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    18 December 2018, Volume 22 Issue 35 Previous Issue    Next Issue
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    Factors related to the fragmentation of ceramic components after fourth-generation ceramic-on-ceramic total hip arthroplasty
    Zhou Chi, He Wei, Liu Yuhao, Guo Hai, Tang Hongyu, Zhang Gangyu, Wang Haibin
    2018, 22 (35):  5577-5582.  doi: 10.3969/j.issn.2095-4344.1002
    Abstract ( 440 )   PDF (781KB) ( 112 )   Save

    BACKGROUND: Total hip arthroplasty has become a most successful and mature surgical procedure, despite tremendous advances in material selection, phenomena such as interfacial wear, osteolysis, and prosthesis loosening severely affect long-term efficacy.

    OBJECTIVE: To analyze the factors related to the fragmentation of ceramic components after fourth-generation ceramic-on-ceramic total hip arthroplasty.
    METHODS: Case data were collected. The literature concerning the factors related to the fragmentation of ceramic components after fourth-generation ceramic-on-ceramic total hip arthroplasty were reviewed by searching the CNKI, PubMed and Web of science databases.
    RESULTS AND CONCLUSION: (1) Although the fourth-generation ceramic-on-ceramic total hip prosthesis possesses high hardness and wear resistance, the possibility of fragmentation still exits. The causes and physical factors, mechanical factors, prosthesis selection and matching, surgery relevant factors are closely related. (2) Therefore, before performing this type of surgery, we should explain clearly to the patient and inform the risk of fragmentation. The ceramic interface joints can provide good results when ensuring proper implantation of ceramic components, especially for young and active patients. 

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Early effects of direct anterior approach versus posterolateral approach in total hip arthroplasty  
    Zha Xiaowei, Cheng Wendan, Lü Hao, Li Ziyu, Liu Wei, Qi Lei, Yu Shuisheng, Jing Juehua
    2018, 22 (35):  5583-5589.  doi: 10.3969/j.issn.2095-4344.1003
    Abstract ( 292 )   PDF (733KB) ( 151 )   Save

    BACKGROUND: Minimally invasive total hip arthroplasty is becoming the most popular procedure for total hip arthroplasty. Direct anterior approach has the advantages of small soft tissue injury and quick recovery after operation, so it is called the best approach of total hip replacement according to the minimally invasive surgical criteria. However, it is difficult to operate and the learning curve is long, and early curative effect remains controversial.

    OBJECTIVE: To compare the tissue injury and early clinical effect between direct anterior approach and posterolateral approach in total hip arthroplasty.
    METHODS: Clinical data of 64 patients undergoing total hip arthroplasty in the Department of Orthopedics, the Second Hospital of Anhui Medical University from October 2016 to August 2017, were analyzed retrospectively. The patients were divided into direct anterior approach group (n=31) and posterolateral approach group (n=33) according to the operative approach. The incision length, operation time, intraoperative blood loss, hospitalization time, drainage volume, serum creatine kinase, C-reactive protein, erythrocyte sedimentation rate, interleukin-6, Visual Analogue ScaIe score, the Harris hip score, and complications were compared between two groups.
    RESULTS AND CONCLUSION: (1) The direct anterior approach group showed significant longer operation time, more intraoperative blood loss, shorter incision length and shorter hospitalization time than those in the posterolateral approach group (P < 0.05). The drainage volume showed no significant difference between two groups (P > 0.05). (2) The levels of creatine kinase, C-reactive protein, and interleukin-6, and erythrocyte sedimentation rate at 1, 2, 3, and 4 days postoperatively in the direct anterior approach group were significantly lower than those in the posterolateral approach group (P < 0.05). (3) The Visual Analogue Scale scores at postoperative 24, 48, and 72 hours in the direct anterior approach group were significantly lower than those in the posterolateral approach group (P < 0.05). (4) The Harris hip scores at 1, 3 and 6 months postoperatively in the direct anterior approach group were significantly superior to those in the posterolateral approach group  (P < 0.05). (5) There was no significant difference in the anteversion or abduction angles of acetabular prosthesis between two groups (P > 0.05). (6) The surgical complications showed no significant differences between two groups (P=1.00). (7) To conclude, there is no significant difference in 6-month complications between direct anterior approach and posterolateral approach. Direct anterior approach in total hip arthroplasty achieves less muscle damage, better early-term clinical effect and better functional recovery compared with the posterolateral approach.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Curative effects of cemented hemiarthroplasty versus proximal femoral nail anti-rotation for treatment of intertrochanteric fractures of cerebral infarction hemiplegia side in older adults
    Wan Qian, Yang Xiaohua, Zhang Qingzhu, Feng Zhen, Gu Rui
    2018, 22 (35):  5590-5595.  doi: 10.3969/j.issn.2095-4344.0611
    Abstract ( 307 )   PDF (645KB) ( 113 )   Save

    BACKGROUND: Cemented hemiarthroplasty and proximal femoral nail anti-rotation in the treatment of senior intertrochanteric fractures both can achieve good clinical curative efficacy, but intertrochanteric fractures of senior cerebral infarction hemiplegia side is a special type. For the surgical treatment program, there are still many disputes.

    OBJECTIVE: To compare the clinical outcomes between cemented hemiarthroplasty and proximal femoral nail anti-rotation placement for the patients with intertrochanteric fractures of senior cerebral infarction hemiplegia side.
    METHODS: A retrospective analysis of 61 patients with intertrochanteric fractures of senior cerebral infarction hemiplegia side admitted in Affiliated Hospital of Chengde Medical University from October 2013 to January 2017 was performed. The subjects were divided into two groups according to different treatment methods: cemented hemiarthroplasty group (n=29) and proximal femoral nail anti-rotation group (n=32). The operation time, intraoperative blood loss, hemoglobin difference before and after operation, postoperative bed time, incidence of perioperative complications, and Harris scores at 6 months and 1 year postoperatively were compared between groups.
    RESULTS AND CONCLUSION: (1) Compared with the proximal femoral nail anti-rotation group, the operation time was significantly lengthened, intraoperative blood loss was significantly increased, and the Harris scores at 6 months postoperatively were significantly increased in the cemented hemiarthroplasty group (P < 0.05). (2) The hemoglobin difference before and after operation, postoperative bed time, incidence of perioperative complications, and Harris scores at 1 year showed no significant differences between two groups (P > 0.05). (3) These results indicate that compared with proximal femoral nail anti-rotation, cemented hemiarthroplasty for the treatment of the patients with intertrochanteric fractures of elderly cerebral infarction hemiplegia side has a better recovery of hip function in a short time, but its operation time is longer and the amount of intraoperative blood loss is more, and there was no significant difference in hemoglobin difference before and after operation, bed rest time, perioperative complications, and long-term hip function recovery between the two methods.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Three-dimensional gait characteristics of patients after knee arthroplasty  
    Huang Ping, Chen Bo, Liu Zhihong, Xu Ping
    2018, 22 (35):  5596-5601.  doi: 10.3969/j.issn.2095-4344.1004
    Abstract ( 420 )   PDF (698KB) ( 123 )   Save

    BACKGROUND: Gait of patients after knee arthroplasty has arisen much attention from physicians and researchers.

