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PURPOSE: To determine the performance of T2* cartilage mapping in diagnosing and assessing disease activity in early axial spondyloarthritis (axSpA), and to investigate the interaction of cartilage damage with clinical characteristics, sacroiliitis MRI scorings, and diffusion metrics. MATERIALS AND METHODS: This prospective study included 83 axSpA patients and 37 no-axSpA patients. Clinical characteristics, the Assessment of SpondyloArthritis International Society-defined active sacroiliitis on MRI, and T2* SIJs values were recorded. In axSpA, disease activity was evaluated using the ankylosing spondylitis disease activity score-C-reactive protein; active sacroiliitis was evaluated using Spondyloarthritis Research Consortium of Canada, intravoxel incoherent motion, and diffusion kurtosis imaging; chronic sacroiliitis was assessed using composite structural damage score (CSDS) and structural score fat. Mann-Whitney U-test, Kruskal-Wallis test with false discovery rate (FDR), ROC curve, and linear regression were used for statistical analysis. RESULTS: AxSpA patients had significantly higher T2*SIJs values than no-axSpA patients. (22.86 ± 2.42 ms vs 20.36 ± 1.30 ms, p < 0.001). The combination of T2*SIJs values and active sacroiliitis on MRI had the highest AUC for identifying axSpA. T2*SIJs values were significantly different between the inactive and very high, moderate and very high, high and very high, as well as inactive and high disease activity groups (all pFDR < 0.05). Dk (ß = 0.48) and CSDS (ß = 0.48) were independently associated with T2*SIJs values. CONCLUSION: T2* values may be a promising biomarker for diagnosing and differentiating disease activity in early axSpA. Both acute and chronic sacroiliitis influence cartilage properties. CLINICAL RELEVANCE STATEMENT: Sacroiliac joint cartilage abnormalities can be quantified with T2* relaxation time and allow better characterization of early axSpA. KEY POINTS: T2* mapping may have value in evaluating axSpA. The combination of T2* values and active sacroiliitis on MRI enhances diagnostic performance for axSpA. Abnormalities measured with T2* values correlate with disease activity, acute sacroiliitis, and degree of structural damage.
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The electrocatalytic carbon dioxide reduction reaction (CO2RR) presents a viable and cost-effective approach for the elimination of CO2 by transforming it into valuable products. Nevertheless, this process is impeded by the absence of exceptionally active and stable catalysts. Herein, a new type of electrocatalyst of transition metal (TM)-doped ß12-borophene (TM@ß12-BM) is investigated via density functional theory (DFT) calculations. Through comprehensive screening, two promising single-atom catalysts (SACs), Sc@ß12-BM and Y@ß12-BM, are successfully identified, exhibiting high stability, catalytic activity and selectivity for the CO2RR. The C1 products methane (CH4) and methanol (CH3OH) are synthesized with limiting potentials (UL) of -0.78 V and -0.56 V on Sc@ß12-BM and Y@ß12-BM, respectively. Meanwhile, CO2 is more favourable for reduction into the C2 product ethanol (CH3CH2OH) compared to ethylene (C2H4) via C-C coupling on these two SACs. More importantly, the dynamic barriers of the key C-C coupling step are 0.53 eV and 0.73 eV for the "slow-growth" sampling approach in the explicit water molecule model. Furthermore, Sc@ß12-BM and Y@ß12-BM exhibit higher selectivity for producing C1 compounds (CH4 and CH3OH) than C2 (CH3CH2OH) in the CO2RR. Compared with Sc@ß12-BM, Y@ß12-BM demonstrates superior inhibition of the competitive hydrogen evolution reaction (HER) in the liquid phase. These results not only demonstrate the great potential of SACs for direct reduction of CO2 to C1 and C2, but also help in rationally designing high-performance SACs.
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Au nano-clusters (Au NCs) were promising electrochemiluminescence (ECL) nano-materials. However, the small size of Au NCs presented a challenge in terms of their immobilization during the construction of an ECL biosensing platform. This limitation significantly hindered the wider application of Au NCs in the ECL field. In this work, we successfully used the reducibility of Ti3C2 to fabricate in situ a self-enhanced nano-probe Ti3C2-TiO2-Au NCs. The strategy of in situ generation not only improved the immobilization of Au NCs on the probe but also eliminated the requirement of adding reducing agents during preparation. In addition, in situ generated TiO2 could serve as a co-reaction accelerator, shortening the electron transfer distance between S2O82- and Au NCs, thereby improving the utilization of intermediates and enhancing the ECL response of Au NCs. The constructed ECL sensing platform could achieve sensitive detection of polynucleotide kinase (PNK). At the same time, the 5'-end phosphate group of DNA phosphorylation could chelate with a large amount of Ti on the surface of Ti3C2, thereby achieving the goal of specific detection of PNK. The sensor based on self-enhanced ECL probes had a broad dynamic range spanning for PNK detection from 10.0 to 1.0 × 107 µU mL-1, with a limit of detection of 1.6 µU mL-1. Moreover, the ECL sensor showed satisfactory detection performance in HeLa cell lysate and serum. This study not only provided insights for addressing the issue of ECL luminescence efficiency in Au NCs but also presented novel concepts for ECL self-enhancement strategies.
