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    24 September 2015, Volume 19 Issue 39 Previous Issue    Next Issue
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    Posterior stabilized knee prosthesis of different types: comparison of intercondylar osteotomy amount
    Weng Jian-hao, Xu Jie, Zhu Qi-qi, Xue Rui-qi, Li Deng, Cai Zhi-qing, Huang Yu-lin, Ma Ruo-fan
    2015, 19 (39):  6233-6239.  doi: 10.3969/j.issn.2095-4344.2015.39.001
    Abstract ( 558 )   PDF (4553KB) ( 448 )   Save

    BACKGROUND: Posterior stabilized femoral knee prosthesis needs additional condyle osteotomy to accommodate the tibial post and femur fossa structures. Intercondylar fossa on both sides connected at the femoral body with concentrated stress is a place easily affecting fractures. Differences in bone mass between different models of different brands did not have specific data, which was not convenient to select prosthesis for clinicians. 
    OBJECTIVE: To compare the difference of intercondylar osteotomy data among clinical commonly used  
    posterior stabilized knee prostheses (six imported and domestic brands), and to provide basis for the selection and application of the prostheses.
    METHODS: The current commonly used posterior stabilized knee prostheses (six imported and domestic brands) were used, including Zimmer NexGen LPS, Stryker Scrorpio NRG Knee-Flexed, Depuy PFC Sigma, Smith & nephew Genesis-2 PS, United-U1 and Wego GKPS. According to the osteotomy template, the osteotomy-surfaces consisting of femoral condyle starting section and cross section, distal section of femoral condyle, and back-oblique section were identified. The corresponding femoral prosthesis diameter lines included condylar ambilateral and anteroposterior diameters, width and depth of femoral intercondylar fossa. The above data were compared and measured.
    RESULTS AND CONCLUSION: The six kinds of knee femoral prostheses were different in ratio of ambilateral diameter and anteroposterior diameter, bone resection of intercondylar fossa, and geometry. Imported prostheses carry shorter diameters in femoral starting and cross sections, so it can catch more posterior condylar osteotomy. With increasing prosthesis sizes, the ratio of bone loss causing by width of intercondylar osteotomy is decreased among six brands. In all sizes, Stryker Scrorpio NRG Knee-Flexed catches shorter width of intercondylar osteotomy. Knee prosthesis osteotomy among six brands is different. The result of this study is not sufficient to evaluate the pros and cons between different prostheses, but as reserving bone is concerned, the design of less intercondylar osteoomy catches more advantages.

    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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    Construction of a rabbit model of knee prosthesis infection: environmental factors in vivo affect Staphylococcus epidermidis and biofilms
    Shen You-liang, Zhu Tong-e, Zhang Jing-jing, Qi Chao, Yu Teng-bo
    2015, 19 (39):  6240-6245.  doi: 10.3969/j.issn.2095-4344.2015.39.002
    Abstract ( 313 )   PDF (925KB) ( 248 )   Save

    BACKGROUND: Bacterial biofilm is the main cause of the infection of the prosthesis. In vitro experiments confirmed that hypertonic sodium chloride and ethanol can apparently promote the formation of staphylococcal biofilms. There are no reports on the effects of ethanol and hypertonic environment surrounding the prosthesis on the formation of biofilms.
    OBJECTIVE: To evaluate the effects of different environment factors surrounding the prosthesis on the growth of Staphylococcus epidermidis and bacterial biofilm formation after replacement.
    METHODS: White rabbit models infected with Staphylococcus epidermidis on the prosthesis were established, and were randomly divided into hypertonic sodium chloride, ethanol and control groups (n=15). The bacteria were injected with 0.1 mL 4% sodium chloride and 4% ethanol into the knee of rabbits in the hypertonic sodium chloride  
    and ethanol groups. The rabbits were injected with 0.1 mL 0.9% sodium chloride in the control group. Three rabbits were sacrificed at 2, 4, 6, 8 and 16 days after inoculated with bacteria. Synovial fluid, prosthesis and tissue surrounding infection were obtained. Bacterium was cultured to extract total RNA. The ica operon transcription levels were detected in the gene levels. Adhesion of bacteria on the surface of the prosthesis was observed using a scanning electron microscope. Tissues surrounding the prosthesis were observed using hematoxylin-eosin staining.
    RESULTS AND CONCLUSION: Histological examination revealed that inflammatory cell infiltration was observed in all the rabbits at 4 days after injection. Colony formation was found at 16 days after injection. At 6 days after injection, inflammatory cell infiltration was observed in the ethanol and control groups. Scanning electron microscope showed that compared with the control group, the bacteria adhered to the prosthetic surface became more in the hypertonic sodium chloride and ethanol groups at 6, 8 and 16 days (P < 0.05). At 6, 8 and 16 days, the expression of icaA mRNA was significantly higher in the hypertonic sodium chloride and ethanol groups than in the control group (P < 0.05). These data showed that the environment factors could affect the growth of Staphylococcus epidermidis and bacterial biofilm formation.

    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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    Unisex total knee prosthesis: gender and therapeutic effects
    Ding Chun-ming, Teng Xue-ren, Tan Hong-lue, Zhou Guang-dong
    2015, 19 (39):  6246-6250.  doi: 10.3969/j.issn.2095-4344.2015.39.003
    Abstract ( 421 )   PDF (1380KB) ( 318 )   Save

    BACKGROUND: There were certain differences in the anatomical structure of knee joint between man and woman. Gender knee solution is a new type of artificial knee joint prosthesis, which is specially designed for women. Theoretically, the outcome of unisex total knee arthroplasty prosthesis should be related to gender, but we did not find very obvious differences in practical clinical work.
    OBJECTIVE: To analyze the differences in curative effects of the unisex knee arthroplasty prosthesis between male and female patients undergoing total knee arthroplasty so as to find out if it is necessary to apply female knee prosthesis among appropriate crowd. 
    METHODS: We retrospectively analyzed the clinical data of patients undergoing total knee arthroplasty from May 2001 to June 2011. Among 312 patients (350 knees receiving total knee arthroplasty), patients who died within 3 years after surgery, lost to follow-up and underwent revision were excluded. Changes in knee functions and 
    imaging were observed between males and females.
    RESULTS AND CONCLUSION: The women and men had similar mean pre-operative knee scores, flexion function, pain score among 285 patients (300 knees). However, the women had significantly lower mean extension function and function scores than the men. There were no significant differences in improvement in the knee scores, flexion, the pain and knee function between women and men before and after surgery. Nevertheless, men had better extension than women. No significant difference in radiolucencies and complications was seen between females and males. Therefore, there was little difference in outcomes between women and men who used the unisex total knee arthroplasty prosthesis.

