Joint Deformity Research Articles

Global trends and research status in ankylosing spondylitis clinical trials: a bibliometric analysis of the last 20 years.

Ankylosing spondylitis (AS) is a rheumatic and autoimmune disease associated with a chronic inflammatory response, mainly characterized by pain, stiffness, or limited mobility of the spine and sacroiliac joints. Severe symptoms can lead to joint deformity, destruction, and even lifelong disability, causing a serious burden on families and society as a whole. A large number of clinical studies have been published on AS over the past 20 years. This study aimed to summarize the current research status and global trends relating to AS clinical trials through a bibliometric analysis. The Web of Science Core Collection database was searched for publications related to AS clinical trials published between January 2003 and June 2023. Bibliometric analysis and web visualization were performed using CiteSpace, VOSviewer, and a bibliometric online analysis platform (https://bibliometric.com), which included the number of publications, citations, countries, institutions, journals, authors, references, and keywords. 1,212 articles published in 201 journals from 65 countries were included in this study. The number of publications related to AS clinical trials is increasing annually. The United States and the Free University of Berlin, the countries and institutions, respectively, that have published the most articles on AS, have made outstanding contributions to this field. The author with the most published papers and co-citations over the period covered by the study was Desiree Van Der Heijde. The journal with the most published and cited articles was Annals of the Rheumatic Diseases. The keywords: "double-blind," "rheumatoid arthritis," "efficacy," "placebo-controlled trial," "infliximab," "etanercept," "psoriatic arthritis" and "therapy" represent the current research hotspots regarding AS. This is the first study to perform a bibliometric analysis and visualization of AS clinical trial publications, providing a reliable research focus and direction for clinicians. Future studies in the field of AS clinical trials should focus on placebo-controlled trials of targeted therapeutic drugs.

Bleeder's Femur: The Proximal Femoral Morphology in Hemophilic Patients Who Underwent Total Hip Arthroplasty.

Patients with hemophilia (PWH) constantly suffer hemarthrosis, which leads to deformity of the hip joint. Therefore, PWH who are going to receive total hip arthroplasty (THA) should be exclusively treated before the surgery with careful measurement of their proximal femur. Hence, we conducted a retrospective study to explore the anatomical parameters of and differences in the proximal femur in hemophilic patients who underwent THA. The retrospective study comprised data of adult patients who received total hip arthroplasty from 2020 to 2022 in the research center. Patients having a diagnosis of hemophilic arthritis and received THA were included in experimental group, and patients with hip arthritis or femoral head necrosis were taken as control group. Parameters including femoral offset, neck-shaft angle (NSA), medullary cavity of 20 mm above mid-lesser trochanter level (T+20), mid-lesser trochanter level (T), and 20 mm blow it (T-20), and canal flare index (CFI), femoral cortical index (FCI) were measured on X-ray and CT images with PACS by two independent doctors. Data was analyzed by SPSS 20. Kolmogorov-Smirnov test was used to test data normality. Student's t-test was performed between PWH and control group. p < 0.05 was considered statistically significant. Among the 94 hips, 39 (41.5%) were included in group hemophilia and 55(58.5%) in control group. The mean age of the patients was 49.36 ± 12.92 years. All cases were male patients. Data demonstrated significantly smaller femoral cortical index (FCI), femoral offset, medullary cavity of 20 mm above mid-lesser trochanter level, mid-lesser trochanter level, and 20 mm below it, and neck-shaft angle (NSA) was obviously larger in PWH than control group (p < 0.05). No significant difference was found in canal flare index (CFI). Hemophilic patients undergoing THA were prone to longer and thinner proximal femur. Preoperative morphological analysis of femur is recommended.

NON-LINEAR APPLICATIONS OF STATISTICAL SHAPE ANALYSIS IN ORTHOPAEDIC RESEARCH

Non-linear methods in statistical shape analysis have become increasingly important in orthopedic research as they allow for more accurate and robust analysis of complex shape data such as articulated joints, bony defects and cartilage loss. These methods involve the use of non-linear transformations to describe shapes, rather than the traditional linear approaches, and have been shown to improve the precision and sensitivity of shape analysis in a variety of applications. In orthopedic research, non-linear methods have been used to study a range of topics, including the analysis of bone shape and structure in relation to osteoarthritis, the assessment of joint deformities and their impact on joint function, and the prediction of patient outcomes following surgical interventions. Overall, the use of non-linear methods in statistical shape analysis has the potential to advance our understanding of the relationship between shape and function in the musculoskeletal system and improve the diagnosis and treatment of orthopedic conditions.

