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Duijnisveld BJ, Koenraadt KLM, van Steenbergen LN, Bolder SBT. Mortality and revision rate of cemented and uncemented hemiarthroplasty after hip fracture: an analysis of the Dutch Arthroplasty Register (LROI). Acta Orthop 2020; 91:408-413. [PMID: 32285730 PMCID: PMC8023919 DOI: 10.1080/17453674.2020.1752522] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background and purpose - Femoral neck fractures are commonly treated with cemented or uncemented hemiarthroplasties (HA). We evaluated differences in mortality and revision rates in this fragile patient group.Patients and methods - From January 1, 2007 until December 31, 2016, 22,356 HA procedures from the Dutch Arthroplasty Register (LROI) were included. For each HA, follow-up until death, revision, or end of follow-up (December 31, 2016) was determined. The crude revision rate was determined by competing risk analysis. Multivariable Cox regression analyses were performed to evaluate the effect of fixation method (cemented vs. uncemented) on death or revision. Age, sex, BMI, Orthopaedic Data Evaluation Panel (ODEP) rating, ASA grade, surgical approach, and previous surgery were included as potential confounders.Results - 1-year mortality rates did not differ between cemented and uncemented HA. 9-year mortality rates were 53% (95% CI 52-54) in cemented HA compared to 56% (CI 54-58) in uncemented HA. Multivariable Cox regression analysis showed similar mortality between cemented and uncemented HA (HR 1.0, CI 0.96-1.1). A statistically significantly lower 9-year revision rate of 3.1% (CI 2.7-3.6) in cemented HA compared with 5.1% (CI 4.2-6.2) in the uncemented HA was found with a lower hazard ratio for revision in cemented compared with uncemented HA (HR 0.56, CI 0.47-0.67).Interpretation - Long-term mortality rates did not differ between patients with a cemented or uncemented HA after an acute femoral neck fracture. Revision rates were lower in cemented compared with uncemented HA.
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Affiliation(s)
| | - Koen L M Koenraadt
- Foundation for Orthopaedic Research, Care and Education, Amphia Hospital, Breda
| | - Liza N van Steenbergen
- Dutch Arthroplasty Register, Landelijke Registratie Orthopedische Implantaten (LROI), ‘s Hertogenbosch
| | - Stefan B T Bolder
- Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands
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Duijnisveld BJ, van den Hout JAAM, Wagenmakers R, Koenraadt KLM, Bolder SBT. No Learning Curve of the Direct Superior Approach in Total Hip Arthroplasty. Orthop Surg 2020; 12:852-860. [PMID: 32424969 PMCID: PMC7307249 DOI: 10.1111/os.12689] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/11/2020] [Accepted: 03/27/2020] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES To assess the learning curve of the direct superior approach (DSA) for total hip arthroplasty (THA) and to compare surgical, clinical, and radiological results with a matched control group using the mini posterior approach (MPA). METHODS A prospective cohort study was performed from October 2016 to May 2017 including our first 52 patients undergoing THA using the DSA. Patients with primary osteoarthritis or osteonecrosis and a body mass index (BMI) < 35 who were eligible for surgery were included. As a control group, 52 patients who underwent the MPA were included, matched based on age, BMI, and ASA classification. In the DSA group, damage to the iliotibial tract and the distal external rotators, including the external obturator and quadriceps femoris muscles, was avoided. Outcome measures were collected, including surgical time, blood loss, postoperative pain, length of stay, implant position, use of walking aids, patient reported outcome measures (PROM), and complications. Unpaired t-tests were used to analyze differences between the DSA and the MPA group in surgical time, blood loss, length of stay, and acetabular and femoral component position. χ2 -tests were used to analyze mobility and the number of complications. Two-way repeated measures ANOVA was used to analyze pain scores and PROM between the DSA and the MPA groups. RESULTS The mean surgical time of 61 min (SD 8) in the DSA group was longer (P < 0.001) compared to that in the MPA group, 46 min (SD 12). No differences were found in blood loss, postoperative pain, or mean length of stay in the hospital. After 6 weeks, 94% of the patients in the DSA group were able to walk inside their home without walking aids compared to 90% in the MPA group. The mobility scores were not different after follow up of 6 weeks and 1 year (P = 0.12 and P = 0.36 respectively). All PROM improved postoperatively in both the DSA and the MPA group (P < 0.01). Acetabular cup and femoral stem position were not compromised by the DSA. Complications included two Vancouver B2 periprosthetic fractures in the DSA group, of which there was one surgical-related fracture and one fracture after a traffic accident. Complications in the MPA group included one periprosthetic fracture, two hip dislocations, and one ischial neuropathy. No infections or thromboembolic events were observed. The 1-year complication rate was not different between the MPA and DSA groups (P = 0.40). CONCLUSION The DSA can be safely introduced as no learning curve in the prosthesis position or the complication rate was found.
