Abstract:[Objective] To explore the clinical outcomes of accurate location of responsible nerve root and percutaneous endoscopic de- compression for multi- segment degenerative lumbar spinal stenosis (DLSS) . [Methods] A retrospective study was conducted on 76 pa- tients who underwent surgical treatment for multi segment DLSS in our department from June 2018 to August 2019. All patients underwent gait load test (GLT) and selective nerve root block (SNRB) for locating the responsible nerve root accurately. According to the results of pre- operative doctor-patient communication, the patients were divided into two groups. Of them, 38 patients received selective open decompres- sion (the open group), while the remaining 38 patients underwent selective endoscopic decompression (the endoscopic group). The perioper- ative, follow-up and radiographic documents were compared between the two groups. [Results] No serious complications occurred in both groups of patients during the operation. The endoscopic group was significantly superior to the open group in terms of operation time, intra- operative blood loss, early postoperative VAS score and hospital stay (P＜0.05) . The patients in both groups were followed up for15~28 months, with an average of (20.93±3.64) months. The endoscopic group resumed walking and full weight bearing activity significantly earli- er than the open group (P＜0.05) . The VAS scores of leg pain and low back pain, as well as ODI score significantly decreased (P＜0.05) , whereas the JOA score significantly increased over time in both groups (P＜0.05) . The endoscopic group was significantly superior to the open group in terms of VAS score of low back pain and lumbar JOA score at 2 weeks and 3 months postoperatively (P＜0.05) , and the ODI score at 3 months postoperatively (P＜0.05) . However, there was no a significant difference in clinical outcomes graded by MacNab’s crite- ria between the two groups at the latest follow-up (P＞0.05) . In term of imaging evaluation, the lumbar lordosis angle significantly improved (P＜0.05) , whereas intervertebral space height remained unchanged in both groups at the latest follow-up compared with those preoperative- ly (P＞0.05) . [Conclusion] On the basis of accurate location of responsible nerve root, selective percutaneous endoscopic decompression has benefits of faster recovery and higher safety over the open decompression for multi-segment degenerative lumbar spinal stenosis.

Abstract:[Objective] To prospectively compare the clinical efficacy of Dynesys dynamic stabilization versus intrumented fusion in the treatment of single-segment degenerative lumbar spondylolisthesis. [Methods] From January 2013 to June 2016, a total of 46 patients with single-segment degenerative lumbar spondylolisthesis were randomly divided into two groups. Of them, 22 patients were treated with Dynesys dynamic stabilization (the Dynesys group) , while the other 24 patients were treated with posterior lumbar interbody fusion (the PLIF group) . The perioperative, follow-up and imaging documents were compared between the two groups. [Results] All the patients in both groups had operation completed smoothly. The Dynesys group was significantly superior to the PLIF group in terms of operation time, intraoperative blood loss and hospital stay (P＜0.05) . All patients were followed up for 18-40 months, with a mean of (25.47± 6.69) months. Both VAS and ODI scores in the two groups significantly decreased at the latest follow-up compared with those preoperatively (P＜0.05) . However, at corresponding time points the Dynesys group was slightly superior to the PLIF group in VAS and ODI scores, despite of the fact that no statistically significant differences were noted between them (P＞0.05) . Radiographically, although there were no significant changes in the involved disc height and adjacent disc height (P＞0.05) , the ROMs of affected segment and the whole lumbar spine decreased signifi- cantly, while ROM of the adjacent segment increased significantly at the latest follow-up in both groups compared with those before opera- tion (P＜0.05) . The Dynesys group had significantly greater overall lumbar ROM than the PLIF group at the last interview (P＜0.05) , addi- tionally, the former proved significantly superior to the latter in term of adjacent segment degeneration by using UCLA scale (P＜0.05) . [Conclusion] Both dynamic stabilization and instrumented fusion achieve satisfactory clinical outcomes for treatment of single-segment de- generative lumbar spondylolisthesis. By contrast, the former retains more segment motion, significantly reduce the incidence of radiographic degeneration of adjacent segments, and has the advantages of less bleeding, less trauma and shorter hospital stay.

