Revision total hip arthroplasty using a fluted, tapered, modular stem follow-up method for a mean of three years: A preliminary study.

Objective: This study aimed to evaluate the results and complications related to revision total hip arthroplasty within a short-to-medium follow up period. Methods: From January 2016 to January 2020, we reviewed 31 prosthetic hip arthroplasty stem revisions using a fluted, tapered modular stem with distal fixation. The median age of the patients was 74.55-79 years. The survival rate was 100%, and there were no re-revisions. The Harris hip score improved from an average of 36.5 ± 7.8 before surgery to 81.8 ± 6.2 at the final follow-up. Results: The average final follow-up was 36 (24-60) months. During this time, there was no periprosthetic infection, no prosthesis loosening or breakage, and no sciatic nerve injury. Complications included four (12.9%) intraoperative fractures and eight (25.8%) dislocations that had no stem fractures. The postoperative limb was lengthened by 17.8 ± 9.8 mm. In most cases, bone regeneration was an early and important finding. Three cases underwent extended trochanteric osteotomy, and bone healing was achieved by the final follow-up. Conclusion: The modular tapered stem reviewed in this study was very versatile, could be used in most femoral revision cases, and allowed for rapid bone reconstruction. However, a long-term follow-up study is needed to confirm these results.

Correlation of serum PTH level and fracture healing speed in elderly patients with hip fracture.

PURPOSE: To access serum parathyroid hormone (PTH) level in elderly patients with hip fracture in relation to fracture healing outcomes. METHODS: This study included 90 elderly male patients with hip fracture and they were defined as the hip fracture group, and they were divided into healing effective group and delayed healing group by final fracture healing outcomes, 45 cases in each group; another 45 male patients older than 70 years without established osteoporosis and hip fracture were included as the control group. The levels of serum PTH level were examined in each group. RESULTS: Serum PTH level was significantly higher in healing effective group patients at the 7 days and 14 days after fracture than the delayed healing patients. CONCLUSIONS: Our results show that serum PTH level may be an effective indicator of hip fracture delayed healing risk in the elderly.

Comparison of the Efficacy and Safety of Aspirin and Rivaroxaban Following Enoxaparin Treatment for Prevention of Venous Thromboembolism after Hip Fracture Surgery.

OBJECTIVE: To compare the efficacy and safety of aspirin with rivaroxaban following treatment with enoxaparin for prevention of venous thromboembolism (VTE) after hip fracture surgery (HFS). METHODS: A total of 390 patients were enrolled in the trial. According to an odd or even number at the end of their registration number, the patients were divided into the aspirin group (n = 198) and the rivaroxaban group (n = 192). All patients were given enoxaparin subcutaneous injection after the operation and returned to the routine dose the next day until postoperative day five. The patients in the aspirin group received an additional 16 days of thromboprophylaxis with 100 mg of aspirin once daily. The rivaroxaban group was assigned to receive an additional 16 days of thromboprophylaxis with 10 mg of oral rivaroxaban once daily. Patients were followed for 90 days regarding VTE and bleeding complications. RESULTS: The incidence of VTE in the aspirin group and rivaroxaban group was 6.6% (13/198) and 5.7% (11/192), respectively (P = 0.83). The rate of major bleeding events occurred in two (1.0%) patients in the aspirin group and in one patient (0.5%) in the rivaroxaban group (P = 1.0). A combination of major bleeding and clinically relevant nonmajor bleeding occurred in five patients (2.5%) in the aspirin group and in six patients (3.1%) in the rivaroxaban group (P = 0.77). During the 90-day follow-up, a pulmonary embolism developed in one patient (0.5%) in the aspirin group and none in the rivaroxaban group (P = 1.0). CONCLUSIONS: Extended prophylaxis for 21 days with aspirin was equivalent to the direct oral anticoagulant rivaroxaban after hip fracture surgery with an initial 5-day postoperative course of enoxaparin. Aspirin may be an effective, safe, convenient, and cheap alternative for extended prophylaxis after hip fracture surgery.

LncRNA BE503655 inhibits osteosarcoma cell proliferation, invasion/migration via Wnt/ß-catenin pathway.

