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Review and update on the management of triangular fibrocartilage complex injuries in professional athletes

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World Journal of Orthopedics 2024年第2期15卷 110-117页

作者： Valerio Pace Francesco Bronzini Giovanni Novello Giuseppe Mosillo Luca Braghiroli department of Trauma and orthopaedics AOSP TerniTerni 05100Italy department of Trauma and orthopaedics University of PerugiaPerugia 06100Italy department of Trauma and orthopaedics Hand UnitAOSP TerniTerni 05100Italy

Triangular fibrocartilage complex injuries are common in amateur and professional *** injuries are mainly caused by acute or chronic repetitive axial loads on the wrist,particularly on the ulnar side and in association with rotations or radial/ulnar *** order to treat professional athletes,a detailed specific knowledge of the pathology is ***,the clinician should fully understand the specific and unique environment and needs of the athletes,their priorities and goals,the type of sport,the time of the season,and the position *** early diagnosis and appropriate management with the quickest possible recovery time are the uppermost goals for both the athlete and the surgeon.A compromise between conservative vs surgical indications,athletes’needs and expectations,and financial implications should be *** procedures should be timely planned when indicated as they could allow early diagnosis and treatment at the same *** measures are often used as first line treatment when *** lesions are treated by arthroscopic repair,whilst central lesions are treated by arthroscopic *** procedures(such as the Wafer procedure,ulnar osteotomies,etc.)have specific indications and great implications with regard to rehabilitation.

关键词： Triangular fibrocartilage complex injuries Professional athletes Ulnar sided wrist pain Wrist arthroscopy Wrist debridement

Lateral clavicle fracture-plating options and considerations

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World Journal of Clinical Cases 2024年第6期12卷 1039-1044页

作者： Sathish Muthu Saravanan Annamalai Velmurugan Kandasamy department of orthopaedics Orthopaedic Research GroupCoimbatore 641045Tamil NaduIndia department of Biotechnology Karpagam Academy of Higher EducationCoimbatore 641021Tamil NaduIndia department of orthopaedics Government Karur Medical CollegeKarur 639004Tamil NaduIndia department of orthopaedics Government Thiruvallur Medical CollegeThiruvallur 631203Tamil NaduIndia department of orthopaedics Government Kilpauk Medical CollegeChennai 600010Tamil NaduIndia

Clavicle fractures are among the most prevalent types of fractures with numerous treatment strategies that have evolved over *** the realm of lateral-third clavicle fracture management,several surgical methods are available,with plate and screw constructs being one of the most frequently employed *** this construct,numerous choices exist for fixing the *** editorial provides an overview of the common plate options utilized in the management of distal third clavicle fractures underscoring the critical considerations and approaches that guide clinicians in selecting the most appropriate fixation techniques,considering the complex landscape of clavicle fractures and their challenging management.

关键词： Clavicle fracture Surgical management Distal clavicle plating Superior plating Anterior plating

Clinical outcomes of triceps reflecting anconeus pedicle and olecranon osteotomy approach for distal humerus intercondylar fractures

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World Journal of Orthopedics 2024年第6期15卷 570-577页

作者： Rohit Ailani Sanjeev Kumar Bhuyan Brejesh Kumar Prasad Amit Kumar Namrata Dawani department of orthopaedics Lovee Shubh HospitalLucknowUttar Pradesh 226002India department of orthopaedics Gauhati Medical CollegeGuahati 781032India department of orthopaedics ESIC Medical College and HospitalFaridabadHaryana 121001India department of orthopaedics All India Institute of Medical SciencesKalyaniWest Bengal 741245India department of Obstetric and Gynecology Kannauj Medical CollegeKannaujUttar Pradesh 209732India