16S rRNA Gene Sequencing of Gut Microbiota in Rheumatoid Arthritis Treated with 99Tc-MDP.

Rheumatoid arthritis (RA) is a common autoimmune disease with the main symptoms being joint swelling and pain. In severe cases, joint deformity or even complete loss of function occurs. Technetium methylene diphosphonate (99Tc-MDP) is widely used for RA treatment in China, but there are no studies on the effects of 99Tc-MDP on intestinal flora. To explore the effects of 99Tc-MDP treatment on the composition and function of the intestinal flora and to provide new information on the mechanism of 99Tc-MDP in RA treatment. Stool samples from RA patients before and after 99Tc-MDP treatment were collected to form two groups (Before and After). Total genomic DNA of the samples was extracted for 16S rRNA gene sequencing. The altered composition of the intestinal flora, the key target bacteria regulated by 99Tc-MDP, and the pathways of action of 99 Tc-MDP were analyzed by bioinformatics. A total of 64 fresh stool samples were collected from 32 RA patients. Compared to the Before group, the After group showed increased Bacteroidetes abundance and decreased Firmicutes abundance. At the genus level, Prevotella increased whereas Escherichia decreased. Both α and β diversity analyses showed that 99Tc-MDP treatment did not affect gut microbial diversity in RA patients. LEfSe analyses and random forest analyses showed Bacteroidetes, Prevotella, Enterococcus, Escherichia and Ruminococcaceae were the main 99Tc-MDP regulating bacteria. Functional enrichment analysis revealed that the functional differences in gut flora of the two groups centered on Metabolism and Genetic Information Processing. This study revealed differences in the composition of the gut microbiota in RA patients before and after 99Tc-MDP treatment. The therapeutic effect of 99Tc MDP is mainly achieved through Bacteroidetes, Prevotella, and Enterococcus. Regulating metabolism and genetic information processing of gut flora may be the mechanism of 99Tc-MDP in treating RA.

Exploring the therapeutic potential of "Tianyu" medicine pair in rheumatoid arthritis: an integrated study combining LC-MS/MS, bioinformatics, network pharmacology, and experimental validation.

Rheumatoid arthritis (RA) is a widespread chronic autoimmune disease that primarily causes joint inflammation and damage. In advanced stages, RA can result in joint deformities and loss of function, severely impacting patients' quality of life. The "Tianyu" pair (TYP) is a traditional Chinese medicine formulation developed from clinical experience and has shown some effectiveness in treating RA. However, its role in the complex biological mechanisms underlying RA remains unclear and warrants further investigation. We obtained gene sequencing data of synovial tissues from both RA patients and healthy individuals using two gene microarrays, GSE77298 and GSE55235, from the GEO database. Through an integrated approach involving bioinformatics, machine learning, and network pharmacology, we identified the core molecular targets of the "Tianyu" medicine pair (TYP) for RA treatment. Liquid chromatography-mass spectrometry was then employed to analyze the chemical components of TYP. To validate our findings, we conducted animal experiments with Wistar rats, comparing histopathological and key gene expression changes before and after TYP treatment. Our data analysis suggests that the onset of RA may be associated with inflammation-related immune cells involved in both adaptive and innate immune responses. Potential key targets for TYP treatment in RA include AKR1B10, MMP13, FABP4, NCF1, SPP1, COL1A1, and RASGRP1. Among the components of TYP, Kaempferol, Quercetin, and Salidroside were identified as key, with MMP13 and NCF1 showing the strongest binding affinity to these compounds. Animal experiments confirmed the findings from bioinformatics and network pharmacology, validating the key targets and therapeutic effects of TYP in treating RA. Our study reveals that TYP has potential clinical value in the treatment of rheumatoid arthritis. This research enhances our understanding of RA's pathogenesis and provides insight into potential therapeutic mechanisms.

