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Effect of body mass index on functional outcomes following arthroplasty procedures

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World Journal of Orthopedics 2015年第11期6卷 991-995页

作者： Gokhan Polat Hasan Huseyin Ceylan Safak Sayar Fatih Kucukdurmaz Mehmet Erdil Ibrahim Tuncay Department of orthopaedics and traumatology Istanbul University Istanbul Medical Faculty Department of Orthopedics and traumatology Sultanciftligi LNB State Hospital Department of orthopaedics and traumatology Bezmialem Vakif University Department of orthopaedics and traumatology Istanbul Medipol University

AIM: To evaluate the body mass index(BMI) change in arthroplasty patients and its impact on the patients' functional results. METHODS: Between October 2010 and May 2013, 606 patients who were operated due to gonarthrosis, coxarthrosis, aseptic loosening of the total knee and hip prosthesis were evaluated prospectively. Patients were operated by three surgeons in three medical centers. Patients who were between 30-90 years of age and who were underwent total knee arthroplasty, total hip arthroplasty, revision knee arthroplasty, or revision hip arthroplasty were included in the study. We excluded the patients who cannot tolerate our standard postoperative rehabilitation program. Additionally, patients who had systemic inflammatory diseases, diabetes mellitus, or endochrinopathies were excluded from the study. The remaining 513 patients comprised our study group. Preoperative functional joint scores, height, weightand BMI of all patients were recorded. We used the Knee Society Score(KSS) for knee and Harris Hip Score(HHS) for hip patients. Postoperative functional scores were measured at 1^(st), 6^(th) and 12^(th) months and recorded separately at outpatient visits. RESULTS: The mean age of the patients was 64.7(range: 30-90) years(207 males/306 females) and the mean follow-up duration was 14.3(range: 12-26) mo. We found that arthroplasty patients had weight gain and had an increase in BMI at the postoperative 1^(st), 6^(th) and 12^(th) months. The mean BMI of the patients was 27.7 preoperatively, 27.8 at the postoperative 1^(st) month, 28.1 at the 6^(th) month and 28.6 at the 12^(th) month(P < 0.01). At the last visit, the mean postoperative HHS of the hip arthroplasty patients was 82.2 ± 7.12(preoperatively, 52.3; 1st month, 78.2; 6^(th) month, 81.1; 12^(th) month, 82.2), and the mean KSS of the knee arthroplasty patients was 79.3 ± 4.31(preoperatively, 35.8; 1^(st) month, 75.2; 6^(th) month, 79.1; 12^(th) month, 79.3). Worse functional results were noted in the pati

关键词： Body mass index Arthroplasty Obesity Functional outcomes Weight gain

Epimedium-Derived Flavonoids Modulate the Balance between Osteogenic Differentiation and Adipogenic Differentiation in Bone Marrow Stromal Cells of Ovariectomized Rats via Wnt/β-Catenin Signal Pathway Activation

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Chinese Journal of Integrative Medicine 2012年第12期18卷 909-917页

作者：许应星吴承亮吴岩童培建金红婷俞楠泽肖鲁伟 Research Institution of orthopaedics and traumatology Zhejiang Traditional Chinese Medical University Department of orthopaedics and traumatology Chinese Medicine Hospital The First Clinical Medical College Zhejiang University of Traditional Chinese Medicine

Objective： To observe the function of wnt/β-catenin signal pathway on the process that epimedium-derived flavonoids （EFs） regulate the balance between osteogenic differentiation and adipogenic differentiation in bone marrow stromal ceils of ovariectomized rats, and to provide an experimental evidence for the mechanism of EFs on treating postmenopausal osteoporosis. Methods： Bone marrow stromal cells from ovariectomized rats were separated and cultivated in the condition of osteoinductive medium or liquid medium for 15 days. Low- （1 μg/mL）, medium- （10 μg/mL） and high- （100 μg/mL） dose EFs were administrated correspondingly. Alkaline phosphatase （ALP） staining, ALP activity determination, oil red O staining and real- time polymerese chain reaction （RT-PCR） were used to determine the effect of EFs on osteogenic differentiation and adipogenic differentiation in bone marrow stromal cells of ovariectomized rats. Moreover, in order to explore the mechanism of EFs on osteogenic differentiation and adipogenic differentiation in bone marrow stromal cells of ovariectomized rats, Dickkopf-related protein 1 （DKK1） was used in the medium group. Enzyme linked immunosorbent assay （ELISA） and RT-PCR were used to determine mRNA levels of 13-catenin, low density lipoprotein receptor-related protein 5 （LRP5） and T cell factor （TCF） protein, known as wnt/β-catenin signal pathway related factors. Results： EFs increased mRNA expression levels of ALP and early osteoblast differentiation factors, such as runt-related transcription factor 2 （Runx2）, osteocaicin and collagen I, and decreased mRNA expression levels of fat generation factors, such as peroxisome proliferator activated receptor gamma 2 （PPAR r/-2） and CCAAT enhancer-binding protein-α （C/EBP α） in a dose-dependent manner. While osteobiast differentiation factors were down-regulated, fat generation factors were up-regulated when DKK1 was applied. Also EFs up-regulated mRNA expression levels of β-catenin, LRP5 and TCF protein which