Subject(s)
Biosensing Techniques , Gold , Limit of Detection , Luminescent Measurements , Polynucleotide 5'-Hydroxyl-Kinase , Titanium , Titanium/chemistry , Biosensing Techniques/methods , Humans , Luminescent Measurements/methods , Gold/chemistry , Polynucleotide 5'-Hydroxyl-Kinase/analysis , Electrochemical Techniques/methods , Metal Nanoparticles/chemistry , Luminescent Agents/chemistryABSTRACT
Background: Reduced graft failure rates have been reported after anterior cruciate ligament (ACL) reconstruction combined with anterolateral complex (ALC) augmentation. However, the preoperative diagnosis of concomitant ALC injury remains a clinical challenge. Purpose: To identify the altered rotational tibiofemoral position on magnetic resonance imaging (MRI) in ACL-injured patients with concomitant ALC injury. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Based on the evaluation of ALC abnormalities on MRI scans by experienced surgeons, 123 patients with nonchronic (<3 months) ACL injury confirmed by arthroscopy were included. The patients were divided into 2 groups-an ALC-injured group (n = 57) and an ALC-intact group (n = 66). The altered rotational tibiofemoral position was evaluated and compared by quantitatively measuring internal rotational tibial subluxation (IRTS) and axial internal tibial rotation (ITRa) on MRI. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were performed to identify the factors associated with concomitant MRI-determined ALC injury. Results: The ALC-injured group showed significantly increased IRTS (P < .001), ITRa (P < .001), lateral anterior tibial subluxation (ATS) (P < .001), and global ATS (GATS) (P = .002) compared with the ALC-intact group, while no significant difference in medial ATS (P = .810) was observed. A strong positive correlation was identified between IRTS and ITRa (rP = 0.809; P < .001). Multivariate analyses revealed that IRTS (P < .001) and GATS (P = .016) were associated factors for the presence of concomitant MRI-determined ALC injury. IRTS (area under the curve [AUC] = 0.734) was more strongly associated with the outcome than GATS (AUC = 0.658) in ROC analyses, suggesting a more significant internal rotational subluxation than anterior subluxation of the tibia. An IRTS threshold of 3.1 mm demonstrated a specificity of 84.2% for indicating the presence of concomitant MRI-determined ALC injury. Conclusion: The presence of concomitant MRI-determined ALC injury in ACL-injured patients was associated with a significant increase in IRTS and ITRa compared with those with intact ALC, indicating that these MRI measurements of the altered rotational tibiofemoral position could serve as potential quantifiable indicators for identifying concomitant ALC injury in clinical practice.
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OBJECTIVE: The hip joint can be affected by extraspinal diffuse idiopathic skeletal hyperostosis (DISH). This study aimed to compare the clinical characteristics of hips with DISH to those with mixed-type femoroacetabular impingement symptoms (FAIS). In addition, patient-reported outcome (PRO) scores were reported among patients with DISH involving the hip joint who underwent arthroscopic treatment. METHODS: A retrospective analysis was performed using data from patients who underwent hip arthroscopy between 2017 and 2021. Patients who had a preoperative diagnosis of extraspinal DISH of the hip joint and postoperative Hip Outcome Score-Activities of Daily Living (HOS-ADL), Hip Outcome Score-Sports Subscale (HOS-SSS), International Hip Outcome Tool 12-component form (iHOT-12), modified Harris Hip Score (mHHS) and visual analog scale (VAS) for pain scores were enrolled in the study. The patients' characteristics were compared with those of a control group (1:2) consisting of mixed-type patients with FAIS. The control group was matched in terms of age, sex, body mass index (BMI), and symptom duration. RESULTS: Eleven hips (0.87%) with extraspinal DISH (study group) were matched to 22 FAIS hips (control group). All the patients were male. The mean age of patients was 42.0 ± 8.0 in the study group. The study group was characterized by a larger preoperative alpha angle (79.1 ± 6.8 vs 64.8 ± 9.7, P < .001), lateral center-edge angle (LCEA) (49.7 ± 6.0 vs 40.7 ± 3.2, P < .001), and postoperative LCEA (36.6 ± 3.0 vs 34.2 ± 2.0, P = .013). In addition, a higher proportion of acetabular (81.8% vs 31.8%, P = .007) and femoral head chondral lesions (45.5% vs 9.1%, P = .016). Cartilage damage has the potential to affect the prognosis of arthroscopic treatment. Nevertheless, at the final follow-up, patients with DISH experienced a significant increase in range of motion (ROM), notable enhancements in all PROs, and favorable rates of minimal clinically important difference (MCID) for the PROs. CONCLUSION: The occurrence of DISH in the hip joint is considerably infrequent, characterized by hip pain and limited ROM. Despite increased alpha angle and LCEA, and more acetabular and femoral head chondral damage noted at the time hip arthroscopy, patients with DISH observed a significant improvement in ROM, notable enhancements in all PROs, and favorable rates of MCID for the PROs.
