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Bone & Joint Research
Vol. 9, Issue 1 | Pages 29 - 35
1 Jan 2020
Choi J Lee YS Shim DM Seo SW

Aims

Receptor activator of nuclear factor-κB ligand (RANKL) is a key molecule that is expressed in bone stromal cells and is associated with metastasis and poor prognosis in many cancers. However, cancer cells that directly express RANKL have yet to be unveiled. The current study sought to evaluate how a single subunit of G protein, guanine nucleotide-binding protein G(q) subunit alpha (GNAQ), transforms cancer cells into RANKL-expressing cancer cells.

Methods

We investigated the specific role of GNAQ using GNAQ wild-type cell lines (non-small-cell lung cancer cell lines; A549 cell lines), GNAQ knockdown cell lines, and patient-derived cancer cells. We evaluated GNAQ, RANKL, macrophage colony-stimulating factor (M-CSF), nuclear transcription factor-κB (NF-κB), inhibitor of NF-κB (IκB), and protein kinase B (Akt) signalling in the GNAQ wild-type and the GNAQ-knockdown cells. Osteoclastogenesis was also evaluated in both cell lines.


Bone & Joint Research
Vol. 8, Issue 7 | Pages 349 - 356
1 Jul 2019
Starlinger J Kaiser G Thomas A Sarahrudi K

Objectives

The osteoprotegerin (OPG) and receptor activator of nuclear factor kappa-B ligand (RANKL) balance is of the utmost importance in fracture healing. The aim of this study was therefore to investigate the impact of nonosteogenic factors on OPG and RANKL levels.

Methods

Serum obtained from 51 patients with long bone fractures was collected over 48 weeks. The OPG and serum sRANKL (soluble RANKL) concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Smoking habit, diabetes, and alcohol consumption were recorded.


The Journal of Bone & Joint Surgery British Volume
Vol. 39-B, Issue 4 | Pages 641 - 658
1 Nov 1957
Burrows HJ

1. By questionnaire, an attempt has been made to ascertain the characteristics of a hundred cases of slipping of the upper femoral epiphysis. 2. The principal object has been to see whether an etiological classification would be possible pending an assessment of the results of treatment. 3. Proper statistical analysis has proved impossible because of the incompleteness of the data. 4. As usual, boys predominated and were usually affected as much as three years older than the girls. 5. It was exceptional to find epiphysial slipping in a girl once she had begun to menstruate. 6. Nearly a quarter of the cases were bilateral, or became so after six to twenty-four months or more. 7. Little information came from an enquiry about dietary fads, the estimation of urinary ketosteroid excretion in twenty-three of the patients, or some minor pathological investigations. 8. No convincing evidence was found of skeletal retardation or of general thickening of epiphysial discs, such as might perhaps be expected in a hormonal disturbance characterised by defective epiphysial maturation. 9. From each child with the necessary data, indices of height, weight and build were ascertained, which would indicate his expectation of finding a place among a hundred physically normal children of his own sex and age, and, if so, where that place would be. From these studies four groups of children seemed to emerge: I) what may be called abnormally heavy children who would not find a place among a hundred, or somestimes a thousand, physically "normal" children of their own age and sex; 2) unusually heavy children who would find a place in the heaviest minority of the normal hundred; 3) a very small group of abnormally small people, among whom might be expected the subjects of pituitary infantilism; and 4) a large group of children of average physique for their sex and age. 10. From this information and from clinical evidence in the case returns, it appeared that a quarter of the assessable boys and nearly two-thirds of the assessable girls showed evidence of endocrine defect, quite apart from those who were merely unusually fat. 11. By distinguishing these two groups of children from a third group of constitutionally "normal," an attempt has been made to see whether there is any correlation between evident endocrine defect and such characteristics as bilateral affection, delayed epiphysial maturation, a history of relevant injury and its nature, and sudden or gradual epiphysial slipping. 12. No relationship was established between any of these characteristics and endocrine type: bilateral affection was no commoner in the endocrine group; delayed maturation was not demonstrated in either; a history of relevant injury was equally common, and its nature identical, in both; slipping might be sudden or gradual in either indiscriminately. 13. There was a history of seemingly relevant injury in half the patients, and it was much commoner with sudden slipping than with gradual slipping. Sudden slipping was often preceded by symptoms of gradual slipping, or sudden slipping of one epiphysis was sometimes followed by gradual slipping of the other. 14. In gradual slipping the cardinal symptoms were pain and limp, usually starting synchronously and gradually; the pain was usually intermittent and referred much more often to the hip than the knee; the limp was usually continuous. 15. Of signs, demonstrable wasting seemed to be absent as often as present, but shortening was usual. Lateral rotation deformity was usually present, adduction often, and flexion sometimes. In more than a third of the cases limitation of movement was slight enough to be easily missed. 16. The radiographic observations confirmed the seeming widening at the affected epiphysial disc, the greater displacement revealed by the lateral view, and the difficulty of identifying avascular necrosis before collapse. 17. Treatment was delayed in thirty-four cases—a third of the whole; the reasons have been analysed; diagnostic failure was the cause in nineteen. 18. A few cases outside the series have been mentioned briefly because of special points of interest: slipping in gross pituitary disease—in pituitary giantism, and(at the age of thirty-three) in pituitary hypogonadism; slipping with defect of the opposite lower limb—infantile paralysis of the leg, and Legg-Calvé-Perthes disease of the hip; familial affection—slipping in two brothers. 19. The results of treatment in the present cases, supplemented by others, have been studied by Dr John Hall and related to some of the clinical features. His paper appears separately