BACKGROUND The preferred treatment for distal humeral intercondylar fractures is open reduction and internal *** there is consensus about the posterior approach,several posterior approaches have been *** is debatable as to which approach is *** To compare triceps reflecting anconeus pedicle(TRAP)and olecranon osteotomy approaches for internal fixation of distal humeral intercondylar *** In total,40 cases of Arbeitsgemeinschaft für Osteosynthesefragen/Association of the Study of Internal Fixation type C,closed,and Gustilo type I intercondylar humeral fractures were *** ranged in age from 18 years to 70 *** patients were randomized into two groups:TRAP group and olecranon osteotomy group,with 20 cases in *** were followed up at 6 wk,3 months,6 months,and 12 *** outcomes were measured in terms of flexion-extension arc,Disabilities of Arm,Shoulder and Hand score,and Mayo Elbow Performance *** The mean age was 43.2 years in the TRAP group and 37.5 years in the olecranon osteotomy *** mean operative time and mean duration of hospital stay in the TRAP group were significantly higher than in the olecranon osteotomy group(119.5 vs 111.5 min and 9.85 vs 5.45 d,respectively).The mean arc of flexion-extension,Disabilities of Arm,Shoulder and Hand score,and Mayo Elbow Performance Score were comparable without any significant difference in the groups at the 12-month follow-up(107.0 vs 106.2,18.3 vs 15.7,and 84.2 vs 86.2,respectively).Ulnar paresthesia and superficial infections were comparable in both groups(2 cases vs 3 cases and 3 cases vs 2 cases,respectively).Hardware prominence was significantly higher in the olecranon osteotomy group,mostly due to tension band *** Both approaches were equivalent,but there is a need for further study including higher numbers of subjects and longer study duration to prove the benefits of one approach over the other.

关键词： Elbow joint Humeral fracture Osteotomy Internal Fracture fixation

Genetic Engineered Ultrasound-Triggered Injectable Hydrogels for Promoting Bone Reconstruction

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Research 2024年第2期2023卷 431-447页

作者： Zhenyu Zhao Huitong Ruan Aopan Chen Wei Xiong Mingzhu Zhang Ming Cai Wenguo Cui department of orthopaedics Shanghai Tenth People's HospitalSchool of MedicineTongji University No.301 Middle Yanchang RoadShanghai 200072China department of orthopaedics Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint DiseasesShanghai Institute of Traumatology and OrthopaedicsRuijin HospitalShanghai Jiao Tong University Schoolof Medicine197 Rujin 2nd RoadShanghai 200025China department of Foot and Ankle Surgery Beijing Tongren HospitalCapital Medical University1 Dongjiao MinxiangBeijing 100730China

Genetic engineering technology can achieve specific gene therapy for a variety of diseases, but the current strategy still has some flaws, such as a complex system, single treatment, and large implantation trauma. Herein, the genetic engineering injectable hydrogels were constructed by ultrasonic technology for the first time to realize in vivo ultrasound-triggered in situ cross-linking and cell gene transfection, and finally complete in situ gene therapy to promote bone reconstruction. First, ultrasound-triggered calcium release was used to activate transglutaminase and catalyze the transamidation between fibrinogen. Simultaneously, liposome loaded with Zinc-finger E-box-binding homeobox 1 (ZEB1) gene plasmid (Lip-ZEB1) was combined to construct an ultrasound-triggered in situ cross-linked hydrogels that can deliver Lip-ZEB1. Second, ultrasound-triggered injectable hydrogel introduced ZEB1 gene plasmid into endothelial cell genome through Lip-ZEB1 sustained release, and then acted on the ZEB1/Notch signal pathway of cells, promoting angiogenesis and local bone reconstruction of osteoporosis through genetic engineering. Overall, this strategy provides an advanced gene delivery system through genetic engineered ultrasound-triggered injectable hydrogels.

关键词： sustained release linking

Efficacy of stromal vascular fraction for knee osteoarthritis:A prospective,single-centre,non-randomized study with 2 years follow-up

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World Journal of Orthopedics 2024年第5期15卷 457-468页

作者： Madhan Jeyaraman Naveen Jeyaraman Tarun Jayakumar Swaminathan Ramasubramanian Rajni Ranjan Saurabh Kumar Jha Ashim Gupta department of orthopaedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennaiTamil Nadu 600077India department of Biotechnology School of Engineering and TechnologySharda UniversityGreater NoidaUttar Pradesh 201310India department of orthopaedics and Regenerative Medicine South Texas Orthopaedic Research InstituteLaredoTX 78045United States department of orthopaedics KIMS-Sunshine HospitalHyderabadTelangana 500032India department of orthopaedics Government Medical CollegeOmandurar Government EstateChennaiTamil Nadu 600002India department of orthopaedics School of Medical Sciences and ResearchSharda UniversityGreater NoidaUttar Pradesh 201306India department of Zoology Kalindi CollegeUniversity of DelhiNew Delhi 110008India department of orthopaedics and Regenerative Medicine Regenerative OrthopaedicsNoida 201301Uttar PradeshIndia department of orthopaedics and Regenerative Medicine Future BiologicsLawrencevilleGA 30043United States department of orthopaedics and Regenerative Medicine BioIntegrateLawrencevilleGA 30043United States

