Comparison of the efficacy between elastic intramedullary injection and autologous bone marrow blood injection in the treatment of bone cyst in children / 中国骨伤

OBJECTIVE@#To evaluate the efficacy of autogenous bone marrow injection and elastic intramedullary injection in the treatment of bone cyst in children.@*METHODS@#From January 2012 to December 2016, 56 children with simple bone cyst were divided into two groups: autogenous bone marrow blood injection group and elastic intramedullary needle group. There were 28 cases in the autogenous bone marrow blood injection group, 16 boys and 12 girls, aged (7.7±1.9) years old, 10 cases of proximal humerus, 8 cases of proximal femur, 6 cases of proximal tibia and 4 cases of femoral shaft. In the elastic intramedullary needle group, there were 28 cases, 18 boys and 10 girls, aged(7.5±2.2) years old, 11 cases of proximal humerus, 7 cases of proximal femur, 5 cases of proximal tibia, 4 cases of femoral shaft and 1 case of distal femur. The treatment effect was evaluated by Capanna standard.@*RESULTS@#All the patients were followed up, including 17 to 35(25.6±4.2) months in the elastic intramedullary needle group and 19 to 35(27.4±4.8) months in the autogenous marrow blood injection group. According to Capanna's evaluation standard of bone cyst, 27 patients in the elastic intramedullary needle group were treated effectively(25 patients cured, 2 patients healed but some remained lesions), 1 patients recurred, 0 patient had no response to treatment; 18 patients in the autogenous bone marrow blood injection group were treated effectively(13 patients cured, 5 patients healed but some remained lesions), 8 patients of cyst recurred, 2 patients had no response to treatment; the difference between the two groups was statistically significant(<0.01). The overall cure time was calculated by the follow-up of 25 cases in the elastic intramedullary injection group and 13 cases in the autogenous marrow blood injection group. The cure time was(20.2±3.5) months in the elastic intramedullary injection group and(27.7±4.9) months in the autogenous marrow blood injection group. The difference was statistically significant(<0.05).@*CONCLUSIONS@#For the treatment of bone cyst in children, the therapeutic effect of elastic intramedullary needle is better than that of autogenous bone marrow blood injection, and the cure time is shorter.

Clinical results of arthroscopic suture for meniscal tear in middle aged adults / 中国骨伤

<p><b>OBJECTIVE</b>To study the characteristics and clinical effect of total hip arthroplasty(THA) for osteoarthritis and (or) avascular necrosis of femoral head after failure of internal fixation of acetabular fracture.</p><p><b>METHODS</b>From February 2009 to October 2014, 31 patients (31 hips) with hip traumatic osteoarthritis and (or) femoral head avascular necrosis after failure of internal fixation of acetabular fracture were treated with THA including 26 males and 5 females, who injured when the average age of(41±12) years. THA were performed, and the duration ranged from 3 to 132 months with a mean of(20.6±26.9) months secondary to traumatic osteoarthritis and(or) femoral head avascular necrosis. All THA were performed with posterior-lateral approach. The postoperative complications were observed. VAS and Harris hip scores were compared pre-operation and post-operation.</p><p><b>RESULTS</b>Twenty-seven cases were followed up, and the duration ranged from 12 to 80 months with a mean of (43.2±11.7) months. One patient had infection around prosthesis. Aseptic loosening occurred in 1 patient, dislocation of prosthesis in 1 patient. No sciatic nerve injury occurred. Hip function and gaits were obviously improved. To the last follow-up, VAS score was decreased from 7.6±1.2 pre-operatively to 1.2±0.9 post-operatively, while the Harris score was improved from 45.5±13.6 pre-operatively to 88.5±7.8 post-operatively, both differences were statistically significant(<0.01). The post-operative ROM of hip was significantly improved compared to pre-operative ROM(<0.05), in addition to extension motion. X-ray showed all the acetabular cups were stable, one femur stem subsided 3 mm. Heterotopic ossification occurred in 2 cases.</p><p><b>CONCLUSIONS</b>Correct dealing with of internal fixation implants, looking out potential infection and reasonable reconstruction of acetabular bone deficiency were the key to the success of THA for osteoarthritis and(or) avascular necrosis of femoral head after failure of internal fixation of acetabular fracture.</p>

