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Total Hip Replacement: Short- and Medium-Term Morbidity and Mortality in the department of orthopedic traumatology of Donka University Hospital, Guinea-Conakry

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Open Journal of orthopedics 2022年第12期12卷 493-502页

作者： Lamah Leopold Diallo Mamadou Moustapha Sidimé Sory Diallo Ibrahima Gallé Barry Alhassane Lamah Philip Bah Mohamed Lamine Camara Nouhou Mangué Diallo Amadou Mamadou Fela Sané André department of orthopedics and traumatology of the Donka University Hospital Conakry Guinea orthopedic traumatology department of the Ignace Deen University Hospital Conakry Guinea orthopedic traumatology Service of the Aristide le Dantec University Hospital in Dakar Dakar Senegal

Introduction: Total hip prostheses are a reliable means of treating hip disorders. It is indicated when pain and reduced mobility of the hip become incompatible with the patient’s daily activities. In low-income countries, the risk factors for hip disease are numerous, but the means for its management, such as total hip prostheses, are not. The aim of this work was to determine the morbi-mortality of total hip prostheses in the short and medium term in our department and to review the literature. Patients and Method: This was a prospective and descriptive study over a period of 9 years. It involved 50 THPs performed on 45 patients. Patients who had received a THP and were followed up for at least two years were included. We excluded patients who were lost to follow-up. The Moore-type posterolateral minimally invasive approach was used. Complications were investigated from the immediate postoperative period and in the medium term. The final functional results were evaluated according to the Postel Merle d’Aubigné score. Results: We performed 50 THPs out of 750 procedures, i.e. , 6.6%. The indications were: primary coxarthrosis 60%, necrosis of the femoral head 26%, post-infectious balloon hip 4%, and pseudarthrosis of the femoral neck 10%. The average time to the consultation was 2.4 years with extremes of 1 and 5 years. According to the terrain, sickle cell disease represented 18%, tuberculosis 12%. Postoperative complications were lameness 12%, dislocation 6%, suppuration 6%, death 4%, peri-prosthetic fracture 8%, loosening 2%, peri-articular ossification 2%, and paralysis of the external popliteal nerve 2%. Conclusion: Whoever performs a THP is obliged to monitor the patient as long as he/she is alive. Complications are possible at any time and can negatively change the assigned goal and force the surgeon to be expensive and sometimes inconclusive secondary interventions.

关键词： THP Morbi-Mortality Short- Medium- Term

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Complication rates after direct anterior vs posterior approach for hip hemiarthroplasty in elderly individuals with femoral neck fractures

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World Journal of orthopedics 2024年第1期15卷 22-29页

作者： Tatiana Charles Nicolas Bloemers Bilal Kapanci Marc Jayankura department of orthopedic Surgery and traumatology HUB-Hospital ErasmeBrussels 1070Belgium

BACKGROUND Dislocation rates after hemiarthroplasty reportedly vary from 1%to 17%.This serious complication is associated with increased morbidity and mortality *** to this surgery are still debated,with no consensus regarding the superiority of any single *** To compare early postoperative complications after implementing the direct anterior and posterior approaches(PL)for hip hemiarthroplasty after femoral neck *** This is a comparative,retrospective,single-center cohort study conducted at a university *** March 2008 and December 2018,273 patients(a total of 280 hips)underwent bipolar hemiarthroplasties(n=280)for displaced femoral neck fractures using either the PL(n=171)or the minimally invasive direct anterior approach(DAA)(n=109).The choice of approach was related to the surgeons’practices;the implant types were similar and unrelated to the *** rates and other complications were reviewed after a minimum followup of 6 *** Both treatment groups had similarly aged patients(mean age:82 years),sex ratios,patient body mass indexes,and patient *** data(surgery delay time,operative time,and blood loss volume)did not differ significantly between the *** 30 d mortality rate was higher in the PL group(9.9%)than in the DAA group(3.7%),but the difference was not statistically significant(P=0.052).Among the one-month survivors,a significantly higher rate of dislocation was observed in the PL group(14/154;9.1%)than in the DAA group(0/105;0%)(P=0.002).Of the 14 patients with dislocation,8 underwent revision surgery for recurrent instability(posterior group),and one of them had 2 additional procedures due to a deep *** rate of other complications(e.g.,perioperative and early postoperative periprosthetic fractures and infection-related complications)did not differ significantly between the *** These findings suggest that the DAA to bipolar hemiarthroplasty f

