Objective： To analyze the extent of postoperative hip abductor insufficiency in primary total hip arthroplasty （THA） patients undergoing anterolateral minimally invasive （ALM1） approach, and to investigate whether the clinical outcomes are more favorable in femoral neck fracture （FNF） patients than in non-femoral neck fracture （nFNF） patients. Methods： A total of 48 patients were enrolled in this study. Each patient underwent a clinical examination preoperatively and 6, 12, 24 and 48 weeks postoperatively. The abductor torque, Trendelenburg＇s sign, gait velocity, Harris hip score, Oxford hip score, Westren Ontario and McMaster Universities （WOMAC） score and visual analog scale pain score were recorded. Statistical evaluation was performed with SPSS software version 18.0. The significance level was set at P〈0.05. Results： The abductor torque of the operated hip and the recovery ratio showed a gradual improving tendency from 6 weeks postoperatively until the last follow-up. Gait velocity, Harris hip score, Oxford hip score and WOMAC score improved significantly after the operation until 24 weeks postoperatively. In the FNF group, the abductor torque of the operated side and the recovery ratio were significantly higher than in nFNF group at 6 weeks postoperatively, however, as time passed, this trend tended to disappear. Conclusion： This study demonstrates that patients can obtain good abductor strength and function in the early postoperative period and the hip abductor function of patients who suffer from hip osteoarthritis, rheumatoid arthritis, avascular necrosis of the femoral head could be significantly improved following ALMI THA.
Background Bone morphogenetic protein 9 （BMP9） and Wnt/13-catenin signaling pathways are able to induce osteogenic differentiation of mesenchymal stem cells （MSCs）, but the role of Wnt/13-catenin signaling pathway in BMP9-induced osteogenic differentiation is not well understood. Thus, our experiment was undertaken to investigate the interaction between BMP9 and Wnt/13-catenin pathway in inducing osteogenic differentiation of MSCs. Methods C3H10T1/2 cells were infected with recombinant adenovirus expressing BMP9, Wnt3a, and BMPg＋Wnt3a. ALP, the early osteogenic marker, was detected by quantitative and staining assay. Later osteogenic marker, mineral calcium deposition, was determined by Alizarin Red S staining. The expression of osteopotin （OPN）, osteocalcin （OC）, and Runx2 was analyzed by Real time PCR and Western blotting. In vivo animal experiment was carried out to further confirm the role of Wnt3a in ectopic bone formation induced by BMP9. Results The results showed that Wnt3a enhanced the ALP activity induced by BMP9 and increased the expressions of OC and OPN, with increase of mineral calcium deposition in vitro and ectopic bone formation in vivo. Furthermore, we also found that Wnt3a increased the level of Runx2, an important nuclear transcription factor of BMP9. Conclusion Canonical Wnt/13-catenin signal pathway may play an important role in BMP9-induced osteogenic differentiation of MSCs, and Runx2 may be a linkage between the two signal pathways.
