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28 May 2013, Volume 17 Issue 22 Previous Issue    Next Issue

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Bone mineral density and pathologic study of osteoporotic vertebral compression fracture Cui Jiang-chao, Sun Jian-min, Cui Xin-gang, Jiang Zhen-song 2013, 17 (22):  3991-3997.  doi: 10.3969/j.issn.2095-4344.2013.22.001 Abstract ( 758 )   PDF (435KB) ( 456 )   Save BACKGROUND: Bone mineral density, as the osteoporosis criteria, has been widely used in clinical disease diagnosis, but its value of reflecting the changes of pathological characteristics of vertebral body fracture has not been explored.  OBJECTIVE: To observe the bone mineral density range and pathological features in different periods of osteoporotic vertebral compression fractures, and to verify the consistency of bone mineral density and pathology.   METHODS: Forty-five cases of osteoporotic vertebral compression fractures in imaging findings were divided into groups according to age, femoral neck and lumbar vertebral bone mineral density (T value) tests were performed before surgery, as well as the routine imaging test. Then, all the patients received percutaneous kyphoplasty, and the living tissues were obtained for the pathological section observation. RESULTS AND CONCLUSION: Preoperative bone mineral density range tests showed that the bone mineral density was decreased with the increasing age; the pathological findings showed that with the reducing bone mineral density, the trabecular became thining and sparse, and the number was reduced, the space between trabeculars was widened; the arrangement was irregular with broken, disorder, or even necrosis, and fibrous tissue proliferation could be seen around the trabecular, and reactive new bone formation could be seen later. There was consistency between the bone mineral density decreasing trend and the pathological manifestations. The results indicate that the bone destruction staging of osteoporotic vertebral fractures is a progressive pathological process, while the decrease in bone mineral density may reflect the extent of vertebral compression damage. Figures and Tables | References | Related Articles | Metrics

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Mechanical analysis of knee dynamic finite element model Hou Bo, Wang Yi, Shen Yu-hui 2013, 17 (22):  3998-4004.  doi: 10.3969/j.issn.2095-4344.2013.22.002 Abstract ( 908 )   PDF (254KB) ( 1111 )   Save BACKGROUND: Knee joint has the characteristics of complex anatomical structure and active diversity. The development of the biomechanical research of human knee joint is slow as in vivo experiments cannot be conducted. The experiments performed on corpse do not have the normal physiological environment of the human body, so the results are not accurate. OBJECTIVE: To investigate the force condition on different parts of the knee joint with engineering finite element analysis method in non-invasive and in vivo conditions. METHODS: CT image was used to build dynamic three-dimensional finite element model of the knee joint. The force on the anterior cruciate ligament, posterior cruciate ligament and patellofemorel joint was analyzed in the range of 0°-90° of knee joint. RESULTS AND CONCLUSION: According to our study we found that the anterior cruciate ligament had the largest tension when the knee joint flexed at 0°, then gradually decreased. There was no significant change when the knee joint flexed at 50° to 90°. The posterior cruciate ligament had the opposite changing trend: there was no significant change when the knee joint flexed between 0° to 50°, and then gradually increased, and the posterior cruciate ligament had the largest tension when the knee joint flexed at 90°. The analysis of the stress experienced on patellofemorel joint showed the stress on the patellofemorel joint was gradually increased along with the increasing of the angle. The dynamic three-dimensional finite element model of the knee joint was able to simulate the motion of knee joint. Studying the stress experienced on different parts of the human knee joint is an important tool for biomechanics analysis in orthopedics. Figures and Tables | References | Related Articles | Metrics

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Multimodal analgesia after total knee arthroplasty Liu Bing-shan, Li Guo-jun, Wang Xiao, Zhang Song, Liu Yang, Zhang Yong-le 2013, 17 (22):  4005-4012.  doi: 10.3969/j.issn.2095-4344.2013.22.003 Abstract ( 925 )   PDF (308KB) ( 559 )   Save BACKGROUND: Perioperative pain management is the focus in total knee arthroplasty. Looking for a safe and effective analgesic way has become one of the important tasks of the surgeons. OBJECTIVE: To compare the analgesia and rehabilitation effect of the epidural analgesia and the femoral nerve analgesia after total knee arthroplasty, and to explore the relative multimodal analgesia proposal. METHODS: Forty patients undergoing unilateral total knee arthroplasty were randomly selected, and the patients were divided into two groups according to different analgesia proposals: epidural analgesia group and femoral nerve analgesia group, 20 patients in each group. All patients received unilateral total knee arthroplasty and preoperative missionary and celecoxib administration under epidural analgesia. Patients in the epidural analgesia group were given analgesia with 0.2% ropivacaine and 2 ug/mL fentanyl after the replacement. The patients in the femoral nerve analgesia group were given analgesia with 0.2% popivacaine from the femoral nerve block vessel. The visual analog scores of the patients were observed at 6, 12 and 24 hours and 2-7 days after total knee arthroplasty, and the range of motion was recorded at 2-7 days after total knee arthroplasty. RESULTS AND CONCLUSION: At 2-7 days after total knee arthroplasty, the visual analog scores of rest/movement pain were decreased in two groups, and the pain degree in the femoral nerve analgesia group was smaller than that in the epidural analgesia group. At 2-7 days after total knee arthroplasty, the range of motion of the patients in two groups was increased gradually, and the range of motion in the femoral nerve analgesia group was larger than in the epidural analgesia group. The results showed that both the epidural analgesia and the femoral nerve analgesia can relieve pain after total knee arthroplasty, but the femoral nerve analgesia can provide better pain relief than epidural analgesia, and it can lead to a quick functional recovery. Multimodal analgesia proposal can effectively control the pain.  Figures and Tables | References | Related Articles | Metrics

