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28 May 2017, Volume 21 Issue 15 Previous Issue    Next Issue

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Influencing factors for the prognosis of the patients undergoing reversion metal-on-metal hip arthroplasty for inflammatory pseudotumor   Wang Heng, Wang Yue 2017, 21 (15):  2297-2302.  doi: 10.3969/j.issn.2095-4344.2017.15.001 Abstract ( 415 )   PDF (1187KB) ( 423 )   Save BACKGROUND: Reversion total hip arthroplasty for inflammatory pseudotumor is little reported. OBJECTIVE: To investigate the prognosis of the reversion total hip arthroplasty for inflammatory pseudotumor and the related factors. METHODS: Eighty-one patients failed metal-on-metal hip arthroplasty were recruited, the medical history, baseline data and information of primary arthroplasty were collected, and all preoperative examinations were completed prior to reversion. The postoperative joint function was evaluated by Hospital for Special Surgery score, and the morphology of prosthesis was observed by radiology. Additionally, the serum levels of cobalt and chromium ions were detected, as well as the incidence of complications and the related factors were analyzed. RESULTS AND CONCLUSION: (1) There was a significant increase in Hospital for Special Surgery hip score and significant decrease in serum levels of cobalt and chromium ions after reversion (P=0.000). (2) The postoperative incidence of complications and secondary reversion rate was 16% and 6%, respectively. (3) Preoperative prosthesis loosening (P=0.012), tissue cirrhosis revealed on MRI (P=0.000) and the injury degree of tissue (P=0.049) were found to be related to the incidence of complications. (4) Kaplan-Meier curve showed that the survival rate of prosthesis was 88% at 30 months postoperatively. (5) These results suggest that the prognosis of reversion total hip arthroplasty is poor, which is related to the preoperative aseptic loosening, tissue cirrhosis surrounding the joint and intraoperative tissue injury, thus providing guidance for surgeons to make an appropriate operative scheme.   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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Alendronate sodium/vitamin D3 for senile patients with osteoporosis after total hip arthroplasty Huang Fei-qi, Zhao Xiao, Yao Nai-jie, Chen Yan-mei 2017, 21 (15):  2303-2307.  doi: 10.3969/j.issn.2095-4344.2017.15.002 Abstract ( 444 )   PDF (1132KB) ( 500 )   Save BACKGROUND: Adverse events following total hip arthroplasty are commonly seen in elderly osteoporotic patients, especially prosthetic loosening caused by reduced bone density surrounding the prosthesis, which even needs reversion. OBJECTIVE: To investigate the effectiveness and safety of alendronate sodium/vitamin D3 for total hip arthroplasty in elderly patients with osteoporosis. METHODS: Seventy-four patients with osteoporosis were randomized to experimental and control groups (n=37 per group), and both received total hip arthroplasty, followed by the calcium supplementary treatment at 1-2 weeks. Meanwhile, the patients in the experimental group were orally given alendronate sodium/vitamin D3 (70 mg), once weekly. The course was 6 months in both two groups. RESULTS AND CONCLUSION: In the experimental group, the bone mineral density of the lumbar vertebrae and contralateral hip were significantly increased at 3, 6 and 12 months postoperatively compared with baseline, and also significantly higher than those in the control group (P < 0.05). (2) The incidence of aseptic loosening and prosthesis adjacent fracture did not differ significantly between two groups (P > 0.05). (3) The serum levels of creatinine, phosphorus and calcium all kept in normal values at baseline and 3, 6 and 12 months postoperatively in both two groups, and showed no significant differences before and after treatment between two groups (P > 0.05). (4) These findings indicate that alendronate sodium/vitamin D3 can effectively increase the bone mineral density of elderly osteoporotic patients after total hip arthroplasty free of significant adverse effects, and exposes no effect on renal function and calcium-phosphorus metabolism. 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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Effectiveness and safety of cemented versus cementless hip arthroplasty for senile unstable intertrochanteric fractures: study protocol for a prospective, nonrandomized, controlled clinical trial   Yu Tie-miao, Miao Hui-ling 2017, 21 (15):  2308-2313.  doi: 10.3969/j.issn.2095-4344.2017.15.003 Abstract ( 412 )   PDF (1091KB) ( 350 )   Save BACKGROUND: For elderly patients with unstable intertrochanteric fractures, hip arthroplasty is mainly applied due to the degenerative body function and difficulty in reduction. OBJECTIVE: To investigate the effectiveness and safety of cemented versus cementless hip arthroplasty for senile unstable intertrochanteric fractures. METHODS: We are conducting a prospective, single-center, non-randomized, controlled clinical trial at the Harrison International Peace Hospital, China. Eighty-six elderly patients with unstable intertrochanteric fractures were enrolled and allotted to control (n=44) and experimental (n=42) groups, followed by treated with cemented and cementless hip arthroplasty, respectively. The follow-up time is 6 months. The primary outcome is good and excellent rate according to Harris hip scores at 6 months postoperatively. The secondary outcomes are Harris hip scores and hip morphology on X-ray at 1, 3 and 6 months postoperatively, intraoperative blood loss, operation time, blood transfusion volume, time of off-bed and drainage volume at 1 month postoperatively, as well as the safety based on the incidence of adverse events at 6 months postoperatively. Partial results show that the blood transfusion volume and drainage volume postoperatively in the experimental group were significaintly higher than those in the control group (P < 0.05). There were no significant differences in the good and excellent rate according to Harris hip scores, Harris hip scores and incidence of adverse events between two groups at 6 months postoperatively (P > 0.05). There were four cases of bone cement implantation syndrome in the control group. The study protocol has been approved by the Ethics Committee of Harrison International Peace Hospital of China, approval number 2013-37. All protocols will be performed in accordance with the Ethical Principles for Medical Research Involving Human Subjects in the Declaration of Helsinki. Written informed consent was provided by each patient and their family members after they indicated that they fully understood the treatment plan. DISCUSSION: Cases were collected in January 2014 and the trial will be finished in December 2017. Cemented and cementless hip arthroplasty are mainly used to treat senile unstable intertrochanteric fractures. This study is designed to investigate the differences between cemented and cementless hip arthroplasty, thus providing referece for the treatment of unstable intertrochanteric fractures in the elderly. Partial trial results indicate that both cemented and cementless hip arthroplasties exhibit good curative efficacy and safety for senile unstable intertrochanteric fractures, while the occurrence of bone cement implantation syndrome in cemented hip arthroplasty should never be neglected. 