Abstract:Ilizarov technique was born in the former Soviet Union in the 1950s, known as one of the milestones in the history of orthope- dic development in the 20th century, and its discovery of the law of tension-stress is one of the greatest discoveries of biology in the history of orthopaedic surgery worldwide. However, this technique was introduced to the West 30 years after it was used because of the iron curtain of the Cold War between East and West in the last century. The discovery of Ilizarov method and its worldwide spread are legends, in which Ita- ly is the first western country to introduce Ilizarov technique and the first Association for Study and Application of the Method of Ilizarov (ASAMI) established in the world. Subsequently, it was spread in Europe, North America, South America, Australia, Japan, South Korea, In- dia, Africa and other countries, due to visa obtained and language exchanging conveniently. The clinician from these countries went to Italy to learn Ilizarov technique and set up their own national ASAMI, and got the chance to study in remote Kurgan in Russia. Entering the 21st century, the law of tension-stress has given birth to new disciplines such as microcirculation reconstruction, transverse bone transport for treatment of diabetic foot. In this paper we reviewed the spreading and innovating Ilizarov technique in Europe to memorize Ilizarov^，s greater contribution to orthopedic worldwide.

Abstract:[Objective] To compare the clinical outcomes of unilateral biportal endoscopy (UBE) versus traditional transforaminal lum- bar interbody fusion (TLIF) for lumbar spine stenosis (LSS). [Methods] A retrospective study were done on 45 patients who received surgical treatment for LSS from November 2019 to July 2021. According to doctor-patient communication, 20 patients received UBE, while the other 25 patients received TLIF. The perioperative period, follow-up and imaging documents were compared between the two groups. [Results] Al- though there were no significant differences in operation time and incision healing grade between the two groups (P＞0.05), the UBE group proved significantly superior to the TLIF group in terms of total incision length [(2.2±2.2)cm vs (10.2±1.7)cm, P＜0.05], intraoperative blood loss [(35.0±21.3)ml vs (472.0±171.4)ml, P＜0.05], intraoperative fluoroscopy times [(6.1±0.9)times vs (10.0 ±2.3)times, P＜0.05], the postoper- ative ambulation time [(1.5±0.7)days vs (3.7±1.0)days, P＜0.05] and hospital stay [(13.4±3.2)days vs (17.8±7.2)days, P＜0.05]. All patients in both groups were followed up for more than 12 months, and the UBE group resumed full weight-bearing activities significantly earlier than the TLIF group [(70.3±11.9)days vs (90.4±13.4)days, P＜0.05]. The VAS scores for back pain and leg pain, as well as ODI and JOA scores sig- nificantly improved in both groups with time (P＜0.05). The UBE group was significantly better than the TLIF group in terms of VAS score for low back pain [(2.5±0.5) vs (4.2±0.9), P＜0.05], ODI score [(11.2±5.0) vs (18.8±9.0), P＜0.05], JOA score [(20.9±3.5) vs (17.5±2.8), P＜0.05] a month postoperatively. However, there were no significant differences in the above indexes between the two groups at the last follow-up (P＞ 0.05). Regarding imaging, the spinal canal area increased significantly in both groups postoperatively compared with those preoperatively (P＜0.05), which in UBE group was significantly smaller than that in TLIF group after operation [(191.6±33.8)cm² vs (244.6±21.9)cm² , P＜0.05]. Moreover, there were no significant changes in intervertebral height and lumbar lordosis angle in both groups before and after surgery (P＞ 0.05), and there were no statistically significant differences between the two groups in intervertebral space height and lumbar lordosis angle at any time points accordingly (P＞0.05). [Conclusion] Both UBE and TLIF do achieve good clinical outcomes in the treatment of LSS. By comparison, the UBE takes advantages of less trauma, faster recovery and less early postoperative lumbago over the TLIF, which is especially suitable for LSS with fewer segments involved.

