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Objective@#To design and evaluate a new method for measuring the center of rotation of the hip joint, and to compare it with the traditional methods.@*Methods@#Data of healthy hips of 120 total hip arthroplasty (THA) patients (120 hips) and bilateral hips of 20 healthy volumteers (40 hips) were collected. A series of X-rays and magnetic resonance imaging (MRI) were taken from each patient with the hip joint abductted at differenct angles (0°, 7.5°, 15°, and 22.5°). The motion track of rotation center was obtained by comparing these X-ray and MRI images. The preoperative and postoperative data of 67 surgical patients who underwent two different measurement methods before surgery were compared.@*Results@#Compared with traditional measurement methods, the accuracy of our new method was significantly improved; the results of hip MRI verified the objectivity and accuracy of our new method; preoperative measurements and postoperative follow-up results showed that our new method had a better clinical effect than traditional measurements.@*Conclusions@#The team′s innovative new measurement method based on pelvic orthotopic X-ray photographs with different abduction angles of the hip shows more accurate data than traditional measurement methods and shows better clinical results.
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Objective To design and evaluate a new method for measuring the center of rotation of the hip joint,and to compare it with the traditional methods.Methods Data of healthy hips of 120 total hip arthroplasty (THA) patients (120 hips) and bilateral hips of 20 healthy volumteers (40 hips) were collected.A series of X-rays and magnetic resonance imaging (MRI) were taken from each patient with the hip joint abductted at differenct angles (0°,7.5°,15°,and 22.5°).The motion track of rotation center was obtained by comparing these X-ray and MRI images.The preoperative and postoperative data of 67 surgical patients who underwent two different measurement methods before surgery were compared.Results Compared with traditional measurement methods,the accuracy of our new method was significantly improved;the results of hip MRI verified the objectivity and accuracy of our new method;preoperative measurements and postoperative follow-up results showed that our new method had a better clinical effect than traditional measurements.Conclnsions The team's innovative new measurement method based on pelvic orthotopic X-ray photographs with different abduction angles of the hip shows more accurate data than traditional measurement methods and shows better clinical results.
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Objective To investigate the relationship between vascular endothelial cell nitric oxide synthase (eNOS) gene polymorphism and the pathogenesis of avascular femoral head necrosis (ANFH).Methods The eNOS full-length CDS fragments,containing 894G or 894T separately,was subcloned into lentiviral expression vector,and then infect the human umbilical vein endothelial cells (HUVEC).The contents of nitric oxide NO and cyclic guanosine monophosphate (cGMP) in cell culture supernatant were detected in a time-dependent manner.The luciferase-labeled reporter plasmid pNF-κB-luc was co-transfected with the reference control plasmid pRL-TK into HUVEC cells infected with LV-eNOS-894G,LV-eNOS-894T,and control lentivirus (LV-NC) for 48 h.The luciferase activity of each group was detected.The expression of nuclear factor (NF)-κB protein and eNOS protein in HUVEC cells were detected by Western blot assay.The HUVEC cells in each group were co-cultured with hFOB1.19 cells,and the concentration of alkaline phosphatase (ALP) or osteocalcin (OCN) in the supernatant were detected at different time points.Results The contents of NO and cGMP in the cell culture supernatant of the full-length lentivirus expressing eNOS gene (containing 894G or 894T) were significantly higher than that in the empty cell group and the empty vector group,and the contents of NO and cGMP in the cell culture supernatant of the 894G group were significantly higher than that of 894T group (P ＜ 0.01).Compared with blank cells,the expression levels of NF-κB/p65 protein and eNOS protein were significantly increased in cells expressing eNOS,and the expression of NF-κB/p65 protein in 894G group was significantly increased than 894T group,but there was no difference in eNOS protein expression between the 894G and 894T groups;each group of HUVEC cells were co-cultured with hFOB1.19 osteoblasts,and at each of the same time points,the concentrations of ALP and OCN in the cell culture supernatant expressing lentivirus were significantly higher than that in the empty cell group and the empty vector group,and the ALP and OCN concentrations in the cell culture supernatant of the 894G group were significantly higher than those in the 894T group.Conclusions The eNOS gene exon G894T mutation reduces the levels of nitric oxide and cGMP produced by vascular endothelial cells through the eNOS-NO pathway,affecting the expression levels of NF-κB/p65 protein and eNOS protein,and reducing osteoblast activity,and blood supply to blood vessels.It may be one of the pathogenic mechanisms leading to femoral head necrosis.
