Search

We attempted to analyze the effects of cisplatin and exogenous hydrogen on the invasion and proliferation of human osteosarcoma cells through EGFR/P13K/Akt signaling pathway. The effects of exogenous hydrogen sulfide and cisplatin on the invasion, apoptosis and proliferation of MG-63 cells were detected by transwell chamber invasion experiment, flow cytometry and CCK-8 method. After 24 and 48 hours of drug action, the inhibition rate of cell proliferation was significantly higher than in the combined treatment. The number of cells decreased significantly, compared with the control group. Western blotting and qRT-PCR showed that the expression of Akt mRNA in MG-63 cells treated with cisplatin+hydrogen sulfide at different concentrations for 48 hours decreased. The expression of Akt, P13K and EGFR were decreased Flow cytometry analysis showed that after the drug treatment of MG-63 cells, the S phase of cisplatin and cisplatin+exogenous hydrogen concentrations with different prolonged concentrations was significantly shortened phase and the G0/G1 was significantly, and the apoptosis rate of each group was significantly increased. Cisplatin and exogenous hydrogen sulfide can synergistically inhibit the proliferation and invasion of human osteosarcoma MG-63 cells, and regulate the apoptosis mechanism of MG-63 cells through EGFR/P13K/Akt signaling pathway.

Background: This study employed a severed finger rat model to analyze the effects of human mesenchymal stem cells (MSCs) on angiogenesis, inflammatory response, apoptosis, and oxidative stress, to evaluate the possible mechanism of the repair effect of MSCs on severed finger (SF) rats. Methods: Sixty Sprague-Dawley (SD) rats were categorized into five groups (n = 12). The pathological changes of severed finger tissues were investigated by Hematoxylin and eosin (H&E) staining on day 14 after the rats were sacrificed. The levels of inflammatory factors and oxidative stress factors were detected by ELISA. Terminal Deoxynucleotidyl Transferase (TdT) dUTP Nick End Labeling (TUNEL) was employed to assess the apoptosis of chondrocytes in severed finger tissues. The expression of osteocalcin (OCN), osteopontin (OPN), Collagen I (Col-1), and CD31 were detected by immunohistochemistry or immunofluorescence assay, respectively. The expression levels of related proteins were determined by western blot. Result: Our study presented evidence that MSCs treatment improved pathological changes of skin and bone tissue, diminished the inflammatory response, prevented oxidative stress injury, suppressed chondrocyte apoptosis, and promoted angiogenesis, and bone formation compared to the model group. In addition, EX527 treatment attenuated the effect of MSCs, SRT1720 and ML385 co-treatment also attenuated the effect of MSCs. Importantly, the MSCs treatment increased the expression of Sirtuin 1(SIRT1)/Nuclear factor erythroid2-related factor 2(Nrf2) relate proteins. Conclusion: Our study indicated that the mechanism of the effect of MSCs on a severed finger was related to the SIRT1/ Nrf2 signaling pathway.

Osteoarthritis (OA) is a common joint disease that is characterized by inflammation and cartilage degradation. Death-associated protein kinase 1 (DAPK1) is a multi-domain serine/threonine kinase and has been reported to be involved in the progression of OA. However, its role and mechanism in OA remain unclear. Here, we found the expression of DAPK1 in OA cartilage tissues was higher than that in normal cartilage tissues. The expression of DAPK1 in chondrocytes was up-regulated by IL-1β. Knockdown of DAPK1 promoted cell viability and anti-apoptotic protein expression, while it inhibited the apoptosis rate and pro-apoptotic protein expressions in IL-1β-induced chondrocytes. In addition, DAPK1 inhibition reduced the levels of inflammatory cytokines and expressions of matrix metalloproteinases (MMPs), and increased the expressions of collagen II and aggrecan. The data of mechanistic investigation indicated that the expression of pigment epithelium-derived factor (PEDF) was positively regulated by DAPK1. Overexpression of PEDF attenuated the effects of DAPK1 knockdown on IL-1β-induced cell viability, apoptosis, inflammation, and cartilage degradation. Furthermore, PEDF overexpression restored the activity of the NF-κB pathway and NLRP3 inflammasome after DAPK1 knockdown. Collectively, down-regulation of DAPK1 inhibited IL-1β-induced inflammation and cartilage degradation via the PEDF-mediated NF-κB and NLRP3 inflammasome pathways.

