To investigate the significance of bone mineral changes in the pathogenic process of steroid-induced osteonecrosis in rabbits. Methods： Seventy adult female Japanese White rabbits were randomly divided into five grou...To investigate the significance of bone mineral changes in the pathogenic process of steroid-induced osteonecrosis in rabbits. Methods： Seventy adult female Japanese White rabbits were randomly divided into five groups Animals in steroid group received an intramuscular injection of methylprednisolone acetate （4 mg/kg） once a week, and killed in four different time after first treatment. Animals in control group received an intramuscular injection with the same volume of normal saline, while 150 kU penicillin was injected twice a week for preventing infection in all groups. The contents of serum calcium （Ca） and phosphorus （P） were determined and the bone mineral densities of the femoral head and neck were measured at the 2nd, 4th, 8th and 10th weeks after first treatment. Meanwhile the general condition such as weight, spirit and hair of rabbits was observed. Results： Compared with the control group, the weight of rabbits in steroid group lost since the first week, and progressively aggravated; the bone mineral density of the femoral head and neck was lowered since the 2nd and 4th week respectively （P〈0.05, P〈0.01）, and lowered more quickly in femoral neck than in femoral head. In steroid group, the bone mineral density of the femoral neck at the 10th week was significantly lower than that at the 8th week （P〈0.05） Compared with the control group, the serum levels of Ca and P in steroid group were lowered since the 2nd week （P〈0.05, P〈0.01）. In steroid group, the serum Ca level at the 10th week was lower than that at the 8th week, and the serum P level waslowered more quickly than Ca level was. Conclusion： Osteonecrosis appears in rabbits shortly after corticoids are first administered, and osteonecrosis in rabbits is chronologically associated with the onset of hypocalcaemia, hypophosphatemia and lowered bone mineral density. Steroid-induced osteonecrosis may be relevant to bone mineral loss and density lowering of the femoral head and neck.展开更多
Objective： To observe the osteoinductive activity of demineralized bone matrix （DBM） and deprotenized bone （DPB） made from human avascular necrotic femoral head. Methods： The femoral head was cut into pieces wi...Objective： To observe the osteoinductive activity of demineralized bone matrix （DBM） and deprotenized bone （DPB） made from human avascular necrotic femoral head. Methods： The femoral head was cut into pieces with the size of 3 mm×3 mm×5 mm, which were made into DBM and DPB. These two kinds of biomaterials were cocultured with human bone mesenchymal stem cells （hBMSCs）. Monolayer cells without biomaterials were cultured as control. Proliferative activity ofhBMSCs was evaluated on days 1, 3, 5, 7 and 14. The concentration of alkaline phosphatase （ALP）, osteocalcin （OC）, and Ca^2＋ were detected on days 1, 7, 14 and 21. Results： Cells cultured in DBM showed higher proliferative activity than did in DPB and monolayer cells （F= 39.773, P〈0.01）. DBM and DPB also had osteoinductive activity. The concentrations of ALP （F=93.162, P〈0.01）, OC （F=236.852, P〈0.01）, Ca^2＋ （F=80.711, P〈0.01）of DBM group were significantly higher than that of DPB and control groups. Conclusions： In vitro, DBM and DPB made from avascular necrotic femoral head have osteoinductive activity when cocultured with hBMSCs, and the former is stronger than the latter.展开更多
Objective： To evaluate the femoral head perfusion and to predict the traumatic avascular necrosis （AVN） of the femoral head by single photon emission computerized tomography and computerized tomography （SPECT/CT）...Objective： To evaluate the femoral head perfusion and to predict the traumatic avascular necrosis （AVN） of the femoral head by single photon emission computerized tomography and computerized tomography （SPECT/CT）. Methods： Totally 18 adult beagle dogs were divided randomly into three equal-sized （n=6） groups. Subsequently different degrees of ischemia model were developed by de- stroying blood vessels of the femoral head. The left hip received sham operation as normal control and the right hip underwent blood interruption. In Group A, the ligamentum teres was cut off. In Group B, the marrow cavity of the right femoral neck was destroyed while in Group C, the soft tis- sues at the base of the femoral neck were stripped in addition to the resection of the ligamentum teres and destruction of the marrow cavity. Three hours after surgery, SPECT/ CT was performed. Laser Doppler Flowmetry （LDF） measurements were also obtained at three different time points （before operation, immediately and three hours after operation） in order to assess the change process of blood supply to the femoral head. Results： SPECT/CT showed no