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1.
Int J Mol Sci ; 25(18)2024 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-39337668

RESUMEN

Ocular adnexal sebaceous carcinoma (SebCA) represents one of the most clinically problematic periocular tumors, often requiring aggressive surgical resection. The pathobiology of this tumor remains poorly understood, and few models exist that are suitable for preclinical testing. The aim of this study was to establish new cell lines to serve as models for pathobiological and drug testing. With patient consent, freshly resected tumor tissue was cultured using conditional reprogramming cell conditions. Standard techniques were used to characterize the cell lines in terms of overall growth, clonogenicity, apoptosis, and differentiation in vitro. Additional analyses including Western blotting, short tandem repeat (STR) profiling, and next-generation sequencing (NGS) were performed. Drug screening using mitomycin-C (MMC), 5-fluorouricil (5-FU), and 6-Diazo-5-oxo-L-norleucine (DON) were performed. JHH-SebCA01, JHH-SebCA02, and JHH-SebCA03 cell lines were established from two women and one man undergoing surgical resection of eyelid tumors. At passage 15, they each showed a doubling time of two to three days, and all could form colonies in anchorage-dependent conditions, but not in soft agar. The cells contained cytoplasmic vacuoles consistent with sebaceous differentiation, and adipophilin protein was present in all three lines. STR profiling confirmed that all lines were derived from their respective patients. NGS of the primary tumors and their matched cell lines identified numerous shared mutations, including alterations similar to those previously described in SebCA. Treatment with MMC or 5-FU resulted in dose-dependent growth inhibition and the induction of both apoptosis and differentiation. MYC protein was abundant in all three lines, and the glutamine metabolism inhibitor DON, previously shown to target high MYC tumors, slowed the growth of all our SebCA models. Ocular adnexal SebCA cell lines can be established using conditional reprogramming cell conditions, and our three new models are useful for testing therapies and interrogating the functional role of MYC and other possible molecular drivers. Current topical chemotherapies promote both apoptosis and differentiation in SebCA cells, and these tumors appear sensitive to inhibition or MYC-associated metabolic changes.


Asunto(s)
Neoplasias de las Glándulas Sebáceas , Humanos , Neoplasias de las Glándulas Sebáceas/patología , Neoplasias de las Glándulas Sebáceas/metabolismo , Neoplasias de las Glándulas Sebáceas/genética , Femenino , Línea Celular Tumoral , Masculino , Proliferación Celular/efectos de los fármacos , Adenocarcinoma Sebáceo/patología , Adenocarcinoma Sebáceo/metabolismo , Adenocarcinoma Sebáceo/genética , Apoptosis , Mitomicina/farmacología , Diferenciación Celular , Anciano , Neoplasias del Ojo/patología , Neoplasias del Ojo/metabolismo , Neoplasias del Ojo/genética , Fluorouracilo/farmacología , Persona de Mediana Edad
2.
J Pers Med ; 14(9)2024 Sep 05.
Artículo en Inglés | MEDLINE | ID: mdl-39338196

RESUMEN

Bone marrow aspirate concentrate (BMAC) has been increasingly used as an injectable treatment for knee osteoarthritis (OA). However, there remains a lack of studies on the pain and complications associated with BMAC treatment. This study compared the pain and complications of BMAC treatment between outpatients and inpatients with Kellgren-Lawrence grade II-III knee osteoarthritis (OA) during a follow-up period of ≥3 months. This study included 40 outpatients (40 knees) and 80 inpatients (80 knees) as controls who received BMAC articular injections for knee OA between December 2023 and March 2024. Outpatients were administered BMAC under local anesthesia alone, whereas inpatients were administered BMAC under local anesthesia and intravenous anesthesia. The outcomes were the visual analog scale (VAS) pain score during the BMAC procedure and the complications associated with harvest and injection sites. The mean VAS pain score in the outpatient group was significantly higher than that in the inpatient group during trocar insertion (5.2 vs. 1.3, p < 0.05) and bone marrow aspiration (6.2 vs. 1.4, p < 0.05), but it was similar between the two groups during BMAC injection (2.2 vs. 2.3, p = 0.858). Transient post-treatment complications were observed in 17.5% (7/40) of outpatients and 16.3% (13/80) of inpatients. No significant differences were observed in complications between the two groups, all of which were resolved within 2 months without any specific problem. Moreover, no major complications occurred in any group. In conclusion, outpatients who received only local anesthesia reported significant pain during BMAC treatment. The addition of intravenous anesthesia is necessary to alleviate pain during the BMAC procedure.

