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Special Issue "Advances in Hip and Knee Joint Replacement and Revision Surgery"

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "General Surgery".

Deadline for manuscript submissions: 30 September 2023 | Viewed by 6541

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Special Issue Editors

Dr. Xinyu Fang

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Guest Editor

Department of Orthopedics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
Interests: osteoarthritis; hip and knee arthroplasty; peripheral nerve injury; periprosthetic joint infection; arthroscopic surgery

Prof. Dr. Xiaoqian Dang

E-Mail Website
Guest Editor

Department of Orthopedics, The Second Affiliated Hospital of Xi 'an Jiaotong University, Xi'an, China
Interests: osteoarthritis; hip and knee arthroplasty; spinal cord injury; osteonecrosis of the femoral head

Special Issue Information

Dear Colleagues,

With the advent of an aging society, the number of patients with osteoarthritis is increasing. The pathogenesis of osteoarthritis is not yet fully elucidated, and patients with end-stage osteoarthritis often require joint arthroplasty, and there are many complications after joint arthroplasty, such as periprosthetic joint infection and aseptic loosening, and revision surgeries are needed. In recent years, with the use of advanced technologies and concepts such as 3D printing, computer navigation, robot surgeon, and enhanced recovery after surgery, significant progresses in joint replacement as well as revision surgery have been made.

However, how to investigate the pathogenesis of osteoarthritis and provide interventional treatment to slow down the development of osteoarthritis, how to effectively promote enhanced recovery after surgery for rapid recovery, how to effectively diagnose and treat periprosthetic joint infection, how to effectively address the large amount of bone loss during revision surgery, and so on are still pressing issues that need to be addressed. Therefore, this Special Issue focuses on, but is not limited to, the latest basic and clinical research advances in the pathogenesis of osteoarthritis, joint replacement, revision surgery, periprosthetic joint infection, and aseptic loosening, so as to advance the understanding of the pathogenesis of osteoarthritis, as well as the treatment of joint replacement and related complications.

Dr. Xinyu Fang
Prof. Dr. Xiaoqian Dang
Guest Editors

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Keywords

osteoarthritis
arthroplasty
revision surgery
periprosthetic joint infection
enhanced recovery after surgery
aseptic loosening after arthroplasty
osteoarticular infection

Published Papers (6 papers)

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Open AccessArticle

Alteration of m⁶A-Tagged RNA Profiles in Bone Originated from Periprosthetic Joint Infection

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J. Clin. Med. 2023, 12(8), 2863; https://doi.org/10.3390/jcm12082863 - 14 Apr 2023

Cited by 1 | Viewed by 642

Abstract

Periprosthetic joint infection (PJI) is a devastating complication. This study aimed to unravel the veil of the N⁶-methyladenine (m⁶A) modification in PJI. Synovium, synovial fluid, sonication fluid and bone samples were collected intraoperatively from Staphylococcus aureus PJI and aseptic failure (AF) patients. The overall m⁶A level was detected by the m⁶A RNA methylation quantification kit, and the expression of m⁶A-related genes was quantified by real-time PCR and Western blot. Finally, an epitranscriptomic microarray and bioinformatics analysis were performed. We showed that there was a significant difference in overall m⁶A level between the PJI group and the AF group (PJI group had a higher overall m⁶A level). The expression level of METTL3 was higher in the PJI group than that in the AF group. There were 2802 differential m⁶A-modified mRNAs. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that differential m⁶A-modified mRNAs were significantly enriched in the NOD-like receptor signaling pathway, Th17 cell differentiation and the IL-17 signaling pathway, which indicates that the m⁶A modification might be involved in the processes of infection and immune response, bone metabolism and programmed cell death in PJI. In summary, the present work demonstrated that m⁶A modification plays a role in PJI and might be a therapeutic target for developing effective treatment strategies. Full article

(This article belongs to the Special Issue Advances in Hip and Knee Joint Replacement and Revision Surgery)

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Open AccessEditor’s ChoiceArticle

The Burden of Rheumatoid Arthritis: Findings from the 2019 Global Burden of Diseases Study and Forecasts for 2030 by Bayesian Age-Period-Cohort Analysis

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J. Clin. Med. 2023, 12(4), 1291; https://doi.org/10.3390/jcm12041291 - 06 Feb 2023