Abstract:[Objective] To compare the clinical efficacy of anterior cervical discectomy fusion (ACDF) under microscope versus direct vision for cervical spondylotic myelopathy. [Methods] A retrospective study was conducted on 65 patients who received ACDF for cervical spondylotic myelopathy from June 2015 to November 2018 in our hospital. According to the results of preoperative communication between doctors and patients, 30 patients were treated with ACDF under microscope, while the remaining 35 patients had ACDF performed under di- rect vision traditionally. Perioperative, follow- up and imaging data were compared between the two groups. [Results] All patient in both groups had operation conducted successfully. The microscopy group got recurrent laryngeal nerve injury in 1 case only, whereas the direct vision group had dural injury in 2 cases and recurrent laryngeal nerve injury in 3 cases, while none of them caused serious adverse conse- quences. The microscopy group proved significantly superior to the direct vision group in terms of operative time and intraoperative blood loss (P＜0.05), nevertheless there were no significant differences in incision length, number of fluoroscopy, incision healing grade, postopera- tive ambulation time and hospital stay between the two groups (P＞0.05). As time went during the followed-up ranged from 12 to 48 months with an average of (20.2±8.0) months, the pyramidal tract signs improved significantly (P＜0.05), VAS and NDI scores decreased significantly (P＜0.05), while JOA score increased significantly (P＜0.05) in both groups. Although there were no statistically significant differences in VAS and NDI scores between the two groups at 6 months postoperatively and the latest follow-up (P＜0.05), the microscopy group was signifi- cantly superior to the direct vision group in term of JOA score (P＜0.05). Radiographically, the area of the spinal canal in the responsible seg- ment, the height of the intervertebral space and the cervical lordosis were significantly increased immediately postoperatively compared with those preoperatively in both groups (P＜0.05) , whereas which remained unchanged at the latest follow-up compared with those immediately postoperatively (P＞0.05) . At any corresponding time points, there was no significant difference in abovesaid imaging indexes between the two groups (P＞0.05) . At the latest follow-up, the fusion rate was of 26/30 (86.7%) in the microscopy group, whereas 30/35 (85.7%) in the di- rect vision group, without a statistically significant difference between the two groups (P＞0.05) . [Conclusion] Compared with traditional op- eration under direct vision, ACDF under microscope is more accurate, and has the advantages of less blood loss, shorter operation time and better functional recovery.

Abstract:[Objective] To compare the clinical efficacy of low-temperature (LT) versus normal-temperature (NT) bone cement perfu- sion in percutaneous vertebroplasty (PVP) for Kummell^，s disease. [Methods] A retrospective study was done on 60 patients who underwent PVP for Kümmell^，s disease in our department from September 2018 to August 2021. Of them, 30 patients received LT intermittent perfusion of bone cement, while the remaining 30 patients had PVP performed with bone cement injection under NT. The perioperative period, followup and imaging data of the two groups were compared. [Results] All the patients in both groups had PVP performed smoothly. The LT group got significantly longer injectable time of bone cement than the NT group [(10.5±1.3)mm vs (4.9±1.0)min, P＜0.05], while the former had sig- nificantly lower leakage rate of bone cement than the latter (6.7% vs 36.7%, P＜0.05), nevertheless there were no significant differences in op- eration time, intraoperative fluoroscopy times, bone cement injection amount, postoperative walking time and hospital stay between the two groups (P＞0.05). All of them in both groups were followed up for (15.0±1.8) months on a mean, and there was no significant difference in the time to return to full weight-bearing activities between the two groups (P＞0.05). Compared with those preoperatively, the VAS, ODI and JOA scores significantly improved in both groups at discharge and the latest follow-up (P＜0.05). Although there was no significant difference in the abovesaid scores between the two groups before surgery (P＞0.05), the LT group proved significantly superior to the NT group at discharge [VAS (2.0±1.3) vs (2.9±1.3), P=0.010; ODI (27.7±3.5) vs (28.1±3.8), P=0.022; JOA (22.9±2.0) vs (21.7±1.7), P=0.010] and at the latest fol- low-up [VAS (2.1±1.2) vs (2.9±1.4), P=0.016; ODI (26.5±2.6) vs (27.7±3.7), P=0.034; JOA (22.5±1.5) vs (21.4±1.8), P=0.033]. Radiographi-cally, the LT group was significantly superior to the NT group in term of satisfactory ratio of bone cement diffusion (56.7% vs 30.0%, P＜ 0.05). Compared with those preoperatively, the relative anterior vertebral height and local Cobb angle in both groups significantly improved immediately after surgery and at the latest follow-up (P＜0.05), whereas which proved not significantly different between the two groups at any time points accordingly (P＞0.05). [Conclusion] Intermittent perfusion of bone cement at low temperature does significantly increase the effective injection time of bone cement, improve the diffusion extent of bone cement in vertebral body, and reduce the risk of bone cement leakage

