Abstract:[Objective] To explore the characteristics and related management measures of mid-term complications of mobile-bearing medial unicompartmental knee arthroplasty (UKA) . [Methods] A retrospective study was conducted on 313 patients (373 knees) who un- derwent UKA for medial knee osteoarthritis in our department from August 2008 to August 2020. The clinical efficacy was evaluated, while complications in mid-term were analyzed. [Results] All patients were followed up for 12~132 months, with an average of (84.68±12.12) months. The VAS scores decreased significantly (P＜0.05) , whereas the KSS clinical score and functional score, as well as knee flexion range of motion (ROM) significantly increased over time postoperatively (P＜0.05) . Radiographically, there was no significant change in term of the lateral compartment Kellgren-Lawrence classification from the time point preoperatively to the latest follow-up (P＞0.05) . In terms of complications, 22 cases (7.03%) of the 313 patients developed postoperative complications, including 3 males (13.64%) and 19 fe- males (86.36%) . In term of frequency of complications up-down, polyethylene liner dislocation was noted in 12 cases (3.83%) , snapping was in 4 cases (1.28%) , pain was found in 4 cases (1.28%) , aseptic loosening was in 1 case (0.32%) and incision complication was in 1 case (0.32%) . By the time of the latest follow-up, 5 patients (5 knees) , including 4 knees of bearing dislocation and 1 knee of prosthesis loosening, received revision total knee arthroplasty, accounting for 1.34% of the total patients. [Conclusion] The main complication leading to failure of mobile-bearing medial unicompartmental knee arthroplasty is bearing dislocation, which should be paid more attention to.

Abstract:[Objective] To clarify whether the kinematic alignment technique improve the trajectory of the bearing movement, as well as the clinical outcomes and radiological presentations in Oxford mobile bearing unicompartmental knee arthroplasty (Oxford MB UKA) . [Methods] We retrospectively analyzed the patients who underwent UKA from January to June, 2019. Of them, 23 patients (30 knees) had UKA performed by the kinematic alignment technique (the kinematic group) , while the other 25 patients (30 knees) received UKA with the conventional alignment technique (the conventional group) . There were no significant differences in term of baseline data preoperatively be- tween the two groups. The intraoperative bearing movement mode, motion distance, clinical outcome and radiographic data were compared between the two groups. [Results] The kinematic group proved significantly superior to the conventional group in term of bearing movement trajectory (P＜0.05) , despite of the fact that no a difference was noticed in the motion distance of the liner between them (P＞0.05) . In terms of clinical outcomes, the kinematic group was significantly superior to the conventional group regarding to intraoperative blood loss and oper- ation time (P＜0.05) , whereas there were no statistically significant differences in KSS clinical and functional scores between the two groups at any matching time point (P＞0.05) . Radiographically, the hip- knee- ankle angle (HKAA) significantly decreased postoperatively com- pared with that preoperatively in both groups (P＜0.05) , which was not statistically different between the two groups at any corresponding time point (P＞0.05) . There were no significant differences in terms of varus-valgus angles of the femoral and tibial components, flexion-ex- tension angle of the femoral component, posterior slope of the tibial tray and relative oblique of the femoral and tibial components between the two groups (P＞0.05) . However, the kinematic group got significantly closer contiguity of the components than the conventional group (P＜ 0.05) . [Conclusion] Although the kinematic technique does achieve similar prosthetic installation accuracy and clinical outcome with the conventional technique for Oxford MB UKA, the former has advantages of less blood loss, shorter operation time, closer contiguity of the fem- oral and tibial components, and more optimal bearing movement trajectory over the latter.