Cited by 5 | Viewed by 1535

Abstract

Background: Rheumatoid arthritis (RA) is a key health issue worldwide. Due to early identification and effective treatment strategies, the disease pattern of RA has also changed. However, the most comprehensive and up-to-date information about the burden of RA and its trends in subsequent years is lacking. Objective: this study aimed to report the global burden of RA by sex, age, region, and forecast for 2030. Method: Publicly available data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 were used in this study. The trends in the prevalence, incidence, and disability-adjusted life years (DALYs) of RA from 1990 to 2019 were reported. The global burden of RA in 2019 was reported by a sex, age, and sociodemographic index (SDI). Finally, the trends in the following years were predicted by Bayesian age-period-cohort (BAPC) models. Results: Globally, the age-standardized prevalence rate increased from 207.46 (95% UI:189.99 to 226.95) in 1990 to 224.25 (95% UI: 204.94 to 245.99) in 2019, with an estimated annual percent change (EAPC) of 0.37% (95% CI: 0.32 to 0.42). Regarding the incidence, the age-standardized incidence rate (ASR) increased from 12.21 (95% UI: 11.13 to 13.38) to 13 (95% UI: 11.83 to 14.27) per 100,000 people from 1990 to 2019, with an EAPC of 0.3% (95% CI: 11.83 to 14.27). The age-standardized DALY rate also increased from 39.12 (95% UI: 30.13 to 48.56) per 100,000 people in 1990 to 39.57 (95% UI: 30.51 to 49.53) in 2019, with an EAPC of 0.12% (95% CI: 0.08% to 0.17%). There was no significant association between the SDI and ASR when the SDI was lower than 0.7, while there was a positive association between the SDI and ASR when the SDI was higher than 0.7 The BAPC analysis showed that the ASR was estimated to be up to 18.23 in females and approximately 8.34 per 100,000 people in males by 2030. Conclusion: RA is still a key public health issue worldwide. The global burden of RA has increased over the past decades and will continue to increase in the coming years, and much more attention should be given to early diagnosis and treatment to reduce the burden of RA. Full article

(This article belongs to the Special Issue Advances in Hip and Knee Joint Replacement and Revision Surgery)

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Open AccessArticle

Causal Relationships of General and Abdominal Adiposity on Osteoarthritis: A Two-Sample Mendelian Randomization Study

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J. Clin. Med. 2023, 12(1), 320; https://doi.org/10.3390/jcm12010320 - 31 Dec 2022

Cited by 3 | Viewed by 1343

Abstract

Background: Adiposity is closely related to osteoarthritis, but the causal effects of different types of adiposity on osteoarthritis are indistinct. This study conducted a Mendelian Randomization (MR) analysis for the causal effects of general adiposity and abdominal adiposity on knee osteoarthritis (KOA) and hip osteoarthritis (HOA). Methods: The general adiposity was assessed by body mass index (BMI), while the abdominal adiposity was evaluated with waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR). The data used in this two-sample MR analysis originated from genome-wide association studies (GWAS). Significant (p < 5 × 10⁻⁸) and independent (r² < 0.01) single-nucleotide polymorphisms were selected as instrumental variables for the MR analysis. Subsequently, this study used the inverse variance weighted, weighted median, and other methods for the causal inference, and the results were presented as odds ratios (OR). Moreover, sensitivity analyses were conducted to assess the stability and reliability of the results. Results: The MR results revealed positive causal effects of BMI on KOA (OR: 1.694; 95% CI: from 1.492 to 1.923; p = 3.96 × 10⁻¹⁶) and HOA (OR: 1.412; 95% CI: from 1.196 to 1.666; p = 4.58 × 10⁻⁵). Additionally, WC and HC both positively and causally related to KOA (WC: OR: 1.827; 95% CI: from 1.564 to 2.134; p = 2.68 × 10⁻¹⁴; HC: OR: 1.610; 95% CI: from 1.357 to 1.912; p = 5.03 × 10⁻⁸) and HOA (WC: OR: 1.491; 95% CI: from 1.254 to 1.772; p = 5.85 × 10⁻⁶; HC: OR: 1.439; 95% CI: from 1.205 to 1.719; p = 5.82 × 10⁻⁵). However, no causal relationship existed between WHR and obesity. These results were robust according to the sensitivity analyses. Conclusions: This study indicated that both general and abdominal obesity had positive causal effects on knee osteoarthritis and hip osteoarthritis. Full article

(This article belongs to the Special Issue Advances in Hip and Knee Joint Replacement and Revision Surgery)

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Open AccessArticle

Joint Replacement Surgeries Can Be Safely Performed in HIV Patients

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J. Clin. Med. 2023, 12(1), 293; https://doi.org/10.3390/jcm12010293 - 30 Dec 2022

