Correlation of meniscus tear type with synovial inflammation and the therapeutic potential of docosapentaenoic acid.

BACKGROUND: Synovitis, characterized by inflammation of the synovial membrane, is commonly induced by meniscus tears. However, significant differences in inflammatory responses and the key inflammatory mediators of synovium induced by different types of meniscal tears remain unclear. METHODS: Magnetic resonance imaging (MRI) was employed to identify the type of meniscus tear, and the quantification of synovial inflammation was assessed through H&E staining assay. Transcription and expression levels of IL-1ß and IL-6 were evaluated using bioinformatics, ELISA, RT-qPCR, and IHC of CD68 staining assays. The therapeutic potential of Docosapentaenoic Acid (DPA) was determined through network pharmacology, ELISA, and RT-qPCR assays. The safety of DPA was assessed using colony formation and EdU staining assays. RESULTS: The results indicate that both IL-1ß and IL-6 play pivotal roles in synovitis pathogenesis, with distinct expression levels across various subtypes. Among tested meniscus tears, oblique tear and bucket handle tear induced the most severe inflammation, followed by radial tear and longitudinal tear, while horizontal tear resulted in the least inflammation. Furthermore, in synovial inflammation induced by specific meniscus tears, the anterior medial tissues exhibited significantly higher local inflammation than the anterior lateral and suprapatellar regions, highlighting the clinical relevance and practical guidance of anterior medial tissues' inflammatory levels. Additionally, we identified the essential omega-3 fatty acid DPA as a potential therapeutic agent for synovitis, demonstrating efficacy in blocking the transcription and expression of IL-1ß and IL-6 with minimal side effects. CONCLUSION: These findings provide valuable insights into the nuanced nature of synovial inflammation induced by various meniscal tear classifications and contribute to the development of new adjunctive therapeutic agents in the management of synovitis.

Surgical considerations for glenoid bone loss in anterior glenohumeral instability: a narrative review.

PURPOSE: Treatment algorithms may consider many factors like glenoid and humeral bone loss, or scores such as the instability severity index score (ISIS). As most studies only evaluate a part of these factors, there is still no evidence-based consensus estalished. Our study aims to summarize the surgical options for treatment of glenoid bone loss (GBL) in anterior shoulder instability. METHODS: Based on the current available literature, surgical options including Bankart repair and glenoid bone augmentation should be considered while taking into consideration the degree of bone loss which has been divided into < 10%, 10-20% and > 20%. RESULTS: There are many new techniques evolving including arthroscopic anatomic glenoid reconstruction with bone blocks. CONCLUSION: Future long-term outcome studies and randomized controlled trials comparing established techniques will be needed for new evidence-based treatment algorithms.

TBX3 regulates the transcription of VEGFA to promote osteoblasts proliferation and microvascular regeneration.

Objective: Osteochondral decellularization can promote local vascular regeneration, but the exact mechanism is unknown. The aim of this study is to study osteogenic microvascular regeneration in single cells. Methods: The scRNA-seq dataset of human periosteal-derived cells (hPDCs) were analyzed by pySCENIC. To examine the role of TBX3 in osteogenesis and vascularization, cell transfection, qRT-PCR, western blot, and CCK-8 cell proliferation assays were performed. Results: TCF7L2, TBX3, FLI1, NFKB2, and EZH2 were found to be transcription factors (TFs) most closely associated with corresponding cells. The regulatory network of these TFs was then visualized. Our study knocked down the expression of TBX3 in human osteoblast cell lines. In the TBX3 knockdown group, we observed decreased expression of VEGFA, VEGFB, and VEGFC. Moreover, Western blot analysis showed that downregulating TBX3 resulted in a reduction of VEGFA expression. And TBX3 stimulated osteoblast proliferation in CCK-8 assays. Conclusion: TBX3 regulates VEGFA expression and promotes osteoblast proliferation in skeletal microvasculature formation. The findings provide a theoretical basis for investigating the role of TBX3 in promoting local vascular regeneration.

Association of Osteoarthritis With Changes in Structural Neuroimaging Markers Over Time Among Non-demented Older Adults.

