Formosan Journal of Musculoskeletal Disorders最新文献

{"title":"Shear stresses modulate chondrogenic and osteogenic genes expression in human bone marrow derived stem cells","authors":"Mel S. Lee, Ming-Tsung Sun, Wen‐Jer Chen, Yu-Han Chang, H. Yip, S. Ueng","doi":"10.6492/FJMD.20150811","DOIUrl":"https://doi.org/10.6492/FJMD.20150811","url":null,"abstract":"Background: Mechanical stimuli in the microenvironment may provide cues for differentiation, maintenance of phenotypes, and extracellular matrix homeostasis. This study investigated bone marrow-derived stem cells (BMSCs) response to mechanical stresses in terms of differentiation and the extracellular matrix/matrix metalloproteinase genes expression. Materials & Methods: Human BMSCs were exposed to shear stresses (20 rpm or 50 rpm) for 2, 5, or 10 days with or without osteogenic induction medium. The expression of chondrogenic (type II collagen and aggrecan) and osteogenic (type I collagen, alkaline phosphatase, osteopontin, osteocalcin) phenotypic genes and matrix metalloproteinase genes (aggrecanse, MMP-2, and MMP-9) were analyzed by reverse transcription polymerase chain reaction. In vitro differentiation of BMSCs after shear stress treatment were analyzed by von Kossa staining on monolayer cultures and safarin-O staining on pelleted cells. Results: Shear stress at 20 rpm significantly upregulatedexpression of type II collagen on the 5th day, type I collagen on the 2nd, 5th, and 10th day, osteopontin on the 2nd and 5th day, and osteocalcin on the 5th day as compared to shear stress at 50 rpm. Combination of osteogenic induction medium and shear stress at 20 rpm decreased the mRNA expression levels of chondrogenic genes (type II collagen on all time points and aggrecan on the 5th and 10th day) as compared with shear stress alone. It also decreased the expression of osteogenic genes (type I collagen, alkaline phosphatase, and osteopontin) on the 10th day as compared to osteogenic induction medium. Concomitantly, shear stress upregulated aggrecanase on the 10th day, MMP-2 on the 10th day, and MMP-9 on the 5th and 10th day as compared with osteogenic induction medium. Shear stress increased mineralization of the extracellular matrix as shown by von Kossa staining on the 2nd, 5th, and 10th day. Chondrogenic differentiation by cell pellet analysis found similar amount of proteoglycans but less organized extracellular matrix in shear stress-treated BMSCs as compared to control cells. Discussion: Although shear stress could modulate chondrogenic gene expression as well as osteogenic genes expression in BMSCs, the combination of shear stress inhibited the expression of osteogenic phenotypic genes induced by osteogenic induction medium. Parallel studies revealed that shear stress concomitantly modulate the expression of extracellular matrix genes and the matrix metalloproteinase genes. In vitro differentiation analysis found that shear stress may enhance osteogenesis but interfere with chondrogenesis. Our results may provide data for the design or development of in vitro bioreactor systems to control lineage differentiation of stem cells for tissue engineering. More studies on the mechanotransduction pathways are needed in the future.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"7 1","pages":"90-98"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85584689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative computed tomography navigation for transpedicular screw placement in posterior instrumentation and correction of adolescent idiopathic scoliosis","authors":"Yen-Yao Li, Ching-Yu Lee, Meng-Huang Wu, Tsung-Jen Huang, Chin‐Chang Cheng, Chien-Yin Lee","doi":"10.6492/FJMD.20160224","DOIUrl":"https://doi.org/10.6492/FJMD.20160224","url":null,"abstract":"Background: Intraoperative computed tomography (iCT) navigation produces high resolution real-time 3-dimensional images, which can be obtained after the well-prepared surgical field of posterior spinal elements is scanned by the iCT. There is a paucity of studies reporting the feasibility of the iCT navigation system integrated into posterior instrumentation and correction for adolescent idiopathic scoliosis (AIS). Purpose: This study is to evaluate the safety and accuracy of transpedicular screws (TPS) placement in AIS using the iCT navigation. Methods: We performed a retrospective review of records of the Spine Operation Registry at the authors’ institution to identify AIS patients who underwent correction with posterior pedicle screw instrumentation via the iCT navigation from year 2010 to 2014. Results: A total of 17 AIS patients underwent correction with posterior instrumentation via iCT navigation. A total of 245 screws including 175 thoracic screws and 70 lumbar screws were placed. The mean estimated blood loss was 718 ml (range, 350–1,500 ml) and the average operative time was 266 