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Corrigendum. 更正。
IF 4.7 2区 医学 Q2 CELL & TISSUE ENGINEERING Pub Date : 2024-11-27 DOI: 10.1302/2046-3758.1311.BJR-2024-00003
Kangpeng Li, Qiang Zhang
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引用次数: 0
Correlation of cross-linking as measured by the trans-vinylene index and in vitro wear of polyethylene from various acetabular liner brands. 用反式乙烯指数测量的交联与不同品牌髋臼衬垫聚乙烯的体外磨损的相关性。
IF 4.7 2区 医学 Q2 CELL & TISSUE ENGINEERING Pub Date : 2024-11-26 DOI: 10.1302/2046-3758.1311.BJR-2024-0203.R1
Peter Wahl, Roman Heuberger, Andrea Pascucci, Thomas Imwinkelried, Markus Fürstner, Niels Icken, Michel Schläppi, Robin Pourzal, Emanuel Gautier

Aims: Highly cross-linked polyethylene (HXLPE) greatly reduces wear in total hip arthroplasty, compared to conventional polyethylene (CPE). Cross-linking is commonly achieved by irradiation. This study aimed to compare the degree of cross-linking and in vitro wear rates across a cohort of retrieved and unused polyethylene cups/liners from various brands.

Methods: Polyethylene acetabular cups/liners were collected at one centre from 1 April 2021 to 30 April 2022. The trans-vinylene index (TVI) and oxidation index (OI) were determined by Fourier-transform infrared spectrometry. Wear was measured using a pin-on-disk test.

Results: A total of 47 specimens from ten brands were included. The TVI was independent of time in vivo. A linear correlation (R2 = 0.995) was observed between the old and current TVI standards, except for vitamin E-containing polyethylene. The absorbed irradiation dose calculated from the TVI corresponded to product specifications for all but two products. For one electron beam-irradiated HXLPE, a mean dose of 241% (SD 18%) of specifications was determined. For another, gamma-irradiated HXLPE, a mean 41% (SD 13%) of specifications was determined. Lower wear was observed for higher TVI.

Conclusion: The TVI is a reliable measure of the absorbed irradiation dose and does not alter over time in vivo. The products of various brands differ by manufacturing details and consequently cross-linking characteristics. Absorption and penetration of electron radiation and gamma radiation differ, potentially leading to higher degrees of cross-linking for electron radiation. There is a non-linear, inverse correlation between TVI and in vitro wear. The wear resistance of the HXLPE with low TVI was reduced and more comparable to CPE.

目的:与传统聚乙烯(CPE)相比,高交联聚乙烯(HXLPE)可大大减少全髋关节置换术中的磨损。交联通常是通过辐照实现的。本研究旨在比较不同品牌的聚乙烯髋臼杯/衬垫的交联程度和体外磨损率:一个中心从 2021 年 4 月 1 日至 2022 年 4 月 30 日收集了聚乙烯髋臼杯/衬垫。采用傅立叶变换红外光谱法测定反式乙烯指数(TVI)和氧化指数(OI)。使用针盘测试法测量磨损情况:结果:共包括 10 个品牌的 47 个样本。TVI 与体内时间无关。除含维生素 E 的聚乙烯外,旧的和现行的 TVI 标准之间呈线性相关(R2 = 0.995)。根据 TVI 计算出的吸收辐照剂量与所有产品的规格相符,只有两种产品除外。对于一种经过电子束辐照的 HXLPE,确定的平均剂量为规格的 241%(SD 18%)。对于另一种经过伽马射线辐照的 HXLPE,测定的平均剂量为规格的 41%(SD 13%)。TVI越高,磨损越低:TVI是衡量吸收辐照剂量的可靠指标,不会随着时间的推移而改变。不同品牌的产品在制造细节上存在差异,因此交联特性也不同。电子辐射和伽马辐射的吸收和穿透不同,可能导致电子辐射的交联程度更高。TVI 与体外磨损之间存在非线性反比关系。低 TVI 的 HXLPE 的耐磨性降低,与 CPE 更为接近。
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引用次数: 0
Multidimensional characteristics are associated with pain severity in osteonecrosis of the femoral head. 多维特征与股骨头坏死的疼痛严重程度有关。
IF 4.7 2区 医学 Q2 CELL & TISSUE ENGINEERING Pub Date : 2024-11-22 DOI: 10.1302/2046-3758.1311.BJR-2024-0105.R2
Chen Yue, Zhang Xue, Yan Cheng, Chaojun Sun, Youwen Liu, Bin Xu, Jiayi Guo

Aims: Pain is the most frequent complaint associated with osteonecrosis of the femoral head (ONFH), but the factors contributing to such pain are poorly understood. This study explored diverse demographic, clinical, radiological, psychological, and neurophysiological factors for their potential contribution to pain in patients with ONFH.

Methods: This cross-sectional study was carried out according to the "STrengthening the Reporting of OBservational studies in Epidemiology" statement. Data on 19 variables were collected at a single timepoint from 250 patients with ONFH who were treated at our medical centre between July and December 2023 using validated instruments or, in the case of hip pain, a numerical rating scale. Factors associated with pain severity were identified using hierarchical multifactor linear regression.

Results: Regression identified the following characteristics as independently associated with higher pain score, after adjustment for potential confounders: Association Research Circulation Osseous classification stage IIIa or IIIb, bone marrow oedema, grade 3 joint effusion, as well as higher scores on pain catastrophizing, anxiety, and central sensitization. The final model explained 69.7% of observed variance in pain scores, of which clinical and radiological factors explained 37%, while psychological and neurophysiological factors explained 24% and demographic factors explained 8.7%.

