BACKGROUND:Clavicular hook plates have been used widely to treat acromioclavicular dislocations in recent years. However, it remains controversial whether coracoclavicular ligament should be repaired during the surgery.
OBJECTIVE:To study the clinical effect and MRI manifestations after treatment of type III and V acute acromioclavicular Rockwood dislocation with clavicular hook plate, and to discuss the necessity of repairing coracoclavicular ligament during the surgery.
METHODS:A total of 44 patients with type III and V acute acromioclavicular Rockwood dislocations were treated with clavicular hook plates without repair of coracoclavicular ligaments, and underwent plate removal operations later. At 24 months after the second surgery, X-rays were taken to measure the width of coracoclavicular joints in both normal and affected limbs, Constant-Murley scores were calculated in both sides, and MR images were used to observe the healing of coracoclavicular ligaments.
RESULTS AND CONCLUSION:39 patients (89%) were fol owed up for 36.9±3.1 months (range, 30 to 45 months). The mean duration for retaining clavicular hook plates was 12.9±3.1 months (range, 6 to 21 months). The mean width of coracoclavicular joints was 6.04±1.21 mm (range, 4.3 to 8.8 mm) in normal limb, while 5.09±1.18 mm (range, 3.4 to 7.8 mm) in affected side without significant difference (P>0.05). The mean Constant-Murley score was 98.9±1.2 (range, 96 to 100) in normal limb, while 96.7±3.4 (range, 90 to 100) in affected side without significant difference (P>0.05). MRI showed healing of the coracoclavicular ligaments and the presence of continuous scar tissue in 38 patients, excluding one patient with recurrence of acromioclavicular joint dislocation. The clinical effects after treatment of type III and V acute acromioclavicular Rockwood dislocation with clavicular hook plate are satisfactory, and it is unnecessary to repair coracoclavicular ligament during the surgery. MR images reveal scar healing of the coracoclavicular ligaments without operative repair.

Objective:To explore the effect of tumor necrosis factor-like weak inducer of apoptosis (TWEAK) on generating chemokines in rat articular chondrocytes cultured in vitro ,and to understand its role in the pathogenesis of OA .Methods :Rat articular chondrocytes were cultured in vitro .The cells of experimental group were induced by 250 ng/mL TWEAK ,while the cells of the control group were not .Levels of chemokines interleukin-8(IL-8) ,monocyte chemotactic protein 1(MCP-1) ,regu-lated upon activation normal T cell expressed and secreted factor (RANTES) ,macrophage inflammatory protein 2(MIP-2) in the nutrient solution of the two groups were detected at 24 ,48 and 72 h .Results:After the induction of TWEAK ,the levels of RANTES in the supernatant of rat articular chondrocytes at 24 ,48 and 72 h were all significantly higher than those in the con-trol groups ,respectively (all P<0 .05) ,and the contents of RANTES were positively correlated with the treatment time of TWEAK (P<0 .05) .The IL-8 and MCP-1 levels in the supernatant of rat articular chondrocytes at 48 and 72 h were signifi-cantly higher than those in the control groups (both P< 0 .05) ,but they had no correlations with the treatment time of TWEAK (P>0 .05) .The MIP-2 levels of the rat articular chondrocytes supernatant at 48 and 72 h were significantly lower than those in the control groups (P<0 .05) ,and the contents of MIP2 were positively correlated with the treatment time of TWEAK (P<0 .05) .Conclusions :TWEAK can induce rat chondrocytes in vitro to generate chemokines (IL-8 ,MCP-1 ,RAN-T ES ) ,so that it is involved in the occurance of OA .