The integrated repair of bone and cartilage boasts advantages for osteochondral restoration such as a long-term repair effect and less deterioration compared to repairing cartilage alone.Constructing multifactorial,sp...The integrated repair of bone and cartilage boasts advantages for osteochondral restoration such as a long-term repair effect and less deterioration compared to repairing cartilage alone.Constructing multifactorial,spatially oriented scaffolds to stimulate osteochondral regeneration,has immense significance.Herein,targeted drugs,namely kartogenin@polydopamine(KGN@PDA)nanoparticles for cartilage repair and miRNA@calcium phosphate(miRNA@CaP)NPs for bone regeneration,were in situ deposited on a patterned supramolecular-assembled 2-ureido-4[lH]-pyrimidinone(UPy)modified gelation hydrogel film,facilitated by the dynamic and responsive coordination and complexation of metal ions and their ligands.This hydrogel film can be rolled into a cylindrical plug,mimicking the Haversian canal structure of natural bone.The resultant hydrogel demonstrates stable mechanical properties,a self-healing ability,a high capability for reactive oxygen species capture,and controlled release of KGN and miR-26a.In vitro,KGN@PDA and miRNA@CaP promote chondrogenic and osteogenic differentiation of mesenchymal stem cells via the JNK/RUNX1 and GSK-3β/β-catenin pathways,respectively.In vivo,the osteochondral plug exhibits optimal subchondral bone and cartilage regeneration,evidenced by a significant increase in glycosaminoglycan and collagen accumulation in specific zones,along with the successful integration of neocartilage with subchondral bone.This biomaterial delivery approach represents a significant toward improved osteochondral repair.展开更多
BACKGROUND Cartilage defects are some of the most common causes of arthritis.Cartilage lesions caused by inflammation,trauma or degenerative disease normally result in osteochondral defects.Previous studies have shown...BACKGROUND Cartilage defects are some of the most common causes of arthritis.Cartilage lesions caused by inflammation,trauma or degenerative disease normally result in osteochondral defects.Previous studies have shown that decellularized extracellular matrix(ECM)derived from autologous,allogenic,or xenogeneic mesenchymal stromal cells(MSCs)can effectively restore osteochondral integrity.AIM To determine whether the decellularized ECM of antler reserve mesenchymal cells(RMCs),a xenogeneic material from antler stem cells,is superior to the currently available treatments for osteochondral defects.METHODS We isolated the RMCs from a 60-d-old sika deer antler and cultured them in vitro to 70%confluence;50 mg/mL L-ascorbic acid was then added to the medium to stimulate ECM deposition.Decellularized sheets of adipocyte-derived MSCs(aMSCs)and antlerogenic periosteal cells(another type of antler stem cells)were used as the controls.Three weeks after ascorbic acid stimulation,the ECM sheets were harvested and applied to the osteochondral defects in rat knee joints.RESULTS The defects were successfully repaired by applying the ECM-sheets.The highest quality of repair was achieved in the RMC-ECM group both in vitro(including cell attachment and proliferation),and in vivo(including the simultaneous regeneration of well-vascularized subchondral bone and avascular articular hyaline cartilage integrated with surrounding native tissues).Notably,the antler-stem-cell-derived ECM(xenogeneic)performed better than the aMSC-ECM(allogenic),while the ECM of the active antler stem cells was superior to that of the quiescent antler stem cells.CONCLUSION Decellularized xenogeneic ECM derived from the antler stem cell,particularly the active form(RMC-ECM),can achieve high quality repair/reconstruction of osteochondral defects,suggesting that selection of decellularized ECM for such repair should be focused more on bioactivity rather than kinship.展开更多
