生物力学测量系统测量软骨损伤后滑膜关节的摩擦性能

背景：骨性关节炎会导致关节摩擦因数及性能的改变,目前尚没有一种方法能够全面客观的评价及测量关节的摩擦性能。目的：应用生物力学测量系统观察不同压力条件下关节摩擦性能的变化,及软骨缺损出现时关节摩擦因数的变化。方法：将羊腕关节固定在生物力学测量系统上,以垂直关节面方向给关节施加100,200,400,800N的压力,左右5。旋转关节测出平均旋转扭矩及关节摩擦因数。然后在关节面上制作面积为16mm。的软骨缺损区,测试在100,200,400,800N压力下的平均扭矩及关节摩擦因数。结果与结论：当无软骨缺损时,羊腕关节在4种压力状态下的旋转扭矩大小分别为：0．0217,0．0317,0．0630,0．1450N·m,关节摩擦因数（u）分别为：0．0067,0．0073,0．0120和0．0145;而在软骨缺损时,4种压力状态下的旋转扭矩大小分别为：0．0270,0．0417,0．0806,0．1724N·m,关节摩擦因数（U）分别为：0．0086,0．0097,0．0137和0．0164。可见,随着压力的增加,旋转扭矩和关节摩擦因数逐渐增大（Pc0．05）,且关节软骨缺损会导致关节旋转扭矩和关节摩擦因数的增大（P〈0．05）。同时关节旋转扭矩与关节摩擦因数明显正相关。     

人膝骨性关节炎滑膜中表达的骨桥蛋白

背景：目前研究显示骨桥蛋白与骨性关节炎关节软骨退变密切相关,但骨桥蛋白与骨性关节炎滑膜病变是否相关,仍少见报道。目的：研究骨桥蛋白在原发性骨性关节炎发生与发展过程中的作用。方法：选取膝骨性关节炎患者关节滑膜标本与下肢外伤患者作对照,根据综合评分法进行分组,采用免疫组化方法检测关节滑膜中骨桥蛋白水平,比较不同程度骨性关节炎组膝关节滑膜中骨桥蛋白的差异,同时比较标本滑膜衬里层和衬里下层骨桥蛋白的水平。结果与结论：骨性关节炎组织中骨桥蛋白阳性呈黄色、棕黄色、棕褐色表达,病变程度越重,颜色表达越深。骨性关节炎组滑膜中骨桥蛋白明显高于对照组,差异有显著性意义（P〈0．05）,且随着骨性关节炎病情加重,骨桥蛋白的表达逐渐增多,呈正相关（p=0．663,P〈0．01）。但滑膜衬里层和衬里下层骨桥蛋白的水平差异无显著性意义（P〉0．05）。说明骨桥蛋白可能与骨性关节炎的发病有关。     

Autologous chondrocyte implantation: complex defects and combined procedures

The treatment of cartilage lesions is often difficult and challenging in the young, complex knee. It is not uncommon to find these lesions associated with complicating factors such as the lesions being uncontained, the presence of bony deficiency, or the involvement of multiple lesions. This chapter presents different approaches and techniques to help manage these surgical complications and outlines the importance of understanding the predisposing factors associated with chondral lesions and degradation. It addresses when and how to manage malalignment, joint instability, and inadequate meniscal function when using a cellular treatment option to treat the chondral lesion. The key to managing these complex cases is to make sure that all joint pathologies are addressed, ensuring that an environment conducive to a successful repair is created.     

Fresh osteochondral allografttransplantation for articular cartilage defects

Fresh osteochondral allografts represent an effective solution for treatment of isolated cartilage defects. The key tosuccessful allograft transplantation is cell viability, with current methods of storage up to 42 days while maintaining acceptable levels of cell viability. Ongoing research and investigations into ways of extending storage time will result in greater availability of osteochondral allografts and pave the road for use of this technique in other joints (ie, shoulder, elbow, wrist, and talus). This article describes the indications, preoperative planning, operative technique, and postoperative care for this procedure.     

T2 Values of Femoral Cartilage of the Knee Joint: Comparison between Pre-Contrast and Post-Contrast Images

Objective

To retrospectively evaluate the relationship between T2 values of pre- and post-contrast magnetic resonance (MR) images of femoral cartilage in patients with varying degrees of osteoarthritis.

Materials and Methods

A total of 19 patients underwent delayed gadolinium-enhanced MRI of cartilage. Six regions of interest for T2 value measurement were obtained from pre- and post-contrast T2-weighted, sagittal, multi-slice, multi-echo, source images in each subject. Regions with modified Noyes classification grade 2B and 3 were excluded. Comparison of T2 values between pre- and post-contrast images and T2 values among regions with the grade 0, 1 and 2A groups were statistically analyzed.

Results

Of a total of 114 regions, 79 regions showing grade 0 (n = 46), 1 (n = 18), or 2A (n = 15) were analyzed. The overall and individual T2 values of post-contrast images were significantly lower than those of pre-contrast images (overall, 35.3 ± 9.2 [mean ± SD] vs. 29.9 ± 8.2, p < 0.01; range of individual, 28.9-37.6 vs. 27.1-36.4, p < 0.01). Pearson correlation coefficients showed a strong positive correlation between pre- and post-contrast images (rho-Pearson = 0.712-0.905). T2 values of pre- and post-contrast images of the grade 0 group were significantly lower than those of the grade 1/2A group (pre T2, p = 0.003; post T2, p = 0.006).

Conclusion

T2 values of the femoral cartilage of the knee joint are significantly lower on post-contrast images than on pre-contrast images. Furthermore, these T2 values have a strong positive correlation between pre- and post-contrast images.     

盘状软骨弹跳征的实验观察及临床意义

目的通过MRI检查和关节镜直视下观察盘状软骨的弹跳征,探索弹跳征出现时半月板的运动轨迹及其临床意义。方法11例盘状软骨患者共12膝行MRI检查,在弹跳征出现前、后分别对外侧半月板的矢状位成像,其中对6膝进行了关节镜下观察和盘状软骨成形术。结果通过观察发现盘状软骨的反常运动与正常半月板的运动有明显区别。随着膝关节的屈曲,正常的半月板向关节的后方移动,而外侧盘状软骨却向关节的前方移动。膝关节由屈曲到伸直的过程中,在弹跳征出现时,盘状软骨会在瞬间出现明显的由前向后的较大距离的位移。盘状软骨成形术可以消除反常运动。结论盘状软骨的患者在半月板未损伤时,即应在关节镜下行半月板成形术,而伴有反常运动和弹跳征的患者,更应早期手术治疗。     

同种异体块状骨植骨支撑治疗跟骨骨折的疗效

目的 探讨同种异体块状骨植骨支撑治疗跟骨骨折的疗效.方法 选取2017-04至2019-12医院收治的52例跟骨距下关节面塌陷伴明显骨缺损骨折患者,根据治疗方法分为切开复位内固定(open reduction and internal fixation,ORIF)+同种异体块状骨植骨组(观察组)和ORIF+同种异体小骨...     

基于CiteSpace对创伤性骨关节炎研究热点与内容的可视化分析

背景:创伤性骨关节炎是运动医学领域多发病及常见病,国际上对其研究逐年递增,但中国对其研究现状、研究力量、研究热点与趋势的研究还比较缺乏.目的:运用Citespace可视化分析软件绘制知识图谱并结合文献探究目前关于创伤性骨关节炎领域的研究热点、研究思路、研究力量分布及其研究主要内容,以期为后续研究该领域的专家学者提供思路...