INTRODUCTIONVascular endothelial growth factor (VEGF) is expressed in osteoarthritic articular cartilage. However, the pattern of VEGF expression throughout the whole life cycle of articular cartilage is not well elucidated. The aim of the study was to investigate the spatiotemporal expression of VEGF and its receptors, vascular endothelial growth factor receptor-1 (VEGFR1) and vascular endothelial growth factor receptor-2 (VEGFR2), in articular cartilage during growth, maturation and degeneration, using the guinea pig model of spontaneous osteoarthritis.

MATERIALS AND METHODSSections of tibial plateaus aged 2, 6 and 12 months were obtained, representing growing, mature and osteoarthritic cartilage respectively. Expression of VEGF and its receptors was determined by immunohistochemistry and in situ hybridisation.

RESULTSAt 2 months, VEGF and its receptors were expressed in chondrocytes within the superficial layer of the articular cartilage. At 6 months, no expression of VEGF and its receptors was noted. In the 12-month-old specimens, VEGF and its receptors were expressed in chondrocytes within articular cartilage that exhibited osteoarthritic changes (medial tibial plateaus), but not in the histologically normal lateral plateaus.

CONCLUSIONThis spatiotemporal distribution of VEGF and its receptors suggests that VEGF is expressed during articular cartilage growth, becomes quiescent at maturity, and is re-expressed in osteoarthritis.

Aging ; metabolism ; Animals ; Cartilage, Articular ; growth & development ; metabolism ; Chondrocytes ; metabolism ; Guinea Pigs ; Immunohistochemistry ; In Situ Hybridization ; Knee Joint ; metabolism ; Male ; Osteoarthritis, Knee ; metabolism ; Tibia ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism ; Vascular Endothelial Growth Factor Receptor-1 ; metabolism ; Vascular Endothelial Growth Factor Receptor-2 ; metabolism

Acute Disease ; Arthroplasty, Replacement, Knee ; adverse effects ; Diagnosis, Differential ; Humans ; Knee Joint ; pathology ; surgery ; Male ; Middle Aged ; Pyoderma Gangrenosum ; diagnosis ; Skin ; pathology ; Surgical Wound Infection ; diagnosis

INTRODUCTIONTraumatic displaced femoral neck fractures in the elderly can be treated with cemented or uncemented hemiarthroplasty with good outcomes. Earlier studies reported a higher incidence of deep vein thrombosis (DVT) associated with cemented prostheses in elective total hip or knee arthroplasty. In addition, the hypercoagulable state after a traumatic femoral neck fracture and possible thrombogenic properties of bone cement could put these patients at greater risk for thromboembolism. We aimed to compare the incidence of DVT and progression to pulmonary embolism (PE) or mortality in cemented and uncemented hemiarthroplasty.

METHODSThe data of 271 patients treated with cemented or uncemented hemiarthroplasty after a traumatic displaced femoral neck fracture was retrospectively analysed for the incidence of DVT. The level of thrombosis, progression to PE and mortality were compared.

RESULTSThere were 133 (49.1%) patients with cemented hemiarthroplasty, while 138 (50.9%) had uncemented hemiarthroplasty. The patients had an average age of 76.6 (range 53-99) years and 11 (4.1%) patients had DVT. There were no significant differences in development of DVT, level of thrombosis, PE and mortality regardless of whether a cemented or an uncemented prosthesis was used.

CONCLUSIONCemented hemiarthroplasty is not associated with higher risks of DVT, PE or mortality in patients with traumatic displaced femoral neck fracture. Cemented prostheses can be safely used for this group of patients.

Aged ; Aged, 80 and over ; Bone Cements ; Female ; Femoral Neck Fractures ; complications ; surgery ; Hemiarthroplasty ; adverse effects ; Humans ; Incidence ; Male ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Risk Management ; Singapore ; epidemiology ; Venous Thrombosis ; epidemiology ; etiology

INTRODUCTIONTotal knee arthroplasty (TKA) is an effective method for alleviating pain and restoring knee function in patients with severe osteoarthritis. However, despite the improvements in surgical technique and postoperative care, it has been reported that up to 19% of patients are dissatisfied after their operations. The aim of this study was to evaluate patient satisfaction levels after TKA in an Asian cohort, as well as assess the correlation between patient satisfaction levels and the results of traditional physician-based scoring systems.

METHODSThe medical data of 103 Asian patients who underwent 110 TKAs between December 2008 and June 2009 were obtained from our hospital's Joint Replacement Registry. The minimum follow-up period was one year and patient expectations were assessed before TKA. Patient satisfaction was assessed postoperatively using a 5-point Likert scale. Reasons for patient dissatisfaction were recorded. Standardised instruments (e.g. the Knee Society Score, the Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] and the generic Short Form-36 health survey) were used to assess the patient's functional status and the severity of symptoms pre- and postoperatively.

RESULTSAmong the 110 TKAs performed, 92.8% resulted in patient satisfaction. Patient satisfaction correlated with postoperative WOMAC function scores (p = 0.028), postoperative WOMAC final scores (p = 0.040) and expectations being met (p = 0.033).

CONCLUSIONAlthough there was a high level of patient satisfaction following TKA in our cohort of Asian patients, a significant minority was dissatisfied. Patient satisfaction is an important outcome measure and should be assessed in addition to traditional outcome scores.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee ; psychology ; Asian Continental Ancestry Group ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; surgery ; Male ; Middle Aged ; Osteoarthritis, Knee ; psychology ; surgery ; Patient Satisfaction ; Postoperative Period ; Quality of Life ; Range of Motion, Articular ; Registries ; Surveys and Questionnaires