To observe the effect of melatonin intervention on rat knee osteoarthritis (KOA) model and explore its mechanism.A total of 81 Sprague-Dawley (SD) rats were employed. Haematoxylin and eosin (HE) staining and safranin o-solid green staining were used to observe the changes of pathology in KOA, and inflammation factors in serum were detected by enzyme-linked immunosorbent assay (ELISA), type II collagen (Col-II) was detected by immunohistochemistry, chondrocyte apoptosis was detected by TdT-mediated dUTP nick-end labeling (TUNEL). The expression of matrix metalloproteinases (MMPs) and JAK2/STAT3 signaling were detected by western blot.Melatonin treatment ameliorated the histomorphology of knee joint in rats compared to the model group. The contents of TNF-α, IL-6, and IL-1β in serum were decreased after melatonin treatment. In addition, compared to the model group, the positive expression of Col-II increased, the chondrocyte apoptosis decreased after melatonin treatment. Interestingly, the expression levels of MMP3, MMP9, MMP13, p-JAK2 and p-STAT3 decreased (p 0.05). Importantly, melatonin combined with AG490 is significantly ameliorates histomorphology of knee joint, reduced cartilage loss compared with melatonin treatment alone.Melatonin treatment can effectively diminish the cartilage injury. Its mechanism may be related to protect the articular cartilage by reducing the release of inflammatory factors, inhibit the expression of MMPs and JAK2/STAT3 signaling.

Purpose: To investigate the expressions of rapamycin target protein (mTOR) conduction pathway in human osteosarcoma MG-63 cells and their stem cells, and to examine the inhibitory effect of different doses of rapamycin.Methods: mTOR mRNA in osteosarcoma stem-like cells and human osteosarcoma MG-63 cells were determined by quantitative reverse transcription polymerase chain reaction (qRT-PCR). The cells were treated with different doses of rapamycin and divided into low dose group (0.5 mg), medium dose group (1.0 mg), high dose group (2.0 mg) and blank (control) group. Apoptosis and cell cycle of MG-63 cells were determined by flow cytometry, while proliferation of MG-63 cells up was assessed by CCK-8 kit.Results: mTOR in human osteosarcoma MG-63 cells was significantly lower than that in osteosarcoma stem-like cells. Compared with the control group, mRNA expression levels of mTOR in MG-63 cells and osteosarcoma stem-like cells were significantly decreased after treatment with different concentrations of rapamycin (p < 0.05). MG-63 cells treated with various doses of rapamycin exhibited a significant decrease in their proliferation, compared with control group, while only the high rapamycin concentration group exhibited a significant decrease in osteosarcoma stem-like cell proliferation (p < 0.05). Treatment with rapamycin in MG-63 cells and osteosarcoma stem-like cells resulted in a significant increase in apoptosis, prolonged G0/G1 phase and shortened S phase (p < 0.05).Conclusion: Rapamycin inhibits the expression of mTOR mRNA in osteosarcoma stem-like and MG-63 cells. It also inhibits the proliferation and cell cycle formation of osteosarcoma stem-like cells and MG-63 cells via mTOR signal pathway. These findings may provide a new target for the treatment of osteosarcoma.