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Total hip arthroplasty versus bipolar hemi-arthroplasty for the treatment of elderly osteoporotic femoral neck fracture Wang Lei, Liu Qing-kuan, Zhang Yuan-min, Wang Xiu-mei, Kong Ying, Duan Guo-qing 2013, 17 (22):  4013-4017.  doi: 10.3969/j.issn.2095-4344.2013.22.004 Abstract ( 587 )   PDF (266KB) ( 353 )   Save BACKGROUND: Total hip arthroplasty and bipolar hemi-arthroplasty are effective methods for the treatment of elderly osteoporotic femoral neck fracture. Due to the influence of physical condition and the underlying disease, the choice of the way for joint replacement in clinic should be considered carefully.  OBJECTIVE: To compare the short-term outcomes of total hip arthroplasty and bipolar hemi-arthroplasty for the treatment of elderly osteoporotic femoral neck fracture. METHODS: Seventy-five patients with osteoporotic femoral neck fracture were treated by artificial joint replacement, including 38 cases in total hip arthroplasty group and 37 cases in the bipolar hemi-arthroplasty group. The average age was (68.4±5.3) years in the total hip arthroplasty group and (72.5±6.2) years in the bipolar hemi-arthroplasty group. The Harris’ hip scores, Merled-Aubigne-Postel hip function grades, operative blood loss, replacement time, postoperative complications and mortality were analyzed and compared in these two groups. RESULTS AND CONCLUSION: All the 75 patients were followed-up for more than 8 months. There were no significant differences in the postoperative hip pain, hip joint range of motion and hip walking ability scores between two groups (P > 0.05). There were no significant differences in postoperative complications and mortality between two groups (P > 0.05). The average operation time in the total hip arthroplasty group was longer than that in the bipolar hemi-arthroplasty group, and the operative blood loss in the total hip arthroplasty group was significantly larger than that in the bipolar hemi-arthroplasty group (P < 0.05). The bipolar hemi-arthroplasty for the treatment of elderly osteoporotic femoral neck fracture has the advantages of short operation time and little operative blood loss, and the operative outcome is as good as the total hip arthroplasty. Figures and Tables | References | Related Articles | Metrics

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Sternum needles for rotator cuff reconstruction of proximal humeral fractures during artificial humeral head replacement Zhang Chi, Shang Xi-fu, Chen Tao, Hu Fei 2013, 17 (22):  4018-4024.  doi: 10.3969/j.issn.2095-4344.2013.22.005 Abstract ( 367 )   PDF (325KB) ( 374 )   Save BACKGROUND: More and more patients who have crushing and serious shift proximal humeral fractures that cannot be reconstructed need artificial humeral head replacement. However, the rotator cuff reconstruction may directly affect surgical effect. Thus, better rotator cuff reconstruction is needed during replacement. OBJECTIVE: To investigate application value of sternum needles in rotator cuff reconstruction of proximal humeral fractures during artificial humeral head replacement. METHODS: Thirty-four cases of four-part proximal humeral fractures received rotator cuff repairing with sternum needles during artificial humeral head replacement, at the age between 67 and 78 years. Artificial humeral head replacement was performed without excessive peeling fracture block or rotator cuff tissue to retain the rotator cuff tissue and bone connected, and then the sternum needle was used to ringclosure the nodules along the surface of the rotator cuff tendon-bone junction for reverse, sternum needle could be used more than one. After prosthesis implantation, anatomic reduction of the large and small nodules of humerus and bone fragments was performed, and then the sternum needle was tightened; the large and small nodules and rotator cuff attached bone fragments were affixed to the bottom of the humeral head in situ. Operation should maximally suture the residual rotator cuff and damaged muscle tissue, and should pay attention to the dynamic equilibrium after suture. The recovery of artificial shoulder joint function was evaluated with Neer criteria. RESULTS AND CONCLUSION: All the patients were followed-up for 1-3 years, and the results showed excellent in 24 cases, good in 10 cases and average in two cases. No joint dislocation, subluxation and joint instability, and no infections, nerve injury or prosthesis loosening were observed. Sternum needles for the repairing of rotator cuff and fixation of large and small nodules during artificial humeral head replacement can make the rotator cuff and large and small nodules close to the anatomical location, and the sternum needle has higher strength than conventional polyester line with stable fixation, which can meet the requirement of rehabilitation training after artificial humeral head replacement and play an important role in the recovery of stability and function of the shoulder joint. Figures and Tables | References | Related Articles | Metrics

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Winged adjustable replacement system for the treatment of lower cervical spine fracture dislocation Sun Jun-kai, Liu Jing-long, Huang Jian-hou 2013, 17 (22):  4025-4033.  doi: 10.3969/j.issn.2095-4344.2013.22.006 Abstract ( 452 )   PDF (398KB) ( 429 )   Save BACKGROUND: ADD plus-winged adjustable replacement system has the advantages of artificial vertebral body and anterior fixation plate integration and artificial vertebral body height-adjustable, as well as simple to operation, shorter operative time, and good histocompatibility, which make it attract more trust of the surgeons. OBJECTIVE: To explore the effect of ADD plus-winged adjustable replacement system in cervical anterior decompression, fusion and graft and internal fixation for the treatment of lower cervical spine fracture dislocation combined with spinal cord injury.  METHODS: The ADD plus-winged adjustable replacement device was used in anterior reduction, decompression, fusion and graft and internal fixation for the treatment of lower cervical spine fracture dislocation combined with spinal cord injury in 12 cases. Clinical evaluation and imaging examination were performed at 3, 6 and 12 months after treatment, and then annually thereafter. RESULTS AND CONCLUSION: All patients were followed-up for 18 months. During the follow-up period, the patients got solid osseous fusion, the regulator was in good position without loosening or fracture; the cervical intervertebral height and physiological curvature were corrected, and the recovery degree of postoperative patient feel and motor function was increased significantly. One case appeared hyponatremia, and no postoperative complications were observed in other patients. The ADD plus-winged adjustable replacement system used in anterior cervical open reduction, internal fixation, decompression and fusion for the treatment of lower cervical spine fracture dislocation combined with spinal cord injury has the advantages of simple and safe operation, good histocompatibility and significant internal fixation effect.   Figures and Tables | References | Related Articles | Metrics

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Titanium mesh and interbody fusion repair medium and severe kyphosis deformity Chu Ge1, Zhang Hong-qi, Tang Ming-xing, Guo Chao-feng, Li Jin-song, Xiang Ze-wen, Bai Jing-ping 2013, 17 (22):  4034-4041.  doi: 10.3969/j.issn.2095-4344.2013.22.007 Abstract ( 468 )   PDF (379KB) ( 381 )   Save BACKGROUND: Scholars have supposed that the treatment of spinal tuberculosis kyphosis with anterior approach and spinal cord decompression may lead to complications such as bone graft collapse, absorption or fracture. Studies have confirmed that one-stage anterior-posterior surgery combined with internal fixation can enhance the corrective effect to kyphosis, avoid bone graft complications, reduce the formation of false joints, help patients with early activities out of bed and promote the functional recovery. OBJECTIVE: To evaluate the clinical outcome for tuberculous spondylitis of thoracolumbar region with two or more affected segments treated with one-stage anterior-posterior debridement, interbody fusion and internal fixation. METHODS: We retrospectively studied 20 cases of tuberculous spondylitis of thoracolumbar region with two or more levels of involvement. All the patients underwent one-stage posterior fixation fusion and anterior debridement and titanium mesh fusion and internal fixation. All the patients received antituberculosis chemotherapy for 9 months after internal fixation. For the first 3 months, the patients were treated with quadruple antituberculosis drugs, and then treated with triple antituberculosis drugs in the later 6 months. The kyphosis angles were measured during follow-up to evaluate the fusion status, neuropathy and functional recovery. RESULTS AND CONCLUSION: All the patients were followed-up for more than 37 months. All patients returned to their previous occupation after firmly segment fusion; only 15 cases (75%) felt mild pain or no pain and three cases (15%) with major limitations in activities. There were 11 patients with neurological deficit before internal fixation, and nine cases of these achieved complete neurological recovery. The kyphosis angles were corrected for 35.1° (84.8%) in average (P < 0.001), and there was no significant difference in correction loss during the follow-up period (P < 0.05). There were no grafts or fixation-related complications. Tuberculous spondylitis with involvements at two or more levels accompanied by medium and severe kyphosis should be treated with circumferential fusion, that is one-stage anterior-posterior fusion and fixation, which can obtain greater correction, help the patients with early activities out of bed, stabilize the lesioned segments, and long-term maintain the correction effect. Figures and Tables | References | Related Articles | Metrics

