维生素E稳定型交联超高分子量聚乙烯在骨关节置换中的研究进展

BACKGROUND: As the latest generation of ultrahigh molecular weight polyethylene, vitamin E-stabilized ultrahigh molecular weight polyethylene has been widely put into use of various kinds of joint replacement. However, wear debris and osteolysis caused by that are still the vital factor influencing the clinical curative effect.      

富血小板血浆修复膝关节骨关节炎

BACKGROUND: Platelet-rich plasma (PRP) containing high levels of platelet-derived growth factor for knee osteoarthritis has achieved good clinical results; however, the effects of RPR on the repair of damaged articular cartilage are still controversial. OBJECTIVE: To study the effects of RPR on the repair of damaged articular cartilage in a rabbit model of knee osteoarthritis. METHODS:The model of osteoarthritis in the rabbit right knee was established by Hulth’s method. Autologous PRP (0.5 mL) (PRP group), sodium hyaluronate (0.5 mL) (sodium hyaluronate group), and normal saline (model group) were injected into the right knee joint cavity, respectively. The morphology of articular surface and nitric oxide contents in knee joint fluid were observed and determined at 8 weeks after surgery. RESULTS AND CONCLUSION: The morphology of articular cartilage in the PRP group was better than that in the other three groups. Mankin scores of articular cartilage and nitric oxide contents of knee joint fluid in the PRP group were significantly decreased compared with the model and sodium hyaluronate groups that in (P < 0.05), while increased compared with the sham-operation group (P < 0.05). Our results suggest that repair effects of PRP on the damaged articular cartilage are superior to sodium hyaluronate treatment. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

自体富血小板血浆对兔膝关节骨性关节炎的治疗效果观察

目的 探讨富血小板血浆(PRP)对膝关节骨性关节炎(KOA)的治疗机制及作用.方法 取成年清洁级新西兰大白兔32只,分为空白对照组(A组)、模型对照组(B组)、PRP治疗组(C组)、玻璃酸钠治疗组(D组).A组行模拟造模,B、C、D组按Hulth方法诱发建立兔KOA动物模型.动物模型建立成功后,C组予PRP 0.5 mL关节腔注射治疗,3周1次,共2次;D组予玻璃酸钠注射液关节腔注射,每周1次,连续5周;A、B组于C组同一时间点给予等量无菌生理盐水注射.在普通光学显微镜下观察关节软骨的组织结构、细胞数量、潮线的完整性和甲苯胺蓝染色等情况,比较各组间Mankin′s评分的差异.收集适量关节液测定各组花生四烯酸的表达情况.结果 A组关节软骨结构形态正常,无明显破坏;B、C、D组关节软骨结构形态均有不同程度的破坏,尤以B组软骨结构改变较大,C、D组软骨形态结构虽有改变,但与A组软骨结构较接近.A组Mankin′s评分最低,B组评分最高,C、D组经干预治疗后评分明显降低;B组与C、D组比较,差异有统计学意义(P<0.05),C组与D组比较,差异有统计学意义(P<0.05).A组花生四烯酸水平最低,B组最高,C、D组水平介于A、B组之间,且C组低于D组(P<0.05).结论 PRP对KOA具有较为明显的治疗及缓解作用.     

颈部伸屈肌群静力增强训练对颈椎病的临床疗效

目的:观察颈部伸屈肌群静力增强训练治疗颈椎病的临床疗效,并建立防治颈椎病的基础运动处方。方法:2010年6月—2014年5月,治疗颈椎病168例,其中男61例,女107例;年龄18—70岁;病程1个月—26年。随机分为两组,治疗组84例,男25例,女59例;年龄18—70岁,平均(48.25±12.06)岁;病程1个月—23年,平均(3.73±4.53)年;颈型10例,神经根型27例,脊髓型5例,椎动脉型15例,交感型4例,混合型23例;给予常规治疗加颈部伸屈肌群静力增强训练治疗。对照组84例,男36例,女48例;年龄18岁—70岁,平均(46.15±11.59)岁,病程1个月—26年,平均(3.90±4.32)年;颈型8例,神经根型32例,脊髓型7例,椎动脉型14例,交感型5例,混合型18例;给予常规治疗。分别观察两组患者自觉症状、临床检查、日常生活动作等指标,比较临床疗效。结果:168例均获随访,随访时间平均约18个月。参照疗效评价方法:治疗组治愈29例,显效41例,有效10例,无效4例;对照组治愈19例,显效35例,有效23例,无效7例,治疗组疗效优于对照组。治疗组累计复发8例(1年内复发5例,1年后复发3例),对照组累计复发38例(1年内复发24例,1年后复发14例),治疗组复发率低于对照组。结论:颈部伸屈肌群静力增强训练在治疗颈椎病中具有缓解症状、改善体征及增强或重建颈椎稳定性的作用,近、远期疗效肯定,能有效预防颈椎病的复发,可作为颈椎病防治的基础运动处方在临床推广应用。