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  1. Article ; Online: Isokinetic training of lower extremity during the early stage promote functional restoration in elder patients with disability after Total knee replacement (TKR) - a randomized control trial.

    Cheng, Yuan-Yang / Chen, Cheng-Hsu / Wang, Shun-Ping

    BMC geriatrics

    2024  Volume 24, Issue 1, Page(s) 173

    Abstract: Background: Transient progressive weakness and disability of lower limb during the early stage after TKR will increase the risk of fall, but the superior postoperative strength training mode have not been elucidated for functional restoration. This ... ...

    Abstract Background: Transient progressive weakness and disability of lower limb during the early stage after TKR will increase the risk of fall, but the superior postoperative strength training mode have not been elucidated for functional restoration. This study aimed to compare whether the isokinetic lower limb training is superior to either isotonic or home isometric exercise during early stage after TKR in older people.
    Methods: A total of 43 recruited old participants (mean age, 68.40 years old) receiving TKR were divided randomly based on the different four-week training modes into three groups including isokinetic, isotonic, and home isometric exercise (control group). The primary outcome was set as functional performance in terms of Timed Up and Go (TUG) test and the secondary outcomes include the peak torque of knee at 60 and 120 degree/ second, Short-Form 36 Health Survey (SF-36), and Western Ontario and McMaster Universities Arthritis index (WOMAC).
    Results: All of the peak torque measurements of the knee improved significantly in both the isokinetic and the isotonic group, but not in the control group. Although isotonic training resulted in more strength gains, a significant enhancement in TUG test was observed in the isokinetic group only (p = 0.003). However, there were no significantly improvement of TUG test after training in other two groups. SF-36 and WOMAC improved after training in all three groups, with no significant difference in the degree of improvement between groups.
    Conclusion: Isokinetic training for 4 weeks following TKR effectively improved all the outcome parameters in this study, including the TUG test, lower limb strength, and functional scores. However, both isokinetic and isotonic training modes could be recommended after TKR because of no significant difference in the degree of improvement between these two groups.
    Trial registration: Clinical trial registration number: NCT02938416.
    Level of evidence: I.
    MeSH term(s) Humans ; Aged ; Arthroplasty, Replacement, Knee/adverse effects ; Exercise Therapy/methods ; Resistance Training/methods ; Knee ; Exercise
    Language English
    Publishing date 2024-02-19
    Publishing country England
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 2059865-8
    ISSN 1471-2318 ; 1471-2318
    ISSN (online) 1471-2318
    ISSN 1471-2318
    DOI 10.1186/s12877-024-04778-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Factors predicting lower limb alignment after Oxford medial unicompartmental knee arthroplasty.

    Shih, Han-Ting / Chen, Kun-Hui / Lee, Cheng-Hung / Tu, Kao-Chang / Wang, Shun-Ping

    Scientific reports

    2024  Volume 14, Issue 1, Page(s) 5597

    Abstract: This study aimed to identify the factors affecting hip-knee-ankle (HKA) angle following Oxford medial unicompartmental knee arthroplasty (MUKA). A retrospective analysis of 200 patients who underwent Oxford MUKA from June 2018 to October 2020 was ... ...