    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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    Knee arthroplasty for treating degenerative femoral intercondylar fossa impingement syndrome
    Chen Hui, Wang Qun, Yan Shuang-xi, Dong Tian-yun, Zou Hai-bing
    2015, 19 (39):  6251-6255.  doi: 10.3969/j.issn.2095-4344.2015.39.004
    Abstract ( 339 )   PDF (886KB) ( 262 )   Save

    BACKGROUND: Traditionally, non-surgical treatment was used to treat degenerative femoral intercondylar fossa impingement syndrome, but it can cause function loss of cruciate ligament, or knee instability. With the development of medical technology, more and more views believed that ligament damage and combined with other knee structural damage should receive surgery as soon as possible.
    OBJECTIVE: To investigate the repair effect of knee arthroplasty for treating degenerative femoral intercondylar fossa impingement syndrome, and compare with AO cannulated screw fixation.
    METHODS: A total of 72 patients with degenerative femoral intercondylar fossa impingement syndrome were equally and randomly divided into treatment group and control group. Patients in the control group were treated with open AO cannulated screw fixation, and patients in the treatment group were subjected to knee arthroplasty. At 7 days after treatment, repair effect was evaluated. Before treatment and 7 days after treatment, knee function  
    was assessed by using Lysholm knee Scoring Scale and the international knee documentation committee knee evaluation form. All patients were followed up for 6 months after treatment to investigate the occurrence of complications.
    RESULTS AND CONCLUSION: The surgery was successfully completed in all patients. At 7 days after treatment, the excellent and good rate was 94% in the treatment group and 75% in the control group. The excellent and good rate was significantly higher in the treatment group than in the control group (P < 0.05). Lysholm scores were significantly greater, but the international knee documentation committee knee evaluation form scores were significantly lower at 7 days after treatment compared with that before treatment in the treatment group (P < 0.05). Simultaneously, Lysholm scores and the international knee documentation committee knee evaluation form scores were significantly better in the treatment group than in the control group at 7 days after treatment (P < 0.05). During 6-month follow-up, wound infection, intra-articular infection, joint pain, and deep vein thrombosis were significantly less in the treatment group than in the control group (P < 0.05). These findings indicate that knee arthroplasty for degenerative femoral intercondylar fossa impingement syndrome can improve short-term efficacy, effectively restore knee function and reduce the incidence of 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

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    Analgesic scheme and safety after total knee arthroplasty
    Wang Rong-guo, Qi Dun-yi
    2015, 19 (39):  6256-6261.  doi: 10.3969/j.issn.2095-4344.2015.39.005
    Abstract ( 282 )   PDF (982KB) ( 246 )   Save

    BACKGROUND: Positive total knee replacement surgery greatly improved the quality of life in patients with knee joint degenerative disease, but widespread perioperative acute pain increases the probability of complications and hinders the rehabilitation exercises of patients; therefore perioperative pain processing has become an important topic of the current knee replacement.
    OBJECTIVE: To compare the efficacy and safety of preemptive analgesia of parecoxib sodium, periarticular analgesia and their combination in the total knee arthroplasty, and explore reasonable and effective analgesic scheme.
    METHODS: 60 patients undergoing knee replacement were randomly selected in Xuzhou Central Hospital from May 2012 to December 2014, and then they were divided with a random number table into four groups: preemptive analgesia with parecoxib sodium, periarticular analgesia, combination and blank control, with 15 cases in each group. Different programs were used in each group during total knee arthroplasty.
    RESULTS AND CONCLUSION: At 6, 12, 24 and 36 hours after operation, rest pain scores, activity pain scores and drug dose were significantly lower in the combination group than other three groups (P < 0.05). Time interval of anesthetic use was significantly longer in the combination group than other three groups (P < 0.05). At 3 days 
    after replacement, active leg-raising time and active genuflex 90° time were significantly shorter in the combination group than other three groups (P < 0.05), and range of motion of the knee was good. The incidence of adverse reaction was lowest in the combination group (P < 0.05). These results indicate that preemptive analgesia of parecoxib sodium combined with periarticular analgesia is a safe and effective analgesic option, can obviously reduce pain after replacement, the amount of anesthetics and adverse reactions, improve range of motion of the knee and promote early rehabilitation of 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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    Strategy of using a tourniquet in simultaneous bilateral total knee arthroplasty
    Gong Ke, An Xiao, Zhang Qi, Dong Ji-yuan
    2015, 19 (39):  6262-6267.  doi: 10.3969/j.issn.2095-4344.2015.39.006
    Abstract ( 355 )   PDF (993KB) ( 308 )   Save

    BACKGROUND: The tourniquet is usually fully used or bilaterally used in partial time during bilateral total knee arthroplasty. However, very few people try to use it on one side and on the other side in partial time. 
    OBJECTIVE: To investigate the effective strategy of using a tourniquet in simultaneous bilateral total knee arthroplasty.
    METHODS: 80 patients (160 knees) with severe osteoarthritis who underwent simultaneous bilateral total knee arthroplasty in the Department of Orthopedics, Chinese PLA Medical School from January to December 2013 were divided into two groups according to the different tourniquet strategies. In test group (n=40), left knees did not receive tourniquet, and right knees received tourniquet in partial time. In control group (n=40), all knees received tourniquet in the whole time. The perioperative and postoperative blood loss, 3-day postoperative thigh swelling rate and pain visual analog scale, 3-week and 1-year postoperative Knee Society Score were recorded in both groups. 
    RESULTS AND CONCLUSION: There were no statistically significant differences between two groups in perioperative total blood loss (P > 0.05). However, postoperative blood loss in test group was less than that in  control group (P < 0.05). The visual analog scale scores were significantly lower in the test group than in the control group at 3 days after surgery (P < 0.05). Visual analog scale scores on the left side were lower than on the right side in the test group at 3 days post surgery (P < 0.05). Bilateral thigh swelling rate was significantly lower in the test group than in the control group at 3 days after surgery (P < 0.05). The thigh swelling rate was lower on the left side than on the right side in the test group at 3 days after surgery (P < 0.05). Knee Society Score was higher in the test group than in the control group in the early stage, and no significant difference in long-term Knee Society Score was detected (P > 0.05). These findings verify that taking the strategy that the first knee without tourniquet and the second knee with part time tourniquet technique in simultaneous bilateral total knee arthroplasty will alleviate pain and swelling after operation and promote early functional rehabilitation without increasing the perioperative total blood loss.

