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Correlation between the coverage percentage of prosthesis and postoperative hidden blood loss in primary total knee arthroplasty

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Chinese Medical Journal 2014年第12期127卷 2265-2269页

作者： Gao Fuqiang Guo Wanshou Sun Wei Li Zirong Wang Weiguo Wang Bailiang Cheng Liming Kush Nepali osteonecrosis and joint-preserving and reconstruction center Department of Orthopedic SurgeryChina-Japan Friendship HospitalBeijing 100029China

Background The aim of this study was to determine the relationship between prosthesis coverage and postoperative hidden blood loss （HBL） in primary total knee arthroplasty （TKA）.Methods A total of 120 patients who had undergone unilateral TKA from August 2012 to May 2013 were retrospectively *** Gross formula was used to calculate the amount of *** standard anteroposterior （AP） and lateral x-ray films of the knee joint were taken postoperatively and used to measure the percentages of coronal femoral and of coronal and sagittal tibial prosthetic *** Pearson＇s correlation analysis was performed to assess the correlations between the percentages of prosthetic coverage for each AP and lateral position and HBL on the first and third postoperative *** The volumes of HBL on the first and third postoperative days after TKA were （786.5±191.6） ml and （1 256.6±205.1） ml,respectively,and lateral x-ray film measurements of percentages of coronal femoral,tibial coronal,and sagittal prosthetic coverage were （87.9±2.5）％,（88.5±2.2）％,and （89.1±2.3）％,***＇s correlation analysis showed statistically significant correlations between percentages of total knee prosthetic coverage for each AP and lateral position and volumes of HBL on the first and third postoperative days （P ＜0.05）.Conclusions HBL after TKA correlates with degree of prosthetic *** some extent,the size of the surfaces exposed by osteotomy determines the amount of *** of the appropriate prosthesis can significantly reduce postoperative *** individualized prostheses would be a worthwhile development in joint replacement surgery.

关键词： arthroplasty replacement, knee prosthetic coverage blood loss hidden

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Local Administration of Bisphosphonate-soaked Hydroxyapatite for the Treatment of osteonecrosis of the Femoral Head in Rabbit

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Chinese Medical Journal 2016年第21期129卷 2559-2566页

作者： Jin-Hui Ma Wan-Shou Guo Zi-Rong Li Bai-Liang Wang Department of Bone and joint Surgery Peking University China-Japan Friendship School of Clinical Medicine Beijing 100029 China Department of Bone and joint Surgery Center for Osteonecrosis and Joint Preserving and Reconstruction China-Japan Friendship Hospital Beijing 100029 China

Background：Systemic administration ofbisphosphonates has shown promising results in the treatment ofosteonecrosis of the femoral head （ONFH）.However,few studies have evaluated the efficacy of local zoledronate （ZOL） administration in the treatment of *** purpose of this study was to investigate whether local administration of bisphosphonate-soaked hydroxyapatite （HA） could improve bone healing in an experimental rabbit model of ***：This experimental study was conducted between October 2014 and June ***-five rabbits underwent simulated ONFH *** following surgery,they were divided into three groups：model （untreated,n =15）,HA （treated with HA alone,n =15）,and HA ＋ ZOL （treated with HA soaked in a low-dose ZOL solution,n =15）.Histological,immunohistochemical,and quantitative analyses were performed to evaluate bone formation and resorption 2,4,and 8 weeks after ***：Gross bone matrix and hematopoietic tissue formation were observed in the HA ＋ ZOL group 4 weeks after *** immunohistochemical staining intensities for 5-bromodeoxyuridine,runt-related transcription factor 2,osteocalcin,osteopontin,and osteoprotegerin were significantly higher in the HA ＋ ZOL group than that in the model （P 〈 0.001,P 〈 0.001,P 〈 0.001,P 〈 0.001,and P =0.018,respectively） and HA groups （P =0.003,P =0.049,P 〈 0.00l,P =0.020,and P =0.019,respectively）,whereas receptor activator of the nuclear factor-κB ligand staining intensity was significantly lower in the HA ＋ ZOL group than that in the model and HA groups （P =0.029 and P =0.015,respectively） 4 weeks after *** significant differences in bone formation or bone resorption marker expression were found between the three groups 2 or 8 weeks after surgery （P 〉 0.05）.Conclusions：Local administration of HA soaked in a low-dose ZOL solution increased new bone formation while inhibiting bone resorption in an animal model of ONFH,which might provide new evidence for joint-preserving surgery

关键词： Bisphosphonate Bone Repair Femoral Head ttydroxylapatite osteonecrosis Zoledronate

