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Henoch-Sch?nlein purpura(HSP) is a common small vessel inflammation in childhood, and most of them have good prognosis.Due to too many inflammatory factors, the body injury will persist in some severe cases of HSP that hormone alone is difficult to improve symptoms in a short time.Recent studies have found that gamma globulin or blood purification combined with hormone can relieve clinical symptoms more quickly.Plasma exchange and hemoperfusion are commomly used.The purpose of this paper is to review the status of gamma globulin and blood purification treatment in severe HSP.
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A survey was conducted to analyze the HIV testing status and related influencing factors of male sexually transmitted diseases(STD) patients attending 18 county-level hospitals in Shandong Province from July 2015 to August 2016. The HIV detection rate of 1 570 subjects was 77.58% (1 218/1 570), and the HIV-antibody positive rate was 0.99% (12/1 218). Compared with general hospitals patients, urinary and anorectal patients, non-sexual patients, and patients with negative attitudes toward HIV testing, patients were more likely to be tested for HIV from specialized hospitals (OR=3.74, 95%CI:2.53-5.54), the skin and venereal section (OR=1.92, 95%CI: 1.31-2.79), the STD group (OR=2.02, 95%CI: 1.34-3.03) and patients with positive attitude (OR=15.20, 95%CI:10.74-21.52).
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Objective@#To understand the survival status of AIDS patients after initiation of antiretroviral treatment (ART) in Shandong province during 2003 to 2017, and to determine the factors associated with survival status.@*Methods@#A retrospective cohort study was conducted among AIDS patients initially received antiretroviral therapy from 2003 to 2017. The epidemiological characteristics of the subjects were described, and life tables were used to estimate the survival rates, the influencing factors were analyzed by Cox regression model.@*Results@#A total of 9 813 cases were enrolled in this study, of the subjects, the median age was 34.9±11.0 years. The median of baseline CD4+ T lymphocyte count was 300.0(P25-P75: 163.0, 428.0)cells/μl, and 83.2% of them were at clinical stage Ⅰ (World Health Organization, WHO). The cumulative survival rates were 97.7%, 96.7%, 95.8% and 93.7%, 1, 3, 5, and 10 years after the initiation of ART respectively. Multivariate Cox regression model analysis showed that the risk of the mortality among those infected through homosexual behavior was 38% lower than that of patients infected via blood or other routes, and HR was 0.62 (95%CI: 0.43-0.89). Higher education level had lower mortality risk(the mortality risk of those with university degree or above was lower, compared to those with primary and lower cultural level, HR=0.41, 95%CI: 0.26-0.65). At baseline, AIDS patients at clinical stage Ⅰ(WHO) had lower mortality risk than those who were at clinical stageⅡ, Ⅲ, and Ⅳ(WHO). Lower baseline CD4+ T lymphocyte count had higher mortality risk.@*Conclusions@#Survival rate was higher after initial antiretroviral therapy among AIDS patients in Shandong province. CD4+ T lymphocyte count level, WHO clinical stage, and presence or absence of clinical symptoms at baseline are the main factors influencing the survival time of AIDS patients after ART.
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Objective To analyze the epidemiological characteristics,dynamic trend of development and related influencing factors of hepatitis C in Shandong,China,2007-2016,also to provide epidemiological evidence for prevention and control of HCV.Methods National surveillance data of hepatitis C from 2007 to 2016 in Shandong was used,with distribution and clustering map of hepatitis C drawn at the county level.Panel Poisson regression was used to explore the influencing factors of hepatitis C at the city level.Results The incidence of hepatitis C in Shandong increased from 1.49/100 000 in 2007 to 4.72/100 000 in 2016,with the high incidence mainly clustered in the urban regions in Jinan,Zibo,Weihai et al.and surrounding vicinities.Majority of the cases were young adults,with 53.16％ (14 711/27 671) of them being farmers.Results from the Multiple panel Poisson regression analysis indicated that factors as:population density (aIRR=1.07,95％ CI:1.05-1.10),number of hospital per hundred thousand people shared (aIRR=1.16,95％CI:1.08-1.24),expenditure of medical fee in rural (aIRR=1.21,95％CI:1.08-1.37) and the proportion of the tertiary industry (aIRR=1.08,95％ CI:1.07-1.09) were all correlated to the incidence of hepatitis C.Conclusions The incidence of hepatitis C had been increasing rapidly in recent years,in Shandong.Prevention and control of HCV should focus on high risk population.In addition,rural,especially in areas with lower economics provision should be under more attentions,so as to find more concealed cases for early treatment.
