Translation and validation of the simplified Chinese version of the anterior cruciate ligament-return to sport after injury (ACL-RSI).

PURPOSE: The aim of this study is to obtain a translation and adaptation of the anterior cruciate ligament-return to sport after injury (ACL-RSI) into simplified Chinese and validate the simplified Chinese version. METHODS: Translation and adaptation were performed according to the guidelines of the American Academy of Orthopaedic Surgeons Outcome Committee. A total of 122 patients who were diagnosed with an ACL injury and underwent primary arthroscopic anterior cruciate ligament reconstruction (ACLR) between 2015 and 2016 were included in this study. The simplified Chinese version of the ACL-RSI (SC-ACL-RSI), Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm score and International Knee Documentation Committee (IKDC) subjective knee form were completed. Psychometric evaluations included score distribution, internal consistency, test-retest reliability, and construct and discriminant validity. RESULTS: SC-ACL-RSI scores exhibited a normal distribution without ceiling and floor effects. Internal consistency was high (Cronbach's alpha = 0.94). The intraclass correlation coefficient was 0.98, indicating excellent test-retest reliability. SC-ACL-RSI scores were correlated with all KOOS subscales (r = 0.30 to 0.69, p < 0.001), the IKDC subjective knee form (r = 0.46, p < 0.001) and the Lysholm score (r = 0.56, p < 0.001). The mean scores between patients who returned to the same preinjury level of sport (65.1 ± 14.3) and those who could not return to the same level (51.0 ± 15.0) were significantly different (p < 0.001). CONCLUSIONS: The SC-ACL-RSI is a reliable and valid instrument to evaluate the psychological impact of a patient returning to sport after ACLR. It is important to evaluate patients' ability to return to sport after an ACL injury. The information provided by the SC-ACL-RSI will affect decisions regarding treatment and rehabilitation plans, which are more likely to influence clinical outcomes. LEVEL OF EVIDENCE: II.

Comparison of artificial graft versus autograft in anterior cruciate ligament reconstruction: a meta-analysis.

BACKGROUND: Critically evaluation and summarization for the outcomes between autografts and artificial grafts using in anterior cruciate ligament (ACL) reconstruction have not been performed currently. The purpose of this study is to compare the clinical outcomes between artificial ligaments and autografts at a short- to mid-term follow-up. METHODS: A computerized search of the databases was conducted including Medline, Embase, and the Cochrane library. Only prospective or retrospective comparative studies with a minimum 2-year follow-up and a minimum sample size of 15 for each group were considered for inclusion. Two independent reviewers performed data extraction and methodological quality assessment. A Mantel-Haenszel analysis was used for pooling of results. Sensitivity analysis was performed in order to maintain the stability of results. RESULTS: Seven studies were included in this study. The total sample size was 403 (autograft group: 206 patients; synthetic graft group: 197 patients). Four studies were randomized controlled trials. Two studies were retrospective comparative studies and one study was non-randomized prospective comparative study. In terms of instrumented laxity, patient-oriented outcomes and complications, no significant difference was occurred between new artificial ligaments and autografts. But the results of IKDC grades and instrumented laxity were worsen in early artificial ligaments compared to autografts. CONCLUSIONS: The outcomes of new generation of artificial ligaments are similar to autografts at a short- to mid-term follow-up. However, the early artificial ligaments are not suggested for ACL reconstruction compared to autografts.

[The influence of oxygen partial pressure change and vascularization of rabbit wound through negative pressure wound therapy].