    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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    Bipolar hemiarthroplasty for osteoporotic hip fractures in the elderly: controversy of prosthesis selection
    Sun Jun-gang, Zhou Wen-zheng, Li Zu-tao, Xu Wan-long, Lu Lin-song, Xu Kuo, Yuan Hong
    2015, 19 (39):  6268-6273.  doi: 10.3969/j.issn.2095-4344.2015.39.007
    Abstract ( 423 )   PDF (993KB) ( 310 )   Save

    BACKGROUND: The number of elderly patients with hip fracture is huge, and this population mainly combines with a variety of internal diseases. The general condition was bad. Compared to total hip arthroplasty, bipolar hemiarthroplasty can shorten operation time, reduce the time of anesthesia and improve surgical safety, but the operation using which fixation mode is always controversial.
    OBJECTIVE: To compare the safety and curative effects of bipolar hemiarthroplasty with cementless or cement femoral stem prosthesis in elderly patients with osteoporotic complex hip fracture.
    METHODS: From June 2007 to June 2010, 198 elderly patients with osteoporotic hip fracture aged more than 75 years old, who were treated with bipolar hemiarthroplasty in the People’s Hospital of Xinjiang Uygur Autonomous Region, China, were enrolled in this study. All patients were divided into cementless group (n=69) and cement group (n=129) according to the type of prognosis. Osteoporosis was treated conventionally in both groups after replacement. Operation time, intraoperative blood loss, incidence of postoperative hip pain, out of bed activity time post surgery, Harris scores of last follow-up and loosening rate of the prognosis were compared between the two groups.
    RESULTS AND CONCLUSION: 176 of above 198 cases were followed up for 48 to 84 months, including 122 in the cement group and 54 in the cementless group. Operation time was longer in the cement group than in the cementless group, but out of bed time was earlier in the cement group than in the cementless group post surgery, and there were significant differences (P < 0.05). The incidences of loosening and hip pain were more in the cement group than in the cementless group post surgery (P < 0.05). No significant difference in intraoperative blood loss and Harris scores of last follow-up was detected between the two groups (P > 0.05). The incidences of loosening rate were 5% and 4% in the cement and cementless groups, respectively, which showed significant differences (P < 0.05). These results indicate that bipolar hemiarthroplasty with or without cement for osteoporotic hip fracture in the elderly can obtain good middle- and long-term effects. Bipolar hemiarthroplasty with cement can reduce the out of bed time, but operation time was longer, and incidences of hip pain and loosening were higher in cement prosthesis than in cementless prosthesis.

    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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    Zweymüller spiral acetabular prosthesis for treating developmental dysplasia of the hip in adults
    Wu Jian, Wang Bing, Yao Li
    2015, 19 (39):  6274-6280.  doi: 10.3969/j.issn.2095-4344.2015.39.008
    Abstract ( 447 )   PDF (821KB) ( 345 )   Save

    BACKGROUND: Spiral acetabular prosthesis has good stability during total hip arthroplasty.
    OBJECTIVE: To observe the early therapeutic effect of Zweymüller spiral acetabular prosthesis in total hip arthroplasty for patients with developmental dysplasia of the hip.
    METHODS: Totally 38 patients (48 hips) with developmental dysplasia of the hip received total hip arthroplasty with Zweymüller spiral acetabular prosthesis from January 2011 to June 2013 were selected. The clinical effect was observed after the operation.
    RESULTS AND CONCLUSION: A total of 38 patients were followed up for 21-46 months (averagely 42.3 months). One case suffered from deep venous thrombosis. Harris scores and Charnely scores apparently increased after surgery compared with that before surgery. The mean length of the osteotomy was 2.42±0.48 cm, and the mean extended length of the affected limb was 4.58±1.15 cm. X-ray films showed that there was no disunion of the osteotomy, no subsidence and loosening of prosthesis. The position of the acetabulum was suitable. The healing time of bone graft was 3-11 months (averagely 5.3 months). The coverage of the acetabular component was 92.5%, with a good initial stability, and the excellent rate of the operation was 90%. The satisfaction rate of patients was 84%. These results indicate that the Zweymüller spiral acetabular prosthesis has the advantages of reasonable design, good initial stability, low loosening rate and high satisfaction degree.  However, the number of cases of this study was relatively small, the follow-up time was short, and only the short-term effect was evaluated. Thus, the midterm and long-term effects need to be observed by the follow-up evaluation.

    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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    Stability of femoral prosthesis after total hip replacement
    Sha Li-rong, Wang Tong-yu
    2015, 19 (39):  6281-6285.  doi: 10.3969/j.issn.2095-4344.2015.39.009
    Abstract ( 272 )   PDF (994KB) ( 277 )   Save

    BACKGROUND: There are many experimental studies about compression mechanics of femur after hip replacement at home and aboard. Therefore, it is very important to study the torque, torsion angle, load-displacement relationship of femur after hip replacement. Comparing and analyzing the properties of compression and torsional mechanics of traditional-type prosthesis and anatomical-type prosthesis is of important significance for studying hip replacement and the stability of artificial prosthesis.
    OBJECTIVE: To compare and analyze the stability of traditional-type prosthesis and anatomical-type prosthesis by stimulating femoral axial compression and torsion tests after hip replacement, so as to provide biomechanical parameters for clinic practice.
    METHODS: Twelve specimens of left- and/or right-side femur were selected. The femoral necks of 6 left-side femur specimens were retained as the anatomical-type titanium artificial joint prosthesis group, and the femoral necks of the 6 right-side femur specimens were removed as the traditional-type cobalt-chromium-molybdenum artificial joint prosthesis group. The femur specimens in these two groups were respectively placed onto the electronic universal testing machine workbench and were imposed compression stress at the experimental  velocity of 5 mm/min. The corresponding displacement values were read under the force of 20, 40, 60, 80 and 100 N. And then, both ends of the femur specimens from these two groups were placed within the chuck of torsion testing machine, and were imposed torque at the experimental velocity of 1(°)/s. The corresponding torsion angle values were read under the torque force of 5, 10, 15 and 20 N•m.
    RESULTS AND CONCLUSION: Under the external force of 100 N, the displacement was (2.03±0.06) mm in the traditional-type prosthesis group, and (1.83±0.05) mm in the anatomical-type prosthesis group. Under the torque force of 20 N•m, the torsion angle values of traditional-type prosthesis was (21.7±0.7)°, and that of anatomical-type prosthesis was (13.2±0.4)°. The displacement under the external force of 100 N and the torsion angle values under the torque force of 20 N•m in the anatomical-type prosthesis group were all significantly less than those in the traditional-type prosthesis group (P < 0.05). These results suggest that traditional-type and anatomical-type prostheses have different compression and torsion mechanical properties. The anatomical-type femur prosthesis has a better stability than traditional-type femur prosthesis.

    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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    Qiangguyin strengthens periprosthetic bone density after hip arthroplasty: a randomized controlled half-year evaluation
    Jian Zhi-fei, Sun Wei, Cao Hong
    2015, 19 (39):  6286-6290.  doi: 10.3969/j.issn.2095-4344.2015.39.010
    Abstract ( 395 )   PDF (836KB) ( 292 )   Save

