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Chinese Journal of Traumatology 2005年第1期8卷 3-7页

作者：汤亭亭徐小良戴尅戎郁朝锋岳冰楼觉人 Bone and Joint Research center Department of Orthopaedic Surgery Shanghai Ninth People's Hospital Shanghai 200011 China orthopaedic Research Laboratory Department of Orthopaedic Surgery Washington University School of Medicine in St. Louis MO USA

Objective: To evaluate the osteogenic potential of bone morphogenetic protein (BMP)-2 gene transfected goat bone marrow-derived mesenchymal stem cells (MSCs). Methods: Goat bone marrow- derived MSCs were transfected by Adv-human bone morphogenetic protein (hBMP)-2 gene(group 1), Adv-beta gal transfected MSCs (group 2)and uninfected MSCs(group 3). Western blot analysis, alkaline phosphatase staining, Von Kossa staining and transmission electron microscopy were adopted to determine the phenotype of MSCs. Then the cells were injected into thigh muscles of the nude mice. Radiographical and histological evaluations were performed at different intervals. Results: Only Adv-hBMP-2 transfected MSCs produced hBMP-2. These cells were positive for alkaline phosphatase staining at the 12th day and were positive for Von Kossa staining at the 16th day after gene transfer. Electron microscopic observation showed that there were more rough endoplasmic reticulum, mitochondria and lysosomes in Adv-hBMP-2 transfected MSCs compared to MSCs of other two groups. At the 3rd and 6th weeks after cell injection, ectopic bones were observed in muscles of nude mice of group 1. Only fibrous tissue or a little bone was found in other two groups. Conclusions: BMP-2 gene transfected MSCs can differentiate into osteoblasts in vitro and induce bone formation in vivo.

关键词： Bone morphogenetic proteins Gene therapy Mesenchymal stem cells Mice, nude

Reducing costly falls after total knee arthroplasty

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World Journal of Orthopedics 2018年第10期9卷 198-202页

作者： Surajudeen Adebola Bolarinwa Wendy Novicoff Quanjun Cui Department of orthopaedic Surgery University of Virginia Health System

AIM To investigate whether adductor canal nerve block(ACB) reduces patient falls when compared to femoral nerve block(FNB) after total knee arthroplasty(TKA). METHODS We conducted an institutional review of all-cause falls after TKA from January 2013 to August 2016 using a quality improvement database. Our inclusion criteria were patients with diagnosis of primary knee osteoarthritis who underwent primary unilateral TKA with either a FNB or an ACB and sustained a fall during their hospitalization. We excluded patients who had revision TKA and extensor mechanism reconstruction. We also excluded patients with a history of post-traumatic arthritis, prior history of lower extremity fracture, history of neurological disease, or cerebrovascular disease. RESULTS A total of 834 patients had TKA with femoral nerve block and knee immobilizer(FNB + KI). Of those patients, 11(1.3%) experienced a fall during their hospital stay. In contrast, 791 patients had TKA with ACB. Of those patients, only one(0.13%) patient fall was recorded within this group. We used the Fisher's exact test to compare the differences between the two groups. The difference between the two groups achieves statistical significance(P = 0.006). We also found that 11 out of the 12 patients that fell had a right TKA procedure while one patient had a left TKA procedure. Nine out of twelve patients that fell were female, while only three patients were *** Given the reduction in the number of falls with ACB, it is recommended that ACB be considered the preferred analgesia for patients undergoing a TKA procedure.

