ABSTRACT
Objective It is a great challenge to perform hip revision surgery especially with severe proximal femoral bone de -fect.This study aims to discuss the short-medium clinical outcomes of using nonmodular full-coated tapered stem in femoral revision with Paprosky Ⅲ bone defect. Methods From May 2011 to October 2015, 58 patients(58 hips)diagnosed as ostiolysis/aseptic loosening with severe femoral bone defect(Paprosky Ⅲ)were treated with hip revision surgery.The cases of septic loosening and tumor were excluded.Harris scoring system and pain visual analogue scale(VAS)were used pre-and post-operatively to evaluate the function of hip joints and the pain level.Radiograph was used to evaluate loosening,subsidence and bone healing of the prosthesis. Results All patients were followed-up with 24-67 months,the mean follow up time was 49.3±12.7 months.None of the patients showed infec-tion or surrounding bone fracture.Dislocation happened in one case after surgery and was treated with manipulative reduction without re -currence.One case had progressive subsidence which led to aseptic loosening and was treated with re-revision.By the end of last follow-up,Haris Score was improved from preoperative 41.6±6.9 points to 83.1±5.7 points, VAS score decreased from preoperative 6.7 ±1.6 points to 2.5 ±1.2 points,(P<0.05). Conclusion Nonmodular full-coated tapered stem can obtain good clinical effect in femoral revision with severe proximal bone defect.
ABSTRACT
As a degenerative disease caused by multiple factors, osteoarthritis is characterized by articular cartilage degeneration and reactive hyperplasia of joint edge and the subchondral bone. Recently, kartogenin (KGN) was identified to promote chondrocyte differentiation. KGN can block interleukin 1β(IL-1β)-caused loss of extracellular matrix and proteoglycan. Transforming growth factor β1(TGF-β1), bone morphogenetic protein 7(BMP-7), and KGN together can synergistically promote the expression of lubricin in chondrocytes. KGN can also induce cartilage-like tissue formation in tendon-bone junction. In addition, chitosan (CHI)-KGN nanoparticles and CHI-KGN microspheres can more effectively induce chondrogenic differentiation than unconjugated KGN. Here in this paper we summarized the roles of KGN in regulating the cartilage regeneration.