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Journal of Bone and Joint Surgery-british Volume最新文献

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John E. Hall, MD 1925-2018 John E.Hall,医学博士,1925-2018
Pub Date : 2018-12-05 DOI: 10.2106/jbjs.18.01047
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引用次数: 1
British Orthopaedic Trainees’ Association (BOTA) Meeting 2017 2017年英国骨科培训生协会(BOTA)会议
Pub Date : 2018-06-06 DOI: 10.2106/jbjs.18.00030
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引用次数: 0
FUSION OF THE LUMBAR SPINE 腰椎融合
Pub Date : 2018-02-21 DOI: 10.1302/0301-620X.84B6.0840783
M. Krismer
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引用次数: 3
Re-rupture rate following primary flexor tendon repair of the hand with potential contributing risk factors: case series 手部初级屈肌腱修复后的再断裂率与潜在的危险因素:病例系列
Pub Date : 2018-02-21 DOI: 10.1016/J.IJSU.2012.06.358
M. Ibrahim, M. Khan, Mai Rostom, A. Platt
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引用次数: 0
THE SPREAD OF FOOT INFECTION AND ITS IMPACT ON THE OUTCOMES OF MAJOR AMPUTATIONS OF LOWER EXTREMITIES IN DIABETIC PATIENTS 糖尿病患者下肢大截肢足部感染的传播及其对预后的影响
Pub Date : 2017-12-01 DOI: 10.1302/1358-992X.2017.22.001
D. Važnaisienė, R. Šulcaitė, D. Jomantienė, É. Beltrand, Artūras Špucis, Anatolijus Reingardas, Vytautas Kymantas, A. Mickienė, É. Senneville
Aim To assess the spread of foot infection and its impact on the outcomes of major amputations of lower extremities in diabetic patients. Method In a multicentre retrospective and prospective cohort study, we included adult diabetic patients (≥ 18 years) who underwent a major amputation of a lower limb in 5 hospitals between 2000 and 2009, 2012 and 2014. A total of 51 patients were included (of which 27 (52.94%) were men and 24 (47.06%) were women) with the mean age of 65.51 years (SD=16.99). Concomitant section9s osseous slice biopsy (BA) and percutaneous bone biopsy of the distal site (BD) were performed during limb amputation. A new surgical set-up and new instruments were used to try and reduce the likelihood of cross-contamination during surgery. A positive culture was defined as the identification of at least 1 species of bacteria not belonging to the skin flora or at least 2 bacteria belonging to the skin flora (CoNS (coagulase negative staphylococci), Corynebacterium spp, Propionibacterium acnes ) with the same antibiotic susceptibility profiles. A doubtful culture was defined as the identification of 1 species of bacteria belonging to the skin flora. The patients were followed-up for 1 year. Stump outcomes were assessed on the delay of complete healing, equipment, need of re-intervention and antibiotics. Results In total, 51 BA were performed during major lower limb amputations (17 above the knee and 34 below the knee) in diabetic patients. Nine (17.65%) bacterial culture results from BA specimens were positive, 7 (13.73%) doubtful and 35 (68.63%) sterile. Before amputation, 23 patients (45.1%) had not received any antibiotics, including 16 (31.37%) with an antibiotic-free interval of 15 days or more. Microorganisms identified in BA were also cultured from the distal site in 33.33% of the cases. Positive BA was associated with prolonged complete stump healing, delay of complete healing (more than 6 months), re-amputation and the need of antibiotics Conclusions The microorganisms identified from BA play a role in stump healing in diabetic patients. BA is useful during major limb amputation due to infectious complications and antibiotic therapy could be corrected on the basis of the BA culture results.
