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2017 Vol. 23, No. 2
Published: 2017-02-25
 
97 Arthroscopic Treatment for Partial Articular Surface Tendon Avulsions by the Transtendon Repair Technique
Wang Wei，Li Jian，Li Hongchuan，et al
Objective  To study the method and efficacy of arthroscopic treatment for partial articular surface tendon avulsions(PASTA).Methods  We collecting the data of 24 patients who had PASTA from 2013.1 to 2015.1 in our department.There were 8 males and 16 females whose age were from 30 to 66 years，the average age was 47.5 years.The 10 cases were the right side and 14 cases were the left side.The 11 cases were caused by direct traumatic violence and 13 cases were no history of trauma，all patients were closed injury.All patients were treated by arthroscopic exploratory.We cleaned up the joint cavity and got into the Subacromialgap，implanted the anchors with line in the footprint by the transtendon technique，then knot and repaired the rotator cuff injury，rebuild the integrity of the rotator cuff.Individualized exercise was performed based on the patient’s conditionpostoperative.Results  There were no infection，no limited function of the shoulder with an average follow-up of 18 months(12～24 months).We scored the shoulder function before and after surgery by the American Shoulder and Elbow Surgery(ASES) score and Constant-Murley score for shoulder function.There was statistically significant different between the scores before and after operation，analyzed the results of shoulder function between preoperative and postoperative with paired t-test(α＝0.05) by the statistical software of SPSS 14.0，α＝0.05，analytical results were shown：P＜0.001，andstatistically significant.Conclusion.Conclusion  For PASTA that was more than 50%，repairing the PASTA by thetranstendon repair technique which can rebuild thefootprint anatomyand restore the integrity of the rotator cuff，is an effective method for treatment.
2017 Vol. 23 (2): 97-104 [Abstract] ( 392 ) HTML (1 KB)  PDF (1127 KB)  ( 346 )
100 Comparison between 2-level ACDF and 1-level ACCF in Treating Cervical Spondylotic Myelopathy
Chen Wenheng，Guo Tuanmao，Liu Qiang
Objective  To compare the clinical outcomes between anterior cervical discectomy and fusion(ACDF) and anterior cervical corpectomy and fusion(ACCF) in treating the adjacent two segments cervical spondylotic myelopathy.Methods  51 patients with cervical spondylotic myelopathy who underwent ACDF and ACCF between June 2009 and March 2014 were enrolled in this study.27 patients underwent ACDF and 24 patients underwent ACCF.We recorded operative time，blood loss，length of hospital stay，complications rates and fusion rates.The JOA score，VAS pain score，NDI index and Cobb angle data were obtained.Results  In ACDF group，the mean follow-up was(30.2±10.5)months.The average operation time was(83.5±15.7)min.The average operative blood loss was(135.5±21.4)mL.The complications rates was 14.8%.The fusion rates was 88.9%.The average postoperative JOA score，VAS pain score，NDI index and Cobb angle improved significantly.In ACCF group，the mean follow-up was(28.3±12.1)months.The average operation time was(118.3±20.9)min，the average operative blood loss was(329.3±70.2)mL，the complications rates was 16.7%，the fusion rates was 91.7%.The average postoperative JOA score，VAS pain score，NDI index and Cobb angle improved significantly.No significant differences were found between 2 groups with respect to VAS pain score，NDI index and JOA score.The operation time、operative blood loss and postoperative Cobb angle of ACDF group was better than that of ACCF group.Conclusion  2-level ACDF has better outcomes compared with 1-level ACCF in treating adjacent two segments cervical spondylotic myelopathy.It has shorter operation time，less bleeding and better Cobb angle.
