-
Journal of Orthopaedic Research :... Dec 2017We completed a systematic literature review of in vivo animal models that use arthrotomy-based methods to study particle-induced peri-implant osteolysis. The purpose of...
We completed a systematic literature review of in vivo animal models that use arthrotomy-based methods to study particle-induced peri-implant osteolysis. The purpose of the review was to characterize the models developed to date, to determine the questions addressed, to assess scientific rigor and transparency, and to identify gaps in knowledge. We probed three literature databases (Medline, Embase, and Scopus) and found 77 manuscripts that fit the search parameters. In the most recent 10 years, researchers mainly used rat and mouse models, whereas in the previous 20 years, large animal, canine, and rabbit models were more common. The studies have demonstrated several pathophysiology pathways, including macrophage migration, particle phagocytosis, increased local production of cytokines and lysosomal enzymes, elevated bone resorption, and suppressed bone formation. The effect of variation in particle characteristics and concentration received limited attention with somewhat mixed findings. Particle contamination by endotoxin was shown to exacerbate peri-implant osteolysis. The possibility of early diagnosis was demonstrated through imaging and biomarker approaches. Several studies showed that both local and systemic delivery of bisphosphonates inhibits the development of particle-induced osteolysis. Other methods of inhibiting osteolysis include the use of anabolic agents and altering the implant design. Few studies examined non-surgical rescue of loosened implants, with conflicting results with alendronate. We found that the manuscripts often lacked the methodological detail now advocated by the ARRIVE guidelines, suggesting that improvement in reporting would be useful to maximize rigor and transparency. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2595-2605, 2017.
Topics: Animals; Disease Models, Animal; Osteolysis
PubMed: 28548682
DOI: 10.1002/jor.23619 -
Frontiers in Oncology 2022Recent evidence suggests the global incidence and mortality of hepatocellular carcinoma (HCC) are increasing. Although the highest incidence of HCC remains entrenched in...
Recent evidence suggests the global incidence and mortality of hepatocellular carcinoma (HCC) are increasing. Although the highest incidence of HCC remains entrenched in WHO regions with high levels of HBV-HCV infection, the etiology of this disease is rapidly changing to include other lifestyle risk factors. Extrahepatic metastasis is a frequent feature of advanced HCC and most commonly locates in the lungs and bone. Bone metastasis in HCC (HCC-BM) signals a more aggressive stage of disease and a poorer prognosis, simultaneously HCC-BM compromises the function and integrity of bone tissue. HCC induced osteolysis is a prominent feature of metastasis that complicates treatment needed for pathologic fractures, bone pain and other skeletal events like hypercalcemia and nerve compression. Early detection of bone metastases facilitates the treatment strategy for avoiding and relieving complications. Although recent therapeutic advances in HCC like targeting agents and immunotherapy have improved survival, the prognosis for patients with HCC-BM remains problematic. The identification of critical HCC-BM pathways in the bone microenvironment could provide important insights to guide future detection and therapy. This review presents an overview of the clinical development of bone metastases in HCC, identifying key clinical features and identifying potential molecular targets that can be deployed as diagnostic tools or therapeutic agents.
PubMed: 35847843
DOI: 10.3389/fonc.2022.943866 -
Journal of Craniovertebral Junction &... 2022Cat scratch disease (CSD), caused by , may atypically present with vertebral osteomyelitis. Antibiotic regimens are tailored to presentation, which is markedly variable... (Review)
Review
Cat scratch disease (CSD), caused by , may atypically present with vertebral osteomyelitis. Antibiotic regimens are tailored to presentation, which is markedly variable and not well defined for any atypical disease. In cases of spinal instability, the use of antibiotics alone may not be sufficient. Atlantoaxial instability caused by osteomyelitis is a rare complication of CSD. In this report, we describe the rare case of vertebral osteomyelitis complicated by atlantoaxial instability, requiring both antibiotics and atlantoaxial fusion. We discuss our case, surgical technique, rationale, and outcome. In addition, we conducted a systematic review of the literature of vertebral osteomyelitis in pediatric secondary to . A 2-year-old child presented with a 2-month history of irritability, fever, and rigid neck pain along with a recent history of feline exposure. Physical examination revealed cervical tenderness and decreased range of motion. Computed tomography (CT) showed osteolysis of the right C1 lateral mass and pars articularis; T1-weighted magnetic resonance imaging with contrast showed enhancement around the right C1 lateral mass. The titer for was high. A diagnosis of cat scratch osteomyelitis with cervical instability was made, for which the patient underwent surgery with atlantoaxial fusion. Postoperative imaging demonstrated resolution of the contrast-enhanced lesion. At 6-year follow-up, the patient showed no signs of residual complications from surgical intervention with a solid fusion. Our review revealed 44 cases of pediatric CSD vertebral osteomyelitis. Conservative management with antibiotic employed in 86% while antibiotics with surgical intervention in 14% of the cases. Surgical intervention was most often in the form of incision for drainage and decompression without fusion. Average follow-up 10 months with 86% achieved complete resolution. Cervical instability caused by osteolysis is a rare complication of CSD. This can subsequently lead to vertebral instability, requiring definitive surgical intervention.