Background To compare the mechanical characteristics of a percutaneous superior pubic intramedullary screw, percutaneous bridging plate and percutaneous screw-rod system of the anterior ring for the treatment of unilateral vertical pubic fractures to provide a reference for clinical application. Methods A finite element model of pelvic anterior ring injury (unilateral vertical pubic fracture) was produced. The fractures were fixed with a percutaneous superior pubic intramedullary screw, percutaneous bridging plate and percutaneous screw-rod system of the anterior ring and their combinations in 5 types of models. The fracture stabilities under vertical, bilateral and anterior-posterior load were quantified and compared based on the displacement of the hip joints’ midpoint as quantificational index of fracture stability. Results In the condition of bilateral and anterior-posterior load, the vertical, bilateral and anterior-posterior displacements of the hip joints’ midpoint of different models were significantly different respectively. In general, the displacements of the 5 pelvic anterior ring fixations were ranked from maximum to minimum as follows: bridging plate, pelvic anterior screw-rod system, combination of bridging plate and pelvic anterior screw-rod system, superior pubic intramedullary screw and combination of superior pubic intramedullary screw and pelvic anterior screw-rod system. Conclusion For the fixation in unilateral pubic fractures of pelvic ring injury, the percutaneous superior pubic intramedullary screw is optimal, the percutaneous pelvic anterior screw-rod system is the second choice, and percutaneous bridging plate ranks the third. The percutaneous pelvic anterior screw-rod system can significantly increase fixation stability of the percutaneous superior pubic intramedullary screw and the percutaneous bridging plate.

It is known that an excellent hyaline cartilage phenotype, an internal microstructure with safe crosslinking and available size flexibility are the key factors of cartilage grafts that allow for clinical application. Living hyaline cartilage grafts (LhCGs) constructed by phase-transfer hydrogel (PTCC) systems were reported to have a hyaline phenotype and bionic microstructure. By employing chondrocytes to secrete matrix in the hydrogel and then removing the material to obtain material-free tissue in vitro, LhCG technology exhibited superior performance in cartilage repair. However, PTCC systems could only produce small-sized LhCGs because of medium delivery limitations, which hinders the clinical application of LhCGs. In this study, we prepared three different noncrosslinked gelatin microspheres with diameters from 200 μm to 500 μm, which replaced the original pore-forming agent. The new PTCC system with the mixed and gradient porous structure was used for the preparation of superlarge LhCGs with a continuous structure and hyaline phenotype. Compared to the original technique, the porous gradient structure promoted nutrient delivery and cartilage matrix secretion. The small size of the microporous structure promoted the rapid formation of matrix junctions. The experimental group with a mixed gradient increased cartilage matrix secretion significantly by more than 50% compared to the that of the control. The LhCG final area reached 7 cm2 without obvious matrix stratification in the mixed gradient group. The design of the scale-changed porous PTCC system will make LhCGs more promising for clinical application.

Background: Visfatin is a novel adipokine, also known as a nicotinamide phosphorybosyltransferase (NAMPT) that is reported to promote the progression of osteosarcoma. The research sought to determine the regulatory network underlying NAMPT on osteosarcoma (OS).Method: The OS tissues and paired normal controls were collected from 45 OS patients. The binding relationship between microRNA-26a-5p (miR-26a-5p) and two genes (NAMPT and NORAD) were predicted by TargetScan V7.2 and confirmed by dual-luciferase reporter assay. To reveal the function of long noncoding RNA NORAD/miR-26a-5p/NAMPT axis on cell viability, cell cycle and apoptosis of U2OS cells, CCK-8 and flow cytometry assays, examination of apoptosis-associated molecules (Bcl-2, Bax, cleaved (C)-caspase-3) were performed. The mRNA and protein levels were separately examined by RT-qPCR and Western blot. Results: NAMPT and NORAD expressions were increased in OS tissue samples, while miR-26a-5p expression was decreased. Functionally, NORAD functions as a ceRNA of miR-136-5p to competitively target NAMPT. Furthermore, miR-26a-5p overexpression inhibited viability, cell cycle and apoptosis resistance of U2OS cells by down-regulating NAMPT along with change the expressions of apoptosis-related molecules. NORAD overexpression promoted viability, cell cycle and apoptosis resistance of U2OS cells by down-regulating MiR-26a-5p along with changes of the expressions of apoptosis-related molecules.Conclusion: LncRNA NORAD, serving as a ceRNA of miR-26a-5p, promoted proliferation and apoptosis resistance of U2OS cells by upregulation of NAMPT.