Differential Diagnosis of Trigger Thumb in Children

Trigger thumb is the most common hand deformity in young children. The differential diagnoses of trigger thumb are thumb-in-palm deformity, hyperextension deformity of the metacarpophalangeal joint, thumb hypoplasia and congenital stiffness of the interphalangeal joint. The knowledge of the typical clinical signs of these different diseases enables the surgeon to make the correct diagnosis, leading to the right treatment.

Mechanism of grain refinement in FSW joints of 6063-T6 aluminum alloy under different rotational speeds

Abstract The inherent properties of aluminum alloys often result in defects like deformation and porosity in joints and welds created through conventional fusion welding. Our paper investigates the impact of varying rotational speeds in the friction stir welding of 4mm thick 6063-T6 aluminum alloy, focusing on microscopic grain refinement and mechanical property alterations in T-joints. Using mechanical stretching and numerical simulation methods, we observed that the initial weld joint is robust, with minimal flying edges and a distinct fish-scale pattern on the surface. Moreover, the grain sizes in the weld’s core area are notably smaller than those in the region affected by the upper axial shoulder. The mechanical properties of the joint experienced a first increase and then a decrease in mechanical properties when the friction stir welding rotational speed, was increased from 600r/min to 1500r/min. Moreover, in 1000r/min rotational speed, the material welded tensile strength and yield strength of the best tensile strength compared to the raw material to enhance the 21MPa, yield strength of 30MPa, elongation close to the raw material of 89.86%.

Toward Swimming Speed Optimization of a Multi-Flexible Robotic Fish With Low Cost of Transport

Due to the complex mechanism and fabrication process of flexible materials, it remains extremely challenging for a flexible robotic fish to achieve fast and efficient locomotion. In this article, taking advantage of the passive bending and energy storage properties of flexible materials, we propose an untethered robotic fish with multiple flexible joints to achieve high performance and low Cost of Transport (COT). First, combining rigid links and flexible materials, a compact flexible tail with a simple and efficient structure is proposed. Next, the pseudo-rigid body theory is applied to analyze the deformation of passive joints, and a full-state dynamic model is established. More importantly, an optimization method by adjusting the phase differences of the passive joints is used to obtain high aquatic performance. Finally, extensive simulations and experiments validate the effectiveness of the proposed method, and the robotic fish can achieve a maximum speed of 1.63 body length (BL) per second and a minimum COT of 4.8 J/m (2.87 J/m <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$\cdot$</tex-math> </inline-formula> kg). Compared with the multi-joint robotic fish with a similar design, the COT is reduced by up to 81.05% with the basically same aquatic ability. Excitingly, the flexible robotic fish can achieve a COT of 7.36 J/m at 1.23 BL/s, which is 15.72%-36.34% lower than that of the bluefin tuna and is within the range of yellowfin tuna, offering valuable insight into high speed and long endurance applications for underwater robots. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Note to Practitioners</i> –This paper is motivated by the design and optimization of an efficient bionic flexible underwater robot with high aquatic abilities, which is conducive to aquatic tasks that require long-time and long-distance sailing, such as underwater topographic exploration, submarine archaeology, and underwater search and rescue. Existing studies of free-swimming bionic underwater robots usually focus on the improvement of swimming speed and rarely consider achieving both high swimming performance and low energy cost. Thus, this paper proposes a bionic underwater robot design with two joints made of flexible materials on the tail to address the problem. Based on detailed analyses of the hydrodynamic force and flexible joint deformation, we propose an effective optimization method for swimming performance. A series of simulations and experiments suggest that the mechatronic design and optimization method are practical and valid. Hopefully, our design and method can provide theoretical guidance for engineers to design and optimize robots with flexible joints.

