Transarticular Screw Fixation in the Treatment of Severe C1-C2 Dislocation: A Case Series Report.

BACKGROUND: To aim of the present paper was to evaluate the results of halo traction and transarticular screw fixation combined with bone autoplasty in patients with severe atlantoaxial dislocation. CASE PRESENTATION: This is a retrospective study of severe cases of atlantoaxial dislocation in nine patients (six men and three women) treated with preoperative halo traction and posterior C1-C2 transarticular screw fixation combined with bone autoplasty from June 2006 to June 2011 at the Saint Paul Hospital (Hanoi). The mean age of patients was 37.48 ± 13.753 years (range, 26-50 years). The possibility of fixing dislocation using a halo apparatus was investigated through a series of preoperative halo corrections performed within a span of 1-2 weeks. For transarticular screw fixation, two transarticular screws were used that were positioned according to the Magerl technique. For bone autoplasty, an iliac crest bone graft approximately 3 × 2 cm in size was used. The postoperative assessment of clinical improvement was performed using the neck disability index (NDI), the American Spinal Injury Association (ASIA) impairment scale, and the visual analog scale (VAS) measurement instruments, through the gradation of atlantoaxial dislocation, and via the clivoaxial angle(CAA) index and the space available for cord (SAC) index after 6 months. The image diagnosis demonstrates that all the cases of atlantoaxial dislocations are unstable and correspond to the Fielding and Hawkins type III dislocation. Eight patients underwent complete reduction using the halo fixation device. In one patient, the C1-C2 displacement was manually reduced during surgery. CT scanning revealed that the accuracy of screw placement was 94.4%. The bone fusion rate was 100% after 6 months. Based on the ASIA impairment scale, the preoperative examination of patients revealed grade C injuries in seven patients and grade D injuries in two patients. After surgery, all patients had grade D injuries. Six months after surgery, four patients had moderate self-reported neck disability (30%-48%) and five patients reported mild disability (10%-28%); that is, the patient perception of the neck problem improved. In the postoperative phase, all patients showed an improvement in VAS pain scores and the SAC score returned to the normal range in all patients. The CAA returned to normal in only seven patients; in the other two patients, the CAA returned to a value that was close to normal (145° and 149°). CONCLUSION: Through halo traction combined with transarticular screw fixation and bone autoplasty, noticeable postoperative improvements were attained based on the clinical scores for NDI, ASIA, and VAS, as well as SAC and CAA.

The effectiveness of knee osteoarthritis treatment by arthroscopic microfracture technique in combination with autologous bone marrow stem cells transplantation.

OBJECTIVE: We aimed to evaluate the efficacy of the treatment of knee osteoarthritis (OA) patients by using microfracture technique in combination with autologous bone marrow stem cell transplantation. METHODS: A clinical study was conducted between November 2011 and January 2015 and involved 46 patients (aged from 46 to 69) with primary knee OA grade II and III (according to Kellgren-Lawrence classification) at the Orthopedic Trauma Department, Vietnam-Germany Friendship Hospital. Patients were randomly assigned to receive knee arthroscopy and then bone-marrow stem cells from their pelvic bones via injection. RESULTS: The mean Visual Analogue Scale (VAS) score of present pain decreased from 5.68 before surgery to 1.7 24 months after surgery. The mean preoperative Knee Injury and Osteoarthritis Outcome Score (KOOS) was 36.34 (± 3.13), which increased to 74.62 (± 2.86) 24 months after surgery. On the MRI scans, the average Noyes score decreased from 12 (± 1.46) to 7 (± 1.50). Cartilage volume increased on average from 0.4512 (± 0.26) cm3 to 0.5463 (± 0.29) cm3 12-24 months after surgery. CONCLUSION: Treatment of osteoarthritis by a combination of arthroscopic microfracture and transplantation of autologous bone-marrow stem cells was an invasive, safe and effective method which showed an improvement in the clinical symptoms (VAS score) and knee functions (KOOS points).

