Hybrid Nanoparticle Engineered with Transforming Growth Factor -β1-Overexpressed Extracellular Vesicle and Cartilage-Targeted Anti-Inflammatory Liposome for Osteoarthritis.

Extracellular vesicles (EVs) possess the characteristics of their parent cells, based on which various studies have actively investigated treatments for diseases using mesenchymal stem cell-derived EVs due to their regenerative activity. Furthermore, in recent years, there have been significant efforts to engineer EVs to improve their native activities and integrate additional functions. Although both endogenous and exogenous methods are used for engineering EVs, endogenous methods may pose the problem of administering substances to cells undergoing metabolic changes, which can cause potential side effects.

Multifunctional extracellular vesicles and edaravone-loaded scaffolds for kidney tissue regeneration by activating GDNF/RET pathway.

With the severity of chronic kidney disease worldwide, strategies to recover renal function via tissue regeneration provide alternatives to kidney replacement therapy. To exclude side effects from direct cell transplantation, extracellular vesicles (EVs) are great substitutes representing paracrine cell signaling. To build three-dimensional structures for implantation into the 5/6 nephrectomy model by incorporating bioactive materials, including multifunctional EVs (mEVs), porous PMEZE/mEV scaffolds were developed in combination with edaravone (EDV; E) and mEV based on PMEZ scaffolds with PLGA (P), MH-RA (M), ECM (E), ZnO-ALA (Z).

Machine Learning Models for Low Back Pain Detection and Factor Identification: Insights From a 6-Year Nationwide Survey.

This study aimed to enhance performance, identify additional predictors, and improve the interpretability of biopsychosocial machine learning models for low back pain (LBP). Using survey data from a 6-year nationwide study involving 17,609 adults aged ≥50 years (Korea National Health and Nutrition Examination Survey), we explored 119 factors to detect LBP in individuals who reported experiencing LBP for at least 30 days within the previous 3 months. Our primary model, model 1, employed eXtreme Gradient Boosting (XGBoost) and selected primary factors (PFs) based on their feature importance scores.

Osteoporotic Bone Regeneration via Plenished Biomimetic PLGA Scaffold with Sequential Release System.

Achieving satisfactory bone tissue regeneration in osteoporotic patients with ordinary biomaterials is challenging because of the decreased bone mineral density and aberrant bone microenvironment. In addressing this issue, a biomimetic scaffold (PMEH/SP), incorporating 4-hexylresorcinol (4HR), and substance P (SP) into the poly(lactic-go-glycolic acid) (PLGA) scaffold with magnesium hydroxide (M) and extracellular matrix (E) is introduced, enabling the consecutive release of bioactive agents. 4HR and SP induced the phosphorylation of p38 MAPK and ERK in human umbilical vein endothelial cells (HUVECs), thereby upregulating VEGF expression level.

Infectious Spondylitis Caused by Streptococcus gordonii.

Infectious spondylitis is a rare but severe disease of the spine caused by bacteria or other pathogens. Particularly in immunocompromised patients, a definitive source of infection often remains uncertain. Among many pathogens, a normal oral flora, is a very rare pathogen in infectious spondylitis.

Development of a Synovial Fistula Through a Screw Hole Following Supramalleolar Osteotomy Hardware Removal: A Case Report.

A synovial fistula is the communication between the synovial space and the skin. In most cases, the fistula tract is located within the soft tissue; therefore, excision and closure of the fistula have been described as surgical treatment. Rarely, fistulas may form within the bone following procedures around the joint, such as core biopsy and bone tunneling for ligament reconstruction.

Safety and efficacy of Wharton's jelly-derived mesenchymal stem cells with teriparatide for osteoporotic vertebral fractures: A phase I/IIa study.

Osteoporotic vertebral compression fractures (OVCFs) are serious health problems. We conducted a randomized, open-label, phase I/IIa study to determine the feasibility, safety, and effectiveness of Wharton's jelly-derived mesenchymal stem cells (WJ-MSCs) and teriparatide (parathyroid hormone 1-34) in OVCFs. Twenty subjects with recent OVCFs were randomized to teriparatide (20 μg/day, daily subcutaneous injection for 6 months) treatment alone or combined treatment of WJ-MSCs (intramedullary [4 × 10 cells] injection and intravenous [2 × 10 cells] injection after 1 week) and teriparatide (20 μg/day, daily subcutaneous injection for 6 months).