PubMed: 36263337
DOI: 10.4103/jcvjs.jcvjs_206_20 -
International Journal of Environmental... Aug 2020Hajdu-Cheney syndrome (HCS) is a rare genetic disease that causes acroosteolysis and generalized osteoporosis, accompanied by a series of developmental skeletal...
Hajdu-Cheney syndrome (HCS) is a rare genetic disease that causes acroosteolysis and generalized osteoporosis, accompanied by a series of developmental skeletal disorders and multiple clinical and radiological manifestations. It has an autosomal dominant inheritance, although there are several sporadic non-hereditary cases. The gene that has been associated with Hajdu-Cheney syndrome is . The described phenotype and clinical signs and symptoms are many, varied, and evolve over time. As few as 50 cases of this disease, for which there is currently no curative treatment, have been reported to date. The main objective of this systematic review was to evaluate the results obtained in research regarding Hajdu-Cheney Syndrome. The findings are reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and were registered on the web PROSPERO under the registration number CRD42020164377. A bibliographic search was carried out using the online databases Orphanet, PubMed, and Scielo; articles from other open access sources were also considered. Finally, 76 articles were included, and after their analysis, we have obtained a series of hypotheses as results that will support further studies on this matter.
Topics: Acro-Osteolysis; Hajdu-Cheney Syndrome; Humans; Mutation; Osteoporosis; Phenotype; Radiography; Rare Diseases; Receptor, Notch2
PubMed: 32854429
DOI: 10.3390/ijerph17176174 -
Orthopaedics & Traumatology, Surgery &... Dec 2020Core decompression (CD) is effective in relieving pain and delaying the progression to total hip arthroplasty (THA) for osteonecrosis of the femoral head (ONFH).... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Core decompression (CD) is effective in relieving pain and delaying the progression to total hip arthroplasty (THA) for osteonecrosis of the femoral head (ONFH). However, the influence of CD on subsequent THA has not yet been established. Therefore, we performed this systematic review to answer: does prior CD have detrimental effect on subsequent THA for ONFH, especially with regards to survivorship and functional results, as well as perioperative and postoperative complications.
PATIENTS AND METHODS
After registration on PROSPERO (CRD42019118861), literature published up to and including November 2018 was searched in the PubMed, Embase and Cochrane library databases with predetermined terms. Comparative studies on the clinical outcomes between conversion to THA with prior CD (the Prior CD group) and primary THA (the Control group) for ONFH were included. The outcomes of interest included survivorship free from revision, the postoperative functional performance, perioperative and postoperative complications. Data was extracted systematically and a meta-analysis was performed.
RESULTS
Overall, 5 retrospective cohort studies with 110 hips were identified for the Prior CD group and 237 hips were identified for inclusion in the Control group. All of the studies were of high quality in terms of the Newcastle-Ottawa Scale. No difference in the rate of revision between the two groups (2/42 (4.8%) vs. 4/160 (2.5%); RR=1.92; 95% CI=0.34 to 10.75; p=0.46) was detected after a minimum two-year follow-up. The mean postoperative Harris Hip Score was similar between the two groups in all 5 studies. The two groups experienced similar blood loss (Mean difference=12.17ml; 95% CI= -15.28 to 39.61ml; p=0.38). Moreover, intraoperative fracture was increased in the Prior CD group, though this did not reach statistical significance (3/31 (9.7%) vs. 0/55 (0.0%); RR=7.05; 95% CI=0.82 to 60.78; p=0.08). Similarly, osteolysis or radiolucent lines were more likely to occur in the Prior CD group without statistical significance (9/81 (11.1%) vs. 6/200 (3.0%); RR=3.14, 95% CI=0.98 to 10.06; p=0.05).
DISCUSSION
The present evidence indicated that prior CD does not detrimentally affect the survivorship nor hip scores of subsequent THA. Attention should be paid, however, to the potential for intraoperative fracture, postoperative osteolysis or radiolucent lines.
LEVEL OF EVIDENCE
III; systematic review and meta-analysis of level III retrospective comparative studies.
