Proteomics is a new field of research in the post-genomic era,which aims at the expression and functional study of proteins in cells,tissues and organisms.It analyses the vital changes of pathological and physiological processes of life by examining proteins.It can detect low-abundance or low molecular weight proteins and polypeptides which contain rich information about diagnosis,treatment and prognosis of diseases,leading to important breakthrough in the field of basic and clinical researches.It has achieved great progress and displayed a promising future in orthopedic researches.This article reviews the development,the present status of proteomic research and its application in orthopedics.

Objective To compare the clinical outcomes of percutaneous Yurt-bone suture versus minimally invasive surgery in the treatment of acute Achilles tendon rupture.Methods Between September 2011 and December 2015,31 patients with acute Achilles tendon rupture were treated at our department.Of them,14 received percutaneous Yurt-bone suture and 17 minimally invasive surgery.The 2 groups were compared in terms of hospital stay,intraoperative bleeding volume,surgery time,decrease in leg circumference,delayed healing of the incision,single heel rise test,rerupture rate,sural nerve lesion and Achilles tendon total rupture scores (ATRS) at the final follow-up.Results The average follow-up period was 17.6 months (range,from 9 to 27 months) for all the patients in the 2 groups.The percutaneous Yurt-bone suture group had significantly less intraoperative bleeding volume (8.5 ± 3.6 mL),shorter surgery time (41.4 ± 5.3 min) and shorter hospital stay (4.2 ± 0.8 days),than the minimally invasive surgery group (43.5 ± 7.6 mL,75.5 ±7.8 min and 5.8 ± 1.3 days,respectively) (P ＜ 0.05).There were no statistically significant differences between the 2 groups regarding decrease in leg circumference (1.9 ± 0.2 cm versus 2.0 ±0.2 cm),delayed healing of the incision(0 versus 2 cases),positive single heel rise test (both one case),sural nerve lesion(one versus 0) or ATRS score (91.2 ± 3.7 versus 90.4 ± 3.3) (P ＞ 0.05).No re-rupture was observed in either group.Conclusion In the treatment of acute Achilles tendon rupture,compared with minimally invasive surgery,percutaneous Yurt-bone suture has advantages of shorter hospital stay,shorter surgery time,less intraoperative bleeding but a similar rate of complications.

OBJECTIVESSurgical repair of Achilles tendon (AT) rupture should immediately be followed by active tendon mobilization. The optimal time as to when the mobilization should begin is important yet controversial. Early kinesitherapy leads to reduced rehabilitation period. However, an insight into the detailed mechanism of this process has not been gained. Proteomic technique can be used to separate and purify the proteins by differential expression profile which is related to the function of different proteins, but research in the area of proteomic analysis of AT 3 days after repair has not been studied so far.

METHODSForty-seven New Zealand white rabbits were randomized into 3 groups. Group A (immobilization group, n equal to 16) received postoperative cast immobilization; Group B (early motion group, n equal to 16) received early active motion treatments immediately following the repair of AT rupture from tenotomy. Another 15 rabbits served as control group (Group C). The AT samples were prepared 3 days following the microsurgery. The proteins were separated employing two-dimensional polyacrylamide gel electrophoresis (2D-PAGE). PDQuest software version 8.0 was used to identify differentially expressed proteins, followed by peptide mass fingerprint (PMF) and tandem mass spectrum analysis, using the National Center for Biotechnology Information (NCBI) protein database retrieval and then for bioinformatics analysis.

RESULTSA mean of 446.33, 436.33 and 462.67 protein spots on Achilles tendon samples of 13 rabbits in Group A, 14 rabbits in Group B and 13 rabbits in Group C were successfully detected in the 2D-PAGE. There were 40, 36 and 79 unique proteins in Groups A, B and C respectively. Some differentially expressed proteins were enzyme with the gel, matrix-assisted laser-desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). We successfully identified 9 and 11 different proteins in Groups A and B, such as GAPDH, phosphoglycerate kinase 1, pro-alpha-1 type 1 collagen, peroxiredoxin 1, alpha-1-antiproteinase E a-1 and MAD2L1 binding protein, etc. And some with the molecular chaperone, oxidative stress, energy metabolism, signal transduction, coupled with the tendon cell expression and protein synthesis, proliferate, differentiate and are closely related to the AT healing. The GAPDH protein was further validated through Western blotting. It was indicated that some differentially expressed proteins were involved in various metabolism pathways and may play an important role in initial healing of AT rupture.

CONCLUSIONDifferentially expressed proteins in rabbit healing AT model may contribute to 3 days healing of AT rupture through a new mechanobiological mechanism due to the application of postoperative early kinesitherapy.

Achilles Tendon ; injuries ; Animals ; Blotting, Western ; Computational Biology ; Electrophoresis, Gel, Two-Dimensional ; Exercise Therapy ; Glyceraldehyde-3-Phosphate Dehydrogenases ; analysis ; Male ; Proteins ; analysis ; Rabbits ; Rupture ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Tendon Injuries ; metabolism ; rehabilitation ; surgery ; Wound Healing ; physiology