Loading...

Table of Content

    27 August 2014, Volume 18 Issue 35 Previous Issue    Next Issue
    For Selected: Toggle Thumbnails
    Blood loss and limb circumference changes in patients undergoing unilateral total knee arthroplasty after intra-articular injection of tranexamic acid: a randomized controlled trial
    Ma Jin-hui, Sun Wei, Gao Fu-qiang, Wang Yun-ting, Li Zi-rong
    2014, 18 (35):  5577-5582.  doi: 10.3969/j.issn.2095-4344.2014.35.001
    Abstract ( 330 )   PDF (643KB) ( 467 )   Save

    BACKGROUND: Tranexamic acid has been more and more used in reducing bleeding after joint replacement, but its usage method and dosage remain controversial, and become a hot focus in recent years. 
    OBJECTIVE: To investigate the efficacy of intra-articular injection of tranexamic acid on postoperative blood loss and limb circumference changes in patients who received unilateral total knee arthroplasty.
    METHODS: From March to October 2013, clinical data of 90 patients undergoing primary unilateral total knee arthroplasty were randomized to the tranexamic acid group and the control group, including 19 males and 71 females. The 30 patients in the tranexamic acid group received 50 mL of 3% tranexamic acid dilute solution inside knee joint after capsule closure, and 60 patients in the control group received the same volume of physiological saline. No significant difference in age, height, body mass index, anticoagulation, the type of prosthesis, tourniquet time and preoperative diagnosis was detected between the two groups (P > 0.05). The amounts of intraoperative and postoperative blood loss and blood transfusion, postoperative drainage volume, the preoperative and postoperative limb circumference 10 cm above the operated knee were recorded. Routine blood  test was reviewed after the surgery.
    RESULTS AND CONCLUSION: There were no significant differences in total blood loss, postoperative drainage volume and limb circumference changes between tranexamic acid and control groups (P > 0.05). The amount of postoperative hidden blood loss was significantly less in the tranexamic acid group than in the control group (t=-2.683, P < 0.05). These data suggested that the intra-articular injection of tranexamic acid intraoperatively in patients receiving total knee arthroplasty could significantly reduce the amounts of postoperative hidden blood loss, and did not affect the postoperative limb circumference changes.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Simultaneous bilateral versus unilateral total knee arthroplasty in treatment of knee osteoarthritis
    Ye Chuan, Liu Ri-guang, Tang Jin, Li Jiang-wei, Zhang Tao, Ren Hou-xiang, Sun Qi, Wu Cheng, Zhao Bao-ping
    2014, 18 (35):  5583-5588.  doi: 10.3969/j.issn.2095-4344.2014.35.002
    Abstract ( 337 )   PDF (666KB) ( 706 )   Save

    BACKGROUND: The safety and efficacy of simultaneous bilateral total knee replacement or selective unilateral total knee arthroplasty in patients with severe osteoarthritis of the knees are still controversial.
    OBJECTIVE: To compare safety and clinical efficacy of patients with osteoarthritis knees after simultaneous bilateral total knee replacement or selective unilateral total knee replacement.
    METHODS: Totally 60 cases with severe osteoarthritis of the knees (90 knees) undergoing total knee replacement were divided into unilateral total knee replacement group (n=30, 30 knees), and the simultaneous bilateral total knee replacement group (n=30, 60 knees).
    RESULTS AND CONCLUSION: There was no significant difference in the incidence of other complications such as infection, mortality, pulmonary embolism in patients of both groups (P > 0.05). The incidence of cardiovascular complications, postoperative blood loss and blood transfusion were higher in the bilateral knee group than in the unilateral knee group (P < 0.05). During follow-up at 1 year after replacement, no significant differences in range of motion, muscle strength of quadriceps and hospital for special surgery knee score were detected in patients of both groups (P > 0.05). However, Visual Analogue Scale scores were significantly lower in the bilateral knee group than in the unilateral group (P < 0.05). These data indicated that the risk of cardiovascular complications was high in patients receiving bilateral total knee replacement. Patients with severe cardiovascular disease should avoid simultaneous bilateral total knee arthroplasty. 


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Safe range of artificial acetabular cup installation angle for different head-neck ratios
    Zhang Zhen-hua, Sun Fu-jie, Hu Ke-zheng, Nie Wen-bo, Wang Ming-xing
    2014, 18 (35):  5589-5594.  doi: 10.3969/j.issn.2095-4344.2014.35.003
    Abstract ( 466 )   PDF (712KB) ( 773 )   Save

    BACKGROUND: Improper angle of prosthesis placement often induces acetabular cup impact, and limits the scope of activity of artificial hip joint, and cannot meet the requirement of daily life. At present, the angle of acetabular cup installation remains controversial during total hip arthroplasty. Moreover, there is lack of targeted guide for the acetabular cup installation during hip arthroplasty with different head-neck ratios.
    OBJECTIVE: To explore the safe range of the artificial acetabular cup installation angle for different head-neck ratios.
    METHODS: In accordance with the calculation formula of range of internal rotation and external rotation, abduction and adduction, flexion and extension after total hip replacement, interpretation of dynamical variety law of acetabular abduction and anteversion, and deriving inequalities depending on Widmer’s standard of artificial hip joint normal activities range: (1) external rotation range was at least 40°, and internal rotation range was at least 80°. (2) Abduction range was at least 50°, and adduction range was at least 50°. (3) Anteflexion range was at least 130°, and extension range was at least 40°. The safety scope of artificial hip joint installation angle at different head-neck ratios was determined by solving the above three groups of inequality.
    RESULTS AND CONCLUSION: The safe range of the artificial acetabular cup installation angle for different head-neck ratios was different. To meet the normal hip joint activities, the head-neck ratios of artificial hip should be greater than 22/12. Artificial hip joint activities gradually increase with the enlargement of head neck ratios. With enlarging the head-neck ratios, the acetabular cup installation safety angle scope of abduction and anteversin gradually increases and the extreme of abduction increases gradually, then with anteversion increasing gradually, the abduction upper extreme of the security scope gradually decrease and lower extreme of the security scope gradually increase, tending to 45° symmetrically. When anteversion is the biggest, the abduction should be 45°. 


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Large-diameter ceramic head articulation against highly cross-linked polyethylene in young patients: 2-year wear rate
    Sun Jiu-yi, Fu Pei-liang
    2014, 18 (35):  5595-5599.  doi: 10.3969/j.issn.2095-4344.2014.35.004
    Abstract ( 1260 )   PDF (574KB) ( 641 )   Save

    BACKGROUND: Prosthesis friction interface is a hot focus in the study of total hip joint. Polyethylene wear particles induced inflammatory reaction, resulting in osteolysis surrounding the prosthesis and prosthesis loosening. To reduce polyethylene wear, ceramics-ceramics and ceramices-polyethylene friction interfaces were selected. High cross-linked polyethylene material with high intensity was selected. In young patients with large activity amount, the application of ceramic head is a great progress.
    OBJECTIVE: To assess the safety of large-diameter alumina ceramic matrix composites (BIOLOX® delta) ball on third-generation highly cross-linked polyethylene (Trident X3, Stryker, Mahwah, NJ) total hip arthroplasty in young patients, and to perform radiological measurements of high cross-linked polyethylene wear rate in the shortest two years after follow-up.
    METHODS: From July 2008 to June 2010, wear analysis of 30 cases aged less than 60 years with 32 hips with 36-mm BIOLOX® delta ceramic femoral heads (CeramTec, Plochingen, Germany) on highly cross-linked polyethylene was performed in the 455 Hospital of Chinese PLA using Roman software (Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom). The mean age of patients was 56.8 ± 6.5 years. 
    RESULTS AND CONCLUSION: Follow-up was conducted from 2 to 3.7 years old. There were no imaging evidences, such as dislocation, the ball head fracture or joint loosening or osteolysis. Mean Harris score was  increased from (19.9±7.3) (11-36) before replacement to (35.3±5.4) at 6 months after replacement. The mean wear rate was (0.022±0.11) mm/year after run-in period. These data indicated that large-diameter ceramic head articulation against highly cross-linked polyethylene in young patients would have high safety for joint dislocation, prosthesis fragmentation and low wear rates.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Mid-term results of Zweymüller SLR-plus® stem used in hip revision
    Li Peng, Zhu Zhi-qi, Hou Ming, Shi Zhan-jun
    2014, 18 (35):  5600-5605.  doi: 10.3969/j.issn.2095-4344.2014.35.005
    Abstract ( 481 )   PDF (778KB) ( 479 )   Save

