RESUMO
PURPOSE: To evaluate the short-term clinical efficacy and advantages of surgery robot positioning system for insertion of Femoral Neck System (FNS) in the treatment of femoral neck fractures. METHODS: The clinical data of 52 patients with Femoral neck fracture (FNF) who had been treated with FNS between June 2020 and September 2021 were retrospectively analyzed. Among them, 26 patients were treated with traditional FNS (control group), while 26 additional patients were treated with FNS assisted by an orthopaedic robot positioning system (study group). The operation duration, frequency of key-guide needle placement, intraoperative blood loss, incision length, fracture healing rate, fracture healing time, and the Harris scores at the last follow-up were calculated and compared between the 2 groups. RESULTS: The study group had shorter operation duration, fewer numbers of placing the key-guide needle, less intraoperative blood loss, and smaller surgical incisions than the control group (all, P < 0.05). There was no significant difference in the rate of fracture healing rate between the 2 groups (P = 0.47), while the fracture healing duration of the study group was shorter than that of the control group (P = 0.03). At the last follow-up, compared with the control group, the Harris score and the number of excellent and good ratings were significantly higher in the study group (all, P < 0.05). CONCLUSIONS: Using orthopaedic surgery robot positioning system-assisted FNS in the treatment of FNFs can effectively improve the efficiency of surgery, shorten operation time, and reduce the number of placing the key-guide needle, intraoperative blood loss, and operative trauma. Simultaneously, it shortens the duration of fracture healing and improves the recovery of hip function.
Assuntos
Fraturas do Colo Femoral , Fenofibrato , Robótica , Ferida Cirúrgica , Humanos , Colo do Fêmur , Perda Sanguínea Cirúrgica , Estudos Retrospectivos , Fraturas do Colo Femoral/diagnóstico por imagem , Fraturas do Colo Femoral/cirurgiaRESUMO
OBJECTIVE: Acute acromioclavicular (AC) joint dislocation is a common orthopedic injury that can significantly impair shoulder function and reduce quality of life. Effective treatment methods are essential to restore function and alleviate pain. To investigate the short-term clinical efficacy of the minimally invasive closed-loop double endobutton fixation assisted by orthopaedic surgery robot positioning system (TiRobot) in the treatment of AC joint dislocation, and to evaluate its feasibility and safety. METHODS: The clinical data of 19 patients with AC joint dislocation who underwent treatment with closed-loop double Endobutton fixation assisted by TiRobot between May 2020 and December 2022 were retrospectively analyzed. Visual Analog Scale (VAS) pain scores, the Constant Murley Score (CMS), and shoulder abduction range of motion were assessed and compared preoperatively and at the last follow-up. Computed tomography (CT) parameters of the acromioclavicular joint, including acromioclavicular distance (ACD), the distance between the upper and lower Endobutton (DED), the horizontal distance between the anterior edge of the distal clavicle and the anterior edge of the acromion (DACC), the diameter of the clavicular tunnel (DCT), and coracoid tunnel diameter (DC), were compared at 2 days, and 1 month after surgery, as well as at the last follow-up, along with the evaluation of intraoperative and postoperative complications. RESULTS: The postoperative VAS, CMS, and shoulder-abduction range of motion were significantly improved compared with the preoperative (all, P<0.05). The statistical analysis showed no significant difference in the CT image parameters of the acromioclavicular joint at 2 days and 1 month after surgery(all, P>0.05). Comparisons of DCT and DC revealed statistically significant differences between the last follow-up and 1 month after surgery (P<0.05), and no statistically significant difference was found in ACD, DED, and DACC(all, P>0.05). There were no complications such as infection or vascular or neurological damage, no cases of rostral or clavicle fractures, loss of reduction, heterotopic ossification, shoulder stiffness, and no loosening or breaking of internal fixations. CONCLUSION: Closed-loop double endobutton internal fixation assisted by TiRobot is an ideal method for the treatment of acute acromioclavicular (AC) joint dislocation. This method has the advantages of relatively simple operation, more accurate localization of bone tunnel during operation, less surgical trauma, and good recovery of shoulder function.
