Application of Tri-Lock bone preservation stem in acetabular protrusion combined with shorten defect of femoral head and neck / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the manipulation technique and clinical outcome of Tri-Lock bone preservation stem for acetabular protrusion combined with shorten defect of femoral head and neck.</p><p><b>METHODS</b>From January 2013 to December 2015, 10 patients(12 hips) with acetabular protrusion combined with shorten defect of femoral head and neck were treated with total hip arthroplasty(THA) including 5 males and 5 female with an average age of(51.6±3.0) years old ranging from 42.5 to 67.5 years old. The acetabular prostheses were all biological prosthesis with the ceramic lining, the whole ceramic femoral head was used in all the cases. The posterior-lateral hip incision was adopted in the surgery. The follow-up was carried out in 12 months after the surgery, and later once a year. The Harris score system in growth of femoral side described was used to assess the joint function of the patients before and after the surgery.</p><p><b>RESULTS</b>Ten patients were followed up for 8 to 48 months with an average of 33.0±3.5. All the incisions healed well and there were no complications such as femoral fracture, infection, dislocation and neurovascular injuries. The biological compression of the acetabulum and the stem of the femur was realized immediately after operation in 10 patients(12 hips). X-ray at 3 months after the operation showed bone growth were extended in a wide range, which could achieve bone fixation, no loosening and re-invagination. The range of hip movement increased from (45.8±7.5)° to (90.0±6.5)° at the final follow-up, with flexion increased to (89.0±6.0)°, abduction increased to (35.5±7.3)° and internal rotation increased to(31.8±6.6)°, the outer rotation increased to(32.6±5.2)°. The mean Harris scores had improved from 45.7±7.5 pre-operatively to 93.5±8.0 post-operatively, there was statistically significant difference between before and after surgery (=144.832,<0.05).</p><p><b>CONCLUSIONS</b>Combined with acetabular treatment, Tri-Lock bone retention of the femoral stem in the treatment of femoral head and neck with shortening of the acetabular retraction and severe hip joint soft tissue contracture in patients, could be well pressed and retained more bone. The reconstruction of the acetabulum and the delamination of soft tissue are required during the operation. The results were safe and satisfactory in the middle and short term follow-up.</p>

Periprosthetic joint infection after artificial joint replacement and preoperative anemia / 中国骨伤

Periprosthetic joint infection is the most serious complication after artificial joint arthroplasty. Epidemiological investigation has indicated that perioperative anemia is an independent risk factor for periprosthetic joint infection, which could play an important role by suppressing cellular mechanisms and autoimmune functions. Many domestic and overseas scholars have studied the relationship between periprosthetic joint infection and postoperative anemia, but the relationship between preoperative anemia and periprosthetic joint infection is relatively rare. However, preoperative anemia can reduce the C3b receptor on surface of red blood cells, decrease immune function of the body, increase blood-borne infection, prolong postoperative rehabilitation time, and lead to periprosthetic joint infection. For patients with preoperative anemia, prophylactic antibiotics could be used to prevent. And complement chalybeate used before operation, correct anemia by hemopoietin, treat chronic complications influence by hemoglobin production and improve patient's own immune status, blood transfusion treatment for patients with blood transfusion indications are performed. It could be better prevent occurrence of periprosthetic joint infection after total joint arthroplasty, and reducing chance of secondary or multiple renovations.

Perioperative and drug management of patients with rheumatoid arthritis treated with joint replacement / 中国骨伤

Rheumatoid arthritis (RA) is a most common inflammatory joint disease with direct invasion of joint synovial membrane, cartilage and bone. Currently, although the RA mitigation drugs are being improved continously, but these drugs only can delay the development of joint dysfunction. Total hip arthroplasty or total knee arthroplasty(THA or TKA) has become the only choices for patients with advanced RA, and the joint function and deformity of the patients after surgical treatment can be improved to some extent. However, the progression of RA has a direct effect on the long-term clinical effect of the surgery, and how to improve perioperative management, and combine the joint replacement surgery and drug therapy effectively, have become the focus of attention in clinical doctors. This article intends to summarize the current situation of domestic and foreign management of usage of pre-operative drugs, operation skills, prosthesis selection, postoperative treatment, rehabilitation and complications, so as to improve the long-term efficacy of joint replacement.

JAK2/STAT3 signal pathway mediating curcumin in cartilage cell metabolism of osteoarthritis / 中国骨伤

<p><b>OBJECTIVE</b>To observe influence of JAK2/STAT3 signal pathway mediating curcumin in cartilage cell metabolism of osteoarthritis and mitochondria oxidative stress resistance;also explore the role of JAK2/STAT3 signal pathway and effect of curcumin in this process.</p><p><b>METHODS</b>Fifteen male SPF C57BL/6 rats rweighted from 10.05 to 15.00 g with an average of 12.80 g were collected and randomly divided into control group, OA group(modeled as OA by Glasson SS), curcumin with OA group (100 mg/kg curcumin were performed intraperitoneal injection every day based on OA group), 5 rats in each group. Rats were taken off the neck after 4 weeks, morphologic change were observed, specimens changes were observed by histochemical methods;p-JAK2, p-STAT3 and Bax protein expression were detected by Western blot;At the same time, the changes of mitochondria oxidative stress index such as succinate dehydrogenase(SDH) and cytochrome C oxydase(COX) in each group were detected.</p><p><b>RESULTS</b>After 4 weeks, cartilage tissue showed translucent shape, no swelling and congestion, the number of cartilage cell increased, nuclei liked oval, chromatin arranged uniform in control group;in curcumin with OA group, joint showed slightly swelling without congestion, the formation of cartilage cell was regular, and number of cell decreased;while in OA group, the surface of joint was roughness with mild damage, cell arrangement was a bit disorder, nuclear was disappeared under vision and dyeing was uneven. Compared with control group, p-JAK2, p-STAT3 protein expression was decreased in OA and curcumin with OA group(<0.05), Bax protein expression was increased (<0.05), SDA and COX protein expression were reduced (<0.05). Compared with OA group, p-JAK2, p-STAT3 protein expression was increased in curcumin with OA, Bax protein expression was decreased (<0.05), SDA and COX protein expression were increased (<0.05), and had statistical differences among three groups.</p><p><b>CONCLUSIONS</b>JAK2/STAT3 signal pathway is closely associated with pathology course of osteoarthritis, curcumin could stimulate JAK2/STAT3 signal pathway and promote mitochondria oxidative stress. It could obviously relieve degeneration of articular cartilage and slow lower progress of OA.</p>