Subject(s)
Arthroscopy , Femoracetabular Impingement , Hip Joint , Hyperostosis, Diffuse Idiopathic Skeletal , Patient Reported Outcome Measures , Humans , Male , Arthroscopy/methods , Hyperostosis, Diffuse Idiopathic Skeletal/surgery , Hyperostosis, Diffuse Idiopathic Skeletal/complications , Retrospective Studies , Hip Joint/surgery , Hip Joint/physiopathology , Middle Aged , Female , Treatment Outcome , Femoracetabular Impingement/surgery , Aged , Activities of Daily Living , Range of Motion, Articular , Pain MeasurementABSTRACT
The electrocatalytic CO2 reduction (CO2RR) is an effective and economical strategy to eliminate CO2 through conversion into value-added chemicals and fuels. However, exploring and screening suitable 2D material-based single-atom catalysts (SACs) for CO2 reduction are still a great challenge. In this study, 27 (3d, 4d, and 5d, except Tc and Hg) transition metal (TM) atom-doped black phosphorus (TM@BP) electrocatalysts were systematically investigated for CO2RR by density functional theory calculations. According to the stability of SACs and their effectiveness in activating the CO2 molecule, three promising catalysts, Zr@BP, Nb@BP, and Ru@BP, were successfully screened out, exhibiting outstanding catalytic activity for the production of carbon monoxide (CO), methyl alcohol (CH3OH), and methane (CH4) with limiting potentials of -0.79, -0.49, and -0.60 V, respectively. A catalytic relationship between the d-band centers of SACs and the limiting potential of CO2RR was used to estimate the catalytic activity of catalysts. Furthermore, Nb@BP has high selectivity for CO2RR to CH3OH compared to H2 formation, while the hydrogen evolution reaction significantly impacts the synthesis of CO and CH4 on Zr@BP and Ru@BP. Nitrogen atom doping in BP is beneficial for enhancing the selectivity of CO2RR, but it is detrimental to the activity of CO2RR. This study offers theoretical guidance for synthesizing highly efficient CO2RR electrocatalysts and further enhances structural modulation methods for layered 2D materials.
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Borderline developmental dysplasia of the hip (BDDH), or borderline hip dysplasia (BHD), traditionally characterized by a relatively low lateral center-edge angle (LCEA), presents a complex challenge in treatment due to its multifaceted etiology involving instability, femoroacetabular impingement (FAI), or a combination thereof. The optimal approach to managing adult BDDH remains a subject of significant debate. Periacetabular osteotomy (PAO) is considered the preferred treatment for addressing severe acetabular under-coverage, as it rectifies the underlying bony deficiency and promotes stability. However, the treatment of BDDH is less straightforward, particularly with the advancement of hip arthroscopy techniques, specifically labral preservation and capsular management. Given the minimally invasive and rapid postoperative rehabilitation advantage for arthroscopic procedures over open surgeries, numerous attempts have been undertaken in this context. Research has revealed favorable patient-reported outcomes (PROs), low failure rates, and a significant proportion of returning to sports (RTS) after arthroscopic management for patients with BDDH. Although we might in the right direction, Level I evidence studies are needed to comprehensively compare long-term PROs, failure rates, and rates of RTS between arthroscopy and PAO in the treatment of BDDH.