Abstract:[Objective] To compare the clinical efficacy of posterior endoscopic decompression versus open extension of the posterior in- terbody fusion (PLIF) for adjacent segment disease secondary to lumbar fusion. [Methods] A retrospective study was done on 26 patients who received surgical treatment for the adjacent segment disease in our hospital from January 2017 to January 2020. According to the doctorpatient communication, 12 patients received posterior endoscopic decompression (endoscopic group) and 14 patients received open prolonga- tion of PLIF (PLIF group). The perioperative period, follow-up and imaging data of the two groups were compared. [Results] All patients in both groups had the corresponding surgical procedures performed successfully without serious complications during the operation. The endo- scopic group proved significantly superior to the PLIF group in terms of operation time [(61.1±20.4)min vs (124.2±27.9)min, P＜0.05], total in- cision length [(0.7±0.1)cm vs (10.7±1.6)cm, P＜0.05], intraoperative blood loss [(8.8±7.1)ml vs (244.4±108.4)ml, P＜0.05], ambulation time [(1.6±0.7)days vs (3.7±1.5)days, P＜0.05] and hospital stay [(5.6±1.9)days vs (9.5±2.5)days, P＜0.05] . All patients in both groups were fol- lowed up for more than 12 months, and the endoscopy group returned to full weight- bearing activities significantly earlier than the PLIF group [(56.7±5.4)days vs (67.3±6.8)days, P＜0.05] . The VASs both for back pain and leg pain, ODI and JOA scores improved significantly over time in both groups (P＜0.05), which were not statistically significant between the two groups at any time points accordingly (P＞0.05). Regarding imaging, the spinal canal area and the sagittal diameter of the lateral recess significantly increased (P＜0.05), whereas the lumbar lordosis angle remained unchanged in both groups at the latest follow-up compared with those preoperatively (P＞0.05). Although there was no significant difference in the abovementioned indexes between the two groups before surgery (P＞0.05), the endoscopic group had signifi- cantly less the spinal canal area [(142.2±14.7)mm² vs (182.0±20.5)mm² , P＜0.05] and lateral recess diameter [(3.4±0.4)mm vs (4.3±0.7)mm, P＜0.05] than the PLIF group at the latest follow-up, whereas without a significant difference in lumbar lordosis angle between the two groups (P＞0.05). [Conclusion] In this study, posterior endoscopic decompression for adjacent segment disease has the advantages of less trauma and faster recovery, and dose achieve the same clinical outcomes as open extension of PLIF.

