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Acetabular components with or without screws in total hip arthroplasty

World Journal of orthopedics 2017年第9期8卷 705-709页

作者： Murad Pepe Onur Kocadal Tamer Erener Kubilay Ceritoglu Ertugrul Aksahin Cem Nuri Aktekin Department of Orthopedics and Traumatology Ankara Training and Research Hospital orthopedics and traumatology MedicalPark Hospital

AIM To compare the operation time, blood loss, and early outcomes of acetabular components with and without the screw.METHODS Thirty patients who underwent cementless acetabular component with or without screw and whose follow-up exceeded one year period in total hip arthroplasty were evaluated. A posterior approach was used in all surgical procedures by one experienced surgeon. Demographic data, operation time, intra-and postoperative blood loss volume, follow-up clinical score, cup migration, and osteolysis were recorded. The Kolmogorov-Smirnov test was performed for testing the normality of study data. Mann-Whitney U test was used to analyze the intergroup differences. A P-value of ≤ 0.05 was considered statistically significant.RESULTS Acetabular components were used in 16(53.3%) patients with screw and 14(46.7%) without screw. After one year of follow-up, an osteolytic lesion of 3 mm was found in only one patient in the screw group. No cup migrationwas encountered. Intra-group mean Harris hip score significantly increased, but there was no significant intergroup difference. While the mean operation time of the screw group was 121.8 min(range; 95-140), it was 102.7 min(range; 80-120) in the no-screw group, and this difference was statistically significant(P = 0.002). The mean intraoperative/postoperative, and total blood loss were 556.6 mL(range: 350-800)/423.3 mL(range: 250-600), and 983.3 mL(range: 600-1350), respectively in the screw group; and 527 mL(range: 400-700)/456 mL(range: 230-600), and 983 mL(range: 630-1250), respectively in the no-screw group. The blood loss difference between the two groups was not significant. In the screw group, the operation time was 19.1 min longer than the no-screw group, and this difference was statistically significant.CONCLUSION Acetabular components with or without screw have similar results, but the use of screw increases the operation time significantly, while not changing the blood loss volume.

关键词： Hip arthroplasty Acetabular fixation With screw Without screw Operation time

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Combined anterior and posterior ring fixation versus posterior ring fixation alone in the management of unstable Tile B and C pelvic ring injuries:A randomized controlled trial

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Chinese Journal of traumatology 2023年第1期26卷 48-59页

作者： Islam Sayed Moussa Ahmed Mohammed Sallam Amr Khairy Mahmoud Elzaher Hassan Elzaher Amr Mohammed Nagy Ahmed Salem Eid Department of Orthopedics and Traumatology Faculty of MedicineAin Shams UniversityCairo11522Egypt

Purpose: Combined anterior and posterior ring (APR) fixation is classically performed in Tile B2 and C1 injuries to achieve superior biomechanical stability.However,the posterior ring (PR) is the main weight bearing portion that is responsible for weight transmission from the upper parts of the body to the lower limbs through the sacrum and the linea terminalis.It is hypothesized that isolated PR fixation can achieve comparable radiological and clinical outcomes to APR fixation.Therefore,we conducted this study to compare the two fixation principles in managing Tile B2 and C1 injuries.Methods: Our study included 20 patients with Tile B2 injuries and 20 patients with Tile C1 injuries.This study was a randomized control single-blinded study via computerized random numbers with a 1:1 allocation by using random block method.The study was performed at a level one trauma center.A total of 40 patients with Tile B2 and C1 injuries underwent combined APR or isolated PR fixation (Group A and B,respectively).Matta & Tornetta radiological principles and Majeed pelvic scoring system were used for the assessment of primary outcomes and postoperative complications.Secondary outcomes included operative time,amount of blood loss,intraoperative assessment of reduction,need of another operation,length of hospital stay,ability to weight bear postoperatively and pain control metrics.We used studentt-test to compare the difference in means between two groups,and Chi-square test to compare proportions between two qualitative parameters.We set the confidence interval to 95% and the margin of error accepted to 5%.So,p ≤ 0.05 was considered statistically significant.Results: The mean follow-up duration was 18 months.The operative time (mean difference 0.575 h) and the intraoperative blood loss (mean difference 97.5 mL) were lower in Group B.Also,despite the higher frequency of rami displacement before union in the same group,there were no significant differences in terms of radiological outcome (excellent outcome withOR = 2.357),clinical

