Highlights ► qPCR assays for kisspeptins, GnRHs, gonadotropins were developed in sea bass. ► Seasonal mRNA profiles in male repeat spawner were analysed. ► Clear seasonal profiles for kiss1 , kiss2 ...and kissr4 mRNAs were shown. ► Kissr4 , fshβ and lhβ mRNA levels increased gradually and peaked during spermatogenesis. ► kiss1 , kiss2 , cGnRHII as well as steroids showed peaks during early spawning.
Purpose
This study aimed at describing the use of oral cyclines (i.e., doxycycline and minocycline) as suppressive antibiotic therapy (SAT) in patients with periprosthetic joint infections (PJIs).
...Methods
Medical charts of all patients with surgical revisions for PJIs who were given cycline-based SAT because of a high failure of various origins were reviewed. Data regarding tolerability and effectiveness of cycline-based SAT were analysed.
Results
Seventy-eight patients of mean age 64 ± 17 years received cycline-base SAT in the period from January 2006 to January 2014. PJIs involved the knee in 37 patients (47%), the hip in 35 (45%), the elbow in 4 (5%), and the shoulder in 2 (3%) and were qualified as early in 31 patients (39.7%).
Staphylococcus
spp. were the most common pathogens accounting for 72.1% of the total number of bacterial strains identified. All included patients had surgery which consisted in debridement and implant retention in 59 of them (75.6%). Doxycycline and minocycline were prescribed as SAT in 72 (92%) and 6 (8%) patients, respectively. Adverse events were reported in 14 patients (18%), leading to SAT discontinuation in 6 of them (8%). After a mean follow-up of 1020 ± 597 days, a total of 22 (28.2%) patients had failed including 3 cases (3.8%) with documented acquisition of tetracycline resistance in initial pathogen(s).
Conclusions
Our results suggest that oral cyclines used as SAT in patients treated for PJI have an acceptable tolerability and effectiveness and appear to be a reasonable option in this setting.
Abstract Introduction Trochlear dysplasia is one of the main elements of patellofemoral instability. Although correction by trochleoplasty seems logical, the long-term outcome of this procedure is ...unknown and the progression to osteoarthritis has not been clarified. Thus, we performed a retrospective study of a series of sulcus deepening trochleoplasties with a 15-year follow-up whose goal was to (1) evaluate the long-term clinical outcome and radiological rate of osteoarthritis, and (2) define the results in relation to the type of instability and the grade of dysplasia. Hypothesis Sulcus deepening trochleoplasty is an effective procedure to stabilize the patellofemoral joint that does not increase the risk of osteoarthritis. Patients and methods This retrospective study analyzed 34 sulcus deepening trochleoplasties based on clinical scores (IKS, Lille, Kujala and Oxford scores) and radiological results (stage of osteoarthritis according to the Iwano score) after a mean follow-up of 15 years (12–19 years). An Insall procedure was systematically associated with an anterior tibial tubercle transfer in 17 cases (7 prior tibial transfers). Results No recurrent objective instability was observed. Seven knees had additional surgery after a mean follow-up of 7 years (2–16): 7 underwent conversion to total knee arthroplasty because of progression of osteoarthritis and one knee had tibial tubercle transfer for pain and episodes of the knee giving way. The mean Lille, Kujala and IKS scores increased from 53.3 (30–92), 55 (13–75) and 127 (54–184) to 61.5 (25–93), 76 (51–94) and 152.4 (66–200) respectively between preoperative and follow-up assessment ( P < 0.05) (revisions included). Functional outcome was significantly better for dysplasia with supratrochlear spurs (IKS score 168 127–200 versus 153 98–198 and Kujula score 81.5 51–98 versus 76 51–94 P < 0.05). Patients were satisfied in 65% of the cases and the total mean Oxford score was 24.1/60 (12–45 points). Occasional pain was present in 53% of the cases. The trochlear prominence decreased from 4.9 mm (3–9 mm) to −1.2 mm (−7–4 mm). Ten cases of preoperative patellofemoral osteoarthritis were identified, but none with > Iwano 2, while osteoarthritis was present in 33/34 cases at the final follow-up with 20 cases > Iwano 2 (65%). Discussion Sulcus deepening trochleoplasty corrects patellofemoral stability even in patients with severe dysplasia and the long-term functional outcome is better in this group. It does not prevent patellofemoral osteoarthritis. It should be limited to severe dysplasia with supratrochlear spurs and associated with procedures to realign the extensor apparatus. Level of evidence IV, retrospective cohort study.
Purpose
Hip arthroplasty with metal-on-metal bearings like hip resurfacing results in the release of metallic ions. In parallel, like every metallic implant, knee arthroplasty implants undergo ...passive corrosion. We analyzed blood levels of cobalt and chromium ions in patients who have a hip resurfacing arthroplasty and compared them to patients who have undergone knee arthroplasty at a minimum follow-up of one year. The hypothesis was that there is no difference in the ion release between hip resurfacing and knee arthroplasty.