Abstract:[Objective] To explore the impact of preoperative depression on patients’ satisfaction and clinical outcome after surgical treatment for lumbar spinal stenosis (LSS) . [Methods] A total of 126 patients who underwent transforaminal lumbar interbody fusion (TLIF) for single-segment LSS from January 2016 to December 2018 were enrolled in this study. According to self-rating depression scale (SDS) preoperatively, 36 patients were fall in the depression group, while the remaining 90 patients were termed as the non-depression group. The VAS-back, VAS-leng, ODI and JOA scores, as well as postoperative satisfaction level of patient were compared between the two groups, and the correlations between preoperative SDS score and postoperative clinical items was analyzed. [Results] All patients in both groups had operation completed successfully with no significant differences in operation time, blood loss, hospital stay and complications between 2 groups (P＞0.05) . All patients were followed up for more than 2 years. The VAS-back, VAS-leg and ODI scores significantly decreased (P＜0.05) , while JOA scores significantly increased in both groups at 2 years postoperatively compared with those before operation (P＜ 0.05) . The depression group had significantly higher VAS-back, VAS-leg and ODI scores (P＜0.05) , whereas significantly lower JOA score than the non-depression group at 2 years after surgery (P＜0.05) . The patients’ satisfaction rate was of 72.22% (26/36) in the depression group, whereas 88.89% (80/90) in the non-depression group, which was statistically significant (P＜0.05) . As results of correlation analysis, the preoperative SDS was significantly positively correlated with postoperative dissatisfaction level (P＜0.05) , significantly positively corre- lated with postoperative ODI score, VAS-back score and VAS-leg score (P＜0.05) , whereas negatively correlated with postoperative JOA score (P＜0.05) . [Conclusion] Preoperative depression has considerably adverse impacts on postoperative satisfaction and surgical efficacy for LSS.

Abstract:[Objective] To compare the clinical efficacy of distraction reduction versus prying reduction combined with anterior corpec-tomy and instrumented fusion for locked low cervical fracture and dislocation. [Methods] A retrospective study was done on 128 patientswho underwent surgical treatment for locked low cervical fracture and dislocation from August 2014 to September 2019. According to conse-quence of the preoperative doctor-patient communication, 67 patients received distraction reduction (the DR group) , while the other 61 pa-tients underwent prying reduction (the PR group) . After reduction, all patients were treated with anterior corpectomy and instrumented fu-sion. Perioperative conditions, follow-up and imaging data were compared between the two groups. [Results] All patients in both groupswere successfully operated on. The early complication rate was of 8.96% (6/67) in the DR group, whereas 21.31% (13/61) in the RPgroup, which was not statistically significant (P=0.05) . There were no significant differences in operative time, incision length, intraoper-ative blood loss, intraoperative fluoroscopy times and hospital stay between the two groups (P＞0.05) . In addition, there were no significantdifferences in the time to remove external fixation and the time to resume full weight-bearing activity between the two groups (P＞0.05) .The ASIA sensory score, motor score and JOA cervical spine score in both groups significantly increased over time (P＜0.05) , which in theDR group were significantly better than those in the PR group at 6 months after surgery and the latest follow-up (P＜0.05) . Radiographical-ly, anterior cervical arc, local angulation and C2~C7 lordosis significantly improved in both groups at 6 months postoperatively and at the lat-est follow- up compared with those preoperatively (P＜0.05) . However, there were no statistically significant differences between the two groups in terms of abovesaid radiographic items at 6 months after surgery and the latest follow-up (P＞0.05) . [Conclusion] The distraction reduction is considerably more conducive to improvement of nerve function than the prying reduction for locked low cervical fracture and dislocation.

Abstract:[Objective] To explore the correlation between the placement of acetabular prosthesis and prosthesis loosening. [Methods] A retrospective study was conducted on 136 patients who underwent primary total hip arthroplasty through modified Hardinge approach in our hospital from September 2010 to March 2017. After follow-up more than 20 months, the patients were divided into two groups accord- ing to whether the prosthetic loosening happened or not. The univariate comparison and binary multiple logistic regression were done to ex- plore the factors related to prosthetic loosening. [Results] At the latest follow-up, 32 of the 136 patients were diagnosed of prosthetic loos- ening, accounting for 23.53%. Among them, 28 patients were acetabular prosthesis loosening only, and 4 patients were combined acetabu- lar and femoral prosthetic loosening. In term of univariate comparison, the loosened group was significantly older than the non-loosening group (P＜0.05) , in addition the former had significantly greater acetabular abduction angle, bilateral difference of offset, abnormal ratio of acetabular abduction angle and abnormal ratio of bilateral difference of offset than the latter (P＜0.05) . However, there was no significant difference between the two groups in gender composition, BMI, acetabular anteversion angle and abnormal ratio of anteversion angle (P＞ 0.05) . As results of logistic regression, the advanced age (OR=0.248, P＜0.05) , abnormal offset (OR=0.159, P＜0.05) , excessive acetabular abduction angle (OR=0.366, P＜0.05) , and abnormal acetabular abduction angle (OR=0.021, P＜0.05) were the independent risk factor for prosthetic loosening. [Conclusion] Poor positioning of the acetabular prosthesis in THA is related to aseptic loosening. During the opera- tion, the abduction angle and prosthetic offset should be kept in a safe range, which will be beneficial to reduce the incidence of aseptic loosening.