Case control study on the biodegradable barbed sutures in total knee arthroplasty / 中国骨伤

<p><b>OBJECTIVE</b>To compare with the clinical outcomes of barbed sutures and routine sutures in total knee arthroplasty.</p><p><b>METHODS</b>From September 2013 to June 2014, total 116 patients with knee osteoarthritis (OA) who underwent primary unilateral total knee arthroplasty (TKA) were enrolled in the series. There were 68 patients in the test group (T), including 58 females and 10 males, with an average age of (65.26±8.50) years old. There were 48 patients in the control group (C), including 41 females and 7 males, with an average age of (64.43±10.08) years old. Absorbable barbed sutures were selected in test group for capsule continuous closure, while coated absorbable VICRYL Plus Sutures were used in control group for continuous hemstick closure. Coated VICRYL Plus Sutures and skin stapler were selected for subcutaneous and skin closures respectively in both groups. Closure time, wound associated complications and postoperative hospital stay as well as special events were recorded, compared and analyzed.</p><p><b>RESULTS</b>The mean closure time in test group was shorter, which were(21.65±4.11) minutes (ranged, 15 to 32 minutes), comparing with (31.83±4.55) minutes in control group (ranged, 22 to 45 minutes), with a significant difference(=0.000). No significant differences were found in wound associated complications (²=1.451,=0.161) or mean postoperative hospital stay (T:5.68±1.36, C:5.46±1.29,=0.407). However, ratio of complications was higher in test group (21/68 versus 10/48), and the most commom complication was continuous effusion.</p><p><b>CONCLUSIONS</b>Barbed suture can significantly shorten the closure time, but leads to a higher incidence of wound complications, therefore the method requires more professional technique and more cautious postoperative observation.</p>

Effects of β-catenin on differentially expressed genes in multiple myeloma / 华中科技大学学报（医学）（英德文版）

This study aimed to identify the differentially expressed genes after silencing of β-catenin in multiple myeloma transduced with β-catenin shRNA. The DNA microarray dataset GSE17385 was downloaded from Gene Expression Omnibus, including 3 samples of MM1.S (human multiple myeloma cell lines) cells transduced with control shRNA and 3 samples of MM1.S cells transduced with β-catenin shRNA. Then the differentially expressed genes (DEGs) were screened by using Limma. Their underlying functions were analyzed by employing Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses. Moreover, DEGs annotation was conducted based on the databases of tumor associated genes, tumor suppressed genes and the transcriptional regulation from patterns to profiles. Furthermore, the protein-protein interaction (PPI) relationship was obtained from STRING and the protein-protein interaction network and the functional modules were visualized by Cytoscape. Then, the pathway enrichment for the DEGs in the functional module was performed. A total of 301 DEGs, including 124 up-regulated and 117 down-regulated DEGs, were screened. Functional enrichment showed that CCNB1 and CDK1 were significantly related to the function of cell proliferation. FOS and JUN were related to innate immune response-activating signal transduction. Pathway enrichment analysis indicated that CCNB1 and CDK1 were most significantly enriched in the pathway of cell cycle. Besides, FOS and JUN were significantly enriched in the Toll-like receptor signaling pathway. FOXM1 was identified as a transcription factor. Moreover, there existed interactions among CCNB1, FOXM1 and CDK1 in PPI network. The expression of FOS, JUN, CCNB1, FOXM1 and CDK1 may be affected by β-catenin in multiple myeloma.