Methods
Sixty-three patients who underwent knee arthroplasty were compared to a cohort of 132 patients who underwent hip resurfacing. The blood levels of cobalt and chromium ions were determined preoperatively and at six and 12 months postoperatively and then compared between groups. We analyzed the relationship between ion release and the change in clinical outcome scores (Harris Hip score, Oxford Hip score, Merle D’Aubigné Postel score, Oxford Knee score, International Knee Society score), the BMI, sex, physical activity, implant size and inclination of the acetabular implant (hip resurfacing patients only). Mixed linear models were used to assess the changes in ion blood levels over time.
Results
The cobalt blood levels were higher in the first 6 months in the resurfacing group (0.87 ug/L vs 0.67 ug/L;
p
= 0.011), while it was higher in the knee arthroplasty group at 12 months (1.20 ug/L vs 1.41 ug/L;
p
= 0.0008). There were no significant differences in chromium levels during the follow-up period.
Conclusion
The increase in metal ion release after knee arthroplasty is as high as after hip resurfacing at the one year follow-up. The monitoring of this parameter probably should not be recommended in case of good clinicals outcomes.
Introduction
Injecting bone marrow or bone morphogenetic protein 7 (BMP) during core decompression for avascular osteonecrosis (AVN) may improve survival. We hypothesized that adding a complementary ...technique (injection of BMP and/or non-concentrated bone marrow) to core decompression would reduce the number of patients requiring a subsequent total hip arthroplasty (THA).
Methods
We retrospectively reviewed 92 cases from 2003 to 2018 with a minimum of 2 years of follow-up and an average follow-up of 64 months (24–204). Twenty-four patients had a core decompression (CD) (26.1% (24/92)), 25 had a CD associated with reinjection of bone marrow and BMP (rhBMP7) (27.2% (25/92)), and 43 patients had a CD with bone marrow reinjection (46.7% (43/92)).
Results
Hip survival after CD was 66.3% (61/92) at two years and 59.8% (55/92) at 10 years. CD with bone marrow and BMP reinjection had a better hip survival at ten years (HR: 0.492 (CI95%: 0.254–0.952)
p
= 0.035). A volume of necrosis greater than 30% (HR = 12.97 (CI95 3.88–43.3 (
p
< 0.001))) and a Kerboul angle greater than 60° (HR: 12.5 (CI95 2.84–54.6 (
p
< 0.001))) were risk factors for a subsequent THA.
Conclusions
CD is an interesting non-invasive technique to preserve the native hip after AVN of the femoral head. Reinjection of bone marrow and/or BMP improved CD hip survival.
In order to assess the effect of dietary phosphorus (P) in reducing vertebral malformations and improving freshwater (FW) performance in triploid Atlantic salmon (Salmo salar), both triploid and ...diploid Atlantic salmon were fed three different dietary P inclusion levels (low: 4.9, medium: 7.7, and high: 9.7 g available P kg−1) from first feeding until smolt. Somatic and skeletal response was assessed at fry (~0.5 g), parr (~5 g) and smolt (~45 g) stages. Triploid parr initially grew faster on the high P diet, while groups fed low P resulted in a significantly higher weight at smolt. Image analysis of double stained Alcian blue and Alizarin red S fry revealed that low P fed triploid fish presented less well mineralised vertebrae, and significantly more malformed vertebrae in both parr and smolt stages following x-ray radiographic assessment. Triploid parr fed high and medium P had similar numbers of malformed vertebrae relative to their diploid counterparts but greater numbers than at smolt. Low P fed triploids had the highest prevalence of jaw and vertebral malformations as well as the highest number of deformed vertebrae in the central caudal vertebral region, which was more pronounced at parr than at smolt. Shorter vertebrae dorso-ventral lengths were observed throughout the spinal column (R1–R4) in parr fed low P and only in the caudal region (R3) at smolt. In parr, both ploidies showed reduced phosphate homeostasis protein fgf23 gene expression in vertebrae when fed low P diets, while triploids showed greater down-regulation of osteogenic factors (alp, opn and igf1r) between diets relative to diploids, suggesting possible greater active suppression of mineralisation and reduced osteogenic potential in triploids. No effects of diet or ploidy on gene expression were evident at smolt. Comparisons between development stages suggest early P supplementation in triploids is crucial for skeletal development. Ultimately, reducing vertebral deformities observed at smolt with higher P supplementation in triploids could contribute towards improving skeletal performance and welfare of the stocks in the marine phase.
•Feeding higher dietary P throughout freshwater significantly reduced occurrence of vertebral malformations in triploid Atlantic salmon.•Triploid growth was improved with higher dietary P within the fry to parr stages but reduced growth from parr to smolt.•Higher dietary P supplementation impeded diploid growth throughout freshwater.