BACKGROUND Current osteoarthritis(OA)treatments focus on symptom relief without addressing the underlying disease *** regenerative medicine,current treatments have *** regenerative medicine,more research is needed for intra-articular stromal vascular fraction(SVF)injections in OA,including dosage optimization,long-term efficacy,safety,comparisons with other treatments,and mechanism *** To compare the efficacy of intra-articular SVF with corticosteroid(ICS)injections in patients with primary knee *** The study included 50 patients with Kellgren-Lawrence grades II and III *** were randomly assigned(1:1)to receive either a single intra-articular SVF injection(group A)or a single intra-articular ICS(triamcinolone)(group B)*** were followed up at 1,3,6,12,and 24 *** analog score(VAS)and International Knee Documentation Committee(IKDC)scores were administered before the procedure and at all *** safety of SVF in terms of adverse and severe adverse events was *** analysis was performed with SPSS Version 26.0,IBM Corp,Chicago,IL,United *** Both groups had similar demographics and baseline clinical ***-up showed minor patient loss,resulting in 23 and 24 in groups A and B *** A experienced a notable reduction in pain,with VAS scores decreasing from 7.7 to 2.4 over 24 months,compared to a minor reduction from 7.8 to 6.2 in Group *** difference in pain reduction in group A was statistically significant from the third month ***,Group A showed significant improvements in knee functionality,with IKDC scores rising from 33.4 to 83.10,whereas Group B saw a modest increase from 36.7 to *** improvement in Group A was statistically significant from 6 months and maintained through 24 *** Our study demonstrated that intra-articular administration of SVF can lead to reduced pain and improved knee function in pa

关键词： Knee osteoarthritis Adipose tissue Stromal vascular fraction Regenerative medicine Orthobiologics

Circular RNA circ_0003609 ameliorates hypertrophied ligamentum flavum by regulating the miR-155/SIRT1 axis

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BIOCELL 2024年第6期48卷 1001-1008页

作者： GUIBIN ZHONG SHURONG WANG YUJIN HE DAMING FENG KE WEI YANQIU YANG JIANWEI CHEN JUNLING CHEN department of orthopaedics Baoshan BranchRen Ji HospitalSchool of Medicine Shanghai Jiao Tong UniversityShanghai200444China department of orthopaedics Ren Ji HospitalSchool of Medicine Shanghai Jiao Tong UniversityShanghai200127China department of Operation and Anaesthesia Ren Ji HospitalSchool of Medicine Shanghai Jiao Tong UniversityShanghai200127China department of orthopaedics Huai Yuan Chang Jiu HospitalHuaiyuan233499China

Background:Hypertrophy of the ligamentumﬂavum(HLF)is a common contributor to spinal stenosis which results in signiﬁcant neurological *** RNA(circRNA)circ_0003609 has been linked to HLF;however,the exact mechanism by which it causes this disease is ***:Circ_0003609 expressions were regulated in HLF cells by overexpression vectors and RNA *** proliferation andﬁbrosis-related gene expression were checked by the Cell Counting Kit-8(CCK-8)assay and western ***’s prediction of the association between miR-155 and circ_0003609 was supported by a dual-luciferase reporter *** function of the miR-155/sirtuin 1(SIRT1)axis in controlling HLFﬁbrosis was further ***:Overexpression of circ_0003609 suppressed HLF cell propagation andﬁbrosis compared to its *** was found that circ_0003609 served as the sponge for miR-155 and that the circ_0003609/miR-155 axis controlled theﬁbrosis of HLF *** was found that circ_0003609 acted as a sponge for miR-155,regulating theﬁbrosis of HLF ***,miR-155 targets SIRT1,and the miR-155/SIRT1 axis promotes HLF cellﬁ***:Circ_0003609 ameliorates hypertrophied ligamentumﬂavum(LF)by modulating the miR-155/SIRT1 axis,indicating a potential treatment approach for HLF.

关键词： Circular RNA Circ_0003609 Hypertrophy of ligamentum flavum MiR-155 Sirtuin 1 Fibrosis

Effect of weight-adjusted antimicrobial antibiotic prophylaxis on postoperative dosage and surgical site infection incidence in total joint arthroplasty

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World Journal of Orthopedics 2024年第4期15卷 318-320页

作者： Ashim Gupta Vijay Kumar Jain department of orthopaedics and Regenerative Medicine Future BiologicsLawrencevilleGA 30043United States department of orthopaedics South Texas Orthopaedic Research Institute(STORI Inc.)LaredoTX 78045United States department of Regenerative Medicine BioIntegrateLawrencevilleGA 30043United States department of orthopaedics and Regenerative Medicine Regenerative OrthopaedicsNoida 201301India department of orthopaedics Atal Bihari Vajpayee Institute of Medical SciencesDr Ram Manohar Lohia HospitalNew Delhi 110001India

