ABSTRACT
Objective To investigate short term effect of brachypodium total hip arthroplasty for young patients with osteonecrosis, and to provide a reference for clinical treatment. Methods From January 2008 to January 2012, 44 cases of femoral head necrosis patients (46 hips) were selected, with age from 28 to 52, and average age (39.94 ± 5.25) years old; according to prosthesis type they were divided into control group and observation group, control group( 22 cases of 24 hips, using metal-on-polyethylene Duraloc total hip prosthesis replacement treatment), and in the observation group (22 cases of 22 hips, with use of ceramic-on-ceramic Metha Brachypodium total hip prosthesis replacement therapy). Patients were followed up for 12 to 36 months, Harris score, range of motion and other indicators were compared in two groups of patients. Results In observation group and control group, the level of WOMAC score, total Harris score and function, motion range, pain, abnormalities score were significantly improved compared with those before operation:in observation group:(27.46 ± 4.19) scores vs.(66.38 ± 5.84) scores, (92.73 ± 7.68) scores vs.(42.67 ± 7.28) scores, (45.28 ± 5.34) scores vs. (22.19 ± 4.19) scores, (4.46 ± 0.63) scores vs. (3.25 ± 0.66) scores, (39.54 ± 1.54) scores vs. (15.39 ± 2.86) scores, (3.45 ± 0.65) scores vs. (1.84 ± 0.32) scores;in control group:(28.16 ± 4.07) scores vs. (65.67 ± 6.22) scores, (93.03 ± 7.54) scores vs.(43.74 ± 7.57) scores, (44.65 ± 5.26) scores vs. (22.45 ± 4.37) scores, (4.74 ± 0.71) scores vs. (3.17 ± 0.59) scores, (39.87 ± 1.26) scores vs. (16.19 ± 2.55) scores, (3.77 ± 0.73) scores vs. (1.93 ± 0.43) scores, and there were significantly differences (P0.05). All patients were follower up for 12-36(23.19 ± 3.66) months. One case in observation group had leg swelling and healed after symptomatic treatment, 1 case in the control group had limb swelling, and 1 case had extensive subcutaneous bleeding .And they were cured after symptomatic treatment 1 case had femoral dislocation, and no secondary dislocation happened after the implementation of manual reduction. Conclusions Brachypodium ceramic ceramic total hip replacement therapy has same effect for young osteonecrosis patients compared to polyethylene and metal prosthesis in improving hip function, but the ceramic-on-ceramic prosthesis brachypodium has better performance in wear resistance with smaller friction coefficient is smaller, and is suitable for young patients.
ABSTRACT
BACKGROUND:Traditionaly, non-surgical treatment was used to treat degenerative femoral intercondylar fossa impingement syndrome, but it can cause function loss of cruciate ligament, or knee instability. With the development of medical technology, more and more views believed that ligament damage and combined with other knee structural damage should receive surgery as soon as possible. OBJECTIVE: To investigate the repair effect of knee arthroplasty for treating degenerative femoral intercondylar fossa impingement syndrome, and compare with AO cannulated screw fixation. METHODS:A total of 72 patients with degenerative femoral intercondylar fossa impingement syndrome were equaly and randomly divided into treatment group and control group. Patients in the control group were treated with open AO cannulated screw fixation, and patients in the treatment group were subjected to knee arthroplasty. At 7 days after treatment, repair effect was evaluated. Before treatment and 7 days after treatment, knee function was assessed by using Lysholm knee Scoring Scale and the international knee documentation committee knee evaluation form. Al patients were folowed up for 6 months after treatment to investigate the occurrence of complications. RESULTS AND CONCLUSION:The surgery was successfuly completed in al patients. At 7 days after treatment, the excelent and good rate was 94% in the treatment group and 75% in the control group. The excelent and good rate was significantly higher in the treatment group than in the control group (P < 0.05). Lysholm scores were significantly greater, but the international knee documentation committee knee evaluation form scores were significantly lower at 7 days after treatment compared with that before treatment in the treatment group (P < 0.05). Simultaneously, Lysholm scores and the international knee documentation committee knee evaluation form scores were significantly better in the treatment group than in the control group at 7 days after treatment (P < 0.05). During 6-month folow-up, wound infection, intra-articular infection, joint pain, and deep vein thrombosis were significantly less in the treatment group than in the control group (P < 0.05). These findings indicate that knee arthroplasty for degenerative femoral intercondylar fossa impingement syndrome can improve short-term efficacy, effectively restore knee function and reduce the incidence of postoperative complications.