Therapeutic Potential of Tauroursodeoxycholic Acid for the Treatment of Osteoporosis.

Tauroursodeoxycholic acid (TUDCA) is a US FDA-approved hydrophilic bile acid for the treatment of chronic cholestatic liver disease. In the present study, we investigate the effects of TUDCA on the proliferation and differentiation of osteoblasts and its therapeutic effect on a mice model of osteoporosis. Following treatment with different concentrations of TUDCA, cell viability, differentiation, and mineralization were measured.

3'-UTR Polymorphisms of Vitamin B-Related Genes Are Associated with Osteoporosis and Osteoporotic Vertebral Compression Fractures (OVCFs) in Postmenopausal Women.

As life expectancy increases, the prevalence of osteoporosis is increasing. In addition to vitamin D which is well established to have an association with osteoporosis, B vitamins, such as thiamine, folate (vitamin B9), and cobalamin (vitamin B12), could affect bone metabolism, bone quality, and fracture risk in humans by influencing homocysteine/folate metabolism. Despite the crucial role of B vitamins in bone metabolism, there are few studies regarding associations between B vitamin-related genes and osteoporosis.

Impact of two- and three-dimensional computed tomography use on intraobserver and interobserver reliabilities of pilon fracture classification and treatment recommendation.

Background: Two-dimensional (2D) and three-dimensional (3D) computed tomography (CT) have been increasingly used in various intra-articular fractures including pilon fracture. However, no study has investigated intraobserver and interobserver reliabilities of pilon fracture classification using 3D CT images.

Hypothesis: (1) Intraobserver and interobserver agreements of fracture classifications and treatment recommendations will improve by using 2D CT images compared to using plain radiographs only; (2) agreements will improve by adding 3D CT images compared to adding 2D CT images; and (3) agreements of orthopedic residents rather than specialists will be influenced more by imaging modality.

Symptomatic posterior fossa and supratentorial subdural hygromas as a rare complication following transarticular screw fixation with posterior wiring for atlantoaxial instability: A case report.

Rationale: Atlantoaxial transarticular screw fixation has been an effective and appealing method for inducing fusion of the C1-C2 complex. This technique is usually performed with Gallie fusion. In performing Gallie fusion using sublaminar wiring, a major concern is the risk of dural tear associated with passing sublaminar wires through the epidural space.

Modification of Titanium Implant and Titanium Dioxide for Bone Tissue Engineering.

Bone tissue engineering using titanium (Ti) implant and titanium dioxide (TiO) with their modification is gaining increasing attention. Ti has been adopted as an implant material in dental and orthopedic fields due to its superior properties. However, it still requires modification in order to achieve robust osteointegration between the Ti implant and surrounding bone.

3'-UTR Polymorphisms of MTHFR and TS Associated with Osteoporotic Vertebral Compression Fracture Susceptibility in Postmenopausal Women.

Postmenopausal osteoporosis is one of the most prominent diseases in postmenopausal women and it is increasing in prevalence with the aging population. Furthermore, osteoporosis and osteoporotic vertebral compression fractures (OVCFs) are related to mortality and decreased quality of life. Therefore, searching for biomarkers that are able to identify postmenopausal women who are at high risk of developing OVCFs is an effective strategy for improving the quality of life of patients and alleviating social and economic burdens.

Extragonadal germ cell tumor of the posterior mediastinum in a child complicated with spinal cord compression: a case report.

Background: Germ cell tumors (GCTs) in children are rare neoplasms with diverse pathological findings according to the site and age of presentation. The most common symptoms in children with mediastinal GCTs, which are nonspecific, are dyspnea, chest pain, cough, hemoptysis, vena cava occlusion syndrome, and fatigue/weakness. Because of these nonspecific symptoms, it is difficult to suspect a mediastinal mass.

Safety and tolerability of intradiscal implantation of combined autologous adipose-derived mesenchymal stem cells and hyaluronic acid in patients with chronic discogenic low back pain: 1-year follow-up of a phase I study.

Background: Adipose tissue-derived mesenchymal stem cells (AT-MSCs) offer potential as a therapeutic option for chronic discogenic low back pain (LBP) because of their immunomodulatory functions and capacity for cartilage differentiation. The goal of this study was to assess the safety and tolerability of a single intradiscal implantation of combined AT-MSCs and hyaluronic acid (HA) derivative in patients with chronic discogenic LBP.

Methods: We performed a single-arm phase I clinical trial with a 12-month follow-up and enrolled 10 eligible chronic LBP patients.