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Corticosteroid-induced osteonecrosis of the Femoral Head:Detection,Diagnosis,and Treatment in Earlier Stages

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Chinese Medical Journal 2017年第21期130卷 2601-2607页

作者： Li-Hua Liu Qing-Yu Zhang Wei Sun Zi-Rong Li Fu-Qiang Gao Peking Union Medical Col ege China-Japan Friendship Institute of Clinical MedicineBeijing 100029China Department of Orthopaedic Surgery Centre for Osteonecrosis and Joint Preserving and ReconstructionChina-Japan Friendship HospitalBeijing 100029China

Objective： This review aimed to provide a current recommendation to multidisciplinary physicians for early detection, diagnosis, and treatment of corticosteroid-induced osteonecrosis of the femoral head （ONFH） based on a comprehensive analysis of the clinical literature. Data Sources： For the purpose of collecting potentially eligible articles, we searched for articles in the PubMed, Cochrane Library, Embase, and CNKI databases up to February 2017, using the following key words：＆quot;corticosteroid＆quot;, ＆quot;osteonecrosis of the femoral head＆quot;,＆quot;risk factors＆quot;, ＆quot;diagnosis＆quot;, ＆quot;prognosis＆quot;, and ＆quot;treatment＆quot;. Study Selection： Articles on relationships between corticosteroid and ONFH were selected for this review. Articles on the diagnosis, prognosis, and intervention of earlier-stage ONFH were also reviewed. Results： The incidence of corticosteroid-induced ONFH was associated with high doses of corticosteroids, and underlying diseases in certain predisposed individuals mainly occurred in the first 3 months of corticosteroid prescription. The enhanced awareness and minimized exposure to the established risk factors and earlier definitive diagnosis are essential for the success of joint preservation. When following up patients with ONFH, treatment should be started if necessary. Surgical treatment yielded better results than conservative therapy in earlier-stage ONFH. The ideal purpose of earlier intervention and treatment is permanent preservation of the femoral head without physical restrictions in daily living. Conclusions： Clinicians should enhance their precaution awareness of corticosteroid-induced ONFH. For high-risk patients, regular follow-up is very important in the 1st year after high-dose prescription of corticosteroids. Patients with suspected ONFH should be referred to orthopedists for diagnosis and treatment in its earlier stage to preserve the joint.

关键词： Corticosteroid Diagnosis osteonecrosis of Femoral Head Prognosis Risk Factors Treatment

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Effects of Lower Limb Alignment and Tibial Component Inclination on the Biomechanics of Lateral Compartment in Unicompartmental Knee Arthroplasty

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Chinese Medical Journal 2017年第21期130卷 2563-2568页

作者： Peng-Fei Wen Wan-Shou Guo Fu-Qiang Gao Qi-Dong Zhang Ju-An Yue Li-Ming Cheng Guang-Duo Zhu Peking University China-Japan Friendship School of Clinical Medicine Beijing 100029China Department of Orthopaedic Surgery Center for Osteonecrosis and Joint Preserving and ReconstructionBeijing Key Laboratory of Arthritic and Rheumatic DiseasesChina-Japan Friendship HospitalBeijing 100029China Beijing University of Chinese Medicine Beijing 100029China

Background： Lateral compartmental osteoarthritis （LCOA）, a major complication after medial mobile-bearing unicompartmental knee arthroplasty （UKA）, is highly associated with the increased stress of the lateral compartment. This study aimed to analyze the effects on the stress and load distribution of the lateral compartment induced by lower limb alignment and coronal inclination of the tibial component in UKA through a finite element analysis. Methods： Eight three-dimensional models were constructed based on a validated model for analyzing the biomechanical effects of implantation parameters on the lateral compartment after medial Oxford UKA： postoperative lower limb alignment of 3° valgus, neutral and 3° varus, and the inclination of tibial components placed in 4°, 2° valgus, square, and 2° and 4° varus. The contact stress of femoral and tibial cartilage and load distribution were calculated for all models. Results： In the 3° valgus lower limb alignment model, the contact stress of femoral （3.38 MPa） and tibial （3.50 MPa） cartilage as well as load percentage （45.78%） was highest compared to any other model, and was increased by 36.75%, 47.70%, and 27.63%, respectively when compared to 3° varus. In the condition of a neutral position, the outcome was comparable for the different tibial tray inclination models. The inclination did not greatly affect the lateral compartmental stress and load distribution. Conclusions： This study suggested that slightly varus （undercorrection） lower limb alignment might be a way to prevent LCOAin medial mobile-bearing UKA. However, the inclination （4° varus to 4° valgus） of the tibial component in the coronal plane would not be a risk factor for LCOA in neutral position.