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Objective To analyze the epidemiological characteristics,dynamic trend of development and related influencing factors of hepatitis C in Shandong,China,2007-2016,also to provide epidemiological evidence for prevention and control of HCV.Methods National surveillance data of hepatitis C from 2007 to 2016 in Shandong was used,with distribution and clustering map of hepatitis C drawn at the county level.Panel Poisson regression was used to explore the influencing factors of hepatitis C at the city level.Results The incidence of hepatitis C in Shandong increased from 1.49/100 000 in 2007 to 4.72/100 000 in 2016,with the high incidence mainly clustered in the urban regions in Jinan,Zibo,Weihai et al.and surrounding vicinities.Majority of the cases were young adults,with 53.16％ (14 711/27 671) of them being farmers.Results from the Multiple panel Poisson regression analysis indicated that factors as:population density (aIRR=1.07,95％ CI:1.05-1.10),number of hospital per hundred thousand people shared (aIRR=1.16,95％CI:1.08-1.24),expenditure of medical fee in rural (aIRR=1.21,95％CI:1.08-1.37) and the proportion of the tertiary industry (aIRR=1.08,95％ CI:1.07-1.09) were all correlated to the incidence of hepatitis C.Conclusions The incidence of hepatitis C had been increasing rapidly in recent years,in Shandong.Prevention and control of HCV should focus on high risk population.In addition,rural,especially in areas with lower economics provision should be under more attentions,so as to find more concealed cases for early treatment.
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Objective@#To analyze the epidemic features of male HIV-infected and AIDS patients by sexual transmission in Shandong Province.@*Methods@#Data on HIV-infected people and AIDS patients (HIV/AIDS) were derived from HIV/AIDS Comprehensive Response Information Management System. To analysis the epidemiological data of male HIV/AIDS by sexual transmission reported in Shandong Province from 1997 to 2016.@*Results@#A total of 8 584 HIV/AIDS were reported by heterosexual transmission or homosexual transmission from 2007 to 2016. 2 421 cases were reported by heterosexual transmission and 6 163 cases were reported by homosexual transmission. Among cases infected by heterosexual transmission. The average age of cases infected by heterosexual transmission was (38.13±12.39) and (31.62±10.22) among cases who infected by homosexual transmission (t=24.95, P<0.001). 84 cases were reported by homosexual transmission and 138 cases by heterosexual transmission from 2007 to 2008, and 6 079 cases were reported by homosexual transmission and 2 283 cases by heterosexual transmission from 2009 to 2016. A total of 770 cases were dead after reported. Among the dead cases, 337 cases were infected by homosexual transmission and 433 cases by heterosexual transmission (χ2=328.21, P<0.001). 61.4% of the dead cases by heterosexual transmission were no longer than 6 months after reported and 54.3% in homosexual transmission (χ2=3.96, P=0.047).@*Conclusion@#Homosexual transmission has been the main transmission of HIV/AIDS in Shandong Province. Epidemiological features and social demographic characteristics of each sexual transmission were different. As part of HIV cases developed to death in 6 months.
