Treating Cervical Vertigo of Elderly Patients through Sling Exercise Combined with Drug / 中国运动医学杂志

Objective To observe the clinical effect of sling exercise therapy(S-E-T)combined with drug treatment for cervical vertigo in elderly patients.Methods Forty-nine elderly patients with cervical vertigo admitted to our hospital between January 2011 and July 2014 were randomly divided into an observation group(n=27)and a control group(n=22).The observation group was given 80 mg Ginaton(Extract of Ginkgo Biloba Leaves Tablets)produced by German Dr.Willmar Schwabe GmbH & Co.KG three times a day,combined with S-E-T,including cervical stability and stretching training for 40min,focusing on the neck global muscle and local stabilize muscle rehabilitation,once every other day.The control group was provided with the same drug treatment.During the 6-month intervention,both groups were given health education by the same therapist.Both groups were assessed using the neck disability index(NDI),visual analogue scale(VAS)and evaluation scale for cervical vertigo(ESCV) before and after the intervention,as well as at the last follow-up visit.Before the treatment and at the last follow-up visit,the cervical X-ray examination and trigger point check were also conducted for both groups.Results All the forty-nine patients were followed up for 4.83 to 6.70 months,with an average of(6.01 ± 0.49)months.Significant improvement was observed in the average ESCV score for both groups after the treatment.Compared with before the treatment,there was significant improvement in the average NDI and VAS right after the treatment and at the last follow-up visit in the observation group,but only at the last follow-up visit in the control group.From the cervical X-ray,no significant differences were found in the vertebral osteophyte formation,facet joints and uncovertebral joint degeneration between the 2 groups(P＞0.05),while significant differences were observed in the number of the neck trigger points(P＜0.05).Conclusion The sling exercise therapy combined with drug treatment can significantly improve cervical function,relieve pain and vertigo symptoms in elderly patients with cervical vertigo.The effect is better than drug treatment alone.

Biomechanics characteristics of four anterior cervical reconstructive techniques in the surgical management of multilevel cervical spondylotic myelopathy:a finite element model study / 中国组织工程研究

BACKGROUND:Surgical treatment is commonly used for decompressing the spinal cord in multilevel cervical spondylotic myelopathy, but the optimum anterior cervical reconstructive method has not been determined. OBJECTIVE:To compare and analyze the biomechanical characteristics of four anterior cervical reconstructive techniques in the surgical management of multilevel cervical spondylotic myelopathy utilizing the three-dimensional finite element model. METHODS:A three-dimensional finite element model of an intact C2–7 segment was developed and validated based on healthy adult male CT images. Four additional models were developed from the fusion model, including anterior cervical discectomy and fusion, anterior cervical corpectomy and fusion, anterior cervical hybrid decompression and fusion and anterior cervical discectomy and fusion with Cage alone. Von Mises stresses on the plate and the disc of adjacent levels (C2/3, C6/7) were comparatively analyzed. RESULTS AND CONCLUSION:(1) The C2/3 disc stress in flexion, extension, lateral bending and rotation condition was significantly higher than the C6/7 disc in 4 anterior cervical reconstructive techniques, and the adjacent disc stress (C2/3, C6/7) was lowest in the anterior cervical discectomy and fusion with Cage alone, and highest in the anterior cervical corpectomy and fusion. (2) The stress at the plate-screw interface was highest in the anterior cervical corpectomy and fusion, and lowest in the anterior cervical discectomy and fusion. (3) In conclusion, among the four anterior cervical reconstructive techniques for multilevel cervical spondylotic myelopathy, the anterior cervical discectomy and fusion with Cage alone makes little effect on the adjacent disc stress, which might reduce the incidence of adjacent segment disease after fusion. However, the accompanying risk of the increased incidence of cage subsidence should never be neglected.