Conclusion: Multidimensional characteristics jointly contribute to the severity of pain associated with ONFH. These findings highlight the need to comprehensively identify potential contributors to pain, and to personalize management and treatment accordingly.

目的:疼痛是股骨头坏死(ONFH)患者最常见的主诉,但导致这种疼痛的因素却鲜为人知。本研究探讨了各种人口学、临床、放射学、心理学和神经生理学因素对股骨头坏死患者疼痛的潜在影响:这项横断面研究是根据 "加强流行病学观察性研究的报告 "声明进行的。研究人员在单一时间点收集了 2023 年 7 月至 12 月期间在本医疗中心接受治疗的 250 名 ONFH 患者的 19 个变量的数据,这些患者均使用了经过验证的工具,如果是髋部疼痛,则使用了数字评分量表。采用分层多因素线性回归法确定了与疼痛严重程度相关的因素:在对潜在的混杂因素进行调整后,回归结果表明以下特征与较高的疼痛评分独立相关:协会研究循环骨分类 IIIa 或 IIIb 阶段、骨髓水肿、3 级关节积液,以及疼痛灾难化、焦虑和中枢敏感性评分较高。最终模型解释了所观察到的疼痛评分变异的 69.7%,其中临床和放射学因素解释了 37%,心理和神经生理学因素解释了 24%,人口统计学因素解释了 8.7%:结论:多维特征共同导致了ONFH相关疼痛的严重程度。这些发现突出表明,有必要全面识别导致疼痛的潜在因素,并据此进行个性化管理和治疗。
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引用次数: 0
Inhibition of PA28γ expression can alleviate osteoarthritis by inhibiting endoplasmic reticulum stress and promoting STAT3 phosphorylation. 抑制 PA28γ 的表达可通过抑制内质网应激和促进 STAT3 磷酸化来缓解骨关节炎。
IF 4.7 2区 医学 Q2 CELL & TISSUE ENGINEERING Pub Date : 2024-11-20 DOI: 10.1302/2046-3758.1311.BJR-2023-0361.R2
Haokun Mo, Kai Sun, Yanjun Hou, Zhaoxuan Ruan, Zhiyi He, Haigang Liu, Liang Li, Zhenggang Wang, Fengjing Guo

Aims: Osteoarthritis (OA) is a common degenerative disease. PA28γ is a member of the 11S proteasome activator and is involved in the regulation of several important cellular processes, including cell proliferation, apoptosis, and inflammation. This study aimed to explore the role of PA28γ in the occurrence and development of OA and its potential mechanism.

Methods: A total of 120 newborn male mice were employed for the isolation and culture of primary chondrocytes. OA-related indicators such as anabolism, catabolism, inflammation, and apoptosis were detected. Effects and related mechanisms of PA28γ in chondrocyte endoplasmic reticulum (ER) stress were studied using western blotting, real-time polymerase chain reaction (PCR), and immunofluorescence. The OA mouse model was established by destabilized medial meniscus (DMM) surgery, and adenovirus was injected into the knee cavity of 15 12-week-old male mice to reduce the expression of PA28γ. The degree of cartilage destruction was evaluated by haematoxylin and eosin (HE) staining, safranin O/fast green staining, toluidine blue staining, and immunohistochemistry.

Results: We found that PA28γ knockdown in chondrocytes can effectively improve anabolism and catabolism and inhibit inflammation, apoptosis, and ER stress. Moreover, PA28γ knockdown affected the phosphorylation of IRE1α and the expression of TRAF2, thereby affecting the mitogen-activated protein kinase (MAPK) and nuclear factor-κB (NF-κB) signalling pathways, and finally affecting the inflammatory response of chondrocytes. In addition, we found that PA28γ knockdown can promote the phosphorylation of signal transducer and activator of transcription 3 (STAT3), thereby inhibiting ER stress in chondrocytes. The use of Stattic (an inhibitor of STAT3 phosphorylation) enhanced ER stress. In vivo, we found that PA28γ knockdown effectively reduced cartilage destruction in a mouse model of OA induced by the DMM surgery.

Conclusion: PA28γ knockdown in chondrocytes can inhibit anabolic and catabolic dysregulation, inflammatory response, and apoptosis in OA. Moreover, PA28γ knockdown in chondrocytes can inhibit ER stress by promoting STAT3 phosphorylation.

目的:骨关节炎(OA)是一种常见的退行性疾病。PA28γ是11S蛋白酶体激活剂的成员之一,参与调控多个重要的细胞过程,包括细胞增殖、凋亡和炎症。本研究旨在探讨 PA28γ 在 OA 发生和发展中的作用及其潜在机制:方法:采用 120 只新生雄性小鼠进行原代软骨细胞的分离和培养。检测OA相关指标,如合成代谢、分解代谢、炎症和细胞凋亡。使用 Western 印迹、实时聚合酶链反应(PCR)和免疫荧光法研究了 PA28γ 在软骨细胞内质网(ER)应激中的作用和相关机制。通过内侧半月板失稳(DMM)手术建立了 OA 小鼠模型,并向 15 只 12 周大雄性小鼠的膝关节腔注射腺病毒以减少 PA28γ 的表达。通过血红素和伊红(HE)染色、黄绿素 O/快绿染色、甲苯胺蓝染色和免疫组化评估了软骨的破坏程度:结果:我们发现,敲除软骨细胞中的 PA28γ 能有效改善合成代谢和分解代谢,抑制炎症、细胞凋亡和 ER 应激。此外,PA28γ敲除会影响IRE1α的磷酸化和TRAF2的表达,从而影响丝裂原活化蛋白激酶(MAPK)和核因子-κB(NF-κB)信号通路,最终影响软骨细胞的炎症反应。此外,我们还发现 PA28γ 的敲除能促进信号转导和转录激活因子 3(STAT3)的磷酸化,从而抑制软骨细胞的 ER 应激。使用 Stattic(STAT3 磷酸化抑制剂)可增强 ER 应激。在体内,我们发现 PA28γ 敲除能有效减少 DMM 手术诱导的 OA 小鼠模型中的软骨破坏:结论:敲除软骨细胞中的 PA28γ 能抑制 OA 中合成代谢和分解代谢失调、炎症反应和细胞凋亡。此外,敲除软骨细胞中的 PA28γ 可通过促进 STAT3 磷酸化来抑制 ER 应激。
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引用次数: 0
Urgent focus on enhanced recovery after surgery of AIDS patients with limb fractures. 亟需关注加强四肢骨折的艾滋病患者手术后的恢复。
IF 4.7 2区 医学 Q2 CELL & TISSUE ENGINEERING Pub Date : 2024-11-12 DOI: 10.1302/2046-3758.1311.BJR-2024-0247.R1
Kangpeng Li, Qiang Zhang