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Objective To analyze the status and its factors associated with HIV/AIDS“90-90-90”-treatment-target in Shandong province,China.Methods Data regarding testing,treatment on HIV/AIDS in Shandong province by December 31,2015 was collected.Chi-square test and logistic regression model were used to analyze related factors associated with the “90-90-90”-treatment-target.Results Of the 11 700 estimated HIV/AIDS,61.2％ were diagnosed,of whom 74.4％ had received Highly active antiretroviral therapy (HAART).More than 80％ of the HIV/AIDS on HAART reached the criteria on viral suppression.HIV/AIDS infected by homosexual contacts were less likely to seek for diagnosis (P＜0.05).HIV/AIDS lived in Qingdao city (OR=1.30,95％CI:1.05-1.60),Yantai city (OR=1.53,95％CI:1.02-2.31) and Weihai city (OR=1.96,95％CI:1.07-3.58) were more likely to receive HAART.HIV/AIDS patients that infected through homosexual or (OR=O.12,95％CI:0.06-0.24) or heterosexual contacts (OR =0.13,95 ％CI:0.07-0.26),through injecting drug use (OR =0.08,95％CI:0.03-0.17) or being diagnosed at the custodial institutions (OR=0.29,95％CI:0.21-0.41)were less likely to receive HAART.HIV/AIDS patients who received HAART at medical institutions (OR=1.81,95％ CI:1.05-3.47) were more likely to meet the level of Viral load (VL) suppression.However,those who were infected through homosexual (OR=0.43,95％ CI:0.25-0.75) or heterosexual contacts (OR =0.49,95％CI:0.28-0.81) or diagnosed at the custodial institutions (OR =0.48,95％CI:0.28-0.80) were less likely to meet the criteria set for VL suppression.Conclusions There was a gap between the status of testing/treatment and the target on HIV/AID “90-90-90”-treatment,especially on the target set for testing,in Shandong Province.Both HIV testing and comprehensive care services need to be strengthened.
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Objective To analyze the spatiotemporal characteristics of HIV/AIDS in Shandong province,2009-2015.Methods Data on HIV/AIDS between 2009 and 2015 were derived from the Shandong provincial HIV/AIDS Comprehensive Response Information Management System at the end of 2015.All the data were geographically referenced based on 139 spatial units in the related counties of Shandong province.Electronic maps were obtained from China CDC.Global Moran's I statistics and LISA statistics were used to detect the global and local spatial distribution patterns of HIV/AIDS in Shandong.Space-time scan statistics method,based on the Poisson Model,was used to detect the space-time clusters of HIV/AIDS.Results A total of 9 144 HIV/AIDS cases were reported during 2009-2015 in Shandong province.The scope of spatial distribution on HIV/AIDS expanded annually and concentrated in certain areas.Spatial distribution of HIV/AIDS in 2009 was randomized,and results showed spatial autocorrelation at the county level,during 2010-2015.Spatial hotspot-clusters mainly appeared in Tianqiao,Shizhong and Licheng districts of Jinan city,and Shinan,Laoshan districts of Qingdao city.Results from the Space-time scan analysis identified 5 spatiotemporal clusters in 2013-2015,including 1 most likely cluster and 4 secondary clusters which involving Lixia,Shizhong,Huaiyin and Tianqiao districts of Jinan city (RR=11.29,LLR=1 592.84,P＜0.001).The covered counties in secondary clusters appeared in Shinan,Shibei and Licang districts of Qingdao city (RR=7.35,LLR=682.40,P＜0.001),Weicheng and Kuiwen districts of Weifang city (RR=7.33,LLR=363.49,P＜0.001),Zhifu and Laishan districts of Yantai city (RR=7.66,LLR=117.63,P＜0.001),Zhoucun and Zhangdian districts of Zibo city (RR =6.09,LLR=268.68,P＜0.001)respectively.Conclusion HIV/AIDS cases in Shandong province appeared clustering features in both dimensions of time and space.Prevention efforts were needed to focus on HIV/AIDS highly clustered areas,such as Jinan city,Qingdao city,Zibo city,Weifang city and Yantai city.
