Pelvic support osteotomy (PSO) is regarded to provide pelvic stability and improve abductor function to delay or even avoid total hip arthroplasty (THA) in young patients with high-riding hip dysplasia. However, some of these patients eventually have to undergo THA. Because of the double-angulation deformity of the femur after PSO, subsequent THA is challenging. This study aimed to analyze whether PSO surgery is suitable for high-riding hip dysplasia and summarize orthopaedic strategy during THA for patients with previous PSO. This case–control study included eight cases of THA for high-riding hip dysplasia patients with previous PSO (study group) and 24 cases of high-riding hip dysplasia patients without any hip surgical therapy (control group) by a 1:3 match (from May 2018 to January 2022). We compared demographics and joint function before and after THA between two groups and recorded all patients’ preoperative imaging data, surgical procedures, postoperative imaging data, and complications. The surgical techniques for patients with previous PSO were highlighted. There was no statistical difference between the two groups in demographic (p > 0.05). The study group had worse hip Harris score (HHS), range of motion (ROM), visual analogue scale (VAS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (p < 0.05) compared with the control group before THA. All patients had concurrent THA and osteotomy at the proximal femur, but the study group experienced longer operation time (p = 0.047) with more blood loss (p = 0.027) and higher complication rate compared with the control group (p = 0.009). At the last follow-up, the study group’s HHS, ROM, VAS, and WOMAC were still worse than those in the control group. PSO did not improve the joint function of high-riding hip dysplasia patients but brought challenges to subsequent THA and affected the surgical outcomes. In short, we suggested that PSO is unsuitable for routine high-riding hip dysplasia patients.

Background Accurate preoperative planning is crucial for successful total hip arthroplasty (THA) for developmental dysplasia of the hip (DDH). The aim of this study was to compare the accuracy of an artificial intelligence-assisted three-dimensional (3D) planning system (AIHIP) with two-dimensional templates in predicting acetabular cup size in THA for DDH. Method This study retrospectively analyzed image data from 103 DDH patients who had THA between May 2019 and August 2023. AIHIP was used for 3D planning, and two-dimensional (2D) templates were used by two experienced surgeons. Accuracy was assessed by comparing predicted and actual cup sizes, and potential factors affecting accuracy were analyzed, including gender, side, BMI, and dysplasia classification. Results AIHIP had higher accuracy in predicting the acetabular cup size compared to the 2D template. Within ± 0 size, AIHIP’s accuracy was 84.1%, while the 2D template’s was 64.0% ( p < 0.05). Within ± 1 size, AIHIP's accuracy was 95.1%, while the 2D template’s was 81.1% ( p < 0.05). Accuracy was unaffected by gender, side, or BMI but was by DDH classification. In subgroup analysis, AIHIP's mean absolute error (0.21 ± 0.54) was significantly lower than the 2D template’s (0.62 ± 0.95) for Crowe II and Crowe III ( p < 0.05). Conclusion AIHIP is superior to 2D templates in predicting the acetabular cup size accurately for THA in DDH patients. AIHIP may be especially beneficial for Crowe II and III DDH patients, as 2D templates may not accurately predict cup size in these cases.

Abstract Background Cruciate-retaining (CR) prosthesis and posterior-substituting (PS) prosthesis are widely used in total knee arthroplasty (TKA). The main discrepancy in kinematics between two designs is that the mechanism of rollback motion during knee flexion is different. In this study, by using image-based robotic assisted system (mako), femoral-tibial contact points of these two types of prostheses during 0°to 140°flexion were recorded to compared with the natural kinematic characteristics of knee joints before TKA, so as to explore which type of prosthesis is close to the natural rollback. Method Twelve patients (15 knees) with MAKO-assisted TKA in our center were included. ①After the registration was completed, the knee joint of the patients was flexed at 0°to 140°(10°increasing, A total of 16 angles, including 45°), the contact point of femur and tibia at each angle was recorded by Mako software; ②After the anterior cruciate ligament(ACL) removed and the posterior cruciate ligament(PCL) retained, the CR model was placed, and the contact point of the femur and tibia at each knee flexion angle was recorded again from 0°to 140 °;③The PCL was removed, and the PS prosthesis was implanted finally. Then the contact position of the femur and tibia at each knee flexion angle from 0°to 140 °was recorded for the third time. Through the above process, we obtained the contact position of the femoral condyle and the tibia during the passive flexion of the knee joint at 16 angles in three conditions (1, the patient with natural knee; 2, the patient with CR prosthesis;3, the patient with PS prosthesis) in order to simulate the rollback of the knee joint and compare the difference of rollback in three groups. Results There was no statistical difference in contact points of the femur and tibia between the CR prosthesis and the natural knee at all 16 flexion angles (P > 0.05). The contact points of the femur and tibia in the PS prosthesis group was close to those of the natural knee at flexion range from 20 ~ 50°(P > 0.05); but at 0 ~ 10°flexion and 60 ~ 140°flexion, there was a statistical difference in contact points of the femur and tibia between the PS prosthesis group and the patient 's natural knee joint(P<0.05). Conclusion By using the intraoperative real-time positioning function of image-based robotic assisted system(Mako)to detect the characteristics of knee joint rollback motion, we found that compared with PS prosthesis, the knee joint rollback of patients using CR prosthesis was closer to the natural state.

