Journal of Orthopaedic Surgery and Research最新文献

{"title":"Sodium alginate microspheres loaded with Quercetin/Mg nanoparticles as novel drug delivery systems for osteoarthritis therapy.","authors":"Jun Chen, Guoya Wu, Jian Wu, Zhijian Jiao","doi":"10.1186/s13018-025-05698-z","DOIUrl":"https://doi.org/10.1186/s13018-025-05698-z","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis (OA) is the most prevalent arthritic disease characterized by cartilage degradation and low-grade inflammation, for which there remains a lack of efficacious therapeutic interventions. Notably, mitigating the impact of oxidative stress (OS) and inflammatory factors could help alleviate or hinder the advancement of OA. Given the benefits of both quercetin (Que) and Magnesium ion (Mg²⁺) in OA treatment, coupled with the structural properties of Que, we have innovatively developed the Que-Mg²⁺ nanoparticles (NPs), aiming to deliver both Que and Mg²⁺ simultaneously and achieve enhanced therapeutic outcomes for OA. Moreover, to avoid the adverse reactions linked to frequent injections, sodium alginate (SA) microspheres encapsulating Que-Mg²⁺ NPs (Que-Mg@SA) were designed to treat the H₂O₂-induced OA cell model.</p><p><strong>Methods: </strong>Que-Mg@SA microspheres were synthesized using the ionotropic gelation technique, with calcium chloride acting as the cross-linking agent. Comprehensive characterization of the Que-Mg@SA was conducted through transmission electron microscope (TEM), dynamic light scattering (DLS), optical microscope, and scanning electron microscope (SEM), which provided detailed insights into their size, zeta potential, morphology, and micromorphology. Additionally, the microsphere swelling rate and Que release were evaluated. The biocompatibility of Que-Mg@SA microspheres, along with their impact on chondrocyte viability, were detected through CCK-8 assay and live/dead cell staining. Furthermore, the antioxidant and anti-inflammatory properties of Que-Mg@SA were evaluated by examining the ROS scavenging ability and pro-inflammatory factors levels, respectively. Finally, the regulatory influence of Que-Mg@SA microspheres on extracellular matrix (ECM) metabolism in OA was assessed by immunofluorescence staining and Western blot.</p><p><strong>Results: </strong>Characterization results revealed that Que-Mg NPs exhibit nanoscale diameter, exceptional stability, and good dispersibility, while Que-Mg@SA possesses high entrapment efficiency (EE%) and loading efficiency (LE%), pronounced hygroscopic properties, and sustained drug-release capabilities. Additionally, in vitro cellular assays revealed that the biocompatible Que-Mg@SA microspheres significantly restored chondrocyte viability, scavenged H₂O₂-induced excessive ROS, reduced the levels of inflammatory cytokines, upregulated cartilage anabolic gene expression, downregulated cartilage catabolic protease gene expression, and maintained the metabolic balance of cartilage tissue.</p><p><strong>Conclusion: </strong>The functionalized Que-Mg@SA microspheres developed in our study hold great promise as a drug delivery system for OA and potentially other biomedical applications.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"300"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of nicotine product use on outcomes of patients receiving cervical disc arthroplasty: a propensity score analysis of the united States nationwide inpatient sample 2005-2020.","authors":"Yu-Jun Lin, Fu-Yuan Shih, Jin-Fu Huang, Chun-Wei Ting, Yu-Chin Tsai, Lin Chang, Hung-Cheng Wang, Wu-Fu Chen","doi":"10.1186/s13018-025-05700-8","DOIUrl":"https://doi.org/10.1186/s13018-025-05700-8","url":null,"abstract":"<p><strong>Background: </strong>Nicotine product use, including cigarette smoking and other nicotine products, is a known risk factor for various health complications. While previous studies have examined its impact on spinal procedures, its specific effects on cervical disc arthroplasty (CDA) remain unclear. This study aims to investigate the association between nicotine product use and inpatient outcomes in patients undergoing CDA.