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Affiliation(s)
- Bouke J Duijnisveld
- Department of Orthopaedic Surgery, Sint Maartenskliniek, Nijmegen, The Netherlands
| | | | - Robert Wagenmakers
- Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands
| | - Koen L M Koenraadt
- Foundation for Orthopaedic Research, Care and Education, Amphia Hospital, Breda, The Netherlands
| | - Stefan B T Bolder
- Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands
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van Lieshout WAM, Duijnisveld BJ, Koenraadt KLM, Elmans LHGJ, Kerkhoffs GMMJ, van Geenen RCI. Adequate joint line restoration and good preliminary clinical outcomes after total knee arthroplasty using the Flexion First Balancer technique. Knee 2019; 26:794-802. [PMID: 31104812 DOI: 10.1016/j.knee.2019.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 03/20/2019] [Accepted: 04/05/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Up to 20% of patients are dissatisfied after total knee arthroplasty (TKA). Factors which could possibly contribute to this dissatisfaction are a decreased posterior condylar offset (PCO) and subsequent joint line elevation which leads to mid-flexion instability. The Flexion First Balancer (FFB) technique aims to adequately restore the medial PCO and thereby reconstruct the medial native joint line to its pre-disease height. METHODS A retrospective cohort of 59 patients operated using the FFB technique was analyzed and matched with a historic measured resection (MR) cohort of 59 patients. Groups were matched for age, gender, BMI and ASA classification. Joint line and PCO changes as well as patient reported outcome measurement scores (PROMs) were evaluated at one year [1.0 - 1.6] postoperatively. RESULTS Radiographic evaluation revealed no changes in joint line height in the FFB group, whereas an elevation in joint line was seen in the MR group (p = 0.002). The PCO increased after surgery in both group without any statistically significant differences. Evaluation of PROMs found no differences between the two groups for total OKS and KOOS scores, nor in re-operation or complication rates. CONCLUSION The FFB technique seems to be a safe technique to use in TKA and reconstructs the pre-disease joint line in contrast to the MR technique. The clinical outcomes were comparable between both groups.
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Affiliation(s)
- W A M van Lieshout
- Amphia, Department of Orthopaedic Surgery, Breda, the Netherlands; Amsterdam University Medical Centers, Department of orthopaedic surgery, Amsterdam, the Netherlands.
| | - B J Duijnisveld
- Amphia, Department of Orthopaedic Surgery, Breda, the Netherlands
| | - K L M Koenraadt
- Amphia, Foundation for Orthopaedic Research, Care & Education (FORCE), Breda, the Netherlands
| | - L H G J Elmans
- Amphia, Department of Orthopaedic Surgery, Breda, the Netherlands
| | - G M M J Kerkhoffs
- Amsterdam University Medical Centers, Department of orthopaedic surgery, Amsterdam, the Netherlands
| | - R C I van Geenen
- Amphia, Department of Orthopaedic Surgery, Breda, the Netherlands
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Duijnisveld BJ, Henseler JF, Reijnierse M, Fiocco M, Kan HE, Nelissen RGHH. Quantitative Dixon MRI sequences to relate muscle atrophy and fatty degeneration with range of motion and muscle force in brachial plexus injury. Magn Reson Imaging 2016; 36:98-104. [PMID: 27989913 DOI: 10.1016/j.mri.2016.10.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 10/14/2016] [Accepted: 10/26/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Assessment of muscle atrophy and fatty degeneration in brachial plexus injury (BPI) could yield valuable insight into pathophysiology and could be used to predict clinical outcome. The objective of this study was to quantify and relate fat percentage and cross-sectional area (CSA) of the biceps to range of motion and muscle force of traumatic brachial plexus injury (BPI) patients. METHODS T1-weighted TSE sequence and three-point Dixon images of the affected and non-affected biceps brachii were acquired on a 3 Tesla magnetic resonance scanner to determine the fat percentage, total and contractile CSA of 20 adult BPI patients. Regions of interest were drawn by two independent investigators to determine the inter-observer reliability. Paired Students' t-test and multivariate analysis were used to relate fat percentage, total and contractile CSA to active flexion and biceps muscle force. RESULTS The mean fat percentage 12±5.1% of affected biceps was higher than 6±1.0% of the non-affected biceps (p<0.001). The mean contractile CSA 8.1±5.1cm2 of the affected biceps was lower than 19.4±4.9cm2 of the non-affected biceps (p<0.001). The inter-observer reliability was excellent (ICC 0.82 to 0.96). The contractile CSA contributed most to the reduction in active flexion and muscle force. CONCLUSION Quantitative measurement of fat percentage, total and contractile CSA using three-point Dixon sequences provides an excellent reliability and relates with active flexion and muscle force in BPI.