Osteochondral tissue is a highly specialized and complex tissue composed of articular cartilage and subchondral bone that are separated by a calcified cartilage interface.Multilayered or gradient scaffolds,often in co...Osteochondral tissue is a highly specialized and complex tissue composed of articular cartilage and subchondral bone that are separated by a calcified cartilage interface.Multilayered or gradient scaffolds,often in conjunction with stem cells and growth factors,have been developed to mimic the respective layers for osteochondral defect repair.In this study,we designed a hyaline cartilage-hypertrophic cartilage bilayer graft(RGD/RGDW)with chondrocytes.Previously,we demonstrated that RGD peptide-modified chondroitin sulfate cryogel(RGD group)is chondro-conductive and capable of hyaline cartilage formation.Here,we incorporated whitlockite(WH),a Mg2+-containing calcium phosphate,into RGD cryogel(RGDW group)to induce chondrocyte hypertrophy and form collagen X-rich hypertrophic cartilage.This is the first study to use WH to produce hypertrophic cartilage.Chondrocytes-laden RGDW cryogel exhibited significantly upregulated expression of hypertrophy markers in vitro and formed ectopic hypertrophic cartilage in vivo,which mineralized into calcified cartilage in bone microenvironment.Subsequently,RGD cryogel and RGDW cryogel were combined into bilayer(RGD/RGDW group)and implanted into rabbit osteochondral defect,where RGD layer supports hyaline cartilage regeneration and bioceramic-containing RGDW layer promotes calcified cartilage formation.While the RGD group(monolayer)formed hyaline-like neotissue that extends into the subchondral bone,the RGD/RGDW group(bilayer)regenerated hyaline cartilage tissue confined to its respective layer and promoted osseointegration for integrative defect repair.展开更多
Background:Osteochondral lesions of the talus(OLTs)are a significant challenge for foot and ankle specialists,which could cause pain and decrease patient function.Researchers can use the findings of this study to shap...Background:Osteochondral lesions of the talus(OLTs)are a significant challenge for foot and ankle specialists,which could cause pain and decrease patient function.Researchers can use the findings of this study to shape future directions for research by exploring global trends and hotspots in OLT.Methods:Web of Science Core Collection was used to retrieve literature related to OLT between 2004 and 2021.This report covers the current state of OLTs,such as publications,journals,trends,hotspots,and the performances of relevant countries,institutions and authors.The co-citation analysis,the coauthorship analysis,the cooccurrence analysis,and the bibliographic coupling analysis were conducted with the Bibliometrix R package,VOSviewer v1.6.10.0,and CiteSpace 5.8.R3.Results:During an 18-year review,717 articles and 76 review articles on OLT published from 2004 to 2021 were reviewed.The USA has made the largest contribution to the OLT-related literature,and a significant contribution has been made by Kennedy JG(48/6.05%)and van Dijk CN(30/3.78%).In terms of total link strength,Foot&Ankle International was the leading journal.Analysis showed that the global research hotspots of OLTs focused on the pathogenesis,diagnosis,clinical research,and surgical treatment of OLT.It would be significant to pay close attention to future research on osteochondral autograft transplantation and management,surgery,multidisciplinary integration and mechanisms of OLT,and its related diseases.Conclusions:The study provides information about the current status and hotspots of research in the domain of OLT over the past 18 years that will assist researchers in identifying potential perspectives on hot topics and research frontiers.展开更多
Sub-articular,post-traumatic necrosis Occurs only on convex surfaees of bone Medial condyle of femur Capitellum Proximal surface of talus Head of 1st metatarsal Most patients are athletic Direct blow is more common ca...Sub-articular,post-traumatic necrosis Occurs only on convex surfaees of bone Medial condyle of femur Capitellum Proximal surface of talus Head of 1st metatarsal Most patients are athletic Direct blow is more common cause than a rotational injury 医学词汇注释与简要讲解Medial condyle内侧髁Capitellum肱骨小头胫骨近端关节面 metatarsal展开更多
