背景:在全髋关节置换术中,后外侧入路被认为在全髋关节置换术后脱位率高于其他手术入路,但后路软组织修复技术弥补了这一局限性。目前临床上应用的修复技术主要为经骨修复技术(TBRT)、经肌腱修复技术(TTRT)以及经锚钉修复技术(TART),尽...背景:在全髋关节置换术中,后外侧入路被认为在全髋关节置换术后脱位率高于其他手术入路,但后路软组织修复技术弥补了这一局限性。目前临床上应用的修复技术主要为经骨修复技术(TBRT)、经肌腱修复技术(TTRT)以及经锚钉修复技术(TART),尽管目前的研究提供了充分的TBRT和TTRT修复后方软组织的结果报道,但对于最佳的后方软组织修复技术骨科医生尚无法达成共识。本综述论述各种后方软组织修复技术的修复结果,并且比较了TBRT与TTRT两种修复技术的修复结果。结果:在行后入路THA中对后方软组织行TBRT与TTRT修复后方软组织对降低术后脱位率是有效的。行TBRT的有效性优于行TTRT修复。此外,对后关节囊进行修复也能有效降低术后脱位率。Background: In total hip arthroplasty, the posterolateral approach is thought to have a higher rate of dislocation after total hip arthroplasty than other surgical approaches, but posterior soft tissue repair techniques compensate for this limitation. Currently, the clinically used repair techniques are mainly through-bone repair technique (TBRT), through-tendon repair technique (TTRT), and through-anchor repair technique (TART). Although current studies have provided sufficient reports on the results of TBRT and TTRT repair of the posterior soft tissue, there is no consensus among orthopedic surgeons on the optimal technique of soft tissue repair. This review discusses the repair results of various posterior soft tissue repair techniques and compares the repair results of TBRT and TTRT repair techniques. Results: TBRT and TTRT in posterior soft tissue repair in posterior approach THA were effective in reducing postoperative dislocation rate. The effectiveness of TBRT is better than that of TTRT repair. In addition, the repair of the posterior joint capsule can also effectively reduce the postoperative dislocation rate.展开更多
BACKGROUND:Adeno-associated virus(AAV)gene therapy has been proven to be reliable and safe for the treatment of osteoarthritis in recent years.However,given the complexity of osteoarthritis pathogenesis,single gene ma...BACKGROUND:Adeno-associated virus(AAV)gene therapy has been proven to be reliable and safe for the treatment of osteoarthritis in recent years.However,given the complexity of osteoarthritis pathogenesis,single gene manipulation for the treatment of osteoarthritis may not produce satisfactory results.Previous studies have shown that nuclear factorκB could promote the inflammatory pathway in osteoarthritic chondrocytes,and bone morphogenetic protein 4(BMP4)could promote cartilage regeneration.OBJECTIVE:To test whether combined application of AAV-p65shRNA and AAV-BMP4 will yield the synergistic effect on chondrocytes regeneration and osteoarthritis treatment.METHODS:Viral particles containing AAV-p65-shRNA and AAV-BMP4 were prepared.Their efficacy in inhibiting inflammation in chondrocytes and promoting chondrogenesis was assessed in vitro and in vivo by transfecting AAV-p65-shRNA or AAV-BMP4 into cells.The experiments were divided into five groups:PBS group;osteoarthritis group;AAV-BMP4 group;AAV-p65shRNA group;and BMP4-p65shRNA 1:1 group.Samples were collected at 4,12,and 24 weeks postoperatively.Tissue staining,including safranin O and Alcian blue,was applied after collecting articular tissue.Then,the optimal ratio between the two types of transfected viral particles was further investigated to improve the chondrogenic potential of mixed cells in vivo.RESULTS AND CONCLUSION:The combined application of AAV-p65shRNA and AAV-BMP4 together showed a synergistic effect on cartilage regeneration and osteoarthritis treatment.Mixed cells transfected with AAV-p65shRNA and AAV-BMP4 at a 1:1 ratio produced the most extracellular matrix synthesis(P<0.05).In vivo results also revealed that the combination of the two viruses had the highest regenerative potential for osteoarthritic cartilage(P<0.05).In the present study,we also discovered that the combined therapy had the maximum effect when the two viruses were administered in equal proportions.Decreasing either p65shRNA or BMP4 transfected cells resulted in less collagen II synthesis.This implies that inhibiting inflammation by p65shRNA and promoting regeneration by BMP4 are equally important for osteoarthritis treatment.These findings provide a new strategy for the treatment of early osteoarthritis by simultaneously inhibiting cartilage inflammation and promoting cartilage repair.展开更多
