scholarly journals The local concentration of Ca2+ correlates with BMP7 expression and osseointegration in patients with total hip arthroplasty

2020 ◽  
Author(s):  
Xiaodong Fu ◽  
Weili Wang ◽  
Xiaomiao Li ◽  
Yingjian Gao ◽  
Hao Li ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Local Concentration ◽  
Mineral Density ◽  
Gruen Zone ◽  
Total Hip ◽  
Significant Difference ◽  
The Impact

Abstract Background: A successful osseointegration of total hip arthroplasty (THA) relies on the interplay of implant surface and bone marrow microenvironment. This study was undertaken to investigate the impact of perioperative biochemical molecules (Ca2+, Mg2+, Zn2+, VD, PTH) on the bone marrow osteogenetic factors (BMP2, BMP7, Stro-1+ cells) in the metaphyseal region of the femoral head, and further on the bone mineral density (BMD) of Gruen R3. Methods: Bone marrow aspirates were obtained from the discarded metaphysis region of the femoral head in 51 patients with THA. Flow cytometry was used to measure the Stro-1+ expressing cells. ELISA was used to measure the concentrations of bone morphologic proteins (BMP2 and BMP7). The perioperative concentrations of the biochemical molecules above were measured by radioimmunoassay. The BMD of Gruen zone R3 was examined at 6 months after THA, using dual-energy X-ray absorptiometry (DEXA).Results: Our data demonstrated that the concentration of Ca2+ was positively correlated with BMP7 expression, and with the postoperative BMD of Gruen zone R3. However, the concentration of Mg2+ had little impact on the R3 BMD, although it was negatively correlated with the expression of BMP7. The data also suggested that the other biochemical molecules, such as Zn2+, VD, and PTH, were not significantly correlated with any bone marrow osteogenetic factors (BMP2, BMP7, Stro-1+ cells). The postoperative R3 BMD of patients of different gender and age had no significant difference.Conclusions: These results indicate the local concentration of Ca2+ may be an indicator for the prognosis of THA patients.

scholarly journals The Local Concentration of Ca2+ Correlates with BMP7 Expression and Osseointegration in Patients with Total Hip Arthroplasty

2020 ◽  
Author(s):  
Xiaodong Fu ◽  
Weili Wang ◽  
Xiaomiao Li ◽  
Yingjian Gao ◽  
Hao Li ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Local Concentration ◽  
Mineral Density ◽  
Gruen Zone ◽  
Total Hip ◽  
Significant Difference ◽  
The Impact

Abstract Background A successful osseointegration of total hip arthroplasty (THA) relies on the interplay of implant surface and bone marrow microenvironment. This study was undertaken to investigate the impact of perioperative biochemical molecules (Ca 2+ , Mg 2+ , Zn 2+ , VD, PTH) on the bone marrow osteogenetic factors (BMP2, BMP7, Stro-1 + cells) in the metaphyseal region of the femoral head, and further on the bone mineral density (BMD) of Gruen R3. Methods Bone marrow aspirates were obtained from the discarded metaphysis region of the femoral head in 51 patients with THA. Flow cytometry was used to measure the Stro-1 + expressing cells. ELISA was used to measure the concentrations of bone morphologic proteins (BMP2 and BMP7). The perioperative concentrations of the biochemical molecules above were measured by radioimmunoassay. The BMD of Gruen zone R3 was examined at 6 months after THA, using dual-energy X-ray absorptiometry (DEXA). Results Our data demonstrated that the concentration of Ca 2+ was positively correlated with BMP7 expression, and with the postoperative BMD of Gruen zone R3. However, the concentration of Mg 2+ had little impact on the R3 BMD, although it was negatively correlated with the expression of BMP7. The data also suggested that the other biochemical molecules, such as Zn 2+ , VD, and PTH, were not significantly correlated with any bone marrow osteogenetic factors (BMP2, BMP7, Stro-1 + cells). The postoperative R3 BMD of patients of different gender and age had no significant difference. Conclusions These results indicate the local concentration of Ca 2+ may be an indicator for the prognosis of THA patients.

scholarly journals The local concentration of Ca2+ correlates with BMP7 expression and osseointegration in patients with total hip arthroplasty

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Xiaodong Fu ◽  
Weili Wang ◽  
Xiaomiao Li ◽  
Yingjian Gao ◽  
Hao Li ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Local Concentration ◽  
Gruen Zone ◽  
Osteoclast Activity ◽  
Total Hip ◽  
The Impact