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Objective To discuss the surgical technique and effectiveness of total knee arthroplasty (TKA) for the valgus knee in adult.Methods Retrospective analysis the clinical data from 2015 January to 2017 May of 38 patients with 40 knees treated in our hospital.Age 46-73(61 ±4.2) years old.The femur-tibia angle (FTA) was 7°-35 ° (11 ° ± 4.3 °),the average range of motion (ROM) was 115 ° ± 10°,the Hospital for Special Surgery (HSS) score was 21-65 (43 ± 8.6).All cases were corrected deformity and improved function by TKA.Results 38 patients were followed up 6 months to 3 years.All patients had no severe pain and dysfunction.The postoperative FTA was 1 °-7°(4 ± 3°),the average ROM was 115° ± 10°,the HSS score was 76 ± 14,showing significant difference compared with preoperative data (P ＜ 0.05).Conclusions The TKA is a conventional therapy for valgus deformed knee in adult.By appropriate approach,precise osteotomy,accurate soft tissue balance,satisfactory joint function and effectiveness can be achieved.
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Under the guidance of meridian theory, the acupoints heat-sensitive moxibustion is a treatment method which applies moxa stick to perform mild moxibustion at heat-sensitive acupoints, which can arouse the meridian sensation transmission and promote the movement of meridian qi; consequently, the qi can be extended to the diseases. For its many advantages, such as no direct contact on skin, no injuries, no pains, fewer side effects, easy operating and moderate cost, the acupoints heat-sensitive moxibustion is widely accepted in dermatology, male urology disease, rectum and anus diseases and breast diseases. The application and research status of the acupoints heat-sensitive moxibustion in traditional Chinese surgery in recent years is reviewed, and several problems and suggestions in its clinical application and research are proposed, aiming to provide clinical basis for its further development and clinical application in traditional Chinese surgery.
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Humans , Acupuncture Points , Clinical Trials as Topic , General Surgery , Moxibustion , SensationABSTRACT
OBJECTIVE@#To investigate the eff ect of icaritin on proliferation and apoptosis in rat chondrocytes and to provide new theory for osteochondropathy treatment.@*METHODS@#Icaritin (with a purity of 99%) at different concentrations (0, 4, 8, 16, 32, 64 μmol/L) was incubated with rat chondrocytes for different time. The cell proliferation and apoptosis was assayed by MTT and fl ow cytometry, respectively.@*RESULTS@#Compared with the control group, the cell proliferation was increased in the groups with icaritin at 4 or 8 μmol/L (P<0.05), whereas the proliferation was decreased in the groups with icaritin at 16, 32 or 64 μmol/L groups compared to the control group (P<0.05); the cell apoptosis ratio in the group with icaritin at 4 μmol/L was obviously lower than that in the control group aft er incubation of icaritin for 24 h and 48 h. Beyond 4 μmol/L, the higher concentration of icaritin, the higher apoptosis ratio of cell. However, it did not show a time-dependent manner at a same concentration of icaritin.@*CONCLUSION@#The icaritin at low concentration (4 or 8 μmol/L) can promote rat chondrocyte proliferation and inhibit cell apoptosis, while the effect of icaritin on rat chondrocyte at high concentration was reversed.
