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Reduction of perioperative blood loss and operating time for arthroscopic rotator cuff repair by intravenous administration of tranexamic acid 静脉注射氨甲环酸减少关节镜下肩袖修复术的围术期出血量和手术时间
IF 2.1 Q3 ORTHOPEDICS Pub Date : 2023-01-01 DOI: 10.1016/j.asmart.2023.01.001
Shinji Kawaguchi , Shoji Fukuta , Masashi Kano , Koichi Sairyo

Background

Tranexamic acid (TXA) is widely used in hip and knee arthroplasty to reduce perioperative bleeding. Recently, its use has been expanded to arthroscopic surgery. The purpose of this study was to evaluate the efficacy of preoperative use of TXA in arthroscopic rotator cuff repair (RCR).

Methods

A cohort comprising 129 consecutive patients who underwent arthroscopic primary RCR at our institution was retrospectively investigated according to whether they received TXA (April 2018 to December 2020, TXA group, n = 64) or did not receive TXA (April 2016 to March 2018, non-TXA group, n = 65). TXA was administered at a dose of 1 g intravenously. Rotator cuff tears were repaired by the suture bridge technique. Videos of the arthroscopic procedures were reviewed and rated for visual clarity using a 10-point numeric rating scale. Arthroscopic procedures were divided into glenohumeral, resection of bursal tissue and acromioplasty, and RCR steps. Each step was rated separately. Age, sex, body mass index, hemoglobin level before and on days 1 and 7 after surgery, operating time, mean arterial pressure, tear size, and number of anchors used for cuff repair were compared between the two groups.

Results

There were no statistically significant differences in the patient demographic data. The operating time was significantly shorter in the TXA group than in non-TXA group (97.8 ± 21.8 min vs 116.2 ± 26.0 min). The clarity of the visual field was similar between the two groups during the glenohumeral phase but was significantly higher in the TXA group during the resection of bursal tissue and acromioplasty and RCR phases. Hemoglobin level was not significantly different between the groups on postoperative day 1 but was significantly higher in the TXA group on day 7.

Conclusion

Administration of a single intravenous dose of TXA improved visual clarity in arthroscopic RCR, decreased the total operating time, and reduced hemoglobin loss on postoperative day 7.

