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Osteoarthritis (OA) is the most prevalent chronic joint disorder and is a major cause of disability among the elderly population. The degeneration and damage of articular cartilage associated with OA can result in a diminished range of motion in joints, subsequently impacting fundamental activities such as ambulation, standing, and grasping objects. In severe cases, it may culminate in disability. Traditional pharmacological treatments are often accompanied by various side effects, while invasive surgical procedures increase the risk of infection and thrombosis. Consequently, identifying alternative new methods for OA treatment remains a formidable challenge. With advancements in responsive hydrogel drug delivery platforms, an increasing number of strategies have emerged to enhance OA treatment protocols. Injectable response hydrogel drug delivery platforms show many advantages in treating OA, including improved biocompatibility, prolonged drug release duration, elevated drug loading capacity and enhanced sensitivity. This article reviews the recent progress of injectable responsive hydrogel drug delivery platform for OA treatment over the past few years. These innovative methodologies present new strategies and directions for future OA treatment while summarizing a series of challenges faced during the clinical transformation of injectable response hydrogel drug delivery platforms. Overall, injectable responsive hydrogel drug delivery platforms show great potential in treating OA, especially regarding improving drug retention time and stimulus-responsive release at the lesion sites. These innovative methods provide new hope for future OA treatment and point the way for clinical applications. [ABSTRACT FROM AUTHOR]

ObjectiveMultiple ligament knee injuries (MLKIs) are rare but severe systemic trauma. Single surgery in the acute setting is preferred, although with an extended operation time. To avoid the complications associated with a tourniquet, we herein describe a method for visibility without a tourniquet: intra-articular administration of adrenaline plus an irrigation pump system.Study designThis is a cohort study with a level of evidence of 3.MethodsFrom April 2020 to February 2022, 19 patients with MLKIs were reviewed retrospectively. All patients got intra-articular administration of adrenaline plus an irrigation pump system for visibility without a tourniquet. The following parameters were assessed: visibility, range of motion, knee stability, visual analog scale (VAS) score, range of motion (ROM), Lysholm score, Tegner activity level, and International Knee Documentation Committee Subjective Knee Form (IKDC).ResultsAll patients were followed up for at least 6 months. At the latest follow-up, the mean VAS score, ROM, Lysholm score, and IKDC were 1.79 ± 0.86, 121.21 ± 10.96, 88.16 ± 5.21, and 88.53 ± 5.06, respectively. The average Tegner activity level decreased significantly from preinjury to postoperation (5.16 ± 0.83 vs. 3.11 ± 0.88, P

Abstract The aim of this study was to evaluate how the Charlson Comorbidity Index (CCI) scores contribute to early recovery and 2-year mortality in elderly patients undergoing surgical treatment of inter-trochanteric fractures. 60 cases with unilateral intertrochanteric fracture were retrospectively analyzed and divided into Low-CCI group (CCI: 1–4) or high-CCI groups (CCI: 5–6). All the patients’ electronic hospital records were reviewed. The preoperative situations (demographic data, comorbidities and fracture conditions), perioperative situations (wait time, operation time, implant choice, blood loss, transfusion or not) and postoperative situations (complications, first time out of bed, function about 1-/2- week and 2-year mortality) were recorded. 51.67% were in low-CCI group and 48.33% in high-CCI group. The survival rates in low- and high-CCI group were 93.5% and 86.2% respectively. According to the functional results of 1- or 2- week after operation, no significant difference was found (P = 0.955, 0.140). Log-rank analysis showed that the main prognostic factors were blood loss, first time out of bed and complication (P

Stent restenosis and late thrombosis compromise endovascular stent implantation clinical benefit, and the mechanism is unclear. Since nitric oxide (NO) plays a pivotal role in maintaining vascular homeostasis, we believe that stenting can affect NO concentration in the host artery, thereby contributing to postoperative adverse events. We numerically investigated NO concentration after stenting based on the patient-specific carotid to verify this hypothesis. The simulation revealed that stent implantation caused blood flow disturbance, a low wall shear stress, and a significant decrease in NO on the luminal surface, especially in the region of the stented segment. Moreover, severe damage to the artery wall or low blood flow, leading to a low NO generation rate, would induce relatively low NO level in the stented segment. Additionally, we demonstrated that NO distribution might be affected by the combination of stent struts and carotid bifurcation geometry, while the host arterial configuration might play a leading role in the distribution of NO concentration. In conclusion, the carotid artery had a relatively low NO concentration level near stent struts, especially at the severely injured artery, low blood flow, long stenting, and complex host artery which might lead to a genesis/development of adverse events after that intervention. [ABSTRACT FROM AUTHOR]