The Bone & Joint Journal
Vol. 101-B, Issue 11 | Pages 1416 - 1422
1 Nov 2019
Rohilla R Sharma PK Wadhwani J Rohilla S Beniwal R Singh R Devgan A

Aims

In this randomized study, we aimed to compare quality of regenerate in monolateral versus circular frame fixation in 30 patients with infected nonunion of tibia.

Patients and Methods

Both groups were comparable in demographic and injury characteristics. A phantom (aluminium step wedge of increasing thickness) was designed to compare the density of regenerate on radiographs. A CT scan was performed at three and six months postoperatively to assess regenerate density. A total of 30 patients (29 male, one female; mean age 32.54 years (18 to 60)) with an infected nonunion of a tibial fracture presenting to our tertiary institute between June 2011 and April 2016 were included in the study.


Bone & Joint Research
Vol. 8, Issue 12 | Pages 582 - 592
1 Dec 2019
Sansone V Applefield RC De Luca P Pecoraro V Gianola S Pascale W Pascale V

Aims

The aim of this study was to systematically review the literature for evidence of the effect of a high-fat diet (HFD) on the onset or progression of osteoarthritis (OA) in mice.

Methods

A literature search was performed in PubMed, Embase, Web of Science, and Scopus to find all studies on mice investigating the effects of HFD or Western-type diet on OA when compared with a control diet (CD). The primary outcome was the determination of cartilage loss and alteration. Secondary outcomes regarding local and systemic levels of proteins involved in inflammatory processes or cartilage metabolism were also examined when reported.


Bone & Joint 360
Vol. 8, Issue 4 | Pages 32 - 34
1 Aug 2019


The Bone & Joint Journal
Vol. 101-B, Issue 9 | Pages 1115 - 1121
1 Sep 2019
Takenaka S Makino T Sakai Y Kashii M Iwasaki M Yoshikawa H Kaito T

Aims

The aim of this study was to explore risk factors for complications associated with dural tear (DT), including the types of DT, and the intra- and postoperative management of DT.

Patients and Methods

Between 2012 and 2017, 12 171 patients with degenerative lumbar diseases underwent primary lumbar spine surgery. We investigated five categories of potential predictors: patient factors (sex, age, body mass index, and primary disease), surgical factors (surgical procedures, operative time, and estimated blood loss), types of DT (inaccessible for suturing/clipping and the presence of cauda equina/nerve root herniation), repair techniques (suturing, clipping, fibrin glue, polyethylene glycol (PEG) hydrogel, and polyglycolic acid sheet), and postoperative management (drainage duration). Postoperative complications were evaluated in terms of dural leak, prolonged bed rest, headache, nausea/vomiting, delayed wound healing, postoperative neurological deficit, surgical site infection (SSI), and reoperation for DT. We performed multivariable regression analyses to evaluate the predictors of postoperative complications associated with DT.


Objectives

Activation of the leptin pathway is closely correlated with human knee cartilage degeneration. However, the role of the long form of the leptin receptor (Ob-Rb) in cartilage degeneration needs further study. The aim of this study was to determine the effect of increasing the expression of Ob-Rb on chondrocytes using a lentiviral vector containing Ob-Rb.

Methods

The medial and lateral cartilage samples of the tibial plateau from 12 osteoarthritis (OA) patients were collected. Ob-Rb messenger RNA (mRNA) was detected in these samples. The Ob-Rb-overexpressing chondrocytes and controls were treated with different doses of leptin for two days. The activation of the p53/p21 pathway and the number of senescence-associated β-galactosidase (SA-β-gal)-positive cells were evaluated. The mammalian target of rapamycin (mTOR) signalling pathway and autophagy were detected after the chondrocytes were treated with a high dose of leptin.


