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© 2019 The Authors.Background Hip resurfacing arthroplasty (HRA) may be a suitable option for treating osteonecrosis of the femoral head (ONFH). However, concerns regarding the extent of osteonecrosis, amount of defect under the prosthesis, and implant-related complications remain. This study aimed to report implant-specific outcomes and risk factors for failure of HRA in ONFH. Methods A total of 202 HRAs (166 patients) performed by a single surgeon were investigated. The stage, size, and location of ONFH were evaluated using preoperative radiographs and magnetic resonance images. Clinical, radiographic results, and serum metal concentrations of articular surface replacement (ASR) and non-ASR devices were compared. Logistic regression analysis was performed to identify the contributors of failures. The mean follow-up duration was 10.6 years. Results Twenty-six hips (12.9%) were operated with Birmingham Hip Resurfacing (BHR), 99 (49.0%) with ASR, and 77 (38.1%) with Conserve Plus. The mean Harris Hip Score improved from 52.1 to 019 The Author(s).Objective To compare the biomechanical characteristics of two transforaminal thoracic interbody fusion cages based on the Chinese population thoracic anatomy. Method Computed tomography scans of the thoracic spine of 150 patients from our institution were collected and analysed. Two cages were designed based on the anatomical parameters of these patients. Further, we used 3D finite element analysis models to compare the stability of two cages by using Mimics 17.0 and ANSYS 15.0 software. Result Two kinds of thoracic cages (box and kidney-shaped) were designed. Under the displacement working condition, the two new fusion cages could achieve immediate postoperative stability, but the kidney-shaped cage was better than the box-shaped cage. Under the stress working condition, no highly focused stress area was found in either cages, but the kidney-shaped cage experienced less stress than the box-shaped cage. read more Conclusion The kidney-shaped cage is more stable and experiences lesser stress than the box-shaped cage after thoracic intervertebral fusion, and it is more suitable for Chinese transforaminal thoracic interbody fusion. The translational potential of this article This article is about thoracic fusion cage design and finite element analysis (FEA) analysis based on the thoracic anatomy parameters. For there is currently no suitable thoracic fusion cage for transforaminal thoracic interbody fusion, the results in this article may have the potential of transferring the two designed cages into clinical use. © 2020 The Authors.Background The role of macrophages (Mφs) in tendon injury healing is controversy. The aims of this study were to determine whether there is a shift in Mφs polarisation after an acute and chronic tendon injury and to assess whether the Mφs polarisation between the partial and complete rupture is different. Methods This systematic review of the scientific literature was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Cochrane guidelines. PubMed database and Excerpta Medica Database (EMBASE) were used for specific search criteria. Only studies measuring Mφs using specific cell markers in Achilles tendon tissue and rotator cuff tendon tissue were included, respectively. Results Five Achilles tendon injury studies and four rotator cuff injury studies were included. Expression of the pan Mϕs marker Cluster of Differentiation (CD) 68 was significantly upregulated in acute Achilles tendon ruptures compared to intact tendons, while no significant changes were found in Mφs control tissues. Both CD68+ Mφs and CD206+ Mφs has an inverse relation to the structural failure in the torn rotator cuff tendon. After tendon rupture, the time point of biopsy specimen collection is an important factor, which could occur in the acute phase or chronic phase. Collectively, the understanding of the roles in Mφs after tendon injury is inadequate, and more research efforts should be devoted to this direction. The translational potential of this article This article provided a potential implication on how pan Mφs or M2 Mφs might be associated with ruptured or torn tendon structure. Managing Mφs numbers and phenotypes may lead to possible novel therapeutic approaches to the management of early tendinopathy, early acute tendon rupture, hence, promote healing after restoration surgery. © 2019 The Authors.Background We wondered whether the third-generation gamma nail-3 (GN-3) was better for junior surgeons to learn to treat geriatric intertrochanteric femur fractures than proximal femoral nail antirotation-II (PFNA-II). Methods This is a prospective randomised study of 350 patients who underwent GN-3 fixation and PFNA-II carried out by junior orthopaedic trauma surgeons from January 2011 February 2017. We compared nail positioning, complication rates, operative and fluoroscopy time, blood transfused, time to mobilisation, hospital stay, fracture union, mismatch, mortality and postoperative outcomes. The minimum follow-up was 12 months (mean, 27.2 months; range, 12-42 months). Results The recovery rate of the GN-3 group was higher than that of the PFNA-II group significantly. Compared with the PFNA-II group, the GN-3 group was superior in fracture gap, while operative time, fluoroscopy time, blood transfused, time to mobilisation, hospital stay, Harris Hip Score, reoperation, mortality and so on had no significmplications, and ultimately improved outcomes. © 2019 The Authors.Background The purposes of this study were to develop a machine learning-based implant recognition program and to verify its accuracy. Methods Postoperative anteroposterior (AP) X-rays (≥300 dpi) were collected of patients who underwent total hip arthroplasty. X-rays with a wire or plate added and those without a true anteroposterior view were excluded. A total of 170 X-ray images of hip implants from 29 brands were collected from five hospitals and a Google image search. These collected images were manually reorganised to ensure appropriate labelling. Collected images were preprocessed to have grey-scaled pixels with histogram equalisation for efficient training. Images varied by +10/-10°, and 3606 unique images derived from the original 170 images were created for training. Discussion of the validation set being derived 25% of training set. The recognition model structure consisted of two steps object detection and clustering. Model training was performed with Keras deep learning platform. Results The 170 X-ray images of hip implants were used to build a stem detection model using YOLOv3.
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