In this study, a new type of ceramic composite (PZSC/ZnO) was successfully synthesized using N, P, and S co‐doped carbon microspheres derived from polyphosphazene with zinc oxide. The morphology and structure were characterized by Fourier transform infrared spectroscopy, X‐ray photoelectron spectroscopy, scanning electron microscopy, energy‐dispersive spectroscopy, Raman, X‐ray diffraction, BET, and thermogravimetric. Batch experiments were used to explore the adsorption performance under different pH values, initial concentrations, contact times, and temperatures. The results showed that the maximum adsorption capacity of the PZSC/ZnO ceramic composite for uranium was 470.5 mg/g (pH = 5.5, t = 40 min, and T = 25°C). The adsorption process followed the nonlinear Langmuir model and the pseudo‐second‐order kinetic model, demonstrating that the monolayered combination of U(VI) with the PZSC/ZnO ceramic composite and the adsorption mechanism was chemical adsorption. Thermodynamic data revealed that the adsorption was a spontaneous endothermic process. Furthermore, P and N may be involved in the adsorption of uranyl ions through binding to the O atoms from ZnO. The main forces between U(VI) and the PZSC/ZnO ceramic composite were attributed to ZnO and heteroatoms doped in the material. [ABSTRACT FROM AUTHOR]

Traumatic acetabular and ipsilateral femoral neck fracture combined with posterior traumatic hip dislocation is a rare presentation. Here, we described such a difficult case treated with one stage total hip arthroplasty (THA) with open reduction and internal fixation. The patient returned to his previous job with good function after 5 months postoperatively. The plain radiograph showed a well-seated prosthesis position with no evidence of subsidence. This present article shows our experience with good results, and makes a literature review. [ABSTRACT FROM AUTHOR]

BACKGROUND: Previous studies on the clinical efficacy of total knee arthroplasty in the treatment of rheumatoid arthritis have been reported, but the effects of total knee arthroplasty on joint function and related biochemical parameters in patients with rheumatoid arthritis are little reported. Thereafter, more clinical evidence is needed. OBJECTIVE: To analyze the effect of total knee arthroplasty on joint function and related biochemical indicators in patients with rheumatoid arthritis. METHODS: Clinical data of 64 patients with 64 knees who underwent total knee arthroplasty were retrospectively analyzed. Comparative analysis of Hospital for Special Surgery, range of motion of the knee joint and quality of life scores before and 1 year after surgery was conducted. Changes of biochemical indicators such as C-reactive protein, rheumatoid factor and erythrocyte sedimentation rate were detected. The incidence of complications at 1 month after surgery was recorded. The study was approved by the Ethical Committee of Changzhou Traditional Chinese Medicine Hospital, and all patients signed the informed consents. RESULTS AND CONCLUSION: (1) Compared with the baseline levels, the Hospital for Special Surgery score, range of motion of the knee joint and quality of life scores at 1 year after surgery was significantly increased (P < 0.01 ), and the levels of C-reactive protein, rheumatoid factor and erythrocyte sedimentation rate were significantly decreased (P < 0.01 ). (2) One patient developed infection and two patients developed deep vein thrombosis of the lower extremity, which was relieved after symptomatic treatment. These results imply that total knee arthroplasty has a good dinical effect on rheumatoid arthritis, which can improve knee function and reduce the levels of C-reactive protein, rheumatoid factor and erythrocyte sedimentation rate, and has good safety. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the roles of miR-149 in the progression of human osteosarcoma (OS).Results: miR-149 level was upregulated in tissues from OS patients more than in normal subjects. Cell proliferation and apoptosis assays revealed that miR-149 increased cell proliferation and inhibited cell apoptosis in OS cell line (MG63). An increase of Bcl-2 gene expression and a decrease of cleaved-caspase-3, and cleaved-PARP expression were observed in MG63 cells with transfection of miR-149. Additionally, bone morphogenetic protein 9 (BMP9) was identified as a target of miR-149 in MG63 cells, and BMP9 expression was negatively correlated with miR149 level in OS clinical samples. Co-overexpression of BMP9 with miR-149 in MG63 cells prohibited miR-149-mediated promotive effects on OS progression. Importantly, overexpression of miR-149 conferred chemoresistance in MG63 cells.Conclusions: miR-149 promotes OS progression via targeting BMP9. [ABSTRACT FROM AUTHOR]

