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Background: The purpose of this study was to develop an optimal diabetes-osteoarthritis (DM-OA) mouse model to validate that diabetes aggravates osteoarthritis (OA) and to evaluate the microarchitecture, chemical composition, and biomechanical properties of subchondral bone (SB) as a consequence of the DM-OAinduced damage induced.Methods: Mice were randomly divided into three groups: DM-OA group, OA group, and sham group.Blood glucose levels, body weight, and food intake of all animals were recorded. Serum calcium (Ca) and osteocalcin (OCN) levels were compared in the three groups. The messenger ribonucleic acid (mRNA) and protein expression of key regulators for bone metabolism were detected. A semi-quantitative grading system [Osteoarthritis Research Society International (OARSI)] was used to evaluate cartilage and SB degeneration.Microspectroscopy, microindentations, micro-computed tomography (CT) imaging, and fracture load of compression testing were also used to evaluate trabecular SB properties.Results: Glycemic monitoring and pancreas pathological results indicated stable high blood glucose and massive destruction of pancreas and islet cells in the DM-OA group. Serum levels of bone specific alkaline phosphatase (ALP-B) and tartrate-resistant acid phosphatase 5b (TRACP-5b) in the DM-group were higher than those of the other two groups while levels of serum Ca and OCN were lower. Meanwhile, the protein and mRNA expression of osteoblast-specific biomarkers [osteoprotegerin/receptor activator of nuclear factor kappa-B ligand (OPG/RANKL) ratio, collagen type I (COL-I), Runt-related transcription factor 2 (RUNX-2), OCN] were suppressed, and osteoclast-specific biomarkers [sclerostin (SOST)] was elevated in the DM-OA group. The mineral-to-collagen ratio, microindentation elastic modulus, hardness, micro-architectural parameters, bone mineral density, and fracture load of SB trabecular bone of the DM-OA group joint were lower than those of the other two groups. On the other hand, The OARSI score, trabecular spacing, and structural model index of the DM-OA group joint were higher than those of the other two groups. Conclusions:The glycemic and pancreatic pathological results indicated that the DM-OA model was a simple and reliable model induced by streptozotocin (STZ) and surgery. The results revealed the mechanisms through which diabetes accelerates OA; that is, by damaging and deteriorating the functions of SB, including its microarchitecture, chemical composition, and biomechanical properties.

Background : The purpose of this study is to develop an optimal DM-OA mice model; to validate that diabetes aggravates OA; and to evaluate the microarchitecture, chemical composition and biomechanical properties of SB as a consequence of the damaged induced by diabetes OA. Methods: Mice were randomly divided into three groups: DM-OA group, OA group and Sham group. Blood glucose levels, body weight and food intake of all animals were recorded. A semi-quantitative grading system (OARSI) was used to evaluated cartilage and SB degeneration. Microspectroscopy, microindentations, micro‑CT imaging and fracture load of compression testing were also used to evaluated the properties of trabecular SB. Results: Glycemic monitoring and pancreas pathological results indicated stable high blood glucose and massive destruction of pancreas and islet cells in the DM-OA group. The mineral-to-collagen ratio, microindentation elastic modulus, hardness, micro-architectural parameters, bone mineral density and fracture load of SB trabecular bone of the DM-OA group joint was lower than other two groups. On the other hand, The OARSI score, trabecular spacing and structural model index of the DM-OA group joint was higher than the other two groups. Conclusions: The glycemic and pancreatic pathological results indicated the DM-OA model to be a simple and reliable model induced by STZ and surgery. The results showed the mechanisms in which diabetes accelerates OA by damaging and deteriorating the functions SB including microarchitecture, chemical composition and biomechanical properties.

Computer‐assisted orthopedic system (CAOS) is rapidly gaining popularity in the field of precision medicine. However, the cost‐effectiveness of CAOS has not been well clarified. We performed this review to summarize and assess the cost‐effectiveness analyses (CEAs) with regard to CAOS. Publications on CEA in CAOS have been searched in PubMed and CEA Registry up to May 31, 2022. The Quality of Health Economic Studies (QHES) instrument was used to estimate the quality of studies. Relationships between qualities and potential factors were also examined. There were 15 eligible studies in the present review. Twelve studies evaluated CAOS joint arthroplasties and found that CAOS joint arthroplasties were cost‐effective compared to manual methods. Three studies focused on spinal surgery, two of which analyzed the cost‐effectiveness of CAOS for patients after spinal fusion, with conflicting results. One study demonstrated that CAOS was cost‐effective in spinal pedicle screw insertion. The mean QHES score of CEAs included was 86.1. The potential factors had no significant relationship with the quality of studies. Based on available studies, our review reflected that CAOS was cost‐effective in the field of joint arthroplasty. While in spinal surgery, the answer was unclear. Current CEAs represent high qualities, and more CEAs are required in the different disciplines of orthopedics where CAOS is employed.