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Digital measurement of the vertebral body during lateral anterior internal fixation of middle and lower thoracic vertebrae Li Xiao-he, Li Zhi-jun, Wang Hai-yan, Wang Jian-wei, Ji Xiao-jun 2013, 17 (22):  4042-4046.  doi: 10.3969/j.issn.2095-4344.2013.22.008 Abstract ( 358 )   PDF (295KB) ( 350 )   Save BACKGROUND: There are many reports on the entrance point of adult vertebral screw, but most of the reports are the general description. Because of the differences in races and segments, the shape of vertebral body is various, and the choice of screw placement position is also varied.  OBJECTIVE: To construct the three-dimensional model of lower thoracic vertebra through CT scanning combined with reverse engineering software, and to digital measure the correlated anatomic CT data of the lateral anterior middle and lower thoracic vertebra of Chinese adults.  METHODS: The CT primary data of non-spinal disorders cases were collected and the data were used for the establishment of three-dimensional model of complete middle and lower thoracic vertebra (T4-T12) of Chinese people with Mimics software. The coronal plane left and right edge height, midsagittal anterior, median and posterior edge height, sagittal diameter and transverse diameter of the upper vertebral endplate and the lower vertebral endplate were measured. RESULTS AND CONCLUSION: The sagittal diameter and transverse diameter of the upper and lower vertebral endplates were gradually increased with the increasing vertebral sequence. The vertebral screw selection had certain regularity when placing in the anterior middle and lower thoracic vertebra; because the transverse diameter of vertebra bodies was always bigger than sagittal diameter for 3.0-4.0 mm, bone graft should be shaped into laterigrade cuboid (the length should be larger than width for 3.0-4.0 mm). The clinical lateral anterior approach internal fixation of middle and lower thoracic vertebra should refer to the data above. Figures and Tables | References | Related Articles | Metrics

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Change of spinal canal morphology after pedicle screw rod system fixation and reduction for thoracolumbar burst fracture Song Sheng, Sun Zhen-zhong, Rui Yong-jun, Cai Fu-jin, Yin Qu-dong, Wei Xu-ming, Wang Jian-bing, Ma Yun-hong 2013, 17 (22):  4047-4054.  doi: 10.3969/j.issn.2095-4344.2013.22.009 Abstract ( 511 )   PDF (532KB) ( 439 )   Save BACKGROUND: At present, the observation index of the thoracolumbar burst fracture after pedicle instrument reset is the imaging examination of vertebral body basic form, and the reports on the changes of morphology of spinal canal after reduction are rare. OBJECTIVE: To analyze the changes of morphology of spinal canal after thoracolumbar fractures treated with pedicle screw rod system fixation and reduction. METHODS: Twenty-eight cases of thoracolumbar burst fracture treated with pedicle screw rod system fixation and reduction were followed-up after operation, and all patients took the thoracolumbar anteroposterior and lateral X-ray film before treatment, 1 week, 1 and 2 years after operation. All the patients underwent CT scans of the upper and lower vertebral body, of which 26 patients obtained the image data of CT scan before treatment, 1 week, 1 and 2 years after operation, and partial image information of two patients lost. Whether the fracture block of the posterior margin of vertebral body went into the spinal canal or not was identified on the thoracic and lumbar spine lateral X-ray film firstly, and the changes of spinal canal morphology were observed; the spinal median sagittal diameter measured based on the CT scanning image data represented the spinal space-occupying degree.      RESULTS AND CONCLUSION: Lateral X-ray films of the 28 cases showed the fracture block of the posterior margin of vertebral body of 18 cases (64.2%) went into the spinal canal before operation, fracture block of six cases (21.4%) went into the spinal canal after operation, two cases (7.1%) at 1 year after operation, one cases (3.5%) at 2 years after operation; the average spinal median sagittal diameter was 42.6% (n=28) before operation. The spinal median sagittal diameter of the 26 cases with complete follow-up imaging data was 75.2% (P < 0.05), and the median sagittal diameter at 1 year after operation was 91.2% (n=26). The occupying reduction effect of spinal canal is obvious after thoracolumbar burst fracture treated with pedicle screw rod system fixation and reduction, the postoperative long-term observation shows the spinal canal morphology can be restored to normal. Figures and Tables | References | Related Articles | Metrics

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Comparison of complications between morbid obesity and normal weight patients with lumbar arthrodesis Jiang Yu, Zhu Guo-xing, Yang Yu-sheng 2013, 17 (22):  4055-4061.  doi: 10.3969/j.issn.2095-4344.2013.22.010 Abstract ( 374 )   PDF (283KB) ( 444 )   Save BACKGROUND: Morbid obesity can result in lumbar and spinal degeneration, especially the lumbar spine degeneration. Related studies have shown that morbid obesity may increase complications of the lumbar fusion, especially wound infection. OBJECTIVE: To analyze whether morbid obesity can alter the rates of complications in patients undergoing lumbar fusion. METHODS: 268 patients (including normal weight patients and morbid obese patients) undergoing lumbar single segment fusion were selected as samples. The lumbar and spinal fusion was divided into two types: anterior lumbar fusion and posterior lumbar fusion. The cancellous bone with autologous anterior superior iliac spine was treated with intervertebral bone grafting, and fixed with Medtronic Sofamor titanium rod. The detection found that there was no bone fragments crumbs backward in the anterior dura mater, then the drainage was placed in the incision and closed layer by layer. Symptomatic treatment was performed to prevent infection after lumbar fusion, and the data of the different complications were statistically analyzed. RESULTS AND CONCLUSION: Among total 268 patients, 104 patients were morbidly obese. The complications of morbidly obese patients included cardiac, renal, pulmonary and wound complications, among them, wound and pulmonary complications were the main complications. There were significant differences in the complications between normal weight patients and morbidly obese patients (P < 0.05). There were no significant differences in the rates of complications between anterior lumbar fusion and posterior lumbar fusion (P > 0.05). Morbid obesity increases the risk of complications in lumbar and spinal fusion surgery, but has no different effects between the patients with anterior lumbar fusion and posterior lumbar fusion. Figures and Tables | References | Related Articles | Metrics

