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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 36 - 36
1 Sep 2012
DEMOGRAPHIC DATA, CLINICAL OUTCOME AND SHORT-TERM SURVIVAL AFTER SHOULDER ARTHROPLASTY: 2320 SHOULDER ARTHROPLASTIES REPORTED TO THE DANISH SHOULDER ARTHROPLASTY REGISTER
Rasmussen J Sorensen AK Olsen B
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Objective

To describe demographic data, clinical outcome and short-term survival after shoulder arthroplasty.

Materials and Methods

The Danish Shoulder Arthroplasty Register was established in 2004. All 40 Danish hospitals and private clinics where shoulder arthroplasty are performed are participating.

Since 2006 where the reporting to the register became mandatory the compliance of reporting has been 88.9%. Data are collected by an internet based clinical measuring system where the orthopaedic surgeon report data such as diagnosis, type of arthroplasty, and demographic data. The follow-up results are collected by sending a questionnaire to the patient 10–14 month after the operation. The questionnaire contains a Western Ontario Osteoarthritis of the Shoulder index (WOOS). Each question is answered on a visual analogue scale with a possible score ranging from 0–100. There are 19 questions and the total score is ranging from 0–1900. For simplicity of presentation the raw scores is converted to a percentage of a normal shoulder.

Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 38 - 38
1 Sep 2012
REGIONAL BODY COMPOSITION, BONE MINERAL DENSITY, AND CLINICAL OUTCOME IN PATIENTS WITH TWO DIFFERENT SHOULDER ARTHROPLASTY DESIGNS
Rasmussen J Zerahn B Paulsen A Andersen K Sorensen AK Olsen B
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Objective

To compare regional body composition, bone mineral density (BMD), and clinical outcome in patients with two different shoulder arthroplasty designs.

Materials and Methods

This cross-sectional study included 54 patients with a total of 63 shoulder arthroplasties. There were 18 men and 45 women with a mean age of 68.9 years SD ± 10.5. Mean follow-up time was 39.2 months SD ± 14.4. The patients were divided into three groups according to their history: 22 patients were diagnosed with a proximal humeral fracture and treated with a stemmed hemi arthroplasty, 11 patients were diagnosed with osteoarthritis and treated with a stemmed hemi arthroplasty, and 30 patients were diagnosed with osteoarthritis and treated with a resurfacing arthroplasty. All patients underwent a one-day protocol: Regional Dual X-ray Absorptiometri (DXA) was used to measure BMD of the distal third of humerus and regional body composition of the upper arm. The clinical outcome was measured using Western Ontario Osteoarthritis of the Shoulder index (WOOS) and Constant-Murley score.

Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_II | Pages 204 - 204
1 May 2011
CHANGES IN S-YKL-40, S-IL-6 AND CIRCULATING MESENCHYMAL PROGENITOR CELLS IN PATIENTS DURING BONE REGENERATION
Gottlieb H Johansen J Olsen B Lausten G Johnsen H Kastrup J
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Summary: Investigation of the specific roles of circulating mesenchymal progenitor cells, YKL-40 and IL-6 during regeneration of planned or traumatic bone traumas.

Introduction: YKL-40 is a growth factor with possible involvement in regeneration of mesenchymal tissue. IL-6 is a pro-inflammatory marker. Mesenchymal progenitor cells (MPC), is a subpopulation of mononuclear cells (MNC), involved in bone regeneration. The aim was to investigate the involvement of YKL-40 in bone regeneration by analysis of the posttraumatic changes in s-YKL-40, s-IL-6, MNC and MPC in patients with planned or traumatic bone traumas.

Materials and Methods: Two cohorts with a total of 50 patients, with either ankle- (Cohort 1: N=13) or hip fracture (Cohort 1: N=10, cohort 2: N=8) or planned hip replacements (Cohort 1: N=9, cohort 2: N=10) were included. Contemporary healthy controls (N=17) were also included. 8 blood samples were taken day 1, 3, 7, 14, 21, 28, 42 and 84 after bone trauma from patients in cohort 1. Patients in cohort 2 had the same blood samples taken, including two additional ones taken 3–5 and 12–15 hours after hip fracture. MNC was counted, Phenotype of MPCs were determined by flow cytometry, s-YKL-40 and s-IL-6 quantified by ELISA.

Results: Changes in MNC, YKL-40 and IL-6 correlated to the magnitude of the traumas, with larger responses in patients with hip fractures or planned hip replacements compared to patients with ankle fractures (MNC: p=0.0006; YKL-40: p=0.0004; IL-6: p< 0.0001). S-YKL-40 further correlated to the type of bone trauma, documented by different levels of YKL-40 in patients with hip fractures or -planned hip replacements, from day 14 to 42 after fracture (Cohort 1: p=0.04; Cohort 2: p=0.005). The posttraumatic changes in YKL-40 and IL-6 did not correlate. Age and number of circulating MNC (p=0.0003, r=−0.61) were inverse correlated. S-YKL-40 correlated positively to a population of circulating cells with a specific phenotype of CD45neg, CD105pos-MNCs (r=0.26, P=0.01) and CD45neg, CD144pos-MNCs (r=0.27, P=0.01). These phenotypes are associated with MPCs. This correlation was only seen in patients with hip fractures.

Conclusions: Circulating MNC, YKL-40 and IL-6 changed posttraumatic according to the magnitude of the trauma. Serum YKL-40 also changed according to the type of bone trauma during early bone regeneration, indicating a pivotal quantitative role for YKL-40 in bone regeneration.

The positive correlation between YKL-40 and circulating CD45neg, CD105pos, CD144pos-MNCs during early ossification in hip fractures is a novel finding, which underlines the important role of these cells and YKL-40 during bone regeneration.

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