Abstract:[Objective] To compare the clinical outcomes of three tibial rotation positioning techniques in Oxford unicompartmental ar- throplasty (UKA) . [Methods] From January 2018 to January 2020, 59 patients with medial compartment osteoarthritis of the knee were en- rolled into this study and were randomly divided into three groups. All the patients received UKA, with tibial rotation positioning by anteri- or superior iliac spine (ASIS) in 19 patients, substitute anteroposterior line (sAP) in 20 patients, and anatomical tibial axis (ATA) in 20 pa- tients. The 3 groups were compared regarding to perioperative, follow-up and radiographic documents. [Results] All the patients in the 3 groups had UKA performed smoothly without serious complications. Although there were no significant differences in terms of operation time, incision length, intraoperative blood loss, time to resume walking, hospital stay and incision healing among the 3 group (P＞0.05) , the anteromedial protrusion of the liner was noted in 5 cases of ASIS with a displacement of (2.07±0.52) mm , whereas 2 cases in the sAP group with a displacement of (1.93±0.38) mm, and none of the ATA group, which proved statistically significant (P＜0.05) . As time went during the follow-up lasted for (14.82±1.05) months on average, the KSS clinical and functional scores significantly increased in all the 3 groups (P＜0.05) . Although there were no statistically significant differences in preoperative KSS clinical score and functional score among the three groups (P＞0.05) , the sAP group and ATA group was significantly superior to the ASIS group in KSS clinical score at 12 months post- operatively (P＜0.05) . Radiographically, the ASIS group had significantly greater external rotation angle of the tibial component than the sAP group and the ATA group postoperatively (P＜0.05) . No dislocation or loosening of the prosthesis was found in anyone of the 3 groups during follow-up. [Conclusion] The external rotation of tibial prosthesis positioning by sAP line and tibial anatomical axis in Oxford UKA is simple and reproducible, which is beneficial to the recovery of postoperative joint function.

Abstract:[Objective] To compare the clinical outcomes of platelet-rich plasma (PRP) versus hyaluronic acid (HA) intraarticularly for treatment of knee osteoarthritis (KOA) . [Methods] All randomized controlled trials on the clinical efficacy of intraarticularly PRP and HA in the treatment of KOA were systematically searched from Cochrane, PubMed and Embase databases as of December 2020. After quality assessment, the data were extracted from the literature, and then a meta-analysis of data was performed using Review Manager 5.3 software. [Results] A total of 13 studies were enrolled into this study involving 1 259 patients, including 644 patients in the PRP group and 615 pa- tients in the HA group, with a followed-up period of 12 months. As results of this meta-analysis, the PRP group proved significantly superi- or to the HA group in terms of overall WOMAC scores (MD=-16.57, 95%CI=-23.34~-9.79, P＜0.001) , WOMAC function score (SMD=- 1.47, 95%CI=-2.34~-0.59, P＜0.001) , WOMAC pain score (SMD=-1.02, 95%CI=-1.69 ~-0.34, P=0.002) , and VAS score (SMD=-2.75, 95%CI=-4.93~-0.57, P=0.013) . However, there was no a significant difference in the incidence of adverse reactions between the two groups (RR=1.07, 95%CI= 0.80~1.42, P=0.100) . [Conclusion] The PRP is superior to the HA in alleviating pain and functional recovery for treatment of KOA, but there is no difference in safety between the two therapies.

Abstract:Intervertebral disc degeneration (IVDD) is a pathological basis for a series of degenerative diseases of the spine, which has a high incidence and seriously affects people’s lives. Traditional Chinese medicine is widely used in the treatment of IVDD with better out- comes. In this paper, the experimental pharmacological mechanism of single medicine, compound medicine and Chinese patent medicine in the treatment of IVDD were summarized, which can provide reference for clinical practice.