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Biomechanical requirement for the reconstruction of patellar fracture treated with cancellous bone screw and nickel-titanium-patellar concentrator internal fixation Gao Zhen-chao, Liu De-chang, Cai Guo-ping 2013, 17 (22):  4062-4069.  doi: 10.3969/j.issn.2095-4344.2013.22.011 Abstract ( 403 )   PDF (408KB) ( 459 )   Save BACKGROUND: There are various internal fixation methods for the clinical treatment of patellar fractures, but each method has advantages and disadvantages, respectively. The selection of proper internal fixation method will directly affect the healing time and recovery of knee joint function.    OBJECTIVE: To investigate the biomechanical reconstruction effect on patellar fracture treated with cancellous bone screw and nickel-titanium-patellar concentrator internal fixation. METHODS: A retrospective analysis was performed on 27 cases of acute patellar fracture patients from January 2011 to January 2012 in the Department of Orthopedics, Jinshan Hospital, Fudan University, including 13 cases of transverse fracture, 11 cases of comminuted fracture and three cases of upper or lower pole fracture. All the 27 patients received cancellous bone screw and nickel-titanium-patellar concentrator internal fixation without plaster external fixation, and then the quadriceps active contraction training was performed from the 2nd day after internal fixation, and bed knee flexion and extension exercises were performed at 1 week after internal fixation. The knee joint function was evaluated with Böstman score system. RESULTS AND CONCLUSION: All the 27 patients were followed-up for 4-14 months. Incisions obtained stage Ⅰ healing, and there was no fracture fixation or shedding, wound infection, skin necrosis or other complications. The average healing time was 8.5 weeks without delayed healing. According to clinical grading scale of Böstman score system, the mean score was 27.9, included 27 cases of excellent (81%), four cases of good (15%), one case of poor (4%), and the excellent and good rate was 96%. The results suggest that cancellous bone screw combined with nickel-titanium-patellar concentrator internal fixation can maintain the advantages of traditional internal fixation method, and can avoid the disadvantages of the traditional internal fixation method.  Figures and Tables | References | Related Articles | Metrics

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Medical titanium cable in the treatment of comminuted patellar fractures Xu Hai-dong, Chen Yong, Zhao Jian-ning 2013, 17 (22):  4070-4075.  doi: 10.3969/j.issn.2095-4344.2013.22.012 Abstract ( 566 )   PDF (298KB) ( 667 )   Save BACKGROUND: Medical titanium cable is easy and simple to handle with strong internal fixation and it can protect the knee function. OBJECTIVE: To study the curative effect of medical titanium cable in the treatment of comminuted patellar fractures. METHODS: Thirty patients with comminuted patellar fractures were divided into two groups according to their wishes: medical titanium cable group and routine steel wire cerclageg pierced group. The fixation time, amount of blood loss, the first knee exercise time after operation, hospitalization time, medical expenses, complications and long-term knee function of the patients in two groups were compared. RESULTS AND CONCLUSION: All patients were followed-up for more than 1 year. The first knee exercise time after operation of the patients in the medical titanium cable group was earlier than that in the routine steel wire cerclage pierced group, and the hospitalization time was shorter, but the medical expenses and long-term knee function Bostman score in the medical titanium cable group was higher than those in  the routine steel wire cerclage pierced group (P < 0.05). The medical titanium cable material can cure comminuted patella fractures with strong internal fixation. The medical titanium cable has advantages of earlier knee exercise time and fewer complications compared with routine steel wire cerclage pierced group. It is considered as the better choice for the treatment of comminuted patella fractures. Figures and Tables | References | Related Articles | Metrics

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Measurement of partial adult proximal femur parameters Ju Peng, Qi Xiao-tong, Liu Xiao-hu, An Hong, Jiang Dian-ming 2013, 17 (22):  4076-4083.  doi: 10.3969/j.issn.2095-4344.2013.22.013 Abstract ( 1100 )   PDF (634KB) ( 478 )   Save BACKGROUND: In the treatment of hip fracture, the design and matching of the internal implants has great significance in achieving mechanical conduction and obtaining long-term stability. However, the impacts of racial heredity and life and work environment will result in differences in race femoral parameters. OBJECTIVE: To determine the partial proximal femoral parameters in the adults of Chongqing. METHODS: Vernier caliper was used to measure five related parameters of femoral head (femoral head diameter, femoral head length, head and neck axis length) of 160 femoral specimens (80 cases of left and right respectively) in Chongqing. Chen CAD software was used to measure the inside and outside radian, angle between head neck axis and lateral femoral cortex on the images of the femur in the patients (80 cases of male and female respectively) of Chongqing.  RESULTS AND CONCLUSION: The entity measurement showed the femoral head diameter was (45.26±3.17) mm; femoral head length was (39.02±2.58) mm; head and neck axis length was (93.23±5.43) mm; minimum upper and lower femoral neck diameter was (31.28±2.18) mm; minimum anterior and posterior femoral neck diameter was (26.23±2.10) mm; measurement of the adult femoral images showed the male inside upper femoral radian was (0.267±0.024) π; male outside upper femoral radian was (0.219±0.019) π; angle between male head neck axis and lateral femoral cortex was (130.92±2.31)°; female inside upper femoral radian was (0.278±0.019) π; female outside upper femoral radian was (0.219±0.019) π; angle between female head neck axis and lateral femoral cortex was (130.68±2.02)°. The femoral head diameter was positively correlated with femoral head length, head and neck axis length, minimum anterior and posterior femoral neck diameter and minimum upper and lower femoral neck diameter, and the correlation coefficient was 0.246-0.588. There was no significant correlation between the inside and outside upper femoral radian in the software measured imaging data (P > 0.05); the angle between female head neck axis and lateral femoral cortex was negatively correlated with the inside upper femoral radian (rmale=-0.446, rfemale=-0.509, P < 0.05), while positively correlated with the outside upper femoral radian (rmale =0.259, rfemale =0.311, P < 0.05). The measurement of partial adult proximal femur parameters can provide reference for the design and production of internal fixation implants that meet the requirement of fixator for local hip fracture. Figures and Tables | References | Related Articles | Metrics

