Establishment and Simulation of 3D Geometric Models of Mini-Pig and Sheep Knee Joints Using Finite Element Analysis.

BACKGROUND Our objective was to establish and compare three-dimensional models of knee joints of mini-pigs and sheep, the 2 most commonly used animal models of osteoarthritis. MATERIAL AND METHODS Three-dimensional geometric models of knee joints were used to assess their biomechanical properties by analysis of the three-dimensional finite element stress load for flexion at 30° and 60°. RESULTS Analysis of multiple tissues indicated that the sheep knee had greater stress peaks than the mini-pig knee at 30° flexion (range: 12.5 to 30.4 Mpa for sheep vs. 11.1 to 20.2 Mpa for mini-pig) and at 60° flexion (range: 17.9 to 43.5 Mpa for sheep vs. 15.9 to 28.9 Mpa for mini-pig). In addition, there was uneven distribution of stress loads in the surrounding ligaments during flexion. CONCLUSIONS Our three-dimensional finite element analysis indicated that the mini-pig knee joint had stress values and changes of cartilage, meniscus, and peripheral ligaments that were similar to those of the human knee.

Annexin A1 involved in the regulation of inflammation and cell signaling pathways.

With the deepening of research, proteomics has developed into a science covering the study of all the structural and functional characteristics of proteins and the dynamic change rules. The essence of various biological activities is revealed from the perspectives of the biological structure, functional activity and corresponding regulatory mechanism of proteins by proteomics. Among them, phospholipid-binding protein is one of the hotspots of proteomics, especially annexin A1, which is widely present in various tissues and cells of the body. It has the capability of binding to phospholipid membranes reversibly in a calcium ion dependent manner. In order to provide possible research ideas for researchers, who are interested in this protein, the biological effects of annexin A1, such as inflammatory regulation, cell signal transduction, cell proliferation, differentiation and apoptosis are described in this paper.

A high-density genetic map and QTL mapping of leaf traits and glucosinolates in Barbarea vulgaris.

BACKGROUND: Barbarea vulgaris is a wild cruciferous plant and include two distinct types: the G- and P-types named after their glabrous and pubescent leaves, respectively. The types differ significantly in resistance to a range of insects and diseases as well as glucosinolates and other chemical defenses. A high-density linkage map was needed for further progress to be made in the molecular research of this plant. RESULTS: We performed restriction site-associated DNA sequencing (RAD-Seq) on an F2 population generated from G- and P-type B. vulgaris. A total of 1545 SNP markers were mapped and ordered in eight linkage groups, which represents the highest density linkage map to date for the crucifer tribe Cardamineae. A total of 722 previously published genome contigs (50.2 Mb, 30% of the total length) can be anchored to this high density genetic map, an improvement compared to a previously published map (431 anchored contigs, 38.7 Mb, 23% of the assembly genome). Most of these (572 contigs, 31.2 Mb) were newly anchored to the map, representing a significant improvement. On the basis of the present high-density genetic map, 37 QTL were detected for eleven traits, each QTL explaining 2.9-71.3% of the phenotype variation. QTL of glucosinolates, leaf size and color traits were in most cases overlapping, possibly implying a functional connection. CONCLUSIONS: This high-density linkage map and the QTL obtained in this study will be useful for further understanding of the genetic of the B. vulgaris and molecular basis of these traits, many of which are shared in the related crop watercress.

rhBMP in lumber fusion for lumbar spondylolisthesis: A systematic review and meta-analysis.

PURPOSE: To compare the efficacy and safety of recombinant human bone morphogenetic protein (rhBMP) and iliac crest autograft in the fusion treatment of lumbar spondylolisthesis. METHODS: The studies using randomized controlled trials to compare the rhBMP with iliac crest autograft in the treatment of lumbar spondylolisthesis were retrieved from Embase, Pubmed, ProQuest dissertations & theses (PQDT), China national knowledge infrastructure (CNKI), Chinese Biomedical Database, Wanfang Data, Cochrane Library (from March 1998 to March 2018). Postoperative fusion rate, clinical success rate, postoperative intervertebral height, complications, operation time, blood loss and duration of hospitalization were chosen as the outcome indicators. Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical software Revman 5.3 was used for data-analysis. RESULTS: Eleven articles were included in the meta-analysis. The results showed that, comparing the efficacy of rhBMP with iliac crest autograft, statistical significance was found in the 24-month fusion rate post operation [95% CI (1.38, 24.70), p = 0.02] and operation time [95% CI (-14.22, -2.08), p = 0.008]. There is not sufficient evidence for statistical differences in the remaining indicators. CONCLUSION: The current literature shows rhBMP is a safe and effective grafting material in the treatment of lumbar spondylolisthesis. Further evidence is dependent on the emergence of more randomized controlled trials with higher quality and larger sample sizes in the future.

