Reconstruction of anterior talofibular ligament and calcaneofibular ligament with autologous peroneus brevis tendon in the treatment of chronic lateral ankle instability / 中国骨伤

OBJECTIVE@#To explore the clinical efficacy of reconstruction the anterior talofibular ligament and calcaneofibular ligament with autologous peroneus brevis tendon for the treatment of chronic lateral ankle instability.@*METHODS@#The clinical data of 42 patients with chronic lateral ankle instability treated by anatomical reconstruction of anterior talofibular ligament and calcaneofibular ligament with autologous peroneus brevis tendon from July 2016 to July 2019 was retrospectively analyzed. Including 30 males and 12 females, age ranged from 25 to 46 years old with an average of (37.6±12.4) years. There were 15 cases of left foot and 27 cases of right foot, the time from injury to operation was 3 to 12 months with a mean of (7.4±2.8) months. And 14 patients had tenderness in lateral collateral ligament area, 28 patients complained of multiple ankle sprains while walking on the flat ground. At 12 months after operation, the talar tilt angle and visual analogue scale(VAS)were observed, ankle joint varus stress and anterior drawer test were performed to check the mechanical stability of the ankle joint, American Orhopaedic Foot and Ankle Society(AOFAS) was used to score the ankle and hindfoot functions and evaluate the curative effect.@*RESULTS@#Forty patients were followed up for 12 to 48 months with an average of (28.3±10.0) months, 2 cases were lost. The VAS decreased from(4.50±0.93) scores before surgery to (1.10±0.30) scores at 12 months after surgery;the talar tilt angle was reduced from (12.26±1.13)° before operation to (4.60±0.45)° at 12 months after operation;the AOFAS score increased from (65.10±7.50)scores before surgery to (84.40±3.95) scores at 12 months after surgery;all the differences were statically significant(P<0.05). According to the AOFAS score, 27 cases got excellent results, 7 good, 5 fair, and 1 poor. One patient had the symptoms of sural nerve injury after operation, and the symptoms were relieved after oral Mecobalamin for 3 months. The remaining patients had no complications such as nerve injury, infection, and skin necrosis. There was no instability of ankle joint, and both ankle varus stress test and drawer test were negative.@*CONCLUSION@#Autologous peroneal brevis tendon with double bone channel pass through the tendon (modified Chrisman-Snook operation) can anatomically reconstruct the anterior talofibular ligament and the calcaneofibular ligament, restore the stability of the patient's ankle joint, reduce postoperative complications, and restore ankle joint function well.

Accuracy verification of anterior cruciate ligament anchor point locating under the guidance of 3D model and AR navigation / 局解手术学杂志

Objective To investigate the precision and clinical practicability of anchor point locating under the guidance of augmented reality (AR) navigation for anterior cruciate ligament (ACL) reconstruction.Methods A cube model was made by 3D print which contained some concentric circles of different diameters to be the target.Fifty orthopedists were chosen and numbered from 1 to 50 to locate with AR guidance.Finally,the results of precision and score of satisfaction were analyzed.Results The location precision guided by AR in different diameter concentric circle were 74％ (0.25 cm),78％ (0.5 cm),83％ (0.75 cm),86％ (1.0 cm),89％ (1.25 cm),96％ (1.5 cm) respectively.The average satisfaction score of the orthopedists' was (8.7 ± 1.3).Conclusion Anchor point locating under the guidance of AR navigation is a feasible and effect method for clinical ACL reconstruction,which can observe the relations of the anchor point and the adjacent structure in real time.

Clinical application of glenohumeral ligament combined with articular capsule in the repair of anterior and infe-rior labrum complete defect / 局解手术学杂志

Objective To investigate the method and effect of arthroscopic repair of recurrent anterior shoulder dislocation caused by anterior and inferior labrum complete defect.Methods Retrospective analyzed the clinical data of 23 patients with anterior and inferior la-brum complete defect who were admitted into hospital from June 2014 to October 2016 and recieved arthroscopic repair opreation with gleno-humeral ligament combined with articular capsule.Intraoperative arthroscopy was used to suture the lower glenohumeral ligament and articular capsule at the missing part of the glenoid labrum.The Rowe score,ASES score and UCLA score were compared before and after operation. Results There was no postoperative complications such as dislocation or infection occurred.All the 23 cases were followed up for 12~42 months,with an average of(19.6 ±3.4)months.The average lost angle of shoulder external rotation was(17.3 ±3.9)°.And the postopera-tive Rowe score,ASES score and UCLA score were significantly better than those before operation.Conclusion Arthroscopic repair opreation with glenohumeral ligament combined with articular capsule can effectively restore the stability of front shoulder joint,and it can be a good method for the treatment of recurrent anterior shoulder dislocation caused by anterior and inferior labrum complete defect.

Clinical analysis on arthroscopic incomplete removal of calcifications of supraspinatus tendinitis / 局解手术学杂志

Objective To evaluate the treatment effect of the arthroscopic incomplete removal of calcifications of the supraspinatus tendinitis without acromioplasty.Methods The clinical data of 20 patients of calcified supraspinatus tendinitis with Ellman Ⅰ or Ⅱ in general hospital of Shenyang military area command from January 2014 to February 2016 were retrospectively analyzed.Of the 20 patients,4 males and 16 females,the age ranged from 45 to 62 years old,with average age (50.2 ± 6.3) years old.All the patients received removal incomplete of calcification without acromioplasty.Pre-and postoperative 3,6,9 months general situation were evaluated by the VAS score,Constant-Murley score,University of California Los Angeles (UCLA) score,X-Radiographs and CT.Results The shoulder function was evidently improved in all 20 patients.The average VAS pain score was (8.2 ± 1.4) preoperatively and (0.8 ± 0.6) at the 6 months follow-up.The average Constant-Murley score was (44.6 ± 7.4) preoperatively and (95.4± 3.4) at the 6 months follow-up.The average UCLA score was (12.2 ± 3.6) preoperatively and (33.1 ± 1.4) at the 6 months follow-up.Conclusion The arthroscopic incomplete removal of calcifications of the supraspinatus tendon without acromioplasty can lead to good results with less iatrogenic injury.

