Reducing Re-fractures Post Percutaneous Kyphoplasty: The Impact of Zoledronic Acid with Calcium and Vitamin D3 in Osteoporotic Patients.

Background: Osteoporosis poses a significant health challenge characterized by reduced bone density and increased fracture risk. Percutaneous kyphoplasty, a common treatment, aims to stabilize vertebral fractures. However, adjunctive therapies like zoledronic acid remain underexplored in improving postoperative outcomes and bone health in these patients. Objective: This study aims to evaluate the efficacy of zoledronic acid combined with calcium carbonate and vitamin D3 in treating osteoporosis, providing valuable clinical insights. Methods: A cohort of sixty-six osteoporosis patients who underwent percutaneous kyphoplasty and received subsequent treatment at our hospital between March 2020 and March 2022 were selected. Thirty-three patients received calcium carbonate and vitamin D3 (control group), while the remaining thirty-three patients were treated with zoledronic acid alongside calcium carbonate and vitamin D3 (research group). Pre- and post-treatment assessments included bone mineral density measurements, bone metabolism and turnover marker evaluations, symptom improvement assessments using the Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI), monitoring of adverse reactions, and assessment of quality of life using the Core Quality of Life questionnaire (QOL-C30). A one-year follow-up was conducted to determine re-fracture incidence. Results: Post-treatment, the research group exhibited significantly lower VAS, ODI, tartrate-resistant acid phosphatase-5b, and osteocalcin levels compared to the control group, while bone alkaline phosphatase levels were higher (P < .05). There was no significant difference in adverse reaction incidence between the groups (P > .05), but the research group demonstrated higher QOL-C30 scores (P < .05). Follow-up analysis revealed no notable difference in re-fracture rates between the groups (P > .05). Conclusions: Zoledronic acid in combination with calcium carbonate and vitamin D3 effectively enhances bone health in osteoporosis patients, warranting its clinical recommendation. This regimen shows promise for improving patient outcomes in osteoporosis management.

lncRNA myocardial infarction-associated transcript (MIAT) knockdown alleviates LPS-induced chondrocytes inflammatory injury via regulating miR-488-3p/sex determining region Y-related HMG-box 11 (SOX11) axis.

Long noncoding RNA (lncRNA) has been shown to be involved in the development of osteoarthritis (OA), an age-related bone and joint disease. However, the function and possible molecular mechanism of lncRNA myocardial infarction-associated transcript (MIAT) in lipopolysaccharide (LPS)-induced chondrocytes injury model remain unexplored. Cell viability and apoptosis were detected by methyl thiazolyl tetrazolium (MTT) and flow cytometry, respectively. Western blot was used to detect protein expression. The concentrations of inflammatory factors were estimated by enzyme-linked immunosorbent assay (ELISA). Abundances of MIAT, microRNA-488-3p (miR-488-3p), and sex determining region Y-related HMG-box 11 (SOX11) were examined by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR). Dual-luciferase reporter and RNA immunoprecipitation (RIP) assays were performed to analyze the interaction between miR-488-3p and MIAT or SOX11. LPS caused chondrocytes injury by reducing cell activity and increasing apoptosis rate and inflammatory factor secretions. Higher levels of MIAT and SOX11 and lower miR-488-3p were observed in LPS-treated C28/I2 cells. Importantly, knockdown of MIAT attenuated the LPS-induced cell injury by targeting miR-488-3p, and miR-488-3p overexpression weakened the LPS-induced cell injury by targeting SOX11. Additionally, repression of MIAT inactivated the LPS-induced NF-κB signaling pathway by decreasing SOX11 and increasing miR-488-3p. Knockdown of MIAT alleviated the LPS-induced chondrocytes injury by inhibiting the NF-κB signaling pathway mediated by the miR-488-3p/SOX11 axis.

[Treatment of floating knee injury in children with elastic intramedullary nail].