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 two different tranexamic acid administration methods on perioperative blood loss in total hip arthroplasty: study protocol for a prospective, open-label, randomized, controlled clinical trial Hou Zhen-yang, Sun Yi-ling, Pang Tao, Lv Dong, Zhu Biao, Li Zhen, Chai Xing-yu, Xu Zheng-wen,Su Chang-zheng 2017, 21 (15):  2314-2319.  doi: 10.3969/j.issn.2095-4344.2017.15.004 Abstract ( 336 )   PDF (1046KB) ( 350 )   Save BACKGROUND: Reducing perioperative blood loss in total hip arthroplasty is a hot topic for joint surgeons. Both intravenous infusion and intra-articular injection of tranexamic acid significantly reduce perioperative blood loss, blood transfusion volume, and need for blood transfusion in patients undergoing total hip arthroplasty. However, differences between the intravenous and intra-articular methods are not clear. OBJECTIVE: To evaluate the effects of these two tranexamic acid administration methods on perioperative blood loss in patients undergoing total hip arthroplasty. METHODS: We are conducting a prospective, single-center, open-label, randomized, controlled clinical trial at the Tengzhou Central People’s Hospital, China. Ninety patients undergoing unilateral total hip arthroplasty have been randomized into three groups. In the intravenous infusion group (n=30), 15 mg/kg tranexamic acid diluted in 100 mL physiological saline was infused intravenously at the beginning of surgery and 20 mL of physiological saline was injected intra-articularly after deep fascia suturing. In the intra-articular injection group (n=30), 100 mL of physiological saline was infused intravenously at the beginning of surgery and a mixture of 1.5 g tranexamic acid and 20 mL physiological saline was injected intra-articularly after deep fascia suturing. In the control group (n=30), 100 mL of physiological saline was infused intravenously at the beginning of surgery and 20 mL of physiological saline was injected intra-articularly after deep fascia suturing. The primary outcome is hidden blood loss at 1 and 3 days postoperatively. The secondary outcomes are visible blood loss, need for blood transfusion, and mean blood transfusion volume intraoperatively and on days 1 and 3 postoperatively. Other outcomes are the incidence of adverse reactions and complications within 3 months of surgery. The study protocol has been approved by the Ethics Committee of Tengzhou Central People’s Hospital of China, approval number 2015-026. All protocols will be performed in accordance with the Ethical Principles for Medical Research Involving Human Subjects in the Declaration of Helsinki. Written informed consent was provided by each patient and their family members after they indicated that they fully understood the treatment plan. DISCUSSION: This trial was designed in April 2015. Cases were collected in July 2015. Data analysis will be finished in December 2017. This study is designed to investigate the effects of intravenous infusion versus intra-articular injection of tranexamic acid on perioperative blood loss in patients undergoing total hip arthroplasty to determine the more effective mode of administration. 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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Comparison of two kinds of femoral prosthesis for femoral neck fractures in hemiarthroplasty Li Guo-wei, Guo Yuan-qing, Chen Tao, Zhang Kui-bo, Zhang Da-wei, Yu Bing, Zhang Rong-kai 2017, 21 (15):  2320-2324.  doi: 10.3969/j.issn.2095-4344.2017.15.005 Abstract ( 579 )   PDF (1300KB) ( 237 )   Save BACKGROUND: Studies have shown that hemiarthroplasty is suitable for single femoral head diseases with normal acetabulum. But indications for choosing bone cement or biological fixation types, short- and long-term efficacy as well as the complications have not yet reached agreement. OBJECTIVE: To discuss the efficacy of two kinds of femoral prosthesis for femoral neck fractures in hemiarthroplasty, and the application of three-dimensional CT reconstruction in displaced fractures. METHODS: Clinical data of 73 cases of femoral head fractures undergoing hemiarthroplasty were analyzed retrospectively, and divided into bone cement and biological groups. All patients were followed up for 1.5 years, and the operation indexes, hospitalization time and hip joint function were compared; the consistent degree with intraoperative findings was compared through hip three-dimensional CT and X-ray examination simultaneously. RESULTS AND CONCLUSION: (1) There was no significant difference in the effective rate between groups (P > 0.05). (2) The operation time in the biological group was significantly shorter than that in the bone cement group (P < 0.05); the intraoperative blood loss and hospitalization time in the bone cement group were significantly less than those in the biological group (P < 0.05). (3) The Harris scores in the bone cement group were significantly higher than those in the biological group at 1 month after replacement (P < 0.05); the Harris scores in the biological group were significantly higher than those in the bone cement group at 18 months after replacement (P < 0.05); while there were no significant differences between two groups at 3, 6 and 12 months after replacement. (4) The hip three-dimensional reconstruction and X-ray examination showed no error compared with the intraoperative findings, reaching 100%. (5) Our findings suggest that age, disease history and bone quality should be considered when choosing an appropriate type of hemiarthroplasty for the patients with femoral neck fractures, and bone cement prosthesis is suitable for the elder patients with severe osteoporosis; while those with good bone quality should receive biological prosthesis. Besides, the diagnosis accuracy of three-dimensional reconstruction is superior to X-ray examination, which is conductive to fully understand displaced fractures.   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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Carbon fiber-reinforced polyetgeretherketone for femoral head prosthesis and its stability: a biomechanical analysis   Ji Zhi-hua, Jia Bing-shen, Zhou Li-yi, Fu Kun, Meng Zhi-bin, Yu Peng, Yun Da-ke 2017, 21 (15):  2325-2330.  doi: 10.3969/j.issn.2095-4344.2017.15.006 Abstract ( 432 )   PDF (1009KB) ( 295 )   Save BACKGROUND: Metal implants have been extensively applied in joint arthoplasty, but the stress shielding effect caused by its high elastic modulus results in a series of complications, such as bone resorption, bone atrophy and prosthesis loosening. Carbon fiber-reinforced polyetheretherketone (CF-PEEK) composites are anisotropic and exhibit more advantages used for prosthesis due to its low elastic modulus and high intensity. OBJECTIVE: To investigate the blood compatibility of CF-PEEK composites, and compare the biomechanical properties after arthroplasty between CF-PEEK composites and Co-Cr-Mo used for femoral head prosthesis. METHODS: (1) The blood compatibility of CF-PEEK composites was evaluated through hemolysis test. (2) Femoral samples from eight fresh cadavers were collected and randomly divided into two groups, followed by subjected to CF-PEEK and Co-Cr-Mo prosthesis replacement, respectively. The displacement between the prosthesis and bone was measured under loading 200, 400, 600, 800 and 1 000 N, and the torsional strength after arthroplasty was detected. RESULTS AND CONCLUSION: (1) The hemolysis rate of the CF-PEEK composites was 3.23% < 5%, which was in line with the national standards for biological evaluation of medical devices. (2) The micromovement in distal prosthesis was significantly less than that of proximal prosthesis under different loads in both two groups (P < 0.05). (3) The torsion angle under different loads in the CF-PEEK group was significantly less than that in the Co-Cr-Mo group (P < 0.05), and the torsion stiffness in the CF-PEEK group was significantly higher than that in the Co-Cr-Mo group (P < 0.05). (4) To conclude, the CF-PEEK composites possess good blood compatibility and stability, which can be used as a prosthesis material. 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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Impact of hypertension on delayed wound healing after femoral head replacement Liu Guo-yin, Jia Xiao-bao, Wu Wei-hua, Sun Xiao-cao, Gu Jie-qiong, Chen Jian-min 2017, 21 (15):  2331-2335.  doi: 10.3969/j.issn.2095-4344.2017.15.007 Abstract ( 568 )   PDF (928KB) ( 490 )   Save BACKGROUND: At present, most of the literature on joint replacement focus on the causes and countermeasures of long-term complications, but seldom focuses on causes of postoperative short-term complications, such as wound exudation and delayed union. Whether the incidence of sustained exudation and delayed wound healing in patients with hypertension after hip replacement is higher than that in patients with normal blood pressure is not reported at present. OBJECTIVE: To identify the correlation of hypertension with persistent wound exudation and delayed wound healing in patients after femoral head replacement. METHODS: Data of 205 elderly patients with femoral neck fractures were retrospectively analyzed. All patients underwent femoral head replacement. In accordance with the hypertension diagnostic criteria of 2010 Chinese Guidelines for the Management of Hypertension, patients were divided into hypertension group and control group. Intraoperative blood loss, postoperative blood loss, the days of prolonged wound exudation, the wound dehiscence, and the prevalence of delayed wound healing were compared between the two groups. Then, we analyzed the relationship of hypertension with wound exudation and delayed wound healing. RESULTS AND CONCLUSION: (1) The average systolic blood pressures were 153.55 mmHg and 128.82 mmHg in the hypertension and control groups, respectively (P < 0.05). (2) No significant difference in age, gender, MNA-SF score, diabetes, body mass index, intraoperative blood loss, and postoperative blood loss was found between the two groups  (P > 0.05). (3) The time of persistent wound exudation was 4.03 days and 2.08 days in the hypertension group and control group, respectively (P < 0.05). (4) The prevalence of delayed wound healing was significantly higher in the hypertension group than that in the control group (P < 0.05). (5) Hypertensive patients had a higher risk of prolonged wound exudation and delayed healing than their normotensive counterparts, and the hypertension is one of the important influence factors for delayed wound healing.  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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Anesthetic effect of different concentrations of low-dose hypobaric ropivacaine in elderly knee or hip replacement   Pang Liu-cheng, Zhao Feng, Yang Jian-sheng, Zhao Yan-fen 2017, 21 (15):  2336-2341.  doi: 10.3969/j.issn.2095-4344.2017.15.008 Abstract ( 441 )   PDF (1138KB) ( 327 )   Save BACKGROUND: Unilateral spinal epidural anesthesia with ropivacaine can reduce the perioperative pain in the elderly undergoing hip or knee arthroplasty, but choosing which concentration of small dose hypobaric ropivacaine is an issue of concern. OBJECTIVE: To explore the anesthetic and analgesic effects of unilateral spinal epidural anesthesia with different concentrations of low dose hypobaric ropivacaine in senile knee or hip replacement. METHODS: Ninety patients undergoing knee or hip replacement in the Henan Province Hospital of TCM from August 2014 to December 2015 were enrolled, and randomized into 0.15%, 0.5% and 0.25% ropivacaine groups (n=30 per group), followed by spinal epidural anesthesia at L3-4 or L2-3 lumbar interspace, respectively. RESULTS AND CONCLUSION: (1) The order of the flat subsided time and motor block recovery time was as follows: 0.15% ropivacaine group < 0.25% ropivacaine group < 0.5% ropivacaine group; the onset time of motor block was longest in the 0.25% ropivacaine group, followed by 0.5% ropivacaine group, and shortest in the 0.15% ropivacaine group (all P < 0.05). (2) The order of the visual analogue scale scores at 1, 5, and 10 hours after anesthesia and 24 hours postoperatively was as follows: 0.5% ropivacaine group < 0.25% ropivacaine group < 0.15% ropivacaine group (P < 0.05). (3) The change levels of heart rate and blood pressure were highest in the 0.5% ropivacaine group, followed by 0.15% ropivacaine group, and lowest in the 0.25% ropivacaine group. (4) The incidence of adverse events was highest in the 0.5% ropivacaine group, followed by 0.15% ropivacaine group, and lowest in the 0.25% ropivacaine group (P < 0.05). (5) To conclude, 3 mL of 0.25% ropivacaine exhibits desired anesthetic 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

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Pedicle screw fixation combined with posterior-lateral fusion with autogenous bone for thoracolumbar burst fractures   Dong You-jun, Wu Liang, Wu Guo-feng, Zhou Jian, Wang Kun, Sun Han, Sun Xiao-liang 2017, 21 (15):  2342-2348.  doi: 10.3969/j.issn.2095-4344.2017.15.009 Abstract ( 482 )   PDF (1382KB) ( 314 )   Save BACKGROUND: Spinal reconstruction plays an important role in the treatment of thoracolumbar burst fractures, but wherther the vertebral fusion can effectively reduce the loss of correction still remains controversial. OBJECTIVE: To investigate the repair effect of pedicle screw fixation combined with posterior-lateral fusion with autogenous bone for thoracolumbar burst fractures. METHODS: Eighty patients with thoracolumbar burst fractures undergoing pedicle screw fixation from January 2011 to June 2015 were enrolled, and were then randomly divided into experimental (posterior-lateral fusion with autogenous bone) and control groups (n=40 per group). The clinical efficacy was assessed according to the operation time, intraoperative blood loss and postoperative drainage volume, wound scale scores, anterior vertebral height and Cobb angle, American Spinal Injury Association impairment scale, and Oswestry dysfunction index. RESULTS AND CONCLUSION: (1) All patients were followed up for 24 months. The operation time, intraoperative blood loss and postoperative drainage volum in the experimental group were significantly more than those in the control group (P < 0.05). (2) The anterior vertebral height and Cobb angle were significantly improved in both two groups (P < 0.01), and there was slight loss in vertebral height and Cobb angle in both two groups durring follow-up, but showed no significant difference between two groups (P > 0.05). (3) The American Spinal Injury Association impairment scale and Oswestry dysfunction index scores were significantly improved in the two groups, but had no significant difference between two groups (P > 0.05). (4) These results suggest that pedicle screw internal fixation is effective and safe for thoracolumbar burst fractures. Posterior-lateral fusion with autogenous bone allograft holds a good histocompatibility, but cannot reduce postoperative correction loss, therefore, it is not recommended for vertebral burst fractures. 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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Anterior cervical microsurgical discectomy combined with cage and anterior locking titanium plate for cervical spondylosis: retrospective analysis of 108 cases Ran Chun-xiao, Lu Jian-min 2017, 21 (15):  2349-2354.  doi: 10.3969/j.issn.2095-4344.2017.15.010 Abstract ( 545 )   PDF (1316KB) ( 378 )   Save BACKGROUND: Anterior cervical discectomy combined with cage and anterior locking titanium plate is widely used for the treatment of various kinds of cervical spondylosis. Microsurgical technique has increasingly become a standard technique. OBJECTIVE: To explore the clinical effects of anterior cervical microsurgical discectomy combined with cage and anterior locking titanium plate for cervical spondylosis. METHODS: Clinical data of 108 patients treated with anterior cervical microsurgical discectomy combined with cage and anterior locking titanium plate were retrospectively analyzed. According to the clinical outcome before and after surgery, including the scores of Japanese Orthopedic Association, visual analogue scale of neck and upper extremities, neck disability index, imaging manifestations (disc space height and Cobb angle) and other indexes, the surgical results were evaluated. RESULTS AND CONCLUSION: Compared with pre-operation, the postoperative Japanese Orthopedic Association score, visual analogue scale score of neck and upper extremities, neck disability index score, disc space height and Cobb angle were markedly improved, with a significant difference (P < 0.05). The improvement-rate of the spinal function included 102 excellent cases and 6 good cases. Complete fusion of bone graft observed in all cases. It suggested that anterior cervical microsurgical discectomy combined with cage and anterior locking titanium plate has significant effect on various types of cervical spondylosis.  中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Titanium mesh cage subsidence following anterior subtotal vertebrectomy for cervical spondylosis: the underlying mechanism and its effect on cervical neurologic function Pan Meng-xiao, Chen De-yu, Chen Yu 2017, 21 (15):  2355-2360.  doi: 10.3969/j.issn.2095-4344.2017.15.011 Abstract ( 596 )   PDF (2105KB) ( 377 )   Save BACKGROUND: Anterior subtotal vertebrectomy and fusion using titanium mesh cage (TMC) is an effective surgical treatment for cervical spondylosis, while TMC subsidence usually occurs. The risk factors for TMC subsidence and its effect on the treatment outcomes remain controversial. OBJECTIVE: To investigate the TMC subsidence after anterior subtotal vertebrectomy and TMC fusion and its effect on the treatment outcomes, thereby understanding the underlying mechanism and related risk factors. METHODS: Clinical data of 34 patients undergoing anterior subtotal vertebrectomy and TMC fusion in the Second Department of Spine, Shanghai Changzheng Hospital Affiliated to the Second Military Medical University from March to September 2015 were analyzed retrospectively. After 12-month follow-up, the height of the fused segments was measured, and the neurologic outcomes were evaluated using the Japanese Orthopedic Association scores. The loss of the fused segments subsided more than 3 mm compared with that at 1 day postoperatively was considered as TMC subsidence, and all patients were allotted to TMC subsidence and control (without TMC subsidence) groups. RESULTS AND CONCLUSION: (1) Totally 19 patients (56%) experienced TMC subsidence that occurred in postoperative (6.00±3.73) months averagely. (2) No significant differences were found in the age, sex or the level of fused segments between two groups (P=0.731, 0.672, 0.053). (3) The Japanese Orthopedic Association recovery ratio in the control group was significantly higher than that in the TMC subsidence group (P=0.01), suggesting that TMC subsidence might be correlated with the poor improvement of neurologic function after surgery. (4) To conclude, TMC subsidence is a common complication after anterior subtotal vertebrectomy, which does harm to the treatment outcomes. Moreover, age, sex or the level of fused segments are not independent risk factors for TMC subsidence. Figures and Tables | References | Related Articles | Metrics

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Variations of sacral slope at the early stage after posterior lumbar interbody fusion and its clinical significance   He Ke-yun, Li Zhi-zhong, Hu Zhao-hui 2017, 21 (15):  2361-2365.  doi: 10.3969/j.issn.2095-4344.2017.15.012 Abstract ( 1478 )   PDF (986KB) ( 283 )   Save BACKGROUND: Loss of sacral slope has been shown to be an important anatomic basis for low back pain. The effect of sacral slope changes after lumbar fusion on pain relief remains unclear. OBJECTIVE: To analyze the variations of sacral slope and clinical significance at the early stage after posterior lumbar interbody fusion at L4-5. METHODS: Sixty patients with herniation at disc levels L4-5 and spinal stenosis (n=38) or lumbar spondylolisthesis at L4 (n=22) undergoing posterior lumbar interbody fusion were enrolled. All patients were followed up for 12-24 months to compare the sacral slop at baseline and postoperatively. The clinical outcomes were evaluated by MacNab criteria, and its correlation with age, sex and sacral slop variations was analyzed. RESULTS AND CONCLUSION: At 12-24 months postoperatively, the sacral slope in the two groups was significantly improved than that at baseline (P < 0.05), but there was no significant difference in sacral slop between two groups (P > 0.05). The age, sex and sacral slop variations showed no significant effects on the early clinical outcomes (P > 0.05). These results suggest that posterior lumbar interbody fusion can markedly improve the sacral slope in patients with spinal stenosis and lumbar spondylolisthesis at early period. Furthermore, age, sex, and sacral slope variations all show no obvious effect on postoperative early functional recovery. 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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Application of spinal localizer in preoperative localization for minimally invasive percutaneous pedicle screw fixation   Yi Guo-liang, Song Xi-zheng, Wang Wen-jun, Yao Nv-zhao 2017, 21 (15):  2366-2371.  doi: 10.3969/j.issn.2095-4344.2017.15.013 Abstract ( 368 )   PDF (3074KB) ( 297 )   Save BACKGROUND: Minimally invasive percutaneous pedicle screw fixation possesses the advantages of less blood loss, less muscle and soft tissue dissection, and rapid recovery; however, accuracy of the screw positioning is the key to be successful. OBJECTIVE: To explore the application value of self-designed spinal localizer in the screw positioning for minimally invasive percutaneous pedicle screw fixation. METHODS: 428 patients with thoracolumber disorders were subjected to minimally invasive percutaneous pedicle screw fixation at the First Affiliated Hospital of University of South China, from March 2009 to March 2015, and randomly underwent the preoperative screw positioning by self-designed spinal localizer or one of traditional localizing methods (iliac crest, ribs, symptomatic vertebral appearance, skin marker, Kirscher wire, puncture needle localizations). The location accuracy, positioning time and radiographic times were compared among methods. RESULTS AND CONCLUSION: (1) Compared with the traditional localization methods, the self-designed spinal localizer was superior in accurate rate (P < 0.05), cost less positioning time (P < 0.05) and received less radiation (P < 0.05). (2) To conclude, the self-designed localizer exhibits a certain application value, which is an ideal method in preoperative localization for minimally invasive percutaneous pedicle 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

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Proximal femoral nail anti-rotation versus locking proximal femoral plate for osteoporotic unstable intertrochanteric fractures in senile patients   Wang Jiang-jing, Hu Si-bin, Song Hong-hui, Cui Lu-kuan 2017, 21 (15):  2372-2377.  doi: 10.3969/j.issn.2095-4344.2017.15.014 Abstract ( 441 )   PDF (1985KB) ( 284 )   Save BACKGROUND: Senile intertrochanteric fracture is characterized as aging, instability, more complications and high mortality, so choosing an appropriate internal fixation method is critical. OBJECTIVE: To compare the curative efficacy of proximal femoral nail anti-rotation and locking proximal femoral plate for senile osteoporotic patients with unstable intertrochanteric fractures. METHODS: Sixty elderly patients with unstable intertrochanteric fractures were enrolled, and the clinical data were collected. They were randomized into treatment and control groups (n=30 per group), and subjected to internal fixation using proximal femoral nail anti-rotation and locking proximal femoral plate, respectively. The operative indexes, functional recovery and complications were observed in the two groups RESULTS AND CONCLUSION: (1) The incision length, operation time, intraoperative blood loss and time of weight bearing in the treatment group were significantly less than those in the control group (P < 0.01). (2) Harris hip scores in the treatment group were significantly higher than those in the control group (P < 0.05). (3) The incidence of complications in the treatment group was obviously lower than that in the control group. (4) To conclude, the proximal femoral nail anti-rotation exhibits satisfactory treatment outcomes in the internal fixation of unstable intertrochanteric fractures. 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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Locking compression plate combined with minimally invasive percutaneous plate fixation versus intramedullary interlocking nailing for senile distal tibia fractures Zhang Zhi-xin, Zhou Jun-dong, Chen Xing-yang, Shao Lei 2017, 21 (15):  2378-2382.  doi: 10.3969/j.issn.2095-4344.2017.15.015 Abstract ( 523 )   PDF (995KB) ( 345 )   Save BACKGROUND: In the treatment of senile distal tibia fractures, locking compression plate (LCP) combined with minimally invasive percutaneous plate osteosynthesis (MIPO) exerts a satisfactory repair effect, and contributes to the function recovery of lower limbs. OBJECTIVE: To retrospectively analyze the efficacy of LCP combined with MIPO versus intramedullary interlocking nailing for senile distal tibia fractures. METHODS: Fifty-six elderly patients with distal tibia fracture were allotted to minimally invasive and intramedullary nailing groups (n=28 per group), and received the treatment of LCP combined with MIPO and intramedullary interlocking nailing fixation, respectively. The operation time, intraoperative blood loss, postoperative AOFAS ankle-hind foot scale scores, postoperative ambulation time, healing time, postoperative complications and the excellent and good rate in Johner-Wruhs’ criteria were compared between two groups. RESULTS AND CONCLUSION: (1) The operation time, AOFAS ankle-hind foot scale scores, ambulation time, and healing time in the minimally invasive group were significantly superior to those in the intramedullary nailing group (P < 0.05). (2) The minimally invasive group showed a significantly higher excellent and good rate (96%) than the intramedullary nailing group (79%) (P < 0.05). (3) Compared with the intramedullary nailing group, the incidence of complications was significantly reduced in the minimally invasive group (P < 0.05). (4) Our findings suggest that the combination of LCP and MIPO not only preserves the most of blood supply, and soft tissues surrounding the fracture end as suggested by the BO principle, but also is conducive for fracture healing, and holds good 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

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Locking plate can prevent the loss of reduction for intra-articular calcaneal fractures Liu Wen-hu 2017, 21 (15):  2383-2387.  doi: 10.3969/j.issn.2095-4344.2017.15.016 Abstract ( 406 )   PDF (1021KB) ( 325 )   Save BACKGROUND: Comminuted intra-articular fractures of the calcaneus are difficult to treat, and inappropriate treatment will lead to some sequelae such as talalgia, traumatic arthritis and flatfoot, which do harm to functional recovery. OBJECTIVE: To compare the clinical efficacy of locking and traditional plates for intra-articular calcaneal fractures METHODS: Seventy-six patients (94 feet) with intra-articular calcaneal fractures were enrolled, and received open reduction and plate internal fixation. All patients were allotted to two groups based on the fixation materials, including locking plate and traditional plate groups. The healing time, AOFAS scores, Visual Analogue Scale scores, loss of Bohler angle and adverse events were compared between groups. In addition, the loss of Bohler angle of osteoporotic patients was compared between groups. RESULTS AND CONCLUSION: There were no significant differences in the healing time, AOFAS scores, Visual Analogue Scale scores and Bohler angle between two groups after surgery (P > 0.05). But for osteoporotic patients, compared with the traditional plate group, the loss of Bohler angle was smaller in the locking plate group. These results suggest that the various clinical and radiographic indicators of locking plate and traditional plate for intra-articular calcaneal fractures show no significant differences. For osteoporotic patients, locking plate has certain advantages in preventing loss of joint reduction, but large-size trials are needed.    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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Dynamic characteristics of the lumbosacral vertebrae based on three-dimensional finite element models    Wu Xiao-dan, Zhang Shun-xin, Fan Shun-cheng, Li Ye, Jia Shao-wei, Xie Jun-de, Han Li 2017, 21 (15):  2388-2394.  doi: 10.3969/j.issn.2095-4344.2017.15.017 Abstract ( 402 )   PDF (1426KB) ( 273 )   Save BACKGROUND: Inherent modal analysis and harmonic response analysis on the human normal lumbosacral vertebrae have been reported, but there is a lack of comparative research on their modal analysis results before and after pedicle screw fixation. OBJECTIVE: To explore the dynamic characteristics of human lumbosacral vertebrae using three-dimensional finite element method. METHODS: Finite element model of lumbosacral vertebrae (L1-S1) before and after pedicle screw fixation was developed and validated based on CT images, and the modal analysis and harmonic response analysis were then conducted. RESULTS AND CONCLUSION: (1) Representative nodes were selected at the spinous process segments of L1, L3 and L5, and numbered as A, B, and C, respectively. (2) The maximum displacement of each node in Y and Z directions of lumbosacral vertebral model after internal fixation was significantly decreased compared with those of the normal lumbosacral vertebral model, suggesting that screw fixation system plays a protective role in lumbosacral vertebrae, and reduces its amplitude under external load, thus diminishing its sensitivity to external load. (3) The lumbosacral vertebral modal analysis can provide basis for further study on dynamic analysis, and the parameters such as natural frequency, modal shape and vibration amplitude of the lumbar spine have been determined. 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 printing technology-aided total knee arthroplasty for osteoarthritis with genu varum deformity   Sun Zhen-guo, Zhu Jia-jun, Cui Yan, Ni Sheng-hui, Zhang Zhi-yu 2017, 21 (15):  2395-2399.  doi: 10.3969/j.issn.2095-4344.2017.15.018 Abstract ( 462 )   PDF (1053KB) ( 476 )   Save BACKGROUND: The complicated localization of intramedullary nails and osteotomy more dependent on surgeons’ experience limit the application of conventional total knee arthroplasty (TKA). The occurrence of three-dimensional (3D) printing technology can achieve precise localization and osteotomy in TKA. OBJECTIVE: To explore the effectiveness of 3D printing technology-aided TKA versus conventional TKA for genu varum. METHODS: Thirty-four patients with genu varum undergoing primary unilateral TKA were recruited and were then divided into two groups (n=17 per group) in accordance with the random number table. One group was treated with TKA with 3D printing guild plate (3D printing group), while the other group received the conventional TKA (conventional group). The intraoperative and postoperative blood loss, operation time, as well as the Hospital for Special Surgery score, range of motion, and lower limb mechanical alignment at 2 weeks postoperatively were compared between two groups. RESULTS AND CONCLUSION: (1) The range of motion of knee in the 3D printing group was larger than that in the conventional group, but had no significant difference at 2 weeks postoperatively (P=0.744). (2) There was no significant difference in the Hospital for Special Surgery scores between two groups at 2 weeks postoperatively (P= 0.532). (3) The postoperative lower limb mechanical alignment showed no significant difference between two groups (t=0.218, P=0.632). (4) The operation time in the 3D printing group was significantly shorter than that in the conventional group (P=0.000). (5) The blood loss in the 3D printing group was significantly less than that in the conventional group (P=0.000). (6) Our findings indicate that 3D printing technology-aided TKA exhibits similar results to the conventional TKA in the Hospital for Special Surgery scores, range of motion, and lower limb mechanical alignment, but it shortens the operation time, reduces the blood loss, and achieves precise osteotomy, which is available for the elderly with poor basic condition, and weak tolerance of 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 Figures and Tables | References | Related Articles | Metrics

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Thoracolumbar pedicle anatomy in Han and Uygur male population in Xinjiang Uygur Autonomous Region: a computed tomography-based morphometric study    Yang Xiao-kai, Liu Shuai, Li Lei, Huang Wei-min, Zhang Yu-kun, Bi Jin-kun, Zhou Gang 2017, 21 (15):  2400-2405.  doi: 10.3969/j.issn.2095-4344.2017.15.019 Abstract ( 508 )   PDF (1190KB) ( 301 )   Save BACKGROUND: Thoracolumbar segments (T11-L2) prone to damage due to its special anatomical and biomechanical characteristics. Therefore, fully understanding the shape of pedicle of vertebral arch and finding the visible, constant, and the point of insertion of the pedicle axis is very important to the safety of pedicle screw placement. OBJECTIVE: To measure the surgically relevant parameters of thoracolumbar pedicles between Han and Uygur males using computed tomography (CT) scan to provide some anatomic reference data for pedicle screw fixation. METHODS: The vertebral bodies and pedicles of adult males were scanned (60 cases of Han people and 60 cases of Uygur people) from T10-L3 with CT. The parameters were processed by three-dimensional reconstruction. Transverse pedicle width, pedicle axis length, transverse pedicle angle, and sagittal pedicle angle were measured by using length and angle measurement tool of browser in bone-window CT images. The age and stature information were recorded. All the data above were processed by SPSS 13.0 software. RESULTS AND CONCLUSION: (1) The mean transverse pedicle width of T12 and L1 in Han was bigger than that in the Uygur. (2) The mean transverse pedicle angle of T12 and L2 in Han was bigger than that in the Uygur. (3) The mean pedicle axis length and sagittal pedicle angle of T11 and L1 in Han were bigger than that in the Uygur (P < 0.05). (4) There were some differences among some parameters of the thoracolumbar pedicles between the Han and Uygur people. Data from any study only can be used as a guide for pedicle screw fixation. Preoperative CT evaluation may provide an individualized strategy to reduce the incidence of postoperative complications caused by misplacement. 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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MRI diagnostic criteria for ischiofemoral impingement syndrome Zhang De-zhou, Li Dong-ming, Yi Xue-bing, Luo Hua 2017, 21 (15):  2406-2409.  doi: 10.3969/j.issn.2095-4344.2017.15.020 Abstract ( 1116 )   PDF (834KB) ( 319 )   Save BACKGROUND: Ischiofemoral impingement (IFI) syndrome has attracted more and more attention, but there is little report on IFI because of its low incidence. Moreover, its imaging characters have not yet been fully understood. OBJECTIVE: To discuss the MRI diagnostic criteria for IFI, thus understanding the imaging characters of IFI revealed on MRI. METHODS: Sixteen cases (21 hips) of suspected IFI were selected as experimental group, and 25 healthy volunteers as control group. The bilateral ischiofemoral space (IFS, the shortest distance between the ischial tuberosity and lesser trochanter of femur) and quadratus femoris space (QFS, distance between the lesser trochanter of femur and hamstring tendon insertion) were measured on MRI axial image. The signal and morphology of the quadratus femoris were observed. The differences in QFS and IFS were compared between two groups. RESULTS AND CONCLUSION: (1) Among 16 patients, there were 13 females, and 3 males, and 5 female cases of bilateral IFI. (2) In the experimental group, the IFS ((13.65±3.87) mm versus (22.17±5.75) mm) and QFS ((7.15±3.50) mm versus (12.89±3.13) mm) showed significant differences between affected and opposite sides (P < 0.01). (3) In the control group, the IFS ((23.59±6.14) mm versus (23.08±5.82) mm) and QFS ((12.41±3.75) mm versus (13.22±3.84) mm) did not differ significantly between left and right sides (P > 0.05). (4) Compared with the control group, there were significant differences in IFS and QFS of the affected side in the experimental group, and no significant differences in IFS and QFS of the opposite side. (5) In the experimental group, quadratus femoris appeared with deformation, edema and atrophy. (6) To conclude, the incidence of IFI in females is significantly higher than that in males, and bilateral hips are usually affected. MRI diagnostic criteria for IFI are IFS ≤ 11.46 mm, QFS ≤ 5.53 mm of the affected side, and quadratus femoris present edema and deformation, which are more sensitive on axial fat-suppressed MRI imaging. 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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Design of the porous orthopedic implants: research and application status Liang Hao-jun, Li Rui-yan, Liu Guan-cong, Qin Yan-guo 2017, 21 (15):  2410-2417.  doi: 10.3969/j.issn.2095-4344.2017.15.021 Abstract ( 545 )   PDF (1059KB) ( 421 )   Save BACKGROUND: Porosity has been proven to improve the stability of orthopedic implants, and the architecture of pores is considered as a significant factor to improve the osseointegration of implants. OBJECTIVE: To introduce the research advance in porous architecture. METHODS: WOS database was searched for the articles addressing the porous structure of the implants published from January 2000 to April 2016 using the keywords of “scaffold, pore size, porosity, osteogenesis”. The literatures were screened according to the inclusion and exclusion criteria. RESULTS AND CONCLUSION: (1) The stability of traditional implants cannot meet the requirements in some specific circumstances, while the implants with porosity can improve the stability due to its osteogenesis ability. (2) Porous structure is a hotspot, and the osseointegration of porous implants in vivo is explored through series of in vitro and in vivo experiments. (3) It has been shown that higher porosity, proper pore size, microporous morphology and microstructure of the pore wall may contribute to the growth and differentiation of bone tissue under enough mechanical support. (4) However, most studies on the porous implants are still on the in vivo and animal experimental stage, and its promoting effects on the osteogenesis and bone in-growth are needed to be investigated in depth.  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 | Related Articles | Metrics

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Characters and progress of three-dimensional printing technology in bone tissue engineering Wu Cheng-cong, Wang Fang, Rong Shu, Wu Zheng, Liu Tao, Liu Ke-ting, Zhu Bo, Huang He-fei 2017, 21 (15):  2418-2423.  doi: 10.3969/j.issn.2095-4344.2017.15.022 Abstract ( 344 )   PDF (1280KB) ( 573 )   Save BACKGROUND: Individual three-dimensional (3D) scaffolds can be constructed by 3D printing via Computer Aided Design based on the given anatomical measurements of related tissues. A rapid and accurate reconstruction of bone, cartilage, muscle and vessel also can be achieved by 3D printing; however, many problems still remain unsolved. OBJECTIVE: To summarize the principle and classification of 3D printing, the classification, characteristics and histocompatibility of scaffolds through reviewing the articles addressing 3D printing applied in bone tissue engineering, thereby providing theoretical foundation for the study on the construction of tissue-engineered bone. METHODS: PubMed and CNKI databases were retrieved for the literatures regarding the application of 3D printing technology in bone tissue engineering published from January 2001 to January 2017 using the keywords of “three-dimensional printing, rapid prototyping manufacturing, bone tissue engineering” in English and Chinese, respectively. Finally, 30 articles were reviewed and discussed in accordance with the inclusion and exclusion criteria. RESULTS AND CONCLUSION: The microstructures of normal tissues can be reconstructed and seed cells are printed on the 3D scaffolds synchronously by 3D printing technology. Moreover, the scaffold degradation and cell differentiation are synchronous, which contributes to tissue repair. Biological ceramics have been widely used in bone tissue engineering because of its good biocompatibility and mechanical properties. However, the urgent problems such as angiogenesis and cellular signal transduction still need to be addressed. 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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Type ll odontoid fractures in the elderly: surgical or conservative method? Du Shi-yao, Ni Bin 2017, 21 (15):  2424-2431.  doi: 10.3969/j.issn.2095-4344.2017.15.023 Abstract ( 279 )   PDF (1096KB) ( 269 )   Save BACKGROUND: Upper cervical spine fractures are easy to lead to severe neurologic dysfunction in the elderly, and along with social progress, the incidence is on the rise. However, the diagnosis and treatment of type ll odontoid fractures in senile patients remain controversial. OBJECTIVE: To review the classification, treatment methods and clinical outcomes of type ll odontoid fractures in elderly patients. METHODS: A computer-based online search was performed in the PubMed and Wanfang databases for the articles concerning the diagnosis and treatment of type ll odontoid fractures in the elderly published from January 1996 to July 2016. The keywords were “odontoid fracture, elderly, treatment, conservative, surgical” in English and Chinese, respectively. RESULTS AND CONCLUSION: (1) The treatment goals of type ll odontoid fractures are different between elderly and young patients. (2) The incidence of nonunion in the conservative approach is higher than that in the surgical treatment, but for elderly patients, it makes no difference. (3) No significant differences are found in the incidence of complications and mortality between conservative and surgical methods in the elderly with type ll odontoid fractures. (4) Minimally invasive surgery is commended for the elderly suffering type ll fractures who cannot tolerate the conservative approach due to poor conditions or accompanied with other serious heart and lung diseases. 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 research of posterior femoral condylar offset Xin Xing, Qu Tie-bing 2017, 21 (15):  2432-2437.  doi: 10.3969/j.issn.2095-4344.2017.15.024 Abstract ( 634 )   PDF (914KB) ( 307 )   Save BACKGROUND: For the orthopedic surgeon, the postoperative functional recovery after total knee arthroplasty, in which the reconstruction of posterior femoral condylar offset plays an important role, is an important goal. OBJECTIVE: To understand the anatomic characteristics of the femoral condylar offset and the mechanism how posterior condylar offset influences the functional recovery of knee joint after total knee arthroplasty. METHODS: The author searched PubMed database and Wanfang database for articles about posterior femoral offset and knee range of motion. The key words were “arthroplasty; replacement; knee; femur; posterior condylar offset; range of motion”. A total of 96 articles were retrieved, and 38 articles met the inclusion criteria. RESULTS AND CONCLUSION: Posterior condylar offset had differences in gender, ethnics and medial and lateral condyles. To restore the biomechanics of the knee joint, the design of knee prosthesis should consider the difference in genders, ethnics, medial and lateral condyles. The influence mechanism is the “femur-tibia impingement” and “gap balance”. However, further clinical research is needed, for contradictory results regarding whether posterior condylar offset has an effect on knee flexion after total knee arthroplasty. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Osteoporotic hip fractures in the elderly: yesterday, today and tomorrow Liang Yu-zhu, Guo Hong-gang 2017, 21 (15):  2438-2443.  doi: 10.3969/j.issn.2095-4344.2017.15.025 Abstract ( 486 )   PDF (1210KB) ( 434 )   Save BACKGROUND: Senile hip fracture is a common disease, and its high disability and lethality severely affect the lifetime and quality of life of the elderly. OBJECTIVE: To summarize the research progress of senile osteoporotic hip fractures. METHODS: A computer-based search of CNKI, CqVip, WanFang and PubMed databases was performed for relevant basic research published from January 1995 to September 2016 using the keywords of “osteoporosis, hip fracture, epidemiology” in Chinese and English, respectively. Meanwhile, references in the searched articles were retrieved, finally 27 eligible articles were enrolled for analysis. RESULTS AND CONCLUSION: (1) The occurrence of senile osteoporotic hip fractures is closely related to the bone mineral density, proximal femur geometry, and fall-strain. (2) The preventions of osteoporotic fractures include primary prevention aiming at risk factors for osteoporosis and secondary prevention for osteoporotic patients. (3) The surgical treatment of femoral neck fracture is divided into open/closed reduction and internal fixation, femoral head arthroplasty and total hip arthroplasty. (4) Sliding hip screw fixation, proximal femoral intramedullary nail, external fixator and femoral head arthroplasty are used to treat intertrochanteric fracture. (5) There are various drugs used for hip fracture, such as calcium, vitamin D, estrogens, calcitonin and bisphosphonates. Indeed, individual treatment contributes to postoperative rehabilitation. 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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Mid- and long-term outcomes of cervical disc arthroplasty versus anterior cervical discectomy and fusion for single-level cervical spondylosis: a meta-analysis Chen Bo, Qu Xia, Tao Yuan, Luo Cheng, Yang Lin, Zou Yong-gen 2017, 21 (15):  2444-2452.  doi: 10.3969/j.issn.2095-4344.2017.15.026 Abstract ( 277 )   PDF (1663KB) ( 442 )   Save BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is the gold standard for degenerative cervical disease, which would be replaced by cervical disc arthroplasty (CDA) with the wide application of CDA. But, the mid- and long-term outcomes of ACDF versus CDA remain controversial. OBJECTIVE: To compare the mid- and long-term outcomes of ACDF and CDA in the treatment of single-level cervical spondylosis. METHODS: PubMed, Medline, EMbase, Cochrane, CBM, CNKI, VIP and WanFang databases were searched for randomized controlled trials addressing CDA versus ACDF for single-level cervical spondylosis published before August 2016. The quality of trails was strictly evaluated, the data were extracted and a meta-analysis was performed on ReviewManager5.3 software. RESULTS AND CONCLUSION: (1) Totally 15 randomized controlled trials involving 2 781 patients were included, with 4-10 years of follow-up. (2) Meta-analysis results showed that compared with ACDF, CDA had better SF-36 scores, larger range of motion at operation level, lower the Neck Disability Index, and Visual Analogue Scale scores for arm pain, lower reoperation rate at operation level and adjacent level at mid- and long-term follow-up. (3) The Visual Analogue Scale scores for neck pain, neurologic success and all-complication rate did not differ significantly between two groups. (4) These results manifest that CDA is superior to ACDF in the mid- and long-term outcomes for single-level cervical spondylosis; however, further large-scale, multi-center and high-quality randomized controlled trials will be necessary. 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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Minimally invasive versus open transforaminal lumbar interbody fusion for spondylolisthesis: a meta-analysis   Yan Bing-shan, Xu Bao-shan, Liu Yue, Yang Qiang 2017, 21 (15):  2453-2460.  doi: 10.3969/j.issn.2095-4344.2017.15.027 Abstract ( 428 )   PDF (1390KB) ( 293 )   Save BACKGROUND:Minimally invasive transforaminal interbody fusion (Mis-TLIF) for spondylolisthesis has been introduced to reduce muscle trauma, minimize blood loss, and achieve earlier rehabilitation. However, there is a lack of evidence-based medicine concerning the therapeutic efficacy of Mis-TLIF versus open TLIF for spondylolisthesis. OBJECTIVE: To systematically evaluate the clinical efficacy and safety of Mis-TLIF versus open TLIF for spondylolisthesis. METHODS: WanFang, CNKI, PubMed, and Cochrane Library databases were searched using the keywords of “spondylolisthesis, minimally invasive transforaminal interbody fusion, open transforaminal interbody fusion” in English and Chinese, respectively. The quality evaluation and data extraction of the included literatures were conducted by two authors independently. A meta-analysis was performed on RevMan 5.3 software. RESULTS AND CONCLUSION: Ten literatures were included, including 7 retrospective and 3 randomized controlled trials; 963 cases were enrolled (489 cases of Mis-TLIF, 474 cases of open TLIF). (1) Meta-analysis results showed that there were no significant differences in the operation time, postoperative complication rate, and fusion rate at the last follow-up between two groups, suggesting that the two methods expose analogical effects on the pain relief and functional recovery. (2) There were significant differences in the intraoperative blood loss and radiological times between two methods. (3) To conclude, Mis-TLIF holds similar operation time, incidence of complications and functional recovery with open TLIF, accompanied by minimized trauma, and reduced intraoperative and postoperative blood loss, which is considered as a safe and effective surgical 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