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Expression of mechanical stress related genes in subchondral bone of rat osteoarthritis model Fang Hang, Zhang Rong-kai, Chen Yu-xian, Song Yan-cheng, Cai Dao-zhang 2013, 17 (22):  4084-4090.  doi: 10.3969/j.issn.2095-4344.2013.22.014 Abstract ( 525 )   PDF (496KB) ( 530 )   Save BACKGROUND: Changes of mechanical stress is a key factor for the development of osteoarthritis. OBJECTIVE: To observe the expression of mechanical stress related genes in subchondral bone of rat osteoarthritis model caused by joint instability, and to provide basis for elaborating the effect of mechanical stress factors in the pathogenesis of osteoarthritis.  METHODS: Sprague Dawley rats were divided into two groups: experimental group and control group, 30 rats in each group. The right knee joints of experimental group underwent both medial collateral ligament resection and medial meniscectomy, while the control group just cut joint capsule. Rats were sacrificed at 1, 2 and 4 weeks after surgery to obtain the right knee joints. Total RNA of the subchondral bone was extracted, and the global gene expression of subchondral bone was researched with DNA microarray technology. The expression of mechanical stress related genes in subchondral bone of rat osteoarthritis model was explored according to the existing literatures, and then the results were identified through quantitative real-time PCR. RESULTS AND CONCLUSION: Three important mechanical stress related differentially expressed genes included: Postn, Ihh and Bmp5, and were confirmed by quantitative real-time PCR. In the experimental group, Postn was significantly expressed at 1 week after operation, and the difference between two groups was significant (P < 0.05), and 2 weeks after operation, Postn was still highly expressed, but there was no significant difference between two groups (P > 0.05). Bmp5 was significantly expressed at 1 week after operation, but the difference between two groups was significant (P < 0.05), and at 2 weeks after operation, Bmp5 was highly expressed, but there was no significant difference between two groups (P > 0.05). Ihh was highly expressed at 1 and 2 weeks after operation, and the difference between two groups was significant (P < 0.05). Mechanical stress is the key stress in osteoarthritis. Further research of mechanical stress related genes and their pathway might provide more evidence for pathogenesis of osteoarthritis, thus discovering the targets for early diagnosis and early treatment. Figures and Tables | References | Related Articles | Metrics

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Dynamical chanracteristics of index finger in response to cold water stimulation: Analysis based on Anybody platform Yin Chuan-sheng, Sun Fang, He Ying, Shao Hong-wei 2013, 17 (22):  4091-4098.  doi: 10.3969/j.issn.2095-4344.2013.22.015 Abstract ( 403 )   PDF (447KB) ( 534 )   Save BACKGROUND: Anybody human modeling and simulation system is a computer-aided ergonomics and biomechanical analysis software, and it is the only software that can analyze the musculoskeletal system completely which can be used to calculate the force deformation of bone, muscle and joint. OBJECTIVE: To investigate the index finger dexterity after cold water stimulation using computing model. METHODS: Based on the available data of the experiment about the index finger movement, the kinematic parameters of index finger in the movement were achieved. Subsequently, a clench fist kinematic model of hand was established with Anybody platform, and then a musculoskeletal model consisting of the extrinsic flexor muscles (flexor digitorum profundus and flexor digitorum superficialis) was developed to describe the changes of muscle force and contraction power in clench fist movement before and after cold simulation through inverse dynamics analysis.  RESULTS AND CONCLUSION: After the cold water stimulation, the average angular velocities of the three joints of index finger were decreased during the flexing movement compared to those before cold water stimulation, and the muscle force of flexor digitorum superficialis was increased significantly in the flexing process. The contract power of flexor digitorum profundus decreased obviously, whereas the contract power of flexor digitorum superficialis was decreased slightly. The results indicate that the finger movement takes more time and the muscle force of flexor digitorum superficialis is more sensitive to the cold stimulation, which further indicates the importance of flexor digitorum superficialis in clench fist movement. Figures and Tables | References | Related Articles | Metrics

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Meta-analysis on the relationship between femoral intercondylar notchsize and anterior cruciate ligament injury Wei Jie, Zeng Chao, Gao Shu-guang, Yang Tu-bao, Lei Guang-hua 2013, 17 (22):  4099-4106.  doi: 10.3969/j.issn.2095-4344.2013.22.016 Abstract ( 442 )   PDF (574KB) ( 385 )   Save BACKGROUND: Previous studies have explored the relationship between femoral intercondylar notch size and anterior cruciate ligament injury, but there is no unified conclusion, and there is no relative meta-analysis.  OBJECTIVE: To analyze the relationship between femoral intercondylar notch size and anterior cruciate ligament injury, in order to provide a scientific basis for the causes of anterior cruciate ligament injury andeffective prevention and control measures. METHODS: The Medline database, AMED database, Embase database, Cochrane Library and Chinese Biomedical database were searched, and the case-control studies and prospective cohort studies on the relationship between femoral intercondylar notch size and anterior cruciate ligament injury were collected. The Revman5.0 and STATA11.0 software package were used for data analysis.  RESULTS AND CONCLUSION: Twenty meta-analysis literatures were involved, including 16 case-control studies and 4 prospective cohort studies. A total of 4 532 subjects were included (1 316 subjects in the injury group and 3 216 in the control group). The pooled weighted mean difference for femoral intercondylar notch index between the injury group and the control group was [-0.04, 95% confidence interval:(-0.05, -0.02), P < 0.05]. The pooled weighted mean difference for femoral intercondylar notch width between the injury group and the control group was [-1.47, 95% confidence interval: (-1.92, -1.02), P < 0.05]. The results of this meta-analysis suggest that there is correlation between femoral intercondylar notch size and anterior cruciate ligament injury, but more high-quality and large sample studies are needed to confirm this conclusion. Figures and Tables | References | Related Articles | Metrics

