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Complication rates after direct anterior vs posterior approach for hip hemiarthroplasty in elderly individuals with femoral neck fractures

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World Journal of orthopedics 2024年第1期15卷 22-29页

作者： Tatiana Charles Nicolas Bloemers Bilal Kapanci Marc Jayankura department of orthopedic surgery and Traumatology HUB-Hospital ErasmeBrussels 1070Belgium

BACKGROUND Dislocation rates after hemiarthroplasty reportedly vary from 1%to 17%.This serious complication is associated with increased morbidity and mortality *** to this surgery are still debated,with no consensus regarding the superiority of any single *** To compare early postoperative complications after implementing the direct anterior and posterior approaches(PL)for hip hemiarthroplasty after femoral neck *** This is a comparative,retrospective,single-center cohort study conducted at a university *** March 2008 and December 2018,273 patients(a total of 280 hips)underwent bipolar hemiarthroplasties(n=280)for displaced femoral neck fractures using either the PL(n=171)or the minimally invasive direct anterior approach(DAA)(n=109).The choice of approach was related to the surgeons’practices;the implant types were similar and unrelated to the *** rates and other complications were reviewed after a minimum followup of 6 *** Both treatment groups had similarly aged patients(mean age:82 years),sex ratios,patient body mass indexes,and patient *** data(surgery delay time,operative time,and blood loss volume)did not differ significantly between the *** 30 d mortality rate was higher in the PL group(9.9%)than in the DAA group(3.7%),but the difference was not statistically significant(P=0.052).Among the one-month survivors,a significantly higher rate of dislocation was observed in the PL group(14/154;9.1%)than in the DAA group(0/105;0%)(P=0.002).Of the 14 patients with dislocation,8 underwent revision surgery for recurrent instability(posterior group),and one of them had 2 additional procedures due to a deep *** rate of other complications(e.g.,perioperative and early postoperative periprosthetic fractures and infection-related complications)did not differ significantly between the *** These findings suggest that the DAA to bipolar hemiarthroplasty f

关键词： Hemiarthroplasty Femoral neck fracture Direct anterior approach Posterior approach Dislocation Mortality

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Lupenone improves motor dysfunction in spinal cord injury mice through inhibiting the inflammasome activation and pyroptosis in microglia via the nuclear factor kappa B pathway

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Neural Regeneration Research 2024年第8期19卷 1802-1811页

作者： Fudong Li Xiaofei Sun Kaiqiang Sun Fanqi Kong Xin Jiang Qingjie Kong department of orthopedics Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghaiChina department of orthopedic surgery Spine CenterShanghai Changzheng HospitalNaval Medical UniversityShanghaiChina department of orthopedic surgery Naval Medical CenterNaval Medical UniversityShanghaiChina department of Anesthesiology Shanghai Changzheng HospitalNaval Medical UniversityShanghaiChina

Spinal cord injury-induced motor dysfunction is associated with *** have shown that the triterpenoid lupenone,a natural product found in various plants,has a remarkable anti-inflammatory effect in the context of chronic ***,the effects of lupenone on acute inflammation induced by spinal cord injury remain *** this study,we established an impact-induced mouse model of spinal cord injury,and then treated the injured mice with lupenone(8 mg/kg,twice a day)by intrape ritoneal *** also treated BV2 cells with lipopolysaccharide and adenosine5’-triphosphate to simulate the inflammatory response after spinal cord *** res ults showed that lupenone reduced IKBa activation and p65 nuclear translocation,inhibited NLRP3 inflammasome function by modulating nuclear factor kappa B,and enhanced the conve rsion of proinflammatory M1 mic roglial cells into anti-inflammatory M2 microglial ***,lupenone decreased NLRP3 inflammasome activation,NLRP3-induced mic roglial cell polarization,and microglia pyroptosis by inhibiting the nuclear factor kappa B *** findings suggest that lupenone protects against spinal cord injury by inhibiting inflammasomes.