Victim of Neglect: Juvenile Spondyloarthropathy (Juvenile-onset Ankylosing Spondylitis)

Spondyloarthropathy refers to a group of overlapping disorders that include spondylitis, sacroiliitis, asymmetrical peripheral arthritis, and enthesitis. If the onset is before 16 years of age, the condition is known as juvenile-onset spondyloarthropathy. We report a case of a 20-year-old male, who presented with history of pain in the left hip joint for 5 years, and pain in the right hip joint for the last 4 months. Flexion deformity of the left hip joint was noted at presentation. He was advised hip replacement at another center. A much delayed rheumatological evaluation revealed bilateral sacroiliitis, eye features of old iritis, and human leukocyte antigen B27 positivity. A positive family history was also present. He was diagnosed as a case of juvenile-onset ankylosing spondylitis and started on appropriate treatment. Timely recognition and management of juvenile spondyloarthropathy go a long way in preserving joints and quality of life.

Hemangiossarcoma cutâneo em equino - relato de caso

ABSTRACT Hemangiosarcoma is a rare neoplasia in horses, with a reported prevalence of 0% to 0.7% and literature reports are few. Here we report a case of cutaneous hemangiosarcoma on the palmaromedial aspect of the metacarpophalangeal joint of the right thoracic limb of a 28-year old mixed breed mare. Macroscopically, the lesion was ulcerated and hemorrhagic, with significant involvement of the surrounding tissues resulting in acquired flexural deformity of the metacarpophalangeal joint and grade 4/5 lameness (AAEP). The diagnosis was confirmed histologically. Surgical ablation was not possible and, in view of the involvement of surrounding tissues and the age of the patient, the lesion was treated conservatively.

The circUbqln1, regulated by XBP1s, interplays with 14–3–3ζ to inhibit collagen synthesis and promote osteoarthritis by controlling PRODH activity and proline metabolism

IntroductionOsteoarthritis (OA) is a degenerative bone disease associated with ageing, characterized by joint pain, stiffness, swelling and deformation. Currently, pharmaceutical options for the clinical treatment of OA are very limited. Circular RNAs(cirRNAs) have garnered significant attention in OA and related drug development due to their unique RNA sequence characteristics.Therefore,exploring the role of cirRNAs in the occurrence and development of OA is of paramount importance for the development of effective medications for OA. ObjectivesTo identify a novel circRNA, circUbqln1, for treating osteoarthritis and elucidate its pathophysiological role and mechanisms in the treatment of OA. MethodsThe circUbqln1 expression and distribution were determined by qRT-PCR and FISH. XBP1 gene knockout(XBP1 cKO) spontaneous OA and DMM model and WT mouse CIOA model were used to explore the role of XBP1 and circUbqln1 in OA.Overexpression or knockdown of circUbqln1 lentivirus was used to observe the impacts of circUbqln1 on primary chondrocytes,C28/I2 and mice in vitro and in vivo.Chromatin immunoprecipitation,luciferase reporter assay,RNA pulldown,mass spectrometry,RNA immunoprecipitation,fluorescence in situ hybridization,and flow cytometry to explore the molecular mechanisms of circUbqln1. ResultsIt was found that cartilage-specific XBP1 cKO mice exhibited a faster OA progression compared to normal’s.Importantly,transcript factor XBP1s has the capacity to impede the biogenesis of circUbqln1,derived from Ubqln1. The circUbqln1 promotes cartilage catabolism and inhibits anabolism, therefore accelerates the occurrence of OA.Mechanismly,circUbqln1 can translocate to the chondrocyte nucleus with the assistance of phosphorylated 14–3–3ζ, upregulate the transcriptional activity of the proline dehydrogenase(Prodh) promoter and PRODH enzyme activity. Consequently, this leads to the promotion of proline degradation and the inhibition of collagen synthesis,ultimately culminating in the impairment of cartilage and its structural integrity. ConclusionCircUbqln1 plays a crucial role in the occurrence and development of OA, indicating that the inhibition of circUbqln1 holds promise as a significant approach for treating OA in the future.

Cytological diagnosis of gouty tophi over the elbow as an initial manifestation in an asymptomatic patient

Abstract Fine needle aspiration (FNA) cytology (FNAC) is becoming the preferred diagnostic method over biopsy to diagnose periarticular nodules. A 56-year-old male patient presented with a solitary soft-tissue nodule surrounding the right elbow. There was no associated joint pain, swelling, deformity, or history of trauma in the past. Soft-tissue neoplasm was taken into consideration clinically. The chalky white aspirate was obtained by FNA, and needle-shaped crystals seen in amorphous granular debris were visible on smears, under the light microscope with condenser down. The needle-shaped crystals are the characteristic feature of monosodium urate crystals A gouty tophi diagnosis was made on cytology. Following that, further investigations were performed including serum uric acid level and X-ray, which were normal. Pathologists should be knowledgeable about the cytological characteristics of gouty tophi as FNAC is a useful diagnostic tool for the diagnosis of periarticular nodules, particularly in cases of unusual presentation.