OBJECTIVE: To observe the clinical effect of elastic intramedullary nail in minimally invasive treatment of floating knee injury in children. METHODS: From January 2009 to September 2017, 11 children with floating knee injury were treated with one-off open reduction and elastic intramedullary nail or external fixator fixation, including 7 males and 4 females, aged 5.0 to 11.0 years, with an average age of 8.3 years. The treatment results were evaluated according to karlstrom's standard. RESULTS: Eleven patients were followed up for 8 to 48 months, with an average of 28 months. All the fractures healed at one time, and there were no complications such as nonunion, malunion and serious dysfunction of knee joint. The length of the affected limb in 2 cases was 1.2 to 1.5 cm longer than that in the opposite side without shortening. According to Karlstrom scoring standard, 8 cases were excellent, 1 case was good and 2 cases were middle. CONCLUSION: Elastic intramedullary nail minimally invasive treatment of floating knee injury in children is a safe and effective treatment, which can effectively reduce the fracture and promote bone healing, which is conducive to early functional recovery.

Simultaneous spontaneous bilateral quadriceps tendon rupture with secondary hyperparathyroidism in a patient receiving hemodialysis: A case report.

RATIONALE: Simultaneous spontaneous bilateral quadriceps tendon rupture is a rare orthopedic injury; its initial diagnosis is misdiagnosed in up to 50% of patients with secondary hyperparathyroidism. Early diagnosis and surgical repair are important to achieve an excellent functional outcome. PATIENT CONCERNS: We report a case of simultaneous spontaneous bilateral quadriceps tendon rupture associated with secondary hyperparathyroidism. DIAGNOSIS: Magnetic resonance imaging showed that the quadriceps tendon was completely ruptured at the osteotendinous junction. We then found bilateral quadriceps tendon rupture during the operation. INTERVENTIONS: The patient underwent successful tendon repair surgery. OUTCOMES: The 31-year-old female patient regained full active movement of both knee joints and was able to participate in her activities of daily living. LESSONS: Simultaneous spontaneous bilateral quadriceps tendon rupture in a patient with secondary hyperparathyroidism (undergoing hemodialysis) is a rare orthopedic injury that can be easily overlooked at the initial presentation. Early diagnosis and surgical repair is important to achieve an excellent functional outcome. For patients with secondary hyperparathyroidism receiving hemodialysis, strict systematic treatment of hyperparathyroidism is needed to prevent rupture or re-rupture of the quadriceps tendon.

[Treatment of Pipkin I and II hip fractures by anterolateral hip approach].

OBJECTIVE: To investigate the clinical effect of absorbable screw fixation by anterolateral approach (McFarland and Osborne approach) for the treatment of Pipkin type I and type II fractures. METHODS: From March 2008 to February 2016, 8 cases of femoral head fractures were treated by absorbable screw fixation through anterolateral approach (McFarland and Osborne approach) including 5 males and 3 females with an average age of 36 years old ranging 23 to 58 years old. The course of the disease was 3 to 12 days (means 5 days). The symptoms at admission included hip pain, deformity and dysfunction. The X-ray and CT image showed femoral head fracture and posterior femoral dislocation. There were 2 cases of Pipkin type I and 6 cases of Pipkin type II. All patients received emergency reduction (Allis) of the posterior dislocation of the hip under the combined intravenous anesthesia. Bone traction was performed after successful reduction. The operation through McFarland and Osborne approach, the Thompson-Epstein system used to evaluate the curative effect postoperative. RESULTS: All the patients had primary healing after operation without other complications occurred. The 8 patients were followed up for 12 to 36 months with an average of 30 months. All of the patients review of X-ray and CT 6 months postoperative showed fractures consolidated, and the healing time was 3 to 6 months with an average of 4 months. According to Thompson-Epstein scoring system, hip function was excellent in 5 cases, good in 2 cases and fair in 1 case. CONCLUSIONS: The anterolateral approach of hip joint can not only retain the residual blood supply of femoral head, but also fully expose the acetabulum and femoral head. It is a relatively ideal surgical approach for the treatment of Pipkin type I and type II fractures.