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Affiliation(s)
- Bouke J Duijnisveld
- Department of Orthopaedics, Leiden University Medical Center, The Netherlands.
| | | | - Monique Reijnierse
- Department of Radiology, Leiden University Medical Center, The Netherlands
| | - Marta Fiocco
- Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, The Netherlands; Mathematica institute Leiden University, Leiden University Medical Center, The Netherlands
| | - Hermien E Kan
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, The Netherlands
| | - Rob G H H Nelissen
- Department of Orthopaedics, Leiden University Medical Center, The Netherlands
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Abstract
PURPOSE The objective of this study was to evaluate the effectiveness of serial casting of elbow flexion contractures in neonatal brachial plexus palsy. METHODS A prospective consecutive cohort study was performed with a median follow-up of 5 years. Forty-one patients with elbow flexion contractures ≥ 30° were treated with serial casting until the contracture was ≤ 10°, for a maximum of 8 weeks. Range of motion, number of recurrences and patient satisfaction were recorded and analyzed using Wilcoxon signed-rank and Cox regression tests. RESULTS Passive extension increased from a median of -40° (IQR -50 to -30) to -15° (IQR -10 to -20, p < 0.001). Twenty patients showed 37 recurrences. The baseline severity of passive elbow extension had a hazard ratio of 0.93 (95% CI 0.89 to 0.96, p < 0.001) for first recurrence. Median patient satisfaction was moderate. Four patients showed loss of flexion mobility and in two patients serial casting had to be prematurely replaced by night splinting due to complaints. CONCLUSION Serial casting improved elbow flexion contractures, although recurrences were frequent. The severity of elbow flexion contracture is a predictor of recurrence. We recommend more research on muscle degeneration and determinants involved in elbow flexion contractures to improve treatment strategies and prevent side-effects.
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Affiliation(s)
- B J Duijnisveld
- Departments of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands
| | - D Steenbeek
- Department of Rehabilitation, Leiden University Medical Center, Leiden, The Netherlands
| | - R G H H Nelissen
- Departments of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands
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Bomer N, den Hollander W, Ramos YFM, Bos SD, van der Breggen R, Lakenberg N, Pepers BA, van Eeden AE, Darvishan A, Tobi EW, Duijnisveld BJ, van den Akker EB, Heijmans BT, van Roon-Mom WMC, Verbeek FJ, van Osch GJVM, Nelissen RGHH, Slagboom PE, Meulenbelt I. Underlying molecular mechanisms of DIO2 susceptibility in symptomatic osteoarthritis. Ann Rheum Dis 2015; 74:1571-9. [PMID: 24695009 PMCID: PMC4516000 DOI: 10.1136/annrheumdis-2013-204739] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 03/14/2014] [Accepted: 03/15/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate how the genetic susceptibility gene DIO2 confers risk to osteoarthritis (OA) onset in humans and to explore whether counteracting the deleterious effect could contribute to novel therapeutic approaches. METHODS Epigenetically regulated expression of DIO2 was explored by assessing methylation of positional CpG-dinucleotides and the respective DIO2 expression in OA-affected and macroscopically preserved articular cartilage from end-stage OA patients. In a human in vitro chondrogenesis model, we measured the effects when thyroid signalling during culturing was either enhanced (excess T3 or lentiviral induced DIO2 overexpression) or decreased (iopanoic acid). RESULTS OA-related changes in methylation at a specific CpG dinucleotide upstream of DIO2 caused significant upregulation of its expression (β=4.96; p=0.0016). This