Green tea extract co-administered with a polymer effectively prevents alcoholic liver damage by prolonged inhibition of alcohol absorption in mice.

AIMS: Alcohol toxicity can induce multiple organ dysfunction, including the liver. Gallated catechins (GCs), the components of green tea extract (GTE), have been known to inhibit intestinal lipid absorption. This study was designed to investigate the inhibitory effect of GC on the absorption of the lipid-soluble ethanol in normal mice. In addition, the effectiveness of prolonging the GC-mediated effect was evaluated as a means of preventing alcoholic liver damage. METHODS: GTE was administered orally immediately or 90 min before ethanol administration and the blood ethanol and acetaldehyde levels were measured. Binge ethanol administration (by gavage every 6 h for 24 h) was used to induce acute liver injury, and GTE was administered 90 min prior to every ethanol administration. RESULTS: When GTE, but not GC-decreased GTE, was administered immediately before ethanol intake, the blood ethanol and acetaldehyde levels were significantly lower than those in the control. On the other hand, GTE has no effect when GTE was administered 90 min before ethanol intake. When GTE was co-administered with polyethylene glycol (PEG) or poly-γ-glutamate (PGA) 90 min before ethanol intake, the lowering effect of GTE on the blood ethanol and acetaldehyde levels was maintained in contrast to the GTE-alone-treated group. After binge ethanol administration, liver weight decreased, and serum alanine aminotransferase and aspartate aminotransferase levels were elevated. Additionally, histopathological changes, such as macrovesicular steatosis and necrosis, were induced in the liver, together with reactive oxygen species generation. When GTE + PEG or GTE + PGA, but not GTE alone, was administered 90 min before ethanol intake, acute liver injury was ameliorated. CONCLUSION: These findings support the development of GTE + PEG or GTE + PGA as an inhibitor of intestinal alcohol absorption for the preventative treatment of acute alcohol toxicity.

Highly cross-linked polyethylene in total hip arthroplasty for osteonecrosis of the femoral head: a minimum 5-year follow-up study.

We evaluated 162 hips with osteonecrosis of the femoral head that had undergone THA using highly cross-linked polyethylene liner after a minimum follow-up of 5 years. Neither femoral nor acetabular components displayed radiographic evidence of mechanical loosening or osteolysis, and no components had been revised at the latest follow-up. The mean rate of linear liner wear was 0.038 mm/year. Univariate regression analysis did not demonstrate that age, gender, weight, activity level or cup inclination had any influence on penetration. While the long term effects of altered mechanical properties of highly cross-linked PE remain unknown, the clinical and radiographic results at a minimum of 5 years are promising for this high-risk population.

Screw augmented cement spacer for deficient acetabulum in periprosthetic infection following Total Hip Arthroplasty.

For periprosthetic joint infection (PJI) treatment, revision total hip arthroplasty using an antibiotic loaded cement spacer is one of the important surgical methods. However, revision total hip arthroplasty using antibiotic-loaded cement spacers poses a risk of spacer dislodgement in patients with acetabular deficiency. We hypothesized that screw augmentation would be more stable and result in lower rates of cement spacer dislodgement in acetabular deficient patients. Thus, we suggest a method of screw augmentation with cement spacers to treat periprosthetic infection in patients with a deficient acetabulum. And we aim to report better clinical outcomes after revision total hip arthroplasty for infection control using screw augmented cement spacer insertion technique. Level of evidence: IV.

Biomaterials Used for Suture Anchors in Orthopedic Surgery.

Suture anchors are broadly used for attaching soft tissue (e.g., tendons, ligaments, and meniscus) to the bone and have become essential devices in sports medicine and during arthroscopic surgery. As the usage of suture anchors has increased, various material-specific advantages and challenges have been reported. As a result, suture anchors are continually changing to become safer and more efficient. In this ever-changing environment, it is clinically essential for the surgeon to understand the key characteristics of existing anchors sufficiently. This paper aims to summarize the current concepts on the characteristics of available suture anchors.