Abstract:[Objective] To compare the clinical results of total knee arthroplasty (TKA) versus unicompartmental knee arthroplasty (UKA) for medial compartment osteoarthritis of the knee. [Methods] From January 2017 to January 2020, 277 patients with simple medial compartment osteoarthritis of the knee were enrolled in this study. According to the results of preoperative doctor-patient communication, 156 patients were treated with TKA, while other 121 patients received UKA. The perioperative, follow-up and imaging data were compared between the two groups. [Results] The UKA group proved significantly superior to the TKA in terms of operative time, incision length, in- traoperative blood loss and hospital stay (P＜0.05) . At the latest follow up lasted more than 12 months, the VAS and WOMAC scores de- creased significantly (P＜0.05) , whereas the ROM and HSS scores significantly increased in both groups compared with those before sur- gery (P＜0.05) . The HSS, VAS, WOMAC score and ROM in UKA group were significantly better than those in TKA group at 3 months post- operatively (P＜0.05) , while which became not statistically significant between the two groups at the latest follow-up (P＜0.05) . In terms of imaging assessment, the femorotibial angle (FTA) reduced significantly in the TKA group at the last follow-up compared with that before surgery (P＜0.05) , while which remained unchanged in the UKA group (P＜0.05) . However, the medial proximal tibial angle (MPTA) in- creased significantly (P＜0.05) , whereas the posterior tibial slope (PTS) significantly decreased in both groups at the latest follow up com- pared with those before operation (P＜0.05) . At the latest follow up the FTA and PTS in TKA group were significantly less than those in UKA group (P＜0.05) , while the MPTA in TKA group was significantly greater than that in the UKA group (P＜0.05) . [Conclusion] In terms of short-term efficacy, UKA has the advantages of less trauma, more obvious pain relief and better recovery of knee function over TKA.

Abstract:[Objective] To compare the clinical outcomes of direct anterior approach (DAA) versus conventional Watson- Jones ap- proach for lightbulb procedures, involving femoral neck-head fenestration, debridement and bone autografting, for treatment of early-stage non-traumatic femoral head necrosis. [Methods] A retrospective study was done on total of 116 patients who received lightbulb procedures for early-stage nontraumatic femoral head necrosis from June 2014 to June 2018. Among them, 40 patients (54 hips) had the operation per- formed through DAA approach, while the other 49 patients (62 hips) had lightbulb procedure conducted through the conventional WatsonJones approach. The perioperative, follow-up and radiographic documents were compared between the two groups. [Results] All patients in both groups were successfully operated on without serious complications. Although there were no significant differences in the operative time and intraoperative radiation exposure time between the two groups (P＞0.05) , the DAA group had significantly less intraoperative blood loss than that in the conventional group (P＜0.05) . The follow- up lasted for 24 to 45 months, with an average of (32.09± 14.08) months. There were no significant differences in the time to return walking and time to full weight-bearing activity between the two groups (P＞0.05) . The VAS scores decreased significantly (P＜0.05) , whereas the hip internal-external rotation range of motion (ROM) and Harris score significantly increased in both groups over time (P＜0.05) . At 6 months after operation, the DAA group was significantly superior to the conventional group in terms of VAS score and Harris score (P＜0.05) . By the time of the latest follow-up, successful rate of hip preserva- tion was 81.48% in the DAA group, whereas 72.58% in the conventional group. Radiographically, there were no statistically significant dif- ferences in terms of joint space, femoral head collapse or lesion area between the two groups at 6 months after surgery or at the latest followup (P＞0.05) . [Conclusion] Compared with the conventional Watson-Jones approach, DAA approach takes benefits of less trauma and bet- ter early functional recovery for treatment of early-stage femoral head necrosis.

Abstract:[Objective] To compare the outcomes of epsilon-aminocaproic acid (EACA) versus tranexamic acid (TXA) used in total hip arthroplasty (THA) . [Methods] From September 2019 to April 2020, a total of 99 patients who were undergoing unilateral primary THA were included in this study, and randomly divided into two groups. Of them, 49 patients had EACA given, while the remaining 50 pa- tients had TXA administered intravenously and locally during operation. The items related to blood loss and parameters of laboratory tests, as well as hospital stay and postoperative complications were compared between the two groups. [Results] There were no statistically sig- nificant difference between the two groups in terms of estimated blood volume, estimated blood loss and postoperative drainage volume, as well as HB, HCT, ALB, Cr, INR, APTT, and PLT at 1 and 3 days postoperatively (P＞0.05) . No one in the EACA group had blood transfu- sion during perioperative period, whereas 2 patients in the TXA group received blood transfusion, which was not statistically significant (P＞0.05) . Compared with those at 1 day postoperatively, the HB, HCT, ALB and PLT slightly declined at 3 days after operation, regard- less of that the difference between the two points was not statistically significant (P＞0.05) . The EACA group had longer hospital stays than the TXA group, but the difference was not statistically significant (P＞0.05) . In terms of postoperative complications, the difference be- tween the two groups was not statistically significant (P＞0.05) . [Conclusion] Both EACA and TXA used in THA do effectively reduce blood loss without remarkable differences in clinical outcomes and complications between them. Therefore, the EACA can be used as an alternative to TXA.

