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18 April 2017, Volume 21 Issue 11 Previous Issue    Next Issue

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Risk factors for heterotopic ossification following total hip arthroplasty in patients with ankylosing spondylitis    Liu Yong, Huo Shao-chuan, Zhou Chi, Tang Hong-yu, Chen De-long, Chen Jian-fa, Guo Hai, Deng Zhang-rong, Wang Hai-bin 2017, 21 (11):  1641-1646.  doi: 10.3969/j.issn.2095-4344.2017.11.001 Abstract ( 306 )   PDF (1196KB) ( 274 )   Save BACKGROUND: Heterotopic ossification (HO) is common following primary total hip arthroplasty (THA) in patients with ankylosing spondylitis (AS), which may cause certain influence on functional recovery. OBJECTIVE: To explore the risk factors for HO after primary THA in AS patients. METHODS: The clinical and radiological data from 87 patients (132 hips) with AS undergoing primary THA between June 2011 and December 2015 were retrospectively analyzed, and followed up for more than 6 months. The radiological information included preoperative and postoperative hip anteroposterior and lateral radiographs. The presence of HO surrounding the prosthesis was evaluated on the radiographs at the last follow-up and graded according to the Brooker classification. Risk factors for HO were divided into invariable factors (age, sex, course and with or without ankylosed hip) and variable factors (preoperative C-reactive protein level, preoperative erythrocyte sedimentation rate, intraoperative blood loss, operation time, prosthesis types and anesthesia methods) to determine the pertinent risk factors. RESULTS AND CONCLUSION: (1) Totally 43 hips (32.6%) were found to have developed into HO. (2) Invariable risk factors including male (P=0.029), preoperative ankylosed hip (P < 0.001), and course (P=0.029) increased the prevalence of HO. Among the variable risk factors, prolonged operation time (P=0.031) and general anesthesia (P=0.003) were associated with the increased occurrence of HO. Age, preoperative C-reactive protein level and erythrocyte sedimentation rate, intraoperative blood loss, and prosthesis types had no obvious correlation with HO. (3) These results suggest that to prevent the formation of HO following THA in AS, efforts to reduce the operation time and avoid general anesthesia should be considered. 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

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Kinesio taping combined with manual lymphatic drainage for lower limb swelling after total knee arthroplasty   Liu Sheng-fa, Zhang Feng 2017, 21 (11):  1647-1651.  doi: 10.3969/j.issn.2095-4344.2017.11.002 Abstract ( 635 )   PDF (957KB) ( 785 )   Save BACKGROUND: Kinesio taping combined with manual lymphatic drainage for lower limb swelling and pain after total knee arthroplasty (TKA) has not been reported. The existing studies mainly concentrate on the instant effect of kinesio taping, and there is a lack of clinical research on its long-term effectiveness. OBJECTIVE: To observe the curative efficacy of kinesio taping combined with manual lymphatic drainage for lower limb swelling and pain after TKA. METHODS: Sixty patients with lower limb swelling following TKA were randomly divided into control and experimental groups (n=30 per group), followed by treated with kinesio taping, and kinesio taping combined with manual lymphatic drainage, respectively. The swelling degree, visual analogue scale scores and curative efficacy at baseline and 10 days after treatment were compared between two groups. RESULTS AND CONCLUSION: (1) The swelling degree and visual analogue scale scores were significantlydecreased in the two groups after treatment (P < 0.05). Compared with the control group, all indicators were significantly improved in the experimental group (P < 0.05). (2) The total effective rate was 80% in the control group and 100% in the experimental group, and the obvious effective rate was 37% in the control group and 63% in the experimental group, both showing significant differences (P < 0.05). (3) These results suggest that the combination of kinesio taping and manual lymphatic drainage can markedly alleviate the low limb swelling and pain after TKA compared with single kinesio taping. 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

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Position and biomechanical characteristics of prosthesis in total hip arthroplasty Wang Chun-cheng, Li Ming-zhe 2017, 21 (11):  1652-1657.  doi: 10.3969/j.issn.2095-4344.2017.11.003 Abstract ( 456 )   PDF (3977KB) ( 226 )   Save BACKGROUND: Total hip arthroplasty is a commonly used treatment, but it is difficult to accurately determine the position of the pelvis, which is easy to cause pelvic displacement postoperatively. Additionally, the implant is likely to present with angle deviation, and the precise location and direction of prosthesis is difficult to identify. OBJECTIVE: To study the position and biomechanical characteristics of prosthesis in total hip arthroplasty. METHODS: (1) One male volunteer received CT examination, and a finite element model of the pelvic was established. Three acetabular placement positions (abduction angles of 0°, 20° and 25° combined with anteversion angles of 35°, 15° and 10°) were used to perform total hip arthroplasty, and the peak von Mises stress was detected under a load of 240 N. (2) Six cadaver specimens were collected and received the same interventions with the former experiment, and the stress changes at the bone cortex surrounding femoral shaft and acetabular anterior and posterior wall were measured using resistance strain technology. RESULTS AND CONCLUSION: (1) The peak von Mises stress in the acetabulum at abduction angle of 25° combined with anteversion angle of 10° increased by 25.7%. The peak von Mises stress in the acetabular cup at abduction angles of 0°, 20° and 25° combined with anteversion angles of 35°,15° and 10° was 135.21, 68.3 and 134.2 MPa, respectively. The peak von Mises stress in the lining at abduction angles of 0°, 20° and 25° combined with anteversion angles of 35°,15° and 10° was 6.8, 3.9 and 6.7 MPa, respectively. The peak von Mises stress in the femoral shaft at abduction angles of 0°, 20° and 25° combined with anteversion angles of 35°,15° and 10° was 127.1, 100.2 and 128.2 MPa, respectively. (2) The stress at the bone cortex surrounding femoral shaft and acetabular anterior and posterior wall at abduction angles of 0° and 25° combined with anteversion angles of 35° and 10° was significantly higher than that at abduction angle of 20° combined with anteversion angle of 15°. To conclude, an abduction angle of 20° combined with anteversion angle of 15° is conductive for functional recovery of the joint.    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

