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Does progress in microfracture techniques necessarily translate into clinical effectiveness?

World Journal of Orthopedics 2024年第3期15卷 266-284页

作者： Sathish Muthu Vibhu Krishnan Viswanathan Manoharan Sakthivel Mohammed Thabrez department of orthopaedics Orthopaedic Research GroupCoimbatore 641045Tamil NaduIndia department of Biotechnology Karpagam Academy of Higher EducationCoimbatore 641021Tamil NaduIndia Manoharan Sakthivel Department of OrthopaedicsGovernment Medical CollegeKarur 639004Tamil NaduIndia department of orthopaedics Devadoss Multispecialty HospitalMadurai 625007Tamil NaduIndia department of Medical Oncology Aster Medcity HospitalKochi 682034India

BACKGROUND Multitudinous advancements have been made to the traditional microfracture(MFx)technique,which have involved delivery of various acellular 2nd generation MFx and cellular MFx-III components to the area of cartilage *** relative benefits and pitfalls of these diverse modifications of MFx technique are still not widely *** To comparatively analyze the functional,radiological,and histological outcomes,and complications of various generations of MFx available for the treatment of cartilage *** A systematic review was performed using PubMed,EMBASE,Web of Science,Cochrane,and *** of any age and sex with cartilage defects undergoing any form of MFx were considered for *** included only randomized controlled trials(RCTs)reporting functional,radiological,histological outcomes or complications of various generations of MFx for the management of cartilage *** meta-analysis(NMA)was conducted in Stata and Cochrane’s Confidence in NMA approach was utilized for appraisal of *** Forty-four RCTs were included in the analysis with patients of mean age of 39.40(±9.46)*** comparing the results of the other generations with MFX-I as a constant comparator,we noted a trend towards better pain control and functional outcome(KOOS,IKDC,and Cincinnati scores)at the end of 1-,2-,and 5-year time points with MFx-III,although the differences were not statistically significant(P>0.05).We also noted statistically significant Magnetic resonance observation of cartilage repair tissue score in the higher generations of microfracture(weighted mean difference:17.44,95%confidence interval:0.72,34.16,P=0.025;without significant heterogeneity)at 1 ***,the difference was not maintained at 2 *** was a trend towards better defect filling on MRI with the second and third generation MFx,although the difference was not statistically significant(P>0.05).CONCLUSION The higher generations of traditional MFx

关键词： Cartilage injury Microfracture Mesenchymal stem cells Platelet-rich plasma Bone marrow aspiration concentrates Clinical outcome Radiological outcome Meta-analysis Network meta-analysis

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Advancing orthopaedic trauma care through WhatsApp:An analysis of clinical and non-clinical applications,challenges,and future directions

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World Journal of Orthopedics 2024年第6期15卷 529-538页

作者： Ravi Saini Madhan Jeyaraman Naveen Jeyaraman Vijay Kumar Jain Swaminathan Ramasubramanian Karthikeyan P Iyengar department of orthopaedics Atal Bihari Vajpayee Institute of Medical SciencesDr Ram Manohar Lohia HospitalNew Delhi 110001India department of orthopaedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennai 600077Tamil NaduIndia department of orthopaedics Government Medical CollegeOmandurar Government EstateChennai 600002Tamil NaduIndia department of Trauma and orthopaedics Southport and Ormskirk HospitalsMersey and West Lancashire Teaching NHS TrustSouthport PR86PNUnited Kingdom

