tendon stump. Although the real significance of this has not been established, surgeons commonly think anatomic restoration would be superior to a ‘leave it alone’ strategy. To cope with this problem, creating bone marrow vents through microfracture instruments would promote the formation of a neotendon and fibrocartilage. The benefits of adding mesenchymal cells to the healing area would also increase the chances of the tendon to bone healing. Yamakado et al. concluded in a prospective randomized trial comparing suture bridge configurations and single-row (medially based) repairs that both techniques lead to the same clinical results. They found that incomplete healing was more common in single-row repairs, and on the other hand, medial cuff failure was more common in patients with bridge constructs. However, the differences were not significant from a statistical point of view [49].
Another argument favoring single-row techniques is that excessive medial sutures in the cuff may lead to a myotendinous junction tear. Despite some authors that studied the use of more medial sutures in vitro, advocating for more stability of the construct, it is accepted globally that this can be dangerous as it might come with a rupture at the level of the muscle, ending up with a tendon stump anchored to the tuberosity but without a healthy muscle able to apply traction on it. Therefore, leaving a security distance from the musculotendinous junction of 10 mm is the wiser choice [51, 52].
It has also been suggested that a single-row technique mimicking the Masson-Allen suture technique might increase the strength of the repair. Despite some studies confirming that these modifications of the original technique (‘modified Mason Allen’ or ‘massive cuff suture configuration’) might increase in vitro the stability of the repair (similar to the original Mason-Allen technique), they have failed to demonstrate a statistical difference or a real relevance clinically. In fact, rotator cuff repairs usually fail at the suture-tissue interface due to poor quality of the latter; therefore, the culprit might not be suture configuration. This the interest in keeping it as simple as possible [53, 54, 55, 56, 57, 58].
4. Conclusions
Rotator cuff tear is a common etiology for pain, disability and loss of function that might be considered a burden for some health systems.
Conservative treatment may be adequate for a large number of patients; however, it is utterly crucial to identify patients who would benefit from an acute repair and not to neglect patients who still suffer and do not achieve a satisfactory result employing conservative methods.
The selection of the surgical technique for those patients who require a rotator cuff repair should be guided by the current evidence. It should favor methods that provide the best results for the patient while maintaining simplicity and cost-effectiveness at the proper levels. Therefore, a modern single-row technique with a more medial anchor placement and bone marrow vents in the rotator footprint is probably the technique that balances all the factors mentioned before.
Acknowledgments
The authors would like to thank ASIS Medica for their support in the development of this study.
Conflict of interest
The authors declare no conflict of interest.
\n',keywords:"rotator, cuff, single-row, transosseous, double-row, mini-open, arthroscopy",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/79972.pdf",chapterXML:"https://mts.intechopen.com/source/xml/79972.xml",downloadPdfUrl:"/chapter/pdf-download/79972",previewPdfUrl:"/chapter/pdf-preview/79972",totalDownloads:85,totalViews:0,totalCrossrefCites:0,dateSubmitted:"December 5th 2021",dateReviewed:"December 6th 2021",datePrePublished:"January 9th 2022",datePublished:null,dateFinished:"January 8th 2022",readingETA:"0",abstract:"Rotator cuff tears are a common cause of pain and disability among adults. Partial tears are usually treated conservatively. Complete tears might be treated conservatively in some cases; however, surgical repair is often performed in selected cases and situations where conservative treatment fails to restore function and pain relief. In addition, some patients with acute tears might be good candidates for acute surgical repair, as will be studied in this chapter. A plethora of techniques is available to repair rotator cuff tears. Among these, the surgeon faces the dilemma to choose the best treatment for the patient. Open techniques were the gold standard in the 1990s. However, the advent of arthroscopy has led the shoulder and sports surgeon community towards these. Arthroscopic rotator cuff repair has become the gold standard nowadays despite the lack of proper evidence to support this change. Furthermore, simple single-row repairs had been discarded favouring double-row techniques, yet new evidence supports the use of the former due to similar results, simplicity and cost-effectiveness. This chapter examines current evidence to help the surgeon decide between open and minimally invasive techniques and select suitable repair configurations.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/79972",risUrl:"/chapter/ris/79972",signatures:"Amhaz Escanlar S, Jorge Mora A and Pino Miguez J",book:{id:"11243",type:"book",title:"Shoulder Surgery for RC Pathology, Arthropathy and Tumors",subtitle:null,fullTitle:"Shoulder Surgery for RC Pathology, Arthropathy and Tumors",slug:null,publishedDate:null,bookSignature:"Dr. Dimitrios D. Nikolopoulos and Dr. George K. Safos",coverURL:"https://cdn.intechopen.com/books/images_new/11243.jpg",licenceType:"CC BY 3.0",editedByType:null,isbn:"978-1-80355-397-9",printIsbn:"978-1-80355-396-2",pdfIsbn:"978-1-80355-398-6",isAvailableForWebshopOrdering:!0,editors:[{id:"228477",title:"Dr.",name:"Dimitrios D.",middleName:null,surname:"Nikolopoulos",slug:"dimitrios-d.