Understanding the mechanochemical synthesis of the perovskite LaMnO3 and its catalytic behaviour.

Mechanochemistry offers a solventless, 'waste free' route to preparing metal oxide catalysts, however, there is limited information on the chemical steps involved. In this work, the perovskite LaMnO3 has been successfully synthesized via mechanochemistry from metal oxide powders, La2O3 and Mn2O3, at room temperature, using a planetary ball mill. Separate ex situ'time slices' were taken during the milling procedure to provide insights into the underlying chemistry. The crystalline material was assessed using XRD, which identified 100% perovskite phase after 3 h of milling. Conversely, characterization by X-ray absorption spectroscopy (XAS) at both the Mn K-edge and La L3-edge provides a very different picture. The XAS data shows that there are significant structural alterations as early as 30 min of milling, with the La precursor dispersed over Mn2O3. Increasing milling time then allows for mechanical activation of both precursors and the formation of powdered LaMnO3, with no calcination step required. The XAS highlights that there is a significant amount of amorphous, oxygen deficient, content even when XRD has identified 100% perovskite phase. The samples were tested for the decomposition of the environmental pollutant N2O; at a milling time of 3 h, the LaMnO3 catalyst displays a much early onset production of N2 compared to a traditional sol-gel synthesized LaMnO3, resulting from increased oxygen deficiency at the surface, confirmed by XPS and STEM-EELS. This is an encouraging sign that mechanochemical routes can be harnessed to provide a sustainable route to preparing mixed metal oxide catalysts with enhanced catalytic performance.

Arthroscopic fixation of ACL avulsion fracture in the saint pault hospital: A review of treatment outcomes: Cohort study.

BACKGROUND: The purpose of this research is to evaluate the results of arthroscopic suture fixation with fiber wires used as treatment for ACL avulsion fracture, and to determine how effective such a technique is when it comes to restoring of knee function. MATERIALS AND METHODS: This prospective study involves 28 patients, who underwent arthroscopic fixation of displaced ACL avulsion fractures at Saint Paul Hospital (Hanoi) from January 2014 to March 2018. RESULTS: The first three weeks were not marked with any abnormalities associated with post-operative sutures and hematomas, infectious complications were not detected either. Post-operative displacement of fracture fragments did not take place among the patients involved in the study. At the 3-month follow-up, the average IKDC score was 90.7 (range: 76-100), and the average Lysholm score was 93.6 (range 82-100). The percentage of excellent scores was 42.9% (12 patients), good scores accounted for 50% (14 patients), while fair/poor scores accounted for 3.6% each (1 patient on each score). The percentage of excellent/good scores was 92.9% in total. CONCLUSION: This study shows that ACL avulsion fracture can be treated effectively by arthroscopic suture fixation with fiber wires. In fact, this technique may restore knee function and stability.

Correction to: Arthroscopic fixation of ACL avulsion fracture in the Saint Paul Hospital: a review of treatment outcomes.

The original version of this article unfortunately contained a mistake. One affiliation was incorrect.

Arthroscopic fixation of ACL avulsion fracture in the Saint Paul Hospital: a review of treatment outcomes.

The purpose of this research is to evaluate the results of arthroscopic suture fixation with fiber wires used as treatment for ACL avulsion fracture, and to determine how effective such a technique is when it comes to restoring of knee function. This prospective study involves 28 patients, who underwent arthroscopic fixation of displaced ACL avulsion fractures at Saint Paul Hospital (Hanoi) from January 2014 to March 2018. The first 3 weeks were not marked with any abnormalities associated with postoperative sutures and hematomas; infectious complications were not detected either. Postoperative displacement of fracture fragments did not take place among the patients involved in the study. At the 3-month follow-up, the average IKDC score was 90.7 (range 76-100), and the average Lysholm score was 93.6 (range 82-100). The percentage of excellent scores was 42.9% (12 patients), good scores accounted for 50% (14 patients), while fair/poor scores accounted for 3.6% each (one patient on each score). The percentage of excellent/good scores was 92.9% in total. This study shows that ACL avulsion fracture can be treated effectively by arthroscopic suture fixation with fiber wires. In fact, this technique may restore knee function and stability.

