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ABSTRACT: The purpose of this study was to evaluate the use of total knee arthroplasty (TKA) using a computer-assisted navigation system for treating osteoarthritis with extra-articular deformity.
Between January 2006 and January 2009, computer-assisted navigation TKAs were performed on eight knees in eight patients, who had severe osteoarthritis with an ipsilateral extra-articular deformity. All patients were followed up for a minimum of 24 months. The involved knees were evaluated by function scores, Knee Society knee scores, and analyzing knee flexion before the operation and at the latest follow-up.
Postoperatively, the function scores, Knee Society knee scores, and knee flexion all improved significantly. The ideal mechanical axis of the lower extremity was obtained in all cases.
TKA using a computer-assisted navigation system might provide an efficient treatment for patients with osteoarthritis in combination with an extra-articular deformity.
European Journal of Orthopaedic Surgery & Traumatology 01/2013; 23(1):93-6. · 0.10 Impact Factor
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ABSTRACT: Local chronic inflammatory reaction plays an important role in the process of aseptic loosening of implants after total joint replacement. In addition, macrophage migration inhibitory factor (MIF) is a key upstream regulator of inflammation, and it is a significant regulator of inflammatory diseases. The purpose of this study is to investigate if the fibroblasts and macrophages in the interfacial membranes overexpress MIF.
The 15 tissue samples of interfacial membranes were obtained from the tissues around the aseptically loosened femoral implants adjacent to osteolytic lesion in 15 patients. The 15 control synovial samples of hip joints were obtained from 15 patients who underwent primary hip arthroplasty because of the fresh fracture of the femoral neck. The levels of MIF protein and mRNA were evaluated by ELISA assay, immunofluorescence labeling, and real-time RT-PCR. Fibroblasts and macrophages were identified by immunofluorescence labeling.
The levels of MIF protein and mRNA were significantly increased, as well as the numbers of MIF+ fibroblasts and macrophages in the interfacial membranes compared with the control synovium.
Not only the macrophages, but also the fibroblasts in interfacial membranes overexpress MIF. MIF may play a significant role in the process of aseptic-loosening implants after total joint replacement.
Journal of Surgical Research 10/2011; 176(2):484-9. · 2.25 Impact Factor
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ABSTRACT: Chronic synovitis of knee joints that cannot be treated by conservative measure effectively can be treated successfully by the operations through resecting the inflamed synovium. The operations include open synovectomy and arthroscopic synovectomy. The purpose of this study is to compare the two operations in alleviating symptoms and cosmetic effect. There were 42 patients in this study, and they suffered from chronic synovitis of knee joints, including rheumatoid arthritis and non-specific synovitis. Twenty-two knees of 22 patients underwent arthroscopic synovectomy with two to five approaches whose lengths were about 1.0 cm, and 20 knees of 20 patients underwent open synovectomy with two approaches whose lengths were more than 10.0 cm. Patients were evaluated by visual analog scale for pain at the 24th hour after operation. Patients were followed up for 16-20 months and were evaluated by the Ogilvie-Harris scoring system. This study showed that both arthroscopic synovectomy and open synovectomy successfully alleviated the symptoms and the short-term results are similar after operation. However, the scars in the patients of the former group were much shorter than the latter group. Pain intensity of patients underwent arthroscopic synovectomy was less than that of open synovectomy at the 24th hour after operation. Both operations could treat chronic synovitis successfully. However, the arthroscopic synovectomy is the preferred operation due to fast recovery, less postoperative pain, and excellent cosmetic effect.
Rheumatology International 03/2011; 32(6):1733-6. · 1.88 Impact Factor
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ABSTRACT: The precision and accuracy of human cortical bone reconstruction using 3D CT scans was evaluated using machined bone segments. Both linear and angular errors were measured. Cadaver adult femoral and tibial cortical bone segments were obtained and machined in six orthogonal planes with a precision milling machine. CT scans were then obtained and the bone segments were reconstructed as digital replicas. Dimensional and angular measurements errors were evaluated for the machined bone segments and the results were compared with known dimensions based on milling machine settings to calculate errors due to scanning and model reconstruction. The model dimensional error in the coronal, sagittal and axial directions had a mean of 0.21 mm, with standard a deviation of 0.12 mm and a maximum error of 0.47 mm. The mean percent error was 0.74% and the maximum percent error was 1.9%. The angular error of models in the coronal, sagittal and axial directions was calculated, yielding a mean of 0.47 degrees with a standard deviation of 0.37 degrees and a maximum of 1.33 degrees. The error in the cross-sectional axial direction had a mean of 0.54 mm with a maximum error of 0.83 mm, depending on the slice interval. The main error source was of the image processing, which was about 70% of the total error. We found that machining cortical bone segments prior to CT scanning is an effective method for accuracy evaluation of CT-based bone reconstruction. This method can provide a reference for assessing the sensitivity, reliability and accuracy of CT-based applications in the study of movement, finite element modeling, and prosthesis construction.
Computerized medical imaging and graphics: the official journal of the Computerized Medical Imaging Society 03/2009; 33(3):235-41. · 1.04 Impact Factor
