Table of Content

22 January 2016, Volume 20 Issue 4 Previous Issue    Next Issue

For Selected:

Download Citations EndNote Reference Manager ProCite BibTeX RefWorks

Toggle Thumbnails

Select

Comparison of perioperative blood loss and transfusion rate in primary unilateral total hip arthroplasty by topical, intravenous application or combined application of tranexamic acid Zhao Qing-bin, Ren Jiang-dong, Zhang Xiao-gang, Wu Hu-zi•Wu Lamu 2016, 20 (4):  459-463.  doi: 10.3969/j.issn.2095-4344.2016.04.001 Abstract ( 387 )   PDF (447KB) ( 524 )   Save BACKGROUND: The tranexamic acid has been widely used in hip arthroplasty. Studies have confirmed that the safety and efficacy of tranexamic acid when it is used in topical or intravenous application, but the effects are not clear when it is used in both topical and intravenous application. OBJECTIVE: To compare perioperative blood loss and transfusion rate in primary unilateral total hip arthroplasty with topical, intravenous and both injection of tranexamic acid.  METHODS: 136 patients undergoing primary unilateral total hip arthroplasty in the First Affiliated Hospital, Xinjiang Medical University between July 2014 and June 2015 were divided into three groups. Topical group: a total of 1 g tranexamic acid was given in the articular cavity of 44 cases. Intravenous group: 1 g tranexamic acid was immersed in 250 mL physiological saline, and given 10 minutes before operation in 44 cases. Combined group: 1 g tranexamic acid was intravenously given before operation, and then given in the articular cavity in 48 cases. Total blood loss, transfusion rate, the maximum hemoglobin decrease, the maximum hematocrit decrease, and incidence of deep vein thrombosis were compared among the three groups.  RESULTS AND CONCLUSION: Total blood loss, the maximum hemoglobin decrease and the maximum hematocrit decrease were significantly lower in the combined group than in the topical group and intravenous group (P < 0.01). No significant difference in total blood loss, the maximum hemoglobin decrease and the maximum hematocrit decrease was detected between the topical group and intravenous group (P > 0.05). Doppler ultrasound examination of lower limb blood vessel at 5 days and 1 month after surgery in 136 patients did not demonstrate deep vein thrombosis. None of them suffered from pulmonary embolism. These findings confirm that intravenous and topical application of tranexamic acid could obviously reduce blood loss in patients with total hip arthroplasty. Curative effect and safety were superior to intravenous or topical application alone. No significant difference in transfusion rate was detected among the three methods.  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 Figures and Tables | References | Related Articles | Metrics

Select

Safety and effectiveness of autologous blood transfusion after total hip arthroplasty Zhao Ji-tong, Jiang Zhong, Chen Jun-feng, Cao Xiao-dong, Luo Yuan, Shen Wei-zhong 2016, 20 (4):  465-469.  Abstract ( 270 )   PDF (464KB) ( 381 )   Save BACKGROUND: Autologous blood transfusion device has been widely used in the clinic, reduces allogeneic blood transfusion, and avoids the occurrence of blood transfusion complications, and effectively improves the patient’s blood safety, but the application of autologous blood transfusion after total hip arthroplasty has been seldom reported. OBJECTIVE: To discuss the safety and effectiveness of autologous blood transfusion after total hip arthroplasty. METHODS: 200 patients were treated by primary unilateral total hip arthroplasty from March 2013 to March 2015. They were randomly divided into two groups. 127 patients in the autologous blood transfusion group received  autologous blood transfusion by a drainage tube. 73 patients in the negative pressure drainage ball group received a negative pressure drainage tube. The standard for allogeneic blood transfusion after replacement was hemoglobin < 80 g/L. The changes in hemoglobin were compared before and 1 and 7 days after replacement between the two groups. Total drainage volume and allogeneic blood transfusion were compared within 6 hours after replacement between the two groups.  RESULTS AND CONCLUSION: There were no statistical differences in hemoglobin levels at 7 days before and after replacement, in drainage volume within 6 hours and the total drainage volume between the two groups (P > 0.05). Hemoglobin levels were significantly higher in the autologous blood transfusion group than in the negative pressure drainage ball group at 1 day after replacement (P < 0.05). In the autologous blood transfusion group, autologous blood transfusion volume was averagely 324.2 mL. Allogeneic blood transfusion volume was averagely 146.7 mL in 31 patients. No reaction was found after autologous blood transfusion. In the negative pressure drainage ball group, 49 patients received allogeneic blood transfusion (averagely 261 mL). The volume and proportion of allogeneic blood transfusion were significantly lower in the autologous blood transfusion group than in the negative pressure drainage ball group (P < 0.05). Among patients receiving allogeneic blood transfusion, seven patients affected pyrogenetic reaction during blood transfusion. These findings suggested that autologous blood transfusion is simple and effective, can effectively reduce the volume and reaction of allogeneic blood transfusion after total hip arthroplasty and avoid blood-borne diseases, with good prospects.    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   Figures and Tables | References | Related Articles | Metrics

Select

Application of individual preoperative simulation osteotomy on selecting tibia prosthesis in total knee arthroplasty Liao Hong-xing, Zou Xue-nong, Huang Jian, Liu Zhan-liang 2016, 20 (4):  470-475.  doi: 10.3969/j.issn.2095-4344.2016.04.003 Abstract ( 351 )   PDF (515KB) ( 491 )   Save BACKGROUND: Inappropriate size of tibia prosthesis will affect the stability and long term curative effect of knee joint. Raising the tibia prosthesis bone coverage through preoperative analysis may further reduce the incidence of loosing and sinking of tibia prosthesis. OBJECTIVE: To select the appropriate prosthesis and maximize the tibia prosthesis bone coverage rate through the three dimensional reconstruction of CT and preoperative tibia osteotomy simulation among the patients preliminarily treated with total knee arthroplasty.  METHODS: Totally 76 (84 knees) patients treated with total knee arthroplasty were enrolled and randomly divided into test group (38 cases, 41 knees) and control group (38 cases, 43 knees). All the patients in the test group were underwent CT scan and three-dimensional reconstruction of CT before operation. Preoperative tibia osteotomy was stimulated. The most appropriate tibia prosthesis was selected by comparatively analyzing the data of tibia osteotomy, and maximizing the tibial plateau prosthesis bone coverage. Three-dimensional reconstruction of CT was absence in the control group by contrast. Tibia plateau bone coverage of patients in these two groups after replacement was evaluated. The repair effect was evaluated during the follow-up. RESULTS AND CONCLUSION: Totally 75 patients were followed up for 13 to 56 months. One patient in the test group withdrew from the study because of periprosthetic fractures. Analyzing from the follow-up after replacement, tibia plateau prosthesis coverage rates of test group and control group were (89.87±4.14)%, (83.15±5.21)% respectively; New York Hospital for Special Surgery scores were respectively (87.48±8.69) points and (82.37±10.14) points, the difference was statistically significant (P < 0.05). However, there were no significant differences in the range of motion and postoperative complications between test and control groups (P > 0.05). These results suggest that choosing the most appropriate type of tibia prosthesis by applying three-dimensional reconstruction of CT and preoperative tibia osteotomy on patients treated with total knee arthroplasty can improve tibial plateau prosthesis bone coverage rate and is conductive to achieve a satisfactory repair 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 Figures and Tables | References | Related Articles | Metrics