背景氨甲环酸(TXA)广泛应用于髋关节和膝关节置换术以减少围手术期出血。最近,它的应用已经扩展到关节镜手术。本研究的目的是评估术前使用TXA进行关节镜下肩袖修复(RCR)的疗效(2016年4月至2018年3月,非TXA组,n=65)。TXA以1g的剂量静脉内给药。采用缝合桥技术修复旋转袖撕裂。对关节镜手术的视频进行了审查,并使用10分数字评分表对其视觉清晰度进行了评分。关节镜手术分为肩关节、囊组织切除和肩峰成形术以及RCR步骤。每一步都是单独评分的。比较两组患者的年龄、性别、体重指数、术前和术后第1天和第7天的血红蛋白水平、手术时间、平均动脉压、撕裂大小和用于袖带修复的锚钉数量。结果患者人口学数据无统计学意义差异。TXA组的手术时间明显短于非TXA组(97.8±21.8min vs 116.2±26.0min)。两组在肩关节期的视野清晰度相似,但TXA组在囊组织切除、肩峰成形术和RCR期的视野清晰度明显较高。术后第1天,两组之间的血红蛋白水平没有显著差异,但在第7天,TXA组的血红蛋白水平显著升高。结论单次静脉注射TXA可提高关节镜下RCR的视觉清晰度,缩短总手术时间,并在术后第7天减少血红蛋白损失。
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引用次数: 1
Femoral-varus tibial-valgus osteotomy (FVTVO) for neutrally-aligned knee osteoarthritis with severe joint line obliquity enables return to sports activities: A case series study 股骨内翻胫骨外翻截骨术(FVTVO)治疗伴有严重关节线倾斜的中性膝关节骨性关节炎,使其能够恢复体育活动:一个病例系列研究
IF 2.1 Q3 ORTHOPEDICS Pub Date : 2023-01-01 DOI: 10.1016/j.asmart.2023.01.002
Ryuichi Nakamura , Masaki Amemiya , Tomoyuki Shimakawa , Masaki Takahashi , Kazunari Kuroda , Yasuo Katsuki , Akira Okano
<div><h3>Background</h3><p>Re-alignment surgeries for uni-compartmental knee osteoarthritis, such as high tibial osteotomy (HTO) for varus knees or distal femoral osteotomy (DFO) for valgus knees, are recognized as standard strategies. However, the treatment strategy has not been established for patients with a neutrally-aligned osteoarthritic knee with severe joint line obliquity (JLO) owing to the combination of a valgus femur and a varus tibia; i.e., type II coronal plane alignment of the knee (CPAK). total knee arthroplasty (TKA) can be an option for CPAK type II-aligned osteoarthritis in older inactive patients. Here, we hypothesized that joint line horizontalization by femoral-varus tibial-valgus osteotomy (FVTVO), which may reduce the shear stress induced by JLO, could be a treatment option for CPAK type II-aligned osteoarthritis in young active patients who wish to return to sports (RTS) activity. Our aim in this study was to evaluate the postoperative results of FVTVO with RTS.</p></div><div><h3>Methods</h3><p>Our indications for FVTVO are as follows: JLO >5°; mechanical medial proximal tibial angle (mMPTA) < 87°; mechanical lateral distal femoral angle (mLDFA) < 87°; typical osteoarthritis patterns for CPAK type II on magnetic resonance images, namely osteoarthritic change of the lateral tibial spine, medial slip of the femur, and/or lateral meniscal extrusion from the lateral femoral condyle; and flexion contracture <10°. We enrolled patients who wished to RTS and who had a pre-symptom Tegner score ≥5 and had completed at least a 1-year follow-up. For FVTVO, closed-wedge DFO was performed in all femurs; both closed-wedge HTO and open-wedge HTO were used in the tibia, depending on the situation. Range of motion exercises began on the first postoperative day, and full weight-bearing was permitted 6 weeks postoperatively. Jogging was permitted 3 months postoperatively after confirming bone union, and patients could gradually return to their sports activity 6–12 months’ postoperatively. The Japanese Orthopaedic Association (JOA) score and knee flexion range were assessed preoperatively and at the last follow-up. Tegner activity scale scores were assessed presymptom, preoperatively, and at the last follow-up. The hip-knee-ankle (HKA) angle, JLO, mMPTA, and mLDFA were evaluated radiologically, and meniscal extrusions, osteoarthritic change, and/or bone marrow edema were assessed on magnetic resonance images.</p></div><div><h3>Results</h3><p>One man and two women were included in this case series. Two were competitive athletes and one was a mountain climber. The patients' ages were 69, 46, and 57 years (Case 1, 2, and 3, respectively). All patients’ CPAK type was converted from type II to type V; i.e., neutral-aligned knee with a neutral joint line, postoperatively. All patients returned to their presymptom sports activity level by the final follow-up. The presymptom/preoperative/final follow-up Tegner scale in Case 1, 2, and 3 we
背景单室性膝关节骨性关节炎的重新定向手术,如膝内翻的胫骨高位截骨(HTO)或外翻膝的股骨远端截骨(DFO),被公认为标准策略。然而,由于股骨外翻和胫骨内翻的组合,中性排列的骨关节炎膝关节具有严重关节线倾斜(JLO)的患者的治疗策略尚未确定;即膝关节的II型冠状面对准(CPAK)。全膝关节置换术(TKA)可以作为治疗老年不活动患者CPAK II型骨关节炎的一种选择。在这里,我们假设通过股内翻-胫骨外翻截骨(FVTVO)进行关节线水平化,可以减少JLO引起的剪切应力,这可能是希望恢复运动(RTS)活动的年轻活跃患者中CPAK II型骨关节炎的治疗选择。我们在本研究中的目的是用RTS评估FVTVO的术后结果。方法我们的FVTVO适应症如下:JLO>;5°;机械性内侧近端胫骨角(mMTTA)<;87°;股骨远端机械外侧角(mLDFA)<;87°;磁共振图像上CPAK II型的典型骨关节炎模式,即胫骨外侧棘的骨关节炎改变、股骨内侧滑动和/或股骨外侧髁的外侧半月板挤出;以及屈曲挛缩<;10°。我们招募了希望RTS的患者,这些患者的症状前Tegner评分≥5,并完成了至少一年的随访。对于FVTVO,所有股骨均进行了闭合楔形DFO;根据情况在胫骨中同时使用闭合楔形HTO和开放楔形HTO。活动范围训练从术后第一天开始,术后6周允许完全负重。在确认骨愈合后3个月允许慢跑,患者可以在术后6-12个月逐渐恢复运动。术前和最后一次随访时评估了日本骨科协会(JOA)评分和膝关节屈曲范围。Tegner活动量表评分在症状前、术前和最后一次随访时进行评估。对髋膝踝(HKA)角、JLO、mMTTA和mLDFA进行放射学评估,并在磁共振图像上评估半月板挤压、骨关节炎变化和/或骨髓水肿。结果本病例系列包括1名男性和2名女性。两个是竞技运动员,一个是登山运动员。患者的年龄分别为69岁、46岁和57岁(分别为病例1、2和3)。所有患者的CPAK类型均由II型转为V型;即具有中性关节线的中性对齐的膝关节。所有患者在最后一次随访时都恢复到了症状前的运动活动水平。病例1、2和3的症状前/术前/最终随访Tegner量表分别为6/1/6、5/2/5和7/3/7。结论FVTVO关节线水平化治疗严重JLO的中立型膝关节提供了非常满意的临床结果,并成功地导致RTS。
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引用次数: 2
Establishment of a mechanism-based in vitro coculture assay for evaluating the efficacy of immune checkpoint inhibitors. 建立基于机制的体外共培养试验,以评估免疫检查点抑制剂的疗效。
IF 5.8 Q3 ORTHOPEDICS Pub Date : 2022-11-01 Epub Date: 2022-04-18 DOI: 10.1007/s00262-022-03201-9
Myeong Joon Kim, Kyeong Hee Hong, Bo Ryeong Lee, Sang-Jun Ha