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Interlocking intramedullary nail versus minimally invasive percutaneous plate osteosynthesis in the treatment of middle and distal tibial fracture in adults: A meta-analysis Zhang Xuan-xuan, Long Teng-fei, Zhang Pi-jun, Zhao Hui, Wang Gang 2013, 17 (22):  4107-4114.  doi: 10.3969/j.issn.2095-4344.2013.22.017 Abstract ( 622 )   PDF (302KB) ( 498 )   Save BACKGROUND: The invasive internal fixation method for the treatment of middle and distal tibial fracture includes interlocking intramedullary naill and minimally invasive percutaneous plate osteosynthesis in clinic. A large number of retrospective studies have confirmed the effectiveness of these two strategies, but there is still no conclusion in which one is better. OBJECTIVE: To compare clinical outcomes of interlocking intramedullary naills and minimally invasive percutaneous plate osteosynthesis in the treatment of middle and distal tibial fracture in adults. METHODS: The PubMed database, Embase database, Cochrane database, CBM database, Wangfang database and CNKI database were searched by computer for the articles on interlocking intramedullary naills and minimally invasive percutaneous plate osteosynthesis in the treatment of middle and distal tibial fracture in adults, and the relevant Chinese and English orthopedic journals were hand-searched, including randomized controlled trials and quasi-randomized controlled trials. Then, the retrieved studies were strictly evaluated in accordance with the Cochrane Collaboration criteria, and the evaluation index included operation time, fracture healing time, bone tissue healing-related adverse events, soft tissue healing-related adverse events and tibia functional recovery. Meta-analysis was performed using RevMan 5.1 software. RESULTS AND CONCLUSION: A total of 7 articles were screened out, including 377 patients, 188 cases in the  interlocking intramedullary naill group and 189 in the minimally invasive percutaneous plate osteosynthesis group. The results of meta-analysis showed that there were no statistically significant differences in the operation time [weighted mean difference=0.58, 95% confidence interval (-28.91, 30.07), P=0.97], the incidence of bone tissue healing-related adverse events [relative risk=0.51, 95% confidence interval (0.22, 1.18), P=0.11], and excellent and good rate of postoperative Johnner-Wruhs function evaluation [relative risk =1.03, 95% confidence interval (0.91, 1.17), P=0.63] between two groups. However, compared with interlocking intramedullary naill group, the fracture healing time was shorter in the minimally invasive percutaneous plate group [weighted mean difference=1.99, 95% confidence interval (0.15, 3.83), P=0.03], and the incidence of bone tissue healing-related adverse events was lower [relative risk=1.84, 95% confidence interval (1.03, 3.27), P=0.04]. The results indicate that the Interlocking intramedullary naill and minimally invasive percutaneous plate osteosynthesis has the same effect in the treatment of middle and distal tibial fracture in adults, but minimally invasive percutaneous plate osteosynthesis can shorten the healing time and reduce the incidence of bone tissue healing-related adverse events. Figures and Tables | References | Related Articles | Metrics

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Clinical trials of traumatic cervical spine injury treated with internal fixation: Registration project analysis Nan Jun, Yuan Hu, Li Kang-jie 2013, 17 (22):  4115-4122.  doi: 10.3969/j.issn.2095-4344.2013.22.018 Abstract ( 354 )   PDF (378KB) ( 523 )   Save BACKGROUND: Traumatic cervical spine injury cannot be ignored, because it will injury the spinal cord and thus leads to paralysis if not treat timely and effectively. OBJECTIVE: To search the Chinese Clinical Trial Register, North American Clinical Trial Register and Thomson Reuters Web of Science database and to perform literature metrological analysis on the registered projects and published literatures of the relative clinical trials about the traumatic cervical spine injury. METHODS: The Chinese Clinical Trial Register was searched with the key words of “cervical vertebrae” for the clinical trial program on the traumatic cervical spine injury; the North American Clinical Trial Register was searched with the key words of “cervical vertebra”, “trauma” or “cervical spine”, “Trauma” for the related clinical trials, and a total of 22 registered projects were obtained; the Thomson Reuters Web of Science database was searched with the key words of “neck vertebra, cervical vertebra, vertebrae cervicales, cervical spine, C-Spine, Trauma” for the literatures on the traumatic cervical spine injury published from 2003 to 2012. RESUTLS AND CONCLUSION: There are only five clinical trial registration projects related to the traumatic cervical spine injury in the Chinese Clinical Trial Register, 22 clinical trial registration projects related to the traumatic cervical spine injury in the North American Clinical Trial Register. The clinical trial registration projects in the Chinese Clinical Trial Register are significantly less than those in the North American Clinical Trial Register. The clinical trial registration projects related to the traumatic cervical spine injury searched from the North American Clinical Trial Register are distributed in three states and 17 countries, and mainly distributed in America. The clinical trial registration projects related to the traumatic cervical spine injury are mainly the intervention studies, and most of the intervention methods are internal fixation. No diagnostic test in the clinical trial registration. The number of literatures on traumatic cervical spine injury published from 2003 to 2012 in the Thomson Reuters Web of Science database have been reached to 1 597, and the amount of literatures published by the United States is accounted for the largest proportion of the total number (46.84%), the Chinese is accounted for 1.94%. The highly cited papers are mainly published on the Journal of Trauma-Injury Infection and Critical Care. The clinical trial registration unit that registered clinical trials on traumatic cervical spine injury in the Chinese Clinical Trial Register did not publish literatures on the Thomson Reuters Web of Science database. The clinical trial registration unit that registered four clinical trials on traumatic cervical spine injury in the North American Clinical Trial Register was the Ottawa Hospital Research Institute, and the unit published the most literatures (30 literatures) was the University of British Columbia, and mainly between 2009 to 2012. The literature on the traumatic cervical spine injury published by the two units above is registered also, the registration number is NCT00290875. Figures and Tables | References | Related Articles | Metrics

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Stability of posterior dynamic stabilization system fixation for thetreatment of lumbar disc herniation Ding Li-xiang, Chen Ying-chun, Zhang Gen-ai, Yao Qi, Hou Yu 2013, 17 (22):  4123-4129.  doi: 10.3969/j.issn.2095-4344.2013.22.019 Abstract ( 472 )   PDF (570KB) ( 504 )   Save BACKGROUND: Posterior dynamic stabilization system can be used to maintain the vertebral motion segment and reduce the degeneration of vertebral body adjacent segment. OBJECTIVE: To investigate the efficacy and stability of posterior dynamic stabilization system for the treatment of lumbar disc herniation. METHODS: Eighteen patients with degenerative lumbar disease and treated with posterior decompression and posterior dynamic stabilization system internal fixation in the Department of Orthopedics, Beijing Shijitan Hospital Affiliated to Capital Medical University from February 2009 to June 2011 were selected, included 11 male patients and seven female patients, the age was 32-67 years old and averaged in 45 years old. The visual analogue scale score was used for pain assessment and the Oswestry disability index was used for clinical evaluation, the flexion and hyperextension X-ray films were used to measure the activity of lumbar intervertebral disc and the adjacent intervertebral disc after posterior dynamic stabilization system fixation. RESULTS AND CONCLUSION: All the patients were followed-up for 20-45 months, averaged in 38 months. The visual analogue scale score before posterior dynamic stabilization system fixation was 7.1-9.4 points, and averaged 8.3 points, the postoperative score was 0-3.1 points, averaged 1.5 points, the improvement rate of visual analogue scale score was 81.5%. The Oswestry disability index before posterior dynamic stabilization system fixation was 35-81 points (average 60 points) and 0-45 points after fixation (average 22 points), and the improvement rate of Oswestry disability index was 63.3%. There was one case of loosening after posterior dynamic stabilization system fixation, one case had lower extremity nerve symptoms transient increasing and relieved after 3 months. The average range of motion after fixation was 5.3°. The posterior dynamic stabilization system for the treatment of lumbar disc herniation can maintain the range of motion and stability of the fixed segment with well recovered medium-term clinical symptoms, suggesting that this system is an alternative non-fusion fixation method for the treatment of lumbar disc herniation, but the effect on the adjacent segment still need to be identified with long-term follow-up Figures and Tables | References | Related Articles | Metrics