    BACKGROUND: Hip arthroplasty is an effective means currently in repair of femoral neck fractures. With the increased in the amount of surgery, surgery failure rate also has increased. In particular, prosthesis loosening and fracture are very common after replacement. Qiangguyin can promote the formation of osteoblasts, resist osteoporosis, inhibit osteoclast activity, and increase bone density. Drynaria invigorates the kidney, strengthens the bone and tendon and relieves pain, and has bidirectional regulatory effects on promoting bone formation and 
    inhibiting bone resorption. 
    OBJECTIVE: To investigate effects of Qiangguyin on periprosthetic bone density in patients with femoral neck fracture after hip arthroplasty.
    METHODS: 96 patients with femoral neck fracture were equally divided into observation group and control group based on the random number table. Both groups were given selective joint replacement. Patients were implanted with femoral head made by US Stryker Corporation, and fixed with bone cement. After replacement, patients in the control group were treated with calcium D3 tablets and capsules alfacalcidol. On this basis, the treatment group was given the Qiangguyin oral drug intervention for a month. Bone density surrounding the prosthesis was observed in both groups. Alkaline phosphatase and tartrate-resistant hydrochloric acid phosphatase activities were detected. Repair effects were compared.
    RESULTS AND CONCLUSION: The surgery was successfully completed in all patients. No infection or loosening of the prosthesis occurred. Ambulation time and healing time were significantly less in the observation group than in the control group (P < 0.05). No significant difference in bone density surrounding the prosthesis was detected between the two groups before medication, and an obvious increased trend was found after medication (P < 0.05). Bone density was significantly higher in the observation group than in the control group after medication (P < 0.05). Serum alkaline phosphatase activity was significantly higher in the two groups after medication, but tartrate-resistant hydrochloric acid phosphatase activity was significantly decreased, which showed significant differences as compared with that before medication (P < 0.05). Simultaneously, significant differences in serum alkaline phosphatase activity and tartrate-resistant hydrochloric acid phosphatase activity were detected between the observation and control groups after medication (P < 0.05). At 6 months after replacement, the excellent and good rate of joint function was significantly higher in the observation group than in the control group (94%, 79%, P < 0.05). These results indicate that Qiangguyin could resist bone resorption and suppress excessive bone turnover, improve bone density around the prosthesis, and restore joint function after hip 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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    Mobi-C cervical disc replacement: a five-year follow-up report in 19 cases
    Bao Da, Ma Yuan-zheng, Chen Xing
    2015, 19 (39):  6291-6295.  doi: 10.3969/j.issn.2095-4344.2015.39.011
    Abstract ( 362 )   PDF (1415KB) ( 321 )   Save

    BACKGROUND: Anterior cervical discectomy and intervertebral disc replacement have been extensively used in treatment of cervical degenerative disease. Its short-term therapeutic effects are encouraging, but it lacks of long-term and comprehensive evaluation.
    OBJECTIVE: To observe the follow-up results of a group of cases of anterior cervical discectomy and Mobi-C intervertebral disc replacement for more than 5 years.
    METHODS: A total of 25 cases of cervical spondylosis were treated in the 309 Hospital of Chinese PLA from January to September 2009. 19 of them were followed up. All patients received anterior cervical discectomy and Mobi-C intervertebral disc replacement. Twenty-three Mobi-C intervertebral disc prostheses were implanted. The range of motion was measured using lateral X-ray films during extension and flexion. Ectopic ossification was assessed by McAfee method. According to the cervical vertebra MRI images, the degeneration of adjacent segments was determined using Pearce classification. NDI score was used to evaluate the function of cervical spine. Pain improvement was evaluated using visual analogue scale score.
    RESULTS AND CONCLUSION: A total of 19 patients were followed up for 59-65 months, averagely 62 months. No significant difference in range of motion was detected before surgery and during final follow-up (P > 0.05). Ectopic ossification in two cases and the degeneration of adjacent segments in one case were found during final follow-up. No prosthesis loosening or displacement appeared. Visual analogue scale score and NDI score were significantly lower during final follow-up compared with that before surgery (P < 0.05). These results indicate that under the premise of reasonable choice of indications, the therapeutic effect of Mobi-C intervertebral disc  replacement for degenerative cervical spondylosis was satisfactory in five-year follow-up. The range of motion was good, and the incidences of ectopic ossification and the degeneration of adjacent segments were low.

    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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    Pedicle screw fixation with bone cement versus pedicle screw fixation alone for L1 compression fractures
    Yalikun•Yasen
    2015, 19 (39):  6296-6301.  doi: 10.3969/j.issn.2095-4344.2015.39.012
    Abstract ( 304 )   PDF (1319KB) ( 276 )   Save

    BACKGROUND: Vertebroplasty and edicle screw fixation are effective repair methods for thoracolumbar fractures. Spine angle loss is a more common complication after removal of implant for thoracolumbar compression fractures. Percutaneous vertebroplasty may be a better choice for preventing spine angle loss.
    OBJECTIVE: To investigate the clinical curative effect and complication of pedicle screw fixation with bone cement for repair of L1 compression fractures, and to compare with pedicle screw fixation alone.
    METHODS: A total of 76 cases of L1 compression fractures were enrolled and assigned to two groups according to fixation repair method. 40 patients in the vertebroplasty group received bone cement and pedicle screw fixation. 36 patients in the pedicle screw fixation group received pedicle screw fixation alone. Repair effects were compared between the two groups. MRI examination was conducted immediately, 3 and 6 months after surgery taking injured vertebral body as a center to measure Cobb angle and the height of anterior border of the injured vertebral body. Simultaneously, visual analogue scale score was recorded. Loosing and breakage of the fixator were seen. 
    RESULTS AND CONCLUSION: Bone union was detected within 6 months of follow-up in the two groups, no screw loosing or breakage. Kyphosis Cobb angle and the height of anterior border of the vertebral body were significantly improved at 6 months after surgery in both groups (P < 0.01). Above indexes were better in the vertebroplasty group than in the pedicle screw fixation group (P < 0.05). Visual analogue scale score was significantly improved at 6 months post surgery in both groups (P < 0.01), but no significant difference was found between the two groups (P > 0.05). These findings suggested that pedicle screw fixation with bone cement and pedicle screw fixation alone for L1 compression fracture obtained satisfactory reduction, and reconstructed the height of the vertebral body. However, results of compressive stability indicated that the fixation effect of pedicle screw fixation with bone cement was better than that of pedicle screw fixation alone. No short-term screw breakage and correction loss occurred. Perfusion with bone cement could elevate the stability of pedicle screw implantation.

    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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    Polyetheretherketone cage for treating type II and type IIa Hangman’s fractures: 6-month follow-up
    Huang Yang-liang, Zhong Yi, Liu Shao-yu
    2015, 19 (39):  6302-6308.  doi: 10.3969/j.issn.2095-4344.2015.39.013
    Abstract ( 421 )   PDF (990KB) ( 352 )   Save

    BACKGROUND: Unstable cases of Hangman’s fracture or traumatic spondylilisthesis which are type II, IIa and III should be treated surgically. Retropharyngeal approach was employed in exposure of anterior upper cervical region. However, dissection and traction around important structures make the procedure complicated and increase the chance of nerve injury.
    OBJECTIVE: To evaluate the clinical curative effect and safety of an innovative operative technique in which a polyetheretherketone cage was used to perform cervical spinal fusion for the treatment of Hangman’s fracture. 
    METHODS: Eight patients with type II or IIa Hangman’s fracture were enrolled in this study and received cervical fusions at C2/3 levels. During follow-up postoperatively, they received X-ray examination. Fusion time and implant position were evaluated. The angle of deformity (α) and the displacement distance (β) were compared pre-operatively and 6-month post-operatively to measure reduction. The functional outcomes were also compared using the Post-Traumatic Neck Score (Mayo) pre-operatively and 6-month post-operatively, while neck pain was further investigated by Visual Analogue Scale score.
    RESULTS AND CONCLUSION: All eight patients were followed-up successfully, with an average follow-up of 13 months (range 6-26 months). Compared with pre-operatively, Clinical Post-Traumatic Neck Score (Mayo) was increased, Visual Analogue Scale score, angle deformity (α) and displacement distance (β) were reduced at 6-month post-operatively (P < 0.05). Neck activity was not limited in final follow-up. Bone fusion was found in all patients at 3 or 6 months post-operatively, and no complication was detected. Results confirm that polyetheretherketone cage for type II and IIa Hangman’s fracture could achieve good outcomes and safety.