Abstract:[Objective] To compare the clinical outcomes of intervertebral disc replacement (IDR) and anterior cervical decompression and fusion (ACDF) for treatment of single-level cervical spondylotic radiculopathy. [Methods] A retrospective study was performed on 63 patients who received surgical treatment for single-segment cervical spondylotic radiculopathy from January 2018 to January 2019. Accord- ing to consequence of the preoperative doctor-patient communication, the patients were divided into two groups. Of them, 30 patients under- went IDR, while the remaining 33 patients had ACDF performed. Perioperative, follow-up and imaging data were compared between the two groups. [Results] All the patients in both groups had operations completed successfully without serious complications. There were no significant differences in operative time, total incision length, intraoperative blood loss, intraoperative fluoroscopy times, time to resume walking and hospital stay between the two groups (P＞0.05) . All patients in both groups were followed up for more than 24 months. Com- pared with those before surgery, the VAS and NDI scores significantly decreased (P＜0.05) , while JOA scores significantly increased at the latest follow-up (P＜0.05) . However, there were no significant differences in VAS, NDI and JOA scores between the two groups at the last follow-up (P＞0.05) . In terms of imaging evaluation, the overall ROM of the fusion group significantly reduced at the latest follow-up com- pared with that preoperatively (P＜0.05) . At the latest follow-up, the IDR group proved significantly superior to the ACDF group regarding to local Cobb angle, C₂~C₇ Cobb angle and overall ROM (P＜0.05) . [Conclusion] Both IDR and ACDF achieve satisfactory and similar clini- cal outcomes for single-level cervical spondylotic radiculopathy, by contrast, the IDR has an advantage of retaining cervical motion in some extent.

Abstract:[Objective] To investigate the significance of magnetic resonance imaging with diffusion tensor imaging (MRI- DTI) for identifying the responsible segments of adult degenerative scoliosis (ADS) . [Methods] A total of 36 patients who were undergoing surgical treatment for ADS in our hospital from June 2017 to September 2019 were enrolled in this study. All patients received conventional preoper- ative MRI and MRI-DTI examinations, and the differences of fractional anisotropy (FA) values between symptomatic and asymptomatic nerve roots were compared. In addition, ODI, JOA, VAS scores and imaging parameters were used to evaluate the clinical efficacy. [Results] There were significant differences in FA values between symptomatic nerve roots and asymptomatic nerve roots in ADS patients (P＜ 0.05) . The MRI-DTI nerve root location was basically consistent with symptoms or nerve block location. The ODI, VAS-BP and VAS-LP scores significantly decreased (P＜0.05) , while JOA scores significantly increased over time (P＜0.05) . However, there were no significant changes in JOA, ODI, VAS-BP and VAS-LP scores among different postoperative time points (P＞0.05) . In terms of image measurement, the Cobb angle, lumbar lordosis (LL) , sacral slope (SS) , pelvic title (PT) , intervertebral space height and intervertebral foramina area sig- nificantly improved after operation compared with those preoperatively (P＜0.05) . [Conclusion] MRI-DTI might be used as the basis to de- termine the nerve root segment related to symptoms, and is highly consistent with clinical symptoms. According to MRI-DTI results, respon- sible segments were located and precise nerve root decompression was performed, with good clinical efficacy.

Abstract:Knee osteoarthritis (KOA) is a kind of degenerative joint diseases mainly characterized by cartilage degeneration and loss. The incidence of KOA is high in all countries around the world. Currently, step therapy is the main strategy for KOA, among which cartilage regeneration therapy represented by mesenchymal stem cells (MSCs) has been widely studied in recent years. However, there are disadvan- tages of low survival rate and differentiation rate after joint cavity injection of MSCs alone. Therefore, it is of great significance to use appro- priate scaffolds to carry MSCs. This article will review the current treatment of KOA with MSCs embedded on different scaffolds.

