Objective To summarize research progress of infrapatellar fat pad derived mesenchymal stem cells (IFP-MSCs) in treatment of osteoarthritis (OA). Methods The recent domestic and international literature on IFP-MSCs was reviewed. The mechanisms and latest research progress of IFP-MSCs in the treatment of OA were summarized and analyzed from aspects such as basic biological characteristics, core therapeutic mechanisms, preclinical research evidence, bioengineering strategies for optimizing therapeutic effects, and the current status of clinical studies and application. ResultsThe main mechanism of IFP-MSCs for OA treatment lies in the significant paracrine effect. By releasing cytokines, exosomes, etc., IFP-MSCs work synergistically to exert anti-inflammatory effects, protect cartilage, and promote repair. Preclinical studies have verified its efficacy and mechanism in vitro and in animal models. To promote clinical translation, researchers have developed a series of bioengineering strategies, including standardized cell preparation and functional preprocessing (such as three-dimensional culture, inflammatory factor stimulation), genetic engineering modification, exosome engineering, and the design of intelligent delivery carriers, aiming to optimize cell functions and achieve precise treatment. Preliminary clinical studies have confirmed its safety and short-term benefits in improving symptoms. ConclusionAlthough there are still challenges such as cell heterogeneity and long-term efficacy verification, by integrating cutting-edge technologies such as three-dimensional organ chips and single-cell omics, IFP-MSCs are expected to promote the development of OA treatment to a new stage of personalization and high efficiency, providing a new direction for future stem cell-based precise repair strategies.
Objective To explore the feasibility and effectiveness of suture anchor double-pulley technique combined with suture three-dimensional binding via bone tunnel technique for avulsion fractures of the inferior pole of the patella. Methods A clinical data of 38 patients with avulsion fractures of the inferior pole of the patella, who met the selective criteria and were admitted between September 2021 and April 2023, was retrospectively analyzed. The fractures were treated with suture anchor double-pulley technique combined with suture three-dimensional binding via bone tunnel technique in 18 cases (group A) and steel wire tension-band fixation in 20 cases (group B). There was no significant difference in terms of age, gender, cause of fracture, side of fracture, and disease duration between the two groups (P>0.05). The length of incision, operation time, occurrence of complications, the range of motion of knee joint, and B?stman score of knee joint at last follow-up were recorded. The fracture healing was evaluated through X-ray films and the time of fracture healing was recorded. Results All incisions healed by first intention. The length of incision was significantly shorter in group A than in group B (P<0.05). There was no significant difference in the operation time between the two groups (P>0.05). All patients were followed up 12-24 months (mean, 16.1 months). X-ray films showed that all fractures healed and there was no significant difference in the healing time between the two groups (P>0.05). At last follow-up, the range of motion and B?stman score of the knee joint in group A were significantly better than those in group B (P<0.05). During follow-up, 1 patient (5.6%) in group A had one anchor mild prolapse and 3 patients (15.0%) occured internal fixation irritation in group B. But there was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion For the avulsion fractures of the inferior pole of the patella, the suture anchor double-pulley technique combined with suture three-dimensional binding via bone tunnel technique has advantages of reliable fixation, small incision, avoidance of secondary operation to remove internal fixator, and fewer complications, with definite effectiveness.
Objective To compare the effectiveness of using a composite loop plate to reconstruct the coracoclavicular ligament around the coracoid process and using a clavicular hook plate for fixation in treatment of Rockwood type Ⅲ acute acromioclavicular joint dislocation. Methods A retrospective analysis was conducted on the clinical data of 60 patients with Rockwood type Ⅲ acute acromioclavicular joint dislocation who were admitted between June 2022 and September 2023 and met the selection criteria. Among them, 30 patients were treated with the composite loop plate to reconstruct the coracoclavicular ligament around the coracoid process (loop plate group) and 30 with clavicular hook plate fixation (hook plate group). There was no significant difference in baseline data between the two groups (P>0.05), including gender, age, injured side, cause of injury, disease duration, preoperative visual analogue scale (VAS) score for pain, and Constant-Murley score. The incision length, operation time, length of hospital stay, and the occurrence of complications during follow-up were recorded. The Constant-Murley score and VAS score were used to evaluate shoulder joint function and pain, and the differences (change values) of the indicators between before operation and at 6 months after operation were calculated for inter-group comparison. In the loop plate group, the coracoclavicular distance (CCD) on the anteroposterior X-ray films of the acromioclavicular joint was measured at 1 day and 6 months after operation to assess the loss of acromioclavicular joint reduction. Results The incision length of the loop plate group was significantly shorter than that of the hook plate group (P<0.05). There was no significant difference in the operation time and the length of hospital stay between the two groups (P>0.05). All incisions healed by first intention after operation. All patients were followed up 12-18 months (mean, 16.3 months). There was no significant difference in the follow-up time between groups (P>0.05). The Constant-Murley scores and VAS scores of both groups significantly improved at 6 months after operation when compared with those before operation (P<0.05); the differences in the change values of the two indicators between groups were significant (P<0.05). The CCD of the loop plate group were (10.40±0.83) mm at 1 day and (10.70±0.68) mm at 6 months and no repositioning loss was observed. Three cases in the hook plate group had residual shoulder joint pain after operation. The difference in the accidence of complications between groups was not significant (P>0.05). Conclusion For Rockwood type Ⅲ acute acromioclavicular joint dislocation, compared with the clavicular hook plate fixation, the composite loop plate for reconstructing the coracoclavicular ligament around the coracoid process has the advantages of simple operation, safety, minimally invasive, good functional recovery, and fewer complications. Moreover, it avoids the need for a second surgery to remove the internal fixation device, and the patient acceptance and satisfaction are higher.