关键词： Reducing falls Adductor canal nerve block Total knee arthroplasty Femoral nerve block Costly falls

Effect of Huqian Wan on liver-Yin and kidney-Yin deficiency patterns in patients with knee osteoarthritis

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Journal of Traditional Chinese Medicine 2015年第4期35卷 417-421页

作者： Chen Qiqing Jin Hongting He Bin Wang Liang Xiao Luwei Tong Peijian the First Clinical Medical College Zhejiang Chinese Medical University Department of orthopaedic Surgery Gansu Provincial Hospital of TCM Institute of orthopaedics and Traumatology of Zhejiang Province Zhejiang Chinese Medical University Department of orthopaedic Surgery the First Affiliated Hospital of Zhejiang Chinese Medical University

OBJECTIVE: To observe the curative effect of Huqian Wan on liver and kidney-Yin deficiency knee osteoarthritis(KOA).METHODS: One hundred patients were randomly divided into a treatment(50 patients) and control group(50 patients). In the treatment group, patients orally took the Chinese medicine Huqian Wan. Control group patients orally took Votalin, 75 mg, once a day, for 8 weeks. The visual analog scale(VAS), Western Ontario and Mc Master University Osteoarthritis Index(WOMAC), and Medical Outcomes Study Short Form 36-Item Health Survey(SF36) were used to evaluate the curative effect before treatment and after 8 and 16 weeks of ***: VAS and WOMAC scores significantly decreased and SF 36 scores significantly increased after treatment in both groups compared with before treatment(P groups at week 16(P groups(P group(P > 0.05).CONCLUSION: Huqian Wan could effectively improve the clinical symptoms and quality of life in patients with KOA. It could also have a better and longer lasting curative effect without obvious adverse events compared with Votalin.

关键词： Osteoarthritis Knee Liver kidney Yin deficiency Treatment outcome Huqian Wan

Digital templating in total hip arthroplasty:Additional anteroposterior hip view increases the accuracy

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World Journal of Orthopedics 2017年第1期8卷 30-35页

作者： Sophia K Stigler Franz J Müller Sebastian Pfaud Michael Zellner Bernd Füchtmeier Clinic for Trauma Orthopaedic and Sports MedicineHospital Barmherzige Brüder

AIM To analyze planning total hip arthroplasty(THA) with an additional anteroposterior hip view may increases the accuracy of preoperative planning in *** We conducted prospective digital planning in 100 consecutive patients: 50 of these procedures were planned using pelvic overview only(first group), and the other 50 procedures were planned using pelvic overview plus antero-posterior(a.p.) hip view(second group). The planning and the procedure of each patient were performed exclusively by the senior surgeon. Fifty procedures with retrospective analogues planning were used as the control group(group zero). After the procedure, the planning was compared with the eventually implanted components(cup and stem). For statistic analysis the x^2 test was used for nominal variables and the t test was used for a comparison of continuous *** Preoperative planning with an additional a.p. hip view(second group) significantly increased the exact component correlation when compared to pelvic overview only(first group) for both the acetabular cup and the femoral stem(76% cup and 66% stem vs 54% cup and 32% stem). When considering planning ± 1 size, the accuracy in the second group was 96%(48 of 50 patients) for the cup and 94% for the stem(47 of 50patients). In the analogue control group(group zero), an exact correlation was observed in only 1/3 of the *** Digital THA planning performed by the operating surgeon and based on additional a.p. hip view significantly increases the correlation between preoperative planning and eventual implant sizes.

关键词： Digital Templating Preoperative planning Hip view Total hip arthroplasty

Three-dimensional analysis of age and sex differences in femoral head asphericity in asymptomatic hips in the United States

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World Journal of Orthopedics 2024年第8期15卷 754-763页

作者： Mahad M Hassan Aliya G Feroe Brenton W Douglass Andrew E Jimenez Benjamin Kuhns Charles F Mitchell Robert L Parisien Daniel A Maranho Eduardo N Novais Young-Jo Kim Ata M Kiapour Department of Orthopedic Surgery University of MinnesotaMinneapolisMN 55454United States Department of Orthopedic Surgery TRIA Orthopaedic CenterBloomingtonMN 55122United States Department of Orthopedic Surgery Boston Children’s HospitalBostonMA 02115United States Department of Orthopedic Surgery Mayo ClinicRochesterMN 55901United States Department of orthopaedics and Rehabilitation Yale School of MedicineNew HavenCT 06510United States Department of Orthopedic Surgery American Hip Institute Research FoundationDes PlainesIL 60018United States Department of Orthopedic Surgery Mount SinaiNew YorkNY 10029United States Department of Biomechanics Medicineand Rehabilitation of the Locomotor SystemRibeirao Preto Medical SchoolUniversity of São PauloRibeirao Preto 14048-900São PauloBrazil

