MicroRNAs (miRNAs ) are small non-coding RNAs
that regulate gene expression. We hypothesised that the functions
of certain miRNAs and changes to their patterns of expression may
be crucial in the pathogenesis of nonunion. Healing fractures and
atrophic nonunions produced by periosteal cauterisation were created
in the femora of 94 rats, with 1:1 group allocation. At post-fracture
days three, seven, ten, 14, 21 and 28, miRNAs were extracted from
the newly generated tissue at the fracture site. Microarray and
real-time polymerase chain reaction (PCR) analyses of day 14 samples
revealed that five miRNAs, miR-31a-3p, miR-31a-5p, miR-146a-5p,
miR-146b-5p and miR-223-3p, were highly upregulated in nonunion.
Real-time PCR analysis further revealed that, in nonunion, the expression
levels of all five of these miRNAs peaked on day 14 and declined
thereafter. Our results suggest that miR-31a-3p, miR-31a-5p, miR-146a-5p,
miR-146b-5p and miR-223-3p may play an important role in the development
of nonunion. These findings add to the understanding of the molecular mechanism
for nonunion formation and may lead to the development of novel
therapeutic strategies for its treatment. Cite this article:
To investigate the appropriate dose and interval for the administration
of triamcinolone acetonide (TA) in treating tendinopathy to avoid
adverse effects such as tendon degeneration and rupture. Human rotator cuff-derived cells were cultured using three media:
regular medium (control), regular medium with 0.1 mg/mL of TA (low
TA group), and with 1.0 mg/mL of TA (high TA group). The cell morphology,
apoptosis, and viability were assessed at designated time points.Objectives
Methods
A novel transcutaneous CO2 therapy significantly enhanced the antitumor effectiveness of X-ray irradiation in human MFH xenografts The results strongly suggest that transcutaneous CO2 therapy could be a novel therapeutic tool for overcoming radioresistance in human malignancies. Hypoxia contributes to tumor radioresistance. In the presence of oxygen, reactive oxygen species (ROS) play crucial roles in cellular apoptosis to irradiation. We previously showed that a novel transcutaneous application of CO2 can improve hypoxia and that it induces apoptosis and decreases the expression of HIF-1α in sarcoma. Therefore, we hypothesised that a transcutaneous application of CO2 may increase radiosensitivity in sarcoma by improvement of hypoxic condition and increasing ROS production in tumors. The purpose of this study is to examine the effect of transcutaneous application of CO2 on radiosensitivity in human malignant fibrous histiocytoma (MFH) cells.Summary Statement
Introduction
Low-intensity pulsed ultrasound (LIPUS) enhanced osteogenic differentiation of osteoprogenitor cells derived from mouse induced pluripotent cells (iPSCs) without embryoid body formation. Our findings provide insights on the development of LIPUS as an effective technology for bone regeneration strategies using iPSCs. iPSCs represent a promising cell source for regenerative medicine such as bone regeneration because of their unlimited self-renewal property and ability of differentiation into all somatic cell types. Recently, we developed an efficient protocol for generating a highly homogeneous population of osteoprogenitor cells from embryonic stem cells by using a direct-plating method without EB formation step. It is well-recognised that LIPUS accelerates the fracture healing. There have been several reports showing that LIPUS stimulates the osteogenic differentiation of mesenchymal stem cells (MSCs) Summary Statement
Introduction
Implant dislocations are often caused by implant or bone impingement, and less impingement is critical to prevent dislocations. Several reports demonstrated that greater femoral offset delayed bony impingement and led to an improved range of motion (ROM) after THA. Therefore, an increase in the femoral offset may improve ROM and decrease implant dislocation. The aim of this study was to clarify the effect of the femoral offset in avoiding component or bony impingement after total hip arthroplasty (THA). Seventy-eight patients underwent THA with a Pinnacle cup and Summit stem (DePuy). Intraoperative kinematic analysis was performed with a navigation system, which was used to obtain intraoperative range of motion (ROM) measurements during trial insertion of stems of 2 different offset lengths with the same head size. Further, ROM was also measured after actual component insertion.Introduction:
Methods:
Increased long-term survival of TKA is becoming more important. Several studies have confirmed that optimal positioning and alignment of prosthetic components is crucial for the best long-term results. Therefore, the purpose of the current study was to compare the postoperative alignment and sizing of femoral prosthesis among patients performed by 3 different navigation systems. Twenty patients who underwent primary TKA (E. motion; B. Braun Aesculap, Tuttlingen, Germany) using a CT-free navigation system (OrthoPilot v 4.2) by modified gap technique were enrolled in this study. The results of this study group were retrospectively compared with those in a control group of 20 matched-paired posterior stabilized TKAs (Triathlon;Stryker; Mahwah, NJ, USA) which were using another CT-free navigation system (Stryker Navigation System) by measured technique and 20 matched-paired posterior stabilized TKAs (Press-fit Condylar prosthesis; DePuy, Tokyo, Japan) using CT-based navigation system (VectorVision) by measured technique. Several parameters were evaluated for each patient using Athena Knee (Softcube Co, Ltd. Osaka, Japan), 3-D image-matching software. The coronal component angles and sagittal component angles were measured in relation to mechanical axis (MA). In addition, axial femoral component angle was measured in relation to surgical epicondylar axis (SEA) and axial tibial component angle was measured in relation to Akagi line.Introduction
Methods
Rapid increase of aged population has been one of major issue affecting national health care plan in Japan. In 2006, Japanese Orthopaedic Association indicated a new clinical entity of musculoskeletal ambulation disorder symptom complex (MADS) to define the higher risk of fall and ambulatory disability in the elderly population caused by musculoskeletal disorders. Osteoarthritis of the knee is one of major cause of MADS. The number of patients with MADS underwent total knee arthroplasty (TKA) had been increased in Japan, and also expected to increase worldwide in the near future. The effectiveness of TKA for the patient with MADS would be a key issue for the patient satisfaction in TKA. In the present study, we analyzed the influence of pre-operative factors on the ambulatory functions in the patients of primary TKA. 132 patients with osteoarthritic knees implanted with posterior-stabilized (PS) TKAs were subjected to this study. There were 113 female and 19 male patients. The mean age of the patients was 73.6 years (range, 59 to 87 years). Patients were pre-operatively subjected to 2 functional performance tests which were essential tests for MADS diagnosis. Firstly, 3 meter timed up and go test (TUG) was used to evaluate ambulation ability. Secondary one leg standing time (ST) with open eyes was measured with both operated and non-operated leg to assess balancing ability. MADS was diagnosed if TUG and ST were not less than 11 seconds and/or less than 15 seconds respectively. The influence of each pre-operative factor was evaluated simple linear regression analysis (p < 0.05). Pre-operative factors consisted of age, sex, weight, height, BMI, standing femoro-tibial angle (FTA) and active knee range of motion.[Introduction]
[Material & Method]
The axis of the fibula in the sagittal plane are known as a landmark for the extramedullary guide in order to minimize posterior tibial slope measurement error in the conventional total knee arthroplasty (TKA). However, there are few anatomic studies about them. We also wondered if the fibula in the coronal plane could be reliable landmark for the alignment of the tibia. This study was conducted to confirm whether the fibula is reliable landmark in coronal and sagittal plane. We evaluated 60 osteoarthritic knees after TKA using Athena Knee (SoftCube Co, Ltd, Osaka, Japan) 3-D image-matching software. Angle between the axis of the fibula (FA) and the mechanical axis (MA) in the coronal and sagittal plane were measured.Background:
Methods:
The goal of total knee arthroplasty (TKA) is to achieve a stable and well-aligned tibiofemoral and patello-femoral (PF) joint, aiming at long-term clinical patient satisfaction. The surgical principles of both cruciate retaining (CR) and posterior stabilized (PS) TKA are accurate osteotomy and proper soft tissue balancing. We have developed an offset-type tensor, and measured intra-operative soft tissue balance under more physiological joint conditions with femoral component in place and reduced PF joint. In this study, we measured intra-operative soft tissue balance and assessed the early post-operative knee joint stability quantitatively, and compared these parameters between CR and PS TKA. Seventy patients with varus osteoarthritis of the knee underwent TKAs (35 CR TKAs: CR and 35 PS TKAs: PS). Mean varus deformity in standing position was 9.8 degrees in CR, and 10.7 degrees in PS (p = 0.45). All TKAs were performed by a single surgeon with measured resection technique. The external rotation of posterior femoral condyle osteotomy was performed according to surgical epicondylar axis (SEA) in pre-operative CT. We measured intra-operative soft tissue balance using an offset-type tensor with 40 lbs of joint distraction force at 0, 10, 30, 45, 60, 90, 120 and 135 degrees of flexion. The joint component gap (mm) and varus angle (degrees) were measured at each flexion angle. Four weeks after operation, we evaluated the knee stability at extension by varus and valgus stress radiography using Telos (10 kg) and at flexion by epicondylar view with 1.5 kg weight at the ankle. We measured joint separation distance at medial as medial joint looseness (MJL) and at lateral as lateral joint looseness (LJL). Joint looseness was defined as the average of MJL and LJL. Intra-operative measurements and post-operative joint stabilities were compared between CR and PS using unpaired t-test.Objective
Material and Method
Recently, tibial insert design of cruciate-substituting (CS) polyethylene insert is employed. However, in vivo kinematics of using CS polyethylene insert is still unclear. In this study, it is hypothesized that CS polyethylene insert leads to stability of femolo-tibial joint as well as posterior-stabilized polyethylene insert, even if posterior cruciate ligament (PCL) is sacrificed after total knee arthroplasty (TKA). The purpose of this study is an investigation of in vivo kinematics of three different tibial insert designs using computer assisted navigation system intra-operatively in TKA. Sixty-four consecutive patients who had knees of osteoarthritis with varus deformity were investigated in this study. All TKAs (Triathlon, Stryker, New Jersey, USA) were performed using computer assisted navigation system. During surgery, three different designs of polyethylene tibial trial inserts (PS, CS, and cruciate-retaining (CR) polyethylene insert) were inserted respectively after implantation of femoral and tibial components. The kinematic parameters of the soft-tissue balance were obtained by interpreting kinematics curve, which display bicompartmental gaps throughout the range of motion (ROM) after implantation of each trial insert (Figure. 1). During record of kinematics, the surgeon gently lifted the experimental thigh three times, flexing the hip and knee. Deviation of these three values in each ROM was calculated in each tibial insert in each patient for descriptive analysis.Introduction
Materials and Methods
It is well known that blood flow is a critical key component of fracture repair. Previously, we demonstrated that transcutaneous application of CO2 increased blood flow in the human body. To date, there has been no report investigating the effect of the carbonated therapy on fracture repair. We hypothesized that the transcutaneous application of CO2 to fracture site would accelerate fracture repair.Introduction
Hypothesis
In most cases of stable type medial femoral neck fracture and some cases of dislocated medial femoral neck fracture, internal fixation was undertaken. Dual SC Screw (DSCS) System is an internal fixation device which has sliding mechanism and preventing mechanism of back out of the screw. The purpose of this study is to evaluate the results and complication of medial femoral neck fracture treated with DSCS. Fifty two patients operated for fractures of the medial femoral neck with DSCS were identified as the study population. All patients followed up at least 2years. Outcome measures included the period of bone union, revision surgery, operating times and clinical symptoms and complication.Introduction
Methods
Recently, some case reports have been published, in which nonunions were successfully healed with parathyroid hormone 1–34 (PTH) administration. Previously, we demonstrated that the intervening tissue at the nonunion site contains multilineage mesenchymal progenitor cells and plays an important role during the healing process of nonunion. We investigated the effect of PTH on osteogenic differentiation of human nonunion tissue-derived cells (NCs) in vitro. We hypothesized that PTH directly promoted osteogenic differentiation of NCs.Introduction
