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1.
Anticancer Res ; 41(4): 1745-1751, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33813378

RESUMO

BACKGROUND/AIM: Osteosarcoma is the most frequent malignant bone tumor. Failure of first-line therapy results in poor prognosis of osteosarcoma. In the present report, we examined the efficacy of the combination of oral recombinant methioninase (o-rMETase) and docetaxel (DOC) on an osteosarcoma patient-derived orthotopic xenograft (PDOX) mouse model. MATERIALS AND METHODS: Osteosarcoma-PDOX models were established by tumor insertion within the tibia of nude mice. The osteosarcoma PDOX models were randomized into four groups (4-5 mice per group): control; o-rMETae alone; DOC alone; o- rMETase combined with DOC. The treatment period was 3 weeks. RESULTS: The combination of o-rMETase and DOC showed significant efficacy compared to the control group (p=0.03). In contrast, there was no significant efficacy of o-rMETase alone or DOC alone (p=0.65, 0.60, respectively). CONCLUSION: o-rMETase converted an osteosarcoma PDOX from DOC-resistant to -sensitive. This combination therapy may be effective against recalcitrant osteosarcoma and other recalcitrant cancers.


Assuntos
Antineoplásicos/farmacologia , Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Neoplasias Ósseas/tratamento farmacológico , Liases de Carbono-Enxofre/administração & dosagem , Docetaxel/farmacologia , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Osteossarcoma/tratamento farmacológico , Tíbia/efeitos dos fármacos , Administração Oral , Adolescente , Animais , Neoplasias Ósseas/patologia , Humanos , Masculino , Camundongos Nus , Osteossarcoma/patologia , Proteínas Recombinantes/administração & dosagem , Tíbia/patologia , Ensaios Antitumorais Modelo de Xenoenxerto
2.
Anticancer Res ; 41(4): 1779-1784, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33813382

RESUMO

BACKGROUND/AIM: Osteosarcoma is a rare type of bone cancer that affects mostly children and adolescents. First-line chemotherapy for osteosarcoma has not been improved for many decades. Eribulin has been used to treat breast cancer and liposarcoma in the clinic. MATERIALS AND METHODS: A patient-derived orthotopic xenograft (PDOX) mouse model of osteosarcoma was established by tumor insertion within the tibia. This model more closely mimics osteosarcoma in clinical settings and was used to test the efficacy of eribulin. Tibia-insertion osteosarcoma PDOX mouse models were randomized into two groups: a control group (n=4) and an eribulin-treatment group (n=5). Mice were treated for fourteen days, four weeks after initial implantation. Tumor size and body weight were measured, and tumor histology was examined. RESULTS: Significant tumor growth inhibition (p=0.044) was observed in mice treated with eribulin compared to the control group. Histology demonstrated necrosis in the eribulin-treated tumors. There was no body-weight loss in the treated mice. CONCLUSION: Eribulin may be a clinically-effective, off-label chemotherapy for recalcitrant osteosarcoma that has failed first- and second-line therapy.


Assuntos
Antineoplásicos/farmacologia , Neoplasias Ósseas/tratamento farmacológico , Furanos/farmacologia , Cetonas/farmacologia , Osteossarcoma/tratamento farmacológico , Tíbia/efeitos dos fármacos , Adolescente , Animais , Neoplasias Ósseas/patologia , Humanos , Masculino , Camundongos Nus , Necrose , Osteossarcoma/patologia , Tíbia/patologia , Carga Tumoral/efeitos dos fármacos , Ensaios Antitumorais Modelo de Xenoenxerto
3.
Arthroscopy ; 37(4): 1066-1067, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33812512

RESUMO

Noninvasive ankle distraction technique is the standard of care for ankle arthroscopic surgery. Noninvasive distraction can be performed safely and with fewer complications when compared side-by-side with the nondistraction dorsiflexion technique. Moreover, distraction techniques allow a single surgeon to operate in the most convenient supine position and in a "hands-free" manner, with adequate space to avoid iatrogenic chondral damage. In addition, distraction allows for dedicated inflow and outflow portals to sufficiently irrigate the joint. Although the nondistraction technique allows excellent visualization of the anterior joint, it fails to provide appropriate visualization of the entire joint, using both anterior and posterior portals. Pathology that is best accessed from the posterior portal includes posterior osteochondral lesions, loose bodies, tears of the transverse ligament, acute ankle fractures, posterior tibial osteophytes, and occasionally an os trigonum. Fortunately, noninvasive distraction techniques plantarflex the ankle, also providing optimal access to the talus through the anterior approach. With the added use of posterolateral and occasionally posteromedial portals, near-universal access to lesions about the ankle can be obtained. In this infographic, the authors present the current indications for noninvasive ankle distraction arthroscopy and illustrate the importance of proper portal placement in obtaining the access and visualization necessary to easily and safely address pathology throughout the entire ankle and subtalar joint.


