关节镜治疗股骨下端慢性骨髓炎合并化脓性膝关节炎

2003年7月-2005年7月,本院采用关节镜下治疗股骨下端慢性骨髓炎及慢性骨髓炎窦道与膝关节相通引起继发性的膝关节化脓性关节炎7例,取得满意疗效,现报告如下。1临床资料本组7例,男5例,女2例;年龄32～73岁;左侧4例,右侧3例;病程最短6个月,最长30年。均有反复膝关节肿痛,皮温增高,     

Relationship of knee joint proprioception to pain and disability in individuals with knee osteoarthritis.

Proprioception plays an integral role in neuromotor control of the knee joint and deficits in knee joint proprioception are well documented in individuals with knee osteoarthritis (OA). However, the functional relevance of these deficits is not clear. This cross-sectional study evaluated the relationship between knee joint proprioception and pain and disability in a large cohort of individuals with knee OA. Two hundred and twenty participants (145 F, 75 M) with symptomatic knee OA were recruited from the community. Five non-weight bearing active tests with ipsilateral limb matching responses were performed at 20 degrees and 40 degrees flexion to measure knee joint position sense. Pain and disability were assessed by self-reported questionnaires and objective measures of balance and gait. Results showed little association between knee joint position sense variables and measures of pain and disability (r values <0.24, most p>0.05). When comparing participants with the worst and best joint position sense, no significant differences in pain and disability could be found (p>0.05). While our study design does not allow causality to be established, these results suggest that deficits in joint position sense may be due to factors other than pain and that deficits are not large enough to impact upon disability.     

小切口治疗后交叉韧带胫骨起点撕脱骨折

膝关节炎(osteoarthritis,OA)是膝关节的慢性退行性疾病,多发于中老年患者,主要病变位置在膝关节承重区的软骨,当软骨发生磨损、破坏时,作为基质主要成分的蛋白多糖(protoglycan,PG)大量分散于关节液中,与人体代谢相关[1],成为可以定量分析关节软骨破坏程度的有效灵敏指标[2]。我院对膝骨关节炎患者采用内服补肝益肾、活血通络中药及关节腔内玻璃酸钠注射,同时以单纯的玻璃酸钠注射作为对照,分别在治疗前后抽取关节液,行PG定量检查,对两组的PG变化趋势进行观察,现将结果报告如下。1资料和方法1·1一般资料将2006年12月至2007年3月的60例…     

关节镜膝关节清理术治疗中重度软骨退变的膝骨关节炎

目的探讨关节镜下膝关节清理术治疗中重度软骨退变的膝骨关节炎的效果. 方法采用关节镜下膝关节清理术联合术后康复训练治疗17例(21膝)中重度软骨退变的膝关节骨关节炎. 结果手术时间55～100 min,平均75 min.无并发症发生.术后住院15～20 d,平均13 d.术中关节被动活动范围0°～120°,术后关节活动度0°～110°.随访5～36个月,平均21个月,良好6例(8膝),尚可9例(11膝),差2例(2膝).关节活动范围0°～120°结论关节镜下膝关节清理术对中重度软骨退变的膝关节骨关节炎有一定的治疗效果.     

鼠骨关节炎动物模型建立的现状

骨关节炎(osteoarthritis，OA)是临床上常见的疾病。探索骨关节炎动物模型的建立方法，是研究其病因和治疗方法的重要课题之一。鼠是一种理想的动物，所用的方法有关节内手术、关节内注射、关节外手术等，各种方法都有自己的长处和不足。本文就鼠骨关节炎动物模型的建立方法、模型特点及其应用等方面进行综述。     

锌指蛋白440在人膝关节OA软骨细胞损伤中的促进作用及机制

探讨锌指蛋白440（ZNF440）在膝关节（Knee）骨性关节炎（OA）软骨细胞损伤和退化变性病理生理学中的作用。方法 Knee软骨中分离人软骨细胞,分为对照组、Knee OA组、ZNF440-GFP（绿色荧光蛋白）组、ZNF440-siRNA组和Scriptaid组。通过免疫组化和Western blotting测定ZNF440在Knee OA软骨中的表达。用ZNF440-GFP过表达和ZNF440-siRNA转染细胞,并给予白细胞介素-1β(IL-1β)刺激。分别用qPCR和WB检测分解代谢、合成代谢和凋亡相关标志物的mRNA和蛋白表达水平。生物信息学分析有可能抑制ZNF440表达的化合物。结果 与对照组相比,ZNF440在Knee OA软骨中的表达有所增加(P＜0.05);ZNF440过表达明显增加基质金属蛋白酶（MMP）13和PARP p85的表达,并降低COL2A1表达(P＜0.05);siRNA敲除ZNF440可部分逆转IL-1β刺激诱导的人Knee OA软骨细胞的分解代谢和细胞凋亡(P＜0.05)。通过生物信息学分析和验证实验,确定Scriptaid是一种有可能下调ZNF440表达的化合物。Scriptaid处理可降低OA软骨细胞中ZNF440的表达,同时降低过表达ZNF440的人Knee OA软骨细胞中MMP13和PARP p85的表达(P＜0.05)。结论 ZNF440在人Knee OA软骨中的表达明显增加,可能通过调节细胞中炎症、分解代谢和凋亡标志物的表达参与软骨退行性机制。此外,Scriptaid可降低ZNF440的表达,并抑制其在OA软骨细胞中的破坏作用     

Patellofemoral joint cartilage restoration with particulated juvenile allograft in patients under 21 years old

BackgroundPatellofemoral joint cartilage defects are difficult to treat due to their unique thickness and topography.PurposeTo report the postoperative outcomes of patients age 21 and younger treated with particulated juvenile allograft cartilage (PJAC) for full-thickness cartilaginous defects of the patellofemoral joint. The primary aim was to report surgical outcomes and complication rates, as well as return to sport activity. A secondary aim was to provide objective scores of defect restoration by magnetic resonance imaging (MRI) assessment.MethodsA retrospective review of all PJAC cases conducted between 2012 and 2019 at a single tertiary care urban musculoskeletal institution was conducted. Patients 21 years old or younger with minimum clinical follow up of 1 year and postoperative MRI at a minimum of 6 months were included. Cartilage restoration by MRI was independently assessed using the International Cartilage Repair Society’s (ICRS) standardized system.ResultsThirty four patients, 36 knees, were included, with mean age 16.1 ± 3.1 years old. Return to sport rate among patients who participated in a sport preoperatively was 100%. On independent MRI assessment, two thirds of defects achieved an overall grade of normal or nearly normal, while 28 patients (78%) had majority defect fill. Primary graft failure occurred in two cases and one patient experienced a surgical complication.ConclusionRestoration of patellofemoral chondral defects in young patients with particulated juvenile allograft results in satisfactory short-term outcomes and postoperative MRI appearance, along with high rates of return to sport and low rate of complications and graft failure.What is known about the subject: Patellofemoral joint cartilage defects are difficult to treat due to their unique thickness and topography. Several cartilage restoration techniques are available, but these rarely achieve the same mechanical properties as native hyaline cartilage. PJAC is a cell-based technique that has demonstrated promise since its introduction in 2007.What this study adds to existing knowledge: This series of patients adds the largest single cohort of pediatric and adolescent patients who receive PJAC for defects of the patellofemoral joint. Surgeons treating patients in this age group should be aware of every technique, and their respective outcomes.