Previous studies have indicated that chronic intermittent hypobaric hypoxia (ciHH) preconditioning can inhibit TnF-α and other related inflammatory cytokines and exerts protective effect on intervertebral disc degeneration disease (idd) in rats; however, the mechanism is still unclear. The present study aimed to explore the repair mechanisms of ciHH on idd in rats. in the experiment, 48 adult Sprague-dawley rats were selected and randomly divided into an experimental group (ciHH-idd), a degenerative group (idd) and a control group (con). The ciHH-idd group of rats (n=16) were treated with ciHH (simulated 3000 m altitude, 5 h per day, 28 days; P o2 =108.8 mmHg) before disc degeneration surgery. The idd group of rats (n=16) underwent tail-vertebral intervertebral disc surgery to establish a model of intervertebral disc degeneration. The con group of rats (n=16) did not receive any treatments. after surgery, the disc height index was calculated using X-ray analysis of rat tail vertebrae, the degeneration process was observed and repair was evaluated by chemically staining degenerative intervertebral disc tissue slices. The expression levels of basic fibroblast growth factor (bFGF), TGFβ1, collagen i and collagen ii were measured in the intervertebral disc tissue using western blotting; while the expression levels of bFGF, TGFβ1 and hypoxia-inducible factor 1-α (HiF-1α) were measured in rat serum using eliSa. The results demonstrated that: i) The degree of intervertebral disc height degeneration in CIHH-IDD rats was significantly lower compared with that in idd rats (P<0.05); ii) the expression levels of bFGF, TGFβ1 and HiF-1α were higher in ciHH-idd rat serum compared with those in idd rat serum (P<0.05); iii) optical microscopy revealed that the degree of disc degeneration was relatively mild in ciHH-idd rats; and iv) the protein expression levels of bFGF, TGFβ1 and collagen ii were increased in ciHH-idd rat intervertebral disc tissues compared with those of idd rats, while the overexpression of collagen i protein was inhibited. overall, after ciHH pre-treatment, the expression levels of bFGF and TGFβ1 were up-regulated, which play notable roles in repairing degenerative intervertebral discs in rats.
Background: Tibial plateau fractures (TPFs) are a challenging type of fracture in orthopedic traumatology.We previously designed a plate (Patent Number: CN201520195596.5) for posterolateral TPF combined with posterior lateral collapse.. In this study, finite element analysis was used to compare the biomechanical characteristics of two internal fixation methods for posterolateral TPF. We investigated the support effect of the new steel plate on lateral TPFs combined with posterior TPFs. Methods: Two models of complex TPF were established. Model A was fixed with the new type of plate, and model B was fixed without the plate. Three axial loads of 500, 1,000, and 1,500 N were applied using FEA on the two fracture models (A and B) to analyze the data.
Background
In tibial plateau fractures, the posterolateral segment of the tibia plateau is frequently affected and challenging to treat. Although there are many surgical approaches and fixation methods for the treatment of these fractures, all of these methods have limitations. We designed a new rotational support plate (RSP) and a special pressurizer that can fix the fracture directly via the anterolateral approach. This method is advantageous because it leads to little trauma, involves a simple operation, and has a reliable fixation effect. This study details the technique of treating these fractures with the RSP and special pressurizer and provides the outcomes.
Methods
From May 2016 to January 2019, the data of 12 patients with posterolateral tibial plateau fractures treated with the RSP and special pressurizer in our hospital were retrospectively analyzed. Postoperative rehabilitation was advised, knee X-rays were taken at follow-ups, and fracture healing, complications, and knee range of motion were assessed. The Hospital for Special Surgery (HSS) knee score and Knee Injury and Osteoarthritis Outcome Score (KOOS) were used to evaluate knee function at the last follow-up.
Results
The average follow-up time of all patients was 16.5 months (range, 12–25 months). The average bony union time was 3.2 months (range, 3–4.5 months). At the last follow-up, the average knee range of motion was 138° (range, 107–145°). The average HSS score was 91 (range, 64–98). The average KOOS Symptoms score was 90 (range, 75–96). The average KOOS Pain score was 91 (range, 72–97). The average KOOS ADL score was 91 (range, 74–97). The average KOOS sport/recreation score was 83 (range, 70–90). The average KOOS QOL score was 88 (range, 69–93). Skin necrosis, incision infections, and fixation failure did not occur during the follow-up period.
Conclusions
With our newly designed RSP and special pressurizer, posterolateral tibial plateau fractures can be easily and effectively reduced and fixed through the anterolateral approach, which serves as a novel treatment for posterolateral tibial plateau fractures.
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