A case-control study of unicompartmental knee arthroplasty with mobile and fixed platform for the treatment of single compartment osteoarthritis of knee / 中国骨伤

OBJECTIVE@#To compare and analyze the early clinical outcomes of unicompartmental knee arthroplasty with mobile and fixed platform for the treatment of single compartment osteoarthritis of knee.@*METHODS@#From January 2013 to December 2014, 86 cases (92 knees) of knee osteoarthritis with single compartment (medial) were randomly divided into two groups. One group consisted of 42 patients, including 18 males and 24 females, underwent unicompartmental knee arthroplasty with fixed platform prosthesis; the other group consisted of 44 patients, including 20 males and 24 females, underwent unicompartmental knee arthroplasty with mobile platform prosthesis. The surgery was performed by the same group of doctors. The operation time, blood loss, ROM, KSS and HSS scores of knee joint before and after surgery were recorded and the clinical follow up was completed.@*RESULTS@#The follow-up duration of the two groups ranged from 8 to 26 months, with an average of (18.20± 4.23) months. During the follow-up period, the periprosthetic fracture was found in 1 patient in the fixed platform group 1 year after operation, and polyethylene liner dislocation was found in 1 patient in the mobile platform group. No complications such as poor wound healing, periprosthetic infection or sterile prothesis loosening were found in all cases. In the fixed platform group, the operation time was (90.05±6.59) minutes and the blood loss was (53.76±6.04) ml. In the mobile platform group, the operation time was (90.73±6.74) minutes and the blood loss was (54.34±6.27) ml. In the fixed platform group, the ROM of knee increased from preoperative (94.52±4.54) degree to postoperative (104.64±4.42) degree. In the mobile platform group, the ROM of knee increased from preoperative (95.05±4.87) degree to postoperative (105.07±4.33) degree. In the fixed platform group, the KSS score increased from preoperative 48.69±5.68 to postoperative 83.55±5.37. In the mobile platform group, the KSS score increased from preoperative 49.39±5.68 to postoperative 84.11±6.14. In the fixed platform group, the HSS score increased from preoperative 45.45±3.62 to postoperative 84.55±6.08. In the mobile platform group, the HSS score increased from preoperative 45.93±4.01 to postoperative 85.16±6.30. There was no significant difference between the two groups.@*CONCLUSION@#There is no significant difference in the early outcome of unicondylar prosthesis with fixed and mobile platforms in the treatment of single compartmental osteoarthritis of knee. The long-term complications and revision rates of the two prostheses need further multi center and large-sample clinical study.

Clinical application of low-molecular-weight heparin (Fraxiparine) in rescuing venous crisis of island skin flap / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of low molecular weight heparin (Fraxiparine) in rescuing venous crisis of island skin flap.</p><p><b>METHODS</b>Of the 73 patients with venous crisis of island skin flap, 47 received subcutaneous injection of low-molecular-weight heparin (group I) and 26 were treated with phlebotomy, local compression and topical application of unfractionated heparin solution gauze (group II).</p><p><b>RESULTS</b>The flap survival ratio was (88.46∓8.64)% in group I and (38.37∓6.53)% in group II (P<0.001). At 0, 2, and 4 h after injection of low-molecular-weight heparin, the activated partial thromboplastin time (APTT) was obviously delayed (24.28∓6.71, 41.35∓7.64 and 32.34∓6.35, respectively, P<0.01), FXa:C level was significantly decreased (152.4∓30.7, 65.8∓24.4 and 83.4∓18.4, respectively, P<0.01), while FIIa:C level underwent no obvious alterations (155.70∓31.61, 143.20∓24.75, and 143.4∓23.35, respectively, P=NS).</p><p><b>CONCLUSION</b>Fraxiparine has good antithrombotic efficacy in rescuing venous crisis of island skin flap without adverse effect on systemic coagulation.</p>

Establishment of a rat model of bone marrow mesenchymal stem cell transplantation for repairing full-thickness skin defect / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish a rat model of full-thickness skin defect to receive bone marrow mesenchymal stem cell transplantation for wound repair.</p><p><b>METHODS</b>A full-thickness skin defect measuring 4 cmx4 cm in 36 F344 rats, which were divided into 3 groups with the wound covered with alloskin graft, acellular dermal matrix, or petrolatum gauze. In vitro cultured BMSCs in the 5th passage were transplanted into the skin defect, and the time of wound dressing dissociation and number of transplanted Brdu-positive cells in the wound were observed 14 days later.</p><p><b>RESULTS</b>The alloskin graft resulted in significantly longer time before dressing dissociation, with greater number of Brdu-positive cells in the wound than the other two wound dressings (P<0.001). The acellular dermal matrix showed better effect than petrolatum gauze in terms of the dressing dissociation time and the viable transplanted cell number in the wound.</p><p><b>CONCLUSION</b>Alloskin graft can be ideal for covering the wound surface to protect the transplanted BMSCs in rats.</p>