关键词： Hemiarthroplasty Femoral neck fracture Direct anterior approach Posterior approach Dislocation Mortality

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Maternal High-Fat Diet Impairs Offspring Glucose Metabolism and Programs Hepatic DNA Methylation Linked to NK Cell-Mediated Cytotoxicity Signaling Pathway at Weaning

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Food Science and Human Wellness 2024年

作者： Sheng Zheng Ling Zhang Shixuan Zhang Guanyu Hu Yikai Li Jia Zheng department of Traditional Chinese orthopedics and traumatology， Center for orthopedic Surgery， The Third Affiliated Hospital of Southern Medical University department of Endocrinology， Peking University First Hospital

Maternal consumption of a high-fat diet has been linked to increased risks of obesity and impaired glucose metabolism in offspring. However， the precise epigenetic mechanisms governing these intergenerational effects， particularly during the early stages of offspring development， remain poorly understood. In this study， female C57BL/6J mice were randomly assigned to either a high-fat diet or normal chow diet throughout gestation and lactation. Methylated DNA immunoprecipitation (MeDIP) coupled with microarray analysis was employed to identify differentially methylated genes in the livers of offspring at weaning age. We found that maternal high-fat diet feeding predisposes offspring to obesity and impaired glucose metabolism as early as the weaning period. DNA methylation profile analysis unveiled a significant enrichment of differentially methylated genes within the natural killer (NK) cell-mediated cytotoxicity pathway. MeDIP-PCR validated reduced methylation levels of specific genes within this pathway， including TNFα， PI3K， and SHC1. Consistently， the expressions of TNFα， PI3K， and SHC1 were significantly upregulated， accompanied by elevated serum TNFα and IL-6 levels in offspring from dams fed with high-fat diet. Moreover， we assessed the expressions of genes associated with NK cell activities， uncovering a notable rise in hepatic granzyme B levels and a trend towards increased CD107a expression in offspring from dams fed a high-fat diet. In addition， methylation levels of TNFα， PI3K， and SHC1 promoters were inversely correlated with glucose response during glucose tolerance testing. In conclusion， our findings underscore the critical role of the NK cell-mediated cytotoxicity signaling pathway in mediating DNA methylation patterns， thereby contributing to the programming effects of maternal high-fat diet consumption on offspring glucose metabolism as early as the weaning period.

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Evaluation of Intraoperative Iatrogenic Lesions and Postoperative Complications in 1140 Patients Treated for Carpal Tunnel Syndrome in the orthopedic Surgery and traumatology department of the Moulins-Yzeure Hospital Center in France

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Surgical Science 2023年第12期14卷 705-711页

作者： Saint Luc Mungina Sedou Charlène Tshitala Jean-François Dumez Issifou Moumouni Kevin Ndangi Kibadi Kapay department of Surgery of the University Clinics of Kinshasa Faculty of Medicine University of Kinshasa Kinshasa Democratic Republic of the Congo Matete General Reference Hospital Kinshasa Democratic Republic of the Congo department of orthopedic Surgery and traumatology Moulins-Yzeure Hospital Center Moulins France

Introduction: Carpal tunnel syndrome is a more common form of upper limb canal syndrome, resulting from compression of the median nerve in the carpal tunnel, but is particularly troublesome. Medical treatment is often unsuccessful, and surgical treatment usually involves transection of the annular ligament. The aim of this study was to assess iatrogenic intraoperative and postoperative complications, as well as patient outcomes following the use of conventional and endoscopic surgery in the surgical management of carpal tunnel syndrome. Hypothesis: Are nerve, vascular and tendon injuries of iatrogenic origin always present in the surgical management of carpal tunnel syndrome, even though this surgery is performed on an outpatient basis? Patients and methods: This retrospective series is composed of 1140 patients, 230 men and 910 women, mean age 58.6 ± 16.4 years, operated on between 2010 and 2020 for carpal tunnel syndrome by conventional surgery and under endoscopy. Medical records, operative reports and consultation letters were consulted. All patients were reviewed regularly at one month post-op until recovery. Results: No nerve, vascular or tendon damage was noted, and at a maximum follow-up of 2 years, 20 patients had recurred, i.e. a 2.51% failure rate. Scar disunion was observed in 0.9%, wound infection in 0.9% and scar fibrosis in 0.9%. 92.98% of patients underwent outpatient surgery, irrespective of the type of anesthesia or surgical technique used. Patients who stayed in hospital for a short time were suffering from carpal tunnel syndrome associated with compression of the ulnar nerve in Guyon’s canal, for which both the median and ulnar nerves were freed during the same operation, under general anaesthetic. All patients were able to return to their previous activity within 30 days of surgery. Conclusion: Intraoperative iatrogenic complications, notably nerve, vascular and tendon lesions, were not identified despite the large sample size. On the other hand