Ilioinguinal approach versus Stoppa approach for open reduction and internal fixation in the treatment of displaced acetabular fractures: A systematic review and meta-analysis.

PURPOSE: To compare the efficacy and safety of open reduction and internal fixation through ilioinguinal approach and Stoppa approach for the treatment of displaced acetabular fractures. METHODS: Case-controlled trials (CCTs) published from January 2010 to August 2015 that compared the ilioinguinal approach and Stoppa approach in the management of displaced acetabular fractures were retrieved from the databases of Cochrane Library, Pubmed, CNKI, and so on. Methodological quality of the trials was critically assessed. Statistical software RevMan 5.0 was used for data analysis. RESULTS: Eight articles were included in the meta-analysis. Through comparing the efficacy and safety of ilioinguinal approach and Stoppa approach in the treatment of displaced acetabular fracture, statistical significance was found in the average operation time [WMD = 68.29, 95% CI (10.52, 126.05), p < 0.05] and the median intraoperative blood loss [WMD = 142.26, 95% CI (9.30, 275.23), p < 0.05]. However, there existed no statistical significance in the fracture end reset satisfaction rate [RR = 0.63, 95% CI (0.17, 2.37), p > 0.05], the early complications rate [RR = 0.89, 95% CI (0.33, 2.40), p > 0.05], the late complications rate [RR = 0.91, 95% CI (0.27, 3.01), p > 0.05], and Harris hip score good function rate [RR = 0.52, 95% CI (0.25, 1.10), p > 0.05]. CONCLUSION: Though both techniques can obtain satisfactory clinical functions in the treatment of displaced acetabular fractures, Stoppa approach is superior to the ilioinguinal approach in terms of operation time and intraoperative blood loss.

Percutaneous poking reduction and fixation versus open reduction and fixation in the treatment of displaced calcaneal fractures for Chinese patients: A systematic review and meta-analysis.

PURPOSE: To compare the efficacy of percutaneous poking reduction and fixationwith open reduction and fixation in the treatment of displaced calcaneal fractures. METHODS: Reports of studies using case-controlled trials (CCT) to compare the percutaneous poking reduction and fixation with the open reduction and fixation in the management of calcaneal fractures were retrieved from the Cochrane Library, PubMed Database, CNKI, Chinese Biomedical Database, Wanfang Data (from January of 2005 to August of 2015). Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical software Revman 5.0 was used for data-analysis. RESULTS: Fifteen articles were included in the meta-analysis. Comparison of the efficacy of percutaneous poking reduction and fixation with open reduction and fixation in the treatment of calcaneal fractures revealed statistical significance in the incidence of complications after operation [RR = 0.32, 95% CI (0.20, 0.5), p < 0.05]. However, there were neither statistical significance in the degrees of recovery for calcaneal Bohler angle [WMD = -1.65, 95% CI (-3.43, 0.14), p > 0.05] and calcaneal Gissane angle [WMD = -3.21, 95% CI (-6.75, 0.33), p > 0.05], nor statistical significance in the rate of good foot function after operation [RR= 0.95, 95% CI (0.90, 1.00), p > 0.05]. CONCLUSION: For the treatment of calcaneal fractures, percutaneous poking reduction and fixation is su- perior to open reduction and fixation in terms of the incidence of postoperative complications. But both techniques can obtain satisfactory clinical function.

The Role of miRNAs in Cartilage Homeostasis.

Osteoarthritis (OA) is an age-related disease with poorly understood pathogenesis. Recent studies have demonstrated that miRNA might play a key role in OA initiation and development. We reviewed recent publications and elucidated the connection between miRNA and OA cartilage anabolic and catabolic signals, including four signaling pathways: TGF-ß/Smads and BMPs signaling, associated with cartilage anabolism; and MAPK and NF-KB signaling, associated with cartilage catabolism. We also explored the relationships with MMP, ADAMTS and NOS (NitricOxide Synthases) families, as well as with the catabolic cytokines IL-1 and TNF-α. The potential role of miRNAs in biological processes such as cartilage degeneration, chondrocyte proliferation, and differentiation is discussed. Collective evidence indicates that miRNAs play a critical role in cartilage degeneration. These findings will aid in understanding the molecular network that governs articular cartilage homeostasis and in to elucidate the role of miRNA in the pathogenesis of OA.