-nikolopoulos",fullName:"Dimitrios D. Nikolopoulos"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"217172",title:"Ph.D.",name:"Alberto",middleName:null,surname:"Jorge-Mora",fullName:"Alberto Jorge-Mora",slug:"alberto-jorge-mora",email:"aljmora@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"240642",title:"Prof.",name:"Jesus",middleName:null,surname:"Pino-Minguez",fullName:"Jesus Pino-Minguez",slug:"jesus-pino-minguez",email:"jpinomg@hotmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"240644",title:"Dr.",name:"Samer",middleName:null,surname:"Amhaz-Escanlar",fullName:"Samer Amhaz-Escanlar",slug:"samer-amhaz-escanlar",email:"sameramhaz@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_1_2",title:"1.1 Risk factors",level:"2"},{id:"sec_2_2",title:"1.2 Classification",level:"2"},{id:"sec_4",title:"2. Treatment",level:"1"},{id:"sec_4_2",title:"2.1 Open vs. arthroscopic",level:"2"},{id:"sec_5_2",title:"2.2 Repair techniques",level:"2"},{id:"sec_6_2",title:"2.3 Single vs. double row",level:"2"},{id:"sec_7_2",title:"2.4 Transsosseous vs. single row",level:"2"},{id:"sec_8_2",title:"2.5 Transosseous vs. double row",level:"2"},{id:"sec_9_2",title:"2.6 Transosseous equivalent vs. double row",level:"2"},{id:"sec_11",title:"3. The art of the single-row technique",level:"1"},{id:"sec_12",title:"4. Conclusions",level:"1"},{id:"sec_13",title:"Acknowledgments",level:"1"},{id:"sec_16",title:"Conflict of interest",level:"1"}],chapterReferences:[{id:"B1",body:'Hantes EM, Chalatsis IG, Mpakagiannis G. Single-row versus double-row repair in rotator cuff tears. In: Surgical Recovery. 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PMID: 11987064'},{id:"B42",body:'Ahmad CS, Stewart AM, Izquierdo R, Bigliani LU. Tendon-bone interface motion in transosseous suture and suture anchor rotator cuff repair techniques. The American Journal of Sports Medicine. 2005;33(11):1667-1671'},{id:"B43",body:'Ryu RKN. Arthroscopic transosseous suture repair and single-row anchor fixation for rotator cuff lesions did not differ for pain, function, or rotator-cuff integrity at 15 months. The Journal of Bone and Joint Surgery. American Volume. 2017;99:1943'},{id:"B44",body:'Zafra M, Uceda P, Muñoz-Luna F, Muñoz-López RC, Font P. Arthroscopic repair of partial-thickness articular surface rotator cuff tears: Single-row transtendon technique versus double-row suture bridge (transosseous equivalent) fixation: Results from a prospective randomized study. Archives of Orthopaedic and Trauma Surgery [Internet]. 2020;140(8):1065-1071. Available from: http://www.ncbi.nlm.nih.gov/pubmed/32170453'},{id:"B45",body:'Waltrip RL, Zheng N, Dugas JR, Andrews JR. Rotator cuff repair. A biomechanical comparison of three techniques. Am J Sports Med. 2003 Jul-Aug;31(4):493-497. DOI: 10.1177/03635465030310040301. PMID: 12860534'},{id:"B46",body:'Siskosky MJ, ElAttrache NS, Chu E, Tibone JE, Lee TQ. Biomechanical evaluation of the “transosseous equivalent”rotator cuff repair technique using the PushLock for lateralfixation compared to the double-row technique. In: Presented at the Annual Meeting of the American Academy of OrthopaedicSurgeons, San Diego, CA, February 14-18. 2007'},{id:"B47",body:'Costic RS, Brucker PU, Smolinski PJ, Gilbertson LG, Ro-dosky MW. Arthroscopic double row anchor repair of fullthickness rotator cuff tear: Footprint restoration and biome-chanical properties. In: Presented at the Annual Meeting of theOrthopaedic Research Society, Chicago, IL, March 19-22. 2006'},{id:"B48",body:'Park MC, ElAttrache NS, Tibone JE, Ahmad CS, Jun BJ, Lee TQ. Footprint contact biomechanics for a new arthroscopictransosseous-equivalent rotator cuff repair technique com-pared to a double-row technique arthroscopic rotator cuffrepair. In: Presented at the Annual Meeting of the American Academy of Orthopaedic Surgeons, Chicago, IL, March 22-26. 2006'},{id:"B49",body:'Yamakado K. Two techniques for treating medium-sized supraspinatus tears: The medially based single-row technique and the suture bridge technique. JBJS Essential Surgical Techniques. 2021 Jun 8;11(2):e20.00004. DOI: 10.2106/JBJS.ST.20.00004. PMID: 34277130; PMCID: PMC8280021'},{id:"B50",body:'Plachel F, Siegert P, Rüttershoff K, Thiele K, Akgün D, Moroder P, et al. Long-term results of arthroscopic rotator cuff repair: A follow-up study comparing single-row versus double-row fixation techniques. American Journal of Sports Medicine. 2020;48(7):1568-1574'},{id:"B51",body:'Virk MS, Bruce B, Hussey KE, Thomas JM, Luthringer TA, Shewman EF, et al. Biomechanical performance of medial row suture placement relative to the musculotendinous junction in transosseous equivalent suture bridge double-row rotator cuff repair. Arthroscopy: The Journal of Arthroscopic and Related Surgery. 2017;33(2):242-250'},{id:"B52",body:'Barber FA. Editorial commentary: Musculotendinous junction mattress sutures are inefficient. Arthroscopy: The Journal of Arthroscopic and Related Surgery. 2017;33:251-253'},{id:"B53",body:'Meisel AF, Henninger HB, Barber FA, Getelman MH. Biomechanical comparison of standard and linked single-row rotator cuff repairs in a human cadaver model. Arthroscopy: The Journal of Arthroscopic and Related Surgery. 2017;33(5):938-944'},{id:"B54",body:'Baleani M, Ohman C, Guandalini L, Rotini R, Giavaresi G, Traina F, et al. Comparative study of different tendon grasping techniques for arthroscopic repair of the rotator cuff. Clinical Biomechanics (Bristol, Avon). 2006;21(8):799-803'},{id:"B55",body:'Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K. The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. The Journal of Bone and Joint Surgery American Volume. 2004;86(2):219-224'},{id:"B56",body:'Wetzler MJ. Editorial commentary: Belt and suspenders—Linked single-row rotator cuff repair. Arthroscopy: The Journal of Arthroscopic and Related Surgery. 2017;33:945'},{id:"B57",body:'Noyes MP, Lederman E, Adams CR, Denard PJ. Triple-loaded suture anchors versus a knotless rip stop construct in a single-row rotator cuff repair model. Arthroscopy: The Journal of Arthroscopic and Related Surgery. 2018;34(5):1414-1420'},{id:"B58",body:'Noyes MP, Ladermann A, Denard PJ. Functional outcome and healing with a load-sharing rip-stop repair compared with a single-row repair for large and massive rotator cuff tears. Arthroscopy: The Journal of Arthroscopic and Related Surgery. 2019;35(8):2295-2300'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Amhaz Escanlar S",address:"sameramhaz@gmail.com",affiliation:'
University Hospital Complex, Spain
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Reconstructive Surgery, University Hospital Complex, Spain
Pediatric Orthopedics and Spine Surgery, University Hospital Complex, Spain
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The company was founded in Vienna in 2004 by Alex Lazinica and Vedran Kordic, two PhD students researching robotics. While completing our PhDs, we found it difficult to access the research we needed. So, we decided to create a new Open Access publisher. A better one, where researchers like us could find the information they needed easily. The result is IntechOpen, an Open Access publisher that puts the academic needs of the researchers before the business interests of publishers.
