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Subsequent total joint arthroplasty: Are we learning from the first stage?

World Journal of orthopedics 2024年第3期15卷 230-237页

作者： Christine Jiang Wu Colin Penrose Sean Patrick Ryan Michael Paul Bolognesi Thorsten Markus Seyler Samuel Secord Wellman Department of Orthopaedic surgery Duke University HospitalDurhamNC 27710United States Department of Orthopaedic surgery Midwest Center for Joint ReplacementIndianapolisIN 46241United States

BACKGROUND With the increasing incidence of total joint arthroplasty(TJA),there is a desire to reduce peri-operative complications and resource utilization.As degenerative conditions progress in multiple joints,many patients undergo multiple proce-dures.AIM To determine if both physicians and patients learn from the patient’s initial arth-roplasty,resulting in improved outcomes following the second procedure.METHODS The institutional database was retrospectively queried for primary total hip arth-roplasty(THA)and total knee arthroplasty(TKA).Patients with only unilateral THA or TKA,and patients undergoing same-day bilateral TJA,were excluded.Patient demographics,comorbidities,and implant sizes were collected at the time of each procedure and patients were stratified by first vs second surgery.Outcome metrics evaluated included operative time,length of stay(LOS),disposition,90-d readmissions and emergency department(ED)visits.RESULTS A total of 642 patients,including 364 undergoing staged bilateral TKA and 278 undergoing bilateral THA,were analyzed.There was no significant difference in demographics or comorbidities between the first and second procedure,which were separated by a mean of 285 d.For THA and TKA,LOS was significantly less for the second surgery,with 66%of patients having a shorter hospitalization(Psurgery.However,when a change in disposition was present from the first surgery,patients were significantly more likely to be discharged to home after the second procedure(P=0.033).There was no difference between procedures for post-operative readmissions(P=0.438)or ED visits(P=0.915).CONCLUSION After gaining valuable experience recovering from the initial surgery,a patient’s perioperative outcomes are improved for their second TJA.This may be the result of increased confidence and decrea

关键词： Staged total joint arthroplasty Asynchronous total joint arthroplasty Subsequent total joint arthroplasty Contralateral total joint arthroplasty Perioperative outcomes

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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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Long-term assessment of collagenase treatment for Dupuytren’s contracture:A 10-year follow-up study

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World Journal of orthopedics 2024年第4期15卷 355-362页

作者： Marco Passiatore Vitale Cilli Adriano Cannella Ludovico Caruso Giulia Maria Sassara Giuseppe Taccardo Rocco De Vitis Department of Bone and joint surgery ASST-Spedali CiviliBrescia 25123Italy Department of Chirurgie de la Main Centre Hospitalier Interregional Edith CavellBruxelles 1160Belgium Department of orthopedics Fondazione Policlinico Universitario Agostino Gemelli IRCSSRome 00168Italy

BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).Despite its benefits,the long-term outcomes remain unclear.This study presented a comprehensive 10-year follow-up assessment of the enduring effects of CCH on patients with DC.AIM To compare the short-term(12 wk)and long-term(10 years)outcomes on CCH treatment in patients with DC.METHODS A cohort of 45 patients was treated with CCH at the metacarpophalangeal(MCP)joint and the proximal interphalangeal(PIP)joint and underwent systematic reevaluation.The study adhered to multicenter trial protocols,and assessments were conducted at 12 wk,7 years,and 10 years post-surgery.RESULTS Thirty-seven patients completed the 10-year follow-up.At 10 years,patients treated at the PIP joint exhibited a 100%recurrence.However,patients treated at the MCP joint only showed a 50%recurrence.Patient satisfaction varied,with a lower satisfaction reported in PIP joint cases.Recurrence exceeding 20 degrees on the total passive extension deficit was observed,indicating a challenge for sustained efficacy.Significant differences were noted between outcomes at the 7-year and 10-year intervals.CONCLUSION CCH demonstrated sustained efficacy when applied to the MCP joint.However,caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient satisfaction.Re-intervention is needed within a decade of treatment.