[Kinematic gait analysis for patients with meniscus injury].

OBJECTIVE: To investigate application of the Codamotion 2CX1 three-dimensional dynamic joint motion capture system to analyze the kinematic characteristics of patients with different degrees of meniscus injury. METHODS: From December 2020 to June 2022, 135 patients with meniscus injury and recruited normal people were collected, including 82 males and 53 females, aged 14 to 29 years old, with disease duration of 1 to 3 months. Combined with clinical symptoms and MRI examination, the diagnosis of meniscus injury was confirmed, and the patients were divided into stages, including 37 cases of grade 0(normal), 30 cases of gradeⅠ, 33 cases of gradeⅡ, 35 cases of grade Ⅲ according to Stoller grading standard. Subjects in each group were tested walking by using Codamotion 2CX1 three-dimensional dynamic joint motion capture system. Quantitative indexes of walking and kinematics were collected, including knee flexion and extension, internal and external rotation and internal and external turning, and their kinematics were analyzed. RESULTS: In the distribution of knee flexion/extension, there were significant differences in maximum knee flexion, minimum knee extension and knee flexion and extension range among 4 groups(P<0.05). In the distribution of internal/external rotation of knee joint, there were significant differences in the range of internal rotation and rotation of knee joint among 4 groups(P<0.05). In the distribution of internal/external turning of knee joint, there were significant differences in the range of internal and external turning of knee joint among 4 groups(P<0.05). The clinical stage progression was positively correlated with the range of motion of knee extension, external rotation, internal and external turning and turning range(P<0.05). It was negatively correlated with knee flexion, internal rotation, flexion extension and rotation range(P<0.05). The internal and external rotation angles of knee joint could be used as independent factors influencing the clinical stage of meniscus injury (P=0.006, 0.019<0.05). CONCLUSION: The knee movement of patients with meniscus injury has obvious changes, and the changes are different under different clinical stages. Gait analysis provides a reliable basis for the kinematic analysis of meniscus injury, helps to better understand the kinematic indexes of joints, and provides a reliable auxiliary diagnosis and treatment plan, which provides a new direction for the follow-up medical research.

[Meta-analysis of autologous bone grafts and bone substitute for the treatment of tibial plateau fractures].

OBJECTIVE: To explore clinical efficacy of autologous bone grafts and bone substitute for the treatment of tibial plateau fractures by Meta analysis. METHODS: Controlled clinical studies on autogenous bone transplantation and bone substitutes in treating tibial plateau fractures published on PubMed,Web of Science,CNKI,Wanfang and other databases from January 2005 to August 2022 were searched by computer. Literature screening and data extraction were performed according to randomized controlled trial(RCT),and the quality of RCT were evaluated by using intervention meta-analysis criteria in Cochrane manual. Meta-analysis of joint depression,secondary collapse rate of articular surface,blood loss,operative time and infection rate between two methods were performed by Rev Man 5.3 software. RESULTS: Seven RCT studies (424 patients) were included,296 patients in bone replacement group and 128 patients in autograft group. Operative time [MD=-16.79,95%CI(-25.72,-7.85),P=0.000 2] and blood loss[MD=-70.49,95%CI(-79.34,-61.65),P<0.000 01] between two groups had statistically differences,while joint depression[MD=-0.17,95%CI(-0.91,0.58),P=0.66],secondary collapse rate of joint surface[RR=-0.74, 95%CI(0.35,1.57),P=0.43],infection rate [RR=1.21,95%CI(0.31,4.70),P=0.78] between two groups had no differences. CONCLUSION: The effects of bone substitute and autograft for the treatment of tibial plateau fracture have similar effects in terms of joint depression,secondary articular surface collapse rate and infection rate. However,compared with autologous bone transplantation,bone replacement could reduce blood loss and shorten operation time.

[Screw versus Kirschner wire fixation for lateral humeral condyle fractures in children:a meta analysis].

