Aims

Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common orthopaedic procedures requiring postoperative radiographs to confirm implant positioning and identify complications. Artificial intelligence (AI)-based image analysis has the potential to automate this postoperative surveillance. The aim of this study was to prepare a scoping review to investigate how AI is being used in the analysis of radiographs following THA and TKA, and how accurate these tools are.

Aims

Alcoholism is a well-known detrimental factor in fracture healing. However, the underlying mechanism of alcohol-inhibited fracture healing remains poorly understood.

Introduction: Alcohol can induce adipogenesis by bone marrow stromal cells and may cause osteonecrosis of the femoral heads. Currently, there are no medications available to prevent alcohol-induced osteonecrosis. The purpose of this study was to evaluate the effects of puerarin on adipocytic differentiation of bone marrow stromal cells and on the prevention of alcohol-induced osteonecrosis.

Materials and Methods: In the in vitro study, bone marrow stromal cells were treated with ethanol as model groups, with ethanol and puerarin as experimental groups, and without ethanol or puerarin to serve as controls. In the in vivo study, model group mice received ethanol intragastrically and normal saline by intramuscular injection. The experimental group received the same dose of alcohol intragastrically and puerarin by intramuscular injection, and the control group received water intragastrically and normal saline by intramuscular injection daily, for 4, 6, 8, and 10 months, respectively.

Results: It was found that in the in vitro experimental group, the number of adipocytes, contents of triglycerides and levels of PPARγ mRNA expression were significantly decreased, and alkaline phosphatase activity, contents of osteocalcin and levels of osteocalcin mRNA expression were significantly increased compared with cells in model groups. In the in vivo experimental group, cholesterol, and triglyceride in serum were significantly decreased, and alkaline phosphatase activity was significantly higher, compared with the model group. Fat cell hypertrophy and proliferation, thinner and sparse trabeculae, diminished hematopoiesis, and increased empty osteocyte lacunae in the subchondral region of the femoral head were observed in the model groups. However, no significant changes were seen in femoral heads of the experimental and the control group.

Discussion: The results showed that puerarin can inhibit adipogenic differentiation by bone marrow stromal cells both in in vitro in cell culture and in vivo animal experiments. These findings indicate that puerarin can prevent alcohol-induced adipogenesis and osteonecrosis.