Objective To compare the clinical results of pre-contoured plates combined with single and multiple antegrade posterior column screw via anterior approach for treatment of both columns acetabular fractures.Methods A retrospective analysis was performed on 33 patients with both columns acetabular fractures treated with pre-contoured plates combine single and multiple antegrade posterior column screw via anterior approach from Jan 2016 to Jun 2022.There were 23 males and 10 females，with an average of (49.8±14.2) years (range，18 to 72 years).Preoperative 3D printing of pelvic model and pre-contoured plates were applied.There were 14 cases in simple posterior column screw group and 19 cases in multiple posterior column screws group.The fracture reduction was assessed with Matta scoring system，and the hip function was evaluated with modified Merle D’Aubigne and Postel scoring system.Results All cases were followed up for 8 to 34 months with an average of (10.3±4.5) months.The acetabular fractures all healed.The operation time，intraoperative blood loss and fluoroscopy time in multiple posterior column screws group were significantly higher than simple posterior column screw group (P＜0.05).No significant difference was found in fracture site healing time between the two groups (P＞0.05).Fracture reduction quality was excellent in 3 cases，good in 9 cases，pool in 2 cases，the excellent and good rate was 85.7% in simple posterior column screw group，and it was excellent in 13 cases，good in 5 cases，poor in 1 case，the excellent and good rate was 94.7% in multiple posterior column screw group.No significant difference was found between the excellent and good rate of fracture reduction (P＞0.05)，but the rate of anatomical reduction in multiple posterior column screw group was significantly higher than simple posterior column screw group (P＜0.05).The hip function was excellent in 4 cases，good in 8 cases，fair in 2 cases，the excellent and good rate was 85.7% in simple posterior column screw group，and excellent in 7 cases，good in 9 cases，fair in 3 case，the excellent and good rate was 84.2% in multiple posterior column screw group.No significant difference was found between the two groups (P＞0.05).Conclusion Pre contoured plates combined with single and multiple posterior column screw via anteriopr approach for treatment of two-columns acetabular fracture have good clinical effecacy.Multiple posterior column screws can get better reduction and fixation.

Objective To explore the clinical effect of “ideal point” isotonic reconstruction of the femoral side of anterior cruciate ligament reconstruction (ACLR)，in order to provide a basis for the clinical operation of ACLR.Methods This study was a retrospective case-control study.The 98 eligible patients with anterior cruciate ligament injury who were admitted to the Department of Orthopaedics of Fuyanshan Hospital of The Affiliated Hospital of Weifang Medical University from January 2020 to October 2022 were Studied.According to the different femoral lateral positioning，the patients were divided into two groups.There were 42 patients in the control group with 22 males and 20 females.The patients aged 19~31 years，with an average age of (25.34±5.93) years.The femoral lateral positioning plan in the over the top position was chosen.The observation group consisted of 56 patients，including 26 males and 30 females.The age of patients was 20 to 32 years，with an average age of (26.14±6.05) years.The Isometric，Direct inserted，Eccentrically located and Anatomical perfect with Low tension (I.D.E.A.L) site for femoral lateral localization was chosen.The general baseline data of the two groups of patients were collected，and the surgery related data were collected.The knee joint pain of the patients was evaluated using the visual analogue scale (VAS) and the numerical rating scale (NRS)，and the knee joint function of the affected limb was evaluated using the international knee documentation committee (IKDC) scoring system and the Lyshlom scoring system，The postoperative complications were counted.Results There was no statistically significant difference in the general data of the two groups，including age，sex，height，weight，BMI，cause of injury，location of broken limb and ligament (P＞0.05).The VAS score and NRS score of the patients in the observation group were significantly lower than those in the control group in the comparison of knee joint pain scores 1 day and 1 month after operation (P＜0.05).In the comparison of knee joint function one day after operation and one month after operation，the IKDC score and Lyshlom score of patients in the observation group were significantly higher than those in the control group (P＜0.05).The incidence of late complications in the observation group was significantly lower than that in the control group (P＜0.05).Conclusion The ACLR operation with I.D.E.A.L positioning on the femoral side can achieve more early postoperative results，reduce postoperative pain and the incidence of late complications.

