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Background: Multiple studies have investigated the use of mesenchymal stem cells (MSCs) for patients undergoing high tibial osteotomy (HTO), and the effectiveness thereof remains controversial. Purpose: To analyze the effectiveness of intra-articular MSC injection in patients who underwent HTO in terms of clinical outcomes, radiological outcomes, and cartilage repair by a meta-analysis of the available literature. Study Design: Systematic review; Level of evidence, 3. Methods: The electronic databases of PubMed, Embase, Web of Science, and the Cochrane Library were searched from their inception to October 30, 2021, for comparative studies between patients who underwent HTO with and without intra-articular injection of MSCs, according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Study quality was assessed by the Coleman Methodology Score (CMS). Data with comparable results were pooled for meta-analysis. The primary outcomes of interest were the Hospital for Special Surgery (HSS), International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score (KOOS), and Lysholm scores, as well as the International Cartilage Regeneration & Joint Preservation Society (ICRS) grade of cartilage repair. Radiological outcomes including femorotibial angle, posterior tibial slope, and hip-knee-ankle (HKA) angle were included as secondary outcomes. A fixed-model effect was used for meta-analyses with low heterogeneity between studies ( I 2 < 25%), while the random-model effect was used for medium- to high-heterogeneity analyses ( I 2 ≥ 25%). Results: A total of 843 studies were screened, of which 6 studies with 452 patients met the inclusion criteria and were included. The mean CMS was 81.17. Patients with MSC injection had significantly higher Lysholm scores ( P = .007) and HSS scores ( P = .01) and higher proportions of ICRS grade 1 ( P = .03) and grade 2 ( P = .02) cartilage repair in the medial femoral condyle and grade 2 cartilage repair in the tibial plateau ( P = .04). There were no significant differences between groups in the IKDC score, KOOS Pain and Symptoms subscales, femorotibial angle, posterior tibial slope, or HKA angle. Conclusion: Intra-articular MSC injection may enhance the cartilage repair for patients who undergo HTO. However, evidence of improvement in knee functions remains limited. Registration: CRD42021291345 (PROSPERO).

Objective To investigate the risk factors which lead to arrhythmias in patients with obstructive sleep apnoea syndrome (OSAS), to explore incidence and types of arrhythmias and to assess the impact of nasal continuous positive airway pressure (nCPAP) on the arrhythmias. Methods All 446 subjects were received polysomnography examination and classifi ed as having mild (5≤AHI≤20/h) or moderate (2040/h) OSAS. 39 patients with both OSAS and heart rhythm disorder (HRD) were given nCPAP therapy for one night (at least 6 h). Results Among 446 patients, the incidence of arrhythmias were 24.4%. Age (p=0.003, Exp=1.030)and the severity of OSAS (p=0.043, Exp=1.857) had a closed relationship with incidence of arrhythmias. Sinus bradycardia (79.1%, p<0.01) and sporadic ventricular premature beat (54.5%, p=0.01) were most likely happened than other types of arrhythmias. With increasing of AHI, the incidence of sinus bradycardia (p<0.05), frequent atrial premature beat (p<0.05), complex arrhythmias (p<0.01), atrial fi brillation (p<0.01) and atrioventricular block (p<0.05) also increased. After more than 6 h of using nCPAP over one night, the incidence of arrhythmias in OSAS patients decreased obviously. Conclusions Arrhythmia is a common complication in patients with OSA. Age and the severity of OSAS are risk factors for the incidence of arrhythmias. Sinus bradycardia and sporadic ventricular premature beat are most commonly seen in OSAS patients. In mild group, ventricular premature beat, sporadic atrial premature beat are the most common while in moderate and severe group, sinus bradycardia, frequent atrial premature beat, atrial fi brillation, atrioventricular block and complex arrhythmias are the most likely to occur. After therapy of nCPAP at least 6 h, not only the condition of OSAS but also the incidence of arrhythmias have been reduced.