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Orthopaedic Proceedings
Vol. 106-B, Issue SUPP_19 | Pages 12 - 12
22 Nov 2024
Wang L Trampuz A Zhang X
Full Access

Aim

Treatment of prosthetic joint infection (PJI) by systemic administration of high doses of long-term antibiotics often proves ineffective, causing severe side effects. Thus, we presented the phage Sb-1, which coding extracellular polymeric substances (EPS) degradation depolymerases, conjugated with rifampicin-loaded liposomes (Lip-RIF@Phage) by bio-orthogonal functionalization strategy to target biofilm (Figure1).

Method

Methicillin-resistant Staphylococcus aureus (MRSA) biofilm was grown on porous glass beads for 24 h in vitro. After the biofilm formation, beads were exposed to 0.9% saline, then sonication. Quantitative and qualitative biofilm analyses were performed by colony counting, scanning electron microscopy and isothermal microcalorimetry. A rat model of total knee arthroplasty infected with the bioluminescent MRSA strain was developed as the PJI model to evaluate the efficacy of Lip-RIF@Phage anti-biofilm therapy in vivo, then the creatinine, alanine transaminase, and aspartate transaminase values were evaluated throughout the entire treatment process.


Orthopaedic Proceedings
Vol. 106-B, Issue SUPP_19 | Pages 42 - 42
22 Nov 2024
Mu W Tarabichi S Xu B Wang F Li Y Lizcano JD Zhang X Parvizi J Cao L
Full Access

Aim

This study aimed to evaluate the impact of intraoperative direct sonication on the yield of traditional culture and the time to positivity (TTP) of cultures obtained for periprosthetic joint infection (PJI), thereby assessing its potential to improve diagnostic efficiency and reduce contamination risk.

Method

A prospective cohort study was conducted at a tertiary care center, involving 190 patients undergoing revision surgery for PJI from August 2021 to January 2024. Patients were included based on the 2018 International Consensus Meeting definition of PJI. The study utilized a novel sonication protocol, which involved direct intraoperative sonication of the implant and tissue, followed by incubation in a BACT/ALERT 3D system. The primary outcomes measured were the number and percentage of positive culture samples, identified microorganisms, and the TTP of each culture. Statistical analysis was performed using R software, with various tests applied to assess the significance of findings.


Orthopaedic Proceedings
Vol. 105-B, Issue SUPP_2 | Pages 119 - 119
10 Feb 2023
Lai S Zhang X Xue K Bubra P Baba M
Full Access

The second wave of COVID-19 infections in 2021 resulting from the delta strain had a significantly larger impact on the state of New South Wales, Australia and with it the government implemented harsher restrictions.

This retrospective cohort study aims to explore how the increased restrictions affected hand trauma presentations and their treatment. Retrospective analysis was performed on patients who underwent hand surgery from the period of June 23 – August 31 in 2020 and 2021 at a level one trauma centre in Western Sydney.

During the second-wave lockdown there was an 18.9% decrease in all hand trauma presentations. Despite widespread restrictions placed on the manufacturing, wholesale, retail and construction industries, there was an insignificant difference in work injuries.

Stay-at-home orders and reduced availability of professional tradespersons likely contributed to an increase in DIY injuries. Significant reductions in metacarpal and phalangeal fractures coincided with significantly curtailed sporting seasons. The findings from this study can assist in predicting the case-mix of hand trauma presentations and resource allocation in the setting of future waves of COVID-19 and other infectious diseases.


Orthopaedic Proceedings
Vol. 102-B, Issue SUPP_8 | Pages 41 - 41
1 Aug 2020
Zhang X Liu J Li J Chen X Qiao Z Xu J Xiao F Cui P
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Osteosarcoma (OS) is the most prevalent bone tumor in children and young adults. Most tumors arise from the metaphysis of the long bones and easily metastasize to the lungs. Current therapeutic strategies of osteosarcoma are routinely surgical resection and chemotherapy, which are limited to the patients suffering from metastatic recurrence. Therefore, to investigate molecular mechanisms that contribute to osteosarcoma progression is very important and may shed light on targeted therapeutic approach to improve the survival of patients with this disease. Several miRNAs have been found expressed differentially in osteosarcoma (OS), In this study, we found that miR-144 significantly suppresses osteosarcoma cell proliferation, migration andinvasion ability in vitro, and inhibited tumor growth and metastasisin vivo. The function and molecular mechanism of miR-144 in Osteosarcoma was further investigated.

