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23 September 2012, Volume 16 Issue 39 Previous Issue    Next Issue

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Effects of intra-operative cervical posture in cervical disc replacement on post-operative cervical range of motion Deng Yu-xiao, Hong Ying, Liu Hao, Hu Tao, Ding Chen, Gong Quan, Li Tao, Song Yue-ming 2012, 16 (39):  7221-7226.  doi: 10.3969/j.issn.2095-4344.2012.39.001 Abstract ( 242 )   PDF (472KB) ( 533 )   Save BACKGROUND: Cervical disc replacement is widely used for cervical spondylosis as it can maintain cervical motion of the target segments and reduce the degeneration of adjacent segments. But few studies have focused on the influence of intra-operative cervical posture in the cervical disc replacement to the post-operative cervical motion. OBJECTIVE: To check the correlation between intra-operative cervical posture and post-operative cervical motion in cervical disc replacement. METHODS: Forty-nine patients that underwent single segmental PRESTIGE LP cervical disc replacement surgery from January 2008 to July 2010 in West China Hospital, Sichuan University were enrolled in this retrospective study. X-ray film of the C-arm fluoroscopy as well as the cervical sagittal neutral position and dynamic position (hyperextension, flexion) before and after replacement were collected, and the target intervertebral disc Cobb angle was measured. Linear correlation and regression were preformed to analyze the relation between angle difference before and during replacement and motion improvement before and after replacement. RESULTS AND CONCLUSION: There was no significant difference of the lordotic angle of the aimed disc during cervical disc replacement before and after replacement (P > 0.05); after replacement, the angle of the artificial disc was improved in neutral position, hyperextension and flexion (P < 0.01), and there was no significant difference of the overall range of motion after replacement; the overall range of motion was increased in flexion direction (P < 0.01), and there was no significant difference of the overall range of motion in extension direction (P > 0.05). There was a linear correlation between the angle and range of motion and angle difference before and during replacement (P < 0.01). A moderate lordotic intra-operative cervical posture is vital to range of motion artificial disc after cervical disc replacement, especially in the flexion direction. Related Articles | Metrics

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Total hip arthrolasty plus structural bone grafting for the treatment of Crowe Ⅲ acetabular dysplasia osteoarthritis Yuan Ming-wu, Pan Jiang, Zhang Xiao-dong 2012, 16 (39):  7227-7231.  doi: 10.3969/j.issn.2095-4344.2012.39.002 Abstract ( 306 )   PDF (420KB) ( 515 )   Save BACKGROUND: In the cases of total hip arthroplasty, Crowe Ⅲ acetabular dysplasia osteoarthritis needs to be treated with total hip arthroplasty. OBJECTIVE: To observe the effect of total hip arthroplasty plus structural bone grafting for the treatment of Crowe Ⅲ acetabular dysplasia osteoarthritis. METHODS: From January 2006 to August 2009 in Department of Orthopedics, Chaoyang Hospital, Beijing, 15 cases (18 hips) of Crowe Ⅲ acetabular dysplasia osteoarthritis were selected and treated with total hip arthroplasty plus structural bone grafting. RESULTS AND CONCLUSION: All cases were followed-up for 12-24 months, averagely 18 months. Acetabular rotating center of all the cases was back to normal, the preoperative length difference of lower limbs was 2.0-3.5 cm and the postoperative length difference of lower limbs was 0-1.5 cm. To the last follow-up, the average Harris score was increased from preoperative 38 points (17-69 points) to postoperative 92 points (86-96). During the total hip arthroplasty for the treatment of Crowe Ⅲ acetabular dysplasia osteoarthritis, reconstructed the acetabular in the true acetabulum, regressed the acetabular rotation center, combined with structural bone grafting can effectively restore the acetabular coverage, maintain the stability of acetabular cup and restore leg length. Related Articles | Metrics

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Optimal entry points of screw in internal fixation of acetabular posterior column fracture with plate Wang Xian-quan, Zhou Wei, Zhang Wei, Wang Jian, Xing Zi-ying, Sun Cheng-liang, Zhang Jin-lu,Sun Shui, Li Wei 2012, 16 (39):  7232-7236.  doi: 10.3969/j.issn.2095-4344.2012.39.003 Abstract ( 311 )   PDF (449KB) ( 520 )   Save BACKGROUND: Recently, open reduction and internal fixation has become a common therapy for pelvic and acetabular fractures. However, screw penetration sometimes damages important vessels or nerves in the pelvic cavity during the internal fixation. OBJECTIVE: To investigate the optimal entry points, direction and length of screw in acetabular posterior column plate technique, and to prevent the serious complications caused by screw penetrating the joint surface. METHODS: Twenty male cadaveric adult semipelvic specimens were taken and prepared into serial cross-sections of the acetabular posterior column. The safe angle of screw entry and the length on all entry points of each cross-section were measured. All data were input into software SPSS 10.0 for statistical process. RESULTS AND CONCLUSION: On margin of acetabulum, lateral-middle 1/4 point, midpoint, medial-middle 1/4 point and medial margin of posterior column of each cross-section, safe entry angle of inclination was 39°, 57°, 74°, 90° and 106°respectively, the length of the screw was 39, 57, 74, 90 and 106 mm respectively. On lateral 1/4 region, lateral-middle 1/4 region, medial-middle 1/4 region and medial 1/4 region, screw posterior column angle was 40°-60°, 60°-75°, 75°-90°, 90°-parallel to the quadrilateral plate, and the length of the screw was 30 mm. Related Articles | Metrics

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Short-segment pedicle instrumentation for the treatment of thoracolumbar fractures Hao Gang, Sun Tian-sheng, Li Shao-guang, Wang Hui-hui 2012, 16 (39):  7237-7241.  doi: 10.3969/j.issn.2095-4344.2012.39.004 Abstract ( 265 )   PDF (416KB) ( 591 )   Save BACKGROUND: Nowadays, the short-segment pedicle instrumentation has been widely used which makes the reliability of the “spine load” scoring system to be questioned, lots of related reports have confirmed the effect of short-segment pedicle instrumentation for the treatment of thoracolumbar fractures. OBJECTIVE: To observe the effect of short-segment pedicle instrumentation for the treatment of thoracolumbar fractures. METHODS: A retrospective analysis was performed on 38 patients with thoracolumbar fractures selected from the Department of Orthopedics, the General Hospital of Beijing Military Area Command of Chinese PLA from May 2007 to October 2010, all the patients were treated with posterior short-segment pedicle instrumentation. RESULTS AND CONCLUSION: All the 38 patients were followed-up for 10.3-28.9 months. The average relative kyphosis Cobb angle at the final follow-up was 9.0°, with an average loss of correction of 6.3°. The average loss of correction was 6.4° in type A fractures, 5.7° in type B fractures, 7.4° in type C fractures; the average loss of correction was 5.7° for Load Sharing Classification point of ≤6 and 7.5° for Load Sharing Classification point of≥7. The average loss of correction among the patients of thoracolumbar fractures (T11-L2) and lower lumbar fracture (L3-L5) was 6.3° and 6.5°, the loss of correction of 11 patients (30%) was more than 10°, the average loss of correction was 11.5° (10.1°-16.3°), and 4 patients in type A fractures, 4 patients in type B fractures, 3 patients in type C fractures, and 5 patients in Load Sharing Classification point of ≤6, 6 patients in Load Sharing Classification point of ≥7. There was no significant difference between different groups. Our data suggest that short-segment pedicle instrumentation can be successful for the treatment of thoracolumbar fractures regardless the AO fracture classification and Load Sharing Classification characteristics of the fracture pattern. The effect of short-segment pedicle instrumentation for the treatment of thoracolumbar fractures and lower lumbar fracture is similar. Related Articles | Metrics

