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Reconstruction of Post-Traumatic Bone Loss (BL) Members: Our Experience about 27 Cases

Open Journal of Orthopedics 2016年第6期6卷 139-143页

作者： Moctar Traore Samba Kone Maurice Kouame Raphael Dallo Gogoua Armand Yepie Michel Anoumou Guy Varango Department of orthopaedic surgery and traumatology C.H.U de Treichville Abidjan Cote d’Ivoire Department of orthopaedic surgery and traumatology C.H.U de Cocody Abidjan Cote d’Ivoire

The purpose of this study is to evaluate our results of treatment of post-traumatic bone defect of members through various bone reconstruction techniques. Patients and method: It is a retrospective study continues from January 2008 to December 2012. It involved 27 patients who had bone loss following trauma members. The average age of patients was 36.2 years. We noted a male predominance (22 men). The causes of injuries were dominated by accidents of public roads (12 cases) and ballistic trauma (14 cases). We noted one case of work accident. The BL was localized in 10 cases the tibia, femur in 4 cases, 8 cases in the humerus, 2 cases in the fibula, 1 case was located in the olecranon, 1 case at the distal radius and 1 case to the ball. All lesions were open fractures. After a mean of support for 3 days, we performed emergency around 19 associated with internal fixation (10 cases external fixation, internal fixation 9 cases), 8 single around. Bone reconstruction was performed secondarily in the majority of cases (24 cases). Only 4 reconstructions were performed in emergency. Reconstruction techniques were dominated by conventional grafts (24 cases) associated or not with the technique of induced membrane. Bone reconstruction techniques we used were as follows: 24 cases of traditional autografts and 3 cases of intertibio-fibular graft. After an average decline of 43.6 months, our patients were evaluated clinically (axis and limb length) and radiological (bone healing). Results: bone healing was achieved in 22 cases after a mean of 3.8 surgeries and an average of 14.8 months. Conclusion: the main principles governing the reconstruction of a defect are pre healing associated infection and repair soft tissue whenever it can do. The current trend is to hybridization of the reconstruction process of the great losses of substance by developing strategies based on both the deliberate shortening.

关键词： Bone Loss Bone Reconstruction Nonunion

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Prosthetic joint infection of the hip and knee due to Mycobacterium species:A systematic review

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World Journal of Orthopedics 2022年第5期13卷 503-514页

作者： Asep Santoso Krisna Yuarno Phatama Sholahuddin Rhatomy Nicolaas Cyrillus Budhiparama Department of orthopaedic and traumatology Universitas Sebelas MaretSurakarta and Prof.Dr.R.Soeharso Orthopaedic HospitalSukoharjo 57162Indonesia Department of orthopaedic and traumatology Universitas BrawijayaSaiful Anwar General HospitalMalang 65112Indonesia Department of orthopaedic and traumatology Universitas Gadjah MadaYogyakarta and Dr.Soeradji Tirtonegoro General HospitalKlaten 57424Indonesia Nicolaas Institute of Constructive orthopaedic Research and Education Foundation at Medistra Hospital Jakarta 12950Indonesia Faculty of Medicine Universitas AirlanggaJawa Timur 60132Indonesia Department of orthopaedics Leiden University Medical CenterLeiden 2333Netherlands

BACKGROUND Mycobacterium species(Mycobacterium sp)is an emerging cause of hip and knee prosthetic joint infection(PJI),and different species of this organism may be responsible for the *** To evaluate the profile of hip and knee Mycobacterium PJI cases as published in the past 30 *** A literature search was performed in PubMed using the MeSH terms“Prosthesis joint infection”AND“Mycobacterium”for studies with publication dates from January 1,1990,to May 30,*** avoid missing any study,another search was performed with the terms“Arthroplasty infection”AND“Mycobacterium”in the same period as the previous *** Preferred Reporting Items for Systematic Reviews and Meta-Analyses chart was used to evaluate the included studies for further *** total,51 studies were included for further evaluation of thecases,type of pathogen,and treatment of PJI caused by Mycobacterium *** Seventeen identified Mycobacterium sp were reportedly responsible for hip/knee PJI in 115 hip/knee PJI cases,whereas in two cases there was no mention of any specific Mycobacterium *** tuberculosis(***)was detected in 50/115(43.3%)of the *** mycobacteria(NTM)included ***(26/115,22.6%),***(10/115,8.6%),***(8/115,6.9%),and ***(8/115,6.9%).Majority of the cases(82/114,71.9%)had an onset of infection>3 mo after the index surgery,while in 24.6%(28/114)the disease had an onset in≤3 *** intraoperative PJI diagnosis was made in 4 cases(3.5%).Overall,prosthesis removal was needed in 77.8%(84/108)of the cases to treat the *** infection rate was controlled in 88/102(86.3%)patients with Mycobacterium *** infection occurred in 10/108(9.8%)patients,while 4/108(3.9%)patients died due to the *** At least 17 Mycobacterium sp can be responsible for hip/knee *** *** is the most common causal pathogen,NTM should be considered as an emerging cause of hi