Abstract:Ferroptosis is an iron-dependent and newly regulated cell death, which characteristics is excessive accumulation of reactive oxygen species (ROS) and lipid peroxidation. Erastin, a classic ferroptosis inducer, can mediates ferroptosis through a variety of molecules. Meanwhile, erastin shows a promise perspective in anti-tumor application. This article reviews the mechanism of erastin inducing ferropto- sis as well as its anti-tumor clinical application.

Abstract:Intervertebral disc degeneration (IDD) is one of the main reasons of low back pain. With the advent of the elderly society, its incidence is increasing year by year. Due to numerous pathogenic factors involving intervertebral disc degeneration, the pathogenesis is still unclear, and there is no effective drug for IDD. As a kind of neuroendocrine hormone secreted by pineal gland, melatonin (MT) has been widely studied in tumor, age-related degenerative diseases and so on because of its excellent anti-oxidation stress, anti-inflammatory and anti-apoptosis effects. This paper reviews the mechanism of MT to delay IDD and provides a reference for future research.

Abstract:[Objective] To investigate the effect of long noncoding RNA 02126 (lncRNA02126) on the prognosis of Ewing’s sarcoma and its potential mechanism. [Methods] The gene expression data of 56 Ewing’s sarcoma patients were obtained from ICGC (International Cancer Genome Consortium) database. Kaplan-Meier survival analysis and univariate analysis were used to explore the relationship be- tween lnc02126 and prognosis of Ewing’s sarcoma. RT-qPCR was used to detect the expression of lnc02126 in Ewing’s sarcoma cells. Go and KEGG analysis were used to understand the possible signal pathway of lnc02126 in the biological progress of Ewing’s sarcoma. CMAP (connectivity map) predicted the potential therapeutic drugs for Ewing’s sarcoma. [Results] The prognosis of Ewing’s sarcoma patients with high expression of lnc02126 was significantly poor (P=0.025) . lnc02126 was an independent prognostic risk factor (P＜0.001) . RT-qPCR results showed that lnc02126 was highly expressed in Ewing sarcoma cells (P＜0.05) . Go and KEGG analysis showed that the molecular mechanism of malignant progression of Ewing’s sarcoma induced by lnc02126 was related to the signal pathways of extracellular structure, tissue construction, cell adhesion and angiogenesis. CMap analysis showed that lycorine, iloprost and thapsigargin had potential therapeutic effects on Ewing’s sarcoma. [Conclusion] lnc02126 is an independent prognostic molecular marker of Ewing’s sarcoma and may be a thera- peutic target for Ewing’s sarcoma.

Abstract:[Objective] To measure the anatomical parameters of cortical bone trajectory (CBT) for lumbar percutaneous pedicle corti- cal placement in middle-aged and elderly persons, and explore the feasibility of CBT percutaneous screw placement. [Methods] The threedimensional CT data obtained from 50 middle-aged and elderly persons were imported into Aquarius iNtuition Viewer V4.4.6 software. The screw insertion angle, safety range, diameter and length of the nail path, the distance between skin screw insertion point and vertebral upper endplate and the distance between screw insertion point and spinous process axis were measured. [Results] There was no significant differ- ence in the distance from the skin entry point to the vertebral upper endplate (P＞0.05) , whereas there was significant difference in the dis- tance from the skin entry point to the spinous process axis from L₁ to L₅ (P＜0.05) . In transvers plane, the diameters of the nail path gradual- ly increased from L₁ to L₅, which was statistically significant (P＜0.05) . The actual length of the nail path in different segments was of statis- tical significance (P＜0.05) , which in the male proved significantly greater than that in the female segments (P＜0.05) . The ideal external de- viation angles of the nail path in each segment of lumbar spine remained consistent, with no significant differences (P＞0.05) . In sagittal plane, the diameters of the nail path gradually decreased from L₁ to L₅, which was statistically significant (P＜0.05) , while no significant dif- ferences in the diameters of the nail path were found between two genders (P＞0.05) . The ideal cephalad inclination angle remained un- changed from L1 to L5 (P＞0.05) , and was not significantly different between the two genders (P＞0.05) . [Conclusion] From the upper end- plate of vertebral body to the midline of spinous process, a body surface positioning point for CBT percutaneous pedicle screw might be as- sured, which varies among different segments. This point can provide reference for the CBT percutaneous pedicle screw placement in mid- dle-aged and elderly people.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of oblique lumbar interbody fusion com- bined with unilateral pedicle screw fixation in the same position. [Methods] From July 2018 to June 2019, 43 patients underwent oblique lumbar interbody fusion combined with unilateral pedicle screw fixation in the same position. After the patient was placed in the right later- al decubitus position, a 4 cm oblique incision was made on the left abdomen to approach to the retroperitoneal space by separating the ab- dominal muscles. As the target intervertebral space was exposed, the disc was resected, and then a fusion cage with bone allografts was in- serted into the space firmly. The patient remained in the right decubitus position, a 6cm posterior para-midline incision was made, the cor- responding articular and transverse processes were exposed through the muscular space. The pedicle screws were placed, and then connect- ing rods were installed for fixation. [Results] All patients had operation completed successfully with intraoperative blood loss of (50.42± 10.34) ml, operation time of (79.2±12.2) min, and the total screw placement time of (18.07±3.63) min, while without no serious nerve or vas- cular injury during operation. In the 43 patients, a total of 86 pedicle screws were inserted with screw placement accuracy of 96.51%. CT re- examination one year after the operation showed that the fusion rate was of 100%. In term of adverse event, 2 patients developed numbness and discomfort in the anteromedial side of the left thigh after surgery, which were significantly improved within 6 months after surgery. [Conclusion] Oblique lumbar interbody fusion combined with unilateral pedicle screw fixation in the same position for lumbar degenerative diseases do simplify the operation process, save the operation time, and have high safety and good clinical efficacy.