Dysplasia Epiphysealis Hemimelica (Trevor’s Disease) of Talus Treated with Excision, Periosteal Flap, and Open Wedge Osteotomy: A Case Report and Review of Literature

Abstract Dysplasia epiphysealis hemimelica (DEH), also known as Trevor’s disease, is a rare disease which is skeletal developmental disorder characterized by asymmetrical growth of epiphyseal cartilage. It most frequently affects the ankle joint. Surgical treatment with complete resection is recommended before irreversible joint damage and deformity occurs. Multiple surgeries may be required if resected at an early age because recurrences are common until skeletal maturity. We present a case of DEH at the anteromedial aspect of a left ankle joint and a review of the literature.

The etiology, pathogenesis, treatment, and development of transdermal drug delivery systems for rheumatoid arthritis

Rheumatoid arthritis (RA) is a long-term autoimmune disease, that causes irreversible deformity of joints and disability of body parts. The symptoms include inflammation of synovial tissue and damage to the...

Determination of driving migration force of interparticle splice surface of powder steels

Interparticle splice process during the formation of hot-deformed powder steels is studied, the driving forces of migration are determinated. The effect of the degree and temperature of deformation on the dislocation density in powder steels is considered. The intensity of development of the splicing and the contact surface is evaluated and the need for joint deformation of the near-contact volumes of material is identified. A significant contribution is made to the theory of powder materials science and the practice of producing hot-deformed powder materials.

Designing a Distributed Sensing Network for Structural Health Monitoring of Concrete Tunnels: A Case Study

Structural health monitoring is essential for the lifecycle maintenance of tunnel infrastructure. Distributed fiber‐optic sensor (DFOS) technology, which is capable of distributed strain measurement and long‐range sensing, is an ideal nondestructive testing (NDT) approach for monitoring linear infrastructures. This research aims to develop a distributed sensing network utilizing DFOS for structural integrity assessment of concrete immersed tunnels. The primary innovations of this study lie in the development of a general flowchart for establishing a sensing network and obtaining reliable field data, as well as its subsequent validation through a detailed case study. Concentrated joint deformations in typical immersed tunnels, detectable by the DFOS, are key indicators of structural integrity. This study addresses crucial elements of field monitoring system design, including the selection of appropriate optical fibers or cables and the determination of vital interrogator system parameters. It also covers sensor parameter determination, installation techniques, field data collection, and postanalysis. Furthermore, this research is exemplified by a case study that illustrates the successful implementation of a distributed sensing network in an operational immersed tunnel, and monitoring data reveals cyclic structural deformations under impacts of daily tide and seasonal temperature variations. The data obtained from this network play a significant role in subsequent condition assessments of tunnel structures. The research findings contribute to the assessment of large‐scale infrastructure health conditions through the application of DFOS monitoring.

Immediate Effect of a Comprehensive Foot Mobility and Strengthening Treatment on Ankle Muscle Activation in Children with Spastic Diplegia

Foot mobility and strengthening treatment (FMST) is a routinely practiced management strategy in musculoskeletal rehabilitation to improve ankle and foot alignment and muscle function, which prevents joint deformities. The FMST may contribute to improvements in foot alignment and muscle function in children with cerebral palsy (CP). However, treatment influence on muscle imbalances and strength in children with spastic diplegic CP is not yet documented. The aim of the study was to determine the effect of FMST on tibialis anterior (TA), medial gastrocnemius (MG), peroneus longus (PL), and soleus muscle activity using electromyography (EMG) in children with spastic diplegic CP. Twenty children with spastic diplegia (mean age: 7.4 years) with GMFCS levels I, II and III were included in this pre and post-experimental (preliminary) study. Muscle activation of TA, MG, PL, and soleus was recorded using surface EMG in a standing position before and after providing the intervention. Muscle activation in RMS-EMG (mV) was calculated. Findings showed a significant increase in muscle activation of TA, MG, and PL in standing position following the intervention. The increase in soleus muscle activation in standing was not statistically significant. We hypothesized that FMST could alter the muscle recruitment pattern. Our findings showed immediate improvement in muscle activation after the intervention. Future studies should consider its carryover effect on motor performance and gait using functional outcomes.

