[High tibial osteotomy combined with lateral retinacular release for the treatment of knee varus osteoarthritis with lateral patellar compression syndrome].

OBJECTIVE: To investigate the clinical effect of high tibial osteotomy combined with arthroscopic lateral retinacular release in the treatment of knee varus osteoarthritis. METHODS: From October 2017 to April 2019, a retrospective analysis was performed on 43 patients with knee varus osteoarthritis and lateral patellar compression syndrome treated by high tibial osteotomy combined with arthroscopic lateral retinacular release. There were 15 males and 28 females, aged 53 to 72(62.05±5.17) years. The visual analogue scale(VAS), Lysholm, and the knee range of motion were used to evaluate knee pain and functional recovery before operation, 2 weeks, 3 months and 12 months after operation. And the congruence angle (CA), patellar tilt angle (PTA), and femala-tibial angle (FTA) were measured respectively before and 12 months after operation to evaluate the congruence of patellar joint, and the improvement of line of gravity of lower limb. RESULTS: All 43 patients were followed up for more than 12 months, with a follow-up time of 14 to 28 (19.60±4.50) months. The VAS scores decreased from 6.65±0.65 before operation to 2.16±0.95, 0.51±0.77 and 0.33±0.64 at 2 weeks, 3 months and 12 months after operation, and the difference was statistically significant (P<0.001). Lysholm score increased from 43.02±8.54 before operation to 46.84±2.81, 72.42±5.30, and 93.40±5.44 at 2 weeks, 3 months and 12 months after operation, and the difference was statistically significant (P<0.001). The knee range of motion increased from (86.97±5.02)° before operation to (99.38±3.27)°, (110.13±4.13)°, and (113.03±4.85)° at 2 weeks, 3 months and 12 months after operation, the difference was statistically significant (P<0.001). The CA decreased from (7.81±1.21)° before operation to (5.82±4.10)° at 12 months after operation, the PTA decreased from (15.87±2.89)° before operation to (13.79±4.26)° at 12 months after operation, and the FTA decreased from(182.61±2.07)° before operation to(170.89±0.89)° at 12 months after operation, and the differences were statistically significant (P<0.05). One case received proper braking and anticoagulation after operation, and was improved after 1 week. The swelling was observed in 14 patients after operation, and subsided about 2 weeks later. CONCLUSION: High tibial osteotomy combined with arthroscopic lateral retinacular release can relieve weight-bearing pain in frontal axis and improve the function of knee in sagittal axis.

[Evaluation of cartilage regeneration by arthroscopy after high tibial osteotomy].

OBJECTIVE: To evaluate the cartilage regeneration in the knee joint by arthroscopy after high tibial osteotomy. METHODS: Eleven patients were included in the study who were treated with high tibial osteotomy and underwent microscopy when the internal fixation was unloaded from September 2017 to September 2019. Among them, there were 2 males and 9 females, aged from 55 to 64 years old. The internal and external compartment pictures of the knee were taken before and after surgery of removing the internal fixation and the International Cartilage Repair Society (ICRS) grading systerm was used to evaluate the degree of cartilage damage on the medial and lateral femoralcondyles and tibial plateau. The Westrn Ontarioand Mcmaster Universities osteoarthritis index (WOMAC) and the weight bearing line (WBL) were used to evaluate the function of the knee and the alignment of the lower limb. RESULTS: All 8 patients were followed up for more than 12 months, ranging from 12 to 22 months. The degenerated cartilage of the medial femoral condyle and medial tibial plateau was covered by newly regenerated cartilage. WOMAC score decreased from 102-127 to 41-52 and WBL was improved from 17%-34% to 58%-64%. All incisions healed in stageⅠ, and no complications such as internal fixation rupture and infection occurred during and after the operation. CONCLUSION: High tibial osteotomy can relieve the pain of the knee and the dysfunction by adjusting lower limb alignment, and the degenerated cartilage could be regenerated in the medial femoral condyle and medial tibial plateau.

[High tibial osteotomy combined with arthroscopy for elderly patients with knee osteoarthritis of medial compartment].