Application of modular cementless femoral stems in complex revision hip arthroplasty / 中国骨伤

<p><b>OBJECTIVE</b>To investigate and clarify the key surgical techniques and evaluate clinical effectiveness of modular cementless femoral stems(LINK MP modular stem) in complex revision hip arthroplasty.</p><p><b>METHODS</b>From January 2002 to December 2013, 470 patients in Chinese PLA General Hospital received revision hip arthroplasties using MP stems. Among them, 246 patients were followed for an average of 5.7 years (ranged, 0.5 to 11 years). There were 148 males and 98 females, with an average age of 62.5 years old (ranged from 26 to 83 years old). The most common reason for revision was aseptic loosening of femoral stems (107 cases, 43.5%), followed by prosthetic joint infection (104 cases, 42.3%). Other reasons included unexplained hip or thigh pain, periprosthetic femoral fracture, prosthesis wear and dislocation. According to Paprosky classification of femoral deficiency, there were 171 cases of type IIIA (69.5%), 14 cases of type I, 39 cases of type II, and 22 cases of type IIIB. The average preoperative Harris hip score (HHS) was 37.4 ± 7.5. In addition, radiographic presentation, degree of patients' subjective satisfaction, and clinical effectiveness were assessed as well.</p><p><b>RESULTS</b>The average Harris score was im- proved to 87.8 ± 4.2 after operation,with significant statistical difference when compared to preoperative score (t = 92.13,P = 0.00). Analysis of patients' subjective satisfaction for leg length discrepancy, stability and overall degree of satisfaction showed that the number of patients with great satisfaction were 27, 60, 61 respectively. The most common complication was the periprosthetic fracture (intraoperatively 21 cases and postoperatively 8 cases). Other complications included infection (7 cases), dislocation (5 cases), numbness possibly caused by incomplete sciatic nerve injury (6 cases) and thigh swelling (3 cases). The X-ray taken at the final follow-up revealed that prosthesis subsidence occurred in 4 cases, 2 of which needed a second revision.</p><p><b>CONCLUSION</b>The application of modular cementless femoral stems (LINK MP modular stem) in complex revision hip arthroplasty (especially in cases with the serious defect of proximal femoral bone) shows good results at both the short-term and long-term follow-up, especially in the revision for prosthetic infection with the high success rate. In order to avoid complications and improve clinical outcomes,the surgeons should carefully select proper surgery candidates,perform the procedure with care, and master the key surgical techniques.</p>

Case-control study on earlier medial tibial pain after total knee arthroplasty / 中国骨伤

<p><b>OBJECTIVE</b>To compare the difference of anterior knee pain after total knee arthroplasty (TKA) between the ways using periosteal dissector and electric scalpel to release medial collateral ligament and pes anserinus.</p><p><b>METHODS</b>From September 2009 to September 2012, 220 patients with unilateral osteoarthritis were treated with primary TKA in hospital 301. All the patients were randomly divided into periosteal dissector group (110 cases) or electric scalpel group (110 cases). In the periosteal dissector group, there were 47 males and 63 females,with an average age of (58.8 +/- 17.2) years old; the degree of genuavarus was (14.0 +/- 3.5) degrees; the weight was (65.6 +/- 12.8) kg; the body mass index (BMI) was (26.6 +/- 3.6) kg/m2. In the electric scalpel group,there were 49 males and 61 females,with an average age of (59.6 +/- 16.7) years old;the degree of genuavarus was (15.0 +/- 4.7) degrees; the weight was (66.4 +/- 13.4) kg; the BMI was (27.4 +/- 4.1) kg/m2. The mean follow-up period was 24.6 months. The AKS, VAS and HSS were used to evaluate clinical results.</p><p><b>RESULTS</b>All incisions healed at the first stage;no deep vein thrombosis of lower limbs or pulmonary embolism occurred. Knee infection occurred in 3 cases (1 in the periosteal dissector group and 2 in the electric scalpel group), and the 3 patients received stage 2 total knee revision using antibiotic bone cement and TC3 prosthesis. No recurrence of infection occurred during follow-up. Among the 20 patients who had anterior knee pain, 16 patients were in the periosteal dissector group and 4 patients were in the electric scalpel group. The occurrence rate of anterior knee pain in the electric scalpel group was lower than that in the periosteal dissector group. The AKS knee score and HSS score after total knee arthroplasty in the electric scalpel group were all higher than those in the periosteal dissector group, and the VAS in electric scalpel group was lower than that of periosteal dossector group.</p><p><b>CONCLUSION</b>Compared with using electric scalpel,using periosteal dissector used to release medial collateral ligament and pes anserinus may cause more anterior knee pain after total knee arthroplasty.</p>