OBJECTIVE: To compare screw versus Kirschner wire fixation in the treatment of lateral humeral condyle fractures in children. METHODS: A systematic search was conducted in PubMed, Embase, the Cochrane library, Web of Science, China National Knowledge Internet(CNKI), Wanfang Datebase from in ception to February 2022. Studies comparing screws and Kirschner wire fixation in the treatment of lateral humeral condyle fractures in children were included. Outcome measures included and excluded by a set of inclusion and exclusion criteria and evaluated for their quality, their excellent and good rate of fracture healing, malunion, delayed union or nonunion, infection, limitation of elbow flexion or extension(>10°) were extracted and analyzed using software Rev Man 5.3. RESULTS: A total of 9 retrospective studies involving 647 patients were included, with 255 patients in the screw fixation group(including screw combined with Kirschner wire) and 392 patients in the Kirschner wire fixation group. Meta analysis showed the following:infection rate in the screw group was significantly lower than that in the Kirschner wire group[OR=0.22, 95%CI(0.09, 0.56), P=0.001]. There were no significant differences between the 2 groups in excellent and good rate of fracture healing, malunion rate(P>0.05). Subgroup analysis showed that infection rate in the screw-only group was significantly lower than that in the Kirschner wire group[OR=0.18, 95%CI(0.05, 0.65), P=0.009]. CONCLUSION: For lateral humeral condyle fractures, Screw fixation alone had a lower infection rate than kirschner wire fixation and screw combined with Kirschner wire fixation. There were no significant differences in the excellent and good rate of fracture healing, malunion. In terms of postoperative efficacy and safety of internal fixation, orthopaedic surgeons are more likely to recommend screws for fixation of lateral humeral condyle fractures in children.

A pH-responsive novel delivery system utilizing carbon quantum dots loaded with PT2385 for targeted inhibition of HIF-2α in the treatment of osteoarthritis.

BACKGROUND: Osteoarthritis (OA) is a progressive joint disorder marked by the degradation of cartilage. Elevated concentrations of hypoxia-inducible factor-2α (HIF-2α) are intricately linked to the pathological development of OA. PT2385 has demonstrated effective inhibition of HIF-2α, thereby potentially impeding the initial advancement of OA. Nevertheless, challenges persist, including limited penetration into the deeper layers of cartilage, issues related to charge rejection, and a heightened rate of clearance from the joint. These constraints necessitate further consideration and exploration. METHODS: It has been demonstrated that PT2385 exhibits efficient inhibition of HIF-2α expression, thereby contributing to the delay in the progression of osteoarthritis. The pH-responsive attributes of carbon quantum dots, specifically those employing m-phenylenediamine (m-CQDs) coated with bovine serum albumin (BSA), have been systematically evaluated. In both in vitro settings involving cartilage explants and in vivo experiments, the efficacy of BSA-m-CQDs-PT2385 (BCP) has been confirmed in facilitating the transport of PT2385 to the middle and deep layers of cartilage. Furthermore, the BCP system demonstrates controlled drug release contingent upon alterations in environmental pH. RESULTS: While the use of PT2385 alone provides protective effects on chondrocytes within an inflamed environment, there exists an opportunity for further enhancement in its efficacy when administered via intra-articular injection. The BCP formulation, characterized by appropriate particle size and charge, facilitates seamless penetration into cartilage tissue. Additionally, BCP demonstrates the capability to release drugs in response to changes in environmental pH. In vitro experiments reveal that BCP effectively inhibits Hif-2α expression and catabolic factors in chondrocytes. Notably, cartilage explants and in vivo experiments indicate that BCP surpasses PT2385 alone in inhibiting the expression of HIF-2α and matrix metalloproteinase 13, particularly in the middle and deep layers. CONCLUSIONS: The BCP drug delivery system exhibits selective release of PT2385 in response to pH changes occurring during the progression of osteoarthritis (OA), thereby inhibiting HIF-2α expression deep within the cartilage. The use of BCP significantly augments the capacity of PT2385 to retard both cartilage degeneration and the progression of osteoarthritis. Consequently, BCP as an innovative approach utilizing m-CQDs to deliver PT2385 into articular cartilage, shows potential for treating osteoarthritis.This strategy opens new avenues for osteoarthritis treatment.

[Meta-analysis of different joint interfaces in total hip arthroplasty under long-term follow-up].