In order to investigate the potential role of the kisspeptin system in the entrainment of reproduction in Atlantic cod, qPCR assays were developed for kiss2 and its receptor kissr4. mRNA expression ...was monitored in the brain over a full reproductive cycle in 2 populations of males and females: 1) a maturing population (exposed to simulated natural photoperiod, SNP) and 2) a maturation inhibited population (exposed to constant light, LL). Pituitary expression of gonadotropin subunit mRNA (fshβ and lhβ) was also measured. Results from this study indicated no clear temporal pattern in expression of kiss2 or kissr4 mRNAs in either population of cod, however acute elevations were apparent in maturing (SNP) individuals, namely an elevation in kiss2 in vitellogenic females and spermiating males and spikes in kissr4 during early vitellogenesis in females and spermatogenesis in males. Gonadotropin mRNA expression displayed strong amplitudinal changes over time with fshβ and lhβ mRNA expression increasing towards spawning in maturing individuals. No firm conclusions on the role of the kisspeptin system in cod puberty can be drawn at this stage, however mRNA increases in kiss2 and kissr4 may elude to conserved kisspeptin functions in cod and opens up interesting avenues on potential gender specific functions.
Abstract Photoperiod is perceived by pineal photoreceptors and transduced into rhythmic melatonin signals. These rhythms can be influenced by light intensity and spectral content. In this study we ...compared the light sensitivity of Atlantic salmon, European sea bass and Atlantic cod by testing ex vivo the effect of different intensities and narrow bandwidth lights on nocturnal melatonin suppression by isolated pineal glands in a flow-through culture system. Using combinations of neutral density and bandpass interference filters we tested a range of light intensities (ranging from 1.22 × 1013 to 3.85 × 106 photons s−1 cm−2 ) and three wavelengths of 80 nm width (472, 555 and 661 nm corresponding to blue, green and red, respectively). Results showed clear species specific light intensity and spectral sensitivities, with cod being from 100 to 1000 times more sensitive than sea bass and salmon. Regarding the influence of spectrum, red light was less efficient on suppressing melatonin than blue and green in salmon but results were not as clear in the two other species studied. Finally, the first evidence of relative photoreception in teleosts was obtained in cod suggesting that the definition of illuminance thresholds (day/night perception) would depend on the day intensity. Indeed, a single order of magnitude increase or decrease in day intensity was shown to elicit a significant shift in the intensity response curve of night-time melatonin suppression. Taken together, this study demonstrated species specific light intensity and spectral sensitivities within temperate teleosts.
Abstract Background Although constrained condylar knee (CCK) inserts are widely used for total knee arthroplasty (TKA), their long-term outcomes remain unclear. We sought to evaluate patients with at ...least 10 years’ follow-up after CCK TKA to identify potential adverse events (osteolysis, loosening, constraint-mechanism failure), assess functional outcomes with special emphasis on range of motion, and determine prosthesis survival. Hypothesis Increasing constraint by implantation of a CCK insert does not increase the long-term frequencies of osteolysis or mechanical loosening. Material and methods We studied 43 knees after Legacy® CCK TKA. The indication was severe deformity ( n = 20), pre-operative laxity ( n = 6), or failure to achieve intra-operative balancing ( n = 17). There were 41 patients with a mean age of 66 years (21–88). A history of one or more surgical procedures was noted for 27 (63%) knees. Outcome measures were the Hospital for Special Surgery (HSS) knee score, Knee Society Score (KSS), and change in the hip-knee-ankle (HKA) angle. Prosthesis survival was assessed using revision surgery for any reason or for reasons other than infection as the censoring criterion. Results Complications other than venous thrombosis occurred in 16% of patients, including 3 who required revision surgery (septic loosening, n = 2; and major instability in a patient with ipsilateral hip arthrodesis). No cases of osteolysis or aseptic loosening were recorded. Mean follow-up was 12.7 years (range, 10–14). At last follow-up, the HSS score had improved from 53 (26–83) pre-operatively to 80 (55–93), the KSS knee component from 42 (16–77) to 90 (77–99), and the KSS function component from 31 (0–80) to 61 (10–90) ( P < 0.001). Mean range of flexion increased from 109° (50°–140°) to 112° (90°–130°) ( P = 0.12). The HKA angle changed from 182° ± 15.5° (150°–210°) to 179.5° ± 2.5° (174°–184°) ( P = 0.5). The 11-year prosthesis survival rate was 88.5% (95% confidence interval, 0.69–0.94) overall and 97.7% (0.76–0.99) after excluding the cases of infection. Discussion Long-term functional gains after CCK TKA were similar to those reported after standard posterior-stabilised TKA, with no cases of constraint-mechanism failure or osteolysis. The complication rate was higher, with decreased survival compared to standard TKA, but the knee deformities and/or instability were particularly severe and two-thirds of knees had a history of one or more surgical procedures. Level of evidence Level IV, retrospective case-series study.
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