    BACKGROUND: The outcomes of SL-Plus® stem in primary total hip arthroplasty have been proved good, but whether SLR-Plus® revision stem can obtain a good outcome in revision hip arthroplasty needs more studies.
    OBJECTIVE: To observe the clinical results of revision hip arthroplasty with Zweymüller SLR-plus® stem.
    METHODS: Revision hip arthroplasty of 41 hips in 39 patients was performed from November 1997 to May 2013 using SLR-plus® stem. There were 26 hips (male) and 15 hips (female). They were at the age of 34-73 years old, 53 on average. In the 41 hips, 36 cemented and 5 uncemented femoral prostheses were used. Prosthetic changes on radiographs were observed. In accordance with Brooker classification, heterotopic ossification was classified to record the region and incidence of heterotopic ossification. Hip joint function was evaluated using Harris Hip Score, and survival rate of the prosthesis was analyzed.
    RESULTS AND CONCLUSION: A total of 31 patients (33 hips) were followed up for 1 to 16 years. The mean preoperative Harris hip score of 34 (range, 13-64) points improved to 85 (range, 55-94) points at the time of final follow-up. 32 hips (97%) had an excellent result. A 1 mm width radiolucent line was found in 1 femoral component without any symptom. Osteolysis and migration were seen in 1 hip, which needed re-revision. Heterotopic ossification developed in 9 hips, including 2 hips of Brooker grade 1, 4 hips of grade 2 and 3 hips of grade 3. Nore-infection was found. Kaplan-Meier survivorship was 92% with radiographic loosening as the end point. Results demonstrated that the SLR-Plus® stem has sufficient immediate and long-term stability, which is reliable for patients undergoing hip revision surgery.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Autologous iliac bone graft and plate fixation in the repair of tuberculosis of the thoracic vertebra
    Huang Jiang, Yang Yuan, Lin Chun-bo, Li Xiao-feng
    2014, 18 (35):  5606-5610.  doi: 10.3969/j.issn.2095-4344.2014.35.006
    Abstract ( 444 )   PDF (696KB) ( 441 )   Save

    BACKGROUND: Thoracic vertebra connected to the corresponding section of the ribs constitute thoracic vertebral, which is deep, and the structure is complicated, so it is difficult to fully expose thoracic vertebrae. Usually, corresponding ribs is removed, and the injured site will be reached through thoracic cavity. The trauma is big. Some complications often occur such as chest pain, and local skin numbness. Therefore, whether it is possible to reach the same target without removal of ribs through intercostal space became a new clinical problem.
    OBJECTIVE: To explore the safety and efficacy of autologous iliac bone graft and plate fixation for tuberculosis of thoracic vertebra.
    METHODS: A total of 30 patients diagnosed with tuberculosis of thoracic vertebra from January 2008 to December 2013 were conventionally treated with anti-tuberculosis treatment for 2 to 3 weeks, and then treated with autologous iliac bone fusion through intercostal space and anterior plate fixation. Postoperative follow-up was conducted from 6 to 22 months. Fracture healing condition, the degree of pain relief, Cobb angle change,  length of incision, blood loss, operation time, postoperative recovery of neurological function were observed.
    RESULTS AND CONCLUSION: In 30 patients, the length of incision was (12.4±1.8) cm; longitudinal incision distraction width was (10±3.2) cm; the time of opening the chest was (16.0±2 .5) minutes; the time of closing the chest was (12.0±1.5) minutes; intraoperative blood loss amount was (430.0±87.4) mL. Preoperative and postoperative average kyphosis angles were respectively 27° and 8°, with an average rectification of 19°. The pain basically relieved at 1 to 2 weeks after the surgery. 28 patients were healed, and the symptoms of 2 patients were improved. Postoperative follow-up radiographs revealed that autologous bone grafts were thoroughly fused, and the fusion time lasted from 4 to 5 months. These data verified that autologous iliac bone graft through intercostal space and plate fixation is an effective, safe method for tuberculosis of thoracic vertebra. The exposed range through intercostal space can satisfy the operation requirements of complete tuberculosis clearance, autologous iliac bone graft and plate fixation, and can ensure the integrity of the whole thorax and spine stability.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Proximal femoral nail anti-rotation versus dynamic hip screw in the repair of intertrochanteric fracture in the elderly
    Xu Hou-gao
    2014, 18 (35):  5611-5615.  doi: 10.3969/j.issn.2095-4344.2014.35.007
    Abstract ( 400 )   PDF (724KB) ( 372 )   Save

    BACKGROUND: For younger patients with intertrochanteric fractures, many fixation methods can provide an effective and robust fixation, but for elderly patients with osteoporosis intertrochanteric fracture, there remains debate for which fixation method is optimum.
    OBJECTIVE: To compare the clinical outcomes of proximal femoral nail anti-rotation and dynamic hip screw in the repair of intertrochanteric fracture.
    METHODS: Clinical data of patients with intertrochanteric fracture treated by proximal femoral nail anti-rotation or dynamic hip screw at the Suzhou Xiangcheng People’s Hospital from January 2010 to January 2013 were selected. In accordance with the inclusion criteria, 140 patients (146 hips) were included, containing 70 patients in the proximal femoral nail anti-rotation group (74 hips) and 70 patients in the dynamic hip screw group (72 hips). No significant difference in preoperative general data was detected in patients of both groups (P > 0.05), showing a comparability. Operative time, intra-operative blood loss, the average length of hospital stay, postoperative ambulation time, perioperative hemoglobin loss amount, postoperative complications, healing time, and Harris score were compared and evaluated in both groups.
    RESULTS AND CONCLUSION: 140 patients were followed up for 8-16 months. The incision was stage I healing. Compared with dynamic hip screw group, operative time, intra-operative blood loss, the average length of  hospital stay, and postoperative ambulation time were better in the proximal femoral nail anti-rotation group (P < 0.05). However, no significant differences in perioperative hemoglobin loss amount, healing time, and postoperative Harris score were visible in the both groups (P > 0.05). These findings suggested that proximal femoral nail anti-rotation and dynamic hip screw in the repair of intertrochanteric fracture could obtain satisfactory clinical outcomes, but proximal femoral nail anti-rotation has some advantages such as short operative time, less blood loss, short mean hospital stay, early postoperative ambulation time and less postoperative complications.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Lateral locking combined with medial support plate versus double support plate for repair of tibial plateau fractures
    Ma Yun-hong
    2014, 18 (35):  5616-5621.  doi: 10.3969/j.issn.2095-4344.2014.35.008
    Abstract ( 493 )   PDF (805KB) ( 433 )   Save

