1,721,003 research outputs found
Editorial: New trends in osteoarthritis treatment
Full text linkOsteoarthritis (OA) is the most common type of arthritis affecting millions of persons
worldwide (1, 2). It is a complex and multifactorial disease that could affect any joint, but
particularly the knee, hip and hands. All the joint tissues are involved, including synovial
membrane, subchondral bone, infrapatellar fat pad, subchondral bone, and especially
cartilage, which undergoes several changes impacting its biomechanical behavior (3–5).
These changes lead to swelling, pain, and difficulty in joint movement, thus impacting
quality of lif
Normalization of chromium and cobalt values after femoral head replacement.
No full textIntroduction
Adverse reaction to metal debris (ARMD) can be caused by metal-on-metal total hip arthoplasty. We treated a case of ARMD in a 61-year-old patient by limited prosthetic revision, replacing the metal head with a polyethylene one.
Presentation of case
Two years after metal-on-metal total arthoplasty of the left hip, radiographic control showed osteolysis of the patient’s greater trochanter. He underwent surgical curettage and the application of demineralized bone matrix. After a few months, blood Co and Cr increased, and at clinical evaluation, the patient had worsening paresthesias. He agreed to prosthetic revision after 14 months.
Discussion
During surgery, the acetabular cup and femoral stem appeared correctly osteointegrated; therefore, the cup was maintained, while the prosthetic femoral head was removed and replaced with a 50 mm polyethylene head.
Conclusion
Blood Cr and urinary Cr and Co decreased and normalized 3 months after surgery, and the patient no longer suffered paresthesias. Blood Co normalized 7 months after revision. Radiographic follow-up showed no change after 30 months post-operatively. We believe this case report could be a starting point for a future randomized clinical trial to test the efficacy of the procedure used compared with complete implant revision
Muscle stem cells: what's new in orthopedics?
Full text linkBackground and aim of the work: Adult stem cells were studied as a source of potentially useful development for tissue engineering and repair techniques. The aim of this review is to clarify the actual and possible uses of muscle stem cells in orthopedics. Methods: A selection of studies was made to obtain a homogeneous and up to date overview on the muscle stem cells applications. Results: In recent years muscle was studied as a good source of adult stem cells that can differentiate into different cell lineages. Muscle stem cells are a heterogeneous population of cells, which demonstrated in vitro a great potential for the regeneration and repair of muscle, bone and cartilage tissue. Among muscle stem cells, satellite stem cells are the most known progenitor cells: they can differentiate in osteoblasts, adipocytes, chondrocytes and myocytes. Conclusions: Although muscle stem cells are a promising field of research, more pre-clinical studies in animal models are still needed to determine the safety and efficiency of the transplant procedures in humans
Musculoskeletal Diseases: From Molecular Basis to Therapy
Full text linkMusculoskeletal diseases (MSDs) comprise a plethora of different disorders (more than 150 conditions) affecting the locomotor system. Importantly, they are associated with significant morbidity and disability, impacting the quality of life of patients. The most common MSDs are osteoarthritis (OA), low-back pain (LBP), neck pain (NP), rheumatoid arthritis (RA), and gout [1]. A recent analysis of the Global Burden of Disease published in 2022 estimated that
approximately 1.71 billion people globally are affected by musculoskeletal disorders [2]. Although MSDs are widespread and the number of affected individuals is expected to increase as the population ages, MSD research has received little attention, likely because MSDs are rarely fatal and are assumed to be irreversible pathologies [1,2]. Thus, a better understanding of the etiology, biomarkers, as well as new and more effective therapeutic treatments, are needed. In this context, the purpose of this Special Issue, entitled “Musculoskeletal Diseases: From Molecular Basis to Therapy”, is to report on advances in pathophysiological mechanisms, the identification of biomarkers, and preclinical and clinical therapeutic approaches
to MSDs
Musculoskeletal Diseases: From Molecular Basis to Therapy (Volume II)
Full text linkMusculoskeletal diseases (MSDs) are among the leading causes of disability worldwide, placing a significant burden on healthcare systems and reducing patients’ quality of life [...
Espressione e modulazione della LIM mineralization protein in condrociti umani
No full textIntroduzione: la LIM mineralization protein (LMP) viene considerata una nuova proteina intracellulare coinvolta nel differenziamento degli osteoblasti. Nell’uomo, sono state identificate tre varianti di splicing che differiscono per la sequenza aminoacidica e per la diversa distribuzione tissutale. In particolare, l’isoforma LMP-1 è regolata dalla Bone Morphogenetic Protein (BMP)-6, molecola coinvolta nell’osteoinduzione, e sembra stimolare il processo di differenziamento nell’embriogenesi e la formazione ossea nell’adulto tramite la secrezione di fattori solubili della famiglia delle BMPs. Anche l’isoforma LMP-3 favorisce il processo di ossificazione inducendo la mineralizzazione ossea e l’espressione di geni specifici dell’osso.