Management of severe femoral bone defect in revision total hip arthroplasty--a 236 hip, 6-14-year follow-up study / 华中科技大学学报（医学）（英德文版）

This study evaluated the clinical effect of impaction bone graft and distal press-fit fixation for the reconstruction of severe femoral bone defect in revision total hip arthroplasty. A total of 234 patients (involving 236 hips) with Paprosky III and IV femoral bone defects were treated with the revision total hip arthroplasty from June 1998 to Aug. 2006. Impaction bone graft technique was used for 112 hips, with allogeneic freeze-dried bone as bone graft and SPII as prosthesis. With 124 hips, modular distal press-fit fixation and tapered femoral stem (MP stem) were employed. After the operation, the subjects were followed up on regular basis and results were assessed by using the Harris Hip Score (HHS) and 12-item Short Form Health Survey (SF-12). Radiolucence, subsidence and loosening were observed and complications, including infection, fracture, dislocation etc. were recorded. A 6-14-year follow-up showed that prostheses failed, due to infection, in 4 patients of impaction bone graft group and that 6 patients in the press-fit fixation group experienced prosthesis failure, with the survival rates for the two techniques being 96.43% and 95.16%, respectively. One-way ANOVA showed that prosthesis survival was significantly associated with surgery-related complications (P<0.05) and was not related to the type of the bone defects (P>0.05). The rate of complications bore significant association with the type of bone defects in the two groups (P<0.05). Our study showed that the two revision methods could achieve satisfactory mid-term and long-term results for the reconstruction of severe bone defects. It is of great significance for attaining high prosthesis survival rate to select suitable operation on the basis of the type of bone defect. Careful operative manipulation and post-operative rehabilitation aimed at reducing complications are also important.

Computer-aided design and custom-made guide in corrective osteotomy for complex femoral deformity / 华中科技大学学报（医学）（英德文版）

Preoperative planning of corrective osteotomy with traditional radiography has limitations in regards to determining the ideal osteotomy location and orientation in three-dimensional femoral deformities. Though a successful operation can be planned preoperatively, intraoperative contingencies might adhere to the procedural plan in the performance of operation. To efficiently perform a planned procedure, proposed is a design to implement three-dimensional reconstruction photography, based on computer-tomography (CT) scan. A custom-made guide was designed to navigate the osteotomy as planned, and additionally, a personalized intramedullary nail was used for fixation after osteotomy. Three-dimensional (3D) photography of deformed femur was established based on the CT dataset and transferred into 3D photography processing software for further planning. Osteotomy planes were designed and adjusted at deformity sites to correct the 3D deformities. The methodology of a custom-made osteotomy guide was introduced in femoral corrective osteotomy, for the first time, to navigate the operation as planned. After the virtual osteotomy and reduction of bone segments, the parameters of a custom-made intramedullary nail were measured for manufacturing. Findings Virtual operation in computer shows complete correction of the 3D deformity. The osteotomy guide, obtained by rapid-prototyping techniques, navigates mimicking surgery on rapid-prototyping model of the involved femur as planned. Internal fixation was achieved using the custom-made intramedullary nail. Interpretation three-dimensional visualization introduces an advantage in preoperative planning for corrective osteotomy of 3D femoral deformity, and the custom-made osteotomy guide is crucial to realize such a deliberate plan during the actual procedures. The internal fixator, such as an intramedullary nail, can be modified or personalized for fixation in unique cases.

Management of severe femoral bone defect in revision total hip arthroplasty-A 236 hip, 6-14-year follow-up study / 华中科技大学学报（医学）（英德文版）