effect was enhanced and appeared driven specifically by DIO2 rs225014 risk allele carriers (β=5.58, p=0.0006). During in vitro chondrogenesis, DIO2 overexpression resulted in a significant reduced capacity of chondrocytes to deposit extracellular matrix (ECM) components, concurrent with significant induction of ECM degrading enzymes (ADAMTS5, MMP13) and markers of mineralisation (ALPL, COL1A1). Given their concurrent and significant upregulation of expression, this process is likely mediated via HIF-2α/RUNX2 signalling. In contrast, we showed that inhibiting deiodinases during in vitro chondrogenesis contributed to prolonged cartilage homeostasis as reflected by significant increased deposition of ECM components and attenuated upregulation of matrix degrading enzymes. CONCLUSIONS Our findings show how genetic variation at DIO2 could confer risk to OA and raised the possibility that counteracting thyroid signalling may be a novel therapeutic approach.
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Affiliation(s)
- Nils Bomer
- Department of Molecular Epidemiology, LUMC, Leiden, The Netherlands
- IDEAL, The Netherlands
| | | | | | - Steffan D Bos
- Department of Molecular Epidemiology, LUMC, Leiden, The Netherlands
- Genomics Initiative, sponsored by the NCHA, Leiden, The Netherlands
| | | | - Nico Lakenberg
- Department of Molecular Epidemiology, LUMC, Leiden, The Netherlands
| | - Barry A Pepers
- Department of Human Genetics, LUMC, Leiden, The Netherlands
| | | | - Arash Darvishan
- Department of Imaging & BioInformatics, LIACS, Leiden, The Netherlands
| | - Elmar W Tobi
- Department of Molecular Epidemiology, LUMC, Leiden, The Netherlands
- IDEAL, The Netherlands
| | | | - Erik B van den Akker
- Department of Molecular Epidemiology, LUMC, Leiden, The Netherlands
- The Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
| | - Bastiaan T Heijmans
- Department of Molecular Epidemiology, LUMC, Leiden, The Netherlands
- Genomics Initiative, sponsored by the NCHA, Leiden, The Netherlands
| | | | - Fons J Verbeek
- Department of Imaging & BioInformatics, LIACS, Leiden, The Netherlands
| | - Gerjo J V M van Osch
- Department of Orthopaedics, Erasmus MC, Rotterdam, The Netherlands
- Deptartment of Otorhinolaryngology, Erasmus MC, Rotterdam, The Netherlands
| | | | - P Eline Slagboom
- Department of Molecular Epidemiology, LUMC, Leiden, The Netherlands
- IDEAL, The Netherlands
- Genomics Initiative, sponsored by the NCHA, Leiden, The Netherlands
| | - Ingrid Meulenbelt
- Department of Molecular Epidemiology, LUMC, Leiden, The Netherlands
- Genomics Initiative, sponsored by the NCHA, Leiden, The Netherlands
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den Hollander W, Ramos YFM, Bomer N, Elzinga S, van der Breggen R, Lakenberg N, de Dijcker WJ, Suchiman HED, Duijnisveld BJ, Houwing-Duistermaat JJ, Slagboom PE, Bos SD, Nelissen RGHH, Meulenbelt I. Transcriptional Associations of Osteoarthritis-Mediated Loss of Epigenetic Control in Articular Cartilage. Arthritis Rheumatol 2015; 67:2108-16. [DOI: 10.1002/art.39162] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 04/14/2015] [Indexed: 12/31/2022]
Affiliation(s)
| | | | - Nils Bomer
- Leiden University Medical Center; Leiden The Netherlands
| | - Stefan Elzinga
- Leiden University Medical Center; Leiden The Netherlands
| | | | - Nico Lakenberg
- Leiden University Medical Center; Leiden The Netherlands
| | | | | | | | | | - P. Eline Slagboom
- Leiden University Medical Center, Leiden, The Netherlands, and The Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging; Rotterdam The Netherlands
| | - Steffan D. Bos
- Leiden University Medical Center, Leiden, The Netherlands, and The Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging; Rotterdam The Netherlands
| | | | - Ingrid Meulenbelt