Select

Functional recovery and complications in elderly patients with total knee arthroplasty after patellar lateral displacement Sun Feng, Wang Jun-xin, Wang Li-ming, Wang Tong 2016, 20 (4):  476-480.  doi: 10.3969/j.issn.2095-4344.2016.04.004 Abstract ( 419 )   PDF (464KB) ( 376 )   Save BACKGROUND: Artificial total knee arthroplasty in the treatment of knee osteoarthritis can effectively eradicate the late knee pain, correct deformity, improve joint function, but the use of patella is not conducive to the recovery, and it is easy to cause postoperative complications. Therefore, patellar lateral shift, instead of patella minimally invasive therapy, has attracted more and more people’s attention, which increased excellent and good rate of operation. OBJECTIVE: To investigate the effects of patellar turnover and patellar lateral displacement on knee function  recovery and complications of elderly patients with total knee arthroplasty. METHODS: A total of 80 knees of 40 elderly patients with bilateral knee osteoarthritis were selected. All patients according to the random number table method were divided into two groups with 40 knees of 20 cases in each group. The patients in the study group received patellar lateral shift operation, while the patients in the control group received the patellar turnover. Curative effects, the recovery of knee joint function and occurrence of complications were compared between the two groups at 1 week, 3 months, 6 months and 1 year after arthroplasty.  RESULTS AND CONCLUSION: No significant difference in 90° flexion time in the knee was detected between the two groups after replacement (P > 0.05). Active straight leg raising time was shorter in the study group than in the control group (P < 0.05). No significant difference in passive range of motion was detectable between the two groups at 6 months after replacement. Active and passive ranges of motion were significantly better in the study group than in the control group at various time points (P < 0.05). There were no significant differences in Visual Analog Scale pain scores and postoperative complications between the two groups (P > 0.05). These results verified that patellar lateral displacement for elderly patients with total knee arthroplasty is conducive to early knee function recovery after surgery, and it is safe and reliable.  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   Figures and Tables | References | Related Articles | Metrics

Select

Effect of femoral intramedullary guides on prosthesis arrangement in total knee arthroplasty Li Le-xiang, Xue Feng, Sheng Xiao-wen, Peng Yu-qin 2016, 20 (4):  481-485.  doi: 10.3969/j.issn.2095-4344.2016.04.005 Abstract ( 328 )   PDF (515KB) ( 351 )   Save BACKGROUND: The femoral intramedullary guides in total knee arthroplasty require high precision, complex operation, it is very important for prosthesis and joint function to choose more precise positioning method and determine the correct needle point. OBJECTIVE: To study the effect of needle point position on prosthesis arrangement when applying different femoral intramedullary guides methods in total knee arthroplasty. METHODS: Totally 80 patients who received the treatment of total knee arthroplasty in Changshu No.1 People’s Hospital from January 2012 to July 2015 were selected and divided into test and control groups according to random number table (n=40/group). The patients in the test group accepted CT scan for femoral   intramedullary guides. The theoretical position of femoral intramedullary guides entry point was marked using radiographic parameters. In the control group, the traditional total knee arthroplasty technology was used to mark the entry point of femoral intramedullary guides. The needle point position when applying different femoral intramedullary guide methods was observed. The effect of femoral intramedullary guides on prosthesis arrangement in total knee arthroplasty was discussed. RESULTS AND CONCLUSION: Compared with the control group, the distance from entry point to femoral anatomic line on positive and lateral X-ray film in the test group was shorter, femoral prosthesis lateral angle and physiological valgus angle were closer to the theoretical value, distance from intersection of femur axis and femoral condyle to block center was shorter; the differences were statistically significant (P < 0.05). These results demonstrate that compared with the traditional two-dimensional intramedullary positioning, the needle point position of three-dimensional CT scan stimulative positioning is more accurate. The location more concentrates on within intercondylar fossa 2-5 mm, more front of intercondylar fossa 3-10 mm, three-dimensional CT scan stimulative positioning is a reliable choice for femoral intramedullary guides.  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 Figures and Tables | References | Related Articles | Metrics

Select

Total knee replacement for severe gouty knee arthritis Liu Kang, Guo Guo-dong, Zhao Jian-ning 2016, 20 (4):  486-491.  doi: 10.3969/j.issn.2095-4344.2016.04.006 Abstract ( 561 )   PDF (599KB) ( 376 )   Save BACKGROUND: The number of patients undergoing total knee replacement due to severe gouty arthritis is increasing rapidly in recent years, and the ages of patients also present younger and younger. However, its clinical efficacy remains controversial, and it is lack of retrospective systematic analysis. OBJECTIVE: To assess the clinical efficacy of total knee replacement for severe gouty knee arthritis from several aspects, such as pain, function, quality of life and complications.  METHODS: From January 2006 to January 2015, 17 patients (20 knees) with severe knee gouty arthritis received  total knee replacement in Department of Orthopedics of Nanjing General Hospital of Nanjing Military Region of Chinese PLA. They underwent knee joint surface replacement with posterior cruciate ligament, and patella was not replaced. Posterior stabilized prosthesis was used. All patients were successfully followed up postoperatively. The Hospital for SpecialSurgery Knee Score, range of motion of the knee, Visual Analogue Scale score and SF-36 scale scores were determined before and after replacement and during final follow-up. RESULTS AND CONCLUSION: Patients were followed up for 1-9 years. No serious complications occurred during and after replacement. The Hospital for Special Surgery Knee Score, range of motion of the knee, Visual Analogue Scale score and SF-36 scale scores were significantly higher after replacement and during final follow-up than those before replacement (P < 0.001). X-ray films showed good prosthesis position, satisfactory limb alignment without radiolucent lines or loosing. These findings verified that total knee replacement was considered as the final way to treat the severe gouty knee arthritis; its short-term clinical effect is significant, but systematic anti-uric acid, prevention and treatment of complications, pain control, function exercising, and healthy mood maintenance were needed to get a better long-term clinical efficacy.  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   Figures and Tables | References | Related Articles | Metrics

Select

Inflammatory reactions-STAT signaling pathway in the mechanism underlying titanium metal ion-mediated osteolysis  Zhao Wen-jie, Dai Min, Zhang Bin, Wan Xi-zhen, Fan Hong-xian 2016, 20 (4):  492-496.  doi: 10.3969/j.issn.2095-4344.2016.04.007 Abstract ( 653 )   PDF (537KB) ( 2134 )   Save BACKGROUND: Inhibition of osteolysis is an important manner to reduce prosthesis loosening, but the mechanism of osteolysis is still unclear. OBJECTIVE: To analyze the correlation of inflammatory reaction-JAK/STAT signal transduction pathway and titanium metal ion-mediated osteolysis.  METHODS: A total of 50 Kunming mice were divided into five groups. In the sham group, the cranium was injected with physiological saline. In other four groups, the cranium was injected with titanium metal wear particle suspension to establish models of calvarial osteolysis. On day 2 after model establishment, mice in three groups were separately intraperitoneally injected with low-, moderate- and high-dose (1, 10, 100 μmol/L) JAK inhibitor   AG490 10 mL/kg, once a day. 28 days later, osteolysis area, number of osteoclasts, tumor necrosis factor α, vascular endothelial growth factor and interleukin-10 levels, JAK1/2/3 and STAT1/3 protein expression, and Caspase3/9 protein expression were detected in each group. RESULTS AND CONCLUSION: (1) Compared with the sham surgery group, osteolysis area of mice was significantly larger in the model group (P < 0.01), and the number of osteoclast was significantly more, and inflammatory factor levels were significantly higher (P < 0.01). JAK/STAT signaling pathway protein and apoptotic protein expressions were significantly higher (all P < 0.01). (2) Compared with the model group, osteolysis area was smaller, the number of osteoclasts was less, inflammatory factor levels were significantly less, JAK/STAT signaling pathway protein and apoptotic protein expression was significantly less in the moderate- and high-dose AG490 groups (all P < 0.01). (3) These findings suggested that JAK inhibitor AG490 alleviates titanium metal ion-mediated osteolysis by inhibiting inflammatory reactions and JAK/STAT signaling transduction pathway.  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   Figures and Tables | References | Related Articles | Metrics