关键词： wnt/β-catenin signal pathway epimedium-derived flavonoids bone marrow stromal cells,osteoporosis osteogenesis adipogenesis cell differentiation

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

Novel Walking Stability-Based Gait Recognition Method for Functional Electrical Stimulation System Control

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Transactions of Tianjin University 2007年第2期13卷 93-97页

作者：明东万柏坤胡勇汪曣王威杰吴英华陆瓞骥 School of Precision Instrument and Opto-Electronics Engineering Tianjin University Department of orthopaedics and traumatology Hong Kong University Department of Orthopaedic and Trauma Surgery University of Dundee Department of traumatology orthopaedics Tianjin Hospital

Gait recognition is the key question of functional electrical stimulation (FES) system control for paraplegic walking. A new risk-tendency-graph (RTG) method was proposed to recognize the stability information in FES-assisted walking gait. The main instrument was a specialized walker dynamometer system based on a multi-channel strain-gauge bridge network fixed on the walker frame. During walking process, this system collected the reaction forces between patient's upper extremities and walker and converted them into RTG morphologic curves of dynamic gait stability in temporal and spatial domains. To demonstrate the potential usefulness of RTG, preliminary clinical trials were done with paraplegic patients. The gait stability levels of two walking cases with 4- and 12-week FES training from one subject were quantified (0.43 and 0.19) from the results of temporal and spatial RTG. Relevant instable phases in gait cycle and dangerous inclinations of patient's body during walking process were also brought forward. In conclusion, the new RTG method is practical for distinguishing more useful gait stability information for FES system control.

关键词： gait recognition functional electrical stimulation parapegic walking risk-tendency-graph

Single nucleotide variations in the development of diabetic foot ulcer: A narrative review

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World Journal of Diabetes 2022年第12期13卷 1140-1153页

作者： Yan-Jun Hu Chen-Sheng Song Nan Jiang Division of orthopaedics and traumatology Department of OrthopaedicsSouthern Medical University Nanfang HospitalGuangzhou 510515Guangdong ProvinceChina

Diabetes mellitus has become a global health problem,and the number of patients with diabetic foot ulcers(DFU)is rapidly ***,DFU still poses great challenges to physicians,as the treatment is complex,with high risks of infection,recurrence,limb amputation,and even ***,a comprehensive understanding of DFU pathogenesis is of great *** this review,we summarized recent findings regarding the DFU development from the perspective of single-nucleotide variations(SNVs).Studies have shown that SNVs located in the genes encoding C-reactive protein,interleukin-6,tumor necrosis factor-alpha,stromal cell-derived factor-1,vascular endothelial growth factor,nuclear factor erythroid-2-related factor 2,sirtuin 1,intercellular adhesion molecule 1,monocyte chemoattractant protein-1,endothelial nitric oxide synthase,heat shock protein 70,hypoxia inducible factor 1 alpha,lysyl oxidase,intelectin 1,mitogen-activated protein kinase 14,toll-like receptors,osteoprotegerin,vitamin D receptor,and fibrinogen may be associated with the development of ***,considering the limitations of the present investigations,future multi-center studies with larger sample sizes,as well as in-depth mechanistic research are warranted.

关键词： Diabetic foot Diabetic foot ulcer Diabetic foot osteomyelitis Single nucleotide variations Narrative review

Internet and social media usage of orthopaedic patients:A questionnaire-based survey

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World Journal of Orthopedics 2017年第2期8卷 178-186页

作者： Tahir Mutlu Duymus Hilmi Karadeniz Mehmet Akif Cacan Baran Komür Abdullah Demirtas Sinan Zehir Ibrahim Azboy Department of orthopaedics Haydarpasa Numune Training and Research Hospital Department of orthopaedics and traumatology Bah?elievler Medikal Park Hospital Department of orthopaedics Bitlis State Hospital Department of orthopaedics Kanuni Sultan Süleyman Training and Research Hospital Department of Orthopedics and traumatology G?ztepe Training and Research HospitalIstanbul Medeniyet University Department of orthopaedics and traumatology Hitit University Faculty of Medicine Department of orthopaedics and traumatology Dicle University Faculty of Medicine

