Application Effect of Different Concentrations of Platelet-Rich Plasma Combined with Quadriceps Training on Cartilage Repair of Knee Osteoarthritis

We investigated the application effect of different concentrations of platelet-rich plasma (PRP) combined with quadriceps training on cartilage repair of knee osteoarthritis. Data of 37 patients with knee osteoarthritis (KOA) treated in our hospital (November 2019–February 2021) were retrospectively analyzed and the patients were divided into low concentration group (LCG) (n = 12), medium concentration group (MCG) (n = 12), and high concentration group (HCG) (n = 13) according to the order of admission. All patients received quadriceps training. Three groups above received knee injection of PRP, and the platelet concentrations were 1000–1400 × 109/L, 1400–1800 × 109/L, and 1800–2100 × 109/L, respectively. Articular cartilage thickness of the medial and lateral femur, knee joint function scores, inflammatory factor levels, and matrix metalloproteinases (MMPs) levels were compared. After treatment, compared with the MCG and HCG, articular cartilage thickness of the medial and lateral femur of the diseased side in the LCG was obviously lower ( P < 0.05 ). At 2 months after treatment (T3), compared with the HCG, articular cartilage thickness of the medial and lateral femur of the diseased side in the MCG was obviously higher ( P < 0.05 ), without remarkable difference in articular cartilage thickness of the medial and lateral femur of the healthy side among three groups ( P > 0.05 ). After treatment, compared with the LCG, knee joint function scores of the MCG and HCG were obviously better ( P < 0.001 ). Compared with the HCG, the knee function score at T3 in the MCG was obviously better ( P < 0.001 ). After treatment, compared with the LCG, inflammatory factor levels and levels of MMPs in the MCG and HCG were obviously lower ( P < 0.05 ). Compared with the HCG, inflammatory factor levels and levels of MMPs at T3 in the MCG were obviously lower ( P < 0.05 ). PRP combined with quadriceps training can accelerate cartilage repair of patients with KOA and reduce inflammatory factor levels and levels of MMPs, but the treatment effect of PRP depends on platelet concentration, with the best range of 1400–1800 × 109/L. Too high or too low platelet concentrations will affect recovery of knee function.

A self-efficacy-enhancing intervention for Chinese patients after total hip arthroplasty: study protocol for a randomized controlled trial with 6-month follow-up

Background Total hip arthroplasty (THA) is a common and effective surgical method for advanced hip arthritis. Rehabilitation exercises are important to improve joint function after THA and are usually conducted in a home-based program. Poor patient adherence limits improvements in pain and function, affecting quality of life. The increasing use of THA in the aging Chinese population underscores the need to develop strategies that maximize functional outcomes. The purpose of this pilot study is to develop and assess the feasibility of a self-efficacy-enhancing intervention (SEEI) to improve exercise adherence in patients undergoing THA. Methods This single-blinded, parallel, randomized control trial will recruit 150 patients after THA and randomly assign them to an intervention or control group using computer-generated block randomization. The control group will receive usual care using evidence-based guidelines. The intervention group will receive the 6-month SEEI comprising personalized exercise guidance and self-efficacy education delivered using one face-to-face education session and four telephone consultations, supplemented by written materials. Participants are encouraged to build confidence in their own abilities, set rehabilitation goals, and self-monitor their physical exercise. Results Assessments will be conducted at baseline and 1, 3, and 6 months postsurgery. The outcome indicators are exercise adherence, physical function, anxiety and depression, self-efficacy of rehabilitation, joint function, and quality of life. Conclusions This study will test a theory-based intervention program to improve self-efficacy in rehabilitation, which may significantly impact out-of-hospital rehabilitation. The results will provide evidence to inform the postoperative recovery of patients undergoing THA or similar procedures. Trial registration Chinese Clinical Trials Registry, ChiCTR2000029422, registered on 31 January 2020

An information integration account for causal generalizations in uncertain causal networks

In reasoning about common cause networks, given that a cause generates an effect, people often need to infer how likely the cause generate another effect. This causal generalization question has not systematically been investigated in previous research. We propose the information integration account for causal generalizations in uncertain casual networks with dichotomized continuous variables. It predicts that causal generalization is the joint function of conditional probabilities of causal links and cause strength indicated by the proportion of present collateral effects. Two experiments investigated causal generalizations in uncertain causal networks with and without probability distributions, respectively. It was found that in the presence of probability distributions there was the joint effect of conditional probability and cause strength on causal generalization; in the absence of probability distributions causal generalization depend only on cause strength. The overall response pattern favors the information integration account over the other alternative accounts.

