A meta-analysis of postoperative outcomes of patients with and without chronic hepatitis C undergoing primary total hip or knee arthroplasty.

Purpose: This investigation provides a rigorous systematic review of the postoperative outcomes of patients with and without chronic hepatitis C who underwent total hip arthroplasty (THA) and total knee arthroplasty (TKA). Methods: We queried PubMed, Embase, Cochrane Database of Systematic Reviews, Scopus, Web of Science and the 'gray' literature, including supplemental materials, conference abstracts and proceedings as well as commentary published in various peer-reviewed journals from 1992 to present to evaluate studies that compared the postoperative outcomes of patients with and without chronic hepatitis C who underwent primary THA or TKA. This investigation was registered in the PROSPERO international prospective register of systematic reviews and follows the guidelines provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. In our literature search, we identified 14 articles that met our inclusion criteria and were included in our fixed-effects meta-analysis. The postoperative outcomes analyzed included periprosthetic joint infection (PJI), aseptic revision, non-homebound discharge and inpatient mortality. Results: Our statistical analysis demonstrated a statistically significant increase in postoperative complications of patients with chronic hepatitis C who underwent primary THA or TKA including PJI (odds ratio (OR): 1.98, 95% CI: 1.86 - 2.10), aseptic revision (OR: 1.58, 95% CI: 1.50 - 1.67), non-homebound discharge (OR: 1.31, 95% CI: 1.28- 1.34) and inpatient mortality (OR: 9.37, 95% CI: 8.17 - 10.75). Conclusion: This meta-analysis demonstrated a statistically significant increase in adverse postoperative complications in patients with chronic hepatitis C who underwent primary THA or TKA compared to patients without chronic hepatitis C.

Human synoviocyte lubricin and bovine synovial fluid lubricin equally improve gliding resistance in a canine model in vitro.

The lubricating ability of human synoviocyte lubricin and bovine lubricin purified from synovial fluid was investigated and compared using a canine in vitro tendon model. Our null hypothesis was that these two forms of lubricin would have equal lubricating ability. Forty two canine hind-limbs were used. The peroneus longus (PL) tendons were harvested, along with the proximal phalanx and flexor digitorum profundus of the second or fifth digit with its proximal fibro-osseous pulley. Forty PL tendons were randomly assigned to one of four treatment groups. After gliding resistance testing, two intact PL tendons and two tendons in each group were randomly selected for surface observation with scanning electron microscopy (SEM). The variance of the PL saline group mean gliding resistance was significantly different from other groups. There was a significant treatment-cycle interaction effect on the mean gliding resistance. On SEM, the surface of the saline treated PL tendons appeared rough, whereas the other tendon surfaces appeared smooth. Human synoviocyte lubricin functioned as well as bovine synovial fluid lubricin to reduce friction of canine PL tendons in vitro. This data suggest that treatment using the two forms of lubricin are mechanically similar.