",metaTitle:"Our story",metaDescription:"The company was founded in Vienna in 2004 by Alex Lazinica and Vedran Kordic, two PhD students researching robotics. While completing our PhDs, we found it difficult to access the research we needed. So, we decided to create a new Open Access publisher. A better one, where researchers like us could find the information they needed easily. The result is IntechOpen, an Open Access publisher that puts the academic needs of the researchers before the business interests of publishers.",metaKeywords:null,canonicalURL:"/page/our-story",contentRaw:'[{"type":"htmlEditorComponent","content":"
We started by publishing journals and books from the fields of science we were most familiar with - AI, robotics, manufacturing and operations research. Through our growing network of institutions and authors, we soon expanded into related fields like environmental engineering, nanotechnology, computer science, renewable energy and electrical engineering, Today, we are the world’s largest Open Access publisher of scientific research, with over 4,200 books and 54,000 scientific works including peer-reviewed content from more than 116,000 scientists spanning 161 countries. Our authors range from globally-renowned Nobel Prize winners to up-and-coming researchers at the cutting edge of scientific discovery.
\\n\\n
In the same year that IntechOpen was founded, we launched what was at the time the first ever Open Access, peer-reviewed journal in its field: the International Journal of Advanced Robotic Systems (IJARS).
\\n\\n
The IntechOpen timeline
\\n\\n
2004
\\n\\n
\\n\\t
Intech Open is founded in Vienna, Austria, by Alex Lazinica and Vedran Kordic, two PhD students, and their first Open Access journals and books are published.
\\n\\t
Alex and Vedran launch the first Open Access, peer-reviewed robotics journal and IntechOpen’s flagship publication, the International Journal of Advanced Robotic Systems (IJARS).
\\n
\\n\\n
2005
\\n\\n
\\n\\t
IntechOpen publishes its first Open Access book: Cutting Edge Robotics.
\\n
\\n\\n
2006
\\n\\n
\\n\\t
IntechOpen publishes a special issue of IJARS, featuring contributions from NASA scientists regarding the Mars Exploration Rover missions.
\\n
\\n\\n
2008
\\n\\n
\\n\\t
Downloads milestone: 200,000 downloads reached
\\n
\\n\\n
2009
\\n\\n
\\n\\t
Publishing milestone: the first 100 Open Access STM books are published
\\n
\\n\\n
2010
\\n\\n
\\n\\t
Downloads milestone: one million downloads reached
\\n\\t
IntechOpen expands its book publishing into a new field: medicine.
\\n
\\n\\n
2011
\\n\\n
\\n\\t
Publishing milestone: More than five million downloads reached
\\n\\t
IntechOpen publishes 1996 Nobel Prize in Chemistry winner Harold W. Kroto’s “Strategies to Successfully Cross-Link Carbon Nanotubes”. Find it here.
\\n\\t
IntechOpen and TBI collaborate on a project to explore the changing needs of researchers and the evolving ways that they discover, publish and exchange information. The result is the survey “Author Attitudes Towards Open Access Publishing: A Market Research Program”.
\\n\\t
IntechOpen hosts SHOW - Share Open Access Worldwide; a series of lectures, debates, round-tables and events to bring people together in discussion of open source principles, intellectual property, content licensing innovations, remixed and shared culture and free knowledge.
\\n
\\n\\n
2012
\\n\\n
\\n\\t
Publishing milestone: 10 million downloads reached
\\n\\t
IntechOpen holds Interact2012, a free series of workshops held by figureheads of the scientific community including Professor Hiroshi Ishiguro, director of the Intelligent Robotics Laboratory, who took the audience through some of the most impressive human-robot interactions observed in his lab.
\\n
\\n\\n
2013
\\n\\n
\\n\\t
IntechOpen joins the Committee on Publication Ethics (COPE) as part of a commitment to guaranteeing the highest standards of publishing.
\\n
\\n\\n
2014
\\n\\n
\\n\\t
IntechOpen turns 10, with more than 30 million downloads to date.
\\n\\t
IntechOpen appoints its first Regional Representatives - members of the team situated around the world dedicated to increasing the visibility of our authors’ published work within their local scientific communities.
\\n
\\n\\n
2015
\\n\\n
\\n\\t
Downloads milestone: More than 70 million downloads reached, more than doubling since the previous year.
\\n\\t
Publishing milestone: IntechOpen publishes its 2,500th book and 40,000th Open Access chapter, reaching 20,000 citations in Thomson Reuters ISI Web of Science.
\\n\\t
40 IntechOpen authors are included in the top one per cent of the world’s most-cited researchers.
\\n\\t
Thomson Reuters’ ISI Web of Science Book Citation Index begins indexing IntechOpen’s books in its database.
\\n
\\n\\n
2016
\\n\\n
\\n\\t
IntechOpen is identified as a world leader in Simba Information’s Open Access Book Publishing 2016-2020 report and forecast. IntechOpen came in as the world’s largest Open Access book publisher by title count.