Improvement and evaluation of modeling method in animal models of osteoporosis / 中国组织工程研究

BACKGROUND:Animal models of osteoporosis play an important role in the research of the pathogenesis, occurrence and development of osteoporosis, as wel as in the clinical diagnosis, prevention and treatment of osteoporosis. OBJECTIVE: To summarize and discuss the establishment and research ideas of osteoporosis models, explore the current situation and advance of osteoporosis models, compare the advantages and disadvantages of various methods, and provide evidence for clinical investigation. METHODS: A computer-based online search was conducted in SinoMed, VIP, Wanfang and PubMed databases by using the key words of “animal model, osteoporosis” from January 1969 to October 2015. The language was limited to both Chinese and English. Relevant articles were screened according to inclusion and exclusion criteria. The documents about the methods of osteoporosis model preparation, method improvement as wel as their advantage and disadvantage were summarized. RESULTS AND CONCLUSION:A total of 576 articles were included. Among them, articles published earlier, duplicated, and similarly were excluded, and 53 articles were finaly included. Various animal models of osteoporosis may only focus on the certain causes, certain stage, some of the main symptoms and some pathophysiological changes of disease. Accordingly, appropriate modeling methods and experimental animals should be selected based on research objective. Rat undergoing castration is the most commonly used model in the modeling of osteoporosis. Among drug methods for constructing osteoporosis model, glucocorticoids is the most commonly used one. Disuse method and nutritional method have limitations, and always combined with castration and drug methods. The effects of gene transfer, gene mutation and brain-derived model deserve

Comparation in outcome of long segment fusion versus short segment fusion for the treatment of adult degenerative scoliosis / 中华老年医学杂志

Objective To investigate the effect of decompression with long-segment (L) or short-segment (S) fusion on the outcomes of the surgical treatment for degenerative adult scoliosis (ADS) patiens.Methods A retrospective study on 32 patients treated in our department for ADS from April 2013 to May 2015 was carried out, including 12 male and 20 female (1 : 1.7).Their average age was 66.4 (range: 51-77 years).All patients underwent decompression and fusion surgeries through posterior approach.They were divided into long-segment fusion group (L) and short-segment fusion group (S) according to fusion range.During follow-ups (FU), clinical outcomes were assessed by means of visual analog scale (VAS) and Oswestry disability index (ODI).Radiographic evaluation on full-length standing film included coronal Cobb's angle, distant between C7plumb line and center sacral vertical line (C7PL-CSVL), thoracic kyphosis (TK) angle, lumbar lordosis (LL) angle, pelvic incidence (PI), and pelvic tilt (PT), PI-LL, sagittal vertical axis(SVA).Postoperative complications were also recorded.Results All patients were followed up for average 2.2 years (range:1.5-3.5 years).No significant difference of age or gender was found between two groups (L: 22, S:10) of patients (P=0.066, 0.182).As for the fusion segments, group L (6.3±1.5) was more than group S (2.9±0.3) (P=0.001).Operation time and blood loss of group L were statistically more than group S (P＜0.05).Postoperative VAS sores of back pain and leg pain as well as ODI were all improved significantly in two groups (P＜0.05).At the final FU, back pain VAS was more in group L than in group S (P＜0.05) , but no significant difference was found in leg pain VAS between two groups (P＞0.05);at the final FU, group L's ODI showed better functional recovery than group S's[(12.8±9.3)％ vs.(25.4±11.4)％, P＜0.05].With no obvious difference in the two groups (P＞0.05), coronal Cobb's angle corrected more satisfactional in group L than group S (P＜0.05).The same situation was found in C7-CSVL correction in two goup in FU (P＜0.05).Sagital balance was restored to normal alignment better in group L than group S, with increase of lumbar lordosis after surgery.The overall incidence of postoperative complications was 31.3％, including wound infection, cerebrospinal fluid leakage, transient neurological symptoms and internal fixed rod breakage, more common in group L than group S.Conclusions Decompression and fusion with internal fixation showed good clinical outcomes in the treatment of ADS.Long-segment fusion yielded better coronal and sagittal correction outcomes with higher peri-operation risks;however, short-segment fusion showed higher safety with relatively inferior correction effect.Appropriate fusion mode should be chose according to the patient's deformity features.