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Animals , Rats , Apoptosis , Cell Proliferation , Cells, Cultured , Chondrocytes , Cell Biology , Flavonoids , ChemistryABSTRACT
Objective To explore the effects of parent-adolescent conflict and cohesion on relational aggression among junior students.Methods Parent-adolescent Conflict Questionnaires,Parent-adolescent Cohesion Questionnaires,and the Relational Aggression Questionnaires were used in investigating 392 junior students.Results The level of relational aggression of junior students was low (22.52±5.15).There was no differences between relational aggression of male students (22.93± 5.43) and female students (22.00± 4.73) (P＞ 0.05),and of grade 1 students(22.72±5.14)and grade 2 students(22.64±5.67),grade 3 students(21.93±4.22) (P＞0.05).The students' relational aggression showed a significantly positive correlation with frequency and intensity of parent-adolescent conflict(r=0.269,r=0.307,r=0.268,r=0.271,P＜0.01),and negative correlation with father-adolescent cohesion(r=-0.171,P＜0.01).Parent-adolescent cohesion was negative predictor of relational aggression(β=-0.123,P＜0.05),and the intensity of parent-adolescent conflict was positive predictor(β=0.301,P＜0.01).Conclusion Parent-adolescent conflict and cohesion have significant effect on relational aggression among junior students.
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BACKGROUND: Many studies have suggested that artificial joint replacement has a greater advantage in the treatment of cases of elderly osteoporosis, comminuted fractures and unable to internal fixation or failure of internal fixation. OBJECTIVE:To analyze the curative effect of cemented artificial femoral head arthroplasty for treatment of elderly unstable intertrochanteric fracture. METHODS: Totaly 18 patients with unstable intertrochanteric fracture, aged>75 years, were enroled and underwent cemented artificial femoral head arthroplasty. At 3 months after replacement, the curative effect was evaluated according to the Harris hip joint function score method. The early complications after replacement and long-term complications of prosthesis were observed by folow-up. RESULTS AND CONCLUSION:Al these 18 patients were folowed up for 13 to 34 months, and had no infections, pressure sores, femoral shaft fractures and other complications. X-ray films showed that the frauture healed wel, without prosthesis infection, dislocation, loosening, sinking and breaking. After 3 months of replacement, al patients returned to pre-injury level of walking function. The curative effect was excelent for eight cases, good for seven cases, fair for two cases, poor for one case. These results demonstrate that cemented artificial femoral head arthroplasty for treatment of elderly unstable intertrochanteric fracture has good biocompatibility and stability, and can restore the limb function of patients.
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Objective To investigate the association of endothelial nitric oxide synthase (eNOS) polymorphisms and avascular necrosis of femoral head (ANFH),to explore possible relationship between the ANFH incidence and 27-bp repeat polymorphism in intron 4 and G894T polymorphism in exon 7.Methods Totally 125 atraumatic ANFH patients and 126 healthy controls without hip trauma history were enrolled.Gene polymorphisms in 27-bp repeat polymorphism in intron 4 and G894T polymorphism in exon 7 were determined.Medical history was collected for etiology analysis.Results In between-group comparison,the frequency of b/a genotype intron 4 in ANFH group was significantly higher than that in healthy control group [19/125 (15.2％) vs 6/126 (4.8％),P =0.0001,OR =4.501],and the result of G/T genotype exon 7 in the ANFH group also indicated a statistical significance with the healthy control group [30/125 (24.0％) vs 17/126 (13.5％),P =0.0094,OR =3.804].In subgroup analysis,genotype b/a and G/T were especially higher in the idiopathic group than that in the healthy control group.Conclusions eNOS gene polymorphisms might be a risk factor of ANFH,there is underlying relevance of eNOS and the disease.Both 27-bp repeat polymorphism in intron 4 and G894T polymorphism in exon 7 are associated with ANFH incidence.