    OBJECTIVE: To quantitatively assess the function and the biomechanical changes of knee joints after knee arthroplasty, and to evaluate the curative effect, so as to select the best treatment strategy and postoperative rehabilitation program.
    METHODS: Twelve patients with knee arthritis undergoing bilateral knee arthroplasties (trial group) and 12 healthy individuals (control group) were enrolled, and the gait test was performed using the British Vicon three-dimensional motion capture system. The walking ability and three-dimensional kinematic and dynamic characteristics of the knee joint were analyzed with Polygon software.
    RESULTS AND CONCLUSION: (1) Time-space parameters (step frequency, bipedal support period, ratio of opposite heel to landing, ratio of toes to off-site of the opposite side, single-foot support period, step length, step time, step width, stride, walking cycle, pace) showed no significant differences between groups (P > 0.05). (2) The peak knee flexion angle, peak knee varus angle, and maximum motion range on the coronal plane were significantly decreased in the trial group, compared with the control group (P < 0.05). (3) The peak value of angular velocity, average angular velocity, peak angular acceleration, and average angular acceleration of the knee joint in the trial group were significantly decreased compared with the control group (P < 0.05). (4) The peak value of the extension torque of the knee joint in the trial group was significantly decreased compared with the control group (P < 0.05). (5) The peak ground reaction force in the Y-axis and Z-axis directions in the trial group was significantly decreased compared with the control group (P < 0.05). (6) These results suggest that there is no significant difference in time-space parameters between trial and control groups during ground walking, indicating that knee arthroplasty is an important treatment for the improvement of lower limb walking function. However, the results of this study also show that there are some abnormalities in the motion and movement mechanics of the prosthetic joint after surgery. The biomechanics of the knee joint is not fully up to normal level. These changes are the sport biomechanical characteristics after knee arthroplasty, which may be an important factor affecting the long-term efficacy of patients. 

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Biomechanical stability of three-dimensional external fixator applied in early-stage senile osteoporotic fracture  
    Liu Yao, Huang Yue, Liu Yong, Luo Yuru, Luo Jing, Ju Mei
    2018, 22 (35):  5602-5606.  doi: 10.3969/j.issn.2095-4344.1005
    Abstract ( 286 )   PDF (600KB) ( 118 )   Save

    BACKGROUND: Improved three-dimensional external fixator can obtain good treatment effect and is expected to become a new effective fixation method for osteoporotic fracture in the elderly for minimally invasion. However, little is reported on its mechanical stability after fixation.

    OBJECTIVE: To investigate the biomechanical effect of three-dimensional external fixator for aged patients with osteoporotic fractures and provide evidence for its clinical application.
    METHODS: From June 2017 to June 2018, 36 aged tibial specimens were selected to prepare the tibia osteoporosis specimen models by 18% EDTA decalcification. After successful modeling, the short oblique osteoporosis fracture model of the middle tibia was established. Then these tibial specimens were randomly divided into three groups (n=12 per group), and fixed with steel plate, intramedullary nail, and three-dimensional external fixator, respectively. Four specimens randomly from each group were measured by compression test, bending test, and torsion test with the BOSE3300 biomechanical testing machine, and the differences in biomechanical stability among groups were determined.
    RESULTS AND CONCLUSION: (1) Under 250 and 500 N of axial force, the displacement value in the three-dimensional external fixator group was significantly higher than that in the intramedullary nail group, and lower than that in the plate group (both P < 0.05). The displacement value under 750 N of axial force in the three-dimensional external fixator group was significantly lower than that in the other two groups (P < 0.05). (2) In the bending test, the deflection under different bending forces in the three-dimensional external fixator group was smaller than that in the other two groups (P < 0.05). The deflection in the intramedullary nail group was smaller than that in the plate group  (P < 0.05). (3) The torsional angle in the three-dimensional external fixator group was smaller than that in the other two groups under different torsion forces (P < 0.05). The torsional angle in the intramedullary nail group was smaller than that in the plate group (P < 0.05). (4) In summary, from the perspective of biomechanics, the three-dimensional external fixator can be widely applied in elderly osteoporotic fractures due to its good biomechanical stability. 

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Efficacy of adjustable external support versus hinged external fixator in the treatment of terrible triad of elbow  
    Hu Panyong, Yang Shaoan, Cai Baota, Cao Jun, Yang Xiao
    2018, 22 (35):  5607-5613.  doi: 10.3969/j.issn.2095-4344.1006
    Abstract ( 313 )   PDF (782KB) ( 103 )   Save

    BACKGROUND: Complications such as instability, stiffness and malunion of elbow joint often occur in terrible triad of elbow after surgery and movement function of the joint is poor. In order to improve the therapeutic effect and the quality of life, it is necessary to perform functional training in the early stage of combined effective external fixation, accelerate the recovery of the elbow joint function and prevent the complications.

    OBJECTIVE: To compare the efficacy of hinged external fixator and external fixator in the treatment of terrible triad of elbow joint.
    METHODS: Sixty-five patients with the “terrible triad of the elbow” admitted in the Zhujiang Hospital of Southern Medical University from January 2013 to January 2017 were analyzed retrospectively. The operation was performed combined with lateral and medial surgery approaches of the elbow joint for the open reduction and fixation of the capitulum radial and coronoid fracture, and repair of the collateral ligament. According to external fixation after surgery, patients were divided into two groups. Support group: 30 patients were treated with adjustable external support after surgery. Fixator group: 35 patients received hinged external fixator after surgery. The range of elbow flexion-extension, forearm pronation-supination range, healing time, and Mayo scores after 1-year follow up were detected.
    RESULTS AND CONCLUSION: (1) Support group: the mean range of elbow flexion-extension was (123.3±6.4)°, mean forearm pronation-supination range was (133.9±6.4)°, and the mean healing time was (12.3±1.9) weeks. According to Mayo scores, there were excellent in 28 cases, and good in 2 cases. Two cases appeared with heterotopic ossification of the elbow, and one case had articular valgus deformity healing. (2) Fixator group: the mean range of elbow flexion-extension was (125.5±6.4)°, mean forearm pronation-supination range was (133.1±6.5)°, and the mean healing time was (12.0±1.9) weeks. According to Mayo scores, there were excellent in 34 cases, and good in 1 case. One case appeared with heterotopic ossification of the elbow, and one case had pin tract infection. (3) In the two groups, the flexion and extension activity of the elbow joint, the range of forearm rotation, healing time and Mayo score were insignificant differences (P > 0.05). (4) Therefore, adjustable external support and hinged external fixator have the same effect on elbow joint flexion and extension activity, range of forearm rotation, healing time and Mayo score, and adjustable external support can replace hinged external fixator under certain conditions. 

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Preoperative planning and operative simulation of three-dimensional printing-assisted upper cervical spine tumor model  
    Chen Yongjun, Zhong Hua, Hua Qiang, Lin Yongxiang, Li Hua, Hu Zhiping, Duan Shaoyin, Zhao Huiyi
    2018, 22 (35):  5614-5619.  doi: 10.3969/j.issn.2095-4344.1007
    Abstract ( 352 )   PDF (809KB) ( 229 )   Save

    BACKGROUND: At present, most of the finite element models of upper cervical spine tumors are established based on CT scanning combined with enhanced image data. The three-dimensional printing simulation model has certain errors with the intraoperative actual tumor. We have established the model based on CT and MR, which is realistic.

