Wei Li

Background: Arthroscopic resection of calcific lesions is an effective treatment for calcific tendonitis. However, accurately locating the calcific foci can be challenging. In this study, we propose the use of preoperative 3D-CT scan technology combined with intraoperative patient position and markings to precisely locate intraoperative lesions. The aim is to reduce exploration time and operative time.Methods: We retrospectively analyzed 51 cases of calcific tendonitis from inpatients at our department from June 2016 to January 2024. The patients were divided into a localization group (n = 26) and a non-localization group (n = 25) based on whether preoperative 3D-CT scan and intraoperative patient markings were used for lesion localization. In the localization group, the calcific lesions were located on the skin surface using the improved preoperative 3D-CT scan and intraoperative patient markings technique. In the non-localized group, a conventional surgical approach was performed. The intraoperative exploration time and operation time were compared between the two groups. ASES scores, VAS scores, and shoulder mobility were recorded before the operation, after the operation, and at the one-month postoperative follow-up.Results: The localization group had significantly shorter intraoperative exploration time and operation time compared to the non-localization group (p < 0.01). There were no significant differences in ASES scores, VAS scores, and shoulder mobility between the two groups (p > 0.05).Conclusion: The improved preoperative 3D-CT scan and intraoperative patient markings technique is a simple and effective method for localizing calcific tendonitis lesions before arthroscopic exploration. This technique can reduce exploration time and shorten operative time.Level of evidence: Level III; Cohort Study; Retrospective Study.

Osteoarthritis (OA), known as one of the most common types of aseptic inflammation of the musculoskeletal system, is characterized by chronic pain and whole-joint lesions. With cellular and molecular changes including senescence, inflammatory alterations, and subsequent cartilage defects, OA eventually leads to a series of adverse outcomes such as pain and disability. CRISPR-Cas-related technology has been proposed and explored as a gene therapy, offering potential gene-editing tools that are in the spotlight. Considering the genetic and multigene regulatory mechanisms of OA, we systematically review current studies on CRISPR-Cas technology for improving OA in terms of senescence, inflammation, and cartilage damage and summarize various strategies for delivering CRISPR products, hoping to provide a new perspective for the treatment of OA by taking advantage of CRISPR technology.

Purpose: This study aims to explore the emerging trends, dynamic development, and research hotspots of clustered regularly interspaced short palindromic repeats (CRISPR) technology associated with extracellular vesicles during the past 7 years and demonstrate them by visualization. Methods: A total of 219 records related to CRISPR technology associated with extracellular vesicles from 2015 to 2022 in the Web of Science Core Collection (WoSCC) database were collected. R language, VOSviewer, CiteSpace, and GraphpadPrism software packages were used to analyze the history of this research, the general characteristics of the literature, and keywords. Finally, the hotspots and latest trends in CRISPR technology associated with extracellular vesicles are predicted. Results: A total of 219 articles were collected for this study. The production of publications about CRISPR technology associated with extracellular vesicles has increased annually. Researchers from China, the USA, and Germany made the most important contributions to this trend, while RLUK Research Libraries UK offers the largest amount of literature in this field. Shenzhen University, Nanjing Medicine University, and Peking University exhibited the closest cooperation. Additionally, active topics burst during different periods, as identified according to 317 keywords belonging to 39 disciplines. Keywords were clustered into seven research subareas, namely exosome, nanovesicles, DNA, gene editing, gene therapy, cancer therapy, and endometrial stromal cells. The alluvial map of keywords reveals that the most enduring concepts are gene therapy, nanovesicles, etc., while the emerging keywords are genome, protein delivery, plasma, etc. Conclusions: We reviewed 219 previous publications and conducted the first bibliometric study of CRISPR technology related to extracellular vesicles from 2015 to 2022. This comprehensive summary constructed a knowledge map and demonstrates the trends in this area. The current trends and potential hotpots for this topic are also identified, which will be a great help for researchers in the future.

Osteoarthritis refers to a degenerative disease with joint pain as the main symptom, and it is caused by various factors, including fibrosis, chapping, ulcers, and loss of articular cartilage. Traditional treatments can only delay the progression of osteoarthritis, and patients may need joint replacement eventually. As a class of organic compound molecules weighing less than 1000 daltons, small molecule inhibitors can target proteins as the main components of most drugs clinically. Small molecule inhibitors for osteoarthritis are under constant research. In this regard, by reviewing relevant manuscripts, small molecule inhibitors targeting MMPs, ADAMTS, IL-1, TNF, WNT, NF-κB, and other proteins were reviewed. We summarized these small molecule inhibitors with different targets and discussed disease-modifying osteoarthritis drugs based on them. These small molecule inhibitors have good inhibitory effects on osteoarthritis, and this review will provide a reference for the treatment of osteoarthritis.

