The objective of the present study was to investigate our novel methods for the repair of massive cartilage defects by joint distraction and motion using an external fixator. In this study, we used a rabbit model of m...The objective of the present study was to investigate our novel methods for the repair of massive cartilage defects by joint distraction and motion using an external fixator. In this study, we used a rabbit model of massive articular cartilage defect in order to evaluate the effectiveness of using joint distraction and motion with a ring-type external fixator. This external fixator has a hinged joint with a center of rotation along the femoral transepicondylar axis, which allows the knee joint to freely flex and extend. Mesenchymal cells from bone marrow, induced by spongialization, were differentiated into mature chondrocytes and formed hyaline-like cartilage as a result of joint distraction and movement. The transplantation of autologous cells expanded from bone-marrow-derived mesenchymal cells, concentrated autologous bone marrow aspirate, and concentrated autologous peripheral blood cells were all effective in promoting cartilage repair. The quality of the cartilage after long-term joint distraction for 6 months was inferior to that after 12 weeks. In general, weight bearing on the regenerated cartilage promoted cartilage repair, although this effect differed based on when gradual weight bearing was begun. Specifically, gradual weight bearing beginning at 9 weeks produced superior results to that beginning at 6 weeks. Our methods provide an optimal environment for cartilage regeneration.展开更多
This paper studies the seismic performance of FRP-strengthened RC interior non-seismically detailed beam-wide columns and beam-wall joints after limited seismic damage.Four eccentric and concentric beam-wide column jo...This paper studies the seismic performance of FRP-strengthened RC interior non-seismically detailed beam-wide columns and beam-wall joints after limited seismic damage.Four eccentric and concentric beam-wide column joints and two beam-wall joints,initially damaged in a previous study,were repaired and tested under constant axial loads(0.1fc′Ag and 0.35fc′Ag) and lateral cyclic loading.The rapid repair technique developed,aimed to restore the original strength and to provide minimum drift capacity.The repair schemes were characterized by the use of:(a) epoxy injections and polymer modified cementitious mortar to seal the cracks and replace spalled concrete;and(b) glass(GFRP) and carbon(CFRP) sheets to enhance the joint performance.The FRP sheets were effectively prevented against possible debonding through the use of fiber anchors.Comparison between responses of specimens before and after repair clearly indicated reasonable restoration in strength,drift capacity,stiffness and cumulative energy dissipation capacity.All specimens failed with delamination of FRP sheets at beam-column joint interfaces.The rapid repair technique developed in this study is recommended for mass upgrading or repair of earthquake damaged beam-column joints.展开更多
Numerical and experimental study was conducted to investigate the failure mode and strength performance of stiffened composite panel repaired by bolted joints under compressive load, and the results were then compared...Numerical and experimental study was conducted to investigate the failure mode and strength performance of stiffened composite panel repaired by bolted joints under compressive load, and the results were then compared with those from virgin stiffened composite panel without any damage. A finite element analysis model was established for repaired and virgin stiffened composite panels under compressive load, the 3D Hashin criteria was applied to identify the composite structure failure, and the secondary stress criteria was adopted to identify the adhesive failure between the base laminate and the stiffener. The failure modes of repaired stiffened composite panels were stiffened composite panels breaking off along the bolt joints. The experimental results were consistent with the finite element analysis results, indicating the reliability of the finite element analysis model.展开更多
Background: Acute dislocation of the thumb carpometacarpal (CMC) joint is a rare and challenging injury, and its treatment remains controversial. The purpose of the study was to evaluate the clinical outcome after sur...Background: Acute dislocation of the thumb carpometacarpal (CMC) joint is a rare and challenging injury, and its treatment remains controversial. The purpose of the study was to evaluate the clinical outcome after surgical repair of the dorsal capsulo-ligamentous complex. Materials and methods: Eight patients with a mean age of 39.8 years (range, 23 - 56 years) treated for the thumb CMC joint were treated in our hospital between 2008 and 2018. The ruptured dorsal capsulo-ligamentous complex was repaired using suture anchors in all patients, and the joint was immobilized with a Kirschner wire pinning and splint for 3 weeks. The clinical outcome was assessed by measuring the range of motion of the thumb CMC joint and the Japanese Society for Surgery of the Hand version of the Quick Disability of the Arm, Shoulder, and Hand (Q-DASH-JSSH) score. Results: The mean radial abduction of the thumb CMC joint was 66°, and the volar abduction was 63°. The mean Q-DASH-JSSH score was 4.8 (range, 0 - 15.6). There were no cases of infection, nerve disturbance, or osteoarthritis. Anatomical reduction was observed in seven patients at the final follow-up and in a rugby football player at 6 months of follow-up;however, subluxation of the thumb CMC joint at 12 months of follow-up due to reinjury was observed. Conclusion: Surgical repair of the dorsal capsulo-ligamentous complex with suture anchors is a reliable and simple treatment for acute unstable dislocation of the thumb CMC joint.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
