Qubo Ni

To investigate the effectiveness of all-arthroscopic treatment for Pipkin type Ⅰ and Ⅱ femoral head fractures. A retrospective analysis was conducted on the clinical data of 13 patients with Pipkin type Ⅰ and Ⅱ femoral head fractures who underwent all-arthroscopic reduction and fixation between May 2015 and May 2024. The cohort included 10 males and 3 females, with an average age of 27.4 years (range, 14-40 years). The mechanisms of injury involved traffic accidents in 11 cases and falls from a height in 2 cases. According to the Pipkin classification, there were 7 type Ⅰ and 6 type Ⅱ fractures. Seven patients presented with concomitant posterior hip dislocation. The interval from injury to surgery ranged from 1 to 10 days, averaging 3.2 days. Fixation was achieved using bioabsorbable suture anchors in 7 cases, bioabsorbable screws in 4 cases, and Herbert screws in 2 cases. Key parameters including operation time, intraoperative blood loss, complications, and fracture healing time were recorded. At last follow-up, hip joint function was evaluated using the Harris hip score and the Thompson-Epstein evaluation criteria. The operation time ranged from 100 to 140 minutes, with an average of 119.5 minutes. The intraoperative blood loss ranged from 20 to 65 mL, with an average of 40.8 mL. No postoperative complication such as neurovascular injuries occurred, and all incisions healed by primary intention. All 13 patients were successfully followed up 9-24 months, with an average of 16 months. The fracture healing time ranged from 10 to 18 weeks, averaging 14.1 weeks. During the follow-up, no complication such as traumatic osteoarthritis, osteonecrosis of the femoral head, heterotopic ossification, or internal fixation failure was observed. At last follow-up, the Harris hip score ranged from 91 to 97, averaging 94.6. Based on the Thompson-Epstein criteria, the clinical outcomes were graded as excellent in 9 cases and good in 4 cases, with an excellent and good rate of 100%. For Pipkin type Ⅰ and Ⅱ femoral head fractures, all-arthroscopic fixation represents a safe and effective therapeutic strategy. The individualized selection of Herbert screws, bioabsorbable screws, or suture anchors based on the specific characteristics of the fracture fragments offers significant clinical advantages. This approach ensures minimal invasiveness, minimal disruption of the femoral head blood supply, and a low complication rate.

Objective This study aimed to identify osteoarthritis (OA) related genes based on microarray data in synovium with a more robust integrative analysis method. Methods Four series GSE55457, GSE12021, GSE55235, and GSE55584 (36 OA and 29 normal samples) were downloaded from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) of GSE55457, GSE12021, and GSE55235 were identified using the LIMMA package. Overlapping DEGs from the intersection of the three series were detected. Simultaneously, samples in the four series were pooled to identify DEGs with integrated analysis using the Sva package. Results In total, 74 overlapping DEGs and 242 DEGs by integrating four series were detected. Based on them, 70 common DEGs were used to construct a protein-protein interaction (PPI) network, involving 61 nodes and 206 edges. Also, three gene modules and five hub genes, named JUN, IL6, VEGFA, MYC, and EGR1, were identified. Conclusions Seventy DEGs were finally identified with a more robust integrative analysis method. JUN, IL6, VEGFA, MYC, and EGR1 were identified as hub genes in the development of OA. Key Points • 76 overlapping DEGs were detected from the intersection of DEGs in GSE55457, GSE12021, and GSE55235. • 242 DEGs were identified by integrating four series using Sva package. • 72 common DEGs were finally identified based on the overlapping DEGs and the integrated DEGs. • JUN, IL6, VEGFA, MYC, and EGR1 were identified as hub genes in the development of OA.