Abstract:[Objective] To compare the clinical outcomes of discectomy with unilateral biportal endoscopy (UBE) versus uniportal inter- laminar endoscopy (UIE) for single-segment lumbar disc herniation (LDH). [Methods] A retrospective study was conducted on 63 patients who underwent endoscopic discectomy in our department from August 2020 to August 2021. According to the preoperative doctor-patient communication, 32 patients received UBE, while the remaining 31 patients received UIE. The perioperative period, follow-up and imaging data of the two groups were compared. [Results] The UBE group proved significantly poorer than the UIE group in terms of operating time [(83.2±10.3)min vs (71.8±8.9)min_, P＜0.05], the total length of incision [(1.5±0.2)cm vs (1.2±0.2)cm, P＜0.05], intraoperative blood loss [(30.0±2.0)ml vs (20.0±1.6)ml, P＜0.05], the ambulation time [(2.5±0.5)days vs (1.6±0.2)days, P＜0.05] and hospital stay [(5.1±0.6)days vs (4.0±0.4)days, P＜0.05], nevertheless there were no significant differences in intraoperative fluoroscopy times and incision healing grade be- tween the two groups (P＞0.05). All of them in both groups were followed up for more than 12 months. VAS scores both for back pain and leg pain, as well as ODI score significantly decreased over time in both groups (P＜0.05). The UBE group was significantly better than the UIE group in terms of VAS score for lumbago [(2.2±0.4) vs (2.5±0.5), P＜0.05] and VAS score of leg pain [(2.4±0.6) vs (2.8±0.7), P＜0.05] and ODI score [(20.2±2.9) vs (22.5±2.5), P＜0.05] a month postoperatively, whereas which became not statistically significant between the two groups at 6 months postoperatively and the latest follow-up. Regarding imaging, the spinal canal occupying ratio significantly decreased (P＜0.05) and intervertebral height remained unchanged (P＞0.05), and the lumbar lordosis increased significantly (P＜0.05) in both group at the latest follow- up compared with those preoperatively. By the time of the last follow- up, the UBE group proved significantly superior to the UIE group in terms of canal occupying ratio [(12.3±3.2)% vs (15.5±4.3)%, P＜0.05] and lumbar lordosis [(52.3±6.2)° vs (47.8±5.9)°, P＜0.05].[Conclusion] Both UBE and UIE are effective in the treatment of LDH, with comparable clinical consequences. By comparison, the UIE is less invasive, while the UBE is more effective decompression.

Abstract:[Objective] To compare the clinical efficacy of arthroscopic versus open Brostr?m-Gould procedure for repair of anterior talofibular ligament (ATFL) in the treatment of chronic lateral ankle instability. [Methods] A retrospective study was conducted on 60 pa- tients who received surgical treatment for chronic lateral ankle instability in our hospitals from August 2018 to September 2019. According to the results of doctor-patient communication, 30 patients underwent arthroscopic repair (the arthroscopic group), while the other 30 pa- tients received open repair (the open group). The perioperative period, follow-up and imaging data were compared between the two groups. [Results] All patients in both groups were operated on successfully without serious complications. The arthroscopic group proved signifi- cantly superior to the open group in terms of total incision length, intraoperative blood loss, intraoperative fluoroscopy times, postoperative walking time and hospital stay (P＜0.05). As time went during follow-up period lasted for more than 12 months, the VAS score and eversioninversion range of motion (ROM) significantly declined (P＜0.05), while the AOFAS score significantly increased in both groups (P＜0.05). At 1 month after operation, the arthroscopic group proved significantly superior to the open group in dorsal extension plantar flexion ROM, eversion-inversion ROM and AOFAS score (P＜0.05), whereas which became not statistically significant at 12 months after operation (P＞ 0.05). In addition, the anterior drawer test and varus test were significantly improved postoperatively in both groups (P＜0.05), but there was no significant difference between the two groups at any corresponding time points (P＞0.05). Regarding imaging, the anterior displacement and talus tilt under stress on X-ray films significantly decreased in both groups after operation (P＜0.05), which were not significantly differ- ent between the two groups at any matching time points (P＞0.05). [Conclusion] Both arthroscopic and open Brostr?m-Gould procedures do effectively repair chronic lateral ankle instability. In contrast, the arthroscopic procedure takes a benefit of minimally invasive surgery, which improves functional recovery in short-term.

Abstract:[Objective] To systematically evaluate the safety of unilateral biportal endoscopic (UBE) lumbar interbody fusion versus con- ventional lumbar interbaody fusion surgery. [Methods] The Cochrane Library, PubMed, Embase, Web of Science, Clinical Trals.gov, CBM, CNKI, VIP and Wanfang Database were searched to collect all comparative studies on UBE and conventional lumbar interbody fusion sur- gery from the establishment of the database to April 13, 2022, and then RevMan5.3 software was used for meta-analysis, additionally de- scriptive qualitative analysis was performed for data that could not be combined. [Results] A total of 9 articles were enrolled into this study, all of which were retrospective cohort studies, including 7 high-quality articles and 2 medium-quality articles. A total of 796 patients were involved, including 365 in the UBE group and 431 in the conventional group. As results of meta-analysis, there were no significant differenc- es in terms of total complication rates (OR=0.94, 95%CI 0.57~1.53, P=0.800), the incidence of epidural hematoma (OR=1.16, 95%CI 0.38~ 3.52, P=0.800), incidence of dural tear (OR=1.80, 95%CI 0.76~4.30, P=0.180), and incidence of infection (OR=0.35, 95%CI 0.09~1.30, P= 0.120) perioperatively between the UBE and traditional groups. Furthermore, there were no significant differences in terms of incidence of transient numbness (OR=1.03, 95% CI 0.22~4.84, P=0.970), incidence of incomplete decompression (OR=0.97, 95% CI 0.18~5.33, P= 0.970) and incidence of revision surgery (OR=0.78, 95%CI 0.17~3.61, P=0.750), and incidence of cage subsidence (OR=0.86, 95%CI 0.30~ 2.47, P=0.780) between the two groups. [Conclusion] UBE lumbar interbody fusion is as safe as conventional lumbar interbody fusion sur- gery.

