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    26 February 2015, Volume 19 Issue 9 Previous Issue    Next Issue
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    Total knee arthroplasty for knee varus deformity: follow-up evaluation of femorotibial angle and range of motion
    Li Guang-wei, Wang Hong-jun, Sun Xiao-zhi, Chen Lin-bin, Gao Yu-liang, Bai Zhong-xu, Cheng Xin-sheng
    2015, 19 (9):  1313-1320.  doi: 10.3969/j.issn.2095-4344.2015.09.001
    Abstract ( 549 )   PDF (399KB) ( 844 )   Save

    BACKGROUND: Total knee arthroplasty is difficult to perform for treating knee varus deformity, it is highly involved in several issues, such as surgical approach, intraoperative osteotomy, the order, method and extent of soft tissue release, as well as soft tissue balance. There are a lot of controversies for this treatment. 
    OBJECTIVE: To observe the femorotibial angle and range of knee joint motion of adults patients with knee varus deformity during 1-year follow-up after total knee arthroplasty. 
    METHODS: A total of 31 patients (35 knees) with knee varus deformity were treated with posterior stabilized prosthesis replacement from June 2006 to June 2013. Using patellar medial approach, the correct osteotomy and selective soft tissue release were performed to restore normal knee alignment and soft tissue balance. Posterior stabilized prosthesis in total knee arthroplasty was applied to achieve knee stability. Postoperative targeted rehabilitation training was also followed. The femorotibial angle was measured before and after surgery. The range of knee joint motion was determined during postoperative follow-up. Patients were evaluated with the Hospital for Special Surgery (HSS) score and the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index.
    RESULTS AND CONCLUSION: All patients were followed up for 12-96 months through out-patient clinic. The femorotibial angle was corrected from preoperative varus 17.69° (5°-30°) to postoperative 5.66° (2°-8°); the range of knee joint motion was improved from preoperative 74.29° (60°-95°) to 119.46° (105°-130°); the HSS score increased from preoperative 26.60 points (14-42 points) to postoperative 89.03 points (82-95 points); and the WOMAC score increased from preoperative 42.83 points (28-54 points) to postoperative 90.17 points (85-95 points). Statistical analysis results showed that, total knee arthroplasty significantly improved the femorotibial angle, range of knee joint motion, HSS score and WOMAC score in all involved patients (P < 0.01). Postoperative X-ray films showed no evidence of periprosthetic lucent zone, normal knee alignment, no patella baja and fracture. Total knee arthroplasty surgery can correct knee varus deformity, significantly improve the functions, and achieve satisfactory results at 1 year after 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


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    Outcomes of one-stage versus two-stage total knee arthroplasty for bilateral knee arthritis
    Maddali Taraka Venkata Pavan, Sun Jun-ying, Zha Guo-chun
    2015, 19 (9):  1321-1328.  doi: 10.3969/j.issn.2095-4344.2015.09.002
    Abstract ( 462 )   PDF (466KB) ( 477 )   Save

    BACKGROUND: When patient presents bilateral degenerative knee osteoarthritis, one-stage or two-stage total knee arthroplasty (TKA) remains controversial at present. 
    OBJECTIVE: To compare the outcomes of one-stage and two-stage bilateral TKA for bilateral knee arthritis.
    METHODS: Patients with bilateral knee arthritis were treated in the First Affiliated Hospital of Soochow University in China from January 2005 to December 2008. They were assigned to one-stage group (n=68) and two-stage group (n=71). These patients were subjected to one-stage and two-stage bilateral TKA using Gemini MK II total knee system.
    RESULTS AND CONCLUSION: Compared to two-stage group, operation time and length of hospital stage were shorter, mean blood transfusion was larger, and hospital charges were lower in the one-stage group. However, no significant differences in postoperative knee function, complications, and patients’ satisfaction were detected between the one-stage and two-stage groups. No osteolysis was observed surrounding the prosthesis during final follow-up. These data confirmed that one-stage bilateral TKA increased the amount of blood transfusion, but could save hospital charges, and reduce the length of hospital stay. Thus, one-stage TKA is a safe effective method to treat bilateral knee arthritis, and deserves 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


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    Primary unilateral cemented total knee arthroplasty: effect of tranexamic acid usage on blood loss
    Hou Zhen-yang, Su Chang-zheng, Pang Tao, Lv Dong, Zhu Biao, Sun Yi-ling, Li Zhen, Chai Xing-yu, Xu Zheng-wen
    2015, 19 (9):  1329-1334.  doi: 10.3969/j.issn.2095-4344.2015.09.003
    Abstract ( 407 )   PDF (716KB) ( 588 )   Save

    BACKGROUND: Increasing evidence has focused on the application of tranexamic acid to reduce bleeding during total knee arthroplasty, but its usage method remains controversial.
    OBJECTIVE: To explore and discuss the effect of tranexamic acid and different usage methods on blood loss in the perioperative period of primary unilateral cemented total knee arthroplasty.
    METHODS: Sixty patients who were candidates for unilateral cemented total knee replacement in the Second Department of Joint Sports Medicine, Tengzhou Central People’s Hospital, from January 2013 to June 2014, were included in this study. All patients were randomly divided into three groups. Group A (n=20): patients were injected with 100 mL normal saline through intravenous drip when the operation began, and then with 10 mL normal saline through intra-articular injection after skin closure. Group B (n=20): patients were injected with 10 mg/kg tranexamic acid which was dissolved in 100 mL normal saline when the operation began, and then with 10 mL normal saline through intra-articular injection after skin closure. Group C (n=20): patients were injected with 100 mL normal saline when the operation began, and then with 500 mg tranexamic acid dissolved in 10 mL normal saline through intra-articular injection after skin closure. The dominant blood loss, hidden blood loss, blood transfusion ratio and per capita of each group were compared. Clinical symptoms of pulmonary embolism and lower limb deep vein thrombosis were observed. Doppler ultrasound examine on lower extremity would be performed if necessary.
    RESULTS AND CONCLUSION: Dominant and hidden blood loss of patients from groups B and C were significantly lower than that of patients from group A (P < 0.05). Although the dominant blood loss between group B and group C showed no significant difference (P > 0.05), the hidden blood loss in group B was significantly less than that in group C  (P < 0.05). The transfusion population and ratio of patients from groups B and C were significantly lower than that of patients from group A (P < 0.05). In all three groups, no deep vein thrombosis was found at 14 days after operation. Tranexamic acid can largely reduce the dominant and hidden blood loss, as well as blood transfusion ratio and per capita of each group after primary unilateral cemented total artificial knee arthroplasty, without increasing the risk of lower extremity deep vein thrombosis. The use of tranexamic acid injecting through intravenous drip is more effective than the use of intra-articular injection.


