Objective To investigate the clinical efficacy of Oxford mobile platform monocondyle arthroplasty in the treatment of spontaneous osteonecrosis of the knee.Methods From January 2017 to July 2021，30 patients with spontaneous osteonecrosis of the knee underwent unicompartmental knee arthroplasty.7 males and 23 females were included.The patients age from 62 to 80 years，with an average of (70.20±4.39)years.There were 11 cases of left knee and 19 cases of right knee.The patients were diagnosed and staged by Xray and MRI before operation.The functional and pain of knee joint and the improvement of lower limb alignment at the last followup were recorded and evaluated.Results All patients were followed up for 12 to 36 months，with an average of (26.43±7.18)months.The visual analogue score was (6.63±1.07) before operation and (1.17±0.95) at the last follow-up after operation(P＜0.05)，and the difference was statistically significant.The American Hospital for Special Surgery knee score was (63.03±5.76) before operation and (93.33±2.81) at last followup.The Oxford knee score was (44.07±3.05) before operation and (21.37±2.91) at last follow-up (P＜0.05)，and the difference was statistically significant.The knee function was significantly improved，with all of them were excellent.The maximum range of motion was (120.73±3.89)° before operation and (121.43±2.74)° at the last follow-up(P＞0.05)，and the difference was not statistically significant.Tibial femur angle was (178.6±1.98)°preoperatively and (174.8±0.71)° postoperatively (P＜0.05)，and the difference was statistically significant.The lower limb alignment was corrected.The posterior Angle of tibial plateau was (6.9±1.06)° before operation and (7.2±0.55)° at the last follow-up(P＞0.05).The difference was not statistically significant.Conclusion Oxford mobile platform monocondylar replacement for spontaneous osteonecrosis of the knee has the advantages of preserving more bone mass，less soft tissue trauma，less bleeding，rapid proprioceptive recovery，better functional recovery and fewer complications after lower extremity line surgery.The clinical efficacy is satisfactory.

Objective To Compare the clinical efficacy of single knee arthroplasty(UKA) and total knee arthroplasty(TKA) with posterior cruciate ligament(PCL) preservation.Methods 102 patients who underwent knee joint replacement surgery at Dongguan Traditional Chinese Medicine Hospital from January 2019 to March 2021 was collected.Among them，58 patients underwent knee joint single condyle replacement surgery and 44 patients underwent posterior cruciate ligament preserving total knee joint replacement surgery.There were 8 males and 50 females in the UKA group.The age ranges from 52 to 83 years，with an average of (66.13±6.67)years old.There were 6 males and 38 females in the TKA group.The age ranges from 54 to 81 years，with an average of (67.79±6.74)years.We evaluated clinical efficacy by comparing patients’ perioperative conditions，joint function scores，and changes in lower limb strength lines.Results Both groups of patients were followed up.The TKA group was followed up for 12 to 21 months，with an average of (15.72±1.89)months，while the UKA group was followed up for 12 to 19 months，with an average of (15.34±1.68)months.The UKA group was superior to the TKA group in terms of surgical time，incision length，hemoglobin decrease，length of hospital stay，first landing time，and abducting time (P＜0.05).One year after surgery，there was no statistically significant difference in VAS between the two groups (P＞0.05)；The UKA group outperformed the TKA group in terms of range of motion(ROM)，Western Ontario and McMaster Universities(WOMAC) knee function score，and hospital for special surgery(HSS) knee score，with statistically significant differences (P＜0.05).The correction ability of the medial proximal tibial angle(MPTA)，mechanical lateral distal femoral angle(mLDFA)，and posterior distal femoral angle(PDFA) in the UKA group was similar (P＞0.05)，while the correction ability of the femorotibial angle(FTA) in the UKA group was slightly inferior to that in the TKA group.Conclusion The UKA group has comparable ability to correct lower limb force lines compared to the TKA group，and has the advantages of better improvement of knee joint function，less trauma，shorter hospital stay，and faster landing.It is recommended to prioritize UKA medial condylar replacement while strictly grasping the surgical indications，in order to improve patient satisfaction after knee joint replacement surgery.