ABSTRACT
BACKGROUND:With the development of surgical techniques and reconstruction material technology, joint replacement has also been widely used in the dislocation of the shoulder;especial y al kinds of custom-made or assembled prosthesis make replacement indications improved evidently. OBJECTIVE:To investigate the long-term effects of arthroscopy or arthroplasty for treating recurrent anterior dislocation of the shoulder joint with severe bone defects. METHODS:144 patients with recurrent anterior dislocation of the shoulder joint with severe bone defects were enrol ed in this study. They were divided into treatment group and control group based on a random drawing (n=72). The control group was given arthroscopic surgery, and the treatment group was subjected to arthroplasty. The 3 years of fol owed-up were done by telephone investigation and further consultation. Neer shoulder score, shoulder activity and complications were recorded. RESULTS AND CONCLUSION:After 3-year fol owed-up, the excel ent and good rate of shoulder function was significantly higher in the treatment group (90%) than in the control group (81%) (P<0.05). The magnitude of the flexion in the 3-year fol owed-up was apparently increased, while the lateral margin external rotation was decreased, which showed significant differences after intragroup comparison (P<0.05). Simultaneously, the magnitude of the flexion and the lateral margin external rotation in the treatment group had statistical y significant differences compared to the control group in the 3-year fol owed-up (P<0.05). The complications of wound infection, shoulder dislocation, and implant loosening in the treatment group during fol ow-up were significantly lower than in the control group (P<0.05). These findings verified that compared with arthroscopic surgery, arthroplasty for treating recurrent anterior dislocation of the shoulder joint with severe bone defects in long-term fol ow-up can effectively restore shoulder function and range of motion, and it has few complications, thereby effectively rebuilds shoulder joint.
ABSTRACT
Objective To investigate effects analysis of joint function and MMP-7 and MMP-9 measurement after synovial ar-throscopic debridement for knee synovitis.Methods 72 patients with knee synovitis method based on a random draw were e-qually divided into the treatment group and the control group,the control group were given the traditional synovial planing surgery.The treatment group were given the arthroscopic debridement synovium.Results After treatment,the response rates in the treatment group and the control group were 97.2% and 80.6% respectively.The response rate of the treatment group were significantly better than the control group.The difference was statistically significant (P <0.05).The postopera-tive Lysholm scores were increased significantly,while the pain scores were significantly reduced,and the postoperative Ly-sholm score and pain scores difference compared between the two groups were also statistically significant.The difference was statistically significant (P <0.05).The postoperative synovial tissue MMP-7 and MMP-9 expression rates were in the two groups significantly lower.The difference was statistically significant (P <0.05),while the postoperative MMP-7 and MMP-9 expression rates of the treatment group were ignificantly lower than the control group (P <0.05).Conclusion Syn-ovial arthroscopic debridement for knee synovitis can relieve pain and improve knee function,reduce the expression of MMP-7 and MMP-9,thereby enhance the overall efficacy of the treatment.
ABSTRACT
BACKGROUND:Arthroscopy can observe the involutive relation of patelofemoral joint directly and dynamicaly, which can be used to judge whether the patelofemoral joint abnormalities can be completely corrected. OBJECTIVE:To analyze the clinical effect of lateral retinacular release and ligament reconstruction under arthroscope for patela recurrent dislocation. METHODS: A total of 58 patients diagnosed as having recurrent patelar dislocations were divided randomly into control and experimental groups, with 29 cases in each group. Patients in the control group received lateral retinacular release and ligament reconstruction under common operation and those in the experimental group received lateral retinacular release and ligament reconstruction under arthroscopy. RESULTS AND CONCLUSION:There was no significant difference in the Lysholm and Kujala scores before treatment in the two groups (P > 0.05), but at 12 months after treatment, the Lysholm and Kujala scores were both increased in the two groups, especialy in the treatment group (P 0.05), and CT measurement values of the congruence angle and lateral patelofemoral angle were both decreased in the two groups, especialy in the experimental group, at 12 months after treatment. In addition, the operation time, healing time, and total effective rate were better in the experimental group than the control group (P < 0.05). These results indicate that the lateral retinacular release and ligament reconstruction under arthroscopy has a better effect on recurrent patelar dislocation.