Basic Research 173 articles
Infection after ACL reconstruction is uncommon but catastrophic. Prophylactic graft saturation in vancomycin reportedly reduces infection rates.
Bone strength depends on both bone quantity and quality. The former is routinely estimated in clinical settings through bone mineral density measurements but not the latter. Bone quality encompasses the structural and material properties of bone. Although its importance is appreciated, its contribution in determining bone strength has been difficult to precisely quantify partly because it is multifactorial and requires investigation of all bone hierarchical levels. Fourier transform infrared spectroscopy provides one way to explore these levels.
Osteonecrosis (ON) of the femoral head is a devastating disease affecting young patients at their most productive age, causing major socioeconomic burdens. ON is associated with various etiologic factors, and the pathogenesis of the disease is unknown. Most investigators believe the disease is the result of secondary microvascular compromise with subsequent bone and marrow cell death and defective bone repair.
Muscle atrophy impacts almost every patient seen for orthopaedic conditions. Unfortunately, no effective treatment is available to date. Matrix metalloproteinases (MMPs), especially MMP-2, are involved in skeletal muscle atrophy. MMP-2 null mice reportedly have substantially reduced muscle atrophy after tendon transection compared with wild-type mice, suggesting MMP-2 plays an important role in muscle atrophy. Although the exact mechanisms remain unknown, a newly-discovered intracellular form of MMP-2 suggests a possible novel mechanism of MMP-2 digesting muscle matrix during muscle atrophy. I propose a new pharmacologic treatment for muscle atrophy using selective MMP-2 inhibitors.
The definition of bone quality is evolving particularly from the perspective of anabolic agents that can enhance not only bone mineral density but also bone microarchitecture, composition, morphology, amount of microdamage, and remodeling dynamics.
Cartilage-mimicking, High-density Brush Structure Improves Wear Resistance of Crosslinked Polyethylene: A Pilot Study
In natural synovial joints under physiologic conditions, fluid thin-film lubrication by a hydrated layer of the cartilage is essential for the smooth motion of the joints. The considerably less efficient lubrication of artificial joints of polyethylene is prone to wear, leading to osteolysis and aseptic loosening and limiting the longevity of THA. A nanometer-scale layer of poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC) with cartilage-mimicking brushlike structures on a crosslinked polyethylene (CLPE) surface may provide hydrophilicity and lubricity resembling the physiologic joint surface.
Osteolysis due to wear of UHMWPE limits the longevity of joint arthroplasty. Oxidative degradation of UHMWPE gamma-sterilized in air increases its wear while decreasing mechanical strength. Vitamin E stabilization of UHMWPE was proposed to improve oxidation resistance while maintaining wear resistance and fatigue strength.
Crack Propagation Resistance Is Similar Under Static and Cyclic Loading in Crosslinked UHMWPE: A Pilot Study
Recent work suggests crack phenomena (eg, crack initiation and propagation) in UHMWPE do not depend on cyclic damage mechanisms. Materials for which crack phenomena occur in static (noncyclic) mode should exhibit similar crack propagation behavior under static and cyclic loading conditions.
High levels of total cholesterol, triglycerides, and low-density lipoprotein are toxic to the vascular endothelium and thus have long been associated with atherosclerosis. Several clinical studies have suggested that elevated cholesterol also has a negative effect on tendon structure and function. Data from our preliminary studies show that the patellar tendons of hypercholesterolemic knockout mice exhibit reduced baseline elastic modulus and strength postinjury compared with controls.
Emerging Ideas: Prevention of Posttraumatic Arthritis Through Interleukin-1 and Tumor Necrosis Factor-alpha Inhibition
Despite surgical and mechanical stabilization of an acutely injured joint through ligament reconstruction, meniscus repair, or labral repair, the risk of posttraumatic arthritis remains high. Joint injury triggers three phases of pathogenic events: the early (acute) phase involves joint swelling, hemarthrosis, expression of inflammatory cytokines (especially interleukin-1 [IL-1] and tumor necrosis factor-α [TNF-α]), and biomarkers of cartilage catabolism; an intermediate phase is characterized by reduction of joint inflammation, ongoing joint catabolism, but no evidence yet for typical features of radiographic osteoarthritis (OA); and a late phase characterized by radiographic OA.