Abstract:With the aging of the population, the incidence of degenerative scoliosis (DS) is increasing in the middle- aged and older adults, and more patients are opting for surgical correction to improve their quality of life. In the diagnosis and treatment of DS, a suitable classification plays an important role in the evaluation of patients^， prognosis and helping surgeons to standardize and systematize the treat- ment. There have been more than ten classifications for DS in the last two decades, like SRS-Schwab classification, Lenke-Silva classifica- tion and MISDEF classification, but a widely accepted classification is still absent. This article reviews, analyzes, and evaluates some impor- tant classifications, and then summarizes the elements that should be included in an ideal classification, in order to promote the formation of an ideal classification to help surgeons choose reasonable and detailed correction approaches.

Abstract:[Objective] To measure the cervical range of motion (ROM) after cervical disc replacement with a novel prosthesis made in China in goats. [Methods] Twelve goats were randomly divided into 3 groups, including hydroxyapatite (HA) coated intervertebral prosthesis group, non-HA coated intervertebral prosthesis group and sham operation group, with 4 goats in each group. In the HA group and the nonHA group, C_3/4 disc was removed and the corresponding prosthesis was implanted, while the sham group had surgical exposure performed without intervertebral disc involved. The C₂~C₅ ROM and C_3/4 ROM were measured regularly by dynamic radigraphs. [Results] All goats sur- vived without incision infection and paralysis in any animal after operation. HA group and sham group remained no significant changes in C₂~C₅ ROM and C_3/4 ROM over time (P＞0.05), whereas the non-HA group had C₂~C₅ ROM and C_3/4 ROM significantly reduced over time post- operatively (P＜0.05). Although there were no significant differences in C₂~C₅ ROM and C_3/4 ROM among the 3 groups before and immediately after surgery (P＞0.05), the HA group and the sham group had significantly greater C₂~C₅ ROM and C_3/4 ROM than non-HA group at 1 and 3 months after surgery (P＜0.05). However, there was no significant difference in C₂~C₅ ROM and C_3/4 ROM between HA group and sham group at 1 and 3 months postoperatively (P＞0.05). [Conclusion] This novel HA coated intervertebral disc prosthesis made in China does properly maintain the range of motion of cervical spine in goats.

Abstract:

[Objective] To explore the dose-effect relationship of recombinant human morphogenetic protein-2 (rhBMP-2) in the criti- cal radius bone defect model in rabbit. [Methods] A total of 36 New Zealand white rabbits were randomly divided into blank group, sponge blank group, bone autograft group, low-dose group (0.25 mg rhBMP-2), medium-dose group (0.5 mg rhBMP-2) and high-dose group (2.5 mg rhBMP-2), with 6 rabbits in each group. After a 15 mm radius bone defect was made in rabbit, the corresponding bone defect treatments were conducted respectively. The X-ray check, Micro CT examination and histological observation were performed at 4 and 8 weeks postop- eratively. [Results] Compared with those 4 weeks after surgery, Lane Sandhu X-ray scores increased in all groups at 8 weeks, which were not significantly different between the two time points in the blank group and sponge blank group (P<0.05), while statistically significantly different in the bone autograft group, low, medium and high dose groups (P<0.05). At the corresponding time points, Lane Sandhu X-ray scores ranked from low to high all as: blank groupP<0.05).Regarding Micro CT assay, the bone mineral density (BMD)and trabecular number (Tb.N) increased in all the 6grorps at 8 weeks comparde with those at 4 weeks after surgery, which proved statistically singnificant between the two time points in the low-dose,medium-dose and high-dose grouups(P<0.05).At the corresponding time points,BMD and Tb.N ranked from low to high as:low dose groupP<0.05).In addition, the histological observation showde that the maturty of new bone was dose-dependent with rhBMP-2.[Conclusion] In the dose range of 0.25mg to 2.5mg, the bone repair outcome of rhBMP-2 in the critical radial bone defect is dose-dependent.