    BACKGROUND: Unilateral support plate in the treatment of complex tibial plateau fractures easily formed eccentrically brace, and easily led to angular deformity. The outer support plate alone is prone to knee varus deformity.
    OBJECTIVE: To compare the clinical and imaging effects with the outer locking plate combined with inner support plate fixation and double support plate using dual lateral incision in the repair of complex tibial plateau fracture.
    METHODS: We retrospectively analyzed the clinical data of 86 patients with complex tibial plateau fractures from March 2009 to November 2013. According to the different fixations, patients were divided into two groups. Outer locking plate combined with inner support plate group: lateral locking plate fixation for complex and comminuted fractures, and support plate was used in the inner side. Double support plate group used internal and external support plates. Patients were followed up for 2 years after the surgery. Clinical and imaging effects of two different fixations were compared.
    RESULTS AND CONCLUSION: Wounds were stage I healing in all the follow-up patients. Bone healing was conducted. No significant difference in operation time, time of tourniquet and intraoperative blood loss was detectable between both groups (P > 0.05). Postoperative follow-up demonstrated that full load time was significantly earlier in the outer locking plate combined with inner support plate group than in the double support plate group (P < 0.05). No significant difference in fracture healing time, hospital for special surgery score, range of knee motion and postoperative tibial plateau angle, posterior slope angle and postoperative 1 year tibial plateau angle, posterior slope angle was detected between the two groups (P > 0.05). These data confirmed that dual lateral incision double plate fixation in the repair of tibial plateau fractures had well clinical and imaging features. Compared with the double support plates, outer locking plate combined with inner support plate has superiority in full load time.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    QWIX screw fixation in repair of patellar fractures: continuous dynamic and static pressure in the broken ends of the bones
    Liu Jie, Gao Shi-chang, Liang An-lin
    2014, 18 (35):  5622-5626.  doi: 10.3969/j.issn.2095-4344.2014.35.009
    Abstract ( 417 )   PDF (660KB) ( 555 )   Save

    BACKGROUND: The most important influence caused by patellar fracture is the breakage of knee extension apparatus continuity and potential uncoordination of patellofemoral joint. The aim of patellar fracture surgery is to restore the smoothness of patellar articular surface and to maintain the continuity of knee extension apparatus, to provide stable effective fixation, so as to do early functional exercises.
    OBJECTIVE: To evaluate the clinical effectiveness of a fixation technique for patellar fractures using QWIX combined with Kirschner wire and wire.  
    METHODS: From September 2011 to September 2012, 30 patients with patellar fractures were treated using QWIX screws combined with Kirschner wire and wire in the First Affiliated Hospital of Chongqing Medical University, China. There were 17 males and 13 females, at the age of 47.7 years on average. In accordance with the situation of comminuted fracture and the degree of displacement, QWIX screws or QWIX screws + tension band wire or QWIX screws + Kirschner wire + tension band wire were used for fixation. Active and passive knee motion exercises began at 1 day after surgery, without any external fixation. At 6 weeks, 3, 6, 12 months, and 1  year after surgery, the patients were followed up in out-patient clinic to identify fracture healing and to make sure whether complications appeared or not. The range of flexion and extension of bilateral knee was measured. The knee function of the affected side was evaluated using Bostman score at 1 year postoperatively.
    RESULTS AND CONCLUSION: All patients were followed up for 12 to 24 months. 24 cases were healed within 3 months after surgery, and 6 cases were healed within 4 months after surgery, with an average healing time of 3.2 months. With time prolonged, the range of flexion and extension of bilateral knee gradually increased. The knee function of patients recovered to the level before injury at 1 year after surgery. During follow-up, one patient experienced knee pain due to Kirschner wire loosening. No infection, knee pain, fixation failure, or flexion dysfunction occurred in the remaining patients. In accordance with Bostman score, there were excellent in 27 cases, good in 3 cases, and poor in 0 case, with an excellent and good rate of 100% at 1 year following surgery. Results data suggested that QWIX screws combined with Kirschner wire and wire fixation in repair of patellar fracture have some advantages such as continuous dynamic and static pressure at the broken ends of the bones, early flexion and extension exercises, and reducing the fixation-related complications. It is an effective method to repair patellar fracture.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Combination of plate screw and Steinmann pin in repair of comminuted calcaneal intra-articular and posterosuperior fractures
    Li Guang-feng, Wu Xian-min, Wang Si-cheng, Yang Guo-qing, Zhang You-zhong, Cao Zhong-hua, He Guo-yun, Yin Zhi-feng, Yang Xiao-yu, Zhang Xin, Peng Yong
    2014, 18 (35):  5627-5632.  doi: 10.3969/j.issn.2095-4344.2014.35.010
    Abstract ( 354 )   PDF (877KB) ( 585 )   Save

    BACKGROUND: The therapeutic regimen of intraarticular calcaneal comminuted fractures commonly selects plate and screw fixation. However, for case of posterosuperior calcaneal fracture, the weakness of achilles tendon stretch and plate screw fixation results in difficulty or maintenance of reduction.
    OBJECTIVE: To investigate the therapeutic effects of open reduction and internal fixation with steel screw and Steinmann pins for comminuted calcaneal intra-articular and posterosuperior fractures.
    METHODS: From December 2009 to December 2013, forty patients with fractures of comminuted calcaneal posterosuperior fractures were randomly divided into two groups. In the control group, patients were treated by open reduction and internal fixation by plate screw only. In the experimental group, patients were treated by open reduction and internal fixation by combination of plate screw and Steinmann pin. The Gissane and Bohler angles of the calcaneus were measured from lateral radiograph before and 4 weeks after surgery, and the MARYLAND score was assessed at the last follow-up. Gissane and Bohler angle and MARYLAND score were compared in each group and among different groups.
    RESULTS AND CONCLUSION: All patients were followed up for 9-23 months. BOHLER and GISSANE angles were significantly bigger at 4 weeks after surgery compared with pre-treatment in both groups (P < 0.05). BOHLER and GISSANE angles were significantly bigger in the experimental group than in the control group at 4 weeks after surgery (P < 0.05). During final follow-up, the average score by MARYLAND Foot Score was 78 in the experimental group and 67 in control group, with their excellent and good rate of 80% and 73%. The excellent and good rate was significantly higher in the experimental group than in the control group (P< 0.05). These data indicated that open reduction and internal fixation with combination of plate screw and Steinmann pin has better efficacy in treatment of the comminuted calcaneal intra-articular and posterosuperior fractures compared with plate and screw fixation alone. Their fixation is firm. Functional exercise can be performed earlier. Postoperative recovery of function of the affected limbs is better than plate and screw fixation alone.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Inhibitory effect of ulinastatin on osteoclast activation and the relationship of ulinastatin to matrix metalloproteinase-2 and matrix metalloproteinase-9: potential of preventing prosthetic osteolysis
    Ru Jiang-ying, Zhao Jian-ning, Guo Ting, Yu Lei, Ding Hao, Jiang Hui
    2014, 18 (35):  5633-5639.  doi: 10.3969/j.issn.2095-4344.2014.35.011
    Abstract ( 328 )   PDF (2757KB) ( 471 )   Save

