The anterior hip capsule is thinner in dysplastic hips: a study comparing different young adult hip patients.

PURPOSE: To investigate the thickness and intra-substance change of anterior capsule of the hip joint, and compare the difference of the capsular features in patients with different statuses of hip stability. METHODS: A retrospective study was performed to review a hip preservation database. Using the lateral center edge angle(LCEA), patients with borderline dysplasia of the hip (BDH) of 20° ≤ LCEA ≤ 25°, femoracetabular impingement(FAI) with LCEA > 30° and dysplasia of the hip (DH) of LCEA < 20° were enrolled and stratified into different treatment groups. The patients' imaging was reviewed by two experienced musculoskeletal radiologists who were blinded to clinical outcomes. Thickness and intra-substance change of the anterior hip capsule was measured on the sagittal oblique sequences of MRI. A surgeon measured the thickness of the anterior hip capsule during arthroscopy. The capsular thickness and intra-substance change were compared among different groups. RESULTS: Thirty patients (17 women and 13 men) enrolled in each group (FAI, BDH, and DH) matched by sex and ages were evaluated. There were no significant differences in terms of age, sex, BMI, Alpha angle, and Tönnis grade among all three groups. The mean thickness of the anterior capsule in the DH group was 3.2 ± 0.5 mm, which was significantly thinner than that in the BDH and FAI groups (4.5 ± 0.8 mm and 4.7 ± 0.6 mm), and there was no significant difference in capsular thickness between the BDH and FAI groups. The Median of anterior capsule thickness via arthroscopic measuring was 6 mm and 7 mm in the BDH and FAI groups respectively, which has no statistical difference. The intra-substance change of the anterior capsule shows a significant difference among the three groups, and a higher incidence of delamination of the capsule was found in DH groups (p < 0.001). CONCLUSIONS: Patients with hip dysplasia have a significantly reduced capsular thickness on MRI and delaminated anterior joint capsule, which could be a sequence of instability. The clinical relevance of this study is that capsular thickness and intra-substance changes of the anterior capsule vary which could alter capsular management strategies. LEVEL OF EVIDENCE: Level III of evidence, DIAGNOSTIC STUDIES, No consistently applied reference standard.

Urinary metabonomics of rats with ketamine-induced cystitis using GC-MS spectroscopy.

Ketamine abuse has dramatically increased in recently years. With the widely application of ketamine, its side effects, especially cystitis induced by long-term use, have attracted more and more attention from the public. In the present study, we aimed to explore the potential generative mechanism of ketamine-induced cystitis by determining the endogenous metabolites at different time points after ketamine treatment. Body weight, bladder/body coefficient, urinary frequency, urinary potassium, serum IL-6, and TNF-α were determined at different time points after ketamine treatment. H&E staining was used to observe the changes of histopathology. Metabonomics was performed to determine the changes of endogenous metabolites. After 12 weeks of treatment, obvious inflammatory reaction was noticed in the KET group; the body weight and urinary potassium of the KET group were significantly lower than the NS group (P < 0.05) and other factors, such as urinary frequency, bladder/body coefficient, serum TNF-α and IL-6 were higher than the NS group (P < 0.05). A total of 30, 28, and 32 significantly changed metabolites were identified at the 1st week, 4th week and 12th week, respectively. Metabolic pathway analysis showed that different metabolic pathways were affected during the treatment process. Linoleic acid metabolism, beta-alanine metabolism, glyoxylate and dicarboxylate metabolism were only affected following long-term administration of ketamine. Those metabolic pathways may have a close relationship with cystitis induced by ketamine.