    OBJECTIVE: To investigate the application of three-dimensional printed upper cervical tumor model for preoperative planning and simulated surgery.
    METHODS: Twenty patients with upper cervical dumbbell tumors (Toyama IIa, IIIa, and V type) admitted in Zhongshan Hospital, Xiamen University from 2015 to 2017 were enrolled, and allocated into two groups (n=10 per group) according to surgical scheme. In the three-dimensional printing group, preoperative CT and MR data of the upper cervical dumbbell tumors were obtained to reconstruct the patients with individualized upper cervical tumor models before surgery, and underwent resection of tumors and reconstruction of spinal stability with atlantoaxial pedicle internal fixation by one-stage posterior approach. The conventional group received conventional surgery. The operation time, blood loss, hospitalization time and postoperative 1-year Japanese Orthopaedic Association improvement rate were compared between two groups. 
    RESULTS AND CONCLUSION: (1) The three-dimensional model could clearly reveal the morphology of the tumor and its spatial relationship with the adjacent blood vessels and the upper cervical spine, and simulate the model in vitro. The intraoperative three-dimensional printing model guided tumor resection and reconstructed upper cervical stability. (2) Compared with the conventional group, the operation time, blood loss, and hospitalization time in the three-dimensional printing group were significantly decreased (P < 0.05). (3) The postoperative 1-year Japanese Orthopaedic Association improvement rate in the three-dimensional printing and conventional groups was (93.0±2.8)% and (75.0±2.3)%, respectively (t=5.634, P < 0.05). (4) All patients showed no internal fixation loosening or kyphosis during follow-up. (5) These results indicate that the three-dimensional-printed upper cervical tumor models are technically feasible, which can effectively assist the development of complex upper cervical diseases surgery program and simulate surgery; therefore, it can help to improve the surgical efficiency and safety.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Best screw placement parameters in S1 pedicle based on three-dimensional reconstruction
    Wan Shengyu, Lin Xu, Wu Chao, Deng Jiayan
    2018, 22 (35):  5620-5624.  doi: 10.3969/j.issn.2095-4344.0364
    Abstract ( 316 )   PDF (648KB) ( 92 )   Save

    BACKGROUND: Placement of S1 pedicle screw is widely used in the treatment of spinal diseases. Because the sacrum itself does not have typical pedicle and lateral block, the transitional area between sacral transverse process and vertebra is defined as pedicle. The bone density of S1 pedicle is significantly lower than that of pedicle of thoracic and lumbar vertebrae. However, the S1 vertebra is usually the end vertebra of the spine arch screw, which suffers great stress, and there are many complications of loose and broken nail in clinical follow-up. Therefore, the fixation of the S1 vertebrae needs to be individualized and precise to obtain the best biomechanics.

    OBJECTIVE: To reconstruct the pelvic ring structure by digital technology to simulate S1 pedicle screw placement, so as to provide anatomical reference for clinical practice.
    METHODS: Pelvic CT data of 108 patients in Zigong Fourth People’s Hospital between April and August, 2017 obtained by CT thin slice scanning were included after excluding congenital malformation, and severe degeneration of the sacral and bilateral iliac bones. Three-dimensional model was reconstructed using Mimics software and optimal space nail was simulated by digital technology. S1 screw entry point was set as the intersection of lines where extension of S1 facet joint inferior margin and lateral margin cross over. The length of the screw, screw position, tangent distance screw nail cap and the iliac wing and the distance between plane wing of ilium nail were measured.
    RESULTS AND CONCLUSION: (1) The left oblique angle (α) of S1 pedicle screws was (20.73±8.04)° in males, and (24.73±8.16)° in females (P=0.013). (2) The right α was (21.57±9.68)° in males and (26.75+7.78)° in females (P=0.003). (3) The distance between the left screw nail cap and the iliac wing (a) was (2.20±4.33) mm in males, and (8.03±8.81) mm in females (P=0.000). (4) The right a was (2.13±3.93) mm in males, and (7.57±6.70) mm in females (P=0.000). (5) The distance between planar iliac bone (b) of screw was (76.96±9.47) mm in males, and (86.52±12.56) mm in females (P=0.000). (6) There was no significant difference in the angle (β) of the left and right sides and the length (d) of screw implantation in females and males (P > 0.05). (7) Three patients could not receive vertical and medial anterior internal fixation due to iliac wing obstruction. (8) These results indicate that the anatomy of the sacral and pelvic rings in South Sichuan is described in detail. The parameters of the S1 pedicle screw implantation can be used as a reference for clinical application.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Development and clinical application of the puncture guidance instrument for percutaneous transforaminal endoscopic discectomy
    Li Ming, Zhong Yanxue, Zhu Zhongjiao, Li Yong, Sun Jinbao, Zhang Guodong
    2018, 22 (35):  5625-5630.  doi: 10.3969/j.issn.2095-4344.0610
    Abstract ( 390 )   PDF (762KB) ( 109 )   Save

    BACKGROUND: Percutaneous transforaminal endoscopic discectomy is currently the most minimally invasive treatment of lumbar disc herniation. It is essential to operation success that the puncture needle can accurately reach the target. But percutaneous transforaminal endoscopic discectomy has steep learning curve. Free hand can easily result in inadequate puncture.

    OBJECTIVE: To evaluate the puncture accuracy and safety of percutaneous puncture guidance instrument for percutaneous transforaminal endoscopic discectomy.
    METHODS: The design principle of puncture guidance instrument for percutaneous transforaminal endoscopic discectomy was right triangle. From January 2014 to July 2016, 60 patients with lumber disc herniation were randomly divided into navigation group (n=33, percutaneous transforaminal endoscopic discectomy with a novel puncture guidance instrument) and free hand group (n=27, percutaneous transforaminal endoscopic discectomy with a free hand method).The times for puncture, puncture time, times for fluoroscopy, Japanese Orthopaedic Association score and Oswestry Disability Index at 1 year postoperatively were recorded and compared between two groups.
    RESULTS AND CONCLUSION: (1) All patients underwent the operation successfully. (2) The average puncture times, the average fluoroscopic exposure time and the preoperative location and puncture-channel time in the navigation group were significantly less than those in the free hand group (P < 0.05). (3) Japanese Orthopaedic Association scores and Oswestry Disability Index at 1 year postoperatively in both groups were significantly improved compared with the baseline (P < 0.05). The scores showed no significant differences between two groups (P > 0.05). (4) Our results indicate that the puncture guidance instrument for percutaneous transforaminal endoscopic discectomy can improve the puncture accuracy, especially for a beginner. 

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Mechanical properties of intact and defective articular cartilage under rolling load  
    Li Zhiqiang, Gao Lilan, Si Yunpeng, Zhang Chunqiu
    2018, 22 (35):  5631-5636.  doi: 10.3969/j.issn.2095-4344.1008
    Abstract ( 356 )   PDF (1132KB) ( 166 )   Save

    BACKGROUND: Knee joint is the main load-bearing tissue during movement and it is also a predilection site for clinical disease. Rolling load makes a great influence on the physiology and pathology of the knee cartilage, but the relative studies are few.