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Objective To analyze the status and its factors associated with HIV/AIDS“90-90-90”-treatment-target in Shandong province,China.Methods Data regarding testing,treatment on HIV/AIDS in Shandong province by December 31,2015 was collected.Chi-square test and logistic regression model were used to analyze related factors associated with the “90-90-90”-treatment-target.Results Of the 11 700 estimated HIV/AIDS,61.2％ were diagnosed,of whom 74.4％ had received Highly active antiretroviral therapy (HAART).More than 80％ of the HIV/AIDS on HAART reached the criteria on viral suppression.HIV/AIDS infected by homosexual contacts were less likely to seek for diagnosis (P＜0.05).HIV/AIDS lived in Qingdao city (OR=1.30,95％CI:1.05-1.60),Yantai city (OR=1.53,95％CI:1.02-2.31) and Weihai city (OR=1.96,95％CI:1.07-3.58) were more likely to receive HAART.HIV/AIDS patients that infected through homosexual or (OR=O.12,95％CI:0.06-0.24) or heterosexual contacts (OR =0.13,95 ％CI:0.07-0.26),through injecting drug use (OR =0.08,95％CI:0.03-0.17) or being diagnosed at the custodial institutions (OR=0.29,95％CI:0.21-0.41)were less likely to receive HAART.HIV/AIDS patients who received HAART at medical institutions (OR=1.81,95％ CI:1.05-3.47) were more likely to meet the level of Viral load (VL) suppression.However,those who were infected through homosexual (OR=0.43,95％ CI:0.25-0.75) or heterosexual contacts (OR =0.49,95％CI:0.28-0.81) or diagnosed at the custodial institutions (OR =0.48,95％CI:0.28-0.80) were less likely to meet the criteria set for VL suppression.Conclusions There was a gap between the status of testing/treatment and the target on HIV/AID “90-90-90”-treatment,especially on the target set for testing,in Shandong Province.Both HIV testing and comprehensive care services need to be strengthened.
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Objective To analyze the spatiotemporal characteristics of HIV/AIDS in Shandong province,2009-2015.Methods Data on HIV/AIDS between 2009 and 2015 were derived from the Shandong provincial HIV/AIDS Comprehensive Response Information Management System at the end of 2015.All the data were geographically referenced based on 139 spatial units in the related counties of Shandong province.Electronic maps were obtained from China CDC.Global Moran's I statistics and LISA statistics were used to detect the global and local spatial distribution patterns of HIV/AIDS in Shandong.Space-time scan statistics method,based on the Poisson Model,was used to detect the space-time clusters of HIV/AIDS.Results A total of 9 144 HIV/AIDS cases were reported during 2009-2015 in Shandong province.The scope of spatial distribution on HIV/AIDS expanded annually and concentrated in certain areas.Spatial distribution of HIV/AIDS in 2009 was randomized,and results showed spatial autocorrelation at the county level,during 2010-2015.Spatial hotspot-clusters mainly appeared in Tianqiao,Shizhong and Licheng districts of Jinan city,and Shinan,Laoshan districts of Qingdao city.Results from the Space-time scan analysis identified 5 spatiotemporal clusters in 2013-2015,including 1 most likely cluster and 4 secondary clusters which involving Lixia,Shizhong,Huaiyin and Tianqiao districts of Jinan city (RR=11.29,LLR=1 592.84,P＜0.001).The covered counties in secondary clusters appeared in Shinan,Shibei and Licang districts of Qingdao city (RR=7.35,LLR=682.40,P＜0.001),Weicheng and Kuiwen districts of Weifang city (RR=7.33,LLR=363.49,P＜0.001),Zhifu and Laishan districts of Yantai city (RR=7.66,LLR=117.63,P＜0.001),Zhoucun and Zhangdian districts of Zibo city (RR =6.09,LLR=268.68,P＜0.001)respectively.Conclusion HIV/AIDS cases in Shandong province appeared clustering features in both dimensions of time and space.Prevention efforts were needed to focus on HIV/AIDS highly clustered areas,such as Jinan city,Qingdao city,Zibo city,Weifang city and Yantai city.
