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Objective:To investigate the effect of Masquelet technique combined with platelet-rich plasma (PRP) on repair of massive tibial defects.Methods:A prospective randomized controlled single blind trial was conducted in the 21 patients who had been admitted to Department of Repair and Reconstruction Surgery, Foshan Hospital of Chinese Medicine for massive tibial defects from June 2016 to June 2018.The length of bone defects ranged from 6.0 to 22.5 cm (mean, 10.8 cm)in length.They were 14 males and 7 females, aged from 29 to 60 years(mean, 42.1 years).The patients were divided into 2 groups by an en-crypting envelope with a random digital table.In the experimental group of 11 cases, the bone defects were repaired with Masquelet technique combined with PRP; in the control group of 10 cases, the bone defects were reconstructed with only Masquelet technique.The 2 groups were compared in terms of operation time, hospital stay, wound healing, weight-bearing time, bony union time, clinical union time, complications and John-er-Wruhs scores at the second stage.Results:The 2 groups were comparable due to insignificant differ-ences between them in the preoperative general data ( P>0.05).All patients were followed up for 12 to 24 months (mean, 14.9 months).There were no significant differences in operation time, hospital stay, wound healing, weight-bearing time, Johner-Wruhs scores or rate of complications at the second stage between the 2 groups ( P>0.05).The bony union time (4.5 months ± 1.2 months) and clinical union time (4.1 months ± 0.9 months) in the experimental group were significantly shorter than those (5.7 months ± 1.5 months and 5.4 months ± 1.1 months) in the control group ( P<0.05).No such postoperative complications as infection, loosening of internal fixator, bone resorption or nonunion were found in the experimental group.One case of wound infection occurred in the control group but responded to dressing change. Conclusion:Masquelet technique combined with PRP is a safe and effective reparative treatment for massive tibial defects and can speed up bone healing.
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Objective@#To explore the role of a customized 3D printing guide in total hip arthroplasty (THA).@*Methods@#A retrospective analysis was performed of the 60 patients who had been treated by THA for avascular necrosis of the femoral head at Department of Orthopaedics and Traumatology, Foshan Hospital of Traditional Chinese Medicine from January 2018 to May 2019. Half of them used the personalized 3D printing guide in THA and half did not. In the guide group there were 17 men and 13 women with an age of 53.4±8.9 years while in the conventional group 19 men and 11 women with an age of 54.7±9.4 years. The acetabular cups were orientated at an abduction angle of 40° and an anteversion angle of 15°. The intraoperative blood loss, operation time and acetabular abduction angle were compared between the 2 groups.@*Results@#The 2 groups were comparable due to insignificant differences between them in gender, age, body mass, cause of disease or staging of avascular necrosis of the femoral head (P>0.05). The guide group had significantly less intraoperative blood loss (286.7±150.8 mL) and operation time (90.5±34.4 min) than the conventional group did (438.3±292.6 mL and 115.6±58.6 min) (P< 0.05). The acetabular cup abduction was 38.9°±4.2° in the guide group and 37.2°±5.5° in the conventional group, showing no significant difference(t=1.315, P=0.194).@*Conclusion@#Use of a personalized 3D printing guide in THA can shorten the time for installation of an acetabular prosthesis and reduce the amount of intraoperative blood loss, but it leads to insignificant difference in the postoperative acetabular cup abduction compared with no use of the guide.
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Objective To explore the role of a customized 3D printing guide in total hip arthroplasty (THA).Methods A retrospective analysis was performed of the 60 patients who had been treated by THA for avascular necrosis of the femoral head at Department of Orthopaedics and Traumatology,Foshan Hospital of Traditional Chinese Medicine from January 2018 to May 2019.Half of them used the personalized 3D printing guide in THA and half did not.In the guide group there were 17 men and 13 women with an age of 53.4 ± 8.9 years while in the conventional group 19 men and 11 women with an age of 54.7 ± 9.4 years.The acetabular cups were orientated at an abduction angle of 40° and an anteversion angle of 15°.The intraoperative blood loss,operation time and acetabular abduction angle were compared between the 2 groups.Results The 2 groups were comparable due to insignificant differences between them in gender,age,body mass,cause of disease or staging of avascular necrosis of the femoral head (P ＞0.05).The guide group had significantly less intraoperative blood loss (286.7 ± 150.8 mL) and operation time (90.5 ± 34.4 min) than the conventional group did (438.3 ± 292.6 mL and 115.6 ± 58.6 min) (P ＜0.05).The acetabular cup abduction was 38.9° ± 4.2° in the guide group and 37.2° ± 5.5° in the conventional group,showing no significant difference (t =1.315,P =0.194).Conclusion Use of a personalized 3D printing guide in THA can shorten the time for installation of an acetabular prosthesis and reduce the amount of intraoperative blood loss,but it leads to insignificant difference in the postoperative acetabular cup abduction compared with no use of the guide.