Effect of MCUR1 on proliferation,cell cycle and apoptosis of K562 cells / 军事医学

Objective To investigate the effect of mitochondrial calcium uniporter(MCU)regulator 1(MCUR1)on proliferation,cell cycle and apoptosis of K562 cells and the possible molecular mechanism.Methods Recombinant plasmid vectors containing short hairpin RNAs(shRNAs)targeting MCUR1 were transfected into K562 cells,before the K562 cells stably expressing low MCUR1 were selected with G418.The expression of MCUR1 mRNA was detected by quantitative real-time polymerase chain reaction(qRT-PCR)assays.Western blotting(WB)assays were used to detect the expressions of MCUR1,P53,BAX and BCL2.The proliferation,cell cycle and apoptosis of K562 cells were detected by cell counting kit-8(CCK-8)assays and flow cytometry, respectively.Results The results of qRT-PCR and WB assays revealed that MCUR1 was stably down-regulated at mRNA and protein levels in the K562 cells transfected with shRNAs targeting MCUR1.Knockdown of MCUR1 significantly inhibited the cell proliferation, induced the cell apoptosis, but did not influence the cells cycle.Meanwhile, knockdown of MCUR1 increased the expression of P53 protein and the ratio of protein BAX/BCL2 in K562 cells.Conclusion MCUR1 promotes cell proliferation and inhibits cell apoptosis in K 562 cells.

Application of arthroscopic repair without traction for non-osseous Bankart injury in shoulder / 局解手术学杂志

Objective To explore the clinical effect of arthroscopic repair without traction for non-osseous Bankart injury.Methods From January 2009 to January 2015,the clinical data of 182 cases underwent arthroscopic Bankart repair for anterior shoulder instability in our hospital were analyzed retrospectively.They were aged from 18 to 39 years old,mean age was(26.5 ± 9.3) years.The course of disease was from 1 to 10 years,mean duration was(3.2 ±2.6) years.Recurrent dislocation was 6 to 62 times,with average of (24.2 ± 17.3) times.All cases were performed arthroscopic repair without traction.Rowes scores and UCLA scores were used for evaluation.Results All of 182 cases were followed up from 6 to 18 months,an average of (12.5 ± 6.7) months.Of the 182 patients,12 cases with postoperative limited 20°external rotation could not attend confrontational training and the other 170 cases had no adverse effect.The average loss of shoulder joint extorsion activity angle were (10.5 ± 4.1) °.Postoperative UCLA score (89 ± 3.5) was more than preoperative (25 ± 6.2),the differences were significant (P ＜ 0.05).Postoperative Rowes score (28.7 ± 2.2) were more than preoperative (7.3 ± 1.6),the differences were significant (P ＜ 0.05).Conclusion Curative effect of arthroscopic repair without traction for non-osseous Bankart injury caused by training is satifactory,which can provide brachial plexus,blood vessel and other tissues during surgery from traction,and be helpful to the popularization and application in basic-level hospitals.

Fabrication of larynx-shape tissue engineered cartilage by means of filling together with wrapping with pedicle myofascial flap / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the method of fabricating larynx-shape tissue engineered cartilage by means of filling together with wrapping with pedicle myofascial flap.</p><p><b>METHODS</b>Serial steps of solution casting, extrusion molding and particulate leaching were used to make larynx-shape [poly (3-hydroxybutyrate-co-3-hydroxyhexanoate), PHBHH] biomaterial models. The chondrocytes were seeded onto PHBHH models to form cell-PHBHH composites for culture in vitro for one week and then to fill and wrap larynx-shape composites with pedicle myofascial flap. After that to implant larynx-shape composites in situ on the back of adult New Zealand white rabbits (experimental groups n = 9). Control groups (n = 3) were the same measure as experimental groups but without chondrocytes on PHBHH models. Finally, morphological observation, HE & special staining and immunohistochemical test were conducted to evaluate the cartilage regeneration and its shape at 6, 8 and 12 weeks following implantation.</p><p><b>RESULTS</b>The PHBHH models appeared to be hollow half-trumpet with edges and corners of larynx-shape and its porosity > 90%. Pedicle myofascial flap using fascia as lining presented rich blood supply and had enough to fill and wrap larynx-shape composites. Tissue engineered larynx-shape cartilage specimens could be harvested at different period. It was demonstrated that the cartilaginous tissue formed in 6 weeks after implantation through histological and immunohistochemical examination and further maturity in 12 weeks and 18 weeks. But no cartilaginous tissue showed without chondrocytes on PHBHH as control groups to implant at the same time.</p><p><b>CONCLUSION</b>It seems that pedicled myofascial flap showed sufficient blood supply and that the filling together with wrapping method with pedicled myofascial flap is appropriate for fabricating larynx-shape tissue engineered cartilage.</p>