Bone & Joint 360
Vol. 7, Issue 6 | Pages 2 - 8
1 Dec 2018
Murray IR Safran MR LaPrade RF


Bone & Joint 360
Vol. 8, Issue 3 | Pages 19 - 21
1 Jun 2019


The Bone & Joint Journal
Vol. 101-B, Issue 7 | Pages 860 - 866
1 Jul 2019
Nicholson JA Searle HKC MacDonald D McBirnie J

Aims

The aim of this study was to investigate the influence of age on the cost-effectiveness of arthroscopic rotator cuff repair.

Patients and Methods

A total of 112 patients were prospectively monitored for two years after arthroscopic rotator cuff repair using the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH), the Oxford Shoulder Score (OSS), and the EuroQol five-dimension questionnaire (EQ-5D). Complications and use of healthcare resources were recorded. The incremental cost-effectiveness ratio (ICER) was used to express the cost per quality-adjusted life-year (QALY). Propensity score-matching was used to compare those aged below and above 65 years of age. Satisfaction was determined using the Net Promoter Score (NPS). Linear regression was used to identify variables that influenced the outcome at two years postoperatively.


Bone & Joint Research
Vol. 7, Issue 2 | Pages 173 - 178
1 Feb 2018
Peng X Wu X Zhang J Zhang G Li G Pan X

Osteoporosis is a systemic skeletal disorder characterized by reduced bone mass and deterioration of bone microarchitecture, which results in increased bone fragility and fracture risk. Casein kinase 2-interacting protein-1 (CKIP-1) is a protein that plays an important role in regulation of bone formation. The effect of CKIP-1 on bone formation is mainly mediated through negative regulation of the bone morphogenetic protein pathway. In addition, CKIP-1 has an important role in the progression of osteoporosis. This review provides a summary of the recent studies on the role of CKIP-1 in osteoporosis development and treatment.

Cite this article: X. Peng, X. Wu, J. Zhang, G. Zhang, G. Li, X. Pan. The role of CKIP-1 in osteoporosis development and treatment. Bone Joint Res 2018;7:173–178. DOI: 10.1302/2046-3758.72.BJR-2017-0172.R1.


Bone & Joint Research
Vol. 8, Issue 2 | Pages 41 - 48
1 Feb 2019
Busse P Vater C Stiehler M Nowotny J Kasten P Bretschneider H Goodman SB Gelinsky M Zwingenberger S

Objectives

Intra-articular injections of local anaesthetics (LA), glucocorticoids (GC), or hyaluronic acid (HA) are used to treat osteoarthritis (OA). Contrast agents (CA) are needed to prove successful intra-articular injection or aspiration, or to visualize articular structures dynamically during fluoroscopy. Tranexamic acid (TA) is used to control haemostasis and prevent excessive intra-articular bleeding. Despite their common usage, little is known about the cytotoxicity of common drugs injected into joints. Thus, the aim of our study was to investigate the effects of LA, GC, HA, CA, and TA on the viability of primary human chondrocytes and tenocytes in vitro.

Methods

Human chondrocytes and tenocytes were cultured in a medium with three different drug dilutions (1:2; 1:10; 1:100). The following drugs were used to investigate cytotoxicity: lidocaine hydrochloride 1%; bupivacaine 0.5%; triamcinolone acetonide; dexamethasone 21-palmitate; TA; iodine contrast media; HA; and distilled water. Normal saline served as a control. After an incubation period of 24 hours, cell numbers and morphology were assessed.


The Bone & Joint Journal
Vol. 101-B, Issue 1_Supple_A | Pages 3 - 9
1 Jan 2019
Alamanda VK Springer BD

Aims

Prosthetic joint infection (PJI) remains a serious complication that is associated with high morbidity and costs. The aim of this study was to prepare a systematic review to examine patient-related and perioperative risk factors that can be modified in an attempt to reduce the rate of PJI.

Materials and Methods

A search of PubMed and MEDLINE was conducted for articles published between January 1990 and February 2018 with a combination of search terms to identify studies that dealt with modifiable risk factors for reducing the rate of PJI. An evidence-based review was performed on 12 specific risk factors: glycaemic control, obesity, malnutrition, smoking, vitamin D levels, preoperative Staphylococcus aureus screening, the management of anti-rheumatic medication, perioperative antibiotic prophylaxis, presurgical skin preparation, the operating room environment, irrigant options, and anticoagulation.