Cancer immunotherapy, which blocks immune checkpoint molecules, is an effective therapeutic strategy for human cancer patients through restoration of tumor-infiltrating (TI) cell function. However, evaluating the efficacy of immune checkpoint inhibitors (ICIs) is difficult because no standard in vitro assay for ICI efficacy evaluation exists. Additionally, blocking a particular immune checkpoint receptor (ICR) is insufficient to restore T cell functionality, because other ICRs still transduce inhibitory signals. Therefore, limiting inhibitory signals transduced via other ICRs is needed to more accurately assess the efficacy of ICIs targeting a particular immune checkpoint. Here, we introduce a newly developed in vitro coculture assay using human peripheral blood mononuclear cells (hPBMCs) and engineered human cancer cell lines. We enriched CD8+ T cells from hPBMCs of healthy donors through low-dose T cell receptor stimulation and cytokine (human IL-2 and IL-7) addition. These enriched CD8+ T cells were functional and expressed multiple ICRs, especially TIM-3 and TIGIT. We also established immune checkpoint ligand (ICL) knockout (KO) cancer cell lines with the CRISPR-Cas9 system. Then, we optimized the in vitro coculture assay conditions to evaluate ICI efficacy. For example, we selected the most effective anti-TIM-3 antibody through coculture of TIM-3+CD8+ T cells with PD-L1-/-PVR-/- cancer cells. In summary, we developed a mechanism-based in vitro coculture assay with hPBMCs and ICL KO cancer cell lines, which could be a useful tool to identify promising ICIs by providing reliable ICI efficacy information.

癌症免疫疗法可阻断免疫检查点分子,通过恢复肿瘤浸润(TI)细胞的功能,是人类癌症患者的一种有效治疗策略。然而,评估免疫检查点抑制剂(ICIs)的疗效十分困难,因为目前还没有用于 ICI 疗效评估的标准体外检测方法。此外,阻断特定的免疫检查点受体(ICR)不足以恢复 T 细胞的功能,因为其他 ICR 仍在传递抑制信号。因此,需要限制通过其他 ICR 传递的抑制信号,以更准确地评估针对特定免疫检查点的 ICIs 的疗效。在此,我们介绍一种新开发的体外共培养试验,该试验使用人外周血单核细胞(hPBMCs)和工程化人癌细胞系。通过低剂量 T 细胞受体刺激和细胞因子(人 IL-2 和 IL-7)添加,我们从健康供体的 hPBMCs 中富集了 CD8+ T 细胞。这些富集的 CD8+ T 细胞具有功能性,并表达多种 ICRs,尤其是 TIM-3 和 TIGIT。我们还利用CRISPR-Cas9系统建立了免疫检查点配体(ICL)敲除(KO)癌细胞系。然后,我们优化了体外共培养试验条件,以评估 ICI 的功效。例如,我们通过 TIM-3+CD8+ T 细胞与 PD-L1-/-PVR-/- 癌细胞的共培养筛选出了最有效的抗 TIM-3 抗体。总之,我们用 hPBMCs 和 ICL KO 癌细胞系开发了一种基于机制的体外共培养试验,它可以提供可靠的 ICI 疗效信息,是一种识别有前景 ICI 的有用工具。
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引用次数: 0
A MINIATURE LASER SPECKLE CONTRAST IMAGER FOR MONITORING OF THE NEURO-MODULATORY EFFECT OF TRANSCRANIAL FOCUSED ULTRASOUND STIMULATION. 用于监测经颅聚焦超声刺激对神经调节作用的微型激光斑点对比成像仪。
Q3 ORTHOPEDICS Pub Date : 2021-04-01 Epub Date: 2021-05-11 DOI: 10.1115/dmd2021-1038
Yinuo Zeng, Molly Acord, Tarana Parvez Kaovasia, Peng Miao, Junfeng Sun, Janaka Senarathna, Nicholas Theodore, Nitish Thakor, Amir Manbachi

Transcranial focused ultrasound stimulation is a neuromodulation technique that is capable of exciting or suppressing the neural network. Such neuro-modulatory effects enable the treatment of brain diseases non-invasively, such as treating stroke. The neuro-modulatory effect on cerebral hemodynamics has been monitored using laser speckle contrast imaging in animal studies. However, the bulky size and stationary nature of the imaging system constrains the application of this imaging technique on research that requires the animal to have different body positions or to be awake. We present the design of a system that combines a miniature microscope for laser speckle contrast imaging and transcranial focused ultrasound stimulation, as well as, test its capability to monitor cerebral hemodynamics during stimulation and compare the result with a benchtop imaging system.

