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Objective. This retrospective study was designed to evaluate the outcomes of four diff erent surgical reconstructions for extensor tendon ruptures in ulnar three fingers in 48 patients with rheumatoid arthritis. Methods. The following four techniques were performed; palmaris longus tendon grafting (PL group; n = 9), extensor indicis proprius (EIP) tendon transfers (EIP group; n = 8), end-to-side transfers with tension-reduced early mobilization (End-to-side group; n ≥ 16), and a combination of end-to-side and EIP transfers (Combination group; n = 15). Loss of extension was evaluated to determine the mean postoperative range of motion of the metacarpophalangeal (MP) joint and clinical outcomes were categorized using modified Geldmacher criteria. Results. Combination group demonstrated the best mean MP joint extension (-3 °), followed by End-to-side group (-12°), EIP group (-16°), and PL group (-21°). Combination group yielded the best clinical outcomes with all cases showing good results. Conclusions. The combination of end-to-side and EIP transfer was an eff ective surgical reconstruction procedure for triple fingers extension loss. [ABSTRACT FROM AUTHOR]

Background: The conventional measuring method for glenoid version is greatly influenced by the scapular body shape that varies widely between patients. We postulated that the glenoid vault version could be more useful than the conventional glenoid version in clinical cases. Objectives: The purposes of this study were to compare the values of glenoid version measured with the conventional method to those with the vault method and to investigate the feasibility of the glenoid vault version. Methods: Computed tomography scans of 150 normal shoulders and 150 arthritic shoulders were analyzed. Three-dimensionally corrected slices were reconstructed from the Digital Imaging and Communications in Medicine (DICOM) data, and glenoid version was measured with both the conventional and vault methods. After determining intra- and interrater reliabilities, differences in glenoid version values between the conventional and vault methods were assessed. In the normal shoulder group, side-to-side differences of glenoid version values were also evaluated in both methods. Results: Both measuring methods demonstrated high intra- and interrater reliabilities. The normal glenoid had 1.1° ± 3.2° retroversion with the conventional method and 8.9° ± 2.7° retroversion with the vault method. The average glenoid retroversion of arthritic shoulders was 10.8° ± 9.3° measured with the conventional method and 18.2° ± 9.1° with the vault method. The vault method showed significantly larger glenoid retroversion than the conventional method in both normal and arthritic shoulder groups. Both conventional glenoid retroversion and glenoid vault retroversion were significantly larger on dominant sides than on nondominant sides in the normal shoulders. Conclusions: The glenoid vault version could be used as an alternative measuring method for glenoid version with high reliability. In clinical use, the glenoid vault version appears to be more useful than the conventional glenoid version to assess the severity of arthritis and difficulty of glenoid replacement. The glenoid vault is not symmetric, but usually retroverted in both normal and arthritic shoulders. [ABSTRACT FROM AUTHOR]

Background: The concept of minimally invasive surgery (MIS) was introduced in total knee arthroplasty (TKA) in the late 1990s. The number of MIS TKAs has clearly decreased in recent years. An implant designed specifically for MIS TKA has been used all over the world, but there are no reports of long-term postoperative results. The purpose of this study was to characterize long-term clinical results with a minimum follow-up of 10 years. Methods: This retrospective study included 109 consecutive patients with 143 NexGen CR-Flex prostheses, which are MIS tibial component prostheses designed specifically for MIS TKA. Twelve-year survival analysis was performed using Kaplan-Meier method. Revision surgery for any reason was the endpoint. Long-term clinical and radiographic results of 74 knees (55%) in 60 patients with more than 10 years of follow-up were analyzed. Results: The cumulative survival rate of the single-radius posterior-stabilized TKA of 74 knees was 94.7% (95% confidence interval, 90-99%) at 12 years after surgery. Seven knees (9%) required additional surgery during the 10-year follow-up because of periprosthetic infections. Mean postoperative Knee Society knee score and functional score were 91 and 74 points, respectively. There were no cases of prosthesis breakage, polyethylene wear, or aseptic loosening of the prosthesis. Conclusion: The prosthesis designed specifically for MIS TKA is associated with good survival and clinical results with a minimum follow-up of 10 years, even though MIS TKA has become less popular. Level of evidence: III [ABSTRACT FROM AUTHOR]

Interleukin (IL)-32 is known to exert adujvant effects on innate immune response, however, receptors and downstream signaling pathways remain to be clarified. Here we found that IL-32γ upregulated serine protease activity of proteinase-3 (PR3), in turn triggering protease-activated receptor 2 (PAR2) signaling. Interestingly, silencing of PR3 or PAR2 using siRNA markedly diminished IL-32γ-induced TNFα and IFN-β mRNA expression. IL-32γ-PAR2 axis utilized TRIF and Ras-Raf-1 pathways. On stimulation with lipopolysaccharide (LPS), differential activation of protein kinase C isoforms modulated the balance between LPS-TLR4-TRIF and IL-32-PAR2-TRIF axes, because LPS was a strong inducer of IL-32γ. IL-32-PAR2-TRIF axis might serve not only as an extracellular sensor of bacterial and autologous proteases, but also as a modulator of innate and adaptive immunity during infection. [ABSTRACT FROM AUTHOR]