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Application of sagittal screw angle based on supraspinous line in the treatment of thoracolumbar fixation Chen Wei-dong, Yang Qing-guo, Zhang Yin-shun, Liu Jin-rui, Bo Ran 2012, 16 (39):  7242-7245.  doi: 10.3969/j.issn.2095-4344.2012.39.005 Abstract ( 298 )   PDF (409KB) ( 596 )   Save BACKGROUND: Ideal reset of the thoracolumbar fractures needs accurate pedicle screw placement angle to achieve the desired stress. In recent years, a variety of means have designed by the experts and scholars at home or abroad, almost all the means are aimed to design a plane with the reference of the anatomical structure of vertebral body or attachments, so accurate degree is not uniform. OBJECTIVE: To analyze whether supraspinous line can be the identification marker of the sagittal screw angle of the pedicle of vertebral arch in the thoracolumbar surgery． METHODS: A total of 49 cases of the nomal thoracolumbar MRI images and 21 cases of T12 thoracolumbar fracture MRI images were included in the study to measure the angle of the vertebral body terminal plate parallel lines and the corresponding supraspinous lines. The comparison and statistical comparative analysis were performed. RESULTS AND CONCLUSION: The angle of vertebral body terminal plate against supraspinous line was 90° at T10-L3, and was about 82° at L4. The angle was not changed before and after thoracolumbar fracture. In the internal fixation surgery of thoracolumbar fracture, if the angle of vertebral body terminal plate against supraspinous line is about 90° at T10-L3 and 80° at L4, the pedicle screw and terminal plate may be maintained in parallel basically. Supraspinous line can be the identification marker for sagittal screw angle of the pedicle of vertebral arch. Related Articles | Metrics

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Three-plate fixation through two incisions for three-column fractures of tibial plateau with complex posterior fractures Lin Wang, Lin Cheng-shou, Liu Shou-kun, Guo Wei-zhong, Wang Ying-ying, Wang Xu, Su Yu, Wang Xiao-lu 2012, 16 (39):  7246-7249.  doi: 10.3969/j.issn.2095-4344.2012.39.006 Abstract ( 298 )   PDF (412KB) ( 456 )   Save BACKGROUND: Three-column fractures of tibial plateau are always caused by high energy violence. The fractures are usually comminuted fracture with the articuar surface breaking and collapsing, and have severe soft tissues injury and many complications which are difficult points of orthopaedic trauma. OBJECTIVE: To describe the operative procedures and clinical outcomes of internal fixation with three-plate fixation through two incisions in treating three columns fractures of tibial plateau with complex posterior fractures. METHODS: Twelve patients with complex three columns fractures of tibial plateau were treated with two incisions three-plate fixation through the anterolateral approach combined with postero-medial approach. One “Golf” shape plate was used through anterolateral approach, and one long plate and one short “T” shape plate were used through postero-medial approach. RESULTS AND CONCLUSION: All patients were followed-up for more than 12 months. All fractures were cured. The mean radiographic bony union time was (14.0±1.1) weeks and the mean full weight-bearing time was (15.1±1.7) weeks. The Rasmussen score of all the patients immediately after operation was (16. 8±0.6). The average range of motion of the affected knee joints at 12 month postoperatively were 126.3° flexion to -1.3° extension. The Hospital for Special Surgery score of all the patients at 12 months postoperatively was (89.1±2.5). There were no significant differences in changes of the tibial plateau varus angle between the group immediately after operation, the group at 3 months postoperatively and the group at 12 months postoperatively and posterior slope angle (P > 0.05). No complication occurred such as necrosis of the incision, deep infection, the loosening and breakage of the internal fixation. The internal fixation with three plates through two incisions gives consideration to the complexity of fractures and the speciality of the posterior anatomy in tibial plateau, and is an effective and safe treatment for three columns fractures of tibial plateau with complex posterior fractures. Related Articles | Metrics

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Fastin anchors for arthroscopic repair of anterior horn injury of the lateral meniscus Xu Wei-peng, Xu Jian-zhong, Tian Ke, Li Chao, Li Yu, Qiao Yuan-xin 2012, 16 (39):  7250-7253.  doi: 10.3969/j.issn.2095-4344.2012.39.007 Abstract ( 356 )   PDF (390KB) ( 597 )   Save BACKGROUND: Fastin anchors have been widely used in repairing rotator cuff injury, ligament injury and so on, but rarely reported for meniscus repair. OBJECTIVE: To evaluate the methods and clinical effectiveness of arthroscopic repair with anchors for anterior horn injury of the lateral meniscus. METHODS: Retrospective analysis was performed on the clinical data of 22 patients who had been diagnosed with anterior horn injury of the lateral meniscus through MRI and definitely diagnosed through arthroscopy, all of them was suitable for repairing and received arthroscopic repair with anchors, the clinical effect was evaluated through symptoms, signs, Lysholm and International Knee Documentation Committee system. RESULTS AND CONCLUSION: All the patients were followed-up for 7-28 months (19.3 months). There were no severe complications. The Lysholm and International Knee Documentation Committee systems showed that the scores ascended respectively from (45.20±7.47) and (41.55±8.91) before surgery to (90.60±5.46) and (91.85±1.09) after surgery (P < 0.05). These indicate that the methods of arthroscopic repair with anchors for anterior horn injury of the lateral meniscus can get a good clinical effect. Related Articles | Metrics

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Determination of the resected surface of the radial osteotomy by digital simulation technique Tan Pei-yong, Xiang Zhou, Huang Xiao, Yang Jing, Song Bin 2012, 16 (39):  7254-7258.  doi: 10.3969/j.issn.2095-4344.2012.39.008 Abstract ( 392 )   PDF (474KB) ( 481 )   Save BACKGROUND: At present, most of the methods to determine the cut planes of corrnective osteotomy are based on two-dimensional X-ray films and empirical judgment, and the accuracy is poor. OBJECTIVE: To accurately determine the cut planes of the radial osteotomy by digital simulation technique. METHODS: A CT scanning data of double carpal joint of a patient with multiple exostoses was imported into Mimics for three-dimensional reconstruction. The computer-aided design and spatial analytic geometry was used to determine the cut planes and measure their parameters, digital simulation technique was used to simulate the surgical procedure of osteotomy and reduction. RESULTS AND CONCLUSION: The method mentioned in article can determine and measure the bilateral cut planes of the radial corrective osteotomy, providing an accuracy and intuitive clinical guide. Related Articles | Metrics

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Finite element analysis of biomechanics of knee joint including posterolateral structures Liu Xiao-min, Liu Jie, Lü Jin, Yuan Jin-bo, Pu Yong-hua, Wu Song 2012, 16 (39):  7259-7262.  Abstract ( 249 )   PDF (363KB) ( 610 )   Save BACKGROUND: Finite element analysis is a numerical analysis method and suitable for analyzing the biomechanics of the human body through three-dimensional finite element. OBJECTIVE: To analysis the biomechanics of the main posterolateral knee ligament (lateral collateral ligament, popliteus tendon and popliteofibular ligament). METHODS: Firstly, the three-dimensional finite element model of the knee including posterolateral structures was established. Secondly, the stress response of posterolateral structures was analyzed by applying the power of forward and backward, the torque of turning inward and outward and the torque of internal and external rotation to the tibia. RESULTS AND CONCLUSION: Posterolateral structures had an important role in limiting the knee to turning inward, internal rotation and moving backward of the tibia, but the limitation on the knee to turning outward, external rotation and moving forward of the tibia was not obvious. The results showed that the posterolateral structures have an obvious influence on the stability of the knee. The lateral collateral ligament plays a major role in the knee posterolateral structures and followed by the popliteal tendon, and popliteofibular ligament plays a supporting role in the posterolateral structures. Related Articles | Metrics

