ABSTRACT
Irreparable rotator cuff tear can result in pain and should disfunction, and the management of patient with it remains a challenge. A variety of treatment options have been proposed, such as debridement, tuberplasty, partial rotator cuff repair, patch augmented rotator cuff repair, tendon transfers, superior capsule reconstruction, suprascapular nerve ablation or kill, inpace and reverse shoulder arthroplasty. These procedures are still widely debated, The aim of this review is to summarise procedures and the results, the operative essence is to restore the stable rotation center of glenohumeral joint, the choice is dictated by our special need.
ABSTRACT
Irreparable rotator cuff tear can result in pain and should disfunction,and the management of patient with it remains a challenge.A variety of treatment options have been proposed,such as debridement,tuberplasty,partial rotator cuff repair,patch augmented rotator cuff repair,tendon transfers,superior capsule reconstruction,suprascapular nerve ablation or kill,inpace and reverse shoulder arthroplasty.These procedures are still widely debated,The aim of this review is to summarise procedures and the results,the operative essence is to restore the stable rotation center of glenohumeral joint,the choice is dictated by our special need.
ABSTRACT
Objective To investigate the clinical effects of arthroscopic patelloplasty combined with lateral patellar retinaculum release and circumpatellar denervation for treatment of moderate and severe patellofemoral osteoarthritis.Methods A retrospective case-control study was done on 80 patients with moderate to severe patellofemoral osteoarthritis who were treated in our hospital between March 2013 and March 2015.According to treatment methods,the patients were divided into two groups:Group A including 40 cases (22 cases of Outerbridge grade Ⅲ degree and 18 cases of Outerbridge grade Ⅳ) undergone arthroscopic debridement,and Group B including 40 cases (22 cases of Outerbridge grade Ⅲ degree and 18 cases of Outerbridge grade Ⅳ) undergone arthroscopic patelloplasty combined with lateral patellar retinaculum release and circumpatellar denervation.The Kujula scores and Lysholm scores of the patellofemoral joint were compared between the two groups before and after operation.The lateral patellofemoral angle was measured according to patellar axial X-ray performed 3 months after operation to evaluate patellofemoral joint function.Results All patients were followed up for 13-36 months (average 19.8 months).The patellofemoral joint scores of the two groups was increased at different degrees after operation.In moderate patellofemoral osteoarthritis patients,at 3 months after operation and the last follow-up of Group B,Kujula scores [(85.1 ± 6.8)points,(86.8 ± 4.6)points] and Lysholm scores [(88.1 ± 1.8) points,(88.4 ± 2.3) points] were higher than that of Group A [(78.1 ± 5.7) points,(78.3±5.3)points,(82.4 ±2.9)points,and (82.5 ±2.5)points] (P＜0.05).In each group,the Kujula scores and Lysholm scores at 3 months after operation and the last follow-up were improved to be higher than preoperation (P ＜ 0.05),with insignificant statistical difference between the two groups (P ＞ 0.05).According to the Lysholm scores,the excellent rate after operation in Group B (86％) was higher than that of Group A (55％) (P ＜ 0.05).For patients with severe patellofemoral osteoarthritis,Kujula scores [(72.3 ± 5.3) points,(72.7 ± 3.6) points] and Lysholm scores [(75.1 ± 1.9) points,(75.3 ± 2.3) points] at 3 months postoperatively and at the last follow-up in Group B were higher than that of Group A [(70.8 ± 5.2) points,(71.1 ± 4.2) points,(73.4 ± 2.8) points,and (73.6 ± 2.5) points],but the difference was not statistically significant (P ＞ 0.05).Within each group,although the Kujula scores and Lysholm scores at 3 months postoperatively and at the last follow-up were improved compared with before operation,but the difference was not statistically significant (P ＞ 0.05).According to the Lysholm scores,although the excellent rate after operation of Group B (33％) was higher than that of Group A (28％),with insignificant statistical difference (P ＞ 0.05).No matter Outerbridge Ⅲ or Ⅳ patellofemoral osteoarthritis a patient was,the lateral patellofemoral angle of Group A after operation had no significant improvement (P ＞ 0.05),while Group B showed significant improvement after operation (P ＜0.01).Group B had better improvements than that of Group A (P ＜0.01).Conclusions Compared with simple arthroscopic debridement,patelloplasty combined with lateral patellar retinaculum release and circumpatellar denervation can better relieve the symptoms of moderate patellofemoral osteoarthritis and improve knee function.But for patients with severe patellofemoral osteoarthritis,this method is not effective.
ABSTRACT
Objective To explore the treatment characteristics and effect of hip fracture in aged patients. Methods A retrospective analysis was performed in 143 elderly patients with hip fracture, aged 75 years and over. 28 cases received non-surgery treatment and 115 cases received surgery treatment. Much of them had at least one chronic disease. The complications, preoperative preparation, operative indications, internal fixation devices, postoperative management, mortality rate and recovery rate were reviewed. Results The mortality rate of nonoperative management patients was 39.3% (11/28) in one year, and that of operative management patient was 8.7% (10/115). The recovery rate of nonoperative management patients was 28.5% (8/28) in one year, and that of operative management patients was 75.3% (79/115). Conclusions If full attention is paid to preoperative treatments, hip fracture of aged patients treated by operation is safe and effective.