min (range, 150–420 min). The mean dose of patient radiation exposure was 20.1 mSv (range, 13.1–30 mSv) and the mean radiation dose per single level exposure was 1.9 mSv (range, 1.2–2.7 mSv). The average Cobb angles of major curve before surgery, in the immediate postoperative period, and at the most recent follow-up were 53.2 degrees, 16.5 degrees, and 17.7 degrees, respectively. The average correction rate was 67% (range, 50%–82%) with an average of 10.7 fused levels (range, 8–14 fused levels). A total of 236 screws (96%) were positioned in the pedicle without cortical breach, including 167 thoracic screws (95%) and 69 lumbar screws (99%). There were 90 wellpositioned screws (96%) on the concave side and 77 well-positioned screws (95%) on the convex side of the thoracic curves. There were 32 wellpositioned screws (100%) the concave side and 37 well-positioned screws (97%) on the convex side of the lumbar curves. Breach grade 1 occurred in one thoracic pedicle screw and one lumbar pedicle screw, and breach grade 2 occurred in seven thoracic pedicle screws. All screws with breach grade 2 were removed. The TPS removal rate was 3% (7/245) without any neurovascular sequela. Conclusion: TPS placement using the iCT navigation system resulted in 96% accuracy in posterior instrumentation and correction of AIS. A malpositioned pedicle screw could be immediately removed during real-time assessment of the TPS position, and no secondary operation was required.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"53 1","pages":"57-62"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84846357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute lower abdominal infections presenting as necrotizing soft tissue infection of the thigh: A report of 3 cases","authors":"Guo-Shou Wang, Chen-Yu Yang, Te-Yang Huang, F. Lee, Po-Li Tsai, Chien‐Kuo Liu","doi":"10.6492/FJMD.20160110","DOIUrl":"https://doi.org/10.6492/FJMD.20160110","url":null,"abstract":"Necrotizing soft tissue infection is an orthopedic surgical emergency. Early diagnosis is often difficult due to the non-specific symptoms and signs and the rapid progression. Herein, we report three cases who had abdominal infections but presented with lower limbs severe soft tissue infections as the initial presentation. The diagnoses included acute appendicitis, diverticulitis, and ruptured colon cancer, which spread to the retroperitoneal space causing necrotizing soft tissue infection of the lower extremities without abdominal symptoms and signs. Necrotizing soft tissue infection of the thigh should raise suspicion of severe abdominal infections. These conditions may be life threatening, and an early diagnosis and aggressive surgical debridement are essential to improve survival.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"19 1","pages":"63-68"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90900683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computer-assisted orthopedic surgery","authors":"Tsan-Wen Huang, R. Hsu","doi":"10.6492/FJMD.20160324","DOIUrl":"https://doi.org/10.6492/FJMD.20160324","url":null,"abstract":"Computer-assisted surgery (CAS) has been used in orthopaedic surgery for over 20 years. Through real-time and quantitative feedback, it provides the surgeons the visibility of surgical anatomy, improves accuracy, reduces the outlier of the surgical results and maximizes the outcomes. CAS has been popularly applied in joint arthroplasty, bone osteotomy, implantation of screws in spine surgery, reconstruction of ligaments in sports medicine, open reduction and internal fixation of long-bone fracture and tumor surgery. The article is to overview the current CAS clinical application status and related outcomes. Whether the better postoperative images can translate into improved clinical functional outcomes deserves long term follow up.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"58 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90658568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computer-assisted surgery does not improve the rotational alignment of the femoral component in total knee arthroplasty for severe genu varus deformity","authors":"Fu-Chun Chang, Shih-Jie Lin, Tsan-Wen Huang, Mel S. Lee, R. Hsu","doi":"10.6492/FJMD.20151124","DOIUrl":"https://doi.org/10.6492/FJMD.20151124","url":null,"abstract":"Background: Accurate femoral rotational alignment is critical for successful total knee arthroplasty (TKA). Debates exist about whether computer-assisted surgery-TKA (CAS-TKA) improves the accuracy of femoral rotational alignment. We hypothesize that it is related to the severity of the preoperative genu varus deformity and that CAS-TKA is beneficial under certain circumstances. Methods: Patients who had osteoarthritis with genu varus deformity and underwent conventional TKA or CAS-TKA between January 2007 