Primary Cementless Bipolar Long Stem Hemiarthroplasty for Unstable Osteoporotic Intertrochanteric Fracture in the Elderly Patients.

BACKGROUND: Intertrochanteric fracture (ITF) is a major part of fracture in femoral head fracture. 95% of ITF are found in elderly patients. Osteosynthese is the preferred method of choice. However, elderly patients had osteoporotic, combined with many of chronic disease conditions that increase the rate of osteosynthese failure. Hemiarthroplasty bipolar long-stem is a surgical method that helps patients relieve pain, facilitate early rehabilitation, limit long-term complications, and improve quality of life for patients. AIM: The aim of our study is to evaluate the clinical of result of primary cementless bipolar long stem hemiarthroplasty in treatment for unstable ITF in the elderly patients who have severe osteoporosis. METHODS: Between 01/2016 and 12/2017, 35 patients with ITF type A2.2 and A2.3 (AO) were included in our prospective study. These patients were over 70 years old and treatment by hemiarthroplasty cementless long stem at E hospital and Saint Paul hospital by one group surgeons. RESULTS: Mean age of studied subjects was 84.29 ± 6.17, the lowest was 71, the highest was 96; ratio male/female was 1/4. Follow-up of 35 patients for at least 6 months showed 88.6% caused by a low-energy injury; Average rehabilitation time was 4.63 ± 1.7 days. The average Harris point at the end was 90.4 ± 4.72. CONCLUSION: Primary cementless bipolar long stem hemiarthroplasty is one of good choices in treatment unstable ITF in elderly patients with severe osteoporosis helped patients improve the quality of life.

The Anatomical Numerical Measurement of Posterior Cruciate Ligament: A Vietnamese Cadaveric Study.

BACKGROUND: The posterior cruciate ligament (PCL) is crucial to restrain the posterior translation of the tibia. Its anatomical structure is complex. A proper understanding of PCL anatomy may assist surgeon in reconstructing anatomically native PCL. AIM: To describe the anatomical numerical measurement of the PCL in Vietnamese adults. METHODS: Twenty-one fresh cadaveric knees were examined. The macroscopic details of the intra-articular PCL, the attachment of the anterolateral bundle (ALB), posteromedial bundles (PMB) to the femur and tibia were analysed. We used a digital camera to photograph the cadaveric specimens and used the ImageJ software to analyse the collected images. RESULTS: The ALB and PMB length were 35.5 ± 2.78 and 32.6 ± 2.28 mm, respectively. The smallest and the biggest diameter of middle third of the PCL were 5.9 ± 0.71 and 10.0 ± 1.39 mm, respectively. The area of cross section of middle third of the PCL was 53.6 ± 12.37 mm2. The femoral insertion area of ALB and PMB were 88.4 ± 16.89 and 43.5 ± 8.83 mm2, respectively. The distance from the central point of femoral ALB, PMB, and total PCL insertion to the Blumensaat line were 5.5 ± 0.91, 11.5 ± 1.98, and 7.6 ± 1.42 mm, respectively. The shortest distance from medial femoral cartilage rim to the central point of femoral ALB, PMB, and total PCL insertion were 7.0 ± 0.79, 7.3 ± 0.95, and 7.8 ± 1.73 mm, respectively. The tibial insertion area of ALB and PMB were 84.5 ± 12.52 and 47.8 ± 6.20 mm2 respectively. The shortest distance from the posterior cartilage corner of the medial tibial plateau to the central point of ALB, PMB, and total PCL insertion to tibia were 8.5 ± 1.02, 9.4 ± 1.11, and 8.3 ± 1.1 mm, respectively. The central point of tibial PCL insertion was 9.7±1.08 mm below cartilage plane of the medial tibial plateau. CONCLUSION: This study describes the detailed anatomical measurement of the PCL and its bundles in adults.