Select

Bone graft fusion in the treatment of two-level contiguous cervical disc herniation: titanium mesh versus interbody fusion cage Qian Xuan-kun, Lin Qiao, Hu Bin, Zheng Xiao-long, Wang Jian-min 2016, 20 (4):  497-503.  doi: 10.3969/j.issn.2095-4344.2016.04.008 Abstract ( 509 )   PDF (550KB) ( 636 )   Save BACKGROUND: Many studies have shown that different types of anterior cervical surgery in the treatment of two-level contiguous cervical disc herniation can obtain satisfactory results, but which method is the best has not yet reached a consensus. OBJECTIVE: To compare the efficacy and safety of three types of anterior cervical surgery for treating two-level contiguous cervical disc herniation.  METHODS: We retrospectively analyzed clinical data of 62 patients with two-level contiguous cervical disc herniation who underwent anterior decompression and fusion. These patients were assigned to three groups. Bone graft group received anterior cervical discectomy with autogenous iliac bone graft fusion. Titanium mesh group received anterior cervical corpectomy with titanium mesh fusion. Cage group received anterior cervical discectomy with cage fusion. Fusion rate of bone graft and improvement of neurological function (Japanese Orthopaedic Association Scores) were evaluated and compared after treatment in the three groups. Cervical vertebra anteroposterior and lateral images were used to measure height of anterior and posterior margin of vertebral body and Cobb angle changes of fusion segment. RESULTS AND CONCLUSION: All 62 patients were followed up and the follow-up time was ranged from 8 to 30 months. Operation time was significantly longer in the bone graft group than in the titanium mesh and Cage groups (P < 0.05). Intraoperative blood loss was larger in the bone graft group than in the titanium mesh and Cage groups (P < 0.05). Japanese Orthopaedic Association Scores were significantly improved after treatment (P < 0.05). No significant difference was found at different time points (P > 0.05). The fusion rate of bone graft was higher in the bone graft group than in the titanium mesh and Cage groups (P < 0.05) at 3 months after treatment, and bone union was found in the final follow-up. Height of anterior and posterior margin of vertebral body was significantly increased after treatment (P < 0.05). No significant difference in the increase of the height of anterior margin was detected among the three groups (P > 0.05). The increase in the height of posterior margin was higher in the Cage group than in the bone graft group and titanium mesh group (P < 0.05). Vertebral height loss of the anterior margin was higher in the bone graft group than in the titanium mesh and Cage groups, but vertebral height loss of the posterior margin was highest in the bone graft group, followed by titanium mesh group and Cage group at 3 months after treatment (P < 0.05). The increase value of Cobb angle was higher in the titanium mesh group than in the bone graft group and Cage group (P < 0.05). At 3 months after treatment, the altered value of Cobb angle was highest in the bone graft group, followed by titanium mesh group and Cage group (P < 0.05). No significant difference in the height of anterior and posterior margins of the vertebral body and Cobb angle was detectable between final follow-up and 3 months post-treatment (P > 0.05). These findings indicated that the three kinds of fusion method for treating two-level contiguous cervical disc herniation could obviously lessen nervous systems and improve cervical vertebra functions. In the bone graft group, operation time was long. Intraoperative blood loss was more. Postoperative height loss of the posterior margin of the vertebral body was visible. Cervical lordosis could be easily induced. Compared with the bone graft group, titanium mesh and Cage groups could better maintain the height and curvature of the cervical vertebra, but the Cage group had apparent 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   Figures and Tables | References | Related Articles | Metrics

Select

Anterior cervical disc replacement and anterior cervical decompression and fusion for treating single segment cervical disc herniation: which has greater effects on adjacent segment degeneration?  Liu Wei, Sheng Wei-bin, Zhang Jian, Deng Qiang, Guo Hai-long 2016, 20 (4):  504-510.  doi: 10.3969/j.issn.2095-4344.2016.04.009 Abstract ( 463 )   PDF (651KB) ( 491 )   Save BACKGROUND: Studies showed that both anterior cervical disc replacement and anterior cervical decompression and fusion can achieve good clinical result in cervical spondylosis. However, it is not conclusive  about which kind of surgical method has an advantage in avoiding the adjacent segment degeneration. OBJECTIVE: To compare the effect on adjacent segment degeneration of single segment cervical disc herniation treated with anterior cervical decompression and fusion and anterior cervical disc replacement.  METHODS: We collected clinical data of 178 patients with cervical disc herniation and receiving anterior cervical disc replacement or anterior cervical decompression and fusion from January 2009 to December 2012. A retrospective analysis was performed. There were 116 cases in the anterior cervical decompression and fusion group and 62 cases in the anterior cervical disc replacement group. RESULTS AND CONCLUSION: (1) Evaluation: visual analogue scale score, Japanese Orthopaedic Association Scores and neck disability index were improved significantly in both groups during final follow-up compared with that pre-treatment (P < 0.05). (2) No significant difference in range of motion of operation segment, adjacent upper segment and adjacent lower segment was detected between final follow-up and pre-operation in the anterior cervical disc replacement group (P > 0.05). At 3 months after surgery, in the anterior cervical decompression and fusion group, surgical segment was confluent, and range of motion lost. During final follow-up, range of motion of adjacent upper segment and adjacent lower segment was significantly increased, and the increased range of motion in the upper segment was bigger than that of the lower segment (P < 0.05). (3) During final follow-up, X-ray films and MRI images revealed the number of degenerated adjacent segment was more in the anterior cervical decompression and fusion group than in the anterior cervical disc replacement group (P < 0.05). The number of degenerated middle and upper segments was more than that of the lower segment in both groups (P < 0.05). (4) The findings confirmed that anterior cervical disc replacement or anterior cervical decompression and fusion for treating cervical disc herniation could effectively relieve nerve symptoms of patients. However, compared with the anterior cervical disc replacement, adjacent segment degeneration occurs more commonly after anterior cervical decompression and fusion.    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   Figures and Tables | References | Related Articles | Metrics