Biomechanical change in adjacent segments after cervical fusion and non-fusion：a meta-analysis of second surgery rate / 中国组织工程研究

BACKGROUND:Adjacent segment disease is a long-term complication of anterior cervical decompression and fusion, and has been paid great attention recently. Cause of disease contains increased range of motion in surgery adjacent segment, intervertebral height loss and high intradiscal pressure. In the clinic, compared with fusion surgery, whether cervical non-fusion can effectively decrease the incidence of adjacent segment disease remains poorly understood. OBJECTIVE:To systematicaly assess the effects of cervical fusion and cervical non-fusion on adjacent segment degeneration. METHODS:We retrieved the randomized controled trial concerning cervical fusionversuscervical non-fusion to repair cervical syndrome in the Medline, PubMed, Embase and Cochrane databases from January 2000 to December 2013. This study compared the effects of two repair methods on adjacent segment disease and evaluated methodological quality of the included studies. A meta-analysis was performed using RevMan 5.2 software. Outcome indicators: second surgery was undergone due to postoperative adjacent segment disease. RESULTS AND CONCLUSION: After screening, five randomized controled trials met the inclusion criteria. There were 1 602 patients. Al patients received surgery due to cervical syndrome. 785 cases underwent anterior decompression and fusion, and 817 cases underwent intervertebral disc replacement. 1 066 patients completed al folow-up, with a total folow-up rate of 66.54%. There were 494 patients treated with anterior decompression and fusion and 572 patients with intervertebral disc replacement. A total of 68 patients underwent second surgery due to adjacent segment disease. Total second surgery rate was 6.38% (68/1 066), including 28 cases after intervertebral disc replacement and 40 cases after anterior decompression and fusion. The grade of quality evaluation of the included studies was high, including five studies with grade A. Moreover, heterogeneity was smal (I2 = 14%). Meta-analysis results revealed that the second surgery rate of adjacent segment disease was lower after cervical non-fusion than after cervical fusion, which showed significant differences (odd ratio = 0.58, 95% confidence interval: 0.35, 0.96). These results suggested that the second surgery rate of adjacent segment disease was higher after cervical fusion than after cervical non-fusion. The alterations in cervical biomechanics caused by fusion greatly affected the occurrence of adjacent segment disease.

Design and clinical application of the instrument for percutaneous posterolateral lumbar foraminoplasty / 中华骨科杂志

ObjectiveTo introduce the design of the instrument for percutaneous posterolateral foraminoplasty and analyze long-term outcomes of percutaneous foraminoplasty and transforaminal endoscopic discectomy in the treatment of non-contained lumbar disc herniation.MethodsFifty-six patients with noncontained lumbar disc herniation confirmed by symptom,physical sign and concordant imaging underwent percutaneous foraminoplasty and transforaminal endoscopic discectomy,including 7 cases of L3-4,30 of L4-5 and 19 of L5S1.The visual analogue scales(VAS) of pre- and post-operative low back pain and sciatica were compared,and the Macnab scores were also evaluated.ResultsAll of the procedures were performed successfully,with mean operation time of 60 min(range,40-120 min),and a mean blood loss of 30 ml (range,20-50 ml).The follow-up time was more than 36 months.Postoperative VAS of low back pain and sciatica were significantly decreased compared with preoperative VAS (P＜0.01).There were 44 cases of excellent,10of good,and 2 of fair according to Macnab score system,with total successful rate (excellent and good) up to 96.4％.Only 5 cases with L5S1 disc herniation were found complicated with sun-burn syndrome,which were relieved by pulsed electro-stimulant therapy for 1 week.ConclusionPercutaneous foraminoplasty and transforaminal endoscopic discectomy is an effective and safe minimally invasive treatment alternative for non-contained lumbar disc herniation.

Significance of Flexion Priority in the Rehabilitation of Posttraumatic Stiffness of Elbow / 中国康复理论与实践

@#ObjectiveTo evaluate the significance of flexion priority strategy and the principle of joint mobilization technique in the rehabilitation of posttraumatic stiffness of the elbow. Methods24 patients with posttraumatic stiffness of the elbow were divided into 2 groups, 12 patients in each group. The treatment group was treated with flexion priority strategy of joint mobilization technique only in the treatment of flexion contracture. In order to decrease the pain caused by joint mobilization training of extension and achieve the restoration of flexion as early as possible, the rehabilitation of extension was altered to self-exercise under the consultation of doctors combined with gentle passive traction by the therapist. The control group was treated with joint mobilization technique of both flexion and extension once a day. All the patients were measured the flexion range, extension range, and flexion-extension arc after 6 weeks of rehabilitation. Results6 weeks after rehabilitation, the treatment group got 124° of flexion (range 95°～135°), much better than the control group of 95° (range 80°～110°) （P<0.01）. There was no significant difference of extension degrees between the treatment group (15°, range 10°～35°) and the control group (16°, range 10°～30°) （P＞0.05）. The final arc of flexion and extension in the treatment group had an increase of 53°, significantly greater than 30° in the control group（P<0.01）. ConclusionFlexion priority strategy of elbow rehabilitation can significantly restore the flexion function of posttraumatic elbow stiffness.

