Outcomes of endobutton and rigidfix femoral fixation methods with hamstring autograft in anterior Cruciate ligament reconstruction / 中国组织工程研究

BACKGROUND: The choice of fixation is an important factor affecting the prognosis of anterior cruciate ligament reconstruction. Endobutton and Rigidfix are two kinds of femoral end suspension fixators which are widely used at present. Their advantages are high fixation strength, large contact area between tendon and bone tunnel, and conducive to tendon-bone healing. However, it is still controversial whether there are differences in clinical efficacy and bone tunnel enlargement between the two fixation methods. OBJECTIVE: To analyze the outcomes of two different femoral fixation methods (Endobutton and Rigidfix) with hamstring autograft in anterior cruciate ligament reconstruction. METHODS: A retrospective analysis was performed on the data of 270 cases which accepted the anterior cruciate ligament reconstruction and second arthroscopic look from June 2015 to December 2017. All patients signed the informed consent. This study was approved by the Hospital Ethics Committee. The patients were divided into two groups according to the method of femoral end fixation. The Endobutton femoral fixed reconstruction was performed in Endobutton group (150 cases). The Rigidfix femoral fixed reconstruction was performed in Rigidfix group (120 cases). Reconstruction of anterior cruciate ligament was done using autologous semitendinosus and gracilis tendon. All cases were fixed with Bioabsorbable Interference Screw and AO hollow nail bolt pile fixing screw at the tibial tunnel. The diameter of bone tunnel was also measured by MRI. The knee joint function recovery and stability were evaluated by Lysholm score, International Knee Documentation Committee score, Tenger score table, drawer test, Lachman test, axle shift test, and KT-1000 joint measuring instrument. Second-look arthroscopic evaluation was performed in all patients, focusing on continuity of the reconstructed anterior cruciate ligament, the synovial coverage and the prevalence of abnormal structure at 1 year after surgery. RESULTS AND CONCLUSION: (1) All patients were followed up for 14 to 44 months. (2) Tunnel widening was significantly increased in the Endobutton group than in the Rigidfix group at 1 year after surgery (P 0.05). (4) At 1 year after surgery, the range of motion of knee joint was not significantly different between the two groups (P > 0.05). (5) There was no significant difference between the two groups in drawer test, Lachman test and axle shift test (P > 0.05). The side-to-side difference of KT-1000 in the Endobutton group was (1.12±1.20) mm, while that of KT-1000 in Rigidfix group was (1.23±0.91) mm. There was no significant difference between the two groups (P > 0.05). (6) Secondary arthroscopic examination showed that there were 1 case of complete graft absorption, 11 cases of graft wear in Endobutton group, 2 cases of complete graft absorption and 15 cases of graft wear in Rigidfix group. There was no significant difference between the two groups (P > 0.05). (7) There were 59 excellent cases, 61 good cases, 30 poor cases in Endobutton group, 47 excellent cases, 49 good cases and 24 poor cases in Rigidfix group. There was no significant difference between the two groups (P > 0.05). (8) The incidence of complication was 2.6% in the Endobutton group and 6.6% in the Rigidfix group, and no significant difference was found between the two groups (P > 0.05). (9) The results suggested that Endobutton and Rigidfix had the same clinical outcome. There was no significant difference in the coverage and continuity of synovial synovial membrane between the second look grafts. However, compared with Rigidfix transverse screw system, Endobutton fixation at the femoral end is more likely to cause bone tunnel enlargement.

Arthroscopic double Endobutton plate internal fixation for acute acromioclavicular joint dislocation / 中华创伤杂志