关键词： Mycobacterium species Prosthetic joint infection Hip Knee Systematic review

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Fibula fractures management

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World Journal of Orthopedics 2021年第5期12卷 254-269页

作者： Gianluca Canton Andrea Sborgia Guido Maritan Roberto Fattori Federico Roman Marko Tomic Massimo Max Morandi Luigi Murena Department of Medical Surgical and Life SciencesOrthopaedics and Traumatology UnitTrieste UniversityTrieste 34149Italy Department of orthopaedic surgery Louisiana State University Health Science CenterShreveportLA 71103United States

Isolated distal fibula fractures represent the majority of ankle *** fractures are often the result of a low-energy trauma with external rotation and supination *** is based on clinical signs and radiographic *** X-rays have a role in detecting associated mortise *** depends on fracture type,displacement and associated ankle *** simple,minimally displaced fractures without ankle instability,conservative treatment leads to excellent *** treatment must also be considered in overaged unhealthy patients,even in unstable *** treatment is indicated when fracture or ankle instability are present,with several techniques *** is excellent in most *** regarding wound healing are frequent,especially with plate fixation,whereas other complications are uncommon.

关键词： Fibula fracture Lateral malleolus Distal fibula Management Treatment Ankle

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Reconstruction of tendon losses

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Plastic and Aesthetic Research 2023年第1期10卷 270-294页

作者： Maddalena Bertolini Carlotta Faccenda Chiara Parolo Sara Stucchi Andrea Marchesini FrancescoDe Francesco Michele Riccio Department of orthopaedic and traumatology Hand and Microsurgery UnitOrthopaedic and Trauma CentreAOU CittàDella Salute E Della Scienza Di TorinoTurin 10126Italy University Department of Hand surgery and Rehabilitation San Giuseppe HospitalIRCCS MultiMedica GroupMilan 20123Italy Department of Plastic and Reconstructive surgery Hand Surgery UnitAzienda Ospedaliero Universitaria delle MarcheAncona 60121Italy

This review discusses the latest literature-based evidence on reconstructive strategies following tendon losses,with a final focus on the innovative regenerative *** improvements in primary tendon repair techniques have radically reduced the failure rate and therefore decreased the use of reconstructive ***,in specific conditions,such as crush injuries with loss of substance,avulsion injuries and inveterate injuries,the tendon gap cannot be repaired with a primary suture,making the procedure much more challenging for the *** article aims to guide the treatment of tendon losses,which is still a complex topic in hand surgery.

关键词： Tendon losses tendon reconstruction hand surgery

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Systematic review of bone marrow stimulation for osteochondral lesion of talus-evaluation for level and quality of clinical studies

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World Journal of Orthopedics 2017年第12期8卷 956-963页

作者： Youichi Yasui Laura Ramponi Dexter Seow Eoghan T Hurley Wataru Miyamoto Yoshiharu Shimozono John G Kennedy 2~(nd) Department of orthopaedic surgery Teikyo University School of Medicine Hospital for Special surgery New York 2~(nd) Rizzoli orthopaedic Institute 2~(nd) Royal College of Surgeons in Ireland Department of orthopaedic surgery Teikyo University School of Medicine

AIM To clarify the quality of the studies indicating lesion size and/or containment as prognostic indicators of bone marrow stimulation(BMS) for osteochondral lesions of the talus(OLT). METHODS Two reviewers searched the Pub Med/MEDLINE and EMBASE databases using specific terms on March 2015 in accordance with the Preferred Reporting Items for Systemic Reviews and Meta-Analyses guidelines. Predetermined variables were extracted for all the included studies. Level of evidence(LOE) was determined using previously published criteria by the Journal of Bone and Joint surgery and methodological quality of evidence (MQOE) was evaluated using the Modified Coleman Methodology Score. RESULTS This review included 22 studies. Overall, 21 of the 22(95.5%) included studies were level Ⅳ or level Ⅲ evidences. The remaining study was a level Ⅱ evidence. MQOE analysis revealed 14 of the 22(63.6%) included studies having fair quality, 7(31.8%) studies having poor quality and only 1 study having excellent quality. CONCLUSION The evidence supporting the use of lesion size and containment as prognostic indicators of BMS for OLTs has been shown to be of low quality.