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Does a fixed distal femur resection angle influence radiographic alignment in total knee arthroplasty?   Ma Lu-yao, Guo Wan-shou, Ma Jin-hui, Yue De-bo 2017, 21 (11):  1658-1663.  doi: 10.3969/j.issn.2095-4344.2017.11.004 Abstract ( 490 )   PDF (4744KB) ( 237 )   Save BACKGROUND: The distal femur resection in total knee arthroplasty is commonly made using a fixed angle relative to an intramedullary rod. Does a fixed distal femur resection angle influence radiographic alignment in primary total knee arthroplasty? OBJECTIVE: To research the femoral mechanical-anatomical angle in Chinese and how it affects the femoral component angle and postoperative mechanical alignment for total knee arthroplasty. METHODS: Totally 109 cases (148 knees) underwent primary total knee arthroplasty. One surgeon used a fixed resection angle of 5° (group A; n=56 cases, 76 knees). The second surgeon adjusted the resection angle according to preoperative coronal alignment, using 5° for neutral/mild varus, 6° for more severe varus, 4° for mild valgus and 3° for severe valgus knees (group B; n=53 cases, 72 knees). Preoperative hip-knee-ankle angle, femoral mechanical-anatomical angle, postoperative hip-knee-ankle angle, femoral component angle and tibial component angle were measured from standing hip-knee-ankle angle radiographs. For postoperative hip-knee-ankle angle, 177°-183° were considered as neutral mechanical axis. For femoral and tibial component angles, the target results were 88°-92°. RESULTS AND CONCLUSION: (1) There was no statistically significant difference between groups in postoperative hip-knee-ankle angle (group A: (178.78±3.57)°, group B: (178.23±2.78)°; P=0.302) and good rate of hip-knee-ankle angle (group A: 62%, group B: 65%). (2) The mean femoral mechanical-anatomical angle was (6.70±1.34)° preoperatively. There was no significant difference in the good rate of hip-knee-ankle angle (hip-knee-ankle angle < 7°: 69%; hip-knee-ankle angle ≥7°: 55%; P=0.108) postoperatively. There was a statistically significant difference about good rate of femoral component angle between different femoral mechanical-anatomical angle angles (femoral mechanical-anatomical angle < 7°: 76%; femoral mechanical-anatomical angle ≥7°: 39%; P < 0.01). (3) There was a statistically significant correlation between preoperative femoral mechanical-anatomical angle and postoperative hip-knee-ankle angle (r=−0.42, P < 0.01) and postoperative femoral component angle (r=−0.58, P < 0.01). (4) The mean femoral mechanical-anatomical angle was larger than foreign values. When the resection angle less than femoral mechanical-anatomical angle, the femoral component may tend to be varus which could affect the lower extremity mechanical alignment. For the larger femoral mechanical-anatomical angle, we advise to adjust the resection angle according to measured value preoperatively.   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

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Degeneration of injured intervertebral disk affected by anterior longitudinal ligament destruction Sun Xin, Jin Wen-jie, Shen Kang-ping, Liu Xing-zhen 2017, 21 (11):  1664-1668.  doi: 10.3969/j.issn.2095-4344.2017.11.005 Abstract ( 384 )   PDF (5146KB) ( 245 )   Save BACKGROUND: The spinal instability would accelerate the degeneration of normal disk. The injuries of anterior longitudinal ligament (ALL) and intervertebral disk were usually caused by cervical trauma, which leaded to spinal instability. Currently, there were few animal researches about the degeneration of injured intervertebral disk affected by ALL destruction. OBJECTIVE: To investigate the degeneration of injured intervertebral disk after spinal instability in the rabbit model of different degrees of ALL and disc destruction. METHODS: A total of 24 New-Zealand rabbits were randomly divided into intervertebral disk injury group (Group A, n=6), partial injury of ALL with disc injury group (Group B, n=6), injury of bony attachment point of ALL with disc injury group (Group C, n=6) and entirely injury of ALL with disc injury group (Group D, n=6). The L2-L3 intervertebral disk and ALL were injured through abdominal cavity. Different groups received different treatments. Computed tomography (CT) scans of the injured disc were performed at the postoperative 4 and 8 weeks, and the middle high of injured discs was calculated on CT sagittal reconstruction. Three rabbits were selected from each group. Hematoxylin-eosin staining of injured disc was performed after the animals were killed. Results were examined under the light microscope. RESULTS AND CONCLUSION: (1) At postoperative 4 weeks, the middle height of injured discs in Group D was decreased significantly compared with Group A (P < 0.05). There were hyperosteogeny and calcification in Group C and Group D. There were nucleus pulposus cells reduction and inflammatory reaction in Group C and Group D on histological staining. (2) At postoperative 8 weeks, the middle height of injured discs respective was decreased significantly compared with Group A (P < 0.05). The hyperosteogeny and calcification became clearer in Group C and Group D than before. There were morphologic changes of nucleus pulposus cells and fibrillation by hematoxylin-eosin staining, and the degree of disc degeneration was Group D > Group C > Group B > Group A. (3) In conclusion, the injury of ALL would accelerate the degeneration of correspondingly injured disk, and the degree of injury of ALL was positively correlated with the degeneration of disk. 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

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Risk factors for hidden blood loss after total hip arthroplasty in patients with ankylosing spondylitis   Chen De-long, Chen Peng, Zhou Chi, Huo Shao-chuan, Liu Yong, Wang Hai-bin, He Wei 2017, 21 (11):  1669-1674.  doi: 10.3969/j.issn.2095-4344.2017.11.006 Abstract ( 327 )   PDF (1081KB) ( 250 )   Save BACKGROUND: Total hip arthroplasty is an effective measure to treat hip involvement in ankylosing spondylitis. Ankylosing spondylitis patients have different degrees of anemia after total hip arthroplasty. The hidden blood loss accounts for a large proportion of perioperative blood loss in total hip arthroplasty, and can affect the recovery of joint function. OBJECTIVE: To investigate risk factors of hidden blood loss after total hip arthroplasty in patients with hip involvement in ankylosing spondylitis. METHODS: We studied a consecutive series of 70 hips in 60 patients with ankylosing spondylitis hip involvement who were converted to cementless total hip arthroplasty. The average age of surgery was 35.12 years. The hidden blood loss was calculated according to Cross formula linear equation. The effects of operation time, erythrocyte sedimentation rate, C-reactive protein, body mass index, Bath ankylosing spondylitis radiology index, allogenic blood transfusion, and osteoporosis on hidden blood loss after total hip arthroplasty in patients with ankylosing spondylitis were analyzed. The patients were divided into the high blood loss group (≥ 480 mL) and the low blood loss group (< 480 mL) according to the high blood loss. Risk factors of high hidden blood loss after total hip arthroplasty in patients with ankylosing spondylitis were analyzed by single factor analysis and multivariate Logistic regression analysis (SPSS 17.0). RESULTS AND CONCLUSION: (1) The hidden blood loss after primary total hip arthroplasty in patients with ankylosing spondylitis was (737.76±419.18) mL, and the total blood loss was (1 312.83±487.41) mL, and the percentage of hidden blood loss was 51.48%. The high blood loss group included 41 hips, and the low blood loss group included 29 hips; and the ratio was 41:29. (2) Single factor analysis showed that the operation time, Bath ankylosing spondylitis radiology index and osteoporosis, allogenic blood transfusion, decrease of hemoglobin were significantly associated with high hidden blood loss. (3) Multivariate Logistic regression analysis showed that Bath ankylosing spondylitis radiology index, allogeneic blood transfusion, and decrease of hemoglobin were significantly associated with high hidden blood loss. (4) Hidden blood loss is an important portion of total blood loss after primary total hip arthroplasty in patients with ankylosing spondylitis. Bath ankylosing spondylitis radiology index, allogeneic blood transfusion and decrease of hemoglobin are risk factors for high hidden 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 Figures and Tables | References | Related Articles | Metrics