Abstract:[Objective] To introduce the surgical technique and preliminary results of replacement with a mass autograft of palmaris lon- gus tendon for defect secondary to lunate resection for avascular necrosis of the lunate. [Methods] From May 2019 to May 2022, 8 patients underwent lunate resection and replacement with mass autograft of palmaris longus tendon for avascular necrosis of the lunate. After a carpal arc-shaped incision was made, the necrotic lunate was exposed and removed completely. The palmaris longus tendon was harvested and pre- pared to a mass graft, and then implanted into the defect. [Results] All the 8 patients had operation performed successfully without serious complications,and were followed up for more than 12 months. The VAS score significantly decreased from (5.5±0.9) before surgery to (0.3± 0.4) at the last follow-up, with a significantly improvement in wrist range of motion postoperatively. In addition, the muscle strength of wrist and finger improved by 1~2 degrees at the latest follow up compared with those before operation. The Mayo score was (91.1±3.3) at the last follow-up, with the excellent and good rate of 100%. In term of imaging examination, there was no displacement of carpal bones with normal arrangement of the structures till the latest follow up. [Conclusion] This mass autograft of palmaris longus tendon might replace the support- ing function of lunate, has benefits of simple operation, and does achieve satisfactory preliminary results.

Abstract:[Objective] To introduce the surgical technique and preliminary results of cerclage fixation of inferior pole fractures of the patella with double suture anchors. [Methods] A total of 26 patients received open reduction and internal fixation with intersected cerclag- es of double anchors for inferior pole fractures of the patella. After double suture anchors were placed on both sides of the intact bone of the proximal end, the inferior pole of the patella was sutured and knotted in a mesh alternatingly. A transvers bone hole 2 mm in diameter was made at the upper 1/3 of the proximal end, and then the sutures were stitched with the patellar retinaculum on both side up to the level of the hole, and passed the hole to the opposite side respectively. The sutures were crossed in 8-figure over the anterior surface of the patella, and stitched with the distal patellar tendon in Krachow manner. [Results] All patients were successfully operated on without serious intraop- erative complications, and followed up for more than 12 months. All the patients got walking function gradually improved over time, with VAS score of 0.1, Bostman score of 29.7 and knee range of motion of 132.8° at the latest follow-up. Radiographically, callus appeared on the fracture ends in all patients 4~6 weeks, and bony union was clear 10~12 weeks after surgery. The Insall-Salvati ratio was of (1.2±0.1) at 30° knee flexion on lateral review 1 year after surgery. All patients had no adverse imaging signs such as anchor loosening and fracture redisplacement. [Conclusion] The intersected cerclages of double anchors for fixation of inferior pole fractures of the patella are feasible and reliable, with satisfactory preliminary clinical outcome.

Abstract:[Objective] To investigate the clinical outcomes of limited soft tissue release combined with different external fixations in the treatment of equinovarus feet in spastic cerebral palsy. [Methods] From September 2019 to December 2020, a total of 41 patients (58 feet) who suffered from spastic cerebral palsy received limited soft tissue release combined with plaster fixation, or limited soft tissue release, osteotomy combined with external fixator fixation for equinovarus feet. The perioperative and follow-up consequences were summarized. [Results] Of 58 feet, Achilles tendon lengthened and tibial posterior tendon lengthened were done in 84.5%, while foot osteotomy or joint fusion in 74.1%. All patients were followed up for at least 24 months. After removal of the external fixator and at the last follow-up, all cases got sig- nificant improvement in terms of extensor strength, valgus strength, muscle tension and efficacy grade (P＜0.05). The AOFAS score of the an- kle and hindfoot was significantly increased (P＜0.05), whereas the ICFSG score and Ashworth score were significantly decreased postopera- tively (P＜0.05). [Conclusion] The limited soft tissue release combined with external fixation can achieve satisfactory results for treatment of clubfoot deformity secondary to spastic cerebral palsy.