关键词： Osteochondral lesion of talus Arthroscopy Bone marrow stimulation Systematic review

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Stimulating factors for regulation of osteogenic and chondrogenic differentiation of mesenchymal stem cells

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World Journal of Stem Cells 2023年第5期15卷 369-384页

作者： Jia-Qi Zhou Hao-Yang Wan Zi-Xuan Wang Nan Jiang division of orthopaedics and traumatology Department of OrthopaedicsNanfang HospitalSouthern Medical UniversityGuangzhou 510515Guangdong ProvinceChina

Mesenchymal stem cells(MSCs),distributed in many tissues in the human body,are multipotent cells capable of differentiating in specific *** is usually considered that the differentiation process of MSCs depends on specialized external stimulating factors,including cell signaling pathways,cytokines,and other physical *** findings have revealed other underrated roles in the differentiation process of MSCs,such as material morphology and *** relevant achievements have substantially advanced the applicability of MSCs,some of these regulatory mechanisms still need to be better ***,limitations such as long-term survival in vivo hinder the clinical application of MSCs *** review article summarizes current knowledge regarding the differentiation patterns of MSCs under specific stimulating factors.

关键词： Mesenchymal stem cells Differentiation Osteogenic Chondrogenic Literature review

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Oxidized phospholipids are ligands for LRP6

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Bone Research 2018年第3期6卷 266-279页

作者： Lei Wang Yu Chai Changjun Li Haiyun Liu Weiping Su Xiaonan Liu Bing Yu Weiqi Lei Bin Yu Janet L.Crane Xu Cao Mei Wan Department of orthopaedics and traumatology Nanfang Hospital Southern Medical University Department of orthopaedic surgery Johns Hopkins University School of Medicine Department of Endocrinology Endocrinology Research Center The Xiangya Hospital of Central South University Department of Dermatology Johns Hopkins University School of Medicine Department of Pediatric Endocrinology Johns Hopkins University School of Medicine

Low-density lipoprotein receptor–related protein 6(LRP6) is a co-receptor for Wnt signaling and can be recruited by multiple growth factors/hormones to their receptors facilitating intracellular signaling activation. The ligands that bind directly to LRP6 have not been identified. Here, we report that bioactive oxidized phospholipids(oxPLs) are native ligands of LRP6, but not the closely related LRP5. oxPLs are products of lipid oxidation involving in pathological conditions such as hyperlipidemia, atherosclerosis, and inflammation. We found that cell surface LRP6 in bone marrow mesenchymal stromal cells(MSCs) decreased rapidly in response to increased oxPLs in marrow microenvironment. LRP6 directly bound and mediated the uptake of oxPLs by MSCs. oxPL-LRP6 binding induced LRP6 endocytosis through a clathrin-mediated pathway, decreasing responses of MSCs to osteogenic factors and diminishing osteoblast differentiation ability. Thus, LRP6 functions as a receptor and molecular target of oxPLs for their adverse effect on MSCs, revealing a potential mechanism underlying atherosclerosis-associated bone loss.

关键词： Low-density lipoprotein receptor–related protein 6

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Stable mechanical fixation in a bionic osteochondral scaffold considering bone growth

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Rare Metals 2022年第8期41卷 2711-2718页

作者： Jian Zhou Hao Huang Li-Jing Wang Maryam Tamaddon Chao-Zong Liu Zi-Yu Liu Teng-Bo Yu Ying-Ze Zhang Department of orthopaedic surgery Qingdao Municipal HospitalQingdao UniversityQingdao266071China Department of Sports Medicine Affiliated Hospital of Qingdao UniversityQingdao266000China division of surgery&Interventional Science University College LondonRoyal National Orthopaedic HospitalLondonHA74LPUK School of Aeronautic Science and Engineering Beihang UniversityBeijing100191China School of Engineering Medicine Beihang UniversityBeijing100191China

In the field of tissue engineering,there is significant subsidence of the porous design scaffold several months after *** avoid stress shielding and stimulate bone and cartilage ingrowth,high scaffold porosity is needed to diminish the mechanical properties of the *** closer the mechanical properties of the scaffold are to those of surrounding tissues,the better biological properties it will ***,adequate mechanical stability is needed as the scaffold needs to be well fixed in the target area and it will endure load after *** the mechanical fixation of the scaffold at the initial stage and the long-term performance of a scaffold for in vivo study is hard,as no facility can be put into the target area for the friction *** study investigated the mechanical stability of the biomimetic scaffold at the initial stage of implantation by finite element analysis(FEA).According to in vivo study,scaffold could not maintain its original position and would sink 1-2 mm in the target *** simulation results suggested that mechanical loading is not the main reason for scaffold subsidence.