关键词： Carpal Tunnel Iatrogenic Complications Patient Outcome Surgical Treatment

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Skeletal interoception in osteoarthritis

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Bone Research 2024年第2期12卷 241-254页

作者： Dinglong Yang Jiawen Xu Ke Xu Peng Xu department of Joint Surgery Honghui HospitalXi’an Jiaotong UniversityXi’an 710054China department of orthopedic Surgery and orthopedic Research Institute West China HospitalSichuan UniversityChengdu 610041China

The interoception maintains proper physiological conditions and metabolic homeostasis by releasing regulatory signals after perceving changes in the internal state of the *** its various forms,skeletal interoception specifically regulates the metabolic homeostasis of ***(OA)is a complex joint disorder involving cartilage,subchondral bone,and *** subchondral bone undergoes continuous remodeling to adapt to dynamic joint *** findings highlight that skeletal interoception mediated by aberrant mechanical loads contributes to pathological remodeling of the subchondral bone,resulting in subchondral bone sclerosis in *** skeletal interoception is also a potential mechanism for chronic synovial inflammation in *** this review,we offer a general overview of interoception,specifically skeletal interoception,subchondral bone microenviroment and the aberrant subchondral *** also discuss the role of skeletal interoception in abnormal subchondral bone remodeling and synovial inflammation in OA,as well as the potential prospects and challenges in exploring novel OA therapies that target skeletal interoception.

关键词： homeostasis inflammation releasing

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Regenerative medicine strategies for chronic complete spinal cord injury

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Neural Regeneration Research 2024年第4期19卷 818-824页

作者： Shogo Hashimoto Narihito Nagoshi Masaya Nakamura Hideyuki Okano department of orthopedic Surgery Keio University School of Medicine department of Physiology Keio University School of Medicine

Spinal cord injury is a condition in which the parenchyma of the spinal cord is damaged by trauma or various *** rapid progress has been made in regenerative medicine for spinal cord injury that was previously untreatable,most research in this field has focused on the early phase of incomplete ***,the majority of patients have chronic severe injuries;therefore,treatments for these situations are of fundamental *** reason why the treatment of complete spinal cord injury has not been studied is that,unlike in the early stage of incomplete spinal cord injury,there are various inhibitors of neural ***,we assumed that it is difficult to address all conditions with a single treatment in chronic complete spinal cord injury and that a combination of several treatments is essential to target severe ***,we established a combination therapy of cell transplantation and drug-releasing scaffolds,which contributes to functional recovery after chronic complete transection spinal cord injury,but we found that functional recovery was limited and still needs further ***,for the further development of the treatment of chronic complete spinal cord injury,we review the necessary approaches to the different pathologies based on our findings and the many studies that have been accumulated to date and discuss,with reference to the literature,which combination of treatments is most effective in achieving functional recovery.

关键词： cell transplantation chronic phase complete transection regenerative medicine spinal cord injury

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The emerging role of tranexamic acid and its principal target,plasminogen,in skeletal health

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Acta Pharmaceutica Sinica B 2024年第7期14卷 2869-2884页

作者： Weixin Xie Antonia Donat Shan Jiang Anke Baranowsky Johannes Keller department of Trauma and orthopedic Surgery University Medical Center Hamburg-EppendorfHamburg 20246Germany

The worldwide burden of skeletal diseases such as osteoporosis,degenerative joint disease and impaired fracture healing is steadily *** acid(TXA),a plasminogen inhibitor and anti-fibrinolytic agent,is used to reduce bleeding with high effectiveness and safety in major surgical *** its widespread clinical application,the effects of TXA beyond anti-fibrinolysis have been noticed and prompted renewed interest in its *** clinical trials have characterized the effects of TXA on reducing postoperative infection rates and regulating immune responses in patients undergoing ***,several animal studies suggest potential therapeutic effects of TXA on skeletal diseases such as osteoporosis and fracture *** a direct effect of TXA on the differentiation and function of bone cells in vitro was shown,few mechanisms of action have been ***,we summarize recent findings of the effects of TXA on skeletal diseases and discuss the underlying plasminogen-dependent and-independent mechanisms related to bone metabolism and the immune *** furthermore discuss potential novel indications for TXA application as a treatment strategy for skeletal diseases.