文摘The objective of the present study was to investigate our novel methods for the repair of massive cartilage defects by joint distraction and motion using an external fixator. In this study, we used a rabbit model of massive articular cartilage defect in order to evaluate the effectiveness of using joint distraction and motion with a ring-type external fixator. This external fixator has a hinged joint with a center of rotation along the femoral transepicondylar axis, which allows the knee joint to freely flex and extend. Mesenchymal cells from bone marrow, induced by spongialization, were differentiated into mature chondrocytes and formed hyaline-like cartilage as a result of joint distraction and movement. The transplantation of autologous cells expanded from bone-marrow-derived mesenchymal cells, concentrated autologous bone marrow aspirate, and concentrated autologous peripheral blood cells were all effective in promoting cartilage repair. The quality of the cartilage after long-term joint distraction for 6 months was inferior to that after 12 weeks. In general, weight bearing on the regenerated cartilage promoted cartilage repair, although this effect differed based on when gradual weight bearing was begun. Specifically, gradual weight bearing beginning at 9 weeks produced superior results to that beginning at 6 weeks. Our methods provide an optimal environment for cartilage regeneration.
文摘This paper studies the seismic performance of FRP-strengthened RC interior non-seismically detailed beam-wide columns and beam-wall joints after limited seismic damage.Four eccentric and concentric beam-wide column joints and two beam-wall joints,initially damaged in a previous study,were repaired and tested under constant axial loads(0.1fc′Ag and 0.35fc′Ag) and lateral cyclic loading.The rapid repair technique developed,aimed to restore the original strength and to provide minimum drift capacity.The repair schemes were characterized by the use of:(a) epoxy injections and polymer modified cementitious mortar to seal the cracks and replace spalled concrete;and(b) glass(GFRP) and carbon(CFRP) sheets to enhance the joint performance.The FRP sheets were effectively prevented against possible debonding through the use of fiber anchors.Comparison between responses of specimens before and after repair clearly indicated reasonable restoration in strength,drift capacity,stiffness and cumulative energy dissipation capacity.All specimens failed with delamination of FRP sheets at beam-column joint interfaces.The rapid repair technique developed in this study is recommended for mass upgrading or repair of earthquake damaged beam-column joints.
文摘Numerical and experimental study was conducted to investigate the failure mode and strength performance of stiffened composite panel repaired by bolted joints under compressive load, and the results were then compared with those from virgin stiffened composite panel without any damage. A finite element analysis model was established for repaired and virgin stiffened composite panels under compressive load, the 3D Hashin criteria was applied to identify the composite structure failure, and the secondary stress criteria was adopted to identify the adhesive failure between the base laminate and the stiffener. The failure modes of repaired stiffened composite panels were stiffened composite panels breaking off along the bolt joints. The experimental results were consistent with the finite element analysis results, indicating the reliability of the finite element analysis model.
文摘Background: Acute dislocation of the thumb carpometacarpal (CMC) joint is a rare and challenging injury, and its treatment remains controversial. The purpose of the study was to evaluate the clinical outcome after surgical repair of the dorsal capsulo-ligamentous complex. Materials and methods: Eight patients with a mean age of 39.8 years (range, 23 - 56 years) treated for the thumb CMC joint were treated in our hospital between 2008 and 2018. The ruptured dorsal capsulo-ligamentous complex was repaired using suture anchors in all patients, and the joint was immobilized with a Kirschner wire pinning and splint for 3 weeks. The clinical outcome was assessed by measuring the range of motion of the thumb CMC joint and the Japanese Society for Surgery of the Hand version of the Quick Disability of the Arm, Shoulder, and Hand (Q-DASH-JSSH) score. Results: The mean radial abduction of the thumb CMC joint was 66°, and the volar abduction was 63°. The mean Q-DASH-JSSH score was 4.8 (range, 0 - 15.6). There were no cases of infection, nerve disturbance, or osteoarthritis. Anatomical reduction was observed in seven patients at the final follow-up and in a rugby football player at 6 months of follow-up;however, subluxation of the thumb CMC joint at 12 months of follow-up due to reinjury was observed. Conclusion: Surgical repair of the dorsal capsulo-ligamentous complex with suture anchors is a reliable and simple treatment for acute unstable dislocation of the thumb CMC joint.
