[Comparative analysis of modified Dewar method versus arthroscopic double Endobutton fixation technique for the treatment of acute acromioclavicular joint dislocation].

OBJECTIVE: To compare the clinical outcomes of modified Dewar method versus arthroscopic double Endobutton fixation technique for the treatment of acute acromioclavicular joint dislocation (Rockwood types III-V). METHODS: All cases with acute acromioclavicular joint dislocation (Rockwood types III-V) were treated at our department from October 1997 to October 2009. Among them, 28 cases undergoing modified Dewar method were followed up. There were 20 males and 8 females aged 18 - 68 years old with a mean follow-up period of 6.8 years. And the arthroscopic technique of Endobutton fixation was employed for another 24 cases. There were 19 males and 5 females aged 19 - 65 years old with a mean follow-up period of 1.5 years. The radiographic findings, clinical outcomes and complications of two groups were compared. RESULTS: The good/excellent rate of modified Dewar group and arthroscopic double Endobutton group were 92.8% and 95.8% respectively. There was no significant difference between two groups. No significant difference existed between two groups as to the VAS (visual analogue scale) pain score and UCLA (University of California at Los Angeles) score. The modified Dewar group had a higher rate of ectopic ossification in coracoclavicular ligament than that of the arthroscopic double Endobutton group (25% vs 8.33%). Yet there was no statistical significance. However, the distance between clavicle and coracoid process was larger in the modified Dewar group (11.96 vs 8.54 mm, P < 0.05). CONCLUSION: Both modified Dewar method and arthroscopic double Endobutton fixation technique are both efficient therapies for acute acromioclavicular dislocation (Rockwood types III-V). The former tends to be more invasive while the latter can better maintain the relationship of coracoid process and clavicle.

Age-related bone mineral density, bone loss rate, prevalence of osteoporosis, and reference database of women at multiple centers in China.

Our study surveyed age-related bone mineral density (BMD), bone loss rate, and prevalence of osteoporosis in women at multiple research centers in China. Survey results were used to establish a BMD reference database for the diagnosis of osteoporosis in Chinese women nationwide. We used dual-energy X-ray absorptiometry bone densitometers to measure BMD at posteroanterior (PA) lumbar spine (L1-L4; n=8142) and proximal femur (n=7290) in female subjects of age 20-89 yr from Beijing, Shanghai, Guangzhou, Chengdu, Nanjing, and Jiaxing. A cubic regression-fitting model was used to describe the change of BMD with age at various skeletal sites. Peak BMD occurred between 30 and 34 yr of age for femur neck and total femur, and between 40 and 44 yr for spine and trochanter measurement sites. Young adult (YA) BMD values (mean and standard deviation [SD], calculated as the average BMD in the age range of 20-39, were 1.116+/-0.12, 0.927+/-0.12, 0.756+/-0.11, and 0.963+/-0.13 g/cm2 at PA spine, femoral neck, trochanter, and total femur, respectively. The BMD of 85-yr-old women reflected a loss of 32% at the spine and 30-35% at femur measurement sites. The prevalence of osteoporosis, defined as a BMD of

[Effects of calcitonin on osteoblast cell proliferation and OPG/RANKL expression: experiment with mouse osteoblasts].

OBJECTIVE: To investigate the effects of calcitonin on the proliferation of osteoblasts and the OPG/RANKL expression therein. METHODS: Osteoblasts were separated by enzyme digestion methods from the cranial bones of 30 newborn mice, cultured, and inoculated in 96-well plate. Calcitonin of the concentrations of 10, 40, and 80 IU/L was administrated into the culture medium for 24, 48, and 72 hours. The proliferation of osteoblasts was detected by MTT method. Flow cytometry was used to analyze the cell cycle. The mRNA expression of osteoprotegerin (OPG) and RANKL and protein expression of OPG were examined by RT-PCR and ELISA respectively. RESULTS: The proliferation rates of the osteoblasts exposed to the calcitonin of the concentrations of 40 and 80 IU/L for 24. 48, and 72 hours cell were all significantly higher than those of the blank control group (P < 0.05, P < 0.01). The index of osteoblasts at the G1 phase was significantly lower and the indexes of the osteoblasts at the S phase and G2-M phase were significantly increased after exposure to calcitonin (all P < 0.01). The OPG mRNA expression of the osteoblasts exposed to 80 IU/L calcitonin was significantly higher and the RANKL mRNA expression was significantly lower compared with the control group (P < 0.05). The OPG protein expression of the osteoblasts exposed to 80 LU/L calcitonin was significantly higher than that of the control group at different time points (P < 0.05, P < 0.01). CONCLUSION: Calcitonin increases the osteoblast proliferation and the OPG mRNA expression in the osteoblasts while RANKL mRNA expression in the osteoblasts is inhibited.