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Effects of lumbar plexus-sciatic nerve block combined with sevoflurane on cognitive function in elderly patients after hip arthroplasty: study protocol for a prospective, single-center, open-label, randomized, controlled, clinical trial   Guo Yan-hong, A Liang-de, Jia Zhen 2017, 21 (11):  1675-1680.  doi: 10.3969/j.issn.2095-4344.2017.11.007 Abstract ( 415 )   PDF (1175KB) ( 249 )   Save BACKGROUND: Elderly patients after total hip arthroplasty often suffer from postoperative cognitive dysfunction, but the precise mechanism remains unclear. Sevoflurane has been shown to regulate the expression of basic fibroblast growth factor in the brain. However, it is poorly understood whether sevoflurane can decrease cognitive dysfunction after hip arthroplasty. We assume that lumbar plexus-sciatic nerve block combined with sevoflurane can effectively decrease the incidence of cognitive dysfunction in elderly patients after hip arthroplasty. OBJECTIVE: To investigate the effects of lumbar plexus-sciatic nerve block combined with sevoflurane on cognitive function in elderly patients after hip arthroplasty. METHODS: A prospective, single-center, open-label, randomized, controlled, clinical trial will be finished at Qinghai University Affiliated Hospital, China. Seventy elderly patients undergoing unilateral total hip arthroplasty will be randomized into two groups. In the observation group, tracheal intubation will be conducted for general anesthesia after lumbar plexus-sciatic nerve block, accompanying sevoflurane inhalation for anesthesia maintenance. In the control group, tracheal intubation will be conducted for general anesthesia, accompanying intravenous administration of propofol for anesthesia maintenance. All patients will be followed up at 1 and 3 days after replacement. The primary outcome: Mini-Mental State Examination will be used to assess cognitive function at baseline, 1 and 3 days postoperatively. The secondary outcomes will be Montreal Cognitive Assessment, serum basic fibroblast growth factor expression at baseline, 1 and 3 days postoperatively; intraoperative blood loss and operation time; incidence of adverse effects intraoperatively, 1 and 3 days postoperatively. This trial has been approved by the Ethics Committee of Qinghai University Affiliated Hospital, China, and will be performed in accordance with the guidelines of the Declaration of Helsinki, formulated by the World Medical Association. Written informed consent will be obtained from all participants prior to the trial. DISCUSSION: This trial will verify that lumbar plexus-sciatic nerve block combined with sevoflurane can improve cognitive dysfunction in elderly patients after hip arthroplasty, observe the changes in serum basic fibroblast growth factor level, and further explore its therapeutic mechanism.  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

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Efficacy and safety of tranexamic acid on blood loss in patients with type 2 diabetes mellitus during total knee arthroplasty   Zhang Song, Zhang Tao, Yang Jian-wen, An Min, Tang Ben-sen 2017, 21 (11):  1681-1687.  doi: 10.3969/j.issn.2095-4344.2017.11.008 Abstract ( 440 )   PDF (1559KB) ( 325 )   Save BACKGROUND: Tranexamic acid has been used to reduce bleeding after total knee arthroplasty in patients for the reason of big trauma and blood loss. Diabetes mellitus patients may have the poor ability to resist infection and heal tissue and vascular lesions. There are still no relevant literature reports about whether the application of tranexamic acid will achieve hemostasis and does not increase the risk of venous thrombosis of lower limbs. OBJECTIVE: To evaluate the efficacy and safety of tranexamic acid on perioperative blood loss in osteoarthritis or rheumatoid arthritis patients complicated with type 2 diabetes mellitus during total knee arthroplasty. METHODS: One hundred patients with the diagnosis of osteoarthritis or rheumatoid arthritis patients complicated with type 2 diabetes mellitus were selected between January 2013 and January 2015. Among all the subjects, 46 patients who received the operation before January 2014 served as the control group and 54 patients who received the operation after January 2014 were selected as the treatment group. Patients in the treatment group received 15 mg/kg tranexamic acid dissolved in 250 mL normal saline by fast intravenous infusion before the end of the operation. The patients in the control group just received 250 mL normal saline. Perioperative bleeding, blood transfusion, hemoglobin, hematocrit and coagulation index level were compared between the two groups, and deep venous thrombosis of lower limbs was observed.  RESULTS AND CONCLUSION: (1) The postoperative drainage, hidden blood loss, total blood loss, transfusion volume, and transfusion rate in the treatment group were lower than that in control group (P < 0.05). (2) The levels of hemoglobin and hematokrit in the two groups were not significantly different, but decreased at 3 hours, 1 and 3 days after the surgery, and increased at 5 days postoperatively, but still lower than preoperatively. The levels of hemoglobin and hematokrit in the treatment group were significantly higher than that in the control group at different time points postoperatively (P < 0.05). (3) Prothrombin time, activated partial thromboplastin time, and fibrinogen were not significantly different preoperatively, during tourniquet removal, at 3 hours, 1 and 5 days postoperatively between the two groups. D-dimer levels were not significantly different preoperatively and during tourniquet removal in both groups, but increased at 3 hours, 1 and 5 days postoperatively; moreover, D-dimer levels were significantly lower in the treatment group than in the control group (P < 0.05). D-dimer levels were not significantly different between the two groups at 5 days after surgery. (4) Deep venous thrombosis of lower limbs was not visible in double lower limb venous ultrasonography in both groups at 5 days and 1 month postoperatively. (5) To decrease the blood loss, intravenous infusion of 15 mg/kg of tranexamic acid during total knee arthroplasty before tourniquet removel is effective and safe in osteoarthritis or rheumatoid arthritis patients complicated with type 2 diabetes mellitus.  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