Assuntos
Articulação do Tornozelo/cirurgia , Artroscopia , Fraturas do Tornozelo/patologia , Humanos , Ligamentos/patologia , Tíbia/patologia
4.
Biomed Res Int ; 2021: 6970591, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33791380

RESUMO

This retrospective study was aimed to evaluate the clinical outcome and the extent of correction of the tibial deformity by a radiological evaluation following total knee arthroplasty (TKA) combined with intra-articular bone resection, in patients with knee arthritis and ipsilateral malunited tibial fractures. Fifteen patients (15 knees) with severe arthritis of the knee and extra-articular malunion of the tibia were treated using TKA with intra-articular bone resection. The extra-articular deformities in the coronal plane were 10 tibia vara (mean 15°, range 9°-30°), 4 tibia valgum (mean 12°, range 6°-20°), and one double deformity in the tibial shaft. The follow-up duration was 84 months (24-240). At the last follow-up, the mean Knee Society knee and function scores had improved, respectively (p = 0.001). The mean arc of knee motion improved from 97° preoperatively to 118.3° at the last follow-up (p < 0.001). The mean mechanical axis improved from a preoperative 15.5° to 1.5° of varus (p = 0.013). Excluding the patient with a double tibial malunion, in the 10 patients with varus tibial angulations, the tibia vara had improved from 15° preoperatively to 2.6° (p = 0.005). There were no observed complications except for one with a postoperative deep infection. In conclusion, our results indicated that TKA with intra-articular resection of the bone is an effective procedure for the treatment of severe arthritis of the knee with extra-articular malunion of the tibia in the coronal plane (≤30° of varus; ≤20° of valgus).


Assuntos
Artroplastia do Joelho , Osteotomia , Tíbia , Fraturas da Tíbia , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/patologia , Osteoartrite do Joelho/fisiopatologia , Osteoartrite do Joelho/cirurgia , Amplitude de Movimento Articular , Tíbia/patologia , Tíbia/fisiopatologia , Tíbia/cirurgia , Fraturas da Tíbia/patologia , Fraturas da Tíbia/fisiopatologia , Fraturas da Tíbia/cirurgia
5.
Ecotoxicol Environ Saf ; 213: 112059, 2021 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-33647747

RESUMO

Tibial dyschondroplasia (TD) is a metabolic disease of young poultry that affects bone andcartilage's growth. It mostly occurs in broilers due to thiram toxicity in the feed. In this disease, tibial cartilage is not yet ripe for ossification, but it also results in lameness, death, and moral convictions of commercial poultry due to numerous apoptotic changes on cell level. These changes serve a cardinal role in this situation. Many potential problems indicate that chlorogenic acid (CGA) performs an extensive role in controlling apoptosis's perception. However, the actual role of CGA in TD affected chondrocytes in-vitro is still unidentified. The current study investigates the imperceptible insight of CGA on chondrocyte's apoptosis via B-cell lymphoma 2 (Bcl-2), Bcl-2 associated x-protein (Bax), and Caspase-3 with CD147 signalling. The expression of these markers was investigated by Immunofluorescence, western blot analysis, and reverse transcription-quantitative polymerase chain (RT-qPCR). Chondrocytes from the growth plate of tibia were isolated, cultured, and processed. A sub-lethal thiram (2.5 µg/mL) was used to induce cytotoxicity and then treated with an optimum dose (40 µg/ mL) of CGA. According to the results, thiram distorted chondrocyte cells with enhanced apoptotic rate. But, in case of CGA, high expression of CD147 enhanced cell viability of chondrocytes, accompanied by downregulation of Bax/Caspase-3 signalling with the upregulation of Bcl-2. The first possibility has ruled out in the present study by the observation that the cells apoptosis marker, Caspase-3 showed a significant change in CD147 overexpressing cells. Conversely, immunodepletion of CD147 with enhanced cleavage of Caspase-3, indicating the activation of apoptosis in chondrocytes cells. Therefore, these findings suggest a novel insight about CD147 in thiram induced TD about the regulation of Bcl-2/Bax/Caspase-3 apoptosis-signalling axis.