</p><p><strong>Methods: </strong>Data from the 2005 to 2020 US Nationwide Inpatient Sample database of hospitalized adults ≥ 18 years old who underwent primary or revision CDA were extracted. Patients were divided into nicotine product users and non-users. Propensity score matching (PSM) was employed to balance the baseline characteristics between the groups. In-hospital mortality, unfavorable discharge, length of stay (LOS), and complications were compared between nicotine product users and non-users through logistic regression analyses.</p><p><strong>Results: </strong>After 1:1 PSM, 5,562 patients were included in the analysis. After adjustment, nicotine product users had a significantly elevated risk of overall complications (adjusted odds ratio [aOR] = 1.37, 95% confidence interval [CI]: 1.13-1.66, p = 0.002) and infection (aOR = 1.74, 95% CI: 1.17-2.58, p = 0.006). No significant association was observed between nicotine product use and the risk of unfavorable discharge or prolonged LOS (both, p > 0.05). In stratified analyses, male, but not female nicotine product users, had a greater risk of infection (aOR = 2.12, 95% CI: 1.22-3.70, p = 0.008). Nicotine product use was significantly associated with higher infection risk among individuals without diabetes, obesity, and chronic pulmonary disease (p < 0.05).</p><p><strong>Conclusions: </strong>Nicotine product use is associated with a higher risk of complications following CDA, particularly infections. The study highlights the importance of considering nicotine product use during preoperative assessments and postoperative care for patients undergoing CDA.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"298"},"PeriodicalIF":2.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High rate of failure after magnesium bioabsorbable compression screw fixation for scaphoid fractures.","authors":"Omer Faruk Egerci, Fırat Dogruoz, Hakan Cetin, Mehmet Baris Ertan, Aliekber Yapar, Ozkan Kose","doi":"10.1186/s13018-025-05701-7","DOIUrl":"https://doi.org/10.1186/s13018-025-05701-7","url":null,"abstract":"<p><strong>Purpose: </strong>This retrospective study aimed to evaluate the clinical and radiological outcomes of magnesium (Mg) bioabsorbable compression screws in the management of scaphoid fractures and nonunion. Despite theoretical benefits, such as osteoinductive properties and gradual degradation facilitating bone remodeling of these novel implants, clinical evidence on their efficacy remains limited.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on 20 patients who underwent scaphoid fracture or nonunion surgery with Mg screws at our hospital between 2015 and 2024. Patients with a minimum of 12 months of radiological follow-up were included. Functional assessments were conducted using the Quick Disabilities of the Arm, Shoulder, and Hand (Q-DASH) and Mayo Wrist Score, while radiographic outcomes focused on union, screw integrity, and cystic changes. Statistical analysis compared grip strength and wrist range of motion to the contralateral side.</p><p><strong>Results: </strong>The mean clinical follow-up period was 78.3 months (SD ± 22.0; range 14-108), and the mean radiological follow-up was 59.1 months (SD ± 30.5; range 12-99). Functional assessments showed a mean Q-DASH score of 11.5 (SD ± 16.9; range 0-68.2) and a Mayo Wrist Score of 75.7 (SD ± 13.3; range 45-95), indicating moderate functional recovery. The non-union rate was 40%, with complications including screw breakage in 25% of patients and cystic lesion formation around screws in most cases. No infections were reported. Wrist range of motion and grip strength were both significantly reduced on the injured side compared to the intact side.</p><p><strong>Conclusions: </strong>Mg screws demonstrate potential benefits for bioabsorbable fixation, but our findings indicate a high rate of complications, including non-union and screw instability, in scaphoid fractures. The study suggests that Mg screws may not provide adequate stability for complex fractures in small bones like the scaphoid.</p><p><strong>Level of evidence: </strong>Level IV, retrospective cohort study.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"296"},"PeriodicalIF":2.