    OBJECTIVE: To explore the mechanical properties of intact and defective cartilage tissue under rolling load at different rolling velocities, different compression amounts, and maximum rolling times of 150.
    METHODS: The intact and defective cartilage tissues from pig knee were prepared. Different loads were controlled using rolling device. The strains of different layers of the intact and defective cartilage tissues under rolling were studied.
    RESULTS AND CONCLUSION: Under rolling load, the normal strains of superficial layers of both intact and defective cartilages were largest, followed by the middle layer, and the deep layer was smallest. The normal strain of each layer near the cartilage defect was greater than that of the intact cartilage. With the increase of compression, the normal strains of different layers of articular cartilage were increased, and the strain of defect cartilage near the defect area was also increases greatly. The faster the rolling rate, the faster the strain reached the maximum stability. In summary, the mechanical properties of different layers of cartilage are affected by rolling velocity, compression and defect. Cartilage defects lead to the increased deformation of the cartilage tissue under rolling loads, which may further aggravate cartilage damage.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Spinal mechanical impulsive manipulation versus conventional physiotherapy for chronic low back pain: differences in range of lumbar motion and trunk muscle strength
    Zhu Zhongliang, Yu Xiaojie, Liu Bangzhong, Zhu Min, Zhao Liya, Yan Dongdong
    2018, 22 (35):  5637-5641.  doi: 10.3969/j.issn.2095-4344.1009
    Abstract ( 356 )   PDF (626KB) ( 124 )   Save

    BACKGROUND: Chronic low back pain has been shown to be related to gestures, muscle and activity characteristics. Etiological factors include decreased or excessive lumbar lordosis, decreased abdominal muscle strength, imbalance of trunk flexors and extensors, and decreased lumbar mobility. Spinal manipulation or chiropractic surgery is a conservative treatment for spinal dysfunction and pain at abroad.

    OBJECTIVE: To assess the efficacy of spinal mechanical impulsive manipulation and conventional physiotherapy by subjective pain and dysfunction as well as range of motion and trunk muscle strength in the patients with chronic low back pain.
    METHODS: This was a prospective, randomized controlled clinical trial. Sixty subjects with an age of 18 to 65 years, who had a primary complaint of low back pain at least 6-week duration with or without radiating pain to the lower extremity were included, and randomized into trial (spinal mechanical impulsive manipulation) and control (conventional physiotherapy) groups. Treatment programs were performed twice weekly, for 4 weeks. The Visual Analogue Scale scores, Roland-Morris dysfunction questionnaire, lumbar spinal range of motion and trunk muscle strength before and 1 month after treatment were detected.
    RESULTS AND CONCLUSION: (1) All subjects had a significant decrease in pain and disability after intervention (P < 0.05). The Visual Analogue Scale score at 1 month after treatment in the trial group was significantly lower than those in the control group (P < 0.05). (2) Both groups showed significant improvements in lumbar flexion, extension, flexor and extensor strength after treatment (P < 0.05). The lumbar flexion range of motion and extensor muscle strength at 1 month after treatment were increased significantly in the trial group compared with the control group (P < 0.05). (3) Both groups showed significant improvements in trunk extensor strength after treatment (P < 0.05). The trunk extensor strength improvement at 1 month after treatment in the trial group was significantly superior to that in the control group (P < 0.05). (4) These results suggest that spinal mechanical impulsive manipulation is more effective in reducing pain and improving range of motion and trunk muscle strength in patients with low back pain compared with conventional physiotherapy. 

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Biomechanical properties of acetabular reconstruction in adult developmental dysplasia of the hip by a three-dimensional finite element analysis
    Tian Fengde, Zhao Dewei, Li Dongyi, Guo Lin, An Ning, Zhang Yao, Cheng Liangliang, Hao Ruihu, Yang Fan
    2018, 22 (35):  5642-5647.  doi: 10.3969/j.issn.2095-4344.1010
    Abstract ( 317 )   PDF (711KB) ( 104 )   Save

    BACKGROUND: Many methods are used to treat adult developmental dysplasia of the hip, such as pericapsular osteotomy and rotational acetabular osteotomy. Due to the limitation of technical conditions, the curative effect is different. Although these methods have improved the relationship between the head and the acetabulum in varying degrees, there is still a certain gap from the ideal state, and some patients have poor results with continuous disease development.

    OBJECTIVE: To analyze the feasibility and effectiveness of acetabular reconstruction in adult hip dysplasia by three-dimensional finite element method and provide theoretical basis for future clinical research.
    METHODS: Thin-slice CT data of unilateral hip dysplasia patient were collected. Mimics 15.0 and Hypermesh were used to establish the model of healthy hip and dysplasia hip, and location and scope of bony defect were calculated, then model of reconstruction of the acetabulum was established by simulating tools. The Von Mises stress distribution in the subchondral bone of each hip joint was analyzed under the condition of single foot standing using Ansys 10.0.
    RESULTS AND CONCLUSION: (1) The results of each model were consistent with the actual situation, and the maximum Von Mises stress value appeared in the acetabular dome and the posteromedial femoral neck. (2) The bone defect appeared in the anterolateral part of acetabulum, the size was 43 mm×14 mm×7 mm. (3) The Von Mises stress peak values of each group after stress loading in the healthy hip were femoral head (2.800±0.012) MPa, acetabulum (3.855±0.035) MPa; femoral head of affected hip (5.066±0.026) MPa; acetabulum (8.168±0.034) MPa; reconstructed hip femoral head (2.769±0.085) MPa, acetabulum (3.804±0.132) MPa. Statistical analysis showed that the peak Von Mises stress in each part of the affected hip was significantly higher than that in the other two groups (P < 0.001). The values between reconstructed hip and healthy hips were similar (P > 0.05), suggesting that the stress distribution of hip joint was normal after acetabular reconstruction. (4) The stress analysis of finite element model indicates that acetabular reconstruction can restore the mechanical structure of hip joint, and this method is feasible to treat adult early developmental dysplasia of the hip.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Mechanism of the low-frequency vibration generated by vehicle driving effects on the human lumbar spine: a dynamic simulation analysis  
    Fan Ruoxun, Liu Jie, Liu Jun, Gao Jiazi
    2018, 22 (35):  5648-5654.  doi: 10.3969/j.issn.2095-4344.1011
    Abstract ( 393 )   PDF (813KB) ( 130 )   Save

    BACKGROUND: Chronically exposing to the low-frequency vibration environment generated by vehicle driving will impair human lumbar spine. However, littler is reported on the underlying mechanism of the low-frequency vibration effects on the human lumbar mechanical properties.