OBJECTIVE: To compare the long-term follow-up effect and complications of ceramic on ceramic (CoC) interface and ceramic on polyethyleneon ceramic (CoP) interface in primary total hip arthroplasty, and provide clinical evidence. METHODS: Search PubMed, EMBase, the CoChrane Library databases, Web of science, Wanfang database, and CNKI from January 2000 to September 2021, screening and inclusion of randomized controlled trials (RCTs) comparing the long-term efficacy and complications of CoC interface and CoP interface in total hip arthroplasty. Literature screening, quality evaluation and data extraction were carried out according to the inclusion and exclusion criteria, using Review Manager 5.3 statistical software. The software was used to perform statistical analysis on joint function, revision, prosthesis fracture, abnormal joint noise, and prosthesis wear rate after CoC or CoP. RESULTS: Seven RCTs studies were included, including 390 cases of hips with CoC artificial joints and 384 cases of hips with CoP artificial joints. The long-term joint function improvement of CoC and CoP artificial joints was similar and there was no significant differences, with an average difference was MD=0.63, 95%CI=(-1.81, 3.07), P=0.61. About the postoperative complications, CoC artificial joints have higher incidence rate of abnormal joint noise, with odds ratio (OR)=11.05, 95%CI=(2.04, 59.84), P=0.005. CoP artificial joints wear faster, with an average MD=-87.11, 95%CI=(-114.40, -59.82), P<0.000 1. There was no significant difference between the two groups in the replacement-related complications such as joint dislocation, prosthesis loosening, osteolysis, and the rate of prosthesis revision caused by various reasons. CONCLUSION: The clinical function results and complications of CoC artificial joints are comparable to those of CoP artificial joints. Although CoP artificial joint prosthesis has a faster wear rate, it does not affect joint function and increase complications, and there is no abnormal joint noise. CoC is expensive and the long-term efficacy is equivalent to CoP. Clinicians should consider cost performance when choosing CoC.

[Platelet-rich plasma vs corticosteroid for treatment of rotator cuff tendinopathy:a Meta-analysis].

OBJECTIVE: To explore clinical effects regrarding functional recovery, pain relief, and range of motion of shoulder of platelet-rich plasma (PRP) injection and corticosteroid(CS) injection in treating rotator cuff tendinopathy. METHODS: Randomized controlled trials (RCT) of PRP injection and CS injection in Cochrane Library, EMBASE(Excerpta Medica Database), PebMed, China knowledge Network(CNKI) and Wanfang database were searched from building database to April 20, 2022. According to inclusion and exclusion criteria, literature screening, data extraction and quality evaluation were carried out between two independent researchers, and extracted data were statistically analyzed by Review Manager 5.4.1 software. Short-term (3-6 weeks), medium-term (8-12 weeks) and long-term (≥24 weeks) visual analogue score (VAS), American Shoulder and Elbow Surgeons (ASES) score, Xi'an Western Ontario Rotator Cuff Index (WORC) and shoulder range of motion (ROM) were compared between two groups. RESULTS: Totally 7 RCT were included with 379 patients, 188 patients in PRP group and 191 patients in CS group. Meta analysis results showed there were no significant difference in VAS, ASES and WORC between short-term group and medium-term group(P>0.05). During long-term follow-up, there were significant differences in ASES score[MD=7.1, 95%CI(2.06, 12.14), P=0.006] and VAS [MD=-1.55, 95%CI(-2.65, 0.55), P=0.002]. There was no significant difference in shoulder ROM between two groups(P>0.05). CONCLUSION: For patients with shoulder cuff tendon disease, there are no significant difference in pain relief and functional recovery during short and medium-term follow-up period. However, RPR injection showed advantages over corticosteroid injection in terms of functional recovery and pain relief during long-term follow-up. There is no significant difference in shoulder range of motion between two groups during the whole follow-up period.

Effectiveness of antibiotics loaded bone cement in primary total knee arthroplasty: A systematic review and meta-analysis.

INTRODUCTION: The application of antibiotics loaded bone cement (ALBC) in the revision of failed total knee arthroplasty (TKA) has been widely accepted to reduce risk of peri-prosthetic infection. However, the prophylactic use of ALBC in primary TKA remains controversial. This study was aimed to identify the prophylactic effect on peri-prosthetic infection and safety of ALBC in primary TKA. HYPOTHESIS: The application of ALBC could reduce the risk of peri-prosthetic infection in primary TKA. MATERIALS AND METHODS: Electronic platforms including PubMed, EMBASE, and CENTRAL were retrieved to identify studies comparing outcomes of prophylactic ALBC and plain cement in primary TKA. For outcomes reported as dichotomous variable and continuous variable, risk ratio (RR) and weighted mean difference (WMD) as well as their 95% confidence intervals (95% CI) were selected as the effect sizes for pooling. While for those outcomes reported the adjusted effect sizes such as odds ratio (OR, derived from multivariate logistic regression), and hazard ratio (HR, derived from multivariate COX proportional hazard model), the reported effect sizes were selected for pooling. RESULTS: A total of 17 studies with 2,074,844 patients (1,093,920 in ALBC group and 980,924 in plain cement group) were eligible for final inclusion. No significant difference was found between ALBC and plain cement groups both for the unadjusted (RR=1.02, 95% CI: 0.86∼1.21, p=0.832) and adjusted (OR=0.94, 95% CI: 0.76∼1.17, p=0.596) peri-prosthetic infection rate. ALBC application was related to significantly increased length of hospital stay (WMD=0.13, 95% CI: 0.10∼0.17, p<0.001). There was no significance on the difference of operation related adverse events between two groups (RR=1.31, 95% CI: 0.68∼2.52, p=0.420). Significantly increased risks of acute renal failure and readmission, and temporarily increased ototoxicity in ALBC group were reported in one of the primary study. DISCUSSION: There is no sufficient evidence supporting decreased peri-prosthetic infection rate with ALBC application in primary TKA. What's more, it must be taken into consideration about the safety and added cost of additional impregnated antibiotics. LEVEL OF EVIDENCE: III; meta-analysis.