关键词： Finite Element Analysis Lateral Compartmental Osteoarthritis Lower Limb Alignment Tibial Component Inclination Unicornpartmental Knee Arthroplasty

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Significance of Lateral Pillar in osteonecrosis of Femoral Head:A Finite Element Analysis

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Chinese Medical Journal 2017年第21期130卷 2569-2574页

作者： Peng-Fei Wen Wan-Shou Guo Qi-Dong Zhang Fu-Qiang Gao Ju-An Yue Zhao-Hui Liu Li-Ming Cheng Zi-Rong Li Department of Orthopaedic Surgery Peking University China-Japan Friendship School of Clinical MedicineBeijing 100029China Department of Orthopaedic Surgery Center for Osteonecrosis and Joint Preserving and ReconstructionBeijing Key Laboratory of Arthritic and Rheumatic DiseasesChina-Japan Friendship HospitalBeijing 100029China Beijing University of Chinese Medicine Beijing 100029China

Background： The lateral pillar of the femoral head is an important site for disease development such as osteonecrosis of the femoral head. The femoral head consists of medial, central, and lateral pillars. This study aimed to determine the biomechanical effects of early osteonecrosis in pillars of the femoral head via a finite element （FE） analysis. Methods： A three-dimensional FE model of the intact hip joint was constructed from the image data of a healthy control. Further, a set of six early osteonecrosis models was developed based on the three-pillar classification. The von Mises stress and surface displacements were calculated for all models. Results： The peak values of von Mises stress in the cortical and cancellous bones of normal model were 6.41 MPa and 0.49 MPa, respectively. In models with necrotic lesions in the cortical and cancellous bones, the von Mises stress and displacement of lateral pillar showed significant variability： the stress of cortical bone decreased from 6.41 MPa to 1.51 MPa （76.0% reduction）, while cancellous bone showed an increase from 0.49 MPa to 1.28 MPa （159.0% increase）; surface displacements of cortical and cancellous bones increased from 52.4 μm and 52.1 μm to 67.9 μm （29.5%） and 61.9 μm （18.8%）, respectively. In addition, osteonecrosis affected not only pillars but also adjacent structures in terms of the von Mises stress and surface displacement levels. Conclusions： This study suggested that the early-stage necrosis in the femoral head could increase the risk of collapse, especially in lateral pillar. On the other hand, the cortical part of lateral pillar was found to be the main biomechanical support of femoral head.

关键词： Displacement Finite Element Analysis osteonecrosis of the Femoral Head Stress Structure Collapse

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Interleukin-22 promotes autophagy and inhibits apoptosis in rheumatoid arthritis through targeting the STAT3 pathway in synovial fibroblasts

Interleukin-22 promotes autophagy and inhibits apoptosis in ...

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中国生物化学与分子生物学会第十二届全国会员代表大会暨2018年全国学术会议

作者： Bo Wang Weikun Hou center for Translational Medicine the First Affiliated Hospital of Xi'an Jiaotong University osteonecrosis and joint reconstruction Ward Joint SurgeryXi'an Honghui Hospital

Rheumatoid arthritis(RA) is a common chronic autoimmune inflammatory *** role of autophagy and apoptosis in the pathogenesis of RA is ***-22(IL-22) as a cytokine of Th22 plays a significant and complicated role in inflammatory and autoimmune rheumatic *** propose that IL-22 regulates activation of autophagy and exerts inhibition of apoptosis in synovial fibroblasts,and is thereby essential for development of *** results showed that the concentration of IL-22 in RA was significantly higher than in HC and *** synovial fibroblasts and chondrocytes treated with rhIL-22,the apoptosis was significantly decreased in synovial fibroblasts,but not in *** protein expression of Bcl-2 was increased in a dose-dependent manner,and cleaved Caspase-3 was ***-22 triggered autophagic flux in synovial fibroblasts,which led to autophagy-related proteins Beclin 1 and LC3(8)were significantly *** induced autophagy and inhibited apoptosis were associated with STAT3 phosphorylation though expression of Bcl-2 and Beclin *** and inhibiting STAT3 by inhibitor or by siRNA led to synovial fibroblasts abrogated the effects of *** importantly,the STAT3 pathway could regulate the balance of apoptosis and autophagy in RA synovial *** conclude that IL-22 inhibited apoptosis and promoted autophagy,and this balance was regulated though STAT3 pathway leading to upreglation of Bcl-2 and Beclin 1 in RA synovial *** pathogenic mechanism suggest a strategy for using anti-STAT3 approach to RA treatment.