文摘背景:在全髋关节置换术中,后外侧入路被认为在全髋关节置换术后脱位率高于其他手术入路,但后路软组织修复技术弥补了这一局限性。目前临床上应用的修复技术主要为经骨修复技术(TBRT)、经肌腱修复技术(TTRT)以及经锚钉修复技术(TART),尽管目前的研究提供了充分的TBRT和TTRT修复后方软组织的结果报道,但对于最佳的后方软组织修复技术骨科医生尚无法达成共识。本综述论述各种后方软组织修复技术的修复结果,并且比较了TBRT与TTRT两种修复技术的修复结果。结果:在行后入路THA中对后方软组织行TBRT与TTRT修复后方软组织对降低术后脱位率是有效的。行TBRT的有效性优于行TTRT修复。此外,对后关节囊进行修复也能有效降低术后脱位率。Background: In total hip arthroplasty, the posterolateral approach is thought to have a higher rate of dislocation after total hip arthroplasty than other surgical approaches, but posterior soft tissue repair techniques compensate for this limitation. Currently, the clinically used repair techniques are mainly through-bone repair technique (TBRT), through-tendon repair technique (TTRT), and through-anchor repair technique (TART). Although current studies have provided sufficient reports on the results of TBRT and TTRT repair of the posterior soft tissue, there is no consensus among orthopedic surgeons on the optimal technique of soft tissue repair. This review discusses the repair results of various posterior soft tissue repair techniques and compares the repair results of TBRT and TTRT repair techniques. Results: TBRT and TTRT in posterior soft tissue repair in posterior approach THA were effective in reducing postoperative dislocation rate. The effectiveness of TBRT is better than that of TTRT repair. In addition, the repair of the posterior joint capsule can also effectively reduce the postoperative dislocation rate.
文摘BACKGROUND:Adeno-associated virus(AAV)gene therapy has been proven to be reliable and safe for the treatment of osteoarthritis in recent years.However,given the complexity of osteoarthritis pathogenesis,single gene manipulation for the treatment of osteoarthritis may not produce satisfactory results.Previous studies have shown that nuclear factorκB could promote the inflammatory pathway in osteoarthritic chondrocytes,and bone morphogenetic protein 4(BMP4)could promote cartilage regeneration.OBJECTIVE:To test whether combined application of AAV-p65shRNA and AAV-BMP4 will yield the synergistic effect on chondrocytes regeneration and osteoarthritis treatment.METHODS:Viral particles containing AAV-p65-shRNA and AAV-BMP4 were prepared.Their efficacy in inhibiting inflammation in chondrocytes and promoting chondrogenesis was assessed in vitro and in vivo by transfecting AAV-p65-shRNA or AAV-BMP4 into cells.The experiments were divided into five groups:PBS group;osteoarthritis group;AAV-BMP4 group;AAV-p65shRNA group;and BMP4-p65shRNA 1:1 group.Samples were collected at 4,12,and 24 weeks postoperatively.Tissue staining,including safranin O and Alcian blue,was applied after collecting articular tissue.Then,the optimal ratio between the two types of transfected viral particles was further investigated to improve the chondrogenic potential of mixed cells in vivo.RESULTS AND CONCLUSION:The combined application of AAV-p65shRNA and AAV-BMP4 together showed a synergistic effect on cartilage regeneration and osteoarthritis treatment.Mixed cells transfected with AAV-p65shRNA and AAV-BMP4 at a 1:1 ratio produced the most extracellular matrix synthesis(P<0.05).In vivo results also revealed that the combination of the two viruses had the highest regenerative potential for osteoarthritic cartilage(P<0.05).In the present study,we also discovered that the combined therapy had the maximum effect when the two viruses were administered in equal proportions.Decreasing either p65shRNA or BMP4 transfected cells resulted in less collagen II synthesis.This implies that inhibiting inflammation by p65shRNA and promoting regeneration by BMP4 are equally important for osteoarthritis treatment.These findings provide a new strategy for the treatment of early osteoarthritis by simultaneously inhibiting cartilage inflammation and promoting cartilage repair.