3.
J Pers Med ; 14(9)2024 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-39338199

RESUMEN

This study reports 12 cases of inaccurate bone cutting from a single-surgeon series of 509 consecutively performed robotic-assisted total knee arthroplasty (TKA) for 1 year. In addition, a complementary technique with the combined benefits of robotic-assisted and manual techniques that address this issue is described. From June 2020 to May 2021, a consecutive series of 509 TKAs was performed on 338 patients using a posterior-stabilized total knee prosthesis with a robotic-assisted system at our hospital. The surgical records were reviewed to identify the causative bone locations and bone re-cutting events correlated with improper trial instrument positioning. The re-cutting rate was 2.4% (12/509). All re-cutting attempts occurred because of improper cutting of the femoral posterior chamfer. Re-cutting was attempted mostly on middle-aged male patients. This complementary technique can facilitate manual bone cutting while retaining the advantages of robotic surgery during robotic-assisted TKA. Additionally, the combined technique of manual bone cutting and robotic-assisted surgery can be a useful alternative for middle-aged male patients with rigid knee bones.

4.
Medicina (Kaunas) ; 60(7)2024 Jun 25.
Artículo en Inglés | MEDLINE | ID: mdl-39064470

RESUMEN

Background and Objectives: The term "Juxtafacet cyst" refers to both synovial cysts and ganglion pseudocysts associated with the lumbar facet joint. As conservative treatment for the juxtafacet cyst has a minimal effect, complete excision through surgery is considered the first choice of treatment. In this study, we retrospectively reviewed the clinical outcomes of percutaneous epidural neuroplasty for symptomatic lumbar juxtafacet cysts. Materials and Methods: We conducted a retrospective review of 34 patients with symptomatic juxtafacet cysts who visited a single institute from January 2010 to September 2023. Patients who received conservative treatment for at least 6 weeks but experienced no or insufficient effects were eligible for this study. After neuroplasty, a medical history check and neurological examination were performed during follow-up at 2 weeks, 1 month, 2 months, 3 months, 6 months, and once a year thereafter. Results: The pain improved for all patients to a VAS score of 3 or less immediately after neuroplasty; however, four of those patients (11%) had pain that worsened eventually to the same level as before the procedure and required surgery. The results showed that, regardless of cyst size, in cases with severe stenosis of the spinal canal, the outcome of neuroplasty was poor and often eventually required surgery. The cyst size was not associated with the procedure results. In addition, if the cyst was present at the L4-L5 level, or if diabetes mellitus was present, the likelihood of future surgery was significant (p-value = 0.003). Conclusions: Percutaneous neuroplasty showed a better success rate than other non-surgical treatments. In addition, severe spinal stenosis (Schizas grade C or higher), L4-L5 level, or diabetes mellitus produced a high possibility of surgery due to recurrence.


Asunto(s)
Vértebras Lumbares , Humanos , Masculino , Femenino , Persona de Mediana Edad , Estudios Retrospectivos , Anciano , Vértebras Lumbares/cirugía , Adulto , Resultado del Tratamiento , Quiste Sinovial/cirugía , Quiste Sinovial/complicaciones , Articulación Cigapofisaria/cirugía , Región Lumbosacra/cirugía
5.
Medicina (Kaunas) ; 60(6)2024 Jun 13.
Artículo en Inglés | MEDLINE | ID: mdl-38929594

