Combined surgical and anti-infective therapy for brucella arthritis of the knee in players: a case report

In some rural areas of northern China, brucellosis is an endemic zoonotic infection caused by a bacteria of the genus Brucella. As a result of brucellosis, osteoarticular involvement is the most common complication. Here, we report the case of a 50-year-old male who presented with severe swelling and pain in the right knee in players. Brucella arthritis was diagnosed based on his contact history, clinical manifestations, and results of serological tests, synovial fluid cultures, and radiological imaging. As part of the treatment plan, surgery including an arthrotomy, debridement, and irrigation of the joint cavity was carried out. In the weeks following surgery, the patient reported significant improvement in his right knee joint's function and a significant reduction in the intensity of his joint pain in players. (AU)

The Role of Autophagy in Chondrocyte Metabolism and Osteoarthritis: A Comprehensive Research Review.

Chondrocytes are the sole cellular constituents of normal cartilage. The degeneration and apoptosis of these cells are considered the main cause of osteoarthritis (OA). Previous studies have suggested that the enhancement of autophagy in chondrocytes can delay the progression of osteoarthritis by affecting intracellular metabolic activity, i.e., by regulating the metabolism of nutrients, which can delay cell aging and death. In this review, we explored the relationship between autophagy and chondrocyte metabolism and provided new ideas for the prevention and treatment of OA.

Clinical application of different operative approach of total knee replacement in knee valgus patients. Retrospective cohort study.

PURPOSE: According to the severity of knee valgus, different operative approaches were applied in total knee replacement. Hence, we assessed the safety and efficacy of different operative approaches in the level IV study. METHODS: From May 2011 to March 2014, a retrospectively analysis was conducted among 31 patients with knee valgus (mild in 10 cases, moderate in 8 cases and severe in 13 cases based on Keblish grade). Medial approach trip knee replacement was performed in mild and moderate patients, which were assigned as medial approach group. Lateral approach was performed in severe patients, which was assigned as lateral approach group. Relevant results were compared between medial approach group and lateral approach group, including valgus corrected angle, postoperative knee joint activity and Kss score. Furthermore, operative time, postoperative blood loss, patellar trajectory and anterior knee pain were also compared between the two groups. RESULTS: All operations were successful without obvious complications. In medial approach group, postoperative knee valgus angle was (7 ±â€¯1)°. Three months after operation, degree of knee joint activity was (85.2 ±â€¯5.2)°, and KSS score of knee joint was (80.1 ±â€¯5.2). Significant differences were detected in these compared with preoperative data (all P < .05). Moreover, similar results were found in lateral approach group with postoperative knee valgus angle as (8.2 ±â€¯2.3)°, degree of knee joint activity three months after operation as (85.2 ±â€¯5.3)°, and KSS score of knee joint as (80.3 ±â€¯3.2). However, no significant differences were found among these three groups in operative time, postoperative blood loss, patellar trajectory or anterior knee pain. CONCLUSIONS: Different operative approaches in total knee replacement according to the severity of knee valgus were proved as effective and safe procedures, which deserved further application.

Detection of anti-cyclic citrullinated peptide antibodies in rheumatoid arthritis patients undergoing total knee arthroplasty.

Rheumatoid arthritis (RA) is the most common chronic inflammatory joint disorder and anti-cyclic citrullinated peptide antibody (anti-CCP Ab) is regarded as a serological marker for diagnosing early and late RA. In the present study, we aimed to determine the levels of anti-CCP Ab in serum, synovial tissue (ST) and synovial fluid (SF) in RA patients undergoing total knee arthroplasty (TKA). 23 patients were included. Rheumatoid factor (RF) and anti-CCP Ab in serum were detected prior to surgery and then at 1, 3, 6 and 12 months after TKA. Synovial samples were obtained by knee arthroscopy and used for anti-CCP detection. One month after TKA, anti-CCP levels were significantly reduced (P < 0.01) in RA patients. However, their levels were not significantly different between pre-surgery and 1 year post-surgery (P > 0.05). Furthermore, anti-CCP levels in ST were much higher than in serum. These findings suggest that RA patients should continue antirheumatic therapy after TKA. ST is the preferred place for the synthesis of anti-CCP Ab.

Elevated chemerin levels in synovial fluid and synovial membrane from patients with knee osteoarthritis.

To test the serum, synovial fluid and synovial membrane levels of the adipokine chemerin in patients with knee osteoarthritis (KOA) and investigate their relationships with the severity of articular cartilage damage and synovitis. According to the American College of Rheumatology criteria for diagnosis of osteoarthritis (OA), 30 cases with OA diagnoses (OA group) were selected from patients who underwent arthroscopic surgery in our hospital from June 2013 to February 2014. Another 30 cases with other knee joint diseases (non-OA group) were included as controls. The synovial fluid and serum levels of chemerin were assayed by ELISA, and the synovial membrane level of chemerin was assayed by the immunohistochemical method. The severity of the knee articular cartilage damage and synovitis-related pathological changes were evaluated by arthroscopy using the Outerbridge and Ayral scores, respectively. The synovial fluid and synovial membrane levels of chemerin in the OA group were higher than those in the non-OA group. Statistically significant differences were found between the two groups in the synovial fluid and synovial membrane levels of chemerin (P < 0.05). The synovial fluid and synovial membrane levels of chemerin were positively correlated with the serum level of high-sensitivity C-reactive protein (HS-CRP), Outerbridge score and Ayral score in the OA group. The synovial fluid and synovial membrane levels of chemerin are increased in KOA patients and are positively correlated with the severity of KOA.