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World Journal of Orthopedics 2019年第4期10卷 212-218页

作者： Martin Gathen Grayson Norris Simon Kay Peter V Giannoudis Department of Orthopedics and trauma Surgery University Hospital of Bonn Academic Department of trauma and orthopaedics School of Medicine University of Leeds Plastic and Reconstructive Surgery School of Medicine University of Leeds

BACKGROUND Leiomyosacromas in the Extremities are rare malignant smooth muscle *** radiation therapy, in combination with wide surgical excision allows the best chance of treatment. During the follow up pathological fractures are common complications that can be accompanied by Implant failure and defect situations that are most challenging in their *** SUMMARY We present a case of a 52-year-old female suffering from a pathological fracture of the humeral shaft 10 yr after resection of a Leiomyosarcoma and postoperative radiotherapy. She developed implant failure after retrograde nailing and another failure after revision to double plate fixation. In a two-stage revision, the implants were removed and the huge segmental defect created after debridement was bridged by a compound osteosynthesis with nancy nails and bone cement for formation of the induced membrane. Due to the previous radiotherapy treatment,20 cm of the humeral shaft were declared devascularized but were left in situ as a scaffold. In the second stage, a vascularized fibula graft was used in combination with a double plate fixation and autologous spongiosa grafts for final *** This combinatory treatment approach led to a successful clinical outcome and can be considered in similar challenging cases.

关键词： Humerus Fibular graft Bone tumor Osseous defect Implant failure Leiomyosarcoma Case report

The horizon of bone organoid: A perspective on constructionand application

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Bioactive Materials 2022年第12期7卷 15-25页

作者： Shuangshuang Chen Xiao Chen Zhen Geng Jiacan Su Institute of Translational Medicine Shanghai UniversityShanghai200444China Department of orthopaedics trauma Changhai HospitalSecond Military Medical UniversityShanghai200433China

Bone defects repair and regeneration by various causes such as tumor resection, trauma, degeneration, etc. havealways been a key issue in the clinics. As one of the few organs that can regenerate after adulthood, bone itselfhas a strong regenerative ability. In recent decades, bone tissue engineering technology provides various types offunctional scaffold materials and seed cells for bone regeneration and repair, which significantly accelerates thespeed and quality of bone regeneration, and many clinical problems are gradually solved. However, the bonemetabolism mechanism is complicated, the research duration is long and difficult, which significantly restrictsthe progress of bone regeneration and repair research. Organoids as a new concept, which is built in vitro withthe help of tissue engineering technology based on biological theory, can simulate the complex biologicalfunctions of organs in vivo. Once proposed, it shows broad application prospects in the research of organdevelopment, drug screening, mechanism study, and so on. As a complex and special organ, bone organoidconstruction itself is quite challenging. This review will introduce the characteristics of bone microenvironment,the concept of organoids, focus on the research progress of bone organoids, and propose the strategies for boneorganoid construction, study direction, and application prospects.

关键词： Bone organoid Bone regeneration Scaffold Disease models

Systematic review on the use of autologous matrix-induced chondrogenesis for the repair of articular cartilage defects in patients

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World Journal of Orthopedics 2017年第7期8卷 588-601页

作者： Nafisa Shaikh Matthew K T Seah Wasim S Khan SAS Facility Faculty of Science University of TechnologySydney Department of trauma and orthopaedics Addenbrookes Hospital University College London Institute of orthopaedics and Musculoskeletal Sciences Royal National Orthopaedic Hospital

AIM To systematically review the results of studies looking at autologous matrix-induced chondrogenesis(AMIC) in humans. METHODS A literature search was performed, adhering to the PRISMA guidelines, to review any studies using such techniques in humans. Our initial search retrieved 297 articles listed on MEDLINE, Google Scholar, CINHal and EMBASE. From these studies, 15 studies meeting the eligibility criteria were selected and formed the basis of our systematic *** The study designs, surgical techniques and outcome measures varied between the studies. Although all studies reported improvements in patient outcome measures, this was not necessarily correlated with magnetic resonance imaging findings. Although there were many additional procedures performed, when AMIC was performed in isolation, the results tended to peak at 24 mo before declining. CONCLUSION Although short-term studies suggest improved patient reported outcomes with a variety of scaffolds, surgical techniques and rehabilitation regimes, the literature remains equivocal on whether the defect size and location, and patient factors affect the outcome. Patientbenefit appears to be maintained in the short-tomedium term but more high level studies with extensive and robust validated outcome measures should be conducted to evaluate the medium-and long-term effect of the AMIC procedure.

