ABSTRACT
BACKGROUND: Although there are many studies on acute patellar dislocation in adolescents, the optimal treatment strategy is under discussion.OBJECTIVE: To summarize the clinical efficacy of reconstruction of the medial patellofemoral ligament (MPFL) in the treatment of adolescent acute patellar dislocation using double-pulley technique.METHODS: Thirty cases of acute patellar dislocation were enrolled and received reconstruction of the MPFL using double-pulley technique. We proceeded to prepare the bone bed for anchor placement at the medial point of the superior edge of the patella and at the upper 1/3 patella along the long axis of the patella using arthroscopic grinding. Two double-loaded 5.0 anchors were respectively placed at the medial point of patella and at the upper 1/3 patella parallel to the patellar articular surface, and then tied using the double-pulley technique. Long longitudinal incisions were performed at the medial condyle and at the adductor tubercle to expose these two structures, the deep fascias tunnel between two incisions were penetrated to pull the tendon weave end through the tunnel until the lateral side along a femoral tunnel; finally the tendon was fixed using screws in appropriate tightness. All patients were followed for more than 10 months, and the patellar-related parameters and knee function parameters were compared before and after operation. RESULTS AND CONCLUSION: There were 12 cases of intra-articular cartilage injury and 4 cases of meniscus injury. The patella title angle, Q-angle and outward shift distance at the last follow-up were less than those before operation. Lysholm and International Knee Documentation Committee scores at the last follow-up were higher than those before operation. The mean operation time was (90±10.5) minutes. There was one patient with knee movement angle from 0° to 30° and one patient with a patellar fracture caused by slipping and treated with internal fixation. None of patients appeared with patellar dislocation, positive apprehension test infection or poor wound healing. These results indicate that the simple and mini-invasive double-pulley technique is a good treatment strategy for acute patellar dislocation, because it is consistent with patellar anatomical stability, holds patellar trajectory visibility, quick recovery and good curative effect. Additionally, osteotomy is recommended when the simple efficacy is not satisfactory.
ABSTRACT
Objective To investigate the association between chromosome variations,abnormalities and male reproductive hor-mones level with spermatogenesis.Methods The chromosome karyotype,serum reproductive hormone including FSH,LH,T,PRL and E2,and semen were detected in 147 patients with male infertility or recurrent sponotaneous abortion.The results were per-formed the comparative analysis.Results Serum FSH,LH level and the incidence rate of azoospermia in the chromosome abnormal-ity group were significantly higher than those in the chromosome variation group and the normal group(P 0.05).Serum FSH,LH level and the incidence rate of azoospermia in the sex chromosome abnormality group were obviously higher than those in the autosomal abnormality group(P <0.05),the serum T level was signifi-cantly lower than that in the autosomal abnormality group(P <0.05).Conclusion The chromosome variation and abnormality are closely related with the reproductive hormones disorder and spermatogenetic function disorder.The obvious increase of serum FSH, LH level and obvious decrease of T level caused by sex chromosome variation and abnormality is one of the pathogenesis of oligo-spermia and azoospermia.