2017 Vol. 23 (2): 100-104 [Abstract] ( 998 ) HTML (1 KB)  PDF (2079 KB)  ( 387 )
105 Application of Synergy Prosthesis in Simultaneous Bilateral THA for Advanced Young RA Patients with Osteoporosis
Liu Jun，Li Xusheng，Zhen Ping，et al
Objective  To investigate the clinical outcomes of Synergy prosthesis in simultaneous bilateral total hip arthroplasty(THA) for advanced RA and young patients.Methods  young patients(5 males and 8 females，ranging in age from 39 to 48 years old，with an average of 42.5 years old)including 26 hips with rheumatoid arthritis were treated with Synergy prosthesis from January 2010 to December 2014.The hip RA duration was 12.7 years in average.The acetabular prostheses were all biological prosthesis，with the ceramic lining in all cases the ceramic femoral head was used in all the cases.The posterior-lateral hip incision was adopted in the surgery.The follow-up was carried out in 3，6，12 months after the surgery，and later once a year.The Harris score system and Engh score of bone in growth of femoral side described were used to assess the joint function of the patients before and after the surgery.Results  All the patients were followed up with an average time of 3.8 years(2.5 to 5.3 years).The Harris score increased from preoperative(44.00±10.00) to (92.50±15.00) at the end of the follow-up，There were statistically significant differences in before and after surgery groups(P＜0.01).The joint activity by the (46.00±8.00)°(0°～60.00°)to improve the final follow-up (105.50±18.00)°(90.00°～130.00°)in the follow-up，There were statistically significant differences before and after surgery groups(P＜0.01).All the incisions healed well and there were no complications such as femoral fracture，infection，dislocation and neurovascular injuries.All the joints had good or excellent clinical results.Conclusion  The simultaneous bilateral of THA had the advantages in rapid recovery of hip function for the advanced RA and osteoporosis patients，but it required precise preoperative assessment and precise operation.
2017 Vol. 23 (2): 105-113 [Abstract] ( 317 ) HTML (1 KB)  PDF (1403 KB)  ( 342 )
110 Efficacy of Fast-tract Surgery in Fractured Neck of Femur Patients Undergoing Hip Replacement
Wang Yu 1，Zhang Pan 2，Han Wenfeng 1，et al
Objective  To investigate the application of the fast-track surgery in the patients with total hip arthroplasty because of fractured neck of femur.Methods  Seventy-nine patients undergoing primary THR were recruited prospectively.After randomization，one group with thirty-nine patients undergoing the fast-track surgery were taken as the experimental group and forty patients undergoing the traditional treatment as the control group.We compared the length in bed，complications，pain，physical activities of daily living and postoperative function.Results  All patients were followed up for 6 months.The length of bed of traditional recoery group was about (3.5±1.0)days，and the length of bed of fast-track recoery group was about (2.1±0.6)days(P＜0.001).The time of activities was about (25.5±14.4)h，and the fasttrack group was about (37.4±10.4)h (P＜0.001).Postoperative complications occurred in 5 patients in the fast-track group，while 10 cases in the traditional group(P＜0.001).The difference on the pain was not significant.The results showed that the scores of Harris were significantly higher in the fast-track recovery group than the traditional group on the day of discharge，3 months after operation and at the end of the 6 month after operation(P＜0.001).Conclusion  Compared with conventional care，fast-track surgery in patients undergoing total hip arthroplasty is safe and feasible.The application of FTS contributed to significant reduction of length in bed and complications.There is significant difference regarding mobilization，postoperative function besides pain.
2017 Vol. 23 (2): 110-113 [Abstract] ( 339 ) HTML (1 KB)  PDF (537 KB)  ( 493 )
114 Curative Effect Observation of Percutaneous Cannulated Screws Fixation Assisted by Robot Navigation and Poking Rduction Technique for Femoral Neck Fractures
Shi Weixiang 1，Luo Xiaozhong 2，Tong Yi 2，et al
Objective  To discuss the effect of fixation with percutaneouscannulated screws assisted by robot navigation and poking reduction technique for femoral neck fractures.Methods  From May 2013 to June 2015，13 patients with femoral neck fracture were treated by internal fixation with percutaneouscannulated screws assisted by robot navigation and poking reduction technique.Record the operation time，X-ray fluoroscopy time，blood loss，total drilling times，the parallel degree of screws，the healing rate of fractures，the Harris scores of all patients.Results  All patients were followed up for 12～25 months with an average of (18.6±6.6)months.Average operation time was(92.2±6.7)min.Average frequency of guide pin insertion was (5.2±1.2)times，X-ray fluoroscopy time was (16.1±4.1)s，blood loss was (10.1±2.1)mL.Garden index was (173.3±8.3)°in AP view and (171.1±11.1)°in the lateral.The X ray showed that the fracture healing rate was 100 percent.The verage healing time was (5.8±1.3) months，Postoperative Harris hip score was (86.9±5.1).The latest follow-up revealeds that none nonunion of fracture or femoral head necrosis was founded in the all patients.Conclusion  Cannulated screw fixation assisted by robot navigation and poking reduction technique has high clinical application value.Which lead to more accurate positioning，better hip function ，less surgical trauma and X-ray exposure times.It is a good method to treat femoral neck fractures.