We report a unique case of lumbar disc herniation, in particular, with end-plate and surrounded by extensive ossification, mimicking a tumor with calcification. A 69-year-old female suffered from right buttock and leg...We report a unique case of lumbar disc herniation, in particular, with end-plate and surrounded by extensive ossification, mimicking a tumor with calcification. A 69-year-old female suffered from right buttock and leg pain. Computed tomography (CT) showed an intracanalar mass with calcification or ossification, which most likely originated from the vertebral body at the L1/2 level epidural space. On a T1-weighted gadolinium magnetic resonance image, the capsule of the mass was enhanced and not only the content of the mass but also that of the L2 vertebral body were partially and slightly enhanced. The final pathological diagnosis was disc herniation with end-plate fracture and secondary ossification. A combination of these pathological conditions as accompanied by both end-plate fractures and extensive secondary ossifications has not been previously reported. This rare pathological condition needs to be recognized as a differential diagnosis.展开更多
Osteochondritis dissecans(OCD)is a disorder of articular cartilage and subchondral bone.In the elbow,an OCD is localized most commonly at the humeral capitellum.Teenagers engaged in sports that involve repetitive stre...Osteochondritis dissecans(OCD)is a disorder of articular cartilage and subchondral bone.In the elbow,an OCD is localized most commonly at the humeral capitellum.Teenagers engaged in sports that involve repetitive stress on the elbow are at risk.A high index of suspicion is warranted to prevent delay in the diagnosis.Plain radiographs may disclose the lesion but computed tomography and magnetic resonance imaging are more accurate in the detection of OCD.To determine the best treatment option it is important to differentiate between stable and unstable OCD lesions.Stable lesions can be initially treated nonoperatively with elbow rest or activity modification and physical therapy.Unstable lesions and stable lesions not responding to conservative therapy require a surgical approach.Arthroscopic debridement and microfracturing has become the standard initial procedure for treatment of capitellar OCD.Numerous other surgical options have been reported,including internal fixation of large fragments and osteochondral autograft transfer.The aim of this article is to provide a current concepts review of the etiology,clinical presentation,diagnosis,treatment,and outcomes of elbow OCD.展开更多
We report a case of abnormal meniscal-like anterior cruciate ligament (ACL), inserting at the 9 o’clock position just beside the cartilage of the lateral femoral condyle, in a stable knee associated with osteochondri...We report a case of abnormal meniscal-like anterior cruciate ligament (ACL), inserting at the 9 o’clock position just beside the cartilage of the lateral femoral condyle, in a stable knee associated with osteochondritis dissecans (OCD) of the medial femoral condyle.展开更多
BACKGROUND Defect treatment with tendon autograft in osteochondral lesions has been published in the literature with an experimental study in dogs.To demonstrate that it is possible to treat knee osteochondral lesions...BACKGROUND Defect treatment with tendon autograft in osteochondral lesions has been published in the literature with an experimental study in dogs.To demonstrate that it is possible to treat knee osteochondral lesions with the technique of autologous tendon transplantation.AIM To evaluate the clinical and radiological results of patients with knee osteochondral lesions who were treated with autologous tendon transplantation.METHODS Twenty patients(22 knees)with osteochondritis dissecans(OCD)lesions involving the knee were treated with autologous tendon transplantation between 2005-2018.All lesions were International Cartilage Repair Society grade IV.All patients were evaluated clinically at final