The integration of WhatsApp,a widely-used instant messaging application(IMA),into the realm of orthopaedics and trauma surgery has emerged as a significant development in recent *** paper explores the multifaceted role of WhatsApp in orthopaedics,focusing on its clinical and non-clinical applications,advantages,disadvantages,and future *** study synthesizes findings from various research papers,emphasizing the growing reliance on mobile technology in ***’s role in orthopaedics is notable for its ease of use,real-time communication,and ***,it facilitates triage,teleconsultation,diagnosis,treatment,patient advice,and post-operative ***-clinically,it supports telemedicine,teleradiology,virtual frac-ture clinics,research,and education in orthopaedic *** application has proven beneficial in enhancing communication among healthcare teams,providing quick responses,and motivating junior *** use in educational settings has been shown to improve learner’s understanding and patient ***,the use of WhatsApp in orthopaedics is not without *** include the potential spread of misleading information,privacy concerns,and issues with image quality affecting diagnosis and treatment *** paper acknowledges the importance of maintaining professional boundaries and the need for oversight measures to ensure content *** forward,the potential of WhatsApp and similar IMAs in orthopaedics lies in their ability to streamline data collection and retrieval,improve doctor-patient communication,and address challenges like bureaucratic red tape and limited *** paper suggests that future orthopaedic practice,particularly in emergency departments,will increasingly rely on such technologies for efficient patient *** shift,however,must be approached with an understanding of the ethical,legal,and practical implications of integrating social media and mobile

关键词： Social media WhatsApp orthopaedics Trauma research

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Biophysical-driven piezoelectric and aligned nanofibrous scaffold promotes bone regeneration by re-establishing physiological electrical microenvironment

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Nano research 2024年第8期17卷 7376-7393页

作者： Aoao Wang Xinbo Ma Yafeng Yang Guoliang Shi Liwei Han Xiantong Hu Rui Shi Jun Yan Quanyi Guo Yantao Zhao Senior department of Orthopedics the Fourth Medical Center of PLA General HospitalBeijing 100048China department of Chemistry Capital Normal UniversityBeijing 100048China National Center for orthopaedics Beijing Research Institute of Traumatology and OrthopaedicsBeijing Jishuitan HospitalCapital Medical UniversityBeijing 100035China Xijing 986 Hospital department The Fourth Military Medical UniversityXi'an 710032China institute of Orthopedics Chinese PLA General HospitalBeijing Key Laboratory of Regenerative Medicine in OrthopedicsKey Laboratory of Musculoskeletal Trauma&War Injuries PLABeijing 100853China

The initial healing stages of bone fracture is a complex physiological process involving a series of spatially and temporally overlapping events,including pathogen clearance,immunological modulation,and *** this study,we have developed a piezoelectric and aligned nanofibrous scaffold composed of ZnO@PCL/PVDF with multiple antibacterial,immunomodulatory,and osteogenic effects using electrospinning *** scaffold’s piezoelectric signal output under ultrasound(US)control can be similar to the physiological electrical signals of healthy bone tissue,creating a truly biomimetic electrical microenvironment in the bone *** vitro studies have shown that ZnO@PCL/PVDF scaffold significantly enhances the proliferation,migration,and osteogenic differentiation of MC3T3-E1 cells under piezoelectric drive provided by ***,the scaffold exhibits inhibitory effects on the growth of *** and ***,as well as the ability to induce M2 macrophage polarization,indicating potent antibacterial and immunomodulatory *** vivo experiments demonstrated that the ZnO@PCL/PVDF scaffold can accelerate the repair of mandibular defects in rats,effectively inhibit bacterial colonization,and reduce inflammatory ***,this study confirms that the newly developed ZnO@PCL/PVDF scaffold effectively promotes bone repair by truly mimicking the endogenous electrical microenvironment and precisely regulating the temporospatial disorders of initial bone healing,thus providing a simple and effective solution for bone defects.