Subject(s)
Femoracetabular Impingement , Hip Dislocation , Adult , Humans , Hip Dislocation/surgery , Hip Joint/surgery , Arthroscopy/methods , Treatment Outcome , Acetabulum/surgery , Femoracetabular Impingement/surgery , Osteotomy/methods , Retrospective StudiesABSTRACT
BACKGROUND: No single graft type has been shown to have a benefit in acetabular labral reconstruction. The native labrum and lateral meniscus share many similarities, suggesting that the meniscus may be a promising source of graft material in labral reconstruction. QUESTIONS/PURPOSES: Using a pig model, we sought to evaluate the healing process of fresh-frozen meniscus allograft for acetabular reconstruction by assessing (1) MRI and macroscopic observations of the meniscus allograft; (2) histologic appearance and immunohistologic evaluation of the meniscus allograft, native meniscus, and labrum; (3) microscopic assessment of the native labrum and meniscus via scanning electron microscopy; and (4) biomechanical assessment of tensile properties. METHODS: Twelve skeletally mature male miniature Bama pigs (24 hips) were randomly divided into two groups: labral defect group (control) and lateral meniscus allograft group. The selection of Bama pig specimens was based on the similarity of their acetabular labrum to that of the human acetabular labrum, characterized by the presence of fibrocartilage-like tissue lacking blood vessels. The pigs underwent bilateral hip surgery. Briefly, a 1.5-cm-long section was resected in the anterior dorsal labrum, which was left untreated or reconstructed using an allogeneic lateral meniscus. The pigs were euthanized at 12 and 24 weeks postoperatively, and then evaluated by macroscopic observations and MRI measurement to assess the extent of coverage of the labral defect. We also performed a histologic analysis and immunohistologic evaluation to assess the composition and structure of meniscus allograft, native labrum, and meniscus, as well as scanning electron microscopy assessment of the microstructure of the native labrum and meniscus and biomechanical assessment of tensile properties. RESULTS: Imaging measurement and macroscopic observations revealed that the resected area of the labrum was fully filled in the lateral meniscus allograft group, whereas in the control group, the labral defect remained at 24 weeks. The macroscopic scores of the meniscus allograft group (8.2 ± 0.8) were higher than those of the control groups (4.8 ± 1.0) (mean difference 3.3 [95% CI 1.6 to 5.0]; p < 0.001). Moreover, in the meniscus allograft group, histologic assessment identified fibrocartilage-like cell cluster formation at the interface between the graft and acetabulum; cells and fibers arranged perpendicularly to the acetabulum and tideline structure that were similar to those of native labrum could be observed at 24 weeks. Immunohistochemical results showed that the average optical density value of Type II collagen at the graft-acetabulum interface was increased in the meniscus allograft group at 24 weeks compared with at 12 weeks (0.259 ± 0.031 versus 0.228 ± 0.023, mean difference 0.032 [95% CI 0.003 to 0.061]; p = 0.013). Furthermore, the tensile modulus of the lateral meniscus allograft was near that of the native labrum at 24 weeks (54.7 ± 9.9 MPa versus 63.2 ± 11.3 MPa, mean difference -8.4 MPa [95% CI -38.3 to 21.4]; p = 0.212). CONCLUSION: In a pig model, lateral meniscus allografts fully filled labral defects in labral reconstruction. Regeneration of a fibrocartilage transition zone at the graft-acetabulum interface was observed at 24 weeks. CLINICAL RELEVANCE: The use of an autograft meniscus for labral reconstruction may be a viable option when labral tears are deemed irreparable. Before its clinical implementation, it is imperative to conduct a comparative study involving tendon grafts, which are extensively used in current clinical practice.
Subject(s)
Cartilage, Articular , Meniscus , Animals , Male , Acetabulum/surgery , Allografts , Cartilage, Articular/surgery , Fibrocartilage/diagnostic imaging , Fibrocartilage/surgery , Hip Joint/surgery , SwineABSTRACT
PURPOSE: To measure femoral torsion on computed tomography images in patients with femoroacetabular impingement syndrome and explore whether femoral torsion was significantly correlated with anterior capsular thickness. METHODS: Prospectively collected data of surgical patients were retrospectively reviewed. Only patients aged 16 to 55 years who underwent primary hip surgery were included in this study. Patients with a history of revision hip surgery, previous knee surgery, hip dysplasia, hip synovitis, and/or incomplete radiographs and medical records were excluded from the study. Femoral torsion was measured via computed tomography imaging using transcondylar slices of the knee. Anterior capsular thickness was measured using oblique-sagittal sequences on a 3.0-T magnetic resonance imaging system. The association between anterior capsular thickness and related variables, including femoral torsion, was assessed via multiple linear regression. The patients were then divided into 2 groups to further confirm the effect of femoral torsion on capsular thickness: Patients in the study group had hips with moderate (20°-25°) or severe (>25°) antetorsion, whereas patients in the control group had hips with normal torsion (5°-20°) or retrotorsion (<5°). Anterior capsular thickness was also compared between the 2 groups. RESULTS: A total of 156 patients (89 female patients [57.1%] and 67 male patients [42.9%]) were finally included in the study. The mean age and body mass index of the included patients were 35.8 ± 11.2 years and 22.7 ± 3.5, respectively. The mean femoral torsion for the entire study population was 15.9° ± 8.9°. Multivariable regression analysis showed that femoral torsion (P < .001) and sex (P = .002) were significantly correlated with anterior capsular thickness. Propensity-score matching yielded 50 hips in the study group and 50 hips in the control group on femoral torsion subanalysis. The results showed that anterior capsular thickness was significantly smaller in the study group than in the control group (3.8 ± 0.5 mm vs 4.7 ± 0.7 mm, P < .001). CONCLUSIONS: Femoral torsion is significantly inversely correlated with anterior capsular thickness. LEVEL OF EVIDENCE: Level III, retrospective comparative study.