Aims: The incidence of limb fractures in patients living with HIV (PLWH) is increasing. However, due to their immunodeficiency status, the operation and rehabilitation of these patients present unique challenges. Currently, it is urgent to establish a standardized perioperative rehabilitation plan based on the concept of enhanced recovery after surgery (ERAS). This study aimed to validate the effectiveness of ERAS in the perioperative period of PLWH with limb fractures.

Methods: A total of 120 PLWH with limb fractures, between January 2015 and December 2023, were included in this study. We established a multidisciplinary team to design and implement a standardized ERAS protocol. The demographic, surgical, clinical, and follow-up information of the patients were collected and analyzed retrospectively.

Results: Compared with the control group, the ERAS group had a shorter operating time, hospital stay, preoperative waiting time, postoperative discharge time, less intraoperative blood loss, and higher albumin and haemoglobin on the first postoperative day. The time to removal of the urinary catheter/drainage tube was shortened, and the drainage volume was also significantly reduced in the ERAS group. There was no significant difference in the visual analogue scale (VAS) scores on postoperative return to the ward, but the ERAS group had lower scores on the first, second, and third postoperative days. There were no significant differences in the incidence of complications, other than 10% more nausea and vomiting in the control group. The limb function scores at one-year follow-up were similar between the two groups, but time to radiological fracture union and time to return to physical work and sports were significantly reduced in the ERAS group.

Conclusion: The implementation of a series of perioperative nursing measures based on the concept of ERAS in PLWH with limb fracture can significantly reduce the operating time and intraoperative blood loss, reduce the occurrence of postoperative pain and complications, and accelerate the improvement of the functional status of the affected limb in the early stage, which is worthy of applying in more medical institutions.

目的:艾滋病病毒感染者(PLWH)肢体骨折的发病率正在上升。然而,由于其免疫缺陷状态,这些患者的手术和康复面临着独特的挑战。目前,急需根据术后强化康复(ERAS)的理念制定标准化的围手术期康复计划。本研究旨在验证ERAS在四肢骨折的 PLWH 围手术期的有效性:本研究共纳入了 2015 年 1 月至 2023 年 12 月间 120 名四肢骨折的 PLWH。我们成立了一个多学科团队,设计并实施了标准化的 ERAS 方案。我们收集并回顾性分析了患者的人口统计学、手术、临床和随访信息:结果:与对照组相比,ERAS组的手术时间、住院时间、术前等待时间、术后出院时间更短,术中失血量更少,术后第一天的白蛋白和血红蛋白更高。ERAS 组拔除导尿管/引流管的时间缩短,引流量也明显减少。术后返回病房时的视觉模拟量表(VAS)评分没有明显差异,但ERAS组在术后第一天、第二天和第三天的评分较低。除对照组恶心和呕吐的发生率高出10%外,其他并发症的发生率无明显差异。随访一年时,两组患者的肢体功能评分相似,但ERAS组患者的骨折放射学结合时间以及恢复体力劳动和运动的时间明显缩短:结论:对四肢骨折的 PLWH 实施一系列基于 ERAS 理念的围手术期护理措施,可明显缩短手术时间和术中失血量,减少术后疼痛和并发症的发生,加速患肢早期功能状态的改善,值得在更多医疗机构推广应用。
{"title":"Urgent focus on enhanced recovery after surgery of AIDS patients with limb fractures.","authors":"Kangpeng Li, Qiang Zhang","doi":"10.1302/2046-3758.1311.BJR-2024-0247.R1","DOIUrl":"10.1302/2046-3758.1311.BJR-2024-0247.R1","url":null,"abstract":"<p><strong>Aims: </strong>The incidence of limb fractures in patients living with HIV (PLWH) is increasing. However, due to their immunodeficiency status, the operation and rehabilitation of these patients present unique challenges. Currently, it is urgent to establish a standardized perioperative rehabilitation plan based on the concept of enhanced recovery after surgery (ERAS). This study aimed to validate the effectiveness of ERAS in the perioperative period of PLWH with limb fractures.</p><p><strong>Methods: </strong>A total of 120 PLWH with limb fractures, between January 2015 and December 2023, were included in this study. We established a multidisciplinary team to design and implement a standardized ERAS protocol. The demographic, surgical, clinical, and follow-up information of the patients were collected and analyzed retrospectively.</p><p><strong>Results: </strong>Compared with the control group, the ERAS group had a shorter operating time, hospital stay, preoperative waiting time, postoperative discharge time, less intraoperative blood loss, and higher albumin and haemoglobin on the first postoperative day. The time to removal of the urinary catheter/drainage tube was shortened, and the drainage volume was also significantly reduced in the ERAS group. There was no significant difference in the visual analogue scale (VAS) scores on postoperative return to the ward, but the ERAS group had lower scores on the first, second, and third postoperative days. There were no significant differences in the incidence of complications, other than 10% more nausea and vomiting in the control group. The limb function scores at one-year follow-up were similar between the two groups, but time to radiological fracture union and time to return to physical work and sports were significantly reduced in the ERAS group.</p><p><strong>Conclusion: </strong>The implementation of a series of perioperative nursing measures based on the concept of ERAS in PLWH with limb fracture can significantly reduce the operating time and intraoperative blood loss, reduce the occurrence of postoperative pain and complications, and accelerate the improvement of the functional status of the affected limb in the early stage, which is worthy of applying in more medical institutions.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"13 11","pages":"647-658"},"PeriodicalIF":4.7,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The antimicrobial properties of exogenous copper in human synovial fluid against Staphylococcus aureus. 人体滑液中的外源性铜对金黄色葡萄球菌的抗菌特性。
IF 4.7 2区 医学 Q2 CELL & TISSUE ENGINEERING Pub Date : 2024-11-07 DOI: 10.1302/2046-3758.1311.BJR-2024-0148.R1
Fernando Diaz Dilernia, David Watson, David Heinrichs, Edward Vasarhelyi

