Background Anterior cervical corpectomy and fusion (ACCF), together with anterior cervical discectomy and fusion (ACDF) are both effective clinical treatments for cervical spondylotic myelopathy (CSM). Cervical sagittal balance is critical to preserving normal alignment, and is also associated with clinical outcomes. Material/Methods We retrospectively reviewed patients who had suffered from CSM and had undergone 1-level ACCF or 2-level ACDF surgery between December 2016 and November 2017. Forty-eight patients were identified: 25 in the ACDF group and 23 in the ACCF group. All patients received follow-up for more than 12 months. The demographic data, radiographic parameters, and clinical efficacy were compared between and within groups, both pre- and postoperatively. Results Both groups acquired good clinical efficacy; both Japanese Orthopedic Association (JOA) scores and Neck Disability Index (NDI) scores improved significantly. At the final follow-up visit, patients in the ACCF and ACDF groups did not differ significantly in C2–C7 Sagittal Vertebral Axis (cSVA), T1 Pelvic Angle (TPA), Neck Tilt (NT), Thoracic Inlet Angle (TIA), JOA, or NDI scores. However, the ACDF group had a significantly larger Cobb angle and T1 Slope (T1S) than the ACCF group. The postoperative Cobb angle increased significantly only in the ACDF group, while postoperative T1S significantly increased in both ACCF and ACDF groups. Conclusions Anterior cervical surgery may change the sagittal balance in terms of T1S or Cobb angle. No significant difference was found between ACCF and ACDF in clinical outcomes or representative global sagittal parameters. ACDF achieved more lordosis improvement than ACCF, with higher T1S. Surgeons need to pay extra attention to cervical sagittal balance, rather than focusing solely on decompression.
BackgroundThe transtibial tunnel technique achieves equal length reconstruction of the anterior cruciate ligament (ACL). This study aimed to investigate whether transtibial tunnel technique can achieve anatomical reconstruction of ACL.MethodsFor 25 corpses, the anterior soft tissue of the knee joint was detached so that the ligamentous surface was fully exposed, then the knee joint was fixed at 90° with an external fixator and the anterior cruciate ligament was removed. Double-sided laser technology was used to establish spatial conformation of ACL.ResultsThe male to female ratio of the subjects was 19:6, with an average age of 59.52 ± 11.13 years. Patellar tendon length was 35.23 ± 5.10 mm, tibial eminence length and width was 15.75 ± 2.44 and 7.80 ± 1.28 mm, respectively, and femoral attachment length and width was 15.40 ± 2.17 and 8.97 ± 1.61 mm, respectively. When the flexion turned 90°, the tibial tunnel length was 31.83 ± 4.09 mm and the distance to the tibial plateau, patellar tendon, and medial collateral ligament was 16.33 ± 4.56, 10.79 ± 5.85, and 23.12 ± 5.99 mm, respectively.ConclusionsWith the aid of double-sided laser technology, transtibial tunnel technique can safely achieve single-bundle reconstruction of ACL.
Osteoarthritis (OA) is a common joint disease characterized by progressive cartilage degeneration, which is regulated by oxidative stress, and there is currently no clinical drug to alleviate its development. Kartogenin (KGN) was found to treat cartilage damage in early OA, but its application is limited by the rapid clearance from synovial fluid. This study synthesized a KGN-loaded nanocarrier based on PLGA/polydopamine core/shell structure to treat OA. The prepared KGN@PLGA/PDA-PEG-E7 nanoparticles could stay in the joint cavity for more than four weeks, ensuring the long-term sustained release of KGN after a single intra-articular injection. Moreover, the polyphenolic structure of PDA makes it effective in scavenging reactive oxygen species (ROS), so the KGN@PLGA/PDA-PEG-E7 NPs could promote chondrogenic differentiation even under oxidative stress conditions. In addition, the BMSCs-targeting peptide E7(EPLQLKM) conferred effective BMSCs affinity to KGN@PLGA/PDA-PEG-E7 NPs, which enhanced the efficacy of inducing cartilage in vitro and in vivo. As a result, the KGN@PLGA/PDA-PEG-E7 nanoparticles could effectively protect cartilage and subchondral bone in a rat ACLT model. In summary, KGN@PLGA/PDA-PEG-E7 nanoparticles can be used for intra-articular injection to effectively alleviate OA progression. This therapeutic strategy can also be extended to the delivery of other drugs or targeting other tissues to treat joint diseases.
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