Polymorphisms of miR-146a, miR-149, miR-196a2, and miR-499 are associated with osteoporotic vertebral compression fractures in Korean postmenopausal women.

Genetic factors have been shown to be a small but significant predictor for osteoporosis and osteoporotic fracture risk. We performed a case-control association study to determine the association between miR-146a, miR-149, miR-196a2, and miR-499 polymorphisms and osteoporotic vertebral compression fracture (OVCF) susceptibility. In total, 286 unrelated postmenopausal Korean women (57 with OVCFs, 55 with non-OVCFs, and 174 healthy controls) were recruited.

Isolated Syndesmosis Diastasis: Computed Tomography Scan Assessment With Arthroscopic Correlation.

Purpose: To investigate which method can predict tibiofibular diastasis more accurately among the tibiofibular interval at the ankle joint level or previous parameters taken 1 cm above the joint line.

Methods: An arthroscopic examination was performed in 78 consecutive patients with anterolateral ankle pain. Four different methods were performed to take measurements of the tibiofibular interval using an axial computed tomography (CT) scan under existing arthroscopic diagnosis.

Association of Plasminogen Activator Inhibitor-1 (PAI-1) Gene Polymorphisms with Osteoporotic Vertebral Compression Fractures (OVCFs) in Postmenopausal Women.

Osteoporosis and osteoporotic fractures are strongly associated with mortality and morbidity, both in developing and developed countries. Menopause accelerates bone loss due to estrogen deficiency and age-related linear bone loss. We investigated plasminogen activator inhibitor-1 () gene polymorphisms in postmenopausal women with osteoporotic vertebral compression fractures (OVCFs).

Distal Tibial Osteotomy without Fibular Osteotomy for Medial Ankle Arthritis with Mortise Widening.

Introduction: A patient with medial ankle osteoarthritis and a widened ankle mortise can be treated successfully with an oblique distal tibial osteotomy, without fibular osteotomy, to narrow the mortise and shift the weight-bearing axis to a more normal position.

Step 1 Patient Positioning And Preoperative Assessment: With the patient under spinal or general anesthesia, check for mortise widening with a valgus stress test.

Step 2 Surgical Approach: Expose the ankle joint through an anterior approach.

Bone loss of the superior adjacent vertebral body immediately posterior to the anterior flange of Bryan cervical disc.

Background: No previous reports have mentioned bone loss of the superior adjacent vertebra immediately posterior to the anterior flange of Bryan cervical disc (Medtronic Sofamor Danek, Memphis, TN, USA), which plays a central role to prevent posterior migration of the device. The purpose of this study is to describe a new potential complication, bone loss immediately posterior to the anterior total disc replacement (TDR) flange on the superior adjacent vertebra following the Bryan cervical TDR and to discuss the possible mechanism.

Methods: The authors retrospectively reviewed 37 patients undergoing cervical TDR with the Bryan cervical disc.

A cohort study of patients undergoing distal tibial osteotomy without fibular osteotomy for medial ankle arthritis with mortise widening.

Background: Although the supramalleolar osteotomy can shift the weight-bearing axis laterally, it cannot reconstruct a widened ankle mortise caused by progression of medial ankle osteoarthritis. The aim of this study was to evaluate radiographic and clinical outcomes of distal tibial osteotomy without fibular osteotomy in patients with medial ankle osteoarthritis and mortise widening.

Methods: Distal tibial osteotomy without fibular osteotomy was performed in eighteen patients to treat medial ankle osteoarthritis with mortise widening.

Bony landmarks for determining the mechanical axis of the femur in the sagittal plane during total knee arthroplasty.

Background: There is no accepted landmark for the mechanical axis of the femoral axis in sagittal plane in conventional total knee arthroplasty.

Methods: As palpable anatomic landmarks of the femur, lateral epicondyle, and anterior margin of the greater trochanter were identified. The line connecting these two landmarks was defined as the "palpable sagittal axis".

Arthroscopic suture anchor repair of posterior root attachment injury in medial meniscus: technical note.

A root attachment injury (root tear) of the meniscus can abolish the ability of the meniscus to bear hoop stress and predispose to increase articular contact stress which contribute to femorotibial degenerative changes. A pull out suture technique to repair the root tear has been described, but the procedure making the tibial tunnel may be difficult and troublesome. This article describes a repair technique using a suture anchor and posterior trans-septal portal.