Objectives

The aim of this study was to investigate the effect of hyperglycaemia on oxidative stress markers and inflammatory and matrix gene expression within tendons of normal and diabetic rats and to give insights into the processes involved in tendinopathy.

INTRODUCTION

An accelerometer-based portable navigation system (KneeAlign2, OrthAlign Inc., Aliso Viejo, CA) is expected to improve mechanical axis and component alignment compared to conventional instrumentation in total knee arthroplasty (TKA). However, past reports have evaluated its accuracy using only radiographic measurements. The purpose of this study was to analyze the accuracy of the KneeAlign2 system with radiography and more detailed three-dimensional (3D) CT.

Introduction

Dysplastic hip has not only deficiency of acetabulum but also femoral deformity. Therefore, selection of stem is important in cementless THA for dysplasia. Especially using of short stem should be challenge for deformed femur. We studied clinical performance and radiological findings after THA with triple tapered short stem (Optimys hip) for dysplastic hip.

Objectives

Triamcinolone acetonide (TA) is widely used for the treatment of rotator cuff injury because of its anti-inflammatory properties. However, TA can also produce deleterious effects such as tendon degeneration or rupture. These harmful effects could be prevented by the addition of platelet-rich plasma (PRP), however, the anti-inflammatory and anti-degenerative effects of the combined use of TA and PRP have not yet been made clear. The objective of this study was to determine how the combination of TA and PRP might influence the inflammation and degeneration of the rotator cuff by examining rotator cuff-derived cells induced by interleukin (IL)-1ß.

Introduction

Patient matched instrumentation (PMI) have been proposed the accuracy of bone cuts through custom cutting blocks and provide the proper alignment of total knee arthroplasty (TKA). On the other hand, there are some reports that the introduction of PMI for guiding bone cuts could increase the incidence of malalignment in primary TKA. Recent comparisons between patient-specific cutting guides and quantitative assessments of postoperative alignment have revealed the presence of outliers with respect to coronal alignment. The purpose of this study was to assess the implanted component alignment post-operatively between one type of MRI based PMI (Visionaire; Smith & Nephew, Inc, Memphis, Tenn) and conventional surgical instrumentation (CI) using radiographs and CT scan.

Introduction

Fixation patterns of cementless stem were known as proximal or distal part. Distal fixation was seen in fully porous coated stem and stress shielding of the proximal femur was indicative. These phenomena did not lower the clinical results, but technical difficulties were more and more in revision surgery because of infection or dislocation. There was lot of reports that alendronate was effective for treatment of osteoporosis by induction of apoptosis in osteoclasts. We can expect alendronate to modify the bone quality around the stem after cementless THA.

We describe our experience in the reduction of dislocation of the hip secondary to developmental dysplasia using ultrasound-guided gradual reduction using flexion and abduction continuous traction (FACT-R). During a period of 13 years we treated 208 Suzuki type B or C complete dislocations of the hip in 202 children with a mean age of four months (0 to 11). The mean follow-up was 9.1 years (five to 16). The rate of reduction was 99.0%. There were no recurrent dislocations, and the rate of avascular necrosis of the femoral head was 1.0%. The rate of secondary surgery for residual acetabular dysplasia was 19.2%, and this was significantly higher in those children in whom the initial treatment was delayed or if other previous treatments had failed (p = 0.00045). The duration of FACT-R was significantly longer in severe dislocations (p = 0.001) or if previous treatments had failed (p = 0.018).

This new method of treatment is effective and safe in these difficult cases and offers outcomes comparable to or better than those of standard methods.

Cite this article: Bone Joint J 2015;97-B:405–11.

Objectives

To investigate the appropriate dose and interval for the administration of triamcinolone acetonide (TA) in treating tendinopathy to avoid adverse effects such as tendon degeneration and rupture.

Objectives

The purpose of the present study was to describe the long-term results of THA for ONFH in patients with SLE.

Introduction

Nociceptive and neuropathic components both contribute to chronic pain. Since these components require different pain management strategies, correct pain diagnosis before and during treatment is important.