关键词： Autologous matrix-induced chondrogenesis Cartilage defects Humans,PRISMA

A Simple Classification System for Hip Fractures

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Open Journal of Orthopedics 2014年第5期4卷 137-143页

作者： Kareem Elsorafy Ahmad Machaurab Tamer Kamal Sherief El-Nikety Sunny Deo Department of trauma and orthopaedics at the Great Western Hospital Swindon UK Department of trauma and orthopaedics at the Robert Jones and Agnes Hunt Orthopaedic Hospital Oswestry UK Department of trauma and orthopaedics at the Royal National orthopaedics Hospital London UK

Background: We have developed a Hip Fracture Classification which stratifies patients into 4 groups upon admission according to fracture complexity. This classification considers patho-anatomic and physiologic parameters and was developed to help identify high-risk patients, with more surgical demands and consequently higher incidence of morbidity. Materials and Methods: Data was gathered prospectively for a cohort of 273 consecutive patients admitted over a 12- month period between 2008 and 2009 and classified according to the Hip Fracture Complexity Classification (C0 - C3). The following outcome measures (mortality and length of hospital stay) were reviewed at thirty days and one year. Result: The overall mortality was 4.4% at 30 days and 20% at 1 year. There were significant differences in 1-year mortality between all stratified groups

关键词： Hip Fracture Mortality Death Classification Stratification

Management of acute spinal cord injury:A summary of the evidence pertaining to the acute management,operative and non-operative management

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World Journal of Orthopedics 2020年第12期11卷 573-583页

作者： Darren Sandean Department of trauma and orthopaedics University Hospitals of Leicester NHS TrustLeicester LE15WWUnited Kingdom

Acute traumatic spinal cord injury is often a lifechanging and devastating event with considerable mortality and *** half a million people suffer from traumatic spinal cord injury annually with the majority resulting from road traffic accidents or *** Individual,societal and economic costs are *** recognition and treatment of acute traumatic spinal cord injury are crucial to limit secondary injury to the spinal cord and to provide patients with the best chance of some functional *** article is an overview of the management of the acute traumatic spinal cord injury patient presenting to the emergency *** review the initial assessment,criteria for imaging and clearing the spine,and evaluate the literature to determine the optimum timing of surgery and the role of non-surgical treatment in patients presenting with acute spinal cord injury.

关键词： traumatic spinal cord injury Acute management Spinal fracture Vertebral fracture Spinal cord transection traumatic myelopathy

Wrist joint moments of walker-assisted gait:a study of biomechanics and instrumentation

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仪器仪表学报 2007年第9期28卷 1537-1542页

作者： Ming Dong Wang Weijie Wan Baikun Hu Yong Department of Biomedical Engineering and Scientific Instrument Tianjin University Tianfin 300072 China Department of Orthopaedic and trauma Surgery University of Dundee UK Department of orthopaedics and traumatology Hong Kong University Hong Kong SAR China

While walkers are commonly prescribed to improve patient stability and ambulatory ability,quantitative study of the biomechanical and functional requirements for effective walker use is *** investigate the changes in wrist joint moments that occur with the use of a standard walker,a strain gauge-based walker instrumentation sys- tem was developed for the measurement of wrist joint *** walker dynamometer was integrated with an up- per extremity biomechanical *** system data were collected for twelve healthy,right-handed young a- dults following informed *** upper extremity kinematic data were acquired with a six-camera motion a- nalysis *** joint moments at the wrist were determined in the three clinical planes using the inverse dy- namics *** showed that during a walker-assisted gait there were several typical demands of wrist abduc- tor,adductor,flexor and external *** interesting'bare phase'of wrist joint moments was also found in phase angle[-30°,30°]of gait *** description of wrist joint moments during walker-assisted gait may pro- vide insight into walker use parameters and rehabilitative strategies.