follow-up with knee injury and osteoarthritis outcome score(KOOS);and radiologically with magnetic resonance observation and cartilage repair tissue(MOCART)and Kellgren-Lawrence(KL)classification.RESULTS A total of 20 patients(22 knees)with a mean age of 25.5±6.8 years were included.The average defect size was 4.2±2.1 cm^(2),and the average defect depth was 0.9±0.4 cm.Total KOOS score was preoperatively 29.4±5.5 and was later found to be 81.5±5.9 after an average of 68.7±37.7 mo follow-up.The mean MOCART score was 56.2±10.7.Preoperatively,all of the patients had KL grades of 0-1;during the follow-up period,80% of the patients showed no radiological progress of osteoarthritis.Patients with less than 4 cm^(2) lesion had statistically significantly better overall KOOS than patients whose more than 4 cm^(2) lesion,particularly in sport and quality of life subscales.CONCLUSION The autologous tendon transplantation is a single-step,safe,simple,cost-effective method for the treatment of knee OCD with satisfactory clinical and radiological outcomes,particularly in patients with less than 4 cm^(2) lesion.展开更多
Based on full scale model of 1-beam and end-plate welding assembly with medium plate, welding temperature field and residual stress were simulated, infrared thermometers were employed to measure the real-time temperat...Based on full scale model of 1-beam and end-plate welding assembly with medium plate, welding temperature field and residual stress were simulated, infrared thermometers were employed to measure the real-time temperature Jbr verification purposes. Results show that the measured thermal cycle curves match well with the simulation result. Simulation results of welding residual stress indicate that the values of longitudinal and transverse stress on the upper surface of the plate are higher than the normal stress; higher tensile stresses exist at the end of the web weld toes and in the central area of the flange weld toes. The dangerous zones are located at the central areas of weld toes of the flange welds and near weld toes of the web welds.展开更多
BACKGROUND Osteochondritis dissecans(OCD)is a rare disease of unclear cause characterized by subchondral bone damage and overlying cartilage defects.The current report presents the results of subchondral bone as a nov...BACKGROUND Osteochondritis dissecans(OCD)is a rare disease of unclear cause characterized by subchondral bone damage and overlying cartilage defects.The current report presents the results of subchondral bone as a novel target for implantation of peripheral blood stem cells(PBSCs)in the treatment of OCD.CASE SUMMARY A 16-year-old patient diagnosed with OCD underwent subchondral bone implantation of PBSCs.Four months later,the patient's visual analog scale scores,Western Ontario and McMaster University osteoarthritis index,and whole-organ magnetic resonance imaging score improved significantly,and regeneration of cartilage and subchondral bone was observed on magnetic resonance imaging.CONCLUSION This is the first case of OCD treated with subchondral bone as an implantation target of PBSCs,which highlights the importance of subchondral bone for cartilage repair.This treatment could be a potential option for articular cartilage and subchondral bone recovery in OCD.展开更多
This study involves the development of an analytical model for understanding the behavior of the extended, stiffened end-plate moment connections with eight high strength bolts. Modeling of the connection as an assemb...This study involves the development of an analytical model for understanding the behavior of the extended, stiffened end-plate moment connections with eight high strength bolts. Modeling of the connection as an assemblage of finite elements (FE) used for load deformation analysis, with material, and contact nonlinearities are developed. Results from the FE mathematical model are verified with results from the ANSYS computer program as well as with the test results. Sensitivity and feasibility studies are carried out. Significant geometry and force related variables are introduced;and by varying the geometric variables of the connections within a practical range, a matrix of test cases is obtained. Maximum end-plate separation, maximum bending stresses in the end-plate, and the forces from the connection bolts for these test cases are obtained. From the FE analysis, a database is produced to collect results for the artificial neural network analysis. Finally, salient features of the optimized Artificial Neural Network (ANN) via Genetic Algorithm (GA) analysis are introduced and implemented with the aim of predicting the overall behavior of the connection.展开更多
