Is single-stage bilateral medial opening wedge high tibial osteotomy advisable?

PURPOSE: To validate the safety and clinical results of single-stage bilateral versus unilateral medial opening wedge high tibial osteotomy (HTO). METHODS: A propensity-matched cohort study was performed from March 2020 to March 2021 in our medical center. Data were prospectively collected. Including 34 patients who underwent single-stage bilateral medial opening HTO(SSBHTO), and 68 cases in the unilateral group. Propensity-matched ration was 2:1 based on age, sex, and body mass index using R software. Comparisons of the length of hospital stay, operative time, blood loss, postoperative adverse events, 90-day readmission rate, conversion to TKA rate, self-reported VAS and WOMAC scores were made to investigate the safety and clinical results of bilateral HTO. RESULTS: The mean length of hospital stay was 7.36 ± 2.23 days for SSBHTO and 7 days (IQR, 3 days; range, 4 to 23 days) for the unilateral group (P = 0.219). The mean operative time was 144 ± 47 min for bilateral HTO and 105(37.5) mins for a unilateral OWHTO (P < 0.001). The mean blood loss was 150(100) ml for SSBHTO and 100(50) ml for unilateral OWHTO (P < 0.001). There were no significant difference of the adverse events and 90-day readmission rate between two groups. No failed HTO or conversion to knee arthroplasty were observed at the end of follow-up. VAS, pain, stiffness, and functional scores of the WOMAC scale were essentially comparable of two groups one year after surgery (P > 0.05). CONCLUSIONS: A single-stage bilateral medial opening wedge high tibial osteotomy is advisable for patients with knee osteoarthritis. Patients benefit from avoiding secondary anesthesia, postoperative complications, and substantial cost savings. LEVEL OF EVIDENCE: Therapeutic Level III.

The Assessment of Chinese Children's English Vocabulary-A Culturally Appropriate Receptive Vocabulary Test for Young Chinese Learners of English.

Millions of Chinese children learn English at increasingly younger ages. Yet when it comes to measuring proficiency, educators, and researchers rely on assessments that have been developed for L1 learners and/or for different cultural contexts, or on non-validated, individually designed tests. We developed the Assessment of Chinese Children's English Vocabulary test (ACCE-V) to address the need for a validated, culturally appropriate receptive vocabulary test, designed specifically for young Chinese learners. The items are drawn from current teaching materials used in China, and the depictions of people and objects are culturally appropriate. We evaluated the instrument's reliability and validity in two field tests with a combined sample size of 1,092 children (181 children for the first field test and 911 children for the second field test, age range from 3.1 to 7.7, mean age: 5.2. Item Response Theory (IRT) analyses show that the ACCE-V is sufficiently sensitive to capture different proficiency levels and that it has good psychometric properties. ACCE-V scores were correlated with Peabody Picture Vocabulary Test scores, indicating concurrent validity. We found that children's age and English learning experience can significantly predict the scores of ACCE-V, but the effect of English learning experience is greater. The ACCE-V thus offers an alternative to existing vocabulary tests. We argue that culturally appropriate assessments like the ACCE-V are fairer to learners and help promote an English learning and teaching environment that is less dominated by Western cultures and native speaker norms.