关键词： piezoelectricity bone defect bacterial infection ZnO nanoparticles immunomodulation osteogenesis

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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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Histone demethylase Kdm5c regulates osteogenesis and bone formation via PI3K/Akt/HIF1α and Wnt/β-catenin signaling pathways

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Genes & Diseases 2024年第1期11卷 64-66页

作者： Ying Li Lingli Ding Yage Zhang Bingyu Zhou Gene Chi Wai Man Min Wang Jinglan Li Yamei Liu Weiping Lin Haibin Wang Sien Lin Liangliang Xu Key Laboratory of orthopaedics&Traumatology Lingnan Medical Research CenterThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou University of Chinese MedicineGuangzhouGuangdong 510000China department of orthopaedics&Traumatology Faculty of MedicineThe Chinese University of Hong KongPrince of Wales HospitalShatinHong Kong SAR 999077China departments of Diagnostics of Traditional Chinese Medicine Guangzhou University of Chinese MedicineGuangzhouGuangdong 510000China orthopaedic research Lab Affiliated Hospital of Guangdong Medical UniversityGuangdong Medical UniversityZhanjiangGuangdong 524001China

Fractures have an extraordinarily negative impact on individuals'quality of life and functional *** or disability of fracture is a major health issue with important clinical,social,and economic implications.1 Mesenchymal stem cells(MSCs)play an indispensable role in the initiation of the fracture repair process including the formation of a callus which is replaced by new *** use of MSCs in the treatment of fractures is very attractive as they can reduce the time of healing and occurrence of nonunion.

关键词： PI3K/Akt HIF1α healing

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Mitochondrial-Oriented Injectable Hydrogel Microspheres Maintain Homeostasis of Chondrocyte Metabolism to Promote Subcellular Therapy in Osteoarthritis

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research 2024年第3期7卷 775-790页

作者： Li Chen Jianye Yang Zhengwei Cai Yanran Huang Pengcheng Xiao Hong Chen Xiaoji Luo Wei Huang Wenguo Cui Ning Hu department of Orthopedics The First Affiliated Hospital of Chongqing Medical UniversityOrthopedic Laboratory of Chongqing Medical UniversityChongqing 400016China 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 Medicine197 Ruijin 2nd RoadShanghai 200025China.

Subcellular mitochondria serve as sensors for energy metabolism and redox balance, and the dynamic regulation of functional and dysfunctional mitochondria plays a crucial role in determining cells' fate. Selective removal of dysfunctional mitochondria at the subcellular level can provide chondrocytes with energy to prevent degeneration, thereby treating osteoarthritis. Herein, to achieve an ideal subcellular therapy, cartilage affinity peptide (WYRGRL)-decorated liposomes loaded with mitophagy activator (urolithin A) were integrated into hyaluronic acid methacrylate hydrogel microspheres through microfluidic technology, named HM@WY-Lip/UA, that could efficiently target chondrocytes and selectively remove subcellular dysfunctional mitochondria. As a result, this system demonstrated an advantage in mitochondria function restoration, reactive oxygen species scavenging, cell survival rescue, and chondrocyte homeostasis maintenance through increasing mitophagy. In a rat post-traumatic osteoarthritis model, the intra-articular injection of HM@WY-Lip/UA ameliorated cartilage matrix degradation, osteophyte formation, and subchondral bone sclerosis at 8 weeks. Overall, this study indicated that HM@WY-Lip/UA provided a protective effect on cartilage degeneration in an efficacious and clinically relevant manner, and a mitochondrial-oriented strategy has great potential in the subcellular therapy of osteoarthritis.

关键词： spheres remove thereby

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Improving corrosion resistance of additively manufactured WE43 magnesium alloy by high temperature oxidation for biodegradable applications

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Journal of Magnesium and Alloys 2024年第3期12卷 940-953页

作者： Jinge Liu Bangzhao Yin Fei Song Bingchuan Liu Bo Peng Peng Wen Yun Tian Yufeng Zheng Xiaolin Ma Caimei Wang State Key Laboratory of Tribology in Advanced Equipment Beijing100084China department of Mechanical Engineering Tsinghua UniversityBeijing 100084China department of orthopaedics Beijing Tsinghua Changgung HospitalInstitute for Precision MedicineTsinghua UniversityBeijing102218China department of orthopaedics Peking University Third HospitalBeijing 100191China Engineering research Center of Bone and Joint Precision Medicine Ministry of EducationBeijing 100191China School of Materials Science and Engineering Peking UniversityBeijing 100871China Beijing AKEC Medical Co. Ltd.Beijing 102200China