and July 2013 at our hospital were enrolled. Based on the degree of preoperative deviation from the mechanical axis (MA), the patients were divided into three subgroups at 5-degree intervals: (1) varus deformity of ＜ 10 degrees, (2) 10–14.9 degrees, and (3) ≥ 15 degrees. Computed tomography was used to determine whether CAS-TKA provided better femoral rotational alignment than did conventional TKA. Component and limb alignment were also radiographically compared. Results: One hundred seventy-three knees on 128 patients met the inclusion criteria. For patients in the ＜ 10 degrees and 10–14.9 degrees groups, the component alignments and postoperative mechanical axes were not significantly different between conventional and CSA-TKA. For patients in the ≥ 15 degrees group, however, the femoral flexion angle was significantly (p ＜ 0.001) better for CSA-TKA, but not for the femoral valgus, tibial valgus, tibial flexion, or femoral rotational angles. Conclusions: CAS-TKA does not improve the accuracy of rotational alignment of the femoral component in patients with genu varus deformity. Level of Evidence: Therapeutic Level III.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"115 1","pages":"36-43"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73414163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcome of two-incision total hip arthroplasty with intraoperative imageless navigation for cup placement: A concise followup, at ten to twelve years, of a previous report","authors":"Feng-Chih Kuo, Tsan-Wen Huang, Kuo-Ching Huang, Bradley Chen, Mel S. Lee","doi":"10.6492/FJMD.20160115","DOIUrl":"https://doi.org/10.6492/FJMD.20160115","url":null,"abstract":"Background: We previously reported at a minimum follow-up of one-year results of the use of imageless navigation for cup placement in primary two-incision total hip arthroplasties (THA). The purpose of the present report is to update that study and report the ten to twelve-year outcomes. Materials and methods: Twelve consecutive patients underwent minimally invasive two-incision (MIS-2) THA done by a single experienced surgeon between September 2003 and January 2005. A retrospective chart review was performed to investigate clinical assessment (the Harris hip score [HHS] and the Western Ontario and McMaster University Osteoarthritis Index [WOMAC] scale), radiographic analysis, the complications and survivorship. Results: At the latest follow-up evaluation, the HHS and WOMAC scale were 95.4 and 96.5 points respectively. There were no radiographic evidence of definite loosening. Injury to the lateral femoral cutaneous nerve occurred in 4 hips. There were no dislocation, no periprosthetic joint infection or fracture. The 10- year Kaplan-Meier analysis revealed 100% survival rate with revision for any reason as the end point. Conclusion: This study demonstrated that imageless navigation system for the two-incision THA give excellent long-term results.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"258 5","pages":"51-56"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91476513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative study between the pinless navigation and the articular surface mounted (ASM) navigation in total knee arthroplasty: Radiographic results and early clinical outcomes","authors":"Pruk Chaiyakit, Anupab Imsumran","doi":"10.6492/FJMD.20150721","DOIUrl":"https://doi.org/10.6492/FJMD.20150721","url":null,"abstract":"Introduction: There were reports showed pinless navigation and articular surface mounted navigation in total knee arthroplasty (TKA) produces better results in term of radiographic outcomes when compared to conventional techniques. However, there was no comparative study between these two systems. Objective: To compare the radiographic results and early clinical outcomes between two systems. Methods: We collect data from all patients underwent TKA using either system from 1 January 2014 to 30 September 2014. We excluded the patient whom underwent navigation on tibia or femur only; the patients with pre-op deviation of mechanical axis more than 15 degrees, and the patients with extra-articular deformity. Radiographic outcomes included pre and post-operative alignment, and post-operative prosthesis alignment in coronal and sagittal plane. Clinical outcomes included demographic data, knee score and functional score, tourniquet time, blood loss, and complications. Results: 83 patients were included (43 pinless group, 40 ASM group). There was no statistical significant difference in the mean of age, BMI, pre-operative deformity, and pre-operative knee score, functional score, blood loss, and post-operative knee score and functional score. However in term of radiographic results, the mean post-operative correction of mechanical axis of pinless navigation was varus 1.1+/-2.16 degree while mean of ASM navigation was varus 0.01+/-1.88 degree. The difference was statistically significant with p-value less than 0.05. Percentage of radiographic outlier of pinless group was 13.95% while ASM group was 2.5%. Conclusion: The ASM navigation showed better result in term of post-operative correction of mechanical axis, which due to the ability to verify bone resection after the bone was resected. This feature could be beneficial in future development of this simple CAS system.