OBJECTIVE: To observe early clinical effect of high tibial osteotomy combined with arthroscopy for elderly patients with knee osteoarthritis of medial compartment. METHODS: Sixty-one elderly patients with medial compartment knee osteoarthritis were treated with high tibial osteotomy combined with arthroscopy from August 2017 to October 2018. Among them, including 17 males and 44 females, aged from 60 to 83 years old with an average of (67.87±6.45) years old. Weight bearing line (WBL) and femora-tibial angle (FTA) were analyzed to assess lower limb alignment before and 12 months after surgery. Visual analogue scale (VAS) score and Hospital for Special Surgery (HSS) score were used to evaluate knee pain and function before and 1, 3, 12 months after surgery. RESULTS: All patients were followed up from 12 to 19 months with an average of (14.27±4.69) months. WBL was improved from (14.79±5.61) % before operation to (59.33±7.82) % at 12 months after operation (t=2.294, P<0.05), FTA was improved from (182.14±2.19) ° before operation to (171.54±3.16) ° at 12 months after operation (t=1.827, P<0.05) . VAS score decreased from 6.14±2.21 before operation to 3.64±0.92, 2.02±0.63 and 0.93±0.61 at 1, 3 and 12 months after operation (F=458.24, P<0.001), HSS score increased from 49.66±13.79 to 58.39±9.26, 71.82±6.06 and 82.71±6.97 at 1, 3 and 12 months after operation (F=266.45, P<0.001) . Three patients had contralateral cortical fracture during surgery, whose osteotomy area healed well at 12 months after surgery. The incision healing of 4 cases was slow, while all healed at 3 to 4 weeks after surgery. CONCLUSION: High tibial osteotomy combined with arthroscopy could adjust lower limb alignment effectively, relieve knee pain and functional dysfunction, which indicated a significant short term efficacy on the elderly patients with knee osteoarthritis of medial compartment.

[Clinical applications of the neurocutaneous axial flap pedicled with perforating vessels].

OBJECTIVE: To report the operative technique and clinical results of the neurocutaneous vascular axial flap with perforating vessels as its pedicle. METHODS: An axial skin flap was designed along the axis of small paraneural vessels that was close to a concomitant cutaneous nerve. The cutaneous perforating branches of major arteries were used as the pedicle, which provided a rotation arc for the flap to cover the defects in the distal site of extremities. 43 neurocutaneous vascular axial flaps were transferred, including 13 sural neurocutaneous axial flaps (30 cm x 12 cm to 16 cm x 8 cm) supplied by perforating branches of the peroneal vessel; 9 saphenous neurocutaneous axial flaps (15 cm x 8 cm to 5 cm x 4 cm) with posterior tibial perforators as the pedicle; 8 posterior antebrachial neurocutaneous axial flaps (16 cm x 6 cm to 10 cm x 4 cm) based on the dorsal branch of the anterior interossea vessel and 13 reversed neurocutaneous axial flaps (6.0 cm x 3.5 cm to 2.5 cm x 1.5 cm) on the dorsal hand pedicled with the perforators at the interdigital web space. RESULTS: 42 flaps survived completely. One flap underwent venous congestion with necrosis on the distal one fourth of the flap. The color and texture of the flaps were good. The appearance and functional results were satisfactory as revealed by follow-up for 6 to 24 months. CONCLUSIONS: The modified operation combines the advantages of both the perforator flap and the neurocutaneous axial flap, enlarges the size of the flap and extends the scope of reconstruction. The flap is characterized with delicate designation, easy dissection and reliable blood supply. It is a good method in repairing the skin defects of the extremities.

Magic doping fractions for high-temperature superconductors.

We report hole-doping dependence of the in-plane resistivity rho(ab) in a cuprate superconductor La(2-x)Sr(x)CuO4, carefully examined using a series of high-quality single crystals. Our detailed measurements find a tendency towards charge ordering at particular rational hole-doping fractions of 1/16, 3/32, 1/8, and 3/16. This observation appears to suggest a specific form of charge order and is most consistent with the recent theoretical prediction of the checkerboard-type ordering of the Cooper pairs at rational doping fractions x = (2m+1)/2n, with integers m and n.

Pair density wave in the pseudogap state of high temperature superconductors.

Recent scanning tunneling microscopy experiments of Bi(2)Sr(2)CaCu(2)O(8+delta) have shown evidence of real-space organization of electronic states at low energies in the pseudogap state [Science 303, 1995 (2004)]]. We argue based on symmetry considerations as well as model calculations that the experimentally observed modulations are due to a density wave of d-wave Cooper pairs without global phase coherence. We show that scanning tunneling microscopy measurements can distinguish a pair density wave from more typical electronic modulations such as those due to charge density wave ordering or scattering from an on site periodic potential.

Quantitative test of SO(5) symmetry in the vortex state of Nd(1.85)Ce(0.15)CuO4.

By numerically solving models with competing superconducting and antiferromagnetic orders, we study the magnetic field dependence of the antiferromagnetic moment in both the weak and strong field regimes. Through a comparison with the neutron scattering results of Kang et al. and Matsuura et al. on Nd(1.85)Ce(0.15)CuO4, we conclude that this system is close to a SO(5) symmetric critical point. We also make a quantitative prediction on increasing the upper critical field B(c2) and the superconducting transition temperature T(c) by applying an in-plane magnetic field.

Antiferromagnetism and hole pair checkerboard in the vortex state of high T(c) superconductors.

We propose a microscopic state for the vortex phase of BSCO superconductors. Around the vortex core or above H(c2), the d wave hole pairs form a checkerboard localized in the antiferromagnetic background. We discuss this theory in connection with recent STM experiments.