BACKGROUND:Studies have reported that the bone bridge and bone plug for meniscal alograft transplantation show better outcomes than simple soft tissue suture, but there are rare studies concerning the comparison of their fixation effects. OBJECTIVE:To compare the clinical effects of bone bridge and bone plug in meniscal alograft transplantation. METHODS:Eighteen patients undergoing arthroscopy-assisted meniscal alograft transplantation were enroled, including nine cases of bone plug fixation and nine cases of bone bridge fixation. Symptoms, physical examination, visual analog scale, Lysholm and Tegner scores were used to evaluate the clinic outcome. Every 6 months post operation, the signal and morphological changes of alograft meniscus was observed with MRI for each patient. RESULTS AND CONCLUSION:Al of the 18 patients were folowed up for 12-36 months after transplantation. No complications, absence of knee pain and effusion, and disappearance of the discomfort within the meniscectomy compartments after prolonged activity during folow-up period were found in al patients. The patients were competent of daily life and sports activity. The visual analog scale, Lysholm and Tegner scores were significantly increased after transplantation. MRI showed that the vicariousness and livability of the alograft menisci appeared within 1 year post operation. The safety and feasibility of the arthroscopy-assisted meniscal alograft transplantation were approved. Knee pain, knee effusion and joint stability and function were improved after arthroscopic-assisted alograft meniscus transplantation, and there was no difference between the clinical curative effects of the two kinds of fixed methods.

BACKGROUND: Preliminary study has prepared three-dimensional printing β-tricalcium phosphate scaffold loaded with icariin. OBJECTIVE: To investigate the role of three-dimensional printing β-tricalcium phosphate scaffold loaded with icariin in the repair of rabbit models of osteonecrosis of the femoral head. METHODS: New Zealand white rabbits (provided by Qinglongshan Laboratory Animal Center of Nanjing) were selected to establish the steroid-induced osteonecrosis of the femoral head. The 27 model rabbits underwent core decompression and debridement, were randomly divided into three groups, and then implanted with autologous bone, β-tricalcium phosphate scaffold, three-dimensional printing β-tricalcium phosphate scaffold loaded with icariin (composite scaffold group) , respectively. The micro-CT scanning and pathological observation were performed at 4, 8, and 12 weeks after implantation. RESULTS AND CONCLUSION: (1) Micro-CT showed that at 4 weeks after implantation, trabecular bone was observed around and in implants in each group. In the autologous bone group, there were a large number of trabecular bones in the grafting area at 8 weeks, and the trabecular bone structure was dense at 12 weeks after implantation. In the tricalcium phosphate and composite scaffold groups, the scaffolds were well integrated with the bone interface. At 4 weeks after implantation, there was a certain amount of trabecular bone surrounding the scaffold, and trabecular grew into the scaffold until 8 weeks in the composite scaffold group. At 4 weeks after implantation, few thin trabecular bone was visible, and extensive trabecular bone formation was observed around the scaffold at 8 weeks in the tricalcium phosphate group. (2) Hematoxylin-eosin staining results showed that there were many mature osteoblasts, and few cartilage matrix, newly born bones integrated well to the implants at 12 weeks in the autologous bone and tricalcium phosphate groups. In the composite scaffold group, there were many cartilage matrixes, and newly born bones integrated poorly to the implants. (3) Masson staining showed that at 12 weeks after implantation, the osteogenic capacity in the composite scaffold group was lower than that in the autologous bone group (P < 0.05) , but higher than that in the tricalcium phosphate group (P < 0.05) . (4) TRAP staining results at 12 weeks after implantation revealed that the amount of osteoclast in composite scaffold group was less than that in the tricalcium phosphate group (P < 0.05) , and was not significantly different from the autologous bone group (P> 0.05) . (5) Immunohistochemical staining at 12 weeks after implantation revealed that the positive rate of vascular endothelial growth factor in the composite scaffold group was higher than that in the tricalcium phosphate group (P < 0.05) , and lower than that in the autologous bone group (P < 0.05) . (6) In summary, three-dimensional printing β-tricalcium phosphate scaffold loaded with icariin implanted into the rabbit model of osteonecrosis of the femoral head can promote the proliferation and differentiation of osteoblasts, inhibit the viability of osteoclasts, promote the angiogenesis, and contribute to the repair of osteonecrosis of the femoral head in rabbits.