Surgical site infections(SSI)following total joint arthroplasty pose a significant concern for both providers and patients across the ***,administration of antimicrobial antibiotic prophylaxis is used throughout the world to reduce the incidence of ***,the correct dosage and frequency of administration remains *** this editorial,we emphasized the determination of the effect of administration of weight-adjusted antimicrobial antibiotic prophylaxis regime on the incidence of SSI and postoperative dosage reduction compared to the conventionally used regime during total joint *** results demonstrated similar efficacy between both regimes with respect to the incidence of *** addition,weight-adjustment led to reduced postoperative dosage and has the potential to reduce chances of achieving lower therapeutic concentration,drug resistance,drug toxicity,and costs.

关键词： Antibiotics Antimicrobial prophylaxis Weight-adjusted Surgical site infections Total joint arthroplasty Knee arthroplasty Hip arthroplasty

Autologous peripheral blood-derived orthobiologics:Different types and their effectiveness in managing knee osteoarthritis

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World Journal of Orthopedics 2024年第5期15卷 400-403页

Knees are the most commonly impacted weight-bearing joints in osteoarthritis(OA),affecting millions of people *** increasing life spans and obesity rates,the incidence of knee OA will further increase,leading to a significant increase in the economic *** treatment modalities utilized to manage knee OA have *** the last decade,the role of various autologous peripheral blood-derived orthobiologics(APBOs)for the treatment of knee OA has been extensively *** editorial provided an overview and focused on defining and shedding light on the current state of evidence based on the most recent published clinical studies concerning the use of APBO for the management of knee *** numerous studies have demonstrated promising results for these preparations,a notable gap exists in the comparative analysis of these diverse *** absence of head-to-head studies poses a considerable challenge for physicians/surgeons in determining the optimal preparation for managing knee OA and achieving sustained longterm ***,more adequately powered,multicenter,prospective,doubleblind,randomized controlled trials with longer follow-ups are needed to establish the long-term efficacy and to aid physicians/surgeons in determining the optimal APBO for the management of knee OA.

关键词： Knee osteoarthritis Platelet-rich plasma Platelet lysate Autologous conditioned serum Gold-induced cytokine Plasma rich in growth factors Growth factor concentrate Autologous protein solution Platelet-rich fibrin Hyperacute serum

Meta-analysis of new intervention measures for preventing side effects of artificial joint replacement

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World Journal of Orthopedics 2024年第5期15卷 469-476页

作者： Wei Jiang Ting-Biao Zhu department of orthopaedics Traditional Chinese Medicine Hospital of PingshanYibin 645350Sichuan ProvinceChina department of orthopaedics The First People's Hospital of QujingQujing 655099Yunnan ProvinceChina

BACKGROUND Intertrochanteric fracture of the femur occurs mostly among older people,and seriously affects daily life and quality of *** present,physical intervention,drug treatment,routine intervention and rehabilitation training are widely used for prevention of side effects,but it is still inconclusive which intervention has the best *** To compare the effects of new intervention measures for preventing side effects of artificial joint *** We searched the Chinese and English literatures for comparative studies on the prevention of side effects of new interventions for artificial joint replacement from July 2013 to June 2023 in China HowNet,PubMed,Wanfang,Weipu and other *** quality was evaluated by improved Jadad scoring standard,and the effects of different interventions on preventing different complications were analyzed by meta-analysis of evidence-based medicine with Review Manager 5.0 *** Ten articles,including 869 cases,were finally *** preventive effects of different interventions on the side effects of artificial joint replacement were studied,and valid data were *** were two articles on the preventive effects of drug intervention,four on comparison of the preventive effects of combined and single interventions,and three on the preventive effects of physical intervention,rehabilitation training and routine ***-analysis showed that the preventive effect of rivaroxaban was significantly better than low molecular weight heparin calcium[mean difference(MD)=-0.16,95%CI:-0.28 to-0.04,P<0.05].The effect of combined intervention was significantly better than that of single intervention(MD=-0.08,95%CI:-0.16 to-0.01,P<0.001).Physical intervention was significantly better than routine intervention and rehabilitation training(MD=0.26,95%CI:0.16–0.36,P<0.001).CONCLUSION Rivaroxaban combined with rehabilitation training is preferred for preventing deep vein thrombosis after artificial

关键词： Artificial joint replacement Venous thromboembolism Side effects Interventions Meta-analysis