关键词： inflammasome inflammation lupenone microglia polarization pyroptosis spinal cord injury

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Conditioned medium from human dental pulp stem cells treats spinal cord injury by inhibiting microglial pyroptosis

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Neural Regeneration Research 2024年第5期19卷 1105-1111页

作者： Tao Liu Ziqian Ma Liang Liu Yilun Pei Qichao Wu Songjie Xu Yadong Liu Nan Ding Yun Guan Yan Zhang Xueming Chen department of orthopedic surgery Beijing Luhe HospitalCapital Medical UniversityBeijingChina department of orthopedic surgery Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina department of Stomatology Beijing Luhe HospitalCapital Medical UniversityBeijingChina department of Anesthesiology and Critical Care Medicine School of MedicineJohns Hopkins UniversityBaltimoreMDUSA department of Neurological surgery School of MedicineJohns Hopkins UniversityBaltimoreMDUSA

Human dental pulp stem cell transplantation has been shown to be an effective therapeutic strategy for spinal cord ***,whether the human dental pulp stem cell secretome can contribute to functional recovery after spinal cord injury remains *** the present study,we established a rat model of spinal cord injury based on impact injury from a dropped weight and then intraperitoneally injected the rats with conditioned medium from human dental pulp stem *** found that the conditioned medium effectively promoted the recovery of sensory and motor functions in rats with spinal cord injury,decreased expression of the microglial pyroptosis markers NLRP3,GSDMD,caspase-1,and interleukin-1β,promoted axonal and myelin regeneration,and inhibited the formation of glial *** addition,in a lipopolysaccharide-induced BV2 microglia model,conditioned medium from human dental pulp stem cells protected cells from pyroptosis by inhibiting the NLRP3/caspase-1/interleukin-1β*** results indicate that conditioned medium from human dental pulp stem cells can reduce microglial pyroptosis by inhibiting the NLRP3/caspase-1/interleukin-1βpathway,thereby promoting the recovery of neurological function after spinal cord ***,conditioned medium from human dental pulp stem cells may become an alternative therapy for spinal cord injury.

关键词： BV2 conditioned medium dental pulp stem cells GSDMD microglia neuroinflammation NLRP3 pyroptosis spinal cord injury

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Dislocation of primary total hip arthroplasty:Analysis of risk factors and preventive options

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World Journal of orthopedics 2024年第6期15卷 501-511页

作者： Dario Regis Mattia Cason Bruno Magnan department of orthopedic and Trauma surgery Integrated University HospitalVerona 37126VenetoItaly

Total hip arthroplasty(THA)is one of the most successful elective operations in orthopedic surgery for improving pain and functional disability in patients with end-stage joint ***,dislocation continues to be a troublesome complication after THA,as it is a leading cause of revision and is associated with substantial social,health,and economic *** is a relatively rare,usually early occurrence that depends on both the patients’characteristics and the surgical *** most recent and important finding is the special attention to be given preoperatively to spinopelvic mobility,which is closely related to the incidence of ***,clinical and radiographic assessment of the lumbar spine is mandatory to identify an altered pelvic tilt that could suggest a different positioning of the *** spinal fusion is currently considered a risk factor for dislocation and revision regardless of whether it is performed prior to or after *** options for its treatment and prevention include the use of prostheses with large diameter of femoral head size,dual mobility constructs,constrained liners,and modular neck stems.

关键词： Dislocation Total hip arthroplasty Revision surgery Review Risk factors Complication

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Total hip arthroplasty after core decompression: Time-to-event analysis and risk factors

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中华医学杂志(英文版) 2024年第16期137卷 1988-1990页

作者： Li Chengsi Wang Tianyu Wu Dongwei Guo Haichuan Yang Zhenbang Cheng Xinqun Zhu Yanbin Zhang Yingze department of orthopedic surgery Therd Hospital Hebei Medical University Shijiazhuang Hebei China orthopedic Research Institute of Hebei Province Key Laboratory of Biomechanics of Hebei Province Shijiazhuang Hebei China

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Prevalence and risk factors of wound complications after transtibial amputation in patients with diabetic foot

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World Journal of Diabetes 2024年第4期15卷 629-637页

