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Neonatal Hip Loading in Developmental Dysplasia: Finite Element Simulation of Proximal Femur Growth and Treatment. 发育不良新生儿髋关节负荷:股骨近端生长和治疗的有限元模拟。
IF 2.5 4区 医学 Q2 Medicine Pub Date : 2023-11-01 Epub Date: 2023-09-13 DOI: 10.1177/15563316231193426
S Mahsa Sadeghian, Owen J Arthurs, Xinshan Li, Cara L Lewis, Sandra J Shefelbine

Background: Abnormal prenatal hip joint loading can lead to compromised hip joint function. Early intervention is crucial for favorable outcomes.

Purpose: This study investigates the impact of treatment timing (initiation and duration) on cartilage growth and ossification in the proximal femur of infants with developmental dysplasia of the hip, a condition affecting newborns.

Methods: We used a mechanobiological model to simulate proximal femur growth during treatment durations of 3 months, 6 months, and a late-start treatment.

Results: The findings indicate that the timing of treatment initiation is crucial, while a longer treatment duration does not contribute to improved morphological development of the hip joint.

Conclusions: Mechanobiological models of growth can be used to develop treatments and therapies that correct loading conditions. Growing bone is particularly sensitive to loading conditions, and altered loading during growth can affect bone shape and functionality.

背景:产前髋关节负荷异常可导致髋关节功能受损。早期干预对取得良好结果至关重要。目的:本研究探讨治疗时机(开始和持续时间)对患有发育性髋关节发育不良的婴儿股骨近端软骨生长和骨化的影响,这种情况会影响新生儿。方法:我们使用机械生物学模型来模拟3个月、6个月和延迟开始治疗期间股骨近端的生长。结果:研究结果表明,开始治疗的时间至关重要,而较长的治疗时间对改善髋关节的形态发育没有帮助。结论:生长的机械生物学模型可用于开发纠正负荷条件的治疗方法。生长中的骨骼对负载条件特别敏感,生长过程中负载的改变会影响骨骼的形状和功能。
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引用次数: 0
Arthritis Foundation/HSS Workshop on Hip Osteoarthritis, Part 3: Rehabilitation and Exercise. 关节炎基金会/HSS髋关节骨性关节炎研讨会,第3部分:康复和锻炼。
IF 2.5 4区 医学 Q2 Medicine Pub Date : 2023-11-01 Epub Date: 2023-09-16 DOI: 10.1177/15563316231192098
Kate N Jochimsen, Jason S Kim, Prakash Jayabalan, Cecelia Lawrence, Cara L Lewis, Heidi Prather, Mathias P Bostrom

Far more publications are available for osteoarthritis of the knee than of the hip. Recognizing this research gap, the Arthritis Foundation (AF), in partnership with the Hospital for Special Surgery (HSS), convened an in-person meeting of thought leaders to review the state of the science of and clinical approaches to hip osteoarthritis. This article summarizes the recommendations gleaned from 5 presentations given on hip-related rehabilitation at the 2023 Hip Osteoarthritis Clinical Studies Conference, which took place on February 17 and 18, 2023, in New York City.

关于膝关节骨性关节炎的出版物比关于髋关节骨性关节病的出版物多得多。认识到这一研究差距,关节炎基金会(AF)与特种外科医院(HSS)合作,召开了一次思想领袖面对面会议,审查髋关节骨关节炎的科学和临床方法的现状。本文总结了2023年2月17日和18日在纽约举行的2023年髋关节骨关节炎临床研究会议上关于髋关节相关康复的5次演讲中提出的建议。
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引用次数: 0
Arthritis Foundation/HSS Workshop on Hip Osteoarthritis, Part 4: Nonoperative Options, Machine Learning in Predicting Total Hip Arthroplasty, Robotics, and Phenotyping to Guide Precision Rehabilitation. 关节炎基金会/HSS髋关节骨性关节炎研讨会,第4部分:非手术选项、预测全髋关节置换术的机器学习、机器人和表型以指导精确康复。
IF 2.5 4区 医学 Q2 Medicine Pub Date : 2023-11-01 Epub Date: 2023-08-17 DOI: 10.1177/15563316231193367
Michelle M McLeod, Jason S Kim, Peter Moley, Mark A Fontana, Jason Blevins, Brian Chalmers, Marcus Bamman, Mathias P Bostrom

Far more publications are available for osteoarthritis of the knee than of the hip. Recognizing this research gap, the Arthritis Foundation (AF), in partnership with the Hospital for Special Surgery (HSS), convened an in-person meeting of thought leaders to review the state of the science of and clinical approaches to hip osteoarthritis. This article summarizes the recommendations gleaned from presentations given in the "late-stage osteoarthritis" session of the 2023 Hip Osteoarthritis Clinical Studies Conference, which took place on February 17 and 18, 2023, in New York City. It covers conservative treatment, decision-making in end-stage hip osteoarthritis, advancements in robotics, and the role of phenotyping in precision rehabilitation post-total hip arthroplasty (THA).