BACKGROUND The sphericity of the femoral head is a metric used to evaluate hip pathologies and is associated with the development of osteoarthritis and femoral-acetabular *** To analyze the three-dimensional asphericity of the femoral head of asymptomatic pediatric *** hypothesized that femoral head asphericity will vary significantly between male and female pediatric hips and increase with age in both *** Computed tomography scans were obtained on 158 children and adolescents from a single institution in the United States(8-18 years;50%male)without hip *** femoral measurements including the femoral head diameter,femoral head volume,residual volume,asphericity index,and local diameter difference were used to evaluate femoral head *** In both sexes,the residual volume increased by age(P13 years)in females,there were no sex-differences in residual volume and aspherity *** were no age-related changes in mean diameter difference in both sexes(P=0.07)with no significant sex-differences across different age groups(P=0.06).In contrast,there were significant increases in local aspherity(maximum diameter difference)across whole surface of the femoral head and all quadrants except the inferior regions in males(P=0.03).There were no sex-differences in maximum diameter difference at any regions and age group(P>0.05).Increased alpha angle was only correlated to increased mean diameter difference across overall surface of the femoral head(P=0.024).CONCLUSION There is a substantial localized asphericity in asymptomatic hips which increases with age *** 2D measured alpha angle can capture overall asphericity of the femoral head,it may not be sensitive enough to represent regional asphericity patterns.

关键词： Hip Femoral head Sphericity Skeletal growth Sex differences

Fragility of statistically significant findings from randomized clinical trials of surgical treatment of humeral shaft fractures:A systematic review

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World Journal of Orthopedics 2022年第9期13卷 825-836页

作者： Stephen Craig Morris Anirudh K Gowd Avinesh Agarwalla Wesley P Phipatanakul Nirav H Amin Joseph N Liu Department of orthopaedic Surgery Loma Linda UniversityLoma LindaCA 92354United States Department of orthopaedic Surgery Wake Forest University Baptist Medical CenterWinston-SalemNC 27157United States Department of orthopaedic Surgery Westchester Medical CenterValhallaNY 10595United States Department of orthopaedic Surgery Premier Orthopaedic and Trauma SpecialistsPomonaCA 91767United States Department of Orthopedic Surgery USC Epstein Family Center for Sports MedicineLos AngelesCA 90089United States

BACKGROUND Despite recent meta-analyses of randomized controlled trials(RCTs),there remains no consensus regarding the preferred surgical treatment for humeral shaft *** fragility index(FI)is an emerging tool used to evaluate the robustness of RCTs by quantifying the number of participants in a study group that would need to switch outcomes in order to reverse the study *** To investigate the fragility index of randomized control trials assessing outcomes of operative fixation in proximal humerus *** We completed a systematic review of RCTs evaluating the surgical treatment of humeral shaft *** criteria included:articles published in English;patients randomized and allotted in 1:1 ratio to 2 parallel arms;and dichotomous outcome *** FI was calculated for total complications,each complication individually,and secondary surgeries using the Fisher exact test,as previously *** Fifteen RCTs were included in the analysis comparing open reduction plate osteosynthesis with dynamic compression plate or locking compression plate,intramedullary nail,and minimally invasive plate *** median FI was 0 for all parameters *** individual outcomes,the FI was 0 for 81/91(89%)of *** FI exceeded the number lost to follow up in only 2/91(2%)*** The FI shows that data from RCTs regarding operative treatment of humeral shaft fractures are fragile and does not demonstrate superiority of any particular surgical technique.