Freynhagen et al. (2006) reported that they had developed and validated the pain-DETECT questionnaire (PD-Q) to detect neuropathic components in chronic low back pain patients. They also reported that 37% of unselected cohort of chronic LBP patients had predominantly neuropathic pain. However, the extent to which neuropathic components relate to the pathomechanism of pain deriving from osteoarthritis of hip joint remains unknown.

The purpose of this study was to utilize PD-Q to investigate the relationship between neuropathic components and pain deriving from osteoarthritis of the hip joint.

Introduction

The purpose of this study was to clarify the incidence of steroid-induced osteonecrosis among different collagen diseases and to evaluate the predictive factors for steroid-induced osteonecrosis in a prospective MRI study.

We usually plan surgery for total hip arthroplasty (THA)using pre-operative X-ray templates. However, the technique provides only two dimensional (2D) images and therefore has limitations for planning three-dimensional (3D) objects. Recently it has become possible to describe 3D images using computer programs that use free down loaded computer software (Hip-op) that enable comparison between 3D templates obtained by computed tomography (CT) and 2D conventional X-ray templates.

Six hip joints in 6 patients (1 male, 5 females; age range at the time of operation, 49–77 years) were evaluated. Five of the patients suffered from secondary osteoarthritis of the hip (secondary OA), while the remaining patient suffered from osteonecrosis of the femoral head (ONFH). All the patients underwent THA using a cement less femoral stem (ANCA-FIT Wright Medical Technology, Arlington, Tennessee, USA). Pre-operative planning was performed using Hip-op software (Rizzoli Institute, Bologna, Italy). After the THA surgery, we carried out a repeat CT scan that was used to analyze stem fitting in the femur.

In all the patients it proved easy to obtain the pre-operative template. In 4 patients, the correct stem size was selected pre-operatively, while in the other 2 patients, the planned stem size was one size smaller than that actually implanted. In the 4 patients in whom the correct stem was selected, 2 had their template correctly assessed by conventional 2D images, 1 patient’s template was one size smaller than the implant, while the remaining patient’s template was two sizes smaller than the implant. In the 2 patients who received implants one size smaller than the CT template, 1 patient had the stem inserted in the virus position while in the other patient a fracture occurred during implantation

Preoperative planning for THA using a CT-based computer templating system proved to be a useful technique for the orthopedic surgeons.

Using a rat model the characteristics of the sensory neurones of the dorsal-root ganglia (DRG) innervating the hip were investigated by retrograde neurotransport and immunohistochemistry.

Fluoro-Gold solution (FG) was injected into the left hip of ten rats. Seven days later the DRG from both sides between T12 and L6 were harvested. The number of FG-labelled calcitonin gene-related peptide-immunoreactive or isolectin B4-binding neurones were counted.

The FG-labelled neurones were distributed throughout the left DRGs between T13 and L5, primarily at L2, L3, and L4. Few FG-labelled isolectin B4-binding neurones were present in the DRGs of either side between T13 and L5, but calcitonin gene-related peptide-immunoreactive neurones made up 30% of all FG-labelled neurones.

Our findings may explain the referral of pain from the hip to the thigh or lower leg corresponding to the L2, L3 and L4 levels. Since most neurones are calcitonin gene-related peptide-immunoreactive peptide-containing neurones, they may have a more significant role in the perception of pain in the hip as peptidergic DRG neurones.

Introduction: Fibroin sponge is purified silk protein from which high-strength gel sponge can be produced. The purified fibroin sponge causes no immune response. This study evaluates unique performances of the fibroin sponge for articular-cartilage regeneration, and mechanical properties of regenerated cartilage were also measured.