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<p><b>OBJECTIVE</b>To explore the influencing factors of AIDS pathogenesis using the Bayesian network.</p><p><b>METHODS</b>Based on follow-up data of 2 431 cases of HIV/AIDS from 1992-2011 in Shandong province, this study constructed the network structure by NPC algorithm, and used the EM algorithm for parameter learning to construct the Bayesian network of influencing factors and AIDS pathogenesis, then did inference by the Bayesian network.</p><p><b>RESULTS</b>A total of 49.77% (1 210/2 431) were AIDS. Get a Bayesian network with 7 nodes and 11 directed arcs and the related parameters by studying the follow-up data of 2 431 cases. The area under receiver operating curve(ROC) was 0.75. There was a direct causal association among sample resource, transmission route, CD4(+)T lymphocyte count of HIV-antibody confirmed positive, antiviral therapy, opportunistic infection therapy, follow-up intervention and AIDS pathogenesis. The incidence probability was 42.83% for those who received antiviral therapy and follow-up intervention, and it was 68.96% for those who received antiviral therapy without follow-up intervention. The probability to receive follow-up intervention was 68.96% for cases transmitted by homosexual behaviors, and it was 34.00%, 42.24%, 1.06% and 22.70% respectively to be reported by medical institutions, testing and counselling, supervision institutions and special surveys.</p><p><b>CONCLUSION</b>The Bayesian network revealed the mutual relation and effect intension among multi-factors and multi-stages by network inference. It showed that the rate of AIDS pathogenesis was lower for those who received antiviral therapy and follow-up intervention.</p>
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Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Síndrome da Imunodeficiência Adquirida , Tratamento Farmacológico , Epidemiologia , Patologia , Teorema de Bayes , China , Epidemiologia , Incidência , Contagem de LinfócitosRESUMO
<p><b>OBJECTIVE</b>To analyze survival time of AIDS death cases receiving Antiretroviral Therapy and related factors.</p><p><b>METHODS</b>A retrospective cohort study was carried out to collect the data on death cases receiving Antiretroviral Therapy by the National HIV/AIDS Comprehensive Response Information Management System. Kaplan-Meier was used to calculate the median survival time, and compare survival time among different groups of age, sex, marriage status, infectious routes, WHO clinical stage, baseline CD4(+)T cell counts, and interval time from the start of ART to HIV confirmation. Life table and survival curve were applied to describe survival distribution. Cox proportional hazard model was used to determine the factors associated with the survival time.</p><p><b>RESULTS</b>Among 142 AIDS death cases, 125 (88.03%) were related with AIDS and 17(11.97%) were not. The total median survival time was 3.100 months (95%CI: 2.279-3.921). The cumulative survival rate was (52 ± 4)%, (33 ± 4)%, (26 ± 4)% in the first 3 months, 3-6 months, and 6-12 months. The median survival time of married or cohabitation group was 2.670 months (95%CI:1.470-3.870), and single (unmarried, divorced, separation, widowed) group was 5.870 months (95%CI: 2.617-9.123). The median survival time of WHO clinical stage I or II group was 5.870 months (95%CI: 3.989-7.751), and WHO clinical stage III or IV group was 1.700 months (95%CI: 0.885-2.515). The median survival time of baseline CD4(+)T cell counts ≤ 50 /µl group was 1.670 months (95%CI: 0.759-2.581), and 51-199 /µl group was 4.400 months (95%CI: 2.735-6.065), and ≥ 200/µl group was 7.100 months (95%CI: 0.000-14.542). The survival time was significantly different among different baseline marital status groups, different WHO clinical stage groups, and different CD4(+)T cell counts groups. The mortality risk of Single (unmarried, divorced, separation, widowed) group was 0.641 times of the risk in married or cohabitation group. The mortality risk of WHO clinical stage III or IV was 1.856 times of the risk in stage I or II. The mortality risk of baseline CD4(+)T cell counts 51-199 /µl group was 0.582 times of the risk in ≤ 50 /µl group, and ≥ 200 /µl group was 0.551 times of the risk in ≤ 50 /µl group.</p><p><b>CONCLUSION</b>The total median survival time was relatively short. Most AIDS deaths happened in the first 3 months or 3-6 months after they received Antiretroviral Therapy, and the mortality trend slowed down in the following months. Married or cohabitation, low-baseline CD4(+)T cell counts, or WHO clinical stage III or IV were found to be the risk factors associated with AIDS death cases receiving Antiretroviral Therapy.</p>
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Humanos , Síndrome da Imunodeficiência Adquirida , Terapia Antirretroviral de Alta Atividade , Contagem de Linfócito CD4 , Estudos de Coortes , Progressão da Doença , Infecções por HIV , Estado Civil , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Taxa de SobrevidaRESUMO
Objective To investigate the epidemiological characteristics of acquired immune deficiency syndrome (AIDS) in Shandong Province,and to provide scientific evidence for formulating prevention and control strategy and carrying out effective measures.Methods Epidemiological data of reported human immunodeficiency virus (HIV) infection and AIDS cases (HIV/AIDS) in Shandong Province from 1992 to 2011 were analyzed.Results A total of 4313 cases of HIV/AIDS were confirmed and reported by the end of 2011,with an average incidence of 2.39 parts per million (ppm) annually.An upward trend was showed for annual reported incidence.The top 5 cities of incidence were Ji'nan,Qingdao,Zibo,Weifang and Weihai,which were 5.72 ppm,4.39 ppm,3.29 ppm,3.10 ppm and 3.02 ppm,respectively.The average annual reported incidence was 3.74 ppm for male,which was significantly higher than that for female (1.39 ppm; x2 =743.96,P＜0.05).The reported incidence was highest among 20-29 age group (5.56 ppm),with 57.18％ of homosexual transmission.The proportion of homosexual transmission in annual reported cases increased from 1.82％ in 2004 to 37.49％ in 2011.Conclusions The epidemic situation of AIDS in Shandong Province is severe,with unbalanced geographical distribution.Sexual transmission is the main route of transmission,and cases of homosexual transmission increase sharply.