Anatomic and clinical study of minimally invasive total hip arthroplasty through anterolateral intermuscular approach / 中华创伤杂志

Objective To investigate the anatomic structure of the Chinese people,develop the procedure of minimally invasive total hip arthroplasty through the anterolateral intermuscular approach and investigate its clinical outcome.Methods Three fresh adult cadavers(6 hips)were used for study of the anatomic construction of the anterolateral intermuscular approach in Chinese people.Sixteen patients were treated with minimally invasive total hip arthroplasty through anterolateral intermuscular approach.The clinical results and operation technique were recorded.Results The anterolateral intermuscular approach was a triangle muscular interval slightly parallel to the femur.The medial-superior angle of the triangle muscular interval consists of the anterior border of gluteus medius and tensor fascia lata muscle with juncture of muscles,where the inferior branch of superior gluteal nerve entered into tensor fascia lata muscle.The average incision length was 8.8 cm(7-10 cm),with mean blood loss of 350 ml(250-550 ml).The patients took out-of-bed activity 3-5 days after operations.During operations,anterior border injury in deep portion of the gluteus medius muscle was observed in seven patients and the injured muscles were trimed or repaired.All patients were followed up for 18-39 months(averaged 27.7 months).Most of the patients had excellent location of the phantoms,except that one acetabulum had a little pitch angle and two acetabulums had a little abduction angle.No complication was observed.The mean Harris scores of hip for all patients was increased from preoperative(39.1±6.7)points to(80.6±11.3)points on six month,(88.7±9.6)points on 12 month and(91.4±13.5)points on 24 months(11 patients).No patient suffered from gluteus medius muscle weakness during the follow-up.ConclusionAnterolateral intermuscular approach has the advantages of simple anatomic construction,small incision,little operative injury,muscle sparing and fast recovery without separate muscle or tendon and is suitable for the Chinese patients.Exact incision and special operative instruments should be emphasized to avoid the increase of acetabular pitch angle and abduction angle.

Small external fixation devices combined with flap for fracture and dislocation of articulations interphalangeaes / 中华显微外科杂志

Objective To explore the outcome of small external fixation devices combined with flap for fracture and dislocation of articulationes interphalangeaes.Methods Twelve cases (13 fingers) with fracture and dislocation of articulationes interphalangeae were treated with small external fixation devices combined with flap.Blood vessel grafting and crossing anastomosis were performed.The area of the flap was 1.0 cm ×1.5 cm -2.5 cm × 3.0 cm.Results Follow-ups lasting from 6 months to 2 years showed that all fingers and flaps were survived postoperatively.Fixation average time of small external fixation was 37 days.Fracture healing was found in all cases with satisfactory effect and with better apperance.Conclusion Small external fixation devices combined with flap was proper for fracture and dislocation of articulationes interphalangeae.

Effect of Progressive Resistance Exercises Combined with Alendronate Sodium on Bone Mineral Density of Lumbar Spine in Patients with Postmenopausal Osteoporosis / 中国康复理论与实践

@#Objective To observe the effect of progressive resistance exercise combined with alendronate sodium on bone mineral density(BMD)of lumbar spine in patients with postmenopausal osteoporosis.Methods 20 patients with postmenopausal osteoporosis were randomly divided into the A and B group with 10 cases in each group.The cases of the group A were treated with progressive resistance exercises combined with alendronate sodium.Those of the group B only took alendronate sodium orally.The course of two groups was 3 months.BMD of lumbar spine was measured by dual-energy X-ray absorptiometry before and 3 months after treatment.Results Before treatment,BMD of two groups was not different.After 3 months treatment,BMD of lumbar spine were significantly improved in group A(raised 4.520±0.68%)than group B(raised 0.100±0.01%),there was a significant difference between two groups(P<0.01).Conclusion Progressive resistance exercises combined with alendronate is more efficacious than alendronate alone in restoring lumbar spine BMD in patients with postmenopausal osteoporosis.