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning curve for full-endoscopic lumbar decompression via interlaminar approach using the learning curve cumulative summation analysis.","authors":"Sung Cheol Park, Sang-Min Park, Hoon-Jae Chung, Yong Jin You","doi":"10.1186/s13018-025-05699-y","DOIUrl":"https://doi.org/10.1186/s13018-025-05699-y","url":null,"abstract":"<p><strong>Background: </strong>Full-endoscopic spine surgery (FESS) is generally considered to have a steep learning curve due to its technical complexity. This study aimed to evaluate the learning curve for full-endoscopic decompressive laminectomy via the interlaminar approach using learning curve cumulative summation test (LC-CUSUM) analysis, which provides objective statistical monitoring of surgical competency acquisition, and determine the number of cases required for surgical competency.</p><p><strong>Methods: </strong>We retrospectively analyzed the first 60 consecutive patients who underwent single-level interlaminar endoscopic unilateral lumbar decompression for lumbar spinal stenosis performed by a single surgeon with 4 years of experience. LC-CUSUM analysis was employed with operative time as the primary outcome measure. The target time was set at 80 min, based on the same surgeon's mean operative time for microscopic laminectomy. The patients were divided into the early (≤ 30 cases) and late (> 30 cases) learning periods and compared.</p><p><strong>Results: </strong>LC-CUSUM analysis revealed that competency was achieved after 51 cases. The mean operative time significantly decreased from 90.20 ± 24.44 min in the early period to 71.47 ± 16.65 min in the late period (p = 0.001). Estimated blood loss showed significant reduction (54.83 ± 42.58 ml vs. 34.83 ± 19.10 ml, p = 0.024). Complication rates remained consistent between periods (10% each), with similar rates of dural tears (6.67% in both periods).</p><p><strong>Conclusions: </strong>The results of this study have demonstrated that a learning period of 51 cases could be required to achieve proficiency in full-endoscopic interlaminar lumbar decompression. However, the procedure can be safely performed even during the early learning period by surgeons with adequate microscopic surgical experience.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"297"},"PeriodicalIF":2.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MYLK-AS1 improves fracture by targeting miR-146a-5p to regulate cell viability and apoptosis in osteoblasts.","authors":"Wuluhan Mahan, Haoze Gao, Ning Liu, Zhenyu Zhao, Yingxuan Huang","doi":"10.1186/s13018-025-05688-1","DOIUrl":"https://doi.org/10.1186/s13018-025-05688-1","url":null,"abstract":"<p><strong>Background: </strong>Delayed fracture healing (DFH) is a significant burden for patients. Therefore, early diagnosis and detection are important for the treatment of DFH. The long non-coding RNA (LncRNA) MYLK-AS1 is abnormally expressed in patients with DFH and has the potential to be used as a diagnostic marker.</p><p><strong>Methods: </strong>40 patients with DFH and 87 patients with normal fracture healing were included. The levels of MYLK-AS1, miR-146a-5p and several mRNA markers of osteogenic differentiation were assessed by RT-qPCR. The diagnostic value of MYLK-AS1, miR-146a-5p was assessed using ROC curves. Cell proliferation ability was assessed by CCK-8, and apoptosis rate was detected by flow cytometry. DLR, RIP and RNA pull down assays demonstrated the targeting relationship between MYLK-AS1 and miR-146a-5p.</p><p><strong>Results: </strong>MYLK-AS1 levels were significantly lower and miR-146a-5p levels were significantly up-regulated in DFH compared to normal healing patients. MYLK-AS1 was found to target miR-146a-5p, and the levels were negatively correlated with each other. MYLK-AS1 with miR-146a-5p is of high value for the diagnosis of DFH. High expression of MYLK-AS1 could inhibit miR-146a-5p levels, support cell proliferation, reduce apoptosis, and increase the levels of osteogenesis-specific matrix proteins and osteogenesis-related regulatory factors.</p><p><strong>Conclusion: </strong>MYLK-AS1 has potential as a diagnostic marker for DFH. By increasing the expression level of MYLK-AS1 in cells can reduce the level of miR-146a-5p, increase the activity of osteoblasts and reduce their apoptosis rate, thus affecting the process of fracture healing.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"295"},"PeriodicalIF":2.