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Objective To investigate effects of arthroscopic reconstruction of medial patellofemoral ligament (MPFL) using partial peroneus longus tendon autograft in treating recurrent patellar dislocation.Methods Forty-six patients (53 knees) with recurrent dislocation of patella received autologous partial peroneus longus tendon grafting for MPFL reconstruction after arthroscopic lateral retinaculum release from May 2009 to April 2010.Anatomic relation between femoral trochlea and patella,and motion path of patella were observed arthroscopically in adjustment of flexion and extension strength of grafted tendon in different angles.Successively,the tendon ends were fixed within bone tunnel of medial femoral condyle by using absorbable interface screws with synchronous superomedial displacement of tibial tuberosity.Stability of patellofemoral joint,dislocation recurrence,subjective symptoms of affected knees and general function recovery condition of affected limbs were studied.Results All patients were followed up for average 18 months (range,12-24 months),which showed the improvement of knee joint stability,without recurrence of patellar dislocation.Apprehensive test was negative.Axial X-ray films and CT of patella showed normal anatomical relation of patellofemoral joint.The Kujala patellar stability questionnaire scored (54.6 ±5.4) points before operation and (92.3 ±8.9) points after operation (t =55.41,P ＜ 0.01).All patients showed some improvement of motor ability after operation.CT examination showed that the congruence angle of patella and femoral trochlea was improved from preoperative (27.8 ± 8.1) ° to postoperative (2.3 ± 9.4) ° (t =20.87,P ＜ 0.01).Otherwise,ankle joint in the tendon donor site acted well,with normal function.Conclusion Arthroscopic lateral patellar retinaculum release and MPFL reconstruction using partialperoneus longus tendon autograft are effective in treatment of recurrent patellar dislocation in combination with superomedial displacement of tibial tuberosity,and avoid potential complications in tendon removal from around knee joint.
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Objective To describe the surgical technique and outcomes of arthroscopic reconstruction anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) and repair of the injured posteromedial complex (PMC) or posterolateral complex (PLC) structures of the knee joint in treatment of multiple ligaments injuries of knee. Methods From March 2005 to May 2007, 43 patients with multiple ligaments injuries of knee underwent arthroscopic reconstruction. Twenty-four patients were treated with arthroscopic reconstruction of combined ACL and PCL with allograft tendons and augmentation of PMC. The other 19 patients were treated with repair the PLC in addition to reconstruction of ACL and PCL. The International Knee Documentation Committee (IKDC) and Lysholm knee score were used for function evaluation. Results All patients were followed up for 24 to 48 months with an average of 33.10±9.65 months. The stability recovered when stress was applied to the knee at 0° and 20° of flexion. According to IKDC there was a significant improvement from severely abnormal (graded D) in 43 cases before surgery to normal (graded A) in 29 cases (67%), nearly normal (graded B) 11 cases (26%) and abnormal (graded C) 3 cases (7%) at follow-up. The average Lysholm score of the all cases were 46.7±4.2 and 89.6±2.8 before operation and at final follow-up, respectively (t=8.563, P＜0.01). Conclusion Excellence clinical results and good stability were achieved with arthrescopic reconstruction of ACL and PCL combined with repair or augmentation of the PMC and PLC simultaneously.