This study evaluated the clinical effect of impaction bone graft and distal press-fit fixation for the reconstruction of severe femoral bone defect in revision total hip arthroplasty. A total of 234 patients (involving 236 hips) with Paprosky III and IV femoral bone defects were treated with the revision total hip arthroplasty from June 1998 to Aug. 2006. Impaction bone graft technique was used for 112 hips, with allogeneic freeze-dried bone as bone graft and SPII as prosthesis. With 124 hips, modular distal press-fit fixation and tapered femoral stem (MP stem) were employed. After the operation, the subjects were followed up on regular basis and results were assessed by using the Harris Hip Score (HHS) and 12-item Short Form Health Survey (SF-12). Radiolucence, subsidence and loosening were observed and complications, including infection, fracture, dislocation etc. were recorded. A 6-14-year follow-up showed that prostheses failed, due to infection, in 4 patients of impaction bone graft group and that 6 patients in the press-fit fixation group experienced prosthesis failure, with the survival rates for the two techniques being 96.43% and 95.16%, respectively. One-way ANOVA showed that prosthesis survival was significantly associated with surgery-related complications (P0.05). The rate of complications bore significant association with the type of bone defects in the two groups (P<0.05). Our study showed that the two revision methods could achieve satisfactory mid-term and long-term results for the reconstruction of severe bone defects. It is of great significance for attaining high prosthesis survival rate to select suitable operation on the basis of the type of bone defect. Careful operative manipulation and post-operative rehabilitation aimed at reducing complications are also important.

Treatment of infected total knee arthroplasty with a self-made, antibiotic-loaded cement articulating spacer / 中国骨伤

<p><b>OBJECTIVE</b>To study the efficacy of self-made, antibiotic-loaded cement articulating spacer in the treatment of infected total knee arthroplasty.</p><p><b>METHODS</b>The self-made molds were used to form the spacer during the operation. From March 2002 to March 2007, 22 patients with infected knee arthroplasty (10 males with 10 knees, 12 females with 12 knees) were treated with this kind of spacer in our center. The mean age of the patients was 59.6 years old (33 to 75 years old). The interval time between primary arthroplasty and first onset of infective syndrome was 6.7 months (1 to 14 months). The diagnosis was established by the clinical presentation,serum laboratory inflammatory markers (white blood cell count,erythrocyte sedimentation rate and C-reactive protein) and knee aspiration. The serum laboratory inflammatory markers were used to measure the systemic response to infection. Clinical and radiographic follow-up was regularly performed by HSS score system and X-ray.</p><p><b>RESULTS</b>All the patients were followed, the average interval between debridement and reimplantation was 4.7 months (3 to 9 months) and the infection control rate was 100% after the implantation of spacer. The average follow-up duration after reimplantation was 29.8 months (10 to 64 months) and there was no recurrence of infection at the latest follow-up. The HSS score increased from 40.5+/-5.9 to 65.8+/-7.5 after the implantation of spacer, furthermore, the score reached 88.7+/-5.1 in average at the latest follow-up. The patient satisfaction rate was 95.3%.</p><p><b>CONCLUSION</b>This self-made molds and spacers is a reliable approach for the management of infected knee arthroplasty with some virtues, such as providing a mobile and functional joint through the treatment course, decreasing the difficulty of reimplantation, avoiding of a long-term post-operative infusion and high effective for eradicating infection.</p>

Computer-aided design and custom-made guide in corrective osteotomy for complex femoral deformity / 华中科技大学学报（医学）（英德文版）

Preoperative planning of corrective osteotomy with traditional radiography has limitations in regards to determining the ideal osteotomy location and orientation in three-dimensional femoral deformities. Though a successful operation can be planned preoperatively, intraoperative contingencies might adhere to the procedural plan in the performance of operation. To efficiently perform a planned procedure, proposed is a design to implement three-dimensional reconstruction photography, based on computer-tomography (CT) scan. A custom-made guide was designed to navigate the osteotomy as planned, and additionally, a personalized intramedullary nail was used for fixation after osteotomy. Three-dimensional (3D) photography of deformed femur was established based on the CT dataset and transferred into 3D photography processing software for further planning. Osteotomy planes were designed and adjusted at deformity sites to correct the 3D deformities. The methodology of a custom-made osteotomy guide was introduced in femoral corrective osteotomy, for the first time, to navigate the operation as planned. After the virtual osteotomy and reduction of bone segments, the parameters of a custom-made intramedullary nail were measured for manufacturing. Findings Virtual operation in computer shows complete correction of the 3D deformity. The osteotomy guide, obtained by rapid-prototyping techniques, navigates mimicking surgery on rapid-prototyping model of the involved femur as planned. Internal fixation was achieved using the custom-made intramedullary nail. Interpretation three-dimensional visualization introduces an advantage in preoperative planning for corrective osteotomy of 3D femoral deformity, and the custom-made osteotomy guide is crucial to realize such a deliberate plan during the actual procedures. The internal fixator, such as an intramedullary nail, can be modified or personalized for fixation in unique cases.

