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Addressing metallosis in knee arthroplasty:From diagnostic challenges to innovative treatments

World Journal of orthopedics 2024年第5期15卷 386-389页

作者： Yvon Maurice Bogdonoff Farid Amirouche department of orthopedics surgery University of Illinois at ChicagoChicagoIL 60612United States department of orthopedics surgery Northshore University Health SystemSkokieIL 60076United States

In this editorial,we comment on the article by Toro et al published in the recent issue of World Journal of orthopedics.This editorial review provides a comprehensive exploration of the landscape surrounding knee arthroplasty metallosis,focusing on key aspects ranging from the mechanisms influencing susceptibility to clinical implications and advanced treatment strategies.We elucidate the complex interplay of implant design,patient-specific variables,and wear-related processes contributing to metallosis.Furthermore,we seek to shed light on diagnostic challenges,the necessity of a multidisciplinary approach,and the imperative for vigilant implant surveillance.Uni-on-uni revision,as a targeted treatment modality,is discussed,highlighting its potential to address metallosis in unicompartmental knee arthroplasty(UKA).There is a need for heightened awareness among clinicians regarding the subtle presentations of metallosis,coupled with the limitations of traditional imaging techniques.Addressing metallosis requires a collaborative,multidisciplinary approach to effectively navigate the complexities associated with this complication.Furthermore,the review emphasizes the evolving paradigm of personalized care,with uni-on-uni revision emerging as a promising surgical solution.In conclusion,the editorial outlines the dynamic nature of knee arthroplasty metallosis and its multifaceted impact on clinical practice.It calls for ongoing collaboration,education,and integration of innovative solutions to enhance diagnostic accuracy,proactive management,and overall patient outcomes in the realm of UKA.

关键词： Ultrasound X-ray Total knee arthroplasty Case report Review Editorial

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Millimeter waves in medical applications:status and prospects

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Intelligent Medicine 2024年第1期4卷 16-21页

作者： Honglin Wang Lin Lu Pengran Liu Jiayao Zhang Songxiang Liu Yi Xie Tongtong Huo Hong Zhou Mingdi Xue Ying Fang Jiaming Yang Zhewei Ye department of orthopedics surgery Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430022China departments of orthopedics Renmin Hospital of Wuhan UniversityWuhanHubei 430060China

Millimeter waves are electromagnetic waves with wavelengths of 1–10 mm,which have characteristics of high frequency and short wavelength.They have gradually and widely been used in engineering and medical fields.We have identified studies related to millimeter waves in the biomedical field and summarized the biological effects of millimeter waves and their current status in medical applications.Finally,the shortcomings of existing studies and future developments were analyzed and discussed,with the aim of providing a reference for further research and development of millimeter waves in the medical field.

关键词： Millimeter wave Biological effects Medical applications Vital signs monitoring

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Biochanin A attenuates spinal cord injury in rats during early stages by inhibiting oxidative stress and inflammasome activation

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Neural Regeneration Research 2024年第9期19卷 2050-2056页

作者： Xigong Li Jing Fu Ming Guan Haifei Shi Wenming Pan Xianfeng Lou department of orthopedics The First Affiliated Hospital of Zhejiang UniversityHangzhouZhejiang ProvinceChina department of Stomatology Xixi HospitalHangzhouZhejiang ProvinceChina department of orthopedics and Spine Surgerythe Affiliated Hospital of Xuzhou Medical Schoolthe Second People’s Hospital of ChangshuChangshuJiangsu ProvinceChina

