ABSTRACT
<p><b>OBJECTIVE</b>To find out the incidence of early DVT in patients after knee arthroscopic surgery with routine use of tourniquet and discuss the associate risk factors.</p><p><b>METHODS</b>Total 1 561 cases undertaken primary knee arthroscopic surgery was reviewed retrospectively from January 2013 to January 2017, including 651 males and 910 females with a mean age of (65.7±8.7) years old ranging from 62 to 81 years old. The cases were divided into DVT group and non-DVT group according to ultrasonic Doppler after surgery. The DVT occurrence rate was calculated and the basic information was analyzed to filter out the risk factors through univariate analysis and multivariate analysis. The cases of DVT group received 6 months anticoagulation therapy and were undertaken a follow-up of 1, 3, 6 months by ultrasonic Doppler.</p><p><b>RESULTS</b>Out of the 1 561 cases, 226(14.5%) developed early DVTs following surgery, 32(2.0%) cases had the proximal DVTs, and 194(12.4%) cases had the isolated distal DVTs. The risk factors include the age(>=73 years), female sex and gastrocnemius vein dilation (GVD), hypertension, longer tourniquet time(>=74 min). The GVD and the length of tourniquet time was considered to be the best predictor of the early DVTs after surgery, with an odds ratio of 2.337 (95% CI, 1.644-3.611) and 2.112 (95%CI, 1.452-3.301). Twelve isolated distal DVTs(6.6%) and 11 proximal DVTs(36.7%) still showed thrombus at 6-month follow-up, but exhibit decreased size and at various stage of resolution.</p><p><b>CONCLUSIONS</b>The incidence of early DVTs after knee arthroscopic surgery is 14.5%. Out of all risk factors, the GVD and the length of tourniquet time have the best power for prediction of DVTs after surgery. Both proximal and distal DVTs received accepted outcomes after formal therapy.</p>
ABSTRACT
<p><b>OBJECTIVE</b>To explore plantar pressure measurement system in treating the first ray hypermobility.</p><p><b>METHODS</b>From June 2013 to January 2014, 16 female patients (20 feet) with hallux valgus with unstable of the first sequence were treated by first tarsometatarsal joint fusion, aged from 42 to 52 years old with an average of(46.5±2.9) years old, the course of disease was from 3 to 5 years. Twenty healthy female(20 feet) were chosen as control group, and single side were only choose, aged from 41 to 55 years old with an average of(46.8±4.5) years old. Preoperative and postoperative AOFAS score was used to evaluate feet function. Plantar pressure measurement system were applied to compare peak value of the dynamic pressure and impulse indicators of affected feet and control normal feet from the first to the fifth head of metatarsal bone.</p><p><b>RESULTS</b>All patients were followed up from 24 to 30 months with an average of 27.4 months. Hallux valgus deformity of affected feet were corrected, pain and swelling of the second head of metatarsal bone were disappeared. There were statistical differences in AOFAS score between preoperative (45.55±12.28) and postoperative (85.45±6.76). There were significant differences in peak pressure, pressure between affected feet and normal feet of the first and second head of metatarsal bone. Postoperative peak pressure, pressure of the first affected head of metatarsal bone were increased than that of before operation, but no differences compared with control group(>0.05). Postoperative peak pressure, pressure of the second affected head of metatarsal bone were decreased before operation(<0.05), but no meaning compared with control group(>0.05). There were no significant differences compared between the forth and fifth affected head of metatarsal bone and control group(>0.05).</p><p><b>CONCLUSIONS</b>There were obvious differences in pressure of the first and second head of metatarsal bone patients with unstable of the first sequence, the first tarsometatarsal joint fusing could recover plantar pressure of the first and second head of metatarsal bone by plantar pressure measurement system.</p>
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical curative effects of internal drainage by expanding arthroscopic gastrocnemius-semimembranosus bursa(GSB) and cyst wall resection for the treatment of popliteal cysts.</p><p><b>METHODS</b>A retrospective analysis of patients from May 2011 to December 2015. Arthroscopic treatment for 41 patients with popliteal fossa cysts, 18 males and 23 females, aged from 34 to 67 years old, averaged 42.6 years old. All the patients had preoperative magnetic resonance imagings to confirm the diagnosis and identify the valvular opening(Gastrocnemius-Semimembranosus bursa, GSB), as well as the associated intra-articular pathology. All the popliteal cysts were unilateral, including 26 cases of right knees and 15 cases of left knees. Five patients had recurrent popliteal cysts, and all of them underwent initial open Surgery. The duration from initial surgery to the recurrence ranged from 6 to 17 months(averaged, 11 months). All the patients had underwent arthroscopic treatment of internal drainage by expanding GSB and cyst wall resection. According to the Rauschning and Lindgren classification, 5 cases were grade I , 30 cases were grade II and 6 cases were grade III. Preoperative Lysholm score, 83.19±6.12 (ranged form 73 to 95).</p><p><b>RESULTS</b>The GSB structure was found in all patients with popliteal cysts during operation, including cartilage degeneration in 33 cases, medial meniscus injury in 27 cases, lateral meniscus injury in 7 cases, free body in 8 cases, pigmented villonodular synovitis in 2 cases, and synovial chondromatosis in 3 cases. There were no complications related to vascular, nerve or surgical incision. All the patients were followed up, and the duration ranged from 8 to 27 months, with an average of 18 months. No recurrence of cysts was found. According to the Rauschning and Lindgren classification, there were 9 cases of grade 0, 27 cases of grade I , 4 cases of grade II, 1 case of grade III. Postoperative Lysholm score:91.32±4.26(ranged from 82 to 98).</p><p><b>CONCLUSIONS</b>Arthroscopic internal drainage by expanding GSB and cyst wall resection surgery in the treatment of popliteal cysts has the advantages of less trauma, faster recovery and low relapse rate, which has a good short-term effect.</p>
ABSTRACT
<p><b>OBJECTIVE</b>To study clinical effects of triad operation including reconstruction of medial patellofemoral ligament, release of lateral retinaculum, Fulkerson tibial tubercle osteotomy, medial transfer and advancement under arthroscopy for the treatment of habitual dislocation of patella.</p><p><b>METHODS</b>From March 2010 to May 2016, 35 patients with habitual patellar dislocation were treated with the triad operation, including 14 males, 21 females, ranging in age from 18 to 38 years old, with an average of 25.8 years old. Twelve patients had dislocations on the left knee, and 23 patients had dislocations on the right knee. The changes of Q angle, TT-TG value and Kujala score were compared before and after operation.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 9 to 35 months (mean, 23 months). The Q angle of male group was improved from preoperative (29.2±2.0)° to postoperative (14.8±1.2)°(<0.05), and the Q angle of female group was improved from preoperative(30.6±2.3)° to postoperative (16.7±1.5)° (<0.05). CT showed that the TT-TG value was improved from preoperative (20.3±2.2) mm to postoperative (10.3±1.2) mm (<0.05). The Kujala score was improved from preoperative 47.8±7.5 to postoperative 88.4±6.2 (<0.05).</p><p><b>CONCLUSIONS</b>The triad operation including reconstruction of medial patellofemoral ligament, release of lateral retinacular, Fulkerson tibial tubercle osteotomy, medial transfer and advancement under arthroscopy for the treatment of habitual dislocation of patella has good short-term clinical effects.</p>