femoral heads
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2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Xilin Xu ◽  
Yiwei Shen ◽  
Hang Lv ◽  
Jun Zhao ◽  
Xiaodong Li ◽  
...  

Steroid-induced osteonecrosis of the femoral head (SIONFH) is a frequent orthopedic disease caused by long-term or high-dose administration of corticosteroids. Tanshinone I (TsI), a flavonoid compound isolated from Salvia miltiorrhiza Bunge, has been reported to inhibit osteoclastic differentiation in vitro. This study aimed to investigate whether TsI can ameliorate SIONFH. Herein, SIONFH was induced by intraperitoneal injection of 20 μg/kg lipopolysaccharide every 24 h for 2 days, followed by an intramuscular injection of 40 mg/kg methylprednisolone every 24 h for 3 days. Four weeks after the final injection of methylprednisolone, the rats were intraperitoneally administrated with low-dose (5 mg/kg) and high-dose (10 mg/kg) TsI once daily for 4 weeks. Results showed that TsI significantly alleviated osteonecrotic lesions of the femoral heads as determined by micro-CT analysis. Furthermore, TsI increased alkaline phosphatase activity and expressions of osteoblastic markers including osteocalcin, type I collagen, osteopontin, and Runt-related transcription factor 2 and decreased tartrate-resistant acid phosphatase activity and expressions of osteoclastic markers including cathepsin K and acid phosphatase 5. TsI also reduced inflammatory response and oxidative stress and activated the nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway in the femoral heads. Taken together, our findings show that TsI can relieve SIONFH, indicating that it may be a candidate for preventing SIONFH.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Lucian Capitanu ◽  
Liliana-Laura Badita ◽  
Constantin Tiganesteanu ◽  
Virgil Florescu

Purpose The purpose of this paper is to study the roughness effect on the fixation of taper junction components and surfaces wear in terms of taper surface design. The roughness of the femoral heads’ taper and of the femoral stems’ trunnions can influence the fretting wear of the taper junction. Design/methodology/approach It was analysed whether a microgrooved taper surface of the femoral stem trunnion improves the fixation and reduces the wear rate at the taper junction of the hip prosthesis. Two models have studied: a femoral head with a smooth tapered surface combined with a microgrooved stem trunnion and a femoral head with a smooth tapered surface combined with a trunnion that had a smooth surface of the tapered. To compare the wear evolution between these two models, a computerised finite element model of the wear was used. Findings The results obtained after analysis carried out during millions of loading cycles showed that the depth of the linear wear and the total material loss were higher for the femoral heads joined with microgrooved trunnions. The main conclusion of this paper is that the smooth surfaces of the taper and of the trunnions will ensure a better fixation at the taper junction, and therefore, will reduce the volumetric wear rates. Originality/value A higher fixation of the taper junction will reduce the total hip prosthesis failure and, finally, it will improve the quality and durability of modular hip prostheses.


Biomedicines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1593
Author(s):  
Yunfei Li ◽  
Yulia Liem ◽  
Zaitunnatakhin Zamli ◽  
Niall Sullivan ◽  
Enrico Dall’Ara ◽  
...  

Background: The purpose of this study was to investigate the relationship between the expression of key degradative enzymes by chondrocytes and the microarchitectural and mineral properties of subchondral bone across different stages of cartilage degradation in human hip osteoarthritis (OA). Methods: Osteochondral samples at different stages of cartilage degradation were collected from 16 femoral heads with OA. Osteochondral samples with normal cartilage were collected from seven femoral heads with osteoporosis. Microcomputed tomography was used for the investigation of subchondral bone microarchitecture and mineral densities. Immunohistochemistry was used to study the expression and distribution of MMP13 and ADAMTS4 in cartilage. Results: The microarchitecture and mineral properties of the subchondral plate and trabecular bone in OA varied with the severity of the degradation of the overlying cartilage. Chondrocytes expressing MMP13 and ADAMTS4 are mainly located in the upper zone(s) of cartilage regardless of the histopathological grades. The zonal expression of these enzymes in OA (i.e., the percentage of positive cells in the superficial, middle, and deep zones), rather than their overall expression (the percentage of positive cells in the full thickness of the cartilage), exhibited significant variation in relation to the severity of cartilage degradation. The associations between the subchondral bone properties and zonal and overall expression of these enzymes in the cartilage were generally weak or nonsignificant. Conclusions: Phenotypic changes in chondrocytes and remodelling of subchondral bone proceed at different rates throughout the process of cartilage degradation. Biological influences are more important for cartilage degradation at early stages, while biomechanical damage to the compromised tissue may outrun the phenotypic change of chondrocytes and is critical in the advanced stages.


2021 ◽  
Author(s):  
Yiwei Chen ◽  
Kexin Liu ◽  
Yu Miao ◽  
Bin Zhu ◽  
Feng Xue ◽  
...  