    OBJECTIVE: To investigate the mechanism of different vibration frequencies effects on the human lumbar spine through dynamic finite element analysis.
    METHODS: A poroelastic finite element model of human L2-L3 was established to perform time-dependent dynamic simulation analysis. The effects of different vibration frequencies generated by normal driving of the vehicle on the human lumbar mechanical properties were investigated.
    RESULTS AND CONCLUSION: (1) The static load caused less stress and displacement values than the dynamic load at the same vibrational time. (2) With the vibration frequency increasing, the axial effective stress and radial displacement in the intervertebral disc were increased, whereas the pore pressure in the nucleus pulposus was decreased. (3) When the vibration frequency reached a certain degree, the numerical fluctuation magnitude of the lumbar mechanical parameters was not changed continuously with increasing vibration frequency. (4) These results indicate that the rapid increase in the stress and displacement and dissipation in the pore pressure are not conducive to the bearing and performance recovery of human lumbar spine. Therefore, static load causes slight influence on spinal mechanical properties. Vibration at the resonant frequency generates the most serious injury to the human lumbar spine. Relatively high vibration frequency generated by the vehicle driving is more detrimental to the lumbar spine health within a certain frequency range.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Correlation of imaging indexes of patellar axial disorder with pain of knee osteoarthritis
    Liu Shengfei, Jiang Yanjun, Cen Zhuohao, Ling Min, Zhang Tian, Chen Yuexuan, Zhou Chi
    2018, 22 (35):  5655-5660.  doi: 10.3969/j.issn.2095-4344.1012
    Abstract ( 356 )   PDF (664KB) ( 148 )   Save

    BACKGROUND: Pain caused by knee osteoarthritis is reflected in imaging. Change of radiographic parameters of the tibial axis slice can provide a reasonable assessment for the clinical pain symptoms of knee osteoarthritis.

    OBJECTIVE: To analyze the correlation between the change of the imaging indexes of patellar axial radiograph and pain area in the knee osteoarthritis, thus providing reference for the diagnosis and treatment of knee osteoarthritis.
    METHODS:Available samples were collected from the First Affiliated Hospital of Guangzhou University of Chinese Medicine between September 2014 and September 2016, where totally 80 knee osteoarthritis patients were selected as pain group and 30 healthy volunteers were selected as control group. All the participants took patellar axial radiograph with knee at 30° through PACS imaging systems to collect five imaging indexes, including patella exponent, femur trochlea angle, congruence angle, lateral patellofemoral angle and tilt angle. Knee osteoarthritis patients in the pain group were divided into four common clinical pain areas which were anterior, posterior, medial and lateral area.
    RESULTS AND CONCLUSION: (1) The patellofemoral pain index, congruence angle, and lateral patellofemoral angle in the pain group were significantly larger than those in the control group (P < 0.05). In the patellofemoral angle, patellofemoral subluxation and femoral trochlear angle parameters, there was no significant difference between two groups (P > 0.05). (2) Two logistic regression analysis showed that there was a correlation between knee osteoarthritis pain and lateral patellofemoral angle (P=0.01). (3) From one way-ANOVA LSD statistical analysis, the patellofemoral angle in patellofemoral anterior and posterior areas had significant difference (P=0.038), and there were no differences in the other imaging parameters between pain areas (P > 0.05). (4) In summary, compared with the health volunteers, in the patients with pain caused by knee osteoarthritis, patellofemoral joint disorder and patella angle affects the pain of anterior and posterior areas, which has a connection with the saphenous nerve, the branches of the sciatic nerve and peroneal nerve branch of conduction.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Quantitative analysis of morphological differences on sagittal magnetic resonance imaging between a torn and an intact discoid lateral meniscus in adults  
    Sun Xiaoxin, Liu Hao, Chai Hongwei, Song Jingfeng, Liang Chunyu
    2018, 22 (35):  5661-5666.  doi: 10.3969/j.issn.2095-4344.1013
    Abstract ( 337 )   PDF (633KB) ( 101 )   Save

    BACKGROUND: Morphological characteristics of the torn discoid lateral meniscus remain unclear, and imaging standards used to evaluate the discoid lateral meniscus tears still need to be explored.

    OBJECTIVE: To determine the quantitative differences on sagittal magnetic resonance imaging between a torn discoid lateral meniscus and an intact discoid lateral meniscus in adults.
    METHODS: Seventy-two cases of discoid lateral meniscus from July 2010 to July 2016 were enrolled in this study. Thirty?nine patients who underwent arthroscopic surgery for torn discoid lateral meniscus were served as torn group, and additional 33 patients having intact discoid lateral meniscus were as control group. All patients were evaluated for morphological indices of discoid lateral meniscus on sagittal magnetic resonance imaging, including the height of the anterior horn and posterior horn of discoid lateral meniscus, distance between the edges of discoid lateral meniscus and the edges of tibia, and anteroposterior diameter of femur. The relative morphological indices (the ratio of the morphological data of discoid lateral meniscus to the anteroposterior diameter of femur) were also calculated. Then the morphological difference of discoid lateral meniscus between a torn and an intact discoid lateral meniscus was compared. These morphological indices were compared between two groups.
    RESULTS AND CONCLUSION: (1) There were no significant differences in the height of the posterior horn of discoid lateral meniscus, distance between posterior edge of discoid lateral meniscus and posterior edge of tibia, and anteroposterior diameter of femur between two groups (P > 0.05). The height of the anterior horn of a torn discoid lateral meniscus (absolute value, relative ratio) was significantly increased compared with the control group (P=0.004, 0.001). The distance between the edge of the anterior horn of discoid lateral meniscus and anterior edge of tibia in the torn group (absolute value, relative ratio) was significantly lower than that in the control group (P=0.001, 0.001). The anteroposterior diameter of a torn discoid lateral meniscus (absolute value, relative ratio) in the torn group was significantly larger than that in the control group (P=0.002, 0.000). (2) There were no significant differences in the morphological indices of sagittal plane between two groups. (3) The interclass correlation coefficient for each parameter indicated a significantly high agreement among two observers (P < 0.001). (4) In summary, the height of the anterior horn and anteroposterior diameter of discoid lateral meniscus, distance between the edge of anterior horn of discoid lateral meniscus and anterior edge of tibia on sagittal magnetic resonance imaging may be useful indicators for evaluating the torn discoid lateral meniscus in 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
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    Significance of routine magnetic resonance imaging examination in evaluating osteoporosis of the lumbar spine  
    Weng Zijing, Huang Xuejing, Yu Jianli, Zhang Minguang
    2018, 22 (35):  5667-5673.  doi: 10.3969/j.issn.2095-4344.1014
    Abstract ( 363 )   PDF (839KB) ( 173 )   Save

    BACKGROUND: MRI of lumbar spine has been more and more extensively applied in patients with low back pain. The conventional MRI signal of lumbar spine is high in older females, which may be related to osteoporosis.