Subject(s)
Bone Diseases , Femoracetabular Impingement , Humans , Male , Female , Femoracetabular Impingement/diagnostic imaging , Femoracetabular Impingement/surgery , Hip Joint/diagnostic imaging , Hip Joint/surgery , Retrospective Studies , Femur/diagnostic imaging , Femur/surgery , Arthroscopy/methodsABSTRACT
Developing a highly selective and sensitive analysis strategy for lincomycin (LIN) is of great significance for environmental protection and food safety. Herein, we reported a novel electrochemiluminescence (ECL) aptasensor based on Ti3C2 QDs-1T/2H MoS2 nano-hybrid luminophore for detection of LIN. The hybridization of Ti3C2 QDs and 1T/2H MoS2 endowed nanocomposite with structural and compositional advantages for boosting the ECL performance of QDs by about three times. This enhancement could be attributed to the remarkable electrocatalytic activity and high conductivity exhibited by 1T/2H MoS2. Secondly, the great surface area of 1T/2H MoS2 is conducive to the high dispersion of Ti3C2 QDs, and its good conductivity could promote charge transfer. On the other hand, the excellent catalytic performance of 1T/2H MoS2 could facilitate the reduction of S2O82- to produce more radical, which significantly enhance the ECL signal of Ti3C2 QDs. Given these features, a sensor for detection of LIN was established based on specific recognition between target and aptamer. The sensor showed a good linear relationship (0.05 ng mL-1 â¼100 µg mL-1) with a detection limit as low as 0.02 ng mL-1. It is worth noting that this work has been validated in testing milk samples, exhibiting great potential application prospects in food analysis.
Subject(s)
Molybdenum , Titanium , Catalysis , Electric Conductivity , LincomycinABSTRACT
PURPOSE: To identify articles that evaluated the efficacy of tele-rehabilitation after total hip replacement and to provide a reference for clinical decision-making and continuous improvement of rehabilitation exercise intervention strategies for clinical medical staff. METHODS: Embase, PubMed, Web of Science, Medline, China National Knowledge Network and Google Scholar databases were searched for randomized controlled trials of tele-rehabilitation after total hip replacement from inception to March 4, 2023. The two researchers used the PEDro scale to assess the methodological quality of the included studies. Two researchers used the PEDro scale to assess the methodological quality of the included studies. RESULTS: Ten studies with 632 participants were analysed.Compared to face-to-face rehabilitation, Internet-based telerehabilitation showed better outcomes in Get-up and go test (SMD -0.54, 95% CI -0.79 to -0.29). telerehabilitation showed no significant difference in outcomes of other functional tests and functional questionnaires. CONCLUSION: In this systematic review and meta-analysis, internet-based tele-rehabilitation and face-to-face rehabilitation had the same effect on patients after total hip replacement, and compliance was higher in the tele-rehabilitation group, but attention should be devoted to standardizing this form of rehabilitation to avoid adverse events. In addition, the number and quality of included studies in this study are limited, and the outcome indicators and intervention means have not been unified. More high-quality studies are needed to verify these conclusions to better evaluate the effectiveness and advantages of telerehabilitation.Implications for rehabilitationWith the development of science and technology, remote rehabilitation technology will be applied to various fields of rehabilitation, providing personalized and extensive rehabilitation services.The application of tele-rehabilitation technology to postoperative rehabilitation after total hip arthroplasty is feasible and can reduce the workload of healthcare professionals to a certain extent.This review evaluated the randomized controlled trials of telerehabilitation after total hip arthroplasty, and the results showed that the clinical efficacy of telerehabilitation after total hip arthroplasty was not inferior to that of traditional rehabilitation.