Abstract:[Objective] To investigate the clinical efficacy of gyroscope extramedullary femoral positioning in total knee arthroplasty (TKA) . [Methods] A retrospective analysis was done on 53 patients who received primary TKA from March 2019 to January 2020. Of them, 27 patients had femoral component placed by using gyroscope for extramedullary positioning (the extramedullary group), while the other 34 patients underwent conventional intramedullary positioning for femoral component placement (the intramedullary group). The clini- cal efficacy was compared between the two groups. [Results] All patients got operation completed successfully. The extramedullary group proved significantly superior to the intramedullary group in terms of the operation time, femur osteotomy time, intraoperative blood loss and postoperative drainage volume (P＜0.05) . However, there was no significant difference in knee KSS scores between 2 groups 3 months after operation (P＞0.05) . Radiographically, there were no significant differences in terms of hip knee and ankle angle (HKA) and femorotibial an- gle (FTA) between the two groups preoperatively and postoperatively (P＞0.05) . [Conclusion] This gyroscope extramedullary positioning is effective technique in TKA, has advantages of reducing the operation time, intraoperative blood loss and postoperative drainage.

Abstract:[Objective] To compare the clinical outcomes of Nice knot technique combined with vacuum assisted closure (the com- bined therapy) versus traction with steel wire and Kirschner wire (the traction therapy) for closure of fasciotomy wounds. [Methods] A retro- spective study was conducted on 45 patients (50 wounds) who had fasciotomies from March 2017 to March 2021. Of them, 24 wounds were treated by combined therapy, while the other 26 wounds were treated by the traction therapy. The perioperative documents, cost and patient satisfaction were compared between the two groups. [Results] The operations were successfully completed in both groups. There were no significant differences in operative time, incision length and intraoperative blood loss between the two groups (P＞0.05) . The com- bined group proved significantly inferior to the traction group in terms of drainage volume within 48h, wound width postoperatively and wound closure time, HCT and therapy expense (P＜0.05) , whereas the former was significantly superior to the latter in the postoperative VAS scores and complication rate (P＜0.05) . However, there was no significant difference in patient satisfaction between the two groups (P＞0.05) . [Conclusion] The two techniques have their own advantages and disadvantages, and should be selected according to the actual situation.

Abstract:[Objective] To explore the clinical outcomes of combined surgical procedures for symptomatic os subfibulare with gouty an- kle arthritis in the teenagers. [Methods] A total of 15 teenaged patients with symptomatic os subfibulare accompanied with gouty ankle ar- thritis underwent arthroscopic debridement, os subfibulare resection, and Brostr?m-Gould procedure with Internal Brace to strengthen the repair of anterior talofibular ligament from February 2018 to August 2019. The patients included 10 males and 5 females, aged 14~18 years with a mean of (15.73±1.03) years. The VAS score and AOFAS score were used to evaluate the postoperative function of the ankle. [Results] All the patients had operation performed smoothly, without serious complications, and got incisions healed well. The followed up peri- od lasted for12~18 months with a mean of (15.25±6.20) months. Compared with those preoperative, the VAS and AOFAS scores significant- ly improved at the latest follow-up. [Conclusion] For symptomatic os subfibulare with gouty ankle arthritis in the teenagers, arthroscopic debridement, os subfibulare resection, Brostr?m-Gould procedure with Internal Brace artificial ligament to strengthen the repair of anterior talofibular ligament does effectively reduce the symptoms, and get early rehabilitation