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Effects of different graft materials and internal fixation methods on the intervertebral fusion time in atlantoaxial dislocation surgery Zou Xiao-bao, Ma Xiang-yang, Yang Jin-cheng, Xia Hong, Wu Zeng-hui, Wang Jian-hua, Ai Fu-zhi, Zhang Kai, Yin Qing-shui 2017, 21 (11):  1688-1694.  doi: 10.3969/j.issn.2095-4344.2017.11.009 Abstract ( 311 )   PDF (1831KB) ( 261 )   Save BACKGROUND: Posterior screw-rod fixation is a popularized method in the treatment of atlantoaxial dislocation to eventually achieve intervertebral fusion. There are various graft materials and fixation methods that show different fusion time. OBJECTIVE: To analyze the effect of different graft materials and internal fixation methods on the fusion time in the posterior atlantoaxial dislocation surgery. METHODS: 286 patients with reducible atlantoaxial dislocation undergoing C1-2 posterior screw-rod fixation and obtaining successful intervertebral fusion from August 2009 to December 2015 were analyzed retrospectively. Complete pedicle screw was used for C1 screw fixation, and pedicle or laminar screws were for C2 screw fixation. The graft materials included autogenous or allogeneic grains of cancellous bone. RESULTS AND CONCLUSION: The fusion time ranged from 3 to 24 months. The fusion time did not differ significantly among fixation methods (F=2.134, P=0.120). There was significant difference in the fusion time between graft materials (F=83.611, P=0.000). Besides, there was no correlation between internal fixation methods and graft materials (F=1.036, P=0.356). These results suggest that different C1-2 posterior internal fixation methods can provide stable and reliable environment for bone fusion, and autogenous bone is more beneficial for intervertebral fusion and shortens fusion time. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Zero-P anterior cervical fixation system for multilevel cervical myelopathy He Sheng-hua, Lai Ju-yi, Wang Ye-guang, Sun Zhi-tao, Wang Jian, Feng Hua-long, Huang Fei-qiang 2017, 21 (11):  1695-1700.  doi: 10.3969/j.issn.2095-4344.2017.11.010 Abstract ( 517 )   PDF (1218KB) ( 209 )   Save BACKGROUND: Zero-P anterior cervical fixation system is an important means for treatment of cervical myelopathy in recent years. Zero-P fixation system can achieve effective decompression of spinal cord and nerve, and restore cervical curvature, with good stability. OBJECTIVE: To investigate the biocompatibility of Zero-P for multilevel cervical myelopathy. METHODS: Totally 62 patients with multilevel cervical disease who were treated by anterior cervical discectomy and fusion with Zero-P were selected, including double segments in 47 cases, three segments in 13 cases and four segments in 2 cases. Clinical efficacy was evaluated by pain visual analogue scale score, Japanese Orthopedic Association score, neck disability index score at postoperative 1, 6, 12, 24 months. Simultaneously, incidence of postoperative complications, cervical intervertebral space height and Cobb angle changes were observed. RESULTS AND CONCLUSION:(1) 54 patients were followed 2 years after treatment by clinic or telephone. Mean operative time was (102.00±32.41) minutes; average blood loss was (62.45±18.36) mL. (2) Two patients affected mild throat discomfort at one day after operation, and the symptoms went to lift six days after. The remaining patients did not experience any other complications. (3) Visual analogue scale score and neck disability index score at 1, 6, 12 and 24 months after operation were all less than preoperatively (P < 0.05); Japanese Orthopedic Association scores were higher than preoperatively (P < 0.05); the Cobb angle was improved significantly and greater than before treatment (P < 0.05). Postoperative cervical intervertebral space height was significantly higher than preoperatively (P < 0.05). Japanese Orthopedic Association results showed that among 54 patients, excellent was found in 34 cases, good in 14 cases, average in 6 cases and poor in 0 cases; the excellent and good rate was 89%. (4) Zero-P has a good clinical efficacy for multilevel cervical myelopathy, relieves symptoms significantly and restores cervical curvature and height, and has a good biocompatibility.   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

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Three-dimensional analysis of pedicle screw entry point and lateral concave between articular process in lower cervical vertebrae   Lu Zheng-hao, Zhou Jing-hua, Wang Wei-guo 2017, 21 (11):  1701-1706.  doi: 10.3969/j.issn.2095-4344.2017.11.011 Abstract ( 329 )   PDF (1625KB) ( 346 )   Save BACKGROUND: The existing technique takes articular process and lateral mass as a reference mark. Due to differences of subjective judgment in operation and the impact of articular hyperplasia, some errors of screw entry point selection and serious complications such as vertebral artery or cervical spinal cord injury easily occurred, which limit the clinical application of the technique. At present, it is very important to select a constant reference mark of cervical pedicle screw entry point. OBJECTIVE: Three-dimensional reconstruction CT images were made to measure the relationship between the lower cervical pedicle screw entry point and “the lateral concave between articular process”. METHODS: Three-dimensional reconstruction of CT scan was performed in 30 patients with cervical deformity, and the occurrence rate and morphological characteristics of “the lateral concave between articular process” were observed. The following parameters were determined on specific reconstructed CT image of C3-C7: (1) the distance between pedicle axis projection point in the posterior surface and the outer edge of lateral mass in transversal section through bilateral pedicle axis and (2) the distance between the point and “the lateral concave between articular process” in oblique sagittal section through homolateral pedicle axis. Mean value and standard deviation were counted and statistics difference was compared. RESULTS AND CONCLUSION: (1) “The lateral concave between articular process” in lower cervical vertebrae was a obvious and less constant proliferative anatomical landmark and its occurrence rate was 100%. (2) Using CT technology of 3D reconstruction, C3-C7 lower cervical transversal section through bilateral pedicle axis and oblique sagittal section through homolateral pedicle axis were successfully obtained. (3) In transversal section, the left and right distances between C3-C7 pedicle axis projection point in the posterior surface and the outer edge of lateral mass were (4.1±0.9) mm and (4.3±0.9) mm, and the difference was not statistically significant (P=0.609). Except for C3 and C7, C4 and C7, there was no significant difference in the measured values of the same side (P > 0.05). (4) In oblique sagittal section, the left and right distances between C3-C7 point and “the lateral concave between articular process” were (-0.3±1.7) mm and (-0.3±1.6) mm, and the difference was not statistically significant (P=0.916). Except for C3 and C4, there was significant difference in the measured values of the same side (P < 0.05). (5) The above results suggest that the lower cervical pedicle entry point and “the lateral concave between articular process” have a relatively constant orientation relationship in transversal section and a large variation in the sagittal section. 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

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Bone graft to repair isthmus defect plus temporary single segmental screw rod fixation for adolescent lumbar spondylolysis Qu Wei, Huang Yun-fei, Song Zong-rang, Wu Qi-ning, Wang Yu-fei 2017, 21 (11):  1707-1711.  doi: 10.3969/j.issn.2095-4344.2017.11.012 Abstract ( 276 )   PDF (1572KB) ( 298 )   Save BACKGROUND: Lumbar spondylolysis is the common cause of teenagers’ low back pain. It should apply internal fixation if conservative treatment is invalid. There are a variety of surgeries, which aims to alleviate pain and bony fusion of pars defect. OBJECTIVE: To observe clinical outcome of bone graft of pars defect plus temporary single segmental pedicle screw rod fixation for adolescent lumbar spondylolysis. METHODS: A total of 32 adolescent patients of lumbar spondylolysis were treated by bone graft of pars defect plus temporary single segmental pedicle screw rod fixation. All the patients had bilateral spondylolysis. 20 patients had no lumbar spondylolisthesis, while the others had I° spondylolisthesis. All the patients received lumbar radiograph, CT and MRI. Visual analogue scale and Oswestry disability index were utilized to evaluate pain improvement before and after operation. MacNab was used to assess efficacy. Bone graft healing at isthmus was observed with lumbar CT after fixation. The internal fixation was removed after bone fusion, then the motion of the fixed segment and the degeneration of adjacent intervertebral disc occurred were recorded. RESULTS AND CONCLUSION:(1) Completed bone fusion of pars defect was achieved in all the patients. The average period of bone union was 7.4 months. (2) The visual analogue scale and Oswestry disability index scores were significantly improved after surgery in all patients (P < 0.05). (3) The fixed segment reserved the motion after internal fixation removal. The signal of adjacent intervertebral disc of fixed segment had no changes compared to preoperative MRI. (4) Bone graft to repair isthmus defect plus temporary single segmental screw rod fixation for adolescent lumbar spondylolysis is very effective, the bone fusion is completed, and temporary fixation may effectively alleviate the degeneration of adjacent disc. 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