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Effective preventive measures against postoperative cognitive dysfunction in older adults are urgently needed. In this study, we investigated the effect of electroacupuncture (EA) on anesthesia and surgery-induced cognitive decline in aged rats by RNA-seq analysis, behavioral testing, Golgi-Cox staining, dendritic spine analysis, immunofluorescence assay and western blot analysis. EA ameliorated anesthesia and surgery induced-cognitive decline. RNA-seq analysis identified numerous differentially-expressed genes, including 353 upregulated genes and 563 downregulated genes, after pretreatment with EA in aged rats with postoperative cognitive dysfunction. To examine the role of CREB in EA, we injected adeno-associated virus (AAV) into the CA1 region of the hippocampus bilaterally into the aged rats to downregulate the transcription factor. EA improved synaptic plasticity, structurally and functionally, by activating the MAPK/ERK/CREB signaling pathway in aged rats. Together, our findings suggest that EA protects against anesthesia and surgery-induced cognitive decline in aged rats by activating the MAPK/ERK/CREB signaling pathway and enhancing hippocampal synaptic plasticity.
Subject(s)
Cognitive Dysfunction , Electroacupuncture , Postoperative Cognitive Complications , Rats , Animals , CA1 Region, Hippocampal/metabolism , Rats, Sprague-Dawley , Postoperative Cognitive Complications/metabolism , Hippocampus/metabolism , Cognitive Dysfunction/prevention & control , Cognitive Dysfunction/metabolismABSTRACT
Articular cartilage lesions remain a major challenge for clinicians and researchers. Several techniques, such as histological scoring, magnetic resonance imaging, and tissue section staining, are available for detecting cartilage degeneration and lesions and evaluating cartilage repairs. Nevertheless, these methods are complex and have numerous influencing factors, which may present obstacles to efficient communication between studies. In this study, we developed a fluorescence observation system that integrated a two-photon laser scanning confocal microscope (TPLSCM) with the second-harmonic generation (SHG) of a cartilage matrix. The observation system enabled the detection of autofluorescence emitted by the cartilage matrix without species specificity, facilitating both qualitative and quantitative analyses of the cartilage matrix. Notably, this observation could be applied three-dimensionally to a fresh specimen in situ up to a depth of 300 µm, obviating the need for traditional histological fixation, slicing, or staining. Furthermore, using this observation system, we reconstructed a three-dimensional (3D) image and a 3D model of the cartilage matrix. The utilization of the 3D fluorescence model may serve as a dependable option for the fabrication of cartilage matrix biomimetic scaffolds in future studies.
Subject(s)
Cartilage Diseases , Cartilage, Articular , Humans , Cartilage, Articular/diagnostic imaging , Cartilage, Articular/pathology , Cartilage Diseases/pathology , Microscopy, Fluorescence , Microscopy, Confocal/methodsABSTRACT
OBJECTIVE: Hip arthroscopy has recently appeared as a successful therapy in treating borderline developmental dysplasia of the hip (BDDH). This study aimed to describe the minimal 2-year follow-up after hip arthroscopy for patients with BDDH in the Asian population and use the combination of lateral center edge angle (LCEA) and alpha angles to detect the appearance of impingement in the BDDH population. METHODS: This retrospective investigation was conducted utilizing information from arthroscopically treated BDDH patients in 2018 and 2019. The following patient-reported outcomes were reported: modified Harris Hip Score, Hip Outcome Score-Activities of Daily Living, International Hip Outcome Tool 12-component form, and Visual Analog Scale. We also considered the clinical data regarding radiological measurements, intraoperative findings, interventions, complications, and subsequent surgical revisions, in the analysis of combination angles in detecting the occurrence of impingement. Patients with asymptomatic contralateral hips from traumatic hip injury (pelvic fracture) served as the control group. A 2:1 propensity score matching was based on age, sex, and BMI. A receiver operating characteristic curve (ROC) was used to identify the thresholds of combination angles and their accuracies. RESULTS: A total of 77 hips met the inclusion and exclusion requirements. After the follow-up period, most patients showed a considerable improvement in patient-reported outcomes compared to their preoperative values (P < 0.001 for all). The overall rate of complications was 5.2%, whereas the rate of revisions was 3.9%. Increasing preoperative alpha angle age was significantly positively correlated with improving patient-reported outcomes. The combined angle cut-off was determined to be 80.5° (AUC, 0.858; 95% CI: 0.757-0.938; sensitivity (SE), 98.1%; specificity (SP), 74.1%; P < 0.001) for the occurrence of impingement in BDDH population. CONCLUSION: Good patient-reported outcomes and low revision rates can be expected in the BDDH population with careful selection of patients in Asian populations. A combination angle >80.5° could be a reliable predictive factor of impingement in BDDH populations.