\\n
\\n\\n
2017
\\n\\n
\\n\\t
Downloads milestone: IntechOpen reaches more than 100 million downloads
\\n\\t
Publishing milestone: IntechOpen publishes its 3,000th Open Access book, making it the largest Open Access book collection in the world
We started by publishing journals and books from the fields of science we were most familiar with - AI, robotics, manufacturing and operations research. Through our growing network of institutions and authors, we soon expanded into related fields like environmental engineering, nanotechnology, computer science, renewable energy and electrical engineering, Today, we are the world’s largest Open Access publisher of scientific research, with over 4,200 books and 54,000 scientific works including peer-reviewed content from more than 116,000 scientists spanning 161 countries. Our authors range from globally-renowned Nobel Prize winners to up-and-coming researchers at the cutting edge of scientific discovery.
\n\n
In the same year that IntechOpen was founded, we launched what was at the time the first ever Open Access, peer-reviewed journal in its field: the International Journal of Advanced Robotic Systems (IJARS).
\n\n
The IntechOpen timeline
\n\n
2004
\n\n
\n\t
Intech Open is founded in Vienna, Austria, by Alex Lazinica and Vedran Kordic, two PhD students, and their first Open Access journals and books are published.
\n\t
Alex and Vedran launch the first Open Access, peer-reviewed robotics journal and IntechOpen’s flagship publication, the International Journal of Advanced Robotic Systems (IJARS).
\n
\n\n
2005
\n\n
\n\t
IntechOpen publishes its first Open Access book: Cutting Edge Robotics.
\n
\n\n
2006
\n\n
\n\t
IntechOpen publishes a special issue of IJARS, featuring contributions from NASA scientists regarding the Mars Exploration Rover missions.
\n
\n\n
2008
\n\n
\n\t
Downloads milestone: 200,000 downloads reached
\n
\n\n
2009
\n\n
\n\t
Publishing milestone: the first 100 Open Access STM books are published
\n
\n\n
2010
\n\n
\n\t
Downloads milestone: one million downloads reached
\n\t
IntechOpen expands its book publishing into a new field: medicine.
\n
\n\n
2011
\n\n
\n\t
Publishing milestone: More than five million downloads reached
\n\t
IntechOpen publishes 1996 Nobel Prize in Chemistry winner Harold W. Kroto’s “Strategies to Successfully Cross-Link Carbon Nanotubes”. Find it here.
\n\t
IntechOpen and TBI collaborate on a project to explore the changing needs of researchers and the evolving ways that they discover, publish and exchange information. The result is the survey “Author Attitudes Towards Open Access Publishing: A Market Research Program”.
\n\t
IntechOpen hosts SHOW - Share Open Access Worldwide; a series of lectures, debates, round-tables and events to bring people together in discussion of open source principles, intellectual property, content licensing innovations, remixed and shared culture and free knowledge.
\n
\n\n
2012
\n\n
\n\t
Publishing milestone: 10 million downloads reached
\n\t
IntechOpen holds Interact2012, a free series of workshops held by figureheads of the scientific community including Professor Hiroshi Ishiguro, director of the Intelligent Robotics Laboratory, who took the audience through some of the most impressive human-robot interactions observed in his lab.
\n
\n\n
2013
\n\n
\n\t
IntechOpen joins the Committee on Publication Ethics (COPE) as part of a commitment to guaranteeing the highest standards of publishing.
\n
\n\n
2014
\n\n
\n\t
IntechOpen turns 10, with more than 30 million downloads to date.
\n\t
IntechOpen appoints its first Regional Representatives - members of the team situated around the world dedicated to increasing the visibility of our authors’ published work within their local scientific communities.
\n
\n\n
2015
\n\n
\n\t
Downloads milestone: More than 70 million downloads reached, more than doubling since the previous year.
\n\t
Publishing milestone: IntechOpen publishes its 2,500th book and 40,000th Open Access chapter, reaching 20,000 citations in Thomson Reuters ISI Web of Science.
\n\t
40 IntechOpen authors are included in the top one per cent of the world’s most-cited researchers.
\n\t
Thomson Reuters’ ISI Web of Science Book Citation Index begins indexing IntechOpen’s books in its database.
\n
\n\n
2016
\n\n
\n\t
IntechOpen is identified as a world leader in Simba Information’s Open Access Book Publishing 2016-2020 report and forecast. IntechOpen came in as the world’s largest Open Access book publisher by title count.
\n
\n\n
2017
\n\n
\n\t
Downloads milestone: IntechOpen reaches more than 100 million downloads
\n\t
Publishing milestone: IntechOpen publishes its 3,000th Open Access book, making it the largest Open Access book collection in the world
\n
\n"}]},successStories:{items:[]},authorsAndEditors:{filterParams:{},profiles:[{id:"396",title:"Dr.",name:"Vedran",middleName:null,surname:"Kordic",slug:"vedran-kordic",fullName:"Vedran Kordic",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/396/images/7281_n.png",biography:"After obtaining his Master's degree in Mechanical Engineering he continued his education at the Vienna University of Technology where he obtained his PhD degree in 2004. He worked as a researcher at the Automation and Control Institute, Faculty of Electrical Engineering, Vienna University of Technology until 2008. 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On September, 29th 2006 he has won a post PhD fellowship from the university of Bologna (from October 2006 to October 2008), at the competitive examination he was ranked first in the industrial engineering area. He extensively served as referee for several international journals. He is author/coauthor of more than 100 research papers. He has been involved in some projects supported by MURST and European Community. His research interests include pattern recognition, bioinformatics, and biometric systems (fingerprint classification and recognition, signature verification, face recognition).",institutionString:null,institution:null},{id:"496",title:"Dr.",name:"Carlos",middleName:null,surname:"Leon",slug:"carlos-leon",fullName:"Carlos Leon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Seville",country:{name:"Spain"}}},{id:"512",title:"Dr.",name:"Dayang",middleName:null,surname:"Jawawi",slug:"dayang-jawawi",fullName:"Dayang Jawawi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Technology Malaysia",country:{name:"Malaysia"}}},{id:"528",title:"Dr.",name:"Kresimir",middleName:null,surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/528/images/system/528.jpg",biography:"K. Delac received his B.Sc.E.E. degree in 2003 and is currentlypursuing