The lifespan and kinetics of human dendritic cell subsets and their precursors in health and inflammation

Dendritic cells (DC) are specialized mononuclear phagocytes that link innate and adaptive immunity. They comprise two principal subsets: plasmacytoid DC (pDC) and conventional DC (cDC). Understanding the generation, differentiation, and migration of cDC is critical for immune homeostasis. Through human in vivo deuterium-glucose labeling, we observed the rapid appearance of AXL+ Siglec6+ DC (ASDC) in the bloodstream. ASDC circulate for ∼2.16 days, while cDC1 and DC2 circulate for ∼1.32 and ∼2.20 days, respectively, upon release from the bone marrow. Interestingly, DC3, a cDC subset that shares several similarities with monocytes, exhibits a labeling profile closely resembling that of DC2. In a human in vivo model of cutaneous inflammation, ASDC were recruited to the inflammatory site, displaying a distinctive effector signature. Taken together, these results quantify the ephemeral circulating lifespan of human cDC and propose functions of cDC and their precursors that are rapidly recruited to sites of inflammation

Comparison of the Kinematics Following Gait Perturbation in Individuals Who Did or Did Not Undergo Total Knee Replacement

We aimed to compare the spatiotemporal parameters and joint kinematics during unperturbed and perturbed gait between individuals with osteoarthritis (OA) who did or did not undergo total knee replacement (TKR) one year post a baseline evaluation. OA subjects scheduled for TKR (TKR group; n = 14) and not scheduled for TKR (NTKR group; n = 17) were age-matched. Outcome measures included: joint range of motion, timed up and go, joint pain levels, Oxford score, and the Activities-specific Balance Confidence Scale. In addition, spatiotemporal gait parameters and joint kinematics were recorded during perturbed and unperturbed gait. After one year, most of the TKR group (71%), but only 41% of the NTKR group, increased their gait velocity by more than 0.1m/sec, which is the meaningful clinical important difference for gait velocity. After perturbation of the contralateral limb, the TKR group showed a greater decrease in the maximal extension of the OA hip compared to the NTKR group (p = 0.031). After perturbation of the OA limb, more subjects decreased their OA knee flexion–extension range in the NTKR group compared to the TKR group (p = 0.011) and more subjects decreased their maximal ankle plantar flexion in the TKR group (p = 0.049). Although the surgery was successful in terms of pain reduction and increased functionality, individuals following TKR exhibited unique compensatory strategies in response to the perturbation of both limbs. These findings might suggest that balance deficits remain in individuals following TKR and therefore are associated with a risk of falls

Cushioned Footwear Effect on Pain and Gait Characteristics of Individuals with Knee Osteoarthritis: A Double-Blinded 3 Month Intervention Study

One of the recommendations for individuals with knee osteoarthritis (OA) is the use of specific footwear, such as sturdy or cushioned shoes. However, the long-term use effects of using cushioned shoes on the pain and spatiotemporal gait parameters in individuals with knee OA are yet to be reported. We therefore aimed to compare the efficacy of cushioned sport footwear versus sham shoes on motor functions, pain and gait characteristics of individuals with knee OA who used the shoes for 3 months. In a double-blinded study, we provided 26 individuals with knee OA with cushioned sport shoes and 12 individuals with knee OA with similar sport shoes without cushioning for 3 months. The gait analysis, the timed up and go (TUG) test and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) were conducted and the pain levels were measured at the baseline, 1 month, and 3 months after the baseline. We found that the cushioned shoes reduce the amount of pain (based on WOMAC) in the affected knee and increase functionality in the research group, but not in the control group. Gait velocity and cadence were increased in both groups. Gait spatiotemporal parameters and their symmetry were unaffected during the intervention. We conclude that the use of cushioned shoes should be recommended to individuals with knee OA for alleviating pain

How resources affect management of periprosthetic fractures of the distal femur: perspectives from Israel, South Sudan, and South Africa

Summary:. Periprosthetic fractures of the distal femur have significant morbidity in both total hip and total knee arthroplasty (THA and TKA, respectively). The incidence of these fractures is growing, with the predominant mechanism of injury being a fall from a standing height and therefore considered fragility fractures. In many countries, improved public funding and a flourishing private health care sector, when coupled with increased life expectancy, translates to more older patients receiving both TKA and THA and therefore an increased prevalence of periprosthetic fractures and their associated complications. These fractures may occur below a long stem THA, above a TKA, or between the two (so-called “interprosthetic fracture”). We will outline fracture classification, risk factors, diagnosis, and treatment options, highlighting perspectives on treating these fractures in Israel, South Africa, and South Sudan. These countries represent differing access to resources, varied comorbidity factors, and differing health care systems. The points of difference and the points of similarity will be considered