Abstract Background A successful osseointegration of total hip arthroplasty (THA) relies on the interplay of implant surface and bone marrow microenvironment. This study was undertaken to investigate the impact of perioperative biochemical molecules (Ca2+, Mg2+, Zn2+, VD, PTH) on the bone marrow osteogenetic factors (BMP2, BMP7, Stro-1+ cells) in the metaphyseal region of the femoral head, and further on the bone mineral density (BMD) of Gruen R3. Methods Bone marrow aspirates were obtained from the discarded metaphysis region of the femoral head in 51 patients with THA. Flow cytometry was used to measure the Stro-1+ expressing cells. ELISA was used to measure the concentrations of bone morphologic proteins (BMP2 and BMP7) and the content of TRACP5b in serum. TRAP staining was used to detect the osteoclast activity in the hip joint. The perioperative concentrations of the biochemical molecules above were measured by radioimmunoassay. The BMD of Gruen zone R3 was examined at 6 months after THA, using dual-energy X-ray absorptiometry (DEXA). Results Our data demonstrated that the concentration of Ca2+ was positively correlated with BMP7 expression, and with the postoperative BMD of Gruen zone R3. However, the concentration of Mg2+ had little impact on the R3 BMD, although it was negatively correlated with the expression of BMP7. Osteoclast activity in hip joint tissue of patients with femoral neck fractures was increased. Compared with the patients before THA, the levels of TRACP5b in serum of patients after THA were decreased. The data also suggested that the other biochemical molecules, such as Zn2+, VD, and PTH, were not significantly correlated with any bone marrow osteogenetic factors (BMP2, BMP7, Stro-1+ cells). The postoperative R3 BMD of patients of different gender and age had no significant difference. Conclusions These results indicate the local concentration of Ca2+ may be an indicator for the prognosis of THA patients.

scholarly journals The local concentration of Ca2+ correlates with BMP7 expression and osseointegration in patients with total hip arthroplasty

2020 ◽  
Author(s):  
Xiaodong Fu ◽  
Weili Wang ◽  
Xiaomiao Li ◽  
Yingjian Gao ◽  
Hao Li ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Local Concentration ◽  
Gruen Zone ◽  
Osteoclast Activity ◽  
Total Hip ◽  
The Impact

Abstract Background: A successful osseointegration of total hip arthroplasty (THA) relies on the interplay of implant surface and bone marrow microenvironment. This study was undertaken to investigate the impact of perioperative biochemical molecules (Ca2+, Mg2+, Zn2+, VD, PTH) on the bone marrow osteogenetic factors (BMP2, BMP7, Stro-1+ cells) in the metaphyseal region of the femoral head, and further on the bone mineral density (BMD) of Gruen R3. Methods: Bone marrow aspirates were obtained from the discarded metaphysis region of the femoral head in 51 patients with THA. Flow cytometry was used to measure the Stro-1+ expressing cells. ELISA was used to measure the concentrations of bone morphologic proteins (BMP2 and BMP7) and the content of TRACP5b in serum. TRAP staining was used to detect the osteoclast activity in the hip joint. The perioperative concentrations of the biochemical molecules above were measured by radioimmunoassay. The BMD of Gruen zone R3 was examined at 6 months after THA, using dual-energy X-ray absorptiometry (DEXA).Results: Our data demonstrated that the concentration of Ca2+ was positively correlated with BMP7 expression, and with the postoperative BMD of Gruen zone R3. However, the concentration of Mg2+ had little impact on the R3 BMD, although it was negatively correlated with the expression of BMP7. Osteoclast activity in hip joint tissue of patients with femoral neck fractures was increased. Compared with the patients before THA, the levels of TRACP5b in serum of patients after THA were decreased. The data also suggested that the other biochemical molecules, such as Zn2+, VD, and PTH, were not significantly correlated with any bone marrow osteogenetic factors (BMP2, BMP7, Stro-1+ cells). The postoperative R3 BMD of patients of different gender and age had no significant difference.Conclusions: These results indicate the local concentration of Ca2+ may be an indicator for the prognosis of THA patients.