a Ph.D. degree at the University of Zagreb, Faculty of Electrical Engineering andComputing. His current research interests are digital image analysis, pattern recognition andbiometrics.",institutionString:null,institution:{name:"University of Zagreb",country:{name:"Croatia"}}},{id:"557",title:"Dr.",name:"Andon",middleName:"Venelinov",surname:"Topalov",slug:"andon-topalov",fullName:"Andon Topalov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/557/images/1927_n.jpg",biography:"Dr. Andon V. Topalov received the MSc degree in Control Engineering from the Faculty of Information Systems, Technologies, and Automation at Moscow State University of Civil Engineering (MGGU) in 1979. He then received his PhD degree in Control Engineering from the Department of Automation and Remote Control at Moscow State Mining University (MGSU), Moscow, in 1984. From 1985 to 1986, he was a Research Fellow in the Research Institute for Electronic Equipment, ZZU AD, Plovdiv, Bulgaria. In 1986, he joined the Department of Control Systems, Technical University of Sofia at the Plovdiv campus, where he is presently a Full Professor. He has held long-term visiting Professor/Scholar positions at various institutions in South Korea, Turkey, Mexico, Greece, Belgium, UK, and Germany. And he has coauthored one book and authored or coauthored more than 80 research papers in conference proceedings and journals. 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Angel Catalá belongto the Editorial Board of Journal of lipids, International Review of Biophysical ChemistryFrontiers in Membrane Physiology and Biophysics, World Journal oExperimental Medicine and Biochemistry Research International, W orld Journal oBiological Chemistry, Oxidative Medicine and Cellular Longevity, Diabetes and thePancreas, International Journal of Chronic Diseases & Therapy, International Journal oNutrition, Co-Editor of The Open Biology Journal.",institutionString:null,institution:{name:"National University of La Plata",institutionURL:null,country:{name:"Argentina"}}},editorTwo:null,editorThree:null},{id:"12",title:"Human Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/12.jpg",isOpenForSubmission:!0,editor:{id:"195829",title:"Prof.",name:"Kunihiro",middleName:null,surname:"Sakuma",slug:"kunihiro-sakuma",fullName:"Kunihiro Sakuma",profilePictureURL:"https://mts.intechopen.com/storage/users/195829/images/system/195829.jpg",biography:"Professor Kunihiro Sakuma, Ph.D., currently works in the Institute for Liberal Arts at the Tokyo Institute of Technology. He is a physiologist working in the field of skeletal muscle. He was awarded his sports science diploma in 1995 by the University of Tsukuba and began his scientific work at the Department of Physiology, Aichi Human Service Center, focusing on the molecular mechanism of congenital muscular dystrophy and normal muscle regeneration. His interest later turned to the molecular mechanism and attenuating strategy of sarcopenia (age-related muscle atrophy). 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He previously worked as a post-doctoral fellow at the Ben-Gurion University of Negev, Israel; University of the Free State, South Africa; and Central University of Technology Bloemfontein, South Africa. He obtained his Ph.D. in Organic Chemistry from Nagaoka University of Technology, Japan. He has published more than seventy-four journal articles and attended several national and international conferences as speaker and chair. Dr. Kendrekar has received many international awards. He has several funded projects, namely, anti-malaria drug development, MRSA, and SARS-CoV-2 activity of curcumin and its formulations. He has filed four patents in collaboration with the University of Central Lancashire and Mayo Clinic Infectious Diseases. His present research includes organic synthesis, drug discovery and development, biochemistry, nanoscience, and nanotechnology.",institutionString:"Visiting Scientist at Lipid Nanostructures Laboratory, Centre for Smart Materials, School of Natural Sciences, University of Central Lancashire",institution:null},{id:"428125",title:"Dr.",name:"Vinayak",middleName:null,surname:"Adimule",slug:"vinayak-adimule",fullName:"Vinayak Adimule",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/428125/images/system/428125.jpg",biography:"Dr. Vinayak Adimule, MSc, Ph.D., is a professor and dean of R&D, Angadi Institute of Technology and Management, India. He has 15 years of research experience as a senior research scientist and associate research scientist in R&D organizations. He has published more than fifty research articles as well as several book chapters. He has two Indian patents and two international patents to his credit. Dr. Adimule has attended, chaired, and presented papers at national and international conferences. He is a guest editor for Topics in Catalysis and other journals. He is also an editorial board member, life member, and associate member for many international societies and research institutions. His research interests include nanoelectronics, material chemistry, artificial intelligence, sensors and actuators, bio-nanomaterials, and medicinal chemistry.",institutionString:"Angadi Institute of Technology and Management",institution:null},{id:"284317",title:"Prof.",name:"Kantharaju",middleName:null,surname:"Kamanna",slug:"kantharaju-kamanna",fullName:"Kantharaju Kamanna",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284317/images/21050_n.jpg",biography:"Prof. K. Kantharaju has received Bachelor of science (PCM), master of science (Organic Chemistry) and Doctor of Philosophy in Chemistry from Bangalore University. He worked as a Executive Research & Development @ Cadila Pharmaceuticals Ltd, Ahmedabad. He received DBT-postdoc fellow @ Molecular Biophysics Unit, Indian Institute of Science, Bangalore under the supervision of Prof. P. Balaram, later he moved to NIH-postdoc researcher at Drexel University College of Medicine, Philadelphia, USA, after his return from postdoc joined NITK-Surthakal as a Adhoc faculty at department of chemistry. Since from August 2013 working as a Associate Professor, and in 2016 promoted to Profeesor in the School of Basic Sciences: Department of Chemistry and having 20 years of teaching and research experiences.",institutionString:null,institution:{name:"Rani Channamma University, Belagavi",country:{name:"India"}}},{id:"158492",title:"Prof.",name:"Yusuf",middleName:null,surname:"Tutar",slug:"yusuf-tutar",fullName:"Yusuf Tutar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/158492/images/system/158492.jpeg",biography:"Prof. Dr. Yusuf Tutar conducts his research