    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


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    Correlation between hypertension and deep venous thrombosis after bilateral total knee arthroplasty
    Wang Pei-cheng, Cao Li, Yang De-sheng, Xu Bo-yong, Guo Wen-tao, Aili•Rehei
    2015, 19 (9):  1335-1339.  doi: 10.3969/j.issn.2095-4344.2015.09.004
    Abstract ( 457 )   PDF (679KB) ( 504 )   Save

    BACKGROUND: Deep vein thrombosis is a serious complication of total knee arthroplasty surgery, if patients are not promptly diagnosed and treated properly, the healing of the patient’s condition may be delayed, and even blood clots shedding causes pulmonary embolism, endangering the lives of patients. At present, no evidence has supported that total knee arthroplasty can increase postoperative deep venous thrombosis incidence in hypertensive patients.
    OBJECTIVE: To observe whether hypertension would influence the occurrence of deep venous thrombosis in patients who underwent total knee arthroplasty.
    METHODS: A retrospective analysis was performed among patients underwent total knee arthroplasty in Department of Joint Surgery, the First Affiliated Hospital of Xinjiang Medical University from September 2010 to March 2014. Patients were divided into hypertension group and control group based on their medical history of hypertension. Doppler ultrasonography was applied to detect both lower extremities among these patients after operation, to diagnose if there was any evidence of deep venous thrombosis. The incidence of deep venous thrombosis in the two groups was compared. The correlation of hypertension and deep venous thrombosis was analyzed.
    RESULTS AND CONCLUSION: A total of 525 patients were involved in this study, including 219 in hypertension group and 306 in control group. Among them, 20 patients appeared deep venous thrombosis and the incidence rate was 3.8%. 13 patients in the hypertension group (2.5%) and 7 patients in the control group (1.3%) developed deep venous thrombosis. Chi-square test showed that, the risk of deep venous thrombosis in the hypertension group was 2.7 times of that in the control group, and the differences were statistically significant between the two groups (P < 0.05). Hypertensive patients suffer a higher incidence rate of deep venous thrombosis after total knee arthroplasty compared with those with normal blood pressure.


    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


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    Clinical pathway and effectiveness of total knee arthroplasty
    Wang Yang, Liu Yi-chao, Ma Jun
    2015, 19 (9):  1340-1344.  doi: 10.3969/j.issn.2095-4344.2015.09.00
    Abstract ( 716 )   PDF (650KB) ( 588 )   Save

    BACKGROUND: The total knee arthroplasty surgery is developing vigorously, due to regional differences, the length of hospital stay and the medications remain controversial and have no consensus. To standardize medical behavior and reduce medical costs, the National Health and Family Planning Commission of the People’s Republic of China (former Ministry of Health of the People’s Republic of China) has formatted and generalized clinical pathway work.
    OBJECTIVE: To explore the effectiveness of clinical pathway in total knee arthroplasty.
    METHODS: One hundred and thirty patients who were candidates of total knee arthroplasty due to osteoarthritis or rheumatoid arthritis were recruited from the First Affiliated Hospital of Xinjiang Medical University between November 2013 and October 2014. Patients were randomly divided into two groups: study group (n=65, clinical pathway intervention) and control group (n=65, no clinical pathway intervention). The length of hospital stay, total and concrete medical fees, antibiotic usage, postoperative complications and postoperative knee function were compared between groups.
    RESULTS AND CONCLUSION: Length of hospital stay and preoperative hospitalization time were shortened in the study group, total cost of hospitalization, drug cost and inspection cost were significantly reduced compared with the control group (P < 0.01). A more reasonable use of antibiotics was found in the study group than in the control group, showing significant differences (P < 0.01). At 3 months after operation, KSS score of knee joint function was significantly higher in the study group than in the control group (P < 0.01). There was no difference between the two groups in the operation fee, postoperative complications and KSS score at postoperative 1 month (P > 0.05). The use of clinical pathway can reduce hospitalization time and medical costs, improve knee function and quality of life of patients following 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


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    Cement and cementless hemi-hip replacement for the repair of femoral neck fracture in the elderly
    Wang Ben-jie, Zhao De-wei, Xie Hui, Yang Lei, Fu Wei-min, Liu Bao-yi, Qiu Xing
    2015, 19 (9):  1345-1351.  doi: 10.3969/j.issn.2095-4344.2015.09.006
    Abstract ( 634 )   PDF (876KB) ( 636 )   Save

    BACKGROUND: Artificial femoral head replacement is an effective measure for displaced femoral neck fracture in the elderly, but the bone mass is poor in these patients. There is a controversy in the selection of bone cement or cementless femoral prosthesis.
    OBJECTIVE: To compare the clinical efficacy of bone cement and cementless femoral prosthesis in elderly patients with displaced femoral neck fracture.
    METHODS: From January 2011 to December 2012, 26 hips with displaced femoral neck fracture were treated with cement hemi-hip arthroplasy and 30 hips were treated with cementless femoral implants. Surgery time, intraoperative bleeding, postoperative drainage, postoperative complications were compared between the two groups. Hip function was evaluated according to Harris hip score system.
    RESULTS AND CONCLUSION: All patients were followed up for 20-44 months. The clinical results were satisfied. At 12 months after replacement, excellent-to-good rate of cement group and cementless group was 89% and 83%, respectively according to Harris hip score evaluation with no significant differences. There were no statistic difference between two groups in intraoperative blood loss and postoperative drainage, but operative time in cement group was longer than in cementless group (P < 0.01). There was no prosthesis loosening, subsidence, infection or joint dislocation during follow-up in both groups. These findings suggested that cementless prosthesis hemi-hip replacement can get good clinical results as cement prosthesis replacement for treatment of displaced femoral neck fracture in elderly patients.


    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


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    Etiology and factors of total hip replacement in Hefei area of China: retrospective analysis on 3 056 cases from 5 hospitals in 6 years
    Ma Zhi-xiang, Yin Zong-sheng, Xu Peng-fei, Gao Wei-lu, Hu Qin, Qi Jia-long
    2015, 19 (9):  1352-1357.  doi: 10.3969/j.issn.2095-4344.2015.09.007
    Abstract ( 379 )   PDF (707KB) ( 488 )   Save

    BACKGROUND: The etiologies of total hip replacement are complex, such as femoral neck fracture, avascular necrosis of the femoral head, primary osteoarthritis, congenital hip dysplasia, rheumatoid arthritis, ankylosing spondylitis, traumatic arthritis and infectious arthritis. Due to different causes and epidemiological characteristics of these diseases, they occupy different percentages in total hip replacement.
    OBJECTIVE: To analyze the etiological composition of patients in Hefei area undergoing total hip replacement and the distribution in ages and genders, in a broader attempt to improve the early screening and prevention of hip diseases and susceptible factors.
    METHODS: A retrospective study was performed in 3 056 patients receiving total hip replacement in five hospitals in Hefei area from January 2008 to December 2013. These patients were divided into 11 groups according to discharge diagnosis, and the constituent ratio of ages and genders was analyzed.
    RESULTS AND CONCLUSION: Among the involved 3 056 patients, 1 763 patients had hip fracture (56.78%), 545 avascular necrosis of femoral head (17.55%), 461 primary osteoarthritis (14.85%), 196 developmental dysplasia of hip (6.31%), 35 rheumatoid arthritis (1.13%), 10 ankylosing spondylitis (0.32%), 26 traumatic arthritis (0.84%),12 infective arthritis (0.39%), 4 tumor of hip (0.13%), 3 fibrous dysplasia of bone (0.097%), and 1 Kaschin Beck disease (0.032%). The proportion of patients over 50 years old was obviously higher than that of the patients under age of 50 years (including 50 years; χ2= 12.7, P < 0.05). The proportion of female patients was higher than that of male patients (χ2=61.07, P < 0.05). The results showed that the etiologies of the patients receiving total hip replacement in five hospitals in Hefei area are complex, the major causes include hip fracture, avascular necrosis of femoral head and primary osteoarthritis, the main patients are over 50 years old, and the proportions of female patients is higher than that of the male patients.