关键词： Interleukin-22 Apoptosis Autophagy STAT3 Rheumatoid arthritis

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Pericollapse Stage of osteonecrosis of the Femoral Head： A Last Chance for joint Preservation

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Chinese Medical Journal 2018年第21期131卷 2589-2598页

作者： Qing-Yu Zhang Zi-Rong Li Fu-Qiang Gao Wei Sun Department of Orthopaedic Graduate School of Peking Union Medical College China-Japan Friendship Hospital Institute of Clinical Medicine Beijing 100029 China Department of Orthopaedic Centre for Osteonecrosis and Joint-Preserving and Reconstruction China-Japan Friendship Hospital Beijing 100029 China Department of Orthopaedic Peking University China-Japan Friendship School of Clinical Medicine Beijing 100029 China

Objective： To propose a new definition of the pericollapse stage of osteonecrosis of the femoral head （ONFH） and review its significance in disease diagnosis and treatment selection. Data Sources： A search for eligible studies was conducted in three electronic databases including PubMed, Cochrane Library, and Embase up to August 10, 2018, using the following keywords：＂osteonecrosis＂, ＂prognosis＂, and ＂treatment＂. Study Selection： Investigations appraising the clinical signs, symptoms, and imaging manifestations in different stages of ONFH were included. Articles evaluating the prognosis of various joint-preserving procedures were also reviewed. Results： The pericollapse stage refers to a continuous period in the development of ONFH from the occurrence of subchondral fracture to early collapse （〈2 mm）, possessing specific imaging features that mainly consist of bone marrow edema and joint effusion on magnetic resonance imaging （MR1）, crescent signs on X-ray films, and clinical manifestations such as the sudden worsening of hip pain. Accumulating evidence has indicated that these findings may be secondary to the changes after subchondral fractures. Of note. computed tomography provides more information for identifying possible subchondral fractures than does MRI and serves as the most sensitive tool for grading the pericollapse lesion stage. The pericollapse stage may indicate a high possibility of progressive disease but also demonstrates satisfactory long- and medium-term outcomes fbr joint-preserving techniques. In tact, if the articular surface subsides more than 2 mm, total hip arthroplasty is preferable. Conclusions： The pericollapse stage with distinct clinical and imaging characteristics provides a last good opportunity for the use of joint-preserving techniques. It is necessary to separate the pericollapse stage as an independent state in evaluating the natural progression of ONFH and selecting an appropriate treatment regimen.

关键词： joint-preserving Procedure osteonecrosis of the Femoral Head Pericollapse Prognosis

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Reconstructing avascular necrotic femoral head through a bioactiveβ-TCP system:From design to application

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Bioactive Materials 2023年第10期28卷 495-510页

作者： Yajie Lu Xiantao Chen Xiao Lu Changning Sun Minghui Li Guojing Chen Zuoyao Long Yuan Gao Haoqiang Zhang Mengquan Huang Chuanlei Ji Hongbin Fan Dong Liu Yuewen Hao Hong Wang Leilei Zhang Hongmei Zhang Jianxi Lu Zhen Wang Jing Li Department of Orthopedics Xijing HospitalAir Force Medical UniversityXi’an710032China Department of Clinical Oncology Xijing HospitalAir Force Medical UniversityXi’an710032China The State Key Laboratory of Cancer Biology Biotechnology center School of PharmacyAir Force Medical UniversityXi’an710032China Department of osteonecrosis of the Femoral Head Luoyang Orthopedic-Traumatological Hospital of Henan ProvinceLuoyang471002China Shanghai Bio-lu Biomaterials Co. LtdShanghai201100China Shanghai Technology Innovation center of Orthopedic Biomaterials Shanghai201100China State Key Laboratory for Manufacturing System Engineering Xi’an Jiaotong UniversityXi’an710054China National Medical Products Administration(NMPA)Key Laboratory for Research and Evaluation of Additive Manufacturing Medical Devices School of Mechanical EngineeringXi’an Jiaotong UniversityXi’an710054China Department of Orthopedics General Hospital of Northern Theater CommandShenyang110000China Department of Orthopedics The 940th Hospital of Joint Logistics Support Force of People’s Liberation ArmyLanzhou730000China Department of Medical Imaging Xi’an Children’s HospitalXi’an710000China Department of Medical Imaging Xijing HospitalAir Force Medical UniversityXi’an710032China