Abstract:[Objective] To explore the significance of fascia iliaca compartment block (FICB) after total hip arthroplasty (THA) in the el- derly. [Methods] A total of140 elderly patients who underwent primary unilateral THA were randomly divided into 2 groups. Of them, 70 pa- tients were treated with high FICB combined with patient-controlled intravenous analgesia (PCIA) (the compound group), while the other 70 patients were treated with PCIA only (the PCIA group). Postoperative analgesia and clinical data were compared between the two groups. [Results] The compound group proved significantly superior to the PCIA group in terms of VAS score [(2.3±0.4) vs (2.6±0.7), P=0.002; (2.7±0.5) vs (3.4±0.7), P＜0.001; (3.0±0.7) vs (3.4±0.6), P＜0.001] and BCS scores [(3.3±0.5) vs (2.4±0.4), P＜0.001; (2.5±0.4) vs (1.9±0.5) , P＜0.001; (2.9±0.6) vs (2.1±0.6), P＜0.001] 8, 12 and 24 hours postoperatively. In addition, the former was also significantly superior to the latter regard- ing to the total number of PCIA compressions within 48 hours [(5.2±2.2)times vs (9.8±1.4)times, P＜0.001] and additional analgesic usage rate [5(7.1%) vs 18(25.7%), P=0.003] . Furthermore, the compound group was significantly superior to the PCIA group in terms of MMSE scores [(8.7±2.1) vs (11.2±1.9), P＜0.001; (7.7±1.7) vs (8.7±1.8), P=0.001] and PSQI score [(8.7±2.1) vs (11.2±1.9), P＜0.001; (7.7±1.7) vs (8.7±1.8), P=0.001] 1 and 3 days after surgery. Moreover, the compound group got significant higher Harris score at discharge (P＜0.05) , with significantly lower complication rate, such as dizziness, nausea, vomiting and constipation within 5 days after operation than the PCIA group (P＜0.05). [Conclusion] High FICB combined with PCIA does effectively alleviate pain, improve postoperative comfort, reduce the in- cidence of postoperative delirium and other complications, improve sleep quality, enhance the rapid recovery of hip function after THA in the elderly.

Abstract:[Objective] To evaluate the short-term efficacy of unilateral biportal endoscopy (UBE) for severe sequestered lumbar disc herniation. [Methods] A retrospective study was done on 30 patients who underwent UBE for severe sequestered lumbar disc herniation in our hospital from June 2020 to June 2021. The clinical consequences and laboratory tests were assessed. [Results] All patients had operation performed smoothly with on serious intraoperative complications, while with operative time of (93.6±17.1) min and hospital stay of (3.8±1.1) days. The VAS and ODI scores significantly decreased (P＜0.05), while JOA scores significantly increased over time (P＜0.001). At 60 days postoperatively, the overall excellent rate was of 96.7% according to modified MacNab criteria. In term of laboratory test, the CRP, ESR, and CPK significantly upgraded 1 day postoperatively compared with those preoperatively (P＜0.05), whereas which declined 3 days postopera- tively to the normal levels. [Conclusion] The UBE technique is highly effective treatment for severe sequestered lumbar disc herniation with satisfactory short-term outcomes.

