Case-control study on clinical effects of arthroscopic single-versus double-bundle ACLs reconstructions / 中国骨伤

<p><b>OBJECTIVE</b>To compare the clinical results of arthroscopic single and double-bundle ACLs reconstructions.</p><p><b>METHODS</b>From January 2009 to May 2010,45 patients with anterior cruciate ligament tear were divided into two groups. In the first group,the anterior cruciate ligament were anatomical reconstructed with double-bundle semitendinous tendon, and in the second group the anterior cruciate ligaments were anatomical reconstrucated with single bundle semitendinous tendon. There were 22 patients (15 males and 7 females) in double-bundle group, with an average age of (27.04 +/- 3.68) years; 18 patients (13 males and 5 females) in single bundle group, with an average age of (28.16 +/- 4.76) years. Therapeutic effects between two groups were compared according to the IKDC, Lysholm scoring standards and Lachman test, knee pivot shift test, KT-1000.</p><p><b>RESULTS</b>Twenty-two patients in double-bundle group and 18 patients in single-bundle group were followed-up, and the mean duration was 12 months. The IKDC score of patients in single-bundle group improved from preoperative 41.40 +/- 6.30 to postoperatively 95.70 +/- 3.10, Lysholm score increased from preoperative 47.20 +/- 6.30 to postoperative 94.20 +/- 2.40. And the IKDC score of patients in double-bundle group improved from preoperative 40.90 +/- 6.10 to postoperative 96.10 +/-3.40, Lysholm score increased from preoperative 48.10 +/- 6.50 to postoperative 95.10 +/- 2.49. There was no statistically significant difference between the two groups. The Lachman test was positive in 2 patients (1 patient in double-bundle group and 1 patient in single-bundle group); and pivot shift test was positive in 2 patients (1 patient in double-bundle group and 1 patient in single-bundle group). KT-1000 of patients in double-bundle group was (1.5 +/- 1.2) mm, and (1.9 +/- 1.5) mm in single-bundle group, there were no statistically significant differences between the two groups.</p><p><b>CONCLUSION</b>Arthroscopic single-bundle reconstruction and double-bundle anterior cruciate ligament reconstruction have no significant differences in clinical effects.</p>

Study on the correlation between knee osteoarthritis imaging and effects of arthroscope / 中国骨伤

<p><b>OBJECTIVE</b>To explore the indications of arthroscope for the treatment of knee osteoarthritis and investigate the correlation between knee osteoarthritis imaging and effects of arthroscope.</p><p><b>METHODS</b>From 2005.8 to 2008.4, 86 patients with knee osteoarthritis underwent arthroscope examination and treatment. Among the patients, 44 patients were male, and 42 patients were female, ranging in age from 46 to 67 years, averaged 56.3 years. Arthrodial cartilage of knee was graded by ICRS MR, and by Kellgern Laqrence X-ray. All the patients were followed up, and the duration ranged from 12 to 30 months. The Lysholm score was evaluated at the follow-up time.</p><p><b>RESULTS</b>Among 86 knees in 86 cases, cartilage injury degree of knees was graded as follows: grade 4 in 30 cases, grade 3 in 22 cases, grade 2 in 20 cases, grade 1 in 12 cases, grade 0 in 2 cases, mean grade (2.77 +/- 1.138). Postoperative Lysholm score ranged from 59 to 100, averaged (95.17 +/- 7.556), Kendall's correlation coefficient was -0.089, P = 0.317. There was no correlations between cartilage injury degree and Lysholm score. X-ray of knees was graded as follows: grade 4 in 0 cases, grade 3 in 24 cases, grade 2 in 38 cases, grade 1 in 17 cases, grade 0 in 7 cases, mean grade was (2.13 +/- 0.67), the Kendall's correlation coefficient was -0.851 with negative correlations (P = 0.036) between postoperative Lysholm score and K/L grade.</p><p><b>CONCLUSION</b>There is no correlation between the grade of knee cartilage injury confirmed by MRI (1.5T) and effects of arthroscopy, and the grade is not a gold standard as an operation indication in arthroscope procedure. The K/L grade in X-ray had important effects.</p>

Comparison of the relativity of MRI appearance of cartilage injuries and postoperative effect of arthroscope on articular cartilage disease of knee / 中国骨伤

<p><b>OBJECTIVE</b>To analyze the indication of arthroscope by examining the correlations between cartilage injury degree confirmed by MRI and postoperative effect.</p><p><b>METHODS</b>From Aug. 2005 to April 2008, 87 cases with knee osteoarthritis were treated by arthroscopes including 44 males and 43 females,aged from 16 to 67 years (means 46.3 years). Arthrodial cartilage of knee was graded by ICRS MR, and the therapeutic effect was evaluated by Lysholm scoring.</p><p><b>RESULTS</b>All 87 knees of 87 cases were followed-up for from 12 to 30 months (averaged 23 months). The cartilage injury degree of knees was graded as follows: grade 4 in 30 cases, grade 3 in 23 cases, grade 2 in 20 cases, grade 1 in 12 cases, grade 0 in 2 cases, means grade (2.770 +/- 1.138). Postoperative Lysholm score was from 59 to 100, means (95.170 +/- 7.556). Coefficient correlation (r) = -0.152, P = 0.159 > 0.05. Although the results had no correlations between cartilage injury degree and Lysholm score, negative correlation tendency existed.</p><p><b>CONCLUSION</b>The patients with higher grade of knee cartilage injury degree confirmed by MRI (1.5T) have worse effect after operation, the grade is not a gold standard as a operation indication in arthroscopic procedure.</p>

Suture menisci with epidural transfixion pin to treating acute meniscus tear under arthroscope / 中国骨伤

<p><b>OBJECTIVE</b>To study the utility and effect of suturing menisci with epidural transfixion pin to treating acute meniscus tear under arthroscope.</p><p><b>METHODS</b>Twenty-two cases with acute meniscus tear were selected, in which 18 were male and 4 were female,aged from 17 to 42 years with average of 28.5. The tearing menisci were sutured with epidural transfixion pin and unabsorbed suture. The follow-up were 6-12 months after operation. Meanwhile, Lysholm score, subjective symptoms and examination were recorded.</p><p><b>RESULTS</b>Preoperative Lysholm scores were 46.72 +/- 13.46, whereas, postoperative ones were 89.43 +/- 18.21. There was significant difference between before and after operation (t = 1.85, P < 0.01). No recurrent interlocking, no pain in joint medialis and post-medialis space. McMurray test was negative. The complications about injury of blood vessel, nerves and tendons were not found during 6-12 months follow-up.</p><p><b>CONCLUSION</b>The technique is advantageous in convenience, reliability, large suture strength and definite curative effect.</p>

Survey and analysis of status quo of rural community doctors in Shanghai / 上海第二医科大学学报

Objective To explore status quo of Shanghai community health services based on the investigation of rural community doctors in Shanghai suburb,and to propose measures on training rural doctors. Methods Retrospective investigation was carried out in 114 rural community health service centers and 1 563 clinics.Primary investigation included the registration,distribution,age,academic titles and education background. Results The results showed insufficient number of human resources and inadequate investment in human capitals in the primary medical services of Shanghai suburbs,and there was a serious shortage of general practitioners.The other problems included older age,insufficient academic qualifications,and without professional titles. Conclusion We should improve the status and treatment of rural doctors.Job training and well-trained professional students should be encouraged for the primary health services.More and more doctors should be attracted to work in community health service centers.General practitioners' personnal information network and general medical training network should be established,and the general medical education system gets improvement.