Objective To observe the application effect of 3D printing model and simulated surgery in total hip arthroplasty (THA) for developmental dysplasia of the hip (DDH).Methods A total of 60 patients with DDH admitted to Department of Orthopedics I of NO.922 hospital of Joint Logistic Support Force from August 2020 to December 2022 were selected as the research object，and 30 patients were divided into groups by random number table method.In group A，the THA was completed according to routine operation.In group B，3D printing technology was used to make a solid model of the affected hip for surgical scheme design and simulated surgery.In group A，there were 13 males and 17 females.The patients’ age ranged from 36 to 69 years，with a mean of (54.81±7.03) years.In group B，there were 10 males and 20 females.The patients age ranged from 35 to 70 years，with a mean of (52.09±7.44) years.The operation indexes，postoperative recovery indexes，matching rate of prosthesis before and after operation，incidence rate of intraoperative femoral condyle fracture，postoperative acetabularfemoral anteversion angle，incidence rate of complications and hip joint function (Harris hip score，HHS) before and 4 weeks after operation were compared between the two groups.Results The intraoperative blood loss in group B was less than that in group A，the operation time，postoperative ground time，and hospital stay in group B were shorter than those in group A (P＜0.05).The matching rate of prosthesis before and after operation in group B (90%) was higher than that in group A (30%)，and the incidence rate of intraoperative femoral condyle fracture (0%) was lower than that in group A (50%) (P＜0.05).At 4 weeks after operation，HHS score in both groups were higher than those before operation (P＜0.05)，bue there was no significant difference between the two groups (P＞0.05).There was no significant difference in postoperative acetabular-femoral anteversion angle between the two groups (P＞0.05).No complications such as femoral and sciatic nerve injury，prosthesis loosening and dislocation，pulmonary embolism，lower limb deep vein thrombosis，periprosthetic fracture，and joint infection occurred in both groups.Conclusion The application of 3D printing model and simulated surgery in THA for DDH patients has a definite effect，which can improve the matching rate of prosthesis，reduce the incidence rate of intraoperative femoral condyle fracture，shorten the operation time，reduce the intraoperative blood loss，and promote rehabilitation，which is worth to be promoted and applied in the clinic.

Objective To investigate the clinical efficacy of arthroscopic patelloplasty combined with lateral retinaculum release in patients with patellofemoral arthritis and the correlation between imaging and gait.Methods From December 2020 to January 2022，a total of 75 patients with patellofemoral arthritis diagnosed in the Department of Orthopedics in Gansu Provincial Hospital of Traditional Chinese Medicine were selected.32 males and 43 females were included.The average age was (56.10±8.17) years old，ranging from 42 to 67 years old.The average course of disease was (4.20±2.44) years.There were 42 cases of left knee and 33 cases of right knee.anteroposterior and lateral X-ray，30 °patellar axial X-ray and knee CT examations were performed before surgery，6 months and 12 months after surgery.Gait tests were performed before surgery and 12 weeks after surgery.The corresponding Insall index，peel index，lateral patellar angle，patellofemoral fit angle，patellar tilt angle and other imaging indicators，as well as gait parameters such as foot distance，gait frequency，gait speed，support time and weight distribution were measured.Pearson correlation analysis was performed between imaging parameters and gait parameters.Results By comparing the imaging indexes and gait parameters before and after treatment，the Insall index，peel index，patellofemoral fitness angle index，lateral patellar angle index and patellar tilt angle index after treatment were significantly improved compared with those before treatment，and the difference was statistically significant (P＜0.05).After treatment，the gait parameters of patients' feet，such as stride distance，gait frequency，support time，weight distribution，were compared.before and after treatment.The gait of patients improved significantly after operation，and the difference was statistically significant (P＜0.05).Pearson correlation analysis showed that there was a certain correlation between the improvement of imaging indicators and gait parameters.The lateral patellar angle was positively correlated with gait，and the correlation coefficient (r value) ranged from 0.512 to 0.682，which was the highest correlation with gait speed.The Insall index，peel index，patellofemoral fit angle and patellar tilt angle were negatively correlated，and the correlation coefficient (r value) ranged from －0.831 to －0.143，which had the highest correlation with weight distribution.Conclusion Arthroscopic patelloplasty combined with lateral retinaculum release can improve the imaging and gait changes of patients with patellofemoral arthritis，and there is a certain correlation between imaging indicators and gait.