2017 Vol. 23 (2): 114-117 [Abstract] ( 309 ) HTML (1 KB)  PDF (1674 KB)  ( 259 )
118 Comparation of Clinical Efficacy in Treatment of Femoral Neck Fracture with Total Hip Arthroplasty and Bipolar Hemiarthroplasty in Elderly
Hao Linjie 1，Qiu Yusheng 2，Zhang Yumin 1，et al
Objective  To compare clinical efficacy and cost-effectiveness in treatment of femoral neck fracture with total hip arthroplasty(THA) and bipolar hemiarthroplasty(BHA) in elderly.Methods  169 patients over 70 years old with femoral neck fractures were treated with either THA or BHA.Comparison between THA and BHA groups were carried out on operation duration，incision size，blood loss，postoperative drainage，transfusion volume，average length of hospital stay，average cost，complication rate，hip function(Harris scores) and X-ray assessment.Results  The patients were followed up for 2 years to 5.7 years，with an average follow-up period of 5.1 years.The operation duration，amounts of blood loss，postoperative drainage，blood transfusion，postoperative dislocation rate and average cost of THA group were greater than those of BHA group(P＜0.05，respectively).Differences of average length of hospitalization，incision size，postoperative Harris scores，incidence of complications and infection rates between the two groups were not significant(P＞0.05，respectively).In the patients over 75 years old，there were not significant differences on Harris scores 2 and 5 years post-operation and mortality between the two groups(P＞0.05，respectively).The Harris scores at 0.5 years post-operation of BHA group was higher than that of THA group(P＜0.05).Conclusion  The clinical efficacy of BHA at mid-term was similar to that of THA in treatment of femoral neck fracture in elderly.However，BHA may be more suitable for patients who are frail and with complications because of it’s advantage in less surgical trauma and risks，quicker recovery and lower cost than THA.
2017 Vol. 23 (2): 118-123 [Abstract] ( 336 ) HTML (1 KB)  PDF (1211 KB)  ( 320 )
124 Effect of Ligament Reconstruction in Patients with Multiple Ligament Injuries of the Knee Joint with Allograft Tendons：3 to 9 Years Follow-up
Cui Shengyu，Liu Wei，Zhu Xinhui，et al
Objective  To assess the curative efficacy of ligament reconstruction in patients with multiple ligament injuries of the knee joint using allograft tendon after 3 to 9 years.Methods  From April 2006 to April 2013，24 patients with multiple ligament injuries were treated.Allogeneic tendons treated by deep hypothermia and radiation were selected as repair and reconstruction materials.Arthroscopic reconstructions of the anterior and posterior cruciate ligaments were performed under arthroscopy.Meanwhile，the medial collateral ligaments or posterolateral structures were repaired or reconstructed，and meniscus injuries were treated at the same time.Postoperative patients rehabilitated accordance with individual plans .Results  In the course of the follow-up period of 36 to 108 months，the patients returned to the outpatient department regularly.The stability of the knee joint was evaluated by Lachman test and KT-1000 examination.The Lysholm knee function score was evaluated and the postoperative functional recovery was evaluated by the International Knee Documentation Committee Rating Scale.The results showed that postoperative knee stability and function significantly improved compared to preoperative (P＜0.05).Conclusion  The results demonstrate that allograft tendon can recover tne stability and knee function in the repair and reconstruction of knee ligament injury.It can also significantly restores knee function with the planned rehabilitation training.In 3 to 9 years of follow-up，knee stability and function can be well maintained.