T lymphocyte subsets and intracellular cytokines after transfer of chemical acellular nerve allograft / 中华创伤骨科杂志

Objective To provide immunological evidence for clinical transfer of chemical extracted acellular nerve allografL Methods One hundred and twenty-eight BALB/C mice were randomly divided into 4 groups of equal size according to their different treatments:negative contrast group(NC),fresh autograft group(AG),fresh allogeneic nerve group(FN)and chemical extracted aceflular allogeneic nerve group(CEN).Then we implanted various kinds of nerve grafts into the thigh muscle of BALB/C mice in corresponding groups.At 3,7,14,28 days postoperatively,8 mice from each group were killed each time to harvest their spleens,from which T lymphocytes were collected.Theu monoclonal antibodies(CD3,CD4 CD8 CD25,IL-2,IFN-γ, TNF-α)were added into the suspension.Then fluorescence.activated cell sorting(FACS)was used to determine the positive rates of cells combined with the above monoclonal antibodies. Results There were no statistically significant differences between CEN group,NC group,and AG group,but indexes of FN group were significantly higher than those of the other 3 groups at corresponding time points. Conclusion There is no obvious immune reiection of chemical extracted acellular nerve allograft when compared with fresh nerve autograft.

Effect of jog stress at fracture site on local basic fibroblast growth factor / 中国组织工程研究

BACKGROUND: Some researches demonstrate that jog stress at fracture part can promote formation of callus, but molecular biological mechanism of jog stress on fracture healing is still unclear.OBJECTIVE:To study the effect of jog stress at fracture site on basic fibroblast growth factor(bFGF)at broken parts.DESIGN:Randomized controlled animal study.SETTING:Department of Orthopaedics,General Hospital of the Second Artilleryman of Chinese PLA;Departments of Orthopaedics and Pharmacy,the First Affiliated Hospital of General Hospital of Chinese PLA.MATERIALS:The experiment was carried out in the Animal Laboratory,the First Affiliated Hospital of General Hospital of Chinese PLA and the 8th Laboratory,Academy of Military Medical Sciences of Chinese PLA from March 2003 to April 2004.A total of 72 healthy purebred New Zealand rabbits,of general grade,5-6 months old,weighing 2.5-3.0 kg,were provided by Animal Center of Academy of Military Medical Sciences of Chinese PLA.All rabbits were randomly divided into jog group and fixation group with 36 rabbits in each group.And then,every 6 rabbits in both groups were respectively observed at 6 time points,including 7,14,21,28,42 and 56 days.METHODS:All animals were anesthetized with ketamine and sumian xinji.Fixation needle was rotated into 3,3.5,5.5 and 6 cm below platform of tibia,respectively,and then external fixators were installed.Chuck which was located at 1.5 cm from internal cortical bone and 4.5 cm below platform of tibia crossly cut off tibia.Fracture space was 2.0 mm and 2.5 mm in the fixation group and jog group,respectively.Animals in the fixation group were fixed with unilateral external fixator to dissect replace fracture part.In addition,animals in the jog group cut off their bone,fixed,and moved 0.5 mm to axis along central staff of external fixator.Animals were able to freely walk and external fixator was slightly shaken based on body mass of animal.Furthermore,all animals were sacrificed at 7,14,21,28,42 and 56 days after operation.According to the center of fracture part,samples in 1 cm length were cut,divided and fixed for 12 hours.Quantitative analysis of bFGF and colorized intensity were detected with immunohistochemical stain and JVC imaging analytic system at 7,14,21,28,42 and 56 days after operation.MAIN OUTCOME MEASURES:①Detecting colored intensity of bFGF;②quantitative analysis of bFGF.RESULTS:A total of 72 rabbits were involved in the final analysis bFGF could express in interstitial cells,vascular endothelial cell,osteoblast,chondroblast and osteocyte plasma.At 14,21 and 28 days after operation,positive indexes of bFGF protein in the jog group were 1.98±0.14,2.04±0.12 and 2.13±0.17,respectively,which were obviously higher than those in fixation group(1.59±0.14,1.68±0.15,1.63±0.27,P＜0.05).CONCLUSION:Jog stress can increase numbers of bFGF at fracture part and promote fracture healing.