[Disassembly of tubulin cytoskeleton disrupts the homeostasis of articular cartilage chondrocytes].

OBJECTIVE: To investigate the influence of tubulin disassembly on the in vitro metabolism of articular chondrocytes. METHODS: Eight New Zealand rabbits aged 2 months were sacrificed by air embolism. The full-thickness cartilages were harvested from both knees under sterile conditions. Then 0.4% pronase and 0.025% II collagenase were used to digest for primary chondrocytes. The cells were cultured for 3 days after attachment and then divided into the control and experimental groups. The control group continued culturing with primary medium and the experimental group with colchicine, a tubulin destructive agent, at a final concentration of 0.1 µmol/L. At Days 1 & 2, the early apoptosis of two cell groups was assayed with phosphatidylserine (Annexin V). At Day 6, the morphological changes of cells were observed by hematoxylin and eosin staining. At Days 3, 6 & 9, the expression levels of type II collagen, proteoglycan and MMP (matrix metalloproteinase)-13 mRNA were measured by real time quantitative fluorescent reverse transcription-polymerase chain reaction (real time RT-PCR). Meanwhile at Days 3, 6 & 9, the cultured supernatant of each group was obtained to detect the contents of type II collagen and proteoglycan by the methods of ELISA (enzyme-linked immunosorbent assay) and Alcian blue. RESULTS: At Day 2, the early cell apoptosis rate of the experimental group was higher than that of the control group (P < 0.05). At Day 6 post-dosing, the experimental cell morphology was found to be irregular and polygonal. Hyperchromatic nucleus and division phase increased while matrix cell decreased. At Days 3, 6 & 9, the expressions of collagen and proteoglycan mRNA in the experimental group decreased versus those in the control group (P < 0.05). The level of MMP-13 mRNA showed no significant changes in the control group at Day 3. And it significantly increased at Days 6 & 9 (P < 0.01). Meanwhile, type II collagen and glycosaminoglycan were significantly lower in the experimental group at Days 3, 6 & 9 than those in the control group (P < 0.05). CONCLUSION: A disassembly of tubulin can induce early apoptosis of chondrocytes. The synthesis and secretion of type II collagen and proteoglycan decrease while there is an elevated expression of MMP-13. The degeneration of cartilage cells and their disrupted synthesis and catabolism result in a serious decline in biological functions.

[Arthroscopic surgery combined with platelet-rich plasma for meniscus injury:a Meta analysis].

OBJECTIVE: To evaluate clinical efficacy of arthroscopic with platelet-rich plasma (PRP) in treating meniscus injury. METHODS: From January 2015 to December 2019, clinical control study on repair meniscus injury by arthroscopic with PRP between arthroscopic were searched by PubMed, Science Direct, Cochrane library, Chinese Journal Full-text Database, Wanfang and VIP database. Literature screening, data extraction and quality evaluation according to inclusion and exclusion criteria. Visual analogue scale(VAS) of knee joint and Lysholm score at 1, 6 and 12 months after opertaion between two groups were compared, and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) at 3, 6 and 12 months after opertaion between twogroups were also compared. RESULTS: Totally 9 literatures and 329 patients with meniscal injuries were screened, include 146 patients treated by arthroscopic with PRP and 183 patients treated by arthroscopic. There were no statistical differences in VAS between two groups at 1, 6 and 12 months after opertaion. There were differences in Lysholm score at 1 and 6 months after operation between two groups [MD=3.85, 95%CI (1.25, 6.44), P<0.05], [MD=2.88, 95%CI (0.13, 5.63), P<0.05];while there was no difference at 12 months[MD=5.88, 95%CI(-8.72, 20.48), P=0.43]. There were differneces in WOMAC score at 3 and 6 months after operation between two groups[MD=-8.07, 95%CI(-11.17, -4.89), P<0.000 01], [MD=-7.96, 95%CI(-11.44, -4.48), P<0.000 01];and no difference at 12 months after operation[MD=-6.61, 95%CI (-16.64, 3.41), P>0.05]. CONCLUSION: Arthroscopic with PRP for repair meniscus injury has short term efficacy of knee function and delay arthritis, while has similar effect in long term clinical efficacy and relieve pain.