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BACKGROUND:Young patients with cruciate ligament injury and high activity levels are prone to grade III medial colateral ligament injury in knee joint. Conventional construction methods such as direct restoration of injured ligaments and muscle-tendon transposition may induce the loosening of medial colateral ligament complex. OBJECTIVE:To explore the clinical effect of autologous tendon transplantation for grade III medial colateral ligament injury of the knee joint. METHODS: Forty-seven patients with grade III medial colateral ligament rupture were treated by operative repair and reconstruction. After repairing the anatomical structure of medial colateral ligaments, we liberated organic semitendinous tendon, bone-patela tendon-bone, and hamstring tendon, to reconstruct superficial medial colateral ligament. RESULTS AND CONCLUSION:Thirty-seven patients were folowed up for 48 months. Preoperative Lysholm score, IKDC score, Tegner score at the final folow-up, and the widened medial joint space on valgus stress X-Ray films were significantly improved compared with before reconstruction (P < 0.05). According to clinical efficacy scores, 12 cases achieved excelent reconstruction, 18 cases achieved good reconstruction, 4 cases achieved moderate reconstruction, and 3 cases achieved poor reconstruction. The excelent and good rate was 82%. Medial colateral ligament reconstruction based on repairing the anatomical structure is effective and satisfactory. Autologous bone-patela tendon-bone or semitendinous tendon is a good choice for medial colateral ligament reconstruction.
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BACKGROUND:Cam-type femoroacetabular impingement can impose elevated mechanical loading in the hip, and may eventual y result in hip osteoarthritis, while mechanical mechanism on how this deformity leads to osteoarthritis is stil unclear. OBJECTIVE:To analyze intra-articular mechanical environment of Cam-type femoroacetabular impingement in hip joint using three-dimensional finite element method, and to further understand the features of pathological mechanics. METHODThree-dimensional geometry models of normal and Cam-type femoroacetabular impingement joints were constructed using Mimics and Hypermesh software with the CT data of normal hip joint. These hip models were imported into LS-DYNA analysis system, then dynamic loads and motions for standing up and sitting down were applied to al joint models. Intra-articular cartilage contact pressures and stresses were analyzed in normal hip joint and hip joint with Cam-type femoroacetabular impingement. RESULTS AND CONCLUSION:Based on CT data, models of normal hip joint and hip joint with Cam-type femoroacetabular impingement including articular cartilage for three-dimensional finite element analysis were accurately constructed. Peak contact pressures were 4.43 and 4.59 MPa at the anterosuperior region of the acetabular rim during sitting down and standing up. The peaks of Cam-type femoroacetabular impingement hip joint were 14.96 and 14.86 MPa. Peak pressures and stress concentration were found at the anterosuperior area of acetabular rim. High contact pressure at the acetabular cartilage may be the mechanical mechanism of osteoarthritis induced by Cam-type femoroacetabular impingement.
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OBJECTIVE@#To investigate the effect and mechanism of herpes simplex virus type 1 (HSV-1) based vector mediated interlukin-1 receptor antagonist (IL-1Rα) gene for knee osteoarthritis in rabbits.@*METHODS@#HSV-1 vectors containing IL-1Rα genes were constructed and injected into the joint space of the osteoarthritis knee in rabbits for 4 weeks. The rabbits were sacrificed, and the knees were lavaged, dissected and the effect of transgene expression was analyzed. Levels of IL-1Rα and IL-1 expression in the recovered lavage fluids were measured with a cytokine ELISA kit. Cartilage from the lesion areas of medial femoral condyle and synovium were observed with hematoxylin and eosin (cartilage and synovium) and toluidine blue (cartilage). The blank control group was injected pHSV-LacZ vector into rabbit knees.@*RESULTS@#Intra-articular delivery of pHSV-IL-1Rα-LacZ resulted in a significant inhibition of IL-1 level and cartilage degradation compared with those in the blank control group (P<0.05).@*CONCLUSION@#pHSV-LacZ is an ideal vector to mediate intra-articular gene delivery in the rabbit model of osteoarthritis. Continuous intra-articular expression of IL-1Rα can treat knee osteoarthritis by inhibiting IL-1.