Aims: The mechanism by which synovial fluid (SF) kills bacteria has not yet been elucidated, and a better understanding is needed. We sought to analyze the antimicrobial properties of exogenous copper in human SF against Staphylococcus aureus.

Methods: We performed in vitro growth and viability assays to determine the capability of S. aureus to survive in SF with the addition of 10 µM of copper. We determined the minimum bactericidal concentration of copper (MBC-Cu) and evaluated its sensitivity to killing, comparing wild type (WT) and CopAZB-deficient USA300 strains.

Results: UAMS-1 demonstrated a greater sensitivity to SF compared to USA300 WT at 12 hours (p = 0.001) and 24 hours (p = 0.027). UAMS-1 died in statistically significant quantities at 24 hours (p = 0.017), and USA300 WT survived at 24 hours. UAMS-1 was more susceptible to the addition of copper at four (p = 0.001), 12 (p = 0.005), and 24 hours (p = 0.006). We confirmed a high sensitivity to killing with the addition of exogenous copper on both strains at four (p = 0.011), 12 (p = 0.011), and 24 hours (p = 0.011). WT and CopAZB-deficient USA300 strains significantly died in SF, demonstrating a MBC-Cu of 50 µM against USA300 WT (p = 0.011).

Conclusion: SF has antimicrobial properties against S. aureus, and UAMS-1 was more sensitive than USA300 WT. Adding 10 µM of copper was highly toxic, confirming its bactericidal effect. We found CopAZB proteins to be involved in copper effluxion by demonstrating the high sensitivity of mutant strains to lower copper concentrations. Thus, we propose CopAZB proteins as potential targets and use exogenous copper as a treatment alternative against S. aureus.

目的:滑膜液(SF)杀灭细菌的机制尚未阐明,需要更好的理解。我们试图分析人体滑液中的外源性铜对金黄色葡萄球菌的抗菌特性:我们进行了体外生长和存活率测定,以确定金黄色葡萄球菌在添加 10 µM 铜的 SF 中存活的能力。我们测定了铜的最小杀菌浓度(MBC-Cu),并通过比较野生型(WT)和 CopAZB 缺陷的 USA300 菌株,评估了其杀菌敏感性:结果:与 USA300 WT 相比,UAMS-1 在 12 小时(p = 0.001)和 24 小时(p = 0.027)时对 SF 更敏感。在 24 小时内,UAMS-1 的死亡数量具有统计学意义(p = 0.017),而 USA300 WT 则在 24 小时内存活。UAMS-1 在 4 小时(p = 0.001)、12 小时(p = 0.005)和 24 小时(p = 0.006)时更容易受到铜的影响。我们证实,在 4 小时(p = 0.011)、12 小时(p = 0.011)和 24 小时(p = 0.011)时,两种菌株对添加外源铜的杀灭都很敏感。WT和CopAZB缺陷的USA300菌株在SF中明显死亡,对USA300 WT的MBC-Cu为50 µM(p = 0.011):结论:SF 对金黄色葡萄球菌具有抗菌特性,UAMS-1 比 USA300 WT 更敏感。加入 10 µM 的铜具有很强的毒性,证实了其杀菌作用。通过证明突变菌株对较低浓度铜的高度敏感性,我们发现 CopAZB 蛋白参与了铜的流出。因此,我们建议将 CopAZB 蛋白作为潜在靶标,利用外源铜作为治疗金黄色葡萄球菌的替代方法。
{"title":"The antimicrobial properties of exogenous copper in human synovial fluid against Staphylococcus aureus.","authors":"Fernando Diaz Dilernia, David Watson, David Heinrichs, Edward Vasarhelyi","doi":"10.1302/2046-3758.1311.BJR-2024-0148.R1","DOIUrl":"10.1302/2046-3758.1311.BJR-2024-0148.R1","url":null,"abstract":"<p><strong>Aims: </strong>The mechanism by which synovial fluid (SF) kills bacteria has not yet been elucidated, and a better understanding is needed. We sought to analyze the antimicrobial properties of exogenous copper in human SF against <i>Staphylococcus aureus</i>.</p><p><strong>Methods: </strong>We performed in vitro growth and viability assays to determine the capability of <i>S. aureus</i> to survive in SF with the addition of 10 µM of copper. We determined the minimum bactericidal concentration of copper (MBC-Cu) and evaluated its sensitivity to killing, comparing wild type (WT) and CopAZB-deficient USA300 strains.</p><p><strong>Results: </strong>UAMS-1 demonstrated a greater sensitivity to SF compared to USA300 WT at 12 hours (p = 0.001) and 24 hours (p = 0.027). UAMS-1 died in statistically significant quantities at 24 hours (p = 0.017), and USA300 WT survived at 24 hours. UAMS-1 was more susceptible to the addition of copper at four (p = 0.001), 12 (p = 0.005), and 24 hours (p = 0.006). We confirmed a high sensitivity to killing with the addition of exogenous copper on both strains at four (p = 0.011), 12 (p = 0.011), and 24 hours (p = 0.011). WT and CopAZB-deficient USA300 strains significantly died in SF, demonstrating a MBC-Cu of 50 µM against USA300 WT (p = 0.011).</p><p><strong>Conclusion: </strong>SF has antimicrobial properties against <i>S. aureus</i>, and UAMS-1 was more sensitive than USA300 WT. Adding 10 µM of copper was highly toxic, confirming its bactericidal effect. We found CopAZB proteins to be involved in copper effluxion by demonstrating the high sensitivity of mutant strains to lower copper concentrations. Thus, we propose CopAZB proteins as potential targets and use exogenous copper as a treatment alternative against <i>S. aureus</i>.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"13 11","pages":"632-646"},"PeriodicalIF":4.7,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11540464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of a saline wash plus vancomycin/tobramycin-doped PVA composite (PVA-VAN/TOB-P) in a mouse pouch infection model implanted with 3D-printed porous titanium cylinders. 生理盐水冲洗加万古霉素/托布津掺杂的 PVA 复合材料(PVA-VAN/TOB-P)在植入 3D 打印多孔钛圆柱的小鼠小袋感染模型中的疗效。
IF 4.7 2区 医学 Q2 CELL & TISSUE ENGINEERING Pub Date : 2024-11-01 DOI: 10.1302/2046-3758.1311.BJR-2023-0334.R2
David C Markel, Therese Bou-Akl, Bin Wu, Paula Pawlitz, Weiping Ren