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Objective To introduce an augmentation technique with 4-strand semitendinesus ten-don in treatment of partial anterior cruciate ligament (ACL) injury of under arthroscope and investigate the clinical outcome of the technique. Methods A total of 26 patients with posterolateral bundle rup-tures of ACL were treated arthroscopically with 4-strand semitendinosus tendon augmentation. The Inter-nationnal Knee Documentation Committee (IKDC) and Lysholm knee score scale were used for evaluation of knee function. The side-to-side difference in anterior knee laxity was examined by KT-1000 (25 de-grees flexion and 301b). Results There was no knee extension limitation, with knee flexion of 130°-150 °(average 142°). The patients were followed up for 12-18 months, which showed grade A in 25 pa-tients (96%) and grade B in one (4%) according to IKDC grade at final follow-up. The subjective IK-DC score was increased from preoperative (71.4±3.7) points to (95.8±3.4) points at final follow-up (t =9.836,P <0.01). The average side-to-side difference in maximal manual test with KT-1000 ar-thrometer at 25° flexion decreased from preoperative (5.1±1.2) mm to (2.1±1.3)mm at final follow-up (t = 10.48 ,P < 0.01). The Lysholm score of all patients was (76.7±3.2) preoperatively and (95. 7±2.4) at final follow-up (t =7.356,P<0.01). Conclusion Augmentation with 4-strand semiten-dinosus tendon under arthroscope can attain excellent clinical results and good anterior stability in treat-ment of partial tears of posterolateral bundle of ACL.
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Objective To investigate the feasibility and clinical effect of the posterolateral depressed tibial plateau fracture by arthroscopically assisted treatment. Methods From March 2006 to September 2007, 26 patients with the posterolateral depressed tibial plateau fracture were reduced by arthroscopy and fixed laterigradely with lag screw through the capitulum fibulae. There were 17 males and 9females, and the patient age at surgery ranged from 19 to 58 years (mean, 34.5 years). According Schatzker classification, type Ⅱ for 21 patients, type Ⅲ for 5 patients. The injury mechanism included traffic injury for 15 cases, building injury for 4 cases, and sport injury for 7 cases. All patients were performed arthroscopy mean 8 days after injury. The operation time, bone union time, full weight-bearing time, range of motion, and related complications in all patients were observed, and HSS scores were used to evaluate the knee function. Results All patients got followed up. The follow-up periods ranged from 4 to 11 months (mean, 9 months). The mean operation time was 35 minutes (range, 20 to 50 minutes). The mean full weight-bearing time and radiographic bone union time were 11 and 13.1 weeks respectively, and the average ROM was 135°. None of the cases was found for infection, deep vein thrombosis, compartment syndrome, screw loosing and broken. The average HSS scores was 93 at the ultimated follow up (range, 84 to 98). There were 25 excellent cases, and 1 good case. The excellent and good rate was 100%. Conclusion Arthroscopically assisted treatment of the posterolateral depressed tibial plateau fracture was an very effective treatment methods, which showed less invasive and direct good reduction.
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Objective To investigate the outcome of augmentation of posterior cruciate ligament (PCL) using suture fixation technique. Methods Thirteen cases of simple PCL raptures were treated arthroscopically with suture fixation to maintain tibial neutralization and augment PCL. The patients were followed up for 12 to 18 months. The IKDC and Lysholm knee score were used for function evaluation. The posterior knee laxity was examined by KT-1000. Results There was no limitation to knee extension.Knee flexion was between 120° and 140°, with an average of 128°. The final IKDC grade was A in 6 cases and B in 7 cases. The IKDC subjective score increased from preoperative 67.4±3. 3 to postoperative 92.5±4. 5 (t=9. 837, P < 0. 01) . The average side-to-side difference in maximal manual test with KT-1000 arthremeter at 90° flexion decreased from 8. 1±1.7 mm to 2.0±1.3 mm ( t = 12. 230, P < 0. 01) . The Lysholm score in the 4 chronic cases was 87.5±3. 1 before surgery and 95.8±3.5 at the last follow-up( t = 5. 376, P < 0.01 ). Conclusion In some cases of PCL injury, excellent clinical results and good posterior stability can be achieved by augmentation of the tom PCL using suture fixation technique.