Abstract:[Objective] To measure and analyze the tortuous sign of patellar ligament on the sagittal MRI of the knee. [Methods] A ret- rospective study was conducted on MRI images of 40 bilateral knee. All 40 patients presented tortuosity of the patellar tendon on one side, whereas normal patellar ligament on the opposite side. The length of patellar ligament and patellar bone were measured by MRI in sagittal plane. The proximal, middle, and distal cross-sectional areas of the patellar ligament were measured on cross-sectional MRI images. The results of the two measurements of the patellar tendon and other pathological findings were compared. [Results] The tortuosity of the patel- lar ligament was seen in the proximal end in 1 case, accounting for 2.50%, the middle section in 2 cases, accounting for 5.00%, the distal end in 27 cases, accounting for 67.50%, while involved the whole section in 10 cases, accounting for 25.00%. Tortuous side was accompa- nied with intraarticular effusion in 11 cases, accounting for 27.50%, and anterior cruciate ligament tear in 4 cases, accounting for 10.00%. In terms of image measurement, there was no significant difference in the patellar length between the two sides (P＞0.05) , however, the tor- tuous side proved significantly shorter length of patellar ligament than the healthy side (P＜0.05) . In addition, the tortuous side had signifi- cantly smaller areas at the proximal, middle and distal cross sections than the healthy side (P＜0.05) . [Conclusion] Tortuosity of the patel- lar ligament on MRI image is a common clinical phenomenon, which is related to the degeneration of the patellar ligament, might be accom- panied by anterior cruciate ligament rupture and intraarticular effusion.

Abstract:[Objective] To evaluate the clinical efficacy of oblique lumbar interbody fusion (OLIF) for treatment of adjacent lumbar de- generation secondary to previous lumbar fusion. [Methods] A retrospective study was done on 50 patients who received OLIF for adjacent segment degeneration after primary lumbar fusion in our department from December 2016 to December 2019. [Results] All the 50 patients were successfully operated without serious complications, and were followed up for 12~16 months, with an average of (13.74±1.63) months. The patient resumed full weight-bearing activity at (12.66±3.64) weeks postoperatively. During the follow-up period, pain gradually re- lieved, whereas function gradually improved. Both VAS and ODI scores significantly decreased at the last follow-up compared with those before operation (P＜0.05) . Radiographically, the lumbar lordosis angle (LL) significantly increased (P＜0.05) , whereas the Cobb angle of scoliosis decreased significantly at the last follow-up compared with those preoperatively (P＜0.05) . By the time of the latest follow-up, all the 50 patients had bony fusion in the involved segment, without displacement or subsidence of the cage. [Conclusion] The OLIF has good safety and efficacy in the treatment of adjacent segment degeneration after previous lumbar fusion.

Abstract:[Objective] To explore the clinical efficacy, safety and advantages of proximal fibular osteotomy (PFO) for treatment of me- dial knee osteoarthritis (KOA) . [Methods] A retrospective study was conducted on a total of 60 patients who underwent PFO for medial KOA in our hospital from February 2020 to February 2021. The VAS, HSS, KSS clinical and functional scores were compared among differ- ent time points. [Results] In terms of adverse events, intermuscular vein thrombosis was seen in 2 patients (3.33%) , limited motion of hal- lux dorsal extension was noted in 1 patient (1.67%) , hallux brevis contracture was found in 2 patients (3.33%) , and palsy of common pero- neal nerve was in only 1 patient (1.67%) . The VAS score decreased significantly (P＜0.05) , whereas the HSS score, as well as KSS clinical and functional scores significantly increased over time (P＜0.05) . At the last follow-up, 43 patients (71.67%) had no medial knee pain total- ly, 15 patients (25.00%) got medial knee pain significantly relieved, 1 patient (1.67%) had pain location changed, and 1 patient (1.67%) re- mained pain unchanged. [Conclusion] PFO is a safe, minimally invasive and cost-efficient surgical treatment, does obviously relieve the pain and improve the function for medial KOA.