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Objective To evaluate the clinical outcomes of partial lateral patellar facetectomy ( PLPF ) combined with lateral retinaculum release ( LRR ) for treatment of patellofemoral osteoarthritis ( PFOA ). Methods From June 2017 to March 2018, 30 PFOA patients underwent PLPF combined with LRR at Department of Orthopedics and Traumatology, Foshan Hospital of Traditional Chinese Medicine. They were 7 men and 23 women with an average age of 56.4 ± 9.7 years. Their patellar position, patellofemoral joint function, overall knee function, and quality of life were assessed by comparing preoperation and last follow-up in patellofemoral congruence angle ( PFCA ) , lateral patellofemoral angle ( LPFA ) , modified Kujala score, The Western Ontario and Mcmaster Universities Osteoarthritis Index ( WOMAC ) , and SF-12 quality of life scale. Results All the patients were followed up for an average of 7.6 ± 3.4 months ( from 4 to 13 months ). The PFCA was improved from preoperative 22.9°± 7.6°to 12.4°± 4.2°at the last follow-up, the LPFA from preoperative 3.2°± 3.7° to 12.9°± 6.0° at the last follow-up, the modified Kujala score from preoperative 17.1 ± 9.8 to 34.3 ± 5.7 at the last follow-up, the WOMAC from preoperative 14.1 ± 5.2 to 5.9 ± 1.7 at the last follow-up, the stiffness index from preoperative 5.5 ± 3.2 to 2.7 ± 1.2 at the last fol-low-up, daily functional index from preoperative 43.9 ± 9.0 to 25.2 ± 5.4 at the last follow-up, and the SF-12 scores from preoperative 31.3 ± 5.2 to 55.7 ± 6.0 at the last follow-up. All the above comparisons showed a significant difference ( P ＜0.05 ) . Conclusion PLPF combined with LRR is a minimally invasive, easy-to-master and effective knee joint preserving procedure for PFOA as it can significantly relieve joint pain and maximally keep patellar functions.
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Objective To observe the influence of early involvement of rehabilitation treadmill on hip function and daily life after total hip arthroplasty (THA).Methods Totally 80 patients receiving THA in Foshan Hospital of Traditional Chinese Medicine from January 2013 to January 2016 were randomized into a trial group (40 cases) and a control group (40 cases).The control group underwent conventional rehabilitation treatment such as training of muscle strength,joint motion and daily life,and the trial group applied rehabilitation treadmill for early training besides above measures.The two groups were compared on Harris score,Barthel scaore and re-visiting rate at the time points of 1,3 and 6 months after THA.Results Follow-up was carried out for the two groups.Harris scores and Barthel scores of the two groups were significantly enhanced 3 and 6 months after THA (P＜0.05).Harris scores in the trial group were (83.08±2.38) and (88.05±2.54) respectively 3 and 6 months after THA,which were statistically higher than (69.03±2.39) and (74.85±3.39) of the control group.Barthel scores in the trial group were (79.25±3.31) and (90.25+2.25) respectively 3 and 6 months after THA,which were obviously higher than (75.13±3.10) and (84.88±3.84) in the control group.The trial group had the re-visiting rate (17.5％) significantly higher than that (37.5％) in the control group 6 months after THA (P＜0.05).Conclusion Early involvement of rehabilitation treadmill combined with conventional training promotes the recovery of hip function,lower limb muscle strength,walking ability and daily life,while decreases the re-visiting rate of the patient.
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AIM To observe the effects of Shangke Huangshui Gauze (Scutellariae Radix,Coptidis Rhizoma,Phellodendri chinensis Cortex,etc.) on postoperative knee joint pain,swelling degree and functional recovery in patients following total knee arthroplasty (TKA).METHODS Eighty patients receiving TKA and routine care in Foshan Hospital of Traditional Chinese Medicine (FHTCM) from 2015.1 to 2016.1 were randomly and equally divided into observation group and control group.The patients in the observation group were given external use of Shangke Huangshui Gauze.The swelling degree,the score of VAS,and the score of HSS in the two groups were compared.RESULTS On the 7th,14th and 30th days after the surgery,the swelling degree in the observation group was lower than that in the control group.On the 7th,14th days,VAS scores in the observation group were significantly lower than those in the control group.In the 1st,3rd and 6th months after the surgery,patients in the two groups got higher HSS scores,but HSS scores in the observation group were significantly higher than those in the control group.All the differences had statistical significances (P ＜ 0.05).CONCLUSION The long-term external use of Shangke Huangshui Gauze can effectively relieve postoperative pain and swelling,and improve knee joint function in patients following TKA.
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Objective To establish the model of distraction osteogenesis for rabbit femur bone defect, and to observe the effect of icariin on regenerate ossification after distraction osteogenesis, thus to find a method for promoting regenerate ossification after distraction osteogenesis. Methods After the rabbit model of bone defect had been established successfully, the rabbits were equipped with distraction device. And then the 24 modeled rab bits were randomly divided into 2 groups. The experimental group was injected with icariin extract of Herba Epimedii into the interspace of bone distraction, and the control group was given local injection of recombinant human bone morphogenetic protein-2 (rhBMP-2, 100μg/kg) . On week 0, 1, 4 and 6 after the resting period, X-ray photography was carried out in both groups. On week 6 after distraction osteogenesis, the bone specimens of distraction osteogenesis region in both groups were observed by micro-computerized tomography ( CT) for the comparison of bone mass, and bone mineral content and mineral density of the newly-formed bone. Results The results of the features of imageology, and the statistical data of the bone mineral content and density showed that osteogenesis speed and osteogenic quality of the experimental group were superior to those of the control group. Conclusion The rabbit model of distraction osteogenesis for femur bone defect has been established preliminarily, and icariin can promote the speed and quality of regenerate ossification after distraction osteogenesis.