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Action mechanism of Ilizarov technique in deformity correction device for elbow and knee flexion extension contracture by finite element analysis Qin Da-ping, Zhang Xiao-gang, Song Min, Wu Sheng-zhi, Cao Lin-zhong 2012, 16 (39):  7263-7267.  doi: 10.3969/j.issn.2095-4344.2012.39.010 Abstract ( 345 )   PDF (478KB) ( 547 )   Save BACKGROUND: At present, few researches have reported the effect mechanism of IIizarov technique in orthopedic disorders limb lengthening and joint contracture external fixation device by finite element analysis. OBJECTIVE: To analyze the effect mechanism of Ilizarov technique in deformity correction device for elbow and knee flexion extension contracture by three-dimensional finite element analysis. METHODS: The joint contracture correction device based on the human body biomechanical properties which can be widely applied to clinical treatment was established by IIizarov biological theory. The mechanical effect and scientificity of Ilizarov technique in the designing of the deformity correction device for elbow and knee flexion extension contracture were analyzed by three-dimensional finite element. RESULTS AND CONCLUSION: A three-dimensional finite element model of elbow and knee joints with realistic appearance and full biomechanical properties were established. The mechanical indexes, such as the elastic modulus and Poisson’s ratio of the bone and soft tissue were calculated through the three-dimensional finite element model and the mechanical analysis. Joint internal and external stress-strain distribution and changes were analyzed through imposing load on the joint contracture correction device. Ilizarov technique can provide the theory basis for the designing and optimizing deformity correction device for elbow and knee flexion extension contracture, and the finite element mechanics analysis reveals the biomechanical change mechanism of elbow and knee flexion contracture lesions organizational structure. Related Articles | Metrics

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Biomechanical analysis on vertical physiological external pressure fixator Wang Xi-bin, Sun Yong-qiang 2012, 16 (39):  7268-7273.  doi: 10.3969/j.issn.2095-4344.2012.39.011 Abstract ( 401 )   PDF (505KB) ( 424 )   Save BACKGROUND: Most of the external fixator is a rigid structure with too much stress shielding on the fracture end which can affect the fracture healing speed and quality of callus, and even lead to fracture nonunion. OBJECTIVE: To compare the difference of biomechanical strength between normal tibia and the tibia with middle transverse fracture after treated with vertical physiological external pressure fixator. METHODS: Twelve fresh tibial specimens were obtained and randomly divided into experimental group and control group, tibia with middle transverse fracture caused by wire saw and fixed with vertical physiological external pressure fixator was the experimental group; the tibias in the control group were the normal tibias. The mechanical loading experiment was performed on the axial load, bending load and torsional load, and the displacement of the tibia and the torsion angle were recorded after each level of load, the axial compression stiffness, bending stiffness and torsional stiffness were calculated. RESULTS AND CONCLUSION: Loading within the physiological range, the left and right strain in the experimental group were slightly larger than those in the control group, but there was no significant difference of overall stiffness after fixation between two groups (P > 0.05); the bending strain in the experimental group was larger than that in the control group, but there was no significant difference of overall stiffness after fixation between two groups (P > 0.05); there was no significant difference of overall torsional stiffness between two groups (P > 0.05); the ultimate bending load in the experimental group was significantly larger than that in the control group (P < 0.05). The vertical physiological external pressure fixator has a sufficient biomechanical strength and good stability, and plays an important role in the biological fixation of fracture. Related Articles | Metrics

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Finite element analysis of osteogenesis model of mandibular distraction zone Song Fu-min, Ji Bao-hui, Tang Zhi-xiong, Wang Chun, Wang Hang 2012, 16 (39):  7274-7278.  doi: 10.3969/j.issn.2095-4344.2012.39.012 Abstract ( 378 )   PDF (512KB) ( 666 )   Save BACKGROUND: Some studies have reported that there exist two kinds of ossification ways, intramembranous ossification and endochondral ossification in the distraction gap. Others also reported that there will be only intramembranous ossification when the tensions forces axial without other direction of external interference. OBJECTIVE: To investigate the level of stress of different occlusal conditions suffered by new tissues, and to verify whether the environment can induce and promote endochondral ossification in order to explain the issue of osteogenesis inconsistent. METHODS: We established a clinical bilateral mandibular distraction osteogenesis model and set the distance of 1 cm. After consolidation for 4 weeks, we exerted muscle force in the site of masticatory muscles’ attachment in order to simulate the actual chewing movement. We selected three basic occlusion statuses, namely clenching in the intercuspal position, left unilateral molar clenching and incisal clenching. The three-dimensional finite element analysis was used to investigate the level of stress (stress/tensile stress, shear stress, the stress paradigm). RESULTS AND CONCLUSION: ①Status of clenching in the intercuspal position: the value of Von Mises stress and shear stress was increased from lingual lateral to the buccal. The compression stress was gradually turned into a tensile stress from lingual and distal lower edge to buccal and distal upper edge. ②Status of incisal clenching: the value of Von Mises stress and shear stress was decreased from lingual lateral to the buccal. Pressure stress was gradually turned into a tensile stress from lingual lateral to the buccal. ③Status of left unilateral molar clenching: the stress distribution of left distract region was very similar to that of the intercuspal position status, but the maximum values were lower than the intercuspal position status. The maximum value of Von Mises stress existed at the upper and lower edge of distal lateral. The minimum value existed at the buccal and mesial lower edge. There is a transition zone between the maximum and minimum value. The characteristics of shear stress were similar to that of Von Mises stress. Compression/tensile stress mainly exited at the mesial lower edge. This indicates that masticatory movement can create a mechanical environment promoting the cartilage formation especially when the fixation is not stable enough and provide a accurate solution to the issue of osteogenesis inconsistent. Related Articles | Metrics

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Computer-aided three-dimensional gait evaluation of muscle strength and pelvic control capability of the children with cerebral palsy Ran Mao-qun, Xiao Nong, Ren Yong-ping, Li Bang-hui, Liu Ling, Chen Yu-xia 2012, 16 (39):  7279-7282.  doi: 10.3969/j.issn.2095-4344.2012.39.013 Abstract ( 330 )   PDF (397KB) ( 462 )   Save BACKGROUND: The pelvic control ability is poor in cerebral palsy children. The time for treatment is long, and the effect is not obvious. OBJECTIVE: To observe the curative effect of appropriateness exercise for power on pelvic control ability under the guidance of three-dimensional gait analysis. METHODS: A total of 60 cerebral palsy children with spastic palsy (≥2 years old) were randomly divided into two groups: treatment group and control group. Treatment group got appropriateness exercise for power under the guidance of three-dimensional gait analysis and chirismus treatment, while the control group only got chirismus treatment. The gross motor function measure, Berg balance score and gross motor function classification system were evaluated before and after treatment. RESULTS AND CONCLUSION: The video showed that both the gait and the motor ability were improved obviously in treatment group, and were better than those in the control group. There was no significant difference of the gross motor function measure score, Berg balance score and gross motor function classification system between two groups (P > 0.05). The post-treatment Berg balance score and gross motor function measure score in the treatment group were significantly higher than those pre-treatment (P < 0.01), and the post-treatment gross motor function classification was lower than that pre-treatment (P < 0.01). The post-treatment Berg balance score and gross motor function measure score in the treatment group were significantly higher than those in the control group (P < 0.01). On the base of the chirismus treatment, appropriateness exercise for power under the guidance of three-dimensional gait analysis can effectively improve the pelvic control ability and accordingly improve the gait and elevate motor ability in the cerebral palsy children. Related Articles | Metrics