关键词：生物力学仪表助行器辅助步法桡腕关节矩

Relationships among body weight,lipids and bone mass in elderly individuals with fractures:A case-control study

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世界骨科杂志:英文版 2023年第9期14卷 720-732页

作者： Xiang-Xu Chen Chu-Wei Tian Li-Yong Bai Ya-Kuan Zhao Cheng Zhang Liu Shi Yuan-Wei Zhang Wen-Jun Xie Huan-Yi Zhu Hui Chen Yun-Feng Rui Department of orthopaedics Trauma CenterSoutheast UniversityNanjing 210009Jiangsu ProvinceChina Department of orthopaedics Zhongda HospitalSchool of MedicineSoutheast UniversityNanjing 210009Jiangsu ProvinceChina

BACKGROUND The prevalence of osteoporosis and low bone mass is steadily rising each *** body weight is commonly linked to diminished bone mass and serves as a robust predictor of ***,the connection between body mass index(BMI),bone mineral density,and lipid profiles among the elderly remains *** To examine the association between BMI and bone mass,explore the correlation between lipid profiles and bone mass,and delve into the interplay between lipid metabolism and bone *** The study included 520 patients aged≥65 years(178 men and 342 women).Age,sex,weight,and height were *** neck bone mineral density and T scores were determined using a dual-energy X-ray absorptiometry *** calcium(Ca),phosphorus(P),albumin(ALB),alkaline phosphatase(ALP),aspartate aminotransferase,alanine aminotransferase,triglyceride(TG),total cholesterol(TC),high-density lipoprotein(HDL)and low-density lipoprotein(LDL)levels were *** were classified by sex(male and female),age(65-79 years and≥80 years),and T score(normal bone mineral density,osteopenia and osteoporosis).RESULTS Age,sex,BMI,and ALP and TG levels were independent risk factors for *** the 65-79-and≥80-yearold groups,females presented lower T scores than ***,P,ALB,ALP,TC,HDL and LDL levels were significantly different between men and women in the 65-79-year-old *** addition,BMI and TG levels were significantly decreased in osteoporotic patients compared with patients with normal bone *** levels declined in 65-to 79-year-old male and female osteoporosis *** the group of women aged≥80 years,osteoporotic patients showed significantly increased ALP ***,we found positive correlations between BMI and TG levels in the male and female patient ***,we found no significant differences in ALB,Ca,P,HDL and LDL levels in osteoporotic patients compared to patients with normal bone *** Osteoporotic

关键词： Osteoporosis Weight loss Elderly patients Body mass index Lipid profiles

Excision of trochanteric bursa during total hip replacement:Does it reduce the incidence of post-operative trochanteric bursitis?

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World Journal of Orthopedics 2023年第7期14卷 533-539页

作者： Wai-Huang Teng Adeel Ditta Jane Webber Oliver Pearce Division of trauma and orthopaedics Milton Keynes University HospitalMilton Keynes MK65LDUnited Kingdom