Evaluation of the impact of preoperative assessment on length of stay after a total hip arthroplasty

2017 ◽  
Vol 80 (6) ◽  
pp. 361-367
Author(s):  
Daniel Harte ◽  
Philip Hamill ◽  
Caroline Williams-Condell ◽  
Stephanie Lewis
Keyword(s):  
Total Hip Arthroplasty ◽  
Length Of Stay ◽  
Hip Arthroplasty ◽  
Preoperative Assessment ◽  
Allied Health Professionals ◽  
Clinical Notes ◽  
Total Hip ◽  
Significant Difference ◽  
Care Package ◽  
The Impact

Introduction To investigate if preoperative assessment delivered by occupational therapists, physiotherapists and social workers for people awaiting a total hip arthroplasty decreased the length of stay in hospital postoperatively. Method A retrospective data review was conducted on all patients who had a primary total hip arthroplasty across a 6-month period. A total of 101 patients (mean age 67.16 years) was included in this evaluation. Clinical notes were used to determine which patients attended or did not attend preoperative assessment. Statistical modeling was used to analyse the association of a series of variables and time spent in hospital after a total hip arthroplasty. Results There was no significant difference in the length of stay for patients who attended preoperative assessment ( P < 0.05) while patients who were medically unfit, lived alone and/or required a care package experienced a significantly higher length of stay ( P < 0.05). Conclusion These results do not support the British Orthopaedic Association’s recommendation that preoperative assessment delivered by allied health professionals helps reduce length of stay. However, it identifies variables which could be managed potentially to reduce length of stay. A large multisite clinical trial is required to determine if preoperative assessment reduces length of stay for people undergoing this surgical procedure.

scholarly journals Perioperative Patient-specific Factors-based Nomograms Predict Short-term Periprosthetic Bone Loss After Total Hip Arthroplasty

2020 ◽  
Author(s):  
Guangtao Fu ◽  
Mengyuan Li ◽  
Yunlian Xue ◽  
Qingtian Li ◽  
Zhantao Deng ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Bone Loss ◽  
Hip Arthroplasty ◽  
Postoperative Period ◽  
Patient Specific ◽  
Mineral Density ◽  
Periprosthetic Bone ◽  
Gruen Zone ◽  
Total Hip ◽  
Periprosthetic Bone Loss

Abstract Background Although medical intervention of periprosthetic bone loss in the immediate postoperative period was recommended, not all the patients experienced periprosthetic bone loss after total hip arthroplasty (THA). Prediction toolsthat enrolledallpotential risk factors to calculate an individualized prediction of postoperative periprosthetic bone loss were strongly needed for clinical decision-making.MethodsData of the patients underwent primary unilateral cementless THA between April 2015 and October 2017 in our center were retrospectively collected. Candidate variables included demographic data and bone mineral density (BMD) in spine, hip and periprosthetic regions that measured 1 week after THA. Outcomes of interest included the risk of postoperative periprosthetic bone loss in Gruen zone 1, 7 and total zones in the 1st postoperative year. Nomograms were presented based on multiple logistic regressions via R language.Bootstrap was used for internal validation. Results 427 patients (195 male and 232 female) were included in this study.The mean BMD of Gruen zone 1, 7,and total were decreased by 4.1%, 6.4%, and 1.7% at the 1st year after THA, respectively. 61.1% of the patients (261/427) experienced bone loss in Gruen zone 1 at the 1st postoperative year, while there were 58.1% (248/427) in Gruen zone 7 and 63.0% (269/427) in Gruen zone total. Bias-corrected c-index for risk of postoperative bone lossin Gruen zone 1, 7 and total zones in the 1st postoperative year were 0.700, 0.785, and 0.696, respectively. The most highly influential factor for the postoperative periprosthetic bone loss was the BMD in the corresponding Gruen zones at the baseline.ConclusionsThe present study presented the perioperative factors-based nomograms for predicting periprosthetic bone loss after THA with adequate predictive discrimination and calibration.Those tools would helpsurgeons to identify high-risk patients who may benefit from anti-bone-resorptive treatment on the early postoperative period effectively. Such prediction model could also provide patients with reasonable expectations following surgery, which may improve satisfaction and patient compliance.

