OBJECTIVETo study the rotation of femoral component and tibial component with CT and evaluate the relationship between patellofemoral complications and rotational alignment of the components.

METHODSThirty patients with isolated patellofemoral complications after total knee arthroplasty were compared with 20 patients with well functioning total knee replacements free of patellofemoral complications. The epicondylar axis and tibial tubercle were used as references on CT scans to quantify the rotational alignment of the femoral and tibial components.

RESULTSPatients with patellofemoral complications had excessive combined (tibial plus femoral) internal component rotation, which was directly proportional to the severity of the patellofemoral complications. Mild combined internal rotation (1 degree-4 degrees) was correlated with patellar and lateral tracking tilting, moderate rotation (3 degrees-8 degrees) with patellar subluxation, and severe rotation (7 degrees-17 degrees) with early patellar dislocation or late patellar prosthesis failure. The control group had combined external rotation of 10 degrees-0 degree.

CONCLUSIONSThe direct correlation of combined internal component rotation to the severity of the patellofemoral complication suggests that internal component rotation may be the predominant cause of patellofemoral complications in patients with normal axis alignment. CT scans can be used intraoperatively and postoperatively to determine whether the rotational malalignment is present to require revision of one or both components.

Adult ; Aged ; Arthroplasty, Replacement, Knee ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee ; diagnostic imaging ; physiopathology ; surgery ; Postoperative Complications ; etiology ; physiopathology ; Prosthesis Failure ; Radiography ; Rotation

OBJECTIVETo study the changes of p38MAPK expressions, the frequency of apoptosis and the distribution of cell cycle of hunan Glioma U251 cells after HCMV infection.

METHODSThe expression of total p38 (both phosphorylated and nonphosphorylated p38) and phosphorylated p38 in U251 cells were detected by Western blotting at 15 min, 30 min, 1 h, 6 h, 10 h, 16 h, 24 h, 36 h and 48 h after HCMV infection. The apoptosis percentage and the cell cycle distribution of U251 cells at 2 d, 5 d and 7 d after HCMV infection were detected by flow cytometry (FCM).

RESULTSThe results of Western blotting demonstrated that a strong increase in phosphorylated p38 was detected from 6 h to 10 h after HCMV infection, with mean gray scales 186.33 +/- 7.51 (t = 5.37, P < 0.01) and 188.00 +/- 7.02 (t = 5.26, P < 0.01 for all) at 6 h and 10 h, respectively, and p38 phosphorylation decreased to the basic level at 16 h after HCMV infection. But the overall levels of p38 protein were not significantly altered during the course of infection. FCM analysis showed that HCMV could significantly increase the apoptotic rates of U251 cells compared with controls (t = 10.84, P < 0.01), and the apoptotic percentages of the cells reached to peak [(10.18 +/- 1.24)%] at 5 d after HCMV infection. The data of FCM showed that HCMV could decrease the number of U251 cells in G1 phase and arrest the cells in S and G2 phase. The numbers of G1 phase U251 cells were significantly lowered to (56.50 +/- 2.57)% (t = 26.45, P < 0.01), (62.33 +/- 2.64)% (t = 21.20, P < 0.01) and (67.45 +/- 4.44)% (t = 10.61, P < 0.01), respectively at 2 d, 5 d and 7 d after infection.

CONCLUSIONHCMV could activate p38MAPK pathway and trigger apoptosis and interfere cell cycle in U251 cells.

Apoptosis ; Blotting, Western ; Cell Cycle ; Cell Line, Tumor ; Cytomegalovirus ; isolation & purification ; Cytomegalovirus Infections ; metabolism ; physiopathology ; Flow Cytometry ; Glioma ; metabolism ; microbiology ; pathology ; Humans ; MAP Kinase Signaling System ; Phosphorylation ; p38 Mitogen-Activated Protein Kinases ; metabolism