    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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    Biomechanical properties of bone cement injectable canulated pedicle screw
    Long Hai-bin, Sun Gui-sen, Wang Wei-guo
    2015, 19 (39):  6309-6314.  doi: 10.3969/j.issn.2095-4344.2015.39.014
    Abstract ( 470 )   PDF (1033KB) ( 351 )   Save

    BACKGROUND: Bony and structural feature often cause pullout strength decrease of pedicle screw, which induces loosening and pullout, and finally results in fixation failure. Thus, it is very important to elevate the stability of pedicle screw.
    OBJECTIVE: To detect the biomechanical stability of bone cement injectable canulated pedicle screw, and to provide reference for bone cement dosage. 
    METHODS: We selected T11-L4 samples of seven fresh adult corpses, containing 40 vertebral bodies. They were randomly divided into bone cement injectable canulated pedicle screw group and DTPSTM pedicle screw group (n=20). After screw implantation, 1, 2, 3 and 5 mL bone cement was injected. The diffuse distribution of bone cement was observed by imaging. The maximum axial pullout strength was measured.
    RESULTS AND CONCLUSION: When the dose of bone cement was 1-3 mL, the average maximum axial pullout strength was significantly greater in the bone cement injectable canulated pedicle screw group than in the DTPSTM pedicle screw group (P < 0.05). When the bone cement dosage was 5 mL, no significant difference in the maximum axial pullout strength was detected between the two groups (P > 0.05). The regression equation was Y=25.269X+133.681 (R2=0.837) in the bone cement injectable canulated pedicle screw, and Y=32.039X+99.251 (R2=0.936) in the DTPSTM pedicle screw group. When the dosage of bone cement was 1-5 mL, the maximum axial pullout strength was highly positively correlated with bone cement dosage (|R| > 0.8). These results suggested that bone cement augmentation pedicle screw could apparently elevate the stability of the screw. The maximum axial pullout strength of the pedicle screw was positively correlated with bone cement dosage. After reaching the satisfactory fixation effects, the bone cement injectable canulated pedicle screw can reduce bone cement dosage, diminish the risk of bone cement leakage, and have more advantages than DTPSTM pedicle screw.

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    Pedicle screw fixation for treating thoracolumbar fracture: related factors influencing vertebral height restoration
    Gui Zhong-shan, Xu Xiao-feng
    2015, 19 (39):  6315-6320.  doi: 10.3969/j.issn.2095-4344.2015.39.015
    Abstract ( 407 )   PDF (1041KB) ( 293 )   Save

    BACKGROUND: Pedicle screw fixation in the treatment of thoracolumbar fracture can effectively restore vertebral body height and physiological radian, and are widely used in the clinic. In the clinic, we found that different surgical methods on restoration of vertebral height are different. Simultaneously, there are differences in relevant factors before repair, which causes that the recovery of vertebral body height is not consistent.
    OBJECTIVE: To explore the related factors influencing the recovery of vertebral height of pedicle screw fixation system for treating thoracolumbar fracture.
    METHODS: Clinical data of 63 patients with thoracolumbar fracture, who were treated by posterior pedicle screw 
    fixation system from September 2012 to March 2015, were summarized. The fracture types were A3 or A4 type in the AO spine thoracolumbar injury classification system, including 32 cases of transpedicular screw fixation (group A) and 31 cases of beyond-injured-vertebral fixation (group B). The related factors including age, course of disease (within 3 weeks), bone mineral density, preoperative degree of vertebral compression and preoperative sagittal Cobb’s angle were recorded. The degree of vertebral height restoration was also observed. Intergroup analysis was conducted using independent sample t-test. Intragroup analysis was performed using bivariate regression analysis in single factor analysis. Multivariate linear regression analysis was applied for multivariate analysis so as to explore the factors related to vertebral height restoration.
    RESULTS AND CONCLUSION: No significant difference in preoperative rate of vertebral compression or Cobb’s angle was detected between the two groups (P > 0.05). Postoperative rate of vertebral height restoration of group A was significantly greater than group B (P < 0.05). Univariate analysis within the group showed that course of disease, preoperative degree of vertebral compression and bone mineral density were strongly associated with the restoration of vertebral height (P < 0.05). In contrast, there was no significant correlation between age, preoperative sagittal Cobb’s angle and the restoration of vertebral height (P > 0.05). Multiple linear regression analysis showed that the preoperative degree of vertebral compression and the course of disease were the predominant factors affecting the vertebral height restoration. The standardized partial regression coefficients were 0.225, -0.621, respectively. These results demonstrate that transpedicular screw fixation can more effectively restore vertebral height than traditional beyond-injured-vertebral internal fixation. The preoperative vertebral compression and course of diseases are the predominant factors affecting the vertebral height restoration, which can predict postoperative vertebral height restoration.

    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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    Semi-restricted non-fusion system (Cosmic) in the treatment of lumbar degenerative disease: mid-term follow-up outcomes
    Li Er-nan, Kuang Zheng-da
    2015, 19 (39):  6327-6332.  doi: 10.3969/j.issn.2095-4344.2015.39.017
    Abstract ( 250 )   PDF (1099KB) ( 301 )   Save

    BACKGROUND: Compared with rigid internal fixation, semi-restricted non-fusion system (Cosmic) can reduce the destruction of lumbar physiological structure during operation, partly retain the range of motion, maintain the stability of surgical segment, and help to prevent the adjacent segment degeneration.
    OBJECTIVE: To observe the mid-term follow-up outcome of semi-restricted non-fusion system (Cosmic) in the treatment of lumbar degenerative disease.
    METHODS: 21 patients with lumbar degenerative disease, including 10 male patients and 11 female patients, at the age of 19-63 years old, received posterior decompression by fenestration, nucleotomy, and Cosmic system internal fixation. Visual analogue scale score and Oswestry disability index were used for clinical evaluation. Intervertebral height and range of motion of surgical segment and the proximal adjacent segment were collected before and after operation.
    RESULTS AND CONCLUSION: All the patients were followed up for 15-48 months. No internal fixator loosening or rupture was found during the follow-up. The visual analogue scale score and Oswestry disability index at the last follow-up were lower than those before operation (P < 0.01). During the last follow-up, there were no significant differences in the intervertebral height of surgical segment and the proximal adjacent segment, and the range of motion of surgical segment was lower than that before operation (P < 0.01). No significant difference was found in range of motion of the proximal adjacent segment. These results suggest that semi-restricted dynamic
    non-fusion system (Cosmic) can reduce the destruction of lumbar physiological structure during operation, partly retain the range of motion, maintain the stability of surgical segment, and help to prevent the adjacent segment degeneration with well mid-term follow-up outcomes.