发育性髋关节发育不良(developmental dysplasia of the hip,DDH),是指髋臼和股骨头等骨性结构发育畸形,导致髋关节形态和功能出现异常的一种疾病.DDH的发生、发展受到遗传因素、宫内环境和外在环境等多重因素影响,疾病表现复杂.本文通过检索PubMed、Embase、ScienceDirect、中国知网及万方数据库,并结合既往临床观察,对近年来发育不良髋关节骨性结构外的相关畸形研究进行综述,主要包括骨盆畸形、脊柱畸形、膝关节畸形、下肢不等长、足踝畸形及软组织(血管、肌肉、神经、韧带)异常.最后我们提出'髋关节发育不良综合征?这一概念,以期通过加强对DDH病人髋关节外畸形的认识、加深对DDH病人整体畸形的理解,用更全面、更宏观的视角看待这一疾病,并做到早诊早治,避免病人出现全身性的结构异常.

Rheumatoid Arthritis is a universal disease that severely affects the normal function of human joints and the quality of life. Millions of people around the world are diagnosed with rheumatoid arthritis every year, carrying a substantial burden for both the individual and society. Hydrogel is a polymer material with good mechanical properties and biocompatibility, which shows great potential in the treatment of rheumatoid arthritis. With the progress of tissue engineering and biomedical material technology in recent years, more and more studies focus on the application of hydrogels in rheumatoid arthritis. We reviewed the progress of hydrogels applied in rheumatoid arthritis in recent years. Also, the needed comprehensive performance and current applications of therapeutic hydrogels based on the complex pathophysiological characteristics of rheumatoid arthritis are also concluded. Additionally, we proposed the challenges and difficulties in the application of hydrogels in rheumatoid arthritis and put forward some prospects for the future research.

Prosthetic joint infection (PJI) is often considered as one of the most common but catastrophic complications after artificial joint replacement, which can lead to surgical failure, revision, amputation and even death. It has become a worldwide problem and brings great challenges to public health systems. A small amount of microbe attaches to the graft and forms a biofilm on its surface, which lead to the PJI. The current standard methods of treating PJI have limitations, but according to recent reports, bioactive materials have potential research value as a bioactive substance that can have a wide range of applications in the field of PJI. These include the addition of bioactive materials to bone cement, the use of antibacterial and anti-fouling materials for prosthetic coatings, the use of active materials such as bioactive glasses, protamine, hydrogels for prophylaxis and detection with PH sensors and fluorescent-labelled nanoparticles, and the use of antibiotic hydrogels and targeting delivery vehicles for therapeutic purposes. This review focus on prevention, detection and treatment in joint infections with bioactive materials and provide thoughts and ideas for their future applications.

Human joints move thousands of times a day. The articular cartilage plays a vital role in joints’ protection. If there is dysfunction in cartilage lubrication, cartilage cannot maintain its normal function. Eventually, the dysfunction may bring about osteoarthritis (OA). Extensive researches have shown that fluid film lubrication, boundary lubrication, and hydration lubrication are three discovered lubrication models at cartilage surface, and analyzing and simulating the mechanism of cartilage lubrication are fundamental to the treatment of OA. This essay concludes recent researches on the progress of cartilage lubrication and biomimetic cartilage, revealing the pathophysiology of cartilage lubrication and updating bio-inspired cartilage lubrication applications.