A variety of techniques have been used for treating avascular necrosis of the femoral head(ANFH),but have frequently *** this study,we proposed aβ-TCP system for the treatment of ANFH by boosting revascularization and bone *** angio-conductive properties and concurrent osteogenesis of the highly interconnected porousβ-TCP scaffold were revealed and quantified through an in vivo model that simulated the ischemic environment of *** test and finite element analysis showed that the mechanical loss caused by tissue necrosis and surgery was immediately partially compensated after implantation,and the strength of the operated femoral head was adaptively increased and eventually returned to normal bone,along with continuous material degradation and bone *** translational application,we further conducted a multi-center open-label clinical trial to assess the efficacy of theβ-TCP system in treating *** hundred fourteen patients with 246 hips were enrolled for evaluation,and 82.1%of the operated hips survived at a 42.79-month median *** imaging results,hip function,and pain scores were dramatically improved compared to preoperative *** stage II disease outperformed stage III in terms of clinical ***,bio-adaptive reconstruction using theβ-TCP system is a promising hip-preserving strategy for the treatment of ANFH.

关键词： Avascular necrosis of the femoral head β-TCP Vascularization Bone regeneration Clinical trial Bioadaptability

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Prevention and management of post-instability glenohumeral arthropathy

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World Journal of Orthopedics 2017年第3期8卷 229-241页

作者： Brian R Waterman Kelly G Kilcoyne Stephen A Parada Josef K Eichinger Department of Orthopaedic Surgery and Rehabilitation William Beaumont Army Medical Center Eisenhower Army Medical center Madigan Army Medical center

Post-instability arthropathy may commonly develop in high-risk patients with a history of recurrent glenohumeral instability,both with and without surgical *** related to anterior shoulder instability,the incidence and rates of arthritic progression may vary *** arthritic changes may be present in up to two-thirds of patients after primary Bankart repair and 30%after Latarjet procedure,with increasing rates associated with recurrent dislocation history,prominent implant position,non-anatomic reconstruction,and/or lateralized bone graft ***,the presence radiographic arthrosis does not predict poor patient-reported *** exhausting conservative measures,both joint-preserving and arthroplasty surgical options may be considered depending on a combination of patient-specific and anatomic *** procedures are optimally indicated for individuals with focal disease and may yield superior symptomatic relief when combined with treatment of combined shoulder *** more advanced secondary arthropathy,total shoulder arthroplasty remains the most reliable option,although the clinical outcomes,wear characteristics,and implant survivorship remains a concern among active,young patients.

关键词： Arthropathy Glenohumeral Dislocation Latarjet Instability

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Molecular events in the jaw vascular unit:A traditional review of the mechanisms involved in inflammatory jaw bone diseases

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生物医学研究杂志:英文版 2023年第5期37卷 313-325页

作者： Ruyu Wang Haoran Wang Junyu Mu Hua Yuan Yongchu Pang Yuli Wang Yifei Du Feng Han Department of Oral and Maxillofacial Surgery the Affiliated Stomatological Hospital of Nanjing Medical UniversityNanjingJiangsu 210029China Jiangsu Province Key Laboratory of Oral Diseases Nanjing Medical UniversityNanjingJiangsu 210029China Jiangsu Province Engineering Research center of Stomatological Translational Medicine NanjingJiangsu 210029China International joint Laboratory for Drug Target of Critical Illnesses Key Laboratory of Cardiovascular and Cerebrovascular MedicineSchool of PharmacyNanjing Medical UniversityNanjingJiangsu 211166China Department of Orthodontics the Affiliated Stomatological Hospital of Nanjing Medical UniversityNanjingJiangsu 210029China.

Inflammatory jaw bone diseases are common in stomatology,including periodontitis,peri-implantitis,medication-related osteonecrosis of the jaw,radiation osteomyelitis of the jaw,age-related osteoporosis,and other specific *** diseases may lead to tooth loss and maxillofacial deformities,severely affecting patients'quality of *** the years,the reconstruction of jaw bone deficiency caused by inflammatory diseases has emerged as a medical and socioeconomic ***,exploring the pathogenesis of inflammatory diseases associated with jaw bones is crucial for improving prognosis and developing new targeted *** evidence indicates that the integrated bone formation and dysfunction arise from complex interactions among a network of multiple cell types,including osteoblast-associated cells,immune cells,blood vessels,and lymphatic ***,the role of these different cells in the inflammatory process and the'rules'with which they interact are still not fully *** many investigations have focused on specific pathological processes and molecular events in inflammatory jaw diseases,few articles offer a perspective of ***,we review the changes and mechanisms of various cell types in inflammatory jaw diseases,with the hope of providing insights to drive future research in this field.

关键词： inflammatory diseases osteogenesis-related cells immune cells blood vessels lymphatic vessels jaw vascular unit

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