Retrospective clinical study of hip replacement in the treatment of traumatic arthritis secondary to acetabular fracture / 中国骨伤

OBJECTIVE@#To investigate the clinical effect of total hip replacement (THA) in the treatment of traumatic arthritis secondary to acetabular fracture.@*METHODS@#From October 2019 to June 2022, 15 patients with secondary traumatic arthritis of acetabulum fracture were treated with THA. There were 8 males and 7 females, aged from 40 to 76 years old with an average of (59.20±9.46) years old. Prosthesis loosening, dislocation of hip joint, range of motion of hip joint, nerve injury and other conditions were recorded before and after surgery. Harris score, visual analogue scale (VAS) and imaging were used to evaluate hip joint function and surgical effect.@*RESULTS@#Follow-up time ranged 6 to 39 months with an average of (18.33±9.27) months. All the 15 patients successfully completed the operation, no nerve and blood vessel injury during the operation, postoperative wound healing was stageⅠ, no infection, one case of acetabular side prosthesis loosening at half a year after operation, and recovered well after revision surgery, one case of hip dislocation was cured after open reduction treatment, no adverse consequences. Harris score at the last postoperative follow-up was (88.60±4.01) points, compared with the preoperative (47.20±11.77) points, the difference was statistically significant (P<0.05), and VAS at the lateat postoperative follow-up was 1 (1) points, compared with the preoperative 8 (2) points, the difference was statistically significant (P<0.05). At the last follow-up, the pain symptoms were relieved or disappeared, and the joint function was satisfactory. The imaging data of the latest follow-up showed joint was well pseudoradiated, no abnormal ossification occurred, and the prosthesis was not loose.@*CONCLUSION@#THA is effective in the treatment of traumatic arthritis secondary to acetabular fracture and can effectively improve the quality of life of patients. Preoperative comprehensive evaluation and bone defect evaluation of patients, and intraoperative management of acetabulum, femur, internal fixation and bone defect are key factors for the success of surgery.

Medium term follow up outcomes of uncemented total hip arthroplasty for traumatic arthritis after intramedullary nail fixation of femoral intertrochanteric fracture / 中国骨伤

OBJECTIVE@#To evaluate the effect of uncemented total hip arthroplasty(THA) on treatment of traumatic arthritis caused by intramedullary nailing interfixation of intertrochanteric fractures.@*METHODS@#Total of 22 patients treated with THA due to traumatic arthritis caused by intramedullary nailing interfixation of intertrochanteric fractures from January 2012 to January 2017 were studied retrospectively, including 10 males and 12 females with a mean age of (72.5±9.8) years old ranging from 61 to 84 years old. Initial internal fixation method:14 patients were treated with Gamma nails and 8 patients were treated wit PFNA.The time from internal fixation surgery to THA was 10 to 68 months with an average of (32.2±21.3) months.Harris scores of the hip joint before and after surgery were compared, and the position of the prosthesis through postoperative imaging at 3, 6, 12 months and the last follow-up were evaluated.@*RESULTS@#One patient was died due to heart failure 1 year after operation. Two patients was died to advanced tumor 2 years after operation. The other 19 patients were followed up for 36 to 64 months with an average of (48.5±11.9) months. At final follow up, 14 patients regained the ability to walk independently, 4 patients needed support of a cane, 1 patient needed assistance of a walker. No serious complications such as joint dislocation, periprosthetic fracture and deep venous thrombosis occurred during follow-up. There were no signs of loosening and subsidence of the prosthesis at the final follow-up. Mean Harris hip score increased from (29.2±12.9) points preoperatively to (74.2±11.2) points at the final follow up(P<0.05);the score was excellent in 9 patients, good in 7 and fair in 3.@*CONCLUSION@#Uncemented total hip arthroplasty for traumatic arthritis after intramedullary nail fixation of femoral intertrochanteric fracture can significantly improve hip function and effectively avoid bone cement implantation syndrome. The medium-term effect is satisfactory.

