Accurate positioning of the femoral insertion of the medial patellofemoral ligament (MPFL) is the main difficulty in MPFL reconstruction. This article describes an all-arthroscopic MPFL reconstruction procedure. Preoperative 3-dimensional computed tomography assists in MPFL patellar and femoral insertion positioning, with arthroscopic reconfirmation of femoral insertion positioning through a subcutaneous tunnel during surgery. In the socket-anchor technique for patellar insertion fixation, a 10-mm-deep bone tunnel (socket) is created along a previously located guide pin at the MPFL patellar insertion; then, an absorbable suture anchor is inserted into the end of the socket to fix the tendon graft. This technique provides the advantages of being minimally invasive, yielding accurate positioning, ensuring a sufficient tendon-bone interface healing area of the graft, and having no need for intraoperative fluoroscopy.

Objective This study quantitatively assessed postoperative changes in graft inclination angle and femorotibial position after ACL reconstruction using MRI, to identify reliable indicators for evaluating knee stability. Methods A retrospective analysis of 50 cases of ACL reconstruction from June 2019 to June 2020 included clinical outcome measures. MRI assessed graft/ACL inclination angles, medial/lateral anterior tibial translation (ATT), and femoral/tibial rotation angles on both surgical and contralateral sides. Femorotibial angle (FTA) and rotational tibial subluxation (RTS) were calculated for comparing MRI results. Results Following ACL reconstruction, graft inclination angles, ATT, and FA/TA were significantly greater than those of the contralateral knee joint (P<0.05). FTA and RTS did not differ significantly between sides, but exhibited significant correlation. Conclusions Graft inclination angles could not fully recover to normal levels post-ACL reconstruction, while notable medial/lateral ATT occurred on the surgical side. Additionally, a significant correlation was observed between FTA and RTS, suggesting their potential as combined clinical indicators for assessing knee joint rotation stability.

OBJECTIVES:The objectives of this paper is to conduct a bibliometric analysis to examine the research status and development trend of anterior cruciate ligament injury and reconstruction in children and adolescents over the past 20 years.DESIGN:Descriptive Research.METHODS:This study obtained information regarding studies on Anterior Cruciate Ligament Reconstruction in Children and Adolescents from the Web of Science Core Collection database. Visual and bibliometric analysis were conducted using VOSviewer, Origin 2022, Pajek64 5.18and Excel 2019. These analytic tools facilitated the analysis of various aspects, including countries/regions, institutions, authors, journals and keywords related to the research.RESULTS:From 2003 to 2023, a total of 1328 articles were retrieved in WOS, and 637 articles were selected by two authors. The most productive institutions are Childrens Hosp Philadelphia, Kocher, ms. Their articles have the highest number of publications and citations. The American journal of sports medicine is the most frequently cited journal for articles on anterior cruciate ligament reconstruction in children and adolescents. The most common keywords used in these articles were "anterior cruciate ligament reconstruction", "injury, children, adolescent", and "skeletally immature patients".CONCLUSIONS:This study provides valuable insights into the research focus of anterior cruciate ligament reconstruction in children and adolescents. In recent years, there has been significant attention paid to areas of "the return to sport, re-repture rate and functional recovery after anterior cruciate ligament reconstruction" in this specific population. These aspects have emerged as key directions for future research in this field.

骨关节炎(osteoarthritis,OA)是临床治疗中常见的骨科疾病,其主要以关节软骨变形、破坏及骨质增生为特征,目前没有根治手段.已有大量研究证明,白介素1(interleukin-1,IL-1)在OA病理进程中发挥关键作用,而IL-1受体拮抗剂(IL-1 receptor antagonist,IL-1Ra)已被证实可以竞争性地与IL-1受体结合,阻断IL-1的生物活性,从而抑制骨关节炎的进展,为OA治疗提供新的可能.本文将针对IL-1Ra在骨关节炎的治疗研究进展进行综述,围绕IL-1Ra介导的相关通路及其治疗骨关节炎的机理和策略进行总结,为OA治疗的研究和临床开发提供参考.

There are debates in residual end preservation technique in anterior cruciate ligament reconstruction whether it would promote the bone-tendon healing, knee proprioception recovery, vascularization of synovial membrane and transplanted ligament. This article retrieved the literatures from January 2018 to September 2022, and provided induction, summary and discussion of the influence of residual preservation in anterior cruciate ligament reconstruction on bone tunnel, proprioception recovery, vascularization of synovial membrane and transplanted ligament, and early knee function recovery. Preservation residual anterior cruciate ligament reconstruction shows advantages in promoting early tendon bone healing and vascularization of synovial membrane and transplanted ligament, and is also conducive to the recovery of proprioception, which in turn accelerate the knee joint function recovery. Clinical doctors should base on the residual type of the anterior cruciate ligament rupture in patients, for patients who meet the conditions of residual reserves, surgeons shall retaine the tissue as far as possible during anterior cruciate ligament reconstruction.