- Leiden University Medical Center, Leiden, The Netherlands, and The Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging; Rotterdam The Netherlands
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Sarac C, Duijnisveld BJ, van der Weide A, Schoones JW, Malessy MJA, Nelissen RGHH, Vlieland TPMV. Outcome measures used in clinical studies on neonatal brachial plexus palsy: A systematic literature review using the International Classification of Functioning, Disability and Health. J Pediatr Rehabil Med 2015; 8:167-85; quiz 185-6. [PMID: 26410060 DOI: 10.3233/prm-150335] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Symptoms of a neonatal brachial plexus palsy (NBPP) can vary widely among individuals and numerous clinical studies have been performed to identify the natural history and to improve treatment. The aim of this study was to identify and describe all outcome measures used in clinical studies on patients with an NBPP and categorize these outcome measures according to the International Classification of Functioning, Disability and Health (ICF). METHOD Electronic searches of different databases were carried out. All clinical studies describing one or more outcomes of NBPP were selected. Data on outcome measures was systematically extracted and the contents were analyzed and linked to the ICF. RESULTS A total of 217 full texts were selected and 59 different outcome measures were identified. The 5 most frequently used outcome measures included range of motion of the shoulder (n= 166 studies, 76%), range of motion of the elbow (n= 87 studies, 40%), the Mallet scale (n= 66 studies, 30%), Magnetic Resonance Imaging (n= 37 studies, 17%) and the Medical Research Council motor grading scale (n= 31 studies, 14%). Assessments related to Body functions and Structures were most frequent, whereas assessments associated with Activities and Participation and Environmental Factors were relatively uncommon. CONCLUSION There was a high variability among the outcome measures used, with measures within the ICF component Body Functions being most common. These results underscore the need for the development and usage of outcome measures representing all domains of health status in patients with NBPP.
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Affiliation(s)
- Cigdem Sarac
- Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Bouke J Duijnisveld
- Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Amber van der Weide
- Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Jan W Schoones
- Walaeus Library, Leiden University Medical Center, Leiden, The Netherlands
| | - Martijn J A Malessy
- Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Rob G H H Nelissen
- Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Thea P M Vliet Vlieland
- Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands
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den Hollander W, Ramos YFM, Bos SD, Bomer N, van der Breggen R, Lakenberg N, de Dijcker WJ, Duijnisveld BJ, Slagboom PE, Nelissen RGHH, Meulenbelt I. Knee and hip articular cartilage have distinct epigenomic landscapes: implications for future cartilage regeneration approaches. Ann Rheum Dis 2014; 73:2208-12. [DOI: 10.1136/annrheumdis-2014-205980] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hogendoorn S, Duijnisveld BJ, van Duinen SG, Stoel BC, van Dijk JG, Fibbe WE, Nelissen RGHH. Local injection of autologous bone marrow cells to regenerate muscle in patients with traumatic brachial plexus injury: a pilot study. Bone Joint Res 2014; 3:38-47. [PMID: 24565688 PMCID: PMC3942869 DOI: 10.1302/2046-3758.32.2000229] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objectives Traumatic brachial plexus injury causes severe functional impairment
of the arm. Elbow flexion is often affected. Nerve surgery or tendon
transfers provide the only means to obtain improved elbow flexion.
Unfortunately, the functionality of the arm often remains insufficient.