    BACKGROUND: It is presumed that urinary trypsin inhibitor could have protective effects on local and systemic tissues and could inhibit osteoclast proliferation and activation under long-term chronic inflammation conditions  and in ischemic and anoxic environment which was induced by prosthetic wear.
    OBJECTIVE: To investigate the inhibitory effect of ulinastatin on receptor activator for nuclear factor-κb ligand-induced differentiation, proliferation and osteoclastogenesis of RAW264.7 cells and its effects on matrix metalloproteinase-2, matrix metalloproteinase-9 expression level and activity.
    METHODS: Mouse monocyte/macrophage cell line RAW264.7 was treated with different concentrations of urinary trypsin inhibitor (0, 500, 5 000 U/mL) for 24, 48 and 72 hours. Experiments were divided into four groups: the blank group (RAW264.7 cells), receptor activator for nuclear factor-κb ligand-induced group (0 U/mL ulinastatin), 500 U/mL ulinastatin group and 5 000 U/mL ulinastatin group.
    RESULTS AND CONCLUSION: (1) MTT results indicated that there was no significant difference on the proliferation of RAW264.7 cells treated with urinary trypsin inhibitor at 0-5 000 U/mL (P > 0.05) (2) Tartrate-resistant acid phosphatase staining results revealed that compared with receptor activator for nuclear factor-κb ligand-induced group, the number of tartrate-resistant acid phosphatase-positive cells was significantly less in the ulinastatin group (P < 0.05), showing a time-dose dependent manner. (3) Immunohistochemisical results found that compared with receptor activator for nuclear factor-κb ligand-induced group, the percentage of matrix metalloproteinase-9-positive cells was apparently lower in the ulinastatin group. (4) Western blot assay results demonstrated that matrix metalloproteinase-9 expression was low in the RAW264.7 cells alone. At 48 hours after addition of receptor activator for nuclear factor-κb ligand, matrix metalloproteinase-9 protein expression was large. At 72 hours after culture in the 5 000 U/mL ulinastatin group, matrix metalloproteinase-9 protein expression was evidently reduced. (5) Gelatin zymography results showed that compared with the receptor activator for nuclear factor-κb ligand-induced group, matrix metalloproteinase-9 expression was significantly lower in the 5 000 U/mL ulinastatin group (P < 0.05). Results suggested that urinary trypsin inhibitor inhibited receptor activator for nuclear factor-κb ligand-induced osteoclastogenesis and diminished matrix metalloproteinase-9 expression and activity.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Construction of three-dimensional finite element model with lateral mass screw fixation following lower cervical three-segment laminectomy
    Song Ming-zhi, Dong Chao, Li Dan, Ma Kai
    2014, 18 (35):  5640-5646.  doi: 10.3969/j.issn.2095-4344.2014.35.012
    Abstract ( 553 )   PDF (2432KB) ( 482 )   Save

    BACKGROUND: With the improvement of cervical posterior surgical techniques, lateral mass screw fixation technology has been widely used in the reconstruction surgery of the cervical spine for stability. However, currently, the finite element study on the lateral mass screw fixation reconstruction of the cervical spine is rare.
    OBJECTIVE: To establish a fine normal lower cervical spine (C3-C7) three-dimensional finite element model and a reconstructed finite element model with three-segment laminectomy with lateral mass screw fixation. Then, to do an initial biomechanical analysis of the lateral mass screw fixation reconstructed lower cervical finite element model.
    METHODS: We collected a normal female volunteer aged 30 years old to do CT scan for the whole cervical spine. The Dicom data were obtained. Then, the CT scanning images were dealt with software Mimics 10.01, Geomagic Studio 12.0, Solidworks2012, HyperMesh 10.1 and Abaqus 6.12 software to build the normal lower cervical spine (C3-C7) finite element model, the laminectomy finite element model and the rebuilt finite element model. At last, we analyzed the stress changes of reconstructed models under the state of flexion, extension, lateral bending and rotational motion.
    RESULTS AND CONCLUSION: The lower cervical spine finite element model contained 503 911 elements and 93 390 nodes with a fine realistic appearance. It successfully passed the validation. The surgical procedure was completed in the software, and the lateral mass screw fixation reconstruction finite element model has been established. Lateral mass screw fixation system provides good stability for the postoperative finite element model. The activity of rebuilt finite element model is much lower than the normal finite element model. In the extension condition, the stress of lateral mass screw fixation system becomes strong. 


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Posterior vertebral column resection osteotomy combined with step correction in treatment of stiff angular kyphosis: a biomechanical analysis
    Ma Hua-song, Wang Xiao-ping, Tan Rong, Chen Zhi-ming, Lu Ming, Yuan Wei, Xu Qi-ming, Ren Dong-yun, Ma Wei, Li Long, Zhang Jing, Zheng Rui, Xin Xin
    2014, 18 (35):  5647-5653.  doi: 10.3969/j.issn.2095-4344.2014.35.013
    Abstract ( 318 )   PDF (3245KB) ( 568 )   Save

    BACKGROUND: Severe spinal angular kyphosis aggravated spinal cord injury and early degeneration, even caused incomplete paralysis or complete paralysis. Surgical treatment is the only solving approaches and method, but it is difficult, exhibits high risk, and easily affects postoperative complications.
    OBJECTIVE: To analyze the science and effectiveness of posterior vertebral column resection osteotomy combined with step correction in treatment of stiff angular kyphosis based on biomechanical principle.
    METHODS: A total of 90 cases underwent posterior vertebral column resection osteotomy combined with bilateral pedicle screw spinal cord gradually shortening echelon tight closure and orthopedic fixation were selected, including 37 males and 52 females, at the average age of 47 years. Kyphotic angle, spinal sagittal imbalance, trunk side offset rate, operation time, intraoperative blood loss were compared and analyzed before and after treatment.
    RESULTS AND CONCLUSION: The kyphotic angles were 31°-138° (averagely 90.1°) preoperatively and 10°-90° (averagely 41.6°) postoperatively, with an improvement rate of 65%. The distance from C7 plumb line to the S1 upper edge was averagely 5.2 mm, with a correction rate of 73%. Intraoperative blood loss was 1 200-6 000 mL, averagely 2 089 mL. Operation time was 212-470 minutes, averagely 326 minutes. The patients were followed up for 20 to 35 months after the surgery. Osteotomy segments had achieved bone fusion in all patients, and no complications of spinal cord injury or orthopedic angle loss appeared. These data verified that in the accordance with cell biomechanics and spinal biomechanical principles, bilateral pedicle screw spinal cord gradually shortening echelon tight closure and orthopedic fixation protected utmost spinal cord cells against injury in the correction of thoracolumbar angular kyphosis. There is sufficient basis for cell physiology and it accorded biomechanical and physiological characteristics. During the surgery, we should pay attention to protection and release of nerve root and avoid postoperative corresponding nerve root irritation. Full fusion ensures kyphosis correction and avoids spine lateral offset, is an effective safeguard for the recovery of spinal function and postoperative orthopedic effect.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Sextant percutaneous pedicle screw fixation for correcting single-segment thoracolumbar fractures
    Ming Jiang-hua, Zheng Hui-feng, Zhao Qi, Chen Qing, Wang Gang
    2014, 18 (35):  5654-5659.  doi: 10.3969/j.issn.2095-4344.2014.35.014
    Abstract ( 243 )   PDF (388KB) ( 422 )   Save

