Abstract:[Objective] To explore the significances of albumin/fibrinogen ratio (AFR), C- reactive protein/ (albumin/globulin) ratio (CAGR) and albumin (ALB) in the diagnosis of periprosthetic joint infection (PJI) secondary to major joint replacement. [Methods] A retro- spective study was done on 95 patients who underwent revision of hip or knee arthroplasty in our hospital from January 2018 to January 2021. Of them, 45 patients were definitively diagnosed of PJI, while the remaining 50 patients were definitively diagnosed of aseptic loosening (AL). The blood test parameters were compared between the two groups, then which were analyzed by ROC curve to calculate the sensitivity and specificity, and the diagnostic efficacy by area under curve (AUC). [Results] The PJI group had significantly higher level of CRP [(42.2±47.4) mg/L vs (8.8±18.4) mg/L, P＜0.05], ESR [(54.2±27.7) mm/h vs (22.2±18.7) mm/h, P＜0.05], FIB [(5.1±1.4) g/L vs (3.4±0.8) g/L, P＜0.05], GLO [(32.1±6.3) g/L vs (27.4±4.5) g/L, P＜0.05] and CAGR [(39.6±43.6) vs (6.6±14.8), P＜0.05], while significantly lower level of ALB [(37.0±7.4) g/ L vs (40.7±4.1) g/L, P＜0.05] and AFR [(7.9±3.1) vs (12.9±3.3), P＜0.05] than the AL group. As results of ROC analysis, the FIB (AUC=0.869, sensitivity=82.0%, specificity=80.0%) , the AFR (AUC=0.864, sensitivity=92.0%, specificity=80.0%), the CAGR (AUC=0.825, sensitivity= 90.0% , specificity=66.7% ), and the GLO was good (AUC=0.768, sensitivity=54.0% , specificity=91.1% ), while the ALB was fair (AUC= 0.754, sensitivity=86.0%, specificity=60.0%). [Conclusion] AFR, FIB and CAGR might be used as new auxiliary marker for PJI diagnosis.

Abstract:[Objective] To compare the clinical outcomes of Oxford unicompartmental knee arthroplasty (UKA) between patients older and younger than 60 years, and to discuss the ideal indications of Oxford UKA. [Methods] A total of 112 patients who received primary UKA for knee osteoarthritis (KOA) from March 2014 to December 2017 were retrospectively reviewed. The patients were divided into two groups according to age at surgical procedure, the ＜60 group and the ≥60 group, with 56 cases in each group. The data regarding to perioperative pe- riod, follow-up and radiographs were compared between the two groups. [Results] All patients in both groups had UKA performed success- fully without serious complications. There were no significant differences in operation time, total length of surgical incision, intraoperative blood loss, time to walk down the ground, grade of incision healing and hospital stay between the two groups (P＞0.05). All patients were fol- lowed up for (69.2±5.3) months on an average, and there was no a significant difference in the time to resume full weight-bearing activities between the two groups (P＞0.05). As time went by, the VAS score was significantly decreased (P＜0.05), while HSS score, KSS clinical and functional scores and knee extension-flexion range of motion (ROM) significantly increased in both groups (P＜0.05). There was no signifi- cant difference in the above items between the two groups before surgery and 6 months after surgery (P＞0.05). The ＜60 group got significant- ly higher KSS clinical score than the ≥60 group at the latest follow-up (P＜0.05), despite that there were no significant differences in knee VAS score, HSS score, KSS functional score and knee ROM between the two groups (P＞0.05). Regarding imaging, femorotibial angle (FTA), mLDFA angle and mMPTA angle significantly improved postoperatively compared with those preoperatively in both groups (P＜0.05), which proved not statistically significantly different at any corresponding time points between the two groups (P＞0.05). [Conclusion] Patients re- ceiving Oxford UKA in age under 60 years show better clinical outcomes in at least 5 years of follow-up, although there was no considerably difference in functional outcomes with those aged ≥60 years.