Joint Deformation Compensation Algorithm for Robust Kinematic Calibration of Serial Robots

Joint Deformation Compensation Algorithm for Robust Kinematic Calibration of Serial Robots

Depression among Rheumatoid Arthritis Patients and its Relationship with Disease Severity

Background: Rheumatoid arthritis (RA) is a chronic systemic inflammatory autoimmune illness characterized by symmetric peripheral polyarthritis. Studies showed that there is an association between inflammation and depression, so most RA patients are suffering from depression. People with RA are twice as likely to have depression as the general population. Prevalence estimates for depression among RA patients range between 9.5%, 8, and 41.5%. Objectives: To study the prevalence of depression among rheumatoid arthritis patients and its relationship with disease severity Methodology: This descriptive cross-sectional study was conducted among patients diagnosed with Rheumatoid arthritis and attending King Khalid Majmaah Hospital (KKMH). for follow-up. Fifty-seven patients were studied. Data was collected using a validated questionnaire and then analyzed using the SPSS Software program. This study protected the confidentiality of participants, and ethical approval was obtained from the King Fahad Medical City Review Board. Results: Most of the participants of this study were married females. 59.6% had been diagnosed with RA for less than five years, and Joint deformities were found in 19.3%. Prevalence of depression RA patients participated in this study. Only 12.3% were moderately depressed, so regular assessment of the RA patients is needed. HAQ results showed that 56.1% were categorized as 0 to 1. No significant association was found between the severity of depression and age group, gender, occupational status, diagnosis duration, family history of RA, joint deformities, serology markers, and conventional or biologic DMARDs. Conclusion: In this study, the prevalence of depression among the RA studied group was 28.1%. Among them, 12.3% were moderately depressed, and the rest had mild depression, so regular assessment of depression symptoms among the RA patients is needed, and antidepressants should be given if the depression worsens. Health-related quality of life (HAQ) results showed that 56.1% were categorized as 0 to 1. No significant association was found between the severity of RA and the level of depression. More extensive sample size studies? We need to confirm our findings in the future.

Long-Term Follow-Up of Orthognathic Surgery in 19 Patients with Juvenile Idiopathic Arthritis.

Dentofacial deformity following juvenile idiopathic arthritis with temporomandibular joint involvement is associated with functional, aesthetic, and psychosocial impairment. Surgical treatment may involve combinations of orthognathic surgery. The aims of this retrospective study were to assess orofacial symptoms, functional and aesthetic status, and stability after orthognathic surgery. Nineteen patients with juvenile idiopathic arthritis of the temporomandibular joint (TMJ) and dentofacial deformities were included. All patients were treated with combinations of bilateral sagittal split osteotomy, Le Fort I and/or genioplasty, between September 10, 2007 and October 17, 2017. Analysis of patient symptoms and clinical registrations, and frontal/lateral cephalograms was performed pre- and postoperative and long-term (mean: 3.8 and 2.6 years, respectively). Patients experienced no changes in orofacial symptoms or TMJ function, and stable normalisation of horizontal and vertical incisal relations at long-term (horizontal overbite; vertical overbite: P < 0.05). Mandibular lengthening was achieved postoperatively (from mean 79.7 to 87.2 mm; P = 0.004) and was stable. Sella-nasion to A point (SNA) and sella-nasion to B point (SNB) angles increased postoperatively (SNA, mean 79.9° to 82.8°; P = 0.022 and SNB, mean 73.9° to 77.8°; P = 0.003), however, largely reverted to preoperative status at long-term. Orthognathic surgery normalized incisal relations while providing stable mandibular lengthening without long-term deterioration of temporomandibular joint function or orofacial symptoms. No long-term effect on jaw advancements was observed.