    OBJECTIVE: To investigate the significance of conventional signal changes on MRI of lumbar spine in evaluating lumbar osteoporosis.
    METHODS: One hundred and ninety-four cases were collected whose bone mineral density was determined by dual-energy X-ray absorptiometry and MRI in the L1-L4 within 1 month, including 50 males and 144 females. Dual-energy X-ray absorptiometry-bone mineral density value and MRI signal of lumbar vertebrae in the sagittal plane MRI-T1WI, T2WI and FS-T2WI and signal difference between T2WI and FS-T2WI were analyzed. With 1 g/cm2 as the dividing line, the dual-energy X-ray absorptiometry- bone mineral density value and the value of MRI signal of vertebral bodies were compared.
    RESULTS AND CONCLUSION: (1) Bone mineral density of female subjects in all four vertebral bodies were significantly lower than that of males, in addition to P=0.003 in L4, the rest P < 0.001. (2) The FS-T2WI was not significantly different between males and females (P > 0.05). In females, the signals of MR-T1WI, T2WI and signal difference between MR-T2WI and FS-T2WI in the sagittal plane of lumbar vertebrae were significantly higher than those in males (P ≤ 0.001). (3) Among different age groups, dual-energy X-ray absorptiometry-bone mineral density and signals of MRI-T1WI, T2WI and signal difference between MRI-T2WI and FS-T2WI were significantly different. (4) In addition to the L4, dual-energy X-ray absorptiometry-bone mineral density of patients under 60 years old was significantly higher than that of patients over 60 years old (P < 0.05), and decreased with age increasing. (5) While the signals of MRI-T1WI, T2WI and signal difference between MR-T2WI and FS-T2WI of patients under 60 years old were significantly lower than that of patients over 60 years old (P < 0.05), and increased with age increased. (6) There were no significant differences in the signal of MRI-FS-T2WI of all age groups. (7) The age and signals of MRI-T1WI, T2WI and signal difference between MRI-T2WI and FS-T2WI of subjects of dual-energy X-ray absorptiometry-bone mineral density ≥ 1 g/cm2 were significantly lower than that < 1 g/cm2 (P < 0.001), while vertebral signals were not significantly different in FS-T2WI (P > 0.05). (8) These results indicate that dual-energy X-ray absorptiometry can quantitatively determine the bone mineral density. MRI can reflect the content of bone fat and water by changes of signal by multi-sequences. It has important significance to judge the content of bone minerals and bone matrix indirectly. 

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Identification of skeletal age using the ossification staging of medial clavicle epiphysis
    Zha Luqin, Cui Erfeng
    2018, 22 (35):  5674-5680.  doi: 10.3969/j.issn.2095-4344.1015
    Abstract ( 571 )   PDF (678KB) ( 173 )   Save

    BACKGROUND: Forensic bone age identification for adolescents has been a hot topic in criminal proceedings. Determination of the bone ossification of the hand and the mineralization of the third molar are common methods for the identification of skeletal age in China, which will have a situation of overassessment, and will affect the justice of the judiciary. Therefore, the identification of skeletal age using the ossification stage of the medial clavicular epiphysis has become an alternative method.

    OBJECTIVE: To investigate the feasibility of the ossification stage of the medial clavicular epiphysis in forensic bone age determination by CT, and to find a criterion to determine whether an individual is adult or not.
    METHODS: Chest CT data of 300 patients with an age of 10-30 years were retrospectively evaluated for ossification stage of the bilateral medial clavicular epiphysis (600 clavicles), and were compared with the sex and chronologic age of the individuals. The ossification stage of the medial clavicular epiphyses was classified from stages I to V using a modified staging system.
    RESULTS AND CONCLUSION: (1) Epiphyseal ossification center appeared from 11 to 21 years old. Partial fusion occurred between 16 and 23 years of age. Complete fusion was first achieved at the age of 18 years for males and 19 years for females. (2) The probability of an individual being > 18 years old was 70.8% in stage III and 100% in stages IIIB, IV, and V in females and males. (3) CT evaluation of the medial clavicular epiphysis is helpful in forensic age determination and stage IIIB can be used as a criterion to make the prediction that an individual is older than 18 years. 

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Characteristics and significance of high-frequency color Doppler ultrasound in assessing tibial nerve and its main branches of healthy adults  
    Yuan Chen, Jing Jiangxin, Liu Chunhong
    2018, 22 (35):  5681-5686.  doi: 10.3969/j.issn.2095-4344.1016
    Abstract ( 371 )   PDF (819KB) ( 95 )   Save

    BACKGROUND: In the past decades, neuromuscular ultrasound has become an effective method for the diagnosis of peripheral nerve diseases. Only a few scholars at abroad have studied the tibial nerve in detail. However, the details of armpit to the plantar branches of the tibial nerve are none reported in China.

    OBJECTIVE: To investigate the features of high-frequency color Doppler ultrasound sonography of normal adult phrenic nerve and its main branches and its possible clinical significance.
    METHODS: Ultrasonography was used to probe 200 healthy adult volunteers with 400 tibial nerves and their main branches to observe the characteristics of the sonographic features, walking, adjoining structures, and blood flow signal display. The anteroposterior diameter, lateral diameter and cross-sectional area of the iliac nerves and soles at the axillary and medial malleolus were measured.
    RESULTS AND CONCLUSION: (1) High-frequency color Doppler ultrasound showed 100% display rate of sacral nerves in 200 healthy adult volunteers, and their walking and sonography had certain characters. (2) There was no significant difference between left and right tibial nerves at the selected sites (P > 0.05). (3) The cross-sectional area of male tibial nerve at the selected sites was slightly larger than that of the females (P > 0.05). (4) The cross-sectional area of tibial nerve was positively correlated with height and body mass (P < 0.01). (5) These results imply that high-frequency color ultrasound has a good display for the tibial nerve and its main branches, which can provide normal human imaging data for anatomical studies. 

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Advances in the application of antibiotics for periprosthetic joint infection after total knee and hip arthroplasties
    Hou Senrong, Lin Jiongtong, Liu Jun, Han Yanhong, Pan Jianke, Zeng Lingfeng, Liang Guihong
    2018, 22 (35):  5687-5693.  doi: 10.3969/j.issn.2095-4344.1017
    Abstract ( 211 )   PDF (797KB) ( 115 )   Save

    BACKGROUND: Periprosthetic joint infection is the severest complication after total hip and knee arthroplasties. Antibiotics are essential for periprosthetic joint infection. However, the administration of antibiotics for periprosthetic joint infection after hip and knee arthroplasties, such as usage timing, optimal treatment course, and administration ways needs a further investigation. 

    OBJECTIVE: To summarize the research progress of antibiotics used in the treatment of periprosthetic joint infection at home and abroad, in order to provide reference for the antibiotic treatment of periprosthetic joint infection after total hip and knee arthroplasties.
    METHODS: Comprehensive search of CBMdisc, CNKI, VIP, and WanFang, PubMed, Embase, and Web of Science databases from 2002 to 2018 was performed. The key words were “joint replacement, postoperative infections, antibiotics” and “knee, hip, arthroplasty, infect, antibiotics” in Chinese and English, respectively. The epidemiology, diagnostic criteria, and treatment methods of periprosthetic joint infection after total hip and knee arthroplasties, as well as usage of antibiotics were summarized.
    RESULTS AND CONCLUSION: (1) Forty-seven articles were included. (2) There is still a lack of uniform standards for the use timing, optimal treatment course, dosage and administration ways of antibiotics for periprosthetic joint infection. Most of studies only show the importance of the choice of antibiotics and combination therapy postoperatively. The specific treatment course, administration ways, and doses are unclear. (3) Use of antibiotics for periprosthetic joint infection is mostly based on expert consensus or experience, and there is no high-quality evidence-based medicine. (4) Therefore, relevant evidence-based and randomized controlled trials are needed to provide high-quality, accurate and effective evidence-based medicine for the management of antibiotic use after total hip and knee arthroplasties, and thus providing reference for clinical practice. 

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Classification and treatment strategy of Rockwood type III acromioclavicular joint dislocation
    Wang Zengliang, Zhao Li
    2018, 22 (35):  5694-5699.  doi: 10.3969/j.issn.2095-4344.1018
    Abstract ( 656 )   PDF (653KB) ( 104 )   Save

    BACKGROUND: Acromioclavicular joint dislocation is a common type of sports injury. The reasonable treatment of Rockwood type III acromioclavicular joint dislocation remains controversial.