Methods: Refined silk yarn was dissolved in 9M lithium bromide aqueous solutions, and was frozen in −20& #8451 freezer for 12 hours. Hydrogel sponge was formed under the room temperature. Articular cartilage slices were taken from the proximal humerus, distal femur and proximal tibia of 4-week-old Japanese white rabbits. The cartilage slices cut into small pieces and were digested with 0.25% trypsin in DMEM containing antibiotics for 30 min at 37& #8451. After rinsing with Tyrode’s balanced solution and centrifuging at 180 G for 5 min, the chondrocytes were isolated with 0.25% collagenase for 8 h at 37& #8451. These cells were harvested and inoculated into the fibroin sponge. The constructs of the chondrocytes and the fibroin sponge were cultured in DMEM containing 10& #65285 FCS and 50mL L-ascorbate for 4weeks. Indentation test and dynamic visco-elastic measurement were carried out for these constructs.

Results and discussion: Cell density of the inoculated chondrocytes was increased to about five times as much as initial volume. This regenerated tissue was intensely stained with safranin-O fast green and showed a meta-chromatic reaction. This also stained positively with immunostain for type & #8545 collagen, but negatively with immunostain for type & #8544 collagen. Mechanical tests showed that time constants of compressive creep and E’ values were increased with cultivation days, and the peak value and frequency of tan& #948 shifted to a lower amount. The change in dynamic visco-elastic properties of the regenerated cartilage is caused by synthesis of extracellular matrix.

Introduction: Several types of “ Total Joint Regeneration System” were proposed where wide defect of cartilage expected to be regenerated under proper mechanical environment. Several types of therapeutic equipments for the Total Joint Regeneration System were designed and animal trial for the system was performed. Fundamental experiment evaluating cartilage generation under continuous sliding motion is also reported.

Material and methods: Three Japanese white rabbits (male, 12~15 weeks-old) weighing 3.0& #13199; and one beagle dog (male) weighing 15& #13199; were used for the trial operation for the Total Joint Regeneration System. A large full-thickness defect of the articular cartilage was made on both knees. And Internal-support type device was fixed to the knee of one side. The device is consisting of 2 parts (the screw and the T-bar). The screw was fixed in tibia from the fore part of ACL attachment to anterior part of the tibia. The rod of the T-bar was inserted into the inner hole of the screw. The upper part of the T-bar hold the femoral intercondyle and keep the regenerated portion in non-weight-bearing condition. Regeneration at the osteochondral defect was evaluated at 4 weeks postoperatively. [Cartilage generation by continuous sliding motion] A coccygeal vertebra of F344 rats (7weeks-old) was osteot-omized, and the distal part of the vertebrae was moved continuously in sliding motion using mobile external fixation.

Results and discussion: Walking conditions were comparatively good in all animals. Macroscopic observation shows better appearance of defected area in the supported side, however the apparent histological difference between control side and internal-support side could not be recognized in the rabbits cases because of inappropriate fitting of the devices. Hyaline cartilage tissue with better metachromatic matrix with safranin-O staining was observed on the supported side of dog knee. Result of fundamental experiment also showed the importance of setting mechanical environment where hyaline cartilage with layer structure similar to normal articular cartilage was produced by controlled sliding motion. We are now improving the design of the Total Joint Regeneration System refering to those results.

Sterilisation by gamma irradiation in the presence of air causes free radicals generated in polyethylene (PE) to react with oxygen, which could lead to loss of physical properties and reduction in fatigue strength. Tissue retrieved from failed total hip replacements often has large quantities of particulate PE and most particles associated with peri-implant osteolysis are oxidised. Consequently, an understanding of the cellular responses of oxidised PE particles may lead to clarification of the pathogenesis of osteolysis and aseptic loosening.

We have used the agarose system to demonstrate the differential effects of oxidised and non-oxidised PE particles on the release of proinflammatory products such as interleukin-1β (IL-1β), IL-6, and tumour necrosis factor-α (TNF-α) from monocytes/ macrophages (M/M). Oxidised PE particles were shown to stimulate human M/M to phagocytose and to release cytokines. Oxidation may alter the surface chemistry of the particles and enhance the response to specific membrane receptors on macrophages, such as scavenger-type receptors.