Influence of defatting procedure on osteogenicity of cancellous bone allograft / 中国矫形外科杂志

[Objective]To explore the influence of defatting procedure on osteogenicity of cancellous bone allograft.[Method]Thirty inbred Lewis rats were killed.Distal femoral metaphyses were resected as cancellous bone grafts.Grafts were randomly divided into four groups which were treated by four different procedures,respectively.Content of total lipid and total protein in grafts were measured.Twelve inbred Fisher344 rats were randomly divided into four groups according to different grouped grafts which were transplanted into femoral metaphysis bone defects of the recipients.Two different fluorochrome dyes were given subcutaneously to the recipients at 14th and 4th days before sacrifice respectively.All rats were killed at the 8th postoperative week.The experimental distal femoral metaphyses were harvested and nondecalcified sections were prepared.Sections were observed with a fluorescent microscope and bone histomorphometries were studied.The correlation analysis was performed between mineral apposition rate(MAR) and the content of total lipid.[Result]Results of measurement showed content of total lipid in four grouped grafts were different and the difference between groups were statistically significant(P

Effects of posterior total laminectomy decompression and reduction with pedicle screws for lower cervical fracture and dislocation / 中国矫形外科杂志

[Objective]To evaluate the indications,efficacy and safety of posterior total laminectomy decompression and reduction with pedicle screws for lower cervical fracture and dislocation.[Method]From June 2005 to February 2008,41 patients with lower cervical fracture and dislocation received posterior total laminectomy decompression and reduction with pedicle screws.The patients(M=32,F=9)were 22-47 years old,with an average of 33.5 years old.There were 38 fresh and 3 old injuries.[Result]All the patients were operated on successfully without severe complications during perioperative period.Totally 252 (89%) screws were exactly implanted in the cervical pedicle.The everage surgery time was 3.1 h (2.5-4 h).The average blood loss during the operation was 460 ml (250-950 ml). The average time of follow-up was 27.5 months(24-36 months). All patients had satisfiactory reduction and no internal fixator failure.Thirty-two patients who were followed up for more than 24 months had complete fusion. The motor and sensory score (ASIA92) were improved significantly at 2 years follow-up(P

Influence of defatting procedure on immunogenicity of cancellous bone allograft / 中国矫形外科杂志

D and the differences between groups were statistically significant(P0.05).Proliferation index increased in the early phase and reached the peak at the 4th post-operative week.Level of proliferation index in four groups was gradiently decreased from group A to group D.At the 4th post-operative week,differences of proliferation index were statistically significant between groups(P0.05).The changing trend of ratio of CD4+/CD8+ was similar to that of proliferation index.Histological observations showed inflammatory cells infiltrated in early phase gradiently decreased from group A to group D.At the 4th post-operative week,histological observations showed neovascularization in group D.At the 8 weeks post-operatively,more new bone formation was observed in group D. The correlation analysis showed significant positive correlation between proliferation index,CD4+/CD8+ ratio at the 4th post-operative week and the content of total lipid (P

Relationship between adjacent segment degeneration and clinical outcome after lumbar spine fusion / 中国矫形外科杂志

[Objective] To determine the relationship between the adjacent segment degeneration(ASD)and the clinical outcome after lumbar spine fusion.[Methods]Totally 436 patients undergoing posterolateral lumbar fusion were followed up for 58.13 months(26~114 months).The patients were divided into 3 groups according to the number of the fusion segments:1 segment,2 segments and 3 or more segments.UCLA grading scale was used to evaluate the degeneration of the adjacent segments.Cinical outcome was evaluated according to the criteria established by Hou SH.[Results]Adjacent segment degeneration(ASD)occurred in 58 patients,including 14 in group A,27 in group B and 17 in group C.Forty-nine patients had their ASD above the fusion level and 9 below the fusion level.For all the 14 patients in group A,the degenerative grade increased by 1 grade.Of the 27 patients in group B,16 increased by 1 grade,7 by 2 grades,and 4 by 3 grades.Of the 17 patients in group C,4 increased by 1 grade,8 by 2 grades and 5 by 3 grades.For the clinical outcome,7 patients in group A increased by 1 grade.In group B,13 patients increased by 2 grade and 5 patients increased by 3 grades.For the clinical effect degrees,7 cases decreased by 1 degree in group A.In group B,13 cases decreased by 1 degree and 6 decreased by 2 degrees.[Conclusion]No significant relationship was found between the adjacent segment degeneration and the clinical outcome.Careful attention is needed for avoidance of multi-segmental fusion.