    OBJECTIVE: To summarize the classification and treatment strategies of Rockwood type III acromioclavicular joint dislocation so as to provide reference for clinical practice.
    METHODS: Relevant articles were searched in PubMed, EMBASE, OVID, Science Direct, CNKI, WanFang, and CBM databases using the following key words of “acromioclavicular, Rockwood, type III, treatment, dislocation” in English and Chinese, respectively. Finally 43 representative articles were included, including 33 English articles and 10 Chinese articles.
    RESULTS AND CONCLUSION: (1) Both surgery and conservative treatments can be used to treat Rockwood type III acromioclavicular joint dislocation. However, the most reasonable treatment method has not yet been confirmed. (2) The new type of Rockwood type III acromioclavicular joint dislocation should be brought to the attention. High-quality, randomized, controlled clinical trials are needed to demonstrate the most appropriate treatment for Rockwood type III acromioclavicular joint dislocation.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Research progression and evaluation of an animal model of cervical radiculopathy
    Zhu Liguo, Tang Bin, Wei Xu, Yin He
    2018, 22 (35):  5700-5705.  doi: 10.3969/j.issn.2095-4344.0579
    Abstract ( 198 )   PDF (739KB) ( 173 )   Save

    BACKGROUND: Incidence of cervical radiculopathy is highest in cervical spondylosis. The ideal animal model is the prerequisite for studies on cervical radiculopathy. However, there are many problems in the conversion of clinical diseases into animal models, which limits the research on the pathogenesis and treatment of cervical radiculopathy.

    OBJECTIVE: To review the selection and construction methods of the cervical radiculopathy model, so as to improve an ideal animal model of cervical radiculopathy.
    METHODS: A retrieval of Medline, PubMed, CNKI, WanFang and VIP databases was performed for the articles addressing experiments and basic studies of constructing cervical radiculopathy published before December 2017. The keywords were “cervical radiculopathy, cervical spondylotic radiculopathy, cervical nerve root compression, animal, model” in English and Chinese, respectively. Finally 41 eligible articles were included for result analysis.
    RESULTS AND CONCLUSION: (1) There are many kinds of animals used for constructing cervical radiculopathy models, and the modeling methods are various, which are divided into two categories: direct and indirect stimulation to cervical nerve roots. (2) The direct stimulation to cervical nerve root model is divided into instantaneous physical compression, transient mechanical stimulation combined with chemical stimulation, continuous physical compression, and transient mechanical stimulation combined with chemical stimulation. It is characterized by reliability, strong controllability, short cycle, but a certain difficulty in operation. (3) The indirect stimulation to cervical nerve root model is divided into surgical intervention and non-surgical intervention. Its characteristics are consistent with the pathological process of chronic degeneration of human body, simple operation, but long modeling period, poor reliability and repeatability. (4) In the basic research of cervical radiculopathy, appropriate animal models should be selected according to research requirements and purposes, experimental conditions and funds. It will be a goal to further create and study more perfect cervical radiculopathy animal models from economy, flexibility, reliability and controllability.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Triaxial accelerometer applied in assessing physical activity: current status and prospects
    Xie Haodong, Luo Jiong, Zhang Tingran
    2018, 22 (35):  5706-5714.  doi: 10.3969/j.issn.2095-4344.0316
    Abstract ( 354 )   PDF (807KB) ( 102 )   Save

    BACKGROUND: Triaxial accelerometer has been widely used in the monitoring of different groups of human activities and has shown high reliability and validity. Foreign studies have applied triaxial accelerometers to animals for physical activity monitoring. At the same time, there are certain errors, and there are few applications for triaxial accelerometers in physical activity in China.

    OBJECTIVE: To review the researches on the physical activity monitoring of triaxial accelerometers at home and abroad so as to understand the research status, problems and research direction.
    METHODS: Elsevier SDOL, Web of Science, and CNKI databases were retrieved with the keywords of “accelerometer, physical activity, energy expenditure” in English and Chinese, respectively, at the end of December 2017. The literatures related to triaxial accelerometers and physical activity were searched and then screened based on inclusion criteria.
    RESULTS AND CONCLUSION: (1) The triaxial accelerometer has good accuracy in motion analysis and can be extensively applied in human motion analysis. However, in the prediction of energy consumption, the triaxial accelerometer only shows high validity in walking and walking activities. (2) Most of the studies have carried the triaxial accelerometer to the waist, which only shows a good reliability and validity for the monitoring of walking and running activities. But, the monitoring of special activities was not in the best position, and the body movements should be considered as the basis. (3) The energy consumption prediction model established at abroad cannot be fully applied to the physical activity consumption of Chinese and needs further improvement. (4) There is a lack of unified standard for physical activity algorithm. (5) Compared to other effects on triaxiality in terms of acceleration accuracy, wearing positions and algorithms are the most important requirements for triaxial accelerometers. In the future, more research should be conducted on these two aspects. More researches on the effects of different wearing positions on energy consumption are needed. New data analysis methods should also be introduced, such as data mining and machine learning to standardize the algorithm. In addition, a large-size and multi-center trials are required. 

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Minimally invasive plate osteosynthesis versus traditional surgical method for adult humeral shaft fractures: a meta-analysis  
    Wang Wei, Chen Yongjia, Shen Lei, Lu Zhengfeng, Li Liubing
    2018, 22 (35):  5715-5723.  doi: 10.3969/j.issn.2095-4344.1019
    Abstract ( 215 )   PDF (779KB) ( 100 )   Save

    BACKGROUND: There are many clinical studies comparing the treatment outcomes of minimally invasive plate osteosynthesis and traditional surgical method for humeral shaft fracture, but which treatment is optimal remains controversial. Therefore, it is necessary to systematically evaluate the curative effect of two kinds of surgical methods.

    OBJECTIVE: To compare the clinical outcomes between minimally invasive plate osteosynthesis and conventional fixation techniques (intramedullary nail fixation and open reduction and plate osteosynthesis) for primary humeral shaft fractures surgery.
    METHODS: A computer-based search was performed in PubMed, EMBASE, ClinicalTrials. gov, Web of Science, Cochrane and CNKI databases for the articles published prior to March 10, 2018. Two authors screened articles in accordance with inclusion and exclusion criteria independently. Meta-analysis was performed on RevMan 5.3.5 software.
    RESULTS AND CONCLUSION: (1) Three randomized controlled trials and three prospective cohort studies were enrolled, involving 324 patients. (2) Meta-analysis results showed that the minimally invasive plate osteosynthesis reduced the incidence of iatrogenic radial nerve injury compared with the conventional fixation techniques (RR=0.35, 95%CI=0.13-0.96, P=0.87, I²=0%). No difference was found in the indices of nonunion, malunion, healing time, operation time, superficial infection, deep infection, implant failure and postoperative functional scores between minimally invasive plate osteosynthesis and conventional fixation techniques. (3) Our results indicate that minimally invasive plate osteosynthesis can reduce the incidence of iatrogenic radial nerve injury compared with conventional fixation techniques. But the healing of fracture, infection, implant failure and functional scores show no significant difference between two methods. Randomized controlled trials with large sample size are needed to confirm these 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
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    Relationship between internal fixation removal and femoral head necrosis after femoral neck fracture in young and middle-aged patients: a meta-analysis
    Zhou Xin, Yang Yanfei, Niu Wenjie, Wei Xiaochun, Duan Wangping
    2018, 22 (35):  5724-5729.  doi: 10.3969/j.issn.2095-4344.1020
    Abstract ( 238 )   PDF (677KB) ( 55 )   Save

    BACKGROUND: Femoral neck fracture in young and middle-aged patients is mainly treated with closed reduction cannulated screws. However, how to deal with the cannulated screws after fracture healing remains unclear.

