Background: Few data are available concerning intercondylar notch dimensions in female nonathletes with knee osteoarthritis (OA) in plateau region. The aim of this study was to assess the relation of intercondylar notch morphology to anterior cruciate ligament (ACL) injuries in female nonathletes with knee OA aged 41–65 years from the Chinese Loess Plateau.Methods: The study was conducted on 330 patients with ACL injury (aged 31–65 years; 159 males, 171 females), 141 patients with OA (aged 31–65 years; 59 males, 82 females), and 89 female healthy controls (aged 41–65 years), and this evaluation included identifying the distribution of patients with OA or ACL injury and measuring the intercondylar notch width indexes (NWIs).Results: There was a significant rising trend in patients with OA (the Kellgren and Lawrence grade = 3) with ACL injury (OA-S + ACL) aged 41–65 years, especially in females. We found that the notches of OA-S + ACL had a smaller NWI compared with control and OA without ACL injury (OA-S-only, P = 0.000, 95% confidence interval [CI] = −0.059–−0.030; P = 0.000, 95% CI = −0.049–−0.016). A similar trend was found in notch shape index (NSI), but not in notch depth index and the cross-sectional area. The cutoff of NWI and NSI value was 0.26, and 0.65, and area under the receiver operating characteristic curve was 0.82, and 0.79, respectively. Further study displayed a significant correlation between a reduced NWI and NSI and OA-S + ACL (P = 0.000, χ2 = 14.012; P = 0.000, χ2 = 14.286).Conclusion: A narrower intercondylar notch and a plateau environment are risk factors of predisposing female nonathletes with knee OA to ACL injury aged 41–65 years.

Background: Multiple surgical interventions exist for the treatment of symptomatic knee osteoarthritis, but the surgeon and patient may often have difficulty deciding which interventions are the best option. Methods: We conducted a systematic review to identify randomized clinical trials (RCTs) that compared complications, revisions, reoperations, and functional outcomes among TKA (total knee arthroplasty), UKA (unicompartmental knee arthroplasty), HTO (high tibial osteotomy), BCA (bicompartmental knee arthroplasty), BIU (bi-unicompartmental knee arthroplasty), and KJD (knee joint distraction). The PubMed, Embase, and Cochrane databases were reviewed for all studies comparing two or more surgical interventions. Direct-comparison meta-analysis and network meta-analysis (NMA) were performed to combine direct and indirect evidence. The risk of bias was assessed using the revised Cochrane risk of bias tool for RCTs. Results: This NMA and systematic review included 21 studies (17 RCTs), with a total of 1749 patients. The overall risk-of-bias assessment of the RCTs revealed that 7 studies had low risk, 5 had some concerns, and 9 had high risk. SUCRA (the surface under the cumulative ranking curve) rankings revealed that KJD had the greatest risk of appearing postoperative complications, revisions, and reoperations, and UKA or TKA had the lowest risk. The majority of comparisons among various treatments showed no difference for functional outcomes. Conclusion: Each surgical intervention is noninferior to other treatments in functional outcomes, but UKA and TKA are better options to treat OA according to SUCRA rankings by comparing complications, revisions, and reoperations. KJD is an imperfect option for treating OA. Other treatments should be carefully considered for each patient in accordance with their actual conditions. However, this conclusion is limited by the selection of reviewed publications and individual variation of surgical indications for patients. Trial registration: This study was registered with Research Registry (reviewregistry1395).

Periprosthetic joint infection (PJI) caused by Brucella spp. is an exceedingly rare occurrence, leading to a lack of consensus regarding its diagnosis and treatment. This review mainly aimed to assess the diagnosis and treatment strategy of Brucella-induced PJI. We summarized the data by reporting 4 cases from the Hexi area of China and conducting a systematic review. A comprehensive literature search was performed in PubMed, Web of Science, Embase, and the Chinese Biology Medicine database for relevant publications using predefined search terms. Included studies were case reports or series on human Brucella-induced PJI that described patient outcomes. Data on demographics, diagnosis, treatment, and outcomes were extracted and analyzed. A total of 61 patients of Brucella-related PJI were summarized. Serological antibody tests provided the best diagnostic yield with a 100% positive rate (35/35), compared to lower sensitivities for joint aspiration culture (53.84%, 21/39) and blood culture (41.67%, 5/12). In the presence of radiological implant loosening, 32 patients underwent one- or 2-stage revision with combination antibiotic therapy. For 29 patients without loosening, treatment included antibiotic therapy alone or combined with drainage and debridement or revision. No recurrence was reported at the end of the follow-up. Preoperative serological tests are prioritized for diagnosing Brucella PJI. Loose implants should be managed with revision surgery, while stable implants may be treated initially with antibiotics alone or combined with debridement.