关键词： Tranexamic acid Osteoporosis Osteoarthritis Fracture healing Bone metabolism Inflammation Plasminogen Fibrinolysis

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Extracellular vesicles for neural regeneration after spinal cord injury

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Neural Regeneration Research 2024年第3期19卷 491-492页

作者： Young-Ju Lim Wook-Tae Park Gun Woo Lee department of orthopedic Surgery Yeungnam University Medical CenterYeungnam University College of MedicineDaeguKorea

What is spinal cord injury:Spinal cord injury(SCI)is the damage to the structure of the bundles of cells and nerves that communicate signals from the brain to the body and *** pathology of SCI includes both primary and secondary injuries(Morales et al.,2016).Physical forces such as compression,shearing,contusion,and tearing are major causes of primary injury in *** are two main processes in primary injury:acute and *** acute phase includes traumatic disruption of axons and hemorrhage of the blood vessels around the spinal *** injury to the vessels can lead to increased edema within the neural and cord tissues,susceptibility to infiltration by microglia and astrocytes,excitotoxicity,and ***,disruption of the blood-spinal cord barrier results in the release of inflammatory cytokines from specific cells and vessels.

关键词： acute injuries nerves

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Irreducible anteromedial radial head dislocation without fracture caused by transposed biceps tendon in an adult:A case report and literature review

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Chinese Journal of traumatology 2024年第3期27卷 180-186页

作者： Ming-Fu Fu Hai-Ning Zuo Tao Sun Ming-Zhang Mu Zhi-Yong Zhou department of orthopedic Surgery Yantaishan HospitalYantaiShandong Province264003China

Irreducible anteromedial radial head dislocation(IARHD)caused by transposed biceps tendon is *** diagnosis and surgical failure often occur.A 46-year-old fisherman presented with 10 days history of painful swelling and restricted movement of his right elbow due to strangulation injury by a fishing boat *** examination,the images of the right elbow reveals in a"semi-extended and pronated"elastic fixation *** and 3-dimensional reconstruction CT reveals an isolated anteromedial radial head dislocation with extreme protonation of the radius and the bicipital tuberosity towards the posterior aspect of the elbow joint,and MRI shows biceps tendon wrapping around the radial neck,similar to umbilical cord wrapping seen in *** Henry approach was applied for the first time to reduce the biceps *** patient achieved a good functional recovery at 26 months,which represents the first reported case of IARHD without fracture caused by biceps tendon in an *** treatment of IARHD,attention should be paid to the phenomenon of biceps tendon *** clinical examination,comprehensive imaging modalities,and appropriate surgical approach are the keys to successful management.

关键词： Biceps tendon Henry approach Irreducible Anteromedial dislocation Radial head Elbow Adult

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Congenital absence of the lateral meniscus:A case report

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World Journal of orthopedics 2024年第5期15卷 477-482页

作者： Hamad Ali Alkhunayfir Abdulaziz Ali AlQahtani Abdulrahman Jalwi Korkoman department of orthopedic Surgery Prince Muhammed bin Abdulaziz HospitalRiyadh 61422Saudi Arabia department of orthopedic Surgery Prince Sultan Military Medical CityRiyadh 12233Saudi Arabia department of orthopedic Surgery University of BishaBisha 67714Saudi Arabia

BACKGROUND Congenital absence of the menisci is a rare anatomical variation characterized by the absence or underdevelopment of one or both menisci in the knee *** menisci are crucial in load distribution,joint stability,and shock *** the clinical presentation,diagnosis,and management of this condition is important for optimal patient *** SUMMARY A 27-year-old male with a long-standing history of knee pain underwent diagnostic arthroscopy,revealing a congenital absence of the *** patient's clinical findings,imaging results,surgical procedures,and pertinent images are *** case presents a unique aspect with the congenital absence of the meniscus,contributing valuable insights to the literature on rare anatomical *** This case of congenital absence of the menisci highlights the diagnostic challenges posed by rare *** diagnostic arthroscopy played a crucial role in identifying the absence of the meniscus and providing an explanation for the patient's persistent knee *** case underscores the importance of individualized treatment approaches,including physical therapy,for optimal management of rare meniscal *** research is warranted to explore effective management strategies for the aforementioned cases and to expand our knowledge of these rare conditions.

关键词： Lateral meniscus Arthroscopy Knee joint Menisci reformation Magnetic resonance imaging Case report

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