Abstract:Osteoarthritis, a common chronic joint disease in the middle-aged and the elderly with the highest incidence in the post- menopausal women, has been suggested that this disease should be closely related to the changes of postmenopausal estrogen levels. Estro- gen and its receptors play many roles on metabolic mechanisms, involving cell proliferation and apoptosis of articular cartilage and subchon- dral bone by multiple ways, which has become a strong argument for the high incidence of osteoarthritis in postmenopausal women. At pres- ent, although there is no lack of studies on the correlation of estrogen and its receptor metabolism with osteoarthritis, the latest unified dis- cussion on this topic remains rare. Therefore, this paper reviews the relationship of estrogen and its receptors with osteoarthritis by the com- mon mechanism, such as estrogen and its receptors influencing the classic Notch signal channel and insulin-like growth factor, interleukin 1 beta, matrix metalloproteinases and other soft cell metabolism regulation of joint mechanism, to provide a reference for the future possible research direction further.

Abstract:Among the 3 717 patients who underwent transforaminal lumbar interbody fusion (TLIF) in our hospital in the past 10 years, 46 had a reoperation, accounted for 1.24%. The reasons for reoperation ranked up-down as follows: surgical site infection (SSI) , spi- nal epidural hematoma (SHE) , poor symptom relief, and adjacent segment disease (ASD) , deep venous thrombosis (DVT) , abnormal inter- nal fixation, urinary retention, leakage of cerebrospinal fluid and rupture of drainage tube. A literature review on the abovesaid reasons was conducted to provide a reference for clinicians to avoid or reduce reoperation after TLIF.

Abstract:Degenerative cervical disc disease, also known as cervical spondylosis, is out of commen diseases that does seriously affect people's physical health and quality of life. Anterior cervical decompression fusion (ACDF) is a classic surgical procedure for cervical spon- dylosis, however, what kind of anterior cervical internal fixation system used will have different effects on surgical outcomes. Compared with the traditional titanium plate combined with cage, the new internal fixation system, zero-profile cage-plate device can significantly shorten the operation time, reduce intraoperative blood loss, reduce the incidence of postoperative dysphagia and sore throat and prevent adjacent segment degeneration. This article reviews the advantages and disadvantages of two anterior cervical internal fixation systems for ACDF in the surgical treatment of cervical spondylosis.

Abstract:[Objective] To further verify whether icariin (ICA) regulate the expression imbalance of mirNA-23B in hormone-induced femoral head bone microvascular endothelial cells (BMECs) , protect the function of BMECs, and prevent the occurrence of hormone-in- duced osteonecrosis of femoral head (ONFH) . [Methods] Ninety female SD rats were randomly assigned to three groups with 30 animals in each group. The animals in the model group were given high dose of methylprednisolone with lipopolysaccharide to establish femoral head necrosis model, and were gavaged with normal saline. Those in the ICA group were given the drugs as the model group, and were simultane- ously gavaged with ICA 60 mg/kg · d-1 intragastrically for 4 weeks. However, the rats in the blank group only received the same amount of normal saline. At 4 weeks, the femoral heads were harvested for histological examination. In addition, BMECs were isolated from the femo- ral heads for identification, detection of apoptosis and bioinformatics analysis of miRNA- 23B expression. [Results] In term of histomor- phometry, the width and area of trabecular bone in the model group were significantly lower than those in blank group and ICA group (P＜ 0.05) , while which was not significantl different between blank group and ICA group (P＞0.05) . The ratio of empty bone lacunae in model group was significantly higher than that in ICA group and blank group (P＜0.05) . In terms of cell apoptosis, the active cell ratios of BMECs were ranked from high to low: the blank group ＞ the ICA group ＞ the model group (P＜0.05) , which in the model group was significantly low- er than the blank group and ICA group (P＜0.05) , while there was no significant difference between blank group and ICA group (P＞0.05) . Conversely, the ratios of early apoptotic cells from high to low was: the model group ＞ the ICA group ＞ the blank group (P＜0.05) , in which the model group was significantly higher than the control group (P＜0.05) , whereas there was no a significant difference between blank group and ICA group (P＞0.05) . As results of bioinformation analysis, mirNA-23B expression was down-regulated significantly in the mod- el group compared with that in the blank group (P＜0.05) , but there was no a significant difference between the ICA group and the blank group (P＞0.05) . [Conclusion] The ICA does effectively prevent the occurrence of steroid-induced ONFH and protect BMECs in this ani- mal models, in which the mirNA-23B in BMECs may be the target of ICA to prevent steroid-induced ONFH.