Unintended Retention of Temporary Articulating Spacers in the Treatment of Periprosthetic Hip Joint Infection.

A considerable number of patients who underwent a 2-stage exchange protocol for periprosthetic hip joint infection could not complete the second-stage reimplantation. The aim of this study was to evaluate the results of unintended retention of temporary articulating spacers for the treatment of periprosthetic hip joint infection. Ninety-four patients with infection after total hip arthroplasty were treated by using a 2-stage exchange protocol with temporary articulating spacers. Of the 94 patients, 35 did not complete the 2-stage exchange protocol and retained spacers for more than 12 months. The authors retrospectively investigated the clinical and radiographic results after a mean follow-up of 36.1 months. Thirty-one patients had well-healed wounds without recurrent infection and did not receive further surgery for any reason (success group). Spacers were revised in 2 patients, and the other 2 patients underwent incision and debridement because of recurrent infection (failure group). There were no statistical differences between the 2 groups in terms of demographics or presence of resistant organisms. After 3 years of follow-up, temporary articulating spacers functioned well in 89% of the patients who retained them. These results support that retention of temporary articulating spacers could be considered an alternative treatment option for select patients. [Orthopedics. 2020;43(4):e251-e257.].

Second-generation cementless total hip arthroplasty in patients with osteonecrosis of the femoral head.

The results of cementless total hip arthroplasties in patients with osteonecrosis have been inferior to those in patients with other diagnoses. Fifty-eight primary total hip arthroplasties with insertion of a femoral stem with a circumferentially proximal porous coating and a cementless acetabular component were followed for a mean of 11.1 years. Fifty-seven (98%) of 58 stems were biologically stable, and one stem was loose. There were acetabular revisions in 18 hips (31%) because of polyethylene wear and osteolysis. One hip (1.7%) underwent revision of both acetabular and femoral components. Osteolysis around the acetabular component was seen on radiographs in 22 hips (37.9%). Femoral osteolysis was seen in 9 hips (15.5%), and there was no osteolysis below the lesser trochanter in any hip. Second-generation femoral prostheses provide excellent fixation in patients with osteonecrosis of the femoral head. However, a high rate of polyethylene wear and osteolysis in these high-risk patients remains a challenging problem.

Green tea extract with polyethylene glycol-3350 reduces body weight and improves glucose tolerance in db/db and high-fat diet mice.

Green tea extract (GTE) is regarded to be effective against obesity and type 2 diabetes, but definitive evidences have not been proven. Based on the assumption that the gallated catechins (GCs) in GTE attenuate intestinal glucose and lipid absorption, while enhancing insulin resistance when GCs are present in the circulation through inhibiting cellular glucose uptake in various tissues, this study attempted to block the intestinal absorption of GCs and prolong their residence time in the lumen. We then observed whether GTE containing the nonabsorbable GCs could ameliorate body weight (BW) gain and glucose intolerance in db/db and high-fat diet mice. Inhibition of the intestinal absorption of GCs was accomplished by co-administering the nontoxic polymer polyethylene glycol-3350 (PEG). C57BLKS/J db/db and high-fat diet C57BL/6 mice were treated for 4 weeks with drugs as follows: GTE, PEG, GTE+PEG, voglibose, or pioglitazone. GTE mixed with meals did not have any ameliorating effects on BW gain and glucose intolerance. However, the administration of GTE plus PEG significantly reduced BW gain, insulin resistance, and glucose intolerance, without affecting food intake and appetite. The effect was comparable to the effects of an α-glucosidase inhibitor and a peroxisome proliferator-activated receptor-γ/α agonist. These results indicate that prolonging the action of GCs of GTE in the intestinal lumen and blocking their entry into the circulation may allow GTE to be used as a prevention and treatment for both obesity and obesity-induced type 2 diabetes.