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Animals , Female , Male , Rabbits , Arthritis, Experimental , Therapeutics , Gene Transfer Techniques , Genetic Therapy , Methods , Genetic Vectors , Herpesvirus 1, Human , Genetics , Injections, Intra-Articular , Interleukin 1 Receptor Antagonist Protein , Genetics , Osteoarthritis, Knee , TherapeuticsABSTRACT
Objective:To evaluate the effect of age and gender on the femoral morphology to guide prosthesis selection in operation and design. Methods:A total of 500 females and males were collected from the departments of orthopedics and medical radiology, Second Xiangya Hospital, Central South University. Informed consent was obtained from all subjects. All patients underwent anteroposterior position scan of the left or right hip joint using Philips Digital Diagnost DR system. The shooting range included the hip joint and at least 2/3 of the proximal femur. The images were measured with Onis 2.3 software. We measured 13 parametersfromthepatients,includingtheexternalparamtersofthefemur,radius-lengthparameters of femoral medullary cavity, and morphological parameters of the femoral medullary cavity. Results:Compared with Westeners, the offset was smaller, while the neck shaft angle was signiifcantly larger in Chinese population (P0.05). The main differences between 31 and 70 years old were the diameter of femoral head, the offset of isthmus, the medullary cavity diameter and extracortical width at isthmus level and the medullary cavity diameter at the level of the lesser trochanter (P<0.05). The modullary transverse diameter at 20 mm below the lesser trochanter and isthmus and extracortical width of isthmus in the male and female group was positively correlated with age (P<0.01), while the parameters of the proximal femoral canal morphology in the female group were negatively correlated with age. The female canal parameters had a stronger correlation. Conclusion:Chinese proximal femoral parameters are signiifcantly different from Westerners. When people, especially females, get older, the medullary cavity diameter of the isthmus and proximal femur becomes wider and the morphology of the femur becomes straight. The difference in the femoral morphology between the male and female decline with the age. There is almost no difference for the over 70 years old. For the 31-70 years old, The male femoral cavity diameter is larger and the position of isthmus is lower than in the females.
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Intra-articular synovial lipoma is an unusual tumorous pathologically benign condition and only a small number of case reports have been published to date. This manuscript describes the case of a 19-year-old adolescent who presented with right knee pain and loss of movement caused by an intra-articular synovial lipoma of the knee joint. A MRI scan revealed an intra-articular soft tissue neoplasm within the lateral compartment of the joint. Arthroscopy confirmed an encapsulated neoplasm that arose from the intra-patellar fat pad, and extended to the lateral compartment and trochlear groove. Additionally, histological analysis revealed synovial lipoma
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Objective To investigate the mechanisms regarding protection of doxycycline from articular cartilage cataplasis in osteoarthritis,and provide experimental evidence for prevention and cure of degenerative osteoarthropathy and for treatment of osteoarthritis.Methods (Ⅰ) Models:Sixteen New Zealand rabbits underwent right anterior cruciate ligament riesction,and fed in each cage.The animals were injected with penicillin 400 thousands IU once a day for 3 days to prevent from infection.On the fourth day after operation,the animals were compelled to use their operated knee by driving 60 minutes per day for 4 weeks.(2) Animal groups:the animals were divided into two groups.The animals in experimental group were injected into the knees with 1.33％ doxycycline 0.3 ml (total 0.4 mg),once a day for 4 weeks.Rabbits in the control group were treated under the same condition using normal saline 0.3 ml.All rabbits were fed in their own cage and not drove.The total time was 4 weeks.(3)Example collection and data analysis:Rabbits were sacrificed by aeroembolism and their knee joints were examined by gross morphology.The mRNA expressions of MMP-3 and TIMP-1 in the cartilage and synovium were analyzed by a reverse transcription polymerase chain reaction ( RT - PCR).Results For the experimental group,condyles of femur cartilage inspection revealed that 6 cases were in Grade 0 and 2 cases were in Grade 1,and whirbone cartilage inspection showed that 5 cases were in Grade 0 and 3 cases were in Grade 1.For the control group,2 cases were in Grade 0 and 6 cases were in Grade 1.The extent of articular cartilage cataplasis was significantly different mRNA expression of MMP-3 ( 1.20 ± 0.32) (experimental) and ( 1.97 ± 0.54) (compared) ( t =3.47,P＜ 0.05).The expression of MMP-3 mRNA in cartilage and synovium was significantly decreased,respectively; while the expression of TIMP-1 mRNA was significantly increased in the experimental group(3.22 ±0.42) compared to the control group( 1.90 ±0.33) ( t =6.99,P ＜ 0.01 ).Conclusions Intra-articular injections of doxycycline inhibits the articular cartilage and synovial MMP-3 mRNA expression and increases TIMP-1 mRNA expression,thereby reducing the extent of degeneration of articular cartilage.
