The role of mesh technology with tumor prosthesis reconstruction to reconstruct the extensor mechanism of knee joint after resection of proximal tibial tumors

Osteoarthritis (OA) is the most frequently diagnosed joint disorder worldwide with increasing prevalence and crucial impact on the quality of life of affected patients through chronic pain, decreasing mobility and invalidity. Although some risk factors, such as age, obesity and previous joint injury are well established, the exact pathogenesis of OA on a cellular and molecular level remains less understood. Today, the role of nitrosative and oxidative stress has not been investigated conclusively in the pathogenesis of OA yet. Therefore, the objective of this study was to identify biological substances for oxidative and nitrosative stress, which mirror the degenerative processes in an osteoarthritic joint. 69 patients suffering from a diagnosed knee pain participated in this study. Based on the orthopedic diagnosis, patients were classified into an osteoarthritis group (OAG, n=24) or in one of two control groups (meniscopathy, CG1, n=11; anterior cruciate ligament rupture, CG2, n=34). Independently from the study protocol, all patients underwent an invasive surgical intervention which was used to collect samples from the synovial membrane, synovial fluid and human serum. Synovial biopsies were analyzed histopathologically for synovitis (Krenn-Score) and immunohistochemically for detection of end products of oxidative (8-isoprostane F2α) and nitrosative (3-nitrotyrosine) stress. Additionally, the fluid samples were analyzed for 8-isoprostane F2α and 3-nitrotyrosine by competitive ELISA method. The analyzation of inflammation in synovial biopsies revealed a slight synovitis in all three investigated groups. Detectable concentrations of 3-nitrotyrosine were reported in all three investigated groups without showing any significant differences between the synovial biopsies, fluid or human serum. In contrast, significant increased concentrations of 8-isoprostane F2α were detected in OAG compared to both control groups. Furthermore, our data showed a significant correlation between the histopathological synovitis and oxidative stress in OAG (r=0.728, P<0.01). There were no significant differences between the concentrations of 8-isoprostane F2α in synovial fluid and human serum. The findings of the current study support the hypothesis that oxidative and nitrosative stress are components of the multi-factory pathophysiological formation of OA. It seems reasonable that an inflammatory process in the synovial membrane triggers the generation of oxidative and nitrosative acting substances which can lead to a further degradation of the articular cartilage. Based on correlations between the observed degree of inflammation and investigated biomarkers, especially 8-isoprostane F2α seems to be a novel candidate biomarker for OA. However, due to the finding that also both control groups showed increased concentrations of selected biomarkers, future studies have to validate the diagnostic potential of these biomarkers in OA and in related conditions of the knee joint.

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ROLE OF PRP AND STEM CELL INJECTIONS IN OSTEOARTHRITIC PATIENTS OF KNEE JOINT

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2015/1370 ◽

2015 ◽

Vol 4 (54) ◽

pp. 9468-9474 ◽

Cited By ~ 1

Author(s):

Srinivas P L ◽

Phani Kumar P

Keyword(s):

Stem Cell ◽

Knee Joint

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Hope, Hype, Hurdles & Future Perspective for PRP, PRP versus Hyaluronic Acid Injection in Osteoarthritis of Knee: A Review Article.

Biologic Orthopedics Journal ◽

10.22374/boj.v2i1.6 ◽

2020 ◽

Vol 2 (1) ◽

pp. e1-e12

Author(s):

Ashok Kumar ◽

Anikait Ghosh Kadamb ◽

Krish Ghosh Kadamb

Keyword(s):

Hyaluronic Acid ◽

Knee Joint ◽

Platelet Rich Plasma ◽

Future Perspective ◽

Osteoarthritis Of The Knee ◽

Stiff Knee ◽

Injection Interval ◽

One Year

BackgroundComparative studies of platelet-rich plasma (PRP) and hyaluronic acid show variable results. PurposeA review was conducted to understand the current role of PRP and its efficacy versus hyaluronic acid in osteoarthritis (OA) of the knee joint. MethodsOut of 170 identified studies, 14 studies involving 1575 patients with 637 males and 938 females were selected based on PRISMA flow chart guidelines and were analyzed for the study. ResultsA standard PRP regimen consisting of 2–3 intra-articular injections (IA) of 4–6 mL of leucocyte poor PRP at 1–2 weekly intervals provides a better result than HA during the first 3–6 months, and which may continue up to one year. PRP and HA may have synergistic effect; pain and swelling are the two most com-mon complications with PRP, the incidence is more with leucocyte rich PRP (LP-PRP) and intra-osseous PRP treatment.ConclusionPRP provides hope and is more effective than hyaluronic acid in pain relief and improving the quality of life in mild to moderate osteoarthritis of the knee joint. However, hype, that is effective in all, irrespective of grades of OA, mal-aligned or stiff knee, ligamentous laxity, and can avoid joint replacement is a big hindrance in establishing it as a preferred treatment in OA knee. The author follows the above-mentioned PRP regimen; and recommends to combine leucocyte poor PRP with HA for IA injections & with LP-PRP injections along with the two most common painful points (medial collateral ligament, pesanisernius) in a highly painful OA knee. PRP may not address extra-articular causes of knee pain (mal-alignment, muscle wasting, tendinosis), should be corrected for optimum outcome. Contact sports, running, exercises putting pressure on knee and NSAID should be avoided during PRP treatment. Also, more randomized controlled trials are required to further standardize the PRP preparation, administration, injection interval & proper documentation of efficacy and complications in the regenerative registry.

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The Role of Nickel-titanium Shape Memory Alloy Embracing Fixator in Determination of the Implantation Angle of Hip Tumor Prosthesis Stem Following Tumor Resection and the Analysis of Its Efficacy: a Retrospective Study

10.21203/rs.3.rs-138932/v1 ◽

2021 ◽

Author(s):

Yang Wang ◽

Panyu Zhou ◽

Demeng Xia ◽

Yunyun Wang ◽

Sheng Wang ◽

...

Keyword(s):

Shape Memory Alloy ◽

Shape Memory ◽

Tumor Resection ◽

Hip Dislocation ◽

Nickel Titanium ◽

Prosthetic Replacement ◽

Limb Function ◽

Tumor Prosthesis

Abstract Background: To explore the role of nickel-titanium(NiTi) shape memory alloy embracing fixator in determination of implantation angle of hip tumor prosthesis stem and analyze its efficacy. Methods: 36 patients with proximal femur tumor were treated with extended tumor resection and prosthetic replacement. 14 patients received prosthetic replacements with the embracing fixators fixing between the junction of the prosthesis stem and the femur temporarily, while the other 22 patients received the same replacements but without the fixators. Following aspects were compared: occurrence of complications, limb function and active hip ROM.Results: There are fewer cases of hip dislocation in the group received prosthetic replacements with the use of embracing fixators. Occurrence of deep infection presented no difference between the two groups. Better limb function and higher active range of motion (ROM) on abduction or flexion were also found in the group using embracing fixators. Conclusion: Ni-Ti shape memory alloy embracing fixator plays a key part in assisting the accurate implantation angle of the prosthesis stem in the prosthetic replacement. The prosthesis stem can be adjusted to the optimal angle with the help of the embracing fixator. Patients have lower chance of dislocation, better limb function, and higher active hip ROM. Trial registration: retrospectively registered.

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