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    Different implants for unstable intertrochanteric fractures in senile patients: biocompatibility characteristics
    Zeng Hao, Liu Zhong, Wu Feng
    2015, 19 (39):  6339-6344.  doi: 10.3969/j.issn.2095-4344.2015.39.019
    Abstract ( 292 )   PDF (941KB) ( 353 )   Save

    BACKGROUND: There was a variety of surgery treatment method in senile patients with unstable intertrochanteric fractures, such as hip replacement and internal fixation, but there was a great deal of controversy about advantages and disadvantages of different methods.
    OBJECTIVE: To evaluate clinical effect and safety of total hip replacement, hemiarthroplasty and proximal femoral nail in senile patients with unstable intertrochanteric fractures.
    METHODS: 103 senile patients with unstable intertrochanteric fractures were selected, including 43 males and 60 females at the age of 62 to 80 years old. There were 28 cases of total hip replacement, 34 cases of 
    hemiarthroplasty and 41 cases of proximal femoral nail. Perioperative complications and recovery of hip function after repair were compared among three groups.
    RESULTS AND CONCLUSION: (1) The incidence of postoperative complications of internal medicine was higher in the proximal femoral nail group than in the total hip replacement and hemiarthroplasty groups (P < 0.05). No significant difference in the incidence of complications was found between the hemiarthroplasty and total hip replacement groups. (2) The incidence of prosthesis complications was lower in the total hip replacement group than in the hemiarthroplasty and proximal femoral nail groups (P < 0.05). No significant difference in the incidence of prosthesis complications was detectable between the total hip replacement and hemiarthroplasty groups. (3) The recovery of hip function was better in the total hip replacement and hemiarthroplasty groups than in the proximal femoral nail group during 12-month follow-up (P < 0.05), and no significant difference in the recovery of hip function was found between the total hip replacement and hemiarthroplasty groups. These results showed that total hip replacement and hemiarthroplasty had good curative effect on unstable intertrochanteric fractures in senile patients, and could effectively restore the hip function and reduce 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

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    Proximal femoral nail anti-rotation and dynamic hip screw for treating intertrochanteric fractures in the aged patients: hip function
    Wu Xian-hong, Liu Jia-su, Ding Xue-ming, Liu Chuan-jiang
    2015, 19 (39):  6345-6349.  doi: 10.3969/j.issn.2095-4344.2015.39.020
    Abstract ( 442 )   PDF (671KB) ( 342 )   Save

    BACKGROUND: Internal fixation is commonly used in an early stage of intertrochanteric fractures of the aged worldwide, and can apparently reduce complications and fatality rate. The commonly used internal fixators contain proximal femoral nail anti-rotation and dynamic hip screw, whose comparison is current research hotspot.
    OBJECTIVE: To evaluate the hip function and stability after internal fixation with proximal femoral nail anti-rotation and dynamic hip screw in repair of intertrochanteric fractures of the aged. 
    METHODS: A total of 64 aged patients with intertrochanteric fractures were enrolled in this study, and assigned to dynamic hip screw group (n=30) and proximal femoral nail anti-rotation group (n=34). The fracture reduction and healing were evaluated using anterioposterior and lateral X-ray films. Operation time, intraoperative blood loss, complication rate, healing time and postoperative hip function were compared and analyzed between the two groups, and then assessed in accordance with Sander’s scoring system.
    RESULTS AND CONCLUSION: Compared with dynamic hip screw group, operation time, intraoperative blood loss, healing time and complication rate after treating unstable intertrochanteric fracture (Tronzo-Evans III, IV and V types) showed significant advantages in the proximal femoral nail anti-rotation group (P < 0.05). Hip function restored better, and the complication rate of stable intertrochanteric fracture (Tronzo-Evans I and II types) was lower after treatment in both groups (P > 0.05). These data show that the effects of proximal femoral nail anti-rotation were better than that of dynamic hip screw for treatment of intertrochanteric fractures, and hip function recovered better. Moreover, proximal femoral nail anti-rotation had biomechanical stability, especially for unstable 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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    Bilateral external fixation combined with limited internal fixation in the repair of open fractures of middle and distal tibia and fibula: reliable fixation on the broken ends
    Liu Jian, Tian Bao-fang, Wang Wen-zhu, Zheng Wei-dong, Feng Li, Du Bao-yin, Tian Da-wei
    2015, 19 (39):  6350-6354.  doi: 10.3969/j.issn.2095-4344.2015.39.021
    Abstract ( 352 )   PDF (891KB) ( 318 )   Save

    BACKGROUND: Open fracture of tibia and fibula is a common fracture of long bones. Simple external fixation is often difficult to achieve thorough and effective reduction and fixation. Shortcomings of open reduction and internal fixation highlighted in the high incidence of postoperative complications, and seriously affected the recovery of joint function. Therefore, external fixation combined with internal fixation for repair of open fractures of tibia and fibula has been extensively used in the clinic. 
    OBJECTIVE: To explore the repair efficacy of bilateral external fixation combined with limited internal fixation on  
    open fractures of middle and distal tibia and fibula.
    METHODS: Clinical data of 56 patients, who were identified by X-ray or CT examination and were diagnosed as having open fractures of middle and distal tibia and fibula in the Jining No.1 People’s Hospital, as the treatment group, were retrospectively analyzed from January 2009 to January 2013. Patients were subjected to thorough debridement, reduction of the fracture fragments, limited internal fixation and fixed bilateral external fixation within 8 hours. They received stage I suture. When the local conditions of the wound permitted, they received stage II grafting, and were repaired with adjacent muscle flap or free flap. The efficacy and postoperative complication were observed. Above data were compared with those of 44 patients with open fractures of middle and distal tibia and fibula who received reduction and internal fixation (control group).
    RESULTS AND CONCLUSION: Among the 56 patients in the treatment group, the outcomes were excellent in 35 cases, good in 16 cases, average in 4 cases and poor in 1 case. The excellent and good rate was 91%. Among the 44 patients in the control group, the outcomes were excellent in 23 cases, good in 10 cases, average in 7 cases and poor in 4 cases. The excellent and good rate was 75%. The excellent and good rate was significantly higher in the treatment group than that of the control group (P < 0.05). Significant differences in incision length, operation time, fracture healing time and bone nonunion rate were detected between the two groups, and above indexes were better in the treatment group than in the control group (P < 0.05). These findings verify that bilateral external fixation combined with limited internal fixation for open fractures of middle and distal tibia and fibula is reliable, can significantly reduce postoperative complications after internal fixation, promote the healing of fracture, and is conducive to the early recovery training of the affected limb.