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OBJECTIVE@#To investigate the effect of C23 down-regulation on proliferation inhibition and apoptosis induced by cisplatin in human osteosarcoma SaOS-2 cells.@*METHODS@#SaOS-2 cells were randomly divided in to 5 groups: a control group, a DDP group, an S+DDP group, an AS+DDP group, and an R+DDP group. Cell growth suppression of each group was analyzed by MTT assay. RT-PCR and Western blot were used to detect the expression of C23, Bcl-2 and Bax mRNA and protein in each group. Morphologic character of apoptosis was evaluated by DAPI staining. The percentage of apoptotic cells was analyzed by flowcytometer assay.@*RESULTS@#C23 antisense oligonucleotides remarkably inhibited the expression of C23 mRNA and protein in SaOS-2 cells (P<0.01). The proliferation of SaOS-2 cells was remarkably inhibited in the AS+DDP group compared with the DDP group (P<0.01). The expression of C23, Bcl-2 mRNA and protein was weaker and that of Bax mRNA and protein was stronger in the AS+DDP group compared with the DDP group (P<0.01). Cisplatin-mediated apoptosis neclei in SaOS-2 cells and the rate of apoptotic cells were higher in the AS+DDP group than those of the DDP group (P<0.01).@*CONCLUSION@#Down-regulation of C23 can contribute to cisplatin-mediated proliferation inhibition and apoptosis in SaOS-2 cells.
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Humans , Antineoplastic Agents , Pharmacology , Apoptosis , Bone Neoplasms , Metabolism , Pathology , Cell Line, Tumor , Cell Proliferation , Cisplatin , Pharmacology , Down-Regulation , Osteosarcoma , Metabolism , Pathology , Phosphoproteins , Metabolism , RNA-Binding Proteins , MetabolismABSTRACT
ObjectiveTo investigate the expression levels of vascular endothelial growth factor (VEGF)in knee synovial membranes and synovial fluids whether it could be a marker for progressive osteoarthritis.MethodsKnee synovial membranes and synovial fluids of patients with osteoarthritis who were underwent total knee arthroplaaty or arthroscopy were collected. They were classified into four groups according to the radiographic grading[Kellegren-Lawrence(K-L) grade]. Appoint K-L-0-grade patients who suffered from menisci injuries only served as controls. The levels of VEGF in the synovial fluid were measured by enzymelinked immunosorbent assay(ELISA) and VEGF-secreting cells were identified by immunohistochemistry.ANOVA was used for statistical analysis. ResultsVarious degrees of inflammation could be found in all the samplesevaluated histologically on HE-stained sections. Synovial tissue inflammation presented as synovial lining thickening, and inflammatory cells infiltration. VEGF expressed in the synovium linings and surrounding blood vessels. The VEGF levels in the synovial fluids were increased accordingly with K-L grades, which reached the peak level in the late stage of osteoarthritis. The levels of VEGF in the synovial fluids were significantly higher in patients with osteoarthritis[from (1181±116), (1632±140) to (2252±216) pg/ml]than in those with menisci injury (P＜0.01); The percent ages positive cell in each groups were (5±4)％ , (9±4)％,(16±6)％ and (21±6)％ respectively, there were significantly differences too (P＜0.01). ConclusionVEGF originated from synovial tissue may play a role in the pathogenesis of osteoarthritis. High levels of VEGF in the synovial fluids can be regarded as the marker of active osteoarthritis.