目的探讨糖尿病下肢大截肢患者足部感染的传播及其对预后的影响。方法在一项多中心回顾性和前瞻性队列研究中,我们纳入了2000 - 2009年、2012 - 2014年在5家医院接受下肢主要截肢手术的成年糖尿病患者(≥18岁)。共纳入51例患者,其中男性27例(52.94%),女性24例(47.06%),平均年龄65.51岁(SD=16.99)。截肢时同时行骨切片活检(BA)和远端经皮骨活检(BD)。为了减少手术过程中交叉污染的可能性,我们使用了新的手术装置和新的器械。阳性培养定义为鉴定出至少1种不属于皮肤菌群的细菌或至少2种属于皮肤菌群的细菌(con(凝固酶阴性葡萄球菌),棒状杆菌,痤疮丙酸杆菌)具有相同的抗生素敏感性特征。可疑培养定义为鉴定出1种属于皮肤菌群的细菌。随访1年。残端结果评估完全愈合的延迟,设备,需要再干预和抗生素。结果糖尿病患者下肢大截肢共51例(膝关节以上17例,膝关节以下34例)。BA标本细菌培养阳性9例(17.65%),可疑7例(13.73%),无菌35例(68.63%)。截肢前23例(45.1%)患者未使用任何抗生素,其中16例(31.37%)患者无抗生素间隔时间为15天及以上。在BA中鉴定的微生物在33.33%的病例中也从远端培养。BA阳性与残端完全愈合时间延长、完全愈合延迟(超过6个月)、再截肢和抗生素需求相关。结论BA鉴定的微生物在糖尿病残端愈合中起作用。在感染性并发症导致的肢体截肢中,BA是有用的,抗生素治疗可以根据BA培养结果进行纠正。
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引用次数: 0
ACHILLES TENDON LENGTH, ATRS AND FUNCTIONAL OUTCOMES FIVE YEARS AFTER ACUTE ACHILLES TENDON RUPTURE TREATED CONSERVATIVELY 急性跟腱断裂保守治疗5年后跟腱长度、atrs和功能结局
Pub Date : 2017-10-01 DOI: 10.1016/J.ARTHRO.2017.08.152
Rasmus Kastoft, J. Bencke, M. Speedtsberg, R. M. Søndergaard, K. Barfod, J. Penny
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引用次数: 0
RATIONALE FOR MOLECULAR TARGETING THE COMMUNICATION OF MULTIPLE MYELOMA AND BONE MARROW NICHE: WHY NOTCH? 分子靶向多发性骨髓瘤与骨髓生态位通讯的基本原理:为什么是缺口?
Pub Date : 2017-09-01 DOI: 10.1302/1358-992X.99BSUPP_1.EORS2016-127
M. Colombo, F. Baccianti, L. Cantone, A. Moschini, N. Platonova, S. Garavelli, S. Galletti, V. Bollati, C. Goodyear, A. Neri, R. Chiaramonte
Multiple myeloma (MM) is an incurable hematological tumor stemming from malignant plasma cells. MM cells accumulate in the bone marrow (BM) and shape the BM niche by establishing complex interactions with normal BM cells, boosting osteoclasts (OCLs) differentiation and causing bone disease. This unbalance in bone resorption promotes tumor survival and the development of drug resistance.The communication between tumor cells and stromal cells may be mediated by: 1) direct cell-cell contact; 2) secretion of soluble factors, i.e. chemokines and growth factors; 3) release of extracellular vesicles/exosomes (EVs) which are able to deliver mRNAs, miRNAs, proteins and metabolites in different body district.Primary CD138+ MM cells were isolated from patients BM aspirates. MM cell lines were cultured alone in complete RPMI-1640 medium or co-cultured with murine (NIH3T3) or human (HS5) BMSC cell lines or murine Raw264.7 monocytes in DMEM medium supplemented with 10% V/V FBS. Silencing of Jagged1 and Jagged2 was obtained by transient expression of specific siRNAs or by lentiviral transduction using a Dox-inducible system (pTRIPZ). EVs were isolated using differential ultracentrifugation. EVs concentration and size were analyzed using Nano Track Analysis (NTA) system. The uptake of PKH26-labelled MM-derived EVs by HS5 or Raw264.7 was measured after 48 hours by confocal microscopy and flow cytometry. Osteoclast (OCL) differentiation of Raw264.7 cells was induced by 50ng/ml mRANKL, co-culturing with MM cells, CM or EVs. OCLs