    BACKGROUND: Though the effects of conservative or traditional open reduction and internal fixation in the treatment of thoracolumbar fractures are reliable and satisfactory for most cases, two methods also have shortages. Minimal-invasive percutaneous pedicle screw system provides a new available method.
    OBJECTIVE: To investigate the clinical effect of Sextant percutaneous pedicle screw system in the treatment of thoracolumbar fractures.
    METHODS: A total of 55 patients, who had undergone percutaneous pedicle screw fixation using Sextant system (25 patients) or traditional open internal fixation (30 patients) for single-level vertebral body compression fractures in Department of Orthopedics of Renmin Hospital of Wuhan University from February 2011 to January 2013, were enrolled in this study. 
    RESULTS AND CONCLUSION: Except two patients in traditional open internal fixation group were lost after discharge, all other patients were followed up for 8-14 months. Operative time, intraoperative blood loss, postoperative drainage amount and hospital day were better in percutaneous pedicle screw fixation group than in the traditional open internal fixation group (P < 0.05). Compared with preoperation, the sagittal Cobb angle, visual analogue scale and Oswestry disability index after operation were significantly lower (P < 0.05), while anterior vertebral body height ratio was significantly higher in each group (P < 0.05). No significant difference was found in terms of correction loss and Oswestry disability index between two groups at 8 months after operation (P > 0.05). The results show that percutaneous pedicle screw fixation using Sextant system has a satisfactory outcome in the treatment of thoracolumbar fractures. However, obeying indication strictly is very important for clinical application.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Accuracy of screw placement in child’s thoracic pedicle assisted by digital navigation template
    Zhang Shao-jie, Wang Xing, Shi Jun, Chen Jie, Ma Shi-feng, Wang Jian, Li Zhi-jun,Zhang Yuan-zhi, Liu Hong-wei
    2014, 18 (35):  5660-5665.  doi: 10.3969/j.issn.2095-4344.2014.35.015
    Abstract ( 295 )   PDF (847KB) ( 505 )   Save

    BACKGROUND: Many scholars at home and abroad have already attempted to apply the technique of the internal fixation pedicle screw placement to cure children’s spinal injuries in recent years, because the children’s thoracic pedicle is more small, anatomical structure variation is big and adjacent relationship is complicated, so the application of adult’s pedicle screw technology simply to children who was in a continuous growth and development can increase operation risk greatly. Above this, improving the accuracy of nailing and reducing error rate become keys for further development of cervical pedicle fixation.
    OBJECTIVE: To provide an individualized and accurate positioning method for screw placement in thoracic  pedicle of children by computer aided design and rapid prototyping technology. 
    METHODS: After computed tomography scan of four cases of child specimens, the original data were made for three-dimensional reconstruction by the software, then the specimens were randomly divided into two groups: one group used the traditional pedicle internal fixation method, and the other group, first created the individual navigation template using the principle of reverse engineering and rapid prototyping technology. The lumbar pedicle screws were put into the samples by the individual navigation template. The position of the pedicle screws was evaluated according to the computer tomography scan.
    RESULTS AND CONCLUSION: The accurate rate of screw placement of the traditional pedicle internal fixation method was 58%; and the accurate rate of screw placement of the individual digital navigation template method was 81%. The success rate was better than the traditional surgery group. Furthermore, chi square test showed that there was a significant difference between two groups (P < 0.05). These findings suggested that there has a high accuracy of the screw placement in thoracic pedicle of children assisted by the individual navigation template, fully reflects the principle of individualization of screw placement, and provides a new feasible method for accurate screw placement in thoracic pedicle of children.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Clinical results of pedicle screws with cement augmentation for treating lumbar degenerative diseases in the elderly
    Chen Rong-guo, Dai Feng-lei, Ou Xian-feng, Yang Chao, Qian Jian-ji, Zeng Yi, Ren Jia-yun, Yu Ze-long
    2014, 18 (35):  5666-5670.  doi: 10.3969/j.issn.2095-4344.2014.35.016
    Abstract ( 358 )   PDF (703KB) ( 400 )   Save

    BACKGROUND: Elderly patients with degenerative lumbar degeneration often appear insufficient holding power of pedicle screw in spine surgery, which is prone to occur de-pinning and leads to insecure fixation. How to increase the holding power of screws has become a hot research.
    OBJECTIVE: To observe the early clinical effect of pedicle screws with cement augmentation for treating lumbar degenerative diseases in elderly patients.
    METHODS: A total of 65 old patients with lumbar degenerative diseases received a treatment between August 2012 and April 2014, and were divided into two groups according to the treatment strategy: treatment group (n=24; internal fixation of pedicle screws with cement augmentation) and control group (n=41; routine internal fixation of pedicle screws). General conditions of patients in two groups were observed and compared. Visual analog scale (VAS) and Japanese Orthopaedic Association (JOA) score system were used for evaluating the lumbar and back pain, and restoration of neurological function in lower limbs respectively.
    RESULTS AND CONCLUSION: All of the patients successfully received the surgery and then were followed up from 3 to 20 months. The anterioposterior and lateral X-ray film revealed no loosening, loss, fracture of the screws, and no loss of intervetebral space height was found. There was no significant difference in the blood loss and  hospital stay between two groups (P > 0.05). JOA at postoperative 3 and 6 months, and VAS score at postoperative 3 months were significantly improved after the treatment of pedicle screws with cement augmentation, when compared to control group (P < 0.05). VAS scores showed no difference at 6 months postoperatively in two groups (P > 0.05). Pedicle screws with cement augmentation for treating lumbar degenerative diseases have the advantages of improving the screws holding strength, reconstructing the stability of lumbar vertebra and obtaining clinical efficacy on degenerative spine.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Hollow pedicle screw fixation with minimal access-posterior lumbar interbody fusion for lumbar disc herniation
    Li Cheng-guo, He Er-xing, Ling Qin-jie
    2014, 18 (35):  5671-5675.  doi: 10.3969/j.issn.2095-4344.2014.35.017
    Abstract ( 368 )   PDF (803KB) ( 603 )   Save

    BACKGROUND: The percutaneous pedicle screw technique effectively reduces the excessive injury of screw placement on paraspinal muscles, and promotes the recovery of the function of low back muscle after surgery. Minimally invasive technique avoids some disadvantages such as large surgical trauma and more bleeding. Folding U-shaped hollow pedicle screw has hollow design and good distraction effect. After fixation, stress intensity, compression time, bending stiffness and torsional mechanical properties have been verified in the clinic.
    OBJECTIVE: To observe the clinical effect of folding U-shaped hollow pedicle screw fixation combined with minimal access-posterior lumbar interbody fusion for single-level lumbar disc herniation.
    METHODS: Between January and December 2012, folding U-shaped hollow pedicle screw fixation with minimal access-posterior lumbar interbody fusion was performed in 30 patients with lumbar disc herniation. The mean follow-up period was 12 months. Lumbago Visual Analog Scale, Oswestry Disability Index and imaging indicators were utilized to evaluate clinical therapeutic effects.
    RESULTS AND CONCLUSION: Preoperative Visual Analog Scale pain score and Oswestry Disability Index for all patients were 7.3±0.7 and 71.4±7.1, 2.9±0.7 and 29.8±3.6 at 3 days after surgery, showing significant differences. At 12 months, no significant difference in Visual Analog Scale pain score and Oswestry Disability 
    Index was detected. Postoperative short-period follow-up demonstrated that all lumbar interbody fusion was achieved in one year. There was no complication such as implant failure or infection. These findings indicated that folding U-shaped hollow pedicle screw fixation with minimal access-posterior lumbar interbody fusion for lumbar disc herniation showed good clinical therapeutic effects, high rate of interbody fusion and a low rate of complications and small trauma. 