The role of large femoral head components in revision of total hip arthroplasty / 中华外科杂志

<p><b>OBJECTIVE</b>To study the efficiency of decreasing instability of large femoral head components in revision total hip arthroplasty (THA).</p><p><b>METHODS</b>From August 2005 to December 2010, 107 patients (112 hips) with 28 mm femoral head components (28 mm group) and 46 patients (46 hips) with 36 mm femoral head components (36 mm group) in revision THA were analyzed retrospectively in order to find if the dislocation rate and Harris hip score were different between the two groups at the time of last follow-up. All the operations were performed by the first author. There were 81 male patients (85 hips) and 26 female patients (27 hips) in 28 mm group with mean age of (62±17) years (26-79 years) and 33 male patients (33 hips) and 13 female patients (13 hips) in 36 mm group with mean age of (60±16) years (31-77 years).</p><p><b>RESULTS</b>The mean follow-up period was 43.3 months (33-71 months) for 28 mm group and 26.7 months (12-37 months) for 36 mm group. There were 7 patients dislocated after revision in 28 mm group, including 2 revised with reinforcement rings (with dislocation rate 9.5%), 3 revised with impaction bone grafting technique (with dislocation rate 8.3%) and 2 revised with cementless cups (with a dislocation rate 3.6%). The dislocation rate of this group was 6.2%. While the dislocation rate of 36 mm group was 2.2%, the only dislocated patient was because of loss of gluteus medius muscle function in the index operation. If this case was excluded, the dislocation rate of 36 mm group would be 0. There was significant difference between the two groups (χ2=103.0095, P<0.01). The Harris hip score was 88±11 for 28 mm group and 89±9 for 36 mm group, there was no significant difference between the two groups (P>0.05).</p><p><b>CONCLUSION</b>The large femoral head components can significantly decrease the instability after revision THA, which should be used in revision THA.</p>

Antibiotic-loaded cement articulating spacer made by a self-made mold system in the treatment of the infected hip replacement / 中华外科杂志

<p><b>OBJECTIVES</b>To summarize the experience and lessons of the using of antibiotic-loaded cement articulating spacer made by a self-made mold system for the treatment of the infected hip replacement, and to evaluate its efficiency and role in the two-stage revision of infected total hip arthroplasty (THA).</p><p><b>METHODS</b>The patients with infected THA treated with two-stage revision protocol from August 2005 to December 2009 were reviewed. All of the 127 patients were debridement thoroughly and followed by implantation of an antibiotic-loaded cement articulated spacer made by a self-made mold system; Two-stage revisions were not followed until the infection were controlled. Among of them, 106 patients, 107 hips were gotten fully followed up. Evaluations were made for the efficiency of infection control, convenience of making, implanting and removing of the spacers, occurrence of complications, the deal of the special circumstances, the function and satisfaction of the patients.</p><p><b>RESULTS</b>The 107 hips were gotten an average of 34.3 months' (3 - 55 months) follow-up. The infection control rate was 96.3% after the first-stage surgery, the infection control rate was 94.4% at last follow-up after two-stage revisions. The breakage rate of the spacer was 4.7%, dislocation rate was 2.8%, removal of the spacers with difficulty were seen in 15 patients (14.0%). The satisfactory rate of the patients was 93.5%.</p><p><b>CONCLUSIONS</b>Antibiotic-loaded cement articulating spacer made by a self-made mold system is an effective methods for the two-stage revision of the infected hip replacement, characterized by simple, good reproducible, high rates of infection control, better joint function after surgeries, high rate of patients satisfaction and other advantages. And it can decrease the complications, such as the breakage, spacer dislocation of hip joint and difficulty in removal of spacer at the second stage revision. Using of metallic internal fixation or allograft bone combined with spacer does not affect the results of infection controlling.</p>