Stem cell therapy could potentially improve muscle strength and
avoid muscle-tendon transfer. This pilot study assesses the safety
and regenerative potential of autologous bone marrow-derived mononuclear
cell injection in partially denervated biceps. Methods Nine brachial plexus patients with insufficient elbow flexion
(i.e., partial denervation) received intramuscular escalating doses
of autologous bone marrow-derived mononuclear cells, combined with
tendon transfers. Effect parameters included biceps biopsies, motor
unit analysis on needle electromyography and computerised muscle tomography,
before and after cell therapy. Results No adverse effects in vital signs, bone marrow aspiration sites,
injection sites, or surgical wound were seen. After cell therapy
there was a 52% decrease in muscle fibrosis (p = 0.01), an 80% increase
in myofibre diameter (p = 0.007), a 50% increase in satellite cells
(p = 0.045) and an 83% increase in capillary-to-myofibre ratio (p
< 0.001) was shown. CT analysis demonstrated a 48% decrease in
mean muscle density (p = 0.009). Motor unit analysis showed a mean
increase of 36% in motor unit amplitude (p = 0.045), 22% increase
in duration (p = 0.005) and 29% increase in number of phases (p
= 0.002). Conclusions Mononuclear cell injection in partly denervated muscle of brachial
plexus patients is safe. The results suggest enhanced muscle reinnervation
and regeneration. Cite this article: Bone Joint Res 2014;3:38–47.
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Affiliation(s)
- S Hogendoorn
- Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands
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Duijnisveld BJ, Saraç C, Malessy MJA, Brachial Plexus Advisory Board TI, Vliet Vlieland TPM, Nelissen RGHH. Developing core sets for patients with obstetricbrachial plexus injury based on the International Classificationof Functioning, Disability and Health. Bone Joint Res 2013; 2:116-21. [PMID: 23836476 PMCID: PMC3693181 DOI: 10.1302/2046-3758.26.2000153] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background Symptoms of obstetric brachial plexus injury (OBPI) vary widely
over the course of time and from individual to individual and can
include various degrees of denervation, muscle weakness, contractures,
bone deformities and functional limitations. To date, no universally
accepted overall framework is available to assess the outcome of patients
with OBPI. The objective of this paper is to outline the proposed
process for the development of International Classification of Functioning,
Disability and Health (ICF) Core Sets for patients with an OBPI. Methods The first step is to conduct four preparatory studies to identify
ICF categories important for OBPI: a) a systematic literature review
to identify outcome measures, b) a qualitative study using focus
groups, c) an expert survey and d) a cross-sectional, multicentre
study. A first version of ICF Core Sets will be defined at a consensus
conference, which will integrate the evidence from the preparatory
studies. In a second step, field-testing among patients will validate this
first version of Core Sets for OBPI. Discussion The proposed method to develop ICF Core Sets for OBPI yields
a practical tool for multiple purposes: for clinicians to systematically
assess and evaluate the individual’s functioning, for researchers
to design and compare studies, and for patients to get more insight
into their health problems and their management.
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Affiliation(s)
- B J Duijnisveld
- Leiden University Medical Center, Departmentof Orthopaedics, P.O. Box 9600, 2300RC Leiden, the Netherlands
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Claessen KMJA, Kloppenburg M, Kroon HM, Bijsterbosch J, Pereira AM, Romijn JA, van der Straaten T, Nelissen RGHH, Hofman A, Uitterlinden AG, Duijnisveld BJ, Lakenberg N, Beekman M, van Meurs JB, Slagboom PE, Biermasz NR, Meulenbelt I. Relationship between the functional exon 3 deleted growth hormone receptor polymorphism and symptomatic osteoarthritis in women. Ann Rheum Dis 2013; 73:433-6. [DOI: 10.1136/annrheumdis-2012-202713] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Beenakker KGM, Duijnisveld BJ, Van Der Linden HMJ, Visser CPJ, Westendorp RGJ, Butler-Brown G, Nelissen RGHH, Maier AB. Muscle characteristics in patients with chronic systemic inflammation. Muscle Nerve 2012; 46:204-9. [PMID: 22806369 DOI: 10.1002/mus.23291] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Histological characteristics of age-related muscle wasting are type II muscle fiber atrophy, accumulation of oxidative stress-induced lipofuscin granules and decreased satellite cell numbers. There is increasing clinical evidence for a strong correlation between chronic systemic inflammation and age-related muscle wasting. The aim of this study was to determine the impact of chronic systemic inflammation on age-related histological muscle characteristics. METHODS As a model for chronic systemic inflammation, we included 10 patients suffering from rheumatoid arthritis (RA) and 27 control patients suffering from osteoarthritis (OA). Biopsies were taken from the vastus medialis muscle. RESULTS No significant differences were found in type II muscle fiber atrophy, lipofuscin accumulation, or satellite cell number in RA compared with OA patients. CONCLUSIONS These results suggest there is no association between chronic systemic inflammation in RA and age-related muscle characteristics. Future research should focus on inflammation and satellite cell function.