Assuntos
Basigina/metabolismo , Fungicidas Industriais/toxicidade , Tiram/toxicidade , Animais , Apoptose , Caspase 2 , Caspase 3/metabolismo , Diferenciação Celular , Sobrevivência Celular , Galinhas/metabolismo , Ácido Clorogênico , Condrócitos/metabolismo , Cisteína Endopeptidases , Lâmina de Crescimento/patologia , Osteocondrodisplasias/tratamento farmacológico , Tíbia/patologia , Regulação para Cima , Proteína X Associada a bcl-2/metabolismo
6.
Bone Joint J ; 103-B(3): 456-461, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33641428

RESUMO

AIMS: To clarify the effectiveness of the induced membrane technique (IMT) using beta-tricalcium phosphate (ß-TCP) for reconstruction of segmental bone defects by evaluating clinical and radiological outcomes, and the effect of defect size and operated site on surgical outcomes. METHODS: A review of the medical records was conducted of consecutive 35 lower limbs (30 males and five females; median age 46 years (interquartile range (IQR) 40 to 61)) treated with IMT using ß-TCP between 2014 and 2018. Lower Extremity Functional Score (LEFS) was examined preoperatively and at final follow-up to clarify patient-centered outcomes. Bone healing was assessed radiologically, and time from the second stage to bone healing was also evaluated. Patients were divided into ≥ 50 mm and < 50 mm defect groups and into femoral reconstruction, tibial reconstruction, and ankle arthrodesis groups. RESULTS: There were ten and 25 defects in the femur and tibia, respectively. Median LEFS improved significantly from 8 (IQR 1.5 to 19.3) preoperatively to 63.5 (IQR 57 to 73.3) at final follow-up (p < 0.001). Bone healing was achieved in all limbs, and median time from the second stage to bone healing was six months (IQR 5 to 10). Median time to bone healing, preoperative LEFS, or postoperative LEFS did not differ significantly between the defect size groups or among the treatment groups. CONCLUSION: IMT using ß-TCP provided satisfactory clinical and radiological outcomes for segmental bone defects in the lower limbs; surgical outcomes were not influenced by bone defect size or operated part. Cite this article: Bone Joint J 2021;103-B(3):456-461.


Assuntos
Transplante Ósseo/métodos , Fosfatos de Cálcio/farmacologia , Fêmur/cirurgia , Ílio/transplante , Procedimentos Cirúrgicos Reconstrutivos/métodos , Tíbia/cirurgia , Adulto , Artrodese , Desbridamento , Feminino , Fêmur/lesões , Fêmur/patologia , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Polimetil Metacrilato , Estudos Retrospectivos , Tíbia/lesões , Tíbia/patologia , Cicatrização/efeitos dos fármacos
7.
Phys Ther Sport ; 49: 178-187, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33744766

RESUMO

OBJECTIVES: Osgood-Schlatter disease (OSD) is a sport- and growth-associated knee pathology with locally painful alterations around the tibial tuberosity apophysis. Up to 10% of adolescents are affected by OSD. Treatment is predominantly conservative. The aims of this systematic review are to comprehensively identify conservative treatment options for OSD, compare their effectiveness in selected outcomes, and describe potential research gaps. METHODS: A systematic literature search was conducted using CENTRAL, CINAHL, EMBASE, MEDLINE, and PEDro databases. In addition, ongoing and unpublished clinical studies, dissertations, and other grey literature on OSD were searched. We also systematically retrieved review articles for extraction of treatment recommendations. RESULTS: Of 767 identified studies, thirteen were included, comprising only two randomised controlled trials (RCTs). The included studies were published from 1948 to 2019 and included 747 patients with 937 affected knees. Study quality was poor to moderate. In addition to the studies, 15 review articles were included, among which the most prevalent treatment recommendations were compiled. CONCLUSION: Certain therapeutic approaches, such as stretching, have apparent efficacy, but no RCT comparing specific exercises with sham or usual-care treatment exists. Carefully controlled studies on well-described treatment approaches are needed to establish which conservative treatment options are most effective for patients with OSD.


Assuntos
Tratamento Conservador/métodos , Osteocondrose/terapia , Adolescente , Adulto , Criança , Exercício Físico , Terapia por Exercício/métodos , Feminino , Humanos , Joelho/patologia , Articulação do Joelho/patologia , Masculino , Exercícios de Alongamento Muscular , Osteocondrose/patologia , Dor/patologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Literatura de Revisão como Assunto , Esportes , Tíbia/patologia , Resultado do Tratamento , Adulto Jovem
8.
Nat Commun ; 12(1): 723, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33526787

RESUMO

Bone metastatic prostate cancer (PCa) promotes mesenchymal stem cell (MSC) recruitment and their differentiation into osteoblasts. However, the effects of bone-marrow derived MSCs on PCa cells are less explored. Here, we report MSC-derived interleukin-28 (IL-28) triggers prostate cancer cell apoptosis via IL-28 receptor alpha (IL-28Rα)-STAT1 signaling. However, chronic exposure to MSCs drives the selection of prostate cancer cells that are resistant to IL-28-induced apoptosis and therapeutics such as docetaxel. Further, MSC-selected/IL-28-resistant prostate cancer cells grow at accelerated rates in bone. Acquired resistance to apoptosis is PCa cell intrinsic, and is associated with a shift in IL-28Rα signaling via STAT1 to STAT3. Notably, STAT3 ablation or inhibition impairs MSC-selected prostate cancer cell growth and survival. Thus, bone marrow MSCs drive the emergence of therapy-resistant bone metastatic prostate cancer yet this can be disabled by targeting STAT3.