Hypothesis
Failures in fracture healing are mainly caused by a lack of neovascularization. We have previously demonstrated that G-CSF-mobilized peripheral blood (GM-PB) CD34+ cells, an endothelial progenitor enriched cell population, contributed to fracture healing via vasculogenesis and osteogenesis. We postulated the hypothesis that local transplantation of culture expanded bone marrow (cEx-BM) CD34+ cells could exhibit therapeutic potential for fracture healing. BM CD34+ cells were cultured in specific medium with 5 growth factors for 1week. A reproducible model of femoral fracture was created in nude rats with periosteum cauterization, which leads to nonunion at 8 weeks post-fracture. Rats received local administration of the following cells or PBS alone(1)cEx-BM, (2)BM, (3)GM-PB CD34+ cells or (4)PBS.Introduction
Materials
Low-intensity pulsed ultrasound (LIPUS) has been reported to enhance healing of fracture and nonunion. Bone morphogenetic protein-7 (BMP-7) has also been reported to promote bone formation. Recently, we demonstrated progenitor cells with osteogenic/chondrogenic differentiation potential existed in human fracture hematoma and nonunion tissue. We hypothesised the combined application of LIPUS and BMP-7 would cause major effect on osteogenesis of hematoma-derived cells (HCs) and nonunion tissue-derived cells (NCs).Introduction
Hypothesis
CXC chemokine receptor 4 (CXCR4) is a specific receptor for stromal-derived-factor 1 (SDF-1). SDF-1/CXCR4 interaction contributes to the regulation of endotherial progenitor cell (EPC) recruitment in ischemic tissues. The purpose of this study is to investigate the mechanistic function of CXCR4 on EPCs for bone fracture healing. We made CXCR4 gene knockout mice using the Cre/loxP system. A reproducible model of femoral fracture was created in both Tie2-Cre CXCR4 knockout mice (CXCR4KO) and wild type mice (control). To evaluate gain function of the SDF-1/CXCR4 pathway, we set three groups of the SDF-1 intraperitoneally injected group, wild type group, and SDF-1 injected CXCR4 KO group.Introduction
Materials and methods
Plate fixations have been recommended for dislocated clavicle fractures. However, existing plates are inadequate for morphological compatibility with the clavicle. The aim of this study is to measure the anatomical shape of the clavicle and to compare the radiographical and clinical outcomes of our tree-dimensional (3D) reconstruction plate with conventional straight plate. Chest CT image of 15 patients with normal clavicle were analyzed. Their clavicles were reconstructed and measured their anatomical variables. A hospital-based case-control study was conducted, including a consecutive series of 52 patients with displaced midshaft clavicle fractures. 3D reconstruction plate was used for 26 patients and another 26 patients were treated with conventional straight plate. Outcome measures included the period of bone union, revision surgery, operating times and clinical symptoms using DASH score.Introduction
Methods
Our previous study using microarray analysis showed that Rad (Ras associated with diabetes) was highly expressed in nonunion. The purpose of this study is to investigate the gene expression and immunolocalization of Rad, and other Ras-related G proteins: Rem1 and Rem2 in fracture/nonunion site using rat experimental models. We hypothesized that Rad had a significant role in nonunion formation.Introduction
Hypothesis
The hematoma occurring at a fracture site is known to play an important role in fracture healing. Previously, we demonstrated that fracture hematoma contained multilineage mesenchymal progenitor cells. On the other hand, the process of fracture healing is associated by two different mechanisms, intramembranous and endochondral. However, there are no reports proving the details about cellular analysis in the process of endochondoral ossification. We hypothesized that one of the cell origins for endochondral ossification after fracture was hematoma.Introduction
Hypothesis
iPSCs represent a promising cell source for bone regeneration. To generate osteoprogenitor cells, most protocols use the generation of embryoid bodies (EBs). However, these protocols give rise to heterogeneous population of different cell lineage. We hypothesized that a direct plating method without EB formation step could be an efficient protocol for generating a homogeneous population of osteoprogenitor cells from iPSCs.Introduction
Hypothesis
