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Periprosthetic infection is a catastrophic complication after joint replacement. Choosing appropriate treatment for patients with different infection characteristics is the key to improve the success rate. The one-stage revision has been applied and studied more and more in clinical work because of its advantages in treatment cycle, functional recovery, complications and cost. Grasping the indications and contraindications, comprehensive analysis and selection of appropriate patients, considering intraoperative details and postoperative anti-infection treatment meticulously, are crucial to reduce the recurrence rate of infection. The purpose of this paper is to describe the main points of the one-stage revision in the treatment of periprosthetic infection, and to summarize the classic and recent research on the one-stage revision.
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Objective:To investigate the effects of posterior condylar offset (PCO) change on functional recovery after high-flexion posterior-stabilized total knee arthroplasty (TKA).Methods:From December 2018 to May 2019, a total of 76 patients (7 males and 69 females) who underwent primary TKA were included. The age of patients was 67.78±5.13 years (56-75 years). Preoperative and postoperative radiological PCO were measured by lateral knee X-ray. The true preoperative PCO was defined as the sum of radiological PCO and the thickness of posterior condylar cartilage. According to the changing of PCO (ture preoperative PCO - postoperative PCO), the subjects were divided into four groups, namely 28 cases in ≤-3 mm group, 23 cases in -3 mm- group, 15 cases in 0 mm- group and 10 cases in ≥3 mm group. The parameters, including age, body mass index, range of motion (ROM), Knee Society Scores (KSS) and visual analogue score (VAS) before the operation, were not significantly different among four groups. ROM, KSS, VAS at 2 weeks, 1 month, 3 months, 6 months after the operation were compared among the four groups.Results:There were good inter-observer reliabilities regarding the parameters measured in this study ( ICC>0.75). The KSS, ROM, VAS of all the subjects after operation were significantly better than those before the operation ( F=318.768, 64.983, 361.749; P=0.000). In all groups, the recovery of KSS and VAS last to 6 months after the operation. The ROM trended to be stable at the 3 months after the operation. At 6 months after operation, ROM, KSS and VAS of ≤-3 mm group was 116.07°±9.66°, 156.25±21.49, and 1.18±0.94, respectively. These parameters of -3 mm- group was 119.57°±7.52°, 162.17±17.09, and 1.26±0.86. However, these parameters of 0 mm- group was 126.07°±5.25°, 161.86±8.86, 1.00±0.55, respectively. These of ≥3 mm group was 118.00°±4.21°, 156.60±16.98 and 1.30±0.95. The KSS, KSS anatomy score, KSS function score and VAS were not significantly different at any follow-up point among four groups. The ROM of 0 mm- group at 1 month, 3 months and 6 months after operation (118.57°±13.07°, 25.00°±6.20°, 126.07°±5.25°) was significantly different from other three groups ( F=4.966, P=0.003; F=4.179, P=0.006; F=5.262, P=0.003), while 0 mm- group's ROM were greater than other three groups ( P<0.05). Conclusion:Increasing within 3 mm of PCO was related to larger postoperative ROM in high-flexion posterior-stabilized TKA. However, change of PCO had no influence on the outcomes of KSS recovery and pain relief.
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Through analysis and summary of the biological characteristics of various biomarkers, to explore the reliability of different markers for early diagnosis of osteoarthritis. Cartilage oligomeric matrix protein, N-terminal crosslinked telopeptide of type Ⅰ collagen and C-terminal crosslinked telopeptide of type Ⅱ collagen are the possible effective markers in osteoarthritis early diagnosis. Hyaluronic acid and C-terminal crosslinked telopeptide of type I collagen are more suitable for evaluating the ollurrence and derelopment of osteoarthritis. The efficacy of miRNA and lncRNA in osteoarthritis diagnosis and evaluation remains to be proved. Each marker may has two or more biological effect, this paper will focus on finding out an accurate and stable marker with the analysis and summary of present bio-markers.
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Through analysis and summary of the biological characteristics of various biomarkers,to explore the reliability of different markers for early diagnosis of osteoarthritis.Cartilage oligomeric matrix protein,Nterminal crosslinked telopeptide of type [collagen and C-terminal crosslinked telopeptide of type Ⅱ collagen are the possible effective markers in osteoarthritis early diagnosis.Hyaluronic acid and C-terminal crosslinked telopeptide of type Ⅰ collagen are more suitable for evaluating the ollurrence and derelopment of osteoarthritis.The efficacy of miRNA and IncRNA in osteoarthritis diagnosis and evaluation remains to be proved.Each marker may has two or more biological effect,this paper will focus on finding out an accurate and stable marker with the analysis and summmary of present bio-markers.
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AIM: To investigate the effects of IL-13 on expression of IL-1? in acute renal ischemia/reperfusion injury. METHODS: Fifty-seven male Wistar rats were randomly divided into 8 group: normal group,sham operation group, ischemia group, ischemia/reperfusion injury group(I/R), normal saline(NS)-treated group 1(C-1), NS-treated group 2(C-2),IL-13-treated group1(T-1)and IL-13-treated group 2(T-2).Rats were subjected to 45 min bilateral renal ischemia followed by reperfusion. rmIL-13 (1.5 ?g/50 g body weight )was injected into the renal arteries through the abdominal aorta before ischemia(T-1) or immediately afterischemia(T-2).The serum level of IL-1? and the renal expression of IL-1? were determined in each group at 24 h post-ischemia. In addition, BUN,Cr and renal histology were also measured. RESULTS: (1)The serum level of IL-1? [C-1to T-1: (27.13?5.51) ng/L to (14.05?3.82) ng/L, P
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AIM: To investigate the effect of interleukin-13 (IL-13) on cell proliferation and interleukin-6 (IL-6) production in mesangial cells. METHODS: Cell proliferation was tested by MTT method. The protein synthesis of IL-6 in mesangial cells was measured by ELISA. The expression of IL-6 mRNA in mesangial cells was evaluated by RT-PCR. RESULTS: IL-13(1 ?g/L-100 ?g/L) inhibited the proliferation of mesangial cell in a dose-dependent manner. Both mRNA and protein of IL-6 in mesangial cells were increased significantly in the presence of LPS and this increase could be reversed by IL-13 (1?g/L-100?g/L). However, this increase could not be reversed by IL-13 if the dose was lower than 0.1?g/L and if the mesangial cells were cultured in 5% FCS RPMI1640. CONCLUSION: IL-13 could inhibit IL-6 expression induced by LPS in mesangial cells . We suggested that IL-13 may be an inhibitory cytokine in the regulation of the mesangial cell proliferaltion and inflammatory reaction in glomerulonephritis.