at the Hamidiye Faculty of Pharmacy, Department of Basic Pharmaceutical Sciences, Division of Biochemistry, University of Health Sciences, Turkey. He is also a faculty member in the Molecular Oncology Program. He obtained his MSc and Ph.D. at Oregon State University and Texas Tech University, respectively. He pursued his postdoctoral studies at Rutgers University Medical School and the National Institutes of Health (NIH/NIDDK), USA. His research focuses on biochemistry, biophysics, genetics, molecular biology, and molecular medicine with specialization in the fields of drug design, protein structure-function, protein folding, prions, microRNA, pseudogenes, molecular cancer, epigenetics, metabolites, proteomics, genomics, protein expression, and characterization by spectroscopic and calorimetric methods.",institutionString:"University of Health Sciences",institution:null},{id:"180528",title:"Dr.",name:"Hiroyuki",middleName:null,surname:"Kagechika",slug:"hiroyuki-kagechika",fullName:"Hiroyuki Kagechika",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180528/images/system/180528.jpg",biography:"Hiroyuki Kagechika received his bachelor’s degree and Ph.D. in Pharmaceutical Sciences from the University of Tokyo, Japan, where he served as an associate professor until 2004. He is currently a professor at the Institute of Biomaterials and Bioengineering (IBB), Tokyo Medical and Dental University (TMDU). From 2010 to 2012, he was the dean of the Graduate School of Biomedical Science. Since 2012, he has served as the vice dean of the Graduate School of Medical and Dental Sciences. He has been the director of the IBB since 2020. Dr. Kagechika’s major research interests are the medicinal chemistry of retinoids, vitamins D/K, and nuclear receptors. He has developed various compounds including a drug for acute promyelocytic leukemia.",institutionString:"Tokyo Medical and Dental University",institution:{name:"Tokyo Medical and Dental University",country:{name:"Japan"}}},{id:"94311",title:"Prof.",name:"Martins",middleName:"Ochubiojo",surname:"Ochubiojo Emeje",slug:"martins-ochubiojo-emeje",fullName:"Martins Ochubiojo Emeje",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94311/images/system/94311.jpeg",biography:"Martins Emeje obtained a BPharm with distinction from Ahmadu Bello University, Nigeria, and an MPharm and Ph.D. from the University of Nigeria (UNN), where he received the best Ph.D. award and was enlisted as UNN’s “Face of Research.” He established the first nanomedicine center in Nigeria and was the pioneer head of the intellectual property and technology transfer as well as the technology innovation and support center. Prof. Emeje’s several international fellowships include the prestigious Raman fellowship. He has published more than 150 articles and patents. He is also the head of R&D at NIPRD and holds a visiting professor position at Nnamdi Azikiwe University, Nigeria. He has a postgraduate certificate in Project Management from Walden University, Minnesota, as well as a professional teaching certificate and a World Bank certification in Public Procurement. Prof. Emeje was a national chairman of academic pharmacists in Nigeria and the 2021 winner of the May & Baker Nigeria Plc–sponsored prize for professional service in research and innovation.",institutionString:"National Institute for Pharmaceutical Research and Development",institution:{name:"National Institute for Pharmaceutical Research and Development",country:{name:"Nigeria"}}},{id:"436430",title:"Associate Prof.",name:"Mesut",middleName:null,surname:"Işık",slug:"mesut-isik",fullName:"Mesut Işık",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/436430/images/19686_n.jpg",biography:null,institutionString:null,institution:{name:"Bilecik University",country:{name:"Turkey"}}},{id:"268659",title:"Ms.",name:"Xianquan",middleName:null,surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/268659/images/8143_n.jpg",biography:"Dr. Zhan received his undergraduate and graduate training in the fields of preventive medicine and epidemiology and statistics at the West China University of Medical Sciences in China during 1989 to 1999. He received his post-doctoral training in oncology and cancer proteomics for two years at the Cancer Research Institute of Human Medical University in China. In 2001, he went to the University of Tennessee Health Science Center (UTHSC) in USA, where he was a post-doctoral researcher and focused on mass spectrometry and cancer proteomics. Then, he was appointed as an Assistant Professor of Neurology, UTHSC in 2005. He moved to the Cleveland Clinic in USA as a Project Scientist/Staff in 2006 where he focused on the studies of eye disease proteomics and biomarkers. He returned to UTHSC as an Assistant Professor of Neurology in the end of 2007, engaging in proteomics and biomarker studies of lung diseases and brain tumors, and initiating the studies of predictive, preventive, and personalized medicine (PPPM) in cancer. In 2010, he was promoted to Associate Professor of Neurology, UTHSC. Currently, he is a Professor at Xiangya Hospital of Central South University in China, Fellow of Royal Society of Medicine (FRSM), the European EPMA National Representative in China, Regular Member of American Association for the Advancement of Science (AAAS), European Cooperation of Science and Technology (e-COST) grant evaluator, Associate Editors of BMC Genomics, BMC Medical Genomics, EPMA Journal, and Frontiers in Endocrinology, Executive Editor-in-Chief of Med One. He has\npublished 116 peer-reviewed research articles, 16 book chapters, 2 books, and 2 US patents. His current main research interest focuses on the studies of cancer proteomics and biomarkers, and the use of modern omics techniques and systems biology for PPPM in cancer, and on the development and use of 2DE-LC/MS for the large-scale study of human proteoforms.",institutionString:null,institution:{name:"Xiangya Hospital Central South University",country:{name:"China"}}},{id:"40482",title:null,name:"Rizwan",middleName:null,surname:"Ahmad",slug:"rizwan-ahmad",fullName:"Rizwan Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/40482/images/system/40482.jpeg",biography:"Dr. Rizwan Ahmad is a University Professor and Coordinator, Quality and Development, College of Medicine, Imam Abdulrahman bin Faisal University, Saudi Arabia. Previously, he was Associate Professor of Human Function, Oman Medical College, Oman, and SBS University, Dehradun. Dr. Ahmad completed his education at Aligarh Muslim University, Aligarh. He has published several articles in peer-reviewed journals, chapters, and edited books. His