OBJECTIVE To present a simple and reliable method for the reconstruction of metacarpophalangeal joint by the cartilage transplantation of metatarsophalangeal joint. METHODS From 1990, nine cases (11 sides) with traumatic metacarpophalangeal joint defect were treated by the autogenous cartilage transplantation of metatarsophalangeal joint followed by modified treatment. Appropriate biological mechanics was provided by internal fixation and collateral ligament repair. RESULTS Followed up 6 months to 7 years, the range of joint motion was increased 35.1 degrees. The fusion of donor phalanges was fine, and the range of joint motion was decreased, even ankylosis after plastic operation, but no pain and no effect on walk. CONCLUSION The key to successful operation is better matching of cartilage, reliable internal fixation, ligament reconstruction, thin cartilage and little bone of the donor, appropriate biological mechanical surroundings.
One of the most difficult problems on tendon surgery is adhesion formation during the process of tendon healing, which causes functional interference. This pathophysiologic pcocess is closely related to the ways of tendon nourishment and types of tendon healing. In order to understand whether the sutured tendon couldheal without blood circulation, the process and types of tendon healing in the synovial fluid were studied by in vivo culture modle. Flexor digitorum profundus (FDP) segments from the front paw of 50 New Zedland white rabbits were cut inthe middle and sutured with microsurgical technique, and then, preserved in thesynovial cavitied of both knees of the rabbits. After 1, 2, 4, 6 weeks, the specimens from the synovial cavities were studied by gross observation, light microscope, scanning and transmission electron microscope, and biochemical determination. The results showed that the tendon which was nourished by synovial fluid not only could survive, but also could heal. Healing of the tendon was completed by activation and proliferation of both peritendon cells and cells in the tendon.The healing could be devided into 3 periods: malnutrition period (less than 1 week), reparative period (2-4 week) and rebuilding period (more than 4 week).
ObjectiveTo investigate the correlation of synovial fluid uric acid, the serum and synovial fluid interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α with knee osteoarthritis (KOA). MethodsThe clinical data of 130 patients with KOA treated between January and December 2013 and 30 patients with gouty arthritis (GA) treated at the same period were collected. The clinical symptoms, Western Ontario and McMaster Universities Osteoarthritis Index score, the serum and synovial fluid IL-1β, IL-6, and TNF-α, uric acid levels, radiographic joint stenosis score, and bone hyperplasia score of the patients were compared using t-test analysis and Spearman correlation analysis. ResultsIn the KOA group, the synovial fluid uric acid and joint stenosis score (r=0.31, P=0.037), bone hyperplasia score (r=0.38, P=0.027) were positively correlated; serum and synovial fluid uric acid gradient and hypnalgia were positively correlated (r=0.34, P=0.031); the synovial fluid IL-6 and joint stenosis score (r=0.33, P=0.029), bone hyperplasia score (r=0.37, P=0.032) were positively correlated; the synovial fluid IL-1β and joint stenosis score (r=0.39, P=0.023), bone hyperplasia score (r=0.34, P=0.034) were positively correlated; and the synovial fluid uric acid and IL-1β (r=0.26, P=0.003), IL-6 (r=0.21, P=0.016) were positively correlated. ConclusionSynovial uric acid, IL-1β and IL-6 play a role in the inflammatory progress of knee osteoarthritis.