BACKGROUND Trochanteric bursitis is a common complication following total hip replacement(THR),and it is associated with high level of disability and poor quality of *** of the trochanteric bursa prophylactically during THR could reduce the occurrence of post-operative trochanteric *** To evaluate whether synchronous trochanteric bursectomy at the time of THR affects the incidence of post-operative trochanteric *** This retrospective cohort study was conducted in the secondary care setting at a large district general *** January 2010 and December 2020,954 patients underwent elective primary THR by two contemporary arthroplasty surgeons,one excising the bursa and the other not(at the time of THR).All patients received the same post-operative rehabilitation and were followed up for 1 *** reviewed all cases of trochanteric bursitis over this 11-year period to determine the incidence of post-THR *** proportion Z-test was used to compare incidences of trochanteric bursitis between *** 554 patients underwent synchronous trochanteric bursectomy at the time of THR whereas 400 patients did not.A total of 5 patients(incidence 0.5%)developed trochanteric bursitis following THR;4 of whom had undergone bursectomy as part of their surgical approach,1 who had *** was no statistically significant difference between the two groups(Z value 1.00,95%CI:-0.4%to 1.3%,P=0.32).There were also 8 other patients who had both trochanteric bursitis and hip osteoarthritis prior to their THR;all of whom were treated with THR and synchronous trochanteric bursectomy,and 7 had resolution of their lateral buttock pains but 1 did *** Synchronous trochanteric bursectomy during THR does not materially affect the incidence of post-operative ***,it is successful at treating patients with known trochanteric bursitis and osteoarthritis requiring THR.

关键词： Total hip replacement Trochanteric bursectomy Trochanteric bursitis Greater trochanteric pain syndrome

Risk of methicillin-resistant staphylococcus aureus prosthetic joint infection in elective total hip and knee arthroplasty following eradication therapy

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World Journal of Orthopedics 2021年第11期12卷 842-849页

作者： Benjamin Pal Kapur Xenia Tonge Gunasekaran Kumar trauma and orthopaedics Royal Liverpool University Teaching HospitalsLiverpool L78XPMerseysideUnited Kingdom

BACKGROUND Prosthetic joint infection(PJI)is a devastating complication requiring prolonged treatment and multiple operations,leading to significant morbidity for the *** are routinely tested for methicillin-resistant staphylococcus aureus(MRSA)*** positive patients are given eradication *** hypothesise that patients who are MRSA positive pre-operatively,have increased risk of developing *** To identify deep wound infection(PJI)rates in patients who are colonised MRSA positive compared with those who are not colonised;and long term clinical and radiological *** All patients who underwent total hip and knee replacements(THR/TKR)between December 2009 and December 2019 were *** who were also identified as being MRSA positive at pre-operative assessment were then *** of prescribing eradication treatment was *** records,including consultation letters,operation notes and microbiology results were reviewed *** of outcomes for each MRSA positive patient was made with 2 MRSA negative patients undergoing the same operation of a similar age by the same *** Screening identified 42 knee and 32 hip arthroplasty patients as MRSA positive,84 MRSA negative knee and 64 hip patients were *** were matched with medical co-morbidities in each *** follow up was 5 *** was identified in 4/32(12.5%)of THR MRSA positive and 3/42(7%)of TKR *** patients had PJI within one year of *** MRSA positive patients are given eradication therapy ***,no confirmation of eradication is *** who have MRSA colonisation preoperatively,in our study had a significantly increased risk of PJI,when compared to negative *** would recommend establishing true eradication after treatment prior to arthroplasty.

关键词： Hip Knee Prosthetic joint infection

Trochanteric bursitis information on the internet;can we trust the information presented?

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World Journal of Orthopedics 2020年第10期11卷 473-474页

作者： Richard Tyrrell Martin Kelly Cian Kennedy Department of trauma and orthopaedics University Hospital LimerickLimerick V94 F858Ireland

Trochanteric bursitis is one of the most common causes of lateral hip pain in *** prevalence of unilateral trochanteric bursitis is 15.0%in women and 8.5%in *** to internet based information has increased dramatically and health related information is now one of the most popular searches in online activity,despite this the quality of information can *** objective of this paper is to examine the quality and readability of internet based information of trochanteric ***,we have found a high variability among not only the quality but also the readability of information *** that appeared first on each search engine for trochanteric bursitis did not necessarily score better,demonstrating the importance of providing patients with high quality *** articles should use more critical appraisal tools in order to provide the reader with more high quality and readable information.

关键词： Internet Quality Readability DISCERN Journal of American Medical Association Flesh Reading Ease