Clinical Outcomes and Risks of Single-stage Bilateral Unicompartmental Knee Arthroplasty via Oxford Phase III / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Osteoarthritis often affects the joint bilaterally, and the single-stage (SS) unicompartmental knee arthroplasty (UKA) is advantageous in terms of a single anesthesia administration, a short hospital stay, lower medical costs, and enhanced patient convenience. However, the complication risk of SS UKA continues to be debated. The aim of this article was to evaluate the clinical effectiveness, complications, and functional recovery of SS and two-stage (TS) UKA.</p><p><b>METHODS</b>From January 2008 to December 2013, we compared a series of 36 SS UKA with 45 TS UKA for osteoarthritis. The mean age was 65.4 years (range: 55-75 years). The mean body mass index was 25.2 kg/m 2 (range: 22-29 kg/m 2 ). The pre- and post-operative Oxford Knee Scores (OKSs), complications, operative times, tourniquet times, the amount of drainage, and hemoglobin (Hb) were evaluated. The Chi-square test, Fisher's exact test, and paired and grouped t-tests were used in this study.</p><p><b>RESULTS</b>The mean follow-up was 50 months. No complications of death, fat embolism, deep vein thrombosis, and prosthetic infection were reported. Patients who underwent SS UKA had a shorter cumulative anesthesia time (113.5 vs. 133.0 min, P < 0.01). There were no significant variations between the values of the mean tourniquet time, the amount of drainage, pre- and post-operative Hb in the different groups. No patient required a blood transfusion. No statistical differences were found in the complications between two groups (P > 0.05). At the final follow-up, the mean OKS improved from 39.48 ± 5.69 to 18.83 ± 3.82 (P < 0.01), with no statistical differences between the two groups (P > 0.05). Patients who underwent SS UKA had a faster recovery.</p><p><b>CONCLUSIONS</b>The single-staged UKA offers the benefits of a single anesthesia administration, reduced total anesthetic time, decreased overall rehabilitation time, and absence of an increase in perioperative mortality or complications compared with the TS bilateral UKA.</p>

Pre-operative assessment of the patellofemoral joint in unicompartmental knee replacement using Oxford Phase III and its influence on outcome / 中华外科杂志

<p><b>OBJECTIVE</b>To determine whether anterior knee pain and/or radiological evidences of degeneration of the patellofemoral joint influence the outcome of unicompartmental knee arthroplasty (UKA).</p><p><b>METHODS</b>Between January 2006 and December 2010, 95 consecutive patients (100 knees) with unicompartmental knee osteoarthritis were treated with Oxford UKA, including 34 males and 61 females. The mean age was 68.2 years (range, 55-82 years). The average Body Mass Index was 26.3 kg/m(2)(range, 24-28 kg/m(2)). Pre-operative there were 43 knees (43.0%) with anterior knee pain and 57 knees (57.0%) without it. Pre-operative radiological status of the patellefemoral joint were defined using Ahlback and Altman systems. The pre- and post-operative results of Oxford Knee Score (OKS), American Knee Society Score (AKS) and Western Ontario and Macmaster (WOMAC) were compared using paired t-test, the results between different groups were compared using grouped t-test.</p><p><b>RESULTS</b>All cases were followed up for average 50 months (24-84 months). At the last follow-up, none had complications of infection, fat embolism, deep vein thrombosis, malposition of prosthesis, dislocation or loosing. The mean femoral component alignment was -0.7° ± 5.2° (valgus/varus), -0.8° ± 4.5°(flexion/extension); the mean tibial component alignment was -0.1° ± 2.2°(valgus/varus), -0.4° ± 2.4° (flexion/extension). The clinical outcomes were significantly improved compared with pre-operation regardless of presence (OKS: t = 19.04, P < 0.01; AKS knee:t = 38.56, P < 0.01;AKS function:t = 39.29, P < 0.01;WOMAC:t = 43.22, P < 0.01) or absence (OKS: t = 31.57, P < 0.01; AKS knee:t = 40.34, P < 0.01; AKS function:t = 43.62, P < 0.01; WOMAC: t = 47.06, P < 0.01) of anterior knee pain. The results were significantly improved compared with pre-operation (P < 0.01) regardless of whether degeneration of the patellofemoral joint. There was no statistically significant difference in outcome between patients with evidence of degeneration in the medial patellofemoral joint and those without (P > 0.05) . Patients with lateral patellofemoral degeneration had a worse score than those without, OKS (t = 2.56, P = 0.01) and WOMAC (t = 2.20, P = 0.03) by the Altman score, OKS (t = 2.29, P = 0.02) by the Ahlback score. For AKS measures there was no statistically significant difference in outcome (P > 0.05) .</p><p><b>CONCLUSIONS</b>Neither anterior knee pain nor radiological evidence of medial patellofemoral joint degeneration would influnence the outcome of UKA, lateral patellofemoral joint degeneration have an increased risk of a poor result.</p>

Inhibitory effect of adenovirus mediated VEGF-siRNA on transplanted osteosarcoma in nude mice / 中国肿瘤生物治疗杂志

Objective: To investigate the inhibitory effect of adenovirus-mediated VEGF-siRNA on transplanted osteo- sarcoma in nude mice.Methods: VEGF-siRNA gene was cloned into the genome of replication-deficient adenovirus to construct Ad-VEGF-siRNA;the latter was then used to infect osteosarcoma MG63 cell line in vitro;and the expression of VEGF gene was detected by RT-PCR.Osteosarcoma transplantation model was established in nude mice;VEGF expression in tumor tissue was analyzed and the inhibitory effect on tumor growth and lung metastasis were also observed.Results: The recombinant adenovirus vector Ad-VEGF-siRNA was successfully constructed.In vivo and in vitro experiment both showed that Ad-VEGF-siRNA significantly downregulated VEGF expression in MG63 cells and transplanted tumor tissue. It was found that Ad-VEGF-siRNA significantly inhibited transplanted osteosarcoma growth(P