Laser powder bed fusion(L-PBF)has been employed to additively manufacture WE43 magnesium(Mg)alloy biodegradable implants,but WE43 L-PBF samples exhibit excessively rapid *** this work,dense WE43 L-PBF samples were built with the relativity density reaching 99.9%.High temperature oxidation was performed on the L-PBF samples in circulating air via various heating temperatures and holding *** oxidation and diffusion at the elevated temperature generated a gradient structure composed of an oxide layer at the surface,a transition layer in the middle and the *** oxide layer consisted of rare earth(RE)oxides,and became dense and thick with increasing the holding *** matrix was composed ofα-Mg,RE oxides and Mg_(24)RE_(5) *** precipitates almost disappeared in the transition *** passivation effect was observed in the samples treated by a suitable high temperature *** original L-PBF samples lost 40%weight after 3-day immersion in Hank’s solution,and broke into fragments after 7-day *** casted and solution treated samples lost roughly half of the weight after 28-day *** high temperature oxidation samples,which were heated at 525℃ for 8 h,kept the structural integrity,and lost only 6.88%weight after 28-day *** substantially improved corrosion resistance was contributed to the gradient structure at the *** one hand,the outmost dense layer of RE oxides isolated the corrosive medium;on the other hand,the transition layer considerably inhibited the corrosion owing to the lack of ***,high temperature oxidation provides an efficient,economic and safe approach to inhibit the corrosion of WE43 L-PBF samples,and has promising prospects for future clinical applications.

关键词： Laser powder bed fusion Biodegradable magnesium alloy High temperature oxidation Corrosion resistance WE43.

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Does topical vancomycin prevent fracture-related infections in closed fractures undergoing open reduction and internal fixation?A randomised controlled trial

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Chinese Journal of Traumatology 2024年第2期27卷 71-76页

作者： Mohit Gandhi Gopisankar Balaji Jagdish Menon Ruben Raj Thomas department of orthopaedics Jawaharlal Institute of Postgraduate Medical Education and ResearchPondicherryIndia department of Preventive and Social Medicine Jawaharlal Institute of Postgraduate Medical Education and ResearchPondicherryIndia

Purpose:The role of topical vancomycin in fracture-related infection(FRI)is *** few studies have reported their efficacy in open and high-risk extremity *** study aimed to assess topical vancomycin's role in reducing FRI in closed fractures undergoing open surgical intervention with an ***:This prospective randomized cohort study was carried out between February 2021 to January *** with isolated closed fractures,who were planned for open reduction and internal fixation within 2 weeks from the time of injury were included for this *** data collected included age,gender,socioeconomic status,mechanism of injury,diagnosis,Tscherne classification,and time interval to take up for *** were randomized into the intervention and control groups using the block randomization *** control group received only systemic antibiotic prophylaxis,whereas the intervention group received topical application of vancomycin powder in the surgical wound alongside systemic antibiotic *** primary outcome measure was the incidence of FRI among these *** and radiological findings and culture reports(in cases with infection)were recorded during the post-operative period and at 6 weeks of *** relevant statistical calculations were done using STATA statistical/data analysis-parallel edition version 16.0(StataCorp LLC).The quantitative variables like age and duration of the surgery were assessed for normalcy by Shapiro-Wilk W *** independent samples t-test with equal variances was applied to the age ***'s exact test was used for the analysis of the primary outcome measure(presence of FRI following surgery),and"Risk of FRI"and"Risk difference"between the 2 groups was *** strength of the association between qualitative variables was assessed using the Fisher's exact and Chi-square tests,***:There were 88 patients included in this *** statistical si

关键词： Infections Antibiotics Vancomycin Fractures

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Speed and surface steepness affect internal tibial loading during running