Objective To investigate the effect of enhanced recovery after surgery(ERAS) concept on the clinical efficacy of minimally invasive unicompartmental knee arthroplasty(UKA) in the treatment of anteromedial knee osteoarthritis.Methods A total of 50 patients with single anteromedial knee osteoarthritis who underwent UKA in our department from June 2020 to June 2021 were randomly divided into two groups：The observation group (ERAS group) and the control group.In the observation group，there were 7 males and 18 females.The patients aged from 49 to 77 years old，with an average age of (65.32±6.77)years.In the control group，there were 9 males and 16 females.The patients aged from 51 to 80 years old，with an average age of (65.56±7.63)years.The operation time，intraoperative blood loss，first walking time，length of hospital stay，and decrease value of hemoglobin value 24 hours after operation were recorded.VAS of knee joint were recorded 1 day，2 and 3 days after operation.Outpatient followup was conducted at 1，3 and 12 months after operation，X-ray was rechecked，complications were recorded，and ROM，VAS and HSS of knee joint were evaluated.Results All patients were followed up until 12 months after surgery.There was no significant difference in operation time between the two groups (P＞0.05).The amount of intraoperative bleeding in the observation group was higher than that in the control group and the difference was statistically significant (P＜0.001).The first walking time，length of hospital stay，and the decrease value of hemoglobin 24 hours after operation in the observation group were lower than those in the control group and the difference was statistically significant (P＜0.001).There was no significant difference in VAS，HSS and ROM of knee joint between the two groups before operation (P＞0.05).The VAS in the observation group was lower than that in the control group at 1 day，2 days，3 days and 1 month after operation，and the difference was statistically significant (P＜0.05).One month after operation，HSS and ROM of knee joint in the observation group were higher than those in the control group and the difference was statistically significant (P＜0.05).There was no significant difference in VAS，HSS and ROM of knee joint between the two groups at 3 and 12 months after operation (P＞0.05).The difference in VAS，HSS and ROM of knee joint within the two groups at different time points were statistically significant (P＜0.001).Up to the last outpatient follow-up，no complications occurred in the observation group and the control group.Conclusion The results of the study prove that minimally invasive unicompartmental knee arthroplasty with ERAS can reduce early postoperative pain and perioperative blood loss，promote early out of bed activities and reduce hospital stay，improve early knee functional exercise，and enhance patient satisfaction.ERAS is an effective measure to optimize the perioperative management of UKA.

Objective To compare and analyze the effectiveness of unicompartmental knee arthroplasty(UKA) and total knee arthroplasty(TKA) in the treatment of osteoarthritis of the knee in the medial compartment.Methods A retrospective analysis was conducted on 78 patients with the knee osteoarthritis(KOA) in the medial compartment who were admitted to the First Affiliated Hospital of Xinxiang Medical College from January 2019 to September 2021.The patients were divided into the UKA and TKA groups according to the surgical method.There were 39 patients in the UKA group，including 7 males and 32 females.The patients’age ranged from 45 to 74 years，with an average of (63.4±7.9)years.And the body mass index(BMI) was (25.92±2.70)kg/m².There were 39 patients in the TKA group，including 12 males and 27 females.The patients’age ranged from 53 to 76 years，with an average age of (65.8±6.3)years，and the BMI was (26.61±4.07)kg/m².The surgical time，intraoperative blood loss，total hospital stay，postoperative drainage volume，visual analogue scale(VAS) pain score，range of motion(ROM) of the knee joint，the hospital for special surgery(HSS) knee score，and the forgotten joint scores(FJS) were compared between the two groups.Results The follow-up time was 12 to 16 months，with a mean of (14.1±1.1)months.The UKA group had significantly less surgical time，total hospital stay，surgical incision length，intraoperative blood loss，and postoperative drainage volume than the TKA group (P＜0.05).There was no statistically significant difference in preoperative VAS，ROM，and HSSs between the two groups(P＞0.05).However，the postoperative 3，6 and 12 months VAS，HSS，and ROM scores of the UKA group were superior to those of the TKA group (P＜0.05).The postoperative 3，6，and 12 months FJS scores of the UKA group were also higher than those of the TKA group，with statistical significance (P＜0.05).Conclusion Both UKA and TKA can significantly relieve knee joint pain and improve knee joint function in the treatment of medial compartment KOA.Compared with TKA，UKA has the advantages of being less invasive，faster recovery，and less noticeable sensation of the prosthesis after surgery.