were stained by TRAP Kit and counted. Bone resorption was assessed by Osteo Assay Surface plates. Flow cytometric detection of apoptotic cells was performed after staining with Annexin V. Gene expression was analyzed by qRT-PCR, while protein levels were determined using flow cytometry ELISA or WB.Notch oncogenic signaling is dysregulated in several hematological and solid malignancies. Notch receptors and ligands are key players in the crosstalk between tumor cells and BM cells. We have demonstrated that: 1) the dysregulated Jagged ligands on MM cells trigger the activation of Notch receptors in the nearby stromal cells by cell-cell contact. This results in the release of anti-apoptotic and growth stimulating factors, i.e. IL6 and SDF1; 2) MM cells promote the development of bone lesions boosting osteoclast differentiation by secreting soluble factors (i.e. RANKL) and by the activation of Notch signaling mediated by direct contact with osteoclast precursors; 3) Finally, we present evidences that EVs play a crucial role in the dysregulated interactions of MM cells with the microenvironment and that Notch signaling regulates their release and participate in this cross-talk.These evidences supports the hypothesis that Jagged targeting on MM cells may interrupt the communication between tumor cells and the surrounding milieu, blocking the activation of the oncogenic Notch pathway and finally resulting in the a reduction of MM-associate
多发性骨髓瘤(MM)是一种无法治愈的血液肿瘤,起源于恶性浆细胞。MM细胞在骨髓(BM)中积累,通过与正常骨髓细胞建立复杂的相互作用,促进破骨细胞(ocl)分化并引起骨病,从而形成骨髓生态位。这种骨吸收的不平衡促进了肿瘤的生存和耐药性的发展。肿瘤细胞与基质细胞之间的通讯可能通过以下途径介导:1)细胞间直接接触;2)可溶性因子的分泌,即趋化因子和生长因子;3)细胞外囊泡/外泌体(EVs)的释放,这些细胞外囊泡/外泌体能够在不同的身体区域递送mrna、mirna、蛋白质和代谢物。原代CD138+ MM细胞从患者骨髓抽吸中分离。将MM细胞系单独培养在完整的rpm -1640培养基中,或与小鼠(NIH3T3)或人(HS5) BMSC细胞系或小鼠Raw264.7单核细胞在添加10% V/V FBS的DMEM培养基中共培养。Jagged1和Jagged2的沉默是通过特异性sirna的瞬时表达或使用dox诱导系统(pTRIPZ)的慢病毒转导获得的。采用差示超离心分离ev。采用纳米径迹分析(NTA)系统对电动汽车的浓度和粒径进行分析。48小时后,通过共聚焦显微镜和流式细胞术检测HS5或Raw264.7对pkh26标记的mm衍生ev的摄取。用50ng/ml mRANKL与MM细胞、CM细胞或ev细胞共培养,诱导Raw264.7细胞的破骨细胞(OCL)分化。用TRAP试剂盒对ocl染色并计数。骨吸收测定采用骨分析表面板。Annexin v染色后流式细胞术检测凋亡细胞,采用qRT-PCR分析基因表达,采用ELISA或WB流式细胞术检测蛋白水平。Notch致癌信号在一些血液和实体恶性肿瘤中是失调的。Notch受体和配体在肿瘤细胞和骨髓细胞之间的串扰中起关键作用。我们已经证明:1)MM细胞上失调的锯齿状配体通过细胞间接触触发附近基质细胞中Notch受体的激活。这导致释放抗凋亡和生长刺激因子,即IL6和SDF1;2) MM细胞通过分泌可溶性因子(即RANKL)和直接接触破骨细胞前体介导的Notch信号激活,促进骨病变的发展,促进破骨细胞的分化;3)最后,我们提供的证据表明,ev在MM细胞与微环境的失调相互作用中起着至关重要的作用,Notch信号调节它们的释放并参与这种串扰。这些证据支持了Jagged靶向MM细胞可能阻断肿瘤细胞与周围环境之间的通讯,阻断致癌Notch通路的激活,最终导致MM相关骨病和耐药减少的假设。
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引用次数: 0
The effect of operating lights on laminar flow 操作灯对层流的影响
Pub Date : 2017-08-01 DOI: 10.1302/0301620X.99B8.BJJ20160581.R2
R. Refaie, P. Rushton, P. McGovern, D. Thompson, I. Serrano-Pedraza, K. Rankin, M. Reed
AimsThe interaction between surgical lighting and laminar airflow is poorly understood. We undertook an experiment to identify any effect contemporary surgical lights have on laminar flow and recom...