Abstract AimsTo analyze microarchitecture and histomorphology characteristics of different regions in femoral heads from patients with glucocorticoid-induced osteonecrosis of femoral head (GIONFH) and alcohol-induced osteonecrosis of femoral head (AIONFH). MethodsPatients diagnosed with GIONFH and AIONFH were recruited. Femoral heads were obtained after total hip replacement. Micro-CT was applied to evaluate the microstructure of 9 regions of interest (ROIs) in the femoral head. Along the supero-inferior orientation, the femoral head was divided into necrotic region, reactive interface, and normal region; along the medio-lateral orientation, the femoral head was divided into medial region, central region and lateral region. Decalcified and undecalcified bone histology were then performed to assess histopathological alterations and bone remodeling levels. Results42 GIONFH patients (50 hips) and 43 AIONFH patients (50 hips) anticipated in the study. In the necrotic region, most of the microarchitectural parameters did not differ significantly between GIONFH and AIONFH, whereas both the reactive interface and normal region illustrated significant differences in the microstructure and histomorphometry. The reactive interface and normal region exhibited a less sclerotic microarchitecture, but a higher bone remodeling level in GIONFH as compared with AIONFH. Despite similar necrotic pathological manifestations, subchondral trabecular microfracture in the necrotic region was more severe and vasculature of the reactive interface was more abundant in GIONFH. ConclusionsAlthough these two subtypes of ONFH shared similar microarchitecture and pathological features in the necrotic region, GIONFH exhibited a less sclerotic microarchitecture and a more active bone metabolic status in both the reactive interface and normal region.


Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1686
Author(s):  
Michail E. Klontzas ◽  
Georgios C. Manikis ◽  
Katerina Nikiforaki ◽  
Evangelia E. Vassalou ◽  
Konstantinos Spanakis ◽  
...  

Differentiation between transient osteoporosis (TOH) and avascular necrosis (AVN) of the hip is a longstanding challenge in musculoskeletal radiology. The purpose of this study was to utilize MRI-based radiomics and machine learning (ML) for accurate differentiation between the two entities. A total of 109 hips with TOH and 104 hips with AVN were retrospectively included. Femoral heads and necks with segmented radiomics features were extracted. Three ML classifiers (XGboost, CatBoost and SVM) using 38 relevant radiomics features were trained on 70% and validated on 30% of the dataset. ML performance was compared to two musculoskeletal radiologists, a general radiologist and two radiology residents. XGboost achieved the best performance with an area under the curve (AUC) of 93.7% (95% CI from 87.7 to 99.8%) among ML models. MSK radiologists achieved an AUC of 90.6% (95% CI from 86.7% to 94.5%) and 88.3% (95% CI from 84% to 92.7%), respectively, similar to residents. The general radiologist achieved an AUC of 84.5% (95% CI from 80% to 89%), significantly lower than of XGboost (p = 0.017). In conclusion, radiomics-based ML achieved a performance similar to MSK radiologists and significantly higher compared to general radiologists in differentiating between TOH and AVN.


PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257216
Author(s):  
Jongmoo Park ◽  
Jaehyeon Park ◽  
Sean Oh ◽  
Ji Woon Yea ◽  
Jeong Eun Lee ◽  
...  

We aimed to compare the volumetric-modulated arc therapy (VMAT) plans with or without multi-criteria optimization (MCO) on commercial treatment-planning systems (Eclipse, Varian Medical System, Palo Alto, CA, USA) for patients with prostate cancer. We selected 25 plans of patients with prostate cancer who were previously treated on the basis of a VMAT plan. All plans were imported into the Eclipse Treatment Planning System version 15.6, and re-calculation and re-optimization were performed. The MCO plan was then generated. The dosimetric quality of the plans was evaluated using dosimetric parameters and dose indices that account for target coverage and sparing of the organs at risk (OARs). We defined the rectum, bladder, and bilateral femoral heads. The VMAT-MCO plan offers an improvement of gross treatment volume coverage with increased minimal dose and reduced maximal dose. In the planning treatment volume, the Dmean and better gradient, homogeneity, and conformity indexes improved despite the increasing hot and cold spots. When implemented through the MCO plan, a steeper fall off the adjacent OARs in the overlap area was achieved to obtain lower dose parameters. MCO generated better sparing of the rectum and bladder through a tradeoff of the increasing dose to the bilateral femoral heads within the tolerable dose constraints. Compared with re-optimization and re-calculation, respectively, significant dose reductions were observed in the bladder (241 cGy and 254 cGy; p<0.001) and rectum (474 cGy and 604 cGy, p<0.001) with the MCO. Planning evaluation and dosimetric measurements showed that the VMAT-MCO plan using visualized navigation can provide sparing of OAR doses without compromising the target coverage in the same OAR dose constraints.


Materialia ◽  
2021 ◽  
pp. 101229
Author(s):  
Federica Buccino ◽  
Luigi Zagra ◽  
Paolo Savadori ◽  
Alessandro Galluzzo ◽  
Chiara Colombo ◽  
...  

2021 ◽  
Vol 21 (9) ◽  
pp. S85-S86
Author(s):  
Hao-Hua Wu ◽  
Dean Chou ◽  
Kevork HIndoyan ◽  
Jeremy Guinn ◽  
Joshua Rivera ◽  
...  

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