Aim: In previous studies, numerous dysregulated long non-coding RNAs (lncRNAs) were identified by RNA-sequencing (RNA-seq). However, the relationship between lncRNA and osteosarcoma remains unclear. In the present study, the function and mechanism of lncRNA BE503655 were investigated. Methods: Transwell, cell cycle and proliferation were used to evaluate the function of lncRNA BE503655. Real-time PCR and Western blotting were used to detect the expression of lncRNA BE503655 and ß-catenin. Results: LncRNA BE503655 is overexpressed in human osteosarcoma and osteosarcoma cell lines. Knockdown lncRNA BE503655 suppresses cell proliferation, invasion and migration. High expression of BE503655 was significantly related to Enneking stage, distant metastasis and histological grade. Moreover, we also provided evidences that lncRNA BE503655 played its functions dependent on regulation of Wnt/ß-catenin signaling in osteosarcoma. Conclusion: Taken together, we verified the role of lncRNA BE503655 and provided possible mechanism in osteosarcoma. Our study provided new insights into clinical treatment of osteosarcoma and further intervention target.

Interface contact profiles of a novel locking plate and its effect on fracture healing in goat.

OBJECTIVE: To evaluate the interface characteristics of the new-designed locking plate (LP) and limited contact-dynamic compression plate (LC-DCP) and compare the fracture healing between LP and LC-DCP in a goat tibia fracture model. METHODS: Eight-hole LP and LC-DCP were applied to fix fresh goat tibiae in a reproducible manner. The average pressure, force and interface contact area were calculated using Fuji prescale pressure sensitive film interposed among the plate and the bone and image analysis system. Eight-hole LP and LC-DCP were applied to each tibia in a goat tibia fracture model. The fracture healing was evaluated by X-ray photography at postoperative 8 weeks. The goats were sacrificed at postoperative 12 weeks. Three-point bending test was conducted in the tibiae. RESULTS: The interface contact of LP system was smaller than that of LC-DCP (P < 0.05), while interface contact force of LP system was higher than that of LC-DCP (P < 0.05). Radiographs revealed that the fracture line disappeared in the LP group, while the fracture line was visible in DCP group at postoperative 8 weeks. At postoperative 12 weeks, the bending strength and bending load of fractured tibia were higher in LP group than in DCP group, respectively. CONCLUSION: The new-designed locking plate can significantly decrease the contact area on the bone interface, which further provides better fracture healing than conventional plates.

Comparison of interface contact profiles of a new minimum contact locking compression plate and the limited contact dynamic compression plate.

In this study, we investigated whether or not a new minimum contact locking compression plate (MC-LCP) can provide advantages over the limited contact dynamic compression plate (LC-DCP) in the context of interface contact area and force. Six matched pairs of cadaveric bones were used for each of three bone types of the humerus, radius and ulna. For each bone type, one of two bone plates was fixed to either of two matched cadaveric bones at the middle of the diaphysis. The interface contact area and force of the plate fixed to three types of human cadaveric bones were evaluated using Fuji prescale pressure sensitive film. Data were quantitated using computer-assisted image analysis. Results showed that the average force between the MC-LCP and humerus or radius was about half of that of the LC-DCP. And the average force between the MC-LCP and ulna was one third less than that of the LC-DCP. Meanwhile, the interface contact area between the MC-LCP and humerus or radius was also about half of that of the LC-DCP, and the interface contact area between the MC-LCP and ulna was less than one third of that of the LC-DCP. These results indicate that the MC-LCP has lower interface contact area and lower average force than that of the LC-DCP. Thus, the MC-LCP system may be a good alternate to treat forearm diaphyseal fractures.

Repair of acutely injured spinal cord through constructing tissue-engineered neural complex in adult rats.

OBJECTIVE: To construct tissue-engineered neural complex in vitro and study its effect in repairing acutely injured spinal cord in adult rats. METHODS: Neural stem cells were harvested from the spinal cord of embryo rats and propagated in vitro. Then the neural stem cells were seeded into polyglycolic acid scaffolds and co-cultured with extract of embryonic spinal cord in vitro. Immunofluorescence histochemistry and scanning electron microscope were used to observe the microstructure of this complex. Animal model of spine semi-transection was made and tissue-engineered neural complex was implanted by surgical intervention. Six weeks after transplantation, functional evaluation and histochemistry were applied to evaluate the functional recovery and anatomic reconstruction. RESULTS: The tissue-engineered neural complex had a distinct structure, which contained neonatal neurons, oligodendrocytes and astrocytes. After tissue-engineered neural complex was implanted into the injured spinal cord, the cell components such as neurons, astrocytes and oligodendrocytes, could survive and keep on developing. The adult rats suffering from spinal cord injury got an obvious neurological recovery in motor skills. CONCLUSIONS: The tissue-engineered neural complex appears to have therapeutic effects on the functional recovery and anatomic reconstruction of the adult rats with spinal cord injury.