Previous studies have shown that Biochanin A,a flavonoid compound with estrogenic effects,can serve as a neuroprotective agent in the context of cerebral ischemia/reperfusion injury;howeve r,its effect on spinal cord injury is still unclea r. In this study,a rat model of spinal cord injury was established using the heavy o bject impact method,and the rats were then treated with Biochanin A(40 mg/kg) via intrape ritoneal injection for 14 consecutive days.The res ults showed that Biochanin A effectively alleviated spinal cord neuronal injury and spinal co rd tissue injury,reduced inflammation and oxidative stress in spinal cord neuro ns,and reduced apoptosis and pyroptosis.In addition,Biochanin A inhibited the expression of inflammasome-related proteins(ASC,NLRP3,and GSDMD)and the Toll-like receptor 4/nuclear factor-κB pathway,activated the Nrf2/heme oxygenase 1 signaling pathway,and increased the expression of the autophagy markers LC3 Ⅱ,Beclin-1,and P62.Moreove r,the therapeutic effects of Biochanin A on early post-s pinal cord injury were similar to those of methylprednisolone.These findings suggest that Biochanin A protected neurons in the injured spinal cord through the Toll-like receptor 4/nuclear factor κB and Nrf2/heme oxygenase 1 signaling pathways.These findings suggest that Biochanin A can alleviate post-spinal cord injury at an early stage.

关键词： apoptosis autophagy Biochanin A heme oxygenase 1 inflammation Nrf2 protein nuclear factor kappa-B oxidative stress spinal cord injury Toll-like receptor 4

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Epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China:a hospital-based retrospective study

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Neural Regeneration Research 2024年第5期19卷 1126-1132页

作者： Hengxing Zhou Yongfu Lou Lingxiao Chen Yi Kang Lu Liu Zhiwei Cai David BAnderson Wei Wang Chi Zhang Jinghua Wang Guangzhi Ning Yanzheng Gao Baorong He Wenyuan Ding Yisheng Wang Wei Mei Yueming Song Yue Zhou Maosheng Xia Huan Wang Jie Zhao Guoyong Yin Tao Zhang Feng Jing Rusen Zhu Bin Meng Li Duan Zhongmin Zhang Desheng Wu Zhengdong Cai Lin Huang Zhanhai Yin Kainan Li Shibao Lu Shiqing Feng department of orthopedics The Second HospitalCheeloo College of MedicineShandong UniversityShandongChina department of orthopedics Shandong University Center for OrthopedicsQilu HospitalCheeloo College of MedicineShandong UniversityShandongChina department of orthopedics Tianjin Medical University General HospitalInternational Science and Technology Cooperation Base of Spinal Cord InjuryTianjin Key Laboratory of Spine and Spinal CordTianjinChina Faculty of Medicine and Health The Back Pain Research TeamSydney Musculoskeletal HealthThe Kolling InstituteUniversity of SydneySydneyNSWAustralia department of Spine surgery Honghui HospitalXi’an Jiaotong UniversityXi’anShaanxi ProvinceChina department of Burns and Plastic surgery The Fourth Medical Center of Chinese PLA General HospitalBeijingChina Faculty of Medicine and Health School of Health SciencesUniversity of SydneyNSWAustralia Sydney Spine Institute BurwoodSydneyNSWAustralia Laboratory of Epidemiology Tianjin Neurological InstituteDepartment of NeurologyTianjin Medical University General Hospital&Tianjin Neurological InstituteKey Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous SystemMinistry of Education and Tianjin CityTianjinChina department of orthopedics Henan Provincial People’s HospitalZhengzhouHenan ProvinceChina department of Spinal surgery The Third Hospital of Hebei Medical UniversityShijiazhuangHebei ProvinceChina department of orthopedics The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan ProvinceChina department of Spine surgery Zhengzhou Orthopedics HospitalZhengzhouHenan ProvinceChina department of Orthopedic surgery and Orthopedic Research Institute West China HospitalSichuan UniversityChengduSichuan ProvinceChina department of orthopedics Xinqiao HospitalArmy Medical UniversityChongqingChina department of orthopedics The First Affiliated Hospital of China Medical UniversityShenyangLiaoning ProvinceChina department of Spinal surgery Shengj

Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death.China has the largest population of patients with traumatic spinal cord injury.Previous studies of traumatic spinal cord injury in China have mostly been regional in scope;national-level studies have been rare.To the best of our knowledge,no national-level study of treatment status and economic burden has been performed.This retrospective study aimed to examine the epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China at the national level.We included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of China.Patient epidemiological and clinical features,treatment status,and total and daily costs were recorded.Trends in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression Program.The percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall(annual percentage change,-0.5%and 2.1%,respectively).A total of 10,053(74.7%)patients underwent surgery.Only 2.8%of patients who underwent surgery did so within 24 hours of injury.A total of 2005(14.9%)patients were treated with high-dose(≥500 mg)methylprednisolone sodium succinate/methylprednisolone(MPSS/MP);615(4.6%)received it within 8 hours.The total cost for acute traumatic spinal cord injury decreased over the study period(-4.7%),while daily cost did not significantly change(1.0%increase).Our findings indicate that public health initiatives should aim at improving hospitals’ability to complete early surgery within 24 hours,which is associated with improved sensorimot

关键词： China clinical features costs epidemiology methylprednisolone sodium succinate methylprednisolone retrospective study traumatic spinal cord injury treatment

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Ruxolitinib improves the inflammatory microenvironment,restores glutamate homeostasis,and promotes functional recovery after spinal cord injury

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Neural Regeneration Research 2024年第11期19卷 2499-2512页

作者： Jiang Cao Xiao Yu Jingcheng Liu Jiaju Fu Binyu Wang Chaoqin Wu Sheng Zhang Hongtao Chen Zi Wang Yinyang Xu Tao Sui Jie Chang Xiaojian Cao department of orthopedics The First Affiliated Hospital of Nanjing Medical UniversityNanjingJiangsu ProvinceChina department of Trauma surgery Subei People’s Hospital of JiangsuClinical Medical College of Yangzhou UniversityYangzhouJiangsu ProvinceChina department of orthopedics Zhongda HospitalSoutheast UniversityNanjingJiangsu ProvinceChina department of Orthopedic surgery Nanjing Drum Tower HospitalThe Affiliated Hospital of Medical School of Nanjing UniversityNanjingJiangsu ProvinceChina

The inflammatory microenvironment and neurotoxicity can hinder neuronal regeneration and functional recovery after spinal cord injury.Ruxolitinib,a JAK-STAT inhibitor,exhibits effectiveness in autoimmune diseases,arthritis,and managing inflammatory cytokine storms.Although studies have shown the neuroprotective potential of ruxolitinib in neurological trauma,the exact mechanism by which it enhances functional recovery after spinal cord injury,particularly its effect on astrocytes,remains unclear.To address this gap,we established a mouse model of T10 spinal cord contusion and found that ruxolitinib effectively improved hindlimb motor function and reduced the area of spinal cord injury.Transcriptome sequencing analysis showed that ruxolitinib alleviated inflammation and immune response after spinal cord injury,restored EAAT2 expression,reduced glutamate levels,and alleviated excitatory toxicity.Furthermore,ruxolitinib inhibited the phosphorylation of JAK2 and STAT3 in the injured spinal cord and decreased the phosphorylation level of nuclear factor kappa-B and the expression of inflammatory factors interleukin-1β,interleukin-6,and tumor necrosis factor-α.Additionally,in glutamate-induced excitotoxicity astrocytes,ruxolitinib restored EAAT2 expression and increased glutamate uptake by inhibiting the activation of STAT3,thereby reducing glutamate-induced neurotoxicity,calcium influx,oxidative stress,and cell apoptosis,and increasing the complexity of dendritic branching.Collectively,these results indicate that ruxolitinib restores glutamate homeostasis by rescuing the expression of EAAT2 in astrocytes,reduces neurotoxicity,and effectively alleviates inflammatory and immune responses after spinal cord injury,thereby promoting functional recovery after spinal cord injury.