关键词： Humerus fracture Open reduction internal fixation Intramedullary nail Fragility index Complications Fragility index

An all-silk-derived functional nanosphere matrix for sequential biomolecule delivery and in situ osteochondral regeneration

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Bioactive Materials 2020年第4期5卷 832-843页

作者： Wei Zhang Chen Ling Aini Zhang Haoyang Liu Yujie Jiang ,Xiaolong Li Renwang Sheng Qingqiang Yao Jialin Chen School of Medicine Southeast University210009NanjingChina Department of orthopaedic Surgery Institute of Digital MedicineNanjing First HospitalNanjing Medical University210006NanjingChina Jiangsu Key Laboratory for Biomaterials and Devices Southeast University210096NanjingChina China Orthopedic Regenerative Medicine group(CORMed) China

Endogenous repair of osteochondral defect is usually limited by the insufficient number of cells in the early stage and incomplete cell differentiation in the later *** development of drug delivery systems for sequential release of pro-migratory and pro-chondrogenic molecules to induce endogenous bone marrow-derived mesenchymal stem cells(BMSCs)recruitment and chondrogenic differentiation is highly desirable for in situ osteochondral *** this study,a novel,all-silk-derived sequential delivery system was fabricated by incorporating the tunable drug-loaded silk fibroin(SF)nanospheres into a SF porous *** loading efficiency and release kinetics of biomolecules depended on the initial SF/polyvinyl alcohol(PVA)concentrations(0.2%,1%and 5%)of the nanospheres,as well as the hydrophobicity of the loaded molecules,resulting in controllable and programmed delivery *** findings indicated that the 5%nanosphere-incorporated matrix showed a rapid release of E7 peptide during the first 120 h,whereas the 0.2%nanosphere-incorporated matrix provided a slow and sustained release of Kartogenin(KGN)longer than 30 *** in vitro culture of BMSCs,this functional SF matrix incorporated with E7/KGN nanospheres showed good biocompatibility,as well as enhanced BMSCs migration and chondrogenic differentiation through the release of E7 and ***,when implanted into rabbit osteochondral defect,the SF nanosphere matrix with sequential E7/KGN release promoted the regeneration of both cartilage and subchondral *** work not only provided a novel all-silk-derived drug delivery system for sequential release of molecules,but also a functional tissueengineered scaffold for osteochondral regeneration.

关键词： Osteochondral regeneration Silk Sequential delivery BMSCs Nanospheres

Volar locking distal radius plates show better short-term results than other treatment options: A prospective randomised controlled trial

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World Journal of Orthopedics 2016年第10期7卷 687-694页

作者： Herwig Drobetz Lidia Koval Patrick Weninger Ruth Luscombe Paula Jeffries Stefan Ehrendorfer Clare Heal orthopaedic Department Mackay Base Hospital James Cook University School of Medicine and Dentistry orthopaedic Department the Prince Charles Hospital orthopaedic Hospital Speising Mathematical Science School Queensland University of Technology orthopaedic Department Kantons Hospital Uri Department of General Practice Mackay Base Hospital James Cook University School of Medicine and Dentistry Anton Breinl Research Centre for Health Systems Strengthening James Cook University