Cited by 1 | Viewed by 1097

Abstract

Whether joint replacement surgery can be performed safely on HIV patients is still a matter of debate. This study aimed to report the surgical efficacy and complications of joint replacement surgery in HIV patients. A total of 21 HIV patients and 27 non-HIV patients who underwent arthroplasties in our hospital were retrospectively reviewed. The 21 HIV patients received 29 joint replacement surgeries including 27 cases of total hip arthroplasty (THA) and 2 cases of total knee arthroplasty (TKA). The non-HIV patients received 16 THA, 10 TKA, and 3 unicompartmental arthroplasty (UKA). The length of hospital stay of HIV patients was significantly lower than that of non-HIV patients. At the last follow-up, there were no significant complications both in the HIV group and the non-HIV groups. No medical staff had any occupational exposure. We concluded that joint replacement surgery in HIV patients is safe and effective. Optimization of patients is key to treatment success. Strictly following the standardized protection protocol can prevent the risk of occupational exposure. Full article

(This article belongs to the Special Issue Advances in Hip and Knee Joint Replacement and Revision Surgery)

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Open AccessArticle

Patient-Reported Outcome on Quality of Life and Pain after Revision Arthroplasty for Periprosthetic Joint Infection: A Cross-Sectional Study

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J. Clin. Med. 2022, 11(23), 7182; https://doi.org/10.3390/jcm11237182 - 02 Dec 2022

Viewed by 650

Abstract

This study aims to explore the quality of life (QOL) and pain after revision surgery for periprosthetic joint infection (PJI) based on patients’ reported outcomes. A cross-sectional questionnaire survey was conducted and 137 valid responses were included (response rate 64.0%). A total of 42 patients underwent debridement with implant retention (DAIR), 31 underwent one-stage revision, and 64 underwent two-stage revision. The average overall SF-36 score was 70.3. The DAIR group had significantly higher SF-36 than the two-stage revision group (p = 0.01). There was no significant difference between the one-stage revision group and the other two groups. A total of 74.5% of patients reported pain with an average McGill Pain Questionnaire (MPQ) score of 8.6. There was no significant difference in the MPQ scores among the three groups. Simple linear regression analyses demonstrated that higher preoperative PMN%, VAS, and shorter hospital stay were associated with pain (adjusted R² = 4%, p = 0.020; adjusted R² = 2.1%, p = 0.048; adjusted R² = 2.1%, p = 0.049; respectively). We concluded that the overall QOL of patients after revision surgery for PJI is generally satisfactory. Persistent pain is prevalent, but the severity was mostly mild. Preoperative PMN%, VAS, and hospital stay were associated with postoperative pain. Full article

(This article belongs to the Special Issue Advances in Hip and Knee Joint Replacement and Revision Surgery)

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Open AccessSystematic Review

Uncemented Tibial Fixation Has Comparable Prognostic Outcomes and Safety Versus Cemented Fixation in Cruciate-Retaining Total Knee Arthroplasty: A Meta-Analysis of Randomized Controlled Trials

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J. Clin. Med. 2023, 12(5), 1961; https://doi.org/10.3390/jcm12051961 - 01 Mar 2023

Viewed by 859

Abstract

Background: Cemented and uncemented fixation are the primary methods of tibial prosthesis fixation in total knee arthroplasty. However, the optimal fixation method remains controversial. This article explored whether uncemented tibial fixation has better clinical and radiological outcomes, fewer complications, and revision rates compared to cemented tibial fixation. Methods: We searched the PubMed, Embase, Cochrane Library, and Web of Science databases up to September 2022 to identify randomized controlled trials (RCTs) that compared uncemented total knee arthroplasty (TKA) and cemented TKA. The outcome assessment consisted of clinical and radiological outcomes, complications (aseptic loosening, infection, and thrombosis), and revision rate. Subgroup analysis was used to explore the effects of different fixation methods on knee scores in younger patients. Results: Nine RCTs were finally analyzed with 686 uncemented knees and 678 cemented knees. The mean follow-up time was 12.6 years. The pooled data revealed significant advantages of uncemented fixations over cemented fixations in terms of the Knee Society Knee Score (KSKS) (p = 0.01) and the Knee Society Score–Pain (KSS–Pain) (p = 0.02). Cemented fixations showed significant advantages in maximum total point motion (MTPM) (p < 0.0001). There was no significant difference between uncemented fixation and cemented fixation regarding functional outcomes, range of motion, complications, and revision rates. When comparing among young people (<65 years), the differences in KSKS became statistically insignificant. No significant difference was shown in aseptic loosening and the revision rate among young patients. Conclusions: The current evidence shows better knee score, less pain, comparable complications and revision rates for uncemented tibial prosthesis fixation, compared to cemented, in cruciate-retaining total knee arthroplasty. Full article

(This article belongs to the Special Issue Advances in Hip and Knee Joint Replacement and Revision Surgery)

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