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Bone & Joint Open
Vol. 4, Issue 12 | Pages 914 - 922
1 Dec 2023
Sang W Qiu H Xu Y Pan Y Ma J Zhu L

Aims

Unicompartmental knee arthroplasty (UKA) is the preferred treatment for anterior medial knee osteoarthritis (OA) owing to the rapid postoperative recovery. However, the risk factors for UKA failure remain controversial.

Methods

The clinical data of Oxford mobile-bearing UKAs performed between 2011 and 2017 with a minimum follow-up of five years were retrospectively analyzed. Demographic, surgical, and follow-up data were collected. The Cox proportional hazards model was used to identify the risk factors that contribute to UKA failure. Kaplan-Meier survival was used to compare the effect of the prosthesis position on UKA survival.


Bone & Joint Research
Vol. 8, Issue 8 | Pages 405 - 413
1 Aug 2019
Huang J Bao X Xia W Zhu L Zhang J Ma J Jiang N Yang J Chen Q Jing T Liu J Ma D Xu G

Objectives

X-linked hypophosphataemic rickets (XLHR) is a disease of impaired bone mineralization characterized by hypophosphataemia caused by renal phosphate wasting. The main clinical manifestations of the disorder are O-shaped legs, X-shaped legs, delayed growth, and bone pain. XLHR is the most common inheritable form of rickets, with an incidence of 1/20 000 in humans. It accounts for approximately 80% of familial cases of hypophosphataemia and serves as the prototype of defective tubular phosphate (PO43+) transport, due to extra renal defects resulting in unregulated FGF23 activity. XLHR is caused by loss-of-function mutations in the PHEX gene. The aim of this research was to identify the genetic defect responsible for familial hypophosphataemic rickets in a four-generation Chinese Han pedigree and to analyze the function of this mutation.

Methods

The genome DNA samples of all members in the pedigree were extracted from whole blood. We sequenced all exons of the PHEX and FGF23 genes, as well as the adjacent splice site sequence with Sanger sequencing. Next, we analyzed the de novo mutation c.1692 del A of the PHEX gene with an online digital service and investigated the mutant PHEX with SWISS-MODEL, immunofluorescence, and protein stability detection.


Aims

The aim of this study was to examine the efficacy and safety of multiple boluses of intravenous (IV) tranexamic acid (TXA) on the hidden blood loss (HBL) and inflammatory response following primary total hip arthroplasty (THA).

Patients and Methods

A total of 150 patients were allocated randomly to receive a single bolus of 20 mg/kg IV TXA before the incision (group A), a single bolus followed by a second bolus of 1 g IV-TXA three hours later (group B) or a single bolus followed by two boluses of 1 g IV-TXA three and six hours later (group C). All patients were treated using a standard peri-operative enhanced recovery protocol. Primary outcomes were HBL and the level of haemoglobin (Hb) as well as the levels of C-reactive protein (CRP) and interleukin-6 (IL-6) as markers of inflammation. Secondary outcomes included the length of stay in hospital and the incidence of venous thromboembolism (VTE).


Bone & Joint Research
Vol. 5, Issue 9 | Pages 393 - 402
1 Sep 2016
Yang Z Liu H Li D Xie X Qin T Ma J Kang P

Objectives

The primary purpose of this meta-analysis was to determine whether statin usage could reduce the risk of glucocorticoid-related osteonecrosis in animal models.

Methods

A systematic literature search up to May 2015 was carried out using the PubMed, Ovid, EBM reviews, ISI Web of Science, EBSCO, CBM, CNKI databases with the term and boolean operators: statins and osteonecrosis in all fields. Risk ratio (RR), as the risk estimate of specific outcome, was calculated along with 95% confidence intervals (CI). The methodological quality of individual studies was assessed using a quantitative tool based on the updated Stroke Therapy Academic Industry Roundtable (STAIR) recommendations.


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_I | Pages 182 - 182
1 Mar 2010
Lutz M Keast-Butler O Ma J Escott B Schemitsch E Waddell J
Full Access

The effect of cup geometry in uncemented Total Hip Arthroplasty has not been investigated. We reviewed the radiological and clinical results of 527 primary total hip arthroplasties. We assessed the bone ingrowth potential of two geometric variations of an uncemented cup and compared hydroxyappetite and porous coated shells.

Patients undergoing primary hip arthroplasty between 1997 and 2004 were prospectively entered into an arthroplasty database. Patients were reviewed at 1,2,4,5,8 and 10 years post surgery. Three acetabular shell types were used. These included hemispherical cups with porous or hydroxyapatite coating, and cups with peripheral expansion with porous coating. Radiographs with minimum 1-year follow-up were examined in 542 cases, using digital templating software. Radiographs were assessed for signs of bone in-growth, lucent lines, migration and polyethylene wear. Survivorship analysis was performed using Kaplan-Meier analysis with 95% confidence intervals. Radiological findings and cup type were analysed using Fishers exact test.

Radiological evidence of bone ingrowth was seen in 82% of hemispherical cups, compared with 59% of peripherally expanded cups, which was significant (p,0.05). Bone ingrowth was not affected by the presence of HA coating. The most common diagnoses were osteoarthritis (67%) and avascular necrosis (12%). The mean age was 56 years. Survivorship with revision or impending revision for aseptic loosening was 95.6% at 7 years (95%CI 1.0134-0.8987). The 3 revisions and 1 impending revision for loosening were in patients with avascular necrosis (3) or previous acetabular and femoral osteotomies for DDH (1), with a mean age of 44 years.

Hemispherical shells have improved radiographic outcome in comparison with peripherally expanded components. At 7 years, clinical results are similar for both components.


Orthopaedic Proceedings
Vol. 87-B, Issue SUPP_III | Pages 328 - 328
1 Sep 2005
Koman L Smith B Smith T Elsaidi G Ma J Shen J
Full Access

Introduction and Aims: In order to evaluate the hypothesis that the ‘temporary and controlled reduction of muscle force protects repair sites come from its safe, active, and passive range of motion and diminishes complications’, a tendon repair model was evaluated.

Method: After heel cord tenotomy, Sprague-Dawley rats (n=36) were randomised to Botulinum A Toxin at six units per kilogram or saline and the tendon repaired with a two-strand core suture and a peritenon running suture. The ankles were pinned in equinus for two days, and then the animals were allowed to move freely within their cages. Analysis included gap, rupture rates, electrophysiologic measurements and mechanical testing.

Results: The treatment group had a statistically significant lower spontaneous partial or total rupture rate than the control (P=0.38). Tendon electrophysiologic testing showed that the toxin group had lower twitch and tetanus values than the control group (evidence of effective denervation). The toxin group also had better histologic healing and better strength of repair (higher rupture strength values). Histologic assessment showed that the toxin-treated group had more normal histology with less scar.

Conclusion: Chemoprotection decreases significantly spontaneous tendon rupture rates following repair in active versus control groups. The active toxin group demonstrated better healing. Decreasing tension across repair sites is equally effective in increasing inastamotic strength and permits active range of motion without rupture.