Trials comparing arthroplasty with anterior cervical discectomy and fusion have shown unclear benefits in terms of clinical results, neck motion at the operated level, adverse events, and the need for secondary surgical procedures. Methods: Only randomized clinical trials were included in this meta-analysis, and the search strategy followed the requirements of the Cochrane Library Handbook. Two reviewers independently assessed the methodological quality of each included study and extracted the relevant data. Results: Twenty-seven randomized clinical trials were included; twelve studies were Level I and fifteen were Level II. The results of the meta-analysis indicated longer operative times, more blood loss, lower neck and arm pain scores reported on a visual analog scale, better neurological success, greater motion at the operated level, fewer secondary surgical procedures, and fewer such procedures that involved supplemental fixation or revision in the arthroplasty group compared with the anterior cervical discectomy and fusion group. These differences were significant (p < 0.05). The two groups had similar lengths of hospital stay, Neck Disability Index scores, and rates of adverse events, removals, and reoperations (p > 0.05). Conclusions: The meta-analysis revealed that anterior cervical discectomy and fusion was associated with shorter operative times and less blood loss compared with arthroplasty. Other outcomes after arthroplasty (length of hospital stay, clinical indices, range of motion at the operated level, adverse events, and secondary surgical procedures) were superior or equivalent to the outcomes after anterior cervical discectomy and fusion. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence....

The development of biomaterials, stem cells and bioactive factors has led to cartilage tissue engineering becoming a promising tactic to repair cartilage defects. Various polymer three-dimensional scaffolds that provide an extracellular matrix (ECM) mimicking environment play an important role in promoting cartilage regeneration. In addition, numerous growth factors have been found in the regenerative process. However, it has been elucidated that the uncontrolled delivery of these factors cannot fully exert regenerative potential and can also elicit undesired side effects. Considering the complexity of the ECM, neither scaffolds nor growth factors can independently obtain successful outcomes in cartilage tissue engineering. Therefore, collectively, an appropriate combination of growth factors and scaffolds have great potential to promote cartilage repair effectively; this approach has become an area of considerable interest in recent investigations. Of late, an increasing trend was observed in cartilage tissue engineering towards this combination to develop a controlled delivery system that provides adequate physical support for neo-cartilage formation and also enables spatiotemporally delivery of growth factors to precisely and fully exert their chondrogenic potential. This review will discuss the role of polymer scaffolds and various growth factors involved in cartilage tissue engineering. Several growth factor delivery strategies based on the polymer scaffolds will also be discussed, with examples from recent studies highlighting the importance of spatiotemporal strategies for the controlled delivery of single or multiple growth factors in cartilage tissue engineering applications.

The objective of this meta-analysis was to compare the fixation outcome of the Gamma nail and dynamic hip screw (DHS) in treating peritrochanteric fractures. Relevant randomised controlled studies were included, and the search strategy followed the requirements of the Cochrane Library Handbook. Methodological quality was assessed and data were extracted independently. Seven studies involving 1,257 fractures were included which compared the effect of the Gamma nail and DHS. The results showed a higher rate of postoperative femoral shaft fracture with the Gamma nail compared to the DHS [relative risk (RR): 7.27, 95% confidence interval (CI): 2.83–18.70, P < 0.0001] but no statistical differences in wound infection (RR: 1.02, 95% CI: 0.56–1.86), mortality (RR: 1.00, 95% CI: 0.81–1.24), re-operation (RR: 1.64, 95% CI: 0.91–2.95) and walking independently after rehabilitation (RR: 0.89, 95% CI: 0.60–1.33). It seemed that there were no obvious advantages of the Gamma nail over the DHS in treating peritrochanteric fractures.