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The modified 5-item frailty index in total hip arthroplasty patients: a retrospective cohort from a low-middle income country.","authors":"Usman Ali, Shahzil Abdur Rehman Malik, Bilal Iqbal, Aribah Bhatti, Sher Baz Khan, Shahryar Noordin, Anum Ali","doi":"10.1186/s13018-025-05505-9","DOIUrl":"https://doi.org/10.1186/s13018-025-05505-9","url":null,"abstract":"<p><strong>Background: </strong>Total hip arthroplasty (THA) is increasing in low- and middle-income countries (LMICs) due to rising rates of hip fractures and an aging population. Identifying frail patients at risk for postoperative complications is vital for improving outcomes. This study examines the utility of the Modified 5-Item Frailty Index (mFI-5) in predicting 30-day morbidity and mortality in THA patients in resource-limited settings, where other models like the Elixhauser Comorbidity Measure (ECM) and Charlson Comorbidity Index (CCI) may be impractical due to data constraints.</p><p><strong>Methods: </strong>This retrospective cohort study included 498 patients undergoing THA at tertiary-care hospital between January 2014 and December 2019. Patients were stratified based on their mFI-5 scores (≤ 1 vs. > 1). Postoperative complications, length of stay, and mortality were compared between groups. Multivariable logistic regression was used to assess outcomes.</p><p><strong>Results: </strong>Of the 498 patients, 62.8% had an mFI-5 score ≤ 1, and 37.2% had a score > 1. Complication rates were higher in the mFI-5 > 1 group (17.8%) versus the ≤ 1 group (9.6%). After adjusting for covariates, patients with mFI-5 > 1 had a 97% higher likelihood of complications (aOR = 1.97, 95% CI 1.06-3.70). Each additional hospital day increased complication risk by 13% (aOR = 1.13, 95% CI: 1.05-1.21).</p><p><strong>Conclusion: </strong>The mFI-5 is a practical, efficient tool for predicting postoperative complications in THA patients, particularly in resource-limited environments. Its use in LMICs could improve preoperative planning, reduce complications, and provide better outcome estimates for patients and healthcare providers. Given the growing geriatric population, integrating the mFI-5 into routine THA planning could enhance patient care and resource allocation. Further research is needed to validate its use across larger datasets.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"299"},"PeriodicalIF":2.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Icariin promotes osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) by activating PI3K-AKT-UTX/EZH2 signaling in steroid-induced femoral head osteonecrosis.","authors":"Wei Ji, Guoqing Gong, Yuanhang Liu, Yan Liu, Jie Zhang, Qiang Li","doi":"10.1186/s13018-025-05697-0","DOIUrl":"10.1186/s13018-025-05697-0","url":null,"abstract":"<p><strong>Background: </strong>Differentiation of bone marrow mesenchymal stem cells (BMSCs) is pivotal in the pathogenesis of steroid-induced femoral head osteonecrosis. Icariin, an active ingredient in Epimedii herba, has the potential to regulate osteogenic differentiation of BMSCs. Nevertheless, the related mechanism is still unclear. The study aimed to explore whether icariin can affect osteogenic differentiation by activating PI3K/AKT signaling to alter UTX and EZH2 expression and thus regulating osteogenesis-related genes in BMSCs.</p><p><strong>Methods: </strong>BMSCs were collected from Sprague Dawley rats and identified by measuring the positive ratios of cell markers using flow cytometry. Cells were treated with 1 μmol/L dexamethasone (DEX) for 24 h with or without 0.1-10 μM of icariin treatment. Cell counting Kit-8 (CCK-8) assays and flow cytometry analyses were performed to measure cell viability and apoptosis. Western blotting was conducted for measurement of apoptotic markers, factors involved in the PI3K/AKT-UTX/EZH2 pathway, osteogenic markers, and adipogenesis-related factors. Alizarin red S staining and Oil-red O staining were performed to measure the effect of DEX, icariin, UTX overexpression, or EZH2 knockdown on osteogenic and adipogenic differentiation of BMSCs.</p><p><strong>Results: </strong>Icariin ameliorated DEX-induced rat BMSC injury. Icariin activated the PI3K/AKT signaling, thereby upregulating UTX and phosphorylated EZH2 levels while inhibiting EZH2 and H3K27me3 expression. Additionally, icariin promoted osteogenic differentiation and inhibited adipogenic differentiation of BMSCs. Importantly, overexpressing UTX or silencing EZH2 exerted similar effects on BMSC differentiation as icariin did.</p><p><strong>Conclusions: </strong>Icariin promotes osteogenic differentiation of DEX-treated BMSCs by activating PI3K/AKT signaling to upregulate UTX and inhibit EZH2, finally inducing H3K27me3 depletion.