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Chinese and western medicines prevent deep venous thrombosis after hipreplacement  Zhao Li-min 2013, 17 (22):  4130-4136.  doi: 10.3969/j.issn.2095-4344.2013.22.020 Abstract ( 469 )   PDF (489KB) ( 569 )   Save BACKGROUND: Medication and physical therapy have a positive effect on the prevention and treatment of deep venous thrombosis after hip replacement. OBJECTIVE: To investigate the efficacy of Chinese and western medicines on the prevention of deep venous thrombosis after hip replacement. METHODS: The literatures related to the effect of Chinese and western medicines on the prevention of deep venous thrombosis after hip replacement were collected to analyze the mechanism of different methods in the preventing of deep venous thrombosis, and to compare the efficacy and safety of Chinese and western medicines on the treatment and prevention of deep venous thrombosis after hip replacement. RESULTS AND CONCLUSION: The effect of fondaparinux sodium on the prevention of total deep vein thrombosis after major orthopedic surgery was better than enoxaparin, and the rivaroxaban was better than low molecular weight heparin in reducing hidden hemorrhage of the patients after joint replacement. Observation from the Chinese medicines, methods of qi-benifiting and blood-activating and blood circulation improvement were used to prevent deep vein thrombosis after hip replacement, and the Huoxuetongmai decoction, Taohongsiwu decoction, Buyanghuanwu decoction, Fushoutongyu decoction, Huoxuetongshuan decoction and Jiaweitaohechengqi decoction had better effect in preventing and treating the deep vein thrombosis. Research on the comparison between Chinese and western medicines found that Chinese medicine or the Chinese and western medicines composition has the same effect in preventing deep vein thrombosis after hip replacement with high safety. Figures and Tables | References | Related Articles | Metrics

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Keyhole and lockpin shank transition combined with interlocking intramedullary nail fixation improve the biological stability of fracture site Qi Shan-hong, Xu Hui-hao, Shi Bai-shou, Xia Chun-huan, He Wen-hao, Wang Shao-feng, Sha Yong 2013, 17 (22):  4137-4143.  doi: 10.3969/j.issn.2095-4344.2013.22.021 Abstract ( 496 )   PDF (1927KB) ( 361 )   Save BACKGROUND: With the wide application of interlocking intramedullary nail, the issues of delayed fracture healing and interlocking nail fracture are gradually revealed, thus the keyhole and lockpin shank transition combined with interlocking intramedullary nail come into being. OBJECTIVE: To observe the stability of keyhole and lockpin shank diameter transition combined with interlocking intramedullary nail and traditional interlocking intramedullary nail fixation. METHODS: Eight bilateral femoral fracture specimens were used and the fracture sites were fixed with eight keyholes and lockpin shanks diameter transition combined with interlocking intramedullary nail and traditional interlocking intramedullary nail fixation. In the experimental group, the customized intramedullary nail distal aiming fine-tuning device was used to install the matching equipment nail, and then interlocking fixed by customized interlocking nail with the diameter of 4.3 mm; in the control group, conventional matching installation equipment was used, and then interlocking fixed by interlocking nail with the conventional diameter of 4.0 mm. The specimens in two groups were fixed with the methods above respectively, and then the displacement from left to right, from forward to backward and the rotation displacement of the femoral fracture sites in two groups were recorded and measured, in order to compare the stability of the fracture fixation. RESULTS AND CONCLUSION: For the treatment of middle femur fracture with keyholes and lockpin shanks transition combined with interlocking intramedullary nail fixation, when loaded with 10 N force, the femoral fracture sites had 1.22 mm displacement from left to right, 1.22 mm from forward to backward and 0.33 mm rotation displacement; when the traditional interlocking intramedullary nail keyhole loaded with 10 N force, the femoral fracture sites had 3.26 mm displacement from left to right, 3.37 mm from forward to backward and 2.15 mm rotation displacement. The displacement from left to right, from forward to backward and the rotation displacement of the fracture sites after fixed with lockpin shanks transition combined with interlocking intramedullary nail were smaller than those after fixed with lockpin shanks transition combined with traditional interlocking intramedullary nail, and the differences were significant. The results indicate that keyhole and lockpin shank transition combined with interlocking intramedullary nail fixation can improve the stability of fracture site. Figures and Tables | References | Related Articles | Metrics

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Total hip arthroplasty for the treatment of acetabular protrusion secondary to rheumatoid arthritis Tang Song-jun, Liu Wei, Li Xiao-hua 2013, 17 (22):  4144-4151.  doi: 10.3969/j.issn.2095-4344.2013.22.022 Abstract ( 878 )   PDF (420KB) ( 633 )   Save BACKGROUND: The rheumatoid arthritis can induce acetabular protrusion, and the reconstruction of the movement center and hip function are the two difficulties for total hip arthroplasty.     OBJECTIVE: To discuss the clinical efficacy of total hip arthroplasty for the treatment of rheumatoid arthritis induced acetabular protrusion. METHODS: Twenty-two hips in 16 patients with rheumatoid arthritis induced acetabular protrusion were involved, including five male patients with 8 hips and 11 female patients with 14 hips. They all received bone graft during total hip arthroplasty. All the patients were followed-up for 28-94 months, 50 months in average, and then imaging assessment was performed with hip X-ray films. The range of motion and the Harris score were used to evaluate the clinical efficacy. RESULTS AND CONCLUSION: Up to the final follow-up, all patients got prosthesis stability and stable bone graft, and there was no obvious radiolucent line around the prosthesis. The Harris score was increased from (42.4±8.6) before replacement to (87.5±5.6) after replacement, and the inflection angle of range of motion was increased from (45.2±5.5)° to (95.6±5.8)°, the abduction angle increased from (15.2±8.5)° to (32.6±6.6)°. Total hip arthroplasty combined with autogenous bone graft for the treatment rheumatoid arthritis induced acetabular protrusion can effectively restore the hip center and reconstruct the hip function. Figures and Tables | References | Related Articles | Metrics

