Clinical outcomes of hip arthroscopic treatment for femoroacetabular impingement:a comparative study between Inside-out and Outside-in approach / 中国骨伤

OBJECTIVE@#To compare the clinical outcomes and complications of hip arthroscopic treatment for femoroacetabular impingement (FAI) performed with either Inside-out or Outside-in approach.@*METHODS@#The clinical date of 48 patients with FAI treated by hip arthroscopy surgery and follow-up from June 2016 to June 2019 were retrospectively analyzed. According to the different operative methods, the patients were divided into two groups. Inside-out group, from central compartment to peripheral compartment;Outside-in group, from peripheral compartment to central compartment. There were 14 males and 10 females in Inside-out group with an averageage of (39.8±7.6)years old, 13 males and 11 females in Inside-out group with an average age of (39.5±9.1)years old in Outside-in group. There was no significant difference in age, gender, body mass index, side, impingement type, medical history and follow-up time between the two groups. The complication occurrence rate, modified Harris hip score (mHHS)and nonarthritic hip score (NAHS) were compared between these two groups.@*RESULTS@#The mHHs and NAHS scores of the two groups were significantly higher than those before operation, but there was no significant difference between the two groups (@*CONCLUSION@#Both hip arthroscopic surgery methods can obtain satisfactory clinical efficacy in the treatment of FAI, but the incidence of postoperative complications of Outside-in surgical method is lower. The out-side in method can be preferentially selected for the patients with the indications of operation.

Arthroscopic technique with fiber tape circular fixation for treating avulsion fracture of tibial insertion of anterior cruciate ligament / 中国组织工程研究

BACKGROUND: The avulsion fracture of tibial Insertion of anterior cruciate ligament needs to be operated and fixed as early as possible. At present, the open reduction (absorbable screw, hollow screw, steel wire, and titanium cable) Is commonly used in the clinical treatment plan for internal fixation, which is more traumatic and has many postoperative complications. Arthroscopic reduction and elastic (suture) Internal fixation of anterior cruciate ligament fracture has the advantages of minimally invasive, clear surgical field, high fixation accuracy, few complications, good fracture reduction and healing, meeting the biomechanical requirements, and allowing rapid recovery of joint function, but also has the disadvantages of Insufficient strength, and osteotomy. OBJECTIVE: To compare the treatment efficacy of arthroscopic technique with Fiber Tape circular fixation and open reduction and fixation for the avulsion fracture of tibial Insertion of anterior cruciate ligament. METHODS: Thirty-two patients with tibial eminence fracture at Department of Orthopedics of Shanghai China Metallurgical Hospital from January 2017 to December 2018 were enrolled. All patients signed the informed consents and the study was approved by the Ethics Committee. The patients were divided into two groups based on surgical methods: Minimally Invasive group (n=17, arthroscopic reduction and Fiber Tape circular fixation) and open group (n=15, open reduction and hollow tension screw fixation). The operation time, blood loss, and postoperative complications were recorded. The range of motion of knee joint, Lysholm score, and International Knee Documenting Committee score before operation, 1 and 6 months after surgery were recorded. X-ray film was used to evaluate fracture healing. RESULTS AND CONCLUSION: (1) All patients were followed up for 6-13 months. (2) There were no significant differences in age composition, fracture type, cause of injury or preoperative score between two groups. (3) X-ray film showed satisfactory fracture reduction after operation. There were no neurological, vascular injury or fracture displacement after surgery. The fractures healed well after 6 months. (4) There was no significant difference In the operation time and postoperative complications between two groups. The blood loss showed significant difference between two groups (P=0.036). (5) The range of motion of knee joint at postoperative 1 month In both groups was significantly larger than that at baseline (P < 0.05). The range of motion of knee joint at postoperative 6 months was significantly larger than that at postoperative 1 month (P < 0.05). The range of motion of knee joint at postoperative 1 and 6 months in the minimally invasive group was significantly larger than that in the open group (P < 0.05). (6) The Lysholm and International Knee Documenting Committee scores at postoperative 1 month in both groups were significantly higher than those at baseline (P < 0.05). The scores at postoperative 6 months were significantly higher than those at postoperative 1 month (P < 0.05). The scores at postoperative 1 and 6 months in the minimally invasive group were significantly higher than those in the open group (P < 0.05). (7) These findings suggest that the patients in both groups after undergoing surgical methods had restored motion of range with time going. Compared with open fixation, arthroscopic reduction and Fiber Tape circular fixation for treating tibial eminence fracture has less blood loss, less trauma, shorter recovery time and higher functional recovery.