Dynamic changes and clinic significance of serum high mobility group box 1 in patients with total hip arthroplasty.

BACKGROUND: Deeper understanding on the risk factors and seeking potential predicted biomarkers for prognosis of total hip arthroplasty (THA) patients are of great significance. Limited researches focused the correlation between high mobility group box protein-1 (HMGB1) and the prognosis of THA patients. OBJECTIVE: The objective of this study was to investigate the role of HMGB1 and inflammatory factors in patients underwent total hip arthroplasty (THA). METHODS: The present prospective study enrolled 208 THA patients who went to our hospital during January 2020 to January 2022. Serum levels of HMGB1, C-reactive protein (CRP), interleukin-1b (IL-1ß), and IL-6 were detected at the admission, 1 day, 3 days, 7 days, 30 days, and 90 days after surgery. The levels of Harris score, Fugl-Meyer, 36-item short-form health survey (SF-36), and Pittsburgh sleep quality index (PSQI) were detected on 90 days after surgery in two groups. Receiver operating characteristic curve (ROC) was performed for analyzing the diagnostic value of HMGB1 and logistic regression model was used for identifying the risk factor for poor prognosis of THA patients. RESULTS: Serum levels of HMGB1 and inflammatory factors increased after surgery compared with the baselines. A positive correlation was found between HMGB1 and CRP on 1 day after surgery, and positive correlations were found among HMGB1, IL-1ß, and IL-6 on 3 day after surgery. Besides, low HMGB1 reduced the incidence of post-operative complications and improved prognosis of THA patients. CONCLUSION: Serum HMGB1 was correlated with inflammatory factors and the prognosis of THA patients.

OBJETIVO: Profundizar la comprensión de los factores de riesgo y buscar predecir biomarcadores potenciales para el pronóstico de pacientes con reemplazo total de cadera es de gran importancia. Los estudios limitados se han centrado en la correlación entre la nhigh mobility group box 1 protein (HMGB1) y el pronóstico en pacientes con artroplastia total de cadera. Investigar el papel de la HMGB1 sérica y los factores inflamatorios en pacientes sometidos a artroplastia total de cadera. MÉTODO: Estudio prospectivo que incluyó 208 pacientes con artroplastia total de cadera que acudieron a nuestro hospital. Los niveles de puntuación de Harris, Fugl-Meyer, encuesta de salud de formato corto de 36 ítems (SF-36) e índice de calidad del sueño de Pittsburgh (PSQI) se determinaron 90 días después de la cirugía en dos grupos. Se realizó la curva característica operativa del receptor (ROC) para analizar el valor diagnóstico de HMGB1 y se utilizó un modelo de regresión logística para identificar el factor de riesgo para mal pronóstico de los pacientes con artroplastia total de cadera. RESULTADOS: Las concentraciones séricas de HMGB1 y los factores inflamatorios aumentaron después de la cirugía en comparación con los valores iniciales. Se encontró una correlación positiva entre la HMGB1 y la proteína C reactiva 1 día después de la cirugía, y correlaciones positivas entre la HMGB1 y las interleucinas 1b y 6 a los 3 días de la cirugía. CONCLUSIONES: La HMGB1 sérica se correlacionó con los factores inflamatorios y con el pronóstico de los pacientes con artroplastia total de cadera.

Evaluation of a combined posterior lateral and anteromedial approach in the treatment of terrible triad of the elbow: A retrospective study.

BACKGROUND: This retrospective study aims to investigate the efficacy and safety of a combined posterior lateral and anteromedial approach in the treatment of terrible triad of the elbow (TTE). METHODS: TTE patients who received a combination of posterior lateral and anteromedial approach or other conservative treatments were included in the present study. The postoperative functions of the elbow and the severity of traumatic arthritis were assessed using the Mayo Elbow Performance Score (MEPS) and visual analog scale (VAS). Extension-flexion of elbow joint and rotation of forearm were also measured. RESULTS: A combined posterior lateral and anteromedial approach or other conservative treatments showed significant improvements in the activity of the elbow, MEPS, VAS, the excellent rate, and x-ray results. The postoperative healing time and complication rate of patients who received a combined posterior lateral and anteromedial approach significantly decreased compared to those who received other conservative treatments. CONCLUSIONS: Patients with TTE who received a combined posterior lateral and anteromedial treatment had an increased fracture healing rate, showed improved recovery of elbow functions and had fewer complications.