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Objective To investigate the effects on knee function between patella plasty and patellar replacement in total knee arthroplasty.Methods From August 2010 to November 2010,48 patients (69 knees) of osteoarthritis performed TKA were covered in this study.All the patients were randomly assigned to the following two groups:one group contained 24 patients (34 knees) performed patella plasty,and the other group contained other 24 patients (35 knees) performed patellar replacement.There was no significant difference between the two groups in age,weight,height,BMI,patellar score and the American Knee Society Score (KSS).Every patient was followed up for 6 weeks,3 months,6 months,one year,and two years.All the results,which were used to compare the difference between the two groups,in KSS knee score,knee function score,patellar score,the incidence of anterior knee pain,and imaging findings.Results In this clinical study,20 patients (30 knees) in patellar replacement group and 20 patients (29 knees) in patella plasty group were followed up.No significant difference was found in the postoperative KSS knee score between 2 groups at each time point.The KSS knee function score in replacement group was significantly higher than that in arthroplasty group at 6,12 and 24 months after operation.The incidence of anterior knee pain after the surgery in replacement group was significant different from the plasty group at every time point after operation.There was no significant difference in tibiofemoral angle,patellar ligament ratio,patellar tilt angle,congruence angle and lateral patellar displacement between two groups at last follow-up.Conclusion Total knee arthroplasty with patella replacement can improve both knee function and patella function,and reduce the incidence of postoperative anterior knee pain.
ABSTRACT
Aseptic loosening of the prosthesis due to periprosthetic osteolysis is one of the main causes that affect the service life following artificial joint replacement. The patient should undergo revision of artificial joints,but the surgery is of high difficulty,high risk and excessive cost,etc. Therefore,using nonsurgical technique to control artificial prosthesis osteolysis is an urgent and realistic task. Currently,the drug prevents osteolysis through inhibiting osteoclast bone resorption,responding to cytokines,and promoting bone formation. In addition,gene therapy and other treatments for osteolysis are under exploration.
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[Objective]To study the correlated factors of hidden blood loss after simultaneous bilateral total knee arthroplasty.[Method]From Feb.2005 to Feb.2007,a retrospective analysis of 44 patients underwent knee arthroplasty was conducted to calculate the mean blood loss and occult blood loss according to Gross formula.The true total blood loss was calculated depending on height weight and pre-and post-operation HCT.[Result]The mean total blood loss were 2 065 ml in these cases with occult blood loss of 1 198 ml.In patients with autologous blood transfusion,the mean total blood loss were 2 180 ml with occult loss of 937 ml(42%).In patients without autologous blood transfusion,the mean total blood loss were 1 195 ml with occult blood loss of 799 ml(41%).[Conclusion]The hidden blood loss result in large volume of the total blood loss in the postoperative period which can not be fully compensated by autologous blood transfusion and it 's very important to additional blood supply during simultaneous bilateral total knee arthroplasty.
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[Objective]To observe the change of ultrapathology in the rat model study of experimental lumbar intervertebral disc degeneration.[Method]Thirty-two Sprague-Dawley(SD)rats were divided into two guoups at random,including in the experimental group and the control group.The experimental group was incised through posterior approach along spinous process,resected below erector spinal muscle,the supraspinal and interspinal ligament and the posterior of the zygapophysial joint at the center of the third lumbar spine for providing the rat degeneration of lumbar intervertebral induced by mechanical instability state.The control group was just incised the skin.All of th rats were examined after eight weeks by electronmicroscope.[Result]There was no special ultrapathological characterization after operation in the control group,while in experimented group most chonduocyte-like cells were degenerated or necrotic and their number decreased markedly,collagenous fibrils appeared various kinds of degeneration including fusion,twist and calcification,and there were gaps between the collagen bundles.[Conclusion]Observing the change in the rat model study of experimental lumbar intervertebral disc degeneration by ultrapathology,it can offer the experimental data studying tile degeneration of lumbar intervertebral disc.
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Objective To investigate the expression of extracellular matrix metalloproteinase induced (EMMPRIN) in the synovial membrane of patients with rheumatoid arthritis (RA).Methods Immunohistochemistry were performed to characterize the EMMPRIN-expressing cells at sites of joint destruction derived from RA and osteoarthritis (OA) patients.Reverse trancription polymerase chain reaction (RT-PCR) was performed to study the existence of EMMPRIN in synovial membrane samples.And it was followed by computer assisted image analysis in order to detect the A values of their experession.Results EMMPRIN immunoreactivity was more intense in RA than in OA synovial membrane (P