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Comparison of different orthosis for improving gait in patients with spinal cord injury Wu Qiang1, Ma Zong-hao2, He Cheng-qi3 2013, 17 (22):  4152-4160.  doi: 10.3969/j.issn.2095-4344.2013.22.023 Abstract ( 920 )   PDF (593KB) ( 471 )   Save BACKGROUND: Drop ring lock knee-ankle-foot orthosis has been widely used in patients with higher level spinal cord injury, with one primary limitation in ambulation being attributable to the absence of knee flexion in swing phase. As a result, an individual is forced to use compensatory upper body motions to advance the legs. At present, the research on the comparison between different knee-ankle-foot orthoses is rare. OBJECTIVE: To investigate and compare the clinical effect of E-MAG and drop ring lock knee-ankle-foot orthosis in the treatment of the patients with spinal cord injury. METHODS: With the approach of case crossover study, the application effect of drop ring lock knee-ankle-foot orthosis in combination with an E-MAG on a patient with a T10 spinal cord injury was observed. With the measurement of three-dimensional gait data, a comparison was made between the scenarios of having the knees locked during the entire gait cycle to that of allowing the knees to flex freely during the swing phase, yet still be locked for stability during stance. RESULTS AND CONCLUSION: Qualitative observation and kinematic three-dimensional gait data demonstrated that this patient ambulated with a faster, more efficient gait pattern when using E-MAG. Despite having no voluntary control of knees, this orthotic option afforded the ability to walk safely and smoothly with both knees flexing during swing and knee lock in stance phase, and with less upper body compensation. Compared with drop ring lock knee-ankle-foot orthosis, E-MAG active orthosis contains stance phase control, so it has higher degree of acceptance and practicality Figures and Tables | References | Related Articles | Metrics

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Movement intervention recovers the Cobb angle of adolescent idiopathic scoliosis Yang Ning, Xu Pan 2013, 17 (22):  4161-4168.  doi: 10.3969/j.issn.2095-4344.2013.22.024 Abstract ( 1074 )   PDF (517KB) ( 1063 )   Save BACKGROUND: Various methods are involved for the treatment of adolescent idiopathic scoliosis; however, reports concerning independent function-mediated training are rare.    OBJECTIVE: To explore the effect of movement intervention on the recovery of Cobb angle of patients with adolescent idiopathic scoliosis. METHODS: One 15-year-old patient with adolescent idiopathic scoliosis was asked to take X-ray film before movement intervention to measure the Cobb angle and define the location. The related muscles were determined according to the bending position, and the functional motion was designed for the targeted exercises and movement pattern exercises. The movement intervention included: exercise for left leg to across the sidebar; exercise for left leg to side touch the rubber band (the rubber band that higher than the head was pulled down with the left hand, and then hooked the rubber band timely with ankle, and the left lumbar muscle should contracted); raking pole exercise (left): wiping exercises, circled exercises, small kicking practice and squatting exercises; left side stretching exercise (stretched the right side muscles); side pulled down the rubber band with arm (bilateral latissimus dorsi); prone sandbags pulling; left arm overhanging exercises; mat tumbling: forward roll, backward roll, and shoulder and elbow handstand; abdominal exercises (forward rotation and side rotation); four sets of rhythmic gymnastics portfolio. All the exercise were completed under the control of music, a total of 50 times intervention, 1-1.5 hours per time, and the course of the exercise was two and a half months. The X-ray films were re-taken to observe the changes of Cobb angle, and the improvement of the neuromuscular function on the affected side before and after intervention was observed. RESULTS AND CONCLUSION: After the rehabilitative training for 50 times in two and a half months (1-1.5 hours per time), the Cobb angle of the patients was recovered from 28° to 34°. The specialists recommend that the brace should not be used. The results indicate that movement intervention has significant effects on the recovery of Cobb angle of the patients with adolescent idiopathic scoliosis Figures and Tables | References | Related Articles | Metrics

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Design and evaluation of the questionnaire about knee osteoarthritis Huan Song-wei, TAM Man-seng, CHEANG Lek-hang, Xia Ji-sheng, Wu Hao, You Tian,Zha Zhen-gang 2013, 17 (22):  4169-4175.  doi: 10.3969/j.issn.2095-4344.2013.22.025 Abstract ( 1348 )   PDF (340KB) ( 1103 )   Save BACKGROUND: There are more and more researches on the risk factors of knee osteoarthritis at home and abroad, but there is no unanimously recognized questionnaire. Knee Osteoarthritis questionnaire can be used for a wide range of clinical epidemiological investigation, which can provide relative basis for the further clinical research and treatment. OBJECTIVE: To design a questionnaire about knee osteoarthritis for analyzing risk factors of knee osteoarthritis, and to assess its reliability and validity. METHODS: Thirty patients with knee osteoarthritis in the First Affiliated Hospital of Jinan University were collected as the research subjects, then a unified questionnaire was designed and the proper statistical methods were used to assess its reliability and validity. RESULTS AND CONCLUSION: The questionnaire was formulated by seven aspects contained 17 items in all, the general Cronbach’s α coefficient of this questionnaire was 0.974, and the analysis of the content validity showed that the subjects can represent the measurement content with high content validity. The questionnaire about knee osteoarthritis has high reliability and validity, and can be used for a wide range of epidemiological investigation in clinical practice. Figures and Tables | References | Related Articles | Metrics

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Characteristics of dynamic balance function in patients with knee osteoarthritis Li Qing, Xie Lian-hong, Yang Jian, Fan Li 2013, 17 (22):  4176-4180.  doi: 10.3969/j.issn.2095-4344.2013.22.026 Abstract ( 379 )   PDF (246KB) ( 464 )   Save BACKGROUND: Patients with knee osteoarthritis have decreased knee muscle strength and knee extensor muscle strength thus affecting the balance control ability. OBJECTIVE: To explore the change characteristics of dynamic balance ability in knee osteoarthritis patients. METHODS: Twenty-two knee osteoarthritis patients (knee osteoarthritis group) and 20 healthy adults (control group) were included. The dynamic balance ability was tested with dynamic balance device. The stability index, anterior/posterior stability index and medial/lateral stability index were measured. In limits of stability test, we measured direction control performance, average direction control performance, forward  direction control performance, back direction control performance, left direction control performance, right direction control performance, forward/left direction control performance, forward/right direction control performance, back/left direction control performance, back/right direction control performance and limits of stability time. RESULTS AND CONCLUSION: The total instability index, anterior/posterior stability index and medial/lateral stability index with eyes open or closed while standing with feet in the knee osteoarthritis group were higher than those in the control group (P < 0.01), and the average direction control performance, forward direction control performance, back direction control performance, left direction control performance and right direction control performance were lower than those in the control group, but the time for accomplish the test was increased significantly (P < 0.01). The results indicated the dynamic balance ability of the knee osteoarthritis patients was decreased. Figures and Tables | References | Related Articles | Metrics