Cementless versus cemented total knee arthroplasty in young patients: a meta-analysis of randomized controlled trials.

PURPOSE: Optimal type of prosthesis in total knee arthroplasty (TKA) remains controversial for young patients. The objective of this meta-analysis is to compare cementless and cemented fixation in TKA. METHODS: In this meta-analysis, we conducted electronic searches of PubMed, Embase, Cochrane Library, and Web of Science in December 2018. We collected randomized controlled trials (RCTs) comparing cementless and cemented TKA in young patients. The outcome measurements consisted of functional outcomes, Knee Society Score, range of motion, radiological outcomes, pain score, and complications. Stata 12.0 software was used for our meta-analysis. Quality assessment for RCTs was conducted according to the Cochrane Handbook for systematic review of interventions. RESULTS: Four RCTs met our inclusion criteria with 255 patients in cemented groups and 229 patients in cementless groups. The present meta-analysis indicated that there was a significant difference between the groups in terms of radiological outcomes and pain score. No significant difference was found regarding KSS, range of motion, or complications. CONCLUSION: Cementless TKA was associated with superior outcomes in terms of radiological outcomes and pain score compared with cemented fixation. We found no significant difference regarding the functional outcome or aseptic loosening between groups. High-quality RCTs were still required for further investigation.

Vitexin alleviates interleukin-1ß-induced inflammatory responses in chondrocytes from osteoarthritis patients: Involvement of HIF-1α pathway.

It has been reported that vitexin has anti-inflammatory effects in osteoarthritis (OA) rats. However, the effects of vitexin on interleukins-1ß (IL-1ß)-stimulated OA patient-derived chondrocytes have not been reported. The purpose of this study was to investigate the anti-inflammatory effects of vitexin on IL-1ß-stimulated human osteoarthritis chondrocytes and to reveal the involvement of hypoxia-inducible factor 1α (HIF-1α) pathway. Enzyme-linked immunosorbent assay, quantitative real-time PCR and Western blotting assays were employed. ELISA results demonstrated that the proinflammatory cytokine levels of interleukins-6 (IL-6) and tumour necrosis factor α (TNF-α) in the serum and synovial fluid and HIF-1α level in the synovial fluid were significantly elevated in OA patients compared to normal healthy subjects. Moreover, the Western blotting results indicated that the protein expression of HIF-1α was significantly higher in the cartilage tissues of OA patients. OA patient-derived chondrocytes were stimulated by IL-1ß and treated with different concentration of vitexin for 24 hours. Vitexin showed no cytotoxicity and increased the survival of chondrocytes under IL-1ß stimulation. Vitexin suppressed IL-1ß-induced production of NO and prostaglandin E2 (PGE2 ) in chondrocytes culture. The treatment of vitexin significantly inhibited IL-1ß-induced expressions of proinflammatory cytokine levels of IL-6, TNF-α, matrix metalloproteinase (MMP)-1, MMP-3 and MMP-13. Furthermore, Western blotting results demonstrated that HIF-1α is involved in vitexin's protective effects on IL-1ß-stimulated injuries in OA patient-derived chondrocytes. Our study demonstrates that vitexin alleviates IL-1ß-induced inflammatory responses in chondrocytes from osteoarthritis patients, which may be attributed partly to the inhibition of HIF-1α pathway.