Objective To investigate the effect of sagittal plane wedge opening on the posterior tibial slope(PTS) during the surgical treatment of knee osteoarthritis (KOA)using medial openingwedge high tibial osteotomy(MOWHTO).Methods A retrospective analysis was conducted on clinical data from 63 KOA patients who underwent MOWHTO treatment in Shandong Hospital of Traditional Chinese Medicine between January 2019 and July 2020.The experimental group included 31 patients，consisting of 13 males and 18 females，with an average age of (56.29±3.49)years and a mean body mass index (BMI) of (26.48±1.77)kg/m².The patients in this group underwent tibial osteotomy with approximate sagittal plane wedge opening between the lower 1/2 to 2/3 of the tibia.The control group included 32 patients，consisting of 14 males and 18 females，with an average age of (55.66±2.66)years and a mean BMI of (27.13±2.39)kg/m²，who underwent conventional osteotomy.Before the surgery，there were no statistically significant differences (P＞0.05) between the two groups regarding gender，age，BMI，preoperative visual analogue scale (VAS) pain scores，hospital for special surgery(HSS) scores，Lysholm scores，PTS，or other baseline characteristics.The first X-ray examination was performed within one week after surgery，and PTS was measured during the final follow-up，which was then compared with the preoperative measurement.The knee joint pain from patients and the functional status were also assessed using VAS scores，HSS scores，and Lysholm scores before surgery and at the final follow-up.Results Both groups of patients successfully completed the follow-up，with a follow-up period ranging from 22 to 32 months，with an average of (26.81±2.12)months.No complications such as vascular or neural injuries or lower limb venous thrombosis were observed in either group.At the final follow-up，both groups showed significant improvements in VAS scores，HSS scores，and Lysholm scores compared to preoperative values，with statistically significant differences (P＜0.05).However，there were no significant differences between the two groups at various time points (P＞0.05).The PTS in the experimental group showed no statistically significant differences at different time points (P＞0.05).In contrast，patients in the control group had a significant increase in PTS after surgery and at the final follow-up (P＜0.05).At both postoperative and final follow-up time points，the experimental group had significantly lower PTS values than the control group，with statistically significant differences (P＜0.05).Conclusion The use of OWHTO for KOA treatment effectively alleviates knee joint pain and improves functionality.Additionally，the utilization of sagittal plane wedge opening effectively prevents an increase in PTS.

Objective To compare the plantar pressure distribution in patients with medial compartment knee osteoarthritis(KOA) who underwent medial opening wedge tibial high osteotomy(OWHTO) or unicoondylar replacement(UKA).Methods From January 2020 to March 2021，17 patients with medial compartment KOA who underwent OWHTO treatment(HTO group) and 19 patients with UKA treatment (UKA group) were selected from the knee joint ward of Xi’an Honghui Hospital as the experimental group，while 22 healthy individuals of the same age were included as control groups using the Pedomedic 40 plantar pressure detection system was tested.The change in plantar pressure was assessed in the medial compartment KOA patients after OWHTO and UKA by comparing max-pressure (Max-P)，force-time integral(FTI) and valgus-varus index(VVI) during walking.Results Compared with the control group，Max-P in the first metatarsal region (MH1)was smaller (P＜0.05)，FTI in the second metatarsal region (MH2)was smaller (P＜0.05)，Max-P in the fifth metatarsal region (MH5) was larger (P＜0.05)，MaxP in the lateral midfoot region (MFL)was larger (P＜0.05)，and FTI in the lateral hindfoot region (RFL)was larger (P＜0.05) in the UKA group.Compared with the control group，the FTI of HTO group in MH1 was larger (P＜0.05)，Max-P in MH5 was smaller (P＜0.05)，and FTI and Max-P in medial midfoot region (MFM)were larger (P＜0.05).The hip knee ankle angle(HKA) of HTO group and UKA group were significantly improved after operation (P＜0.05)，but there was significant difference between the two groups (P＜0.05).In terms of the Knee Society score(KSS)，both groups were significantly improved compared with those before operation(P＜0.05)，and there was no significant difference between HTO group and UKA group after operation (P＞0.05).Conclusion The plantar pressure distribution of patients with medial compartment KOA after UKA is closer to that of normal people than after OWHTO.Prospective，multi center，large sample clinical observation and study are still needed to evaluate in the next step.