Assuntos
Adenocarcinoma/secundário , Neoplasias Ósseas/secundário , Células-Tronco Mesenquimais/patologia , Neoplasias da Próstata/patologia , Receptores de Interferon/metabolismo , Ácidos Aminossalicílicos/farmacologia , Ácidos Aminossalicílicos/uso terapêutico , Animais , Apoptose/efeitos dos fármacos , Benzenossulfonatos/farmacologia , Benzenossulfonatos/uso terapêutico , Neoplasias Ósseas/tratamento farmacológico , Diferenciação Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Proliferação de Células , Meios de Cultivo Condicionados/metabolismo , Modelos Animais de Doenças , Docetaxel/farmacologia , Docetaxel/uso terapêutico , Humanos , Interferons/genética , Interferons/metabolismo , Masculino , Camundongos Knockout , Osteoblastos/patologia , Cultura Primária de Células , Neoplasias da Próstata/tratamento farmacológico , RNA Interferente Pequeno/metabolismo , Receptores de Interferon/genética , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Fator de Transcrição STAT1/metabolismo , Fator de Transcrição STAT3/antagonistas & inibidores , Fator de Transcrição STAT3/metabolismo , Tíbia/patologia
9.
Bone Joint J ; 103-B(2): 338-346, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33517724

RESUMO

AIMS: This study aimed to identify the tibial component and femoral component coronal angles (TCCAs and FCCAs), which concomitantly are associated with the best outcomes and survivorship in a cohort of fixed-bearing, cemented, medial unicompartmental knee arthroplasties (UKAs). We also investigated the potential two-way interactions between the TCCA and FCCA. METHODS: Prospectively collected registry data involving 264 UKAs from a single institution were analyzed. The TCCAs and FCCAs were measured on postoperative radiographs and absolute angles were analyzed. Clinical assessment at six months, two years, and ten years was undertaken using the Knee Society Knee score (KSKS) and Knee Society Function score (KSFS), the Oxford Knee Score (OKS), the 36-Item Short-Form Health Survey questionnaire (SF-36), and range of motion (ROM). Fulfilment of expectations and satisfaction was also recorded. Implant survivorship was reviewed at a mean follow-up of 14 years (12 to 16). Multivariate regression models included covariates, TCCA, FCCA, and two-way interactions between them. Partial residual graphs were generated to identify angles associated with the best outcomes. Kaplan-Meier analysis was used to compare implant survivorship between groups. RESULTS: Significant two-way interaction effects between TCCA and FCCA were identified. Adjusted for each other and their interaction, a TCCA of between 2° and 4° and a FCCA of between 0° and 2° were found to be associated with the greatest improvements in knee scores and the probability of fulfilling expectations and satisfaction at ten years. Patients in the optimal group whose TCCA and FCCA were between 2° and 4°, and 0° and 2°, respectively, had a significant survival benefit at 15 years compared with the non-optimal group (optimal: survival = 100% vs non-optimal: survival = 92%, 95% confidence interval (CI) 88% to 96%). CONCLUSION: Significant two-way interactions between the TCCA and FCCA demonstrate the importance of evaluating the alignment of the components concomitantly in future studies. By doing so, we found that patients who concomitantly had both a TCCA of between 2° and 4° and a FCCA of between 0° and 2° had the best patient-reported outcome measures at ten years and better survivorship at 15 years. Cite this article: Bone Joint J 2021;103-B(2):338-346.