目的探讨运动员距骨骨软骨损伤的临床特点及对齐软骨下骨自体骨软骨移植治疗的临床效果。方法回顾性分析2019年6月至2022年6月在宁波市第六医院入院被诊断为距骨骨软骨损伤并接受对齐软骨下骨的自体骨软骨移植手术治疗的23例患者的临床...目的探讨运动员距骨骨软骨损伤的临床特点及对齐软骨下骨自体骨软骨移植治疗的临床效果。方法回顾性分析2019年6月至2022年6月在宁波市第六医院入院被诊断为距骨骨软骨损伤并接受对齐软骨下骨的自体骨软骨移植手术治疗的23例患者的临床资料,比较本组病例手术前后的视觉模拟评分法(visual analogue scale,VAS)评分、美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)后足评分和健康调查简表(the MOS item short from health survey,SF-36)评分,并对距骨骨软骨损伤的临床特点进行分析。结果本组研究人群均成功行对齐软骨下骨的自体骨软骨移植术,平均随访时间为(39.2±8.4)个月,软骨损伤面积为(1.29±0.24)cm²。根据距骨软骨的分区,1区为3例,3区为1例,4区为17例,6区为2例。与术前比较,术后的VAS评分、AOFAS评分、SF-36评分和踝关节活动度均显著改善(P<0.01)。结论对齐软骨下骨的自体骨软骨移植手术可以帮助距骨骨软骨损伤运动员恢复到伤前竞技水平。二次关节镜检查提示对齐软骨下骨的自体软骨移植后软骨形态及弹性与自体距骨软骨一致。展开更多
目的探讨壮筋养血汤对Hepple分型Ⅰ、Ⅱ型距骨骨软骨损伤(osteochondral lesion of the talus,OLT)的临床疗效。方法选取2021年2月至2022年12月在杭州市萧山区中医院就诊的62例OLT患者为研究对象,根据随机数字表法将患者分为观察组和对...目的探讨壮筋养血汤对Hepple分型Ⅰ、Ⅱ型距骨骨软骨损伤(osteochondral lesion of the talus,OLT)的临床疗效。方法选取2021年2月至2022年12月在杭州市萧山区中医院就诊的62例OLT患者为研究对象,根据随机数字表法将患者分为观察组和对照组,每组各31例。对照组采用常规西药治疗,观察组在对照组基础上联合壮筋养血汤治疗。比较两组患者治疗前后的血清基质金属蛋白酶13(matrix metalloproteinase 13,MMP-13)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、踝关节视觉模拟评分法(visual analogue scale,VAS)评分、美国足踝外科学会(American Orthopedic Foot and Ankle Society,AOFAS)踝-后足功能评分、中医证候积分及软骨修复组织磁共振观察(magnetic resonance observation of cartilage repair tissue,MOCART)评分。结果治疗后5周、3个月,两组患者的MMP-13、TNF-α、VAS评分、中医证候积分均显著低于本组治疗前,AOFAS踝-后足功能评分、MOCART评分均显著高于本组治疗前(P<0.05);观察组患者的MMP-13、TNF-α、中医证候积分均显著低于对照组,MOCART评分显著高于对照组(P<0.05)。治疗后5周,观察组患者的VAS评分显著低于对照组,AOFAS踝-后足功能评分显著高于对照组(P<0.05)。结论壮筋养血汤治疗Hepple分型Ⅰ、Ⅱ型OLT的近期疗效良好,其具有抗炎镇痛、改善关节功能和促进软骨修复的作用。展开更多
基金the Natural Science Foundation of China(Grant Nos.82072413,82101649)National Key Research and Development Program of China(Grant Nos.2021YFE0105400).
文摘The integrated repair of bone and cartilage boasts advantages for osteochondral restoration such as a long-term repair effect and less deterioration compared to repairing cartilage alone.Constructing multifactorial,spatially oriented scaffolds to stimulate osteochondral regeneration,has immense significance.Herein,targeted drugs,namely kartogenin@polydopamine(KGN@PDA)nanoparticles for cartilage repair and miRNA@calcium phosphate(miRNA@CaP)NPs for bone regeneration,were in situ deposited on a patterned supramolecular-assembled 2-ureido-4[lH]-pyrimidinone(UPy)modified gelation hydrogel film,facilitated by the dynamic and responsive coordination and complexation of metal ions and their ligands.This hydrogel film can be rolled into a cylindrical plug,mimicking the Haversian canal structure of natural bone.The resultant hydrogel demonstrates stable mechanical properties,a self-healing ability,a high capability for reactive oxygen species capture,and controlled release of KGN and miR-26a.In vitro,KGN@PDA and miRNA@CaP promote chondrogenic and osteogenic differentiation of mesenchymal stem cells via the JNK/RUNX1 and GSK-3β/β-catenin pathways,respectively.In vivo,the osteochondral plug exhibits optimal subchondral bone and cartilage regeneration,evidenced by a significant increase in glycosaminoglycan and collagen accumulation in specific zones,along with the successful integration of neocartilage with subchondral bone.This biomaterial delivery approach represents a significant toward improved osteochondral repair.
基金National Natural Science Foundation of China,No.U20A20403This study was conducted in accordance with the Animal Ethics Committee of the Institute of Antler Science and Product Technology,Changchun Sci-Tech University(AEC No:CKARI202309).
