Background Multimodal cocktail periarticular injection （MCPI） with a large volume of low concentration local anesthetics, adrenaline, and anti-inflammatory agents such as non-steroidal anti-inflammatory drug or ster...Background Multimodal cocktail periarticular injection （MCPI） with a large volume of low concentration local anesthetics, adrenaline, and anti-inflammatory agents such as non-steroidal anti-inflammatory drug or steroids have shown good pain control and improvement in range of motion after surgery. This study compares the efficacy of pain control after total knee arthroplasty, using multimodal cocktail periarticular injection with steroid or without steroid.展开更多
Reconstruction of subarticular bone defects is an intractable challenge in orthopedics.The simultaneous repair of cancellous defects,fractures,and cartilage damage is an ideal surgical outcome.3D printed porous anatom...Reconstruction of subarticular bone defects is an intractable challenge in orthopedics.The simultaneous repair of cancellous defects,fractures,and cartilage damage is an ideal surgical outcome.3D printed porous anatomical WE43(magnesium with 4 wt%yttrium and 3 wt%rare earths)scaffolds have many advantages for repairing such bone defects,including good biocompatibility,appropriate mechanical strength,customizable shape and structure,and biodegradability.In a previous investigation,we successfully enhanced the corrosion resistance of WE43 samples via high temperature oxidation(HTO).In the present study,we explored the feasibility and effectiveness of HTO-treated 3D printed porous anatomical WE43 scaffolds for repairing the cancellous bone defects accompanied by split fractures via in vitro and in vivo experiments.After HTO treatment,a dense oxidation layer mainly composed of Y2O3 and Nd2O3 formed on the surface of scaffolds.In addition,the majority of the grains were equiaxed,with an average grain size of 7.4μm.Cell and rabbit experiments confirmed the non-cytotoxicity and biocompatibility of the HTO-treated WE43 scaffolds.After the implantation of scaffolds inside bone defects,their porous structures could be maintained for more than 12 weeks without penetration and for more than 6 weeks with penetration.During the postoperative follow-up period for up to 48 weeks,radiographic examinations and histological analysis revealed that abundant bone gradually regenerated along with scaffold degradation,and stable osseointegration formed between new bone and scaffold residues.MRI images further demonstrated no evidence of any obvious damage to the cartilage,ligaments,or menisci,confirming the absence of traumatic osteoarthritis.Moreover,finite element analysis and biomechanical tests further verified that the scaffolds was conducive to a uniform mechanical distribution.In conclusion,applying the HTO-treated 3D printed porous anatomical WE43 scaffolds exhibited favorable repairing effects for subarticular cancellous bone defects,possessing great potential for clinical application.展开更多
Rheumatoid arthritis(RA) is a common chronic inflammatory disease and periarticular osteoporosis or osteopenia of the inflamed hand joints is an early feature of RA Quantitative measurement of hand bone loss may be an...Rheumatoid arthritis(RA) is a common chronic inflammatory disease and periarticular osteoporosis or osteopenia of the inflamed hand joints is an early feature of RA Quantitative measurement of hand bone loss may be an outcome measure for the detection of joint destruction and disease progression in early RA. This systematic review examines the published literature reporting hand bone mass in patients with RA, particularly those using the dual X-ray absorptiometry(DXA) methods The majority of the studies reported that hand bone loss is associated with disease activity, functional statusand radiological progression in early RA. Quantitative measurement of hand bone mineral density by DXA may be a useful and practical outcome measure in RA and may be predictive for radiographic progression or functional status in patients with early RA.展开更多
目的评价腘动脉-膝关节后囊间隙(infiltration between the popliteal artery and the capsule of the posterior knee,iPACK)阻滞对比关节周围注射(periarticular injection,PAI)在全膝关节置换(total knee arthroplasty,TKA)术后镇痛...目的评价腘动脉-膝关节后囊间隙(infiltration between the popliteal artery and the capsule of the posterior knee,iPACK)阻滞对比关节周围注射(periarticular injection,PAI)在全膝关节置换(total knee arthroplasty,TKA)术后镇痛中的作用。方法检索PubMed、EMBASE、Web of Science、中国生物医学文献数据库(CBM)、中文科技期刊全文数据库(VIP)、中国期刊全文数据库(CNKI)及万方数据库中iPACK对比PAI对TKA术后镇痛的随机对照试验(RCT),时间均从建库至2021年12月。2位研究者按照纳入标准筛选文献、提取资料,2位评价员独立对纳入文献的质量进行评价,采用RevMan5.3进行meta分析。结果纳入6个RCT共440例患者。与PAI相比,iPACK组术后24 h吗啡累积使用量较少(MD=-4.21,95%CI:-7.18~-1.24,P=0.005),术后12 h运动状态和24、48 h静息状态、运动状态下疼痛视觉模拟评分(Visual Analogue Scale,VAS)降低,差异有统计学意义(P<0.05),术后12 h静息状态VAS差异无统计学意义(P>0.05);2组术后第1天、第2天行走距离相当,差异无统计学意义(P>0.05)。结论与PAI相比,iPACK阻滞能更有效地减轻TKA术后疼痛,减少阿片类药物用量,不影响术后活动,用于TKA术后镇痛安全有效。展开更多
文摘Background Multimodal cocktail periarticular injection （MCPI） with a large volume of low concentration local anesthetics, adrenaline, and anti-inflammatory agents such as non-steroidal anti-inflammatory drug or steroids have shown good pain control and improvement in range of motion after surgery. This study compares the efficacy of pain control after total knee arthroplasty, using multimodal cocktail periarticular injection with steroid or without steroid.