Assuntos
Artroplastia do Joelho/métodos , Hemiartroplastia/métodos , Prótese do Joelho , Osteoartrite do Joelho/cirurgia , Idoso , Idoso de 80 Anos ou mais , Artroplastia do Joelho/instrumentação , Fenômenos Biomecânicos , Feminino , Fêmur/patologia , Fêmur/fisiologia , Fêmur/cirurgia , Seguimentos , Hemiartroplastia/instrumentação , Humanos , Articulação do Joelho/patologia , Articulação do Joelho/fisiologia , Articulação do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Desenho de Prótese , Falha de Prótese , Sistema de Registros , Tíbia/patologia , Tíbia/fisiologia , Tíbia/cirurgia , Resultado do Tratamento
11.
Biochem Biophys Res Commun ; 546: 185-191, 2021 03 26.
Artigo em Inglês | MEDLINE | ID: mdl-33601314

RESUMO

Type 1 diabetes mellitus (T1DM) is characterized by hyperglycemia manifesting as insufficient insulin. Toll-like receptor-4 (TLR4) has been implicated in diabetic osteoporosis. We established streptozotocin (STZ)-induced diabetic mouse model and examined the relevant osteoporosis factors in different experimental groups, the WT-CON group, WT-STZ group, KO-CON group and KO-STZ group, respectively. No obvious protection of TLR4 deletion was shown in mice with diabetes. There was no obvious difference in the body weight or blood glucose concentration between WT-STZ group and KO-STZ group. However, TLR4 deletion reduced the receptor activator of NF-κB ligand (RANKL)-induced osteoclast differentiation. Furthermore, TLR4 knockout attenuated STZ-induced diabetic osteoporosis via inhibiting osteoblasts and pre-inflammation factors mediated by the NF-κB pathway. TLR4 deletion ameliorated STZ-induced diabetic osteoporosis in mice, and TLR4 may be used as a potential therapeutic target for the treatment of diabetic osteoporosis.


Assuntos
Diabetes Mellitus Experimental/induzido quimicamente , Diabetes Mellitus Experimental/complicações , Modelos Animais de Doenças , Osteoporose/induzido quimicamente , Osteoporose/genética , Estreptozocina , Receptor 4 Toll-Like/deficiência , Receptor 4 Toll-Like/genética , Animais , Osso Esponjoso/citologia , Osso Esponjoso/diagnóstico por imagem , Osso Esponjoso/patologia , Diferenciação Celular/genética , Diabetes Mellitus Experimental/genética , Diabetes Mellitus Experimental/patologia , Diabetes Mellitus Tipo 1/induzido quimicamente , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/genética , Masculino , Camundongos , Terapia de Alvo Molecular , Fator 88 de Diferenciação Mieloide/metabolismo , Osteoclastos/citologia , Osteoclastos/patologia , Osteoporose/complicações , Osteoporose/patologia , Ligante RANK/metabolismo , Tíbia/citologia , Tíbia/diagnóstico por imagem , Tíbia/patologia , Microtomografia por Raio-X
12.
West Afr J Med ; 38(1): 84-92, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33463713

RESUMO

Giant cell tumours of bone are relatively uncommon, accounting for about 5% of all primary bone tumours. They are generally classified as benign bone tumours. However, some of them might be locally aggressive. The peak incidence is between second and fourth decades of life. They are commonly found at the epiphyseal and, occasionally, metaphyseal zones of long bones such as radius, femur and tibia. They most often present as painless swellings; however, pain may be experienced as a result of pressure on the surrounding soft tissues. The relevant diagnostic investigations that help in establishing the diagnosis include plain x-rays, Magnetic resonance imaging (MRI), CT and tissue biopsy for histological confirmation. Traditionally, surgery is the mainstay of treatment of the disease. Other modalities include radiation, tumour embolization and injectable drugs for surgically inaccessible or recurrent cases.


Assuntos
Neoplasias Ósseas , Tumor de Células Gigantes do Osso , Tíbia , Biópsia , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/terapia , Tumor de Células Gigantes do Osso/diagnóstico por imagem , Tumor de Células Gigantes do Osso/terapia , Humanos , Imageamento por Ressonância Magnética , Tíbia/diagnóstico por imagem , Tíbia/patologia , Tomografia Computadorizada por Raios X
13.
Anticancer Res ; 41(2): 635-640, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33517267

RESUMO

BACKGROUND: A mouse model of metastatic osteosarcoma is imperative to identify effective agents for metastatic osteosarcoma, which is a recalcitrant disease. In the present study, we established osteosarcoma patient-derived cells (OS-PDCs) and transfected them with green fluorescent protein (GFP). MATERIALS AND METHODS: The OS-PDCs were transfected with GFP-lentivirus. GFP-expressing OS-PDCs (2.0×105) were then injected into the tibia of nude mice to establish the patient-derived orthotopic cell (PDOC) model (n=3). Six weeks after injection, the primary tumor and each organ were resected and imaged. RESULTS: Primary orthotopic tumors were established in two out of three mice. The GFP-expressing OS-PDCs in the PDOC model were visualized. Multiple GFP-expressing lung metastases were detected in one of the two mice with primary tumor. CONCLUSION: The present study proves the concept that a GFP-expressing PDOC model can mimic clinical lung-metastatic osteosarcoma. This model can serve as a paradigm to screen for effective drugs for osteosarcoma lung metastasis.