[Objective] To compare the mechanical characteristics of percutaneous long plate, percutaneous pubic superioris intramedullary screw and percutaneous pelvic anterior screw-rod system for the treatment of bilateral vertical pubic fractures to provide reference for clinical application. [Methods] A finite element model of pelvic anterior ring injury (bilateral vertical pubic fracture) was produced. The fractures were fixed with percutaneous long plate, percutaneous pubic superioris intramedullary screw, percutaneous pelvic anterior screw-rod system and their combination in 5 types of models. The fracture stability under vertical, bilateral and anterior-posterior load were quantified and compared based on the displacement of the hip joints’ midpoint as quantificational index of fracture stability. [Results] In condition of bilateral and anterior-posterior load, the vertical, bilateral and anterior-posterior displacement of the hip joints’ midpoint of different models were significantly different respectively. In general, the displacement of the 5 pelvic anterior ring fixation models were ranked from maximum to minimum as follows: long plate, pelvic anterior screw-rod system, combination of long plate and pelvic anterior screw-rod system, pubic superioris intramedullary screw and combination of pubic superioris intramedullary screw and pelvic anterior screw-rod system. [Conclusion] For the fixation in bilateral pubic fractures of pelvic injury, the percutaneous pubic superioris intramedullary screw was optimal, percutaneous pelvic anterior screw-rod system was the second choice, and percutaneous long plate ranked the third. The percutaneous pelvic anterior screw-rod system can significantly increase fixation stability of the percutaneous pubic superioris intramedullary screw and the percutaneous long plate.

To compare the risk of breakage of lengthened sacroiliac screw and ordinary sacroiliac screw for the treatment of unilateral vertical sacral fractures to provide reference for clinical application. A finite element model of Tile C pelvic ring injury (unilateral type Denis Ⅱ fracture of sacrum) was produced. The sacral fractures were fixed with lengthened sacroiliac screw and ordinary sacroiliac screw in 6 types of models respectively. The maximal Von Mises stresses and stress distribution of the two kinds of screws in the case of standing on both feet were measured and compared. The maximal Von Mises stress of lengthened screw is less than that of ordinary screw. Compared with ordinary screw, the stress distribution in lengthened screw is more homogeneous. In conclusion, the breakage risk of screws fixed in double-segment is lower than that of screws fixed in single-segment, and the breakage risk of lengthened screws is lower than that of ordinary screw, and the breakage risk of screws fixed in S2 segment is lower than that of screws fixed in S1 segment.

BackgroundThe aim of the current paper is to evaluate the effects of robot-navigation-assisted core decompression compared with conventional core decompression surgery for early-stage osteonecrosis of the femoral head.MethodsTwenty patients with a total of 36 hips who were diagnosed with Association Research Circulation Osseous stage 2 avascular necrosis of the femoral head and who received core decompression with or without robotic assistance were reviewed. The Harris hip score and visual analog scale score were used to assess clinical function. Intraoperative radiation exposure and operation time were used to evaluate the effectiveness of the robot-assisted system.ResultsAt a mean follow-up of 26.4 months (24–36 months), the Harris hip score, visual analog scale score, and survival rate of the patients were similar between the conventional and robot-assisted groups. The guidewire insertion time, number of guidewire attempts, and radiation exposure during guidewire insertion were all significantly lower in the robot-assisted group than in the conventional group.ConclusionsRobot-assisted core decompression of the femoral head is as safe and effective as a conventional core decompression surgery. It can reduce operation time and decrease intraoperative radiation exposure.