文摘BACKGROUND Cartilage defects are some of the most common causes of arthritis.Cartilage lesions caused by inflammation,trauma or degenerative disease normally result in osteochondral defects.Previous studies have shown that decellularized extracellular matrix(ECM)derived from autologous,allogenic,or xenogeneic mesenchymal stromal cells(MSCs)can effectively restore osteochondral integrity.AIM To determine whether the decellularized ECM of antler reserve mesenchymal cells(RMCs),a xenogeneic material from antler stem cells,is superior to the currently available treatments for osteochondral defects.METHODS We isolated the RMCs from a 60-d-old sika deer antler and cultured them in vitro to 70%confluence;50 mg/mL L-ascorbic acid was then added to the medium to stimulate ECM deposition.Decellularized sheets of adipocyte-derived MSCs(aMSCs)and antlerogenic periosteal cells(another type of antler stem cells)were used as the controls.Three weeks after ascorbic acid stimulation,the ECM sheets were harvested and applied to the osteochondral defects in rat knee joints.RESULTS The defects were successfully repaired by applying the ECM-sheets.The highest quality of repair was achieved in the RMC-ECM group both in vitro(including cell attachment and proliferation),and in vivo(including the simultaneous regeneration of well-vascularized subchondral bone and avascular articular hyaline cartilage integrated with surrounding native tissues).Notably,the antler-stem-cell-derived ECM(xenogeneic)performed better than the aMSC-ECM(allogenic),while the ECM of the active antler stem cells was superior to that of the quiescent antler stem cells.CONCLUSION Decellularized xenogeneic ECM derived from the antler stem cell,particularly the active form(RMC-ECM),can achieve high quality repair/reconstruction of osteochondral defects,suggesting that selection of decellularized ECM for such repair should be focused more on bioactivity rather than kinship.
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Korean government(NRF-2021K1A3A1A57086407,NRF-2021R1A2C2008821,NRF-2022R1I1A1A01071991)Arun Kumar Rajendran was supported by the National Research Foundation of Korea(NRF)grant Brain Pool program funded by the Ministry of Science and ICT through the National Research Foundation of Korea(2020H1D3A1A04081286)The Institute of Engineering Research at Seoul National University provided research facilities,and additional support came from the SNU Engineering-Medicine Collaboration grant.
文摘Osteochondral tissue is a highly specialized and complex tissue composed of articular cartilage and subchondral bone that are separated by a calcified cartilage interface.Multilayered or gradient scaffolds,often in conjunction with stem cells and growth factors,have been developed to mimic the respective layers for osteochondral defect repair.In this study,we designed a hyaline cartilage-hypertrophic cartilage bilayer graft(RGD/RGDW)with chondrocytes.Previously,we demonstrated that RGD peptide-modified chondroitin sulfate cryogel(RGD group)is chondro-conductive and capable of hyaline cartilage formation.Here,we incorporated whitlockite(WH),a Mg2+-containing calcium phosphate,into RGD cryogel(RGDW group)to induce chondrocyte hypertrophy and form collagen X-rich hypertrophic cartilage.This is the first study to use WH to produce hypertrophic cartilage.Chondrocytes-laden RGDW cryogel exhibited significantly upregulated expression of hypertrophy markers in vitro and formed ectopic hypertrophic cartilage in vivo,which mineralized into calcified cartilage in bone microenvironment.Subsequently,RGD cryogel and RGDW cryogel were combined into bilayer(RGD/RGDW group)and implanted into rabbit osteochondral defect,where RGD layer supports hyaline cartilage regeneration and bioceramic-containing RGDW layer promotes calcified cartilage formation.While the RGD group(monolayer)formed hyaline-like neotissue that extends into the subchondral bone,the RGD/RGDW group(bilayer)regenerated hyaline cartilage tissue confined to its respective layer and promoted osseointegration for integrative defect repair.
文摘Background:Osteochondral lesions of the talus(OLTs)are a significant challenge for foot and ankle specialists,which could cause pain and decrease patient function.Researchers can use the findings of this study to shape future directions for research by exploring global trends and hotspots in OLT.Methods:Web of Science Core Collection was used to retrieve literature related to OLT between 2004 and 2021.This report covers the current state of OLTs,such as publications,journals,trends,hotspots,and the performances of relevant countries,institutions and authors.The co-citation analysis,the coauthorship analysis,the cooccurrence analysis,and the bibliographic coupling analysis were conducted with the Bibliometrix R package,VOSviewer v1.6.10.0,and CiteSpace 5.8.R3.Results:During an 18-year review,717 articles and 76 review articles on OLT published from 2004 to 2021 were reviewed.The USA has made the largest contribution to the OLT-related literature,and a significant contribution has been made by Kennedy JG(48/6.05%)and van Dijk CN(30/3.78%).In terms of total link strength,Foot&Ankle International was the leading journal.Analysis showed that the global research hotspots of OLTs focused on the pathogenesis,diagnosis,clinical research,and surgical treatment of OLT.It would be significant to pay close attention to future research on osteochondral autograft transplantation and management,surgery,multidisciplinary integration and mechanisms of OLT,and its related diseases.Conclusions:The study provides information about the current status and hotspots of research in the domain of OLT over the past 18 years that will assist researchers in identifying potential perspectives on hot topics and research frontiers.