Short- and mid-term effectiveness of unicompartmental knee arthroplasty for post-traumatic arthritis of knee / 中国修复重建外科杂志

OBJECTIVE@#To investigate the short- and mid-term effectiveness of unicompartmental knee arthroplasty (UKA) for post-traumatic arthritis (PTA) of knee.@*METHODS@#The clinical data of 30 patients with PTA of unilateral knee between March 2014 and September 2021 was retrospectively analyzed. There were 14 males and 16 females with an average of 64.5 years (range, 33-81 years). The average body mass index was 26.7 kg/m 2 (range, 19.8-35.6 kg/m 2). The types of injuries that caused PTA included intra-articular fracture in 16 cases, extra-articular fracture in 8 cases, and soft tissue injury in 6 cases. The initial injuries were treated by conservative therapy in 12 cases and by surgical therapy in 18 cases. Ten cases were medial compartment osteoarthritis and 20 cases were lateral compartment osteoarthritis. According to Kellgren-Lawrence staging, there were 19 cases of grade Ⅲ and 11 cases of grade Ⅳ. The operative time, the length of hospital stay, complications, and subjective satisfaction were recorded. The Oxford Knee Function Score (OKS), Hospital for Special Surgery (HSS) score, and knee range of motion (ROM) were used to evaluate knee function. Weight-bearing X-ray films were taken to measure the femoro-tibial angle (FTA) and to assess alignment correction of the lower limb.@*RESULTS@#The operative time ranged from 50 to 95 minutes (mean, 63.7 minutes), the length of hospital stay ranged from 3 to 8 days (mean, 6.9 days). Superficial infection occurred in 2 patients, while the remaining incisions healed by first intention. There was no deep vein thrombosis or neurovascular injury. All patients were followed up 17-109 months (median, 70 months). At last follow-up, OKS score, HSS score, and ROM in 30 cases significantly improved when compared with those before operation (P<0.05). Lower limb alignment was significantly corrected and there was significant difference in FTA of the varus and valgus knees between pre- and post-operation ( P<0.05). The patient satisfaction rate was 86.7% (26/30). Two cases developed contralateral osteoarthritis progression during follow-up. No bearing dislocation, prosthesis loosening or sinking occurred and none required further revision.@*CONCLUSION@#For patients with PTA of knee, UKA can obtain definite short- and mid-term effectiveness with high patient satisfaction.

Current status of surgical treatment for traumatic arthritis / 解放军医学杂志

Traumatic arthritis (TA) is one of the common diseases of bone and joint caused by trauma. The main pathological changes are degeneration of articular cartilage and secondary hyperplasia and ossification of cartilage. The main clinical manifestations are joint pain and dysfunction of movement. Its pathogenesis is still unclear. At present, the treatment of TA is based mainly on symptoms rather than etiology, including physical therapy, drug treatment, surgical treatment, etc. Conservative treatment (physical therapy, drug treatment) can only alleviate short-term pain, and the long-term effect is not satisfactory. Thus, patients with middle and late TA tend to choose surgical treatment. At present, the surgical treatment of TA includes arthroscopic debridement, arthrodesis, cartilage repair, osteotomy, artificial joint replacement, 3D printing technology, etc. There are differences in the postoperative efficacy. This article reviews the current situation of surgical treatment for TA.