Select

Anterior cervical discectomy and fusion for treating cervical spondylosis of nerve root type: relationship between intervertebral foramen changes and effects Zhang Bin, Shi Jian-gang, Shi Guo-dong, Liu Yang, Zheng Bing, Kong Qing-jie, Wang Hai-bo, Sun Jing-chuan, Wang Yuan 2016, 20 (4):  511-516.  doi: 10.3969/j.issn.2095-4344.2016.04.010 Abstract ( 242 )   PDF (598KB) ( 407 )   Save BACKGROUND: Cervical intervertebral foramen stenosis induced by cervical spondylosis of nerve root type usually requires surgical treatment. The ways mainly include anterior cervical discectomy and fusion and cervical posterior intervertebral foramen decompression. Which is the best way is still inconclusive. With innovation, anterior cervical discectomy and fusion for cervical spondylosis of nerve root type has become the mainstream in the current treatment. OBJECTIVE: To study the relationship between curative effects and intervertebral foramen-associated parameter changes in patients with cervical spondylosis of nerve root type after anterior cervical discectomy and fusion. METHODS: From March 2011 to April 2013, 132 patients with cervical spondylosis of nerve root type were treated with anterior cervical discectomy and fusion in the Changzheng Hospital Affiliated to the Second Military Medical University. Neck pain and arm pain visual analogue score, neck disability index score and imaging changes were evaluated before and after treatment. RESULTS AND CONCLUSION: 132 patients were followed up for 25(4-28) months. Significant differences in neck pain visual analogue scale, anterior intervertebral disc height, posterior intervertebral disc height, intervertebral foramen height, anterior and posterior diameters of the intervertebral foramen, the area of the intervertebral foramen, and the Cobb angle of the fused segment were detected in all patients before and after treatment (P < 0.05). Posterior intervertebral disc height was positively correlated with intervertebral foramen area (r=0.427, P=0.000). The increased Cobb angle of the fused segment was negatively associated with the size of intervertebral foramen (r=-0.273, P=0.003). Intervertebral foramen area was negatively associated with arm pain visual analogue score (r=-0.502, P=0.000). These results indicated that anterior cervical discectomy and fusion with an interbody fusion cage can obviously enlarge intervertebral foramen in patients with cervical spondylosis of nerve root type, and obtain good curative effect. The size of the intervertebral foramen is negatively related to the axial pain. The reconstruction of the intervertebral disc height is necessary to expand the intervertebral foramen. However, the increase of the curvature fusion segments is not helping to expand the intervertebral foramen.  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 Figures and Tables | References | Related Articles | Metrics

Select

Stability and interbody fusion of augmented pedicle screws with bone cement for lumbar spondylolisthesis accompanied with osteoporosis Yao Zhen-song, Tang Yong-chao, Chen Kang, Jiang Xiao-bing, Liang De, Jin Da-xiang, Zhuang Hong, Zhang Shun-cong, Yang Zhi-dong, Ding Jin-yong 2016, 20 (4):  517-521.  doi: 10.3969/j.issn.2095-4344.2016.04.011 Abstract ( 306 )   PDF (419KB) ( 667 )   Save BACKGROUND: In lumbar spondylolisthesis patients with severe osteoporosis, screw is easily loose and pulls out during reposition, or loss of reduction and internal fixation failure easily occur after repair. Therefore, it is very  important to elevate the intensity of pedicle screw fixation during repair. At present, few studies concern application of bone cement screw enhancement technology in lumbar spondylolisthesis patients with osteoporosis. OBJECTIVE: To investigate the clinical value of augmented pedicle screw with polymethylmethacrylate for lumbar spondylolisthesis accompanied with osteoporosis. METHODS: From June 2009 to June 2011, 27 patients suffering from lumbar spondylolisthesis accompanied with osteoporosis were included in this retrospective study. These patients received augmented pedicle screw with polymethylmethacrylate. The levels of disability and pain were evaluated by Oswestry Disability Index and visual analog scale. The internal fixation and fusion were evaluated by radiological findings. All complications were recorded. RESULTS AND CONCLUSION: All cases were followed up for 15-37 months. Oswestry Disability Index and visual analog scale scores were significantly better in final follow-up than that pre-treatment (P < 0.05). Imaging results revealed that bone cement tightly connected to bone interface. The position of screw and bone cement was good. Symptomatic bone cement leakage was not found. No fixation failure was detected during final follow-up. All patients achieved interbody fusion. These results suggested that polymethylmethacrylate bone cement could increase the gripping force of the pedicle screw in osteoporotic vertebral body. It is safe and effective to treat spondylolisthesis accompanied with osteoporosis with augmented pedicle screws. Satisfactory fixation stability and interbody fusion can be obtained.   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 Figures and Tables | References | Related Articles | Metrics

Select

Vertebral and inter-vertebral screw fixation for treating thoracolumbar compression fracture: a long-term follow-up of spinal stability Xie Shen, Zhu Shao-bo 2016, 20 (4):  522-528.  doi: 10.3969/j.issn.2095-4344.2016.04.012 Abstract ( 284 )   PDF (638KB) ( 423 )   Save BACKGROUND: Posterior pedicle screw fixation is a common method for treatment of thoracolumbar compression fractures. The fixation method contains long-segment fixation, short-segment fixation and vertebral fixation. Clinical effects of vertebral fixation and inter-vertebral short-segment fixation for treating thoracolumbar fractures remain unclear.  OBJECTIVE: To compare the stability of posterior vertebral fixation and inter-vertebral pedicle screw fixation for treating thoracolumbar compression fractures.  METHODS: Clinical data of 46 patients with thoracolumbar compression fractures were retrospectively analyzed. According to the fixation methods, they were divided into the vertebral fixation group (n=21) and inter-vertebral fixation group (n=25). The operation time, intraoperative bleeding, intraoperative blood transfusion, the time of lying in bed, vertebral Cobb angle, anterior vertebral height and visual analog scores were evaluated for a long time. RESULTS AND CONCLUSION: (1) During repair, in both groups, operation time, intraoperative bleeding and intraoperative blood transfusion were better in the inter-vertebral fixation group than in the vertebral fixation group (P < 0.05-0.01). The time of lying in bed was better in the vertebral fixation group than in inter-vertebral fixation group (P < 0.01). (2) No significant difference in Cobb angle and anterior vertebral height was detected before and after treatment and during repair in both groups, but final follow-up and follow-up loss were better in the vertebral fixation group than in inter-vertebral fixation group (P < 0.05-0.01). (3) No significant difference in visual analog scores was detected before and after treatment in both groups. Visual analog scores were better in the vertebral fixation group than in the inter-vertebral fixation group (P < 0.01). (4) These results suggested that the two fixation methods obtained satisfactory repair effects in long-term follow-up. The dominance in maintaining the height and curvature of the spine was more obvious in the vertebral fixation group than in the inter-vertebral fixation group. The vertebral fixation can be more effective to reconstruct the spinal physiological sequence and restore its stability. After repair, low back pain can also be effectively controlled.    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 Figures and Tables | References | Related Articles | Metrics