Background: All-inside anterior cruciate ligament reconstruction (ACLR) is a novel technique that has gained attention due to its minimally invasive and graft-saving properties. However, studies comparing MRI-based graft maturity between all-inside and standard ACLR are lacking. Purpose: This study focused on the functional, knee laxity, and MRI-based graft maturity characteristics of all-inside and standard single-bundle ACLR. Study Design: Randomized controlled trial (RCT). Methods: Fifty-four patients were randomly assigned to an all-inside reconstruction group (n = 27) or standard reconstruction group (n = 27). Using the same rehabilitation strategy. The Tegner, International Knee Documentation Committee, and Lysholm scores were recorded at postoperative months 3, 6, and 12 to assess functional recovery. MRI was conducted to measure the signal/noise quotient (SNQ) of the intra-articular graft to assess the maturity. A higher SNQ indicates lower graft maturity. Knee laxity was assessed using GNRB arthrometer at the postoperative month 12. Results: The graft SNQ of the all-inside group was significantly higher than that of the standard group at postoperative month 6 (p < 0.05). There was no statistical difference in graft SNQ between the two groups at postoperative months 3 and 12 (p > 0.05). Both groups exhibited the highest SNQ in the middle region of the graft, followed by the proximal region, and the distal region. Functional scores improved significantly for both groups and had no statistical difference (p > 0.05). The knee laxity was higher in the all-inside group (p < 0.05) at postoperative month 12. There was no correlation between the functional scores and graft maturity in both groups (p > 0.05). Conclusions: All-inside and standard single-bundle ACLR show good functional outcomes; however, knee laxity was relatively higher in the all-inside ACLR group than in the standard ACLR group. Moreover, both techniques exhibited poor maturity in the middle graft region and the best in the distal region. Graft maturity with all-inside ACLR is inferior to that with standard ACLR in the early postoperative stages. There is no correlation between knee function and graft maturity. Trial registration: Clinical trial registration numbers: ChiCTR1800018543. Date of registration: 09/23/2018.

Background: Individualized rehabilitation based on graft maturity is necessary to optimize patient function and prevent graft re-injury. But there is a lack of studies on graft maturity in the all-inside single-bundle anterior cruciate ligament reconstruction.Hypothesis/Purpose: Compared to the difference in graft maturity, functional scores, and stability between all-inside and anatomical single-bundle anterior cruciate ligament reconstruction, it was assumed that the stability of all-inside reconstruction is relatively insufficient, and its graft maturity is worse than the anatomical reconstruction.Study Design: Randomized controlled clinical trial.Methods: Fifty-four patients were recruited in this study and randomly assigned to the all-inside reconstruction group (n = 27) and the anatomical reconstruction group (n = 27) using the same rehabilitation strategy. The Tegner, International Knee Documentation Committee, and Lysholm score were recorded at postoperative 3^rd, 6^th, and 12^th month to assess functional recovery. Magnetic resonance imaging was conducted to measure the Signal/Noise quotient (SNQ) of the intra-articular graft to observe the maturity. Stability was assessed using GNRB relaxation measuring instrument at the postoperative 12^th month.Results: The graft SNQ of the all-inside group was significantly higher than that in the anatomical group during the postoperative 6^th month (p < 0.05). There was no statistical difference in graft SNQ between the two groups at postoperative 3^rd and 12^th month (p > 0.05). Both groups exhibited the graft’s highest SNQ in the middle region, followed by the proximal region, and the lowest was the distal region. Functional scores improved significantly in both groups and had no statistical difference (p > 0.05). The stability recovered well in both groups during the postoperative 12^th month, but the GNRB relaxation was higher in the all-inside group (p < 0.05). There was no correlation between functional scores and graft maturity in the two groups (p > 0.05).Conclusions: All-inside reconstruction graft maturity is inferior to the anatomical reconstruction during postoperative 6^th month, which may cause relatively insufficient stability of all-inside reconstruction compared with anatomical reconstruction under the same rehabilitation strategy. A more conservative rehabilitation strategy for all-inside reconstruction around the postoperative 6^th month may achieve better stability.