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Meta-analysis of the outcomes of patella resurfacing in total knee arthroplasty Dai Hong-jie, Jin Xian-hui, Cui Sheng-jie, Gao Chun-guang 2012, 16 (39):  7283-7287.  doi: 10.3969/j.issn.2095-4344.2012.39.014 Abstract ( 509 )   PDF (704KB) ( 544 )   Save BACKGROUND: There is controversy on whether the patellar resurfacing should be performed during total knee arthroplasty. OBJECTIVE: To compare the outcomes of total knee arthroplasty with or without patellar resurfacing, and to analyze the problems and the strategies that need to be improved of patellar resurfacing. METHODS: The PubMed database, Medline database, Elsevier database, Embase database, OVID database, ProQuest database, Springer database, BlackWell database, JohnWiley database, CBM database, CNKI database and VIP database were used to search the randomized controlled trials on total knee arthroplasty with or without patellar resurfacing that published before 2011-11-15. For the articles of the same sample, we selected those with the longest follow-up. The reoperation rates, incidence of anterior knee pain and functional scores were analyzed by the Revman 5.0 software provided by the International Cochrane Collaboration Group. RESULTS AND CONCLUSION: A total of 18 randomized controlled trials of 7 075 patients were selected (3 463 in the resurfacing group and 3 612 in the non-resurfacing group). Meta-analysis showed that there was no significant difference of the incidence of anterior knee pain between resurfacing group and non-resurfacing group (RR=0.150, 95%CI: 0.129-0.185, P > 0.05). Compared with non-resurfacing group, the reoperation rates more than 5 years in the resurfacing group was decreased (RR=0.135, 95%CI:0.118-0.166, P < 0.05). There was no significant difference of the functional scores between two groups (WMD=-0.144, 95%CI: -1.122-2.109, P > 0.05). It indicates that there is no significant difference in the outcome of total knee arthroplasty with or without patellar resurfacing, so more usage of national registry joint replacement data should be encouraged to provide the basis for the identification of whether the patellar resurfacing should be performed during total knee arthroplasty. Related Articles | Metrics

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Average acetabular coverage of femoral head after developmental dislocation of the hip measured by CT three-dimensional reconstruction Hu Gang-feng, Qian Ping-yan, Ding Guo-liang, Qian Bin, Hu Xiao-hua, Wu Jing-tao 2012, 16 (39):  7288-7291.  doi: 10.3969/j.issn.2095-4344.2012.39.015 Abstract ( 426 )   PDF (352KB) ( 544 )   Save BACKGROUND: A three-dimensional structure of acetabular and femoral head can be clearly displayed by using three-dimensional reconstruction through volume rendering technique of multi-slice spiral CT, and provide help to measure the average acetabular coverage of femoral head and observe the development change of abnormal acetabulum. OBJECTIVE: To measure the changes of average acetabular coverage of femoral head in children with developmental dislocation of the hip by multi-slice spiral CT three-dimensional reconstruction for 4 consecutive years. METHODS: Fifty-three cases of development dislocation children treated with closed reduction and external fixation were included to perform the retrospective analysis. Before the restoration, within 24 hours after restoration, the entire complex after 12, 24, 36 and 48 months, the multi-slice spiral CT scan axial acetabular and image processing system was used to reconstruct and measure the average acetabular coverage of femoral head. RESULTS AND CONCLUSION: The average acetabular coverage of femoral head after closed reduction was significantly higher than that before treatment (P < 0.01). After followed-up for 4 years, the average acetabular coverage of femoral head was gradually increased after closed reduction, it increased most within 1 year, and closed to the normal control group at the 4th year. The multi-slice spiral CT three-dimensional reconstruction can clearly show the relationship between three-dimensional positiosns, and provide a new mean for the research of the relationship between hips of children with developmental dislocation and the position of femoral head; the average acetabular coverage of femoral head measured by three-dimensional reconstruction after closed reduction is higher than that before treatment. Related Articles | Metrics

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Multi-slice spiral CT and post-processing technology in the evaluation of abdominal and perivascular adipose tissue Hu Chun-ting, Tian Gang 2012, 16 (39):  7292-7297.  doi: 10.3969/j.issn.2095-4344.2012.39.016 Abstract ( 369 )   PDF (502KB) ( 595 )   Save BACKGROUND: At present, the measurement of abdominal fat mainly depends on the abdominal fat area on the single level, and it may be influenced by the uniform distribution of fat and cannot accurately measure the content of the visceral fat. The reports on the measurement of perivascular adipose tissue by multi-slice spiral CT are rare. OBJECTIVE: To investigate the value of multi-slice spiral CT and post-processing technology in the evaluation of abdominal and perivascular adipose tissue. METHODS: CT scan of abdomen cavity was performed in thirty-five patients with abdominal obesity by 16-slice spiral CT. In addition, the imagery of abdominal and perivascular adipose tissue was observed by General Electric AW4.3 work station with volume rendering. The volumes of total abdominal adipose tissue, subcutaneous adipose tissue, visceral adipose tissue, perivascular adipose tissue were measured by Histogram software, repeating each index in order to compare the difference of twice bulking value. RESULTS AND CONCLUSION: Multi-slice spiral CT and post-processing technology could visually display the distribution of abdominal and perivascular adipose tissue, and could measure the volume of adipose tissue in the sweep range and in different parts. There was no significant difference in volume of abdominal and perivascular adipose tissue between twice CT post-processing (P > 0.05). It was feasible and repeatable to evaluate the distribution and content of abdominal and perivascular adipose tissue by multi-slice spiral CT and post-processing technology. Related Articles | Metrics

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Segmentation of coronary artery from dual-source CT images Li Li-hua, Huang Yue-shan, Yang Rong-qian, Wu Xiao-ming 2012, 16 (39):  7298-7301.  doi: 10.3969/j.issn.2095-4344.2012.39.017 Abstract ( 477 )   PDF (556KB) ( 588 )   Save BACKGROUND: Segmenting the three-dimensional coronary artery from dual-source CT images aided by computer can provide the basis for quantitative evaluation. However, the complicated three-dimensional shape and narrowness of coronary artery make it a challenging task to accurately segment the coronary artery. OBJECTIVE: To solve accurate coronary artery segmentation problem. METHODS: A three-step data processing strategy was used to achieve coronary artery segmentation. The three-dimensional dual-source CT images were first pre-segmented with threshold method. Then, the origins of left and right coronary artery which were connected to aorta were segmented using an interaction method. Finally, according to the location of coronary artery’s origin, three-dimensional coronary artery was segmented using a method based on morphology and neighboring connection relationship between slice images. RESULTS AND CONCLUSION: The proposed approach based on morphology and connection relatioship between slice images could accurately segment the left and right coronary artery from dual-source CT images. It suggests that the proposed approach is adequate for segmenting three-dimensional coronary artery. Related Articles | Metrics

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Design and implementation of hybrid segmentation method for brain MRI based on Insight Segmentation and Registration Toolkit Ren Xiao-ying, Yu Da-hua 2012, 16 (39):  7302-7306.  doi: 10.3969/j.issn.2095-4344.2012.39.018 Abstract ( 395 )   PDF (478KB) ( 583 )   Save BACKGROUND: In the brain MRI images, for the low information contrast and the complex brain tissue shape, the choice of the segmentation method is more difficult, the single algorithm is difficult to obtain satisfactory segmentation results. OBJECTIVE: To develop and customize effective segmentation application algorithm according to the characteristics of brain MRI by using the existing algorithm synthetically. METHODS: According to the advantages and disadvantages of neighborhood connected and Canny level set algorithms used in the experiment, and combining the image characteristics, we took the results of the neighborhood connected methods as the prior segmentation model of Canny level set algorithm in order to determine the lower threshold of Canny level set algorithm and thus finished hybrid segmentation method. RESULTS AND CONCLUSION: Compared the white matter and gray matter segmentation result of the hybrid segmentation method with the result of the experts’ manual segmentation, it proved that this method had achieved good segmentation effect, and thus proved that making use of the existing algorithm synthetically could not only avoid the repeated labor, but also could develop and customize more effective segmentation application algorithm and had good potential application. Related Articles | Metrics