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"290"},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of surgery for multipleligament knee injuries on patellar position and patellofemoral function: a retrospective study.","authors":"Yuanping Liao, Xiao Wang, Xiaotao Shi, Guorui Cao, Honglue Tan","doi":"10.1186/s13018-025-05652-z","DOIUrl":"https://doi.org/10.1186/s13018-025-05652-z","url":null,"abstract":"<p><strong>Background: </strong>Patients who undergo reconstruction for multiligament knee injuries (MLKIs) often exhibit knee instability and poor overall knee function during postoperative follow-up. This may be related to the changes in patellar position and decline in patellofemoral function after surgery.</p><p><strong>Objective: </strong>To evaluate the outcomes following reconstruction of MLKIs through the assessment of: (1) changes in patellar height; (2) anatomical changes in patellofemoral alignment, such as tilt or displacement; and (3) functional outcomes of the patellofemoral joint.</p><p><strong>Methods: </strong>This retrospective study included 45 patients who underwent reconstruction for MLKIs at our hospital between November 2015 and September 2022, with complete data and meeting the inclusion criteria. These patients formed the case group. An additional 20 outpatients without ligament injuries or patellar dislocation were selected as the normal control group. Patellar height changes in the case group were assessed preoperatively and postoperatively using the Caton-Deschamps (CD) and Insall-Salvati (IS) indices on lateral X-rays. Magnetic resonance imaging (MRI) was used to measure patellofemoral alignment parameters in both groups, including the sulcus angle (SA), patellar tilt angle (PTA), lateral patellofemoral angle (LPA), congruence angle (CA), and patellofemoral index (PI), to evaluate patellofemoral positioning. Additionally, the Kujala score questionnaire was used to assess the stability function of the patellofemoral joint.</p><p><strong>Results: </strong>Preoperative patellar height in the case group, measured by the CD and IS indices, was (1.07 ± 0.10, 1.10 ± 0.09), showing a statistically significant difference when compared to postoperative measurements (0.96 ± 0.13, 1.05 ± 0.10) (P < 0.05). However, postoperative patellofemoral alignment parameters, including SA, PTA, LPA, CA, and PI, in the case group showed no statistically significant differences compared to the control group (P > 0.05). At the latest follow-up, the patellofemoral function score in the case group was (89.0 ± 5.3), which was not significantly different from the control group (91.0 ± 2.9) (P > 0.05).</p><p><strong>Conclusion: </strong>After reconstruction of MLKIs, patellar height decreased but remained within the normal range. Patellofemoral alignment was well-maintained, and patellofemoral function was maintained.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"291"},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibroblast IRF7-mediated chondrocyte apoptosis affects the progression of collapse in steroid-induced osteonecrosis of the femoral head.","authors":"Han Longfei, Fang Weihua, Han Mingli, Zhuang Zhikun, He Mincong, Wei Qiushi","doi":"10.1186/s13018-025-05557-x","DOIUrl":"10.1186/s13018-025-05557-x","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this study was to identify potential genes implicated in the \"peri-collapse\" synovium of osteonecrosis of the femoral head through coding gene sequencing and to further clarify their specific mechanisms via in vitro experiments.</p><p><strong>Methods: </strong>Steroid-induced osteonecrosis of the femoral head (SIONFH) (n = 3), femoral neck fracture (FNF) (n = 3), and hip osteoarthritis (HOA) (n = 3) Synovial tissue of the hip joint was collected in total hip arthroplasty. A cellular model of SIONFH constructed from rat synovial fibroblasts by lipopolysaccharide intervention. Lentiviral technology was used to construct a model for fibroblast knockout of the Irf7 gene. HE was used to compare the characteristics of synovial tissue damage, and immunofluorescence and immunohistochemistry were used to compare the expression levels of VIM, IRF7, and IFNα. PCR, WB, and IF were used to examine Irf7 knockdown efficiency, chondrocyte proliferation (Col2a1, Aggrecan, Sox9), cartilage matrix degradation (Mmp13), and apoptosis (Bcl2, Bax, and Caspase3) expression under co-culture conditions. Crystalline violet staining was used to observe the migration rate of fibroblasts, and flow cytometry was used to detect the apoptosis level of chondrocytes under co-culture conditions.