OBJECTIVE This experimental study was aim to investigate the osteogenesis of ceramic-like xenogeneic bone (CXB) combining with bone marrow (BM). METHODS The CXB combining BM was implanted into the sacrospinalis muscle of rabbits, and CXB implanted alone was used as control. Eighteen Japanese rabbits with long ear were used. The size of CXB was 5 mm x 5 mm x 5 mm, and the implanted materials were taken out at 2, 4, 8, 12, 16 and 24 weeks after implantation. The histological and histochemical characteristics were investigated. RESULTS There existed cartilage and new bone in the groups of CXB combining BM in 2 weeks. Later, be cartilage turned out to the bone and in eight weeks the medullary cavity appeared. However, as the time went on, new bone formation increased and typical osteogenesis could be found. While in the groups of CXB alone, no formation of new bone or cartilage was found. CONCLUSION The implantation of CXB combined with BM could result in new bone formation in the way of osteoconduation, osteoinduction, and providing, osteoblasts or chondroblasts. It could be an ideal bone substitute, and its clinical use in future seemed very hopeful.
Objective To review the research progress of internal tension relieving technique in assisting anterior cruciate ligament (ACL) reconstruction with tendon grafts. MethodsThe in vivo and in vitro biomechanical tests, animal experiments, and clinical studies on the use of internal tensioning relieving technique assisted ACL reconstruction in recent years were extensively reviewed, the impact of this technology on the biomechanics, histological changes of grafts, and the clinical effectiveness were analyzed and summarized. Results The internal tensioning relieving technique based on non-absorbable high-strength sutures can reduce the risk of relaxation and rupture by enhancing the biomechanical strength of tendon grafts in vitro and in vivo, it shows good biocompatibility and support for the ligamentation of the tendon grafts and the establishment of the direct tendon-bone interface in terms of histology. This technique improves postoperative initial joint stability, range of motion, and functional scores in clinical practic, when combining with the enhanced recovery after surgery can effectively promote patients to return to pre-injury exercise level without serious complications. Conclusion The preliminary research results have confirmed the efficacy and safety of the internal tension relieving technique on assisting ACL reconstruction, then showes some degree of significance and prospect, but more research is needed to further optimize tension-relieving devices and related surgical techniques, and clarify the specific effects of this technique on graft’s structure remodeling, biomechanical function, and long-term clinical results.
ObjectiveTo summarize the regulatory effect of long non-coding RNA (lncRNA) on osteoarthritis (OA) cartilage injury.MethodsThe molecular functions and mechanisms of lncRNA were introduced and its regulatory effects on the pathological processes of OA were elaborated by referring to the relevant literature at domestic and abroad in recent years.ResultsThe pathological characteristics of OA are degeneration of articular cartilage and inflammation of synovial tissue, but its etiology and pathological mechanism have not been clarified. lncRNA is a kind of heterogeneous non-coding RNA, which plays a regulatory role in many inflammation-related diseases and exerts a wide range of biological functions. lncRNA is a regulator involved in the pathogenesis of OA, and is abnormally expressed in OA cartilage, leading to the degeneration of the extracellular matrix of cartilage.ConclusionAt present, there have been preliminary studies on the pathological effects of lncRNA in regulating OA and the biological functions of chondrocytes. However, the pathogenesis of lncRNA and its regulatory network in OA and the way in which it regulates inflammatory pathways are still unclear, and further exploration is needed.
Objective To summarize the on augmentation repair of anterior talofibular ligament (ATFL) under arthroscopy. Methods The domestic and international studies from the past decade on augmentation techniques for the ATFL. The advantages and limitations of each approach were summarized and the outcomes of these augmentation techniques when applied to ATFL repair were evaluated. Results Mechanical augmentation techniques (suture tape or internal brace technology, double anchor enhancement technology) can increase the strength after ATFL repair, but it will increase the economic burden of the patients; bioenhanced repair technology (inferior extensor retinaculum enhancement, anterior tibiofibular ligament’s distal fascicle transfer augmentation) can also increase the strength after ATFL repair, but it will damage the anatomical structure in the ankle cavity to a certain extent, and the surgery is difficult, and the operation time will prolong and also increase the incidence of perioperative complications. Regardless of the augmentation techniques used, the benefits are higher for patients with high exercise needs, and active postoperative rehabilitation is required to maximize the surgical effect. Conclusion Although augmentation repair of ATFL offers several advantages, its use—whether augmentation should be employed and, if so, which technique is preferable—requires further study across patient subgroups owing to increased costs, potential disruption of ankle anatomy, and longer operation time.
