ABSTRACT
BACKGROUND: Patients with unstable os acromiale often complain of shoulder pain. Numerous surgical treatment options have been introduced with inconsistent clinical results. In this study, a novel surgical treatment using polyester sutures to fix unstable os acromiale was introduced, and clinical results were reported. METHODS: We retrospectively studied 10 shoulders that were diagnosed with os acromiale from January 2014 to January 2016. All 10 cases were of the meso-acromion type. Except for the first case in our series, cases of os acromiale were fixed using polyester sutures arthroscopically. The standardized scores and visual analog scale (VAS) were recorded preoperatively and at each follow-up. A computed tomography (CT) scan was ordered at the follow-up of 12 months. RESULTS: The average follow-up length was 28.7 months, ranging from 26 to 33 months. The average Constant score before surgery was 40.50±4.53 points, which significantly improved to 75.60±5.17 points after surgery. The average VAS score was reduced from 5.20±1.14 points to 1.60±0.84. At the follow-up of 12 months, a CT scan was ordered. All the patients showed a bony union of the os acromiale. On the CT scan, two small pits could be seen on the medial and lateral side of the acromion, which indicated the level of the os acromiale. The position of the os acromiale was good, and no evident sclerosis was found on the edges of the fragments. CONCLUSIONS: Polyester sutures could provide reliable strength for the fixation of os acromiale without any irritation from hardware.
ABSTRACT
BACKGROUND: Osteochondral fracture (OCF) is one of the severe complications following a patellar dislocation. The appropriate fixation method for patients with OCF remains controversial. METHODS: Eighteen patients who had undergone surgery after a patellar dislocation were recruited retrospectively. Patellar OCF was fixed with an absorbable suture in an unreported method. The medial patellofemoral ligament (MPFL) was repaired or reconstructed if necessary. The Lysholm and Kujala knee scoring systems were used to evaluate the knee function. Imaging examinations were used to confirm the fracture healing. RESULTS: The mean period of follow-up was 36 months. All patients recovered well postoperatively without symptomatic complications. The Lysholm score and the Kujala score improved significantly from 37.6 (SD =6.8) and 45.9 (SD =6.4) preoperatively to 80.9 (SD =7.4) and 89.4 (SD =6.8) postoperatively at the latest follow-up, respectively. Imaging evidence including X-ray and MRI revealed good healing of the OCFs. CONCLUSIONS: This study showed satisfactory mid-term outcomes of OCF fixation using absorbable suture, which supports this method's potential to be a novel surgical method in the treatment of patellar OCF caused by a patellar dislocation.
ABSTRACT
OBJECTIVE: To study the effects of zuogui pill (ZP) contained serum on the gene expressions of type-II collagen and proteoglycan during the differentiation of mesenchymal stem cells (MSCs) towards chondrocytes. METHODS: MSCs isolated from rat bone marrow were in vitro induced differentiation towards chondrocytes and stimulated with high- (57 g/kg), middle- (28.5 g/kg), and low-dose (9.5 g/kg) ZP contained serums and serum of blank rats. The proliferation of MSCs was analyzed by CCK-8 method. The 3rd-passage MSCs were divided into the blank control group (by adding serum of the blank group rats), the induction control group (by adding the induction fluid and serum of the blank group rats), and the ZP contained serum group (by adding the induction fluid and middle-dose ZP contained serum). The expressions of type-II collagen and proteoglycan were determined using reverse transcriptase PCR, Real-time PCR, and immunohistochemistry. RESULTS: Compared with the blank control group, the proliferation of MSCs could be promoted by ZP contained serum at different doses (P < 0.05), with the most obvious effect shown in the middle-dose ZP contained serum group (P < 0.05). The mRNA and protein expressions of type-II collagen could be identified in the induction control group and the ZP contained serum group on the 21st day of the induction. Of them, the mRNA expression of type-II collagen in ZP contained serum groups was obviously higher than that of the induction control group. Results of Real-time PCR showed that on the 21st day of the induction, the mRNA expression quantitation of proteoglycan in ZP contained serum groups was about 16-fold and 3-fold of the levels on the 7th day and the 14th day (P < 0.05), obviously higher than those of the induction control group (P < 0.05). CONCLUSION: ZP contained serum could induce MSCs proliferation, the gene expressions of type- II collagen and proteoglycan, which might be one of its molecular bases for protecting the cartilage.