关键词： Osteochondral scaffold Mechanical fixation Scaffold subsidence Bone ingrowth

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Deletion of Glutl in early postnatal cartilage reprograms chondrocytes toward enhanced glutamine oxidation

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Bone Research 2021年第4期9卷 507-520页

作者： Cuicui Wang Jun Ying Xiangfeng Niu Xiaofei Li Gary J.Patti Jie Shen Regis J.O’Keefe Department of orthopaedic surgery School of MedicineWashington UniversitySt.LouisMOUSA Institute of orthopaedics and traumatology The First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhouChina Zhejiang Chinese Medical University HangzhouChina Department of Chemistry Genetics and MedicineWashington UniversitySt.LouisMOUSA

Glucose metabolism is fundamental for the functions of all tissues,including *** the emerging evidence related to glucose metabolism in the regulation of prenatal cartilage development,little is known about the role of glucose metabolism and its biochemical basis in postnatal cartilage growth and *** show here that genetic deletion of the glucose transporter Glutl in postnatal cartilage impairs cell proliferation and matrix production in growth plate(GPs)but paradoxically increases cartilage remnants in the metaphysis,resulting in shortening of long *** the other hand,articular cartilage(AC)with Glutl deficiency presents diminished cellularity and loss of proteoglycans,which ultimately progress to cartilage ***,predisposition to Glutl deficiency severely exacerbates injury-induced *** of the disparities in glucose metabolism between GP and AC chondrocytes under normal conditions,both types of chondrocytes demonstrate metabolic plasticity to enhance glutamine utilization and oxidation in the absence of glucose ***,uncontrolled glutamine flux causes collagen overmodification,thus affecting extracellular matrix remodeling in both cartilage *** results uncover the pivotal and distinct roles of Glutl-mediated glucose metabolism in two of the postnatal cartilage compartments and link some cartilage abnormalities to altered glucose/glutamine metabolism.

关键词： metabolism cartilage chondrocytes

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Mid-term outcomes of microfragmented adipose tissue plus arthroscopic surgery for knee osteoarthritis:A randomized,activecontrol,multicenter clinical trial

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World Journal of Stem Cells 2023年第12期15卷 1063-1076页

作者： Cong-Zi Wu Zhen-Yu Shi Zhen Wu Wen-Jun Lin Wei-Bo Chen Xue-Wen Jia Si-Cheng Xiang Hui-Hui Xu Qin-Wen Ge Kai-Ao Zou Xu Wang Jia-Li Chen Ping-Er Wang Wen-Hua Yuan Hong-Ting Jin Pei-Jian Tong Institute of orthopaedics and traumatology of Zhejiang Province The First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhou 310053Zhejiang ProvinceChina epartment of Orthopedic surgery The First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhou 310006Zhejiang ProvinceChina Department of orthopaedic surgery Tongde Hospital of Zhejiang ProvinceHangzhou 310012China Department of orthopaedic surgery The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325015Zhejiang ProvinceChina Department of orthopaedic surgery Ruian Hospital of Traditional Chinese MedicineWenzhou 325299Zhejiang ProvinceChina Department of orthopaedics Ningbo First HospitalNingbo 315010Zhejiang ProvinceChina The First College of Clinical Medicine Zhejiang Chinese Medical UniversityHangzhou 310053Zhejiang ProvinceChina

BACKGROUND Osteoarthritis(OA)is the most prevalent form of degenerative whole-joint *** the final option of knee replacement,arthroscopic surgery was the most widely used joint-preserving surgical *** regenerative therapies,such as those involving platelet-rich plasma,mesenchymal stem cells,and microfragmented adipose tissue(MFAT),have been pushed to the forefront of treatment to prevent the progression of ***,MFAT has been successfully applied to treat different types of orthopedic *** To assess the efficacy and safety of MFAT with arthroscopic surgery in patients with knee OA(KOA).METHODS A randomized,multicenter study was conducted between June 2017 and November 2022 in 10 hospitals in Zhejiang,***,302 patients diagnosed with KOA(Kellgren-Lawrence grades 2-3)were randomized to the MFAT group(n=151,were administered MFAT following arthroscopic surgery),or the control group(n=151,were administered hyaluronic acid following arthroscopic surgery).The study outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score,the visual analog scale(VAS)score,the Lequesne index score,the Whole-Organ Magnetic Resonance Imaging Score(WORMS),and safety over a 24-mo period from *** The changes in the WOMAC score(including the three subscale scores),VAS pain score,and Lequesne index score at the 24-mo mark were significantly different in the MFAT and control groups,as well as when comparing values at the posttreatment visit and those at baseline(P<0.001).The MFAT group consistently demonstrated significant decreases in the WOMAC pain scores and VAS scores at all follow-ups compared to the control group(P<0.05).Furthermore,the WOMAC stiffness score,WOMAC function score,and Lequesne index score differed significantly between the groups at 12 and 24 mo(P<0.05).However,no signicant between-group differences were observed in the WORMS at 24 mo(P=0.367).No serious adverse events

关键词： Osteoarthritis Microfragmented adipose tissue Lipogems Arthroscopic surgery Knee

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