Thromboprophylaxis is a controversial and challenging topic in joint replacement surgery. Mechanical prophylaxis in combination with the use of anticoagulants have been shown to have greater efficacy than single modalities. But the early use of anticoagulants has the potential to increases the risk of postoperative bleeding. The purpose of this study was to evaluate the thromboprophylactic effects of sequential combined method using early-mechanical compression with delayed rivaroxaban in total knee arthroplasty. A retrospective cohort study, including 369 patients receiving simultaneous combined mechanical and pharmacological thromboprophylactic modality and 385 patients receiving sequential combined modality with early-mechanical compression treatment followed by rivaroxaban 2 days later after primary total knee arthroplasty surgery was conducted. The incidence rates of proximal and distal deep vein thrombosis (DVT) on the 2nd day and the 5th week and the volume of wound drainage were compared postoperatively. On the 2nd postoperative day, the incidence rates of proximal and distal DVT in the sequential group (1.56, 4.16%) had no significant difference compared with those (1.08, 3.25%) in the simultaneous group (p = 0.569, 0.507, respectively). No difference was found in the incidence rate of proximal and distal DVT on the 5th week between groups. No pulmonary embolism occurred. The mean volume of wound drainage in the sequential group was 343 mL which was 98 mL lesser than in the simultaneous group (p

MicroRNAs (miRNAs) perform important roles in the development and progression of human malignancy. miR-874, as a tumor suppressor, is decreased in malignant tumors, including osteosarcoma. However, the potential mechanism of miR-874 in osteosarcoma remains largely unknown. In the present study, a dual-luciferase reporter system supported cyclin-dependent kinase 9 (CDK9) as a direct target gene of miR-874. miR-874 mimics evidently repressed CDK9 expression in osteosarcoma. Furthermore, osteosarcoma tissues and cell lines exhibited increased expression of CDK9, and CDK9 expression levels were inversely correlated (R=-0.725) with that of miR-874 in osteosarcoma tissues. Finally, CDK9 overexpression reversed the potential effect of miR-874 on the proliferation and invasion of osteosarcoma cells. Overall, the results revealed that miR-874, as a tumor suppressor, is involved in osteosarcoma progression and metastasis by targeting CDK9, indicating that the miR-874/CDK9 pathway may serve as a potential therapeutic target for the treatment of osteosarcoma.

Background To conduct radiologic anatomical study on the relation between S1 sacroiliac screws’ entry points and the route of the pelvic outer superior gluteal artery branches with the aim to provide the anatomical basis and technical reference for the avoidance of damage to the superior gluteal artery during the horizontal sacroiliac screw placement. Methods Superior gluteal artery CTA (CT angiography) vascular imaging of 74 healthy adults (37 women and 37 men) was done with 128-slice spiral CT (computed tomography). The CT attendant-measuring software was used to portray the “safe bony entrance area” (hereinafter referred to as “Safe Area”) of the S1 segment in the standard lateral pelvic view of three-dimensional reconstruction. The anatomical relation between S1 sacroiliac screws’ Safe Area and the pelvic outer superior gluteal artery branches was observed and recorded. The number of cases in which artery branches intersected the Safe Area was counted. The cases in which superior gluteal artery branches disjointed from the Safe Area were identified, and the shortest distance between the Safe Area and the superior gluteal artery branch closest to the Safe Area was measured. Results Three cases out of the 74 sample cases were excluded from this study as they were found to have no bony space for horizontal screw placement in S1 segment. Among the remaining 71 sample cases, there are 32 cases (45.1%) where the deep superior branch of superior gluteal artery passes through the Safe Area of S1 entrance point. There was no distinguishing feature and rule on how the deep superior branches and the Safe Area overlapped. In the 39 cases in which superior gluteal artery branches disjointed from the Safe Area, the deep superior branches of superior gluteal artery were the branches closest to the Safe Area and the part of the branch closest to the Safe Area was located in front of the widest part of the Safe Area. The shortest distance between the deep superior branch and the Safe Area is 0.86 ± 0.84 cm. Conclusion There is a high risk of accidental injury of the deep superior branches of superior gluteal artery in the process of S1 sacroiliac screw placement. Even if the entry points are located in the safe bony entrance area, the absolute secure placement cannot be assured. We suggest that great attention should be paid to make thorough preoperative plans.