Objective To investigate the clinical efficacy of arthroscopic double Endobutton plate internal fixation in the treatment of acute acromioclavicular joint dislocation.Methods A retrospective case series study was performed to analyze the clinical data of 32 patients with Rockwood type Ⅲ or Ⅴ acute acromioclavicular joint dislocation admitted to Foshan Hospital of TCM from May 2015 to February 2018.There were 26 males and six females,aged 22-56 years [(37.7 ± 1.6)years].There were 22 patients with Rockwood type Ⅲ and 10 patients with type Ⅴ.The duration from injury to operation was 2-5 days.All patients were treated with arthroscopic double Endobutton plate internal fixation for coracoclavicular ligament reconstruction.The operation time,hospitalization time,and postoperative shoulder joint braking time were recorded.The shoulder joint function was evaluated by the Constant-Murley score (CMS),visual analogue scale (VAS),American shoulder and elbow surgeons (ASES) score,University of California Los Angeles (UCLA) score and simple shoulder test (SST) before operation and at the last follow-up.Meanwhile,complications such as infection,loosening and joint dislocation were recorded.Results All patients were followed up for 8-48 months [(27.8 ± 11.6) months].The operation time was 48-93 minutes [(65.0 ± 24.6) minutes],the hospitalization time was 3.2-10 days [(6.5 ± 2.6)days],and the postoperative braking time was 21-35.3 days [(28.2 ± 7.1)days].All patients had a grade A healing of surgical incision.The VAS was decreased from preoperative (5.7 ±2.5)points to (1.2 ±0.8)points at the last follow-up (P ＜0.01);CMS wasvincreased from preoperative (29.3 ± 3.4) points to (93.2 ± 2.1) points at the last follow-up (P ＜0.05);ASES score was increased from preoperative (28.9 ± 10.1) points to (95.7 ± 5.6) points at the last follow-up (P ＜ 0.05);UCLA score was improved from preoperative (11.6 ± 2.8) points to (34.2 ±1.5)points at the last follow-up (P ＜0.05);SST score was improved from preoperative (3.5 ±1.2)points to (9.7± 1.4)points at the last follow-up (P ＜ 0.O1).The incidence of intraoperative and postoperative complications was 16％ (5/32).In two patients,the surgery was changed to U shape fixation circulating the coracoid base due to the coracoidbone tunnel cutting out.One patient was found to have insufficient reduction and received the acromioclavicular joint operation.One patient had reduction loss due to the clavicle button collapsing,and one patient had excessive reduction.Conclusions For Rockwood type Ⅲ or Ⅴ acute acromioclavicular dislocation patients,arthroscopic double Endobutton plates for coracoclavicular ligament reconstruction has the advantages of less intraoperative trauma,quick recovery and satisfactory clinical result.However,the incidence of intraoperative and postoperative complications is relatively high,and indications should be strictly controlled.

The effect of zoledronic acid on osteoporotic intertrochanteric fractures / 中华骨科杂志

Objective To compare of the effect of intravenous zoledronic acid and calcitonin on the elderly with osteoporotic intertrochanteric fractures.Methods From June 2009 to November 2012,610 patients with osteoporotic intertrochanteric fractures were treated with closed reduction and internal fixation.543 consecutive patients were grouped sequentially according to the admission time.From June 2009 to April 2011,control group (n=325)received calcitonin for osteoporosis (male 107,female 218,mean age 75.02±5.65 years).The number of Evans-Jensen type Ⅰ,Ⅱ,and Ⅲ type patients were 87,136,and 102,respectively.Average lumbar bone mineral density (BMD) and hip BMD were 0.737±0.08 g/cm2 and 0.725±0.05 g/cm2,respectively.From May 2011 to November 2012,218 patients (male 82,female 136,mean age 74.71±5.32 years) received zoledronic acid for osteoporosis.The number of Evans-Jensen type Ⅰ,Ⅱ,and Ⅲ type patient were 62,91 and 65,respectively.Average lumbar BMD and hip BMD were 0.738±0.05 g/cm2 and 0.722±0.06 g/cm2,respectively.All patients received once-yearly intravenous zoledronic acid in one week after operation.The BMD during hospitalization and one year after operation were compared between the two groups.Harris score and VAS score were applied to evaluate the function and pain degree of the operated hip joint.Results The average follow-up time were 12.8 months (range,5 to 22 months) in control group and 12.5 months (range,4 to 19 months) in treatment group.The average fracture union time,Harris score,VAS score were 14.25±1.38 weeks,68.88±5.71 points,and 0.36±0.55 points respectively in treatment group and 14.39± 1.12 weeks,69.47±4.60 points,and 0.33±0.48 points respectively in control group.There were no statistical differences between two groups in fracture union time,Harris score and VAS score.The average lumbar BMD and hip BMD were 0.76±0.06 g/cm2 and 0.75±0.04 g/cm2 in treatment group,which were 0.75±0.07 g/cm2 and 0.74± 0.07 g/cm2 in control group one year after operation,respectively.Compared with the baseline,the BMD of lumbar spine and hip one year after operation slightly increased without statistically significant difference in control group.The BMD increased significantly in treatment group.Conclusion Early administration of intravenous zoledronic acid does not influence bone healing and it could increase BMD one year after closed reduction and internal fixation.