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Objective To establish a 3-dimensional (3-D) finite element knee model in healthy Chinese males, to verify the validity of the model, and to analyze the biomechanics of this model under axial load, flexion moment, varus/valgus torque, and internal/external axial torque. Methods A set of consecutive transectional computerized tomography images of normal male knee joints in upright weight-bearing position was selected. With image processing and inversion technology, the 3-D finite element model of the normal knee joint was established through the software ABAQOUS/STANDARD Version-6.5.Biomechanical analysis of this model was processed under axial load, flexion moment, varus/valgus torque, and internal/external axial torque.Results A 3-D finite element model of healthy Chinese males was successfully established. The ranges of motion of varus and valgus were both small and the difference between them has no statistical significance (P>0.05). The motion of internal and external rotation of the knee took place only in flexion situation.The range of motion of external rotation was larger than that of internal rotation in the same knee (P<0.05).Conclusion The 3-D geometrical model of the knee resembles the actual knee segments. It can immitate the knee response to different loads. This model could be used for further study on knee biomechanics.
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OBJECTIVE@#To explore the clinical effect of particulate bone grafting on reconstruction of femoral defects in revision total hip arthroplasty.@*METHODS@#Fifteen patients (20 hips) with femoral defects were treated by revision total hips arthroplasty with particulate bone grafting. After the operations, 14 patients (19 hips) were evaluated by X-rays and the Harris score.@*RESULTS@#During a follow-up of 43.6 months (11 approximately 65 months), 17 hips (89.5%) were cured, without obvious bone absorption or prosthesis sinking. Harris scores improved from 34.18 pre-operation to 86.6 post-operation.@*CONCLUSION@#Reconstruction of femoral defects with particulate bone grafting is an effective method for bone defects in revision total hip arthroplasty.
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Aged , Female , Humans , Male , Middle Aged , Acetabulum , Pathology , General Surgery , Arthroplasty, Replacement, Hip , Methods , Bone Cements , Bone Substitutes , Bone Transplantation , Methods , Femur , Pathology , General SurgeryABSTRACT
OBJECTIVE: To explore the clinical results of rotating hinged knee systems in the treatment of complex knee diseases. METHODS: A total of 18 patients (11 males and 7 females, aged 58.7 years, ranging 34-66 years) with complex knee diseases were selected from Second Xiangya Hospital of Central South University, who underwent 20 primary knee arthroplasties (11 left and 9 right knees) using rotating hinged prosthesis from June 2003 to May 2008. These cases included 8 rheumatoid arthritis and 10 osteoarthritis, and presented 20?-30? varus or valgus deformity or 25?-40? fixed flexion deformity. Two patients underwent bilateral knee arthroplasty. Preoperatively bone loss and deformities in all cases was evaluated by AORI and X-ray. Postoperatively the clinical results were evaluated by the HSS knee rating score system. RESULTS: Knee arthroplasty was performed in all patients successfully and unilateral operative time was 95-147 minutes (average 129 minutes). The patients were followed up form 11 months to 6 years (average 4.2 years). All the knee pain was released and the deformities were corrected. The range of joint movements was up to 100?-136?. The patients could walk without assistance of walking stick. No light or deep infection, prosthesis subsidence, dislocation or fracture resorption was found. The average HSS score was 86 (78-95 scores) post-operation while 42 (25-56 scores) pre-operation. Excellent results were received in 11 cases, good in 6 cases. The rate of excellent or good was 94%. CONCLUSION: The knee arthroplasty using rotating hinged knee systems is an effective method to treat complex knee diseases such as severe extroversion or varus. It can release the knee pain and improve joint function and the quality of life.