关键词： Collagenase Xiapex Dupuytren disease Dupuytren recurrence Long term follow-up

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SPOCK2， a novel potential target for cereal intake in knee osteoarthritis

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Food Science and Human Wellness 2024年

作者： Erliang Li Jin Sun Haishi Zheng Jiachen Wang Peng Xu Department of orthopedics The First Affiliated Hospital of Xi'an Jiaotong University Department of joint surgery Honghui Hospital Xi'an Jiaotong University Department of Orthopaedics The Tangdu Hospital of Air Force Military Medical University

Lifestyle is related to many chronic diseases， such as knee osteoarthritis （KOA）. Food intake is important because it can be controlled. However， the causal relationship of food intake and KOA still remain unclear. To identify the relationship between food intake and KOA and to screen relevant targets. First， we performed two-sample Mendelian randomization （MR） analysis. A total of 16 kinds of food intake datasets were included， the inverse variance-weighted analysis showed that the KOA was negatively correlated with cereal intake (odds ratio[OR]0.48; 95% CI 0.35-0.68; P = 1.98 × 10-5). Second， potential drug targets of KOA in plasma were explored， SPOCK2 as the causal protein for plasma with KOA， and increased SPOCK2 (OR 0.84; 95% CI 0.77 – 0.92; P = 5.52 × 10- 5)， decreased the risk of KOA. Integrated transcriptomic analysis （P = 0.0285） and in vivo （P = 0.0395） showed consistent results. Finally， by metabolomics analysis and molecular docking， seven co-expressed small molecules were detected in cereal and were bound to SPOCK2. Our findings indicate the cereal intake was negatively correlated with KOA， and support the SPOCK2 as a novel potential target for cereal intake in KOA. Our study will provide clinical dietary guidance for KOA patients and provide a theoretical basis for the development of novel， side-effect-free drugs for KOA.

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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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ADAM8 inactivation retards intervertebral disc degeneration in mice

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Genes & Diseases 2024年第3期11卷 91-94页

作者： Zuozhen Tian Frances S.Shofer Mingyue Fan Alec Z.Sandroni Lutian Yao Lin Han Ling Qin Motomi Enomoto-lwamoto Yejia Zhang Department of Physical Medicine&Rehabilitation Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPA19146USA Department of Emergency Medicine Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPA 19104USA Department of Orthopedic surgery Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPA 19104USA School of Biomedical Engineering Science&Health SystemsDrexel UniversityPhiladelphiaPA 19104USA Department of orthopedics/Sports Medicine and joint surgery the First Hospital of China Medical UniversityShenyangLiaoning 110001China Department of orthopedics University of Maryland School ofMedicineBaltimoreMD21201USA Section of Rehabilitation Medicine Corporal Michael J.Crescenz Veterans Affairs Medical CenterPhiladelphiaPA 19104USA

ADAM8 has been identified as the fibronectin-cleaving enzyme in human degenerative intervertebral disc(IVD)tissues.^(1)Increase of the active form of ADAM8 and its cleavage product,fibronectin fragment,correlated with an increased degree of IVD degeneration.1 Furthermore,fibronectin fragments have been shown to accelerate the progression of IVD degeneration.^(2)These findings suggest that ADAM8 may play a role in degenerative disc disease,a clinical problem with tremendous socioeconomic burdens in the United States.

关键词： ADAM8 degeneration intervertebral

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Management and classification of the fracture of lateral process of talus:An overview and literature update

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World Journal of Clinical Cases 2024年第15期12卷 2487-2498页

作者： Chao-Qun Wang Ulrich Stockle Sheng-Nan Dong Xu-Gui Li Ze-Xi Ling Department of Traumatic orthopedics The Affiliated Hospital of Wuhan Sports UniversityWuhan 430079Hubei ProvinceChina Center of Musculoskeletal surgery Berlin CharitéMedical University HospitalBerlin 13353Germany

Fracture of the lateral process of the talus(FLPT)is uncommon in clinical practice and can be easily missed or misdiagnosed.In recent years,as researchers from all over the world have further deepened their research on FLPT,there has been a breakthrough in the classification,and the methods and principles of clinical management have changed accordingly;however,there is still no standardized guideline for the diagnosis and management of FLPT,and there have been few relevant literature review articles related to this kind of fracture in the past at least 5 years.In this article,we review the clinical classification,classification-based therapeutic recommendations,and prognosis of FLPT,with the aim of providing a reference for the clinical diagnosis and management of this infrequent fracture.