关于膝关节骨性关节炎的出版物比关于髋关节骨性关节病的出版物多得多。认识到这一研究差距,关节炎基金会(AF)与特种外科医院(HSS)合作,召开了一次思想领袖面对面会议,审查髋关节骨关节炎的科学和临床方法的现状。本文总结了2023年2月17日和18日在纽约举行的2023年髋关节骨关节炎临床研究会议“晚期骨关节炎”会议上提出的建议。它涵盖了保守治疗、终末期髋关节骨性关节炎的决策、机器人技术的进步以及表型在全髋关节置换术后精确康复中的作用。
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引用次数: 0
Revealing a Natural Model of Pre-Osteoarthritis of the Hip Through Study of Femoroacetabular Impingement. 通过股骨髋臼撞击的研究揭示了髋关节前骨性关节炎的自然模型。
IF 2.5 4区 医学 Q2 Medicine Pub Date : 2023-11-01 Epub Date: 2023-08-09 DOI: 10.1177/15563316231190084
Cecilia Pascual-Garrido, Kenichi Kikuchi, John C Clohisy, Regis J O'Keefe, Tomoyuki Kamenaga

Femoroacetabular impingement (FAI) is considered the mechanical cause of hip osteoarthritis (OA). Surgical intervention involves labrum repair and osteochondroplasty to remove the impingement, alleviating symptoms. Nevertheless, some patients progress to hip OA after surgery, indicating that factors other than mechanical abnormality are contributing to hip OA progression. This review article discusses our laboratory's studies on hip FAI and OA, undertaken to identify key molecular players in the progression of hip OA. Transcriptome analysis identified peroxisome proliferator activated receptor gamma (PPARγ) as a crucial molecule in early hip OA. PPARγ, widely expressed in chondrocytes, has a protective role in preventing OA, but its true mechanism remains unknown. We observed a dysregulation of DNA methyltransferase (DNMT) in the progression of hip OA, with high expression of DNMT1 and 3A and downregulation of DNMT3B. Moreover, we established that DNMT3A is the main molecule that is binding to PPARγ promoter CpG area, and hypermethylation of this area occurs during disease progression. This suggests that epigenetic changes are a main mechanism that regulates PPARγ expression. Finally, we developed a novel rabbit model of hip FAI and OA and are currently performing studies to validate our small-animal model to human FAI.

股骨髋臼撞击(FAI)被认为是髋关节骨性关节炎(OA)的机械原因。手术干预包括阴唇修复和骨软骨成形术,以消除撞击,减轻症状。然而,一些患者在手术后进展为髋关节骨性关节炎,这表明除机械异常外的其他因素也有助于髋关节OA的进展。这篇综述文章讨论了我们实验室对髋关节FAI和OA的研究,旨在确定髋关节OA进展中的关键分子参与者。转录组分析确定过氧化物酶体增殖物激活受体γ(PPARγ)是早期髋关节骨性关节炎的关键分子。PPARγ在软骨细胞中广泛表达,在预防OA中具有保护作用,但其真正机制尚不清楚。我们观察到DNA甲基转移酶(DNMT)在髋关节骨性关节炎的进展中失调,DNMT1和3A高表达,DNMT3B下调。此外,我们确定DNMT3A是与PPARγ启动子CpG区域结合的主要分子,该区域的高甲基化发生在疾病进展过程中。这表明表观遗传学变化是调节PPARγ表达的主要机制。最后,我们开发了一种新型的髋关节FAI和OA兔模型,目前正在进行研究,以验证我们的小动物模型对人类FAI的有效性。
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引用次数: 0
Arthritis Foundation/HSS Workshop on Hip Osteoarthritis, Part 1: Epidemiology, Early Development, and Cohorts From Around the World. 关节炎基金会/HSS髋关节骨性关节炎研讨会,第1部分:世界各地的流行病学、早期发展和队列。
IF 2.5 4区 医学 Q2 Medicine Pub Date : 2023-11-01 Epub Date: 2023-08-06 DOI: 10.1177/15563316231189748
Jason S Kim, Rintje Agricola, Young-Jo Kim, Nancy E Lane, Michael B Millis, Amanda E Nelson, Jos Runhaar, Sandra J Shefelbine, Mathias P Bostrom

Far more publications are available for osteoarthritis of the knee than of the hip. Recognizing this research gap, the Arthritis Foundation, in partnership with the Hospital for Special Surgery, convened an in-person meeting of thought leaders to review the state of the science of and clinical approaches to hip osteoarthritis. This article summarizes the recommendations and clinical research gaps gleaned from 5 presentations given in the "how hip osteoarthritis begins" session of the 2023 Hip Osteoarthritis Clinical Studies Conference, which took place on February 17 and 18, 2023, in New York City.