Subject(s)
Developmental Dysplasia of the Hip , Femoracetabular Impingement , Hip Dislocation , Humans , Hip Joint/surgery , Retrospective Studies , Femoracetabular Impingement/diagnostic imaging , Femoracetabular Impingement/surgery , Hip Dislocation/surgery , Treatment Outcome , Arthroscopy , Activities of Daily Living , Developmental Dysplasia of the Hip/surgery , Follow-Up StudiesABSTRACT
OBJECTIVE: When considering surgical treatment options, many patients who undergo hip arthroscopy value continuing active lifestyles. To address these concerns, the purpose of this study was to determine the effect of preoperative activity level on postoperative patient-reported outcomes (PROs) in femoroacetabular impingement syndrome (FAIS) patients following hip arthroscopy. METHODS: Data was retrospectively reviewed for FAIS patients who received hip arthroscopy between 2016 and 2018. Patients were divided into active group and inactive group based on preoperative HOS-SSS scores. Preoperative active patients were 1:1 propensity-score matched to inactive patients based on age, sex, BMI, and follow-up period. PROs (HOS-ADL, HOS-ADL, iHOT-12, mHHS), VAS scores, radiographic measures, performed procedures, complications, and revision surgery were compared and analyzed for both groups by Student's t test. RESULTS: A total of 71 patients in the active group and 71 patients in the inactive group were found using propensity-score matching. Active patients had superior preoperative HOS-ADL, HOS-SSS, iHOT-12, mHHS (p < 0.001 for all), and VAS (p = 0.002) scores compared with inactive patients. At the final follow-up, active patients still had better PROs in HOS-ADL (p = 0.003), HOS-SSS (p < 0.001), iHOT-12 (p = 0.043), and mHHS scores (p = 0.003). There was no difference detected in postoperative VAS score (p = 0.117) between the two groups. However, inactive patients showed significantly higher net improvement in HOS-ADL (p = 0.009), HOS-SSS (p = 0.005), and iHOT-12 (p = 0.023). CONCLUSIONS: Active patients have absolute higher preoperative PROs and achieve better postoperative PROs than inactive patients. However, inactive patients can obtain greater net improvements in PROs following hip arthroscopic surgery, with comparable pain alleviation as active patients.
Subject(s)
Femoracetabular Impingement , Humans , Femoracetabular Impingement/surgery , Hip Joint/surgery , Arthroscopy/methods , Retrospective Studies , Treatment Outcome , Activities of Daily Living , Follow-Up StudiesABSTRACT
OBJECTIVE: There has been no definite consensus on the ideal depth of acetabuloplasty, especially in cases of global pincer femoroacetabular impingement (FAI). This study aims to determine whether the depth of acetabuloplasty influences postoperative outcomes in cases of global pincer FAI. METHODS: Data were retrospectively collected from patients with global pincer FAI who underwent hip arthroscopy with a minimum follow-up period of 2 years from May 2014 to December 2018. Patients with global pincer FAI were subdivided into low or high resection depth groups based on whether the intraoperative acetabular rim was resected by more than 3 mm. Radiographic measurements; arthroscopic procedures; preoperative and postoperative PROs were recorded. Achievement of MCID and PASS was compared for the VAS, mHHS, HOS-ADL, and iHOT-12. A paired Student t-test was used to evaluate the significance of preoperative and postoperative PROs and two-tailed unpaired Student t-test was used to compare demographic data and PROs between different groups. MCID and PASS were evaluated using the chi-square test or the Fisher's exact test. RESULTS: A total of 41 hips with global pincer FAI (15 and 26 patients in low or high resection depth groups, respectively) were included in this study. Both groups showed significant postoperative improvements in the scores of all PROs (p < 0.001). Compared to the low resection depth group, the high resection depth group had a lower degree of improvement through hip arthroscopy, which manifested as lower postoperative mHHS scores (94.29 vs. 85.08, p = 0.006), higher VAS scores (0.93 vs. 2.54, p = 0.002), and lower improvements in VAS (-5.00 vs. -3.35, p = 0.028), HOS-ADL (34.99 vs. 23.90, p = 0.017) and iHOT-12 (39.89 vs. 29.27, p = 0.036). Patients in high resection depth group were less likely to achieve the MCID for the VAS score compared to low resection depth group in significant (73.3 vs. 26.9%, p = 0.004). CONCLUSIONS: For patients with global pincer, the outcomes in high resection depth group were slightly worse than the the low resection depth group. It is indicated that excessive resection of the acetabular rim during the procedure should be avoided.