关键词： Tile B2 and C1 injuries Percutaneous sacroiliac screw Posterior ring fixation Radiological outcome Majeed pelvic score

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Treatment of knee osteochondritis dissecans with autologous tendon transplantation:Clinical and radiological results

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World Journal of orthopedics 2021年第11期12卷 867-876页

作者： Ahmet Ugur Turhan Sezgin Acil Orkun Gul Kerim Oner Ahmet Emin Okutan Muhammet Salih Ayas Department of Orthopedics and Traumatology Karadeniz Technical University Faculty of MedicineTrabzon 61080Turkey Department of Orthopedics and Traumatology Tirebolu State HospitalGiresun 28100Turkey Department of Orthopedics and Traumatology Medical Park Trabzon HospitalTrabzon 61080Turkey Department of Orthopedics and Traumatology Samsun Training and Research HospitalSamsun 55100Turkey Department of Orthopedics and Traumatology Erzurum Regional Training and Research HospitalErzurum 25070Turkey

BACKGROUND Defect treatment with tendon autograft in osteochondral lesions has been published in the literature with an experimental study in dogs.To demonstrate that it is possible to treat knee osteochondral lesions with the technique of autologous tendon transplantation.AIM To evaluate the clinical and radiological results of patients with knee osteochondral lesions who were treated with autologous tendon transplantation.METHODS Twenty patients(22 knees)with osteochondritis dissecans(OCD)lesions involving the knee were treated with autologous tendon transplantation between 2005-2018.All lesions were International Cartilage Repair Society grade IV.All patients were evaluated clinically at final follow-up with knee injury and osteoarthritis outcome score(KOOS);and radiologically with magnetic resonance observation and cartilage repair tissue(MOCART)and Kellgren-Lawrence(KL)classification.RESULTS A total of 20 patients(22 knees)with a mean age of 25.5±6.8 years were included.The average defect size was 4.2±2.1 cm^(2),and the average defect depth was 0.9±0.4 cm.Total KOOS score was preoperatively 29.4±5.5 and was later found to be 81.5±5.9 after an average of 68.7±37.7 mo follow-up.The mean MOCART score was 56.2±10.7.Preoperatively,all of the patients had KL grades of 0-1;during the follow-up period,80% of the patients showed no radiological progress of osteoarthritis.Patients with less than 4 cm^(2) lesion had statistically significantly better overall KOOS than patients whose more than 4 cm^(2) lesion,particularly in sport and quality of life subscales.CONCLUSION The autologous tendon transplantation is a single-step,safe,simple,cost-effective method for the treatment of knee OCD with satisfactory clinical and radiological outcomes,particularly in patients with less than 4 cm^(2) lesion.

关键词： Osteochondritis dissecans Knee Tendon Transplantation Autologous Peroneus

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Jisuikang, a Chinese herbal formula, increases neurotrophic factor expression and promotes the recovery of neurological function after spinal cord injury

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Neural Regeneration Research 2017年第9期12卷 1519-1528页

作者： Yang Guo Yong Ma Ya-lan Pan Su-yang Zheng Jian-wei Wang Gui-cheng Huang Institute of traumatology & orthopedics and Laboratory of New Techniques of Restoration & Reconstruction of orthopedics and traumatology Nanjing University of Chinese Medicine department of traumatology & orthopedics Affiliated Hospital of Nanjing University of Chinese Medicine department of traumatology & orthopedics Wuxi Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine

The Chinese medicine compound, ]isuikang, can promote recovery of neurological function by inhibiting lipid peroxidation, scavenging oxygen free radicals, and effectively improving the local microenvironment after spinal cord injury. However, the mechanism remains unclear. Thus, we established a rat model of acute spinal cord injury using a modified version of Allen＇s method. Jisuikang （50, 25, and 12.5 g/kg/d） and prednis- olone were administered 30 minutes after anesthesia. Basso, Beattie, and Bresnahan locomotor scale scores and the oblique board test showed improved motor function recovery in the prednisone group and moderate-dose Jisuikang group compared with the other groups at 3-7 days post-injury. The rats in the moderate-dose Jisuikang group recovered best at 14 days post-injury. Hematoxylin-eosin staining and transmis- sion electron microscopy showed that the survival rate of neurons in treatment groups increased after 3-7 days of administration. Further, the structure of neurons and glial cells was more distinct, especially in prednisolone and moderate-dose Jisuikang groups. Western blot assay and immunohistochemistry showed that expression of brain-derived neurotrophic factor （BDNF） in injured segments was maintained at a high level after 7-14 days of treatment. In contrast, expression of nerve growth factor （NGF） was down-regulated at 7 days after spinal cord injury. Re- al-time fluorescence quantitative polymerase chain reaction showed that expression of BDNF and NGF mRNA was induced in injured segments by prednisolone and Jisuikang. At 3-7 days after injury, the effect of prednisolone was greater, while 14 days after injury, the effect of moder- ate-dose Jisuikang was greater. These results confirm that Jisuikang can upregulate BDNF and NGF expression for a prolonged period after spinal cord injury and promote repair of acute spinal cord injury, with its effect being similar to prednisolone.

关键词： nerve regeneration spinal cord injury Jisuikang Chinese medicine prednisolone microenvironment axon regeneration secondary changes neuronal apoptosis brain-derived neurotrophic factor nerve growth factor neural regeneration

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Superenhancers activate the autophagy-related genes Beclin1 and LC3B to drive metastasis and drug resistance in osteosarcoma

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Frontiers of Medicine 2022年第6期16卷 883-895页

作者： Hongyi Wang Zhuochao Liu Jun Wang Fangqiong Hu Qi Zhou Li Wei Qiyuan Bao Jizhuang Wang Jing Liang Zhihong Liu Weibin Zhang department of orthopedics Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai200025China Shanghai Institute of traumatology and orthopedics Shanghai200025China

Metastasis and drug resistance are the leading causes of poor prognosis in patients with osteosarcoma.Identifying the relevant factors that drive metastasis and drug resistance is the key to improving the therapeutic outcome of osteosarcoma.Here,we reported that autophagy was highly activated in metastatic osteosarcoma.We found increased autophagolysosomes in metastatic osteosarcoma cell lines by using electron microscopy,Western blot,and immunofluorescence experiments.We further examined the expression of the autophagy-related genes Beclin1 and LC3B in 82 patients through immunohistochemistry and found that Beclin1 and LC3B were highly related to unfavorable prognosis of osteosarcoma.Knockdown of Beclin1 and LC3B reduced invasion,metastasis,and proliferation in metastatic osteosarcoma cells.In vitro and in vivo studies also demonstrated that inhibiting by 3-MA inhibited cell growth and metastasis.Moreover,we demonstrated that autophagy-related genes were activated by SEs and that the inhibition of SEs by JQ-1 decreased the metastasis of osteosarcoma.Overall,our findings highlighted the association of autophagy with osteosarcoma progression and shed new light on autophagy-targeting therapy for osteosarcoma.

关键词： osteosarcoma autophagy metastasis drug resistance Beclin1 LC3B

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Factors for Postponement or Cancellation of Operating Programs Set in the orthopedics-traumatology department of Yalgado Ouédraogo University Teaching Hospital in Ouagadougou (Burkina Faso)

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Open Journal of orthopedics 2022年第12期12卷 451-462页

作者： Mamoudou Sawadogo Alexandre Stanislas Korsaga Sayouba Tinto Anatole Ouedraogo Didier Denne Christian Darga Abdourahmane Ouangre Anne Valérie Kabore Orthopedic-traumatology department Yalgado Ouedraogo University Hospital Center Ouagadougou Burkina Faso orthopedics-traumatology department Regional University Teaching Hospital Ouahigouya Burkina Faso

Objective: The purpose of this work was to study the factors of cancellations or postponement of regulated operating programs of the Orthopedic-traumatology unit of Yalgado Ouédraogo University Teaching Hospital. Materials and Methods: This was a prospective descriptive study over a period of six months. All interventions postponed or canceled during the study period were included. Patients who died or were lost to follow-up before surgery were not included. Results and Comments: the postponement/ cancellation rate was 24.5%. Out of 83 operations cancelled, 72.3% of patients were under 50 years old [extreme 15 and 88 years old]. ASA classes I and II were dominant with 57% and 37% of patients canceled, respectively. There were more postponed interventions (67.5%) than definitive cancellations (32.5%). The causes found were avoidable in 68.7% of cases. The most common was the unavailability of labile blood products (57%), the lack of financial means (36%) and the absence of the patient (28%). The results of our study show that 53% of the causes of cancellations were related to the organization of the hospital. Conclusion: the cancellation rate of orthopedic surgeries remains high at Yalgado Ouédraogo University Teaching Hospital. Most of the causes of cancellations are potentially preventable and the vast majority of them are related to the organization of the hospital. Financial accessibility to care plays an important role in cancellations.