    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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    Minimally invasive and open reduction plate fixation for proximal humerus fractures: range of motion of the shoulder joint
    Li Dong, Zhang Guang-wu, Liu Jia-bang
    2015, 19 (39):  6355-6359.  doi: 10.3969/j.issn.2095-4344.2015.39.022
    Abstract ( 344 )   PDF (845KB) ( 268 )   Save

    BACKGROUND: The conservative treatment of humeral fracture is difficult to achieve a good reduction. Minimally invasive percutaneous plate fixation has been widely used, and has good repair results, but the specific mechanism of action is not clear.
    OBJECTIVE: To compare the repair effect of different fixation methods on proximal humerus fractures.
    METHODS: From August 2011 to October 2014, we selected 96 patients with proximal humerus fractures from the Shougang Hospital of Peking University. These patients were equally divided into two groups according to the principle of random draw. Patients in the control group were treated with open reduction and conventional surgery fixation. Patients in the treatment group received minimally invasive percutaneous plate fixation. Operation time, intraoperative blood loss, incision length and postoperative hospital stay were recorded in both groups. At 8 weeks after treatment, patients received radiography to identify the reduction. Range of motion of the shoulder joint was scored. Within 8 weeks after treatment, the occurrence of complications was observed and compared in  
    both groups.
    RESULTS AND CONCLUSION: Intraoperative blood loss, incision length and postoperative hospital stay were significantly less in the treatment group than in the control group (P < 0.05). No significant difference in operation time was found between the two groups (P > 0.05). At 8 weeks after treatment, the excellent and good rate of会reduction was significantly higher in the treatment group than in the control group (98%, 81%, P < 0.05). Flexion, abduction, external rotation and internal rotation scores were significantly higher in the treatment group than in the control group (P < 0.05). Bone compartment syndrome, vascular injury, infection and bleeding were significantly lower in the treatment group than in the control group (P < 0.05). These findings confirm that compared with open reduction and internal fixation, minimally invasive percutaneous plate fixation of proximal humerus fractures has less impact on the body, can promote reduction of the fracture, has few complications, and contributes to the recovery of shoulder function.

    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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    A randomized controlled comparison between digital three-dimensional reconstruction and percutaneous balloon kyphoplasty
    Wang Lei, Wang Li-ming, Huang Yan, Lu Qin
    2015, 19 (39):  6360-6365.  doi: 10.3969/j.issn.2095-4344.2015.39.023
    Abstract ( 458 )   PDF (1240KB) ( 286 )   Save

    BACKGROUND: Experience of the surgeon has a direct effect on the operation time and the repair effect of percutaneous balloon kyphoplasty. Digital technology-assisted rehabilitation program opened up new ideas.
    OBJECTIVE: To compare the differences of operation time and repair effect between digital technology and percutaneous balloon kyphoplasty.
    METHODS: A total of 64 patients treated with percutaneous balloon kyphoplasty in the Department of Orthopedics of the Second People’s Hospital of Huaian from January 1, 2013 to November 20, 2014 were enrolled in this study. Using a randomized controlled method, according to the order of admission, odd number received digital technology-assisted percutaneous balloon kyphoplasty (experimental group). Even number received percutaneous balloon kyphoplasty (control group). Onset age, preoperative visual analogue scale score, operation time, 3-day postoperative visual analogue scale score and the decreased value of visual analogue scale score were compared and analyzed between the two groups.
    RESULTS AND CONCLUSION: Significant differences in operation time, 3-day postoperative visual analogue scale score and the decreased value of visual analogue scale score were detected between the two groups (P < 0.05), and above indexes were better in the experimental group than in the control group. These findings confirm that digital technology-assisted percutaneous balloon kyphoplasty could significantly shorten operation time, optimize repair program, obtain ideal repair effect and elevate patient satisfaction.

    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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    Digital internal fixation for proximal tibial fracture guides clinical restorative treatment
    Chen Xuan-huang, Wu Xian-wei, Lin Hai-bin, Wu Chang-fu, Zheng Feng, Guo Qing-qing, Zhang Guo-dong
    2015, 19 (39):  6366-6372.  doi: 10.3969/j.issn.2095-4344.2015.39.024
    Abstract ( 494 )   PDF (2792KB) ( 469 )   Save

    BACKGROUND: On CT reconstruction of three-dimensional model, fracture virtual reduction and internal fixation cannot be achieved, so reasonable operation scheme cannot be formulated. It cannot fully meet the needs of clinical orthopedics physicians.
    OBJECTIVE: To explore the methods to perform three-dimensional reconstruction, reduction on proximal tibial fracture and designing digital internal fixation using Mimics and Solidworks software, and to guide the operation and to observe the clinical efficacy.
    METHODS: A total of 40 cases of proximal tibial fracture patients were enrolled and treated with high-speed CT scan. Three-dimensional reconstruction and reduction were performed in Mimics. The plates and screws were designed and selected in Solidworks. Virtual internal fixation on the reduced three-dimensional models was performed. This operation scheme was prepared and applied. Union of fracture and self-evaluation (MacNab standard) were observed after surgery.
    RESULTS AND CONCLUSION: Three-dimensional reconstruction, reduction and accurate fixation of plates and screws were conducted in all bone fracture models. The clinical operation was smoothly going, completed successfully according to the digital scheme of the preoperative design. The curative effect is satisfied. A total of 40 patients were followed up for 12-24 months. The time of fracture union was 12-18 weeks, averagely 13.6 weeks. The time of complete weight loading was 15-17 weeks, averagely 15.8 weeks. In accordance with MacNab standard, there were excellent in 29 cases, good in 9 cases, average in 2 cases, poor in 0 case, with the excellent and good rate of 95%. Plate and screw specifications, screw length, diameter, position, and angle were consistent with preoperative data. These findings show that the digital scheme of internal fixation for proximal tibial fracture could be designed in Mimics and Solidworks with a personal computer. Our experience can provide a good reference for the practical operation

    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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    Intertrochanteric fracture: design and biomechanical evaluation of triangle truss locking plate
    Miao Xu-man, Zuo Hao, Yao Shu-zhi
    2015, 19 (39):  6373-6378.  doi: 10.3969/j.issn.2095-4344.2015.39.025
    Abstract ( 478 )   PDF (702KB) ( 309 )   Save

    BACKGROUND: The design of proximal femoral locking compression plate existed defects. Therefore, our team designed triangle truss locking plate with hyper-short arm according to proximal femoral locking compression plate (patent No. 201220051751.2).
    OBJECTIVE: To design and make triangle truss locking plate and evaluate its biomechanical properties. 
    METHODS: Triangle truss locking plate with hyper-short arm was designed based on the support of two proximal screws of proximal femoral locking compression plate. Five pairs of fresh adult femur specimens were prepared, and the model of A3.1 (AO classification) reverse intertrochanteric fracture was established. Experimental group (right side) was fixed with triangle truss locking plate. Control group (left side) was fixed with proximal femoral locking compression plate. Stress distribution of the screws of proximal end of the plate, stress distribution of the fracture ends, the opening angle of fracture, and maximum load were detected.
    RESULTS AND CONCLUSION: (1) Stress distribution of the four screws of the proximal femoral locking compression plate was average in the experimental group, and the stress distribution of the two screws of triangle truss locking plate was close. Stress distribution of the four screws was not average in the control group. The proximal screw bearing stress was bigger in the control group than in the experimental group (P < 0.05). (2) Open angle under different loads were significantly smaller in the experimental group than in the control group (P < 0.05).    (3) Maximum load was higher in the experimental group than in the control group (P < 0.05). Moreover, the position of damage was different between the two groups. The fixation in the experimental group was reasonable. These findings suggest that various biomechanic properties of the triangle truss locking plate with hyper-short arm were better than that of proximal femoral locking compression plate. Its fixation was reliable. Triangle truss locking plate could effectively reduce or avoid breakage of the plate and screw or coxa vara. 