Aims: The efficacy of saline irrigation for treatment of implant-associated infections is limited in the presence of porous metallic implants. This study evaluated the therapeutic efficacy of antibiotic doped bioceramic (vancomycin/tobramycin-doped polyvinyl alcohol composite (PVA-VAN/TOB-P)) after saline wash in a mouse infection model implanted with titanium cylinders.

Methods: Air pouches created in female BalBc mice by subcutaneous injection of air. In the first of two independent studies, pouches were implanted with titanium cylinders (400, 700, and 100 µm pore sizes) and inoculated with Staphylococcus aureus (1 × 103 or 1 × 106 colony-forming units (CFU)/pouch) to establish infection and biofilm formation. Mice were killed after one week for microbiological analysis. In the second study, pouches were implanted with 400 µm titanium cylinders and inoculated with S. aureus (1 × 103 or 1 × 106 CFU/pouch). Four groups were tested: 1) no bacteria; 2) bacteria without saline wash; 3) saline wash only; and 4) saline wash plus PVA-VAN/TOB-P. After seven days, the pouches were opened and washed with saline alone, or had an additional injection of PVA-VAN/TOB-P. Mice were killed 14 days after pouch wash.

Results: The first part of the study showed that low-grade infection was more significant in 400 µm cylinders than cylinders with larger pore sizes (p < 0.05). The second part of the study showed that saline wash alone was ineffective in eradicating both low- and high-grade infections. Saline plus PVA-VAN/TOB-P eradicated the titanium cylinder-associated infections, as manifested by negative cultures of the washouts and supported by scanning electron microscopy and histology.

Conclusion: Porous titanium cylinders were vulnerable to bacterial infection and biofilm formation that could not be treated by saline irrigation alone. Application of PVA-VAN/TOB-P directly into the surgical site alone or after saline wash represents a feasible approach for prevention and/or treatment of porous implant-related infections.

