Type 2 diabetes （T2D） is associated with systemic abnormal bone remodeling and bone loss. Meanwhile, abnormal subchondral bone remodeling induces cartilage degradation, resulting in osteoarthritis （OA）. Accordingl...Type 2 diabetes （T2D） is associated with systemic abnormal bone remodeling and bone loss. Meanwhile, abnormal subchondral bone remodeling induces cartilage degradation, resulting in osteoarthritis （OA）. Accordingly, we investigated alterations in subchondral bone remodeling, microstructure and strength in knees from T2D patients and their association with cartilage degradation. Tibial plateaus were collected from knee OA patients undergoing total knee arthroplasty and divided into non-diabetic （n---70） and diabetes （n = 51） groups. Tibial plateaus were also collected from cadaver donors （n = 20） and used as controls. Subchondral bone microstructure was assessed using micro-computed tomography. Bone strength was evaluated by micro-finite-element analysis. Cartilage degradation was estimated using histology. The expression of tartrate-resistant acidic phosphatase （TRAP）, osterix, and osteocalcin were calculated using immunohistochemistry. Osteoarthritis Research Society International （OARSI） scores of lateral tibial plateau did not differ between non-diabetic and diabetes groups, while higher OARSI scores on medial side were detected in diabetes group. Lower bone volume fraction and trabecular number and higher structure model index were found on both sides in diabetes group. These microstructural alterations translated into lower elastic modulus in diabetes group. Moreover, diabetes group had a larger number of TRAP~ osteoclasts and lower number of Osterix~ osteoprogenitors and Osteocalcin~ osteoblasts. T2D knees are characterized by abnormal subchondral bone remodeling and microstructural and mechanical impairments, which were associated with exacerbated cartilage degradation. In regions with intact cartilage the underlying bone still had abnormal remodeling in diabetes group, suggesting that abnormal bone remodeling may contribute to the early pathogenesis of T2D-associated knee OA.展开更多
Objective To diagnose and evaluate soft tissue injuries in intra-articular fractures of the distal radius using arthroscopy.Methods Twenty young patients with displaced intra-articular fractures of distal radius were ...Objective To diagnose and evaluate soft tissue injuries in intra-articular fractures of the distal radius using arthroscopy.Methods Twenty young patients with displaced intra-articular fractures of distal radius were recruited in this prospective study.Three AO C2 and 17 C3 fractures were included.After arthroscopic examination fractures of distal radius were treated by external fixation with limited internal fixation or open plate fixation.Results Triangular fibrocartilage complex(TFCC)injury was found in 18 patients(90%).Most were isolated Palmer type 1D injuries(67 %).Scapho-lunate ligament injury wa s found in two patients:one partial tear(grade Ⅱ)and one complete tear(grad e Ⅲ).Follow-ups ranged from 6 to 18 months.At the last follow-up,wrist fun ction was excellent in one patient(6%),good in eight(44%)and fair in 11(50 %).Conclusion TFCC injuries are common in intra-articular fractures of the distal radius while injuries to scapho-lunate ligament are uncommon.展开更多
基金supported by National Natural Science Foundation of China(NSFC Nos.81601930 and U1613224)Natural Science Foundation of Guangxi(2016JJB140050)+1 种基金Research Grant Council of Hong Kong(HKU715213 and 17206916)Shenzhen Peacock Project
文摘Type 2 diabetes （T2D） is associated with systemic abnormal bone remodeling and bone loss. Meanwhile, abnormal subchondral bone remodeling induces cartilage degradation, resulting in osteoarthritis （OA）. Accordingly, we investigated alterations in subchondral bone remodeling, microstructure and strength in knees from T2D patients and their association with cartilage degradation. Tibial plateaus were collected from knee OA patients undergoing total knee arthroplasty and divided into non-diabetic （n---70） and diabetes （n = 51） groups. Tibial plateaus were also collected from cadaver donors （n = 20） and used as controls. Subchondral bone microstructure was assessed using micro-computed tomography. Bone strength was evaluated by micro-finite-element analysis. Cartilage degradation was estimated using histology. The expression of tartrate-resistant acidic phosphatase （TRAP）, osterix, and osteocalcin were calculated using immunohistochemistry. Osteoarthritis Research Society International （OARSI） scores of lateral tibial plateau did not differ between non-diabetic and diabetes groups, while higher OARSI scores on medial side were detected in diabetes group. Lower bone volume fraction and trabecular number and higher structure model index were found on both sides in diabetes group. These microstructural alterations translated into lower elastic modulus in diabetes group. Moreover, diabetes group had a larger number of TRAP~ osteoclasts and lower number of Osterix~ osteoprogenitors and Osteocalcin~ osteoblasts. T2D knees are characterized by abnormal subchondral bone remodeling and microstructural and mechanical impairments, which were associated with exacerbated cartilage degradation. In regions with intact cartilage the underlying bone still had abnormal remodeling in diabetes group, suggesting that abnormal bone remodeling may contribute to the early pathogenesis of T2D-associated knee OA.
文摘Objective To diagnose and evaluate soft tissue injuries in intra-articular fractures of the distal radius using arthroscopy.Methods Twenty young patients with displaced intra-articular fractures of distal radius were recruited in this prospective study.Three AO C2 and 17 C3 fractures were included.After arthroscopic examination fractures of distal radius were treated by external fixation with limited internal fixation or open plate fixation.Results Triangular fibrocartilage complex(TFCC)injury was found in 18 patients(90%).Most were isolated Palmer type 1D injuries(67 %).Scapho-lunate ligament injury wa s found in two patients:one partial tear(grade Ⅱ)and one complete tear(grad e Ⅲ).Follow-ups ranged from 6 to 18 months.At the last follow-up,wrist fun ction was excellent in one patient(6%),good in eight(44%)and fair in 11(50 %).Conclusion TFCC injuries are common in intra-articular fractures of the distal radius while injuries to scapho-lunate ligament are uncommon.