Objective To compare the effects of arthroscopic debridement (AD)combined with bone marrow concentrate (BMAC)or plateletrich plasma (PRP)on symptoms，functional improvement and cartilage repair in patients with knee cartilage injury by a clinical prospective randomized controlled trial.Methods A total of 62 patients with unilateral knee cartilage injury admitted to 920th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army from July 2020 to August 2021 were included in this study，which including 29 males and 33 females.And their age ranged from 18 to 65 years old，with an average of (32.57±8.58)years old.The mean BMI was (23.02±1.26)kg/m2.And among them，there were 30 cases of grade Ｉ and 32 cases of grade Ⅱ according to the international cartilage repair society (ICRS)classification.Next，these clinical trial patients were randomly divided into AD+BMAC group (n＝22)，AD+PRP group (n＝18)，and AD group (n＝22).Lysholm score，Tegner score，and numerical rating scale (NRS)were used to evaluate the improvement of symptoms and function of patients.MRI and magnetic resonance observation of cartilage repair tissue (MOCART)scores were used to evaluate the effect of cartilage repair.Results The follow-up time was 12 months.According to Lysholm，Tegner，and NRS scores，the symptoms and function of the three groups improved after operation (P＜0.05)，and the improvement was most obvious at 1 month after operation.And at 3，6，and 12 months after operation，the knee joint condition gradually decreased，but was still better than that before operation.The Lysholm，Tegner，and NRS scores of the AD+BMAC group were significantly better than those of the AD+PRP group and the AD group at 1，3，and 6 months after operation (P＜0.05)，while there was no significant difference in the relevant scores compared with the AD+PRP group at 12 months after operation (P＞0.05)，but they were still better than those of the AD group (P＜0.05).And the Lysholm，Tegner，and NRS scores of the AD+PRP group were significantly better than those of the AD group at 1 and 3 months after operation (P＜0.05)，but no significant difference was found at 6 and 12 months after operation (P＞0.05).In addition，the MOCART scores of the three groups at 12 months after operation were not significantly different from those before operation (P＞0.05)，and there was no significant difference between the three groups after operation (P＞0.05).Conclusion In general，compared with AD alone，AD combined with BMAC or PRP is better in relieving symptoms and improving knee joint function，and both have achieved satisfactory short-term efficacy.Specifically，the efficacy of AD combined with BMAC is better than that of AD combined with PRP，and the effect lasts longer.Both AD combined with BMAC or PRP can prevent the further deterioration of knee joint injury，but there is no significant advantage in cartilage repair.

Objective To study the clinical application of knee joint locking mechanism in Oxford Ⅲ generation unicondylar prosthesis replacement.Methods 73 patients with AMOA admitted to our hospital from January 2020 to January 2021 were divided into two groups according to random number table (conventional method group and new method group).The conventional method group (38 cases) underwent vertical tibial osteotomy against the anterior cruciate ligament，and the new method group (35 cases) had an average internal rotation of about 5 °~10 ° during vertical tibial osteotomy compared with the traditional method group.The Oxford Ⅲ monocondyle prosthesis was installed according to the new surgical osteotomy design.Statistical analysis was performed using SPSS 26.0 software to compare the results of the two methods in the postoperative hospital for special surgery，HSS)，visual analogue scale (visual analogue scale，VAS)，western Ontario and mcmaster universities osteoarthritis index (WOMAC)and associated differences in threedimensional knee gait.Results During postoperative followup，the HSS，WOMAC score and VAS of the two groups were improved compared with those before surgery，with statistical significance (P＜0.05).HSS，WOMAC score and standing VAS of the new method group were improved compared with the traditional method group at 3 d，1 months，6 months and 12 months after surgery，and the differences were statistically significant (P＜0.05).There was no statistically significant difference in sitting VAS between the two groups at postoperative follow-up (P＞0.05).There was statistical significance in the excellent and good rate of the two groups at the last follow-up (P＜0.05).At the last follow-up，three-dimensional gait analysis of knee joint was performed，and the result showed that the internal and external rotation Angle of the new method was higher than that of the conventional method，and the difference was statistically significant (P＜0.05).Conclusion Combined with the locking mechanism of the knee joint，the average internal rotation of the tibial end during vertical osteotomy is about 5°~10° compared with the traditional method，which can improve the functional score of the knee joint and achieve a higher excellent and good rate.At the same time，compared with the conventional method，this method can make the internal and external rotation more close to the normal range of physiological movement.