Objective: The systematic review aimed to determine the potential side effects of antibacterial coatings in orthopaedic implants.Methods: Publications were searched in the databases of Embase, PubMed, Web of Science and Cochrane Library using predetermined keywords up to 31 October 2022. Clinical studies reporting side effects of the surface or coating materials were included.Results: A total of 23 studies (20 cohort studies and three case reports) reporting the concerns about the side effects of antibacterial coatings were identified. Three types of coating materials, silver, iodine and gentamicin were included. All of studies raised the concerns regarding safety of antibacterial coatings, and the occurrence of adverse events was observed in seven studies. The main side effect of silver coatings was the development of argyria. For iodine coatings, only one anaphylactic case was reported as an adverse event. No systemic or other general side effects were reported for gentamicin.Conclusion: Clinical studies on the side effects of antibacterial coatings were limited. Based on the available outcomes, the most reported side effects of antibacterial coatings in clinical use were argyria with silver coatings. However, researchers should always pay attention to the potential side effects of antibacterial materials, such as systematic or local toxicity and allergy.

Background: Continuous passive motion (CPM) is commonly used as a postoperative rehabilitation treatment, along with physical therapy, for postoperative knee rehabilitation. However, the comparison between the two in terms of efficacy in postoperative knee replacement recovery is unclear. Purpose: To compare efficacy and safety of combined CPM versus physical therapy alone in postoperative rehabilitation after knee arthroplasty. Methods: PubMed, Embase, and Web of Science databases were used to retrieve and access clinical studies on the efficacy of CPM compared with physical therapy. Review Manager software was used for study publication bias assessment and data analysis based on inclusion criteria. Results: A total of 6 articles covering 557 patients were included in the study. In terms of range of motion (ROM), passive knee flexion was similar between CPM and physical therapy (PT) (WMD, − 0.17; 95% CI, − 0.98–0.64; p = 0.68). At long-term follow-up, passive knee extension was similar between CPM and physical therapy (PT) (WMD, − 0.28; 95% CI, − 1.47 to − 0.92; I² = 65%, p =0.65). In addition, CPM generates significantly higher in length of stay (WMD, 0.50; 95% CI, − 0.31 to 0.69; I² = 3%, p < 0.001). CPM generates significantly higher treatment costs and incurs more care costs relative to physical therapy. Conclusion: Compared to PT, combined with CPM failed to significantly improve ROM of the knees and patient’s satisfaction. In addition, CPM treatment significantly increased the cost of hospitalization.

Background: The meta-analysis aimed to estimate the efficacy of mesenchymal stem cells on lumbar discogenic pain in patients with intervertebral disc degeneration.Methods: A comprehensive literature search was conducted in the PubMed, Web of Science, Embase and Cochrane Library databases with predetermined search strategy up to 18 September 2022. The clinical studies focusing on evaluating the efficacy and safety of mesenchymal stem cells in patients with intervertebral disc degeneration were identified. The primary outcomes were changes of pain score and Oswestry Disability Index. The Newcastle-Ottawa Scale for cohort studies was used for quality assessment. Review Manager was used to conduct the statistical analysis. Pooled risk ratios were calculated based on the random effect model. Heterogeneity, subgroup, and publication bias analyses were also performed.Results: There were 2,392 studies were identified in the initial search, and 9 eligible studies with 245 patients were eventually included in this review. The Visual Analogue Scale score was significantly lower in patients after receiving mesenchymal stem cells therapy (mean difference = 41.62; 95% confidence interval 24.32 to 58.93; Heterogeneity: I² = 98%; p < 0.01). And the pooled mean difference of Oswestry Disability Index was 22.04 from baseline to final follow-up points (95% confidence interval 8.75 to 35.33; p = 0.001; Heterogeneity: I² = 98%; p < 0.001). The pooled reoperation proportion was 0.074 (95% confidence interval 0.009 to 0.175; Heterogeneity: I² = 72%; p < 0.01). There were no serious related adverse events associated with the therapy.Conclusion: The findings of this meta-analysis indicated that mesenchymal stem cells therapy may be effective in relieving pain and improving Oswestry Disability Index significantly in patients with lumbar discogenic pain. Mesenchymal stem cells therapy may also be associated with a lower risk of adverse events and reoperation rates.