    OBJECTIVE: To explore the association of implant removal or retention with femoral head necrosis, and to provide reference for the management of implant after femoral neck fracture in young and middle-aged patients.
    METHODS: The English studies addressing implant removal or not effects on the femoral head necrosis after femoral neck fracture in the EMBASE, Cochrane Library, PubMed, WanFang, and CNKI databases were retrieved and from January 2000 to January 2018. Methodological quality of the trials was assessed, relevant data were extracted, and heterogeneity test was performed. A meta-analysis was conducted to calculate the OR value and 95%CI.
    RESULTS AND CONCLUSION: (1) A total of 418 articles were searched and 20 eligible studies involving 6 271 patients were included. (2) The random effect model result showed that compared with implant maintenance, implant removal was more likely to cause femoral head necrosis (OR=2.49, 95%CI (1.47, 4.22), P=0.000 7). (3) Three articles mentioned the effect of implant removal on femoral head blood supply after femoral neck fracture. One article suggested that removing the implant after fracture healing would destroy the blood supply of the femoral head, doming harm to the reconstruction of the femoral head. Two articles considered that discontinuously removing the implant could improve femoral head blood supply. (4) The maximum compressive stress of the femoral head showed no significant change when the nail removal after fracture healing. However, the long-term presence of implant would increase the incidence of local bursitis and affect the function of injured limbs. (5) These results indicate that compared with the implant maintenance, implant removal is more likely to destroy the blood supply and induce femoral head necrosis. We should actively explore the removal method of the implant in young and middle-aged patients after femoral neck fracture to prevent femoral head necrosis. 

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Association of methylenetetrahydrofolate reductase C677T polymorphism with femoral head necrosis: a meta-analysis  
    Fan Siqi, Zeng Ping, Lai Chongrong, Liu Xiong
    2018, 22 (35):  5730-5734.  doi: 10.3969/j.issn.2095-4344.0580
    Abstract ( 198 )   PDF (611KB) ( 63 )   Save

    BACKGROUND: Whether methylenetetrahydrofolate reductase (MTHFR) gene C677T is the susceptible gene of femoral head necrosis diseases remains controversial.

    OBJECTIVE: To evaluate the association of C677T polymorphism of MTHFR gene with the occurrence of femoral head necrosis.
    METHODS: A computer-based retrieval of PubMed, Embase, the Cochrane Library, Web of Science, CBM, CNKI, VIP and WanFang databases was conducted for the case-control trials concerning MTHFR gene C677T polymorphism and femoral head necrosis published before January 2018. According to the inclusion and exclusion criteria, the literature was screened, the quality of the included literature was assessed and meta-analysis was performed. Heterogeneity test was conducted on Stata 12.0 software, and the index values of each odd ratio(OR) and 95% confidence interval (CI) were calculated. The publication bias was evaluated by funnel plot and Egger regression test.
    RESULTS AND CONCLUSION: (1) Six articles involving 1 174 patients were enrolled, including 395 patients with femoral head necrosis and 779 healthy controls. (2) Meta-analysis results showed that the incidence of femoral head necrosis in MTHFR C677T carriers (CC or CT type) and wild-type patients (CC type) was related to the incidence of femoral head necrosis: CT+TT vs. CC genotype (OR=1.43, 95%CI (1.09-1.89), P=0.011); T vs. C (OR=1.46, 95%CI (1.19-1.78), P=0.000); TT vs. CT genotype (OR=1.91, 95%CI (1.28-2.86), P=0.002); TT vs. CC+CT genotype (OR=1.79, 95%CI (1.29-2.50), P=0.001). (3) Egger regression results showed no publication bias. (4) Meta-analysis results imply that the polymorphism of C677T in MTHFR gene was associated with the occurrence of femoral head necrosis. 

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Efficacy of platelet-rich plasma versus glucocorticoid for lateral humeral epicondylitis: a meta-analysis
    Gong Dong, Liu Jun, Dong Chenhui, Deng Yinshuan, Zhou Yanfeng, Yang Xinle, Zhen Ping
    2018, 22 (35):  5735-5740.  doi: 10.3969/j.issn.2095-4344.1021
    Abstract ( 289 )   PDF (654KB) ( 74 )   Save

    BACKGROUND: Lateral epicondylitis, a common elbow disease, is often treated with glucocorticoid, but its long-term efficacy is not ideal. Platelet-rich plasma has been used as a new method for the treatment of bone and chronic inflammation, so it is necessary to systematically evaluate and analyze the therapeutic effects of the two methods.

    OBJECTIVE: To systematically review the effectiveness of platelet-rich plasma versus steroid for lateral humeral epicondylitis.
    METHODS: Related randomized controlled trials about platelet-rich plasma versus glucocorticoid for epicondylitis were searched in the databases of PubMed, EMbase, the Cochrane Library, CNKI, VIP, CBM and WanFang before May 2018. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Then meta-analysis was performed on RevMan 5.3 software.
    RESULTS AND CONCLUSION: (1) Ten randomized controlled trials involving 661 patients were included. (2) The meta-analysis results showed that, in pain relief, glucocorticoids were superior to platelet-rich plasma at 2-4 weeks (SMD=0.75, P=0.01); there was no significant difference between two groups at 6-8 weeks and 12 weeks (6-8 weeks: SMD=0.38, P=0.25; 12 weeks: SMD=-0.16, P=0.33). Platelet-rich plasma was better than glucocorticoids at 6 months and 1 year (6 months: SMD=-0.95, P < 0.000 01; 1 year: SMD=-0.83, P < 0.000 01). (3) In improving joint function, glucocorticoids were superior to platelet-rich plasma at 2-4 weeks and 6-8 weeks (2-4 weeks: SMD=0.74, P < 0.000 01; 6-8 weeks: SMD=0.46, P=0.000 5); there was no significant difference between two groups at 12 weeks (SMD=-0.24, P=0.22); platelet-rich plasma was better than glucocorticoids at 6 months and 1 year (6 months: SMD=-0.65, P=0.03; 1 year: SMD=-0.53, P=0.001). (4) These results imply that in the treatment of lateral epicondylitis, glucocorticoids can relieve pain (2-4 weeks) and improve joint function (2-8 weeks), platelet-rich plasma appears to be more effective in relieving pain and improving function in the long term (6 months to 1 year). Considering the long-term therapeutic effect of platelet-rich plasma, we recommend platelet-rich plasma as the preferred option for lateral humeral epicondylitis. Due to the limited quality of included studies, more high quality studies are needed to verify the above conclusion. 

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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