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To detect the cartilage changes of hip joint with osteonecrosis of femoral head (ONFH) in stages II and III and provide evidence for understanding cartilage changes of femoral head of osteonecrosis before collapse.The cartilage changes of ONFH were determined by delayed gadolinium enhanced magnetic resonance imaging of cartilage (dGEMRIC). According to ARCO classification of ONFH, the samples were divided into three groups: Group A, 11 hips, stageII; Group B, 13 hips, stage III; Group C, 10 hips, normal. All participates underwent the tests by dGEMRIC. And the data of T1Gd were collected and analyzed.The values of T1Gd were 420 ± 60 (Group A), 361 ± 54(Group B) and 538 ± 26 (Group C) respectively. There was a significant difference among three groups. The values of T1Gd in the ONFH patients were lower than their healthy counterparts. The values of TIGd of Group B was 14% lower than those of Group A. And the difference was significant statistically.Cartilage of the femoral head undergoes abnormal metabolic changes before collapse. There is a loss of GAG in the cartilage and it aggravates with the worsening of ONFH.

To understand the curve of thoracolumbar junction in patients with thoracolumbar intervertebral disc herniation and analyze the relation between thoracolumbar intervertebral disc herniation and spinal sagittal curve.The radiographic films of thoracolumbar junction of spine from 27 patients with thoracic disc herniation and 37 healthy persons as control were taken at reclining position. The Cobb angles of sagittal plane of thoracolumbar junction of spine were measured and statistically compared by SPSS (statistics package for social science).The Cobb angles of T10-L2, T10-L12 and T12-L2 in patients with thoracolumbar intervertebral disc herniation were greater than those in healthy controls respectively.The Cobb angles of sagittal plane of thoracolumbar junction of spine in patients with thoracolumbar intervertebral disc herniation are greater than those in healthy controls. The abnormal spinal curve is possibly responsible for thoracolumbar intervertebral disc herniation by abnormal biomechanical action.

To assess the efficacy of UKA versus HTO in the treatment of unicompartmental knee osteoarthritis.Comparative studies of UKA and HTO were retrieved from the domestic and foreign literatures and included for a meta-analysis.Seven eligible randomized controlled trials included 196 UKAs and 219 HTOs. The result of Meta-analysis indicated that the ratio for an excellent outcome was higher in UKA than HTO. The combined OR was 2.43, 95%CI (1.46, 4.05) (P = 0.0006). The risks of revision and complications were lower in UKA than HTO. The combined OR was 0.47 and 0.24 and 95%CI (0.23, 0.97), (0.10, 0.56).UKA reduces the risk of postoperative revision and complications and provides excellent outcomes.

To investigate the changes of structure and metabolism of the cartilage of femoral head overlying the bone defect in animal model and analyse the possible effect of the necrotic area of the femoral head on the cartilage overlying there.18 adult hybrid dogs was applied for bone defect model of femoral head. Of the femoral heads, the left was applied for bone defect model, the right for shame-operation. 5, 5, and 8 animals were sacrificed respectively 4, 12 and 24 weeks after operation and the femoral heads were received for examinations. The X-rays films were taken just before the animals were sacrificed. After the cartilage specimens were decalcified, dehydrated and embedded, sections 6, u thick were made. They were stained with hematoxylin-eosin, sirius-red and toilude blue. The biochemical assay were performed.12 and 24 weeks after operation of bone defect, cartilage histology and biochemistry demonstrated the signs of articular cartilage pathological changes. The arrangement of chondrocytes were disorder. The number of chondrocytes decreased. The cartilage surface lost its smoothness, and these kinds of changes were more severe in the area next to the bone defect. Fibrosis and vasi formation were found. Tidemark had the changes of discontinuation and veil. Glycosaminoglycans decreased.The bone defect, whose damaged structure strength and decreased blood supply is similar, had effect on the structure and metabolism of the articular cartilage near the bone defect, and suggest osteonecrosis at the stage of pro-collapse may affect the cartilage overlying it.