Evaluation of mid-term knee joint function and quality of life in elderly patients undergoing mobile-bearing versus fixed-bearing total knee arthroplasty / 中华老年医学杂志

Objective To retrospectively analyze the mid-term functional outcome and quality of life in elderly patients undergoing the mobile-bearing versus fixed-bearing total knee arthroplasty.Methods Patients aged over 65 years who underwent total knee arthroplasty during January 2002 to December 2010 were followed up.The knee joint function was assessed by Western Ontario and McMaster Universities (WOMAC) score.Quality of life was assessed by using SF-16 (Short Form36) questionnaire.Data of mobile-bearing versus fixed-bearing groups were statistically analyzed.Results 157 cases (194 knees) were followed up completely.The mean follow-up period was (5.06±2.47) years (range 2.08-10.75 years).The mean age was (72.4±4.3) years (range 65-86 years old).Preoperative versus postoperative WOMAC scores were (48.2 ± 14.9) vs.(10.7±9.1) (P＜0.01).There was no significant difference in WOMAC score between the fixed-bearing group and the mobile-bearing group during the follow up [(10.12±8.76) vs.(11.38±9.55),t=0.861,P＞0.05].The mean SF-36 score was (119.65± 12.03) in the overall population of patients,which showed no significant difference as compared with the good and moderate optimal truncation value of 117 (t =2.759,P＞0.05).There was no significant difference in SF-36 score between the fixed-bearing group and the mobile-bearing group [(120.17±11.06) vs.(119.06±13.07),t=0.575,P＞0.05].Conclusions Total knee arthroplasty can improve the knee joint function and quality of life in elderly patients with severe knee osteoarthritis.For the elderly,the mid-term functional outcome and life of quality are similar in the mobile-bearing and the fixed-bearing total knee arthroplasty,and any kind of prostheses can be chosen to use,

Fixation of displaced proximal humeral fractures with proximal humeral internal locking plate in the elderly / 中华老年医学杂志

Objective To investigate the treatment effect of the proximal humeral internal locking system (PHIL()S) on the elderly patients with displaced proximal humeral fractures.MethodsFrom Feb 2004 to Mar 2007, 36 patients (mean age: 72.2 years) with proximal humeral fractures were treated with PHILOS plate fixation which included 14 cases with 2-part, 17 cases with three-part and 5 cases with four-part fractures according to Neer classification.Operation time,intraoperative blood loss, blood transfusion, perioperative complications and function evaluation of the operated shoulder joint were calculated with 14.5 months follow-up at average.Results The average operation time and blood loss were (61.5± 11.6) min and ( 165.2±91.2) ml, respectively. 1 case with accidents of blood vessel and 1 case with pneumonia were found without neurovascular injuries. All fractures were radiographically healed in an average of 3-5 months.No necrosis of humeral head appeared and 30 (83.3％) cases were excellent or good according to Neer scoring system. Two part fracture and early operation ( within 3 days after operation) might improve the postoperative function of shoulder joint, but the patient's age, gender and ASA score were not statistically with Neer score.Conclusions PHILOS plate fixation is a suitable procedure for displaced proximal humeral fractures via stable fixation and early rehabilitation, especially for elderly patients combined with osteoporosis.