A comparative study of mini-locking plate and external fixator in the treatment of comminuted cuboid fracture / 中国组织工程研究

BACKGROUND: Open reduction internal fixation and external fixation are two main surgical treatments for comminuted cuboid fractures. With the development of internal fixation devices, especially the appearance of mini-locking plate, the therapeutic effect of internal fixation has been improved. OBJECTIVE: To compare the clinical and imaging effects of mini-locking plate and external fixator in the treatment of comminuted cuboid fracture. METHODS: The data of 43 patients with comminuted cuboid fracture admitted to the Department of Orthopedics, Tianjin Port Hospital from January 2013 to March 2018 were retrospectively analyzed. According to different treatment methods, the patients were divided into two groups: 23 cases in the mini-locking plate group and 20 cases in the external fixator group. All patients signed the informed consent This study was approved by the Hospital Ethics Committee. The patients in both groups were confirmed as comminuted cuboid fracture by CT and three-dimensional reconstruction scan before operation. Bone graft support of allograft was performed during the operation, and the external fixator was removed within 3-4 months after operation. At the last follow-up, bilateral standing and anteroposterior and lateral X-ray examination was performed to compare the loss of height, length, width, lateral longitudinal arch angle, calcaneal fifth metatarsal angle, Maryland loot score, American Orthopedic Foot and Ankle Society Score and the incidence of complications between the two groups. RESULTS AND CONCLUSION: (1) All patients were followed up for more than one year. (2) There were no significant differences in height loss of cuboid bone, width loss, last lateral longitudinal arch angle, and calcaneal fifth metatarsal angle between the two groups (P > 0.05). (3) There were significant differences in the loss of cuboid bone length, Maryland foot score and American Orthopedic Foot and Ankle Society Score and the incidence of complications between the two groups (P < 0.05). Mini-locking plate group was superior to the external fixator group in above indexes. (4) These findings indicated that mini-locking piate and external fixator are effective methods for the treatment of comminuted cuboid fracture. Micro-locking plate has more advantages in maintaining the length of cuboid bone, clinical function and reducing complications. With the prolongation of time, stable foot and good function can be achieved.

Reemplazo total de rodilla en pacientes menores de 55 años con gonartrosis. Seguimiento de 2 a 13 años / Total knee arthroplasty for gonarthrosis in patients <55 years old. A 2 to 13-year follow-up study

Introducción: Los reemplazos totales de rodilla en jóvenes siguen aumentando. Se publicaron resultados inconstantes sobre la función y las complicaciones, inclusive en pacientes con artritis reumatoide. El propósito de este estudio fue analizar un grupo de reemplazos totales de rodilla en pacientes <55 años para evaluar la sobrevida de la prótesis, las fallas radiológicas y los resultados funcionales. Materiales y Métodos: Se analizaron retrospectivamente 53 reemplazos totales de rodilla en 46 pacientes (promedio de edad: 49 años [rango 26-54]) y un seguimiento promedio de 6.5 años (rango 2-15). Los diagnósticos preoperatorios fueron: 46 gonartrosis idiopáticas, 5 postraumáticas y 2 osteonecrosis. Veintidós tenían cirugías previas. Se utilizaron 49 implantes importados y 4 nacionales. Los resultados clínico-funcionales se evaluaron mediante el Knee Society Score y el WOMAC, la evaluación radiológica se efectuó con el sistema de la Knee Society. Resultados: El puntaje KSS funcional mejoró de 49,3 a 92,6 en promedio y el puntaje propio de rodilla pasó de 46,8 a 91,4 en el posoperatorio. El puntaje WOMAC promedio fue de 2,3 para dolor, 2,6 para rigidez y 27,3 para capacidad funcional. El 16% presentó líneas de radiolúcidas <1 mm que no progresaron. Hubo tres infecciones que requirieron una revisión en dos tiempos, con evolución favorable, y cuatro casos de rigidez tratados mediante movilización artroscópica. La sobrevida de la prótesis fue del 94,34%. Conclusiones: El reemplazo total de rodilla en pacientes <55 años fue un procedimiento confiable en cuanto a la mejoría de la función, con una aceptable sobrevida de la prótesis considerando los antecedentes quirúrgicos. No se observaron fallas radiológicas al final del seguimiento. Nivel de Evidencia: IV