    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


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    Cervical disc arthroplasty versus cervical discectomy and fusion for single-level cervical spondylosis: mid-term follow-up of a randomized controlled trial
    Luo Cheng, Qu Xia, Chen Bo, Peng Zhong-yi, Zou Yong-gen
    2015, 19 (9):  1358-1364.  doi: 10.3969/j.issn.2095-4344.2015.09.008
    Abstract ( 342 )   PDF (844KB) ( 714 )   Save

    BACKGROUND: Anterior cervical discectomy and fusion is the gold stanard for the surgical treatment of degenerative cervical disease. However, with the increasing numer of cases and long-term clinical follow-up data, more and more negative problems happen. The short-term clinical outcomes of cervical disc arthroplasty in the treatment of single-level cervical spondylosis have been recognized, but the mid- and long-term effects are still unclear.
    OBJECTIVE: To evaluate the clinical outcomes of anterior cervical discectomy and fusion and Discover cervical disc arthroplasty in the treatment of single-level cervical spondylosis.
    METHODS: From January 2009 to October 2011, 71 patients with single-level cervical disc disease, ineffective by conservative therapy, were randomly divided into arthroplasty group (n=34) and fusion group (n=37), receiving Discover cervical disc arthroplasty and anterior cervical discectomy and fusion, respectively. All patients were determined with Visual Analogue Scale (VAS) score, Japanese Orthopedics Association (JOA) score, Neck Disability Index (NDI) score and radiographic examinations before surgery, at 3, 6, 12, 24, 48 months afte surgery, as well as at final follow-up. Complications and secondary treatment were recorded during follow-up.
    RESULTS AND CONCLUSION: The 71 patients were followed up for average 33.5 months. The VAS scores of neck and arm, JOA score and NDI score were significantly improved at each follow-up time point as compared with preoperative score in all patients (P < 0.05), and these indexes were better in the arthroplasty group than in fusion at 3, 6, 12 and 24 months postoperatively (P < 0.05). In the arthroplasty group, the range of motion of repairing segment and the whole activity of cervical vertebra were higher than that in the fusion group at each follow-up time piont postoperatively  (P < 0.05). None of patients experienced serious complications of neurovascular injury during perioperative period. During follow-up, there were 3 patients with heterotopic ossification, 1 patient with prosthesis antedisplacement (< 3 mm) and 2 patients undering the revision surgery due to cranial adjacent degeneration, in the arthroplasty group. While in the fusion group, 9 patients accepted the revision surgery, with pseudarthrosis and fusion failure in 1, screw breakage in 1, cranial disc degeneration and neurological deficit in 3 and spinal cord decompression due to caudal disc degeneration in 2. The mid-term outcome of Discover cervical disc arthroplasty is better than anterior cervical discectomy and fusion in the treatment of single-level cervical spondylosis.


    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


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    Posterior short-segment pedicle screw fixation and bone grafting in the treatment of thoracic and lumbar fracture: follow-up evaluation
    Ding Hao, Shen Qiang, Zhu Liang, Wei Xiao-kang
    2015, 19 (9):  1365-1370.  doi: 10.3969/j.issn.2095-4344.2015.09.009
    Abstract ( 364 )   PDF (1253KB) ( 643 )   Save

    BACKGROUND: Traditional internal fixation for treating the thoracic and lumbar vertebral fracture is prone to induce poor reduction and loss of vertebral height. While the use of posterior short-segment pedicle screw internal fixation can effectively correct the kyphosis and maintain the correcting effect in the treatment of thoracolumbar fracture.
    OBJECTIVE: To explore the clinical effect of posterior short-segment pedicle screw fixation and posterolateral bone graft fusion in treatment of thoracolumbar fracture.
    METHODS: A retrospective analysis was performed on the clinical data of 41 patients who underwent thoracic and lumbar posterior open reduction, internal fixation of short-segment pedicle screw system and posterolateral bone graft fusion for the treatment of thoracolumbar fractures in the First People’s Hospital Affiliated to Shanghai Jiaotong University from March 2009 to November 2013. Patients were detected by X-ray and CT examination, to observe internal fixation effect. In addition, lumbar function improvement (Japanese Orthopaedic Association Scores, Visual Analog Score, scoliosis, vertebral edge height ratio, and spinal nerve function) was also assessed.
    RESULTS AND CONCLUSION: Patients were followed up for 5 months to 4 years and 1 month after internal fixation. All patients achieved fracture healing and the internal fixators were removed 1 year after surgery. Follow-up results showed that, 1 case appeared the loosening and 2 cases appeared the fracture (fracture ends were not effectively fused during operation), no cases appeared secondary spinal kyphotic deformity aggravation.  Height of injured vertebra was significantly recovered and the spinal nerve function was obviously improved at 5 months after surgery. Posterior short-segment pedicle screw fixation and posterolateral bone graft fusion can obtain good clinical curative effect in treatment of thoracolumbar 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


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    Posterior interbody fusion and pedicle screw fixation in the repair of recurrent lumbar disc herniation: 6-month follow-up
    Feng Hao-yu, Ma Xun, He Li-ming, Chen Chen, Chang Qiang, Zhang Yan-nan
    2015, 19 (9):  1371-1376.  doi: 10.3969/j.issn.2095-4344.2015.09.010
    Abstract ( 333 )   PDF (877KB) ( 532 )   Save

    BACKGROUND: Recurrent lumbar disc herniation is very common in the clinic. Most patients have adjacent segment degeneration at the same time, and second operation is more difficult than first time.
    OBJECTIVE: To investigate the more than 6-month follow-up results of posterior interbody fusion and pedicle screw fixation in the repair of recurrent lumbar disc herniation.
    METHODS: Complete follow-up data of 40 patients with recurrent lumbar disc herniation, who were treated from January 2010 to January 2012, were retrospectively analyzed. All secondary surgeries received posterior laminectomy, discectomy, interbody fusion and pedicle screw fixation. Japanese Orthopaedic Association     (29 scores) and low back pain Visual Analog Scale were used to assess neurological functions and rational symptoms before and after treatment and during final follow-up. Therapeutic effects after treatment were assessed and improvement rate was calculated.
    RESULTS AND CONCLUSION: 40 patients were followed up from 6 to 36 months. Japanese Orthopaedic Association scores were significantly improved at 2 months after treatment and during final follow-up compared with pre-treatment (P < 0.05). Visual Analog Scale scores were significantly improved at 2 months after treatment and during final follow-up compared with pre-treatment (P < 0.05). These data suggested that first surgery destroys stability of spine, speeds up adjacent degeneration. Posterior interbody fusion and pedicle screw fixation in the repair of recurrent lumbar disc herniation can solve some problems such as complete decompression,stable integration, scar adhesion and oppression, and obtain good repair effects.