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Anatomical study of plate invention for acetabular anterior column and baffle plate for acetabular quadrilateral body    Chen Hui-wen, Zhou Zheng-zhen, Wang Chao-jun, Zuo Rui, Guo Chun-yun, Huang Feng, Feng Ying-dong, Wei Bo, Kong Zhen, Chang Si-ling, Sun Yong-jian 2017, 21 (11):  1712-1717.  doi: 10.3969/j.issn.2095-4344.2017.11.013 Abstract ( 365 )   PDF (1341KB) ( 245 )   Save BACKGROUND: It remains poorly understood whether anterior column quadrilateral wing plate exists to solve intraoperative multiple plastic and quadrilateral in vivo shift for treating acetabular anterior column and acetabular quadrilateral body fractures. OBJECTIVE: To figure out the promising application on measurement of anatomical character parameters when designing acetabular anterior column and acetabular quadrilateral body using Mimics software. METHODS: 60 pelvic CT scan data were collected and three-dimensionally reconstructed by Mimics software. The following anatomical character parameters were measured, including the angle between plane of arcuate line of true pelvis and plane of quadrilateral surface, the four boundary lines of quadrilateral body, and the thickness of substance of bone in quadrilateral region. The projection curve on quadrilateral surface of acetabular margin and dangerous zone for screw placement were both drew. Above all, the study attempted to find out the proper safe entry point of quadrilateral screw and to measure their leaning inside angles. RESULTS AND CONCLUSION: (1) The angle between plane of arcuate line of true pelvis and plane of quadrilateral surface was not significantly different between males and females. (2) The minimum thickness of quadrilateral body in males was larger than that in females. (3) The maximum leaning angle flapper plate screw P1 and P2 for quadrilateral body was significantly smaller in males than in females, but that of screw P3 was not significantly different between males and females. (4) The application of Mimics software made it easier, more intuitive and more practical for the design or development of new plate for acetabular anterior column and acetabular quadrilateral body. The common points and difference between acetabular anterior column and acetabular quadrilateral body could be specifically described by the new anatomical character parameters, which are defined by bone surface features of pelvis.  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

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Augmentation plating and single plating for lower and distal femoral fractures with medial comminution    Wu Yong-wei, Rui Yong-jun, Gu San-jun, Sun Zhen-zhong, Yin Qu-dong, Zhou Zi-hong 2017, 21 (11):  1718-1722.  doi: 10.3969/j.issn.2095-4344.2017.11.014 Abstract ( 351 )   PDF (1473KB) ( 241 )   Save BACKGROUND: Lateral locking plate is a classical fixation method to treat lower and distal femoral fractures. However, the incidences of delayed healing, nonunion, plate extubation, and internal fixation rupture exceed 20% after internal fixation. OBJECTIVE: To compare the effectiveness of augmentation plating and single plating for distal and lower femoral fractures with medial comminution. METHODS: Totally 60 patients of lower and distal femoral fractures with medial comminution treated with open reduction and plate fixation were divided into augmentation plating (treatment group, 28 cases) and single lateral plating (control group, 32 cases). We observed the operation time and blood loss, recorded the out-off-bed rehabilitation time, full weight bearing time and complication. The functionary recovery of knee joint was evaluated according to Schatzker-Lambert method for distal femoral fractures in final follow-up. RESULTS AND CONCLUSION: (1) All patients were followed for at least 12 months. All incisions were healed by first intention. (2) The operation time and blood loss in the treatment group were greater than those in the control group (P < 0.05). (3) The healing time (3.11±0.31 months), out-off-bed rehabilitation time (4.36±0.91 weeks), full weight bearing time (3.67±0.62 months), complication (0) and excellent and good rate of knee functionary recovery (100%) in the treatment group were better than those in the control group [(5.65±2.33), (7.25±1.02), (6.03±2.61) months, 8, 65.6%] (P < 0.05). (4) Although augmentation plating for treatment of lower and distal femoral fractures with medial comminution prolongs operation time and increases surgical blood loss, the results including the healing rate, complication and satisfaction rate are superior to those treated with single lateral plating.  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

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Cervical vertebra corpectomy decompression with preserving the posterior wall of the corpectomied vertebral body combined with titanium-meshes and AO plate fixation: a finite element analysis Kang Zheng-yang, Wang Ke, Liu Bai-feng 2017, 21 (11):  1723-1729.  doi: 10.3969/j.issn.2095-4344.2017.11.015 Abstract ( 407 )   PDF (2664KB) ( 196 )   Save BACKGROUND: Cervical vertebra corpectomy decompression is one of the commonly used methods of anterior cervical decompression. In recent years, under the guidance of the principle of anterior cervical surgery, scholars propose the anterior cervical vertebra corpectomy decompression with preserving the posterior wall of the corpectomied vertebral body. It retains the posterior wall of the vertebral body, not only increases the stability of the cervical spine, but also increases the area of bone graft, which is conducive to the long-term fusion. At the same time, retaining posterior wall of the vertebral body can effectively prevent bone- and implant-induced spinal cord injury. OBJECTIVE: To evaluate the biomechanical stability of anterior cervical vertebra corpectomy decompression with preserving the posterior wall of the corpectomied vertebral body procedure on sheep by the establishment of finite element model with CT data. METHODS: Cervical vertebra specimens of adult sheep were selected, and scanned to capture its CT data. The geometrical model captured by CT was then transformed into finite element model through finite element software (without surgery). In the posterior wall preserving group, C4 corpectomy decompression was conducted while preserving its posterior wall followed by titanium-meshes and AO plate fixation. On the basis of posterior wall preserving group, corpectomy decompression was operated without preserving the posterior wall in another group; titanium mesh and plate were fixed. Finite element software was used to test and analyze the changes in stress and displacement of cervical vertebra under different conditions. RESULTS AND CONCLUSION: (1) The displacement was slightly small, and immediate postoperative stability was good in the posterior wall preserving group. However, the displacement and stress were not significantly different between posterior wall preserving group and posterior wall non-preserving group. (2) To sum up, a procedure preserving posterior wall of the vertebra body gains better immediate postoperative stability compared with conventional method. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Clinical application of the computer-aided movable and measurable ankle-foot orthosis Wang Yun-xia, Ran Chun-feng, Tang Ying, Chen Wei 2017, 21 (11):  1730-1736.  doi: 10.3969/j.issn.2095-4344.2017.11.016 Abstract ( 568 )   PDF (1453KB) ( 241 )   Save BACKGROUND: The traditional ankle-foot orthosis focuses on the protection, correction, stability, and compensation; therefore, it is important to explore a new rehabilitation method for ankle joint dysfunction. OBJECTIVE: To explore the effect of computer-aided movable and measurable ankle-foot orthosis that designed by the Department of Rehabilitation in Longgang Central Hospital of Shenzhen on postoperative dysfunction after ankle fracture. METHODS: Fifty-two patients with ankle fractures at 3 weeks after internal fixation were selected and equivalently randomized into two groups. Both groups received conventional oral medication and rehabilitation therapy. In addition, the patients in control group were given joint mobilization treatment, while those in experimental group were given computer-aided movable and measurable of ankle-foot orthosis, 20 minutes daily, 6 days weekly for consecutive 4 weeks. The efficacy was evaluated by muscle strength, active range of motion, Kofoed ankle score and visual analogue scale on computer at baseline, 7, 14, and 28 days after training. RESULTS AND CONCLUSION: (1) There were no significant differences in baseline data and ankle function scores between two groups before training (P > 0.05), and all above indicators were significantly improved in both two groups at 4 weeks after training (P < 0.05). (2) Compared with the control group, the muscle strength, Kofoed ankle score and visual analogue scale scores on computer in the experimental group were significantly improved at 7, 14 and 28 days after training (P < 0.05). (3) The active plantar flexion angle in the experimental group was significantly larger than that in the control group at 28 days after training (P < 0.05).The active plantar flexion and dorsiflexion angles at 7 and 14 days after training, and active dorsiflexion angle at 28 days after training did not differ significantly between two groups (P > 0.05). To conclude, the unique ankle-foot orthosis can reduce postoperative pain, enhance muscle strength and improve ankle mobility after ankle 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 Figures and Tables | References | Related Articles | Metrics