Introduction: Total knee arthroplasty is being performed with increasing frequency in young patients. Published data on the clinical scores and long-term durability for total knee arthroplasty in these patients are limited and most include patients with rheumatoid arthritis. The purpose of this study was to analyze a group of total knee arthroplasties in patients <55 years old, excluding those with rheumatoid arthritis, in order to assess prosthetic survival, radiographic failures and functional outcomes. Methods: A total of 53 total knee arthroplasties were retrospectively analyzed in 46 patients (average age: 49 years [range 26-54]) and a mean follow-up of 6.5 years (range 2-15). The preoperative diagnoses accounted for 46 idiopathic knee osteoathritis, 5 post-traumatic arthritis and 2 osteonecrosis. Twenty-two patients had previous surgeries. The clinical and functional outcomes were assessed using the Knee Society Score and the WOMAC, whereas radiological assessment system of the Knee Society was used. Results: Clinical and functional KSS improved from 49.3 to 92.6 and from 46.8 to 91.4 postoperatively on average, respectively. The average WOMAC score was 2.3 for pain, 2.6 for stiffness and 27.3 for functional capacity. Radiolucent lines <1 mm were observed in 16%, without progression over time. There were 3 infections requiring two-stage revision evolving favorably and 4 cases of stiffness that were manipulated under anesthesia or arthroscopy. The prosthetic survival rate was 94.34%. Conclusions: Total knee arthroplasty in patients <55 years provides functional improvements, with an acceptable prosthetic survival considering previous surgeries. At the end of the follow-up, no radiological failures were observed. Level of Evidence: IV

Evaluation of the efficacy and safety of cellular bone allograft for ankle arthrodesis / 临床外科杂志

Objective To evaluate the efficacy and safety of cellular bone allograft(CBA)in ankle arthrodesis.Methods The clinical data of 56 patients with traumatic ankle joint injury and ankle joint injury treated in our hospital from April 2013 to April 2016 were retrospectively analyzed.Imaging was performed at 3 months after surgery,and the visual analogue(VAS)score of the patients,the ankle and foot surgery score(AOFAS),and the SF-36 health status questionnaire score were recorded.The group included 33 patients who were treated with CBA,and patients with simple fusion in the treatment group(n=23).Results 2 months after operation,the fusion rate of CBA group was 87.9% and the fusion rate of without CBA group was 52.2%.3 months after operation,the fusion rate of CBA group was not higher than that of group CBA,and the fusion rate was in group.The data showed a significant improvement in pain,function,and quality of life.No adverse events caused by CBA were observed during the study.Conclusion The rate of fusion was higher in patients treated with bone allograft(CBA)than in patients with autologous bone graft,and the fusion rate was not affected by high risk factors.CBA is a safe and effective graft material for the bone healing of damaged joints,which can provide an effective bone graft substitute for ankle arthrodesis.

Total Hip Arthroplasty on Treatment of Traumatic Arthritis Caused by Internal Fixation Failures of Intertrochanteric Fractures / 中山大学学报(医学科学版)

[Objective]To investigate the efficacy of total hip arthroplasty(THA)on the treatment of traumatic arthritis that caused by internal fixation failures of intertrochanteric fractures.[Methods]During January 2009 and March 2016,35 cases of trau?matic arthritis(male:18 cases;female17 cases;49 ~ 86 years old,with an average age of 68.5 years)caused by internal fixation failures or malunion of intertrochanteric fractures,were undergo THA. Among 35 cases,13 cases were performed with the proximal femoral fixation stems,10 cases were with distal fixation stems,and 12 cases were with extended stems.[Results]With 3~65 months follow-up,the hip joint HSS score was elevated from 44.1(31 ~ 65)preoperative to 82.5(58 ~ 94)postoperative without obvious loosening. No postoperative deep infectionwas found. The femoral stems in 2 cases were found to sink 5 mm and 10 mm,respectively. No obvious prosthesis loosening was found. Taken together ,the satisfaction rate of THA on the joint function of traumatic arthritis was 91.4%.[Conclusion]Total hip arthroplasty is recommended as an effective approach for treating traumatic arthritis caused by internal fixation failures of intertrochanteric fractures. Distal fixed prosthesis was recommended due to bone sclerosis or defects of proximal femur. Coupled with emphasis on reconstruction of the greater trochanter ,good therapeutic effects could be achieved.

Association of synovial fluid vasoactive intestinal peptide levels with disease severity of ankle post-traumat-ic osteoarthritis:A preliminary study / 实用医学杂志

Objective To explore the association of synovial fluid vasoactive intestinal peptide levels with cartilage damage,radiological changes and symptomatic severity in patients with ankle post-traumatic osteoarthritis. Methods 74 patients with ankle traumatic osteoarthritis undergoing ankle anthroscopic debridement or joint replacement and 69 healthy controls receiving body check were enrolled in the this study. Serum and synovial fluid VIP concentrations were measured by a special radioimmunoassay method. Cartilage degradation biomarker colla-gen type Ⅱ(CTX-II)and inflammatory marker interleukin-6 were determined by enzyme-linked immunosorbent assay (ELISA). The symptomatic and functional severity was evaluated using Teeny & Wiss and AOFAS ankle-hindfoot rating scale. The radiographic progression of PTAOA was identified according to the modified ankle osteoar-thritis Kellgren-Lawrence (K-L) grading system. The mankin score was used for assessing the histopathological severity for cartilage lesions. Receiver operating characteristic (ROC) curve was conducted and the area under curve(AUC)was used to evaluate the diagnostic value of VIP,IL-6 and CTX-II levels for the prediction of the modified K-L grading by comparing with other biomarkers. Results There were no significant differences in serum VIP levels between PTAOA patients and controls. VIP levels in synovial fluid showed a negative correlation with modified ankle K-L grading,Mankin scores,CTX-Ⅱand IL-6. In addition,VIP levels were also positively associated with Teeny&Wiss and AOFAS ankle-hindfoot scores. The AUC area of VIP was similar to CTX-Ⅱat early stage of the disease. Conclusions Synovial fluid VIP levels show an independent and negative correlation with disease severity in patients with PTAOA. Low level of VIP in SF can be used as a potential biomarker for reflecting disease progression.

Association of synovial fluid vasoactive intestinal peptide levels with disease severity of ankle post-traumat-ic osteoarthritis:A preliminary study / 实用医学杂志

Objective To explore the association of synovial fluid vasoactive intestinal peptide levels with cartilage damage,radiological changes and symptomatic severity in patients with ankle post-traumatic osteoarthritis. Methods 74 patients with ankle traumatic osteoarthritis undergoing ankle anthroscopic debridement or joint replacement and 69 healthy controls receiving body check were enrolled in the this study. Serum and synovial fluid VIP concentrations were measured by a special radioimmunoassay method. Cartilage degradation biomarker colla-gen type Ⅱ(CTX-II)and inflammatory marker interleukin-6 were determined by enzyme-linked immunosorbent assay (ELISA). The symptomatic and functional severity was evaluated using Teeny & Wiss and AOFAS ankle-hindfoot rating scale. The radiographic progression of PTAOA was identified according to the modified ankle osteoar-thritis Kellgren-Lawrence (K-L) grading system. The mankin score was used for assessing the histopathological severity for cartilage lesions. Receiver operating characteristic (ROC) curve was conducted and the area under curve(AUC)was used to evaluate the diagnostic value of VIP,IL-6 and CTX-II levels for the prediction of the modified K-L grading by comparing with other biomarkers. Results There were no significant differences in serum VIP levels between PTAOA patients and controls. VIP levels in synovial fluid showed a negative correlation with modified ankle K-L grading,Mankin scores,CTX-Ⅱand IL-6. In addition,VIP levels were also positively associated with Teeny&Wiss and AOFAS ankle-hindfoot scores. The AUC area of VIP was similar to CTX-Ⅱat early stage of the disease. Conclusions Synovial fluid VIP levels show an independent and negative correlation with disease severity in patients with PTAOA. Low level of VIP in SF can be used as a potential biomarker for reflecting disease progression.

The relationship between the expression of inflammatory factors and joint function in patients with traumatic arthritis and the expression of inflammatory factors in joint fluid / 国际检验医学杂志

Objective To study the relationship between the expression of inflammatory factors and joint function in patients with traumatic arthritis and the expression of inflammatory factors in joint fluid.Methods 90 cases of knee joint trauma in our hospital for the treatment of traumatic arthritis patients from September 2015 to September 2016 as the object of study,90 healthy volunteers as control group,two groups were detected in the synovial fluid of patients with inflammatory factors,to explore the level of inflammatory factors in synovial fluid (TNF-α,IL-6,IL-8) in patients with X-ray classification and joint function.Results TNF-α,IL-6 and IL-8 levels in the synovial fluid of patients with traumatic arthritis were significantly higher than that in healthy adults(P<0.05),radiographic evidence of traumatic osteoarthritis in patients with grade Ⅰ 37 cases,Ⅱ 23 cases,Ⅲ grade 21 cases,9 cases of grade Ⅳ,with bone damage aggravated statistically significant TNF-α,IL-6,IL-8 level is high and the differences between groups,patients with HSS score and KSS score in patients with joint X-ray classification,TNF-α and IL-6 in synovial fluid and IL-8 level is negatively related to(P<0.05).Conclusion The expression of inflammatory factors and joint function in patients with traumatic arthritis were closely related to the expression of inflammatory factors.

Primary open reduction and wire-pin fixation for total talar dislocation: a report of twelve cases / 中华创伤骨科杂志

Objective To evaluate primary open reduction and wire-pin fixation for total dislocation of talus.Methods A retrospective study was conducted of the 12 patients who had been admitted into our hospital from October 2009 to December 2013 for total talar dislocation without fracture of the talar neck or body and had been available for complete follow-up.They were 10 males and 2 females.Their range of age was from 17 to 56 years (average,34.2 years).The total dislocation was open in 4 cases and close in 8.All of them underwent primary open reduction and wire-pin fixation.The functions of ankle joint and hindfoot were evaluated according to the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale.Results The follow-up time ranged from 22 to 72 months (average,35.6 months).Postoperatively,one case suffered skin necrosis and another superficial infection,both of whom responded to skin flap transferring after debridement.Traumatic arthritis of the talotibial or subtalar joint was found more or less in 7 cases,one of whom complained of severe pain but refused the subtalar arthrodesis advised.Their AOFAS scores at the final follow-up ranged from 42 to 96 points (average,72.2 points).Five cases developed avascular necrosis of the talus,but no talar collapse happened.Conclusions Primary open reduction and wire-pin fixation is effective for treatment of close total talar dislocation and open total dislocation of Gustilo type Ⅲ A or below.Although avascular necrosis and traumatic arthritis are common postoperative complications,satisfactory functions can be achieved if there is no collapse,severe pain or infection.

Experimental research on intraperitoneal injection of saturated hydrogen saline for treating traumatic ar-thritis in rabbits / 医学研究生学报

Objective Inflammatory response is an important part in pathological change of traumatic arthritis(TA).Studies show that hydrogen has antioxidate and anti-inflammatory properties, however, there are few reports on treating TA with it.So this research aimed to investigate curative effects of curing traumatic arthritis in rabbits with intraperitoneal injection of saturated hydrogen saline solution . Methods A total of 26 New Zealand white rabbits were divided into three groups:normal control group (n=6), model experimental group (n=10), and model control group (n=10).Rabbits in model experimental group were intraperitoneally injected with 8 ml /kg saturated hy-drogen saline, once every three day;equivalent saline was injected in rabbits of model control group;while no treatment was done on normal control group.The treatment lasted for 6 weeks.Before and after the treatment, the serum and joint fluid of the rabbits in the three groups were respectively taken to determine the content of nitric oxide (NO) and hyaluronic acid (HA), which was used to evaluate therapeutic effect in combination with the behavioral performance of the rabbits . Results Significant improvement in behavior was found in model ex-perimental group after the treatment (P0.05), but model experimental group was superior to model control group in knee swelling scores after the treatment (P0.05).The content of serum HA in model experimental group declined dramatically (P<0.05) and the joint fluid increased after the treatment ([1.72 ±0.37] vs [2.47 ±0.62],P<0.05), while no significant changes were found in model control group before and after the treatment. Conclusion The intraperitoneal injec-tion of saturated hydrogen saline may be effective in the treatment of trau-matic arthritis.

Screening and identification of siRNA-mediated TNF-α expression in synovial cells of Human / 重庆医学

Objective To design and identify small interfering RNA (siRNA) targeting tumor necrosis factor‐α (TNF‐α) ex‐pression ,siRNAs were electroporated into synovial cells of Human to screen those which can effectively suppress TNF‐α expres‐sion .Methods Three TNF‐α specific double stranded siRNA were designed targeting different regions of TNF‐α mRNA(compared with negative control group) .RT‐PCR and Elisa were applied to detect TNF‐α ,mRNA expression and the secretion of TNF‐α in cell supernatant ,respectively .Results Two of the three customized TNF‐α siRNA could inhibit the expression of TNF‐α mRNA in synovial cells of Human (P< 0 .01) .At the same time ,the secretion of TNF‐α decreased in cell supernatant ,the difference was sig‐nificant statistically compared with the control group(P< 0 .01) .Conclusion TNF‐α siRNA can be successfully designed and syn‐thesized ,which can specifically and effectively suppress TNF‐α mRNA expression .

Total Talus Dislocation: A Case Report / 대한족부족관절학회지

Talar fracture and total dislocation, each known as one of rare injuries mainly caused by high-energy trauma, tend to cause avascular necrosis, post-traumatic arthritis, non-union, skin necrosis and infection because of weak blood supply. The authors have experienced and reports a total talus dislocation of 16 year old male associated with medial malleoalr fracture, who showed relatively good result by early reduction and operation.

Protein Expression Profile of Synovial Fibroblasts in Experimental Post-traumatic Arthritis

OBJECTIVE: To evaluate and compare protein expression profiles of synovial fibroblasts using proteome analysis in swine knee injuries with joint instability, during early post-traumatic arthritis (PTA) development. METHOD: Experimental PTA was induced by transection of the anterior cruciate ligament (ACL) in swine left knee joints. After sacrifice at 8 weeks, cartilage and synovium obtained from both knee joints were prepared for histopathologic examination. Cultured synovial fibroblasts were processed for 2-dimensional electrophoresis and mass spectrometric analysis. Histopathologic examination showed overt arthritic changes that supported the development of early PTA. RESULTS: Proteome analyses led to the identification of more than 1,500 protein spots and of 11 differently expressed protein spots. Of those, six proteins were down-regulated (cytoskeletal beta actin, cofilin-1, destrin, Rho GDP dissociation inhibitor alpha, and unnamed protein product), and five proteins were up-regulated (alpha-B crystallin, smooth muscle protein 22-alpha, and cytoskeletal beta actin) in ACL-transected synovial fibroblasts. That is, proteins related to cellular organization and signal transduction are down-regulated, and those related to cell rescue, defence, and stress are up-regulated. CONCLUSION: These results may suggest that joint instability contributes to the development of PTA and is one of the major etiologic factors of PTA. In addition, this suggests that the proteome analysis of synovial fibroblasts is a useful approach in examining a joint after an injury and can be used to understand the pathogenesis of PTA.

Treatment of unstable pelvic fractures with complex fixation / 中国矫形外科杂志

[Objective]To evaluate the outcomes of treatment of unstable pelvic fractures with complex fixation.[Method]Twenty-eight cases of patients with unstable pelvic fracture from January 2000 to June 2007 were treated and followed-up.Eighteen cases were male,10 cases were female,aged from 22 to 68 years old,with the average of 38-years-old.The types of fracture were classified by Tile classification:Type B2 9 cases,Type B3 8 cases,Type C1 6 cases,Type C2 2cases,Type C3 3 cases.The 28 cases had different complicated injury,all the patients were treated with complex fixation.[Result]After being evaluated by the Matta scale and the functional outcome,the outcomes of reduction were excellent in 18 cases,good in 7,fair in 2 and poor in 1,with an excellent and good rate of 85%.[Conclusion]External fixation can win the time for the rescue,choose internal fixation after stable condition,the complex fixation technology is a good way to treat unstable pelvic fractures.

Curable effect of total hip arthroplasty in the post-traumatic arthritis following acetabular fracture / 中国矫形外科杂志

0.05).There was statistic significance in blood lose with more lose in initial conservative group(P

Retrograde intramedullary nail for traumatic tibiotalocalcaneal arthritis / 中国矫形外科杂志

[Objective]To evaluate the outcome of tibiotalocalcaneal fusion in traumatic arthritis patients using the locked retrograde intramedullary nail with graft.[Method]Eighteen ankles underwent this procedure.There were 8 males and 10 females,9 with valgus and 2 with talipes equinovarus,all unilateral.The mean age of patients was 57.5 years(ranged,42~69) and the mean time between the procedure from primary trauma was 7.6 years(5~13 years).Bone graft were picked from distal fibula.The nail was inserted through a plantar approach with locking screws placed both proximally and distally.Patients were evaluated by a standardized follow-up examination using the AOFAS and the fusion outcome were observed radiographically.[Result]All patients were available for an average duration of follow-up of 13.5 months(ranged,6~22 months).All wound healed normally.The mean time of full bearing from operation was 13.6 weeks(ranged,9-16 weeks).One patient was found cerebral thrombosis after operation.One patient had moderate pain while walking on even surface,2 mild to moderate pain on uneven surface,1mild pain while standing and 14 relieved from pain.The average AOFAS score improved from 43.5(ranged,40~52) to 69(ranged,56~84) points.Solid fusion was achieved in 13 ankles(72%) after a mean follow-up of 16.8 months(ranged,12~24 months).Partial union was observed in 3 patients(17%) and non-union in 2 patients(11%).[Conclusion]Locked retrograde intramedullary nail fusion with bone graft is effective for traumatic tibiotalocalcaneal arthritis.

Clinical Outcomes of Semiconstrained Total Elbow Arthroplasty : Non-traumatic Arthritisversus Traumatic Arthritis / 대한정형외과학회잡지

PURPOSE: This study evaluated the clinical and radiological outcomes of semiconstrained total elbow arthroplasty. MATERIALS AND METHODS: Thirty-nine elbows with semiconstrained total elbow arthroplasty and who were followed up for at least 3 years were enrolled in this study. There were 29 and 10 cases in the non-traumatic arthritis and traumatic arthritis groups, respectively. The mean age at the time of surgery was 53.9 years, and the mean follow-up period was 54 months. RESULTS: At the last follow-up, the pain score during motion decreased from 7.37 to 1.23. The Mayo elbow performance score was 86. The mean loss of terminal extension improved from 32degrees to 11degrees and the mean maximum flexion improved from 90.3degrees to 125.2degrees. Radiology analysis, 15 elbows showed radiolucency and 8 elbows showed loosening. There were 13 cases of radiolucency and 7 cases of loosening in the non-traumatic arthritis group. In the traumatic arthritis group, there were 2 cases of radiolucency and 1 case of loosening. CONCLUSION: Semiconstrained total elbow arthroplasty for non-traumatic and traumatic arthritis of the elbow produced satisfactory functional results. The non-traumatic arthritis group had a higher incidence of radiolucency and loosening than the traumatic group.