area of specialization is free radical biochemistry and autoimmune diseases.",institutionString:"Imam Abdulrahman Bin Faisal University",institution:{name:"Imam Abdulrahman Bin Faisal University",country:{name:"Saudi Arabia"}}},{id:"41865",title:"Prof.",name:"Farid A.",middleName:null,surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41865/images/system/41865.jpg",biography:"Farid A. Badria, Ph.D., is the recipient of several awards, including The World Academy of Sciences (TWAS) Prize for Public Understanding of Science; the World Intellectual Property Organization (WIPO) Gold Medal for best invention; Outstanding Arab Scholar, Kuwait; and the Khwarizmi International Award, Iran. He has 250 publications, 12 books, 20 patents, and several marketed pharmaceutical products to his credit. He continues to lead research projects on developing new therapies for liver, skin disorders, and cancer. Dr. Badria was listed among the world’s top 2% of scientists in medicinal and biomolecular chemistry in 2019 and 2020. He is a member of the Arab Development Fund, Kuwait; International Cell Research Organization–United Nations Educational, Scientific and Cultural Organization (ICRO–UNESCO), Chile; and UNESCO Biotechnology France",institutionString:"Mansoura University",institution:{name:"Mansoura University",country:{name:"Egypt"}}},{id:"329385",title:"Dr.",name:"Rajesh K.",middleName:"Kumar",surname:"Singh",slug:"rajesh-k.-singh",fullName:"Rajesh K. Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",biography:"Dr. Singh received a BPharm (2003) and MPharm (2005) from Panjab University, Chandigarh, India, and a Ph.D. (2013) from Punjab Technical University (PTU), Jalandhar, India. He has more than sixteen years of teaching experience and has supervised numerous postgraduate and Ph.D. students. He has to his credit more than seventy papers in SCI- and SCOPUS-indexed journals, fifty-five conference proceedings, four books, six Best Paper Awards, and five projects from different government agencies. He is currently an editorial board member of eight international journals and a reviewer for more than fifty scientific journals. He received Top Reviewer and Excellent Peer Reviewer Awards from Publons in 2016 and 2017, respectively. He is also on the panel of The International Reviewer for reviewing research proposals for grants from the Royal Society. He also serves as a Publons Academy mentor and Bentham brand ambassador.",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",country:{name:"India"}}},{id:"142388",title:"Dr.",name:"Thiago",middleName:"Gomes",surname:"Gomes Heck",slug:"thiago-gomes-heck",fullName:"Thiago Gomes Heck",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/142388/images/7259_n.jpg",biography:null,institutionString:null,institution:{name:"Universidade Regional do Noroeste do Estado do Rio Grande do Sul",country:{name:"Brazil"}}},{id:"336273",title:"Assistant Prof.",name:"Janja",middleName:null,surname:"Zupan",slug:"janja-zupan",fullName:"Janja Zupan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/336273/images/14853_n.jpeg",biography:"Janja Zupan graduated in 2005 at the Department of Clinical Biochemistry (superviser prof. dr. Janja Marc) in the field of genetics of osteoporosis. Since November 2009 she is working as a Teaching Assistant at the Faculty of Pharmacy, Department of Clinical Biochemistry. In 2011 she completed part of her research and PhD work at Institute of Genetics and Molecular Medicine, University of Edinburgh. She finished her PhD entitled The influence of the proinflammatory cytokines on the RANK/RANKL/OPG in bone tissue of osteoporotic and osteoarthritic patients in 2012. From 2014-2016 she worked at the Institute of Biomedical Sciences, University of Aberdeen as a postdoctoral research fellow on UK Arthritis research project where she gained knowledge in mesenchymal stem cells and regenerative medicine. She returned back to University of Ljubljana, Faculty of Pharmacy in 2016. She is currently leading project entitled Mesenchymal stem cells-the keepers of tissue endogenous regenerative capacity facing up to aging of the musculoskeletal system funded by Slovenian Research Agency.",institutionString:null,institution:{name:"University of Ljubljana",country:{name:"Slovenia"}}},{id:"357453",title:"Dr.",name:"Radheshyam",middleName:null,surname:"Maurya",slug:"radheshyam-maurya",fullName:"Radheshyam Maurya",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/357453/images/16535_n.jpg",biography:null,institutionString:null,institution:{name:"University of Hyderabad",country:{name:"India"}}},{id:"418340",title:"Dr.",name:"Jyotirmoi",middleName:null,surname:"Aich",slug:"jyotirmoi-aich",fullName:"Jyotirmoi Aich",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000038Ugi5QAC/Profile_Picture_2022-04-15T07:48:28.png",biography:"Biotechnologist with 15 years of research including 6 years of teaching experience. Demonstrated record of scientific achievements through consistent publication record (H index = 13, with 874 citations) in high impact journals such as Nature Communications, Oncotarget, Annals of Oncology, PNAS, and AJRCCM, etc. Strong research professional with a post-doctorate from ACTREC where I gained experimental oncology experience in clinical settings and a doctorate from IGIB where I gained expertise in asthma pathophysiology. A well-trained biotechnologist with diverse experience on the bench across different research themes ranging from asthma to cancer and other infectious diseases. An individual with a strong commitment and innovative mindset. Have the ability to work on diverse projects such as regenerative and molecular medicine with an overall mindset of improving healthcare.",institutionString:"DY Patil Deemed to Be University",institution:null},{id:"349288",title:"Prof.",name:"Soumya",middleName:null,surname:"Basu",slug:"soumya-basu",fullName:"Soumya Basu",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035QxIDQA0/Profile_Picture_2022-04-15T07:47:01.jpg",biography:"Soumya Basu, Ph.D., is currently working as an Associate Professor at Dr. D. Y. Patil Biotechnology and Bioinformatics Institute, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India. With 16+ years of trans-disciplinary research experience in Drug Design, development, and pre-clinical validation; 20+ research article publications in journals of repute, 9+ years of teaching experience, trained with cross-disciplinary education, Dr. Basu is a life-long learner and always thrives for new challenges.