Topics: Arthroplasty, Replacement, Hip; Decompression, Surgical; Femur Head; Femur Head Necrosis; Humans; Retrospective Studies; Treatment Outcome
PubMed: 33189665
DOI: 10.1016/j.otsr.2020.07.004 -
European Journal of Radiology Open 2019This review aims to consolidate the published demographics, clinical and radiological features of calcific tendonitis affecting the linea aspera. Using the PRISMA... (Review)
Review
This review aims to consolidate the published demographics, clinical and radiological features of calcific tendonitis affecting the linea aspera. Using the PRISMA protocol, 55 clinical cases were extracted from 19 shortlisted papers. In a patient presenting with thigh and/or hip pain, radiologic evaluation should commence with plain radiographs; subsequent cross-sectional imaging, if necessary. Our review of the literature indicates that calcific tendonitis can be safely diagnosed when intratendinous calcification is observed in the region of the linea aspera with cortical erosion but no discrete soft tissue mass.
PubMed: 30815518
DOI: 10.1016/j.ejro.2018.12.002 -
Scientific Reports Mar 2024To test the hypothesis that genetic and pharmacological modulation of the classical cannabinoid type 1 (CB) and 2 (CB) receptors attenuate cancer-induced bone pain, we... (Meta-Analysis)
Meta-Analysis
To test the hypothesis that genetic and pharmacological modulation of the classical cannabinoid type 1 (CB) and 2 (CB) receptors attenuate cancer-induced bone pain, we searched Medline, Web of Science and Scopus for relevant skeletal and non-skeletal cancer studies from inception to July 28, 2022. We identified 29 animal and 35 human studies. In mice, a meta-analysis of pooled studies showed that treatment of osteolysis-bearing males with the endocannabinoids AEA and 2-AG (mean difference [MD] - 24.83, 95% confidence interval [CI] - 34.89, - 14.76, p < 0.00001) or the synthetic cannabinoid (CB) agonists ACPA, WIN55,212-2, CP55,940 (CB-non-selective) and AM1241 (CB-selective) (MD - 28.73, CI - 45.43, - 12.02, p = 0.0008) are associated with significant reduction in paw withdrawal frequency. Consistently, the synthetic agonists AM1241 and JWH015 (CB-selective) increased paw withdrawal threshold (MD 0.89, CI 0.79, 0.99, p < 0.00001), and ACEA (CB-selective), AM1241 and JWH015 (CB-selective) reduced spontaneous flinches (MD - 4.85, CI - 6.74, - 2.96, p < 0. 00001) in osteolysis-bearing male mice. In rats, significant increase in paw withdrawal threshold is associated with the administration of ACEA and WIN55,212-2 (CB-non-selective), JWH015 and AM1241 (CB-selective) in osteolysis-bearing females (MD 8.18, CI 6.14, 10.21, p < 0.00001), and treatment with AM1241 (CB-selective) increased paw withdrawal thermal latency in males (mean difference [MD]: 3.94, CI 2.13, 5.75, p < 0.0001), confirming the analgesic capabilities of CB ligands in rodents. In human, treatment of cancer patients with medical cannabis (standardized MD - 0.19, CI - 0.35, - 0.02, p = 0.03) and the plant-derived delta-9-THC (20 mg) (MD 3.29, CI 2.24, 4.33, p < 0.00001) or its synthetic derivative NIB (4 mg) (MD 2.55, CI 1.58, 3.51, p < 0.00001) are associated with reduction in pain intensity. Bioinformatics validation of KEGG, GO and MPO pathway, function and process enrichment analysis of mouse, rat and human data revealed that CB and CB receptors are enriched in a cocktail of nociceptive and sensory perception, inflammatory, immune-modulatory, and cancer pathways. Thus, we cautiously conclude that pharmacological modulators of CB receptors show promise in the treatment of cancer-induced bone pain, however further assessment of their effects on bone pain in genetically engineered animal models and cancer patients is warranted.
Topics: Male; Rats; Humans; Mice; Animals; Receptors, Cannabinoid; Osteolysis; Cannabinoids; Cannabinoid Receptor Agonists; Cancer Pain; Neoplasms; Receptor, Cannabinoid, CB2; Receptor, Cannabinoid, CB1
PubMed: 38461339
DOI: 10.1038/s41598-024-56220-0 -
Bulletin of the NYU Hospital For Joint... 2011Adverse local soft-tissue reactions have been associated with severe osteolysis and implant failure in metal-on-metal total hip arthroplasty (THA). Such a causal... (Review)
Review
UNLABELLED
Adverse local soft-tissue reactions have been associated with severe osteolysis and implant failure in metal-on-metal total hip arthroplasty (THA). Such a causal relationship has not often been associated with non metal-on-metal bearing surfaces. The purpose of this study was to assess the literature for cases of adverse soft-tissue reactions in non-metal-on-metal bearings in order to determine if a consistent histological diagnosis existed and if it was bearing-specific.