Subject(s)
Acetabuloplasty , Femoracetabular Impingement , Humans , Femoracetabular Impingement/surgery , Hip Joint/surgery , Follow-Up Studies , Retrospective Studies , Arthroscopy/methods , Treatment Outcome , Activities of Daily LivingABSTRACT
OBJECTIVES: To evaluate the diagnostic performance in identifying an anterior cruciate ligament (ACL) injury and the reliability between two measuring protocols of anterior tibial subluxation (ATS). MATERIALS AND METHODS: A total of 165 patients with ACL injury and 157 ACL-intact patients were included in this study. Two different measuring protocols of ATS were performed on sagittal MR images, including the modified protocol using the longitudinal tibial axis (axis protocol) and the established protocol using a line perpendicular to the tibial plateau (plateau protocol). Receiver-operating characteristic (ROC) curves were calculated to evaluate the diagnostic performance in identifying an ACL injury, and areas under the curves (AUCs) were compared between the two protocols. Intra- and interobserver reliability tests were performed to evaluate the reliability of the measurements. RESULTS: Lateral ATS (P < 0.001) and medial ATS (P < 0.001) were increased in patients with ACL injury under both protocols. To identify an ACL injury, ATS measured under the axis protocol showed higher AUC values than the plateau protocol, including lateral ATS (AUC 0.828 vs. 0.688, P < 0.001), medial ATS (AUC 0.829 vs. 0.789, P = 0.013), and the combined indicator of lateral and medial ATS (AUC 0.885 vs. 0.810, P < 0.001). Reliability tests showed that both protocols were reliable. CONCLUSIONS: ATS measured under the modified protocol using the longitudinal tibial axis showed superior diagnostic performance in identifying an ACL injury compared to the established protocol, indicating that the modified protocol may better reflect the characteristics of an ACL-deficient knee.
Subject(s)
Anterior Cruciate Ligament Injuries , Anterior Cruciate Ligament Reconstruction , Joint Dislocations , Humans , Anterior Cruciate Ligament Injuries/diagnostic imaging , Anterior Cruciate Ligament Injuries/surgery , Reproducibility of Results , Anterior Cruciate Ligament Reconstruction/methods , Tibia/diagnostic imaging , Tibia/surgery , Knee Joint/surgery , Joint Dislocations/surgery , Magnetic Resonance Imaging , Retrospective StudiesABSTRACT
Excess of carbon dioxide (CO2) in the atmosphere poses a significant threat to the global climate. Therefore, the electrocatalytic carbon dioxide reduction reaction (CO2RR) is important to reduce the burden on the environment and provide possibilities for developing new energy sources. However, highly active and selective catalysts are needed to effectively catalyze product synthesis with high adhesion value. Single-atom catalysts (SACs) and double-atom catalysts (DACs) have attracted much attention in the field of electrocatalysis due to their high activity, strong selectivity, and high atomic utilization. This review summarized the research progress of electrocatalytic CO2RR related to different types of SACs and DACs. The emphasis was laid on the catalytic reaction mechanism of SACs and DACs using the theoretical calculation method. Furthermore, the influences of solvation and electrode potential were studied to simulate the real electrochemical environment to bridge the gap between experiments and computations. Finally, the current challenges and future development prospects were summarized and prospected for CO2RR to lay the foundation for the theoretical research of SACs and DACs in other aspects.
ABSTRACT
BACKGROUND: Hip joint capsular ligaments serve a fundamental role in balancing functional mobility and joint stability. However, few studies had focused on postoperative capsule changes in patients with borderline developmental dysplasia of the hip (BDDH). PURPOSE: To evaluate the integrity and thickness of anterior hip capsular thickness on pre and postoperative MRI in BDDH patients. STUDY DESIGN: Case series study; Level of evidence III. METHODS: A retrospective analysis was performed using data from BDDH patients who had arthroscopy between 2016 and 2019. Two groups were created and propensity-score matched based on whether the capsule was sutured. The study group comprised patients who have undergone routine capsule repair between 2018 and 2019. The control group includes BDDH patients with unrepaired capsulotomy between 2016 and 2018. Capsular integrity and thickness were measured on MRI before surgery and at least one year postoperatively. Furthermore, analysis was performed on correlations between the presence of a capsular defect and related factors. RESULTS: Propensity-score matching yielded 37 hips in the repair group and 37 hips in the non-repair group. There were no significant differences detected in age, sex, and BMI between the two groups. MRI detected capsular defects in 3 hips (8.1%) in the repair group and 10 hips (27.0%) in the non-repair group (p = 0.032). The defect was found to be along the interportal capsulotomy line in all capsular defect cases. Moreover, the postoperative anterior capsule thickness in the study group was significantly thinner compared with preoperative (2.9 ± 0.5 mm vs 3.7 ± 0.6 mm; p < 0.001), and no significant difference was detected in the control group. There were no statistically significant correlations between the presence of a defect capsule and demographic characteristics such as patient age, sex, BMI, preoperative alpha angle, or lateral center-edge angle (LCEA). CONCLUSION: The majority (91.9%) of the repaired hip capsules in BDDH patients remained closed compared with patients without repair (73.0%). The anterior capsule was significantly thinner in the zone of capsulotomy postoperative compared with preoperative in patients with unrepaired capsules. The presence of a defective capsule does not correlate with demographic factors.