To investigate the hematological changes and related gene mutation of post-severe acute respiratory syndrome (SARS) patients with osteonecrosis so as to find the sensitive molecular symbols for early screening of the high risk populations.Fast peripheral venous blood samples were collected from 61 post-SARS patients with osteonecrosis, 25 males and 36 females, aged 30.4 (20 - 60), and 52 sex and age-matched healthy persons as controls. ELISA was used to detect the coagulation and fibrinolysis indicators: activated partial thromboplastin time (APTT), protein C (PC), antithrombin III (AT-III), plasminogen activator inhibitor (PAI), activated protein C resistance (APC-R), plasminogen (PLG), von Willebrand factor (VWF), D-dimer (D-D), and fibrinogen (Fib). Real-time PCR was used to detect the mutation of factor V G1601A (FV Leiden) and prothrombin G20210A.The levels of PC, AT-III, and PLG of the osteonecrosis group were 85% +/- 34%, 84 +/- 29%, and 69 +/- 23%, significantly lower than that of the control group (109% +/- 20%, 104% +/- 14%, and 94% +/- 15% respectively, all P0.01). PAI of the osteonecrosis group was 16 U/ml +/- 14 U/ml, significantly higher than that of the control group (8.0 U/ml +/- 4.3 U/ml, P0.01). The percentage of patients with abnormal indicators was 99.5% (54/61) in the osteonecrosis group, significantly higher than that of the control group (36.5%, 19/52, P0.01). The percentage of patients with 3 or more abnormal indicators was 72.1% (44/61) in the osteonecrosis group, significantly higher than that of the control group (17.3%, 9/52, P0.01). No mutations of F V Leiden and prothrombin G20210A was found in both groups.Trends of hypercoagulation and hypofibrinolysis exist in the post-SARS patients with osteonecrosis. APTT, PC, AT-III, and PLG can be used as sensitive indicator for screening high risk populations of osteonecrosis.

To explore the role of interleukin-1 receptor antagonist (IL-1Ra) in suppression of cartilage matrix degradation and pathologic changes.Thirty New Zealand White rabbits underwent partial synovectomy of the left knee. Synovial fibroblasts were isolated and cultured. The rabbits underwent anterior cruciate ligament transection (ACLT) in the right knee. After the ACLT the rabbits were forced to run 4 hours a day for 4 weeks so as to establish the osteoarthritis (OA) model. Three days after the ACLT the rabbits were randomly divided into 3 groups of 10 rabbits: group 1, to be injected with the cultured autologous synovial fibroblasts into the right knees; group 2, injected with the autologous synovial fibroblasts transfected with marker gene, and group 3, injected with autologous synovial fibroblasts transfected with IL-1Ra gene. Two and 4 weeks after the injection 5 rabbits in each group were killed respectively. Their right knee joints were lavaged and the lavage fluid was extracted. IL-1Ra level in the synovial fluid (SF) was determined by ELISA. 20 mg of articular cartilage were taken from the condyle of right femur and digested by papain. The glycosamino-glycan (GAG) level in the SF and in the cartilage digest were evaluated using dimethylmethylene blue assay. Two pieces of cartilage were taken from each rabbit's and were sliced and stained to undergo pathologic changes.The IL-1Ra level in the SF of the group 3 was (20.2 +/- 1.8) ng/ml 2 weeks after, and was (4.8 +/- 0.5) ng/ml 4 weeks after, significantly lower than those in the group 2 (84 +/- 7) micro g/ml and group 3 (84 +/- 6) micro g/ml IL-1Ra was not detected in the SF of the group 1. The GAG level in SF was 40.1 micro g/ml with an inhibitory rate of 56.2%, and those in the group 2 and group 3 were 30.2 micro g/mg and 10.8 micro g/mg respectively. The GAG levels 4 weeks after in the cartilage digest of the group 1 and group 2 were (10.1 +/- 1.2) micro g/mg and (10.8 +/- 0.9) micro g/mg respectively, both significantly lower than that in the group 3 [(30 +/- 3) micro g/mg, both P0.05]. Pathological examination showed that the articular cartilage of the left knee was all normal in all the rabbits. However, obvious damage was found in the articular cartilage of the right knees of all the rabbits. However, the damage in the group 3 was significantly milder than that in the other 2 groups.Intraartilcular injection of synovial cells transfected with IL-1Ra gene can suppress articular cartilage matrix degradation and pathologic changes.