    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


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    Posterior pedicle screws with iliac bone grafts to repair multi-segmental lumbosacral tuberculosis: to reconstruct lumbosacral stability 
    Yu Ming, Qiu Nan-hai
    2015, 19 (9):  1377-1381.  doi: 10.3969/j.issn.2095-4344.2015.09.011
    Abstract ( 310 )   PDF (657KB) ( 564 )   Save

    BACKGROUND: The treatment of lumbosacral tuberculosis with multi-segmental vertebral destruction is complex. Besides, debridement and relief of spinal cord compression, it is necessary to restore spine vertebral body height and stability of the spine.
    OBJECTIVE: To investigate the surgical treatment effect of multi-segmental lumbosacral tuberculosis by posterior vertebral pedicle fixation and anterior debridement with autologous iliac bone graft.
    METHODS: A total of 25 cases of L2-S2 vertebral tuberculosis with various degrees of damage, who were treated from March 2005 to December 2012, were selected in this study. After regular anti-tuberculosis treatment for 2-4 weeks, first-phase posterior pedicle screw fixation with anterior debridement and autologous iliac bone graft was performed. Postoperative X-ray and CT scan were conducted to assess bone fusion and deformity correction. Adverse events and material host reaction were recorded.
    RESULTS AND CONCLUSION: After repair, average 16-month follow-up was performed. 23 cases of postoperative wound were totally healed, with 2 cases of incisions delaying healing, no sinus formation. After surgery, the lumbago and leg pain disappeared in all patients. During follow-up, graft displacement had no slippage, broken nails or broken rods. Within 6 months, bony fusion occurred. At 1 year after operation, there was no recurrence of tuberculosis with normal erythrocyte sedimentation. X-ray films showed lesion vertebra turned out to be bony union. Postoperative lumbosacral angle was 16°-36°, averagely 26°, and 15°-30° during final follow-up, averagely 20°. These results confirmed that one-stage debridement for multi-segmental lumbosacral tuberculosis and concomitant posterior pedicle fixation system for kyphosis correction therapy, which could reconstruct lumbosacral stability, and restore sagittal plane balance. Autologous iliac bone graft improved fusion rate and obtained satisfactory outcomes.


    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


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    Fusion for treating double-segment lumbar spondylisthesis: follow-up evaluation of lumbar height, pelvic tilt angle and sacral slope angle
    Yang Si-zhen, Ma Jin-feng, Wang De-chun
    2015, 19 (9):  1382-1387.  doi: 10.3969/j.issn.2095-4344.2015.09.012
    Abstract ( 531 )   PDF (818KB) ( 557 )   Save

    BACKGROUND: Posterior lumbar interbody fusion with pedicle screws has been applied maturely in treating single-level lumbar spondylisthesis. However, little evidence has focused on the application of this operation in treatment of double-segment lumbar spondylolisthesis.
    OBJECTIVE: To investigate the clinical efficacy of posterior lumbar interbody fusion with pedicle screws in treatment of double-segment lumbar spondylolisthesis.
    METHODS: Twenty patients with double-segment lumbar spondylolisthesis were treated with posterior lumbar interbody fusion with pedicle screws, including posterior lumbar-spinal canal decompression, nerve root release, interbody graft fusion, pedicle screws reduction and fixation. Clinical functional recovery was assessed by Oswestry disability index and visual analog scale. Radiographic data including lumbar slippery percentage, lumbar slippery angle, lumbar height, pelvic tilt angle and sacral slope angle were measured. All data was collected 1 day before surgery, 1 day, 3 months, 6 months and 1 year after surgery, and every year constantly.
    RESULTS AND CONCLUSION: All 20 patients were followed up for 6 months to 3 years. Oswestry disability index and visual analog scale were lower after surgery and at the final follow-up, when compared with before surgery (P < 0.05). Lumbar disc height was significantly increased after surgery and at the final follow-up, than those of pre-operation (P < 0.05). Lumbar slippery percentage, pelvic tilt angle and sacral slope angle were improved significantly after surgery and at the final follow-up, when compared with before surgery (P < 0.05). During the follow-up, there were no signs of rupture, loosing or falling in the internal fixation and no pseudarthrosis. Reposition and reliable fusion of the bone graft were achieved satisfactorily in all patients. All patients are satisfactory of posterior operation with pedicle screw internal fixation, reduction, decompression in treating double-segment lumbar spondylolisthesis, due to satisfactory reduction, reliable fixation, high fusion rate and reconstruction of normal sagittal sequence in lumbar spine, which can enhance the stability of lumbar 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


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    Bone fusion and fixation in the repair of lumbar brucellar spondylitis: spinal stability in 6-month follow-up
    Niu Guang-xu, Kahaer•Aikenmu, Zhao Jiang, Chu Ge, Wang Zhen-bin, Gu Wen-fei, Tu Lai-yong
    2015, 19 (9):  1388-1392.  doi: 10.3969/j.issn.2095-4344.2015.09.013
    Abstract ( 535 )   PDF (653KB) ( 613 )   Save

    BACKGROUND: After simple debridement and fusion of brucella spondylitis, bed time is long. Activities are likely to cause spinal instability. Bone nonunion rate is very high, and the curative effects are poor.
    OBJECTIVE: To investigate the efficacy of debridement and interbody fusion fixation for repair of lumbar brucellar spondylitis and for stable spine structure.
    METHODS: A total of 31 cases of lumbar brucellar spondylitis were obtained from Affiliated Hospital of Chinese Medicine, Xinjiang Medical University between January 2007 to August 2013, including 22 males and 9 females, at the age of 42-73 years, averagely 52 years. Their course of disease was 3-13 months, averagely 5 months. All patients were administered combination therapy of rifampin and minocycline and streptomycin, and then received one-stage debridement and fusion, spinal pedicle screw fixation system. Japanese Orthopaedic Association scores were compared before and after the surgery for assessing prognosis and functional recovery. Bone fusion was observed using X-ray during follow-up. 
    RESULTS AND CONCLUSION: All patients were followed up for 6-24 months, averagely 12.6 months. After repair, Japanese Orthopaedic Association scores were increased, showing significant differences compared with pre-treatment (P < 0.05). No recurrence or severe complications appeared during follow-up. All patients were rechecked using X-ray within 5 days after repair. Results showed that the internal fixation and bone graft fusion were good. Final follow-up radiographs revealed that bone healing was good, and the spine was stable. Above data confirmed that on the basis of triple-drug therapy, debridement and interbody fusion and internal fixation for treating lumbar brucellar spondylitis can maintain spinal stability, reduce complications, and obtain reliable repair effects.


