ABSTRACT
Objective:To observe any effect of early-stage body weight-supported treadmill training on the progression of osteoporosis after a stroke.Methods:Sixty stroke survivors with osteoporosis were randomly divided into a treatment group and a control group, each of 30. Both groups were given routine medication including Miacalcic, α-D3 and Fosamax, along with standard rehabilitation training. The treatment group was additionally subjected to body weight-supported treadmill training. The bone mineral density (BMD), serum osteoprotegerin (OPG) and serum NF-κ B ligand receptor activator (RAKNL) levels were measured for both groups before and after 3, 6 and 12 months of treatment.Results:The average BMD, OPG and RAKNL levels and the RANKL/OPG ratio in both groups improved with treatment. After 3, 6 and 12 months of treatment, all four average indicators were superior to those of the control group at the same time points.Conclusion:Body weight-supported treadmill training can significantly retard the development of osteoporosis.
ABSTRACT
Objective To explore the clinical results of total knee arthroplasty (TKA) in the treatment of knees with bony ankylosis in extension.Methods From June 2000 to June 2007,10 patients had knees with bony ankylosis in extension were treated with TKA,including 4 males and 6 females,with an average age of 49 years (range,29 to 63 years).The primary diseases were as follows:ankylosing spondylitis in 3 cases,rheumatoid arthritis in 2 cases,hemophilic arthritis in 1 care,traumatic arthritis in 3 cases and pyogenic arthritis in 1 case.The range of motion (ROM) was 0° in all knees,and the average HSS (the Hospital for Special Surgery) score before operation was 32.5±10.26.Two patients underwent bilateral TKA,and 8 underwent unilateral TKA.Results All patients were followed up for 3 to 10 years (average,5.3 years).The average HSS score was improved to 87.75±6.45 at the last follow-up,and there was significant difference compared with that before operation (t=18.668,P=0.000).The average ROM was improved to 97.08°±11.57°at the last follow-up,and there was remarkable difference compared with that before operation (t=29.063,P=0.000).The postoperative complications included cutaneous necrosis in 2 cases,deep venous thrombosis of lower limb in 1 case,periprosthetic fracture in 1 case,and deep prosthetic infection in 1 case who underwent revised TKA later.The postopertative X-ray showed no looseness of the prostheses.Conclusion TKA through medial parapatellar approach,with dissection of the rectus femoris,secondary osteotomy and soft tissue balance intraoperatively is effective in the treatment of knees with bony ankylosis in extension,which can correct the ankylosed knee deformitis successfully.Combining with the correct rehabilitation exercise,it is possible to improve significantly the function of knee and life quality in these patients.