[Effects of 1,25-dihydroxyvitamin D3 on the expressions of osteoprotegerin and receptor activator of NF-kappaB ligand in mouse osteoblasts].

OBJECTIVE: To study the effects of 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] on the expression of osteoprotegerin (OPG) and receptor activator of NF-kappaB ligand (RANKL) mRNA in mouse osteoblasts. METHODS: Calvariae derived from CD-1 neonatal mouse (after born 24 h). Bone samples were processed by the collagenase/trypsin digestion method. Mouse osteoblasts were cultured in vitro. After 48 hours of addition of 1,25(OH)2D3 (0, 10(-8), 10(-9), 10(-11) mol/L) to the culture medium of mouse osteoblasts, the content of the OPG protein in culture medium was estimated with enzyme linked immunosorbent assay. Total RNA was prepared from mouse osteoblasts. mRNA expression of OPG and RANKL were detected by reverse transcription-polymerase chain reaction. RESULTS: The mRNA expression of OPG in osteoblasts added with 1,25(OH)2D3 significantly decreased compared with the controls, which was markedly dose-dependent. OPG protein production in the medium decreased after treatment with 1,25(OH)2D3. In contrast, RANKL mRNA expression levels in osteoblasts significantly increased after 48 h of culture with 1,25(OH)2D3. CONCLUSION: 1,25 (OH)2D3 can stimulate RANKL mRNA expression, but decrease OPG mRNA levels in vitro in mouse osteoblasts.

[Evaluation of the postoperative quality of life in the elderly over 80 years old who underwent hip hemiarthroplasty for femoral neck fracture].

OBJECTIVE: To evaluate the postoperative quality of life of aged patients (> 80 years old) who underwent hip hemiarthroplasty for femoral neck fracture one year ago. METHODS: From February 1995 to February 2001, 52 elderly patients (> 80 years old) underwent the hip hemiarthroplasty after femoral neck fractures. There were 28 males and 24 females, with the average age of 84.2 years old (ranged from 80 - 95 years old). The fracture type was Garden III or IV, and all the patients underwent the hip hemiarthroplasty of domestic prosthesis. Before the operation, most of them were accompanied with pre-existed diseases. Harris hip score including symptoms and the ability of daily life at the one year after operation was adopted for the follow-up. Postoperative A-P and lateral X-ray of hip joint in different phase were also assayed. RESULTS: Forty-six patients (88.46%) were free of pain and satisfied their operations, only 6 patients (11.54%) complained about slight pain. Twenty-four patients (46.2%) were able to walk without any assistant, 24 patients (46.2%) managed to walk by walker, 4 patients (7.7%) could only lie on the bed or move by wheel chair. Postoperatively, patients with neurological diseases such as Parkinson dementia, Senile dementia, cerebrovascular diseases got poor result of the quality of life. However, the other comorbid diseases such as cardiovascular diseases, diabetes mellitus, chronic renal failure, chronic bronchitis did not affect the result. Thirty-eight patients had the postoperative X-ray when they were followed up. Postoperatively, the X-ray were taken from 3 months to 5 years and 6 months, averaged 54.2 months. Sclerotic line were discovered around the shaft of prosthesis only in 3 patients. No complications such as femoral head central dislocation or hip osteoarthritis were found. CONCLUSION: Operative treatment could be actively adopted for aged femoral neck fracture patients without surgical contraindication, which can contribute to obtain the motion ability, reduce complication caused by lying in bed, and keep a good quality of life.