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"7 1","pages":"25-29"},"PeriodicalIF":0.0,"publicationDate":"2015-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81525280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Accuracy of Ct-Based Navigation for Rotational Acetabular Osteotomy","authors":"Nobuhiko Suganoa, M. Takao, T. Sakai, T. Nishii, H. Miki","doi":"10.6492/FJMD.20151007","DOIUrl":"https://doi.org/10.6492/FJMD.20151007","url":null,"abstract":"Background: Although there are several clinical reports of the accuracy and safety of navigation for total hip arthroplasty, there have been few clinical reports on navigation for rotational acetabular osteotomy (RAO). The purpose of this study was to evaluate clinically the safety and accuracy of CT-based navigation for RAO. Method: We retrospectively reviewed consecutive 36 hips of 29 cases with symptomatic hip dysplasia who underwent RAO using the CTbased navigation between July 1999 and September 2009. Results: All patients were female. The average age at operation was 31years with a range of 17 to 48 years. Radiographic measurements showed the level of the osteotomy from the articular surface ranged from 15 mm to 20 mm with an average of 16 mm ± 1.3 mm (SD). No fragmentation or crack of the acetabulum due to intra-articular osteotome perforation was identified. The average center-edge angle improved significantly from 1° on preoperative radiographs to 34° on the immediate postoperative radiographs (p ＜ 0.001). All patients were followed-up for a minimum of five years with an average follow-up term of eight years (range, 5 to 15 years). There were no complications such as infection, nonunion, avascular necrosis or neuro-vascular injuries. The Merle d’Aubigne and Postel hip score improved from 13.7 preoperatively to 16.9 at the latest follow-up. Radiographically, progression of the joint space narrowing was found in one hip. The remaining cases showed no progression of osteoarthritis. No hip was converted to total hip arthroplasty. Conclusion: CT-based navigation for RAO is safe and accurate with substantial clinical improvement in patients with hip dysplasia.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"97 1","pages":"44-50"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82433445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigation System Provides Better Functional Outcomes of Total Knee Arthroplasty","authors":"Seung-Hun Lee, E. Song, J. Seon","doi":"10.6492/FJMD.20150914","DOIUrl":"https://doi.org/10.6492/FJMD.20150914","url":null,"abstract":"Computer assisted navigation systems are currently being widely used in orthopedic surgery, and especially for total knee arthroplasty (TKA). Using a navigation system in knee surgery provided useful intraoperative information about the anatomical placement that’s done intraoperatively in real time. It helps perform accurate surgery, it improves the radiologically assessed implantation and it allows precise correction of a mechanical axis, and so we can expect improved clinical results. In this article, we review the navigation system, surgical method, advantages, disadvantages and presents a balanced view of navigationassisted TKA and discusses controversies about navigation systems regarding coronal alignment, axial alignment, and clinical outcomes.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"60 1","pages":"8-16"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88175080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of computer assisted surgery in revision total knee arthroplasty","authors":"D. Bae, D. Hur","doi":"10.6492/FJMD.20150807","DOIUrl":"https://doi.org/10.6492/FJMD.20150807","url":null,"abstract":"Computer assisted surgery (CAS) is used to improve accuracy of neutral mechanical axis and ligament balancing in primary TKA. However, its efficiency in revision TKA is not clear. The application of CAS in revision TKA provide a significant improvement of prosthesis alignment, balanced flexion and extension gaps, data about joint line position throughout the surgery. However, it requires further investigations about long-term clinical results and survival rate.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"8 1","pages":"17-24"},"PeriodicalIF":0.0,"publicationDate":"2015-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88098967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}