    Abstract This study aimed to identify the factors affecting hip-knee-ankle (HKA) angle following Oxford medial unicompartmental knee arthroplasty (MUKA). A retrospective analysis of 200 patients who underwent Oxford MUKA from June 2018 to October 2020 was conducted. Univariate and multivariate analyses were performed to investigate the impact of surgical and radiographic characteristics on the postoperative HKA angle. The mean HKA angle was 9.5 ± 4.3° before surgery and 3.6 ± 3.7° after surgery (p < 0.001). The postoperative HKA angle significantly correlated with the preoperative HKA angle, bearing size, tibial component alignment angle, and BMI (r = 0.71, p < 0.001; r =  - 0.24, p = 0.001; r = 0.21, p = 0.004; r =  - 0.18, p = 0.011). Multiple linear regression analysis revealed that the preoperative HKA angle (β = 0.68, p < 0.001), bearing size (β =  - 0.31, p < 0.001), tibial component alignment angle (β = 0.14, p = 0.003), and BMI (β =  - 0.09, p = 0.047) significantly affected the postoperative HKA angle. In conclusion, larger preoperative varus deformity, smaller bearing size, greater varus alignment of the tibial component, and lower BMI lead to greater postoperative varus alignment of the lower limb in Oxford MUKA. With this concept, surgeons can more accurately predict postoperative lower limb alignment and avoid malalignment in Oxford MUKA.
    MeSH term(s) Humans ; Arthroplasty, Replacement, Knee ; Retrospective Studies ; Osteoarthritis, Knee/diagnostic imaging ; Osteoarthritis, Knee/surgery ; Knee Joint/diagnostic imaging ; Knee Joint/surgery ; Lower Extremity/surgery ; Tibia/diagnostic imaging ; Tibia/surgery
    Language English
    Publishing date 2024-03-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-024-56285-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Biomechanical comparisons of F.E.R.I. techniques with different type of intramedullary screws fixation for Jones fractures.

    Su, Kuo-Chih / Yen, Yu-Chun / Wang, Chun-Hsiang / Wang, Yi-Lun / Wang, Shun-Ping

    Frontiers in bioengineering and biotechnology

    2024  Volume 12, Page(s) 1389127

    Abstract: Introduction: ...

    Abstract Introduction:
    Language English
    Publishing date 2024-05-01
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2719493-0
    ISSN 2296-4185
    ISSN 2296-4185
    DOI 10.3389/fbioe.2024.1389127
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: The compensatory hypertrophy of transferred flexor hallucis longus tendon for insertional Achilles tendinopathy: a retrospective MRI study.

    Liao, Wei-Jen / Tang, Shih-Chieh / Shih, Han-Ting / Su, Kuo-Chih / Tu, Kao-Chang / Wang, Shun-Ping

    Scientific reports

    2023  Volume 13, Issue 1, Page(s) 20475

    Abstract: Flexor hallucis longus (FHL) transfer is an effective surgery in treating insertional Achilles tendinopathy (IAT). However, limited data exist regarding the post-surgery changes in the transferred FHL. The study aimed to compare the sequential changes ... ...

    Abstract Flexor hallucis longus (FHL) transfer is an effective surgery in treating insertional Achilles tendinopathy (IAT). However, limited data exist regarding the post-surgery changes in the transferred FHL. The study aimed to compare the sequential changes and hypertrophy of FHL after isolated FHL transfer (FHLT). We retrospectively enrolled patients who underwent isolated FHLT for insertional Achilles pathology from 2015 to 2020 and divided them into two groups based on whether reattachment of the residue Achilles stump to the FHL was performed or not. We recorded demographic characteristics, MRI parameters, and functional outcome. We also analyzed the correlation between the collected data and FHL hypertrophy. Results revealed no significant differences in most MRI parameters of FHL and functional outcomes between the groups. However, the fat distribution within the FHL showed significant reduction and notable 20.2% hypertrophy after FHLT. Interestingly, the hypertrophy of the FHL was significantly more pronounced in the non-reattached group. Furthermore, we observed a positive correlation between the follow-up period and FHL hypertrophy. In conclusion, the FHL demonstrated significant enlargement over time following FHLT. The compensatory hypertrophy of the transferred FHL was particularly evident and the cumulative incidences of FHL enlargement over time were higher in the non-reattached groupcompared to reattached group. However, both reattachment and non-reattachment of Achilles stump on FHL transfer for insertional Achilles tendinopathy carried similar postoperative functional outcomes.
    MeSH term(s) Humans ; Retrospective Studies ; Achilles Tendon/diagnostic imaging ; Achilles Tendon/surgery ; Tendon Transfer/methods ; Tendinopathy/diagnostic imaging ; Tendinopathy/surgery ; Magnetic Resonance Imaging ; Hypertrophy
    Language English
    Publishing date 2023-11-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-023-47725-1
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  5. Article ; Online: Hydroxygenkwanin Improves the Efficacy of Cytotoxic Drugs in ABCG2-Overexpressing Multidrug-Resistant Cancer Cells.

    Li, Yan-Qing / Murakami, Megumi / Huang, Yang-Hui / Hung, Tai-Ho / Wang, Shun-Ping / Wu, Yu-Shan / Ambudkar, Suresh V / Wu, Chung-Pu

    International journal of molecular sciences

    2022  Volume 23, Issue 21

    Abstract: Hydroxygenkwanin, a flavonoid isolated from the leaves of ... ...

    Abstract Hydroxygenkwanin, a flavonoid isolated from the leaves of the
    MeSH term(s) Humans ; Drug Resistance, Multiple ; ATP Binding Cassette Transporter, Subfamily G, Member 2/metabolism ; Drug Resistance, Neoplasm ; Neoplasm Proteins/metabolism ; Cell Line, Tumor ; Antineoplastic Agents/pharmacology ; Antineoplastic Agents/chemistry ; Flavonoids/pharmacology ; ATP-Binding Cassette Transporters/metabolism ; Neoplasms/drug therapy
    Chemical Substances ATP Binding Cassette Transporter, Subfamily G, Member 2 ; hydroxygenkwanin (20243-59-8) ; Neoplasm Proteins ; Antineoplastic Agents ; Flavonoids ; ATP-Binding Cassette Transporters ; ABCG2 protein, human
    Language English
    Publishing date 2022-10-23
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms232112763
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  6. Article ; Online: Novel Radiographic Measurements for Operatively Treated Haglund's Deformity.

    Tang, Shih-Chieh / Tu, Kao-Chang / Liao, Wei-Jen / Hsu, Chang-Te / Shih, Han-Ting / Tung, Kuan-Kai / Wu, Min-Huan / Wang, Shun-Ping

    Tomography (Ann Arbor, Mich.)

    2022  Volume 8, Issue 1, Page(s) 284–292

    Abstract: Background: Haglund's deformity, which is characterized by a bony prominence of the posterosuperior aspect of the calcaneus, causes posterior heel pain. To date, there is no standard radiographic parameter to diagnose symptomatic Haglund's deformity. ... ...

    Abstract Background: Haglund's deformity, which is characterized by a bony prominence of the posterosuperior aspect of the calcaneus, causes posterior heel pain. To date, there is no standard radiographic parameter to diagnose symptomatic Haglund's deformity. Herein, we proposed novel radiographic measurements to distinguish between patients with and without symptomatic Haglund's deformity.
    Methods: We retrospectively evaluated ankle radiographs of 43 patients who underwent surgery for symptomatic Haglund's deformity (Haglund group) and 41 healthy individuals (control group) free of heel complaints. Fowler-Phillip angle (FPA), Heneghan-Pavlov parallel pitch lines (PPL), Haglund's deformity height, bump height, and bump-calcaneus ratio were measured and compared between the groups. Furthermore, the reliability and cut-off value of each parameter were validated via ICC and ROC curve analysis, respectively.
    Results: The bump height (
    Conclusions: This study proposes two novel radiographic parameters to identify operatively treated Haglund's deformity, namely bump height and bump-calcaneus ratio. They are easy to measure and intuitive. Both of them are effective diagnostic parameters for Haglund's deformity. Furthermore, bump-calcaneus ratio is more reliable diagnostic parameter than bump height.
    MeSH term(s) Achilles Tendon/surgery ; Exostoses ; Heel Spur/diagnosis ; Humans ; Reproducibility of Results ; Retrospective Studies
    Language English
    Publishing date 2022-02-01
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2379-139X
    ISSN (online) 2379-139X
    DOI 10.3390/tomography8010023
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  7. Article ; Online: Validation and modification of the Coronal Plane Alignment of the Knee classification in the Asian population.

    Hsu, Cheng-En / Chen, Chao-Ping / Wang, Shun-Ping / Huang, Jen-Ting / Tong, Kwok-Man / Huang, Kui-Chou

    Bone & joint open

    2022  Volume 3, Issue 3, Page(s) 211–217

    Abstract: Aims: The Coronal Plane Alignment of the Knee (CPAK) classification is a simple and comprehensive system for predicting pre-arthritic knee alignment. However, when the CPAK classification is applied in the Asian population, which is characterized by ... ...

    Abstract Aims: The Coronal Plane Alignment of the Knee (CPAK) classification is a simple and comprehensive system for predicting pre-arthritic knee alignment. However, when the CPAK classification is applied in the Asian population, which is characterized by more varus and wider distribution in lower limb alignment, modifications in the boundaries of arithmetic hip-knee-ankle angle (aHKA) and joint line obliquity (JLO) should be considered. The purposes of this study were as follows: first, to propose a modified CPAK classification based on the actual joint line obliquity (aJLO) and wider range of aHKA in the Asian population; second, to test this classification in a cohort of Asians with healthy knees; third, to propose individualized alignment targets for different CPAK types in kinematically aligned (KA) total knee arthroplasty (TKA).
    Methods: The CPAK classification was modified by changing the neutral boundaries of aHKA to 0° ± 3° and using aJLO as a new variable. Radiological analysis of 214 healthy knees in 214 Asian individuals was used to assess the distribution and mean value of alignment angles of each phenotype among different classifications based on the coronal plane. Individualized alignment targets were set according to the mean lateral distal femoral angle (LDFA) and medial proximal tibial angle (MPTA) of different knee types.
    Results: A very high concentration, 191 from 214 individuals (89.3%), were found in knee types with apex distal JLO when the CPAK classification was applied in the Asian population. By using aJLO as a new variable, the high distribution percentage in knee types with apex distal JLO decreased to 125 from 214 individuals (58.4%). The most common types in order were Type II (n = 70; 32.7%), Type V (n = 55; 25.7%), and Type I (n = 46; 21.5%) in the modified CPAK classification.
    Conclusion: The modified CPAK classification corrected the uneven distribution when applying the CPAK classification in the Asian population. Setting individualized TKA alignment targets according to CPAK type may be a practical method to recreate optimal LDFA and MPTA in KA-TKA. Cite this article:
    Language English
    Publishing date 2022-03-11
    Publishing country England
    Document type Journal Article
    ISSN 2633-1462
    ISSN (online) 2633-1462
    DOI 10.1302/2633-1462.33.BJO-2022-0001.R1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Intermittent parathyroid hormone treatment affects the bone structural parameters and mechanical strength of the femoral neck after ovariectomy-induced osteoporosis in rats.

    Wang, Shun-Ping / Chen, Ying-Ju / Hsu, Cheng-En / Chiu, Yung-Cheng / Tsai, Ming-Tzu / Hsu, Jui-Ting

    Biomedical engineering online

    2022  Volume 21, Issue 1, Page(s) 6

    Abstract: Background: Menopause-induced decline in estrogen levels in women is a main factor leading to osteoporosis. The objective of this study was to investigate the effect of intermittent parathyroid hormone (PTH) on bone structural parameters of the femoral ... ...

    Abstract Background: Menopause-induced decline in estrogen levels in women is a main factor leading to osteoporosis. The objective of this study was to investigate the effect of intermittent parathyroid hormone (PTH) on bone structural parameters of the femoral neck in ovariectomized rats, in addition to correlations of maximum fracture force.
    Methods: Fifteen female Wister rats were divided into three groups: (1) control group; (2) ovariectomized (OVX) group; and (3) OVX  +  PTH group. All rats were then killed and the femurs extracted for microcomputed tomography scanning to measure volumetric bone mineral density (vBMD) and bone structural parameters of the femoral neck. Furthermore, the fracture forces of femoral neck were measured using a material testing system.
    Results: Compared with the control and OVX  +  PTH groups, the OVX group had significantly lower aBMD, bone parameter, and mechanical strength values. A comparison between OVX and OVX  +  PTH groups indicated that PTH treatment increased several bone parameters. However, the OVX  +  PTH groups did not significantly differ with the control group with respect to the bone structural parameters, except for trabecular bone thickness of cancellous bone, which was greater. In addition, among the bone structural parameters, the CSA and BSI of cortical bone were significantly correlated with the maximum fracture force of the femoral neck, with correlations of, respectively, 0.682 (p  = 0.005) and 0.700 (p  = 0.004).
    Conclusion: Intermittent PTH helped treat ovariectomy-induced osteoporosis of cancellous bone and cortical bone in the femoral necks of rats. The ability of the femoral neck to resist fracture was highly correlated with the two parameters, namely cross-sectional area (CSA) and bone strength index (=  vBMD  ×  CSA), of cortical bone in the femoral neck and was less correlated with aBMD or other bone structural parameters.
    MeSH term(s) Animals ; Female ; Femur Neck/diagnostic imaging ; Humans ; Osteoporosis/drug therapy ; Osteoporosis/etiology ; Ovariectomy ; Parathyroid Hormone ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; X-Ray Microtomography
    Chemical Substances Parathyroid Hormone
    Language English
    Publishing date 2022-01-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 2084374-4
    ISSN 1475-925X ; 1475-925X
    ISSN (online) 1475-925X
    ISSN 1475-925X
    DOI 10.1186/s12938-022-00978-9
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  9. Article: Comparison of the Therapeutic Effects Between Isokinetic and Isotonic Strength Training in Patients After Total Knee Replacement: A Prospective, Randomized Controlled Trial.

    Cheng, Yuan-Yang / Liu, Chuan-Ching / Lin, Shih-Yi / Lee, Cheng-Hung / Chang, Shin-Tsu / Wang, Shun-Ping

    Orthopaedic journal of sports medicine

    2022  Volume 10, Issue 6, Page(s) 23259671221105852

    Abstract: Background: Rebuilding the strength of the quadriceps as soon as possible after total knee replacement (TKR) is important so as to restore gait stability. To date, there are no standard postoperative strength training programs during the early recovery ... ...

    Abstract Background: Rebuilding the strength of the quadriceps as soon as possible after total knee replacement (TKR) is important so as to restore gait stability. To date, there are no standard postoperative strength training programs during the early recovery stage after TKR.
    Purpose: To compare the therapeutic effects between isokinetic and isotonic strengthening in patients after TKR.
    Study design: Randomized controlled trial; Level of evidence, 1.
    Methods: From April 2018 to August 2020, 37 patients met the inclusion criteria and were randomly assigned to perform either 4-week isokinetic or isotonic strength training programs. Other components of the rehabilitation program were kept the same between the 2 groups. All cases were evaluated by the Timed Up and Go (TUG) test, peak torque of knee extension and flexion (60 and 120 deg/s), 36-item Short Form Health Survey (SF-36), and Western Ontario and McMaster Universities Arthritis Index (WOMAC).
    Results: After undergoing a 4-week strength training regimen, significant improvements in the TUG test were noted in both groups; however, the time improvement in the isotonic group did not reach the minimal detectable change. All peak torque measurements improved in the isokinetic group but not in the isotonic group for knee flexion at 60 deg/s. The pain subdomain, physical domain, mental domain, total SF-36 score, and WOMAC index all improved significantly in both groups after training. Both training groups improved significantly in peak torque of knee strength, TUG test, and functional scores, but the differences between isokinetic and isotonic training were not statistically significant.
    Conclusion: The study findings showed that a 4-week strengthening exercise program in the early postoperative stage, involving either isokinetic or isotonic training, resulted in significant improvements in patients undergoing TKR.
    Registration: NCT02938416 (ClinicalTrials.gov identifier).
    Language English
    Publishing date 2022-06-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2706251-X
    ISSN 2325-9671
    ISSN 2325-9671
    DOI 10.1177/23259671221105852
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: The WD repeat-containing protein 5 (WDR5) antagonist WDR5-0103 restores the efficacy of cytotoxic drugs in multidrug-resistant cancer cells overexpressing ABCB1 or ABCG2.

    Wu, Chung-Pu / Hsieh, Ya-Ju / Tseng, Han-Yu / Huang, Yang-Hui / Li, Yan-Qing / Hung, Tai-Ho / Wang, Shun-Ping / Wu, Yu-Shan

    Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie

    2022  Volume 154, Page(s) 113663

    Abstract: The development of multidrug resistance (MDR) is one of the major challenges in the treatment of cancer which is caused by the overexpression of the ATP-binding cassette (ABC) transporters ABCB1 (P-glycoprotein) and/or ABCG2 (BCRP/MXR/ABCP) in cancer ... ...

    Abstract The development of multidrug resistance (MDR) is one of the major challenges in the treatment of cancer which is caused by the overexpression of the ATP-binding cassette (ABC) transporters ABCB1 (P-glycoprotein) and/or ABCG2 (BCRP/MXR/ABCP) in cancer cells. These transporters are capable of reducing the efficacy of cytotoxic drugs by actively effluxing them out of cancer cells. Since there is currently no approved treatment for patients with multidrug-resistant tumors, the drug repurposing approach provides an alternative route to identify agents to reverse MDR mediated by ABCB1 and/or ABCG2 in multidrug-resistant cancer cells. WDR5-0103 is a histone H3 lysine 4 (H3K4) methyltransferase inhibitor that disrupts the interaction between the WD repeat-containing protein 5 (WDR5) and mixed-lineage leukemia (MLL) protein. In this study, the effect of WDR5-0103 on MDR mediated by ABCB1 and ABCG2 was determined. We found that in a concentration-dependent manner, WDR5-0103 could sensitize ABCB1- and ABCG2-overexpressing multidrug-resistant cancer cells to conventional cytotoxic drugs. Our results showed that WDR5-0103 reverses MDR and improves drug-induced apoptosis in multidrug-resistant cancer cells by inhibiting the drug-efflux function of ABCB1 and ABCG2, without altering the protein expression of ABCB1 or ABCG2. The potential sites of interactions of WDR5-0103 with the drug-binding pockets of ABCB1 and ABCG2 were predicted by molecular docking. In conclusion, the MDR reversal activity of WDR5-0103 demonstrated here indicates that it could be used in combination therapy to provide benefits to a subset of patients with tumor expressing high levels of ABCB1 or ABCG2.
    MeSH term(s) ATP Binding Cassette Transporter, Subfamily B/metabolism ; ATP Binding Cassette Transporter, Subfamily G, Member 2/metabolism ; ATP-Binding Cassette Transporters ; Antineoplastic Agents/chemistry ; Antineoplastic Agents/pharmacology ; Cell Line, Tumor ; Drug Resistance, Multiple ; Drug Resistance, Neoplasm ; Humans ; Intracellular Signaling Peptides and Proteins/metabolism ; Molecular Docking Simulation ; Neoplasm Proteins/metabolism ; Neoplasms ; WD40 Repeats
    Chemical Substances ABCB1 protein, human ; ABCG2 protein, human ; ATP Binding Cassette Transporter, Subfamily B ; ATP Binding Cassette Transporter, Subfamily G, Member 2 ; ATP-Binding Cassette Transporters ; Antineoplastic Agents ; Intracellular Signaling Peptides and Proteins ; Neoplasm Proteins ; WDR5 protein, human
    Language English
    Publishing date 2022-09-05
    Publishing country France
    Document type Journal Article
    ZDB-ID 392415-4
    ISSN 1950-6007 ; 0753-3322 ; 0300-0893
    ISSN (online) 1950-6007
    ISSN 0753-3322 ; 0300-0893
    DOI 10.1016/j.biopha.2022.113663
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