    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


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    Comparison of different ways of repairing fresh femoral neck fracture in the elderly
    Li Gui-chun, Wang Wen-ji
    2015, 19 (9):  1393-1399.  doi: 10.3969/j.issn.2095-4344.2015.09.014
    Abstract ( 278 )   PDF (744KB) ( 794 )   Save

    BACKGROUND: The internal fixation and total hip replacement are two main methods for the treatment of fresh femoral neck fracture in elderly patients. But, the surgical indications and the pros and cons still have a lot of controversies.
    OBJECTIVE: To compare the effects of closed reduction and internal fixation, open reduction and internal fixation + joint capsule decompression, and total hip replacement in the treatment of fresh femoral neck fracture in elderly patients.
    METHODS: A retrospective study of clinical data among 213 patients with femoral neck fractures was performed. Depending on the type of fracture, the involved patients were divided into non-displacement (A group) and displacement (group B); according to operation methods, the A group was further assigned into closed reduction and internal fixation (A1), open reduction and internal fixation + joint capsule decompression (A2), and total hip replacement (A3); in the same way, the B group was assigned into B1, B2, B3. Patients were followed up for 1-3 years, the operative time, intraoperative blood loss, postoperative ambulation time, postoperative weight-bearing time, postoperative complications, and postoperative Harris scores were compared.
    RESULTS AND CONCLUSION: Harris score in A2 group was significantly better than the A1 and A3 groups, Harris score in B2 group was also significantly better than the B1 and B3 groups. The incidence of avascular necrosis in B2 group was significantly lower than that in B1 group. The operative time and intraoperative blood loss in the A1 and A2 groups were significantly better than the A3 group, but postoperative ambulation time and postoperative weight-bearing time were significantly less. For the vast majority of the elderly patients with fresh femoral neck fracture, the preferred treatment is anatomical repositioning using reliable internal fixation, open reduction and hollow tension screw internal fixation + joint capsule decompression is pronounced, and the treatment is suggested to be completed within 6-12 hours after injury. Total hip replacement should be considerably selected based on the specific circumstances of patients, the surgeon experience, and comprehensive analysis of surgical indications.


    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


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    Absorbable screws and anatomical plate of medial femoral condyle for treatment of medial condyle Hoffa fractures: good steel plate attachment and firm fixation
    Qiu Chang-mao, Liu Hong-zhi, Zhang Yin-guang, Liu Zhao-jie, Tian Wei, Jia Jian
    2015, 19 (9):  1400-1404.  doi: 10.3969/j.issn.2095-4344.2015.09.015
    Abstract ( 497 )   PDF (617KB) ( 546 )   Save

    BACKGROUND: Medial condyle Hoffa fractures is often accompanied by joint surface grinding, so improper therapy would induce disunion of fracture or knee dysfunction. Screw fixation alone is difficult to realize entirety of comminuted fracture block. Fixation intensity is poor. In addition, common steel plate for medial condyle Hoffa fractures requires constant shaping during surgery. Moreover, it limits the direction of the screw and impacts the stability of fracture fragments after resetting.
    OBJECTIVE: To explore the characteristics of medial condyle Hoffa fractures, and analyze the effects of absorbable screws combined with femoral condyle anatomical plate in the treatment of above fracture.
    METHODS: Data of 12 patients with medial condyle Hoffa fractures treated with absorbable screws combined with distal medial femoral anatomic plates in the Department of Traumatic Orthopedics of Tianjin Hospital in China from May 2010 to June 2013 were retrospectively analyzed. There were 8 males and 4 females at the age of 21-67 years, averagely 42 years. Before treatment, all patients were subjected to knee anterioposterior, lateral X-ray films and CT, and MRI examination. 12 patients received open reduction and internal fixation, intraoperative fracture with absorbable screw combined with anatomic plate fixation. After treatment, fracture healing and the knee joint function recovery were observed during follow-up.
    RESULTS AND CONCLUSION: All patients were followed up for 16-48 months. Fractures were healed. No loosening or fracture re-displacement occurred. Flexion range of knee joint was from 110° to 135°. According to Leteneur’s functional assessment system, there were excellent in 9 cases, good in 2 cases, fair in 1 case with the excellent and good rate of 92%. The absorbable screw fixation can realize the entirety of articular surface of crushed bone. The absorbable screw fixation combined with anatomic plate is effective in treatment of medial condyle Hoffa fracture, which further strengthened fixation. Its operation is convenient. Steel plate attachment is good, has some advantages, such as firm fixation, less complications, early functional exercises, and good repair effects. Thus, it can provide reference for the repair of above fractures.


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    Feasibility of proximal femoral nail antirotation with small incision in treatment of intertrochanteric fracture in the elderly patients 
    Shi Shao-hua, Lv Shu-jun
    2015, 19 (9):  1405-1409.  doi: 10.3969/j.issn.2095-4344.2015.09.016
    Abstract ( 290 )   PDF (675KB) ( 532 )   Save

    BACKGROUND: Internal fixations have achieved good outcomes in treatment of intertrochanteric fracture among the elderly. The commonly used internal fixation methods include extramedullary fixation (dynamic screws) and intramedullary fixation (proximal femoral nail). Although dynamic screws have been widely applied due to low cost and easy operations, the failure rate of internal fixation is relatively high. Intramedullary fixation can make up for the shortcomings of extramedullary fixation.
    OBJECTIVE: To evaluate the feasibility of proximal femoral nail antirotation with small incision in treatment of intertrochanteric fracture in the elder patients, and to compare with dynamic screws.
    METHODS: From August 2012 to June 2013, 40 elderly patients with unstable intertrochanteric fractures were included in this study and were randomly divided into two groups: experimental group and control group. Patients in the experimental group were given proximal femoral nail antirotation with small incision, while patients in the control group were treated with dynamic screws internal fixation. Postoperative index and Harris score of hip functions in the two groups were compared.
    RESULTS AND CONCLUSION: There was no differences in the Harris score of hip functions between the two groups (P > 0.05), while the experimental group showed shorter operation time and hospital stay, less blood loss and complications then the control group (P < 0.05). Compared with dynamic screws internal fixation, proximal 
    femoral nail antirotation therapy with small incision shows good repairing effects, with fewer complications, small trauma and high healing rate, it is suitable for the treatment of intertrochanteric fractures among the elderly patients.


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    Repair of unstable pelvic fracture in 60 cases: pathway of metallic implants
    Li Jie, Zhuang Yan-feng, Wang Bing-zhan
    2015, 19 (9):  1410-1415.  doi: 10.3969/j.issn.2095-4344.2015.09.017
    Abstract ( 473 )   PDF (716KB) ( 588 )   Save

    BACKGROUND: The unstable pelvic fracture is a common type of fracture, has the characteristics of complex disease and complications. Clinical treatment can use conservative or surgical methods. However, the most conservative treatment cannot achieve satisfactory therapeutic effects. Therefore, surgical treatment of different metal implants has become the main mode of treatment of unstable pelvic fracture.
    OBJECTIVE: To explore the application value of metallic implants in the treatment of unstable pelvic fracture.
    METHODS: A total of 60 patients with unstable pelvic fracture in the Department of Orthopedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA in China from September 2012 to September 2013 were selected and were given different treatments of metal implants operation after typed, including 8 cases of type B1, 20 cases of type B2, 9 cases of type B3, 15 cases of type C1 and 8 cases of type C2. According to different types of fracture, anterior and posterior approaches were performed. Generally, patients with type B received anterior approach, and those with type C received anterior + posterior approach. After treatment, antibiotics were used to prevent infection. Drainage tube was pulled out within 48-72 hours. Rehabilitation training was gradually performed at 3 days after treatment.
    RESULTS AND CONCLUSION: All patients were followed up for 1-12 months after treatment. The excellent and good rate was 95%. Complications occurred in seven patients after operation. The complication rate was 12%. They received active symptomatic treatment and were cured. No serious complications appeared. Above results confirmed that unstable pelvic fracture patients obtained good repair effect using different metal implants, and have a certain value in clinical application.