\r\nHer research area is the design and synthesis of small molecule partial agonists of PPAR-γ in lung cancer. She is also using artificial intelligence and deep learning methods to understand the exosomal miRNA’s role in cancer metastasis. Dr. Basu is the recipient of many awards including the Early Career Research Award from the Department of Science and Technology, Govt. of India. She is a reviewer of many journals like Molecular Biology Reports, Frontiers in Oncology, RSC Advances, PLOS ONE, Journal of Biomolecular Structure & Dynamics, Journal of Molecular Graphics and Modelling, etc. She has edited and authored/co-authored 21 journal papers, 3 book chapters, and 15 abstracts. She is a Board of Studies member at her university. She is a life member of 'The Cytometry Society”-in India and 'All India Cell Biology Society”- in India.",institutionString:"Dr. D.Y. Patil Vidyapeeth, Pune",institution:{name:"Dr. D.Y. Patil Vidyapeeth, Pune",country:{name:"India"}}},{id:"354817",title:"Dr.",name:"Anubhab",middleName:null,surname:"Mukherjee",slug:"anubhab-mukherjee",fullName:"Anubhab Mukherjee",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y0000365PbRQAU/ProfilePicture%202022-04-15%2005%3A11%3A18.480",biography:"A former member of Laboratory of Nanomedicine, Brigham and Women’s Hospital, Harvard University, Boston, USA, Dr. Anubhab Mukherjee is an ardent votary of science who strives to make an impact in the lives of those afflicted with cancer and other chronic/acute ailments. He completed his Ph.D. from CSIR-Indian Institute of Chemical Technology, Hyderabad, India, having been skilled with RNAi, liposomal drug delivery, preclinical cell and animal studies. He pursued post-doctoral research at College of Pharmacy, Health Science Center, Texas A & M University and was involved in another postdoctoral research at Department of Translational Neurosciences and Neurotherapeutics, John Wayne Cancer Institute, Santa Monica, California. In 2015, he worked in Harvard-MIT Health Sciences & Technology as a visiting scientist. He has substantial experience in nanotechnology-based formulation development and successfully served various Indian organizations to develop pharmaceuticals and nutraceutical products. He is an inventor in many US patents and an author in many peer-reviewed articles, book chapters and books published in various media of international repute. Dr. Mukherjee is currently serving as Principal Scientist, R&D at Esperer Onco Nutrition (EON) Pvt. Ltd. and heads the Hyderabad R&D center of the organization.",institutionString:"Esperer Onco Nutrition Pvt Ltd.",institution:null},{id:"319365",title:"Assistant Prof.",name:"Manash K.",middleName:null,surname:"Paul",slug:"manash-k.-paul",fullName:"Manash K. Paul",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/319365/images/system/319365.png",biography:"Manash K. Paul is a Principal Investigator and Scientist at the University of California Los Angeles. He has contributed significantly to the fields of stem cell biology, regenerative medicine, and lung cancer. His research focuses on various signaling processes involved in maintaining stem cell homeostasis during the injury-repair process, deciphering lung stem cell niche, pulmonary disease modeling, immuno-oncology, and drug discovery. He is currently investigating the role of extracellular vesicles in premalignant lung cell migration and detecting the metastatic phenotype of lung cancer via machine-learning-based analyses of exosomal signatures. Dr. Paul has published in more than fifty peer-reviewed international journals and is highly cited. He is the recipient of many awards, including the UCLA Vice Chancellor’s award, a senior member of the Institute of Electrical and Electronics Engineers (IEEE), and an editorial board member for several international journals.",institutionString:"University of California Los Angeles",institution:{name:"University of California Los Angeles",country:{name:"United States of America"}}},{id:"311457",title:"Dr.",name:"Júlia",middleName:null,surname:"Scherer Santos",slug:"julia-scherer-santos",fullName:"Júlia Scherer Santos",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/311457/images/system/311457.jpg",biography:"Dr. Júlia Scherer Santos works in the areas of cosmetology, nanotechnology, pharmaceutical technology, beauty, and aesthetics. Dr. Santos also has experience as a professor of graduate courses. Graduated in Pharmacy, specialization in Cosmetology and Cosmeceuticals applied to aesthetics, specialization in Aesthetic and Cosmetic Health, and a doctorate in Pharmaceutical Nanotechnology. Teaching experience in Pharmacy and Aesthetics and Cosmetics courses. She works mainly on the following subjects: nanotechnology, cosmetology, pharmaceutical technology, aesthetics.",institutionString:"Universidade Federal de Juiz de Fora",institution:{name:"Universidade Federal de Juiz de Fora",country:{name:"Brazil"}}},{id:"219081",title:"Dr.",name:"Abdulsamed",middleName:null,surname:"Kükürt",slug:"abdulsamed-kukurt",fullName:"Abdulsamed Kükürt",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/219081/images/system/219081.png",biography:"Dr. Kükürt graduated from Uludağ University in Turkey. He started his academic career as a Research Assistant in the Department of Biochemistry at Kafkas University. In 2019, he completed his Ph.D. program in the Department of Biochemistry at the Institute of Health Sciences. He is currently working at the Department of Biochemistry, Kafkas University. He has 27 published research articles in academic journals, 11 book chapters, and 37 papers. He took part in 10 academic projects. He served as a reviewer for many articles. He still serves as a member of the review board in many academic journals. He is currently working on the protective activity of phenolic compounds in disorders associated with oxidative stress and inflammation.",institutionString:null,institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"178366",title:"Dr.",name:"Volkan",middleName:null,surname:"Gelen",slug:"volkan-gelen",fullName:"Volkan Gelen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178366/images/system/178366.jpg",biography:"Volkan Gelen is a Physiology specialist who received his veterinary degree from Kafkas University in 2011. Between 2011-2015, he worked as an assistant at Atatürk University, Faculty of Veterinary Medicine, Department of Physiology. In 2016, he joined Kafkas University, Faculty of Veterinary Medicine, Department of Physiology as an assistant professor. Dr. Gelen has been engaged in various academic activities at Kafkas University since 2016. There he completed 5 projects and has 3 ongoing projects. 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