Abstract:[Objective] To explore the effect of ubiquitously transcribe tetropeptide repeat on chromosome X (UTX) genes transfection on bone marrow mesenchymal stem cells (BMSCs) in vitro. [Methods] BMSCs were isolated from C57 mice and identified by morphology and flow cytometry. Lentivirus transfection was used to establish UTX-down group, UTX-NC group and UTX-up group of cells. RT-PCR was performed to detect UTX mRNA expression. In addition, osteogenesis, chondrogenesis and type II collagen expression were assayed and compared. [Results] The third-generation cells obtained in this study proved consistent with the typical morphological characteristics and surface antigen characteristics of BMSCs. The relative expression levels of UTX mRNA detected by QRT-PCR were ranked down-up as follows: UTX-down group ＜ UTX-NC group ＜ UTX-up group, with statistically significant differences among the 3 groups (P＜0.05) . Furthermore, the number of alizarin red staining cells in osteogenic culture, the number of Alcian blue staining cells after chondrogenic cul- ture, and the OD values of type II collagen immunofluorescence staining all were ranked from low to high as follows: UTX-down group ＜ UTX-NC group ＜ UTX-up group, which all were statistically significantly different (P＜0.05) . [Conclusion] BMSCs overexpression of UTX do promote the occurrence of osteogenesis and chondrogenesis, and production of type II collagen. It may be used to promote the repair of annulus fibrosus defect of intervertebral disc.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical outcomes of cross-tunnel tendon-bone reattach- ment of tibialis posterior tendon transfer for spastic clubfoot. [Methods] A total of 20 patients received cross-tunnel tendon-bone reattach- ment of tibialis posterior tendon transferred to cuboid or third cuneiform after selective peripheral neurotomy (SPN) for spastic foot equin- ovarus. A central tunnel and three surrounding tunnels were made to communicate with each other on the bone. As sutures were introduced into the tunnels and stitched with the tendon, the tendon was reattached into the central tunnel. The ends of sutures were knotted and se- cured in pairs outside the surrounding tunnels. The tendon and bone healing, ankle flexion-extension range of motion (ROM) , Holden scale of walking ability and 6-minute walking distance were assessed during follow-up period lasted for 6 months. [Results] The solid tendonbone healing of posterior tibialis transfer achieved in all patients with healing rate of 100%. The varus deformity was completely corrected, whereas walking function improved significantly in all patients. Compared with those before surgery, the triceps muscle tension MAS score, ROM, 6-min walking distance and Holden scale of walking capacity significantly improved at 6 months after surgery (P＜0.05) . [Conclusion] This cross-tunnel tendon-bone reattachment for tibialis posterior tendon transfer is a safe and reliable technique to correct varus equi- nus deformity, and improve the weight-bearing walking function of lower limbs.

Abstract:[Objective] To introduce the surgical technique of modified Stoppa approach combined with iliac spine approach for periac- etabular osteotomy. [Methods] Periacetabular osteotomy through modified Stoppa approach combined with iliac spine approach was per- formed in 3 patients for adult developmental hip dysplasia, including 1 case with unilateral involved and 2 cases with bilateral affected, in our department from 2018 to 2019. Before operation a 3D printed pelvic model was made to measure the lateral center edge angle (LCE) , anterior center edge angle (ACE) and Tonnis angle, additionally, mimic the osteotomies preoperatively. In the real operation, a Stoppa inci- sion on the middle of the abdomen was made to expose the rectus abdominis sheath, separate the rectus abdominis along the white line, ex- pose the suprapubic branch and the quadrilateral along the extraperitoneal space. Locating the acetabulum with guide pins, the pubis and quadrilateral osteotomies were conducted. After that, an iliac spine approach was made to expose the anterior superior iliac spine and the ili- ac plate, iliac osteotomy in the direction of the ischial notch was done, and then rotate the osteotomy block, fix it with 4 cortical screws. [Results] All the 3 patients had osteotomies performed successfully without complications, such as vascular and nerve injuries. The LCE and ACE increased significantly, whereas the Tonnis angle decreased significantly postoperatively compared with those preoperatively (P＜ 0.05) . At 6 weeks after the operation, all the 3 patients resumed walking with a single crutch. By the time 12 weeks after surgery, the Xrays showed the osteotomy completely healed, and all the patients returned to walking with full weight bearing without crutches. [Conclusion] This surgical technique can perform osteotomy of the pubic ramus, posterior acetabular column and quadrilateral under direct vision, avoiding the risk of intraoperative osteotomy penetrating the joint.