OBJECTIVE: To investigate the effect of vacuum sealing drainage (VSD) on variation of oxygen partial pressure (PtO2) and vascularization. METHODS: The 12 cases of rabbit's wound models were undergoing the VSD (vacuum group, n = 6) or conventional therapy (conventional group, n = 6). Variation of PtO2 was measured by oxygen partial pressure admeasuring apparatus, expression of hypoxia inducible factor 1α (HIF-1α) mRNA was measured by real-time fluorescent quantitative PCR, content of vascular endothelial growth factor (VEGF) was measured by ELISA after tissue homogenate in 7 days. Vascular endothelial cell (VEC) and new blood capillary (NBC) of hematoxylin-eosin slice of tissue were counted by using light microscope. RESULTS: Average value of PtO2 of vacuum group was significant lower than conventional group (t = -99.780 to -5.305, P < 0.01). Expression of HIF-1α (30 minutes, 1, 6, 12 hours were 3.11 ± 0.07, 3.68 ± 0.26, 4.16 ± 0.13 and 3.91 ± 0.26 respectively) and content of VEGF (30 minutes, 1, 6, 12 hours were 103.3 ± 2.4, 134.2 ± 9.0, 167.8 ± 3.8 and 232.1 ± 9.5 respectively) of vacuum group were increased after 30 minutes and significant lower than conventional group (t = 13.038 - 80.208, P < 0.01), and both of them were reduced after 24 hours (P < 0.05). Counting numbers of VEC (2.47 ± 0.45 to 4.70 ± 0.38) and NBC (1.33 ± 0.49 to 4.33 ± 0.68) of vacuum group were increased at the same time-point and significant higher than conventional group (t = -0.670 to 16.500, P < 0.05). CONCLUSIONS: PtO2 of wound surface could be reduced significantly by VSD. Expression of HIF-1α and content of VEGF were increased by VSD for enhancing differentiated state of VEC and construction of NBC, which were better for vascularization and wound healing.

Early Follow-Up of Arthroscopic Latarjet Procedure with Screw or Suture-Button Fixation for Recurrent Anterior Shoulder Instability.

OBJECTIVE: To evaluate the early clinical and radiographic results of arthroscopic Latarjet procedure using screw or suture-button fixation in patients with recurrent anterior shoulder dislocation. METHODS: Twelve patients who underwent arthroscopic Latarjet procedure between January 2015 and December 2018 at our institution were retrospectively studied. Data of the patients' history, including age, gender, side of affected arm, body mass index (BMI), and the number of dislocations since fist dislocation were collected. Preoperative and postoperative clinical follow-up data were evaluated using Walch-Duplay score, American Shoulder and Elbow Society (ASES) score, and modified Rowe score. Active external rotation and active internal rotation at 90° of abduction as well as active elevation were evaluated preoperatively and postoperatively. The position and healing condition of the transferred coracoid bony graft were also assessed using computed tomography (CT) and Mimics 19.0 software. RESULTS: Mean follow-up was 24.9 months (range, 13 to 53 months) of all patients. At final follow-up, the average ASES score (preoperative vs postoperative values) had improved from 68.9 ± 7.9 to 91.1 ± 6.1 in screw fixation group and 68.9 ± 8.9 to 87.5 ± 6.7 in suture-button fixation group; the average Rowe score (preoperative vs postoperative values) had improved from 25.0 ± 8.4 to 92.5 ± 4.2 in screw fixation group and 21.7 ± 13.7 to 93.3 ± 4.1 in suture-button fixation group; the average of Walch-Duplay score (preoperative vs postoperative values) had improved from 12.5 ± 15.1 to 91.7 ± 4.1 in screw fixation group and 18.3 ± 20.7 to 88.3 ± 7.5 in button fixation group. The forward flexion was 175.0° ± 8.4° preoperatively and 178.3° ± 4.1° postoperatively in screw fixation group while 174.8° ± 10.2° preoperatively and 175.0° ± 5.5° postoperatively in suture-button fixation group. The active external rotation was 77.5° ± 5.2° preoperatively and 71.7° ± 4.1° postoperatively in screw fixation group while 72.5° ± 6.9° preoperatively and 68.3° ± 7.5° postoperatively in suture-button fixation group. The average of active internal rotation was 66.7° ± 6.1° preoperatively and 67.5° ± 6.1° postoperatively in screw fixation group while 68.3° ± 11.3° preoperatively and 66.7° ± 7.5° postoperatively in suture-button fixation group. In postoperative CT scan, 91.7% grafts midline center were located at or under the equator in the en face view; 75% of the bone blocks were flush to the glenoid face in the axial view, with only two grafts exhibiting slight medial placement in screw fixation group (33.3%) and one graft exhibiting slight lateral placement in suture-button fixation group (16.7%). All grafts achieved bone union. Graft absorption mostly occurred outside of the "best-fit" circle. The average bony absorption rates of the coracoid grafts were 25.2% and 10.18% in screw fixation group and suture-button fixation group, respectively, at 6 months postoperative follow-up. CONCLUSION: Both suture-button fixation and screw fixation techniques in arthroscopic Latarjet procedure revealed excellent clinical outcomes with low complication rates in the early follow-up. The suture-button fixation exhibited a flexible fixation pattern that allowed for self-correction to some extent, even slight lateralization could finally remodel over time.