经颅聚焦超声刺激是一种神经调控技术,能够刺激或抑制神经网络。这种神经调节作用可以无创治疗脑部疾病,如治疗中风。在动物实验中,利用激光斑点对比成像技术监测了神经调节对脑血流动力学的影响。然而,成像系统体积庞大且固定不动,这限制了这种成像技术在需要动物不同体位或清醒状态的研究中的应用。我们介绍了一种结合了激光斑点对比成像和经颅聚焦超声刺激的微型显微镜系统的设计,并测试了其在刺激过程中监测脑血流动力学的能力,并将结果与台式成像系统进行了比较。
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引用次数: 0
Erratum regarding missing Declaration of Competing Interest statements in previously published articles 关于先前发表的文章中缺少竞争利益声明的勘误表
IF 2.1 Q3 ORTHOPEDICS Pub Date : 2020-11-01 DOI: 10.1016/j.wse.2020.12.008
Anonymous
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引用次数: 0
6- and 12-Month Results of A Prospective, Multi-Center, Randomized, Trial Comparing Safety and Effectiveness of Cooled Radiofrequency Ablation to Corticosteroid Injection For Management of Osteoarthritic Knee Pain 一项前瞻性、多中心、随机试验的6个月和12个月结果,比较冷却射频消融与皮质类固醇注射治疗骨关节炎性膝关节疼痛的安全性和有效性
IF 2.1 Q3 ORTHOPEDICS Pub Date : 2018-04-01 DOI: 10.1016/J.JOCA.2018.02.627
M. Desai, T. Davis, E. Loudermilk, M. Depalma, C. Hunter, D. Lindley, N. Patel, D. Choi, M. Soloman, Anita K. Gupta, A. Buvanendran, L. Kapural
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引用次数: 2
Clinical results of rotator cuff repair in patient of glenohumeral osteoarthritis 肩袖修复治疗盂肱骨关节炎的临床效果
IF 2.1 Q3 ORTHOPEDICS Pub Date : 2017-09-25 DOI: 10.1016/J.ASMART.2017.05.100
J. Yoon
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引用次数: 0
The primary outcomes of osteolytic lesion of greater tuberosity in calcific tendinitis of the shoulder 钙化性肩肌腱炎大结节溶骨性病变的主要转归
IF 2.1 Q3 ORTHOPEDICS Pub Date : 2017-09-25 DOI: 10.1016/j.asmart.2017.05.263
Jia-yin Ma
{"title":"The primary outcomes of osteolytic lesion of greater tuberosity in calcific tendinitis of the shoulder","authors":"Jia-yin Ma","doi":"10.1016/j.asmart.2017.05.263","DOIUrl":"https://doi.org/10.1016/j.asmart.2017.05.263","url":null,"abstract":"","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"9 1","pages":"112"},"PeriodicalIF":2.1,"publicationDate":"2017-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.asmart.2017.05.263","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42729992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Shoulder - Rotator cuff tear and disorderA comparison of clinical outcomes after arthroscopic rotator cuff repair using single-row, double-row and suture bridge technique 肩袖撕裂与肩袖紊乱关节镜下单排、双排及缝合桥技术修复肩袖的临床疗效比较
IF 2.1 Q3 ORTHOPEDICS Pub Date : 2017-07-01 DOI: 10.1016/J.ASMART.2017.05.102
Huanghe Song, W. Qing
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引用次数: 0
How the results of conservative treatment for ACL tears are different by posterior tibial slope 胫后斜度不同,前交叉韧带撕裂保守治疗的效果有何不同
IF 2.1 Q3 ORTHOPEDICS Pub Date : 2017-07-01 DOI: 10.1016/j.asmart.2017.05.167
Yoon-Seok Youm, S. Cho, Youngjin Choi, Y. Joo, Moon-Hee Bae
{"title":"How the results of conservative treatment for ACL tears are different by posterior tibial slope","authors":"Yoon-Seok Youm, S. Cho, Youngjin Choi, Y. Joo, Moon-Hee Bae","doi":"10.1016/j.asmart.2017.05.167","DOIUrl":"https://doi.org/10.1016/j.asmart.2017.05.167","url":null,"abstract":"","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"9 1","pages":"78"},"PeriodicalIF":2.1,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.asmart.2017.05.167","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48961339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology
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