Assuntos
Neoplasias Ósseas/patologia , Proteínas de Fluorescência Verde/metabolismo , Neoplasias Pulmonares/secundário , Osteossarcoma/secundário , Tíbia/patologia , Adolescente , Animais , Neoplasias Ósseas/genética , Neoplasias Ósseas/metabolismo , Rastreamento de Células , Feminino , Proteínas de Fluorescência Verde/genética , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/metabolismo , Camundongos Nus , Transplante de Neoplasias , Osteossarcoma/genética , Osteossarcoma/metabolismo , Tíbia/metabolismo , Transfecção , Células Tumorais Cultivadas
14.
Jt Dis Relat Surg ; 32(1): 28-34, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33463415

RESUMO

OBJECTIVES: This study aims to investigate whether variables such as body mass index (BMI), size of the cement with screw augmentation area (CSA), distance between the base of tibial plate and the deepest point of the defect area (DPDA) may cause any mechanical problems leading to deterioration in tibiofemoral alignment or impact clinical outcomes when the surgeon utilizes bone cement with screw augmentation (BCSA) technique in the treatment of moderate non-contained tibial bone defects in total knee arthroplasty (TKA). PATIENTS AND METHODS: This cross-sectional study, conducted between March 2018 and March 2019, included 37 knees of 28 patients (4 males, 24 females; mean age 71.3±8.9; range, 55 to 86 years) with moderate tibial bone defects requiring treatment with BCSA during primary TKA. Patients with BMI >30 were scored with Hospital for Special Surgery (HSS) score for clinical outcomes; besides, CSA, DPDA, and tibiofemoral alignment were calculated on plain X-rays. RESULTS: Mean BMI was 34.1±5.7 (range, 24.9 to 45.9). Patients had a mean follow-up period of 44±13.9 (range, 28 to 75) months. Mean postoperative CSA was 98.2±35.3 (range, 42 to 180) mm2 and DPDA was 7.4±2.6 (range, 3.5 to 12.9) mm. Mean HSS score at last follow-up was 88.0±7.5 (range, 71 to 97). CONCLUSION: Bone cement with screw augmentation technique was associated with satisfactory clinical outcomes and tibiofemoral alignment was not significantly deviated in patients with high BMI. We determined that neither the depth of DPDA nor the size of CSA had any correlation with clinical outcomes.


Assuntos
Artroplastia do Joelho , Índice de Massa Corporal , Sobrepeso , Complicações Pós-Operatórias , Tíbia , Idoso , Artroplastia do Joelho/efeitos adversos , Artroplastia do Joelho/instrumentação , Artroplastia do Joelho/métodos , Cimentos Ósseos/uso terapêutico , Parafusos Ósseos , Estudos Transversais , Feminino , Humanos , Prótese do Joelho , Masculino , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/cirurgia , Avaliação de Processos e Resultados em Cuidados de Saúde , Sobrepeso/complicações , Sobrepeso/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Radiografia/métodos , Tíbia/diagnóstico por imagem , Tíbia/patologia
15.
Arthroscopy ; 37(5): 1599-1609, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33453346

RESUMO

PURPOSE: To examine the relationship between posterior tibial slope and lateral meniscal bone angle (LMBA) on anterior cruciate ligament (ACL) tear risk in a pediatric population. METHODS: In this case-control study, non-contact ACL-injured pediatric patients with no significant lateral meniscal lesions were matched by age and sex in a 1:1 ratio to a group of radiologically normal controls. Knee magnetic resonance imaging (MRI) studies were analyzed by 3 independent, blinded observers measuring the medial posterior tibial slope (MTS), lateral posterior tibial slope (LTS), and LMBA. Sagittal slope asymmetry was calculated as the absolute difference in degrees between slopes, and the relationship between LMBA and LTS was calculated as a ratio. Binary logistic regressions identified independent predictors of ACL injury. Receiver operator characteristics were performed to determine predictive accuracy. RESULTS: 20 study patients were compared with 20 sex- and age-matched controls (age 14.8 ± 2.42, mean ± standard deviation). LTS was significantly higher in the ACL-injured group (11.30° ± 3.52° versus 7.00° ± 2.63°, P = .0001), as were the absolute slope difference (7.10 ± 2.92° versus 3.14 ± 3.25°, P = .0002) and LTS:LMBA ratio (0.46 ± 0.17 versus 0.26 ± 0.12, P = .0001). No significant differences were observed for MTS or LMBA. Independent predictors were LTS (odds ratio [OR] 1.58, 95% confidence interval [CI] 1.18 to 2.13, P = .002), LTS:LMBA ratio (OR 3.13, 95% CI 1.48 to 6.62, P = .003), and absolute slope difference (OR 1.65, 95% CI 1.17 to 2.32, P = .005). LTS:LMBA ratio was the strongest predictor variable (area under the curve 0.86). CONCLUSION: This study suggests that LTS, absolute slope difference, and LTS:LMBA ratio are significant pediatric ACL-injury risk factors. All 3 demonstrate good predictive accuracy; however, the relationship between steep LTS and shallow LMBA was the strongest predictor. LEVEL OF EVIDENCE: III, case-control study.


