Effect of open-wedge high tibial osteotomy and lateral patellofemoral retinacular release on patellar position: an X-ray imaging-based comparative study.

Background: Open-wedge high tibial osteotomy (OWHTO) may cause adverse changes in the mechanical environment of the patellofemoral joint. For patients with lateral patellar compression syndrome or patellofemoral arthritis, intraoperative management is still challenging. The effect of lateral retinacular release (LRR) on patellofemoral joint mechanics after OWHTO remains unclear. Our study aimed to evaluate the effect of OWHTO and LRR on the patellar position based on lateral and axial radiographs of the knee joint. Methods: The study comprised 101 knees (OWHTO group) undergoing OWHTO alone and 30 knees (LRR group) undergoing OWHTO and concomitant LRR. The following radiological parameters were statistically analyzed preoperatively and postoperatively: femoral tibial angle (FTA), medial proximal tibial angle (MPTA), weight-bearing line percentage (WBLP), Caton-Deschamps index (CDI), Insall-Salvati index (ISI), lateral patellar tilt angle (LPTA), and lateral patellar shift (LPS). The follow-up duration ranged from 6 to 38 months, with a mean of 13.51±6.84 months in the OWHTO group and 12.47±7.81 months in the LRR group. The Kellgren-Lawrence (KL) grading system was used to evaluate changes in patellofemoral osteoarthritis (OA). Results: Regarding the patellar height, preliminary analysis demonstrated a statistically significant decrease in the CDI and ISI in both groups (P<0.05). However, there was no significant difference in changes in CDI or ISI between the groups (P>0.05). In the OWHTO group, although there was a significant increase in the LPTA (P=0.033), the postoperative decrease in the LPS was not significant (P=0.981). In the LRR group, both the LPTA and LPS significantly decreased postoperatively (P=0.000). The mean changes in LPS were 0.03 mm in the OWHTO group and 1.44 mm in the LRR group, indicating a significant change in LPS (P=0.000). However, there was no significant difference in changes in LPTA between the groups, which was contrary to our expectations. Imaging showed no change in patellofemoral OA in the LRR group and progressive changes (from KL grade I to II) in patellofemoral OA in 2 (1.98%) patients in the OWHTO group. Conclusions: OWHTO can cause a significant decrease in patellar height and an increase in lateral tilt. LRR can significantly improve the lateral tilt and shift of the patella. The concomitant arthroscopic LRR should be considered for the treatment of patients with lateral patellar compression syndrome or patellofemoral arthritis.

Emerging trends and research foci of deep learning in spine: bibliometric and visualization study.

As the cognition of spine develops, deep learning (DL) emerges as a powerful tool with tremendous potential for advancing research in this field. To provide a comprehensive overview of DL-spine research, our study utilized bibliometric and visual methods to retrieve relevant articles from the Web of Science database. VOSviewer and CiteSpace were primarily used for literature measurement and knowledge graph analysis. A total of 273 studies focusing on deep learning in the spine, with a combined total of 2302 citations, were retrieved. Additionally, the overall number of articles published on this topic demonstrated a continuous upward trend. China was the country with the highest number of publications, whereas the USA had the most citations. The two most prominent journals were "European Spine Journal" and "Medical Image Analysis," and the most involved research area was Radiology Nuclear Medicine Medical Imaging. VOSviewer identified three visually distinct clusters: "segmentation," "area," and "neural network." Meanwhile, CiteSpace highlighted "magnetic resonance image" and "lumbar" as the keywords with the longest usage, and "agreement" and "automated detection" as the most commonly used keywords. Although the application of DL in spine is still in its infancy, its future is promising. Intercontinental cooperation, extensive application, and more interpretable algorithms will invigorate DL in the field of spine.

Circ_0093887 regulated ox-LDL induced human aortic endothelial cells viability, apoptosis, and inflammation through modulating miR-758-3p/BAMBI axis in atherosclerosis.

