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Management of proximal tibial stress fracture associated with advanced knee osteoarthritis:A systematic review

Chinese Journal of Traumatology 2024年第3期27卷 147-152页

作者： Mukesh Kumar Saini Mahendra Singh Devendra Singh Prem Manohar Seervi Pera Jayavardhan Reddy Neelam Ramana Reddy department of orthopaedics Dr SN Medical CollegeJodhpur342011India department of orthopaedics Star HospitalsB Block Banjara HillsHyderabad500034India

Purpose:Tibial stress fracture associated with knee osteoarthritis is an unusual and difficult clinical *** is no clear existing treatment guideline for this uncommon clinical *** aim of this study is to review the impact of various treatment options for patients with advanced knee osteoarthritis associated with proximal tibial stress ***:The study was performed using the databases of PubMed and *** index for non-randomized studies score was used to evaluate the included studies’*** concluded data included the treatment approach,reported outcome measure,and time to fracture *** literature search was started in December 2021 and accomplished in January 2022.A narrative description of the different methods and comparison of their results were ***:Out of total assessed 69 studies,9 studies were included in our *** commonest treatment approach used was total knee arthroplasty by long tibial stem *** mean preoperative knee society score and knee functional score were 30.62 and 23.17,*** mean postoperative knee society knee score was 86.87,while the functional score was *** average reported time to achieve fracture union was 4 months(a range of 2.07-5.50 months).Conclusion:The optimal clinical outcome for treating either acute or mobile tibial stress fracture in patients with advanced knee osteoarthritis can be achieved with long stem total knee ***,due to heterogeneity of data,comparison of different treatment options for chronic proximal tibial stress fracture mal-union/non-union coexisting with knee osteoarthritic and such inferences need to be judged cautiously.

关键词： Tibial stress fracture Knee osteoarthritis Total knee arthroplasty

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In Situ Sustained Macrophage-Targeted Nanomicelle-Hydrogel Microspheres for Inhibiting Osteoarthritis

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Research 2024年第1期2023卷 1-16页

作者： XiaoXiao Li Xingchen Li Jielai Yang Yawei Du Liang Chen Gang Zhao Tingjun Ye Yuan Zhu Xiangyang Xu Lianfu Deng Wenguo Cui department of orthopaedics Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint DiseasesShanghai Institute of Traumatology and OrthopaedicsRuijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025P.R.China

There are stillchallenges in applying drug nanocarriers for in situ sustained macrophage targeting and regulation,due to the rapid clearance of nanocarriers and burst drug release ***,a nanomicellehydrogel microsphere,characterized by its macrophage-targeted nanosized secondary structure that allows it to accurately bind to M1 macrophages through active endocytosis,is employed for in situ sustained macrophage targeting and regulation,and addresses the insufficient osteoarthritis therapeutic efficacy caused by rapid clearance of drug *** 3-dimensional structure of a microsphere can prevent the rapid escape and clearance of a nanomicelle,thus keeping it in joints,while the ligand-guided secondary structure can carry drugs to accurately target and enter M1 macrophages,and release drugs via the transition from hydrophobicity to hydrophilicity of nanomicelles under inflammatory stimulation inside the macrophages.

关键词： micelle release spheres

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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

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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

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Ipsilateral fractures of the acromion and coracoid processes of the scapula

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Chinese Journal of Traumatology 2024年第2期27卷 121-124页

作者： Yusuf Omar Qalib Srinivasa Reddy Medagam Sunil Dachepalli department of orthopaedics The Fifth Affiliated Hospital of Sun Yat-Sen UniversityZhuhai519000GuangdongChina department of orthopaedics Yashoda HospitalsSomajigudaHyderabadTelangana500082India

A fracture of the acromion and coracoid processes of scapula is rarely seen in the outpatient clinic,due to the acromion's anatomical position and shape,as well as the strong ligaments and muscles that are attached to *** fractures are caused by either direct or indirect high-energy trauma injuries to the shoulder joint,leading to severe pain and a grossly restricted range of *** acromial classifications were reported,but this type of longitudinal plane fracture of the acromion process in our case is yet to be described in the current *** present a rare combination of the coracoid process and unstable acromion bony projection fractures that have not previously been noted for this type of *** closest to this is Kuhn's type III classification.A 51-year-old male presented to our emergency department complaining of the right shoulder pain and difficulty raising his arm following a 2-wheeler *** patient was managed by open reduction and internal fixation with 3 cannulated cancellous screws fixation and progressed well with no postoperative *** was asymptomatic postoperatively and regained full range of motion after 4 months.

关键词： Acromion Scapular fracture Coracoid process

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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

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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

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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

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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

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Total hip arthroplasty for sequelae of childhood hip disorders:Current review of management to achieve hip centre restoration

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World Journal of Orthopedics 2024年第8期15卷 683-695页

作者： Anil Thomas Oommen department of orthopaedics Christian Medical College HospitalVellore 632004India

Adults requiring total hip arthroplasty(THA)for childhood disorder sequelae present with shortening,limp,pain,and altered ***,which can be particularly challenging due to altered anatomy,requires careful planning,assessment,and computed tomography *** templating is essential to establish the appropriate acetabular and femoral *** regarding neck length and offset is needed to ensure the proper options are available at *** centre restoration must be planned preoperatively and achieved intraoperatively with appropriate exposure,identification,and stable fixation with optimum-size *** the actual acetabular floor is essential as changes include altered anatomy,distortion of the margins and version *** femur changes include anatomical variation,decreased canal diameter,cortical thickness,changes in anteversion,and metaphyseal and diaphyseal *** assessment should consist of limb assessment for variations due to prior surgical *** of the shortening pattern with the relationship of the lesser trochanter to the teardrop would help identify and plan for subtrochanteric shortening osteotomy,especially in high-riding *** surgical approach must ensure adequate exposure and soft tissue release to achieve restoration of the anatomical hip *** femoral components may require modularity to enable restoration of anteversion and optimum fixation.

关键词： Total hip arthroplasty Childhood disorder sequelae Templating Hip centre restoration Soft tissue release Offset

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