RESUMEN

This study aimed to identify the effectiveness and potential complications on the harvest site and knee of bone marrow aspirate concentrate (BMAC) treatment of patients with Kellgren-Lawrence (K-L) grades II-III knee osteoarthritis (OA) over a minimum follow-up period of 6 months. This study retrospectively evaluated data from 231 patients (285 knees) with knee OA treated with BMAC articular injection at a single center from August 2023 to October 2023. The inclusion criteria were a longstanding knee pain unresponsive to conservative treatments for at least 6 weeks with K-L grades II-III OA. The exclusion criteria were age of <40 years or >80 years, previous knee surgery, rheumatological or other systemic disease, malignancy, uncontrolled diabetes mellitus, or infections. Bone marrow was aspirated from the anterior iliac crest and concentrated by the single-spin centrifugation technique. The visual analog scale (VAS) pain score and Knee Society Score were used to evaluate the clinical outcomes and complications associated with harvest and injection sites were evaluated. The mean follow-up period was 7.2 months (range: 6-8 months). The pretreatment VAS pain score decreased from 4.3 to 0.4 points at the final follow-up (p < 0.05). Pretreatment Knee Society knee and function scores were improved from 86.9 to 98.1 (p < 0.05) and from 68.4 to 83.3 points (p < 0.05), respectively. A total of 15 complications (5.3%, 15/285) were observed, including 3 hematomas, 2 numbness, 2 contact dermatitis, and 1 superficial infection in the harvest site and 4 mild and moderate swelling and 3 severe swelling and pain in the injection site. BMAC is a reliable and effective treatment for patients with K-L grades II-III knee OA, but the orthopedic surgeon should consider that bleeding tendency by heparin causes severe joint swelling and pain after intra-articular knee injection.


Asunto(s)
Osteoartritis de la Rodilla , Humanos , Osteoartritis de la Rodilla/complicaciones , Masculino , Femenino , Persona de Mediana Edad , Estudios Retrospectivos , Anciano , Resultado del Tratamiento , Adulto , Dimensión del Dolor , Trasplante de Médula Ósea/métodos , Trasplante de Médula Ósea/efectos adversos , Inyecciones Intraarticulares , Anciano de 80 o más Años
6.
Adv Sci (Weinh) ; 11(28): e2401022, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38666392

RESUMEN

Although sodium-ion batteries (SIBs) offer promising low-cost alternatives to lithium-ion batteries (LIBs), several challenges need to be overcome for their widespread adoption. A primary concern is the optimization of carbon anodes. Graphite, vital to the commercial viability of LIBs, has a limited capacity for sodium ions. Numerous alternatives to graphite are explored, particularly focusing on disordered carbons, including hard carbon. However, compared with graphite, most of these materials underperform in LIBs. Furthermore, the reaction mechanism between carbon and sodium ions remains ambiguous owing to the structural diversity of disordered carbon. A straightforward mechanical approach is introduced to enhance the sodium ion storage capacity of graphite, supported by comprehensive analytical techniques. Mechanically activated graphite delivers a notable reversible capacity of 290.5 mAh·g-1 at a current density of 10 mA·g-1. Moreover, it maintains a capacity of 157.7 mAh·g-1 even at a current density of 1 A·g-1, benefiting from the defect-rich structure achieved by mechanical activation. Soft X-ray analysis revealed that this defect-rich carbon employs a sodium-ion storage mechanism distinct from that of hard carbon. This leads to an unexpected reversible reaction on the solid electrolyte surface. These insights pave the way for innovative design approaches for carbon electrodes in SIB anodes.

7.
World Neurosurg ; 175: e455-e464, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-37024085

RESUMEN

BACKGROUND: Minimally invasive surgery has many advantages, including early recovery and cosmetic preservation. However, the higher radiation exposure to physicians and patients has drawbacks. Preoperative tissue dyeing techniques are feasible options for reducing radiation exposure and procedure time, but their efficacy has not yet been evaluated. Therefore, this study aimed to evaluate surgical outcomes and reduce radiation exposure during unilateral biportal endoscopy surgery. METHODS: This was a prospective, case-controlled analysis in a tertiary hospital. Patients receiving experimental tissue dye and controls in the nondye group were compared from May 2020 to September 2021. The ipsilateral posterolateral approach (IPA) and the far lateral approach (FLA) were analyzed separately among all single-level spinal procedures without instrumentation. Operative details (operation time, improvement of back and leg pain, and length of hospital stay) and radiation exposure (dose and duration) were compared. RESULTS: A total of 88 cases were included, consisting of 64 interlaminar approaches (experimental: 33, control: 31) and 24 FLAs (experimental: 13 and control: 11). In the IPA approach, the patient and physician radiation exposure doses and duration decreased significantly. Conversely, for the FLA, only the duration of the physician exposure decreased significantly. CONCLUSIONS: Preoperative tissue dyeing techniques using IPA can reduce radiation exposure for physicians and patients. However, a decrease in the duration of radiation was observed only in physicians using the FLA. The dyeing technique is effective in IPA, but the efficacy of FLA is doubtful.


Asunto(s)
Vértebras Lumbares , Exposición a la Radiación , Humanos , Vértebras Lumbares/cirugía , Estudios Prospectivos , Endoscopía/métodos , Procedimientos Quirúrgicos Mínimamente Invasivos , Exposición a la Radiación/prevención & control , Resultado del Tratamiento
8.
Arch Orthop Trauma Surg ; 143(9): 5807-5813, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-36720735

RESUMEN

PURPOSE: The purpose of this study was to assess tibial post fracture between highly cross-linked polyethylene (HXPE) and conventional polyethylene inserts in consecutive posterior-stabilized (PS) total knee arthroplasty (TKA) over a minimum 10-years follow-up period. METHODS: Between July 2008 and December 2011, a consecutive series of 3264 primary TKAs was performed in 2098 patients using a PS total knee prosthesis at a single institution. The final cohort was classified into the HXPE group (792 cases) and the conventional group (2113 cases) according to insert material used during the procedure. RESULTS: The mean follow-up period was 11.4 years in the HXPE group and 11.8 years in the conventional group. Both cases of tibial post fracture occurred in the HXPE group, a complication rate of 0.25%. These two cases required replacement with a thicker tibial insert with retention of the femoral and tibial components. There were no cases of tibial post fracture in the conventional group. CONCLUSION: There was no difference in tibial post fracture rate between the HXPE group and the conventional group in PS TKA on long-term follow-up. LEVEL OF EVIDENCE: IV.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Prótesis de la Rodilla , Fracturas de la Tibia , Humanos , Polietileno , Articulación de la Rodilla/cirugía , Estudios de Seguimiento , Diseño de Prótesis , Prótesis de la Rodilla/efectos adversos , Fracturas de la Tibia/cirugía , Falla de Prótesis
9.
Arthroplast Today ; 19: 101075, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36605495

RESUMEN

Background: We report 4 cases with a tibial post refracture following isolated tibial insert exchange in posterior-stabilized total knee arthroplasty at a single center. Methods: In our institution, 27 cases (26 patients) underwent reoperation due to tibial post fracture in posterior-stabilized total knee arthroplasty between July 2008 and November 2020. Of these 27 cases, 4 (4 patients) tibial post refractures occurred at a mean follow-up period of 9.1 years. Results: All 4 cases of tibial post refracture occurred in a group of 21 cases with isolated tibial insert exchange. There was no tibial post refracture in patients with a tibial revision surgery. The incidence of this complication following isolated tibial insert exchange was 19.0%. The mean elapsed time from tibial insert exchange to the diagnosis of a post refracture was 2.5 years (range: 1.1-6.6 years). Conclusions: Isolated exchange of a tibial insert with excessive thickness as a treatment for tibial post fracture is associated with a high probability of tibial post refracture. The treatment method should be selected after a thorough analysis according to the cause of fracture. Level of evidence: IV.

10.
J Knee Surg ; 36(10): 1102-1104, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35817054

RESUMEN

The purpose of this study was to determine the outcomes of the placement of a pin tracker in the distal femur in robotic-assisted total knee arthroplasty (TKA) over a minimum follow-up period of 1 year. A consecutive series of 81 TKAs were performed in 59 patients using a robotic-assisted system (Mako) at our hospital. The mean follow-up period was 1.1 years (range, 1-1.2 years). No periprosthetic fracture at a pin tracker site was reported at a minimum of 1 year of follow-up. No patients reported minor or major complications associated with the distal femoral pins. In addition, unicortical pin-site drilling marks in all patients disappeared on one-postoperative-year follow-up radiographs. Our technique, which used unicortical pin placement in the distal femur in robotic-assisted TKA, demonstrated that it was a safe and reliable method at a minimum follow-up period of 1 year. The level of evidence is IV.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Fracturas del Fémur , Procedimientos Quirúrgicos Robotizados , Humanos , Artroplastia de Reemplazo de Rodilla/efectos adversos , Artroplastia de Reemplazo de Rodilla/métodos , Procedimientos Quirúrgicos Robotizados/efectos adversos , Estudios de Seguimiento , Fracturas del Fémur/etiología , Fracturas del Fémur/cirugía , Fémur/cirugía , Articulación de la Rodilla/cirugía
11.
J Knee Surg ; 36(4): 435-438, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-34507358

RESUMEN

The purpose of this study was to determine the effectiveness of the placement of pin trackers in the medial sagittal plane of the distal femur in robotic-assisted total knee arthroplasty (TKA) over a minimum follow-up period of 3 months. From August 2020 to October 2020, a consecutive series of 81 TKAs were performed in 59 patients using the Triathlon posterior-stabilized total knee prosthesis with a robotic-assisted system (Mako) at our hospital. Patient charts were reviewed for complications associated with the pin sites, including fracture, infection, thigh pain, and the need for reoperation. No patients had any minor or major complications associated with distal femoral pins. This technique, which used pin trackers in the medial sagittal plane of the distal femur, could be a useful option for surgeons performing robotic-assisted TKA. This is a Level IV study.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Fracturas del Fémur , Prótesis de la Rodilla , Osteoartritis de la Rodilla , Procedimientos Quirúrgicos Robotizados , Cirugía Asistida por Computador , Humanos , Artroplastia de Reemplazo de Rodilla/efectos adversos , Procedimientos Quirúrgicos Robotizados/efectos adversos , Cirugía Asistida por Computador/métodos , Fémur/cirugía , Prótesis de la Rodilla/efectos adversos , Fracturas del Fémur/cirugía , Articulación de la Rodilla/cirugía , Osteoartritis de la Rodilla/cirugía
12.
J Orthop Sci ; 28(5): 1068-1073, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-36075842

RESUMEN

BACKGROUND: This study compared the functional outcomes, implant survival rates, and complications of total knee arthroplasty (TKA) performed in patients with windswept deformity (WSD) and non-WSD patients over at least 10 years of follow-up. METHODS: From January 2008 to December 2010, 40 TKAs were performed in 20 patients with WSD (WSD group). Additionally, 60 propensity score-matched patients without WSD who had undergone primary bilateral TKA were chosen for the control group in a three-to-one ratio. Then, the functional outcomes, implant survival rates, and complications of TKA in the two groups were compared. The mean follow-up periods were 10.8 years in the WSD group and 11.5 years in the control group. RESULTS: The mean Knee Society knee scores in the WSD and control groups improved from 37.7 to 38.1 points preoperatively to 79.5 and 79.2 points at final follow-up (p = 0.974), while the mean function scores in the WSD and control groups improved from 36.5 to 37.2 points preoperatively to 77.8 and 77.4 points at final follow-up (p = 0.863). Two knees in the WSD group required revision surgery, including one due to septic loosening and one due to aseptic loosening. Five knees in the control group required revision surgery, including three due to septic loosening and two due to aseptic loosening. Kaplan-Meier survivorship analysis with the revision of either component as an endpoint in the WSD and control groups estimated 95.0% and 95.8% chances of survival for 10 years, respectively (p = 0.824). CONCLUSIONS: TKA performed in patients with WSD yielded good clinical outcomes and survivorship at least 10 years later. LEVEL OF EVIDENCE: IV.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Prótesis de la Rodilla , Humanos , Artroplastia de Reemplazo de Rodilla/efectos adversos , Prótesis de la Rodilla/efectos adversos , Resultado del Tratamiento , Falla de Prótesis , Articulación de la Rodilla/cirugía , Reoperación , Estudios de Seguimiento , Estudios Retrospectivos
13.
Orthopedics ; 46(2): e125-e128, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36067046

RESUMEN

Perineural (Tarlov) cysts are a common benign pathology in the lumbosacral area but are rarely symptomatic, even when compressing the spinal root. Despite the rarity of Tarlov cyst formation in the foramen of the spine, this type is more symptomatic than those in other sites due to the narrow space. We introduce a biportal endoscopic fenestration for symptomatic foraminal Tarlov cysts. We present the case of a 40-year-old woman experiencing radiating pain in her right lower leg for 4 years. On seeking treatment, her great toe and ankle plantar flexion power had decreased. Magnetic resonance imaging revealed a cystic mass located in the L5-S1 intervertebral foramen that compressed the lumbar nerve root. Partial laminotomy was performed using a percutaneous biportal endoscopic system with a far lateral approach. An oval cystic mass of 2.6×1.1 cm was identified on high-definition images. Partial bone and foraminal ligament removal and cystic membrane fenestration were performed for nerve decompression. After decompression, the patient's motor weakness and radiating pain improved. Due to high-definition images and the minimally invasive laminotomy procedures associated with percutaneous biportal endoscopic fenestration, a foraminal Tarlov cyst was fenestrated safely, and weakness arising from radiculopathy was resolved in the current case. [Orthopedics. 2023;46(2):e125-e128.].


Asunto(s)
Quistes de Tarlov , Humanos , Femenino , Adulto , Quistes de Tarlov/complicaciones , Quistes de Tarlov/diagnóstico por imagen , Quistes de Tarlov/cirugía , Descompresión Quirúrgica/métodos , Endoscopía , Laminectomía/métodos , Vértebras Lumbares/cirugía
14.
Clin Case Rep ; 10(12): e6773, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36545561

RESUMEN

The cause of early aseptic loosening in total knee arthroplasty (TKA) is uncertain, although several possibilities could be offered. We report that osteonecrosis of the knee should be considered as a possible cause or contributing etiologic factor for early aseptic loosening following primary TKA.

15.
Orthop Res Rev ; 14: 445-451, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36444241

RESUMEN

Background: Achieving proper axis alignment can be difficult in the presence of posttraumatic extra-articular deformities in either the femur or the tibia. We present radiological outcomes following robot-assisted total knee arthroplasty (TKA) in patients with osteoarthritis of the knee accompanied by posttraumatic extra-articular deformities. Methods: We analyzed the outcomes of five knees in five patients with (1) Kellgren-Lawrence (K-L) Grade III-IV osteoarthritic knees, (2) the presence of posttraumatic extra-articular deformities either in the femur or the tibia, and (3) who underwent robot-assisted TKA. Their radiological findings were evaluated. Results: All five knees with initial deformity (mean 14.8°, range 12.7-18.5°) were corrected to neutral alignment (mean 0.7°, range -1.1-2.7°). There was no postoperative outlier of hip-knee-ankle (HKA) angle. Conclusion: Our results indicate that robot-assisted TKA can be used to achieve proper limb alignment in patients with posttraumatic extra-articular deformities.

16.
J Exp Orthop ; 9(1): 108, 2022 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-36302997

RESUMEN

PURPOSE: The purpose of this study was to compare the mechanical axis, accuracy of component positioning, and polyethylene liner thickness between robot-assisted total knee arthroplasty (TKA) and conventional TKA. METHODS: From July 2020 to December 2020, 154 TKAs were performed in 110 patients with Kellgren-Lawrence grade IV varus knees using a robot-assisted system (MAKO group). Additionally, 110 propensity score-matched patients who had undergone primary conventional TKA were chosen in a one-to-one ratio for the conventional group. Post-operative radiographs were used to evaluate mechanical axis and component coronal and sagittal positioning. The polyethylene liner thickness was investigated. The respective mean error values and outliers were obtained for the two study groups and were compared to determine the mechanical axis and the accuracy of the postoperative component positioning. RESULTS: Patients in the MAKO group achieved better accuracy than those in the conventional group in terms of postoperative mean mechanical axis (1.9˚ vs. 2.8˚, p < 0.05), femur coronal inclination (91.2˚ vs. 91.8˚, p < 0.05), tibia coronal inclination (90.8˚ vs. 91.1˚, p < 0.05), and tibia sagittal inclination (90.7˚ vs. 91.7˚, p < 0.05). However, there was no difference between the two groups in polyethylene liner thickness. CONCLUSIONS: Robot-assisted TKA showed improved mechanical axis and higher accuracy of component positioning compared to the conventional TKA technique, with no significant difference in polyethylene liner thickness between the two groups. Long-term follow-up studies are needed to compare the clinical outcomes of robot-assisted TKA. LEVEL OF EVIDENCE: IV.

17.
Cancers (Basel) ; 14(13)2022 Jun 25.
Artículo en Inglés | MEDLINE | ID: mdl-35804893

RESUMEN

Alterations in metabolism and energy production are increasingly being recognized as important drivers of neoplasia, raising the possibility that metabolic analogs could disrupt oncogenic pathways. 3'-deoxyadenosine, also known as cordycepin, is an adenosine analog that inhibits the growth of several types of cancer. However, the effects of cordycepin have only been examined in a limited number of tumor types, and its mechanism of action is poorly understood. We found that cordycepin slows the growth and promotes apoptosis in uveal melanoma, as well as a range of other hard-to-treat malignancies, including retinoblastoma, atypical teratoid rhabdoid tumors, and diffuse midline gliomas. Interestingly, these effects were dependent on low adenosine deaminase (ADA) expression or activity. Inhibition of ADA using either siRNA or pharmacologic approaches sensitized tumors with higher ADA to cordycepin in vitro and in vivo, with increased apoptosis, reduced clonogenic capacity, and slower migration of neoplastic cells. Our studies suggest that ADA is both a biomarker predicting response to cordycepin and a target for combination therapy. We also describe a novel mechanism of action for cordycepin: competition with adenosine triphosphate (ATP) in binding to Hsp90, resulting in impaired processing of oncogenic Hsp90 client proteins.

18.
Orthop Res Rev ; 14: 199-206, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35707697

RESUMEN

Purpose: The purpose of this study was to assess the medium-term results of trabecular metal cones for the reconstruction of large bone defects in revision TKA. Methods: Thirteen patients who had undergone revision TKA using trabecular metal cones for femoral and/or tibial large bone defects were identified. We included patients who had a minimum of three years follow-up in the study. We evaluated their functional outcomes, implant survivorship, radiological findings, and complications. Results: At a mean follow-up of 6.9 years (range of 3.5-9.4 years), all trabecular metal cones and implants were well fixed and did not exhibit any radiographic evidence of migration or loosening. At the final follow-up, the mean Knee Society knee scores had improved from 37.2 to 78.1 (p < 0.05), and function scores had improved from 35.5 to 77.5 points (p < 0.05). One intraoperative fracture in the distal femur occurred in an 85-year-old woman during impaction of a single trabecular metal cone. The fracture was successfully affixed to the femoral cone and bone three months postoperatively. Conclusion: The present study of trabecular metal cones demonstrates excellent clinical outcomes and survivorship in revision TKA during medium-term follow-up periods. However, longer-term follow-up studies are needed to further investigate these implants in revision TKA. Additionally, the necessity of metal cones in revision procedures should be carefully considered depending on patient needs and economic capabilities.

19.
Front Surg ; 9: 863931, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35402480

RESUMEN

Background: Extradural spinal tumors arise from soft or bony tissues in the spine and account for majority of spinal tumors. Interest in the unilateral biportal endoscopic (UBE) technique is rising, because it can easily decompress the bony spinal canal and accommodate all open surgical instruments under endoscopic guidance. However, reports of this technique have been limited to certain diseases. This study first demonstrates the UBE technique for extradural tumor biopsy and removal, and percutaneous stabilization in a 72-year-old female patient with dramatic symptom improvement. Methods: We used the UBE technique for decompression and the percutaneous screw fixation technique for stabilization in a patient with an extradural mass compressing the thecal sac and destroying the posterior element. Under endoscopic guidance, a unilateral approach was used, and decompression and flavectomy were performed bilaterally. After decompression, tumor removal and biopsy were performed using various forceps and biopsy needles. After confirming sufficient spinal canal decompression, the screw was placed percutaneously. We evaluated the technical process of the procedure, the patient's pre- and postoperative pain (using the visual analog scale), and operative radiology and pathologic results. Results: Postoperative pain and disability improved clinically, and spinal alignment stabilized radiologically. As the pathology findings confirmed an aneurysmal bone cyst, the treatment was completed without adjuvant therapy. Conclusions: We treated an unstable spine due to an extradural tumor with the UBE and percutaneous screw techniques.

20.
Clin Case Rep ; 10(3): e05574, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35317063

RESUMEN

Arthroscopic saucerization of the lateral discoid meniscus is considered due to an increase in the load of the lateral compartment after high tibial osteotomy (HTO). We report a case of lateral discoid meniscus regeneration after arthroscopic saucerization in a middle-aged female patient who underwent HTO.

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