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Biomechanical property of tension band plate in the treatment of unstable pelvic fracture   Wang Qi 2017, 21 (11):  1737-1741.  doi: 10.3969/j.issn.2095-4344.2017.11.017 Abstract ( 570 )   PDF (927KB) ( 276 )   Save BACKGROUND: Tension band steel in unstable pelvic fractures can achieve the desired effect, but has not yet been confirmed by biomechanics. OBJECTIVE: To observe treatment effect and biomechanical property of the three kinds of tension band steel in different fixed positions of unstable pelvic fracture. METHODS: Nine adult antiseptic specimen pelvises were made into unstable pelvic injury models after completing normal pelvis detection. Depending on the position of the tension band fixation plate, these models were divided into group A, group B and group C. Group A: Plate fixation in bilateral posterior superior iliac spine, parallel to the plate ends with the pubis; group B: fixation on posterior superior iliac spine, both ends of the plate pointing forward; group C: plate below the posterior superior iliac spine, front top at both ends of the plate. Efficacy was compared among the three groups. The pelvic specimen was placed on the biomechanical testing machine. Axial stiffness and torsional stiffness were measured. Biomechanical properties of tension band plate in the treatment of unstable pelvic fracture were analyzed. RESULTS AND CONCLUSION: (1) The axial stiffness of the pelvic ring of the same specimens measuring three times was not significantly different (P > 0.05). The pelvic ring axial stiffness in order: group A > group C > group B (P < 0.05). (2) Torsional stiffness of the same specimens measuring three times was not significantly different (P > 0.05). Torsional stiffness was significantly lower in group A than in groups B and C (P < 0.05). (3) Vertical displacement of the same specimens measuring three times was not significantly different (P > 0.05). Vertical displacement in order: group B > group C > group A (P < 0.05). (4) The fixation on posterior superior iliac spine with both ends of the plate pointing forward obtained better biomechanical properties, and could be given priority by combining with pelvic fracture type. 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

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Biomechanical analysis of dynamic simulation of meniscus under different loading conditions Chen Wen-dong, Yang Guang 2017, 21 (11):  1742-1747.  doi: 10.3969/j.issn.2095-4344.2017.11.018 Abstract ( 410 )   PDF (2685KB) ( 477 )   Save BACKGROUND: At present, the meniscus injury is very common, and can lead to serious injury of the knee joint. Meniscus biomechanics has been reported, but no studies have concerned the biomechanical characteristics of the meniscus in knee buckling during gait under different loading conditions. OBJECTIVE: To simulate and analyze the biomechanical characteristics of the knee joint meniscus under different loading conditions using finite element method. METHODS: Based on the knee magnetic resonance imaging data of normal adult volunteers, three-dimensional finite element model of knee joint was reconstructed. The stress, distribution and changes in the meniscus under different flexion angles were analyzed at 300 N, 400 N and 500 N. RESULTS AND CONCLUSION: (1) Under the respectively loading conditions of 500 N, 400 N and 300 N, the maximum stress point all from the place of posterior horn of medial meniscus anterior surface of tibia moved to the posterior margin of the anterior tibial attachment of the lateral meniscus, and the maximum displacement all from the place of midpoint of the inner edge of the medial meniscus moved to front outer edge of the lateral meniscus during normal dynamic buckling process of 0°, 30°, 60° and 90°, and the range of stress and displacement of lateral meniscus was greater than that of medial meniscus; simultaneously, the distribution range of stress and displacement was proportional to the size of the loading and the angle of the buckling. (2) The three-dimensional finite element model of the knee joint meniscus can be used to effectively dynamically simulate the distribution of force and displacement under different loading conditions, and can provide evidence for speculation of the mechanism of the injury of the meniscus in clinic.  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

