No abstract

DHS fixation has a larger skin incision and more soft tissue dissection, but it is associated with lower rates of fixation failure, reoperation, and overall rate of postoperative complications, and its use in elderly patients with osteoporosis is still recommended due to simplicity, efficacy, and high overall success rate. Multicenter RCTs with large samples are needed to better understand the comparative efficacy and safety of MCS and DHS in femoral neck fractures of restricted fracture type.

Mesenchymal stem cells (MSCs) are previously found to have potential capacity to differentiate into osteocytes when exposed to specific stimuli. However, the detailed molecular mechanism during this progress remains largely unknown. In the current study, we characterized the lncRNA NKILA as a crucial positive regulator for osteogenesis of MSCs. NKILA attenuation significantly inhibits the calcium deposition and alkaline phosphatase activity of MSCs. More interestingly, we defined that NKILA is functionally involved in the regulation of RXFP1/PI3K‐AKT and NF‐κB signalling. Knockdown of NKILA dramatically down‐regulates the expression of RXFP1 and then reduces the activity of AKT, a downstream regulator of RXFP1 signalling which is widely accepted as an activator of osteogenesis. Moreover, we identify NF‐κB as another critical regulator implicated in NKILA‐mediated osteogenic differentiation. Inhibition of NF‐κB can induce the expression of RUNX2, a master transcription factor of osteogenesis, in a HDAC2‐mediated deacetylation manner. Thus, this study illustrates the regulatory function of NKILA in osteogenesis through distinct signalling pathways, therefore providing a new insight into searching for new molecular targets for bone tissue repair and regeneration.

Preoperative intravenous TXA and postoperative topical TXA significantly reduced postoperative blood loss and transfusion rates among the patients who underwent primary unilateral THA and the short-term safety was good. The data suggest that topical injection of TXA is safer and more effective, without postoperative complications.

ObjectiveThis study aimed to investigate the damage pattern of the stress transfer path (STP) for the Japanese Investigation Committee (JIC) classification of pre-collapse osteonecrosis of the femoral head. We aimed to provide a specific biomechanical basis for treatment decisions of each subtype.MethodsFive computational models were used in the experiment. Different necrotic classifications were simulated based on the JIC classification system. Damage patterns of the STP were used for qualitative assessment and average stresses were used for quantitative analysis.ResultsThe STP of type A showed a strong similarity to the healthy level, which was consistent with the bone density distribution in X-rays and previous simulations results. The damaged area of principal stress of type B was approximately 25% of the healthy level. The STPs of types C1 and C2 were broken and the damaged areas of principal stress were more than 50% of the healthy level. The efficiency of stress transfer was reduced.ConclusionsThese results indicate that the damage patterns and stress transfer efficiency of the femoral head are associated with necrotic classifications.