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Bone cement kyphoplasty for repair of rheumatoid arthritis combined with Kümmell’s disease: a follow-up addressing vertebral height and spinal stabilization
    Wang Jing-liang, Pi An-ping, Xin Zhi-qiang, Yu Bao-xin, Wang Jian-wen, Ye Yong-liang, Pan Meng,Zheng Quan-xin
    2014, 18 (35):  5676-5680.  doi: 10.3969/j.issn.2095-4344.2014.35.018
    Abstract ( 454 )   PDF (2355KB) ( 571 )   Save

    BACKGROUND: For patients with rheumatoid arthritis and Kümmell’s disease, how to effectively control back pain, to recover patient’s locomotor activity and to avoid a vicious cycle of disuse osteoporosis is a key therapeutic target. Kyphoplasty is a recently developed new technology of minimally invasive spine surgery. Few reports concerned the kyphoplasty for rheumatoid arthritis and Kümmell’s disease.
    OBJECTIVE: To assess the clinical outcome of bone cement kyphoplasty for the treatment of Kümmell’s disease combined with rheumatoid arthritis.
    METHODS: From June 2012 to July 2013, 11 female patients at the age of 65.4±5.1 years with Kümmell’s disease combined with rheumatoid arthritis, who suffered from severe back pain, were treated with bone cement vertebroplasty. Back pain and imaging indexes were compared and observed before surgery and during follow-up. Imaging indexes contained preoperative and postoperative anterior height of vertebral body after fractures, the ratio of anterior height to posterior height of the vertebral body, and local kyphosis angle (Cobb method).
    RESULTS AND CONCLUSION: No patients were lost to follow up. 11 patients were followed up for 6 to 12 months. Significant differences in follow-up and preoperative Visual Analogue Scale scores, anterior height of vertebral body after fractures, the ratio of anterior height to posterior height of the vertebral body, and local kyphosis angle were detected (P < 0.05). Two patients experienced bone cement leakage. No severe complications appeared such as pulmonary embolism or neurological dysfunction. These data confirmed that bone cement vertebroplasty for rheumatoid arthritis combined with Kümmell’s disease can effectively lessen back pain, partially restore the height of vertebral body after fracture, rebuild spinal stabilization, reduce local kyphosis, and is a safe effective repair method.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Application of titanium miniplate to posterior cervical laminoplasty: a short-term follow-up
    Xie Bai-zhen, Hua Qiang, Zhao Hui-yi
    2014, 18 (35):  5681-5686.  doi: 10.3969/j.issn.2095-4344.2014.35.019
    Abstract ( 1025 )   PDF (777KB) ( 3676 )   Save

    BACKGROUND: During cervical posterior expansive open-door laminoplasty for multisegmental cervical spondylosis, spinal canal restenosis, loss of cervical lordosis, and axial symptoms are the important factors affecting curative effects. It is very necessary to maintain spinal canal expanded state and to reduce interference of the posterior cervical structure in the clinical treatment.
    OBJECTIVE: To observe clinical outcomes and short-term follow-up effect of posterior expansive open-door laminoplasty via titanium miniplate in treatment of cervical spondylotic myelopathy. 
    METHODS: A total of 67 patients with cervical spondylotic myelopathy who underwent posterior expansive open-door laminoplasty at the Zhongshan Hospital, Xiamen University from April 2006 to April 2013 were retrospectively analyzed. Titanium miniplate group (n=27) received titanium miniplate fixation. Suture group (n=40) received traditional suture suspension. All patients had decompression ranged from C3-7. Operation time, intraoperative blood loss, improvement rate of Japanese Orthopedic Association score during follow-up, value of cervical curvature, axial symptoms, and lamina opened angle were compared between the two groups.
    RESULTS AND CONCLUSION: No significant difference in operation time, intraoperative blood loss and improvement rate of Japanese Orthopedic Association score was detectable between two groups (P > 0.05). Cervical curvature changes in both groups: loss of cervical curvature at 6 months postoperation was not significant in the titanium miniplate group, but cervical curvature partially lost in the suture group, and significant differences in the cervical curvature were detected between the two groups (P < 0.05). The incidence of axial symptoms was significantly lower in the titanium miniplate group than in the suture group at 6 months after surgery (P < 0.05). During final follow-up, no significant difference in the lamina open-angle was detected between titanium miniplate group (35.2±6.2)° and suture group (34.0±4.7)° (P > 0.05). These data suggested that posterior expansive open-door laminoplasty for treatment of cervical spondylotic myelopathy using both titanium miniplate and suture methods can obtain good clinical outcomes. However, titanium miniplate fixation can relieve postoperative axial symptoms and prevent loss of cervical curvature.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Relationship between bone structure parameters in lower lumbar spine and lumbar disc herniation
    Lin Zhi-jun, Li Yu-mao, Xie Xiao-yong, Li Ping-sheng, Li Tian-ran, Liu Ai-hua, Liu Hang-tao
    2014, 18 (35):  5687-5692.  doi: 10.3969/j.issn.2095-4344.2014.35.020
    Abstract ( 476 )   PDF (711KB) ( 652 )   Save

    BACKGROUND: Changes in the parameters of lumbar spine bone structure are direct reaction of morphological changes in lower lumbar spine bone structure. These changes possibly result from normal structure strain of the spine affected by long-term external or internal factors. Whether the conditions reflected by different parameters are identical, and whether corresponding clinical symptoms are correlative still deserves further exploration.
    OBJECTIVE: To measure and compare the construction parameters of lumbar spine bone structure in lower lumbar disc herniation patients, and to investigate whether abnormalities of lumbar bony structure could lead to lower lumbar disc herniation and to evaluate the significance in degenerative lumbar disc.
    METHODS: From March 2008 to March 2010, 207 cases of lower lumbar disc herniation were randomly selected from the Department of Orthopedics, First Affiliated Hospital, Fuzhou General Hospital, Nanjing Military Area Command of Chinese PLA. They received CT examination at the Department of Radiology at the same period, and results revealed that 143 cases of lower lumbar disc non-herniation served as control group. According to gender, they were divided into male and female groups. According to ages, they were divided into 25-34 group, 35-44 group, 45-54 group and 55-65 group. They were studied by measuring spinous process deflection angle, facet joint angle, lumbar vertebrae curvature, angle of lumbar vertebrae curvature, lumbosacral angle.
    RESULTS AND CONCLUSION: Process deflection angle at L4 and L5 levels had a significant statistical difference between the lower lumbar disc herniation group and the control group. The date did not show normal distribution. Using Rank sum test, it had a significant statistical difference (Z = -10.609, -12.074, P < 0.01). There was not significant statistical difference between the lower lumbar disc herniation group and the control group on the facet asymmetry, lumbar vertebrae curvature, angle of lumbar vertebrae curvature and lumbosacral angle at various ages (P > 0.05). There only was significant difference on lumbosacral angle between male group and female group (P= 0.007 < 0.01). There was significant difference on the facet asymmetry, lumbar vertebrae curvature, angle of lumbar vertebrae curvature and lumbosacral angle between 55-65 age group and 25-34 age group or 35-44 age group (P < 0.01), and there was significant difference between 45-54 age group and 25-34 age group (P < 0.01). These data suggested that the abnormalities of lumbar bony structure could not directly lead to the lumbar disc herniation, but the abnormalities of lumbar bony structure aggravate the lumbar intervertebral disc degeneration. 