作者： Young Uk Park Seong Hyuk Eim Young Wook Seo department of orthopedic surgery Ajou University School of MedicineAjou University HospitalSuwon 16499South Korea

BACKGROUND Diabetic foot(DMF)complications are common and are increasing in *** factors related to wound complications are yet to be established after transtibial amputation under the diagnosis of DMF *** To analyze the prognosis and risk factors related to wound complications after transtibial amputation in patients with *** This retrospective cohort study included seventy-two patients with DMF complications who underwent transtibial amputation between April 2014 and March *** groups were categorized based on the occurrence of wound complications,and we compared demographic data between the complication group and the non-complication group to analyze risk ***,a multivariate logistic regression analysis was performed to identify risk *** The average follow-up period was 36.2 *** the 72 cases,31(43.1%)had wound *** these,12 cases(16.7%)received further treatment,such as debridement,soft tissue stump revision,and re-amputation at the proximal *** a group that required further management due to wound complications after transtibial amputation,the hemoglobin A1c(HbA1c)level was 9.32,while the other group that did not require any treatment had a 7.54 HbA1c *** prevalence of a history of kidney transplantation with wound complications after transtibial amputation surgery in DMF patients was significantly greater than in cases without wound complications(P=0.02).Other factors did not show significant *** Approximately 43.1%of the patients with transtibial amputation surgery experienced wound complications,and 16.7%required additional surgical *** HbA1c levels and kidney transplant history are risk factors for postoperative wound complications.

关键词： Diabetic foot Transtibial amputation Wound complications Risk factor

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Discoid meniscus:Treatment considerations and updates

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World Journal of orthopedics 2024年第6期15卷 520-528页

作者： Waleed Albishi Amjad Albaroudi Abdulrahman M Alaseem Sarah Aljasser Ibrahim Alshaygy Abdullah Addar department of orthopedic surgery College of MedicineKing Saud UniversityRiyadh 11362Saudi Arabia

A discoid meniscus is a morphological abnormality wherein the meniscus loses its normal‘C’*** most patients are asymptomatic,patients might still present with symptoms such as locking,pain,swelling,or giving *** resonance imaging is usually needed for confirmation of *** on a constellation of factors,including clinical and radiological,different approaches are chosen for the management of discoid *** purpose of this review is to outline the treatment of discoid meniscus,starting from conservative approach,to the different surgical options for this *** PubMed and Google Scholar databases were used for this *** discussing the treatment of discoid meniscus from 2018 to 2023 were *** there were 369 studies retrieved,and after removal of studies using the exclusion criteria,26 studies were included in this *** such as stability,presence of tear,and morphology can help with surgical *** approaches have been used to treat discoid meniscus,where the choice is tailored for each patient ***,factors that may positively impact patient outcomes include male sex,body mass index<18.5,age at symptom onset<25 years,and duration of symptoms<24 *** conventional approach is partial meniscectomy with or without repair;however,recently,there has been an increased emphasis on discoid-preserving techniques such as meniscoplasty,meniscopexy,and meniscal allograft transplantation.

关键词： Discoid meniscus Saucerization Partial meniscectomy Meniscoplasty Meniscopexy Meniscal allograft transplantation Arthroscopy Knee

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Mortality rate after total knee arthroplasty or total hip arthroplasty in patients with a history of liver transplant

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World Journal of orthopedics 2024年第4期15卷 310-311页

作者： E Carlos Rodriguez-Merchan department of orthopedic surgery La Paz University Hospital-IdiPazMadrid 28046Spain

In this editorial I comment on the article by Ahmed et al published in a recent issue of the World J Orthop 2023;14:*** is well known that patients who have undergone a liver transplant(LT)may need to have a total hip arthroplasty(THA)or total knee arthroplasty(TKA)*** et al stated that the mortality rate in these patients was similar to the one of the general ***,there are three articles previously published that found higher mortality in LT patients who experienced THA/TKA than in the general population(individuals without LT).Therefore,in this Editorial I would like to point out that there is controversy in the literature regarding whether LT patients undergoing THA/TKA have higher mortality than the general ***,future research should attempt to resolve this controversy.