Objective The inclination angle of the graft and the femorotibial position relationship after anterior cruciate ligament (ACL) reconstruction surgery has been widely discussed for long. However, studies comparing the surgical side with the healthy side are rarely reported. This study aimed to quantitatively describe the changes in the inclination angle of the graft and the femorotibial position relationship of the knee joint after ACL reconstruction relative to the healthy side based on magnetic resonance imaging (MRI), so as to identify effective indicators for quantifying the femorotibial relationship. Methods A retrospective analysis was performed on 50 cases of ACL reconstruction operated in the Sports Medicine Department of Shenzhen Second People’s Hospital from June 2019 to June 2020. MRI of the surgical side and healthy side was obtained for each patient. Based on the MRI, the inclination angle of the graft/ACL on the coronal plane and sagittal plane, the medial and lateral anterior tibial translation (ATT), and the femoral rotation angle (FA) and tibial rotation angle (TA) of both knees were measured. Then, the femorotibial angle (FTA) and the rotational tibial subluxation (RTS) were calculated in order to evaluate the differences in MRI results between the surgical and healthy sides. Results After ACL reconstruction, the inclination angle of the graft on the coronal plane and sagittal plane, the medial and lateral ATT, and the FA and TA were all greater than those of the healthy knee joint (P < 0.05). There were no significant differences in the FTA and RTS between the surgical and healthy sides, but there was a significant correlation between these two indicators. Conclusions After ACL reconstruction, the inclination angle of the graft cannot be restored to the level of the healthy knee joint, and obvious medial and lateral ATT occurred on the surgical side compared to the healthy side of the knee joint. In addition, there is a significant correlation between FTA and RTS, which are expected to be used as combined clinical indicators for evaluating the stability of knee joint rotation.

Purpose: To evaluate the degree of graft healing after "tension suspension" reconstruction of "Sherman II" anterior cruciate ligament injuries versus non-remnant preserving anatomical reconstruction and to compare the clinical outcomes of the two procedures. Method: The clinical data of 64 patients were retrospectively included. There were 31 cases in the "tension suspension" remnant-preserving reconstruction group and 33 cases in the non-remnant-preserving anatomical reconstruction group. The International Knee Documentation Committee (IKDC) score, the Tegner score, and the Lysholm activity score were assessed preoperatively and at 6 months, 1 year, and 2 years postoperatively, respectively. The signal/noise quotient (SNQ) of the grafts was measured at 6 months, 1 year, and 2 years after surgery to quantitatively evaluate the maturity of the grafts after ACL reconstruction; the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of the reconstructed ACL region of interest (ROI) were measured using DTI. Result: A total of 64 patients were included in the study. The mean SNQ values of the grafts in the 6 months, 1 year, and 2 years postoperative remnant-preserving reconstruction (RP) groups were lower than those in the non-remnant-preserving (NRP) reconstruction group, with a statistically significant difference (p < 0.05). At each postoperative follow-up, the SNQ values of the tibial and femoral sides of the RP group were lower than those of the NRP group; the SNQ values of the femoral side of the grafts in both groups were higher than those of the tibial side, and the differences were statistically significant (p < 0.05). At 6 months, 1 year, and 2 years postoperatively, the FA and ADC values of the grafts were lower in the RP group than in the NRP group, and the differences were statistically significant (p < 0.05); the IKDC score and Lysholm score of the RP group were higher than the NRP group, which was statistically significant (p < 0.05). Conclusion: For Sherman II ACL injury, the graft healing including ligamentization and revascularization at 2 years after the "tension suspension" remnant-preserving reconstruction was better than that of non-remnant-preserving anatomic reconstruction.

Interleukin-1 (IL-1) is an important inflammatory factor in multi-organ inflammation and tissue damage. Interleukin-1 receptor antagonist (IL-1RA) is a bioactive receptor for IL-1. The interaction of these two—IL-1 and its particular receptor antagonist, IL-1RA—influences the propensity and severity of numerous illnesses. Importantly, therapies using IL-1RA have been applied in treatment of human inflammatory diseases like rheumatoid arthritis. In this study, we designed a “decoy” cell-derived nanocapsule, which uses stably-expressed HEK293T cells to display the IL-1RA on the outer surface of exosomes to act as a decoy antagonist against IL-1. After preparation, the decoy exosomes were characterized using Western Blot, transmission electron microscopy (TEM), and nanoparticle tracking analysis (NTA) to confirm whether they retained the correct size and shape of naturally-occurring exosomes. Results indicated that the IL-1Ra protein was successfully expressed on exosomes that had been secreted by HEK293T cells that were transfected with a pcDNA3.1(+)-IL-1RA-N-termSyntenin recombinant plasmid. This work provides a favorable, exosome-based tool for the targeted delivery of IL-1Ra for the treatment of joint inflammatory diseases.

Anterior cruciate ligament injury is the most common sports injury in orthopaedics, which can adversely affect knee joint function and exercise of patients. Using arthroscopy to reconstruct the anterior cruciate ligament has become the first choice for treating anterior cruciate ligament rupture. However, different degrees of articular cartilage injury of the knee can be observed in patients after anterior cruciate ligament reconstruction. More importantly, the articular cartilage injury after anterior cruciate ligament reconstruction indicates that it will develop into osteoarthritis in the long term. It is of great significance to fully understand the factors that lead to the occurrence and development of cartilage injury. This article reviews the effects of surgical methods, meniscus status, different grafts, time from injury to surgical intervention, postoperative knee joint stability, postoperative rehabilitation, knee joint anatomical factors, and demographic characteristics of patients on articular cartilage degeneration after anterior cruciate ligament reconstruction. The present review provides insights into the anterior cruciate ligament reconstruction, which can be used to investigate new treatment strategies to delay and prevent the progress of osteoarthritis. At the same time, it provides a holistic understanding of the influence of multiple factors on cartilage lesions after anterior cruciate ligament reconstruction.