Background: Due to the adverse effects of cemented hip arthroplasty, uncemented stems with hydroxyapatite (HA) coating reduces these risks and enhanced integration. The concept of an extensive HA coating for the fixation of a tapered femoral stem (Corail) was introduced, which can achieve durable biological fixation and preserve normal periprosthetic bone activity. Here we describe the clinical and radiological outcome in patients with the Corail stem. Methods: 92 total hip replacements in 81 patients using the Corail stem were followed-up. 47 patients were women, and the mean age at surgery was 62.9 ± 8.7 (34-71) years. The indications included: osteoarthritis of the hip (71.1%), avascular necrosis (13.6%), femur neck fractures in elderly (9.7%) and post-traumatic osteoarthritis (6.8%). Findings: Eight patients died during follow-up. The revision was only found in two patients due to line wear and resulted in an 10-year Kaplan-Meier estimated overall survival rate of 97.83%. The clinical results were good, with a mean Harris hip score of 92.3 ± 5.6 (72-100). The mean total Merle d'Aubigné and Postel score was 6.8 ± 0.5 pre-operatively and 16.1 ± 1.4 at latest follow-up. All unrevised implants were radiographically stable, with a mean liner wear of 0.07 mm/year. Conclusion: This long-term analysis confirmed the durability of the functional and radiographic results. Our findings suggest the long-term results of Corail HA-coated stem are more satisfactory which is preferable to any other system. [ABSTRACT FROM AUTHOR]

Background: Metal-on-metal resurfacing arthroplasty is an attractive alternative to conventional total hip arthroplasty in patients with osteoarthritis secondary to developmental dysplasia of the hip (DDH). The purpose of this study was to assess the mid-term clinical outcome and mid-term survivorship of Metal-on-metal resurfacing arthroplasty in patients suffering from osteoarthritis secondary to DDH., Material/methods: Between May 2003 and Dec. 2005, 15 operations using ASR™ and 19 using Corin were performed in 29 patients to treat advanced osteoarthritis secondary to DDHs. There were 6 males (20.7%) and 23 females (79.3%), with an average age of 47.2 years (range, 36-64 years). Clinical and radiographic results were observed. All patients were followed up at the 1st, 2nd, 3rd, 6th, and 12th months after surgery and annually thereafter., Results: The overall survival was 88.2% at a minimum follow-up of 8 years, but the survival was 91.2% after excluding the infections as the cause of component loosening and failure. The mean Harris hip score improved from 48.27±3.13 (range, 14-71) to 89.63±3.42 (range, 65-100) at latest follow-up. The flexion was from 75.14±8.05° to 107.21±9.34. Only 4 failed because of deep infection, femoral neck fracture, and aseptic loosening., Conclusions: Metal-on-metal resurfacing arthroplasty showed perfect results at a minimum of 8-years of follow-up in our study, and may be a reasonable option for osteoarthritis secondary to developmental dysplasia of the hip (DDH).

Granulocytic sarcoma (GS) may be a presenting sign of myelogenous leukemia. Occasionally, an extramedullary neoplasm composed from myelocytic precursor cells occurs in patients without evidence of leukemia. Rarely, undiagnosed leukemia occurs initially manifesting with paralysis to spinal cord GS. We present a case report of 20-year-old girl with an undiagnosed leukemia, initially manifesting as paralysis. En bloc spondylectomy with chemotherapy postoperatively constituted the treatment of choice for this tumor. After two courses of chemotherapy, the patient made a good postoperative recovery with notable bilateral lower extremity improvement.