AIM To evaluate social media usage of orthopaedic patients to search for solutions to their health problems. METHODS The study data were collected using face-to-face questionnaire with randomly selected 1890 patients aged over 18 years who had been admitted to the orthopaedic clinics in different cities and provinces across Turkey. The questionnaire consists of a total of 16 questions pertaining to internet and social media usage and demographics of patients, patients' choice of institution for treatment, patient complaints on admission, online hospital and physician ratings, communication between the patient and the physician and its *** It was found that 34.2%(n = 647) of the participants consulted with an orthopaedist using the internet and 48.7%(n = 315) of them preferred websites that allow users to ask questions to a physician. Of all questionaskers, 48.5%(n = 314) reported having found the answers helpful. Based on the educational level of the participants, there was a highly significant difference between the rates of asking questions to an orthopaedist using the internet(P = 0.001). The rate of questionasking was significantly lower in patients with an elementary education than that in those with secondary, high school and undergraduate education(P = 0.001) The rate of reporting that the answers given was helpful was significantly higher in participants with an undergraduate degree compared to those who were illiterate, those with primary, elementary or high school education(P = 0.001). It was also found that the usage of the internet for health problems was higher among managers-qualified participants than unemployed-housewives, officers, workers-intermediate staff(P < 0.05).CONCLUSION We concluded that patients have been increasingly using the internet and social media to select a specific physician or to seek solution to their health problems in an effective way. Even though the internet and social media offer beneficial effects for physician

关键词： Patient Internet Orthopedist Social media Communication

Coverage of soft tissue defect in palm with prefabricated flap

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Chinese Journal of traumatology 2008年第3期11卷 190-192页

作者：张功林蔡国荣章鸣郑良军张燕 Department of orthopaedics Orthopaedics and Traumatology Hospital of Taizhou Wenling 317500 Zhejiang Province China

The coverage of large soft tissue defects in palm remains a challenge in the plastic reconstructive surgery. There are many local tissue transfers described for small-sized defects of hand, whereas large defect require regional flaps such as the radial forearm flap or free tissue transfer,1-5 We used prefabricated flap of the palmar skin to cover the palmar defect and obtained satisfactorv clinical results.

关键词：手掌软组织损伤生物材料再造手术

Biepicondylar fracture dislocation of the elbow joint concomitant with ulnar nerve injury

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World Journal of Orthopedics 2013年第2期4卷 94-97页

作者： M Nuri Konya Ahmet Aslan Hakan Sofu Timur Y?ld?r?m Departmants of orthopaedics and traumatology Afyonkarahisar State Hospital 03030 MerkezAfyonkarahisar Turkey Departmants of orthopaedics and traumatology Suluova State Hospital 05500 Suluova Amasya Turkey Departmants of orthopaedics and traumatology Baltaliman? Bone Disease Hospital 34470 Baltaliman? ?stanbulTurkey

In this article, we present a case of humeral biepicondylar fracture dislocation concomitant with ulnar nerve injury in a seventeen year-old male patient. Physical examination of our patient in the emergency room revealed a painful, edematous and deformed-looking left elbow joint. Hypoesthesia of the little finger was also diagnosed on the left hand. Radiological assessment ended up with a posterior fracture dislocation of the elbow joint accompanied by intra-articular loose bodies. Open reduction-Internal fixation of the fracture dislocation and ulnar nerve exploration were performed under general anesthesia at the same session as surgical treatment of our patient. Physical therapy and rehabilitation protocol was implemented at the end of two weeks post-operatively. Union of the fracture lines, as well as the olecranon osteotomy site, was achieved at the end of four months post-operatively. Ulnar nerve function was fully restored without any sensory or motor loss. Range of motion at the elbow joint was 20-120 degrees at the latest follow-up.

关键词： Elbow injury Fracture dislocation Biepiconylar humeral fracture Ulnar nerve injury

Isolated dorsal approach for the treatment of neglected volar metacarpophalangeal joint dislocations

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World Journal of Orthopedics 2014年第1期5卷 62-66页

作者： Hakan Ba?ar Mustafa Erkan ?nanmaz Kamil ?a?r? K?se Cihangir Tetik Department of Orthopaedic and traumatology Sakarya Training and Research Hospital Department of orthopaedics and traumatology Acibadem Maslak Hospital

Here, we present the clinical and radiological results of three neglected volar metacarpophalangeal dislocations in 2 patients, which were treated with open reductions 10 and 24 mo after the dislocations. There was a mean of a 20°(range 10°-30°) limitation of extension and a 53.3°(range 30°-70°) limitation of flexion preoperatively. Postoperatively, there was no limitation of extension(at 8 and 12 mo) in any of the fingers. In terms of flexion, one finger had full function, one had a 10° and the last one had a 30° limitation of flexion. Two of the fingers presented anesthesia preoperatively, which improved to hypesthesia postoperatively. One finger had hypesthesia, which improved postoperatively. During surgery, a ruptured dorsal capsule was found to have interposed into the joint, making closed reduction impossible. Our experience with these two patients demonstrated that, even in neglected cases, open reduction using an isolated dorsal approach may result in satisfactory clinical andradiological outcomes.

关键词： metacarpophalangeal dislocation Neglected dislocation Surgical treatment Dorsal surgical approach metacarpophalangeal dislocation rehabilitation