Assuntos
Lesões do Ligamento Cruzado Anterior/diagnóstico , Meniscos Tibiais/patologia , Tíbia/patologia , Adolescente , Adulto , Lesões do Ligamento Cruzado Anterior/diagnóstico por imagem , Lesões do Ligamento Cruzado Anterior/patologia , Estudos de Casos e Controles , Criança , Feminino , Humanos , Joelho/diagnóstico por imagem , Modelos Logísticos , Imageamento por Ressonância Magnética , Masculino , Meniscos Tibiais/diagnóstico por imagem , Variações Dependentes do Observador , Razão de Chances , Curva ROC , Reprodutibilidade dos Testes , Fatores de Risco , Tíbia/diagnóstico por imagem
16.
Clin Nucl Med ; 46(1): 81-83, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33156056

RESUMO

A 76-year-old man with previously treated prostatic adenocarcinoma (Gleason 8) was referred for a Ga-prostate-specific membrane antigen PET/CT scan due to a rising serum PSA level. An intensely PSMA-avid focus was demonstrated in the left proximal tibia with no evidence of local recurrence or metastatic disease elsewhere. This was diagnosed and managed as enthesopathy. A Tc-MDP bone scan with SPECT/CT performed 9 months later confirmed an intensely osteoblastic mixed lytic/sclerotic metastasis at the left proximal tibia.


Assuntos
Adenocarcinoma/patologia , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/secundário , Entesopatia/diagnóstico por imagem , Glicoproteínas de Membrana , Compostos Organometálicos , Neoplasias da Próstata/patologia , Tíbia/patologia , Idoso , Diagnóstico Diferencial , Humanos , Masculino , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tíbia/diagnóstico por imagem
17.
Aging (Albany NY) ; 12(24): 24778-24797, 2020 12 23.
Artigo em Inglês | MEDLINE | ID: mdl-33361529

RESUMO

Osteoarthritis (OA) is the most common musculoskeletal disorder among the elderly. It is characterized by progressive cartilage degradation, synovial inflammation, subchondral bone remodeling and pain. Lipocalin prostaglandin D synthase (L-PGDS) is responsible for the biosynthesis of PGD2, which has been implicated in the regulation of inflammation and cartilage biology. This study aimed to evaluate the effect of L-PGDS deficiency on the development of naturally occurring age-related OA in mice. OA-like structural changes were assessed by histology, immunohistochemistry, and micro-computed tomography. Pain related behaviours were assessed using the von Frey and the open-field assays. L-PGDS deletion promoted cartilage degradation during aging, which was associated with enhanced expression of extracellular matrix degrading enzymes, matrix metalloprotease 13 (MMP-13) and a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS-5), and their breakdown products, C1,2C, VDIPEN and NITEG. Moreover, L-PGDS deletion enhanced subchondral bone changes, but had no effect on its angiogenesis. Additionally, L-PGDS deletion increased mechanical sensitivity and reduced spontaneous locomotor activity. Finally, we showed that the expression of L-PGDS was elevated in aged mice. Together, these findings indicate an important role for L-PGDS in naturally occurring age-related OA. They also suggest that L-PGDS may constitute a new efficient therapeutic target in OA.


Assuntos
Envelhecimento/genética , Cartilagem Articular/metabolismo , Oxirredutases Intramoleculares/genética , Lipocalinas/genética , Osteoartrite/genética , Prostaglandina D2/metabolismo , Proteína ADAMTS5/genética , Proteína ADAMTS5/metabolismo , Agrecanas/genética , Agrecanas/metabolismo , Envelhecimento/metabolismo , Envelhecimento/patologia , Animais , Comportamento Animal , Cartilagem Articular/patologia , Contagem de Células , Colágeno Tipo II/genética , Colágeno Tipo II/metabolismo , Fêmur/diagnóstico por imagem , Fêmur/metabolismo , Fêmur/patologia , Imuno-Histoquímica , Locomoção , Metaloproteinase 13 da Matriz/genética , Metaloproteinase 13 da Matriz/metabolismo , Camundongos , Camundongos Knockout , Osteoartrite/diagnóstico por imagem , Osteoartrite/metabolismo , Osteoartrite/patologia , Sinovite , Tíbia/diagnóstico por imagem , Tíbia/metabolismo , Tíbia/patologia , Microtomografia por Raio-X
18.
Int J Nanomedicine ; 15: 7143-7153, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33061372

