ObjectiveTo evaluate the effect of leucocyte- and platelet-rich plasma (L-PRP) on the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) in treating avascular necrosis of the femoral head (ANFH) in rabbits. MethodsTwenty-four New Zealand white rabbits (4-6 months old, both genders, weighing 2.0-3.0 kg) were used for the establishment of bilateral ANFH models and divided into 4 groups (n=6). BMSCs were isolated from the bone marrow of iliac crest, cultured and identified. L-PRP was prepared by Landesberg method. Core decompression only (group A), core decompression and L-PRP implantation (group B), core decompression and BMSCs implantation (group C), and core decompression and implantation of BMSCs and L-PRP were performed in 4 groups. To evaluate bone formation and remodeling of the defects, X-ray photography was taken at 2, 4, and 8 weeks postoperatively. The modified Lane-Sandhu scoring system was used to evaluate the bone formation. Two rabbits were sacrificed at 2, 4, 8 weeks after operation to harvest the specimens for histological observation, new blood vessel count and new bone area ratio. ResultsThe observations of radiology and histology displayed different degrees of bone regeneration at bone defect sites in each group. At 2, 4, and 8 weeks postoperatively, the results of Lane-Sandhu X-ray photography scoring, new blood vessel count, and new bone area ratio showed that groups C and D were significantly better than groups A and B, group D was significantly better than group C. and group B was significantly better than group A (P<0.05). ConclusionThese findings demonstrate that L-PRP can promote osteogenic differentiation of BMSCs in treating ANFH in rabbits, and core decompression associated with BMSCs and L-PRP is an effective and feasible method to treat ANFH.
ObjectiveTo evaluate the short-term effectiveness of unicompartmental knee arthroplasty (UKA) for medial compartmental osteoarthritis of the knee. MethodsBetween January 2008 and October 2013, 18 patients with medial compartmental osteoarthritis of the knee were treated by UKA, including 11 males and 7 females with an average age of 67.2 years (range, 60-72 years). The disease duration ranged from 3 to 5 years (mean, 3.7 years). All patients had loading pain and walk-associated pain of the medial compartmental knee. The preoperative visual analogue scale (VAS) score was 6.8±1.4. The full-length radiograph of lower limb and anteroposterior and lateral radiographs of the knee showed medial compartmental osteoarthritis of the knee. According to Ahlback staging, 8 knees were at stageⅡand 10 knees at stageⅢ. The knee range of motion (ROM) was (112.3±11.3)°, and the angle of genu varus was (13.2±1.3)°. The American Hospital for Special Surgery (HSS) score was 59.0±6.4. ResultsPrimary healing of incision was obtained in all patients, and no infection or lower limb deep venous thrombosis occurred. All of the patients were followed up 6-50 months (mean, 28 months). No prosthetic loosening and dislocation or lesions of contralateral compartment and patellofemoral joint developed. At 6 months after operation, the VAS score was significantly reduced to 2.8±1.2 (t=9.20, P=0.00); most of patients achieved significant relief of pain. The HSS score was significantly increased to 92.0±3.1 (t=19.69, P=0.00); and the results were excellent in 12 cases, good in 5 cases, and poor in 1 case, with an excellent and good rate of 94.4%. The knee ROM was (115.2±10.2)°, showing no significant difference when compared with preoperative one (t=-0.81, P=0.23). The alignment of limbs showed that the angle of genu varus was significantly reduced to (6.8±2.1)° (t=10.99, P=0.00). ConclusionUKA has satisfactory short-term effectiveness in the treatment of medial compartmental knee osteoarthritis, however, long-term effectiveness need further studies.