This study aimed at comparing the risk of breakage of lengthened sacroiliac screw and ordinary sacroiliac screw for the treatment of bilateral vertical sacral fractures to provide reference for clinical application. A finite element model of type C pelvic ring injury (bilateral type Denis II fracture of sacrum) was produced. The bilateral sacral fractures were fixed with lengthened sacroiliac screw and ordinary sacroiliac screw in seven types of models, respectively. The maximal Von Mises stresses and stress distribution of the two kinds of screws in the case of standing on both feet were measured and compared. (1) Whether in lengthened sacroiliac screw or ordinary sacroiliac screw, the maximal Von Mises stress of screw fixation only in S1 segment is the largest, and the maximal Von Mises stress of screw fixation only in S2 segment is minor, and the maximal Von Mises stress of screw fixation in S1 and S2 segments, respectively, is the least. (2) When S1 and S2 were both fixed with ordinary screws, the maximal Von Mises stress of screw in S1 segment is larger than that of S2. When S1 and S2 were both fixed with lengthened screws, the maximal Von Mises stress of screw in S1 segment is similar to that of S2. (3) The maximal Von Mises stresses of bilateral symmetrical screws are similar. (4) When only S1 was fixed, the maximal Von Mises stress of lengthened screw is less than that of ordinary screw. When only S2 was fixed, the maximal Von Mises stress of lengthened screw is larger than that of ordinary screw. When S1 and S2 were both fixed, the maximal Von Mises stress of lengthened screw is slightly less than that of ordinary screw. (5) Whether in lengthened screw or ordinary screw, the stress concentrations all exhibited at the regions of screws corresponding to the sacral fracture regions and the part between sacral bilateral fracture lines. Compared with ordinary screw, the stress distribution in lengthened screw is more homogeneous. Whether in lengthened screw or ordinary screw, the stress distribution of only one sacral segment fixation is more concentrated than that of two sacral segments’ fixation. When S1 and S2 were both fixed, the stress distribution of upper screw is more concentrated and that of lower screw is more homogeneous. In a finite elements simulated type C pelvic ring disruption (bilateral type Denis II sacral fracture), the breakage risk of screws fixed in double-segment bilaterally symmetrically is low, and the breakage risk of screws fixed in S2 segment is lower than that of S1 segment. The bilaterally symmetrical screw fixation in double-segment is strongly recommended to reduce the breakage risk of screws. In addition, the breakage risk of lengthened screws is lower than that of ordinary screws except when screws are fixed in only S2 segment, which merits attention.

Many patients undergoing total knee arthroplasty (TKA) have diabetes mellitus, which may increase the risk of deep vein thrombosis (DVT) after TKA. We therefore assessed whether diabetes mellitus increased the incidence of DVT within 14 days after TKA.The incidence of DVT within 14 days of surgery was compared in diabetic and non-diabetic patients undergoing TKA in our hospital between June 2011 and February 2013. The relationships between diabetes mellitus and DVT were analyzed.Of the 358 enrolled patients, 70 (19.6%) had diabetes and 288 (80.4%) did not. DVT occurred within 14 days in 198 patients, 52 of 70 (74.3%) in the diabetes group and 146 of 288 (50.7%) in the non-diabetes group (p = 0.012). DVT of the contralateral leg was observed in 16 and 50 patients, respectively (p = 0.452). Logistic regression analysis showed that the risk of DVT was 2.71-fold higher in patients with than without diabetes mellitus (95% CI 1.183-6.212, p = 0.018). There were no significant differences in age, gender, hypertension, BMI, duration of surgery, intra-operative blood loss, and duration of tourniquet between the two groups.The incidence of DVT 14 days after TKA was significantly higher in patients with than without diabetes.