Tissue samples from fifty-one osteosarcoma patients were obtained from Shanghai Ninth People's Hospital. The in vitro function of miR-144 in Osteosarcoma was investigated by cell viability assay, wound healing assay, invasion assay, the molecular mechanism was identified by Biotin-coupled miRNA capture, Dual-luciferase reporter assays, etc. the in vivo function of miR-144 in osteosarcoma was confirmed by osteosarcoma animal model and miR-144−/− zebrafish model.

Mechanically, we demonstrated that Ras homolog family member A (RhoA) and its pivotal downstream effector Rho-associated, coiled-coil containing protein kinase 1 (ROCK1) were both identified as direct targets of miR-144. Moreover, the negative co-relation between downregulated miR-144 and upregulated ROCK1/RhoA was verified both in the osteosarcoma cell lines and clinical patients' specimens. Functionally, RhoA with or without ROCK1 co-overexpression resulted a rescue phenotype on the miR-144 inhibited cell growth, migration and invasion abilities, while individual overexpression of ROCK1 had no statistical significance compared with control in miR-144 transfected SAOS2 and U2-OS cells.

This study demonstrates that miR-144 inhibited tumor growth and metastasis in osteosarcoma via dual-suppressing of RhoA and ROCK1, which could be a new therapeutic approach for the treatment ofosteosarcoma.


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_5 | Pages 57 - 57
1 Apr 2018
Dong N Yang S Zhu Z Wang A Gao J Qiu Y Zhang X
Full Access

Introduction

One of the objectives of total hip arthroplasty is to restore femoral and acetabular combined anteversion. It is desirable to reproduce both femoral and acetabular antevesions to maximize the acetabular cup fixation coverage and hip joint stability. Studies investigated the resultant of implanted femoral stem anteversion in western populations showed that the implanted femoral stems had only a small portion can meet the desirable femoral anteversion angle1, and anteversion angle increases after the implantation of an anatomical femoral stem with anteverted stem neck comparing to anatomical femoral neck2. The purpose of this study was to anatomically measure the anteversion angular difference between metaphyseal long axis and femoral neck in normal Chinese population. The metaphyseal long axis represents the coronal fixation plane of modern cementless medial-lateral cortical fitting taper stem. This angular difference or torsion Δ angle provides the estimation of how much the neck antevertion angle of femoral stem would be needed to match for desirable anatomical femoral neck version.

Methods

140 (77 male and 63 female) anonymous normal adult Chinese CT data with average age of 54.6 (male 54.6, female 54.5, P=0.95) were segmented and reconstructed to 3D models in Trauson Orthopeadic Modeling and Analytics (TOMA) program. Femoral head center, femoral neck axis and center point of diaphyseal canal 100mm bellow calcar formed the femoral neck plane. The metaphyseal stem implantation plane was determined by the center point of medial calcar, proximal canal central axis formed by femoral neck plane and the center point of diaphyseal canal 100mm bellow calcar. [Fig. 1] The angle between two planes was the torsion Δ angle between femoral placement plane and anatomical femoral neck. [Fig. 2] The torsion Δ angles were measured for all 140 cases. The traditional anteversion angle for anatomical femoral neck was also measured by Murphy's method. Student T test was perform to compare the angles for male and female. The 98% confidence level was assumed.


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_1 | Pages 118 - 118
1 Jan 2016
Dong N Rickels T Bastian A Wang A Zhou Y Zhang X Wang Y
Full Access

Objective

The purpose of this study was to compare the proximal femoral morphology between normal Chinese and Caucasian populations by 3D analysis derived from CT data.

Materials and Methods

141 anonymous Chinese femoral CT scans (71 male and 70 female) with mean age of 60.1years (range 20–93) and 508 anonymous Caucasian left femoral CT scans (with mean age of 64.8years (range 20–93). The CT scans were segmented and converted to virtual bones using custom CT analytical software. (SOMA™ V.4.0) Femoral Head Offset (FHO) and Femoral Head Position (FHP) were measured from head center to proximal canal central axis and to calcar or 20mm above Lesser Trochanter (LT) respectively. The Femoral neck Anteversion (FA) and Caput-Collum-Diaphyseal (CCD) angles were also measured. The Medial Lateral Widths(MLWn) of femoral canal were measured at 0, -10, LT, -30, -40, -60, -70 and -100mm levels from calcar. Anterior Posterior Widths (APWn) were measured at 0, -60 and -100mm levels. The Flare Index (FI) was derived from the ratio of widths at 0 and -60mmor FI=W0/W−60. All measurements were performed in the same settings for both populations. The comparison was analyzed by Student T test. P<0.05 was considered significant.