Transcription factor nuclear factor kappa B (NF-κB) plays a major role in the pathogenesis of chronic inflammatory diseases in all organ systems. Despite its importance, NF-κB targeted drug therapy to mitigate chronic inflammation has had limited success in preclinical studies. We hypothesized that sex differences affect the response to NF-κB treatment during chronic inflammation in bone. This study investigated the therapeutic effects of NF-κB decoy oligodeoxynucleotides (ODN) during chronic inflammation in male and female mice. We used a murine model of chronic inflammation induced by continuous intramedullary delivery of lipopolysaccharide-contaminated polyethylene particles (cPE) using an osmotic pump. Specimens were evaluated using micro-CT and histomorphometric analyses. Sex-specific osteogenic and osteoclastic differentiation potentials were also investigated in vitro, including alkaline phosphatase, Alizarin Red, tartrate-resistant acid phosphatase staining, and gene expression using reverse transcription polymerase chain reaction (RT-PCR).Aims
Methods
Accurate cup placement in total hip arthroplasty (THA) for the patients with developmental dysplasia of the hip (DDH) is one of the challenges due to distinctive bone deformity. Robotic-arm assisted system have been developed to improve the accuracy of implant placement. This study aimed to compare the accuracy of robotic-arm assisted (Robo-THA), CT-based navigated (Navi-THA), and manual (M-THA) cup position and orientation in THA for DDH. A total of 285 patients (335 hips) including 202 M-THAs, 45 Navi-THAs, and 88 Robo-THA were analyzed. The choice of procedure followed the patient's preferences. Horizontal and vertical center of rotation (HCOR and VCOR) were measured for cup position, and radiographic inclination (RI) and anteversion (RA) were measured for cup orientation. The propensity score-matching was performed among three groups to compare the absolute error from the preoperative target position and angle. Navi-THA showed significantly smaller absolute errors than M-THA in RI (3.6° and 5.4°) and RA (3.8° and 6.0°), however, there were no significant differences between them in HCOR (2.5 mm and 3.0 mm) or VCOR (2.2 mm and 2.6 mm). In contrast, Robo-THA showed significantly smaller absolute errors of cup position than both M-THA and Navi-THA (HCOR: 1.7 mm and 2.9 mm, vs. M-THA, 1.6 mm and 2.5 mm vs. Navi-THA, VCOR:1.7 mm and 2.4 mm, vs. M-THA, 1.4 mm and 2.2 mm vs. Navi-THA). Robo-THA also showed significantly smaller absolute errors of cup orientation than both M-THA and Navi-THA (RI: 1.4° and 5.7°, vs. M-THA, 1.5° and 3.6°, vs. Navi-THA, RA: 1.9° and 5.8° vs. M-THA, 2.1° and 3.8° vs. Navi-THA). Robotic-arm assisted system showed more accurate cup position and orientation compared to manual and CT-based navigation in THA for DDH. CT-based navigation increased the accuracy of cup orientation compared to manual procedures, but not cup position.