Arthroscopic reconstruction of ACL with double-bundle semitendinosus / 中国矫形外科杂志

[Objective]To study and evaluate the result of the surgical treatment for arthroscopic reconstruction of anterior cruciate ligament(ACL) with double-bundle semitendinosus.[Method]Thirty-one cases who underwent surgical treatment of arthroscopic reconstruction of ACL with double-bundle semitendinosus during 1990～1998 were analyzed retrospectively.The mean follow up time was 127.36 months(98～168 months).Among them,11 case was simplicity ACL injury,15 cases associated with medial meniscus injury,8 cases combined with lateral meniscus injury,6 cases combined with medial collateral ligament injury,2 case combined with lateral collateral ligament injury.All the patients with medial collateral ligament injury were associated with medial meniscus injury.The analysis was performed on the symptom,physical sign,Lysholm score system and IKDC score pre and postoperation recently.[Result]All the patients had good clinical results with no click,locking,"give way",extra-extension pain,and floating patella test were negative.There were no other complications correlated with semitendinosus grafting.But mild pain were seen in 11 cases,Lachman test were positive in 3 cases,anterior drawer test were positive in 8 cases without complications of instability.The Lysholm score:preoperation was 49.62?8.22 and 76.60?7.68 in follow-up time(P

Establishment of the allograft menisci bank and preliminary clinical application / 中国矫形外科杂志

[Objective] To investigate the establishment of the Allograft Menisci Bank so as to provide suitable allograft meniscus for clinical study of allograft meniscus transplantation.[Method]The allograft menisci from the plentiful donors of the tissue bank were achieved and preserved with the deep-frozen technique.Clinical use of allograft menisci should be based on practical requirement of patients and the data recorded in the Menisci Bank.[Result]From 2005 to the end of 2006,an Allograft Menisci Bank was established which consisted with about 300 different-sized menisci and 14 allograft menisci were provided for clinical study.[Conclusion]Establishment of the Allograft Menisci Bank can provide a base for clinical meniscus transplantation.The short-term effects of the allograft menisci transplantation are satisfactory,but the long-term outcomes need more cases and further observation.

Clinical problems of arthroscopic meniscal allograft(two-cases report and literature review) / 中国矫形外科杂志

[Objective]To discuss the clinical problems of meniscal transplantation based on 2 cases clinical practical results including the harvest and preserved methods of meniscal allograft,operative procedure,rehabilitation plan and side-effect,combining with literature review,so as to provide reference for further clinical practice and research.[Method]The meniscal allograft were perfumed with arthroscopic technique on 2 patients,younger than 50 years,suffering from severe meniscus tear or defect at the time of other procedures.The initial clinical results about relieving of symptoms,recovery of functions were evaluated after short time rehabilitations.[Result]There was no operative side-injury and signs of knee instability.The incisions healed well without exudation.The knee joint swelling disappeared in 6 weeks.Rejection reaction was not observed in all of laboratory tests.The VAS were 8,6 preoperatively and 3,2 postoperatively.The processes of rehabilitation were normal.[Conclusion]Considering the difficult in maintaining severe tear meniscus and the characteristics of immune evasion of meniscus,meniscal allograft may be expectable option in the future.Very many researches have provided theoretical base.The results of long-time following-up should be further observed and wany clinical problems need to be further solved.

Mini-invasion surgical treatment of stenosing tenosynovitis by endoscopical technique assisted / 中国矫形外科杂志

[Objective]To treat stenosing tenosynovitis by a kind of mini-invasion operation with endscopy assisted,and to observe the clinical results,and to discuss the problem of open and percutaneous A1 pulley release.[Method]Eleven cases,suffering from stenosing tenosynovitis,were treated by the technique of mini-invasion operation with endscopy assisted with a kind of special release knife.The clinical results was investigated and the operative methods was investigated.[Result]All of the patients showed relieving of symptoms of disfunction and trigger finger.There was no serious complication,such as injury of nerves,infection,wound ununion and hand disability.None recurrent case in the follow-up period of 6 to 36 months.[Conclusion]The method of miniinvasion surgical treatment of stenosing tenosynovitis by endscopical technique assisted is safe,effective and low-cost with few complications,which fit for treating stenosing tenosynovitis,specially for those patients with cortisone injection,diabetes and thumb stenosing tenosynovitis.