目的手术照明与层流气流之间的相互作用尚不清楚。我们进行了一项实验,以确定当代手术灯对层流的任何影响,并建议…
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引用次数: 0
A NEW SURGICAL TECHNIQUE FOR THE POSITIONING OF HIP PROSTHETIC IMPLANTS: THE MEDIAL-INGUINAL APPROACH 髋关节假体植入定位的新手术技术:腹股沟内侧入路
Pub Date : 2017-06-28 DOI: 10.17265/1548-6648/2017.03.005
L. Lucente, A. Palmesi, D. Longo, M. Papalia
Introduction seeking full compliance with the Tissue Sparing Surgery principles, we introduced this new surgical approach to the coxa-femoral joint via the medial inguinal region. Patients/Materials and Methods we performed total hip arthroplasty on 20 patients suffering from hip arthritis while 15 cases of medial femoral fracture received hemiarthroplasty with bipolar prostheses implants. Results reduced surgery times, lower blood loss, zero complications and significantly speedier recovery were observed in all the above cases. Discussion/ Conclusion this new surgical approach we devised enables a quick, safe and easy replacement of the hip. The muscles of the hip remain totally unharmed; maximum exposure is gained, with visualization of the acetabulum, directly fronting the surgeon, at its very best, favourably comparing with any other known approach. No particular equipment is needed and no special operating table. And it does not in the least imply a steep learning curve. Dislocation risks are non-existent allowing the patient any position in bed immediately after surgery. It is aesthetically preferable, the scar remaining almost invisible in between the inguinal skin lines. The patient can at once resume a steady walk, Canadian crutches being needed only for the first few days. It is the authors9 opinion that such a technique, thanks to its being safe, fast, economical and easy to replicate, results in undoubted benefits for the patient, not least because it requires much shorter and far easier rehabilitation; and it can be counted as a valid alternative for surgeons to the most common approaches currently in use.
为了完全符合组织保留手术原则,我们介绍了这种经腹股沟内侧区域进入髋股关节的新手术入路。患者/材料与方法对20例髋关节关节炎患者行全髋关节置换术,对15例股骨内侧骨折患者行双极假体半髋关节置换术。结果手术次数少,出血量少,无并发症,术后恢复明显加快。讨论/结论我们设计的这种新的手术入路能够实现快速、安全、简便的髋关节置换术。臀部的肌肉完全没有受到伤害;与其他已知入路相比,获得最大暴露,髋臼正对着外科医生,处于最佳状态。不需要特别的设备,也不需要特别的手术台。这一点也不意味着学习曲线会很陡峭。脱位的风险是不存在的,允许患者在手术后立即在床上的任何位置。它在美学上更可取,疤痕在腹股沟皮肤线之间几乎看不见。病人可以立即恢复稳定的行走,只在最初几天需要加拿大拐杖。作者认为,由于这种技术安全、快速、经济且易于复制,它无疑给病人带来了好处,不仅因为它需要更短的时间和更容易的康复;对于外科医生来说,这是一种有效的替代目前使用的最常用方法的方法。
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引用次数: 0
Analysis of Gender-Specific Aspects of the Morphology of the Distal Femur 股骨远端形态的性别特征分析
Pub Date : 2017-06-13 DOI: 10.29007/X8VD
M. Asseln, C. Hänisch, Fabian Schick, K. Radermacher
In total knee arthroplasty (TKA) the implant design is one key factor for a proper functional restoration of the diseased knee. Therefore, detailed knowledge on the shape (morphology) is essential ...
在全膝关节置换术(TKA)中,植入物的设计是病变膝关节功能恢复的关键因素之一。因此,关于形状(形态学)的详细知识是必不可少的……
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引用次数: 0
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Journal of Bone and Joint Surgery-british Volume
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