A comparative study of the role of two femoral shortening techniques in total hip arthroplasty on patients with Crowe's IV congenital dislocated hips / 中华外科杂志

<p><b>OBJECTIVE</b>To compare proximal femoral resection with transverse subtrochanteric osteotomy in the treatment of Crowe's IV congenital dislocated hip (CDH) with total hip arthroplasty (THA).</p><p><b>METHODS</b>Thirty-six primary hip arthroplasties were performed in patients with Crowe grade IV CDH from April 2003 to October 2007. These patients were divided into two groups, one for proximal femoral resection (n = 20) and another for subtrochanteric osteotomy (n = 16). The leg length discrepancy, rotation center height and Harris score were measured pre- and post-operation to compare the two methods of osteotomy.</p><p><b>RESULTS</b>All surgeries were successfully performed. The average leg discrepancy was 0.6 cm (range from 0 to 1.5 cm) for subtrochanteric osteotomy group and 0.3 cm (range from -1.0 to 1.5 cm) for proximal femoral resection group, there was no significant difference between them (P > 0.05). There were also no statistically significant difference between the two groups in other index. The complication rates were much higher in the proximal femoral resection group. At the latest follow up, the Harris score of subtrochanteric osteotomy group was 90 +/- 6, and the proximal femoral resection group was 83 +/- 8. There was statistical difference between the two groups (P < 0.05).</p><p><b>CONCLUSIONS</b>Although both the femoral shortening techniques can restore the leg length of Crowe IV CDH, the subtrochanteric osteotomy technique has advantage of avoiding the potential complications in the high riding patients (high dislocation > 4 cm).</p>

Arthroscopic assisted Bankart repair with bio-absorbable fixation tacks / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluated the curative effect of arthroscopic Bankart repair with use of bio-absorbable fixation tacks.</p><p><b>METHODS</b>Sixteen patients were with traumatic recurrent anterior instability of the shoulder. Twelve were males, and 4 were females. Nine were in left shoulder, and 7 in right shoulder. The mean age at the time of the operation was 25 years. The average time from injury to operation was six months. Before operation the shoulder image had been done, in which X-ray film in 16, MRA in 7, CTA in 6 and MRI in 5. The arthroscopic technique included of debridement and Bankart repair using 2 to 3 bio-absorbable fixation tacks underwent arthroscopic.</p><p><b>RESULTS</b>All of the patients were followed up, average time 11 months, no redislocation and instability. According to the UCLA (University of California at Los Angeles) score showed all shoulder scores improved after surgery, preoperative (22.5 +/- 5.6) and postoperative (31.4 +/- 5.8), excellent score in 9, good score in 5 and fair score in 2; no poor score.</p><p><b>CONCLUSION</b>Arthroscopic capsulolabral repair with use of bio-absorbable fixation tacks has provided a satisfactory outcomes in function, stability and range of motion. The procedure has many advantages, such as the operation convenient, fixation safety, mini-invasion, rapid recovery and early rehabilitation.</p>

Arthroscopic therapy of Baker's cyst with radiofrequency / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the feasibility of arthroscopic therapy of Baker's cysts with radiofrequency.</p><p><b>METHODS</b>Since Feb. 2000 to Oct. 2002 a surgical arthroscopic treatment for popliteal cyst in a series of 21 patients. Men 14 and female 7, the age from 45 to 66 year. To do CT scan 11 and MR in 8. To insert a arthroscope to Baker's cyst, and inject salline in the visceral layer of capsule under the arthroscope, so that remove of the capsule easily. The radiofrequency to clear the capsule of cyst and hemostasia.</p><p><b>RESULTS</b>All of the cases studied, a connection between joint space and cyst was found in 13 cases. The popliteal cyst was found to be almost invariably associated with other knee disorders. Follow-up in all of the case. No nerve and blood vessel injure, no infection in this group. The function is well include 3 cases relapsed after re-operation by arthroscope debridement.</p><p><b>CONCLUSIONS</b>Surgical arthroscopic therapy of Baker's cysts is safety and reliable; To removal of capsule integrity and repair of all intraarticular lesions and sealing of the junction between Baker's cyst and the dorsal recessus of the knee joint for preventing recurrent are very important.</p>