2017 Vol. 23 (2): 124-127 [Abstract] ( 437 ) HTML (1 KB)  PDF (2001 KB)  ( 291 )
128 Comparison of the Early Metaphase Efficacy of Total Knee Arthroplasty for the Treatment of Rheumatoid Arthritis and Degenerative Arthritis of the Knee
Yin Haibo，Sun Junying，Zhao Xijiang，et al
Objective  To compare the efficacy of total knee arthroplasty (TKA) for the treatment of rheumatoid arthritis and degenerative arthritis of the knee.Methods  Clinical data of 68 cases (68 knees)with rheumatoid arthritis and degenerative arthritis of the knee who had undergone primary TKA procedure from December 2006 to December 2013 were retrospectively analyzed.There were 12 males and 56 females，aged from 40 to 84 years，with an average age of (61.6±9.7) years.They were divided into RA group and OA group by the different primary diseases.peroperative bleeding，operation time ，postoperative drainage volume，intraoperative and postoperative blood transfusion，recover time of muscle strength of four head of femur after operation，walking without stick time，postoperative aid use time，leaving a sickbed time，hospitalization time，claudication disappear time，postoperative limb swelling disappeared time，postoperative complication were recorded.Clinical evaluation of Arthroplasty has been made by referring to the Hospital for special surgery system、the Range of motion、the VAS pain scoring，the subjective satisfaction.According to the imaging observation of periprosthetic radiolucency component loosening as a judgment basis.Results  All patients were followed up for 24 to 96 months (average 40.6 months).There were statistically significant between two groups in age，course of disease，peroperative bleeding，operation time ，postoperative drainage volume，intraoperative and postoperative blood transfusion，recover time of muscle strength of four head of femur after operation，walking without stick time，postoperative aid use time，leaving a sickbed time，hospitalization time，claudication disappear time，postoperative limb swelling disappeared time (P＜0.05).Among them，In 6 months after the operation，two groups of patients with HSS score，ROM，VAS pain score difference were statistically significant (P＜0.05)，and there was no significant difference in subjective satisfaction.At the last follow-up，there were no significant difference in HSS score、VAS pain score and subjective satisfaction.NO patellar and prosthetic loosening or infection was observed according to X-ray.In RA group：one case appeared postoperative deep venous thrombosis symptoms，one case had joint stiffness early，two cases had superficial infection，one case had extensor weakness.In OA group：one case had joint stiffness early，no DVT，superficial infection of the skin，inability to extend the knee and other complications.Conclusion  TKA treatment of RA in patients with peri operative efficacy and postoperative early curative effect is worse than OA，but eventually the two early midterm no difference can achieve satisfactory clinical efficacy.
2017 Vol. 23 (2): 128-133 [Abstract] ( 290 ) HTML (1 KB)  PDF (2154 KB)  ( 265 )
134 Clinical Study on SDS9900 Spinal Decompression System in Non-Operative Therapy for Cervical Spondylotic Radiculopathy
Dang Peiye，Yang Zhiquan，Wang Yandong，et al
Objective  To study the clinical effect and safety of SDS9900 in non-operative therapy for patients with cervical spondylotic radiculopathy(CSR).Methods  We retrospectively reviewed 106 patients with CSR from 2012.1 to 2015.1 which were divided into 2 groups：treatment group and control group as the way of traction.The cases in treatment group(30 cases) were treated with conventional drug therapy and non-surgical spinal decompression system of SDS9900 and those in control group were treated with conventional drug therapy and cervical traction.All patients received at least 12 months fellow-up.The clinical outcomes were evaluated by the height of intervertebral space，visual analogue scale(VAS) and NDI score.Results  The height of intervertebral space in both groups broadened significantly after the treatment(P＜0.05).The height of the treatment group broadened significantly after the treatment，comparing with those of the control group(P＜0.05).The VAS and NDI score in both groups were significantly lower than that before the treatment(P＜0.05).Comparing the VAS score and NDI index of the two groups after the treatment：the scores of the treatment group decreased more significantly than those of the control group (P＜0.05).There was no complication in all patients.Conclusion  The non-surgical spinal decompression system of SDS9900 can increase the height of intervertebral space in treating the cervical spondylotic radiculopathy，relieve the pain of neck effectively，and promote the recovery of cervical function.It should be further application and promotion in clinic.
2017 Vol. 23 (2): 134-137 [Abstract] ( 325 ) HTML (1 KB)  PDF (808 KB)  ( 253 )
138 Correlation between the Serum Ferritin as well as Sclerostin and Bone Mineral Density in Elderly Male Patients with Type 2 Diabetes Mellitus
Ye Yanbin，An Rongze，Qi Xinwen，et al
Objective  To analyze the correlation between serum ferritin(SF) as well as serum sclerostin(Sost) levels and bone mineral density(BMD) in elderly male patients with type 2 diabetes mellitus(T2DM).Methods  The dual-energy X-ray bone densitometers(Challenger，DMS，France) manufactured in France was adopted to determine the BMD in the second to the fourth lumbar vertebra(L2～4 ) in anteroposterior position，the left femoral neck，the Ward’s triangle area as well as the greater trochanter region of the 48 cases of elderly male T2DM patients with the age of above 70-year-old；in addition，the SF，Sost and glycosylated hemoglobin(HbA1c) levels were determined；then the same measuring method was utilized to measure the same indicators of the 48 cases of elderly male non-T2DM patients with the age of above 70-year-old(the control group)；and retrospective statistical analysis was conducted to analyze the correlation between the SF as well as Sost levels and the BMD in each part.Results  Firstly，the Sost(325.56±123.63)pg/mL and SF(565.72 ±237.63)ng/mL levels in the T2DM group were remarkably higher than those in the control group(204.64±84.76)pg/mL and(355.26±107.62)ng/mL，respectively，with the difference being of highly statistical significance(P＜0.01).Secondly，HbA1c was positively correlated with the Sost and SF levels.Thirdly，the Sost and SF levels in the T2DM group were negatively correlated with the BMD in the femoral neck and the Ward’s triangle area，but they showed no correlation with that in the L2～4 and the greater trochanter region.Conclusion  The results indicated that the Sost and SF levels in elderly male patients with T2DM are notably higher than those in elderly male patients with no T2DM；the Sost and SF levels in the former are markedly negatively correlated with the BMD in the hip，which suggested that poor blood glucose control might induce increased Sost and SF levels in elderly male patients with no T2DM，thus inhibits bone formation and finally the decreases BMD in the hip.