Objective: Although emerging evidence suggests that both osteoarthritis (OA) and brain atrophy (as assessed by structural neuroimaging markers) are associated with the risk of dementia, little is known about the association between OA and structural neuroimaging markers. This study aimed to examine the association of OA with changes in structural neuroimaging markers among non-demented older people. Methods: We examined the cross-sectional and longitudinal associations between OA and structural neuroimaging markers (hippocampal volume, entorhinal volume, ventricular volume, and volume of gray matter of the whole brain) among non-demented older people. We categorized our participants as those without OA (OA-) and those with OA (OA+). At baseline, we included 1,281 non-demented older adults, including 1,050 without OA and 231 with OA. Results: In the cross-sectional analysis, we did not observe any significant difference in structural neuroimaging markers between the two OA groups. In the longitudinal analysis, we found that compared to participants without OA, those with OA showed a steeper decline in volumes of the gray matter of the whole brain among non-demented older adults. Conclusions: OA was associated with a steeper decline in volumes of the gray matter of the whole brain over time among non-demented older people.

[Incidence and risk factors of early deep venous thrombosis after knee arthroscopy operation under conventional tourniquet].

OBJECTIVE: To find out the incidence of early DVT in patients after knee arthroscopic surgery with routine use of tourniquet and discuss the associate risk factors. METHODS: Total 1 561 cases undertaken primary knee arthroscopic surgery was reviewed retrospectively from January 2013 to January 2017, including 651 males and 910 females with a mean age of (65.7±8.7) years old ranging from 62 to 81 years old. The cases were divided into DVT group and non-DVT group according to ultrasonic Doppler after surgery. The DVT occurrence rate was calculated and the basic information was analyzed to filter out the risk factors through univariate analysis and multivariate analysis. The cases of DVT group received 6 months anticoagulation therapy and were undertaken a follow-up of 1, 3, 6 months by ultrasonic Doppler. RESULTS: Out of the 1 561 cases, 226(14.5%) developed early DVTs following surgery, 32(2.0%) cases had the proximal DVTs, and 194(12.4%) cases had the isolated distal DVTs. The risk factors include the age(>=73 years), female sex and gastrocnemius vein dilation (GVD), hypertension, longer tourniquet time(>=74 min). The GVD and the length of tourniquet time was considered to be the best predictor of the early DVTs after surgery, with an odds ratio of 2.337 (95% CI, 1.644-3.611) and 2.112 (95%CI, 1.452-3.301). Twelve isolated distal DVTs(6.6%) and 11 proximal DVTs(36.7%) still showed thrombus at 6-month follow-up, but exhibit decreased size and at various stage of resolution. CONCLUSIONS: The incidence of early DVTs after knee arthroscopic surgery is 14.5%. Out of all risk factors, the GVD and the length of tourniquet time have the best power for prediction of DVTs after surgery. Both proximal and distal DVTs received accepted outcomes after formal therapy.

[Postoperative clinical effects of plantar pressure measurement system in treating the first ray hypermobility].

OBJECTIVE: To explore plantar pressure measurement system in treating the first ray hypermobility. METHODS: From June 2013 to January 2014, 16 female patients (20 feet) with hallux valgus with unstable of the first sequence were treated by first tarsometatarsal joint fusion, aged from 42 to 52 years old with an average of(46.5±2.9) years old, the course of disease was from 3 to 5 years. Twenty healthy female(20 feet) were chosen as control group, and single side were only choose, aged from 41 to 55 years old with an average of(46.8±4.5) years old. Preoperative and postoperative AOFAS score was used to evaluate feet function. Plantar pressure measurement system were applied to compare peak value of the dynamic pressure and impulse indicators of affected feet and control normal feet from the first to the fifth head of metatarsal bone. RESULTS: All patients were followed up from 24 to 30 months with an average of 27.4 months. Hallux valgus deformity of affected feet were corrected, pain and swelling of the second head of metatarsal bone were disappeared. There were statistical differences in AOFAS score between preoperative (45.55±12.28) and postoperative (85.45±6.76). There were significant differences in peak pressure, pressure between affected feet and normal feet of the first and second head of metatarsal bone. Postoperative peak pressure, pressure of the first affected head of metatarsal bone were increased than that of before operation, but no differences compared with control group(P>0.05). Postoperative peak pressure, pressure of the second affected head of metatarsal bone were decreased before operation(P<0.05), but no meaning compared with control group(P>0.05). There were no significant differences compared between the forth and fifth affected head of metatarsal bone and control group(P>0.05). CONCLUSIONS: There were obvious differences in pressure of the first and second head of metatarsal bone patients with unstable of the first sequence, the first tarsometatarsal joint fusing could recover plantar pressure of the first and second head of metatarsal bone by plantar pressure measurement system.

