Clinical transformation of cartilage tissue engineering: Challenges and opportunities / 医学研究生学报

Cartilage is a tissue simple in composition, complex in structure and difficult to repair after injury. The development of cartilage tissue engineering has been prompted by the limitations of current treatment methods, but is now faced with difficulties in further clinical transformation. With an introduction to the present situation in the treatment of cartilage injury, we analyzed the challenges opportunities in the clinical transformation of cartilage tissue engineering, hoping to provide some ideas and methods to promote its development andclinical transformation.

Revision total hip arthroplasty using a cementless prosthesis / 中华外科杂志

<p><b>OBJECTIVE</b>To assess the operative technique and results with the usage of cementless prosthesis in hip revision.</p><p><b>METHODS</b>Retrospective study was done on revision of total hip arthroplasty with cementless prosthesis in 72 patients (41 males and 31 females) with an average age of 65.7 years (28-82 years) from January 2004 to December 2009. The reason for revision was 2 infection, 54 aseptic loosening, 4 periprosthetic fractures, 5 fracture of femoral stems and 7 cases of acetabular abrasion after hemi-arthroplasty. The operation time, bleeding loss, complications of infection, dislocation, periprosthetic fractures and loosening were evaluated. The Harris score were used for hip function evaluation.</p><p><b>RESULTS</b>The average operation time was (146±47) minutes (70-280 minutes) and bleeding loss during the operation was (970±540) ml (200-2500 ml). Bacterium cultivation during operation demonstrated infection in 2 patients. Bone windows at the lateral femoral were opened in 4 patients and extend trochanteric osteotomy was done in 7 patients. Fracture of the proximal femur occurred in 8 cases. Twenty-nine patients were treated with bone graft including 18 autografts and 11 allografts. Sixty-seven patients were followed up for an average time of 66 months (20-92 months). Additional revisions were performed in 3 cases including 2 dislocations and 1 infection. There were no death, no damage of major blood vessels and nerves. The bone graft healed during 3-5 months. The survival rates of the femoral prosthesis and the acetabulum prostheses were 95.5% and 98.4%. The mean Harris score was 86±8 (55-95 points). Osteolysis were seen in 13 hips but migration was seen in only 1 patient.</p><p><b>CONCLUSIONS</b>The cementless prosthesis is useful in revision total hip arthroplasty and the perfect clinical results are related to the reliable primary fixation.</p>

Association of estrogen receptor alpha gene polymorphisms with bone mineral density: a meta-analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A number of studies have examined the association between estrogen receptor alpha (ESR-α) gene polymorphisms and bone mineral density (BMD), but previous studies of ESR-α gene XbaI (rs9340799) and PvuII (rs2234693) polymorphisms have been hampered by small sample size, regional restrictions and inconclusive results. Thus a meta-analysis is needed to assess their pooled effects.</p><p><b>METHODS</b>This study reviewed all published articles indexed in Pubmed using the keywords in the title or abstract. All data were extracted independently by two reviewers using a standard form, the studies were meta-analyzed and minor discrepancies were resolved by authors' discussion.</p><p><b>RESULTS</b>Twenty seven eligible studies involving 8467 women and 2032 men were identified. The XbaI and PvuII polymorphisms were significantly associated with BMD of the lumbar spine. XX and PP homozygotes had a protective effect in comparison with carriers of the x and p alleles, the effects were more significant in premenopausal women or Western women. At the femoral neck, the results were different. XX served as a protective factor in postmenopausal women, Western women, Western postmenopausal women, and men, while PP was likely to serve as a risk factor in Eastern women, Eastern postmenopausal women, and men.</p><p><b>CONCLUSIONS</b>The XbaI polymorphism is correlated to BMD at diverse skeletal sites. PP had a protective role for the lumbar spine but might be a risk factor for the femoral neck.</p>

Clinical analysis and prevention from coating shedding of uncemented hip prosthesis / 中国骨伤

<p><b>OBJECTIVE</b>The long-term biological effects of HA-coated prostheses remain uncertain. The purpose of the study is to analyze the reasons of coating shedding of uncemented hip prothesis, so as to provide evidences for the preventions and treatment.</p><p><b>METHODS</b>From 2002.10 to 2009.2, 5 patients with coating shedding of uncemented hip prosthesis were treated with kip revision operation. Among the patients, 3 patients were male and 2 patients were female, ranging in age from 55 to 68 years. The hip prosthesis were taken out in the operation and the cause of coating shedding was analyzed. Another ten normal prosthesis taken out from the revision operation were used as the control group. The histomorphology and microarchitecture of hip prosthesis were observed. The micrometer caliper and vickers hardness test were used to measure the thickness and hardness. The interface shearing force was measured by push-out test. The function of hip joint was evaluated by Harris score.</p><p><b>RESULTS</b>There were difference between control and experience groups in his tomorphology observation. In the 2 patients with HA-coated shedding, the thickness of coating were 112 microm and 138 microm respectively; Vickers hardness were 5,843 Hv and 4,524 Hv respectively; and the shear strength were 12.4 MPa and 11.6 MPa respectively. In the 3 patients with Ti-coated shedding, the Harris scores were 82, 88 and 87 respectively.</p><p><b>CONCLUSION</b>There are many reasons of coating shedding of uncemented hip prosthesis. But most reasons have relationship with the quality of hip prosthesis. Nowadays, there are many methods to enhance the binding strength between the coating and prosthesis, and to prevent the early coating shedding.</p>