Objective To investigate the short-term effectiveness of Swanson artificial joint replacement in treating post-traumatic metacarpophalangeal joint stiffness. Methods Between August 2007 and May 2010, 11 cases (13 fingers) of metacarpophalangeal joint stiffness with soft tissue defects underwent Swanson artificial joint replacement. There were 7 males (9 fingers) and 4 females (4 fingers), aged 43 to 65 years with an average of 49 years. The involved fingers included 4 thumbs, 4 index fingers, 3 middle fingers, and 2 ring fingers. The types of injury included open and crush injury in 8 fingers, fracture of the metacarpophalangeal joint in 3 fingers, metacarpophalangeal joint severing in 2 fingers. The time from joint stiffness to hospitalization was 12 to 48 weeks (mean, 24 weeks). The joint activity was (136.82 ± 28.96)°. According to total active motion (TAM) assessment, included good in 1 finger, fair in 6 fingers, and poor in 6 fingers before operation. The activities of daily living were assessed by Sollerman score, which was 45.64 ± 11.04. The X-ray films and CT scan showed traumatic arthritis of the metacarpophalangeal joint. Results The incision healed by first intention. All patients were followed up 12 to 34 months (mean, 24.1 months). At last follow-up, the joint activity was (194.64 ± 28.86)°, showing significant difference when compared with preoperative value (t=25.214, P=0.000). According to TAM assessment, including excellent in 1 finger, good in 4 fingers, fair in 7 fingers, and poor in 1 finger. The Sollerman score was 67.45 ± 8.20 postoperatively, showing significant difference when compared with the preoperative score (t=10.470, P=0.000). X-ray examination showed no prosthesis fracture, periprosthetic fracture, or joint dislocation occurred at last follow-up. Conclusion Swanson artificial joint replacement can be appl ied to treat posttraumatic metacarpophalangeal joint stiffness, which can improve the joint activity and has satisfactory short-term effectiveness.
Carbon fiber reinforced poly ether ether ketone (CF/PEEK) composite possesses excellent biocompatible, biomechanical and bio-tribological properties. It is one of the most promising implant materials for artificial joint. Many factors influence the bio-tribological properties of CF/PEEK composites. In this paper, the authors reviewed on the biotribology research progress of CF/PEEK composites. The influences of various factors such as lubricant, reinforcement surface modification, functional particles, friction counterpart and friction motion modes on the bio-tribological properties of CF/PEEK composites are discussed. Based on the recent research, the authors suggest that the further research should be focused on the synergistic effect of multiple factors on the wear and lubrication mechanism of CF/PEEK.
ObjectiveThe antifriction and antiwear effects of gelatin nanoparticles (GLN-NP) on artificial joint materials in bionic joint lubricant were investigated to provide a theoretical basis for the development of new bionic joint lubricant. MethodsGLN-NP was prepared by cross-linking collagen acid (type A) gelatin with glutaraldehyde by acetone method, and the particle size and stability of GLN-NP were characterized. The biomimetic joint lubricants with different concentrations were prepared by mixing 5, 15, and 30 mg/mL GLN-NP with 15 and 30 mg/mL hyaluronic acid (HA), respectively. The friction reduction and antiwear effects of the biomimetic joint lubricants on zirconia ceramics were investigated on a tribometer. The cytotoxicity of each component of bionic joint lubricant on RAW264.7 mouse macrophages was evaluated by MTT assay. ResultsThe particle size of GLN-NP was about 139 nm, and the particle size distribution index was 0.17, showing a single peak, indicating that the particle size of GLN-NP was uniform. In complete culture medium, pH7.4 PBS, and deionized water at simulated body temperature, the particle size of GLN-NP did not change more than 10 nm with time, indicating that GLN-NP had good dispersion stability and did not aggregate. Compared with 15 mg/mL HA, 30 mg/mL HA, and normal saline, the friction coefficient, wear scar depth, width, and wear volume were significantly reduced by adding different concentrations of GLN-NP (P<0.05); there was no significant difference between different concentrations of GLN-NP (P>0.05). Biocompatibility test showed that the cell survival rate of GLN-NP, HA, and HA+GLN-NP solution decreased slightly with the increase of concentration, but the cell survival rate was more than 90%, and there was no significant difference between groups (P>0.05). ConclusionThe bionic joint fluid containing GLN-NP has good antifriction and antiwear effect. Among them, GLN-NP saline solution without HA has the best antifriction and antiwear effect.
Doctor-patient shared decision making is an expansion and extension of the patient-centered concept, which emphasizes communication and collaboration between doctors and patients in making decisions, focuses on patients, needs, enhances communication and exchange between doctors and patients, and improves the status of patients in medical decision making. This paper reviews the concept, domestic and international research overview, advantages, and application of doctor-patient shared decision making in hip and knee arthroplasty, and discusses the future research directions, in order to provide a reference for the application of shared decision making between doctors and patients in hip and knee arthroplasty in China.