significant difference in the radionuclide uptake between the right and left femo- ral heads in Group A （t=-0.09,P=-0.94） and Group B （t= 0.52, P=0.62）. However, in Group C, it was 261±62 for the right femoral head, only 12% of that in the left femoral head. LDF measurements indicated that the femoral head perfusion was decreased from （45.0±3.3） PU to （39.1±3.7） PU in Group A, from （44.0±2.7） PU to （34.3±2.6） PU in Group B, and from （47.3±2.1） PU to （4.96±0.6） PU in Group C immediately after operation. However, the perfusion was restored and returned to normal values three hours after operation except in Group C. Conclusion： SPECT/CT could assess the perfusion of the femoral head semiquantitatively, which might be useful in predicting the development of traumatic AVN.展开更多
This paper discussed the injury mechanism and management of a patient who had concomitant ipsilateral hip and knee dislocations and contralateral open leg fracture. A 32-year-old man presented with ipsilateral fractu...This paper discussed the injury mechanism and management of a patient who had concomitant ipsilateral hip and knee dislocations and contralateral open leg fracture. A 32-year-old man presented with ipsilateral fracturedislocations of the left hip （Pipkin＇s type IV） and knee （Moore II）joints and contralateral open fracture of the leg bones after a car accident. After emergency resuscitative measures, the hip joint was reduced and Pipkin＇s fracture was fixed using Ganz approach with lag screws; knee joint was reduced closely and tibial plateau fracture was stabilized with lateral buttress plate and a transarticular spanning fixator. The open fracture on the other leg was debrided and fixed with an external fixator. There was no insta-bility in both joints after fixation when he was examined under anesthesia. The fractures united after 3 months and the patient had no residual instability of hip and knee. There was no clinical or radiological evidence of osteonecrosis in the hip joint after 6 months. At one-year follow-up, he had satisfactory functional outcome with almost normal range of motion at both joints. Ipsilateral hip and knee dislocations are rare injuries and more caution is needed for early diagnosis. A timely appropriate intervention can provide good functional outcome to the patient in this situation.展开更多
Objective： To explore the therapeutic ef- fect of osteogenically induced adipose-derived stem cells （ADSCs） on vascular deprivation-induced osteonecrosis of the femoral head （ONFH） in rabbit model. Methods： Vas...Objective： To explore the therapeutic ef- fect of osteogenically induced adipose-derived stem cells （ADSCs） on vascular deprivation-induced osteonecrosis of the femoral head （ONFH） in rabbit model. Methods： Vascular deprivation-induced ONFH was established by intramuscular injection of methylpre- dnisolone, and vascular occlusion of the capital femoral epiphysis by electrocoagulation in adult New Zealand white rabbits. Eight weeks afLer the establishment of vascular dep- rivation-induced ONFH, animals were randomly divided into three equal groups. In Group A （control）, no therapy was given. In Group B, core decompression was performed by drilling a hole （1.2 mm in diameter） from the outer cortex 2.5 cm distal to the proximal end of the greater trochanter. In Group C, 1 x 107 osteogenically induced ADSCs were resus- pended in 0.5 ml PBS, and then injected directly into the femoral head. Femoral head specimens were obtained at postoperative 8 weeks. The bone formation and three-di- mensional microstructure of the femoral head was evaluated by micro-computed tomography scans （u-CT）. Immunohistochemical analysis was performed to detect the expression ofosteocalcin. Angiogenesis and repair of the femoral head were observed histologically. Results： In trabecular bone at the proximal femur region, the trabecular volume was higher in Group C （130.70 mm3± 4.33 mm3） than that in Groups A （101.07 mm3±7.76 mm3） and B （107.89 mm3±8.6g mm3, P〈0.01）. Bone volume was significantly increased in Group C （40.09 mm3±6.35 mm3） than in Groups A （29.65 mm3±4.61 mm3） and B （31.80 mm3± 4.01 mm3, P〈0.01）. The trabecular number was higher in Groups C （1.58±0.25） than other two groups （1.15±0.18, 1.16± 0.21, P〈0.01）. Bone mineral density showed statistically significant difference between Groups C and A or B （375.38± 23.06） mg HA/ccm, vs （313.73 ± 19.30） mg HA/ccm and （316.09± 16.45） mg HA/ccm, P〈0.01）. Histological examination indicated that there was more new bone formation in Group C than in other groups. Conclusion： Treatment with autologous osteogenically induced ADSCs transplantation results in an enhanced osteogenesis and microstructure of the vascular deprivation-induced osteonecrosis in rabbits.展开更多
