Analysis of distribution, phenotype and clinical correlation of CD163 positive macrophages in osteoarthritis / 中华疾病控制杂志

Objective The aim of this study was to analyze the distribution characteristics of CD163+ macrophages in peripheral blood and synovium of patients with osteoarthritis (OA)，and investigate the correlation of CD163+ macrophages, intracellular tumour necrosis factor(TNF-α), interleukin-10 (IL-10) expression with the disease duration, inflammation level and body mass index (BMI). Methods The percentages of CD163+ macrophages in synovium and peripheral blood and their intracellular levels of TNF-α and IL-10 were detected by flow cytometry. Meanwhile, immunofluorescence was uesed to observe the distribution of CD163+ macrophages in synovial tissue of patients with OA or fracture. Results (1) There were significant differences in the percentage of CD163+ macrophages in synovial and peripheral blood between OA and fracture patients(all P<0.05). (2) The expression of TNF-α in CD163+ macrophages of synovium and blood of OA patients with disease duration below 10 years was significantly higher than that of patients with OA disease duration above 10 years (all P<0.05) . The expression of IL-10 was significantly lower than that of patients with OA disease duration above 10 years (all P<0.05). (3) C-reactive protein (CRP) was positively correlated with BMI in patients with OA disease duration below 10 years (r=0.680， P<0.001), while showed no correlation with BMI in patients with OA duration above 10 years(r=0.084， P=0.187). (4) Immunofluorescence confocal microscopy showed a large number of CD163+ macrophages invaded around the synovial vessel of patients with OA. Conclusion The distribution of CD163+ macrophages in synovium and peripheral blood of OA patients with different course of disease was different, and showed differentiated cell subtypes.

Arthroscopic treatment of tibial intercondylar eminence fractures in children with single Kirschner wire and suture avoiding epiphyseal line fixation technique / 中国骨伤

<p><b>OBJECTIVE</b>To discuss arthroscopic technique of single Kirschner wire and suture avoiding epiphyseal line fixation for tibial intercondylar eminence fracture and its clinical results.</p><p><b>METHODS</b>From May 2008 to December 2012, 21 patients (13 males, 8 females, ranging in age from 6 to 14 years old) with tibial intercondylar eminence fracture were treated arthroscopically with single Kirschner wire and suture avoiding epiphyseal line fixation technique. According to Meyers and McKeever classification, 7 patients were type II, 10 patients were type III, and 4 patients were type IV. Active rehabilitation began at one week after operation. The patients were followed up for 10 to 30 months. X-ray films were taken to evaluate fracture healing at 1, 3, 6 months after operation; range of motion, the anterior drawer test, the lachman test and the Lysholm knee score were used to evaluate clinical effects.</p><p><b>RESULTS</b>All fractures were healed without displacement at 6 weeks after operation. Anterior drawer test and the lachman test were both negative in all patients at 3 months after operation. Lysholm knee score was 95.5 ±2.5 at 6 months after operation, and postoperative X-ray film did not find epiphyseal line broadening or narrowing.</p><p><b>CONCLUSION</b>Arthroscopic treatment for tibial eminence intercondylar fracture with single Kirschner wire and 8-shaped suture avoiding epiphyseal line fixation technique has many advantages, such as firm fixation,early mobilization, less invasive, less injury of physis and satisfactory effect.</p>

Total hip replacement with collum femoris preserving for the treatment of advanced stage of femoral head necrosis of young patients: a report of results of more than five years follow-up / 中华外科杂志

<p><b>OBJECTIVE</b>To observe the results of total hip replacement with collum femoris preserving for the treatment of advanced stage of femoral head necrosis of youth.</p><p><b>METHODS</b>From August 2002 to November 2009, 21 patients (28 hips) with advanced stage of femoral head necrosis were treated with total hip replacement with collum femoris preserving. Sixteen males (22 hips) and 5 females (6 hips) with an average age of 36 years (range from 26 to 51 years) were included. All patients were evaluated clinically using Harris score, the prosthesis components were assessed for position, loosening, bone resorption and other conditions with radiographs.</p><p><b>RESULTS</b>Nineteen patients (26 hip) were followed up for mean 5 years and 7 months (ranging 5 years and 3 months to 7 years and 1 month), 2 patients were missed. The average Harris score increased from the preoperative average 48.5 to 90.2. The leg-length discrepancy (the difference was less than 2 cm) occurred in 3 cases. No thigh pain and revision.</p><p><b>CONCLUSION</b>Total hip arthroplasty with collum femoris preserving is one of the best choices for the treatment of advanced stage of femoral head necrosis of young patients with good midterm outcome.</p>

Arthroscopic diagnosis and treatment of posttraumatic chronic ankle pain / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the arthroscopic diagnosis and treatment of the chronic ankle pain after injury.</p><p><b>METHODS</b>From April 1999 to June 2008, 39 patients with posttraumatic chronic ankle pain were treated. The mean duration between the initial injury and treatment was 18 months (2 months to 11 years). There were 15 males and 24 females with a mean age of 32 years (15 to 58 years). All the patients were treated with arthroscopic debridement. The preoperative and postoperative ankle functions were evaluated by the AOFAS (the American Orthopaedic Foot and Ankle Society) Clinical Rating System for the ankle-hindfoot.</p><p><b>RESULTS</b>Twenty-six patients had osteochondral lesions. Impingement syndrome in ankle was observed in 21 patients. The impingement tissue included synovial hypertrophy in 3 patients, ligament injury in 10 patients (7 patients had anterior talofibular ligament injury and 3 patients had anteroinferior tibiofibular ligament injury), meniscoid tissue in 6 patients, pathological labrum in 3 patients. All the patients were followed up with an average of (14.2+/-8.4) months (ranged from 5 to 36 months). The AOFAS scores increased significantly from pre-operative (59.7+/-16.9) to post-operative (68.8+/-21.2), and it was obvious in relieving pain, which was pre-operative (22.8+/-10.0) and post-operative (29.5+/-12.1).</p><p><b>CONCLUSION</b>Arthroscopy can be used to diagnose the cause of chronic ankle pain after injury. Furthermore, arthroscopic debridement was useful to relieve the pain and improve the joint function, and it is appropriate for patients who had no fractures and dislocations.</p>