关键词： Fracture of the lateral process of the talus Fracture of the talus Hindfoot injuries Intraarticular fracture Subtalar joint

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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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Extracellular vesicles derived from mesenchymal stem cells mediate extracellular matrix remodeling in osteoarthritis through the transport of microRNA-29a

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World Journal of Stem Cells 2024年第2期16卷 191-206页

作者： Fan Yang Wan-Qi Xiong Chen-Zhi Li Ming-Jian Wu Xiu-Zhi Zhang Chun-Xiao Ran Zhen-Hao Li Yan Cui Bao-Yi Liu De-Wei Zhao Department of orthopedics Affiliated Zhongshan Hospital of Dalian UniversityDalian 116001Liaoning ProvinceChina

BACKGROUND Knee osteoarthritis(KOA)is a common orthopedic condition with an uncertain etiology,possibly involving genetics and biomechanics.Factors like changes in chondrocyte microenvironment,oxidative stress,inflammation,and immune responses affect KOA development.Early-stage treatment options primarily target symptom relief.Mesenchymal stem cells(MSCs)show promise for treatment,despite challenges.Recent research highlights microRNAs(miRNAs)within MSC-released extracellular vesicles that can potentially promote cartilage regeneration and hinder KOA progression.This suggests exosomes(Exos)as a promising avenue for future treatment.While these findings emphasize the need for effective KOA progression management,further safety and efficacy validation for Exos is essential.AIM To explore miR-29a’s role in KOA,we’ll create miR-29a-loaded vesicles,testing for early treatment in rat models.METHODS Extraction of bone marrow MSC-derived extracellular vesicles,preparation of engineered vesicles loaded with miR-29a using ultrasonication,and identification using quantitative reverse transcription polymerase chain reaction;after establi-shing a rat model of KOA,rats were randomly divided into three groups:Blank control group injected with saline,normal extracellular vesicle group injected with normal extracellular vesicle suspension,and engineered extrace-llular vesicle group injected with engineered extracellular vesicle suspension.The three groups evaluation,histological detection,and immunohistochemical detection to compare and evaluate the progress of various forms of arthritis.RESULTS General behavioral observation results showed that the extracellular vesicle group and engineered extracellular vesicle group had better performance in all four indicators of pain,gait,joint mobility,and swelling compared to the blank control group.Additionally,the engineered extracellular vesicle group had better pain relief at 4 wk and better knee joint mobility at 8 wk compared to the normal extracellular vesicle group.Imaging examinat

关键词： Exosomes Osteoarthritis Mesenchymal stem cells MicroRNA-29a Intra-articular injection

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Inhibiting MMP13 Attenuates Deep Vein Thrombosis in a Mouse Model by Reducing the Expression of Pdpn

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Current Medical Science 2024年第2期44卷 369-379页

作者： Ji LUO Jin ZHOU Jing-zeng LUO Hai-long WANG Xue-ling ZHAO Ru-dan ZHOU Department of Intensive Care Unit The First People's Hospital of ZiyangZiyang 641300China Department of orthopedics Kunming Medical University Second Affiliated HospitalKunming 650033China Department of orthopedics Kunming Medical University First Affiliated HospitalKunming 650032China Department of orthopedics The Third People's Hospital of Yunnan ProvinceKunming 650200China

Objective:Matrix metalloproteinase 13(MMP13)is an extracellular matrix protease that affects the progression of atherosclerotic plaques and arterial thrombi by degrading collagens,modifying protein structures and regulating inflammatory responses,but its role in deep vein thrombosis(DVT)has not been determined.The purpose of this study was to investigate the potential effects of MMP13 and MMP13-related genes on the formation of DVT.Methods:We altered the expression level of MMP13 in vivo and conducted a transcriptome study to examine the expression and relationship between MMP13 and MMP13-related genes in a mouse model of DVT.After screening genes possibly related to MMP13 in DVT mice,the expression levels of candidate genes in human umbilical vein endothelial cells(HUVECs)and the venous wall were evaluated.The effect of MMP13 on platelet aggregation in HUVECs was investigated in vitro.Results:Among the differentially expressed genes,interleukin 1 beta,podoplanin(Pdpn),and factor VIII von Willebrand factor(F8VWF)were selected for analysis in mice.When MMP13 was inhibited,the expression level of PDPN decreased significantly in vitro.In HUVECs,overexpression of MMP13 led to an increase in the expression level of PDPN and induced platelet aggregation,while transfection of PDPN-siRNA weakened the ability of MMP13 to increase platelet aggregation.Conclusions:Inhibiting the expression of MMP13 could reduce the burden of DVT in mice.The mechanism involves downregulating the expression of Pdpn through MMP13,which could provide a novel gene target for DVT diagnosis and treatment.

关键词： deep vein thrombosis matrix metalloproteinase 13 podoplanin

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