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Journal of Sport and Health Science 2024年第1期13卷 118-124页

作者： Hannah Rice Markus Kurz Patrick Mai Leon Robertz Kevin Bill Timothy R.Derrick Steffen Willwacher department of Physical Performance Norwegian School of Sport SciencesOslo 0806Norway Sports Tech research Centre Mid Sweden UniversityÖstersund SE-83125Sweden department of Mechanical and Process Engineering Offenburg University of Applied SciencesOffenburg 77652Germany institute of Biomechanics and orthopaedics German Sport University CologneCologne 50933Germany department of Kinesiology Iowa State UniversityAmesIA 50011USA

Background:Internal tibial loading is influenced by modifiable factors with implications for the risk of stress *** encounter varied surface steepness(gradients)when running outdoors and may adapt their speed according to the *** study aimed to quantify tibial bending moments and stress at the anterior and posterior peripheries when running at different speeds on surfaces of different ***:Twenty recreational runners ran on a treadmill at 3 different speeds(2.5 m/s,3.0 m/s,and 3.5 m/s)and gradients(level:0%;uphill:+5%,+10%,and+15%;downhill:-5%,-10%,and-15%).Force and marker data were collected synchronously *** moments were estimated at the distal third centroid of the tibia about the medial-lateral axis by ensuring static equilibrium at each 1%of *** was derived from bending moments at the anterior and posterior peripheries by modeling the tibia as a hollow ***-way repeated-measures analysis of variance were conducted using both functional and discrete statistical ***:There were significant main effects for running speed and gradient on peak bending moments and peak anterior and posterior *** running speeds resulted in greater tibial *** uphill at+10%and+15%resulted in greater tibial loading than level *** downhill at-10%and-15%resulted in reduced tibial loading compared to level *** was no difference between+5%or-5%and level ***:Running at faster speeds and uphill on gradients≥+10%increased internal tibial loading,whereas slower running and downhill running on gradients≥-10%reduced internal *** running speed according to the gradient could be a protective mechanism,providing runners with a strategy to minimize the risk of tibial stress injuries.

关键词： Bending moments Gradient Musculoskeletal modeling Overuse injury Tibial stress Training factors

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Antioxidant and anti-inflammatory injectable hydrogel microspheres for in situ treatment of tendinopathy

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Regenerative Biomaterials 2024年第3期3卷 92-104页

作者： Qibin Han Lang Bai Yinhua Qian Xiaoyu Zhang Juan Wang Jing Zhou Wenguo Cui Yuefeng Hao Xing Yang department of Orthopedics The Affliated Suzhou Hospital of Nanjing Medical UniversitySuzhou Municipal HospitalGusu SchoolNanjing Medical University Suzhou215008P.R.China department of Orthopedics Kunshan Hospital of Traditional Chinese MedicineSuzhou 215300P.R.China 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

Tendinopathy is a common disorder that causes local dysfunction and reduces quality of *** research has indicated that alterations in the inflammatory microenvironment play a vital role in the pathogenesis of ***,injectable methacrylate gelatin(GelMA)microspheres(GM)were fabricated and loaded with heparin-dopamine conjugate(HDC)and hepatocyte growth factor(HGF).GM@HDC@HGF were designed to balance the inflammatory microenvironment by inhibiting oxidative stress and inflammation,thereby regulating extracellular matrix(ECM)metabolism and halting tendon *** growth factors with heparin was expected to improve the encaption,the catechol groups on dopamine have adhesion and antioxidant properties,allowing potential attachment at the injured site,and better function synergized with ***@HDC@HGF injected in situ in rat Achilles tendinopathy(AT)models significantly downregulated oxidative stress and inflammation,and ameliorated ECM *** conclusion,the multifunctional platform developed presents a promising alternative for the treatment of tendinopathy.

关键词： tendinopathy oxidative stress inflammation microspheres

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