关键词： astrocytes EAAT2 excitotoxicity glutamate homeostasis JAK-STAT pathway locomotor function neurotoxicity ruxolitinib spinal cord injury transcriptome analysis

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Activatable fluorescent probes for imaging and diagnosis of rheumatoid arthritis

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Military Medical Research 2024年第2期11卷 287-307页

作者： Pan Luo Fu-Qiang Gao Wei Sun Jun-You Li Cheng Wang Qing-Yu Zhang Zhi-Zhuo Li Peng Xu department of Joint surgery Honghui HospitalXi'an Jiaotong UniversityXi'an 710054China department of orthopedics China-Japan Friendship HospitalBeijing 100029China department of Orthopaedic surgery of the Perelman School of Medicine University of PennsylvaniaPhiladelphiaPA 19104USA School of Mechanical Engineering Sungkyunkwan UniversitySuwon 16419South Korea department of Orthopaedic surgery Peking University Third HospitalPeking UniversityBeijing 100191China department of orthopedics Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021China State Key Laboratory of Pharmaceutical Biotechnology Division of Sports Medicine and Adult Reconstructive SurgeryDepartment of Orthopedic SurgeryNanjing Drum Tower Hospitalthe Affiliated Hospital of Nanjing University Medical SchoolNanjing 210008China

Rheumatoid arthritis(RA)is a systemic autoimmune disease that is primarily manifested as synovitis and polyarticular opacity and typically leads to serious joint damage and irreversible disability,thus adversely affecting locomotion ability and life quality.Consequently,good prognosis heavily relies on the early diagnosis and effective therapeutic monitoring of RA.Activatable fluorescent probes play vital roles in the detection and imaging of biomarkers for disease diagnosis and in vivo imaging.Herein,we review the fluorescent probes developed for the detection and imaging of RA biomarkers,namely reactive oxygen/nitrogen species(hypochlorous acid,peroxynitrite,hydroxyl radical,nitroxyl),pH,and cysteine,and address the related challenges and prospects to inspire the design of novel fluorescent probes and the improvement of their performance in RA studies.

关键词： Rheumatoid arthritis Fluorescent probe Imaging Diagnosis Biomarker

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Advances in the application of hydrogel-based scaffolds for tendon repair

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Genes & Diseases 2024年第4期11卷 296-313页

作者： Renqiang Chen Fanglin Chen Kenian Chen Jian Xu department of orthopedics The First Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiang 310003China department of orthopedics The Fourth Affiliated Hospital of Guangxi Medical UniversityLiuzhou Guangxi 545005China

Tendon injuries often lead to joint dysfunction due to the limited self-regeneration capacity of tendons.Repairing tendons is a major challenge for surgeons and imposes a signif-icant financial burden on society.Therefore,there is an urgent need to develop effective stra-tegies for repairing injured tendons.Tendon tissue engineering using hydrogels has emerged as a promising approach that has attracted considerable interest.Hydrogels possess excellent biocompatibility and biodegradability,enabling them to create an extracellular matrix-like growth environment for cells.They can also serve as a carrier for cells or other substances to accelerate tendon repair.In the past decade,numerous studies have made significant prog-ress in the preparation of hydrogel scaffolds for tendon healing.This review aims to provide an overview of recent research on the materials of hydrogel-based scaffolds used for tendon tis-sue engineering and discusses the delivery systems based on them.

关键词： Application Hydrogel-based Repairscaffolds Review Tendon injury Tissue engineering

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Hydralazine represses Fpn ubiquitination to rescue injured neurons via competitive binding to UBA52

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Journal of Pharmaceutical Analysis 2024年第1期14卷 86-99页

作者： Shengyou Li Xue Gao Yi Zheng Yujie Yang Jianbo Gao Dan Geng Lingli Guo Teng Ma Yiming Hao Bin Wei Liangliang Huang Yitao Wei Bing Xia Zhuojing Luo Jinghui Huang department of orthopedics Xijing HospitalFourth Military Medical UniversityXi'an710032China