Abstract:[Objective] To investigate the clinical outcomes of long-time traction based on Ilizarov theory for cervical radiculomyelopa- thy. [Methods] A total of 56 patients with cervical radiculomyelopathy were enrolled in this study from January 2016 to December 202, and were divided into two groups by using random number table method. Of them, 28 patients received long -ime traction, while the other 28 pa- tients underwent conventional traction. The clinical and electrophysiological documents were compared between the two groups. [Results] All patients in both groups had traction treatment performed smoothly withou adverse reactions during the treatment. The VAS scores and JOA scores significantly improved 4 weeks after treatment in both groups compared with those before treatment (P＜0.05). Although there were no significant differences in VAS score and JOA score between the two groups before treatment (P＞0.05), the long-time group proved significantly superior to the conventional group in above scores 4 weeks after treatment (P＜0.05). In addition, median nerve and ulnar nerve potential latency were significantly shortened, while the conduction velocity significantly accelerated in both groups 4 week after treatment compared with those before treatment (P＜0.05), which were not statistically significant between the two groups before treatment (P＞0.05), whereas the long-time group proved significantly superior to the conventional group 4 weeks after treatment (P＜0.05). [Conclusion] Pro- longed traction therapy can effectively improve the clinical symptoms and electrophysiological manifestations of cervical radiculomyelopathy with better clinical efficacy over the conventional traction therapy.

Abstract:[Objective] To investigate the clinical outcomes of core decompression and bone grafting with a self-developed guided tre- phine set for early-middle-stage femoral head necrosis (Ficat stage I and II). [Methods] From October 2016 to October 2020, 36 patients (44 hips) underwent core decompression and bone grafting with the self-developed guided trephine set for femoral head necrosis in early and middle stage. The clinical and imaging documents were evaluated. [Results] All the patients were successfully operated on, without serious complications such as important neurovascular injury during the operation, while with the operation time of (65.2±8.4) min, blood loss of (32.5±5.6) ml, intraoperative fluoroscopy times of (20.3±3.6) times, and the hospital stay of (7.0±1.8) days. All the patients were followed up for (20.8±9.3) months on an average , and resumed weight bearing activity on the affected extremity in (5.1±0.9) months on a mean. The Har- ris score [(69.5±5.9), (80.2±7.8), (82.8±6.6), P＜0.05], hip flexion-extension range of motion (ROM) [(56.6±7.8)°, (85.5±6.3)°, (91.2±8.2)°, P＜0.05] and hip internal-external rotation ROM [(35.2±5.3)°, (56.5±6.9)°, (62.7±7.2)°, P＜0.05] significantly increased over time. Radio- graphically, 2 hips developed to Ficat stage III 1 year after surgery, and 2 hips developed femoral head collapse. [Conclusion] This self-de- veloped guided trephine set for core decompression and bone grafting has the advantages of intuitive position, precise curettage of dead bone and sufficient decompression and bone grafting, and does achieve satisfactory preliminary clinical results for femoral femoral head necrosis in early and middle stage.

Abstract:[Objective] To explore the preliminary results of community education and intervention for osteoporosis (OP). [Methods] From July 2019 to June 2020, the intervention station for OP were set up in 16 primary healthcare unites in Cixi city, a total of 854 subjects were included and randomly divided into two groups. Of them, 459 cases in the intervention group (IG) were given education and correspond- ing intervention for OP, while 395 cases in the control group (CG) received routine community management without relevant education and intervention for OP with the 1-year intervention period. Compared with the control group, and before and after the intervention, the under- standing to OP risk factors, bone mineral density (BMD) and occurrence of related adverse events were evaluated. [Results] Although there was no significant difference in the recognition rate of OP and fall risk factors between the IG and the CG before intervention (P＜0.05), the average cognition rate to all risk factors increased significantly in the IG after the intervention, which was significantly higher than the CG (P＜0.05). Both the lumbar bone mineral density(BMD) and femoral neck BMD significantly increased in the IG after intervention compared with those before intervention (P＜0.05), whereas which remained unchanged in the CG (P＞0.05). The IG proved significantly superior to the CG in terms of lumbar BMD [(0.7±0.1)g/cm² vs (0.5±0.1)g/cm² , P＜0.05] and femoral neck BMD [(0.8±0.1)g/cm² vs (0.7±0.1)g/cm² , P＜0.05] af- ter intervention. During the 1-year intervention, the incidence of adverse events, including fracture, disability and death, was 122(26.6%) in the IG and 111 (28.1%) in the CG, which in the former were lower than the latter despite of that the difference was not statistically significant (P＞0.05). [Conclusion] This community education and intervention for OP does significantly improve the awareness rate of related risk fac- tors and increase bone density, which has positive significance for the prevention of osteoporotic fracture.