Background: Both modular and monoblock tapered fluted titanium (TFT) stems are increasingly being used for revision total hip arthroplasty (rTHA). However, the differences between the two designs in clinical outcomes and complications are not yet clear. Here, we intend to compare the efficacy and safety of modular versus monoblock TFT stems in rTHA. Methods: PubMed, Embase, Web of Science, and Cochrane Library databases were searched to include studies comparing modular and monoblock implants in rTHA. Data on the survivorship of stems, postoperative hip function, and complications were extracted following inclusion criteria. Inverse variance and Mantel–Haenszel methods in Review Manager (version 5.3 from Cochrane Collaboration) were used to evaluate differences between the two groups. Results: Ten studies with a total of 2188 hips (1430 modular and 758 monoblock stems) were finally included. The main reason for the revision was aseptic loosening. Paprosky type III was the most common type in both groups. Both stems showed similar re-revision rates (modular vs monoblock: 10.3% vs 9.5%, P = 0.80) and Harris Hip Scores (WMD = 0.43, P = 0.46) for hip function. The intraoperative fracture rate was 11.6% and 5.0% (P = 0.0004) for modular and monoblock stems, respectively. The rate of subsidence > 10 mm was significantly higher in the monoblock group (4.5% vs 1.0%, P = 0.003). The application of extended trochanteric osteotomy was more popular in monoblock stems (22.7% vs 17.5%, P = 0.003). The incidence of postoperative complications such as periprosthetic femoral fracture and dislocation was similar between both stems. Conclusions: No significant difference was found between modular and monoblock tapered stems as regards postoperative hip function, re-revision rates, and complications. Severe subsidence was more frequent in monoblock stems while modular ones were at higher risk of intraoperative fracture. Level of evidence: Level III, systematic review of randomized control and non-randomized studies. Trial Registration: We registered our study in the international prospective register of systematic reviews (PROSPERO) (CRD42020213642).

Objective: The aim of the present study is to focus on the most popular winter sports programs, and to investigate the global research status and trends in sports-related injuries. Methods: The Web of Science (WoS) Core Collection database was chosen as original data and used for extracting publications on ice and snow sports injuries on 18 February 2022. Articles published in English between 1995 to 2022 were selected for this study. Results: Finally, for the topic search, a sum of 1605 articles were extracted and used for further analysis. The country and journal ranked first—in terms of total number, total citations and the highest H-index of publications—were the USA and American Journal of Sports Medicine, respectively. The affiliation with the most cited publications was the Norwegian School of Sport Sciences. The most influential first author with the most citations (2537 times), the greatest average citations per article (65.05 times) and the highest H-index (26) was Bahr R. Articles were divided into five main clusters based on keyword analysis: injuries study, head and neck damage study, risk study, therapy study and epidemiology study. Studies related to epidemiology and brain damage in ice and snow sports will continue to be research hot topics. Conclusions: In conclusion, our study indicates that the ice and snow sports injuries research domain is more prevalent in North America and Europe. This study contributes to a comprehensive understanding of ice and snow sports injuries and provides hotspot directions.

IIntervertebral disc(IVD) degeneration(IDD)is a primary cause of low back pain(LBP)in people, which is associated with nucleus pulposus-derived mesenchymal stem cells(NPMSCs). In this study, the involvement of lipopolysaccharide(LPS) in the pyroptosis of NPMSCs was investigated, The effect of RADKPS on the pyroptosis of NPMSCs and the underlying mechanism behind the impact of RADKPS on the proliferative capacity of NPMSCs were also studied.Pyroptosis of NPMSCs was induced with 10 μg/ml LPS and its effects on the downstream signaling pathways were explored. The protective effect of RADKPS on NPMSCs under the action of LPS and its possible mechanism were explored. Usinng different techniques such as immunohistochemical analysis, cell proliferation assay, qPCR, and Western blot analysis. Accordingly, Caspase1/p20/p10, a protein associated with pyroptosis, was found to be over-expressed in LPS-challenged NPMSCs, Furthermore, the qPCR results demonstrated that LPS promoted the expression of pyroptosis-related gene IL-1β(P<0.0001) ,while down-regulated the expression of sox-9(p<0.001),which was a gene associated with the extracellular matrix(ECM). The immunohistochemical results identified lowered ERK1/2 expression and phosphorylated (p-)ERK1/2 in the degenerated IVD tissues. In this study, the influence of RADKPS on the proliferative ability of NPMSCs was evaluated using two-dimensional and three-dimensional cultures. It was noted that RADKPS promoted the proliferation of NPMSCs in the two-dimensional and three-dimensional cultures. The findings of the western blot experiments revealed that RADKPS inhibited the expression of pyroptosis-related proteins, while it upregulated the p-ERK1/2 (p < 0.001), RhoA (p < 0.01), collagen II (p < 0.01), and sox-9 (p < 0.01), while ERK inhibitor PD98059 and RhoA signaling pathway inhibitor CCG-1423 inhibited their expression.These findings reveal to us that RADKPS hydrogel may protect NPMSCs from pyroptosis. It was also noted that cell proliferation-related signaling pathways may promote the proliferation of NPMSCs. The results revealed that RADKPS hydrogel could be used as a potential therapeutic approach for IDD.