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Internal fixation of metal graft for repairing Lisfranc injury: biomechanical evaluation in 18 cases
    Hou Yan-jie, Yan Bin, Han Ya-jun, Yilihamu•tuoheti
    2014, 18 (35):  5693-5698.  doi: 10.3969/j.issn.2095-4344.2014.35.021
    Abstract ( 367 )   PDF (784KB) ( 752 )   Save

    BACKGROUND: Lisfranc injury is rarely seen in clinical practice, with a low incidence and a high misdiagnosis rate. At present, open reduction and internal fixation is the major treatment, but there is little evidence available on the long-term follow-up following injury and foot motor functions following surgery.
    OBJECTIVE: To evaluate the change of foot functions after metal graft internal fixation in patients with Lisfranc injury.
    METHODS: Eighteen patients with Lisfranc injury were treated with internal fixation of metal grafts, such as Kirschner wire, screws and steel plate. At 6-8 weeks postoperatively, patients began to walk with crutches. After 1 year follow-up, the Footscan balance system and AOFAS scores were applied to evaluate the foot stability and function of patients.
    RESULTS AND CONCLUSION: After 1 year of internal fixation, all bone fractures were healed, the peak pressure of affected foot in the fourth metatarsal (M4) and the fifth metatarsal (M5) was significantly increased (P < 0.05), and the impulse in the fifth metatarsal (M5) and mid-foot bottom (MID) was higher than the contralateral side (P < 0.05). The AOFAS score of affected foot was 87.26 ± 21.13 points, the rate of excellent and good efficacy accounted for 88.9%. Internal fixation can rebuild Lisfranc complex stability, the body weight is transferred from the inside to the outside in the front foot, and the remaining pressure did not change significantly, thus the foot function is recovered satisfactorily.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Efficacy and safety of tranexamic acid application in total hip arthroplasty: a meta-analysis
    Liu Bing-gen, Pang Qing-jiang
    2014, 18 (35):  5699-5706.  doi: 10.3969/j.issn.2095-4344.2014.35.022
    Abstract ( 436 )   PDF (800KB) ( 830 )   Save

    BACKGROUND: Whether tranexamic acid can effectively and safely reduce blood loss and allogeneic transfusion rate in total hip arthroplasty remains controversial at present.
    OBJECTIVE: To assess the efficacy and safety of tranexamic acid administration in total hip arthroplasty using meta-analysis.
    METHODS: Clinical randomized controlled trials concerning tranexamic acid application in total hip arthroplasty published from January 1969 to December 2013 were retrieved from the PubMed, Ovid, Elsevier, Cochrane library, China National Knowledge Infrastructure and Wanfang database. Intraoperative blood loss, postoperative blood loss, total blood loss, allogeneic transfusion rate and incidence of venous thromboembolism were compared using meta-analysis between the tranexamic acid and control groups. Detection and literature references were used as supplementary data. RevMan 5.0 software provided by Cochrane collaboration was used for meta-analyses. Conclusion was obtained according to analysis. The analysis checked the heterogeneity of data.
    RESULTS AND CONCLUSION: After comprehensive and rigorous screening, 19 high-quality (Jadad score not less than 3) randomized controlled studies were included. Meta-analysis results demonstrated that compared with the control group, tranexamic acid decreased the total blood loss [weighted mean difference (WMD)=-341.04, 95% confidence interval (CI) (-508.10, -173.97), P < 0.001], intraoperative blood loss  
    [WMD=-63.26, 95%CI (-111.33, -15.18), P=0.01] and postoperative blood loss [WMD=-229.53, 95%CI (-338.11, -120.94), P < 0.000 1], and diminished allogeneic transfusion rate [relative risk=0.45, 95%CI (0.35, 0.57),P < 0.000 1] in patients undergoing total hip arthroplasty. No significant difference in incidence of venous thromboembolism was detectable. These data suggested that tranexamic acid could reduce blood loss and transfusion rate in patients undergoing total hip arthroplasty without increasing the risk of incidence of venous thromboembolism.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Meta-analysis of limb and prosthesis alignment restoration after navigated total knee arthroplasty versus conventional total knee arthroplasty
    Wang Zeng-liang, Zhao Li, Zhao Jia-guo
    2014, 18 (35):  5707-5714.  doi: 10.3969/j.issn.2095-4344.2014.35.023
    Abstract ( 432 )   PDF (944KB) ( 478 )   Save

    BACKGROUND: Computer-assisted navigation technique has been widely applied in total knee arthroplasty. However, whether computer-assisted navigation total knee arthroplasty is better than traditional total knee arthroplasty remains unclear.
    OBJECTIVE: To systemically evaluate and compare the limb and prosthesis alignment restoration post computer-assisted navigation and traditional total knee arthroplasty.
    METHODS: The PubMed/Medline, EMBASE, Cochrane CENTRAL, ScienceDirect database were searched from established to June 2013 and the randomized controlled trials about computer-assisted navigation and traditional total knee arthroplasty were selected. Meta analysis was performed with Rev Man 5.2 software. The evaluating data included the hip-knee-ankle mechanical axis or tibiofemoral angle, femoral prosthesis coronal angle, femoral prosthesis sagittal angle, tibial prosthesis coronal angle, and tibial prosthesis sagittal angle. The malalignment was defined as a deviation 2° or 3° from the natural line.
    RESULTS AND CONCLUSION: 19 randomized controlled trials involving 2 654 cases (3 392 knees) were included in this study. Meta-analysis showed that, the limb alignment restoration post computer-assisted navigation was significantly better than traditional total knee arthroplasty (3°, P < 0.000 01 and 2°, P=0.000 8). The 3° of femoral prosthesis coronal angle deviation post computer-assisted navigation was significantly superior to traditional total knee arthroplasty (P=0.002), while the 2° deviation had no significant difference between the two surgeries (P=0.290). The 3° deviation of femoral prosthesis sagittal angle post computer-assisted navigation was significantly better than traditional total knee arthroplasty (P=0.040); however, the 2° deviation had no significant difference between the two surgeries (P=0.950). 3° and 2°tibial prosthesis coronal angle deviation post computer-assisted navigation was significantly superior to traditional total knee arthroplasty (3°, P=0.030); the 2° deviation had no significant difference between the two surgeries (P=0.260). Computer-assisted navigation has better limb alignment, femoral and tibial prosthesis alignment 3° deviation than the traditional total knee arthroplasty, but the 2° deviation of femoral prosthesis coronal angle, femoral prosthesis sagittal angle, and tibial prosthesis sagittal angle had no significant difference between the two surgeries.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Locking compression plate versus dynamic hip screw for femoral intertrochanteric fractures: a systematic review
    Wen Hao, Duan Kan, Yuan Chang-shen, Mei Qi-jie, Guo Jin-rong, Yu Hui
    2014, 18 (35):  5715-5722.  doi: 10.3969/j.issn.2095-4344.2014.35.024
    Abstract ( 357 )   PDF (789KB) ( 430 )   Save

