To evaluate the efficacy of nanohydroxyapatite/polyamide 66 (nHA/Pa66)-coated femoral stem prosthesis in total hip arthroplasty (THA) and the advantages of combined post-operative staged rehabilitation functional exercises (SRFE) in restoring hip function, 112 patients with femoral neck fractures were enrolled in the clinical study. Patients were randomized to routine and nHA/Pa66 groups. Patients in the nHA/Pa66 group were treated with nHA/Pa66-coated femoral stem prosthesis and the post-operative SRFE program. We evaluated the physical properties, cytotoxicity, and osteogenic capacity of nHA/Pa66 in an in vitro trial, and the clinical treatment, postoperative improvement in joint function (Barthel score, VAS score, Harris score), imaging performance, and incidence of adverse events were compared between groups. The porosity of nHA/Pa66 was ∼75% and its pore size was in the range of 300–500 μ m. Moreover, nHA/Pa66 had good biocompatibility and could improve bone marrow stem cells (BMSCs) activity and enhance the osteogenic function of BMSCs, effectively increasing the levels of COL I, ALP, and OCN. A combination of nHA/Pa66 and SRFE could effectively shorten hospital stay, better restore hip function, and reduce the incidence of complications. Therefore, nHA/Pa66-coated femoral stem prosthesis combined with SRFE showed great potential in THA for femoral neck fractures.

Background: Traumatic knee injury is common and highly debilitating. Its signs and symptoms usually persist long enough to produce muscle atrophy and, sometimes, even permanent contractile dysfunction. Aim: Our goal was to evaluate the effect of combined rehabilitative exercise and celecoxib treatment on the inflammatory reaction in spastic rat quadriceps after traumatic knee injury. Methods: Rats were randomly assigned to one of /bur subgroups: a control group, exercise group, celecoxib treatment group, and combined rehabilitative exercise and celecoxib treatment. From each group, quadriceps muscles were collected four, eight, 12, 16, and 20 weeks after traumatic knee injury. In addition to range of motion in each rat, expression of IL-1, IL-2, TNF-a, COX-1, and COX-2 was evaluated at each time point using real-time polymerase chain reaction and immunohistochemistry. Results: Our results showed that, consistent with an apparent decrease in range of motion after knee injury, expression of the cytokines IL-1, IL-2, COX-1, and COX-2 significantly increased in the spastic rat quadriceps, which was at least partially reversed using combined rehabilitative exercise and celecoxib treatment, resulting in reduced expression of those molecules and improved behavioral outcomes. Conclusion: This study clearly shows that combined rehabilitative exercise and celecoxib treatment relieves acute and chronic inflammation in spastic rat quadriceps after traumatic knee injury.

The primary purpose of this study was to investigate cytokine expression in the quadriceps of rats with posttraumatic knee stiffness (PTKS) and to determine the effect of exercise training on these cytokines at different follow-up time points. The PTKS rats were randomly assigned into two even groups. The treatment group received exercise training, while the control group received no treatment. Quadriceps specimens were harvested randomly from each group at 8, 12, 16, and 20 weeks. RT-qPCR and immunohistochemical analyses were used to assess the protein and mRNA expression levels of the cytokines IL-1, IL-2, TNF-α, COX-1, and COX-2. TNF-α immunostaining did not differ between the treated and control group tissues, whereas weak immunostaining was observed for all other cytokines in the specimens from the treatment group compared with those from the control group at approximately 12 and 20 weeks. The cytokine levels decreased at approximately 8 weeks in the treatment group, whereas these levels remained elevated or plateaued in the control group. These differences were statistically significant (p<0.05). This study demonstrated that the expression of cytokines IL-1, IL-2, COX-1, and COX-2 increased in the quadriceps of rats with PTKS and that exercise training affected the observed profile trends of these cytokines.

Neurogenic heterotopic ossification (NHO) is a common complication in patients with spinal cord injury (SCI) and traumatic brain injury (TBI). Although there are many reports regarding the etiology, pathophysiology, and medical management, few studies elaborate the anatomical details of NHO, which leads to ankylosis of the hip joint. A prospective study on surgical resection of NHO in patients with hip ankylosis was conducted. Radiography and magnetic resonance imaging (MRI) were used to assess the relationship of the NHO block with the blood vessels, peripheral nerve, and surrounding muscles and bones. The anatomical relationships were also assessed and documented during the surgical procedures. NHO, which is anterior to the hip and causes hip ankylosis, settles into tissue planes without involving the tissue itself and does not disrupt the femoral neurovascular structures. The NHO bone block can then fuse to the cortex of adjacent bone. During resection, the normal bony contour should be exposed as a marker to guide the resection in order to avoid iatrogenic fracture.

Objective Explore discipline of expression of inflammatory cytokines in quadriceps for post-traumatic knee stiffness and rehabilitation process.Methods Sclect thirty-six,9-week-old,male SD rats.Establish knee joint stiffness model.Choose quadriceps to detect immunohistochemistry and Reverse transcriotion-polymerase chain reaction (RT-PCR) of Interleukin (IL)-1,IL-2,Tumor necrosis factor-α (TNF-α),cyclooxygenase (COX)-1 and COX-2.Results Comparation of rehabilitation and observation groups:(1) After 12 weeks,IL-1 rehabilitation group IA (Integrated optical density) value:158 976.8 ± 27 475.8,the observation group IA value:338 956.1 ± 32 126.7,IL-2 rehabilitation group IA value:274 188.1 ± 20 514.8,the observation group IA value:410 647.7 ± 24 070.6,there are significant differences between two groups (P ＜ 0.05).(2) After 8 weeks,COX-1 rehabilitation group IA value:413 716.7 ± 40 176.8,the observation group IA value:500 528.2 ± 28 400.5,COX-2 rehabilitation group IA value:294 577.5 ±28 712.6,the observation group IA value:420 301.2 ±30 663.4,there are significant differences between two groups (P ＜ 0.05).(3) mRNA levels of RT-PCR measurement results are consistent with the above between two groups.Conclusion Knee trauma caused by the stiffness.In the rehabilitation process,IL-1,IL-2,COX-1 and COX-2 inflammatory cytokine expression of quadriceps increased firstly and then decreased.