AIM To evaluate the treatment of osteonecrosis of the femoral head(ONFH) with the use of vascular endothelial growth factor(VEGF).METHODS In 30 mature beagles(6 groups of 5 beagles) ONFH was induced cryosurgically and...AIM To evaluate the treatment of osteonecrosis of the femoral head(ONFH) with the use of vascular endothelial growth factor(VEGF).METHODS In 30 mature beagles(6 groups of 5 beagles) ONFH was induced cryosurgically and one of the following solutions was administered locally in the femoral head(FH) in each group: Single injection of 500 μg VEGF(t-VEGFμ group); single injection of 500 ng VEGF(t-VEGFn group); continuous delivery of 500 μg VEGF through osmotic micropump(t-VEGFpump-μ group); continuous delivery of 500 ng VEGF through osmotic micropump(t-VEGFpump-n group); single injection of 0.9% sodium chloride(t-NS group), while one group that served as control group did not receive any local solution(No-t group). FHs were retrieved 12 wk postoperatively, underwent decalcification and hematoxylin/eosin and toluidine blue staining. In two canines per group, one half of FH was processed without decalcification and stained with modified Masson Trichrome. Histological sections were observed by light microscopy and measured with a semi-automatized bone histomorphometry system and Bone Volume/Total Volume(BV/TV), Marrow Volume/Total Volume(MaV/TV), and Trabecular Thickness(TbT h) were assessed. Standard and robust tests(Welch, Brown Forsythe) of analysis of variance along with multiple comparisons, were carried out among the categories.RESULTS The untreated(No-t) group had signs of osteonecrosis, whereas the VEGF groups revealed reversal of the osteonecrosis. Statistical analysis of the decalcified specimens revealed a significantly better BV/TV ratio and a higher Tb Th between the VEGF treatment groups(except the t-VEGFn group) and the No-t group or the control t-NS group. Single dose 500 μg VEGF group had significantly better BV/TV ratio and higher Tb Th when compared to the No-t group(50.45 ± 6.18 vs 29.50 ± 12.27, P = 0.002 and 151.44 ± 19.07 vs 107.77 ± 35.15, P = 0.161 respectively) and the control t-NS group(50.45 ± 6.18 vs 30.9 ± 6.67, P = 0.004 and 151.44 ± 19.07 vs 107.14 ± 35.71, P = 0.151 respectively). Similar differences were found for the prolonged VEGF delivery/pump groups of 500 μg and 500 ng. Analysis of the totality of specimens(decalcified/non-decalcified) enhanced the aforementioned differences and additionally revealed significant differences in the comparison of the TbT h.CONCLUSION In an experimental model of ONFH in canines it was found that local treatment with VEGF leads to bone tissue remodeling and new bone formation.展开更多
Purpose: The aims of this study were to assess differences of limb symmetry index(LSI) in strength-and coordination-related tasks between high-level, competitive, noninjured ski racers of different age-related perform...Purpose: The aims of this study were to assess differences of limb symmetry index(LSI) in strength-and coordination-related tasks between high-level, competitive, noninjured ski racers of different age-related performance levels and to prospectively assess limb differences as a possible risk factor for traumatic and overuse injury in youth ski racers.Methods: The study(Study 1) included 285 high-level competitive ski racers(125 females, 160 males) of 3 age-related performance levels and based on the school system: 95 youth(10à14 years, secondary modern school), 107 adolescent(15à19 years, grammar school), and 83 elite athletes(20à34 years). To investigate the second aim(Study 2), 67 of the 95 youth athletes were included and any traumatic or overuse injuries were prospectively recorded over 2 seasons. All athletes performed 4 unilateral tests(strength related: one-leg counter movement jump(OL-CMJ) and one-leg isometric/isokinetic press strength test(OL-ILS); coordination related: one-leg stability test(OL-ST) and one-leg speedy jump test(OL-SJ)). The LSI was calculated by dividing the dominant leg by the nondominant leg and multiplying by 100. Kruskal-Wallis H tests and binary logistic regression analyses were conducted.Results: There were significant differences between the LSI of the 3 age-related performance-level groups only in the strength-related tests: the OL-CMJ(x2(2, 285) = 9.09; p = 0.01) and the OL-ILS(x2(2, 285) = 14.79; p < 0.01). The LSI for OL-ILS was found to be a significant risk factor for traumatic injury in youth ski racers(Wald = 7.08; p < 0.01). No significant risk factors were found for overuse injuries.Conclusion: Younger athletes display slightly greater LSI values only in the strength-related tests. The cut-off value of limb differences of <10%for return to sport decisions seems to be appropriate for elite athletes, but for youth and adolescent athletes it has to be critically discussed. It seems to be necessary to define thresholds based on specific performance tasks(strength vs. coordination related) rather than on generalizations,and age-related performance levels must be considered. Limb differences in unilateral leg extension strength represent a significant injury risk factor in youth ski racers.展开更多