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    Complex tibial plateau fractures involving posteromedial column: implantation of “bamboo raft” plate and posteromedial support plate
    Han Zhi-wei, Zhao Jie, Xin Jie
    2015, 19 (9):  1416-1422.  doi: 10.3969/j.issn.2095-4344.2015.09.018
    Abstract ( 418 )   PDF (862KB) ( 532 )   Save

    BACKGROUND: Medial tibial fracture after involvement of the tibial plateau is complex fractures caused by high-energy injuries. If we cannot choose the appropriate time, reasonable fixation approach and fixation way, local skin necrosis delayed fracture healing or non-healing, internal fixation failure and knee joint dysfunction will occur.
    OBJECTIVE: To investigate the method and effect of complex tibial plateau fractures of medial column after involving the tibia platform.
    METHODS: On the basis of CT three-dimensional reconstruction and three-column type theory tibial plateau, data of 37 patients with complex fractures of tibial plateau involved in the medial column were retrospectively analyzed. All cases received fixation treatment. Anterior lateral incision and medial incision fixation approaches were used. The lateral side used “bamboo raft” type anatomic locking plate fixation, formulated by Association for the Study of Internal Fixation. Posteromedial column used this locking fixation plate according to fracture situation. Moreover, artificial bone graft was performed. The recovery of knee joint function was assessed using Merchant scoring criteria.
    RESULTS AND CONCLUSION: All patients were followed up for 12.8 months averagely. Fractures achieved clinical healing standard. No complications appeared. Recovery conditions of knee joint function are as follows: excellent in 25 cases, good in 9 cases, average in 2 cases, and poor in 1 case, with excellent and good rate of 92%. Results confirmed that after anterior lateral incision combined with posteromedial incision + tibia lateral “bamboo raft” steel plate and posteromedial support steel plate fixation in the treatment of tibial plateau fractures involving in posteromedial column of tibial plateau using artificial bone graft obtained good therapeutic effects.


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    Internal fixation with plate and Kirschner wire to repair calcaneal fractures: comparison of Gissane angle, Bohler angle and calcaneus height
    Ma Dong-di, Yang Zhen-jian, Song Jin-xu, Gao Zhi-feng, Sun Li-heng, Pan Xue-wen
    2015, 19 (9):  1423-1428.  doi: 10.3969/j.issn.2095-4344.2015.09.019
    Abstract ( 814 )   PDF (712KB) ( 547 )   Save

    BACKGROUND: Effects of percutaneous poking fixation with Kirschner wire and open reduction and internal fixation for long-term prognosis of calcaneal fractures are controversial. Percutaneous poking fixation with Kirschner wire is a simple method with small trauma to repair calcaneal fractures. However, the effect of fixation with Kirschner wire is poor, and external fixation is needed. Thus, it severely limits early activities and weight-bearing walking in patients.
    OBJECTIVE: To compare and analyze the prognosis effect of open reduction and internal fixation and percutaneous poking fixation with Kirschner wire for calcaneal fractures.
    METHODS: A total of 62 patients with calcaneal fractures, who were treated in Tangshan Fengnan District Hospital from March 2012 to September 2013, were selected for this study. The patients were divided into two groups according to the therapy strategy: open reduction and internal fixation group (n=29) and percutaneous poking fixation with Kirschner wire group (n=33). Gissane angle, Bohler angle, calcaneus height, incidence of postoperative complication and AOFAS score (1-year follow-up) were compared between the two groups.
    RESULTS AND CONCLUSION: The Gissane angle, Bohler angle and calcaneus height in open reduction and internal fixation group were higher than percutaneous poking fixation with Kirschner wire group (P < 0.05). There was no statistical difference in the incidence of postoperative complication between the two groups (P > 0.05). The AOFAS score during 1-year follow-up was significantly higher in open reduction and internal fixation group than in the percutaneous poking fixation with Kirschner wire group (P < 0.05). Results indicated that open reduction and internal fixation could recover the regular structure of calcaneus and subtalar joint. Surgeon with skilled operation skills could ensure the safety of surgery. Open reduction and internal fixation can promote the prognosis of calcaneal fractures, and is better than percutaneous poking fixation with Kirschner wire.


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    Volar locking plate internal fixation and external fixator in repair of unstable distal radius fractures: randomized controlled trial
    Li De-sheng, Li Hao-huan
    2015, 19 (9):  1429-1434.  doi: 10.3969/j.issn.2095-4344.2015.09.020
    Abstract ( 438 )   PDF (725KB) ( 447 )   Save

    BACKGROUND: Unstable distal radius fractures are the most common fractures of the human skeleton. Although various methods have demonstrated good results, the choice of the best option remains controversial.
    OBJECTIVE: To investigate clinical outcomes, complications, and radiographic results of external fixation and open reduction and internal fixation with locking compression plate for repairing the unstable distal radius fractures using prospective randomized controlled method.
    METHODS: From September 2011 to September 2013, 122 patients with the unstable distal radius fractures were enrolled in this prospective randomized study. These patients were randomized into two groups. The external fixation group (n=61) received closed reduction and external fixation. Plate group (n=61) received open reduction and internal fixation using a volar locking compression plate. Hospital days, fracture healing time, wrist function and complication rate were compared between the two groups. Quality of reduction was evaluated using imaging, including palmar angle, ulnar deviation, radial height and articular surface level.
    RESULTS AND CONCLUSION: Follow-up time was 12-26 months in the external fixation group, and 12-28 months in the plate group. There was no significant difference in length of follow-up in both groups (P= 0.300). Clinical outcomes and imaging results were compared after treatment in both groups. Hospital days, fracture 
    healing time and postoperative recovery degree palmar angle were significantly larger in the plate group than in the external fixation group. No significant differences in ulnar deviation, radial height, wrist function, incidence of postoperative complications and articular surface level were detected between both groups (P > 0.05). Above findings suggested that for unstable distal radius fractures, the use of external fixation or volar locking plate treatment, can obtain satisfactory clinical outcomes, but the external fixation has the advantages of a less invasive, shorter hospital days, minor complications, faster fracture union, which is particularly suitable for treatment of the distal radius fracture in the elderly.