To investigate the influences of the distal femoral cut, the anterior and posterior femoral cuts, the proximal tibial cut on the dynamic alignment of the lower extremity in total knee arthroplasty.Based on the three-dimensional geometric model, imitating the flexion movement of the knee without axial rotation after total knee arthroplasty, the influence of each of the three bone cuts on the dynamic alignment was analyzed with the assumption of standard bone cuts of the other two and equality of the medial and lateral soft tissue balancing. The dynamic alignment was defined as the angle between the mechanical axis of the tibia and the sagittal plane of the body when the knee was in any angle of flexion. With two of the three major bone cuts standard, the track of the tibial movement was established when the other one bone cut deviated from the ideal section of angle A. Based on the principle of geometry, the mathematical formula were established to present the influences of three bone cuts on the dynamic alignment of the lower extremity.All of the three kinds of bone cuts in total knee arthroplasty influenced the dynamic alignment of the lower extremity not just in one static position, but during the whole range of motion. At the θ angle of knee flexion, the alignment of the lower extremity was arcsin(cosθsinA) when the varus/valgus femoral component alignment was A; the alignment of the lower extremity was arcsin(sinθsinA) when the rotational femoral component alignment was A; the alignment of the lower extremity was A when the varus/valgus tibial component alignment was A.The influences of the distal femoral cut, the anterior and posterior femoral cuts, the proximal tibial cut on the dynamic alignment of the lower extremity in total knee arthroplasty are dynamically changed during the flexion movement of the knee.

To summarize our experiences of applying percutaneous multiple needle puncturing technique for releasing adductor muscle during total hip arthroplasty (THA) for ischemic necrosis of femoral head and provide rationales for clinical practice.From January 2008 to December 2012, 36 adult patients with ischemic necrosis of femoral head (36 hips) and 36 adult patients with femoral neck fracture (36 hips) were recruited. The group of ischemic necrosis of femoral head was designated as experiment group in which there were 29 males and 7 females with an average age of 67.9 (60-78) years. According to the Ficat system, there were type III (n = 24) and type IV (n = 12) . The affected leg shortening of this group prior to surgery was over 2 cm. The group of femoral neck fracture was selected as control group in which there were 16 males and 20 females with an average age of 70.1 (60-82) years. According to the Garden system, there were type III (n = 16) and type IV (n = 20). All cases underwent THA with Press-fit prosthesis. After fixing prosthetic components, leg length discrepancy was corrected. And percutaneous multiple needle puncturing was applied for releasing adductor muscle in experiment group. The follow-up period was 2 years. The safety and efficiency were evaluated by HHS (Harris Hip Score) and the range of motion (ROM) of hip extorsion and abduction.There was no occurrence of such early complications as palsy of obturator nerve, hematoma in adductor muscle area or serious deep vein embolism.No serious complications of deep infection, femoral head dislocation, recurrent adductor muscle contracture, prosthesis loosening, subsidence, excursion or penetration occurred up until the final follow-up. The range of hip motion of extorsion and abduction: (1) in experimental group, the postoperative ROM (abduction:44.9 ± 0.8, extorsion:45.1 ± 0.9) was significantly larger than that of preoperative (abduction: 30.0 ± 4.6, extorsion:31.5 ± 4.6) ; (2) the postoperative ROM of experimental group had no significant changes until the final follow-up (abduction: 44.7 ± 0.9, extorsion:45.25 ± 0.81); (3) at the last time of follow-up, no significant inter-group difference existed in ROM (abduction:44.86 ± 0.68, extorsion:45.6 ± 0.8). HHS: (1) in experimental group, HHS increased significantly from 39.64 ± 3.93 preoperatively to 82.8 ± 3.6 at 3 months postoperatively; (2) in two groups, HHS of 2 years postoperation (experimental group: 88.6 ± 4.1, control group: 89.1 ± 4.0) was significantly larger than that of 3 months postoperation (experimental group: 82.8 ± 3.6, control group:83.1 ± 3.1); (3) at the time of 3 months and 2 years postoperation, no significant inter-group difference existed in HHS.The technique percutaneous multiple needle puncturing for releasing adductor muscle during THA for ischemic necrosis of femoral head is both safe and efficacious. And it solves the problems of soft tissue balancing mini-invasiveness.