目的:在多孔金属种植体存在的情况下,生理盐水冲洗治疗种植体相关感染的疗效有限。本研究评估了掺入抗生素的生物陶瓷(掺入万古霉素/托布津的聚乙烯醇复合材料(PVA-VAN/TOB-P))在生理盐水冲洗植入钛圆柱的小鼠感染模型后的疗效:通过皮下注射空气在雌性 BalBc 小鼠体内形成气囊。在两项独立研究中的第一项研究中,小鼠气囊内植入钛圆柱(孔径分别为 400、700 和 100 µm),并接种金黄色葡萄球菌(1 × 103 或 1 × 106 菌落总数形成单位 (CFU)/气囊)以形成感染和生物膜。一周后杀死小鼠,进行微生物分析。在第二项研究中,将 400 µm 的钛圆柱植入小袋,并接种金黄色葡萄球菌(1 × 103 或 1 × 106 CFU/袋)。测试分为四组:1)无细菌;2)无生理盐水清洗的细菌;3)仅生理盐水清洗;4)生理盐水清洗加 PVA-VAN/TOB-P。七天后,打开小袋,仅用生理盐水清洗,或额外注射 PVA-VAN/TOB-P。洗袋 14 天后处死小鼠:研究的第一部分显示,与孔径较大的圆筒相比,400 微米圆筒的低度感染更为严重(p < 0.05)。研究的第二部分显示,仅用生理盐水清洗无法有效消除低度和高度感染。生理盐水加 PVA-VAN/TOB-P 可根除与钛圆柱相关的感染,洗出液的阴性培养证明了这一点,扫描电子显微镜和组织学也证明了这一点:结论:多孔钛缸容易受到细菌感染并形成生物膜,仅靠生理盐水冲洗无法根治。在手术部位直接使用 PVA-VAN/TOB-P 或在生理盐水冲洗后使用 PVA-VAN/TOB-P 是预防和/或治疗多孔种植体相关感染的可行方法。
{"title":"Efficacy of a saline wash plus vancomycin/tobramycin-doped PVA composite (PVA-VAN/TOB-P) in a mouse pouch infection model implanted with 3D-printed porous titanium cylinders.","authors":"David C Markel, Therese Bou-Akl, Bin Wu, Paula Pawlitz, Weiping Ren","doi":"10.1302/2046-3758.1311.BJR-2023-0334.R2","DOIUrl":"10.1302/2046-3758.1311.BJR-2023-0334.R2","url":null,"abstract":"<p><strong>Aims: </strong>The efficacy of saline irrigation for treatment of implant-associated infections is limited in the presence of porous metallic implants. This study evaluated the therapeutic efficacy of antibiotic doped bioceramic (vancomycin/tobramycin-doped polyvinyl alcohol composite (PVA-VAN/TOB-P)) after saline wash in a mouse infection model implanted with titanium cylinders.</p><p><strong>Methods: </strong>Air pouches created in female BalBc mice by subcutaneous injection of air. In the first of two independent studies, pouches were implanted with titanium cylinders (400, 700, and 100 µm pore sizes) and inoculated with <i>Staphylococcus aureus</i> (1 × 10<sup>3</sup> or 1 × 10<sup>6</sup> colony-forming units (CFU)/pouch) to establish infection and biofilm formation. Mice were killed after one week for microbiological analysis. In the second study, pouches were implanted with 400 µm titanium cylinders and inoculated with <i>S. aureus</i> (1 × 10<sup>3</sup> or 1 × 10<sup>6</sup> CFU/pouch). Four groups were tested: 1) no bacteria; 2) bacteria without saline wash; 3) saline wash only; and 4) saline wash plus PVA-VAN/TOB-P. After seven days, the pouches were opened and washed with saline alone, or had an additional injection of PVA-VAN/TOB-P. Mice were killed 14 days after pouch wash.</p><p><strong>Results: </strong>The first part of the study showed that low-grade infection was more significant in 400 µm cylinders than cylinders with larger pore sizes (p < 0.05). The second part of the study showed that saline wash alone was ineffective in eradicating both low- and high-grade infections. Saline plus PVA-VAN/TOB-P eradicated the titanium cylinder-associated infections, as manifested by negative cultures of the washouts and supported by scanning electron microscopy and histology.</p><p><strong>Conclusion: </strong>Porous titanium cylinders were vulnerable to bacterial infection and biofilm formation that could not be treated by saline irrigation alone. Application of PVA-VAN/TOB-P directly into the surgical site alone or after saline wash represents a feasible approach for prevention and/or treatment of porous implant-related infections.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"13 11","pages":"622-631"},"PeriodicalIF":4.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11527520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Appropriate sagittal positioning of femoral components in total knee arthroplasty to prevent fracture and loosening. 在全膝关节置换术中对股骨组件进行适当的矢状定位,以防止骨折和松动。
IF 4.7 2区 医学 Q2 CELL & TISSUE ENGINEERING Pub Date : 2024-10-24 DOI: 10.1302/2046-3758.1310.BJR-2023-0362.R2
Qian Wan, Qing Han, Yang Liu, Hao Chen, Aobo Zhang, Xue Zhao, Jincheng Wang

Aims: This study aimed to investigate the optimal sagittal positioning of the uncemented femoral component in total knee arthroplasty to minimize the risk of aseptic loosening and periprosthetic fracture.

Methods: Ten different sagittal placements of the femoral component, ranging from -5 mm (causing anterior notch) to +4 mm (causing anterior gap), were analyzed using finite element analysis. Both gait and squat loading conditions were simulated, and Von Mises stress and interface micromotion were evaluated to assess fracture and loosening risk.

Results: During gait, varied sagittal positioning did not lead to excessive Von Mises stress or micromotion. However, under squat conditions, posterior positioning (-4 and -5 mm) resulted in stress exceeding 150 MPa at the femoral notch, indicating potential fracture risk. Conversely, +1 mm and 0 mm sagittal positions demonstrated minimal interface micromotion.

Conclusion: Slightly anterior sagittal positioning (+1 mm) or neutral positioning (0 mm) effectively reduced stress concentration at the femoral notch and minimized interface micromotion. Thus, these positions are deemed suitable to decrease the risk of aseptic loosening and periprosthetic femoral fracture.

目的:本研究旨在探讨全膝关节置换术中非骨水泥股骨组件的最佳矢状定位,以最大限度地降低无菌性松动和假体周围骨折的风险:采用有限元分析方法分析了股骨组件的十种不同矢状位置,从-5毫米(造成前方凹槽)到+4毫米(造成前方间隙)不等。模拟了步态和下蹲加载条件,并评估了冯米塞斯应力和界面微动,以评估骨折和松动风险:结果:在步态过程中,不同的矢状定位不会导致过大的 Von Mises 应力或微动。然而,在下蹲条件下,后方定位(-4 和-5 毫米)导致股骨缺口处的应力超过 150 兆帕,表明存在潜在的骨折风险。相反,+1 毫米和 0 毫米的矢状定位显示出最小的界面微动:结论:矢状位稍前(+1 毫米)或中立位(0 毫米)可有效减少股骨切迹处的应力集中,并将界面微动降至最低。因此,这些位置被认为适合用于降低无菌性松动和股骨假体周围骨折的风险。
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引用次数: 0
The degenerated glenohumeral joint. 退化的盂肱关节
IF 4.7 2区 医学 Q2 CELL & TISSUE ENGINEERING Pub Date : 2024-10-21 DOI: 10.1302/2046-3758.1310.BJR-2024-0026.R1
Stefan Toegel, Luca Martelanz, Juergen Alphonsus, Lena Hirtler, Ruth Gruebl-Barabas, Melanie Cezanne, Mario Rothbauer, Philipp Heuberer, Reinhard Windhager, Leo Pauzenberger