Bone & Joint 360
Vol. 7, Issue 6 | Pages 29 - 31
1 Dec 2018


Objectives

Adult mice lacking the transcription factor NFAT1 exhibit osteoarthritis (OA). The precise molecular mechanism for NFAT1 deficiency-induced osteoarthritic cartilage degradation remains to be clarified. This study aimed to investigate if NFAT1 protects articular cartilage (AC) against OA by directly regulating the transcription of specific catabolic and anabolic genes in articular chondrocytes.

Methods

Through a combined approach of gene expression analysis and web-based searching of NFAT1 binding sequences, 25 candidate target genes that displayed aberrant expression in Nfat1-/- AC at the initiation stage of OA, and possessed at least four NFAT1 binding sites in the promoter of each gene, were selected and tested for NFAT1 transcriptional activities by chromatin immunoprecipitation (ChIP) and promoter luciferase reporter assays using chondrocytes isolated from the AC of three- to four-month-old wild-type mice or Nfat1-/- mice with early OA phenotype.


The Bone & Joint Journal
Vol. 101-B, Issue 1_Supple_A | Pages 25 - 31
1 Jan 2019
Greco NJ Manocchio AG Lombardi AV Gao SL Adams J Berend KR

Aims

Despite declining frequency of blood transfusion and electrolyte supplementation following total joint arthroplasty, postoperative blood analyses are still routinely ordered for these patients. This study aimed to determine the rate of blood transfusion and electrolyte restoration in arthroplasty patients treated with a perioperative blood conservation protocol and to identify risk factors that would predict the need for transfusion and electrolyte supplementation.

Patients and Methods

Patients undergoing primary total joint arthroplasty of the hip or knee between July 2016 and February 2017 at a single institution were included in the study. Standard preoperative and postoperative laboratory data were collected and reviewed retrospectively. A uniform blood conservation programme was implemented for all patients. Need for blood transfusion or potassium supplementation was determined through a coordinated decision by the care team. Rates of transfusion and supplementation were observed, and patient risk factors were noted.


Aims

The aim of this study was to evaluate the outcomes of a salvage procedure using a 95° angled blade plate for failed osteosynthesis of atypical subtrochanteric femoral fractures associated with the long-term use of bisphosphonates. These were compared with those for failed osteosynthesis of subtrochanteric fractures not associated with bisphosphonate treatment.

Patients and Methods

Between October 2008 and July 2016, 14 patients with failed osteosynthesis of an atypical subtrochanteric femoral fracture were treated with a blade plate (atypical group). Their mean age was 67.8 years (60 to 74); all were female. During the same period, 21 patients with failed osteosynthesis of a typical subtrochanteric fracture underwent restabilization using a blade plate (typical group). Outcome variables included the time of union, postoperative complications, Harris Hip Score, and Sanders functional rating scale.


Bone & Joint Research
Vol. 7, Issue 1 | Pages 105 - 110
1 Jan 2018
Abar O Dharmar S Tang SY

Objectives

Advanced glycation end-products (AGEs) are a post-translational modification of collagen that form spontaneously in the skeletal matrix due to the presence of reducing sugars, such as glucose. The accumulation of AGEs leads to collagen cross-linking, which adversely affects bone quality and has been shown to play a major role in fracture risk. Thus, intervening in the formation and accumulation of AGEs may be a viable means of protecting bone quality.

Methods

An in vitro model was used to examine the efficacy of two AGE-inhibitors, aminoguanidine (AG) and pyridoxamine (PM), on ageing human cortical bone. Mid-diaphyseal tibial cortical bone segments were obtained from female cadavers (n = 20, age range: 57 years to 97 years) and randomly subjected to one of four treatments: control; glucose only; glucose and AG; or glucose and PM. Following treatment, each specimen underwent mechanical testing under physiological conditions via reference point indentation, and AGEs were quantified by fluorescence.


Bone & Joint Research
Vol. 7, Issue 11 | Pages 601 - 608
1 Nov 2018
Hsu W Hsu W Hung J Shen W Hsu RW

Objectives

Osteoporosis is a metabolic disease resulting in progressive loss of bone mass as measured by bone mineral density (BMD). Physical exercise has a positive effect on increasing or maintaining BMD in postmenopausal women. The contribution of exercise to the regulation of osteogenesis in osteoblasts remains unclear. We therefore investigated the effect of exercise on osteoblasts in ovariectomized mice.

Methods

We compared the activity of differentially expressed genes of osteoblasts in ovariectomized mice that undertook exercise (OVX+T) with those that did not (OVX), using microarray and bioinformatics.