[Treatment of habitual dislocation of patella with reconstruction of medial patellofemoral ligament combined with release of lateral retinaculum and medial transfer and advancement of tibial tuberosity under arthroscopy].

OBJECTIVE: To study clinical effects of triad operation including reconstruction of medial patellofemoral ligament, release of lateral retinaculum, Fulkerson tibial tubercle osteotomy, medial transfer and advancement under arthroscopy for the treatment of habitual dislocation of patella. METHODS: From March 2010 to May 2016, 35 patients with habitual patellar dislocation were treated with the triad operation, including 14 males, 21 females, ranging in age from 18 to 38 years old, with an average of 25.8 years old. Twelve patients had dislocations on the left knee, and 23 patients had dislocations on the right knee. The changes of Q angle, TT-TG value and Kujala score were compared before and after operation. RESULTS: All the patients were followed up, and the duration ranged from 9 to 35 months (mean, 23 months). The Q angle of male group was improved from preoperative (29.2±2.0)° to postoperative (14.8±1.2)°(P<0.05), and the Q angle of female group was improved from preoperative(30.6±2.3)° to postoperative (16.7±1.5)° (P<0.05). CT showed that the TT-TG value was improved from preoperative (20.3±2.2) mm to postoperative (10.3±1.2) mm (P<0.05). The Kujala score was improved from preoperative 47.8±7.5 to postoperative 88.4±6.2 (P<0.05). CONCLUSIONS: The triad operation including reconstruction of medial patellofemoral ligament, release of lateral retinacular, Fulkerson tibial tubercle osteotomy, medial transfer and advancement under arthroscopy for the treatment of habitual dislocation of patella has good short-term clinical effects.

[Therapeutic effects of internal drainage by expanding arthroscopic gastrocnemius-semimembranosus bursa and cyst wall resection for the treatment of 41 patients with popliteal cysts].

OBJECTIVE: To investigate the clinical curative effects of internal drainage by expanding arthroscopic gastrocnemius-semimembranosus bursa(GSB) and cyst wall resection for the treatment of popliteal cysts. METHODS: A retrospective analysis of patients from May 2011 to December 2015. Arthroscopic treatment for 41 patients with popliteal fossa cysts, 18 males and 23 females, aged from 34 to 67 years old, averaged 42.6 years old. All the patients had preoperative magnetic resonance imagings to confirm the diagnosis and identify the valvular opening(Gastrocnemius-Semimembranosus bursa, GSB), as well as the associated intra-articular pathology. All the popliteal cysts were unilateral, including 26 cases of right knees and 15 cases of left knees. Five patients had recurrent popliteal cysts, and all of them underwent initial open Surgery. The duration from initial surgery to the recurrence ranged from 6 to 17 months(averaged, 11 months). All the patients had underwent arthroscopic treatment of internal drainage by expanding GSB and cyst wall resection. According to the Rauschning and Lindgren classification, 5 cases were grade I , 30 cases were grade II and 6 cases were grade III. Preoperative Lysholm score, 83.19±6.12 (ranged form 73 to 95). RESULTS: The GSB structure was found in all patients with popliteal cysts during operation, including cartilage degeneration in 33 cases, medial meniscus injury in 27 cases, lateral meniscus injury in 7 cases, free body in 8 cases, pigmented villonodular synovitis in 2 cases, and synovial chondromatosis in 3 cases. There were no complications related to vascular, nerve or surgical incision. All the patients were followed up, and the duration ranged from 8 to 27 months, with an average of 18 months. No recurrence of cysts was found. According to the Rauschning and Lindgren classification, there were 9 cases of grade 0, 27 cases of grade I , 4 cases of grade II, 1 case of grade III. Postoperative Lysholm score:91.32±4.26(ranged from 82 to 98). CONCLUSIONS: Arthroscopic internal drainage by expanding GSB and cyst wall resection surgery in the treatment of popliteal cysts has the advantages of less trauma, faster recovery and low relapse rate, which has a good short-term effect.