关于膝关节骨性关节炎的出版物比关于髋关节骨性关节病的出版物多得多。认识到这一研究差距,关节炎基金会与特种外科医院合作,召开了一次思想领袖面对面会议,审查髋关节骨关节炎的科学和临床方法的现状。本文总结了2023年2月17日和18日在纽约市举行的2023年髋关节骨关节炎临床研究会议“髋关节骨性关节炎如何开始”会议上发表的5篇演讲中的建议和临床研究差距。
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引用次数: 0
Preoperative Education and Prehabilitation in Total Hip Arthroplasty Patients: A Commentary. 全髋关节置换术患者的术前教育和预适应:综述。
IF 2.5 4区 医学 Q2 Medicine Pub Date : 2023-11-01 Epub Date: 2023-08-20 DOI: 10.1177/15563316231193394
Cecelia Lawrence
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引用次数: 0
Methods for the Clinical Translation of Quantitative MRI for the Evaluation of Patients With Femoroacetabular Impingement. 定量MRI评估股骨髋臼撞击患者的临床转换方法。
IF 2.5 4区 医学 Q2 Medicine Pub Date : 2023-11-01 Epub Date: 2023-08-23 DOI: 10.1177/15563316231193404
Riccardo Lattanzi
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引用次数: 0
Does Participation in Virtual or In-Person Preoperative Education Relate to Reduced Length of Stay After Total Joint Arthroplasty? 参加虚拟或面对面的术前教育与全关节置换术后住院时间的缩短有关吗?
4区 医学 Q2 Medicine Pub Date : 2023-10-28 DOI: 10.1177/15563316231208454
Susan Camillieri
Background: Advancements in surgical procedures for total joint arthroplasty (TJA) have resulted in more effective procedures with more rapid recovery. To prepare patients for surgery, many organizations offer a preoperative “joint class,” which has been associated with reduced length of stay (LOS). Virtual modes of education are increasingly favored for those having TJA. Purpose: To determine whether participation in an individually administered preoperative educational session (“Prehab”) relates to reduced LOS or increased likelihood of same-day discharge (SDD) for those undergoing TJA. Additionally, to establish whether and the virtual mode of education provision is superior or inferior to the in-person mode with regards to LOS benefits. Methods: The author conducted a case-control study of 2532 patients who had a primary or revision TJA between January 2022 and August 2022 at a single institution. Data were obtained from the electronic medical record. A total of 1118 patients attended Prehab; 1414 patients did not. Patients were included if they were over the age of 18 and had a total hip arthroplasty (THA) or total knee arthroplasty (TKA) during the study period. T-tests, chi-square χ 2 tests, and binomial logistic regression were used to evaluate the LOS and SDD outcomes for those who participated in Prehab compared with those who did not. Results: Those receiving Prehab in any form had shorter LOS than those who had not. Those receiving virtual Prehab had the shortest LOS. There was no difference in the rate of SDD for outpatient-class patients. Conclusion: Preoperative education is associated with LOS benefits to patients undergoing TJA. The virtual mode of education provision is at minimum non-inferior, and may be superior, to the in-person mode. The lack of statistically significant between-group differences for SDD outcomes may be explained by a lack of SDD-specific educational content provided during Prehab.
背景:全关节置换术(TJA)手术方法的进步使得手术更有效,恢复更快。为了让患者做好手术准备,许多组织提供术前“关节班”,这与缩短住院时间(LOS)有关。虚拟教育模式越来越受到TJA患者的青睐。目的:确定参加单独管理的术前教育课程(Prehab)是否与接受TJA的患者减少LOS或增加当日出院(SDD)的可能性有关。此外,确定虚拟教育提供模式在LOS效益方面是否优于面对面模式。方法:作者对2022年1月至2022年8月在同一机构进行的2532例原发性或改进性TJA患者进行了病例对照研究。数据来自电子病历。Prehab共有1118名患者;1414名患者没有。如果患者年龄超过18岁并在研究期间进行了全髋关节置换术(THA)或全膝关节置换术(TKA),则纳入研究。使用t检验、卡方χ 2检验和二项逻辑回归来评估参加Prehab的患者与未参加Prehab的患者的LOS和SDD结果。结果:接受任何形式Prehab治疗的患者的LOS均短于未接受Prehab治疗的患者。接受虚拟Prehab的人LOS最短。门诊级患者的SDD发生率无差异。结论:术前教育与TJA患者的LOS获益相关。教育提供的虚拟模式至少不逊于面对面的模式,甚至可能优于面对面的模式。SDD结果在组间没有统计学上的显著差异,可能是由于Prehab期间缺乏针对SDD的教育内容。