关键词： Liver transplant Total knee arthroplasty Total hip arthroplasty Results Mortality

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A new perspective on intervertebral disc calcification—from bench to bedside

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Bone Research 2024年第1期12卷 50-61页

作者： Emanuel J.Novais Rajkishen Narayanan Jose A.Canseco Koen van de Wetering Christopher K.Kepler Alan S.Hilibrand Alexander R.Vaccaro Makarand V.Risbud department of Orthopaedic surgery Sidney Kimmel Medical CollegeThomas Jefferson UniversityPhiladelphiaPAUSA Unidade Local de Saúde do Litoral Alentejano Orthopedic DepartmentSantiago do CacémPortugal Rothman orthopedic Institute at Thomas Jefferson University PhiladelphiaPAUSA

Disc degeneration primarily contributes to chronic low back and neck ***,there is an urgent need to understand the spectrum of disc degeneration phenotypes such as fibrosis,ectopic calcification,herniation,or mixed *** these phenotypes,disc calcification is the least *** calcification,by definition,is the pathological mineralization of soft tissues,widely studied in the context of conditions that afflict vasculature,skin,and ***,disc calcification is associated with poor surgical outcomes and back pain refractory to conservative *** is frequently seen as a consequence of disc aging and progressive degeneration but exhibits unique molecular and morphological characteristics:hypertrophic chondrocyte-like cell differentiation;TNAP,ENPP1,and ANK upregulation;cell death;altered Pi and PPi homeostasis;and local *** studies in mouse models have provided a better understanding of the mechanisms underlying this *** is essential to recognize that the presentation and nature of mineralization differ between AF,NP,and EP ***,the combination of anatomic location,genetics,and environmental stressors,such as aging or trauma,govern the predisposition to ***,the systemic regulation of calcium and Pi metabolism is less important than the local activity of PPi modulated by the ANK-ENPP1 axis,along with disc cell death and differentiation *** there is limited understanding of this phenotype,understanding the molecular pathways governing local intervertebral disc calcification may lead to developing disease-modifying drugs and better clinical management of degeneration-related pathologies.

关键词： degeneration metabolism intervertebral

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Brain regulates weight bearing bone through PGE2 skeletal interoception: implication of ankle osteoarthritis and pain

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Bone Research 2024年第1期12卷 107-121页

作者： Feng Gao Qimiao Hu Wenwei Chen Jilong Li Cheng Qi Yiwen Yan Cheng Qian Mei Wan James Ficke Junying Zheng Xu Cao department of orthopedic surgery Johns Hopkins University School of MedicineBaltimoreMaryland 21205USA department of Biomedical Engineering Johns Hopkins University School of MedicineBaltimoreMaryland 21205USA

Bone is a mechanosensitive tissue and undergoes constant remodeling to adapt to the mechanical loading ***,it is unclear whether the signals of bone cells in response to mechanical stress are processed and interpreted in the *** this study,we found that the hypothalamus of the brain regulates bone remodeling and structure by perceiving bone prostaglandin E2(PGE2)concentration in response to mechanical *** PGE2 levels are in proportion to their weight *** weight bearing changes in the tail-suspension mice,the PGE2 concentrations in bones change in line with their weight bearing *** of cyclooxygenase-2(COX2)in the osteoblast lineage cells or knockout of receptor 4(EP4)in sensory nerve blunts bone formation in response to mechanical ***,knockout of TrkA in sensory nerve also significantly reduces mechanical load-induced bone ***,mechanical loading induces cAMP-response element binding protein(CREB)phosphorylation in the hypothalamic arcuate nucleus(ARC)to inhibit sympathetic tyrosine hydroxylase(TH)expression in the paraventricular nucleus(PVN)for ***,we show that elevated PGE2 is associated with ankle osteoarthritis(AOA)and ***,our data demonstrate that in response to mechanical loading,skeletal interoception occurs in the form of hypothalamic processing of PGE2-driven peripheral signaling to maintain physiologic bone homeostasis,while chronically elevated PGE2 can be sensed as pain during AOA and implication of potential treatment.

关键词： pain elevated PGE2

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