Short-term outcomes of robotically assisted patello-femoral arthroplasty

Purpose

The purpose of this study was to determine the outcomes in patients treated with robotically assisted patello-femoral arthroplasty (PFA).

Methods

This technique offers a safe, reliable, and reproducible way of obtaining correct implant positioning in patello-femoral arthroplasty, and as a result, reduces revision surgery due to implant malalignment. We evaluated 30 knees in 29 patients who underwent robotically assisted patello-femoral arthroplasty between June 2009 and May 2011. Mean follow-up was 15.9 months. This was a retrospective study that involved chart reviews and radiographic analysis. Radiographic analysis included pre-operative and postoperative plain films for implant positioning. Functional outcomes were evaluated using the Oxford Knee Score (OKS), range of motion, University of California at Los Angeles (UCLA) patient activity-level ratings, visual analog pain scale (VAS), and the Knee Society Score (KSS).

Results

The patients had an average OKS of 21.7 pre-operatively and reached an average of 33.5 postoperatively (p = 0.0033). Pre-operative UCLA patient activity-level ratings was 3.1, compared with 4.8 postoperatively. Average VAS pre-operatively was 8 and postoperatively it decreased to 2.1 (p = 0.0033). The average KSS final score pre-operatively was 56 and postoperatively it increased to 68.3 while the functional score pre-operatively was 47.2 compared to 68.1 postoperatively (p = 0.011). As a result, patello-femoral arthroplasty is an emerging knee resurfacing technique that is an alternative to the total knee arthroplasty.

Conclusions

The early retrospective data for robotically-assisted PFA show encouraging results. Advantages of this technique include a smaller incision, faster rehabilitation, preservation of bone stock, and implantation without malalignment.

     

Relationship between thigh skinfold measurement, hand grip strength, and trunk muscle endurance: Differences between the sexes

This study was conducted to examine the relationship between thigh skinfold measurement, hand grip strength, and trunk muscle endurance and compare this relationship in men and women. The current study included 200 healthy subjects (111 women and 89 men), with a mean age of 31.58±13.78 y. Trunk muscle endurance was evaluated with the use of curl-up, horizontal side bridge, and static back endurance tests. Significant differences were found between women and men in performance of the curl-up and horizontal side bridge tests (P< .05); however, no significant difference was found between the sexes in the static back endurance test scores (P≥.05). The investigators discerned a significant negative correlation between thigh skinfold measurements and all trunk muscle endurance tests in female patients (curl-up,r=−.501; horizontal side bridge,r=−.454; static back,r=−.479;P< .05). A rather weak correlation was found in male patients (curl-up,r=−.348; horizontal side bridge,r=−.182; static back,r=−.330;P< .05). On the other hand, no significant correlation was found between hand grip strength and trunk muscle endurance test scores in female patients (P≥.05), although a significant positive correlation was found in male patients in curl-up and side bridge test results (curl-up,r=.319; horizontal side bridge,r=.307; static back,r=.123;P< .05). The results of this study suggest that women have lower endurance test scores compared with men. The investigators detected the presence of a significant negative correlation between thigh skinfold measurement and trunk muscle endurance tests in both men and women and concluded that there is a positive significant relationship between hand grip strength, curl-up, and horizontal side bridge tests. Additional studies are needed to evaluate the relationship between muscle endurance and physical characteristics as they relate to the sex of the individual.     

Protective effect of rutin on mercuric chloride-induced reproductive damage in male rats

This study investigated the effects of rutin against reproductive damage caused by toxic mercury in male rats. Thirty-five Sprague Dawley rats were used. Control group was injected with saline for 7 days. The rutin-100 group received 100 mg/kg/b.w. rutin for 7 days. Mercuric chloride (HgCl₂) group received 1.23 mg/kg/b.w. of HgCl₂ for 7 days. Mercury chloride + rutin-50 group received 50 mg/kg/b.w. rutin and HgCl₂ 1.23 mg/kg/b.w. for 7 days. HgCl₂ + rutin-100 group received 100 mg/kg/b.w. rutin and HgCl₂ 1.23 mg/kg/b.w. for 7 days. It was detected that HgCl₂ treatment increased malondialdehyde (MDA) levels, tumour necrosis factor-α (TNF-α) and cyclooxygenase-2 (COX-2) expressions, necrosis and degeneration of spermatogonium, dead and abnormal sperm percentages; tubular walls thinning; and decreased antioxidant enzyme activities and sperm motility. It was determined that rutin application reduced testicular damage caused by HgCl₂. In conclusion, rutin administration may treat HgCl₂ toxicity in testes.     

The relationship between the severity of erectile dysfunction and aortic stiffness

Aortic stiffness increases in patients with erectile dysfunction (ED) but it is not known whether aortic stiffness affects the degree of ED. In the present study, we aimed to determine whether there is any relationship between aortic stiffness and the severity of ED. Patients with ED were divided into 3 groups according to the International Index of Erectile Function (IIEF) scores. Mild ED was named as group 1, moderate ED as group 2 and severe ED as group 3. The values of fasting blood glucose (FBG), serum lipid values, total testosterone (T. tes), and free testosterone (F tes) were recorded. Aortic stiffness was determined by pulse wave velocity (PWV) and augmentation index (AIX) measurements. The mean or median values of the laboratory parameters among the groups were similar (p > .05). No statistical difference was found between the groups in terms of AIX value (p = .386). Mean PWV values were calculated as 7.26, 8.30 and 8.78 in group 1, group 2 and group 3 respectively. PWV values were significantly different between groups (p < .0001). PWV values were found to be increased with increasing severity of erectile dysfunction.     

Targeting the LRP5 Pathway Improves Bone Properties in a Mouse Model of Osteogenesis Imperfecta

The cell surface receptor low‐density lipoprotein receptor‐related protein 5 (LRP5) is a key regulator of bone mass and bone strength. Heterozygous missense mutations in LRP5 cause autosomal dominant high bone mass (HBM) in humans by reducing binding to LRP5 by endogenous inhibitors, such as sclerostin (SOST). Mice heterozygous for a knockin allele (Lrp5^p.A214V) that is orthologous to a human HBM‐causing mutation have increased bone mass and strength. Osteogenesis imperfecta (OI) is a skeletal fragility disorder predominantly caused by mutations that affect type I collagen. We tested whether the LRP5 pathway can be used to improve bone properties in animal models of OI. First, we mated Lrp5^+/p.A214V mice to Col1a2^+/p.G610C mice, which model human type IV OI. We found that Col1a2^+/p.G610C;Lrp5^+/p.A214V offspring had significantly increased bone mass and strength compared to Col1a2^+/p.G610C;Lrp5^+/+ littermates. The improved bone properties were not a result of altered mRNA expression of type I collagen or its chaperones, nor were they due to changes in mutant type I collagen secretion. Second, we treated Col1a2^+/p.G610C mice with a monoclonal antibody that inhibits sclerostin activity (Scl‐Ab). We found that antibody‐treated mice had significantly increased bone mass and strength compared to vehicle‐treated littermates. These findings indicate increasing bone formation, even without altering bone collagen composition, may benefit patients with OI. © 2014 American Society for Bone and Mineral Research.