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引用次数: 0
Outpatient Hip and Knee Arthroplasty Can be Safe in Patients With Multiple Medical Comorbidities via Use of Evidence-Based Perioperative Protocols 通过循证围手术期协议,门诊髋关节和膝关节置换术对有多种合并症的患者是安全的
4区 医学 Q2 Medicine Pub Date : 2023-10-28 DOI: 10.1177/15563316231208431
Sohum Patel, Leonard T. Buller
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引用次数: 0
Social Risk Determinants for Successful Same Calendar Day Discharge in Total Joint Arthroplasty 全关节置换术成功当日出院的社会风险决定因素
4区 医学 Q2 Medicine Pub Date : 2023-10-28 DOI: 10.1177/15563316231204231
Rex W. Lutz, Danielle Y. Ponzio, Hope S. Thalody, Harrison A. Patrizio, Miranda M. Czymek, Michael Ast, Zachary D. Post, Alvin C. Ong
Background: While many studies have examined the impact of comorbidities on the success of same calendar day discharge (SCDD) in total joint arthroplasty (TJA), literature surrounding the impact of social determinants is lacking. Purpose: We sought to investigate the relationship between various social determinants and success of SCDD after primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). Methods: We conducted a retrospective review of 1160 THA and 1813 TKA performed at a single academic institution between November 2020 and August 2022. Social factors including substance use, occupation, marital status, income, and participation in physical exercise were included. In addition, aspects of discharge planning were reviewed such as living situation and transportation details. Results: Overall, 952 (32%) patients had successful SCDD, whereas 2021 (68%) patients were discharged on postoperative day 1 (POD1) or greater. Successful SCDD patients were more likely to have health care (4.8% vs 2.5%) and active (5.4% vs 4.6%) rather than sedentary occupations, be married (79.6% vs 67.4%), have access to transportation (95.6% vs 92.9%), live in a higher median income area ($64,044 [16,183] vs $61,572 [14,594]), and exercise weekly (62.6% vs 23.9%). Interestingly, the successful patients had more stories in their homes (1.62 [0.56] vs 1.43 [0.53]), more stairs to enter their homes (5.19 [5.22] vs 4.60 [5.24]), lived farther from the hospital (43.3 [138.0] vs 32.0 [75.9] miles), and a higher prevalence of alcohol use (60.7% vs 44.7%) and tobacco use (19.3% vs 17.3%). Conclusion: These findings may help arthroplasty surgeons to better understand the social factors that contribute to successful SCDD in TJA patients, ultimately aiding in patient selection and preoperative counseling.
背景:虽然许多研究已经检查了合并症对全关节置换术(TJA)中同日出院(SCDD)成功的影响,但缺乏有关社会决定因素影响的文献。目的:我们试图探讨各种社会因素与原发性全髋关节置换术(THA)和全膝关节置换术(TKA)后SCDD成功之间的关系。方法:我们对2020年11月至2022年8月在同一学术机构进行的1160例THA和1813例TKA进行了回顾性分析。社会因素包括药物使用、职业、婚姻状况、收入和参加体育锻炼。此外,还对生活状况和交通细节等排放规划方面进行了审查。结果:总体而言,952例(32%)患者成功完成SCDD,而2021例(68%)患者在术后第1天(POD1)或更早时间出院。成功的SCDD患者更有可能拥有医疗保健(4.8%对2.5%)和运动(5.4%对4.6%),而不是久坐不动的职业,已婚(79.6%对67.4%),交通便利(95.6%对92.9%),生活在收入中位数较高的地区(64,044美元[16,183美元]对61,572美元[14,594美元]),每周锻炼(62.6%对23.9%)。有趣的是,成功的患者在家中有更多的故事(1.62[0.56]对1.43[0.53]),更多的楼梯进入他们的家(5.19[5.22]对4.60[5.24]),住得离医院更远(43.3[138.0]对32.0[75.9]英里),以及更高的酒精使用率(60.7%对44.7%)和烟草使用率(19.3%对17.3%)。结论:这些发现可能有助于关节置换外科医生更好地了解导致TJA患者SCDD成功的社会因素,最终帮助患者选择和术前咨询。
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