Objective To review the recent research progress on shoulder arthroplasty, and to predict future research direction. Methods Recent l iterature concerned the shoulder arthroplasty was reviewed and analyzed in terms of appl iedanatomy, designs of prosthesis, patterns of prosthesis and fixation ways of prosthesis. Results The shoulder arthroplastyrepresented the treatments of choice for the patients with end-stage shoulder diseases and traumatic diseases. It could provide good and stable results in pain rel ief and functional outcomes. Conclusion There are still many controversies about the patterns of prosthesis, fixation ways and kinds of materials in cl inical practice. Currently, the main research is about the designs of the glenoid prosthesis and the cl inical practice in young patients.
Objective To review the recent researches of basic fibroblast growth factor (bFGF) in tendon tissue engineering. Methods Recentoriginal related literature was extensively reviewed and analyzed. Results bFGF played an important role in establishing standard tendon tissue engineering cell lines, inducing the compound and analysis of extracellular matrix, enhancing interactions between cells and extracellular matrix and accelerating tissue engineering materials’ neovascularization. Conclusion The progresses in increasing endogenetic bFGF expression, controlling the release of exogenous bFGF and improving the bioutilization of bFGF has laid foundation for wider use of bFGF in tendon tissue engineering.
Objective To review the recent advances in the application of graphene oxide (GO) for bone tissue engineering. Methods The latest literature at home and abroad on the GO used in the bone regeneration and repair was reviewed, including general properties of GO, degradation performance, biocompatibility, and application in bone tissue engineering. Results GO has an abundance of oxygen-containing functionalities, high surface area, and good biocompatibility. In addition, it can promote stem cell adhesion, proliferation, and differentiation. Moreover, GO has many advantages in the construction of new composite scaffolds and improvement of the performance of traditional scaffolds. Conclusion GO has been a hot topic in the field of bone tissue engineering due to its excellent physical and chemical properties. And many problems still need to be solved.
Objective Based on images of pelvic CT three-dimensional reconstruction, to establish three-dimensional coordinate system of pelvis and investigate the three-axis displacement classification of pelvic fracture and its reduction principles. Methods Between June 2015 and May 2016, 21 cases of normal pelvic CT data were included in the study, and the mean pelvic three-dimensional model was established. The pelvic three-dimensional axis was established by defining the origin as the midpoint of the anterior superior iliac spine. Based on this coordinate system, a three-axis displacement classification of pelvic fracture were built. To assess the clinical guidance value of the three-axis classification, 55 cases (29 males and 26 females, aged 11-66 years with an average of 35.6 years) of pelvic fractures were analyzed by this classification, and replaced and fixed according to the principles of the reverse reduction. Results According to the theory of three-axis, pelvic fractures were divided into x-axis positive displacement/negative displacement, positive rotation/negative rotation; y-axis positive displacement/negative displacement, positive rotation/negative rotation; z-axis positive displacement/negative displacement, positive rotation/negative rotation. The average incision of included patients with pelvic fractures was 7.1 cm. The average reduction time was 12.2 minutes and the average radiation time was 55.3 s. The average time of screw implantation was 27.2 minutes. Postoperative pelvic X-ray films or three-dimensional CT showed all pelvic fracture was reducted well and the screw or plate was implanted correctly. The average intraoperative blood loss was 96.5 mL, the average operation time was 2.1 hours, and the average hospitalization time was 18.7 days. All patients were followed up 6-53 months (mean, 16.7 months). At last follow-up, according to Matta standard by pelvic radiography evaluation, there were excellent in 39 cases, good in 13 cases, and fair in 3 cases, the excellent and good rate was 94.55%. Conclusion Based on three-dimensional coordinate system, three-axis displacement classification of pelvic fracture can illustrate the displacement mode of patient simply and accurately, and can also guide the intraoperative reduction precisely.
OBJECTIVE: To sum up the clinical results of allogeneic humeral transplantation with vascular anastomosis, and evaluate the clinical significance. METHODS: From September to November 1979, 1 case with humeral shaft defect of 10 cm in length and 2 cases with tibia shaft defect of 12 cm in length were repaired by allogeneic humeral transplantation with vascular anastomosis. Azathiopurine and prednisone were applied for 3 months postoperatively. All cases were followed up for 20 years. RESULTS: Case 1 recovered well with good bone union and reconstruction after operation, and could work normally. In case 2, five chronic rejections were occurred during 3 years after operation, and recovered after treatment, the allograft bone was fractured after 2 years of operation, and unioned by autogeneous iliac bone transplantation. In case 3, the distal part of allograft bone was fractured after 46 months, and unioned by autogeneous iliac bone transplantation. The middle part of allograft bone was non-unioned after 20 years follow-up in case 3, but the patient could still work normally. CONCLUSION: The clinical results of allogeneic long bone transplantation can be improved by rational tissue matching test, application of effective immunosuppressive drugs in a certain period according to the principles of modern transplantation immunology.