文摘To investigate the significance of bone mineral changes in the pathogenic process of steroid-induced osteonecrosis in rabbits. Methods： Seventy adult female Japanese White rabbits were randomly divided into five groups Animals in steroid group received an intramuscular injection of methylprednisolone acetate （4 mg/kg） once a week, and killed in four different time after first treatment. Animals in control group received an intramuscular injection with the same volume of normal saline, while 150 kU penicillin was injected twice a week for preventing infection in all groups. The contents of serum calcium （Ca） and phosphorus （P） were determined and the bone mineral densities of the femoral head and neck were measured at the 2nd, 4th, 8th and 10th weeks after first treatment. Meanwhile the general condition such as weight, spirit and hair of rabbits was observed. Results： Compared with the control group, the weight of rabbits in steroid group lost since the first week, and progressively aggravated; the bone mineral density of the femoral head and neck was lowered since the 2nd and 4th week respectively （P〈0.05, P〈0.01）, and lowered more quickly in femoral neck than in femoral head. In steroid group, the bone mineral density of the femoral neck at the 10th week was significantly lower than that at the 8th week （P〈0.05） Compared with the control group, the serum levels of Ca and P in steroid group were lowered since the 2nd week （P〈0.05, P〈0.01）. In steroid group, the serum Ca level at the 10th week was lower than that at the 8th week, and the serum P level waslowered more quickly than Ca level was. Conclusion： Osteonecrosis appears in rabbits shortly after corticoids are first administered, and osteonecrosis in rabbits is chronologically associated with the onset of hypocalcaemia, hypophosphatemia and lowered bone mineral density. Steroid-induced osteonecrosis may be relevant to bone mineral loss and density lowering of the femoral head and neck.
文摘Objective： To observe the osteoinductive activity of demineralized bone matrix （DBM） and deprotenized bone （DPB） made from human avascular necrotic femoral head. Methods： The femoral head was cut into pieces with the size of 3 mm×3 mm×5 mm, which were made into DBM and DPB. These two kinds of biomaterials were cocultured with human bone mesenchymal stem cells （hBMSCs）. Monolayer cells without biomaterials were cultured as control. Proliferative activity ofhBMSCs was evaluated on days 1, 3, 5, 7 and 14. The concentration of alkaline phosphatase （ALP）, osteocalcin （OC）, and Ca^2＋ were detected on days 1, 7, 14 and 21. Results： Cells cultured in DBM showed higher proliferative activity than did in DPB and monolayer cells （F= 39.773, P〈0.01）. DBM and DPB also had osteoinductive activity. The concentrations of ALP （F=93.162, P〈0.01）, OC （F=236.852, P〈0.01）, Ca^2＋ （F=80.711, P〈0.01）of DBM group were significantly higher than that of DPB and control groups. Conclusions： In vitro, DBM and DPB made from avascular necrotic femoral head have osteoinductive activity when cocultured with hBMSCs, and the former is stronger than the latter.
文摘Objective： To evaluate the femoral head perfusion and to predict the traumatic avascular necrosis （AVN） of the femoral head by single photon emission computerized tomography and computerized tomography （SPECT/CT）. Methods： Totally 18 adult beagle dogs were divided randomly into three equal-sized （n=6） groups. Subsequently different degrees of ischemia model were developed by de- stroying blood vessels of the femoral head. The left hip received sham operation as normal control and the right hip underwent blood interruption. In Group A, the ligamentum teres was cut off. In Group B, the marrow cavity of the right femoral neck was destroyed while in Group C, the soft tis- sues at the base of the femoral neck were stripped in addition to the resection of the ligamentum teres and destruction of the marrow cavity. Three hours after surgery, SPECT/ CT was performed. Laser Doppler Flowmetry （LDF） measurements were also obtained at three different time points （before operation, immediately and three hours after operation） in order to assess the change process of blood supply to the femoral head. Results： SPECT/CT showed no significant difference in the radionuclide uptake between the right and left femo- ral heads in Group A （t=-0.09,P=-0.94） and Group B （t= 0.52, P=0.62）. However, in Group C, it was 261±62 for the right femoral head, only 12% of that in the left femoral head. LDF measurements indicated that the femoral head perfusion was decreased from （45.0±3.3） PU to （39.1±3.7） PU in Group A, from （44.0±2.7） PU to （34.3±2.6） PU in Group B, and from （47.3±2.1） PU to （4.96±0.6） PU in Group C immediately after operation. However, the perfusion was restored and returned to normal values three hours after operation except in Group C. Conclusion： SPECT/CT could assess the perfusion of the femoral head semiquantitatively, which might be useful in predicting the development of traumatic AVN.