Select

Posterior pedicle subtraction osteotomy at the apical vertebra with transpedicular instrumentation in the treatment of rigid angular kyphosis of thoracolumbar spine: a medium-term curative effects Ao Shuang, Jia Yi-ming, Leng Hui, Zhao Yu, Sui Yu-xin, Zhang Hao 2016, 20 (4):  529-533.  doi: 10.3969/j.issn.2095-4344.2016.04.013 Abstract ( 301 )   PDF (477KB) ( 389 )   Save BACKGROUND: During spinal orthopedic repair, the main difficulty is to maximize the correction of the deformity, simultaneously, to reduce the incidence of trauma and complications, especially to avoid the corresponding spinal nerve injury. OBJECTIVE: To evaluate the curative effect of one-stage posterior pedicle subtraction osteotomy of apical vertebra with transpedicular instrumentation in the treatment of rigid angular kyphosis of thoracolumbar spine. METHODS: We retrospectively analyzed the data of 42 cases of rigid angular kyphosis of thoracolumbar spine that were treated by one-stage posterior pedicle subtraction osteotomy of apical vertebra with transpedicular instrumentation. All patients received detailed imaging examination before and after operation. Kyphosis angle, Frankel grading and perioperative complications were recorded in all patients. X-ray films or CT films showed the bone graft fusion during follow-up. RESULTS AND CONCLUSION: Patients were followed up for 10-36 months after treatment. The average time of bone graft fusion was 5.1 months. Cobb’s angle of kyphosis was corrected from 78.4° (38°-110°) preoperatively to 7°(-8°-24°) at 10 days after treatment. The correction rate was 90%. The average angle during final follow-up was 7.9°, with an average loss of 0.9°. In 16 paresis patients, Frankel grading results showed grade B in 0 case, grade C in 3 cases, grade D in 5 cases, and grade E in 8 cases during final follow-up, showing significant improvement as compared with that pre-treatment (P < 0.05). Among 42 patients, 5 cases had complications. At 7 months after treatment, there were screw and titanium rod loosening at the distal end of the fusion segment in 1 case, cerebrospinal fluid leakage in 2 cases, transient double lower limb weakness in 1 case, pain in one side of lower limb in 1 case, and no severe complications appeared. These results verified that one-stage posterior pedicle subtraction osteotomy of apical vertebra with transpedicular instrumentation could achieve satisfactory clinical outcomes in rigid angular kyphosis of thoracolumbar spine. The internal fixation was stable and with a high fusion rate and few complications. The medium-term effect was satisfactory.  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 Figures and Tables | References | Related Articles | Metrics

Select

Percutaneous vertebroplasty repairs non-osteoporotic single-segmental vertebral traumatic compression fractures Zhang Qiang, Luo Jin, Yang Liu-zhu, Li Rui-long,Li Zhao-fei, Yan Xin-ping, Wu Bo, Liang Da-di 2016, 20 (4):  534-538.  doi: 10.3969/j.issn.2095-4344.2016.04.014 Abstract ( 441 )   PDF (473KB) ( 344 )   Save BACKGROUND: It is still controversial about whether percutaneous vertebroplasty can be as an option for treatment of non-osteoporotic single-segmental vertebral traumatic compression fractures. OBJECTIVE: To observe the effect of percutaneous vertebroplasty in repair of non-osteoporotic single-segmental vertebral traumatic compression fractures. METHODS: Totally 20 patients who underwent percutaneous vertebroplasty in repair of non-osteoporotic single-segmental vertebral traumatic compression fractures between March 2010 and January 2013 were collected. The variation of visual analog scale scores and the Oswestry disability index scores of patients was observed before and after the repair. RESULTS AND CONCLUSION: (1) The visual analog scale scores and the Oswestry disability index scores of patients were significantly reduced after repair compared with those before repair, moreover, the visual analog scale scores and the Oswestry disability index scores of patients at the 3, 6, 12 and 18 months after repair were similar. (2) All patients had no adverse effects and complications. (3) These results suggest that percutaneous vertebroplasty in repair of non-osteoporotic single-segmental vertebral traumaticcompression fractures quickly   relieves back pain and improves the actives of thoracolumbar segments.  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 Figures and Tables | References | Related Articles | Metrics

Select

Percutaneous kyphoplasty versus percutaneous vertebroplasty for osteoporotic vertebral compression fractures: a randomized comparison Tan Bin, Liu Xiong-wen, Liu Gang, Li Yong-sheng, Qin Zhong-jun, Yang Chun-peng 2016, 20 (4):  539-543.  doi: 10.3969/j.issn.2095-4344.2016.04.015 Abstract ( 522 )   PDF (442KB) ( 671 )   Save BACKGROUND: Recent literatures have showed that percutaneous kyphoplasty can effectively avoid nerve damage, pulmonary embolism, and insufficient vertebral height and other security risks when bone cement is infused into affected vertebrae in percutaneous vertebroplasty. OBJECTIVE: To compare the effect of percutaneous kyphoplasty and percutaneous vertebroplasty in repair of osteoporotic vertebral compression fractures. METHODS: A total of 106 patients with senile osteoporotic vertebral compression fractures were randomly divided into trial group and control group (n=53 per group). Patients in the trial group were treated with percutaneous kyphoplasty, and those in the control group treated with percutaneous vertebroplasty. All patients were followed up for 6 months after repair. The vertebral compression deformation, bone cement distribution, midline vertebral bone cement condition, vertebral height restoration, bone cement leakage, vertebral kyphosis, progressive spinal collapse, nerve damage, as well as visual analog scale scores and Oswestry disability index scores in these two groups were compared. RESULTS AND CONCLUSION: Compared with the control group, there was less bone cement leakage and vertebral compression deformation in the trial group. Moreouer, in the trial group, bone cement distributed uniformly, vertebral height restoration was good and effective, pain was obviously relieved, and the probability of vertebral kyphosis, progressive spine collapse and nerve damage was significantly reduced (all P < 0.05). These results suggest that percutaneous kyphoplasty can effectively relieve the pain of patients with osteoporotic vertebral compression fractures, restore vertebral body height and reduce the incidence of complications, which effectively guarantees the postoperative restoration of motor 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   Figures and Tables | References | Related Articles | Metrics

Select

Relationship of hidden blood loss, implants and sex during the perioperative treatment of elderly intertrochanteric fracture Wang Feng, Li Zhen-wu, Yin Rui-feng, Li Zhi-an 2016, 20 (4):  544-548.  doi: 10.3969/j.issn.2095-4344.2016.04.016 Abstract ( 424 )   PDF (447KB) ( 350 )   Save BACKGROUND: With the continuous renewal and development of clinical repair techniques, the intraoperatie  blood loss has been greatly reduced in the treatment of intertrochanteric fracture; however, no matter what kind of repair methods should be adopted, there are still a large amount of perioperative hidden blood loss, however, there are few clinical reports for the reasons and related factors. OBJECTIVE: To study the correlation of perioperative hidden blood loss with gender and internal fixation methods in the surgery of elderly femoral intertrochanteric fractures． METHODS: Totally 121 patients with elderly femoral intertrochanteric fractures who received the treatment at Department of Orthopedics, Nanyang City Center Hospital from March 2010 to June 2013 were divided into two groups according to the condition and treatment wishes of patients, and were respectively treated with dynamic hip screw and proximal femoral anti-rotation intramedullary nail internal fixation. The preoperative hidden blood loss, postoperative hidden blood loss, the total hidden blood loss, dominant blood loss and total blood loss of patients in these two groups were compared. The multiple linear regression analysis on the correlation of perioperative hidden blood loss with gender and internal fixation methods was conducted. RESULTS AND CONCLUSION: There was no significant difference in the preoperative hidden blood loss between these two groups (P > 0.05). The total blood loss, postoperative hidden blood loss and total hidden blood loss in the proximal femoral anti-rotation intramedullary nail group were significantly higher than those in the dynamic hip screw group (P < 0.05), and the dominant blood loss was significantly lower than that in the dynamic hip screw group (P < 0.05). There were significant differences in the preoperative, postoperative hidden blood loss and total hidden blood loss between males and females (P < 0.05), and above indexes in males were significantly lower than in females. The multiple linear regression analysis showed that gender and internal fixation methods were correlated with hidden blood loss (P < 0.05). These results suggest that the perioperative hidden blood loss in surgery for elderly femoral intertrochanteric fractures is closely related to gender and above indexes in internal fixation methods. The perioperative hidden blood loss of male patients is less than that of female patients, and the patients treated with proximal femoral anti-rotation intramedullary nail fixation have more hidden blood loss than dynamic hip screw fixation.  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   Figures and Tables | References | Related Articles | Metrics