A major impedance to neuronal regeneration after peripheral nerve injury (PNI) is the activation of various programmed cell death mechanisms in the dorsal root ganglion. Ferroptosis is a form of programmed cell death distinguished by imbalance in iron and thiol metabolism, leading to lethal lipid peroxidation. However, the molecular mechanisms of ferroptosis in the context of PNI and nerve regeneration remain unclear. Ferroportin (Fpn), the only known mammalian nonheme iron export protein, plays a pivotal part in inhibiting ferroptosis by maintaining intracellular iron homeostasis. Here, we explored in vitro and in vivo the involvement of Fpn in neuronal ferroptosis. We first delineated that reactive oxygen species at the injury site induces neuronal ferroptosis by increasing intracellular iron via accelerated UBA52-driven ubiquitination and degradation of Fpn, and stimulation of lipid peroxidation. Early administration of the potent arterial vasodilator, hydralazine (HYD), decreases the ubiquitination of Fpn after PNI by binding to UBA52, leading to suppression of neuronal cell death and significant acceleration of axon regeneration and motor function recovery. HYD targeting of ferroptosis is a promising strategy for clinical management of PNI.

关键词： Ferroptosis UBA52 Ferroportin Ubiquitination Hydralazine Peripheral nerve injury

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Neurophysiological, histological, and behavioral characterization of animal models of distraction spinal cord injury: a systematic review

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Neural Regeneration Research 2024年第3期19卷 563-570页

作者： Bo Han Weishi Liang Yong Hai Duan Sun Hongtao Ding Yihan Yang Peng Yin department of orthopedics Beijing Chao-Yang HospitalCapital Medical UniversityBeijingChina

Distraction spinal cord injury is caused by some degree of distraction or longitudinal tension on the spinal cord and commonly occurs in patients who undergo corrective operation for severe spinal deformity.With the increased degree and duration of distraction,spinal cord injuries become more serious in terms of their neurophysiology,histology,and behavior.Very few studies have been published on the specific characteristics of distraction spinal cord injury.In this study,we systematically review 22 related studies involving animal models of distraction spinal cord injury,focusing particularly on the neurophysiological,histological,and behavioral characteristics of this disease.In addition,we summarize the mechanisms underlying primary and secondary injuries caused by distraction spinal cord injury and clarify the effects of different degrees and durations of distraction on the primary injuries associated with spinal cord injury.We provide new concepts for the establishment of a model of distraction spinal cord injury and related basic research,and provide reference guidelines for the clinical diagnosis and treatment of this disease.

关键词： animal models behavior distraction heterogeneity histology mechanism neurophysiology spinal cord injury systematic review tension

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Pulsed lavage in joint arthroplasty: A systematic review and metaanalysis

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World Journal of orthopedics 2024年第3期15卷 293-301页

作者： Mohammad Daher Gaby Haykal Marven Aoun Marc Moussallem Ali Ghoul Jean Tarchichi Amer Sebaaly department of orthopedics Saint Joseph UniversityBeirut 1001Lebanon

BACKGROUND Knee and hip osteoarthritis affects millions of people around the world and is expected to rise even more in frequency as the population ages.Joint arthroplasty is the surgical management of choice in these articulations.Heterotopic ossi-fication and radiolucent lines formation are two frequent problems faced in hip and knee replacements respectively.Some studies show that the usage of pulsed lavage may prevent their formation.AIM To compare pulsed lavage to standard lavage in joint arthroplasty.METHODS PubMed,Cochrane,and Google Scholar(page 1-20)were searched till December 2023.Only comparative studies were included.The clinical outcomes evaluated were the heterotopic ossification formation in hip replacements,radiolucent lines formation,and functional knee scores in knee replacements.RESULTS Four studies met the inclusion criteria and were included in this meta-analysis.Pulsed lavage was shown to reduce the formation of radiolucent lines(P=0.001).However,no difference was seen in the remaining outcomes CONCLUSION Pulsed lavage reduced the formation of radiolucent lines in knee replacements.No difference was seen in the remaining outcomes.Furthermore,the clinical significance of these radiolucent lines is poorly understood.Better conducted randomized controlled studies and cost-effectivity studies are needed to reinforce these findings.

关键词： Knee arthroplasty Hip arthroplasty Pulsed lavage Syringe lavage Heterotopic ossification Radiolucent lines

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