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Affiliation(s)
- Karel G M Beenakker
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
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Bos SD, Bovée JVMG, Duijnisveld BJ, Raine EVA, van Dalen WJ, Ramos YFM, van der Breggen R, Nelissen RGHH, Slagboom PE, Loughlin J, Meulenbelt I. Increased type II deiodinase protein in OA-affected cartilage and allelic imbalance of OA risk polymorphism rs225014 at DIO2 in human OA joint tissues. Ann Rheum Dis 2012; 71:1254-8. [PMID: 22492780 DOI: 10.1136/annrheumdis-2011-200981] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Genetic variation at the type II deiodinase (D2) gene (DIO2) was previously identified as osteoarthritis (OA) risk factor. To investigate mechanisms possibly underlying this association, we assessed D2 protein in healthy and OA-affected cartilage and investigated allelic balance of the OA risk polymorphism rs225014 at DIO2 in human OA joints. METHODS Immunohistochemical staining of healthy and OA-affected cartilage was performed for D2. We then assessed allelic balance of DIO2 mRNA within OA-affected cartilage both at and away from the lesion, ligaments and subchondral bone. Allelic balance was measured by the amount of alleles 'C' and 'T' of the intragenic OA risk polymorphism rs225014 in heterozygous carriers. RESULTS A markedly higher amount of D2 positive cells and staining intensity was observed in OA cartilage. A significant, 1.3-fold higher presence was observed for the OA-associated rs225014 'C' allele relative to the 'T' allele of DIO2, which was significant in 28 of 31 donors. CONCLUSION In OA cartilage, D2 protein presence is increased. The allelic imbalance of the DIO2 mRNA transcript, with the OA risk allele 'C' of rs225014 more abundant than the wild-type 'T' allele in heterozygote carriers provides a possible mechanism by which genetic variation at DIO2 confers OA risk.
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Affiliation(s)
- Steffan D Bos
- LUMC, Molecular Epidemiology, Einthovenweg 20, Leiden 2333 ZC, The Netherlands.
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15
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Duijnisveld BJ, Bigot A, Beenakker KGM, Portilho DM, Raz V, van der Heide HJL, Visser CPJ, Chaouch S, Mamchaoui K, Westendorp RGJ, Mouly V, Butler-Browne GS, Nelissen RGHH, Maier AB. Regenerative potential of human muscle stem cells in chronic inflammation. Arthritis Res Ther 2011; 13:R207. [PMID: 22171690 PMCID: PMC3334660 DOI: 10.1186/ar3540] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Revised: 10/13/2011] [Accepted: 12/15/2011] [Indexed: 02/08/2023] Open
Abstract
Introduction Chronic inflammation is a profound systemic modification of the cellular microenvironment which could affect survival, repair and maintenance of muscle stem cells. The aim of this study was to define the role of chronic inflammation on the regenerative potential of satellite cells in human muscle. Methods As a model for chronic inflammation, 11 patients suffering from rheumatoid arthritis (RA) were included together with 16 patients with osteoarthritis (OA) as controls. The mean age of both groups was 64 years, with more females in the RA group compared to the OA group. During elective knee replacement surgery, a muscle biopsy was taken from the distal musculus vastus medialis. Cell populations from four RA and eight OA patients were used for extensive phenotyping because these cell populations showed no spontaneous differentiation and myogenic purity greater than 75% after explantation. Results After mononuclear cell explantation, myogenic purity, viability, proliferation index, number of colonies, myogenic colonies, growth speed, maximum number of population doublings and fusion index were not different between RA and OA patients. Furthermore, the expression of proteins involved in replicative and stress-induced premature senescence and apoptosis, including p16, p21, p53, hTERT and cleaved caspase-3, was not different between RA and OA patients. Mean telomere length was shorter in the RA group compared to the OA group. Conclusions In the present study we found evidence that chronic inflammation in RA does not affect the in vitro regenerative potential of human satellite cells. Identification of mechanisms influencing muscle regeneration by modulation of its microenvironment may, therefore, be more appropriate.
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Affiliation(s)
- Bouke J Duijnisveld
- Department of Orthopaedics, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
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