BACKGROUND: Compelling evidence demonstrated that circular RNAs (circRNAs) were involved in the progression of atherosclerosis (AS). However, the role of circ_0093887 in the progression of AS is unclear. The purpose of this study was to explore the role and mechanism of circ_0093887 in oxidized-low density lipoprotein (ox-LDL)-induced human aortic endothelial cells (HAECs). METHODS: HAECs were stimulated by ox-LDL to simulate AS-like injury in vitro. Circ_0093887, microRNA-758-3p (miR-758-3p), and BMP And Activin Membrane-Bound Inhibitor (BAMBI) levels were detected by quantitative real-time polymerase chain reaction (qRT-PCR). PCNA, Bax, Bcl-2, and BAMBI protein levels were detected by western blot. Cell viability and apoptosis were examined by Cell Counting Kit-8 (CCK-8) assay and flow cytometry. Tube formation assay was used to assess tube formation. The levels of inflammatory factors TNF-α and IL-1ß were detected by corresponding ELISA kits. The relationship between miR-758-3p and circ_0093887 or BAMBI was tested via dual-luciferase reporter analysis and RNA immunoprecipitation. Oxidative stress related indexes (ROS and MDA) were detected by corresponding kits. RESULTS: The expression levels of circ_0093887 and BAMBI were prominently downregulated in ox-LDL-induced HAECs compared with control, whereas the expression of miR-758-3p was upregulated. Overexpression of circ_0093887 promoted HAECs viability and tube formation, and restrained cell apoptosis in ox-LDL-induced HAECs compared with untreated HAECs. Mechanistically, circ_0093887 regulated the expression of BAMBI through miR-758-3p. Further experiments showed that upregulation of miR-758-3p reversed changes in cell function induced by circ_0093887. In addition, reduced BAMBI salvaged miR-758-3p knockdown mediated effects on cell function. CONCLUSION: Circ_0093887 demonstrated its diagnostic and therapeutic value in AS by promoting the role of the miR-758-3p/BAMBI axis in the ox-LDL-induced endothelial injury of HAECs.

Association between the inclination angle of the proximal tibiofibular joint surface and medial compartment knee osteoarthritis.

BACKGROUND: Fibular support for the lateral tibial plateau through the proximal tibiofibular joint (PTFJ) results in nonuniform settlement of the tibial plateau in middle-aged and elderly persons and may lead to medial compartment knee osteoarthritis. However, the inclination angle of the PTFJ surface varies widely and may affect nonuniform settlement. The purpose of this case-control study was to assess the association between the inclination angle of the PTFJ surface and medial compartment knee osteoarthritis. METHODS: The fibular inclination angle (FIA) and tibial inclination angle (TIA) of the PTFJ surface were measured using radiographs. Differences of FIA and TIA among groups were assessed with t tests and the odds ratios (ORs) for risk factors of medial compartment knee osteoarthritis were calculated with binary logistic regression analysis. RESULTS: Forty patients and 40 control participants were included in this case-control study. Patients had both a lower FIA (P=0.005) and TIA (P=0.000) than the controls, and logistic regression analysis showed that FIA (OR =7.000) and TIA (OR =17.000) were risk factors for medial compartment knee osteoarthritis. CONCLUSIONS: A lower inclination angle of the PTFJ surface is associated with a risk of medial compartment knee osteoarthritis. Clinically, early prevention of medial compartment knee osteoarthritis should be considered for middle-aged and elderly persons with low PTFJ inclination angles.

[Comparison of curative effect between osteochondral mosaic transplantation and micro-fracture in the treatment of knee joint articular cartilage injury].

OBJECTIVE: To compare the clinical outcomes of microfracture and autogenous osteochondral mosaic transplantation in the treatment of knee joint cartilage injury. METHODS: A retrospective analysis of 71 patients with articular cartilage defects on the femoral condyles who were by autogenous osteochondral mosaic transplantation or microfracture from February 2011 to February 2016, and these patients were followed up for at least 2 years. According to the sugical procedures, the patients were divided into two groups. In the microfracture group, there were 33 patients, 20 males and 13 females, with a mean age of(28.1±4.2) years old; in the mosaicplasty group, there were 38 patients, 26 males and 12 females, with a mean age of(27.8±3.5) years old. The Lysholm knee score, Hospital for Special Surgery (HSS) knee score and the Ahlbäck classification grade were recorded to evaluate the clinical efficacy. Complications were also recorded. RESULTS: The mean Lysholm scores of the microfracture group and the mosaicplasty group improved from 62.9±6.8 and 60.3±7.5 preoperatively to 77.0±5.4 and 85.8±5.6 post-operatively, respectively(P<0.05). Mean HSS scores of the microfracture group and the mosaicplasty group improved from 81.5±7.6 and 79.6±8.6 preoperatively to 88.0±4.7 and 91.9±4.7 post-operatively, respectively(P<0.05). The mean Lysholm score and HSS score were significantly higher in the mosaicplasty group than those in the microfracture group at the latest follow-up. One patient in the mosaicplasty group suffered superficial wound infection. During the follow-up, no knee osteoarthritis was observed in two groups. CONCLUSIONS: Autogenous osteochondral mosaicplasty and microfracture are proved to be safe and effective procedures for knee articular cartilage defects. However, the mosaicplasty has better clinical outcome than the microfracture.