</p><p><strong>Results: </strong>Transcriptome sequencing of synovial tissue and fibroblasts ultimately screened for six differential genes, HOOK1, RNPC3, KCNA3, CD48, IRF7, SAMD9. Compared to FNF and HOA, synovial inflammatory cell recruitment and synovial hyperplasia were more pronounced in SIONFH. IF and IHC confirmed high expression of IRF7 and IFNα in the synovium of SIONFH. PCR and WB results suggested that fibroblasts highly expressed Irf7, Hook1, Rnpc3, Kcna3, Cd48, Samd9, Il-6, and Tnfα after lipopolysaccharide intervention, and the expression levels of Il-6 and Tnfα were significantly reduced after knockdown of Irf7 (P < 0.001). In the co-culture system, fibroblasts intervened with lipopolysaccharide significantly promoted chondrocyte apoptosis, the rate of cartilage matrix degradation, while inhibiting the level of chondrocyte proliferation, and this result was significantly reversed in Irf7 knockout fibroblasts. This was supported by flow cytometry results.</p><p><strong>Conclusions: </strong>IRF7, HOOK1, RNPC3, KCNA3, CD48, and SAMD9 as potential genes affecting the progression of SIONFH collapse. Irf7 mediates the fibroblast inflammatory response and affects the collapse process of SIONFH by influencing chondrocyte apoptosis. Thus, intervention in IRF7 holds promise as one of the key targets for reversing the collapse process of SIONFH.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"292"},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for metachronous periprosthetic joint infection in patients with multiple prosthetic joints: a systematic review and meta-analysis.","authors":"Yi Li, Xiaolin Quan, Cheng Zhou, Xin Duan, Mao Nie, Haibo Si","doi":"10.1186/s13018-025-05694-3","DOIUrl":"10.1186/s13018-025-05694-3","url":null,"abstract":"<p><strong>Object: </strong>Although periprosthetic joint infection (PJI) can affect multiple joints simultaneously, most individuals with multiple joint involvement exhibit PJI in only one joint. Data regarding the metachronous PJI management for these patients are limited. This study aimed to explore the risk factors for metachronous PJI in patients with multiple prosthetic joints, thereby guiding and optimizing clinical practice.</p><p><strong>Methods: </strong>The MEDLINE, Web of Science, Cochrane Library, and EMBASE were searched for all clinical studies of metachronous PJI from inception until May 2024. The clinical studies on risk factors for metachronous PJI in patients with multiple prosthetic joints after experiencing a periprosthetic infection were collected, with two authors independently screening the literatures. Newcastle Ottawa scale was used as a quality assessment tool for the included studies, and the meta-analysis was conducted to evaluate the potential risk factors of metachronous PJI.</p><p><strong>Results: </strong>A total of 1,544 patients with PJI after multiple joint arthroplasties were reported in 9 studies, including 189 with metachronous PJI. The meta-analysis showed that methicillin-resistant staphylococcus aureus (MRSA; OR, 3.43; 95%CI, 1.71-6.88; p = 0.0005), rheumatoid arthritis (RA; OR, 2.38; 95%CI, 1.06-5.38; p = 0.04), history of steroid use (OR, 2.93; 95%CI, 1.58-5.43; p = 0.0007), and previous or ongoing non-periprosthetic infection (OR, 4.47; 95%CI, 1.45-13.82; p = 0.009) were identified as significant risk factors for metachronous PJI in patients with multiple prosthetic joints. However, there was no significant difference between the metachronous PJI group and non-metachronous group in terms of revision, age, diabetes, and gender.</p><p><strong>Conclusion: </strong>Patients with MRSA, RA, history of steroid use, previous or ongoing non-periprosthetic infection are at significantly higher risk for metachronous PJI. Further research is needed to optimize management strategies for preventing metachronous PJI in patients with multiple prostheses after a single joint PJI.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"293"},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}