关键词： Postponement Cancellation Settled Surgery orthopedics-traumatology Causes

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Internal fixator vs external fixator in the management of unstable pelvic ring injuries:A prospective comparative cohort study

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World Journal of orthopedics 2023年第7期14卷 562-571页

作者： Mohamed Abo-Elsoud Mostafa I Awad Mahmoud Abdel Karim Sherif Khaled Mohamed Abdelmoneim Department of Orthopedics and Traumatology Cairo University HospitalsCairo 11562Egypt department of Trauma and orthopedics Mataria Teaching HospitalCairo 4540046Egypt

BACKGROUND Reconstruction of the pelvic ring anatomy in unstable anterior pelvic ring injuries is a significant step to reduce the mortality rate associated with these injuries efficiently.There is a debate on using either an anterior subcutaneous pelvis internal fixator(INFIX)or an anterior supra-acetabular external fixator(EXFIX)to manage an unstable anterior pelvic ring fracture.AIM To compare the functional and radiological outcomes and complications of INFIX vs EXFIX in managing unstable pelvic ring injuries.METHODS A prospective cohort study included 54 patients with unstable pelvic ring fractures.The patients were divided into two groups;the INFIX group,in which 30 cases were fixed by INFIX,and the EXFIX group,in which 24 patients were treated by EXFIX.The average age in the EXFIX group was 31.17 years(16-57 years),while in the INFIX group,it was 34.5 years(17-53 years).The study included 20(66.7%)males and 10(33.3%)females in the INFIX group and 10(41.7%)males and 14(58.3%)females in the EXFIX group.The radiological outcomes were evaluated using Matta and Tornetta's score,and the functional outcomes using the Majeed score.RESULTS The results revealed a statistically significant difference between both groups(P=0.013)regarding radiological outcomes,according to Matta and Tornetta's score in favor of the INFIX group.Sitting,standing,and walking abilities were measured at a 3-mo follow-up visit using Majeed score modules.It was significantly better among the INFIX group than the EXFIX group in all three modules.At the final follow-up,both groups had no statistically significant difference according to the Majeed score;92.35 in the INFIX group and 90.99 in the EXFIX group(P=0.513).A lower surgical site infection rate was noticed in the INFIX group(P=0.007).CONCLUSION Anterior subcutaneous pelvis INFIX is associated with better radiological outcomes and a lower infection rate than anterior supra-acetabular EXFIX in managing patients with unstable anterior pelvic ring fractures.

关键词： Internal fixator External fixator Unstable Anterior Pelvic Injuries

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Iloprost inhibits fracture repair in rats

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Chinese Medical Journal 2014年第16期127卷 2960-2965页

作者： Ali Dogan Fatih Duygun A. Murat Kalender Irfan Bayram Ibrahim Sungur Department of Orthopedics and Traumatology Education andResearch HospitalAntalya Turkey Department of Orthopedics and Traumatology Sutcu ImamUniversity School of Medicine Kahramanmaras Turkey department of Pathology Yuzuncu Yil University School ofMedicine Van Turkey Department of Orthopedics and Traumatology Haseki Education and Research Hospital Istanbul Turkey