Antiphospholipid score is a novel risk factor for idiopathic osteonecrosis of the femoral head in patients with systemic lupus erythematosus

Rheumatology ◽  
2018 ◽  
Vol 58 (4) ◽  
pp. 645-649 ◽  
Author(s):  
Ryo Hisada ◽  
Masaru Kato ◽  
Naoki Ohnishi ◽  
Eri Sugawara ◽  
Yuichiro Fujieda ◽  
...  
Keyword(s):  
Risk Factor ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Odds Ratio ◽  
Univariate Analysis ◽  
High Dose ◽  
Total Hip ◽  
Local Bone ◽  
The Impact

Abstract Objective Idiopathic osteonecrosis of the femoral head (ION) is a common complication of SLE associated with CS therapy. Although the pathogenesis of ION involves local bone ischaemia favoured by thrombophilia, the involvement of aPL in lupus ION remains to be elucidated. We have previously reported the aPL score (aPL-S) as a quantitative marker of aPL and the development of thrombotic events in autoimmune diseases. The aim of this study was to identify the impact of aPL on the development of ION using aPL-S. Methods This was a single-centre retrospective study comprising 88 consecutive SLE patients who underwent MRI of the hip joints from January 2000 to March 2017. Baseline characteristics, pharmacotherapy and total hip arthroplasty performed during follow-up were evaluated. Results The presence of ION was confirmed by MRI scan in 38 patients (43.1%). Male gender, positivity of any aPL, aPL-S, high aPL-S (≥30) and high dose of CS were identified as risk factors for ION by univariate analysis. Multivariate analysis revealed high aPL-S (odds ratio 5.12, 95% CI 1.18–29.79) and use of high-dose CS (odds ratio 10.25, 95% CI 3.00–48.38) as independent variables. Kaplan–Meier analysis showed that patients with high aPL-S received total hip arthroplasty more frequently than those without aPL (P = 0.010). Conclusions We newly identified high aPL-S as an important risk factor for ION development in SLE, suggesting the involvement of aPL-induced coagulopathy in the pathophysiology of lupus ION.

scholarly journals Perioperative patient-specific factors-based nomograms predict short-term periprosthetic bone loss after total hip arthroplasty

2020 ◽  
Author(s):  
Guangtao Fu ◽  
Mengyuan Li ◽  
Yunlian Xue ◽  
Qingtian Li ◽  
Zhantao Deng ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Bone Loss ◽  
Hip Arthroplasty ◽  
Postoperative Period ◽  
Patient Specific ◽  
Mineral Density ◽  
Periprosthetic Bone ◽  
Gruen Zone ◽  
Total Hip ◽  
Periprosthetic Bone Loss

Abstract Background: Although medical intervention of periprosthetic bone loss in the immediate postoperative period was recommended, not all the patients experienced periprosthetic bone loss after total hip arthroplasty (THA). Prediction tools that enrolled all potential risk factors to calculate an individualized prediction of postoperative periprosthetic bone loss were strongly needed for clinical decision-making. Methods: Data of the patients underwent primary unilateral cementless THA between April 2015 and October 2017 in our center were retrospectively collected. Candidate variables included demographic data and bone mineral density (BMD) in spine, hip and periprosthetic regions that measured 1 week after THA. Outcomes of interest included the risk of postoperative periprosthetic bone loss in Gruen zone 1, 7 and total zones in the 1st postoperative year. Nomograms were presented based on multiple logistic regressions via R language. 1000 Bootstraps were used for internal validation. Results: 563 patients met the inclusion criteria were enrolled, and the final analysis was performed in 427 patients (195 male and 232 female) after the exclusion. The mean BMD of Gruen zone 1, 7, and total were decreased by 4.1%, 6.4%, and 1.7% at the 1st year after THA, respectively. 61.1% of the patients (261/427) experienced bone loss in Gruen zone 1 at the 1st postoperative year, while there were 58.1% (248/427) in Gruen zone 7 and 63.0% (269/427) in Gruen zone total. Bias-corrected c-index for risk of postoperative bone loss in Gruen zone 1, 7 and total zones in the 1st postoperative year were 0.700, 0.785, and 0.696, respectively. The most highly influential factors for the postoperative periprosthetic bone loss were primary diagnosis and BMD in the corresponding Gruen zones at the baseline. Conclusions: To the best of our knowledge, our study represented the first time to use the nomograms in estimating the risk of postoperative periprosthetic bone loss with adequate predictive discrimination and calibration. Those predictive models would help surgeons to identify high-risk patients who may benefit from anti-bone-resorptive treatment on the early postoperative period effectively. It is also beneficial for patients, as they can choose the treatment options based on a reasonable expectation following surgery.

