ABSTRACT
Purpose: This study aimed to demonstrate the application of orthotopic bone flap transplantation with a fibula transplantation (OBFT-FT) in open-wedge high tibial osteotomy (OW-HTO) and to assess the effect of OBFT-FT on gap healing. Patients and methods: From January to July 2020, 18 patients who underwent OW-HTO with OBFT-FT were reviewed for this study. Demographics, postoperative complications, and radiological and clinical outcomes of patients were collected. Finally, the clinical outcomes of patients were analyzed. Results: A total of 14 patients were included in this study. The average age and body mass index were 59.6 ± 9.2 years and 28.1 ± 4.5â kg/m2, respectively. The average correction angle and gap width were 9.5 ± 1.8° and 10.2 ± 2.7â mm, respectively. The rates of radiological gap healing at sixth week, third month, and sixth month were 42.9%, 85.7%, and 100%, respectively. The mean Lysholm score, International Knee Documentation Committee score, and visual analog scale scores at sixth-month follow-up were significantly better than the preoperative scores (p < 0.001, p < 0.001, p = 0.001, respectively). And, no delayed union or non-union, collapse, loss of correction, or surgical site infection were found. Conclusions: As a new technique for autologous bone graft, the OBFT-FT could be successfully applied in the treatment of gap healing after OW-HTO, and excellent radiological and clinical outcomes could be seen on patients' short-term follow-up.
ABSTRACT
We examined the relationship between city size and environmental efficiency and found sequential growth of environmental efficiency in 282 Chinese cities from 2003 to 2019 and also tested the mechanism of industrial transfer. The empirical results show that as the period advances, the relationship between the environmental efficiency of cities and the city size changes from an upward-sloping straight line to a "U-shaped" structure, indicating that the urbanization advantages of megacities are shifting to large or medium-sized cities. This shift is the result of the industrial transfer. The government should refrain from excessive market interventions in industrial shifts. Simultaneously, it should facilitate population mobility in large cities and enhance public services for medium-sized cities. Small cities undergoing population decline should not be hindered.