文摘This paper discussed the injury mechanism and management of a patient who had concomitant ipsilateral hip and knee dislocations and contralateral open leg fracture. A 32-year-old man presented with ipsilateral fracturedislocations of the left hip （Pipkin＇s type IV） and knee （Moore II）joints and contralateral open fracture of the leg bones after a car accident. After emergency resuscitative measures, the hip joint was reduced and Pipkin＇s fracture was fixed using Ganz approach with lag screws; knee joint was reduced closely and tibial plateau fracture was stabilized with lateral buttress plate and a transarticular spanning fixator. The open fracture on the other leg was debrided and fixed with an external fixator. There was no insta-bility in both joints after fixation when he was examined under anesthesia. The fractures united after 3 months and the patient had no residual instability of hip and knee. There was no clinical or radiological evidence of osteonecrosis in the hip joint after 6 months. At one-year follow-up, he had satisfactory functional outcome with almost normal range of motion at both joints. Ipsilateral hip and knee dislocations are rare injuries and more caution is needed for early diagnosis. A timely appropriate intervention can provide good functional outcome to the patient in this situation.
基金This work is supported by a grant from the National Natural Science Foundation of China （30960390） and Doctoral Innovation Fund of Xinjiang Medical University （DC2010-12）.
文摘Objective： To explore the therapeutic ef- fect of osteogenically induced adipose-derived stem cells （ADSCs） on vascular deprivation-induced osteonecrosis of the femoral head （ONFH） in rabbit model. Methods： Vascular deprivation-induced ONFH was established by intramuscular injection of methylpre- dnisolone, and vascular occlusion of the capital femoral epiphysis by electrocoagulation in adult New Zealand white rabbits. Eight weeks afLer the establishment of vascular dep- rivation-induced ONFH, animals were randomly divided into three equal groups. In Group A （control）, no therapy was given. In Group B, core decompression was performed by drilling a hole （1.2 mm in diameter） from the outer cortex 2.5 cm distal to the proximal end of the greater trochanter. In Group C, 1 x 107 osteogenically induced ADSCs were resus- pended in 0.5 ml PBS, and then injected directly into the femoral head. Femoral head specimens were obtained at postoperative 8 weeks. The bone formation and three-di- mensional microstructure of the femoral head was evaluated by micro-computed tomography scans （u-CT）. Immunohistochemical analysis was performed to detect the expression ofosteocalcin. Angiogenesis and repair of the femoral head were observed histologically. Results： In trabecular bone at the proximal femur region, the trabecular volume was higher in Group C （130.70 mm3± 4.33 mm3） than that in Groups A （101.07 mm3±7.76 mm3） and B （107.89 mm3±8.6g mm3, P〈0.01）. Bone volume was significantly increased in Group C （40.09 mm3±6.35 mm3） than in Groups A （29.65 mm3±4.61 mm3） and B （31.80 mm3± 4.01 mm3, P〈0.01）. The trabecular number was higher in Groups C （1.58±0.25） than other two groups （1.15±0.18, 1.16± 0.21, P〈0.01）. Bone mineral density showed statistically significant difference between Groups C and A or B （375.38± 23.06） mg HA/ccm, vs （313.73 ± 19.30） mg HA/ccm and （316.09± 16.45） mg HA/ccm, P〈0.01）. Histological examination indicated that there was more new bone formation in Group C than in other groups. Conclusion： Treatment with autologous osteogenically induced ADSCs transplantation results in an enhanced osteogenesis and microstructure of the vascular deprivation-induced osteonecrosis in rabbits.