文摘Sub-articular,post-traumatic necrosis Occurs only on convex surfaees of bone Medial condyle of femur Capitellum Proximal surface of talus Head of 1st metatarsal Most patients are athletic Direct blow is more common cause than a rotational injury 医学词汇注释与简要讲解Medial condyle内侧髁Capitellum肱骨小头胫骨近端关节面 metatarsal
文摘We report a unique case of lumbar disc herniation, in particular, with end-plate and surrounded by extensive ossification, mimicking a tumor with calcification. A 69-year-old female suffered from right buttock and leg pain. Computed tomography (CT) showed an intracanalar mass with calcification or ossification, which most likely originated from the vertebral body at the L1/2 level epidural space. On a T1-weighted gadolinium magnetic resonance image, the capsule of the mass was enhanced and not only the content of the mass but also that of the L2 vertebral body were partially and slightly enhanced. The final pathological diagnosis was disc herniation with end-plate fracture and secondary ossification. A combination of these pathological conditions as accompanied by both end-plate fractures and extensive secondary ossifications has not been previously reported. This rare pathological condition needs to be recognized as a differential diagnosis.
文摘Osteochondritis dissecans(OCD)is a disorder of articular cartilage and subchondral bone.In the elbow,an OCD is localized most commonly at the humeral capitellum.Teenagers engaged in sports that involve repetitive stress on the elbow are at risk.A high index of suspicion is warranted to prevent delay in the diagnosis.Plain radiographs may disclose the lesion but computed tomography and magnetic resonance imaging are more accurate in the detection of OCD.To determine the best treatment option it is important to differentiate between stable and unstable OCD lesions.Stable lesions can be initially treated nonoperatively with elbow rest or activity modification and physical therapy.Unstable lesions and stable lesions not responding to conservative therapy require a surgical approach.Arthroscopic debridement and microfracturing has become the standard initial procedure for treatment of capitellar OCD.Numerous other surgical options have been reported,including internal fixation of large fragments and osteochondral autograft transfer.The aim of this article is to provide a current concepts review of the etiology,clinical presentation,diagnosis,treatment,and outcomes of elbow OCD.
文摘We report a case of abnormal meniscal-like anterior cruciate ligament (ACL), inserting at the 9 o’clock position just beside the cartilage of the lateral femoral condyle, in a stable knee associated with osteochondritis dissecans (OCD) of the medial femoral condyle.
文摘BACKGROUND Defect treatment with tendon autograft in osteochondral lesions has been published in the literature with an experimental study in dogs.To demonstrate that it is possible to treat knee osteochondral lesions with the technique of autologous tendon transplantation.AIM To evaluate the clinical and radiological results of patients with knee osteochondral lesions who were treated with autologous tendon transplantation.METHODS Twenty patients(22 knees)with osteochondritis dissecans(OCD)lesions involving the knee were treated with autologous tendon transplantation between 2005-2018.All lesions were International Cartilage Repair Society grade IV.All patients were evaluated clinically at final follow-up with knee injury and osteoarthritis outcome score(KOOS);and radiologically with magnetic resonance observation and cartilage repair tissue(MOCART)and Kellgren-Lawrence(KL)classification.RESULTS A total of 20 patients(22 knees)with a mean age of 25.5±6.8 years were included.The average defect size was 4.2±2.1 cm^(2),and the average defect depth was 0.9±0.4 cm.Total KOOS score was preoperatively 29.4±5.5 and was later found to be 81.5±5.9 after an average of 68.7±37.7 mo follow-up.The mean MOCART score was 56.2±10.7.Preoperatively,all of the patients had KL grades of 0-1;during the follow-up period,80% of the patients showed no radiological progress of osteoarthritis.Patients with less than 4 cm^(2) lesion had statistically significantly better overall KOOS than patients whose more than 4 cm^(2) lesion,particularly in sport and quality of life subscales.CONCLUSION The autologous tendon transplantation is a single-step,safe,simple,cost-effective method for the treatment of knee OCD with satisfactory clinical and radiological outcomes,particularly in patients with less than 4 cm^(2) lesion.