[Design of combined lower limb elastic compression device and comparative study with elastic bandage].

OBJECTIVE: To compared with the modified Robert Jones bandage of 3M elastic bandage, to evaluate the fitness, convenience, safety and comfort of the modular combination lower limb elastic compression device. METHODS: Forty healthy adult college students, including 28 males and 12 females, aged 16 to 25 (20.3±2.2) years old and weighing 40 to 81 (60.4±20.2) kg, were randomly divided into two groups with 40 samples in each group. According to the body surface parameters of Chinese lower limbs and guided by the concept of modularization, a group of modular combined lower limb elastic compression device was designed. Each module was combined to evaluate the fitness of the modular combined compression device in thelength and circumference of the lower limbs. The left and right lower limbs were randomly paired and divided into groups, with 40 samples in each group. The convenience of the operation time, adjustment times and required time were compared between two groups. The safety of the two groups after 24 hours of application of pressure injury was compared. The subjective pain feeling changes within 24 hours were recorded by visual analogue scale (VAS) to evaluate the comfort. RESULTS: The device was composed of several elastic compression outer lining modules with different length and width of 15 cm, an inner lining module for buffering, positioning and attaching the main body, and an elastic ankle compression module. The length of the elastic compression outer lining module covers the circumference of the human lower limbs. The length of a single outer lining module increased from 15 cm to 80 cm every 5 cm interval, and the length of a single inner lining module increased from 62 cm to 83 cm every 3 cm interval. After the modules were selected and combined, the length and circumference of the lower limbs can reach 100% fitness. The operation time of the first placement(118.23±7.33) s and re operation(60.08±5.88) s of experimental group were significantly shorter than those of control group (164.68±8.93) s and re operation (131.23±7.91) s. The adjustment times (3) and operation time (3.50±0.71) s of experimental group were significantly shorter than those of control group(11)and operation time(139.00±5.66) s (P<0.05), but there was no significant difference between two groups (P>0.05). The VAS score of experimental group was significantly lower than that of control group at each time point (P<0.01). CONCLUSION: The modular combined elastic compression device has good fitness, better placement and flexible adjustment, convenience and safety, and better comfort than modified Robert Jones bandage of 3M elastic bandage.

Studies of Articular Cartilage Repair from 2009 to 2018: A Bibliometric Analysis of Articles.

OBJECTIVE: To perform a bibliometric analysis of research on articular cartilage repair published in Chinese and English over the past decade. Fundamental and clinical research topics of high interest were further comparatively analyzed. METHODS: Relevant studies published from 1 January 2009 to 31 December 2018 (10 years) were retrieved from the Wanfang database (Chinese articles) and six databases, including MEDLINE, WOS, INSPEC, SCIELO, KJD, and RSCI on the website "Web of Science" (English articles), using key words: "articular cartilage" AND "injury" AND "repair". The articles were categorized according to research focuses for a comparative analysis between those published in Chinese vs English, and further grouped according to publication date (before and after 2014). A comparative analysis was performed on research focus to characterize the variation in research trends between two 5-year time spans. Moreover, articles were classified as basic and clinical research studies. RESULTS: Overall, 5762 articles were retrieved, including 2748 in domestic Chinese journals and 3014 in international English journals. A total of 4937 articles focused on the top 10 research topics, with the top 3 being stem cells (32.1%), tissue-engineered scaffold (22.8%), and molecular mechanisms (16.4%). Differences between the numbers of Chinese and English papers were observed for 3 topics: chondrocyte implantation (104 vs 316), osteochondral allograft (27 vs 86), and microfracture (127 vs 293). The following topics gained more research interest in the second 5-year time span compared with the first: microfracture, osteochondral allograft, osteochondral autograft, stem cells, and tissue-engineered scaffold. Articles with a focus on three-dimensional-printing technology have shown the fastest increase in publication numbers. Among 5613 research articles, basic research studies accounted for the majority (4429), with clinical studies described in only 1184 articles. The top 7 research topics of clinical studies were: chondrocyte implantation (28.7%), stem cells (21.9%), microfracture (19.2%), tissue scaffold (10.6%), osteochondral autograft (10.5%), osteochondral allograft (6.3%), and periosteal transplantation (2.8%). CONCLUSION: Studies focused on stem cells and tissue-engineered scaffolds led the field of damaged articular cartilage repair. International researchers studied allograft-related implantation approaches more often than Chinese researchers. Traditional surgical techniques, such as microfracture and osteochondral transplantation, gained high research interest over the past decade.