AIM To compare the outcomes of displaced distal radius fractures treated with volar locking plates and with immediate postoperative mobilisation with the outcomes of these fractures treated with modalities that necessitate 6 wk wrist *** A prospective, randomised controlled single-centre trial was conducted with 56 patients who had a displaced radius fracture were randomised to treatment either with a volar locking plate(n = 29), or another treatment modality(n = 27; cast immobilisation with or without wires or external fixator). Outcomes were measured at 12 wk. Functional outcome scores measured were the Patient-Rated Wrist Evaluation(PRWE) Score; Disabilities of the Arm, Shoulder and Hand and activities of daily living(ADLs). Clinical outcomes were wrist range of motion and grip strength. Radiographic parameters were volar inclination and ulnar *** Patients in the volar locking plate group had significantly better PRWE scores, ADL scores, grip strength and range of extension at three months compared with the control group. All radiological parameters were significantly better in the volar locking plate group at 3 mo. CONCLUSION The present study suggests that volar locking plates produced significantly better functional and clinical outcomes at 3 mo compared with other treatment modalities. Anatomical reduction was significantly more likely to be preserved in the plating group. Level of evidence: Ⅱ.

关键词： Volar locking distal radius plate Prospective randomised controlled Postoperative mobilisation Distal radius fracture Short-term outcome

Prevention effect of medical self-crosslinking sodium hyaluronate gel on epidural scar adhesion after laminectomy

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Asian Pacific Journal of Tropical Medicine 2014年第6期7卷 501-504页

作者： Hua Liu Hai-Feng Li Jian-Yuan Wang orthopaedic Department of PLA 474 Hospital Spinal Surgery Department of of First Affiliated Hospital of Xinjiang University

Objective:To analyze the effect and medical sclf-crosslinking sodium hyaluronate gel on epidural scar adhesion after ***:A total of 24 New Zealand L5 laminectomy rabbits were randomly divided into four groups,group A as the control group without any treatment:group B covered by sodium hyaluronate gel;group C and group D covered by 0.5 and1.0 mL medical self-crosslinking sodium hyaluronate *** rabbits were scored at various time points after 2.4,6,8,12 weeks,then the formation of scar was ***:In groups B,C,D loose scar tissue occurred after 2 weeks of the operation,scar tissues were significantly less than that in group A,with mild inflammatory *** 8 weeks,the scar tissues of group B were significantly more than that of groups C,*** two weeks,group B,C were back to the preoperative level;After 4 weeks,group D was back to the preoperative level;After four weeks,the CSEP of group A was increased significantly,which was significantly higher than that in groups B,C,*** motor function score of group A,group B and group C were the same as preoperative,but that in group D it was decreased significantly,and then it gradually *** 4 weeks it kept a stable *** motor function score of group A was decreased gradually after the operation,which kept a stable level after 4 weeks,the motor function score was significantly lower man that in groups B,C,***:Determination of somatosensory evoked potentials is sensitive indicator of spinal cord injury;Application of medical selfcrosslinking sodium hyaluronate gel is effective on epidural scar adhesion after laminectomy.

关键词： Animal Hyaluronic acid Laminectomy Induced potentials Somatosensory

Reconstruction of tendon losses

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Plastic and Aesthetic Research 2023年第1期10卷 270-294页

作者： Maddalena Bertolini Carlotta Faccenda Chiara Parolo Sara Stucchi Andrea Marchesini FrancescoDe Francesco Michele Riccio Department of orthopaedic and Traumatology Hand and Microsurgery UnitOrthopaedic and Trauma CentreAOU CittàDella Salute E Della Scienza Di TorinoTurin 10126Italy University Department of Hand Surgery and Rehabilitation San Giuseppe HospitalIRCCS MultiMedica GroupMilan 20123Italy Department of Plastic and Reconstructive Surgery Hand Surgery UnitAzienda Ospedaliero Universitaria delle MarcheAncona 60121Italy

This review discusses the latest literature-based evidence on reconstructive strategies following tendon losses,with a final focus on the innovative regenerative *** improvements in primary tendon repair techniques have radically reduced the failure rate and therefore decreased the use of reconstructive ***,in specific conditions,such as crush injuries with loss of substance,avulsion injuries and inveterate injuries,the tendon gap cannot be repaired with a primary suture,making the procedure much more challenging for the *** article aims to guide the treatment of tendon losses,which is still a complex topic in hand surgery.

关键词： Tendon losses tendon reconstruction hand surgery