基金Supported by Piedmont Orthopaedic Foundation,United States
文摘AIM To evaluate the treatment of osteonecrosis of the femoral head(ONFH) with the use of vascular endothelial growth factor(VEGF).METHODS In 30 mature beagles(6 groups of 5 beagles) ONFH was induced cryosurgically and one of the following solutions was administered locally in the femoral head(FH) in each group: Single injection of 500 μg VEGF(t-VEGFμ group); single injection of 500 ng VEGF(t-VEGFn group); continuous delivery of 500 μg VEGF through osmotic micropump(t-VEGFpump-μ group); continuous delivery of 500 ng VEGF through osmotic micropump(t-VEGFpump-n group); single injection of 0.9% sodium chloride(t-NS group), while one group that served as control group did not receive any local solution(No-t group). FHs were retrieved 12 wk postoperatively, underwent decalcification and hematoxylin/eosin and toluidine blue staining. In two canines per group, one half of FH was processed without decalcification and stained with modified Masson Trichrome. Histological sections were observed by light microscopy and measured with a semi-automatized bone histomorphometry system and Bone Volume/Total Volume(BV/TV), Marrow Volume/Total Volume(MaV/TV), and Trabecular Thickness(TbT h) were assessed. Standard and robust tests(Welch, Brown Forsythe) of analysis of variance along with multiple comparisons, were carried out among the categories.RESULTS The untreated(No-t) group had signs of osteonecrosis, whereas the VEGF groups revealed reversal of the osteonecrosis. Statistical analysis of the decalcified specimens revealed a significantly better BV/TV ratio and a higher Tb Th between the VEGF treatment groups(except the t-VEGFn group) and the No-t group or the control t-NS group. Single dose 500 μg VEGF group had significantly better BV/TV ratio and higher Tb Th when compared to the No-t group(50.45 ± 6.18 vs 29.50 ± 12.27, P = 0.002 and 151.44 ± 19.07 vs 107.77 ± 35.15, P = 0.161 respectively) and the control t-NS group(50.45 ± 6.18 vs 30.9 ± 6.67, P = 0.004 and 151.44 ± 19.07 vs 107.14 ± 35.71, P = 0.151 respectively). Similar differences were found for the prolonged VEGF delivery/pump groups of 500 μg and 500 ng. Analysis of the totality of specimens(decalcified/non-decalcified) enhanced the aforementioned differences and additionally revealed significant differences in the comparison of the TbT h.CONCLUSION In an experimental model of ONFH in canines it was found that local treatment with VEGF leads to bone tissue remodeling and new bone formation.
文摘Purpose: The aims of this study were to assess differences of limb symmetry index(LSI) in strength-and coordination-related tasks between high-level, competitive, noninjured ski racers of different age-related performance levels and to prospectively assess limb differences as a possible risk factor for traumatic and overuse injury in youth ski racers.Methods: The study(Study 1) included 285 high-level competitive ski racers(125 females, 160 males) of 3 age-related performance levels and based on the school system: 95 youth(10à14 years, secondary modern school), 107 adolescent(15à19 years, grammar school), and 83 elite athletes(20à34 years). To investigate the second aim(Study 2), 67 of the 95 youth athletes were included and any traumatic or overuse injuries were prospectively recorded over 2 seasons. All athletes performed 4 unilateral tests(strength related: one-leg counter movement jump(OL-CMJ) and one-leg isometric/isokinetic press strength test(OL-ILS); coordination related: one-leg stability test(OL-ST) and one-leg speedy jump test(OL-SJ)). The LSI was calculated by dividing the dominant leg by the nondominant leg and multiplying by 100. Kruskal-Wallis H tests and binary logistic regression analyses were conducted.Results: There were significant differences between the LSI of the 3 age-related performance-level groups only in the strength-related tests: the OL-CMJ(x2(2, 285) = 9.09; p = 0.01) and the OL-ILS(x2(2, 285) = 14.79; p < 0.01). The LSI for OL-ILS was found to be a significant risk factor for traumatic injury in youth ski racers(Wald = 7.08; p < 0.01). No significant risk factors were found for overuse injuries.Conclusion: Younger athletes display slightly greater LSI values only in the strength-related tests. The cut-off value of limb differences of <10%for return to sport decisions seems to be appropriate for elite athletes, but for youth and adolescent athletes it has to be critically discussed. It seems to be necessary to define thresholds based on specific performance tasks(strength vs. coordination related) rather than on generalizations,and age-related performance levels must be considered. Limb differences in unilateral leg extension strength represent a significant injury risk factor in youth ski racers.