Aims: This study aimed to define the histopathology of degenerated humeral head cartilage and synovial inflammation of the glenohumeral joint in patients with omarthrosis (OmA) and cuff tear arthropathy (CTA). Additionally, the potential of immunohistochemical tissue biomarkers in reflecting the degeneration status of humeral head cartilage was evaluated.

Methods: Specimens of the humeral head and synovial tissue from 12 patients with OmA, seven patients with CTA, and four body donors were processed histologically for examination using different histopathological scores. Osteochondral sections were immunohistochemically stained for collagen type I, collagen type II, collagen neoepitope C1,2C, collagen type X, and osteocalcin, prior to semiquantitative analysis. Matrix metalloproteinase (MMP)-1, MMP-3, and MMP-13 levels were analyzed in synovial fluid using enzyme-linked immunosorbent assay (ELISA).

Results: Cartilage degeneration of the humeral head was associated with the histological presentation of: 1) pannus overgrowing the cartilage surface; 2) pores in the subchondral bone plate; and 3) chondrocyte clusters in OmA patients. In contrast, hyperplasia of the synovial lining layer was revealed as a significant indicator of inflammatory processes predominantly in CTA. The abundancy of collagen I, collagen II, and the C1,2C neoepitope correlated significantly with the histopathological degeneration of humeral head cartilage. No evidence for differences in MMP levels between OmA and CTA patients was found.

Conclusion: This study provides a comprehensive histological characterization of humeral cartilage and synovial tissue within the glenohumeral joint, both in normal and diseased states. It highlights synovitis and pannus formation as histopathological hallmarks of OmA and CTA, indicating their roles as drivers of joint inflammation and cartilage degradation, and as targets for therapeutic strategies such as rotator cuff reconstruction and synovectomy.

目的:本研究旨在确定肱骨头软骨退行性变和盂肱关节滑膜炎症患者的组织病理学特征。此外,还评估了免疫组化组织生物标志物在反映肱骨头软骨退化状况方面的潜力:方法:对 12 名 OmA 患者、7 名 CTA 患者和 4 名遗体捐献者的肱骨头和滑膜组织标本进行组织学处理,并采用不同的组织病理学评分标准进行检查。对骨软骨切片进行免疫组化染色,检测 I 型胶原、II 型胶原、胶原新表位 C1、2C、X 型胶原和骨钙素,然后进行半定量分析。使用酶联免疫吸附试验(ELISA)分析滑液中基质金属蛋白酶(MMP)-1、MMP-3和MMP-13的水平:结果:肱骨头软骨退变与以下组织学表现有关:在 OmA 患者中,1)软骨表面增生的脓疱;2)软骨下骨板中的孔隙;3)软骨细胞簇。相比之下,滑膜内层的增生是炎症过程的一个重要指标,主要出现在 CTA 中。胶原蛋白 I、胶原蛋白 II 和 C1、2C 新表位的丰度与肱骨头软骨的组织病理学退化有显著相关性。没有证据表明 OmA 和 CTA 患者的 MMP 水平存在差异:本研究提供了盂肱关节内肱骨软骨和滑膜组织在正常和患病状态下的全面组织学特征。它强调了滑膜炎和脓肿的形成是 OmA 和 CTA 的组织病理学特征,表明它们是关节炎症和软骨退化的驱动因素,也是肩袖重建和滑膜切除等治疗策略的目标。
{"title":"The degenerated glenohumeral joint.","authors":"Stefan Toegel, Luca Martelanz, Juergen Alphonsus, Lena Hirtler, Ruth Gruebl-Barabas, Melanie Cezanne, Mario Rothbauer, Philipp Heuberer, Reinhard Windhager, Leo Pauzenberger","doi":"10.1302/2046-3758.1310.BJR-2024-0026.R1","DOIUrl":"10.1302/2046-3758.1310.BJR-2024-0026.R1","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to define the histopathology of degenerated humeral head cartilage and synovial inflammation of the glenohumeral joint in patients with omarthrosis (OmA) and cuff tear arthropathy (CTA). Additionally, the potential of immunohistochemical tissue biomarkers in reflecting the degeneration status of humeral head cartilage was evaluated.</p><p><strong>Methods: </strong>Specimens of the humeral head and synovial tissue from 12 patients with OmA, seven patients with CTA, and four body donors were processed histologically for examination using different histopathological scores. Osteochondral sections were immunohistochemically stained for collagen type I, collagen type II, collagen neoepitope C1,2C, collagen type X, and osteocalcin, prior to semiquantitative analysis. Matrix metalloproteinase (MMP)-1, MMP-3, and MMP-13 levels were analyzed in synovial fluid using enzyme-linked immunosorbent assay (ELISA).</p><p><strong>Results: </strong>Cartilage degeneration of the humeral head was associated with the histological presentation of: 1) pannus overgrowing the cartilage surface; 2) pores in the subchondral bone plate; and 3) chondrocyte clusters in OmA patients. In contrast, hyperplasia of the synovial lining layer was revealed as a significant indicator of inflammatory processes predominantly in CTA. The abundancy of collagen I, collagen II, and the C1,2C neoepitope correlated significantly with the histopathological degeneration of humeral head cartilage. No evidence for differences in MMP levels between OmA and CTA patients was found.</p><p><strong>Conclusion: </strong>This study provides a comprehensive histological characterization of humeral cartilage and synovial tissue within the glenohumeral joint, both in normal and diseased states. It highlights synovitis and pannus formation as histopathological hallmarks of OmA and CTA, indicating their roles as drivers of joint inflammation and cartilage degradation, and as targets for therapeutic strategies such as rotator cuff reconstruction and synovectomy.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"13 10","pages":"596-610"},"PeriodicalIF":4.7,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Artificial intelligence in traumatology. 创伤学中的人工智能。
IF 4.7 2区 医学 Q2 CELL & TISSUE ENGINEERING Pub Date : 2024-10-17 DOI: 10.1302/2046-3758.1310.BJR-2023-0275.R3
Rosmarie Breu, Carolina Avelar, Zsolt Bertalan, Johannes Grillari, Heinz Redl, Richard Ljuhar, Stefan Quadlbauer, Thomas Hausner