Select

Extraarticular proximal tibial fractures repaired with multifunctional locking intramedullary nail and locking plate Chen De-ming, Xu Xiao-yang, Wang Wei, Zhang Li, Chang Le 2016, 20 (4):  549-553.  doi: 10.3969/j.issn.2095-4344.2016.04.017 Abstract ( 343 )   PDF (485KB) ( 1187 )   Save BACKGROUND: Many researchers at home and abroad think that interlocking intramedullary nails may be more suitable for comminuted fractures of the tibia with severe soft tissue injury. Plate fixation is more advantageous for distal tibial fractures. OBJECTIVE: To compare the effects of multifunctional locking intramedullary nail and locking plate in treatment of extraarticular proximal tibial fractures. METHODS: 156 patients with extraarticular proximal tibial fractures were included and divided into intramedullary nail group (n=78) and the locking plate group (n=78) according to repair method. Curative effects and healing time were compared between the two groups. At 3 months after treatment, Johner-Wruh tibial fracture scores were used to assess the repair effect in both groups. In addition, operation time, blood loss, healing time and complications were compared between the two groups.  RESULTS AND CONCLUSION: Mean healing time was 9.3 months in the locking plate group and 9.2 months in the intramedullary nail group. At 3 months after treatment, the repair effect was significantly better in the intramedullary nail group than in the locking plate group (P < 0.05). Blood loss and time were less in the intramedullary nail group than in the locking plate group (P < 0.05), and surgical difficulty was high. At 3 months after treatment, the incidence rates of tibia eversion/inversion, neurovascular injury and nonunion/infection were significantly lower in the intramedullary nail group than in the locking plate group (P < 0.05). These findings confirmed that the multifunctional locking intramedullary nailing for extraarticular proximal tibial fractures obtained reliable efficacy, exact effect, reduced blood loss and low incidence of complications. Thus, it is better than locking plate.     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 Figures and Tables | References | Related Articles | Metrics

Select

Computer aided technology assesses adult acetabular dysplasia after total hip arthroplasty: biological performance Shao Zheng-hai, Xu Wei-dong 2016, 20 (4):  554-558.  doi: 10.3969/j.issn.2095-4344.2016.04.018 Abstract ( 366 )   PDF (473KB) ( 462 )   Save BACKGROUND: Currently, total hip arthroplasty is a recognized and preferred method for treatment of adult congenital acetabular dysplasia, however, there were lack of ideal evaluation methods to precisely solve acetabular reconstruction in the process of treatment. OBJECTIVE: To investigate the evaluating effects and biological properties of computer aided technology in adult acetabular dysplasia after total hip arthroplasty. METHODS: The clinical data from 80 patients with adult congenital acetabular dysplasia who received the treatment at Department of Bone and Joint Surgery, Changhai Hospital, Second Military Medical University of Chinese PLA from January 2015 to August 2015 were selected and analyzed. All the enrolled patients underwent total hip arthroplasty. All the patients were randomly divided into control and computer-aided technology groups. CT scanning was conducted in these two groups before replacement. Three-dimensional reconstruction measuring and surgical rehearsal on the acetabular site were conducted using M3D visualization software in the computer-aided technology group. The effects and biological properties of total hip arthroplasty were compared between these two groups. RESULTS AND CONCLUSION: Patients in these two groups primarily healed after replacement. The excellent and good rate, Harris score after treatment, acetabular component, valgus angle and anteversion in the computer-aided technology group were significantly higher than those in the control group (P < 0.05). The acetabular cup abduction angle offset degrees, acetabular cup anteversion offset degrees, and the incidences of complications after replacement were significantly decreased compared with those in the control group (P < 0.05). These results suggest that the effect of computer-aided evaluation in adult acetabular dysplasia after total hip arthroplasty is ideal, and can accurately grasp the true acetabular anatomical characteristics and the corresponding relationship with the prosthesis, so as to help patients to choose the proper acetabulum and acetabular prosthesis and reconstruction ways and improve the biological performance of acetabulum after replacement, with a high clinical value.   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 Figures and Tables | References | Related Articles | Metrics

Select

Absorbable screw fixation repairs simple lateral malleolus fracture: a finite element analysis Huang Xiao-wei, Gong Zhong-hua, Yu Bao-qing, Li Ze-xiang, Ao Rong-guang 2016, 20 (4):  559-563.  doi: 10.3969/j.issn.2095-4344.2016.04.019 Abstract ( 340 )   PDF (533KB) ( 771 )   Save BACKGROUND: Compared with the metal screws, absorbable screws have more obvious advantages, such as does not have to conduct internal fixation removal, non-metallic components, no influence on the magnetic resonance imaging of patients after implantation, relatively simple operations, namely drilling-tapping-screws fixation, more in line with the principles of minimally invasive in orthopedics. OBJECTIVE: To investigate the biomechanical characteristics of absorbable screw fixation in repair of simple lateral malleolus fractures by means of finite element technology. METHODS: The three-dimensional model of simple lateral malleolus fractures and absorbable screw model were established, and then fixed according to standard orthopedic surgical techniques. The reference load when the load bearing of fibulotalar joint reaching the peak value in a normal adult gait cycle was loaded. The stress distribution and displacement of fibula and absorbable screws were analyzed. RESULTS AND CONCLUSION: There were totally 38 542 units, 8 790 nodes in the single screw fixation model. When the articular facet of lateral malleolus loading 300 N, the maximum stress of screws was 89.35 MPa, the maximum displacement was 0.5 mm, the maximum displacement of the distal fracture was 0.5 mm. When the articular facet of lateral malleolus loading 450 N, the maximum stress of screws was 152.58 MPa, the maximum displacement was 0.59 mm, the maximum displacement of the distal fracture was 0.77 mm. There were totally 43 115 units, 9 496 nodes in the double screws fixation model. When the articular facet of lateral malleolus loading 300 N, the maximum stress of screws was 38 MPa, the maximum displacement was 0.44 mm, the maximum displacement of the distal fracture was 0.44 mm. When the articular facet of lateral malleolus loading 450 N, the maximum stress of screws was 66.68 MPa, the maximum displacement was 0.48 mm, the maximum displacement of the distal fracture was 0.49 mm. The experiment verified the biomechanical feasibility of absorbable screw fixation in repair of simple lateral malleolus fractures. For simple involving only the lower lateral fibular fracture, absorbable screw fixation is entirely feasible, and usually requires at least two screws to maintain the stability of the articular surface of the reset.   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 Figures and Tables | References | Related Articles | Metrics