Besides the long-leg standing X-ray film focusing on static standing mechanical alignment of the lower extremity, dynamic alignment from full extension to 90° flexion after total knee arthroplasty (TKA) is rarely mentioned. Computer-assisted surgical technology enables surgeons to measure and assess knee behaviour during surgery. This study was designed to analyse the influences of femoral rotation on dynamic alignment of the lower extremity in TKA. Seventy-six consecutive patients with end-stage knee osteoarthritis were enrolled. External rotation osteotomy of the distal femur during TKA was completed according to the pre-operative external rotation angle (ERA), intra-operative transepicondylar axis (TEA) and anteroposterior (AP) line. Passive dynamic alignment of the lower extremity during knee flexion was recorded. The variation trend of hip–knee–ankle (HKA) alignment and the influences of femoral external rotation osteotomy were analysed. Postoperative deviation of HKA alignment from 0° to 90° flexion was associated with the rotational alignment of the femoral component (r = −0.769, p

Study design This is a retrospective study comparing polyethylene wear between ceramic ball heads and metal ball heads in total hip arthroplasty. Background The ceramic-on-polyethylene bearing option has been introduced as an alternative to metal-on-polyethylene to minimize polyethylene wear debris and reduce subsequent osteolysis and aseptic loosening. However, the reported data were debatable. We designed this retrospective study to compare polyethylene wear between alumina ceramic ball heads and cobalt-chrome ball heads. Methods Bilateral simultaneous primary total hip arthroplasty was performed in 22 patients between January 2002 and December 2002, with one side using metal-on-polyethylene bearing surface and the other side using alumina ceramic-on-polyethylene bearing surface. After 10 years of follow-up, the wear rate of polyethylene liner on both sides was measured using the Dorr method and compared. Results The annual wear rate of the polyethylene liner was 0.133 mm with a standard deviation of 0.045 in the metal-on-polyethylene group and 0.056 mm with a standard deviation of 0.032 in the ceramic-on-polyethylene group. The wear rate per year was significantly lower in the ceramic-on-polyethylene group (p < 0.001). Conclusions Although the implication is still controversial, our study showed that the use of ceramic head lowered the liner wear rate. Clinical relevance Ceramic is harder and more resistant to scratching than cobalt-chrome. By increasing polyethylene liner survivorship and decreasing potential osteolytic response and aseptic loosening, ceramic head is a better alternative than cobalt-chrome head.

This paper introduces several basic principles of chaos generated by memristive circuits in accordance with the characteristic of memristor, and a new three-dimensional chaotic system with only one equilibrium are further proposed based on a series memristive circuit. The numerical results show that the proposed memristive system has the common features of nonlinear system under different parameters, such as periodic orbit and chaos which are demonstrated by numerical simulations, bifurcation analysis. Most importantly, the system can be used for illustrating continuous period-double bifurcations routing to chaos.

We explored if there was an increased risk of DVT in patients with diabetes mellitus undergoing total knee arthroplasty within 14days followup. We reviewed 245 patients undergoing total knee arthroplasty in our hospital between 2003 and 2011. The incidence of DVT within 14days after operations was compared between diabetic patients and non-diabetic patients. There were 37 patients with DVT in the diabetes group and 88 in the non-diabetes group within 14days followup (p=0.002). The risk of DVT in patients with diabetes mellitus was 2.76 times the risk in patients without diabetes mellitus using logistic regression modeling (OR=2.76, p=0.003). Although it is still controversial, patients with diabetes had a higher incidence rate of DVT after total knee arthroplasty in our study.