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With the development of the knee-preservation concept and surgical techniques, lateral unicompartmental knee arthroplasty (UKA) has become an effective method for the lateral compartment osteoarthritis of the knee.The incidence of knee osteoarthritis is low in the lateral compartment, which is different from the medial compartment in anatomical and kinematic characteristics. These two factors increase the challenge of lateral UKA, so the clinical efficacy of lateral UKA has been controversial. With the improvement and renewal of treatment concepts, surgical techniques and prosthesis design, the clinical effect of lateral UKA and the survival rate of the prosthesis have been continuously optimized. This article aims to summarize the characteristics of lateral compartment knee osteoarthritis, clinical efficacy, prosthesis selection, reasons for revision, future application and prospects, combined with relevant literature in recent years, to review the current progress of lateral UKA.
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Bone defects caused by trauma, infection, tumor and other factors is a thorny problem in orthopedic clinic, and promoting bone repair and regeneration is the key and difficult point of treatment. In addition to autologous bone grafting, artificial bone materials are often used for large bone defects. β-tricalcium phosphate has good biocompatibility, bone conduction and bone induction properties, and has been studied deeply because of its excellent drug delivery performance and has shown broad application prospects. In this paper, the author will summarize the research progress of β-tricalcium phosphate composites loaded with different drugs in the treatment of bone defects caused by trauma, infection and tumor.
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Purpose To perform MRI examination after the death of SD rat model due to cerebral infarction and to investigate the changing characteristics of cerebral infarction during postmortem examination. Materials and Methods Middle cerebral artery occlusion (MCAO) model was established on 21 SD rats by applying modified suture method. 13 to 56 h after modeling, 12 dead SD rats were collected for the experiment. The bodies were stored at an environment with a temperature of 10-15°C and relative humidity of 45%-55%. Head MRI was performed 12 h after modeling and at 8, 24, 48, 72 and 96 h after death respectively, and apparent diffusion coefficient (ADC) values of infarction and contralateral brain tissue were calculated. At each post-mortem time point, ADC values of bilateral cerebral hemispheres, ADC values of infarction and living infarction, and ADC values of non-infarcted brain and living non-infarcted zone were compared. Brain tissue was taken after scan for pathological diagnosis and compared with diagnostic results of postmortem MRI (pmMRI). Results The right cerebral signal of rats was abnormal 12 h after cerebral infarction and after death. Eight rats were found to have shifted cerebral middle-line structure to the left. ADC values of infarction at each time point after death were lower than that of non-infarction, the difference of which was statistically significant (P<0.05); ADC values of infarction were lower than that of living infarction, the difference of which was statistically significant (P<0.05); ADC value of non-infarcted area at each time point was lower than that of living non-infarcted area, the difference of which was statistically significant (P<0.05). Necrosis and disintegration of neurons, disintegration and liquefaction of glial fibers, infiltration of inflammatory cells and leakage of red blood cells were spotted in necrotic areas after receiving cerebral HE staining in rat. HE staining was consistent with the infarction zone indicated by pmMRI. Conclusion pmMRI can be used for the diagnosis of cerebral infarction via virtual necropsy.
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Objective To explore the relationship between the orbital fat volume and the age,gender,orbital anteroposterior and transverse diameter in healthy person.Methods 210 healthy person (105 males and 105 females)were enrolled and equally divided into 7 groups according to the age.The area of the orbital fat,orbital anteroposterior and transverse diameter in all the above groups were measured in axial CT images.Then the volume of the orbital fat were computed using equation.The relationship between the orbital fat volume and the age,gender,orbital anteroposterior and transverse diameter were analyzed in the different gender and age groups.Results The volume of orbital fat was symmetrical in all age groups,and the mean fat volume of bilateral orbital was(18 957±4 143)mm3,in which adults (age＞20 years old)had the average orbital fat volume (20 340±3 514)mm3.The mean values of the orbital anteroposterior and transverse diameter were (5.16±0.37)mm and (3.74±0.23)mm,respectively.The orbital fat volume in male was greater than that in female in all age group,in addition,it was positively correlated with the age,orbital oranteroposterior and transverse diameter (P＜0.001).Conclusion The orbital fat volumes are associated with the age,gender,orbital anteroposterior and transverse diameter in healthy person.In addition,the orbital fat volume in male is greater than that in female.
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Objective To investigate the role of clinical pharmacist in anti-infection therapy for patients with augmented renal clearance (ARC).Methods A case with multi-site severe infection after traffic accident was treated with anti-infection therapy.According to the characteristics of infection and pharmacokinetics,clinical pharmacist discussed the intervention by clinical pharmacist in terms of formulating anti-infection program and adjustment of individual dose.Results After consultation and evaluation by clinical pharmacist,the patient was diagnosed as ARC.According to pharmacokinetics characteristics reported by literature,vancomycin was adjusted to 1 g (once per 8 h).Based on detection result of pathogenic bacteria,meropenem was replaced by cefoperazone/sulbactam,and the dose was increased to 3 g (once per 6 h).And then,vancomycin concentration was detected again,and it reached ＞ 10 μg· mL-1;pathogenic bacteria culture result was negative.This patient obtained good therapeutic effect.Conclusion Clinical pharmacist could assist physician on anti-infection treatment and dose adjustment of ARC patient,and improve ARC patient's therapeutic effect.
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BACKGROUND:Dynamic hip screws have been considered as a classic method for intertrochanteric fracture. However, migration of the hip screw resulting in cut-out of the femoral head remains the most common mechanical failure, which requires secondary surgery. OBJECTIVE:On the basis of the traditional dynamic hip screw, we modified the lag screw, designed new internal fixation system as cemented dynamic hip screws to explore the feasibility and the biomechanical properties for the treatment of osteoporotic intertrochanteric fracture. METHODS:A total of 24 hip samples were harvested from fresh cadavers with osteoporosis. Bone density was measured. According to the standards, the specimens were made into intertrochanteric fracture models of AO31-A1 type. Of each specimen, one side implanted with cemented dynamic hip screws served as experimental group, and another side implanted with traditional dynamic hip screw served as control group. Axial compression, twisting and fatigue load biomechanics were tested. Their biomechanical functions were compared. RESULTS AND CONCLUSION:Stress intensity, axial stiffness and horizontal shear stiffness were higher in the experimental group than in the control group (P<0.05). At torsion angle of 3°, torsional moment was higher in the experimental group than in the control group (P<0.05). Fatigue load was higher in the experimental group than in the control group (P<0.05). Results suggested that cemented dynamic hip screw internal fixation system in the treatment of senile osteoporotic intertrochanteric fracture can effectively enhance the hip screw holding force and prevent femoral cutting. Biomechanical property, stiffness, endurance resistance and stability of cemented dynamic hip screw are better than traditional dynamic hip screw.