METHODS
A systematic review was performed in Medline and Embase databases, utilizing keyword searches to target reports of soft tissue complications following THA. Strict exclusion criteria were applied to retrieved studies in order to ensure that analyzed papers involved non-metal-on-metal bearing surfaces, had a final histological diagnosis, and had no previous history of periprosthetic infection or neoplastic process. Presenting symptoms, diagnostic work-up, histological diagnosis, and operative treatment were recorded for all reports retained for analysis.
RESULTS
Twenty-seven reports representing 31 cases of adverse soft-tissue reactions for non-metal-on-metal THAs met the criteria for analysis. In the majority of cases, patients presented with painful, limited motion in the affected hip, and radiological evidence of severe osteolysis. Histological examination often revealed a cystic mass, denoted by a granulomatous reaction comprised of histiocytes and giant cells, but few plasma cells. Revision of loose components was the most common successful therapeutic strategy utilized.
CONCLUSION
The present analysis revealed that similar adverse soft-tissue reactions have been described for both metal-on-polyethylene and ceramic bearing surfaces. When encountering such reactions in patients, a comprehensive diagnostic workup, including computed tomography (CT) scanning, lesion biopsy, and revision planning to alternate bearing surfaces should be considered.
Topics: Arthroplasty, Replacement, Hip; Foreign-Body Reaction; Hip Prosthesis; Humans; Metals
PubMed: 22035485
DOI: No ID Found -
Journal of Orthopaedics and... Feb 2022Press-fit cementless acetabular cup is widely used in total hip arthroplasty (THA). However, the use of additional screws for the acetabular cup has been extensively... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Press-fit cementless acetabular cup is widely used in total hip arthroplasty (THA). However, the use of additional screws for the acetabular cup has been extensively debated. The purpose of this review is to compare the stability, revision rate, wear rate, and clinical scores of cementless acetabular cups with and without screws in THA.
MATERIALS AND METHODS
Comprehensive literature searches of the following databases were performed: Cochrane Library, Pubmed, Web of Science, OVID, Elsevier ClinicalKey, Clinicaltrials.gov, and EMBASE. We searched for trials that compared cementless acetabular cups with screws or without screws, and were published in the English language. We evaluated the stability of the prosthesis by osteolysis and migration. The clinical scores included Harris hip scores (HHS) and pain scores.
RESULTS
Nineteen articles involving 4046 THAs met the inclusion criteria. Our analysis revealed that additional screws did not increase the stability of acetabular cups, and there was no statistical significance between the groups with and without screws in osteolysis and clinically relevant migration. Revision rates showed no significant difference between the groups with and without screws. There was no difference in wear between the two groups. Our analysis showed no difference in pain scores and HHS between groups.
CONCLUSION
Press-fit without screws could achieve sufficient acetabular cup stability. Acetabular cups without screws showed no difference from acetabular cups with screws in many outcomes. Additional screws are not required for cementless acetabular cups.
LEVEL OF EVIDENCE
Level III.
Topics: Acetabulum; Arthroplasty, Replacement, Hip; Bone Screws; Hip Prosthesis; Humans; Osteolysis; Prosthesis Design; Prosthesis Failure
PubMed: 35142933
DOI: 10.1186/s10195-022-00629-8 -
Chinese Medical Journal May 2015Wear debris of polyethylene has become a restraining factor of the durability for total hip arthroplasty (THA). Ceramic on ceramic (COC) has better wear resistance while... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Wear debris of polyethylene has become a restraining factor of the durability for total hip arthroplasty (THA). Ceramic on ceramic (COC) has better wear resistance while the squeaking sound and prosthesis fracture are of concern. It is still a controversy that bearing couples are better for THA.
METHODS
We performed a systematic review of all English articles identified from PubMed (1966-), Embase (1980-) and the Cochrane Library. Clinical outcomes, complications, revision rates, and radiographic outcomes of COC-THA and ceramic on polyethylene (COP)-THA were compared and evaluated.
RESULTS
Eight prospective randomized trials enrolling a total of 1508 patients and 1702 THA surgeries were identified. Our results demonstrated the prosthesis fracture and the squeaking sound is significantly higher in COC group and higher wear rate of the COP. Hip function, loosening rate, dislocation rate, revision rate, and the osteolysis rate were comparable between two groups. According to Grading of Recommendations Assessment, Development and Evaluation system assessment, the strength of evidence was high for prosthesis fracture, dislocation, osteolysis, and moderate for radiolucent line or loosening, hip noise, and revision.
CONCLUSIONS
Up to now, there is insufficient evidence to identify any clinical advantage of COC compared with COP. Longer follow-up of larger randomized trial is needed to clarify the outcomes.
Topics: Arthroplasty, Replacement, Hip; Ceramics; Hip Prosthesis; Humans; Polyethylene
PubMed: 25947407
DOI: 10.4103/0366-6999.156136