Assuntos
Articulação Acromioclavicular , Luxações Articulares , Amplitude de Movimento Articular , Procedimentos Cirúrgicos Robóticos , Humanos , Articulação Acromioclavicular/cirurgia , Articulação Acromioclavicular/lesões , Articulação Acromioclavicular/diagnóstico por imagem , Masculino , Feminino , Adulto , Estudos Retrospectivos , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Robóticos/métodos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Luxações Articulares/cirurgia , Luxações Articulares/diagnóstico por imagem , Resultado do Tratamento , Adulto Jovem , Procedimentos Ortopédicos/métodos , Procedimentos Ortopédicos/instrumentação , Tomografia Computadorizada por Raios X , Estudos de ViabilidadeRESUMO
Calcium phosphate cement (CPC) has been widely used in bone tissue repairing due to its physical mechanical properties and biocompatibility. Addition of trace element to CPC has shown promising evidence to improve the physical properties and biological activities of CPC. Lithium (Li) has effect on osteoblast proliferation and differentiation. In this study, we incorporated Li to CPC and examined the physical properties of Li/CPC and its effect on osteoblast proliferation and differentiation. We found that Li doped CPC maintained similar setting time, pore size distribution, compressive strength, composition, and morphology as CPC without Li. Additionally, Li doped CPC improved osteoblast proliferation and differentiation significantly compared to CPC without Li. To our knowledge, our results, for the first time, show that Li doped CPC has beneficial effect on osteoblast in cell culture while keeps the excellent physical-mechanical properties of CPC. This study will lead to potential application of Li doped CPC in bone tissue engineering. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 944-952, 2017.
Assuntos
Cimentos Ósseos/química , Fosfatos de Cálcio/química , Diferenciação Celular , Proliferação de Células , Lítio/química , Osteoblastos/metabolismo , Animais , Força Compressiva , Teste de Materiais , Camundongos , Osteoblastos/citologiaRESUMO
By virtue of its excellent bioactivity and osteoconductivity, calcium phosphate cement (CPC) has been applied extensively in bone engineering. Doping a trace element into CPC can change physical characteristics and enhance osteogenesis. The trace element lithium has been demonstrated to stimulate the proliferation and differentiation of osteoblasts. We investigated the fracture-healing effect of osteoporotic defects with lithium-doped calcium phosphate cement (Li/CPC) and the underlying mechanism. Li/CPC bodies immersed in simulated body fluid converted gradually to hydroxyapatite. Li/CPC extracts stimulated the proliferation and differentiation of osteoblasts upon release of lithium ions (Li+) at 25.35 ± 0.12 to 50.74 ± 0.13 mg/l through activation of the Wnt/ß-catenin pathway in vitro. We also examined the effect of locally administered Li+ on defects in rat tibia between CPC and Li/CPC in vivo. Micro-computed tomography and histological staining showed that Li/CPC had better osteogenesis by increasing bone mass and promoting repair in defects compared with CPC (P < 0.05). Li/CPC also showed better osteoconductivity and osseointegration. These findings suggest that local release of Li+ from Li/CPC may accelerate bone regeneration from injury through activation of the Wnt/ß-catenin pathway in osteoporosis.
Assuntos
Cimentos Ósseos/farmacologia , Regeneração Óssea , Durapatita/farmacologia , Cloreto de Lítio/farmacologia , Fraturas por Osteoporose/terapia , Via de Sinalização Wnt , Animais , Cimentos Ósseos/química , Cimentos Ósseos/uso terapêutico , Linhagem Celular , Liberação Controlada de Fármacos , Durapatita/uso terapêutico , Feminino , Cloreto de Lítio/farmacocinética , Cloreto de Lítio/uso terapêutico , Camundongos , Osteoblastos/citologia , Osteoblastos/efeitos dos fármacos , Osteoblastos/metabolismo , Osteogênese , Ratos , Ratos Sprague-DawleyRESUMO
To investigate whether monosodium urate (MSU) crystals could induce the production of VCAM-1 (vascular cell adhesion molecule 1) in human synovial cells and its possible signaling pathways, human synovial cells isolated from synovial tissue explants were stimulated with various doses of MSU crystals for different time intervals. Expression of VCAM-1 was evaluated with Western blotting. To explore the underlying mechanisms, VCAM-1 protein expression was also evaluated after activation of several signaling molecules including mitogen-activated protein kinases (MAPKs) and peroxisome proliferator-activated receptor γ (PPARγ) were blocked. Exposure of synovial cells to MSU crystals induced VCAM-1 expression in culture medium in a dose- and time-dependent manner, reaching a plateau at 1000 µM and 24 h. Inhibition of the activation of MAPKs and PPARγ could block this increase. The present results demonstrated that MSU crystals could induce VCAM-1 expression. MAPKs and PPARγ signaling pathways regulated the induced VCAM-1 expression.