ObjectiveTo systematically review the safety and efficacy of operative versus non-operative treatment for displaced midshaft clavicle fractures.MethodsDatabases including PubMed, The Cochrane Library, EMbase, MEDLINE(Ovid), CBM, CNKI and WanFang Data were searched to collect randomized controlled trials (RCTs) and cohort studies about operation versus non-operation for displaced midshaft clavicle fractures from inception to June 3rd, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by RevMan 5.2 software.ResultsA total of 14 RCTs and 5 prospective cohort studies involving 1 543 patients were included. The results of meta-analysis showed that operation was superior to non-operation in the Constant score (SMD=0.76, 95%CI 0.40 to 1.13, P<0.000 1), DASH score (SMD=–0.49, 95%CI –0.91 to 0.06,P=0.02), nonunion rate (RR=0.17, 95%CI 0.10 to 0.30, P<0.000 01), malunion (RR=0.20, 95%CI 0.12 to 0.33,P<0.000 01) and patients’ satisfaction rate (RR=1.39, 95%CI 1.13to 1.71,P=0.002), respectively.ConclusionCurrent evidence shows that operation could improve the function of the upper limbs, reduce nonunion and malunion, and improve the satisfaction of the patients with midshaft clavicle fractures. Due to the limited quality of the included studies, more large-scale, high-quality studies are required to verify the above conclusion.
ObjectiveTo investigate the effect of graphene oxide (GO)-carboxymethyl chitosan (CMC) hydrogel loaded with interleukin 4 (IL-4) and bone morphogenetic protein 2 (BMP-2) on macrophages M2 type differentiation and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs).MethodsGO solution was mixed with CMC, then the phosphate buffered saline (PBS), IL-4, BMP-2, or IL-4+BMP-2 were added to prepare different GO-CMC hydrogel scaffolds with or without different cytokines under crosslinking agents. The characteristics of pure GO-CMC hydrogel were characterized by gross observation, scanning electron microscope (SEM), and Fourier transform infrared spectroscopy (FTIR), and the CMC hydrogel was used as control. The sustained release of GO-CMC hydrogels with different cytokines was also tested. Macrophages were isolated and cultured from female Sprague Dawley rats aged 4-5 weeks, and then cultured with GO-CMC hydrogels with and without different cytokines, respectively. CD206 immunofluorescence staining was used to detect the differentiation of macrophages after 24 hours. The 3rd generation of rats BMSCs were cultured with GO-CMC hydrogels with and without different cytokines respectively for osteogenic induction. The early osteogenesis was observed by alkaline phosphatase (ALP) staining after 10 days, and the late osteogenesis was observed by alizarin red staining after 21 days.ResultsGenerally, GO-CMC hydrogel was brown and translucent. SEM showed that the pore diameter and wall thickness of GO-CMC hydrogel were similar to that of CMC hydrogel, but the inner wall roughness increased. FTIR test showed that CMC polymerized to form hydrogel. In vitro, the sustained release experiments showed that the properties of GO-CMC hydrogels loaded with different cytokines were similar. CD206 immunofluorescence detection showed that GO-CMC hydrogels could induce macrophages differentiation into M2-type. ALP and alizarin red staining showed that GO-CMC hydrogels could induce BMSCs osteogenic differentiation, in which GO-CMC hydrogel loaded with IL-4+BMP-2 showed the most significant effect (P<0.05).ConclusionThe GO-CMC hydrogel loaded with IL-4 and BMP-2 can induce macrophages differentiation into M2-type and enhance the ability of BMSCs with osteogenic differentiation in vitro, which provide a new strategy for bone defect repair and immune regulation.
Objective To review the application of urine derived stem cells (USCs) in regeneration of musculoskeletal system. Methods The original literature about USCs in the regeneration of musculoskeletal system was extensively reviewed and analyzed. Results The source of USCs is noninvasive and extensive. USCs express MSCs surface markers with stable proliferative and multi-directional differentiation capabilities, and are widely used in bone, skin, nerve, and other skeletal and muscle system regeneration fields and show a certain repair capacity. Conclusion USCs from non-invasive sources have a wide application prospect in the regeneration of musculoskeletal system, but the definite biological mechanism of its repair needs further study.
OBJECTIVE To review the recent research progress of bone-marrow stromal stem cells (BMSCs) in the conditions of culture in vitro, chondrogenic differentiation, and the application in cartilage tissue engineering. METHODS: Recent original articles related to such aspects of BMSCs were reviewed extensively. RESULTS: BMSCs are easy to be isolated and cultivated. In the process of chondrogenesis of BMSCs, the special factors and interaction between cells are investigated extensively. BMSCs have been identified to form cartilage in vivo. One theory is the committed chondrocyte from BMSCs is only a transient stage. CONCLUSION: BMSCs are the alternative seeding cells for cartilage tissue engineering. The conditions promoting mature chondrocyte should be further investigated.
Cell sheet technology refers to the preparation of cells into thin sheets, which retains a large amount of extracellular matrix, cell-cell junctions, and has a wide range of applications in the repair and regeneration of osteochondral tissues. This paper discusses the types, properties, and construction methods of stem cell sheets, and reviews the current research status of vascularization of stem cell sheets and their composite application with various cytokines and scaffolding materials for bone and cartilage repair, with the aim of exploring the direction of the further development of stem cell sheets in the field of bone and cartilage.