Separation and purification of total flavones from Herba Epimedii by macroporous adsorption resin with the help of ultrasonic extraction / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the optimal separation of the total flavones from Herba Epimedii by macroporous adsorption resin.</p><p><b>METHOD</b>Nine types of macroporous adsorption were evaluated for separating efficiency by measuring the adsorption ratio, eluting ratio of total flavones.</p><p><b>RESULT</b>The D-101 macroporous adsorption resin had the best separating efficiency. After enrichment and purification with it, the product purity of total flavones was up to 63.8%.</p><p><b>CONCLUSION</b>This method is simple, feasible and fit for industry production.</p>

Arthroscopic observation and surgical treatment of traumatic recurrent anterior dislocation of the shoulder / 中华创伤杂志

Objective To observe the pathologic type and degree of traumatic recurrent anterior dislocation of the shoulder by means of arthroscopy and discuss clinical results of modified Bristow method and arthroscopic Bankart reconstruction so as to provide refeFences for selecting operation methods.Methods A retrospective study was done off 62 patients(62 shoulders,44 males and 18 females.at av-erage age of 39.8 years.ranging from 21 to 67 years)with anterior recurrent dislocation of shoulder (mean duration of 87 months)admitted into our hospital from July 1997 to Oetcher 2007.All patients un-derwent preoperative arthroscopic examination that showed pathologic changes including injury of shoulder and humerus head,Bankart injury severity and laxitas of humerus glenoid ligament of articular capsule,which were used as referenee of surgical procedures.Modified Bristow's method or arthroscopic suture anchor Bankart reconstruction were performed according to arthroscopic results(pathologic change).The patients were assessed with the University of California at Los Angeles(UCLA)shoulder rating scale.Results There were 45 patients treated with modified Bristow,s method and 17 with arthroscopic suture anchor Bankart reconstruction.The follow.uD for mean 64.2 months showed that pre-and post-operative mean UCLA scores were(22.6±4.4)points and(29.8±4.2)points respectively(P＜0.01),the mean forward flexion(136.8±14.2)°and(156.6±17.8)°respectively(P＜0.01)and the mean ex-ternal rotation in 90°abduction(52.5±16.4)°and(72.4±11.3)°(P＜0.01).There were no redis-location at final follow-up,but there were 6 patients(9.6%)with positive apprehension test.Of all,60 patients(97%)returned to their pre-injury.work. Conclusions Observation of pathologic change of surgical procedure.Both modified Bristow's method and arthruscopic Bankart reconstruction are good methtxts for treatment of recurrent anterior shoulder dislocation under conditions of successful management of pathologic change of shoulder, restoration of normal anatomic structure of shoulder ioint and strict indi-cation control.

Immunological functions of T-lymphocyte in elderly patients after orthopedic operation / 中华老年医学杂志

Objective To evaluate the T lymphocyte functions in elderly patients following major orthopedic operation. Methods From May 1998 to Feb 1999, 39 elderly patients (65 95 years old) hospitalized for orthopedic operation were studied. The patients' peripheral blood samples in the experimental group were obtained on days 1, 3, 7 and 14 postoperation, respectively. At the same days, blood samples were taken from 15 elder patients without trauma and operation (65 80 years old) within 6 months as controls. T lymphocyte subpopulations were differentiated by means of quantitative assay with autocounting method of FCM. Results CD3 T cell count was significantly decreased on day 1(54 4?11 3)% and day 14(58 5?12 6)%, compared with controls (63 9?8 3)% ( P

Study on alcohol extraction process of Rhizoma Chuanxiong / 中成药

Objective: To ascertain the condition for extracting tetramethylpyrazine from Rhizoma Chuanxiong with alcohol. Methods: With the transferring rate of tetramethylpyrazine as index, the optimum extraction condition for the first time was selected by uniform test, and the times of extraction was studied. Results: Taking 80% alcohol as solvent, Rhizoma Chuanxiong was extracted two times with 8 and 6 times volume of alcohol for 2hr and 1.5hr, respectively. In this condition, tetramethylpyrazine could be effectively extracted. Conclusion: The experimental results provided the basis for the ascertainment of extraction process of Rhizoma Chuanxiong preparation.