Select

Changes in sagittal balance following corrective osteotomy for lumbar degenerative kyphosis Ren Zhou-liang, Zhu Song-qing, Liang Wei-dong, Sheng Wei-bin, Sheng Jun 2016, 20 (4):  564-570.  doi: 10.3969/j.issn.2095-4344.2016.04.020 Abstract ( 406 )   PDF (588KB) ( 462 )   Save BACKGROUND: At present, more and more scholars pay attention to the influence of spine and pelvis sagittal balance on the quality of life of patients. Postoperative changes in spine imaging parameters following corrective osteotomy for lumbar degenerative kyphosis have not been reported. OBJECTIVE: To evaluate postoperative changes in sagittal balance following corrective osteotomy for lumbar degenerative kyphosis. METHODS: We retrospectively analyzed 35 consecutive lumbar degenerative kyphosis patients treated with posterior osteotomy fixation in the First Affiliated Hospital of Xinjiang Medical University from February 2012 to December 2014. Imaging parameters were measured before fixation, immediately after fixation and during final follow-up. RESULTS AND CONCLUSION: (1) There were significant differences between preoperative and postoperative parameters except for pelvic incidence angle (P < 0.05). (2) There were significant differences between postoperative and last follow-up parameters except for Cobb angle, pelvic incidence angle, thoracic kyphosis angle and the thoracolumbar kyphosis (P < 0.05). (3) Pelvic tilt angle was negatively correlated with lumbar lordosis after fixation (r=-0.610, P < 0.001). Thoracic kyphosis was positively correlated with lumbar lordosis (r=0.598, P < 0.001). (4) Results suggested that lumbar sagittal contour can be significantly improved by corrective osteotomy for lumbar degenerative kyphosis. Simultaneously, reciprocal changes in the adjacent areas such as thoracic spine and pelvis occur to adapt to the new sagittal balance.  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   Figures and Tables | References | Related Articles | Metrics

Select

Pedicle screw fixation into the injured vertebra for thoracolumbar fractures: a long-term effect and biomechanical analysis Zeng Hong-sheng, Chen Zi-hua, Chen Jian-wei, Fang Lei, You Jun, Zhou Yun 2016, 20 (4):  571-576.  doi: 10.3969/j.issn.2095-4344.2016.04.021 Abstract ( 389 )   PDF (499KB) ( 510 )   Save BACKGROUND: Pedicle screw fixation is a common repair method for thoracolumbar fractures. Of them, pedicle screw placement into the injured vertebra is an important method. However, the long-term effects and the related biomechanical properties deserve further analysis. OBJECTIVE: To analyze the long-term effect and biomechanical characteristics of the internal fixation of thoracolumbar fractures by pedicle screw implantation.  METHODS: A retrospective analysis was performed in 126 cases of thoracolumbar fractures. The patients were treated with pedicle screw implantation and the treatment was followed up regularly. Ten specimens of fresh calf chest and lumbar spines were obtained. Five specimens served as an experimental group to prepare models of anterior middle column fractures, and these specimens received pedicle screw fixation into the injured vertebra. The other five specimens served as the control group, and did not receive any treatment. In the two groups, along the sagittal axis, axial compression displacement, anterior flexion displacement, posterior extension displacement, torsion angle and pull-out strength were measured and recorded.  RESULTS AND CONCLUSION: (1) Clinical trial results: 126 patients were followed up for 10-36 months. Compared with pre-treatment, compression ratio of the injured vertebra, the height of intervertebral space, vertebral slip distance, visual analogue score and Cobb angle were significantly improved at 1 month after treatment and during final follow-up (all P < 0.05). No significant difference in above indexed was detected between 1 month and final follow-up (all P > 0.05). At the end of follow-up, Frankel spinal cord injury grade was significantly improved (Z=-4.127, P < 0.05). After operation, three patients suffered from pulmonary infection, four patients affected urinary tract infection, and one patient experienced delayed wound healing. (2) Biomechanical results: axial compression displacement, anterior flexion displacement, posterior extension displacement, torsion angle and pull-out strength were smaller in the experimental group than in the control group (all P > 0.05). (3) Above findings showed that pedicle screw fixation into the injured vertebra for thoracolumbar fractures obtained good long-term effects, and had good biomechanical properties. Figures and Tables | References | Related Articles | Metrics

Select

Application of three-dimensional printing technology in spinal surgery Pang Jiao-yang, Zhao Yan, Xiao Yu-long, Xin Da-qi 2016, 20 (4):  577-582.  doi: 10.3969/j.issn.2095-4344.2016.04.022 Abstract ( 847 )   PDF (551KB) ( 1318 )   Save BACKGROUND: Three-dimensional printing technology is a new technology which can quickly and accurately transform the virtual computer-aided design into the three-dimensional physical prototypes. Three-dimensional printing physical model method can replace the method of traditional preoperative planning and repair surgical simulation, with the characteristic of repeatable, which has been deepened day after day in clinical application of spine surgery. OBJECTIVE: To summarize the application status of three-dimensional printing technology in spine surgery and look forward to its future development directions. METHODS: The articles regarding the application of three-dimensional printing technology on clinical applications in spine surgery were retrieved from PubMed databases, Google Scholar, China National Knowledge Infrastructure and Wanfang Database from January 2000 to July 2015. The key words were 3D printing technology, rapid prototyping technology, spine, vertebra, department of orthopedics, fracture, joint, hand and foot, bone tumor, trauma, cervical vertebrae, thoracic vertebrae, lumbar vertebrae, sacral vertebrae, pedicle of vertebral arch, vertebral body, intervertebral disc, and clinical application. A total of 50 articles with a good representation were selected and discussed after repetitive studies and reviews were excluded. RESULTS AND CONCLUSION: The three-dimensional printing technique has been applied in preoperative diagnosis, individualized orthosis customerization, the communication between doctors and patients, teaching, the formulation of individualized and high-accurate repairing plan, intraoperative navigation and individualized implant customization. These results suggest that with the rapid development of medical imaging, digital medicine and technologies of the cell and tissue culture and new materials, three-dimensional printing technology will have a wide range of applications in spine 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 References | Related Articles | Metrics