Background Previous studies have shown that prostaglandins （PGs） dramatically stimulate healing processes in bone.However,the effect of prostaglandin l2 （PGI2） on fracture healing remains unclear.To investigate the effect of PGI2,a study on fracture healing process in closed tibia fractures was designed.Methods Thirty-six Sprague-Dawley male rats were randomized into two groups.On the first day,their right tibias were fractured by three-point bending technique.The study group （n=18） received a single injection of 10 μg/kg iloprost for 5 days,while the control group （n=18） received saline solution in the same way.On the 7th,14th and 28th days following the fracture,six rats were sacrificed and their right legs were harvested in each group.The progression of fracture healing was assessed for each specimen by the scores of radiography （by Lane-Sandhu） and histology （by Huo et al）.Results On the 7th day,the radiographic and histologic scores were equal.On the 14th day radiographic total score was 6 and histologic total score was 23 in the iloprost group,whereas radiographic total score was 11 and histologic total score was 33 in the control group.On the 14th day radiographic and histologic scores were significantly decreased in the iloprost group compared to the control group （P 〈0.05）.On the 28th day radiographic total score was 12 and histologic total score was 37 in the iloprost group,whereas radiographic total score was 15 and histologic total score was 40 in the control group.On the 28th day although there was a decrease in radiographic and histologic scores of the iloprost group acording to control group,it was not statistically significant （P 〉0.05）.Conclusion Iloprost delays fracture healing in early stage in rats.

关键词： epoprostenol iloprost fracture healing bone rats prostaglandin I2

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Acetabular cup version modelling and its clinical applying on plain radiograms

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World Journal of orthopedics 2017年第12期8卷 929-934页

作者： Anton Denisov Stanislav Bilyk Anton Kovalenko Orthopedic department Vreden Russian Research Institute of Traumatology and Orthopedics

AIM To measure the sensitivity and specificity of the cup version assessment by using only anteroposterior hip and pelvis views, evaluate the incidence of inadequate cup version in patients with repeated dislocations after total hip arthroplasty(THA). METHODS Radiographic retrospective analysis of 2 groups of patients, with follow up of 6-60 mo, after undergoing primary THA. First group of 32 patients(20 female, 12 male) with unilateral THA(32 hips) required early revision arthroplasty for reasons of dislocation. The mean age and mode were 59(from 38 to 83) and 66 ages respectively. The average body mass index(BMI) was 24.2(from 17.7 to 36.3), mode 23.9. Second group was consisted of 164 patients(101 female, 63 male) without dislocations during the follow-up period(170 hips). Among them 6 patients required bilateral THA. The mean age was 60(from 38 to 84) and mode 59. BMI was 24.8(17.2-36.8), mode 25.2. Clinical significance of the cup anteversion sign was estimated with cross tabulation 2 × 2. RESULTS The value of the χ~2 yates was 10.668(P < 0.01).Sensitivity of SAI(sign of anteversion insufficiency) was 29%(95%CI: 9%-46%), and specificity was 92%(95%CI: 88%-96%). Relative risk of dislocation in patients with SAI was 3.4(95%CI: 1.8-6.3). CONCLUSION This method provides the surgeons with the ability to perform a reliable and simple qualitative assessment of the acetabular component version. It can be useful during patient examination with early loosening of the implant, dislocations, and impingement. Additionally, it can provide necessary information during planning of revision surgery, especially when considering question about cup replacement, although final assessment of the cup position should be done with a computed tomography scan.

关键词： Hip arthroplasty Acetabular component Retroversion Dislocation

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Open reduction of a total talar dislocation: A case report and review of the literature

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World Journal of Clinical Cases 2019年第14期7卷 1850-1856页

作者： Furkan Yapici Mehmet Coskun Muhammet Coskun Arslan Erman Ulu Yunus Emre Akman Department of Orthopedics and Traumatology Metin Sabancl Baltalimanl Bone and Joint Diseases Education and Research HospitalIstanbul 34470Turkey Department of Orthopedics and Traumatology Demiroglu Bilim University Faculty of MedicineIstanbul 34387Turkey

BACKGROUND Total talar dislocation (TTD) is very uncommon for many orthopedic surgeons and emergency/trauma specialists. Scarce cases of TTD have been reported, mainly in the form of open fracture-dislocation injury. CASE SUMMARY We report a very rare injury of closed TTD with a follow-up period of 36 mo. Initial closed reduction was not successful because of a fractured highly unstable medial malleolus displaced into the ankle mortise, blocking the relocation of the talus. The patient was able to walk pain-free after the 3rd month of surgery. At the 36-mo follow-up, there were 10 degrees of flexion loss and 10 degrees of extension loss in the tibiotalar joint. Furthermore, 5 degrees of subtalar joint inversion-eversion loss was present. CONCLUSION Open reduction should be performed for closed TTDs unless closed reduction is successful.

关键词： Total talar dislocation Pan-talar dislocation Talus Case report

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