Translation and validation of the Simplified Chinese version of Western Ontario Osteoarthritis of the Shoulder Index (WOOS).

To produce a cross-cultural adaptation and translation of the English version of the Western Ontario Osteoarthritis of the Shoulder index (WOOS) into Simplified Chinese and to validate its reliability, validity, and responsiveness.A total of 52 consecutive patients were included. The inclusion criteria were as follows: diagnosed to have primary shoulder osteoarthritis (OA) and referred to undergo conservative treatment, able to speak Chinese, and able to read Simplified Chinese. WOOS, the Oxford Shoulder Score (OSS), and Short Form 36 (SF-36) were filled at the first visit, and WOOS alone was filled at the second visit with an interval of 3 to 7 days after the first visit. Four months after appropriate treatments, the WOOS was again sent to patients by e-mail for the evaluation of responsiveness.The intraclass correlation coefficient ranged from 0.90 to 0.98, which showed good test-retest reliability. As we had hypothesized, construct validity was high according to a significant correlation among WOOS, SF-36 (3 subscales, namely physical functioning, bodily pain, and role-physical), and OSS. High responsiveness was documented by the evaluation of standard response mean (from 1.09 to 1.33) and effect size (from 0.80 to 0.97).The Simplified Chinese version of WOOS (SC-WOOS) was shown to be a reliable, valid instrument for evaluating the quality of life of patients suffering from shoulder OA in China.

Overexpression of mitofusin 2 inhibits reactive astrogliosis proliferation in vitro.

Astrocytes become activated in response to central nervous system (CNS) injury, and excessive astrogliosis is considered an impediment to axonal regeneration by forming glial scar. Mitofusin 2 (Mfn2), a key protein in mitochondrial network, has been reported to negatively regulate cell proliferation. The present study aimed to explore whether reactive astrogliosis could be suppressed by Mfn2 overexpression. Scratch injury and starvation-serum stimulation models in cultured astrocytes were combined to address this issue. In scratch model, reactive proliferation status of damaged astrocytes was implicated by migration of high ratio of EdU(+) cells into lesion region and significantly increased expression of GFAP and PCNA. At meantime, Mfn2 expression was found to exert a down-regulated trend both in gen and protein levels. Pretreatment of cells with adenoviral vector encoding Mfn2 gene increased Mfn2 expression and subsequently attenuated injury-induced astrocytes hyperplasia, activation-relevant protein synthesis, cellular proliferation, eventually delayed wound healing process. Furthermore, Mfn2 overexpression markedly inhibited astrocytes proliferation induced by serum stimulation, by arresting the transition of cell cycle from G1 to S phase. Together, these in vitro results demonstrated that reactive astrogliosis can be effectively suppressed by up-regulation of Mfn2, which might contribute to a promising therapeutic intervention in CNS disease characterized by glia-related damage.