    BACKGROUND: Locking compression plate and dynamic hip screw are the two major extramedullary fixations for the femoral intertrochanteric fractures, however, the comparison of the clinical efficacy between two methods is still controversial. 
    OBJECTIVE: To systematically evaluate the clinical efficacy of locking compression plate versus dynamic hip screw in the treatment of femoral intertrochanteric fractures, and provide a theoretical basis for clinical application.
    METHODS: Authors searched for controlled studies on locking compression plate and dynamic hip screw in the treatment of femoral intertrochanteric fractures in PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP periodical database, Wanfang resource database, Chinese Biomedical Literature service systems published from January 1999 to April 2014. The inclusion and exclusion criteria were made, and the literature meeting the criteria was screened, and the methodological quality of the included studies was evaluated. Meta-analysis was carried out using the RevMan 5.2 software.
    RESULTS AND CONCLUSION: Ultimately 682 patients from 8 studies met the inclusion criteria, including 336 patients in the locking compression plate group and 346 patients in the dynamic hip screw group. Meta-analysis results showed that: there were no statistically significant differences in operating time [MD=-12.07, 95%CI (-29.85, 5.71), P=0.18], peri-operative bleeding loss [MD=-15.01, 95%CI (-87.85, 57.83), P=0.69], post-operation drainage [MD= -13.62, 95%CI (-28.49, 1.26), P=0.07], ambulation time [MD=-0.14, 95%CI (-0.68, 0.41), P=0.63], length of hospitalization [MD=-0.74, 95%CI (-2.29, 0.82), P=0.35], bone union time [MD=-1.18, 95%CI (-2.78, 0.42), P=0.15] between locking compression plate and dynamic hip screw groups. The excellent and good rate of postoperative hip function reduction [OR=2.03, 95%CI (1.23, 3.36), P=0.006] was significantly higher in locking compression plate group than in the dynamic hip screw group. The incidence of coxa vara was lower in the locking compression plate group than in the dynamic hip screw group [OR=0.34, 95%CI (0.12, 0.96), P=0.04]. There were no significant differences in looseness, breakage, withdrawal of internal fixation [OR=1.20, 95%CI (0.59, 2.45), P=0.61] and the incidence of total complications [OR=0.55, 95%CI (0.24, 1.28), P=0.16] between locking compression plate and dynamic hip screw groups. However, the included studies have high possibility of selection bias and measurement bias, and will affect proof strength of results. Therefore, more clinical randomized controlled studies with compact design are needed for verification.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Deltoid-splitting approach and deltopectoral approach in the repair of proximal humeral fracture: a meta-analysis
    Guo Hong-liang, Han Ya-jun, Yilihamu•Tuoheti
    2014, 18 (35):  5723-5729.  doi: 10.3969/j.issn.2095-4344.2014.35.025
    Abstract ( 579 )   PDF (897KB) ( 532 )   Save

    BACKGROUND: Numerous studies confirmed that compared with deltopectoral approach, deltoid-splitting approach for proximal humeral fractures has good therapeutic effects, but precise superiority remains poorly understood.
    OBJECTIVE: To compare the therapeutic effects of deltopectoral approach and small incision deltoid-splitting approach in the repair of proximal humeral fractures using meta-analysis.
    METHODS: We retrieved MEDLINE, Embase, the Cochrane library, Wanfang Database and PubMed by computer for articles on controlled trials of deltopectoral approach and small incision deltoid-splitting approach in the repair of proximal humeral fractures published from 2010 to 2014. Neer score, operation time, intraoperative blood loss, incision length, length of hospital stay, Visual Analogue Scale score, fracture healing time, and Constant score were used as evaluation indexes of Meta analysis. RevMan 5.2 software was used for analysis.
    RESULTS AND CONCLUSION: Eventually nine articles were included, totally 721 patients, published from 2010 to 2014 years. There were eight in Chinese, and one in English. Meta-analysis results showed that compared with deltopectoral approach, deltoid-splitting approach in the treatment of proximal humeral fractures could shorten operation time, reduce intraoperative blood loss, shorten length of incision, elevate Neer score and Constant score (P < 0.05). No significant difference in fracture healing time, hospitalization days, and Visual Analogue Scale score was detected between the two methods of surgical approach. These data indicated that compared with deltopectoral approach, deltoid-splitting approach in the repair of proximal humeral fracture has certain superiority. Deltoid-splitting approach can be firstly selected in the permit of hospital conditions.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Vertebroplasty and kyphoplasty: entry point and angle of percutaneous pedicle positioning
    Yuan Cui-hua, Wang Xu, Liu Shou-kun, Wang Chun
    2014, 18 (35):  5730-5735.  doi: 10.3969/j.issn.2095-4344.2014.35.026
    Abstract ( 1085 )   PDF (755KB) ( 435 )   Save

    BACKGROUND: The key of vertebroplasty and percutaneous kyphoplasty to success is whether the puncture needle can accurately reach the vertebral body through pedicle. Therefore, it is important to identify the correct point and direction of needling in the X-ray fluoroscopy. Among many methods published in present reports, the puncture point and the puncture angle are not fixed. Few reports concerned whether the puncture needle perforated pedicle medial wall.
    OBJECTIVE: To seek safe, effective puncture point and the puncture angle of percutaneous pedicle from the perspective of anatomy and radiography.
    METHODS: The best entry point during percutaneous vertebroplasty in the X-ray fluoroscopy: dissection was performed on thoracic, lumbar skeletal samples (T6-L5) to find the position of pedicle axis leading to the rear of the vertebral body, and this position is the best entry point of percutaneous vertebroplasty. It was fixed with mini-screw. The relationship of the best entry point and pedicle developing position in the X-ray fluoroscopy was analyzed to find the best entry point in the X-ray fluoroscopy. The best entry angle during percutaneous vertebroplasty: The average included angle of pedicle axis and vertebral sagittal line was measured using autopsy and CT scanning on adult thoracic and lumbar skeletal samples (T6-L5). The best entry angle during percutaneous vertebroplasty was found.
    RESULTS AND CONCLUSION: During percutaneous vertebroplasty, the best entry point in the X-ray fluoroscopy was the left pedicle projection 9 area and right pedicle projection 3 area. The optimal needle angle during percutaneous vertebroplasty: 5°-10° in lumbar vertebra L1-L4; 20° in L5, not more than 25°; about 5° in thoracic vertebra T6-T12.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Risk factors for perioperative pulmonary infection in patients with senile hip fracture
    Li Li, Chen Nian, Ke Liu, Wen Xiao-feng
    2014, 18 (35):  5736-5740.  doi: 10.3969/j.issn.2095-4344.2014.35.027
    Abstract ( 329 )   PDF (1765KB) ( 400 )   Save

    BACKGROUND: At present, few studies concerned pulmonary infection after treatment of senile fracture. For special parts of senile patients, there are no studies on complications of pulmonary infection in perioperative period after hip fracture.
    OBJECTIVE: To study risk factors for pulmonary infection in patients with senile hip fractures in perioperative period.
    METHODS: The data of 46 senile hip fracture patients with perioperative pulmonary infection were retrospectively analyzed. A matched case-control study was conducted in 46 senile hip fracture patients without pulmonary infection in the same hospital and the same period. The difference in perioperative various clinical indexes was compared between the two groups. Risk factors of pulmonary infection received Logistic regression analysis.
    RESULTS AND CONCLUSION: Multivariate analysis screened out 14 possible perioperative pulmonary infection factors: chronic obstructive pulmonary disease, smoking, diabetes mellitus, heart disease, mechanical ventilation, intraoperative bleeding amount, erythrocyte infusion, operation time, preoperative low body mass index (body mass index <18.5 kg/m2), serum albumin < 35 g/L, electrolyte disturbance, time of entering intensive care unit and length of stay. Logistic regression analysis displayed that chronic obstructive pulmonary disease (OR = 23.317; 95%CI: 2.702-60.312; P=0.000), entering intensive care unit (OR= 7.890; 95%CI: 2.624-76.012; P=0.008), mechanical ventilation (OR=35.210; 95%CI: 8.464-131.203; P=0.017) and operation time (OR= 12.122; 95%CI: 5.154-99.098;P=0.012) were independent risk factors for perioperative pulmonary infection in patients with senile hip fracture. These data indicated that one should be alert to the possible occurrence of pulmonary infection in senile hip fracture patients with the presence of chronic obstructive pulmonary disease, entering intensive care unit and mechanical ventilation.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics