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08 November 2018, Volume 22 Issue 31 Previous Issue    Next Issue

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Expression of histone demethylase jumonji domain-containing protein 2 and estrogen receptor in bones of postmenopausal osteoporosis patients undergoing hip arthroplasty   Guo Cheng, Tang Hong-yu, Huo Shao-chuan, Zhou Chi, Dong Lu-jue, Chen Jian-fa, Liu Yong, Wang Hai-bin 2018, 22 (31):  4921-4925.  doi: 10.3969/j.issn.2095-4344.0382 Abstract ( 296 )   PDF (598KB) ( 112 )   Save BACKGROUND: Histone demethylase has been shown to promote osteoblast differentiation. However, little is reported on the association between postmenopausal osteoporosis and histone demethylase and estrogen receptor. OBJECTIVE: To study the changes in the histone demethylase jumonji domain-containing protein 2 (JMJD2) family expression in patients with postmenopausal osteoporosis, and its correlation with estrogen receptor. METHODS: Postmenopausal patients with hip osteoarthritis undergoing total hip arthroplasty, aged 50-70 years, were enrolled, including 15 postmenopausal osteoporosis patients (experimental group) and 15 patients with no postmenopausal osteoporosis (control group). During the arthroplasty, the cancellous bone specimens from the femoral neck were collected. Then, the expression levels of JMJD2A, JMJD2B, estrogen receptor α and estrogen receptor β were detected by real-time quantitative PCR, and western blot assay. RESULTS AND CONCLUSION: Compared with the control group, the relative expression of JMJD2A, JMJD2B, estrogen receptor α and estrogen receptor β in the experimental group were significantly decreased (P < 0.01). JMJD2A and JMJD2B were positively correlated with estrogen receptor α and estrogen receptor β (P < 0.01). These findings indicate that there is a decrease in the expression levels of JMJD2A and JMJD2B in postmenopausal osteoporosis patients. The decreased JMJD2A and JMJD2B expression is closely related to the decrease of estrogen receptor α and estrogen receptor β. Thereafter, JMJD2 may be involved in the pathogenesis of postmenopausal osteoporosis. 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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The Wihteside soft tissue releasing technique combined with the Ranawat soft tissue releasing technique in the total knee arthroplasty of genu valgus   Tan Mei-yun, Fan Zhong-wei, Wu Tian-hao, Liu Shao-feng, Wang Sen, Zhang Zhong-jie, Guo Xing 2018, 22 (31):  4926-4930.  doi: 10.3969/j.issn.2095-4344.0363 Abstract ( 378 )   PDF (634KB) ( 172 )   Save BACKGROUND: Soft tissue balance is critical for the stability after total knee arthroplasty (TKA). Dealing with the soft tissue balance of valgus knee is usually more complex than the soft tissue balance of genu varus, and the methods of soft tissue balance in TKA of genu valgum has not yet been unified. OBJECTIVE: To investigate the curative effect of Wihteside combined with Ranawat release in the soft tissue balance in the TKA of genu valgus. METHODS: Twenty-six patients (30 knees) with knee valgus admitted at the Affiliated Hospital of Southwest Medical University from 2011 to 2014 were selected. All patients received the TKA with medial parapatellar approach, posterior stabilized prosthesis, conventional osteotomy, and Wihteside combined with Ranawat release. The femorotibial angle, range of motion of the knee joint, the Hospital for Special Surgery and Knee Society Score at baseline and last follow-up were compared to evaluate the curative efficacy. RESULTS AND CONCLUSION: (1) Twenty-six patients (30 knees) all followed up for 12-48 months. At the last follow-up, no prosthesis loosening or subsidence was seen on the radiographic images. (2) Compared with the baseline, the Hospital for Special Surgery, Knee Society Score, femorotibial angle, and range of motion of the knee joint at last follow-up were significantly improved (P < 0.05). (3) These results imply that the TKA of genu valgus through medial parapatellar approach, using posterior stabilized prosthesis, conventional osteotomy, and Wihteside combined with Ranawat release can obtain satisfactory outcomes.   中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Gender and implant fixation affect the healing of alcohol-inactivated bone   Tian Zhi-chao, Gu Zhi-yuan, Wang Xin, Liu Zhi-yong, Yao Wei-tao, Wang Jia-qiang, Zhang Peng, Cai Qi-qing, Ge Hong 2018, 22 (31):  4931-4936.  doi: 10.3969/j.issn.2095-4344.0554 Abstract ( 336 )   PDF (711KB) ( 101 )   Save BACKGROUND: Alcohol inactivated replantation is widely used in the treatment of malignant bone tumors, but the postoperative bone healing is little reported. OBJECTIVE: To analyze the related factors affecting the bone healing of the autograft bone after alcohol inactivated replantation. METHODS: Twenty-one patients with malignant bone tumor who received alcohol-inactivated autograft bone replantation were enrolled, including 8 males and 13 females with an age of 7-56 years. Among which, 17 cases underwent plate-screw internal fixation, and 4 cases received intramedullary nailing fixation. All patients were followed up to observe the bone healing. The related factors of the autograft bone healing were analyzed. RESULTS AND CONCLUSION: (1) The follow-up time was 2-6 years, with an average of 3.8 years. (2) Eleven patients (1 male and 10 females, with an average age of 20.8 years) achieved bone union, the average length of autograft bone was 17.36 cm, all fixed using plates, and the average healing time was 20 months. (3) Bone nonunion occurred in 10 patients (7 males and 3 females, with an average age of 20.5 years), the average length of autograft bone was 16.10 cm, 4 cases of intramedullary nailing fixation, and 6 cases of plate-screw fixation. (4) The differences in the average age and average length of autograft bone were insignificant between two groups. The sex and internal fixation ways showed significant differences between two groups (P < 0.05). (5) These results suggest that the age and the length of the autograft bone have no significant effect on autograft bone healing. The female patients and plate-screw internal fixation are beneficial for bone healing after alcohol inactivated replantation.  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 trabecular tantalum cage in anterior cervical discectomy and fusion for cervical spondylosis and its anatomical characteristics Huang Ming-zhi, Zhuang Yong, Zhang Hao, Shang Xian-wen 2018, 22 (31):  4937-4942.  doi: 10.3969/j.issn.2095-4344.0547 Abstract ( 394 )   PDF (701KB) ( 147 )   Save BACKGROUND: Trabecular tantalum cage plays an important role in anterior cervical discectomy and fusion (ACDF) for cervical spondylosis, but its anatomical morphology remains controversial. OBJECTIVE: To investigate the effect and anatomical characteristics of trabecular tantalum cage in ACDF for patients with cervical spondylosis. METHODS: Ninety-three patients with cervical spondylosis were enrolled, and underwent ACDF using bone autograft (n=31, autograft group), polyether ketone cage combined with bone autograft (n=31, polyether ketone group) or trabecular tantalum cage combined with bone autograft (n=31, trial group). The perioperative complications were recorded. Before and 6 months after treatment, the Visual Analogue Scale, Japanese Orthopedic Association, Neck Disability Index, intervertebral fusion, intervertebral space height, and anterior lordosis of fused segment on CT were detected. RESULTS AND CONCLUSION: (1) There was no difference in the incidence of complication among groups. (2) The Visual Analogue Scale, Japanese Orthopedic Association, and Neck Disability Index scores at 6 months after treatment in each group were significantly improved compared with baseline (P < 0.05). The Japanese Orthopedic Association, and Neck Disability Index scores at 6 months after treatment in the autograft and trial groups were significantly improved compared with the polyether ketone group (P < 0.05), and the scores showed no significant difference between autograft and trial groups. The Visual Analogue Scale scores at 6 months after treatment did not differ significantly among groups. (3) The intervertebral space height, anterior lordosis of fused segment, and fusion area at 6 months after treatment in each group were significantly improved compared with baseline (P < 0.05). The imaging indexes in the autograft and trial groups were significantly improved compared with the polyether ketone group (P < 0.05), but showed insignificant difference between autograft and trial groups. (4) At 6 months after treatment, the fusion rate in the trial group was significantly higher than that in the autograft and polyether ketone groups (P < 0.05). (5) These results imply that trabecular tantalum cage applied in ACDF obtains satisfactory outcomes, and can achieve cervical reconstruction and good stability, which is accordance with the anatomical requirements.  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 two-level anterior cervical discectomy and fusion on cervical sagittal balance Sun Bai-han, Liu Yong-tao, Liu Meng, Guo Kai-jin, Huang Dong, Xin Bing 2018, 22 (31):  4943-4948.  doi: 10.3969/j.issn.2095-4344.0392 Abstract ( 436 )   PDF (1452KB) ( 166 )   Save BACKGROUND: Cervical posterior surgeries exert obvious effects on the sagittal balance of the cervical spine. But, cervical anterior decompression and internal fixation is the “gold standard” for cervical spondylosis, and its effect on the sagittal balance of the cervical spine is little reported. OBJECTIVE: To analyze the effect of cervical anterior decompression and internal fixation on the sagittal balance of the cervical spine and to compare the differences in biological function after implant fixation through two different anterior approaches. METHODS: Forty-five patients undergoing anterior cervical discectomy and fusion (n=21) and anterior cervical corpectomy and fusion (n=24) at Department of Spine Surgery, the Affiliated Hospital of Xuzhou Medical University from December 2014 to March 2017 were enrolled. The imaging parameters of cervical X-ray films were measured at baseline and last follow-up, including C2-7 Cobb angle, C2-7 sagittal vertical axis, T1 slope angle, and segment angle. The Japanese Orthopaedic Association was used to evaluate the neural function. The Visual Analogue Scale was used to assess the degree of neck and upper limb pain. Pearson correlation was used to analyze the correlation among imaging parameters at each time point. RESULTS AND CONCLUSION: The follow-up time was (14.21±5.73) months. At the last follow-up, there were significant differences in the imaging parameters (except T1-slope) compared with those before operation (P < 0.05). There were significant differences in the imaging parameters (except T1-slope) at the same time between two groups at 3 months postoperatively and the last follow-up (P < 0.05). The Japanese Orthopaedic Association score and Visual Analogue Scale score of both group were significantly decreased postoperatively (P < 0.05). The Pearson analysis showed that negative correlations were presented between C2-7 sagittal vertical axis and C2-7 Cobb (r=-0.55, P < 0.05). While C2-7 Cobb angle was positively correlated with segmental angle (r=0.40, P < 0.05). In summary, the anterior cervical surgery shows little effect on T1-slope, and may make lower risk in slippage. The anterior approach is used to restore the sagittal balance by increasing the curvature of the cervical spine. Both cervical anterior surgeries can restore the angle of the operative segment, the curvature of the cervical spine and effectively improve the nerve function, but anterior cervical discectomy and fusion is more advantageous than the anterior cervical corpectomy and fusion in maintaining segment angle and cervical lordosis. 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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Long-arm uniaxial screws through Wistle approach versus AF system through conventional approach in the treatment of thoracic and lumbar compressive fractures   Han Li-qiang, Jiang Han, Wang Shu-sen, Li Xiao-dong, Zheng Jin-xin 2018, 22 (31):  4949-4954.  doi: 10.3969/j.issn.2095-4344.0374 Abstract ( 441 )   PDF (706KB) ( 127 )   Save BACKGROUND: With the improvement of the concept of treatment, the reduction of iatrogenic injury has gradually been paid much attention. At present, the AF system is gradually withdrawing from the market. The surgical treatment of thoracic and lumbar spine fractures requires new internal fixations and operative approach. OBJECTIVE: To evaluate the treatment outcomes of long-arm uniaxial screws through Wistle approach versus AF system through the conventional approach for thoracic and lumbar compressive fractures. METHODS: From March 2011 to December 2016, 55 patients with thoracic and lumbar spine fractures treated with long-arm uniaxial screws through Wistle approach were served as Wistle approach, and 85 cases treated with AF system through the conventional approach from January 2006 to January 2011 were served as control group. The operation time, intraoperative blood loss, postoperative drainage, preoperative and postoperative Visual Analogue Scale scores, vertebral height correction rate, and Oswestry Disability Index scores at 3 months postoperatively were compared by independent-samples t test. RESULTS AND CONCLUSION: (1) There was none of nail/rod broken in each group. (2) The Wistle approach group was significantly advantageous in the operation time, intraoperative blood loss, postoperative drainage and Visual Analogue Scale scores at 1 and 3 days postoperatively compared with the control group (P < 0.05). The preoperative Visual Analogue Scale scores, vertebral height correction rate, and Oswestry Disability Index scores at 3 months postoperatively did not differ significantly between two groups. (3) Compared with the AF system through the conventional approach, long-arm uniaxial screws through Wistle approach can retain the posterior ligament complex, is an effective and minimally invasive treatment and can reduce the iatrogenic injury, which is an appropriate repair method for the patients with simple thoracic and lumbar fractures without neurologic symptoms. 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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Whether surgical sequence is a risk factor for incision infection after lumbar surgery   Liu Yun-tao, Tuerhongjiang•Abudurexiti, Wang Yi, Ma Liang, Zhu Song-qing, Jin Ge-le 2018, 22 (31):  4955-4958.  doi: 10.3969/j.issn.2095-4344.0337 Abstract ( 356 )   PDF (478KB) ( 140 )   Save BACKGROUND: Incidence of postoperative infection in lumbar surgery is higher than that in cervical surgery. However, there are few studies on the relationship between surgical sequence and incision infection. OBJECTIVE: To investigate whether surgical sequence is a risk factor for postoperative incision infection. METHODS: Clinical data of 778 patients with lumbar disc herniation and lumbar spinal stenosis undergoing posterior surgical treatment were analyzed retrospectively. Age, sex, surgical sequence, operation time, blood loss, blood transfusion, internal fixator usage, Cage usage and surgical segment were used for single-factor analysis, and risk factors were confirmed by Logistic regression analysis. RESULTS AND CONCLUSION: (1) In this study, 778 lumbar disc herniation and lumbar spinal stenosis patients had a 4.2% incidence of infection (33/778), including 23 cases of superficial wound infection and 10 cases of deep wound infection. (2) The surgical sequence (P=0.020, OR=3.050, 95%CI=1.196-7.780), age (P=0.019, OR=2.123, 95%CI=1.133-3.979), operation time (P=0.034, OR=3.035, 95%CI=1.089-8.457) and blood loss (P=0.024, OR=2.059, 95%CI=1.099-3.860), were the risk factors for postoperative infection. (3) The incision length (P=0.106, OR=1.805, 95%CI=0.881-3.969), intraoperative blood transfusion (P=0.107, OR=2.171, 95%CI=0.846-5.570), and surgical segment (P=0.206, OR=0.578, 95%CI=0.223-1.499) had no significant effect on postoperative infection. (4) In summary, for lumbar disc herniation and lumbar spinal stenosis patients except age, operation time, and intraoperative blood loss, surgical sequence is a critical risk factor for incision infection after posterior approach surgery in patients with lumbar disc herniation and lumbar spinal stenosis. 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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Ancillary effect of three-dimensional printing technology applied in the orthopedic surgery of severe rigid kyphoscoliosis   Yang Yang, Liu Lin, Xue Wen, Wang Zeng-ping, Qian Yao-wen, Gao Xue-min, Fan Li-zhen, Wen Jie 2018, 22 (31):  4959-4964.  doi: 10.3969/j.issn.2095-4344.0550 Abstract ( 411 )   PDF (716KB) ( 202 )   Save BACKGROUND: For severe rigid kyphoscoliosis patients, due to severe spinal deformity, and high risk for orthopedic surgery, designing an individualized and precise placement and osteotomy scheme preoperatively is needed to reduce surgery risk. OBJECTIVE: To evaluate the clinical effect of three-dimensional (3D) printing applied in the orthopedic surgery for severe rigid kyphoscoliosis. METHODS: Thirty-two patients with severe rigid kyphoscoliosis from January 2015 to June 2017 were included. Sixteen cases underwent 3D-assisted osteotomy (preoperative spinal reconstruction by 3D printing, and designing rational osteotomy scheme, trial group), and other 16 cases received orthopedic surgery under X-ray (control group). The perioperative indexes, postoperative correction effect, accuracy of pedicle screw placement and incidence of complications were recorded. RESULTS AND CONCLUSION: The operation time, intraoperative blood loss, intraoperative fluoroscopy time, postoperative drainage, postoperative incidence of complications, postoperative scoliosis and kyphosis Cobb angle in the trial group were significantly lower than those in the control group, but the accuracy of pedicle screw placement, scoliosis and kyphosis corrective rate were significantly higher than those in the control group (P < 0.05). To conclude, based on 3D printing, an individualized and precise placement and osteotomy scheme is designed for severe rigid kyphoscoliosis, can improve the operation safety, reduce the trauma, and obtain satisfactory clinical outcomes. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Three-dimensional digital analysis of the trajectory of scaphoid bone Zhang Zhi-feng, Li Da-wei, Zhang Yuan-zhi, Huang Jian, Wei Jing, Wang Xing, Zheng Lei-gang 2018, 22 (31):  4965-4969.  doi: 10.3969/j.issn.2095-4344.0551 Abstract ( 378 )   PDF (615KB) ( 124 )   Save BACKGROUND: Scaphoid fracture is commonly seen in wrist fracture, but its nonunion rate is high. Therefore, studying trajectory of normal scaphoid bone is of great significance for selecting optimal fixation way and position. OBJECTIVE: To study the trajectory of normal scaphoid bone, and to provide method for three-dimensional kinematics analysis. METHODS: Twenty normal adults (n=10 in either sexes) were enrolled, and the right wrist underwent spiral CT scan in neutral, palmar flexion, dorsiflexion at 15, 30, 45 and 60 degrees, radial deviation at 10 and 20 degrees and ulnar deviation at 15 and 30 degrees, respectively. The original DICOM data were imported into Materialise Mimics Innovation Suite 15.0 to reconstruct distal radius and scaphoideum, and three-dimensional registration. The centroid of each bone was measured, and trajectory of scaphoideum was reconstructed to calculate the displacement value. RESULTS AND CONCLUSION: In palmar flexion and dorsiflexion or radial/ulnar deviation, the distance between centroid of scaphoideum and distal radius was different. In the 60 degrees of dorsiflexion and 30 degrees of ulnar deviation, the displacement was largest. In the 30 degrees of dorsiflexion and 20 degrees of radial deviation, the displacement was smallest. The displacement value in different positions showed significant differences between sexes. In summary, the accurate determination of the centroid of scaphoid bone provides a new scientific method for the reconstruction of scaphoid movement.  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 changes of atlantoaxial pedicle screw-rod fixation: a finite element analysis   Chen Shu-jin, Ma Xiang-yang, Yang Jin-cheng, Yin Qing-shui, Yang Min, Zou Xiao-bao 2018, 22 (31):  4970-4974.  doi: 10.3969/j.issn.2095-4344.0362 Abstract ( 367 )   PDF (625KB) ( 197 )   Save BACKGROUND: Atlantoaxial pedicle screw-rod fixation has been extensively applied in clinic, especially for upper cervical lesions with osteoporosis. But there are few biomechanical studies. OBJECTIVE: To investigate the biomechanical features of atlantoaxial pedicle screw-rod fixation by three-dimensional finite element analysis. METHODS: CT data of occipital bone and atlantoaxial vertebrae were obtained from a healthy adult volunteer, and the three-dimensional finite element analysis model of atlantoaxial pedicle screw-rod fixation was established. The changes of von Mises Stress of the internal fixation system under different loads (flexion, extension, left and right lateral bending, as well as left and right axial rotation by Abaqus) were analyzed. RESULTS AND CONCLUSION: (1) Atlantoaxial pedicle screw-rod fixation significantly reduced the motion range of upper cervical vertebra. (2) The stress concentrated on the bone-screw interface and screw-rod interface under different postures. The maximum stress located at the root of axoid pedicle screws under flexion, left and right lateral bending, as well as left and right axial rotation. (3) The maximum stress located at the root of atlas pedicle screws under extension. (4) Mises stress was obviously increased under rotation. (5) Atlantoaxial pedicle screw-rod fixation is safe and reliable. Stress concentration always appears at the root of screw and the Mises stress is increased obviously under rotation.  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 characteristics of tibio-femoral joint under different flexion angles by finite element analysis   Wang Jun-ran, Du Wei-jin, Wang Chang-jiang, Guo Yuan, Chen Wei-yi 2018, 22 (31):  4975-4981.  doi: 10.3969/j.issn.2095-4344.0336 Abstract ( 410 )   PDF (885KB) ( 301 )   Save BACKGROUND: Despite three-dimensional (3D) finite element model is helpful for the analysis of the injury mechanism and mechanical characteristics of knee joint, there are few researches on dynamic movement simulation of knee joint. OBJECTIVE: A 3D finite element model of normal male knee joint was established to dynamically simulate the movement of knee joint and analyze the biomechanical characteristics and relative movement of the tibio-femoral joint under different flexion angles, so as to provide a 3D finite element model for the investigation of knee biomechanics, and provide basis for the design of personalized knee prosthesis and 3D printing. METHODS: The knee joint from a healthy male adult was scanned by CT. Then, a normal 3D finite element model of knee joint was constructed by Mimics, Hypermesh and Abaqus. Simulation and stress analysis of knee joint were carried out under different loads. RESULTS AND CONCLUSION: (1) The constructed finite element model of knee joint could accurately reflect the geometrical structure and biomechanical characteristics of the knee joint, and could simulate multiple movements of knee joint and was effective for biomechanical research of the knee joint. (2) In the process of simulating knee flexion at 0°-60°, the range of knee valgus angle was 3.34°-6.13°, and the range of internal rotation angle was 1.56°-29.17°. The femur had a significant posterior shift relative to tibia, and the shifted distance was from 4.36 mm to 7.23 mm. (3) At knee flexion 0°, the maximum contact stresses of femur cartilage, tibial cartilage and meniscus were 1.45, 1.03 and 2.59 MPa, respectively, and 6.41, 6.73 and 8.65 MPa, respectively at knee flexion 60°. (4) Our findings indicate that in the process of simulating knee flexion at 0°-60°, the range of knee valgus angle is relatively small, and stable, while the range of internal rotation angle is relatively large. In the process of simulating knee flexion at 0°-60°, the contact stress of femoral and tibial cartilage gradually increased with the varied flexion angle, while the changes of contact stress of medial and lateral menisci are different, the changes of medial meniscus are much great, and the contact stress of lateral meniscus is relatively stable. The contact stress of medial meniscus is greater than that of lateral menisci. 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 analysis of locking axial lumbosacral interbody fusion cage Yi Xin, Song Xi-zheng 2018, 22 (31):  4982-4986.  doi: 10.3969/j.issn.2095-4344.0856 Abstract ( 284 )   PDF (641KB) ( 120 )   Save BACKGROUND: In order to improve lumbosacral stability and fusion, we developed a locking axial lumbosacral fusion cage for Chinese lumbosacral vertebrae. OBJECTIVE: To establish an effective three-dimensional finite element model of axial lumbosacral interbody fusion with locking plate and to analyze the stress distribution of the screw under different loads, and to provide targets and evaluation indexes to be improved. METHODS: A normal adult lumbosacral vertebra finite element model was established by reverse engineering software Mimics and Geomagic. The locking axial lumbosacral fusion cage was assembled into the effective lumbosacral vertebra model by simulating the surgical procedure. The mesh model was divided into two groups. A finite element mesh model of lumbosacral vertebrae fitted with the locking axial fusion cage was established. According to the material properties of lumbosacral vertebrae and fusion cages, the model was assigned and imported into SolidWorks 2011 to obtain the final finite element model. Under physiological and ultimate loads, the model was subjected to flexion, extension, lateral bending and rotation motions. The stress distribution in the axial-direction cage with locking was completed by Hypermesh software to evaluate its biomechanical properties. RESULTS AND CONCLUSION: The maximal compressive force of the locking axial lumbosacral fusion cage under the vertical compression+flexion+left-handed condition was 1 500.08 MPa, and the stress concentration point was located at the left and right sides of the bone hole. Then, under the vertical compression+flexion+right-hand limit load, the maximum pressure to be absorbed by the fusion cage was 1 318.00 MPa, and the stress concentration point was at the left and right sides of the bone hole, and there was a lower pressure at the upper and lower sides of the bone hole. Physiological load holders provide adequate strength, stability and bone-graft fusion. Under vertical compression+flexion+rotation conditions, the maximum stress exceeds the yield strength of the screw. Therefore, to improve the process and strengthen the weak points of bone graft, postoperative early bed rest, wearing a brace, and to avoid over-stretch, flexion or torsion and other high strength movement are recommended. 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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Locus characteristics of plantar pressure center in walking and running modes Zhu Yao-jia, Huo Hong-feng 2018, 22 (31):  4987-4992.  doi: 10.3969/j.issn.2095-4344.0375 Abstract ( 453 )   PDF (593KB) ( 260 )   Save BACKGROUND: Walking and running are essential exercises in daily life. Foot joints are flexible and most likely to damage. Displacement of the pressure center can reflect the inner-lateral and anteroposterior movement of the foot, which is an index for evaluating the function of the foot, and is used to describe the complex dynamic function of the foot and sole interface in the gait process. OBJECTIVE: To analyze the characteristics and regularity of plantar pressure center in different movement modes by studying the locus of plantar pressure center in the course of walking and running in young males. METHODS: The walking and running patterns of 45 healthy young men were tested with Footscan force measuring plate, and gait test and analysis were carried out. The foot pressure trajectory and foot progression angle were observed. RESULTS AND CONCLUSION: (1) The percentage of the pressure center locus in the left foot walking and running was significantly different in the initial contact phase, the forefoot contact phase and the foot flat phase (P < 0.05). There was no significant difference at the forefoot push off phase (P > 0.05). There were significant differences in all stages of the right foot (P < 0.05). (2) There was no significant difference in the percentage of center of pressure locus between left and right feet in the walking mode (P > 0.05). The results of left and right feet in running mode were similar to those of walking. (3) There were significant differences in foot progression angle between walking and running mode in initial contact phase, forefoot contact phase, foot flat phase, and forefoot push off phase (P < 0.05). (4) In summary, there are differences in each stage of running support period. The time of foot following the running period becomes short and the heel relative load decreases with the increase of speed. The center of pressure trajectory of the left and right feet of the same motion pattern is not very different, and the center of pressure trajectory can be used to distinguish different motion patterns, and more centers of pressure tracks are offset in the running mode. The foot progression angle in walking and running is largest in the stage of leaving the ground in the front palm, smallest in the contact stage of the whole foot, and the rotation outside the foot in the first two stages, and in the latter two stages. In the initial contact phase and the forefoot push off phase, the foot progression angle is smaller than the walk, while in the other two stages, the foot progression angle is greater than the walk. 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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Reliability of evaluating C2-7 Cobb angle for cervical degenerative disease with unclear C7 vertebrae on X-ray, CT and MRI   Wu Tao, Liu Jun, Wang Gang 2018, 22 (31):  4993-4997.  doi: 10.3969/j.issn.2095-4344.0334 Abstract ( 392 )   PDF (570KB) ( 113 )   Save BACKGROUND: In some patients with cervical degenerative disease, C7 is unclear on the cervical lateral films due to anatomical position, which severely affects the measurement accuracy of C2-7 Cobb angle. OBJECTIVE: To explore whether CT and MRI can be used to evaluate sagittal alignment of cervical spine as the substitute of X-ray in patients with unclear C7 vertebrae. METHODS: Eighty-two eligible patients undergoing lumbar surgeries were included. Based on the C7 revealed on the X-ray, there were 28 patients with unclear C7 vertebrae (group A), and 54 patients with clear C7 vertebrae (group B). The cervical sagittal morphology on X-ray, CT and MRI was evaluated by C2-7 Cobb angle. Paired-t test, intra-class correlation coefficient and Pearson correlation coefficient were used to analyze the difference, reliability and correlation of sagittal alignment on X-ray, CT and MRI. RESULTS AND CONCLUSION: (1) C2-7 Cobb angles measured on CT and MRI were significantly lower than those on X-ray (P < 0.05). The reliability of measurement on X-ray in the Group A was found to be obviously lower than that on CT and MRI (ICC=0.768, 0.977, 0.986), while the reliability of measurement on X-ray in the Group B was similar to that on CT and MRI (ICC=0.953, 0.976, 0.977). (2) Correlation analysis showed that the C2-7 Cobb angles measured on CT and MRI were highly correlated with those on X-ray (r=0.569, P < 0.05; r=0.670, P < 0.05). (3) The formulations were calculated as follow: C2-7 Cobb angle (CT)=0.60×C2-7 Cobb angle (X-ray)-6.78°; C2-7 Cobb angle (MRI)=0.70×C2-7 Cobb angle (X-ray)-0.30°. (4) In summary, CT and MRI can avoid the inference of unclear C7 vertebrae, and can be used to evaluate the sagittal alignment of cervical spine as the replacement of X-ray. 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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Reconstruction accuracy of sparse angle CT imaging: ADMM-CT algorithm based on LP-norm Song Jie, Chen Ping, Pan Jin-xiao 2018, 22 (31):  4998-5002.  doi: 10.3969/j.issn.2095-4344.0563 Abstract ( 502 )   PDF (762KB) ( 396 )   Save BACKGROUND: Sparse-view CT imaging reconstruction is an effective method for reducing radiation dosage. But the reconstruction accuracy affects its promotion in clinic. OBJECTIVE: To explore the availability of the alternating direction method of multipliers (ADMM)-CT reconstruction algorithm based on LP-norm, so as to improve the reconstruction accuracy of sparse angle CT imaging. METHODS: To solve the optimized problem with gradient prior constraint, translate the constrained optimized problem into unconstrained optimization problem in the method of augmented Lagrange. Then, the ADMM could achieve the target that decomposed the optimized model into three sub-problems, which were equivalent to the original problem. Finally, the steepest descent method and the generalized shrinkage algorithm were used to solve the sub-problem separately. RESULTS AND CONCLUSION: (1) Compared with the traditional TV-POCS algorithm, ART-LP algorithm and Split-Bregman-LP algorithm, the root-mean-square error of the proposed algorithm was lower and the details of the reconstruction image were more complete when projection numbers were 36. (2) To conclude, for sparse angles CT reconstruction, the proposed algorithm named ADMM-LP can obtain high image quality. 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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Serum levels of inflammatory factors in patients with tibial bone defect treated by Ilizarov bone transport: X-ray assessment Zhang Song, Zhang Tao, Tong Chao, Lin Lian-yang, Zhang Yong-hong, Zhou Xue-ru 2018, 22 (31):  5003-5008.  doi: 10.3969/j.issn.2095-4344.0379 Abstract ( 296 )   PDF (738KB) ( 106 )   Save BACKGROUND: Therapeutic effects of traditional debridement and bone graft for tibial defect were obvious, but this method has a certain limitation in large bone defect. OBJECTIVE: To observe the treatment therapy and serum levels of inflammatory factors in patients with tibia bone defect treated by Ilizarov bone transport. METHODS: Seventy-eight patients with tibia bone defect were selected and randomized into observation group (n=40, Ilizarov bone transport) and control group (n=38, unilateral external fixator). The total effective rate of iconography was measured by radiography at postoperative 6 months. The clinical effect was measured by paley evaluation criterion. The incidence of complications was detected by 12-month follow-up. The serum levels of C-reactive protein, tumor necrosis factor-α and nuclear factor-κB were measured by ELISA. RESULTS AND CONCLUSION: The difference was significant in the iconography effect between two groups at 6 months postoperatively (P < 0.05), total effective rate of iconography and excellent and good rate in the observation group were significantly higher than those in the control group (P < 0.05). At postoperative 12 months, the serum levels of C-reactive protein, tumor necrosis factor-α and nuclear factor-κB as well as incidence of complications in the observation group were significantly lower than those in the control group (P < 0.05). To conclude, Ilizarov bone transport is more effective compared with traditional remedies in tibia bone defect, and the incidence of complications is lower. It has a certain inhibitory effect on inflammatory factors.  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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Computed tomography for the detection of distal radioulnar joint instability fracture: normal variation and reliability of four scoring systems   Wang Xin 2018, 22 (31):  5009-5014.  doi: 10.3969/j.issn.2095-4344.0365 Abstract ( 481 )   PDF (676KB) ( 120 )   Save BACKGROUND: Computed tomography (CT) is the core method for evaluating distal radioulnar joint (DRUJ) facture, including radioulnar line, subluxation ratio, epicenter and radioulnar ratio methods. There is a lack of study on the advantages and disadvantages, accuracy and optimal condition of these four methods. OBJECTIVE: To evaluate the consistency of radioulnar line, subluxation ratio, epicenter and radioulnar ratio methods in the diagnosis of DRUJ fracture, and to calculate the normal range of motion, so as to provide evidence for the diagnosis of DRUJ fracture. METHODS: Forty-six patients (92 wrists) with unilateral DRUJ fracture undergoing conservative treatment were included. CT scans of both wrists were conducted, and images were analyzed independently by two physicians using the radioulnar line, subluxation ratio, epicenter and radioulnar ratio methods. The inter- and intra-observer agreement was assessed and normal values were determined based on the uninjured wrists.  RESULTS AND CONCLUSION: Inter- and intra-observer agreement was best for the epicenter method (ICC=0.73 and 0.82). Each method showed a wide normal range for normal DRUJ translation. Normal range for the epicenter method was -0.35 to -0.05 in pronation and -0.12 to 0.20 in supination. These results indicate that DRUJ translation on CT in pro- and supination can be reliably evaluated in both normal and posttraumatic wrists, however with large normal variation. The epicenter method seems most reliable. Scanning of both wrists may be helpful to prevent the radiological over diagnosis of DRUJ instability.  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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Double anterior cruciate ligament sign: a magnetic resonance imaging performance of unstable tear of discoid lateral meniscus in adults Sun Xiao-xin, Liu Hao, Chai Hong-wei, Liang Chun-yu 2018, 22 (31):  5015-5020.  doi: 10.3969/j.issn.2095-4344.0564 Abstract ( 389 )   PDF (662KB) ( 203 )   Save BACKGROUND: Double anterior cruciate ligament sign is a imaging performance of the bucket handle tear of lateral meniscus. While, the relationship between double anterior cruciate ligament sign and the tearing type of discoid lateral meniscus is still unclear. OBJECTIVE: To investigate the meaning and value of double anterior cruciate ligament sign on the instability of torn discoid lateral meniscus in adults. METHODS: Clinical and imaging data of 95 cases of torn discoid lateral meniscus were retrospectively reviewed. All MRI images of the knee were observed and analyzed by two chief physicians of radiology. The incidence of double anterior cruciate ligament sign on preoperative MRI was calculated, and the relation between double anterior cruciate ligament sign and tearing type, surgical method and clinical symptoms of torn discoid lateral meniscus were analyzed. RESULTS AND CONCLUSION: (1) Among 95 knees with torn discoid lateral meniscus, 17 knees (18%) were diagnosed as definite double anterior cruciate ligament sign. (2) The incidence of double anterior cruciate ligament sign in complete discoid lateral meniscus was 29%, which was significantly higher than that of 7% in incomplete discoid lateral meniscus (P=0.005). The incidences of longitudinal tear and peripheral tear were 35% and 41% in positive group of double anterior cruciate ligament sign, which were significantly higher than that of 9% (P=0.013) and 14% (P=0.025) in negative group. (3) The cases of preoperative click (P=0.021), extension block (P=0.003), the Visual Analogue Scale score (P=0.008) of the knee and the intraoperative meniscus suture (P=0.010) in positive group of double anterior cruciate ligament sign were significantly higher than those in the negative group, while the Lysholm score was lower than that in the negative group (P=0.020).(4) Our findings indicate that double anterior cruciate ligament sign is a MR imaging feature associated with a displaced tear of the discoid lateral meniscus in adults. Therefore, it may be a reliable indicator for evaluating the tear pattern and the operation method for adult patients with torn discoid lateral meniscus.  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 non-human primate models for bone defect implant materials Yan Xia, Zhang Ya-nan, Meng Zeng-dong 2018, 22 (31):  5021-5026.  doi: 10.3969/j.issn.2095-4344.0565 Abstract ( 288 )   PDF (680KB) ( 129 )   Save BACKGROUND: Incidence of bone defects is increasing, and autologous bone and allogeneic bone are subjected to various restrictions in the treatment of bone defects. Thereafter, the development and screening of bone defect repair materials that can effectively solve above problem have received attention. OBJECTIVE: To summarize the current research status of bone defect implant materials repairing bone defects in non-human primate models. METHODS: The articles addressing the experimental research and research progress of animal models of bone defect implant materials were retrieved in PubMed and CNKI databases. The keywords were “bone defect, implant material, repair, non-human primate, animal model” in English and Chinese, respectively. A total of 40 articles were included, and highly correlated with the experimental research and progress of bone defect implant materials and animal models. RESULTS AND CONCLUSION: Through investigating the current research status of non-human primate models of bone defect implant materials, we can find that the studies on non-human primate models of bone defect implant materials are few. The correlation between the articles is low, but the research results are good. Bone defect implant materials with single component have been extensively applied in clinical practice. However, bone defect implant materials with composite components are little reported, and its research is mainly on the stage of animal experiments. Among them, most studies focus on the composite materials which combine bone growth factors (such as bone morphogenetic protein-2 and transforming growth factor-β) or seed cells (such as bone marrow stromal cells and dental pulp stromal cells). 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 three-dimensional printing metal implants in orthopedics   Zhao Min-chao, Huang Yan, Yuan Wei-jian, Chi Yu-fei, Li Zu-hao, Wu Han 2018, 22 (31):  5027-5033.  doi: 10.3969/j.issn.2095-4344.0566 Abstract ( 401 )   PDF (944KB) ( 198 )   Save BACKGROUND: For the complicated bone defects caused by severe trauma, tumor resection and arthroplasty, conventional metal implants cannot achieve satisfactory results because of the large and irregular defect and limited ability of bone regeneration in pathological condition. OBJECTIVE: To introduce the clinical application of three-dimensional (3D)-printed metal implants in orthopedics and to discuss how to further optimize the 3D-printed implant system in basic research, strengthen the bone regeneration at the defect region and the integrative effect in the host bone. METHODS: A computer-based retrieval of PubMed, Web of Science, Springerlink, Medline, WanFang and CNKI databases was performed for relevant articles published from 2005 to 2018. The keywords were “3D printing, bone defect, metal implant, prosthesis” in English and Chinese, respectively. Initially, 401 articles were retrieved, and finally 67 eligible articles were included for result analysis. RESULTS AND CONCLUSION: (1) 3D printing technology has been widely used in medicine, automobile manufacturing, aerospace and other fields. (2) 3D printing metal joints, acetabulum, vertebral body, pelvis and other implants have been applied in clinical practice. The follow-up results show that patients with 3D printing internal plants have early stability, the close implant-bone connection, and prosthesis loosening is rare, and the clinical results are satisfactory. (3) The further optimization of 3D printing metal plants in basic research, the application of optimizing the pore structure and material selection of 3D printing stents, hydroxyapatite, beta tricalcium phosphate, strontium salt and other biological coatings, including the local action of exogenous stem cells and growth factors, can promote the state of health or the pathological state. (4) The individualized design of 3D printed metal implant, good mechanical properties and the ability to induce bone growth significantly promote the integration effect of the prosthesis-host bone and provide a new direction for orthopedics. 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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Anatomy, classification and internal fixation of sacral fractures Jia Wen-chao, Xue Fei, Feng Wei, Jia Yan-fei 2018, 22 (31):  5034-5040.  doi: 10.3969/j.issn.2095-4344.0567 Abstract ( 418 )   PDF (787KB) ( 381 )   Save BACKGROUND: Various types of sacral fractures caused by high energy injury are becoming more and more common, and the severe clinical manifestations after nerve injury, unknown prognosis, and unstable lumbosacral junction in some fractures make sacral fracture become a hotspot. The classifications commonly used in the clinic are Denis, Tile and Young-Burgess. In recent years, classifications of the lumbosacral lesions and scoring systems of the injury severity have often been used for treatment selection. Although there are many kinds of internal fixation used for sacral fracture, different internal fixation methods have their own indications. As clinicians, the indications should be strictly identified and controlled. OBJECTIVE: To summarize the research progress in the classification and internal fixation treatments of sacral fractures. METHODS: A computer-based online retrieval of PubMed, Embase and CNKI databases was performed for relevant literatures published from October 1976 to December 2017 with the keywords of “sacral fracture, sacral fractures, sacrum fracture, anatomy, classification, bones, therapy, 3D fluoroscopy-based navigation, internal fixation, sacroiliac screw fixation, minimal invasive” in Chinese and English, respectively. The articles concerning classification and treatment of sacral fractures were collected, and those outdated and repetitive studies and meta-analysis studies were excluded. RESULTS AND CONCLUSION: (1) In the past 30 years, the operative methods for sacral fracture at all levels have been studied, and the advantages and disadvantages of various types of surgeries are analyzed and summarized. The surgical indications of unstable sacral fracture have been confirmed. (2) We summarize the anatomy, classification and treatment of sacral fractures, which suggests that the minimally invasive surgery has become popular. (3) With the full understanding of the recovery of the nerve injury, postoperative complications, and the recovery time of the sacral fracture, a further investigation is 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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Characteristics and clinical applicability of lumbar interspinous spacer Wang Bao-dong, Lu Jun-feng, Cao Yang 2018, 22 (31):  5041-5047.  doi: 10.3969/j.issn.2095-4344.0568 Abstract ( 453 )   PDF (740KB) ( 186 )   Save BACKGROUND: Lumbar degenerative disease is a common disease in orthopedics. The treatment methods include conservative treatment, interbody fusion and interbody non-fusion, and the classical surgical treatment is posterior lumbar interbody fusion. Non-fusion technology has become more and more widely used, especially the interspinous spacer. Compared with the traditional fusion technology, it has unique biomechanical advantages and ideal clinical efficacy, but the potential problems and deficiencies are gradually emerging. OBJECTIVE: To review the biomechanical characteristics and disadvantages of interspinous spacer, the value and controversy of clinical applicability, the reasons for the limitation of clinical applicability and the improvement in biomechanics, so as to provide a reference for clinical practice. METHODS: The first author retrieved CNKI, WanFang, PubMed and SpringerLink databases with the keywords of “lumbar spine, interspinous spacer, interspinous devices, biomechanics, clinical therapeutic effect, cost-effectiveness, complications of interspinous spacer, indication and contraindication of interspinous spacer, spinous process morphology, new interspinous spacer” in English and Chinese, respectively. Relevant studies published between 2003 and 2018 were included and the repeated studies were excluded. Finally, 42 studies were enrolled, with 38 English studies and 4 Chinese studies through reading abstracts. RESULTS AND CONCLUSION: (1) The interspinous spacer holds special biomechanical characteristics and certain shortcomings in structure. (2) All kinds of interspinous spacers obtain good clinical effects in short- and medium-time follow-up. However, there are some disadvantages, such as high rate of recurrence and reversion, inaccurate clinical efficacy, low cost-effectiveness, and frequent complications. (3) The inaccurate surgical indications and contraindications, unstandardized operation and the specificity in the anatomic morphology of spinous process are the main reasons for the limitation of clinical applicability. (4) The research and development of new device provide an improved concept and direction for biomechanical study.  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 antibiotic-loaded cement spacers in two-stage revision for periprosthetic joint infection after total knee arthroplasty Yu Qiang, Tian Jing 2018, 22 (31):  5048-5055.  doi: 10.3969/j.issn.2095-4344.0569 Abstract ( 442 )   PDF (807KB) ( 150 )   Save BACKGROUND: Antibiotic-loaded cement spacers have played an important role in two-stage revision for chronic periprosthetic joint infection. It can not only sustain articular space and prevent muscle contracture, but also increase the concentration of antibiotics in articular cavity and clear up the infection. There are many types of spacers, and how to choose an optimal spacer is the mutual goal for orthopedic surgeons. OBJECTIVE: To review the basic concept of periprosthetic joint infection as well as the two-stage revision, the types of knee spacers, the advantages and limitations of each kind of spacer, and to provide valuable information for surgeons to choose an optimal spacer. METHODS: The first author searched MEDLINE, Science Direct, CNKI and VIP databases for the articles addressing knee spacers used in two-stage revision after periprosthetic joint infection published between January 1980 and May 2018. The keywords were “periprosthetic joint infection, antibiotic-loaded cement spacer, two-stage revision, total knee arthroplasty, infection” in English and Chinese, respectively. Totally 114 articles were retrieved, and 78 articles were eligible for inclusion criteria. RESULTS AND CONCLUSION: (1) Periprosthetic joint infection of knee is a devastating complication after total knee arthroplasty. Two-stage revision is considered as the “gold standard” for prosthetic infection. (2) Spacers are used in two-stage revision process to prevent soft tissue contraction and to add an intra-articular concentration of antibiotics. Antibiotic-loaded cement spacers may be classified in two types: static spacers and articulating spacers. Several versions of articulating spacer interfaces are presently available: cement-on-cement, cement- on-polyethylene, and metal-on-polyethylene. (3) Different spacers vary in mechanic characteristics and clinical outcomes. (4) At present, there is no clear consensus on the best selection of a spacer, but numerous comparative studies and meta-analysis have provided valuable information for surgeons to make the choice.  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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The latest advances in surgical treatment of osteonecrosis of femoral head: how to achieve the goal of hip joint preserving treatment   Wang Jun, Ge Qiao-feng, Wu Zhuang-zhuang, Lü Zhi 2018, 22 (31):  5056-5061.  doi: 10.3969/j.issn.2095-4344.0378 Abstract ( 406 )   PDF (655KB) ( 119 )   Save BACKGROUND: Arthroplasty is an effective method for osteonecrosis of femoral head (ONFH). The hotspot of ONFH treatment focuses on the hip joint preserving surgery. OBJECTIVE: To summarize the characteristics of various operative methods for ONFH and the latest research progress. METHODS: The first author searched the databases of PubMed, Web of Science and Medline for the articles concerning surgical treatments of ONFH published from 2008 to 2018. The keywords were “osteonecrosis of femoral head, core decompression, stem cell transplantation, vascularized free bone grafting, porous tantalum rod implantation, intertrochanteric osteotomy, total hip arthroplasty”. Totally 104 articles were retrieved, and finally 52 eligible articles were enrolled based on inclusion criteria. RESULTS AND CONCLUSION: (1) There are a large number of operative methods for ONFH. Core decompression can relieve the internal pressure of femoral head, but it only suits for the patients in the early stage of ONFH. The application of tantalum rod can provide strong support for femoral head and good base for osteogenesis. Application of new biological agents such as bone marrow mesenchymal stem cells, growth factor, can contribute to the regeneration of necrotic bone and create a new approach to preserve hip joint for ONFH. (2) With the development of microsurgical technique, bone transplantation with blood vessels is applied extensively. (3) Osteotomy changes the weight-bearing area of femoral head and effectively slows the disease progression. (4) The invention of the third generation alumina ceramic extends the life of artificial joint, especially is applicable for the late stage of ONFH. But the specific indications need to be studied 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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Biomechanical effect and advantages of kinesio taping in the prevention and rehabilitation of knee joint   Duan Gao-ying, Luo Jiong, Liu Li, Zhang Ting-ran, Luo Zhi-zhu 2018, 22 (31):  5062-5068.  doi: 10.3969/j.issn.2095-4344.0333 Abstract ( 633 )   PDF (868KB) ( 328 )   Save BACKGROUND: Kinesio taping was firstly known as a clinical adjuvant therapy. With the further exploration of the patching function, its practical value in the exercise rehabilitation becomes more and more prominent. However, there is a lack of comprehensive and systematic cognition about biomechanical mechanism and empirical research of kiensio taping. OBJECTIVE: To review the biomechanical characteristics of the knee joint after treatment with kinesio taping, and to reveal the characteristics of biomechanical parameters such as kinematics, dynamics, and myoelectricity of the knee joint between non-kinesio and kinesio taping, so as to provide reference for athletes, coaches and bodybuilders when using kinesio taping of knee joints. METHODS: Ovid Medline, EBSCO, Elsevier SDOL, PubMed and CNKI databases were retrieved for the Chinese and English literatures concerning the biomechanics of kinesio taping published before December 2017. The literature was screened based on the inclusion criteria. RESULTS AND CONCLUSION: (1) Most of researches support that different kinesio taping methods do positive effect on the stability of knee joint. (2) Kinesio taping can increase the strength of stabilizing the knee-related muscles, but some scholars hold opposite view, so further researches on whether kinesio taping can immediately improve the muscle strength and increase the degree of muscle activation are needed. (3) Kinesio taping not only protects knee joint muscles of healthy athletes, but also is effective in preventing knee joint injuries and reducing secondary injuries. (4) Kinesio taping can shorten the activation time of the medial muscle in patients with knee injury, and achieve the timing balance between medial and lateral femoral muscles to stabilize the knee joint. (5) Kinesio taping has a certain influence on the flexion, pronation, and external rotation angles of patients with knee injuries, and can effectively reduce the anterior translation of the patients with anterior cruciate ligament injury. 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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Treatment outcomes of casting versus plate for distal radius fracture in adults: a meta-analysis Gao Wei-xu, Chen Xiao, Wang Qiang 2018, 22 (31):  5069-5076.  doi: 10.3969/j.issn.2095-4344.0394 Abstract ( 391 )   PDF (818KB) ( 188 )   Save BACKGROUND: For fracture of distal radius in adults, choosing casting external or open reduction and internal fixation (ORIF) with plates remains controversial. OBJECTIVE: To analyze the results of closed reduction and casting versus ORIF with plates in treatment of fracture of distal radius in adults. METHODS: Databases of PubMed, EMbase, The Cochrane Library (Issue 11, 2017), OVID, Web of Science, CNKI and WanFang were searched. The randomized controlled trials about casting and plate for the fracture of distal radius published before March 2018 were collected. The literature screening was conducted by two researchers independently based on the incision and exclusion criteria, followed by data extraction and bias evaluation. Meta-analysis was performed on RevManager 5.3 software. RESULTS AND CONCLUSION: (1) Fifteen randomized controlled trials were included involving 1 545 patients. (2) Meta-analysis results showed that there were no significant differences in the Disabilities of the Arm, Shoulder and Hand scores (MD=1.83, 95%CI (-0.06, 3.72), P=0.06), Patient-Rated Wrist Evaluation Questionnaire scores (MD=4.01, 95%CI (-4.96, 12.99), P=0.38), range of motion of the wrist joint in dorsiflexion and ulnar deviation (MD=-7.47, 95%CI (-15.40, 0.47), P=0.07; MD=-5.45, 95%CI (-13.82, 2.93), P=0.20) between two groups. The plate groups had a higher Gartland and Werley category (OR=0.52, 95%CI (0.30, 0.90), P=0.02) and grip strength (MD=-10.01, 95%CI (-17.04，-2.99), P=0.005). (3) In the plate group, the incidence of tendinitis (RR=0.10, 95%CI (0.02, 0.51), P=0.006), carpal tunnel syndrome (RR=3.20, 95%CI (1.14, 8.96), P=0.03) and finger stiffness (RR=9.29, 95%CI (1.80, 47.79), P=0.008) were significantly increased. (4) To conclude, for adult patients with fracture of distal, the long-term function between casting and plate is similar. Although the radiological parameters of closed reduction and casting are poor, it does not reduce the range of motion of the wrist joint, nor increase the rate of reoperation, which is firstly chosen for older adults. 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 of clinical outcomes of computer-navigated versus conventional opening wedge high tibial osteotomy Shi Jun-heng, Zhong De-gui, Hong Wei-wu, Huang Yong-quan 2018, 22 (31):  5077-5084.  doi: 10.3969/j.issn.2095-4344.0549 Abstract ( 342 )   PDF (690KB) ( 107 )   Save BACKGROUND: Traditional high tibia osteotomy relies on preoperative planning and intraoperative fluoroscopy to adjust the angle of correction, but it is affected by position, perspective and measurement error, so it is instability. Some studies have reported that computer navigated high tibia osteotomy can improve the accuracy of the correction angle. As the number of cases in previous studies is small and controversial, it is necessary to systematically analyze and evaluate the clinical and imaging results of computer navigated high tibia osteotomy and traditional surgery. OBJECTIVE: To systematically evaluate the clinical and imaging results of computer navigated versus conventional opening wedge high tibial osteotomy. METHODS: Databases of PubMed, EMbase, Cochrane Library, Web of Science, CNKI, CBM, WanFang, and VIP were retrieved for the clinical studies about computer navigated versus conventional opening wedge high tibial osteotomy before April 2018. The quality of the studies was evaluated by two researchers, and heterogeneity test and meta-analysis were conducted on RevMan 5.3 software. RESULTS AND CONCLUSION: (1) Thirteen clinical studies involving 1 030 patients with genu varum were enrolled, 471 patients underwent computer navigated high tibial osteotomy (navigation group), and 559 patients underwent opening wedge high tibial osteotomy (traditional group). (2) Results of meta-analysis showed that compared with the traditional group, patients in the navigation group had better weight bearing line ratio, closest to Fujisawa point (MD=2.14, 95%CI (0.23, 4.05)), less increase in tibial posterior slope (MD=-1.27, 95%CI (-1.95, -0.60)), more exact mechanical axis (MD=0.81, 95%CI (0.37, 1.25)), lower in outliers of alignment (OR=0.39, 95%CI (0.27, 0.59)) and longer operation time (MD=14.90, 95%CI (9.93, 19.88)). There were no significant differences in Lysholm score (MD=1.30, 95%CI (-0.31, 2.90)), range of motion of knee (MD=3.19, 95%CI (-1.60, 7.98)), delayed union rate at tibia osteotomy (OR=1.58, 95%CI (0.44, 5.65)), and infection rate (OR=1.75, 95%CI (0.37, 8.30)) between two groups. (3) These results indicate that compared with conventional opening wedge high tibial osteotomy, computer-navigated high tibial osteotomy obtains more accurate radiographic results, and longer operation time, but no difference is found in Lysholm score, delayed union rate or infection rate. Due to the limitations of this study, the conclusion still needs to be investigated by large samples and long-term randomized controlled studies to confirm the long-term efficacy and imaging findings. 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