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    Herbert screw fixation for repairing capitellum fracture through anterior elbow approach: evaluation for fracture reduction and healing
    Zhang Yi, Tao Sheng-xiang, Zhang Yong, Hu Feng, Zhang Guo-hua
    2015, 19 (9):  1435-1440.  doi: 10.3969/j.issn.2095-4344.2015.09.021
    Abstract ( 473 )   PDF (741KB) ( 604 )   Save

    BACKGROUND: The treatment of capitellum fracture has obtained primary consensus in the clinic, that is, open reduction and fixation for a displaced fracture. However, the selection of operation approach and the type of internal fixation are still controversial.
    OBJECTIVE: To explore the effects of Herbert screw in the treatment of capitellum fracture through anterior elbow approach.
    METHODS: A total of 12 patients with displaced fractures of the humeral capitellum were chosen from August 2008 to May 2012 in the Department of Orthopedics, Puren Hospital, Wuhan University of Science and Technology. They received Herbert screw fixation through anterior elbow approach. According to Bryan and Morrey classification, there were eight cases of type I fractures, three cases of type II fractures, and one case of type III fracture. The outcomes of fracture healing, elbow functions and complications were observed after fixation.
    RESULTS AND CONCLUSION: In the two-year follow up, fractures in all patients were healed. There were excellent in ten patients and good in two patients according the Mayo elbow performance index. The elbow function of most patients recovered to normal. There was no evidence of the post-operative complications. These findings indicate that treatment of displaced capitellum fracture using Herbert screws through anterior elbow approach obtained satisfactory outcomes. The recovery of elbow function was good after fixation, and presented apparent advantages.


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    Arthroscopy assisted double titanium plate TightRope in repair of the acromioclavicular joint dislocation: strong fixation in early stage
    Zhang Li-ming, Wang Zhi-fang, Shi Hai-wei
    2015, 19 (9):  1441-1446.  doi: 10.3969/j.issn.2095-4344.2015.09.022
    Abstract ( 961 )   PDF (780KB) ( 1390 )   Save

    BACKGROUND: Repair methods for acromioclavicular joint dislocation are various. Different fixation or reconstitution obtains different outcomes. Moreover, various postoperative complications exist, and impact shoulder function. With the development of concept of minimal invasion and rapid generalization of arthroscopy, arthroscopy began to be used in the minimally invasive treatment of acromioclavicular dislocation, and its effectiveness and safety have been verified.
    OBJECTIVE: To explore the clinical efficacy of double titanium plate TightRope fixation and anatomic reconstruction of beak lock ligament under arthroscopy in the treatment of acromioclavicular joint dislocation.
    METHODS: 12 patients with type III-VI acromioclavicular joint dislocation were treated with double titanium plate TightRope fixation and anatomic reconstruction of beak lock ligament. After fixation, they were rechecked with X-ray at 1, 6 and 12 weeks. Pain condition was evaluated using Visual Analog Scale. Shoulder joint function was assessed using University of California, Los Angeles (UCLA) grading evaluation after surgery.
    RESULTS AND CONCLUSION: 12 cases had been followed up for 4.5-15 months. X-ray examination confirmed that the acromioclavicular joint dislocation was completely reset, and dislocation did not appear again. Significant differences in Visual Analog Scale scores were detected at 1, 6, and 12 weeks after fixation compared with pre-fixation (P < 0.05). Significant differences in Visual Analog Scale scores were detectable between 6 and 12 weeks and 1 week after fixation (P < 0.05). Significant differences in UCLA scores were found at 1, 6 and 12 weeks after fixation compared with pre-fixation (P < 0.05). Significant differences in UCLA scores were seen at 6 weeks after fixation compared with 1 week (P < 0.05). These results indicated that TightRope fixation and anatomic reconstruction of beak lock ligament under arthroscopy for acromioclavicular joint dislocation is stable, obtains small trauma, and can be easily accepted by patients. Moreover, patients can receive early joint functional exercise so as to restore joint function better, which do not damage the joint surface, without shoulder peak impact or secondary surgery. Curative effect is satisfied.


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    CT-based three-dimensional reconstruction navigation technique assisted pedicle screw placement in lumbar and sacral bone
    Chen Xiao-ming, Chen Qian-fen, Xiao Zeng-ming, Zong Shao-hui
    2015, 19 (9):  1447-1451.  doi: 10.3969/j.issn.2095-4344.2015.09.023
    Abstract ( 628 )   PDF (760KB) ( 636 )   Save

    BACKGROUND: Pedicle screw fixation techniques have been widely used in the treatment of lumbar and sacral disease, such as trauma, deformity, tumor and degeneration. How to improve the accuracy of screw placement is a hot topic. CT-based three-dimensional reconstruction navigation technique provides real-time, multi-perspective, three-dimensional visualization of lumbar and sacral anatomy, and surgeons can perform the pedicle screw insertion procedures confidently with increase of accuracy and safety.
    OBJECTIVE: To study the clinical value of CT-based three-dimensional reconstruction navigation technique in the application of lumbar and sacral pedicle screw placement.
    METHODS: A total of 203 patients with lumbar and sacral diseases, including lumbar fracture, lumbar spondylolysis and lumbar spinal stenosis, were recruited from Department of Spine & Osteopathy, the First Affiliated Hospital of Guangxi Medical University between July 2008 and November 2014. Patients received pedicle screw placement in lumbar and sacral bone under the guidance of CT-based three-dimensional reconstruction navigation. Postoperative X-ray films and three-dimensional CT scan of lumbar bone were routinely examined in each patient. The accuracy of pedicle screw insertion was evaluated with postoperative CT scan according to Andrew classification.
    RESULTS AND CONCLUSION: A total of 1 088 screws were inserted in the lumbar and sacral bone. The accuracy of pedicle screw insertion was rated as grade I in 1 068 screws (98.2%) according to postoperative CT scan. 152 cases were followed up for average 12 months without any complications, such as internal fixator displacement and rupture. Preoperative CT-based three-dimensional reconstruction navigation technique provides three-dimensional anatomical information, assists to develop pedicle screw insertion plan, enhances the accuracy and further improves the safety of pedicle screw insertion.


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    Biomechanical study of different internal fixations in the treatment of supracondylar femoral fractures
    Yang Qing, Guo Wei-chun, Liu Yang, Tan Jun-feng, Zhang Mi, Li Ming-hui, Zhang Hong-qi
    2015, 19 (9):  1452-1456.  doi: 10.3969/j.issn.2095-4344.2015.09.024
    Abstract ( 345 )   PDF (664KB) ( 611 )   Save

    BACKGROUND: There are various fixation methods in the treatment of supracondylar femoral fractures, including plates and interlocking intramedullary nails. Due to differences in biomechanical properties, the clinical curative effect of the two methods in the treatment of supracondylar femoral fracture is different.
    OBJECTIVE: To compare the biomechanical properties of two fixations in the treatment of supracondylar femoral fractures, explore the stress distribution differences of two fixations for supracondylar femoral fractures, and provide clinical basis for the selection of ideal fixation.
    METHODS: Twelve sets of adult cadaveric femoral bone were selected, and the supracondylar femoral bone was sawn with an electric saw to establish supracondylar femoral fracture models. After anatomic reduction, the fracture samples were fixed with less invasive stabilization system (LISS) plates and retrograde interlocking intramedullary nails, respectively. Six strain gages were mounted near the fracture plane and pin track, then the fracture models were placed in the Zwick Z100 electronic universal material test machine and torisional testing machine (RNJ-500), receiving a linear load of 0-400 N and a torisional load of 0-20 N•m. Local stresses were detected, and their distributions under the same load in the two fixations were also measured.
    RESULTS AND CONCLUSION: In the experimental loading condition, the stress at the fracture end and around the pin track increased with the increase of the load both in the LISS plate groups and retrograde interlocking intramedullary nail groups. In the same linear loading, the strain value at six testing points in the retrograde interlocking intramedullary nail groups was higher than that in the LISS plate groups (P < 0.01); in the same torsional loading, the LISS plate groups showed high strain value than the retrograde interlocking intramedullary nail groups in the six test points (P < 0.01). Retrograde interlocking intramedullary nails can obviously reduce stress-shielding in the treatment of supracondylar femoral fractures, which is beneficial to the stress conduction. It also resists axial force and torsion. Therefore it can be applied in the clinical practice.


