Identification of HTRA1, DPT and MXRA5 as potential biomarkers associated with osteoarthritis progression and immune infiltration.

BACKGROUND: Our study aimed to identify potential specific biomarkers for osteoarthritis (OA) and assess their relationship with immune infiltration. METHODS: We utilized data from GSE117999, GSE51588, and GSE57218 as training sets, while GSE114007 served as a validation set, all obtained from the GEO database. First, weighted gene co-expression network analysis (WGCNA) and functional enrichment analysis were performed to identify hub modules and potential functions of genes. We subsequently screened for potential OA biomarkers within the differentially expressed genes (DEGs) of the hub module using machine learning methods. The diagnostic accuracy of the candidate genes was validated. Additionally, single gene analysis and ssGSEA was performed. Then, we explored the relationship between biomarkers and immune cells. Lastly, we employed RT-PCR to validate our results. RESULTS: WGCNA results suggested that the blue module was the most associated with OA and was functionally associated with extracellular matrix (ECM)-related terms. Our analysis identified ALB, HTRA1, DPT, MXRA5, CILP, MPO, and PLAT as potential biomarkers. Notably, HTRA1, DPT, and MXRA5 consistently exhibited increased expression in OA across both training and validation cohorts, demonstrating robust diagnostic potential. The ssGSEA results revealed that abnormal infiltration of DCs, NK cells, Tfh, Th2, and Treg cells might contribute to OA progression. HTRA1, DPT, and MXRA5 showed significant correlation with immune cell infiltration. The RT-PCR results also confirmed these findings. CONCLUSIONS: HTRA1, DPT, and MXRA5 are promising biomarkers for OA. Their overexpression strongly correlates with OA progression and immune cell infiltration.

Risk-factor analysis of the proximal tibia morphology for secondary ipsilateral injury after anterior cruciate ligament reconstruction: A retrospective cross-sectional study.

Many studies have reported the risk factors associated with primary anterior cruciate ligament (ACL) injury. However, few studies have focused on the bony morphology of secondary ipsilateral injury after ACL reconstruction. This study aimed to investigate the morphological risk factors of the proximal tibia contributing to secondary ipsilateral injury after ACL reconstruction. Twenty patients who were selected from secondary ipsilateral injury after ACL reconstruction between January 2015 and May 2020 were included in the secondary injury group. They were matched in a 1:2 ratio to the control group, which underwent primary ACL reconstruction during the same period and did not experience reinjury at the minimum 2-year follow-up, based on age, gender, and body mass index. All parameters, including medial tibial posterior slope, lateral tibial posterior slope (LTPS), medial tibial plateau depth, and lateral tibial plateau height, were recorded by using magnetic resonance imaging. Binary logistic regression analysis and receiver operator characteristic curves were conducted to explore the risk factors for reinjury and determine the cutoff value for the significant parameter. The LTPS was significantly larger in the secondary injury group than in the control group (9.6 ±â€…1.5° to 7.0 ±â€…1.4°, P < .001), and there was no significant difference in the medial tibial posterior slope, medial tibial posterior slope, and lateral tibial plateau height between the 2 groups (P > .05). The LTPS was found to be an independent risk factor for secondary ipsilateral injury after ACL reconstruction (odds ratio = 3.220, 95% confidence interval = 1.904-5.446, P < .001). The cutoff value of the LTPS was 8.8°, with a sensitivity of 91.7% and a specificity of 81.2%. The LTPS could be a unique predictor of secondary ipsilateral injury after ACL reconstruction. Orthopedists should implement effective measurements during primary reconstruction when the LTPS is >8.8°.

Determining the rotational alignment of the tibial component referring to the tibial tubercle during total knee arthroplasty: the tibial tubercle-trochlear groove can be an aid.

BACKGROUND: There is no consensus on anatomic landmarks or reference axes with which to accurately align rotational position of tibial component. Using the tibial tubercle, commonly referring to the Akagi line and the Insall line, for anatomic reference was widely accepted. However, it is unknown about the predictors that may affect the reliability of using the tibial tubercle for aligning tibial component rotation. The aims of our study were (1) to investigate the reproducibility and accuracy of using the tibial tubercle for aligning tibial component rotation and (2) to determine predictors resulting in discrepancies of the tibial component rotation when referring to the tibial tubercle. METHOD: A total of 160 patients with osteoarthritis were recruited before total knee arthroplasty. The angle α formed by the tibial anteroposterior (AP) axis and the Akagi line and the angle ß formed by the tibial AP axis and the Insall line were measured to quantify the discrepancies of the Akagi line and the Insall line. Independent variables, including the tibial tubercle-to-trochlear groove distance (TT-TG), tibial tubercle to posterior cruciate ligament (TT-PCL), and knee rotation angle (KRA), hip-knee-ankle angle (HKA), medial proximal tibial angle (MPTA), and tibial bowing (TB), were measured. Pearson's product moment correlation coefficients and multivariable linear regression analysis were calculated to assess relationships between independent variables and the two defined angles. RESULTS: All defined measurement were available for 140 patients. The Akagi line rotated internally with 1.03° ± 4.25° in regard to the tibial AP axis. The Insall line rotated externally in regard to the tibial AP axis with 7.93° ± 5.36°. Three variables, including TT-TG, TT-PCL, and KRA, tended to be positively correlated with the angle α and the angle ß. In terms of a cutoff of TT-TG = 9 mm, 100% cases and 97% cases for using the Akagi line and Insall line, respectively, were located in the defined safe zone (- 5° to 10°). CONCLUSION: The tibial tubercle (the Akagi line and Insall line) is found to be a useful and promising anatomic landmark for aligning the tibial component rotation. The TT-TG, with a cutoff value of 9 mm, is helpful to choose the Akagi line or Insall line, alternatively.

[Treatment of comminuted inferior femoral fractures with combination of supracondylar locked intramedullary nail and shape memory block hoop internal fixator under arthroscopy].

OBJECTIVE: To investigate the advantages and the clinical outcomes of the treatment of comminuted inferior femoral fractures with combination of supracondylar locked intramedullary nail and shape memory block hoop internal fixator under arthroscopy. METHODS: From June 2002 to December 2004, 12 cases of comminuted inferior femoral fractures were treated (9 males, 3 females). Of them, 5 cases were classified as type B and 7 cases as type C according to AO classification. All cases were treated with combination of supracondylar locked intramedullary nail and shape memory block hoop internal fixator under arthroscopy. In 12 cases of one-stage bone grafting, there 5 of autologous cancellous bone grafting and 7 allo-freeze drying bone grafting. RESULTS: With a follow-up of 6 to 18 months, all fractures healed within 3 to 6 months. There were no infection and nonunion. The function of all the knees joint was excellent. According to Noye's criterion for knee scoring, the results were excellent in 9 cases and good in 3 cases; the excellent and good rate was 100%. CONCLUSION: It is a good method to treat comminuted inferior femoral fractures with combination of supracondylar locked intramedullary nail and shape memory block hoop internal fixator under arthroscopy. It has many advantages of less injury to knee joint, good anatomic reduction and reliable fixation.

[Reconstruction of wrist joint by transplanting fibular head pedicled with lateral inferior genicular artery].

OBJECTIVE: To investigate a new operative method to reconstruct wrist joint for treating the defect of the distal radius after excision of tumor. METHODS: From October 1999 to December 2001, 3 cases of giant cell tumor in the distal radius were resected and the wrist joint was reconstructed by transplanting the fibular head pedicled with the lateral inferior genicular artery. RESULTS: After followed up for 6 to 18 months, all patients achieved the bony healing within 4 months without tumor relapse and had good function of the wrist joint. CONCLUSION: This operation is simple and reliable. The fibular head can be cut according to the tumor size of the radius.