RESUMO

Introduction: Tobacco mosaic virus-based nanoparticles (TMV VNPs) were previously shown to promote osteogenic differentiation in vitro. This study aims to investigate whether and how TMV VNPs impact on osteoclastogenesis in vitro and bone injury healing in vivo. Methods: Raw264.7 cells were cultured in osteoclastogenic medium in culture plates coated with or without TMV and TMV-RGD1 VNPs, followed by TRAP staining, RT-qPCR and WB assessing expression of osteoclastogenic marker genes, and immunofluorescence assessing NF-κB activation. TMV and TMV-RGD1-modified hyaluronic acid hydrogel were used to treat mouse tibial bone injury. Bone injury healing was checked by micro-CT and Masson staining. Results: TMV and TMV-RGD1 VNPs significantly inhibited osteoclast differentiation and downregulated the expression of osteoclastogenic marker genes Ctr, Ctsk, Mmp-9, Rank, and Trap. Moreover, TMV and TMV-RGD1 VNPs inhibited NF-κB p65 phosphorylation and nuclear translocation, as well as activation of mTOR/AKT signaling pathway. TMV and TMV-RGD1-modified HA hydrogel strongly promoted mouse tibial bone injury with increased bone mass compared to plain HA hydrogel. The amount of osteoclasts was significantly reduced in TMV and TMV-RGD1 treated mice. TMV-RGD1 was more effective than TMV in inhibiting osteoclast differentiation and promoting bone injury repair. Discussion: These data demonstrated the great potential of TMV VNPs to be developed into biomaterial for bone injury repair or replacement.


Assuntos
Nanopartículas/química , Osteogênese , Transdução de Sinais , Serina-Treonina Quinases TOR/metabolismo , Vírus do Mosaico do Tabaco/fisiologia , Animais , Osso e Ossos/patologia , Diferenciação Celular/efeitos dos fármacos , Camundongos , NF-kappa B/metabolismo , Nanopartículas/ultraestrutura , Osteoclastos/efeitos dos fármacos , Osteoclastos/patologia , Fosforilação , Proteínas Proto-Oncogênicas c-akt/metabolismo , Células RAW 264.7 , Ratos , Transdução de Sinais/efeitos dos fármacos , Tíbia/patologia , Cicatrização
19.
Clin Imaging ; 67: 237-245, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32871428

RESUMO

OBJECTIVE: We present a series of 20 cases of a sleeve-type injury of the distal tibia characterized by traumatic periosteal stripping caused by a high ankle sprain. We characterize the magnetic resonance imaging findings associated with this injury and highlight its association with distal tibial osteonecrosis. MATERIALS AND METHODS: We collected 20 cases of high ankle sprains with periosteal stripping of the distal tibia through teaching files and a search through our PACS database. We recorded the presence and pattern of syndesmotic ligamentous injury and the presence or absence of syndesmotic widening in patients with periosteal stripping. The presence or absence of associated fractures and osteonecrosis was noted and characterized by location. RESULTS: The most commonly torn ligament was the anterior inferior tibiofibular ligament. 25% (5/20) of the patients in our series developed osteonecrosis. Osteonecrosis developed as early as 3-4 weeks following the initial injury. Of the patients with osteonecrosis, 40% (2/5) had fractures of the posterior malleolus. All patients with osteonecrosis had widening of the syndesmosis. Two of the five patients with osteonecrosis were in the pediatric age group. CONCLUSION: In contrast to conventional syndesmotic and interosseous ligamentous tearing, high ankle injuries with tibial periosteal stripping may result in avulsion of the extra-osseous vasculature supplied by the periosteum, leading to osteonecrosis. This pattern of injury has not been emphasized in the literature. Our findings underscore the importance of the integrity of the periosteum for maintaining adequate vascularity of the distal tibia.


Assuntos
Traumatismos do Tornozelo/diagnóstico por imagem , Osteonecrose/diagnóstico por imagem , Adolescente , Traumatismos do Tornozelo/patologia , Feminino , Fraturas Ósseas , Humanos , Ligamentos Laterais do Tornozelo/lesões , Imageamento por Ressonância Magnética/métodos , Masculino , Ruptura , Ossos do Tarso , Tíbia/patologia
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