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Biomechanical effects of intervertebral disc degeneration on the cervical spine: a finite element analysis Li Bin, Zhao Wen-zhi, Chen Bing-zhi 2017, 21 (11):  1748-1752.  doi: 10.3969/j.issn.2095-4344.2017.11.019 Abstract ( 297 )   PDF (1073KB) ( 240 )   Save BACKGROUND: The biomechanics of cervical spine is complicated. It is an important way to select the appropriate biomechanical model and research method so as to explore the diagnosis and evaluation mechanism of cervical spine injury and prognosis judgement. OBJECTIVE: To discuss the alternation of cervical biomechanics after the degeneration of cervical disc and the influence of degeneration on cervical stability. METHODS: (1) A three-dimensional finite element model of cervical spine was established from the CT scan images of cervical spine of a healthy male volunteer, Solid-Works2015, HyperMesh and ANSYS11.0. We created a cervical three-dimensional finite element model. To simulate the degenerative disc by modified the mechanical characters and height of the disc model, we observed the biomechanics of the impact on the cervical spine (the range and the stress on intervertabral disc). RESULTS AND CONCLUSION: (1) The entire model with a total of 97 705 nodes and 372 896 elements. Ligament and joint capsule were also constructed. Face to face contact element was used in the facet joint, with complete structure and high accuracy of measurement of spatial structure. (2) The range of motion of cervical spine increased during degeneration compared with normal cervical segments (P < 0.05). (3) Intervertebral disc degeneration caused angle increase at disc and motion segment. Osteophyte formed on vertebral edge. Intervertebral disc degeneration caused cervical instability. Simultaneously, instability increased the disc degeneration.  中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Finite element model establishment of thoracolumbar hemangioma and biomechanical analysis   Jiang Ren-bing, Dong Lei, Liu Qi-zhen, Wu Jun-shen, Bai Jing-ping 2017, 21 (11):  1753-1757.  doi: 10.3969/j.issn.2095-4344.2017.11.020 Abstract ( 354 )   PDF (1083KB) ( 217 )   Save BACKGROUND: Most of studies focus on the biomechanical characteristics of thoracic spine neoplasm, but there is little report on the fracture risk in the patients with vertebral hemangioma through finite element analysis. OBJECTIVE: To establish a finite element model of vertebral hemangioma, and to analyze its biomechanical characteristics, and assess the risk of vertebral fracture. METHODS: Three-dimensional finite element models of T12-L2 vertebrae from normal individuals, the patients with vertebral hemangioma (hemangioma accounting for 20%, 40%, 60%, 80% of the vertebral cancellous bone) and bone cement filling were established, respectively, and then the mechanical characteristics were analyzed. The stress distribution and characters of each model were determined under a vertical static pressure of 600 N. RESULTS AND CONCLUSION: (1) Three-dimensional finite element models of T12-L2 vertebrae were established successfully. Under static pressure, the stress distribution of L1 cortical bone showed no significant difference among models, and the maximum stress all occurred at the base of pedicle, zygapophysial joint and isthmus. (2) The stress distribution did not differ significantly between vertebral hemangioma accounting for 20%-40% of vertebral cancellous bone with complete cortical bone and normal ones, but which differed significantly in hemangioma accounting for 60%-80%. (3) To conclude, the established thoracolumbar three-dimensional model is available. Additionally, biomechanical tests manifest that the completeness of cortical bone and destruction ratio of cancellous bone destruction are key factors for the fracture risk of vertebral hemangioma. 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

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Accuracy of X-ray fluoroscopy versus CT three-dimensional image navigation in cervical pedicle screw insertion   Yu Wei, Wang Lei, He Si-feng, Guo Hong-bin, Liu Dong-sheng 2017, 21 (11):  1758-1763.  doi: 10.3969/j.issn.2095-4344.2017.11.021 Abstract ( 375 )   PDF (1121KB) ( 392 )   Save BACKGROUND: Navigation systems all can improve the accuracy rate in cervical pedicle screw insertion, but cannot achieve desired outcomes because of some shortcomings, such as poor imaging quality, complicated operation, poor real-time performance, and invasive navigation. OBJECTIVE: To study the accuracy of X-ray fluoroscopy and CT three-dimensional image navigation in cervical pedicle screw insertion. METHODS: Totally 90 patients undergoing cervical pedicle screw insertion from the First Affiliated Hospital of Nanyang Medical College were enrolled, and randomly divided into control and experimental groups (n=45 per group). 132 cervical pedicle screws were inserted into the patients in the control group manually under X-ray fluoroscopy, and 128 ones were inserted into the patients in the experimental group assisted with CT three-dimensional image navigation. The operation time and intraoperative blood loss in the two groups were recorded. Postoperative CT three-dimensional reconstruction was performed to compare the placement accuracy between two groups. RESULTS AND CONCLUSION: The excellent and good rate of placement in the experimental group (95.3%) was significantly higher than that in the control group (88.6%, P < 0.05). (2) The operation time and intraoperative blood loss in the experimental group were significantly higher than those in the control group, and the navigation matching time and radiant quantity in the experimental group were significantly less than those in the control group (P < 0.05). (3) The Japanese Orthopedic Association scores showed no significant difference between two groups before surgery (P > 0.05), and were significantly improved in the experimental group compared with the control group at 3 and 6 months postoperatively (P < 0.05). The incidence of complications in the experimental group was significantly lower than that in the control group (7% versus 16%, P < 0.05). (5) These results suggest that compared with X-ray fluoroscopy, CT three-dimensional image navigation can improve the accuracy of cervical pedicle screw insertion, showing higher safety and precision. However, it needs complicated operation skills, and long operation time results in massive intraoperative blood loss; thereafter, choosing which placement method depends on the patient condition.   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

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Effect of femoral bowing angle on the lower limb alignment in different positions based on CT three-dimensional reconstruction   Wu Wei, Guo Wan-shou, Li Chuan-dong, Liu Zhao-hui, Zhang Qi-dong, Cheng Li-ming 2017, 21 (11):  1764-1769.  doi: 10.3969/j.issn.2095-4344.2017.11.022 Abstract ( 451 )   PDF (1171KB) ( 199 )   Save BACKGROUND: Measuring result of the lower limb alignment is often influenced by various factors, such as femoral bowing angle (FBA) in different positions. OBJECTIVE: To measure the FBA and femoral valgus correction angle (VCA) in different positions after CT reconstruction of lower limb model, and simulating X-ray examination, and to explore the rule of FBA affecting lower limb alignment. METHODS: Twenty patients undergoing CT angiography of lower extremity artery were enrolled, three-dimensional reconstruction of low limb was established on Mimics13.0 software based on CT data, and the FBA in standard posture was determined. All patients were divided into groups A (FBA > 2°), B (2° > FBA > 0°), C (0° > FBA > -2°) and D (FBA < -2°) (n=5 per group). Then each model was revolved through the vertical axis from 20° of internal rotation to 20° of external rotation by 2° for one motion, and 21 three-dimensional images were transformed into two-dimensional images to obtain the X-ray images of low limb. FBA and VCA in different positions were measured. RESULTS AND CONCLUSION: (1) The outcome measurements showed that FBA tended to be decreased in internal rotation and increased in external rotation. (2) VCA tended to be increased in external rotation and decreased in internal rotation. (3) FBA was positively correlated with VCA in the different positions (P < 0.01). (4) These results suggest that FBA can be altered with rotation and even expose influence on VCA. The bigger FBA is, the more influence on the lower limb alignment. Therefore, it is advisable to conduct the full length X-ray of lower limb in a standard posture, especially for the patients with larger FBA.    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

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Research advance in the biological characteristics of osteoclasts Xie Bing-jie, Feng Jie, Han Xiang-long 2017, 21 (11):  1770-1775.  doi: 10.3969/j.issn.2095-4344.2017.11.023 Abstract ( 407 )   PDF (1155KB) ( 311 )   Save BACKGROUND: Bone is a connective tissue that continuously modeling and remodeling. The dynamic homeostasis of bone is regulated by the process of osteoblasts synthesizing bone matrix and osteoclasts absorbing bone matrix. Osteoclasts have always been attracting numerous researches for its bone absorption. Along with the rapid development of gene knockout, biomolecular and other technologies, we have gone deeper and further lifting the veil of osteoclasts. OBJECTIVE: To overview the research regarding the molecular mechanisms and regulating factors of osteoclast formation, differentiation and function. METHODS: The first author retrieved PubMed database for the articles concerning molecular mechanisms and regulating factors of osteoclast formation, differentiation and function published from 1980 to 2015 using the keywords of “osteoclast, molecular regulation, bone resorption, regulation mechanisms”. Subsequently, a systamatice management, summary and analysis was performed. RESULTS AND CONCLUSION: A total of 151 literatures were searched, and 29 eligible articles were ultimately enrolled according to the inclusion and exclusion criteria. RANK/RANKL/OPG axis plays a significant role in modulating bone formation and resorption. Understanding the signaling pathways and molecular mechanisms of osteoclasts is of great significance for exploring osteoarticular diseases, osteogenesis, osteoimmunology, biomaterials and other aspects. 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