Objective To review the research progress of the location marker of rotational alignment of the distal femur. Methods The recent literature concerning the location marker of rotational alignment of the distal femur at home and abroad was extensively reviewed and analyzed. Results Femoral prosthesis malrotational alignment could lead to some patellofemoral complications, such as dislocation of the patella, snapping, wear, and patellar pain. There are many methods to determining femoral component rotational alignment in the artificial total knee arthroplasty, including transepicondylar axis line, anterior posterior axis, the posterior condyles line, flexion gap balance technology, and computer navigation technology. Correct choice of the rotational alignment of the distal femur is crucial in reducing postoperative complications and the revision rate. Suitable reference axis is chosen during total knee arthroplasty to ensure the accuracy of the rotation axis of the femoral prosthesis, but it is currently still controversial. Conclusion The rotational alignment of the distal femur is an extremely important part to affect the prognosis of total knee arthroplasty. The methods to determine the rotational alignment of the distal femur need to be further improved.
Objective To review the influencing factors of medial patellofemoral ligament (MPFL) reconstruction for patellar dislocation. Methods The literature of MPFL reconstruction for patellar dislocation at home and abroad in recent years were summarized and analyzed. Results The influencing factors such as the location of the femoral insertion point, the tension and the fixed angle of the grafts, the dysplasia of the femoral trochlear before operation, the abnormal tuberositas tibiae-trochlear groove value, the high position of the patellar, and the tilting angle of the patellar, are all the factors affecting the effectiveness of MPLF reconstruction. Conclusion During MPFL reconstruction, the surgical techniques and elimination of other factors that caused patellar instability need to be focused in order to reduce the complications and operation failure.
ObjectiveTo review the research progress of location methods and the best femoral insertion position of medial patellofemoral ligament (MPFL) reconstruction of femoral tunnel, and provide reference for surgical treatment.MethodsThe literature about femoral insertion position of the MPFL reconstruction in recent years was extensively reviewed, and the anatomical and biomechanical characteristics of MPFL, as well as the advantages and disadvantages of femoral tunnel positioning methods were summarized.ResultsThe accurate establishment of the femoral anatomical tunnel is crucial to the success of MPFL reconstruction. At present, there are mainly two kinds of methods for femoral insertion: radiographic landmark positioning method and anatomical landmark positioning method. Radiographic landmark positioning method has such advantages as small incision and simple operation, but it can not be accurately positioned for patients with severe femoral trochlear dysplasia. It is suggested to combine with the anatomical landmark positioning method. These methods have their own advantages and disadvantages, and there is no unified positioning standard. In recent years, the use of three-dimensional design software can accurately assist in the MPFL reconstruction, which has become a new trend.ConclusionFemoral tunnel positioning of the MPFL reconstruction is very important. The current positioning methods have their own advantages and disadvantages. Personalized positioning is a new trend and has not been widely used in clinic, its effectiveness needs further research and clinical practice and verification.
Objective To review recent advance in the application and research of three-dimensional digital knee model. Methods The recent original articles about three-dimensional digital knee model were extensively reviewed and analyzed. Results The digital three-dimensional knee model can simulate the knee complex anatomical structure very well. Based on this, there are some developments of new software and techniques, and good clinical results are achieved. Conclusion With the development of computer techniques and software, the knee repair and reconstruction procedure has been improved, the operation will be more simple and its accuracy will be further improved.
ObjectiveTo review the recent progress in the application of three-dimensional digital technology in knee arthroplasty. MethodsThe relevant literature at home and abroad about the three-dimensional digital technology in the applications of knee arthroplasty in recent years was extensively reviewed. ResultsThe three-dimensional digital technology can obtain arthroplasty knee morphology and biomechanics, and can estimate preoperative planning osteotomy and the sizes of prostheses, so it can guide knee arthroplasty precisely. ConclusionThree-dimensional digital technology can reduce the operation error, improve the operation precision, and improve the effectiveness in knee arthroplasty.