scholarly journals Thirty patients with one-stage hip arthroplasty and multiple drilling decompression for bilateral osteonecrosis of the femoral head:outcomes at two-year follow up

2019 ◽  
Author(s):  
Lu Ding ◽  
Yu-Hang Gao ◽  
Shi Zhang ◽  
Yi-Fan Huang ◽  
Jian-Guo Liu ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Internal Rotation ◽  
Hip Arthroplasty ◽  
External Rotation ◽  
Radiographic Evaluation ◽  
Two Stage ◽  
Total Hip ◽  
One Stage ◽  
Significant Difference

Abstract Background: To investigate the postoperative outcome of decompresed hip following contralateral replacement in patients with bilateral osteonecrosis of the femoral head (ONFH). M ethods: This study retrospectively reviewed 30 patients with bilateral ONFH who underwent one-stage total hip arthroplasty (THA) and multiple drilling decompression from February 2014 to February 2016. For all patients, alendronate was prescribed. Postoperative Harris Hip Scores (HHSs), Oxford Hip Scores (OHSs), Self-Administered Patient Satisfaction (SAPS), hip internal and external rotation angles, and the time of one-leg standing were evaluated. All patients were followed up for an average of 30.33 months (ranged from 8 months to 48 months). Results: Twenty-four patients had no progression or collapse on radiographic evaluation within 2 years postoperatively. The following scores of the decompressed sides were significantly lower than those of the replaced sides: HHSs (mean: 96.5 versus 98.25, P <0.05), SAPS (mean: 96.35 versus 99.48, P <0.001), internal rotation (mean: 27.58° versus 30.50°, P <0.05), and the time of single-leg standing (mean: 24.17 s versus 31.83 s, P <0.05). There was no significant difference in OHSs and external rotation between the sides. The remaining 6 patients underwent two-stage THA on the decompressed sides within 2 years. Four of them underwent THA for severe pain and femoral head collapse. The other 2 patients showed no progression on radiographic evaluation but complained of an uncomfortable feeling in the joint. Conclusions: One-stage THA and multiple drilling decompression are effective surgical procedures for bilateral ONFH at different stages. However, a few patients with no progression on radiographic evaluation may require two-stage THA on the decompressed sides because of more pain, poorer internal rotation, and weaker gluteal muscle strength when compared with the replaced sides. Keywords: osteonecrosis of the femoral head, postoperative satisfaction, total hip arthroplasty, multiple drilling decompression

scholarly journals Impact of Surgeon Handedness in Manual and Robot-assisted Total Hip Arthroplasty

2019 ◽  
Author(s):  
Xiangpeng Kong ◽  
Minzhi Yang ◽  
Xiang Li ◽  
Ming Ni ◽  
Guoqiang Zhang ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Adverse Impact ◽  
Harris Hip Score ◽  
Robot Assisted ◽  
Total Hip ◽  
Significant Difference ◽  
Manual Group ◽  
The Impact ◽  
Cup Positioning

Abstract Background The purpose of this study was to examine whether surgeon handedness could affect cup positioning in manual total hip arthroplasty (THA), and whether robot could diminish or eliminate the impact of surgeon handedness on cup positioning in robot-assisted THA.Methods Fifty-three patients who underwent bilateral robot-assisted THA and sixty-two patients who underwent bilateral manual THA between August 2018 and July 2019 in our institute were respectively analyzed in this study. When the difference between the bilateral anteversion or inclination was greater than 5°, the patient was regarded as having different cup positioning between bilateral THA. Their demographics, orientation of acetabular cup and postoperative 3 month Harris hip score (HHS) were recorded for analysis.Results There were no significant difference in the gender, age, BMI, diagnosis's composition, preoperative and postoperative HHS between the robotic and manual group. Two left hips dislocated in the manual group. The anteversion of left hip was significantly larger than that of right hip (24.77±10.44 vs 22.44±8.67, p=0.043) in the manual group. There were no significant difference of cup positioning between bilateral robot-assisted THA. The patients in manual group were significantly more likely to have different cup positioning between bilateral hips than those in robotic group (77% vs 45%, p=0.000).Conclusions Surgeon's handedness had adverse impact on anteversion of the non-dominant side in manual THA and right-handed surgeons were more likely to place the left cup in larger anteversion. Robot could help surgeon eliminate the adverse impact caused by personal innate handedness.

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