[Outcomes of quadriceps tendon autograft versus bone-patellar tendon-bone autograft for anterior cruciate ligament reconstruction:a Meta-analysis].

OBJECTIVE: To evaluate clinical effect of quadriceps tendon autograft and bone-patellar tendon-bone autograft on anterior cruciate ligament reconstruction by Meta-analysis. METHODS: From the time of building databases to May 2019, literatures on case control study on quadriceps tendon and bone-patellar tendon-bone autograft on anterior cruciate ligament reconstruction were searched form PubMed, EMbase, the Cochrane library, Wanfang and CNKI database. Literature screening, quality evaluation and data extraction were carried out according to include and exclude standard. Difference of forward displacement between the affected and health knee, Lachman test, axial shift test, Lysholm score, international knee documentation committee (IKDC) objective grade, anterior knee joint pain and transplant failure rate were analyzed by Meta analysis. RESULTS: Totally 6 literatures were included, including 915 patients with anterior cruciate ligament reconstruction, 495 patients with quadriceps tendon autograft and 420 patients with bone patellar tendon bone autograft. There were no statistical differences in anterior displacement of tibia was less than 3 mm[OR=1.53, 95%CI(0.68, 3.44), P=0.31], 3 to 5 mm [OR=0.64, 95%CI(0.31, 1.35), P=0.24], greater than 5 mm[OR=1.18, 95%CI(0.33, 4.22), P=0.80], negative rate of Lachman test[OR=0.88, 95%CI(0.38, 2.02), P=0.76], negative rate of axial shift test[OR=0.63, 95%CI(0.24, 1.68), P=0.36] between two groups. There were no differences in Lyshlom score[MD=-0.56, 95%CI(-2.00, 0.89), P=0.45], IKDC objective grade A and B[OR=0.87, 95%CI (0.47, 1.60), P=0.66], and transplant failure rate [OR=0.76, 95%CI (0.28, 2.02), P= 0.58]. In reducing anterior knee pain, quadriceps tendon autograft was better than that of bone patellar tendon bone autograft [OR=0.16, 95%CI (0.09, 0.29), P<0.000 01]. CONCLUSION: Quadriceps tendon autograft and bone patellar tendon bone autograft on anterior cruciate ligament reconstruction has equal clinical and functional outcomes, transplant failure rate, quadriceps tendon autograft could reduce anterior knee pain. For patients with anterior cruciate ligament reconstruction, quadriceps tendon autograft could be seen as suitable alternative bone graft substitutes for anterior cruciate ligament reconstruction.

Effect of Cholecystectomy on the Occurrence of Knee Osteoarthritis.

OBJECTIVE: To evaluate the effect of cholecystectomy on the occurrence of knee osteoarthritis (KOA). METHODS: The present study was a case-control study with a retrospective, cross-sectional, and longitudinal study design. The clinical data for knee osteoarthritis in the Second Hospital of Shanxi Medical University from January 2016 to September 2018 was analyzed. Clinical data, including gender, age, height, weight, smoking, alcohol abuse, prior medical history, and previous surgical history, were recorded. A logistic regression model was used for the univariate and multivariate analysis. RESULTS: A total of 1659 patients with KOA (KOA group) and 1195 limb fracture patients (control group) were included in this study. Among the 1659 patients with KOA, 388 patients were male and 1271 were female, while among the 1195 patients in the control group, 638 patients were male and 557 patients were female. The period between cholecystectomy and knee osteoarthritis onset ranged from 0.5 years to 17 years; the average interval time was 8.73 ± 2.11 years. The age at disease onset was significantly older when compared to the control group, while the body mass index in the KOA group was significantly higher when compared to the control group (P < 0.05). There were 97 patients undergoing cholecystectomy in the KOA group and there were 15 patients undergoing cholecystectomy in the control group. The proportion of cholecystectomy in the two groups was statistically significant. After the univariate analysis, there was a statistically significant difference in distribution between the two groups (P < 0.05). The multivariate logistic regression analysis revealed that there was a significant difference in the distribution of these two groups (P < 0.05), indicating that cholecystectomy is associated with the occurrence of KOA. CONCLUSION: There is a close relationship between cholecystectomy and KOA. However, the specific mechanism remains unknown and should be further researched.