基金This research was supported by the National Natural Science Foundation of China （51171093）.
文摘Based on full scale model of 1-beam and end-plate welding assembly with medium plate, welding temperature field and residual stress were simulated, infrared thermometers were employed to measure the real-time temperature Jbr verification purposes. Results show that the measured thermal cycle curves match well with the simulation result. Simulation results of welding residual stress indicate that the values of longitudinal and transverse stress on the upper surface of the plate are higher than the normal stress; higher tensile stresses exist at the end of the web weld toes and in the central area of the flange weld toes. The dangerous zones are located at the central areas of weld toes of the flange welds and near weld toes of the web welds.
文摘BACKGROUND Osteochondritis dissecans(OCD)is a rare disease of unclear cause characterized by subchondral bone damage and overlying cartilage defects.The current report presents the results of subchondral bone as a novel target for implantation of peripheral blood stem cells(PBSCs)in the treatment of OCD.CASE SUMMARY A 16-year-old patient diagnosed with OCD underwent subchondral bone implantation of PBSCs.Four months later,the patient's visual analog scale scores,Western Ontario and McMaster University osteoarthritis index,and whole-organ magnetic resonance imaging score improved significantly,and regeneration of cartilage and subchondral bone was observed on magnetic resonance imaging.CONCLUSION This is the first case of OCD treated with subchondral bone as an implantation target of PBSCs,which highlights the importance of subchondral bone for cartilage repair.This treatment could be a potential option for articular cartilage and subchondral bone recovery in OCD.
文摘This study involves the development of an analytical model for understanding the behavior of the extended, stiffened end-plate moment connections with eight high strength bolts. Modeling of the connection as an assemblage of finite elements (FE) used for load deformation analysis, with material, and contact nonlinearities are developed. Results from the FE mathematical model are verified with results from the ANSYS computer program as well as with the test results. Sensitivity and feasibility studies are carried out. Significant geometry and force related variables are introduced;and by varying the geometric variables of the connections within a practical range, a matrix of test cases is obtained. Maximum end-plate separation, maximum bending stresses in the end-plate, and the forces from the connection bolts for these test cases are obtained. From the FE analysis, a database is produced to collect results for the artificial neural network analysis. Finally, salient features of the optimized Artificial Neural Network (ANN) via Genetic Algorithm (GA) analysis are introduced and implemented with the aim of predicting the overall behavior of the connection.
文摘目的探讨运动员距骨骨软骨损伤的临床特点及对齐软骨下骨自体骨软骨移植治疗的临床效果。方法回顾性分析2019年6月至2022年6月在宁波市第六医院入院被诊断为距骨骨软骨损伤并接受对齐软骨下骨的自体骨软骨移植手术治疗的23例患者的临床资料,比较本组病例手术前后的视觉模拟评分法(visual analogue scale,VAS)评分、美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)后足评分和健康调查简表(the MOS item short from health survey,SF-36)评分,并对距骨骨软骨损伤的临床特点进行分析。结果本组研究人群均成功行对齐软骨下骨的自体骨软骨移植术,平均随访时间为(39.2±8.4)个月,软骨损伤面积为(1.29±0.24)cm²。根据距骨软骨的分区,1区为3例,3区为1例,4区为17例,6区为2例。与术前比较,术后的VAS评分、AOFAS评分、SF-36评分和踝关节活动度均显著改善(P<0.01)。结论对齐软骨下骨的自体骨软骨移植手术可以帮助距骨骨软骨损伤运动员恢复到伤前竞技水平。二次关节镜检查提示对齐软骨下骨的自体软骨移植后软骨形态及弹性与自体距骨软骨一致。