Aims: The aim of this study was to create artificial intelligence (AI) software with the purpose of providing a second opinion to physicians to support distal radius fracture (DRF) detection, and to compare the accuracy of fracture detection of physicians with and without software support.

Methods: The dataset consisted of 26,121 anonymized anterior-posterior (AP) and lateral standard view radiographs of the wrist, with and without DRF. The convolutional neural network (CNN) model was trained to detect the presence of a DRF by comparing the radiographs containing a fracture to the inconspicuous ones. A total of 11 physicians (six surgeons in training and five hand surgeons) assessed 200 pairs of randomly selected digital radiographs of the wrist (AP and lateral) for the presence of a DRF. The same images were first evaluated without, and then with, the support of the CNN model, and the diagnostic accuracy of the two methods was compared.

Results: At the time of the study, the CNN model showed an area under the receiver operating curve of 0.97. AI assistance improved the physician's sensitivity (correct fracture detection) from 80% to 87%, and the specificity (correct fracture exclusion) from 91% to 95%. The overall error rate (combined false positive and false negative) was reduced from 14% without AI to 9% with AI.

Conclusion: The use of a CNN model as a second opinion can improve the diagnostic accuracy of DRF detection in the study setting.

目的:本研究旨在创建人工智能(AI)软件,为医生提供第二意见,以支持桡骨远端骨折(DRF)检测,并比较有软件支持和没有软件支持的医生的骨折检测准确性:数据集包括 26121 张匿名的腕关节前后位(AP)和侧位标准视图射线照片,包括有无桡骨远端骨折。对卷积神经网络(CNN)模型进行了训练,通过比较有骨折和无骨折的X光片来检测是否存在DRF。共有 11 名医生(其中 6 名外科医生正在接受培训,5 名手外科医生)对随机选取的 200 对腕部数字 X 光片(正侧位和侧位)进行了评估,以确定是否存在 DRF。首先在没有 CNN 模型支持的情况下评估相同的图像,然后在有 CNN 模型支持的情况下评估相同的图像,并比较两种方法的诊断准确性:研究结果表明,CNN 模型的接收器工作曲线下面积为 0.97。人工智能辅助将医生的灵敏度(正确的骨折检测)从 80% 提高到 87%,特异性(正确的骨折排除)从 91% 提高到 95%。总体错误率(假阳性和假阴性的总和)从无人工智能时的 14% 降至有人工智能时的 9%:结论:在研究环境中,使用 CNN 模型作为第二意见可提高 DRF 检测的诊断准确性。
{"title":"Artificial intelligence in traumatology.","authors":"Rosmarie Breu, Carolina Avelar, Zsolt Bertalan, Johannes Grillari, Heinz Redl, Richard Ljuhar, Stefan Quadlbauer, Thomas Hausner","doi":"10.1302/2046-3758.1310.BJR-2023-0275.R3","DOIUrl":"https://doi.org/10.1302/2046-3758.1310.BJR-2023-0275.R3","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study was to create artificial intelligence (AI) software with the purpose of providing a second opinion to physicians to support distal radius fracture (DRF) detection, and to compare the accuracy of fracture detection of physicians with and without software support.</p><p><strong>Methods: </strong>The dataset consisted of 26,121 anonymized anterior-posterior (AP) and lateral standard view radiographs of the wrist, with and without DRF. The convolutional neural network (CNN) model was trained to detect the presence of a DRF by comparing the radiographs containing a fracture to the inconspicuous ones. A total of 11 physicians (six surgeons in training and five hand surgeons) assessed 200 pairs of randomly selected digital radiographs of the wrist (AP and lateral) for the presence of a DRF. The same images were first evaluated without, and then with, the support of the CNN model, and the diagnostic accuracy of the two methods was compared.</p><p><strong>Results: </strong>At the time of the study, the CNN model showed an area under the receiver operating curve of 0.97. AI assistance improved the physician's sensitivity (correct fracture detection) from 80% to 87%, and the specificity (correct fracture exclusion) from 91% to 95%. The overall error rate (combined false positive and false negative) was reduced from 14% without AI to 9% with AI.</p><p><strong>Conclusion: </strong>The use of a CNN model as a second opinion can improve the diagnostic accuracy of DRF detection in the study setting.</p>","PeriodicalId":9074,"journal":{"name":"Bone & Joint Research","volume":"13 10","pages":"588-595"},"PeriodicalIF":4.7,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Bone & Joint Research
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