2017 Vol. 23 (2): 138-141 [Abstract] ( 364 ) HTML (1 KB)  PDF (468 KB)  ( 235 )
142 Modulations of FOXL2 on Cartilage and Skeletal Development in Mice
Xue Jianli
Objective  Haploinsufficiency of the Foxl2 transcription factor in humans causes Blepharophimosis/Ptosis/Epicanthus Inversus syndrome(BPES)，characterized by eyelid anomalies and premature ovarian failure.Mice lacking Foxl2 recapitulate human eyelid/forehead defects and undergo female gonadal dysgenesis.Our experiment aims to explore the influence of lacking Foxl2 in postnatal growth and embryonic bone and cartilage formation in mice.Methods  Foxl2－/－ male mice at different stages of development have been characterized and compared to wild type.Body length and weight were measured and growth curves were created.Skeletons were stained with alcian blue and/or alizarin red.Bone and cartilage formation was analyzed by Von Kossa staining and immunofluorescence using anti-Foxl2 antibodies followed by confocal microscopy.Analysis of the GH-IGF1 pathway was done evaluating the expression of several hypothalamic-pituitary-bone axis markers by RT-qPCR.Results  Compared to wild-type，Foxl2 null mice are smaller and show skeletal abnormalities and defects in cartilage and bone mineralization，with down-regulation of the GH/IGF1 axis.Conclusion  Our results support Foxl2 as a master transcription factor in a spectrum of developmental processes，including growth，cartilage and bone formation.
2017 Vol. 23 (2): 142-146 [Abstract] ( 321 ) HTML (1 KB)  PDF (3357 KB)  ( 246 )
154 PFNA in Different Position for the Treatment of Elderly Patients with Femoral Intertrochanteric Fractures
Luo Yongxin，Chen Jingzhong，Yu Huawei，et al
Objective  To investigate the PFNA in supine position and lateral decubitus position for the treatment of elderly patients with femoral intertrochanteric fractures for Evans Ⅱ～Ⅲ type.Methods  120 elderly patients with femoral intertrochanteric fractures for Evans Ⅱ～Ⅲ type were chosen in the period from April 2010 to April 2013 in our hospital and randomly divided into both group including A group (60 patients) with PFNA  in supine position and B group (60 patients) with PFNA in lateral decubitus position；and the peri-operative indexes levels，the excellent and good rate of Harris scores postoperative for hip joint function and postoperative complication incidence of both groups were compared.Results  The incision length，operative time and intraoperative blood loss of B group was significantly better than A group (P＜0.05).The intraoperative X-ray dose of A group was significantly better than B group (P＜0.05).There was no significant difference in fracture healing time between 2 groups(P＞0.05).There was no significant difference in the excellent and good rate of Harris scores postoperative for hip joint function between 2 groups(P＞0.05).There was no significant difference in the postoperative complication incidence between 2 groups(P＞0.05).Conclusion  PFNA including supine position and lateral decubitus position in the treatment of elderly patients with femoral intertrochanteric fractures for Evans Ⅱ～Ⅲ type possess the same effect to promote recovery process of hip joint function and not induce the serious postoperative complication；PFNA in the lateral decubitus position application can efficiently reduce the trauma degree in the operation and shorten the operation time，but increase the intraoperative X-ray dose.
2017 Vol. 23 (2): 154-157 [Abstract] ( 351 ) HTML (1 KB)  PDF (852 KB)  ( 403 )
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