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Research and progress of high placement technique in total hip arthroplasty   Piao Shang, Du Yin-qiao, Zhou Yong-gang 2017, 21 (11):  1776-1782.  doi: 10.3969/j.issn.2095-4344.2017.11.024 Abstract ( 425 )   PDF (1825KB) ( 327 )   Save BACKGROUND: Bone defects are widely seen in patients with development dysplasia of hip or revision, thus resulting in a difficulty in acetabular treatment. High placement technique has been suggested to ensure the appropriate bone-prosthesis contact and simplify the surgery. Because biomechanics is involved, it has aroused many concerns, even its curative efficacy. OBJECTIVE: To summarize the research and progress of high placement technique applied in total hip arthroplasty (THA). METHODS: A computer-based online research was conducted for articles published until December 2016 in PubMed and CNKI databases using the keywords of “proximal placement, superior placement, high placement, high hip center, elevated hip center, total hip arthroplasty, revision total hip arthroplasty, dysplasia of developmental hip” in English and Chinese, respectively. Totally 67 literatures were retrieved, and finally 45 eligible articles were enrolled in accordance with the inclusion criteria. RESULTS AND CONCLUSION: (1) High placement technique is feasible for acetabular bone defects in THA, especially can simplify THA with complicated conditions. (2) Seemingly it goes against the principle of restoring anatomic hip center, but THA with high placement can obtain initial stability based on enough bone contact through adjusting the reconstruction position properly, interface improvement, appropriate prosthesis, as well as developed operations and conception, meanwhile, exposes no effect on biomechanics of hip. (3) Notably, the definition and term of high placement are chaotic in Chinese and English literatures, which need to be standardized further. 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

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Research progress of classification and pathogenesis in ankylosing spondylitis animal models Tan Xi, Xu Yong-yue, Qiu Dong-ni, Huang Run-yue, He Yi-ting 2017, 21 (11):  1783-1789.  doi: 10.3969/j.issn.2095-4344.2017.11.025 Abstract ( 551 )   PDF (1244KB) ( 316 )   Save BACKGROUND: Ankylosing spondylitis is a chronic inflammatory antoimmune disease involving the axial skeletion. So far, the pathogenesis of the disease is not clear. It still needs to build a more mature and stable animal model to promote further research. Since human tissue specimens of the spine and sacroiliac joint are very difficult to obtain, research has been hinders by limits availability of tissue samples from patients. The understanding of ankylosing spondylitis pathogenesis greatly depends on ankylosing spondylitis animal models. Howerer, the several animal models we have today cannot very good represent ankylosing spondylitis pathogenesis and disease progress.  OBJECTIVE: To summarize clinical and pathological characteristics of animal models of ankylosing spondylitis to further provide the basis for further improvement of this animal model.  METHODS: The databases of PubMed/CNKI were retrieved with key words of “Ankylosing Spondylitis, Animal Models, HLA-B27”. We excluded clinical research of new drugs and studies in animal models for the research methods or studies that did not mention the mechanism of animal models. Pathogenesis and pathological characteristics of animal models of ankylosing spondylitis were summarized. RESULTS AND CONCLUSION: This review included 37 studies and summarized three kinds of animal models of ankylosing spondylitis. All kinds of animal models have their own characteristics and disadvantages. They can simulate some features of ankylosing spondylitis. But to some extent, there is still lack of animal models of representing ankylosing spondylitis. The incidence of ankylosing spondylitis is closely related to the intestinal flora. The combination of different types of animal models is possible to reproduce more stable and perfect animal model of ankylosing spondylitis.  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

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Recent advances in vivo model of lumbar disc degeneration   Ma Sheng, Jia Yu-song, Sun Qi 2017, 21 (11):  1790-1797.  doi: 10.3969/j.issn.2095-4344.2017.11.026 Abstract ( 465 )   PDF (1473KB) ( 199 )   Save BACKGROUND: Establishment of lumbar disc degeneration in animal models can help doctors understand the development rules and pathophysiological changes of this disease, and can explore and research more rational treatment by creating animal models.  OBJECTIVE: To review recent advances in vivo model of lumbar disc degeneration. METHODS: The first author used the computer to search related articles on PubMed database and Chinese Journal Full-text Database from inception to May 2016. The search key words were “lumbar disc, degeneration, animal model, vivo model”. A total of 161 related articles were retrieved and 49 of them met the inclusion criteria. RESULTS AND CONCLUSION: (1) Building an intuitive and reliable animal model of lumbar disc degeneration will not only help the basic research of degenerative disc disease, but also provide a good experimental carrier for the repair treatment of degenerative lumbar disc. (2) After more than 80 years of development, the animal model of lumbar disc degeneration has formed a production mode of “more species, more methods and newer ideas”. Current models have their own advantages, cannot be replaced. However, problems such as poor controllability, low degree of safety or long observation period are still exiting more or less. All these need further research and exploration. 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

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Meta-analysis on interspinous dynamic stabilization system Wallis versus Coflex for lumbar degenerative disease   Zhao He, Yu Xing, Tang Xiang-sheng, He Feng, Yang Yong-dong, Xiong Yang, Hu Zhen-guo, Xu Lin 2017, 21 (11):  1798-1804.  doi: 10.3969/j.issn.2095-4344.2017.11.027 Abstract ( 553 )   PDF (1909KB) ( 213 )   Save BACKGROUND: It is still controversial that interspinous dynamic stabilization system Wallis and Coflex which one can provide better clinical effects for lumbar degenerative disease. OBJECTIVE: To systematically assess the clinical effectiveness and safety of Wallis and Coflex for lumbar degenerative disease. METHODS: According to the computer-based online search of PubMed, Embase, Medline, Cochrane Library, CBM, CNKI, Wanfang Database, and VIP, articles published before August 1st, 2016 were searched. Articles about Wallis comparing with Coflex for lumbar degenerative disease were included; the quality score of methodology was assessed by MINORS. Research data abstracted and synthesized by Review Manager 5.3 were used for meta-analysis. RESULTS AND CONCLUSION: (1) Six studies were included, and all studies were designed for non-randomized controlled trial. (2) There were no significant statistical differences in Japanese Orthopedic Association, Oswestry disability index, visual analogue scale score, Prolo functional score, segmental lordosis angle, and segment movement degree. Incidence of adverse events was significantlue scale less in the Wallis group than in the Conflex group (P < 0.05). (3) There was no significant difference in clinical efficacy between Wallis and Coflex in the early and mid-term follow-up. We can conclude that Wallis may provide better clinical safety than Coflex. 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