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    Applications and prospects of digital orthopedics: more precise, individual and intuitional outlook
    Huo Li-feng, Ni Heng-jian
    2015, 19 (9):  1457-1462.  doi: 10.3969/j.issn.2095-4344.2015.09.025
    Abstract ( 415 )   PDF (650KB) ( 590 )   Save

    BACKGROUND: Digital orthopedic technology is the combination of digital information technology and clinical orthopedics. At present, digital orthopedic technology has been widely used in the field of orthopedics and achieved some progress, it is regarded as one of the important motivations to develop clinical orthopedics.
    OBJECTIVE: To summarize the application and prospects of digital orthopedic technology in recent years and provide a reference for clinical guidance.
    METHODS: A computer-based online retrieval of PubMed (between January 2009 and January 2015), MEDLINE (between January 2009 and January 2015), EMbase (between January 2009 and January 2015), CNKI (between January 2010 and December 2014), VIP (between January 2010 and December 2014) and Wanfang database (between January 2010 and December 2014) was performed, with the key words of “digital orthopedics, digital simulation, finite element analysis” in Chinese. At the same time, six orthopedic journals published in Chinese were manually reviewed and the attached references were consulted. Documents addressing the digital orthopedics were screened according to the inclusion criteria, and the quality was strictly evaluated.
    RESULTS AND CONCLUSION: Finally 44 articles were included in this review. The review analysis showed that, digital orthopedic technology has a mutual correlation with traditional orthopedics, they promote, fuse and influence each other. The mutual development allows a more precise, individual and intuitional outlook of the diagnosis and treatment for various fractures with complex biomechanical structure and anatomy. Digital orthopedic technology has a great impact on the clinical practice and orthopedic studies. Due to limited cases in the present study, multicenter, large-sample-size, and long-term clinical randomized controlled studies are needed to further verify the reliability of digital orthopedic technology.


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    Meta-analysis for the efficacy and safety of tranexamic acid in total knee arthroplasty
    Li Fei-xiong, Wang Zhi-yong, Zhang Zhi-qiang
    2015, 19 (9):  1463-1469.  doi: 10.3969/j.issn.2095-4344.2015.09.026
    Abstract ( 673 )   PDF (701KB) ( 561 )   Save

    BACKGROUND: Increasing evidence has found that, tranexamic acid could reduce blood loss during total knee arthroplasty, but the efficacy and safety remain controversial. Whether tranexamic acid can reduce blood loss and increase the risk of thrombosis during the perioperative period, needs further systemic evaluation. 
    OBJECTIVE: To explore the safety and effectiveness of tranexamic acid in the total knee arthroplasty through a meta-analysis.
    METHODS: Randomized controlled trials on tranexamic acid in total knee arthroplasty were retrieved from relevant databases. All retrieved documents and references were used as supplementary information. According to the inclusion and exclusion criteria, retrieved documents were screened and the quality was assessed, then meta-analyses were performed by using the RevMan 5.1 software. The mean difference of blood loss, the risk ratio of transfusion, and the incidence of deep vein thrombosis and pulmonary embolism in the tranexamic acid and control groups were calculated.
    RESULTS AND CONCLUSION: Totally 17 randomized controlled studies were included. Meta-analysis results showed that, tranexamic acid significantly reduced the total blood loss [MD=-314.96, 95%CI(-448.76, -181.16)], postoperative blood loss [MD=-417.72, 95%CI(-508.87, -326.56)], and the proportion of patients requiring blood transfusion [RR=0.43, 95%CI(0.37, 0.51)], when compared with the control group. The incidence of deep vein thrombosis [RR=0.98, 95%CI(0.38, 2.52)] and pulmonary embolism showed no significant difference between the two groups. Tranexamic acid could reduce blood loss and blood transfusion for patients undergoing total knee arthroplasty, without increasing the risk of deep vein thrombosis and infection.


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    Electrical stimulation treatment on cerebral palsy: gross motor function measure, passive activity of ankle joint and foot dorsiflexion angle
    Miao Wei, Lu Xia, Mu Ta Li-fu, Ai Ke Bai-er, Mai Er A-ba, Yan Bao-feng, Luan Xin-ping
    2015, 19 (9):  1470-1476.  doi: 10.3969/j.issn.2095-4344.2015.09.027
    Abstract ( 448 )   PDF (810KB) ( 433 )   Save

    BACKGROUND: There are a variety of therapeutic strategies for cerebral palsy, electrical stimulation has been regarded as a potential treatment of cerebral palsy. However, systemic evaluation of electrical stimulation in treatment of cerebral palsy is rarely reported.
    OBJECTIVE: To evaluate the effect of electrical stimulation on gross motor function measure, passive activity of ankle joint and foot dorsiflexion angle of cerebral palsy patients.
    METHODS: A computer-based online retrieval of Wanfang Database, VIP Database for Chinese Technical Periodicals, CNKI Database, Chinese Biomedical Literature Database, PubMed Database, and Ovid Database was performed for randomized controlled trials with comparable baseline and clear diagnosis. The quality of the literatures was strictly evaluated using RevMan5.1 software according to the Cochrane Reviewer’s Handbook.
    RESULTS AND CONCLUSION: Eventually 8 papers were included in the Meta analysis. Meta analysis results showed that, electrical stimulation treatment was better than simple rehabilitation in the improvement of patient’s sialorrhea (OR=8.37, 95%CI: 2.86-24.51, P=0.000 1), the degree of gastrocnemius spasm (OR=-0.62, 95%CI: -0.84 to -0.41, P < 0.000 01), gross motor function score in D area (standing) (OR=9.86, 95%CI: 1.70-18.02, P=0.02), gross motor function score in E area (going, running, jumping) (OR=9.54, 95%CI: 7.47-11.62, P < 0.000 01), and the ability to walk (OR=6.12, 95%CI: 3.65-8.58, P < 0.000 01). Our findings indicate that, electrical stimulation is an effective treatment on cerebral palsy, it could improve gross motor function measure, passive activity of ankle joint and foot dorsiflexion angle of cerebral palsy patients. The therapeutic effect is more obvious combined with rehabilitation therapy.


    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


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