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Detection of the invisible control points by least square method Zhang Bin, Bi Yan-ping, Zhao Li-jing, Dong Bing-chao 2012, 16 (39):  7307-7311.  doi: 10.3969/j.issn.2095-4344.2012.39.019 Abstract ( 340 )   PDF (643KB) ( 422 )   Save BACKGROUND: Digital subtraction angiography system uses the X-ray image intensifier as an image detector and the geometric distortion exists between the real image and the obtained image. OBJECTIVE:To correct the geometric distortion of digital subtraction angiography image in order to achieve three-dimensional reconstruction of cerebral blood vessels. METHODS: Based on mathematical morphology to detect visual control point, a method of least squares was used in this article to process the images in order to gain the coordinates of the invisible control points. The obtained 672 control points were used to do the nonlinear partial correction on the original image. RESULTS AND CONCLUSION: Experiment results showed that there were better results in the edge correction without distortion in arc region basically. The method of least squares curve achieved high accuracy control points and good image correction results, it could be used in distortion correction of digital subtraction angiography images and provided guarantee for a subsequent three-dimensional reconstruction. Related Articles | Metrics

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Three-dimensional finite element analysis and establishment of the lumbar spinal stenosis model in the rats Dai Feng-lei, Liu Yi, Li Qin-liang, Chu Zhao-ming, Chen Jin-chuan, Wang Xi 2012, 16 (39):  7312-7316.  doi: 10.3969/j.issn.2095-4344.2012.39.020 Abstract ( 293 )   PDF (451KB) ( 562 )   Save BACKGROUND: The establishments of lumbar spinal stenosis model are variable, and the results of spinal stenosis caused by silicone implant are similar to which caused by degeneration of the human body. OBJECTIVE: To establish the lumbar spinal stenosis model using silicon chip to implant spinal canal in the rats, and to analyze the model through measuring the walking function and three-dimensional finite element. METHODS: Thirty male Sprague Dawley rats were divided into two groups. Two pieces of silicone rubber were implanted into the lumbar (L4 and L5) epidural space to cause spinal stenosis in experimental group. Operation processes were the same in both groups, but silicone rubber was not implanted in the control group. RESULTS AND CONCLUSION: In the experimental group, the postoperative running distance was significantly decreased as compared with the preoperation (P < 0.05), and the spinal was compressed about 50%-70%. The density of normal spinal canal was (32.4±19.58) Hu in the control group, while in the experimental group was (101.96±32.85) Hu. The results showed that the rat models of lumbar spinal stenosis are successfully established, and the making method is simple, effective and economical. Related Articles | Metrics

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Progress of magnesium ions and magnesium alloy implant application in the clinical orthopaedics Xie Xing-wen, Huang Jin, Li Ning, Xu Wei, Hu Bin, Xu Shi-hong 2012, 16 (39):  7317-7321.  doi: 10.3969/j.issn.2095-4344.2012.39.021 Abstract ( 489 )   PDF (642KB) ( 708 )   Save BACKGROUND: Magnesium ions are constant element, can be absorbed by the body and have obvious advantages as medical biomaterials. OBJECTIVE: To summarize the advantages, disadvantages, and research progress of magnesium ions and magnesium alloys application in orthopedics in recent years. METHODS: PubMed database and CNKI database were used to search the articles published from 2000 to 2011 on the progress of magnesium ions and magnesium alloys application in medical field. RESULTS AND CONCLUSION: The traditional medical metal materials including stainless steel, cobalt-based alloy and titanium based alloys which have the disadvantages of poor biocompatibility, un-matched biomechanical properties and the second surgery, and other defects. Magnesium alloys have good biomechanical compatibility, biodegradable performance, bio-security and rich resource. Magnesium alloys have the characteristics of degradation through the corrosion under physiological electrolyte environment and show a great application potential in the orthopedics field. Related Articles | Metrics

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Research and application of hydroxyapatite coated hip prosthesis Ling Zhong-hua, Zhao Jian-ning 2012, 16 (39):  7322-7326.  doi: 10.3969/j.issn.2095-4344.2012.39.022 Abstract ( 526 )   PDF (590KB) ( 436 )   Save BACKGROUND: Nowadays, biological hip prosthesis coated by hydroxyapatite has been widely used in clinical treatment. OBJECTIVE: To review relevant literatures and to summarize the biological characteristics and clinical application of hydroxyapatite coated hip prosthesis. METHODS: PubMed database were retrieved by computer for articles published from 1988 to 2011 that related to the biological characteristics and clinical application of hydroxyapatite coated hip prosthesis. The key words were “hydroxyapatite, hip arthroplasty, hip prosthesis”. Articles published earlier, repetitive and similar studies were excluded and 29 literatures were included to review. RESULTS AND CONCLUSION: Hydroxyapatite is a kind of calcium phosphate that has excellent biocompatibility and bioactivity. By deal with the surface, it can form a thin layer on the metal surface, this approach can greatly improve the osseointegration of pressed prosthesis, it can make the prosthesis bony fixed until the bone growth into the porous surface of the prosthesis. The hydroxyaptite coated uncemented hip prosthesis can promote bone growth in early implant stage and permit early weight-bearing, leading to a stable and reliable mechanical and biologic fixation. The incidence of long-term complications such as aseptic loosening, periprosthetic osteolysis and prosthesis subsidence is not higher than those of non-hydroxyaptite coated hip prosthesis. However, there is no consensus in the thickness, particle size, crystallinity of the hydroxyaptite coating material, so the further research and discussion are required. Related Articles | Metrics

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Research and clinical application of CT and finite element digital pelvic model construction Zhao Hai-bo, Long Teng-he, Yang Wei-jiang, Luo Huan-jiang, Wang Yong 2012, 16 (39):  7327-7332.  doi: 10.3969/j.issn.2095-4344.2012.39.023 Abstract ( 372 )   PDF (735KB) ( 528 )   Save BACKGROUND: Spiral CT three-dimensional reconstruction can reproduce pelvic structure intuitively and completely and provide accurate and reliable basis for the treatment of pelvic lesions. OBJECTIVE: To evaluate the research and clinical application of CT and finite element digital pelvic model. METHODS: A computer-based online search was performed on PubMed database and Vip database for the relate articles from January 2006 to November 2011 with the key words of “pelvis, CT, finite element modeling” in Chinese and English. The pelvis model reconstruction and application-related articles were included and the duplicate research or Meta analysis articles were eliminated. Finally, 26 documents were used to investigate the research and application of CT and finite element model in the pelvis. RESULTS AND CONCLUSION: CT and finite element model in the pelvic lesions had important application value, the reconstruction of a pelvis finite element model provided reliable operation model for the clinician, and designed the reasonable program for the surgery. Reasonable application of the finite element model and CT three-dimensional model can provide more reliable image information for the pelvic lesions operation. Clinicians can design the surgical program based on the model and simulate the surgical process which can greatly reduce the risk of the surgery. Related Articles | Metrics

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Radiological evaluation and significance of internal fixation implants Guan You-bing, Wu Shun-fen, Tang Guang-yao 2012, 16 (39):  7333-7337.  doi: 10.3969/j.issn.2095-4344.2012.39.024 Abstract ( 410 )   PDF (619KB) ( 503 )   Save BACKGROUND: With the development of bone tissue engineering in clinical orthopedics, stability of internal fixation has been the focus of clinical research, then what are the means to a better grasp of the biomechanical changes after implantation? OBJECTIVE: To summarize the biomechanical evaluation of the application-level imaging in orthopedic implants. METHODS: The CNKI database and PubMed database (1999-01/2012-06) were used to search the related articles about radiographic evaluation of orthopedic implants. The key words of “orthopedics, implantation, steel plate, screw, X-ray, CT, MRI” in English and Chinese were put in the title and abstract for searching the articles. The articles that related to the radiographic evaluation of orthopedic implants were selected, and for the articles in the same field, those published recently or in the authorized journals were preferred. A total of 172 articles were obtained after the initial survey, and finally 25 articles were included for review according to the inclusion criteria. RESULTS AND CONCLUSION: X-ray, CT and MRI in the evaluation after implantation of internal fixation play an important role, through the imaging pathway can grasp the location of the placement of the implants, angle, and the integration of implant materials with the host, as well as their corrosion, and it can evaluate the biomechanical stability of implants and the biocompatibility of implanted host. X-ray plain film shows the details of bone structure best, MRI is mainly used for detecting the soft tissue and cartilage, and CT can be used for representing the bone structure and detecting the soft tissue and cartilage both. X-ray plain film, CT and MRI have their advantages. Radiation and orthopedic doctors should understand the characteristics, pros and cons of various inspections, and combined with the circumstances of each patient to select the appropriate inspection methods which is more conducive to grasp the post-implantation efficacy. Related Articles | Metrics

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Radiologic imaging techniques in diagnosis of patella alta Fu Xiao-dong, Wang Wei-li 2012, 16 (39):  7338-7344.  doi: 10.3969/j.issn.2095-4344.2012.39.025 Abstract ( 2334 )   PDF (795KB) ( 657 )   Save BACKGROUND: Patella alta is considered as the primary reason for pain of anterior knee, unstability of patellofemoral joint, Osgood-Schlatter apophysitis and chondromalacia patellae, so it is important to perform early diagnosis. OBJECTIVE: To summarize the research advances of the radiologic imaging techniques in diagnosis of patella alta. METHODS: A computer-based search of PubMed database was undertaken by the first author to identify the articles related to the research on patella alta between January 1971 and November 2011, with the key words of “patella alta, diagnosis, radiologic imaging techniques”. Repetitive studies were excluded, totally 38 articles were reviewed. RESULTS AND CONCLUSION: To date, X-ray is the most convenient and most commonly used diagnostic method of patella alta, but the sensitivity is lower than CT. Although CT has great advantage than X-ray in identifying the position of patella alta, it cannot provide more effective information. Considering the high radiation dose, CT can only be used as the substitute exam method of X-ray. But magnetic resonance imaging can show accurate imaging and description on the cartilage surface wear and bone marrow edema without exposure to radiation, it may be more effective in finding early cases though it has high economic cost and time cost. Thus, the osteopathic physicians in different regions should take flexible choice in diagnostic imaging method according to different patients. Related Articles | Metrics

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Post-trauma contracture of joints Lu Guo-qiang 2012, 16 (39):  7345-7349.  doi: 10.3969/j.issn.2095-4344.2012.39.026 Abstract ( 303 )   PDF (482KB) ( 387 )   Save BACKGROUND: Joint contracture is a difficult problem in the trauma treatment. Joint contracture during the treatment of joint trauma often results in lifelong dysfunction. The present study shows that joint contractures often occur in the synovium, and synovial tissue fibrosis is the main reason for the joint contractures. Previous studies suggest that transforming growth factor β plays a key role in the lung, liver, kidney and skin fibrosis, but the effect of transforming growth factor β in joint contracture is not clear. OBJECTIVE: To review the effect and mechanism of the factors in joint contraction. METHODS: The CNKI database and Medline database (2000/2010) were searched by the first author with the key words of “trauma, joint contracture” in Chinese and “joint contracture, synovium, fixation, transforming growth factor-β1” in English. We reviewed from the morphological changes of the joint contracture, the effect of the cytokines and the interaction of cytokines. We introduced from the aspects of morphological changes and the regulation mechanism in joint contracture. A total of 196 articles were obtained, and 39 articles were included according to the exclusion and inclusion criteria. RESULTS AND CONCLUSION: Joint synovial tissue fibrosis is the biological basis of joint contractures, the cells and cytokines including transforming growth factor β, connective tissue growth factor, a-smooth muscle actin, matrix metalloproteinase and metalloproteinase tissue inhibitors participate in process of fibrosis, and transforming growth factor β is the center factors of the joint contracture. The mechanical effect on the regulation mechanism of transforming growth factor β is unclear, so the effect of time on the degree of joint contracture needs further study. Related Articles | Metrics

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Reason analysis on prosthesis loosening after artificial hip arthroplasty Qin Xiao-dong 2012, 16 (39):  7350-7357.  doi: 10.3969/j.issn.2095-4344.2012.39.027 Abstract ( 528 )   PDF (688KB) ( 486 )   Save BACKGROUND: Artificial hip arthroplasty has been widely used, aseptic loosening of the prosthesis is a common complication after artificial joint arthroplasty, and it is one of the important reasons for the failure of artificial hip arthroplasty. The prosthesis loosening is correlated with a variety of factors. OBJECTIVE: To analyze the reason of prosthesis loosening after artificial hip arthroplasty, and to compare and multi-level analyze the trends of domestic and foreign researches and literatures. METHODS: The correlation between artificial hip arthroplasty and prosthesis loosening was analyzed from the aspects of wear particles and related cytokines, and the articles on the prosthesis loosening after artificial hip arthroplasty were searched from the CNKI database and Web of Science database from 2002 to 2011 and analyzed. The characteristics of the data were analyzed by the analysis capabilities of the database and chart function of Excel software. RESULTS AND CONCLUSION: The aseptic prosthesis loosening after artificial hip arthroplasty is correlated with wear particles, cytokines, biomechanics, the patient's own factors, intraoperative operation, post-operative instructions and other relevant factors. A total of 66 articles on the prosthesis loosening after artificial hip arthroplasty were screened out from the CNKI database from 2002 to 2011, and 891 articles were screened out from Web of Science database, and the number of the articles is in the increasing trend. There is great difference of the number and the cited frequency between the domestic articles and foreign articles. Bone and Joint Surgery: American Volume is the core magazine of the prosthesis loosening after artificial hip arthroplasty. Understanding the reasons for prosthesis loosening after artificial hip arthroplasty can guide the clinicians to prevent the occurrence of prosthesis loosening and improve the quality of life of patients. Related Articles | Metrics

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Cervical pedicle screw internal fixation for the treatment of cervical spine instability Zhu Yu-qi 2012, 16 (39):  7358-7365.  doi: 10.3969/j.issn.2095-4344.2012.39.028 Abstract ( 300 )   PDF (658KB) ( 639 )   Save BACKGROUND: Cervical pedicle screw internal fixation has a high risk for the treatment of cervical spine instability. Research and analysis on the fixation effect of cervical pedicle screw placement for the treatment of cervical spine instability should be performed in order to determine the feasibility and reliability of cervical pedicle screw placement for the treatment of cervical spine instability. OBJECTIVE: To in-depth analyze the fixation effect of cervical pedicle screw placement for the treatment of cervical spine instability, and to provide the important data and reference information for the treatment of cervical spine instability. METHODS: The biomechanics, morphology and clinical follow-up test of the instable cervical spine were analyzed after cervical pedicle screw placement, and the fixation effect of cervical pedicle screw placement for the treatment of cervical spine instability was analyzed. We have analyzed from different aspects in order to determine the feasibility and safety of cervical pedicle screw system in treating the cervical spine instability. RESULTS AND CONCLUSION: The cervical pedicle screw placement has a satisfactory therapeutic effect in the treatment of cervical spine instability no matter from the biomechanical and morphological aspects, or from the aspect of clinical applications. The cervical pedicle screw placement is one of the reliable and safe treatment methods for cervical spine instability as it has an important significance in improving the patient's clinical symptoms and relieving the pain. Related Articles | Metrics

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Biomechanical analysis on the materials for the percutaneous vertebroplasty and percutaneous kyphoplasty Wang Hong-bin 2012, 16 (39):  7366-7369.  doi: 10.3969/j.issn.2095-4344.2012.39.029 Abstract ( 242 )   PDF (615KB) ( 615 )   Save BACKGROUND: Percutaneous vertebroplasty and kyphoplasty are recently developed new minimally invasive surgical techniques in spinal surgery, can enhance the mechanical stability of the vertebra with less complications and satisfactory results by injecting the bone cement into the vertebral body via percutaneous directly or balloon dilatation. However, the research on the biomechanical of spinal also showed some problems after angioplasty. OBJECTIVE: To explore the effect of the material on percutaneous vertebroplasty and percutaneous kyphoplasty and biomechanical analysis. METHODS: A computer-based research was performed on CNKI database and PubMed database from January 1999 to August 2012 for the articles on the materials for percutaneous vertebroplasty/percutaneous kyphoplasty and the articles on the biomechanics after treatment. The key words of “percutaneous vertebroplasty, rcutaneous kyphoplasty, polymethyl methacrylate, cement, glass ceramic, biomechanics, biocompatibility, complication” in Chinese and “percutaneous vertebroplasty, percutaneous kyphoplasty, PMMA, cement, biomechanics, Biocompatibility, treatment” in English were put into the title and the abstract. The articles on the materials for percutaneous vertebroplasty/percutaneous kyphoplasty were selected, and for the articles in the same field, those published recently or in the authorized journals were preferred. A total of 132 articles were obtained after initial search, and 19 articles were included for review according the inclusion criteria. RESULTS AND CONCLUSION: The purpose of the vertebroplasty is to recover the stiffness and compressive strength of the compressed vertebral. Different materials have different impacts on the properties of the vertebral biomechanics. Development of the material can effectively enhance the vertebral compression capability and maintain the good morphological characteristics; it can also recover the vertebral biomechanical properties to the best state. Related Articles | Metrics

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Application of digital technology and reverse engineering technology in complex orthopaedic surgery Cao Zhen-hua, Yan Jin-yu, Yin He-ping, Zhang Yuan-zhi, Li Shu-wen, Bai Ming, Du Zhi-cai, Meng Ge-dong 2012, 16 (39):  7370-7374.  doi: 10.3969/j.issn.2095-4344.2012.39.030 Abstract ( 399 )   PDF (566KB) ( 493 )   Save BACKGROUND: The rapid development of medical data visualization technology and constantly permeate to the medical field make a fundamental change in diagnosis and treatment of orthopedics. The changes are developing toward the “precision, individuality and minimally invasive”, and the medical data visualization technology has become an important means in the clinical orthopaedic surgery. OBJECTIVE: To determine the breakthrough of research by analyzing the application of digital technology in complex orthopaedic surgery. METHODS: The PubMed database, Wanfang database, VIP database and CNKI database from 1990 to 2011 were searched by the first author with the key words of “personalized navigation template, digital anatomical models, screw internal fixation, reverse engineering technology, rapid prototyping technology”. The literatures were related to the research on the navigation template preparation process and technology, the study of finite element theory, and the experimental and clinical applications. The old and repetitive literatures were excluded as well as the literatures have nothing to do with this article. RESULTS AND CONCLUSION: The navigation template reconstructed by digital technology provides a new method for orientation and directional fixation of orthopaedics bolts internal fixation. The individual navigation templates can be made by the digital reconstruction technique, and closely stick to the corresponding anatomical structure for the navigation puncture, then the accurate positioning and orientation are completed, which has a irreplaceable significance for the complex orthopaedic surgery, especially the anatomical structure deformity patients. It lays a good foundation for clinical surgery design and improves accuracy and safety of the surgery. Related Articles | Metrics

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Intervertebral disc degeneration related molecular biological factors Zhou Xu, He Shi-sheng 2012, 16 (39):  7375-7379.  doi: 10.3969/j.issn.2095-4344.2012.39.031 Abstract ( 383 )   PDF (591KB) ( 449 )   Save BACKGROUND: With the age, excessive activity and overload capacity may accelerate ageing of the vertebral body, and under the action of external force and the secondary pathological changes, the annulus of the intervertebral disc rupture and intervertebral disc nucleus pulposus highlight appeared which led to the low back pain and neural dysfunction. OBJECTIVE: To sum up the research advancement of intervertebral disc degeneration related molecular biological factors and the trend of its development. METHODS: A computer-based search was performed on the PubMed database, CNKI database, Wanfang database and Vip database from February 2000 to January 2012 for the articles about the intervertebral disc degeneration related molecular biological factors. The searched literatures included original articles and reviews, and repetitive studies were excluded. RESULTS AND CONCLUSION: Totally 32 articles were concluded to summarize. Intervertebral disc degeneration is caused by a variety of relevant factors interact under long-term conditions; it is the premise of the series spinal degenerative disease and the basis of chronic disease pathological process. Disc nucleus pulposus cells are not only the residual notochord cells, but also play an important role in maintaining the whole disc function. The study of nucleus pulposus cells in RNA, DNA and protein level related molecular biological factors, provides the possibility of delay and treatment, as well as the future torsion and repair of the intervertebral disc degeneration. Related Articles | Metrics

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Relationship between deoxypyridinoline/creatinine and Singh index in elderly hip fracture patients Hao Wei, Yang Tie-yi, Zhang Yan, Liu Yue, Shao Jin 2012, 16 (39):  7380-7384.  doi: 10.3969/j.issn.2095-4344.2012.39.032 Abstract ( 330 )   PDF (441KB) ( 436 )   Save BACKGROUND: The deoxypyridinoline and creatinine ratio (DPD/Cr) and Singh index are widely used in measuring bone strength and bone lost in clinic, but the relationship between them is rarely reported. OBJECTIVE: To analyze the relationship between DPD/Cr and Singh index in elderly hip fracture patients. METHODS: A total of 100 samples over the age of 60 were collected from patients suffered fresh femoral neck fracture and intertrochanteric fracture. The deoxypyridinoline, urinary creatinine and Singh index were measured, and the relationship between DPD/Cr and Singh index was calculated. RESULTS AND CONCLUSION: The DPD/Cr of 100 patients that suffered fresh femoral neck fracture and intertrochanteric fracture was (6.11±2.09) nmol/mmol; among them, 97 cases were higher than normal, and the other 3 cases were normal. The Singh index showed below grade IV in 91 cases, grade V in 9 cases. Spearman correlation analysis showed that the DPD/Cr in elderly hip fracture was negatively correlated with Singh index (r=-0.32, P=0.007). There was liner correlation between DPD/Cr and Singh index, the DPD/Cr and Singh index were consistent in the evaluation of bone quality. Related Articles | Metrics

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Injury factor in the 3 128 inpatients with first onset fracture from Lanzhou area Wang Lei, Hu Long, Wang Feng-feng, Chen Gen-yuan, Wang Tao, He Yu-ping 2012, 16 (39):  7385-7389.  doi: 10.3969/j.issn.1673-8225.2012.39.033 Abstract ( 275 )   PDF (373KB) ( 366 )   Save BACKGROUND: In developed countries, studies have identified the injury of various fractures. However, in developing countries, particularly in Asia, there still lacks of relevant researches. OBJECTIVE: To analyze the data of the inpatients with fracture and to understand the relevant injury factor. METHODS: The inpatients with fracture (except for skull fracture) were selected from the First Affiliated Hospital of Lanzhou University, People’s Hospital of Gansu Province and The General Hospital of Military District of LanZhou during 2006-2010. Descriptive analysis was performed on the incidence of fracture. RESULTS AND CONCLUSION: For incidence of fracture, the patients in 31-50 years old were the highest and followed by the patients in the 0-10 years old. Male was more than female in the patients aged below 60 years old, and the most injury position were arms and legs, the major reason of fracture was traffic accidence. Female was more than male in patients aged over 60 years old, the most injured sites were backbone and femur and the major reason of fracture was fall. Worker and urban residents were the highest incidence rate of fracture. Fracture took place mainly on the road and most number of incidence cases of fracture occurred in summer and autumn. Related Articles | Metrics

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Methods based on core decompression for treating early-stage femoral head necrosis Wei Bo, Wang Li-ming, Xu Yan, Chen Jia-jia, Li Liang-liang 2012, 16 (39):  7390-7394.  doi: 10.3969/j.issn.2095-4344.2012.39.034 Abstract ( 346 )   PDF (447KB) ( 387 )   Save BACKGROUND: Core decompression can relieve the symptoms of early-stage femoral head necrosis effectively. This method is simple and feasible. Even if the long term result is not ideal, artificial total hip replacement can be performed with no influence. OBJECTIVE: To explore the clinical effect of three methods based on core decompression in treating the early-stage femoral head necrosis. METHODS: Forty-six cases (61 hips) with femoral head necrosis were included. There were 21 cases (29 hips) in phaseⅠ, 25 cases (32 hips) in phase Ⅱ based on Association Research Circulation Osseous classification. They were all treated with core decompression, of which 15 cases (23 hips) were only treated with core decompression (group A), 18 cases (25 hips) were treated with core decompression and autologous bone marrow mononuclear cells implantation after separation and collection of bone marrow mononuclear cells (group B), 13 cases (13 hips) were treated with core decompression plus porous tantalum rod insertion (group C). RESULTS AND CONCLUSION: All the patients were followed-up for 12 months. The last follow-up Harris scores of three groups were higher than that of preoperation (P < 0.01). The Harris score of last follow-up in group B and group C was higher than that in the group A (P < 0.01), and there was no significant difference between group B and group C (P > 0.05). Postoperative X-ray image showed that 2 cases (3 hips) developed to femoral head collapse in group A, while 1 case (1 hip) in group B and 2 cases (2 hips) in group C developed to femoral head collapse. The three methods based on core decompression have positive effect in treating early stage femoral head necrosis. The effect of core decompression combined with autologous bone marrow mononuclear cells implantation or porous tantalum rod insertion was superior to simple core decompression. Related Articles | Metrics

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Alendronate plus alfacalcidol for the treatment of severe bone loss and osteoporotic fractures Liu Feng, Zhang Jun, Wang Wen-xiu, Zhang Ming-qiang, Zhang Zhi-feng, Hou Hai-tao 2012, 16 (39):  7395-7399.  doi: 10.3969/j.issn.2095-4344.2012.39.035 Abstract ( 610 )   PDF (421KB) ( 658 )   Save BACKGROUND: Alendronate and alfacalcidol can inhibit the bone transformation and increase bone mineral density of the patients with osteoporotic fractures. OBJECTIVE: To investigate the effect of alendronate plus alfacalcidol for the treatment of severe bone loss and osteoporotic fractures. METHODS: Patients with severe bone loss and osteoporotic fractures were selected, and then the patients were treated with alendronate plus alfacalcidol for 2 years. RESULTS AND CONCLUSION: Compared with before treatment, the lumbar spine bone density of the patients was increased after treated with alendronate plus alfacalcidol (P < 0.05) followed by urine of type Ⅰ collagen N-terminal peptide levels and serum alkaline phosphatase activity decreased (P < 0.05). It confirmed that the alendronate plus alfacalcidol has good effect for the treatment of severe bone loss and osteoporotic fracture patients. Related Articles | Metrics

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One-stage reconstruction after knee joint multi-ligaments injury during 5-year follow-up Zhang Yan, Liu Yun-peng, Hua Guo-jun, Bai Guang-fu, Zou Ming, Luo Yu-chun 2012, 16 (39):  7400-7404.  doi: 10.3969/j.issn.2095-4344.2012.39.036 Abstract ( 401 )   PDF (487KB) ( 572 )   Save BACKGROUND: Anterior and posterior cruciate ligament injury combined with Ⅲ degree medial collateral ligament injuries has damage to the stability of the knee joint, short-term efficacy has been confirmed, but the medium-term efficacy is not plausible. OBJECTIVE: To assess the medium-term efficacy after multi-ligaments injury reconstruction. METHODS: A total of 40 patients with anterior and posterior cruciate ligament injury combined with Ⅲ degree medial collateral ligament injuries were selected (30 males, 10 females, age from 19-48 years old). All the patients with anterior and posterior cruciate ligament injury received allogeneic tendon reconstruction under arthroscopy, and the patients with medial collateral ligament injury were repaired with rivet. The Lachman test, IKDC classification, Lysholm scores and KT-1000 value were performed before and after surgery to evaluate the efficacy of reconstruction. RESULTS AND CONCLUSION: A total of 40 cases were followed-up for 60 months. All preoperative symptoms got better apparently, such as the pain of the knee joint, swelling and limitation of range of motion. The Lachman test, IKDC classification, Lysholm scores and KT-1000 value after reconstruction were significantly increased when compared with that prior to surgery (P < 0.05). The results demonstrate that allogeneic tendon reconstruction of anterior and posterior cruciate ligaments and reconstruction of medial collateral ligament with rivet can recovery the stability and knee function, It also has advantages in short-term efficacy and medium-term efficacy. Related Articles | Metrics

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Thera-Band resistance exercise therapy for cervical spondylosis Chen Xiang-xian, Qi Xiang, Lü Pin 2012, 16 (39):  7405-7410.  doi: 10.3969/j.issn.2095-4344.2012.39.037 Abstract ( 725 )   PDF (478KB) ( 781 )   Save BACKGROUND: Recent studies have proved that diseased muscles around the cervical vertebra are closely related to the onset and progression of cervical spondylosis. OBJECTIVE: To observe the effect of Thera-Band resistance exercise on the cervical function of cervical spondylosis patients. METHODS: Eighty patients with cervical spondylosis caused by extra vertebral canal and diseased soft tissue were selected from the Laboratory of “Physiological and Biochemical Testing and Exercise Rehabilitation” of Anhui Normal University during 2010-03/2011-10, 30 cases in male and 50 cases in female, the age was ranged from 65 to 17 and average was 35.4 year-old, the course of disease was 1 to 17 years. According to the China Rehabilitation Medicine Diagnostic and Treatment Practices, the patients were divided into neck type (n=28), vertebral artery (n=22), nerve root type (n=18) and sympathetic type (n=12). Resistance exercise rehabilitation therapy was conducted; the elastic band was performed with passive stretching and active anti-resistance in order to train the neck muscles. RESULTS AND CONCLUSION: The scores of cervical function, muscle strength around the cervical spine and cervical activity after experiment were significantly higher than those before experiment (P < 0.05); the symptoms of cervical disease was alleviated, and there was no significant difference of the improvement index and the improvement rate among groups (P > 0.05). The resistance exercise-based rehabilitation therapy for cervical muscle has significant effect on various types of cervical disease, and the Thera-Band elastic band is safe and can meet the multiple perspectives needs of neck muscle exercise. Related Articles | Metrics