Abstract:[Objective] To study effects of two surgical methods on interleukin 17 (IL-17) and transforming growth factor β1 (TGF-β1) in knee osteoarthritis. [Methods] A total of 127 patients received surgical treatment for knee osteoarthritis in our hospital from December 2018 to December 2019. Of them, 63 patients were treated with total knee arthroplasty (TKA) , while the remaining 64 patients underwent proximal fibular osteotomy (PFO) . The perioperative data, VAS, WOMAC and HSS scores, as well as serum level of IL-17 and TGF- β1 were compared between the two groups. [Results] All the patients in both groups had operation performed smoothly without serious intraop- erative complications. The PFO group proved significantly superior to the TKA group in terms of operation time, intraoperative blood loss, hospital stay and hospital expenses (P＜0.05) . Compared with those preoperatively, the VAS and WOMAC score significantly decreased (P＜ 0.05) , whereas the HSS score significantly increased at 1 month postoperatively (P＜0.05) . The PFO group proved significantly superior to the TKA group in abovesaid scores at 1 month postoperatively (P＜0.05) . Regarding to laboratory test, the Il-17 significantly decreased, while the TGF-β1 significantly increased postoperatively in both groups compared with those before operation (P＜0.05) . The PFO group had significantly lower IL-17 and TGF-β1 than the TKA group postoperatively (P＜0.05) . [Conclusion] The proximal fibular osteotomy has sound outcomes for knee osteoarthritis, and can effectively improve Il-17 and TGF-β1 levels.

Abstract:[Objective] To explore the effect of anterior cervical decompression and fusion (ACDF) on the sagittal cervical balance. [Methods] A retrospective study was conducted on a total of 116 patients who underwent ACDF for degenerative cervical spondylosis in our hospital from May 2019 to March 2020 with complete follow-up data. The VAS, JOA, and NDI scores, as well as sagittal cervical balance parameters measured on radiographs were compared before surgery and at the last follow-up to determine the changes. [Results] All pa- tients were successfully operated on without serious complications. The patients were followed up for 12 to 15 months, with a mean of (13.52±1.43) months. The VAS and NDI scores significantly declined (P＜0.05) , while the JOA score significantly increased at the latest fol- low up compared with those preoperatively (P＜0.05) . In terms of imaging assessment, the C_2-7 SVA at the last follow-up decreased com- pared with that before surgery, but the difference was not statistically significant (P＞0.05) , whereas the C_2-7 Cobb angle and intervertebral space height significantly increased (P＜0.05) . [Conclusion] Anterior cervical decompression and fusion not only relieve the compression of spinal cord and nerves directly, but also improve the sagittal balance of cervical spine.

Abstract:[Objective] To explore the clinical efficacy of unilateral biportal endoscopy for far-migrated lumbar intervertebral disc her- niation. [Methods] From April 2020 to December 2020, 19 patients underwent unilateral biportal endoscopy for far-migrated lumbar inter- vertebral disc herniation in our department. The documents of perioperative period, follow-up and radiographic results were summarized. [Results] All patients had operation completed successfully without serious complications, while with operation time of (75.37±13.62) min, blood loss of (61.84±20.45) ml, and times of fluoroscopy of (2.84±0.83) . The VAS score for lower back pain and leg pain continued to de- crease significantly after the operation (P＜0.05) , and the pain almost disappeared by 30 days after the operation. The modified ODI score decreased significantly, while the JOA score increased significantly over time (P＜0.05) . Based on Modified Macnab criterion, the clinical outcomes were marked as excellent in 16 cases, good in 2 cases and fair in 1 case with excellent and good rate of 94.74%. At the latest fol- low-up, MRI showed far-migrated lumbar intervertebral discs were successfully removed without recrudescence. [Conclusion] Unilateral biportal endoscopy is an effective method for treatment of far-migrated lumbar intervertebral disc herniation.