A case report of phosphaturic mesenchymal tumor-induced osteomalacia.

RATIONALE: Tumor-induced osteomalacia (TIO) is a rare and often misdiagnosed syndrome. Surgical resection is currently the first line treatment for TIO. PATIENT CONCERNS: Here we report the case of a 49-year-old woman presented with intermittent pain in the right chest and bilateral hip that had persisted for over two years. DIAGNOSES: She was diagnosed of TIO caused by a phosphaturic mesenchymal tumor based on the following examinations. Laboratory tests revealed high serum alkaline phosphatase, high urinary phosphorus, hypophosphatemia and normal serum calcium levels. 18-FDG PET/CT indicated a systemic multi-site symmetrical pseudo fracture and a tumor in the 7th right rib. INTERVENTIONS: Curettage of the tumor was performed, and pathological analysis also confirmed our diagnoses as a phosphaturic mesenchymal tumor. OUTCOMES: At seven months post-surgery, the symptoms were relieved, proximal muscle strength was improved and serum levels of phosphorus and alkaline phosphatase normalized. The bilateral femoral neck and bilateral pubic bone fractures were blurred in the pelvic plain X-ray, suggesting that the fracture was healing. LESSONS: This case report strengthened the importance of recognition of this rare disease to avoid delay of diagnosis and surgical removal of the causative tumor is recommended.

[Mini-open repair for the treatment of acute closed achilles tendon ruptures].

OBJECTIVE: To evaluate the clinical efficacy of mini-open repair for the treatment of acute closed achilles tendon ruptures. METHODS: From April 2012 and October 2013,14 patients (14 feet) with acute closed achilles tendon ruptures were treated in our department. They were 9 males and 5 females, with an average age of 30.5 years old (ranged, 25 to 49 years old). The interval between injury and operation ranged from 1 to 13 days (8 days on average). A longitudinal incision approximately 1.5 to 2.0 cm in length was made around the ruptured achilles tendon for mini-open repair after insertion of oval clamp. Postoperative rehabilitation was carried out. RESULTS: The wounds healed at the first stage except 2 cases with slow recovery. All the patients were followed up for 6 to 24 months, with an average of 11 months. According to the ankle-hindfoot scoring system of American Orthopaedic Foot & Ankle Society (AOFAS),the score was 92.71 ± 6.58 (82 to 100). CONCLUSION: The surgical treatment of acute achilles tendon rupture with mini-open repair has advantages of little invasion, a low rate of incision problems, quick function recovery, and simple operation, and it is suitable for primary hospital.

[Clinical applications of sternoclavicular hook plate for the treatment of sternoclavicular joint dislocation].

OBJECTIVE: To observe the clinical therapeutic effects of sternoclavicular hook plate for the treatment of sternoclavicular joint dislocation. METHODS: From June 2010 to June 2012, 7 patients with sternoclavicular joint dislocation were treated with sternoclavicular hook plate fixation. Among the 7 patients, 5 patients were male and 2 patients were female, and the average age was 42.3 years, ranging from 38 to 54 years. The course of the disease ranged from 1 to 4 weeks. All the patients had trauma history. The clinical manifestations included: obvious swelling and pain of sternoclavicular joint, restricted shoulder joint activity. The sternoclavicular joint dislocation was proved by preoperative X-ray and CT. The postoperative curative effect was evaluated according to Rockwood scoring method. RESULTS: According to Rockwood scoring method, the excellent results obtained in 6 cases, good in 1. There were no complications such as internal fixation loosening or broken, second dislocation, pain in the sternoclavicular joint, and deformity. The function of shoulder joint was good, and the limb activity was free and no pain appeared. CONCLUSION: The sternoclavicular hook plate for the treatment of sternoclavicular joint dislocation has follow advantages: simple procedure, stable fixation, definite therapeutic effects.