Scopo dello studio: valutare se condrociti umani esprimano il gene LMP e a quale isoforma appartenga. Inoltre, se la sua espressione genica venga modulata da uno stimolo infiammatorio quale IL-1beta.
Materiali e metodi: sono state allestite colture primarie di condrociti da cartilagine della testa di femore proveniente da pazienti sottoposti ad intervento di artroprotesi. Le cellule al secondo passaggio sono state stimolate con IL-1beta umana ricombinante a diverse concentrazioni (5, 10, 20 ng/ml) in un terreno privo di siero; al termine delle 24 ore è stato estratto l’RNA totale e ne è stata valutata l’espressione tramite metodo semiquantitativo-comparativo RT/PCR, utilizzando come gene di riferimento rRNA 18S. Le sequenze sono state determinate mediante l’uso di un sequenziatore automatico ABI PRISM 310 Genetic Analyzer.
Risultati: i condrociti esprimono basalmente il gene LMP e l’analisi della sequenza dimostra che l’isoforma espressa è la 1. Il trattamento con IL-1beta stimola l’espressione di LMP-1 in maniera dose-dipendente, con un picco del 60% alla concentrazione di 20 ng/ml rispetto a cellule non trattate.
Conclusioni: questo studio dimostra per la prima volta l’espressione genica di LMP-1 in condrociti umani e una sua modulazione da parte di IL-1beta. Riteniamo che, visto il ruolo osteoinduttivo che sembra avere la proteina LMP-1, uno stimolo infiammatorio quale quello citochinico, possa contribuire, almeno in parte, al rimodellamento cartilagineo e al processo di neoapposizione ossea
Mechanical insights into fat pads: a comparative study of infrapatellar and suprapatellar fat pads in osteoarthritis
No full textObjective: Osteoarthritis (OA) is the most common musculoskeletal disorder, primarily affecting knee joints and causing pain and disability. The infrapatellar (IFP) and the suprapatellar (SFP) fat pad are knee adipose tissues that play essential mechanical roles during articular activity but are also sources of adipokines and cytokines, contributing to OA progression. For this reason, this work aims to provide new insights into IFP and SFP implications in knee OA. Materials and methods: IFP and SFP tissue mechanical properties were studied through compression, indentation and shear mechanical tests performed on samples collected from patients who underwent total knee arthroplasty surgery due to end-stage OA. The energy loss, peak stress, and initial and final elastic moduli were calculated from the unconfined compression tests. The time-dependent response, evaluated in terms of equilibrium relative stiffness, was computed from stress-relaxation loading conditions. Considering shear tests, they provided strain-energy dissipation density, peak shear stress, and the shear moduli. Results: Experimental results showed the typical adipose tissue mechanics features: non-linear stiffening with strain and time-dependent response. Experimental results showed that OA IFP is stiffer than OA SFP, indeed IFP final compression elastic modulus was greater than the SFP (84.43 kPa vs 35.54 kPa respectively) (p = 0.042). Regarding the viscoelastic properties they were comparable: the equilibrium relative stiffness was reported as 0.13 for IFP and 0.11 for SFP (p = 0.026). Conclusions: These outcomes provide new insights into the OA influence on knee mechanics and lay the basis for developing computational tools to improve knee prosthesis design
The challenging management of a delayed union midshaft clavicle fracture complicated by an acute pseudoaneurysm of the subclavian artery in a superelderly diabetic patient
Full text linkClavicle fractures are among the most common fractures, accounting for 2.6–4% of all adult fractures and for 35–44% of those of the shoulder girdle. Up to 80% occur at the midshaft. Nowadays, the majority of these fractures tend to be treated non-operatively, even when displaced, using an arm supporting sling or a “figure-of-eight” bandage, with good clinical outcomes and an acceptable rate of nonunion.
On the contrary, operative treatment is commonly performed in cases of open fractures, skin tenting with the potential for progression to open fracture, “floating shoulder,” and associated acute neurovascular injuries. Despite the proximity of the clavicle to the subclavian vessels, vascular complications in closed clavicle fractures are uncommon, with an incidence of 0.4% [2]. Nevertheless, their prompt diagnosis and proper knowledge is essential because of the high morbidity and mortality rates associated. This report describes the clinical, diagnostic, and therapeutic approaches to address an acute subclavian artery pseudoaneurysm caused by a closed displaced clavicle fracture, complicated by delayed union, in a comorbid octogenarian patient
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