    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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    Improved design and biomechanical characteristics of the rotary self-locking intramedullary nail of the humerus
    Bai Xiao-bing, Zhao Qin-peng
    2015, 19 (39):  6379-6384.  doi: 10.3969/j.issn.2095-4344.2015.39.026
    Abstract ( 240 )   PDF (766KB) ( 299 )   Save

    BACKGROUND: Humeral fractures can be treated by using rotary self-locking intramedullary nail. The previous spin in self-locking intramedullary nail has some limitations in application, so it should be improved in its design so as to obtain better biomechanical effect.
    OBJECTIVE: To improve the design of the rotary self-locking intramedullary nail of the humerus, and to analyze its biomechanical characteristics and application effect, and to provide reference for the clinical treatment of humeral fractures.
    METHODS: (1) The design of the rotary self-locking intramedullary nail was improved and tested by mechanics test. (2) A total of 63 cases of humeral fractures were randomly divided into two groups: control group (31 cases) and experimental group (32 cases). Patients in the control group received conventional rotary self-locking intramedullary nail, and patients in the experimental group received improved nail.
    RESULTS AND CONCLUSION: Results of mechanical test concerning anti-axial compression, tensile, torsion and bending were obviously better after improvement than before improvement. No significant difference in range of motion was detected between the two groups (P > 0.05). Compared with that before treatment, the range of motion was significantly increased after treatment in both groups (P < 0.01 or P < 0.05). The range of motion was significantly higher in the experimental group than in the control group (P < 0.05). Simultaneously, the excellent and good rate was significantly higher in the experimental group than in the control group (P < 0.05). These data
    suggest that the improved rotary self-locking intramedullary nail has better mechanical characteristics and can obtain better clinical 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

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    Pedicle screw fixation for scoliosis using Iso-C arm three-dimensional navigation: problems and advantages
    Chen Qiang, Zhang Yi-yuan, Lin Miao-kuo, Feng Er-you
    2015, 19 (39):  6385-6389.  doi: 10.3969/j.issn.2095-4344.2015.39.027
    Abstract ( 334 )   PDF (783KB) ( 424 )   Save

    BACKGROUND: Due to variation of spinal anatomic structure, vertebral body rotation, absence of vertebral body, and spinal canal deformation in patients with scoliosis, the deviation of pedicle screw placement can induce catastrophic results. Recently, with the wide application of pedicle screw and the continuous development of computer navigation, scoliosis surgery becomes more accurate and safe.
    OBJECTIVE: To review the existing problems and advantages of Iso-C arm three-dimensional (3D) navigation system for guiding internal fixation of pedicle screw implantation in the treatment of scoliosis.
    METHODS: The first author searched PubMed (http://www.ncbi.nlm.nih.gov/PubMed) and CNKI (http://www.cnki.net/) for articles published until December 2012. The key words were “computer navigation, scoliosis, pedicle screw”. The literatures with abstracts containing above key words were retrieved. Totally more than 50 articles were found, and 13 articles were accorded with the inclusion criteria.
    RESULTS AND CONCLUSION: Iso-C arm 3D navigation system for guiding internal fixation of pedicle screw implantation in the treatment of scoliosis had obvious advantages. It fully combined the advantages of CT 3D navigation and intraoperative X-ray navigation, and can quickly and accurately capture the image data. Real time display of images could ensure the safety of repair operation. Automatic registration function of Iso-C arm 3D navigation undoubtedly improves the efficiency and accuracy of the repair, and helps physicians with more accurate and safe ways to carry out a variety of complex scoliosis 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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    Micro-titanium plate fixation versus suture suspension fixation in cervical posterior expansive open-door laminoplasty: a meta-analysis
    Ruan Wen-feng, Jin Qi, Liu Hui, Wang Wen-da, Li Jing-feng, Feng Fan, Ping An-song
    2015, 19 (39):  6390-6396.  doi: 10.3969/j.issn.2095-4344.2015.39.028
    Abstract ( 410 )   PDF (761KB) ( 446 )   Save

    BACKGROUND: Many studies concern the comparison of micro-titanium plate fixation and suture suspension fixation during cervical posterior expansive open-door laminoplasty, but the sample size of many studies has limitations. There is lack of objective evaluation on advantages and disadvantages of micro-titanium plate.
    OBJECTIVE: To systemically evaluate the efficacy and safety of micro-titanium plate fixation versus suture suspension fixation in cervical posterior expansive open-door laminoplasty.
    METHODS: English and Chinese randomized controlled trials were searched by two reviewers. They retrieved 
    the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMbase, the ISI Web of Knowledge Database, CNKI, CMB, VIP and Wanfang database for randomized controlled trials addressing micro-titanium plate fixation versus suture suspension fixation in cervical posterior expansive open-door laminoplasty published from database foundation to March 1, 2015. The references were also searched by hand. Meta-analyses were performed by using the Rev-Man 5.3 software, provided by the Cochrane Collaboration.
    RESULTS AND CONCLUSION: A total of 9 studies involving 642 patients were included. The results of meta-analyses showed that: (1) safety: There were no significant differences between the two groups in operation time [SMD=-0.02, 95%CI (-0.57, 0.54), P=0.95 > 0.05], and intraoperative blood loss [SMD=0.07, 95%CI (-0.26, 0.40), P=0.69 > 0.05]. (2) Efficacy: compared with suture suspension fixation, Japanese Orthopaedic Association Scores were higher [SMD=0.26, 95%CI (0.10, 0.42), P=0.001 < 0.05], the angle of the opened laminae was bigger [SMD=0.25, 95% CI (0.02, 0.48), P=0.04 < 0.05], cervical curvature was better [SMD=0.46, 95% CI (0.27, 0.65), P < 0.000 01], and incidence of axial symptoms was lower [RR=0.40, 95% CI (0.29, 0.56), P < 0.000 01] after micro-titanium plate fixation. These findings suggest that during expansive open-door laminoplasty for treatment of cervical spondylosis, micro-titanium plate fixation and suture suspension fixation can obtain good clinical outcomes. However, Japanese Orthopaedic Association Scores were higher and the angle of the opened laminae was better in micro-titanium plate fixation than in suture suspension fixation. Micro-titanium plate fixation could effectively prevent loss of cervical curvature and reduce the incidence of axial symptoms. For the poor quality of the original studies and small sample size, a prudent choice is suggested. More high-quality large-sample studies are needed for further 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

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