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Objective:To assess causes for revision total knee arthroplasty (TKA) in China using the data of revision TKA in the past 15 years in our single center andcompare the differences in survival time, operation time and blood loss among different revision reasons.Methods:Data of 337 patients (345 knees) with revision TKAs at our institution from January 2007 to December 2021 (15 years) were retrospectively analyzed. The included population consists of 57 males and 288 females. The causes for first revision TKA were identified and compared according to the time of revision surgery as early (up to 2 years) and late revision (more than 2 years). The reason for revision before 2012 and after 2012 was also compared. Furthermore, the differences of survival time, operation time and blood loss among different revision reasons were compared.Results:The most common reasons for revision of knee joints in 345 cases were periprosthetic infection (133 knees, 38.6%), followed by aseptic loosening (97 knees, 28.1%) and joint instability (35 knees, 10.1%). Early revisions were performed in 171 knees (49.6%), while late revisions were performed in 174 knees (50.4%). Periprosthetic infection (96 knees, 56.1%) and aseptic loosening (86 knees, 49.4%) were the most common reasons for early and late revisions, respectively. There were 59 revisions performed before 2012 and 286 revisions performed after 2012, with periprosthetic infection being the main reason for revision in both groups. The percentage of revisions due to infection decreased from 64.4% before 2012 to 33.2% after 2012, and this difference was statistically significant (χ 2=18.790, P<0.001). The proportion of revisions due to aseptic loosening was 15.3% before 2012, which was significantly lower than the proportion of 30.8% after 2012 (χ 2=5.083, P=0.024). The median survival time of the prostheses in the included patients was 30 months, with shorter survival time observed in patients with stiffness, patellar complications, and periprosthetic infection, and longer survival time observed in patients with polyethylene wear and aseptic loosening. There were significant differences in operation time and blood loss among different reasons for revision ( P<0.001). Conclusion:In our specialized arthroplasty center periprosthesis infection was the most common reason for revision. Periprosthesis infection and aseptic loosening needed to be considered for early or late-stage revision. With the development of technique of total knee arthroplasty, the proportion of periprosthesis infection is decreasing, while the incidence of aseptic loosening is increasing.
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Objective To analyze the differentially expressed genes in peripheral blood of human immunodeficiency(HIV)/tubercle bacilli co-infected patients and explore the biological regulatory mechanism and network of key proteins,so as to provide new evidence for early diagnosis and clinical treatment of HIV/TB co-infected patients. Methods Microarray gene chip data of HIV/TB co-infected patients were downloaded from public databases GEO and imported into the analysis software GEO,STRING,PANTHER,and GenClip. The gene expression profiles,protein interaction networks,processes of molecular biology,and gene functions were analyzed. Results The expression profiles of 15 529 genes between the two groups of patients were similar,and gene expression profiles from 44 subjects were highly correlated. The 251 differentially expressed genes had good diagnostic capabilities in the differential diagnosis of HIV/TB infection. RPLP1 might be a key gene in the diagnosis of HIV/TB infection. The differentially expressed genes and positive regulators showed certain functions such as external stimuli,signal transduction pathways in cells,migration of neutrophils,and immunological and other relevant functionalities. Meanwhile,they may also be involved in free radical-related apoptosis,inflammation,and activation pathways. Conclusions A total of 251 differentially expressed genes are found to be able to distinguish simple HIV infection from HIV/TB infection. Protein-protein interaction network of top 40 differential expression genes includes RPLP1 gene,which is possibly associated with HIV/TB co-infection and may be involved in and the positive regulation of external stimuli,signal transduction pathways in cells,migration of neutrophils,and immunological functions. These findings may provide certain evidence for the diagnosis and treatment of HIV/TB infection.
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The development of osteoarthritis (OA) is associated with the synovium around the joints, and the synovitis is closely related to the pain and swelling of OA. The synovitis is not only involved in the early OA, but also played an important role in the progression of OA throughout.
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@#The development of osteoarthritis (OA) is associated with the synovium around the joints, and the synovitis is closely related to the pain and swelling of OA. The synovitis is not only involved in the early OA, but also played an important role in the progression of OA throughout.