Select

Scoliosis fixation system implantation and the application of three-dimensional reconstruction technique Wang Shi-jun, Li Yu-ting, Li Chun-de 2016, 20 (4):  583-588.  doi: 10.3969/j.issn.2095-4344.2016.04.023 Abstract ( 448 )   PDF (558KB) ( 774 )   Save BACKGROUND: Scoliosis is a complex three-dimensional plane deformity, including lateral bending on the coronal plane, before physiological kyphosis reduction or increase in the sagittal plane, the rotational deformity of the spine in the axial plane. The method of full decompression, maximum reconstruction of spinal balance in coronal and sagittal plane, long-segmental fixation and short-segmental fusion is the more ideal orthopedic method for degenerative scoliosis. OBJECTIVE: To analyze the characteristics of scoliosis fixation system. METHODS: The articles about scoliosis fixation system were retrieved from PubMed database, Chinese Journal Full-text database from 1999 to 2015 by the first author using computer. “Scoliosis, Internal Fixation, Three-dimensional Correction” were taken as the search terms in English and Chinese. Totally 163 relevant articles were retrieved, and eventually 34 articles met the inclusion criteria. RESULTS AND CONCLUSION: With the development of fixation materials, the spinal fixation system which was designed based on three-dimensional orthopedic concept of spine is a dynamically developed system. The goal is to restore the balance of spine in three dimensions as comprehensive as possible. At present, the general spinal system within very broad application includes TSRH spinal fixation system, ISOLA spinal internal fixation system, Moss Miami spinal fixation system, CD Horizon spinal internal system and China Great Wall spinal fixation system. Spinal fixation system possesses three-dimensional orthopedic capability, and can correct the spinal deformity in coronal and sagittal plane, and biomechanics is reasonable, fixed and reliable. Bone grafting material is the key factor of preventing breakage of internal fixation, screw extraction and other complications. Compared with such bone grafting materials made of autologous bone, allograft bone and xenograft bone, artificial bone can shorten the orthopedic time and reduce the risk of concurrent diseases because of bone grafting, which is the future trend of bone grafting material. Meanwhile, three-dimensional reconstruction has been used in clinical practice, and can develop programs for scoliosis orthopedic treatment, provide imaging reference to ensure the security of internal fixation and also has played a huge role in improving the comprehensive efficacy of spinal internal fixation system.   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   References | Related Articles | Metrics

Select

Hip dysfunction-associated factors after total hip arthroplasty for ankylosing spondylitis Chen Wen-zhong, Yu Tao, Zhao Ya-nan, Li Rui, Li Shi-long, Liu Bo, Jiang Jia-bin 2016, 20 (4):  589-594.  doi: 10.3969/j.issn.2095-4344.2016.04.024 Abstract ( 303 )   PDF (565KB) ( 350 )   Save BACKGROUND: Total hip arthroplasy is an effective method to treat hip disease caused by ankylosing spondylitis. Long-term follow-up studies have shown that there have been hip function problems after total hip arthroplasy, and it still lacks of perfect rehabilitation programs.   OBJECTIVE: To systematically review the influential factors for dysfunction after total hip arthroplasy in ankylosing spondylitis patients. METHODS: The first and second authors retrieved PubMed and Sciencedirect Databases, CNKI, and Wanfang digital database for relevant articles published from January 1970 to July 2015. The key words were “arthroplasty, replacement, hip, spondylitis, ankylosing, function”. Finally, relevant articles were included. RESULTS AND CONCLUSION: A total of 40 articles were summarized, including 8 Chinese articles and 32 English articles. After total hip arthroplasy, hip function problems were mainly associated with patient’s factors, disease, surgery, prosthesis, postoperative recovery and postoperative complications. Avoiding above relevant factors can improve joint function after total hip arthroplasy for ankylosing spondylitis patients, and improve patient’s quality of life.  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 Figures and Tables | References | Related Articles | Metrics

Select

Ceramic-on-ceramic versus ceramic-on-polyethylene bearing surfaces in total hip arthroplasty: a meta analysis of efficacy and safety Mohammed Alezzi Mohammed, Fang Shu-ying, Liao Wei-ming, Zhao Xiao-yi, Luo Jia-yue, Zhang Zi-ji 2016, 20 (4):  595-601.  doi: 10.3969/j.issn.2095-4344.2016.04.025 Abstract ( 508 )   PDF (567KB) ( 356 )   Save BACKGROUND: Greatly importance has been attached to ceramic-on-ceramic bearing surface due to its excellent wear resistance. But the risks of squeaking and ceramic fracture also go with it. Up till now, the choice  between ceramic-on-ceramic and ceramic-on-polyethylene bearing surfaces in primary total hip arthroplasty remains controversial.  OBJECTIVE: To compare the clinical outcomes and safety between ceramic-on-ceramic versus ceramic-on-polyethylene bearing surfaces in total hip arthroplasty based on meta analysis. METHODS: We electronically searched databases including PubMed/Medline, Embase, Web of Science, Cochrane Collaboration database, Chinese Biomedical Literature Database (CBMdisc) and China National Knowledge Internet for randomized controlled trials on the comparison between ceramic-on-ceramic versus ceramic-on-polyethylene bearing surfaces in total hip arthroplasty from inception to January 2015. References of the included studies were also retrieved. Investigators severely selected the studies, extracted data and assessed the quality according to the inclusion and exclusion criteria. Then, meta-analysis was performed using RevMan 5.2 software. RESULTS AND CONCLUSION: Nine randomized controlled trials were included, involving 1 231 hips with ceramic-on-ceramic prosthesis and 932 hips with ceramic-on-polyethylene prosthesis. Meta analysis showed that both bearing surfaces achieved satisfied function recovery. But ceramic-on-ceramic had significantly increased risks of squeaking and ceramic fracture, meanwhile ceramic-on-polyethylene showed significantly higher wear rate. There were no significant differences in intra- or post-operative dislocation, osteolysis and other complications and prosthesis failure with any reason between two bearing surfaces. These results suggest that during the short- to mid-term follow-up period, no sufficient evidence can tell that ceramic-on-ceramic was obviously super than ceramic-on-polyethylene. Long-term follow-up is required for further 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 Figures and Tables | References | Related Articles | Metrics

Select

A meta-analysis of proximal femoral nail antirotation and total hip arthroplasty for treating intertrochanteric fractures in the elderly Abulimiti•Amuti, Liu Li-guo, Yan Bin, Xu Chao 2016, 20 (4):  602-607.  doi: 10.3969/j.issn.2095-4344.2016.04.026 Abstract ( 411 )   PDF (479KB) ( 332 )   Save BACKGROUND: Now, the current study has not yet confirmed two treatment methods of the proximal femoral nail antirotation and total hip arthroplasty for treating intertrochanteric fractures in the elderly, which method has more advantages, and there is no clear conclusion at present.  OBJECTIVE: To systematically compare the repair effect of proximal femoral nail antirotation and total hip arthroplasty for treatment of intertrochanteric fractures in the elderly.  METHODS: We searched the related literatures from 2011 to 2015 on Wanfang database, PubMed, MEDLINE and Embase database by computer. We retrieved the journals in China by hand and collected randomized controlled trials on proximal femoral nail antirotation and total hip arthroplasty in the treatment of intertrochanteric fractures in the elderly. Intraoperative blood loss, operation time, hospitalization time, ambulation time after operation, and Harris score were selected as evaluation indexes. Data were analyzed using RevMan 5.2 software.  RESULTS AND CONCLUSION: Finally, 7 Chinese literatures were included, with 811 patients. The results of meta analysis showed that the hospitalization time and ambulation time after operation were significantly shorter in the total hip arthroplasty group than in the proximal femoral nail antirotation group (P < 0.000 01), which reduced the pain of patients. Operation time and intraoperative blood loss were poorer in the total hip arthroplasty group than in the proximal femoral nail antirotation group (P < 0.000 01). No significant difference in Harris hip score was detected between the two groups (P > 0.05). These results confirmed that the internal fixation of proximal femoral nail antirotation in minimally invasive therapy when reducing operation time and blood loss has a certain advantage. The total hip arthroplasty can make the recovery of hip function earlier, allow early weight-bearing walking, reduce the patients’ bedridden time and reduce the complications in bed. Thus, the clinicians in the practical work should choose the appropriate therapy with considering the patient’s condition, damage degree, fracture type, and financial capability. Figures and Tables | References | Related Articles | Metrics