基金funded by the National Key Research and Development Program of China(No.2018YFE0104200)National Natural Science Foundation of China(51875310,52175274,82172065)Peking University Medicine Sailing Program for Young Scholars’Scientific&Technological Innovation(BMU2023YFJHPY015).
文摘Reconstruction of subarticular bone defects is an intractable challenge in orthopedics.The simultaneous repair of cancellous defects,fractures,and cartilage damage is an ideal surgical outcome.3D printed porous anatomical WE43(magnesium with 4 wt%yttrium and 3 wt%rare earths)scaffolds have many advantages for repairing such bone defects,including good biocompatibility,appropriate mechanical strength,customizable shape and structure,and biodegradability.In a previous investigation,we successfully enhanced the corrosion resistance of WE43 samples via high temperature oxidation(HTO).In the present study,we explored the feasibility and effectiveness of HTO-treated 3D printed porous anatomical WE43 scaffolds for repairing the cancellous bone defects accompanied by split fractures via in vitro and in vivo experiments.After HTO treatment,a dense oxidation layer mainly composed of Y2O3 and Nd2O3 formed on the surface of scaffolds.In addition,the majority of the grains were equiaxed,with an average grain size of 7.4μm.Cell and rabbit experiments confirmed the non-cytotoxicity and biocompatibility of the HTO-treated WE43 scaffolds.After the implantation of scaffolds inside bone defects,their porous structures could be maintained for more than 12 weeks without penetration and for more than 6 weeks with penetration.During the postoperative follow-up period for up to 48 weeks,radiographic examinations and histological analysis revealed that abundant bone gradually regenerated along with scaffold degradation,and stable osseointegration formed between new bone and scaffold residues.MRI images further demonstrated no evidence of any obvious damage to the cartilage,ligaments,or menisci,confirming the absence of traumatic osteoarthritis.Moreover,finite element analysis and biomechanical tests further verified that the scaffolds was conducive to a uniform mechanical distribution.In conclusion,applying the HTO-treated 3D printed porous anatomical WE43 scaffolds exhibited favorable repairing effects for subarticular cancellous bone defects,possessing great potential for clinical application.
文摘Rheumatoid arthritis(RA) is a common chronic inflammatory disease and periarticular osteoporosis or osteopenia of the inflamed hand joints is an early feature of RA Quantitative measurement of hand bone loss may be an outcome measure for the detection of joint destruction and disease progression in early RA. This systematic review examines the published literature reporting hand bone mass in patients with RA, particularly those using the dual X-ray absorptiometry(DXA) methods The majority of the studies reported that hand bone loss is associated with disease activity, functional statusand radiological progression in early RA. Quantitative measurement of hand bone mineral density by DXA may be a useful and practical outcome measure in RA and may be predictive for radiographic progression or functional status in patients with early RA.
文摘目的评价腘动脉-膝关节后囊间隙(infiltration between the popliteal artery and the capsule of the posterior knee,iPACK)阻滞对比关节周围注射(periarticular injection,PAI)在全膝关节置换(total knee arthroplasty,TKA)术后镇痛中的作用。方法检索PubMed、EMBASE、Web of Science、中国生物医学文献数据库(CBM)、中文科技期刊全文数据库(VIP)、中国期刊全文数据库(CNKI)及万方数据库中iPACK对比PAI对TKA术后镇痛的随机对照试验(RCT),时间均从建库至2021年12月。2位研究者按照纳入标准筛选文献、提取资料,2位评价员独立对纳入文献的质量进行评价,采用RevMan5.3进行meta分析。结果纳入6个RCT共440例患者。与PAI相比,iPACK组术后24 h吗啡累积使用量较少(MD=-4.21,95%CI:-7.18~-1.24,P=0.005),术后12 h运动状态和24、48 h静息状态、运动状态下疼痛视觉模拟评分(Visual Analogue Scale,VAS)降低,差异有统计学意义(P<0.05),术后12 h静息状态VAS差异无统计学意义(P>0.05);2组术后第1天、第2天行走距离相当,差异无统计学意义(P>0.05)。结论与PAI相比,iPACK阻滞能更有效地减轻TKA术后疼痛,减少阿片类药物用量,不影响术后活动,用于TKA术后镇痛安全有效。