Abstract:[Objective] To explore the short-term clinical outcomes of rotating hinged total knee arthroplasty (TKA) for end-stage Char- cot joint of the knee. [Methods] From January 2013 to January 2020, 11 patients with Charcot arthropathy of the knee were treated by rotat- ing hinged total knee arthroplasty. The documents regarding to perioperative period, follow-up and radiographs were summarized. [Results] All the patients had operation completed successfully without neurovascular injuries and other serious complications. All patients were fol- lowed up for 18~84 months, with an average of (38.73±13.51) months. The AKSS clinical score and functional score, as well as SF-36 score and range of motion (ROM) significantly improved at the latest follow-up compared with those before operation (P＜0.05) . Radiographically, the hip-knee-ankle (HKA) angle significantly increased, whereas the medial proximal tibial angle (MPTA) significantly decreased at the latest follow up compared with those preoperatively (P＜0.05) , however, the posterior tibial slope (PTS) remained unchanged (P＞0.05) . By the time of last follow-up, the prostheses were in good position with no loosening and no periprosthetic fractures in anyone of them. [Conclusion] The rotating hinged total knee arthroplasty does achieve sound short-term clinical outcomes for treatment of end-stage knee neuro- arthropathy, but its long-term outcome needs further follow-up.

Abstract:[Objective] To evaluate the clinical outcomes of arthroscopic ankle arthrodesis with headless compression cannulated screws for end-stage traumatic ankle arthritis (TAA) . [Methods] A retrospective study was done on the patients who underwent ankle ar- throdesis in our hospital from January 2017 to May 2020. Of them, a total of 39 patients who received arthroscopic ankle arthrodesis for uni- lateral end-stage TAA were included in this study. The clinical and auxiliary examination data of the patients were summarized. [Results] All the 39 patients were successfully operated without serious complications. The VAS scores decreased significantly (P＜0.05) , whereas the AOFAS score significantly increased over time in 39 patients (P＜0.05) . In terms of radiographic examination, all 39 patients got good tibial foot alignment and proper implant position on anteroposterior and lateral X-ray films. Radiographs showed bony fusion was of 28/39 (71.79%) at 3 months and 39/39 (100%) at 12 months postoperatively. In term of blood tests, the levels of TNF-α, IL-1β, IL-6, SOD and MDA were significantly increased 3 days after operation, whereas decreased significantly 7 days after operation compared with those before operation (P＜0.05) . [Conclusion] Arthroscopic ankle arthrodesis with headless compression cannulated screws is considerably effective for the end-stage TAA, associated with remarkable subsidence of inflammatory and stress reaction postoperatively

Abstract:[Objective] To explore the initial results of transtheoretical model (TTM) in the rehabilitation of primary unilateral total knee arthroplasty (TKA) . [Methods] From January 2021 to June 2021, a total of 123 patients who were undergoing TKA were randomly di- vided into two groups by lotting. All patients received primary unilateral TKA, of them, 63 patients were given perioperative TTM interven- tion, while the other 60 patients received conventional rehabilitation intervention. The self-management ability, knee function and quality of life were compared between the two groups. [Results] In terms of self-management ability, the SMAS scores in both groups increased sig- nificantly after intervention compared with those before intervention (P＜0.05) , and the TTM group proved significantly superior to the con- ventional group in all subscores of SMAS after intervention (P＜0.05) . In terms of knee function, HSS scores increased significantly over time in both groups (P＜0.05) , which in TTM group was significantly higher than that in conventional group at 1 and 3 months after opera- tion (P＜0.05) . In terms of quality of life, the GQOLI-74 scores were significantly increased in both groups after intervention in comparison of those before intervention (P＜0.05) , and all subscores of GQOLI-74 in TTM group were significantly higher than those in conventional group after intervention (P＜0.05) . [Conclusion] The rehabilitation intervention enhanced by transtheoretical model does effectively im- prove patients' self-management ability, promote the recovery of knee function and improve the quality of life.