Diagnostic Algorithm for Joint Pain in Patients with Inflammatory Bowel Disorders

Aim. An algorithm development for joint pain differential diagnosis in patients with inflammatory bowel disorders (IBD) and its validation in clinical practice.Materials and methods. A total of 349 IBD patients hospitalised for gastroenterological complaints at the Chelyabinsk Regional Clinical Hospital during 2017–2020 have been examined.Results. Upon survey, 97 (27.8%) IBD patients complained of joint pain. Ulcerative colitis (UC) predominated (79 patients; 81.4%), Crohn’s disease (CD) had a 18.6% incidence. In survey, 27% UC and 32.1% CD patients reported joint pain (p = 0.26). Among IBD patients, 52.6% had mechanical, and 47.4% — inflammatory pain. The inflammatory back pain (IBP) rate in survey cohort was 23.7%. Use of a diagnostic algorithm allowed concomitant rheumatic disease detection in 7 (7.2%) patients from the IBD–joint pain cohort: 2 patients were diagnosed with psoriatic spondyloarthritis, 2 — rheumatoid arthritis, 1 — gout and 2 — with ankylosing spondylitis. IBD-associated arthritis was diagnosed in 41 (42.3%) cases, osteoarthritis — in 38 (39.2%) IBD patients with joint pain, arthralgia with no objective inflammation, impaired joint function or lesions in X-ray and/or ultrasound — in 13 (13.4%) patients.Conclusion. Joint pain complaints are common in IBD patients and require a multispecialty rheumatologists-involving approach to proceed with differential diagnosis and opting for treatment tactics. A clinically verified algorithm coupled with laboratory tests and instrumental imaging facilitates diagnosis and optimal therapy selection in IBD patients with complaints of joint pain.

The proximal fibular free flap - an ideal material for reconstructing distal radius defect after Giant tumor cell resection. A case report

Giant cell tumors (GCT) of the distal end of radius are relatively common tumors, representing approximately 5% of all primary bone tumors. It is the third most common location for GCT following distal femur and proximal tibia. In general, treatment includes thorough tumor excision, reconstruction of the defect, and wrist joint rehabilitation. The proximal fibular free flap is an ideal material for distal radius reconstruction after giant cell tumor excision. We present a case of a 57-year-old female, admitted to the hospital due to painful and limited proper wrist movement. Based on X-ray and Magnetic resonance imaging (MRI) images and histopathology findings, the patient was diagnosed with a stage 3 giant cell tumor of the distal radius. The patient underwent a one-step surgery of tumor excision and distal radius reconstruction by a vascularized proximal fibular free flap. 2 years follow-up post-surgery showed that the patient had no pain of the wrist, improved wrist joint function, no sign of recurrence, and good flap vitality and the knee joint remains normal. In conclusion, the surgery was successful with no further prolonged pain, improvement of the wrist joint function and overall improvement of the patient quality of life.

Sodium Hyaluronate Combined with Jintiange on Knee Joint Function After Arthroscopy for Knee Osteoarthritis

Objective: To explore the effects of sodium hyaluronate combined with Jintiange on knee joint function after arthroscopic debridement. Methods: Totally 122 knee osteoarthritis patients underwent arthroscopic debridement were randomized into control and experimental groups. The interleukin-1β, interleukin-6 and tumor necrosis factor-α serum levels were tested via Elisa before and after treatment. The Lysholm knee joint function score, effective rate of treatment, interleukin-1β, interleukin-6 and tumor necrosis factor-α expression, visual analogue scale of pain, incidence of adverse reactions and patient satisfaction were compared. Results: Compared with the control group, the effective rate of treatment and the score of Lysholm knee joint function in the other were higher (both P <0.001), and the serum interleukin-1β, interleukin-6, tumor necrosis factor-α expression and visual analogue scale score were lower (all P <0.001). The incidence of adverse reactions revealed no marked difference (P >0.05), but the satisfaction scores of the experimental group were higher (P <0.01). Conclusion: sodium hyaluronate combined with Jintiange is helpful for knee joint function recovery after arthroscopic knee osteoarthritis, which effectively decreases the level of inflammatory factors and increase patients’ satisfaction.

Effects of Lumbar Stability and Hip Joint Mobility Exercise with Pilates Devices on Pain Level and Muscle-Joint Function in Middle-Aged Women with Chronic Low Back Pain

PURPOSE: This study aimed to compare the effects of 10 weeks of lumbar stability and hip mobility exercises using Pilates devices on pain level and muscle joint function in middle-aged women with chronic low back pain (CLBP). Further, we aimed to investigate the efficacy of Pilates hip mobility exercise (HME) as an exercise for improving CLBP in middle-aged women by comparing the effectiveness of lumbar stability exercise (LSE) and HME.METHODS: Thirty-two middle-aged women with CLBP were enrolled and randomly divided and placed into two groups: the LSE group (n=16) and HME group (n=16). Both groups performed Pilates exercises for 50 minutes twice a week for 10 weeks.RESULTS: The Korean Oswestry Disability Index score in both the LSE and HME groups decreased at 5 weeks (p<.05). Hip internal rotation range of motion (ROM) and external rotation ROM increased at 5 and 10 weeks in both the LSE and HME groups (p<.01). Lumbar mobility increased at 5 weeks in both the LSE (p<.01) and HME groups (p<.001). Lumbar stability in the prone plank test significantly increased at 5 weeks in the LSE group (p<.001) and at 5 and 10 weeks in the HME group (p<.001). Lumbar stability by the side plank test significantly increased at 5 and 10 weeks in both the LSE and HME groups (p<.001).CONCLUSIONS: We found that using Pilates to perform both LSE and HME helped relieve back pain and improve muscle joint function in middle-aged women with CLBP. There was no significant difference between LSE and HME in terms of efficacy. HME is a highly effective exercise for improving CLBP in middle-aged women.