Abstract:[Objective] To compare the clinical outcomes of non-fusion versus fusion pedicle screw fixation for multi-segment lumbar degenerative diseases. [Methods] A total of 62 patients with three-segment lumbar degenerative diseases were included in this study from January 2018 to December 2019. According to preoperative doctor-patient communication, 30 patients were treated with spinal decompres- sion and non-fusion pedicle screw fixation with PEEK rod, while the remaining 32 patients received decompression and conventional pedi- cle screw-rod fixation and fusion. The the latest follow-up [(5.2±3.4)° vs (6.3±3.2)°, P＜0.001; (5.3±3.7)° vs (6.7±3.8)°, P＜0.001], whereas significantly greater fixed segment ROM at 3, 12 months and the latest follow-up [(8.4±3.6)° vs (2.1±0.9)°, P＜0.001; (9.7±2.3)° vs (1.4±0.5)°, P＜0.001; (11.5±2.9)° vs (0.9±0.4)°, P＜ 0.001], and significantly greater overall lumbar ROM at the last follow-up than the fusion group [(26.2±6.8)° vs (23.4±3.5)°, P=0.012]. In ad- dition, the non-fusion group had significantly better Pfirrmann grade for the upper adjacent space at the last follow-up [I/II/III/IV/V: (5/15/7/ 3/0) vs (4/12/11/4/2) , P=0.014]. [Conclusion] The non-fusion fixation does remains partial motion of fixed segment with less stiffness of lumbar spine, which has relatively little impact on the degeneration of adjacent intervertebral disc.perioperative, follow-up and imaging data were compared between the two groups. [Results] Although there were no significant differences in incision length, postoperative drainage volume, incision healing grade, postoperative walking time and hospital stay between the two groups (P＜0.05), the non-fusion group proved significantly superior to the fusion group in terms of opera- tive time [(172.2±48.7) min vs (216.5±75.4) min, P＜0.05] and intraoperative blood loss [(216.5±75.4) ml vs (268.8±94.5) ml, P＜0.05]. With time of follow-up lasted for (28.1±3.8) months on a mean, the VAS scores for back pain and leg pain, as well as ODI and LSDI score signifi- cantly improved in both groups (P＜0.05). Despite of the fact that there were no significant differences in the VAS scores for lumbago and leg pain as well as ODI score between the two groups at any time points accordingly (P＞0.05), the non-fusion group was significantly superior to the fusion group in LSDI score 12 months postoperatively [(7.2±4.1) vs (9.7±3.9), P＜0.05] and at the latest follow-up [(6.8±3.7) vs (8.9±3.6), P＜0.05]. Radiographically, there were no statistically significant differences in preoperative upper adjacent segment range of motion (ROM), fixed segment ROM, total lumbar ROM and Pfirrmann grade for degeneration of the upper adjacent intervertebral disc between the two groups (P＜0.05). However, the non-fusion group had significantly less ROM of the upper adjacent segment at 12 months postoperatively and

Abstract:[Objective] To compare the clinical outcomes of endoscopic transforaminal lumbar interbody fusion (E- TLIF) versus oblique lumbar interbody fusion (OLIF) for degenerative spondylolisthesis (DS). [Methods] From April 2019 to January 2021, 82 patients with DS were surgically treated in our hospital. According to preoperative doctor-patient communication, 41 patients underwent E-TLIF, while the remaining 41 patients received OLIF. The perioperative, follow-up and imaging data were compared between the two groups. [Results] All patients in both groups had operation performed successfully without serious complications. The OLIF group proved significantly superior to the E- TLIF group in terms of operation time, total incision length, intraoperative blood loss, intraoperative fluoroscopy times, walking time and hospital stay (P＜0.05). In addition, the OLIF group had significantly lower ESR, PCT and β-EP than the E-TLIF group at 1 day after operation (P＜0.05). The VAS and ODI scores decreased significantly (P＜0.05), while the JOA scores significantly increased over time in both groups (P＜0.05). The OLIF group was marked significantly lower VAS score than the E-TLIF group at 1 week and 3 months af- ter operation (P＜0.05), whereas there were no significant differences in ODI and JOA scores between the two groups at any corresponding time points postoperatively (P＞0.05). In terms of imaging, the intervertebral space height and lumbar lordotic angle significantly increased in both groups after surgery compared with those preoperatively (P＜0.05), which in the OLIF group were significantly higher than those in the E-TLIF group at 3 months and latest follow-up (P＜0.05). There was no significant difference in vertebral slippage percentage and Lenke grade for intervertebral fusion between the two groups at corresponding time points (P＞0.05). [Conclusion] Both E-TLIF and OLIF are ef- fective treatment for DS. By comparison, the OLIF has advantages of less bleeding, faster recovery, less trauma, and less impact on serum markers over the E-TLIF.

Abstract:[Objective] To compare the clinical outcomes of the unilateral biportal endoscopic discectomy (UBED) versus Quadrantchannel discectomy (QCD) in the treatment of single-level lumbar disc herniation. [Methods] A retrospective study was performed on 61 pa- tients who were treated by minimally invasive surgeries for single-segment lumbar disc herniation in our department from June 2021 to De- cember 2021. According to doctor-patient communication, 32 patients were treated by UBED, while the other 29 patients were by QCD. The perioperative period, follow-up and imaging data were compared between the two groups. [Results] All patients in both groups had corre- sponding surgical procedures performed successfully with 1 case of dural tear in each group that not leaded serious adverse consequences. Although the UBED group consumed significantly longer operative time [(58.3±7.0) min vs (42.0±6.7) min, P=0.039] and more intraoperative fluoroscopy [(4.5±1.0) times vs (3.6±1.2) times, P=0.003] than the QCD group, the former proved significantly superior to the latter in terms of total incision length [(2.7±0.2) cm vs (3.3±0.2) cm, P＜0.001], intraoperative blood loss [(45.8±12.6) ml vs (56.2±13.5) ml, P=0.003], and postoperative walking time [(2.2±0.5) days vs (2.9±0.7) days, P＜0.001]. All patients in both groups were followed up for 12~14 months with a mean of (12.8±0.7) months, and the UBED group resumed full weight-bearing activity significantly earlier than the QCD group [(6.0±1.1) weeks vs (6.7±1.1) weeks, P=0.023]. The VAS scores for low back pain and leg pain, as well as ODI scores significantly decreased in both groups over time (P＜0.05), which proved not statistically significant between the two groups at any time point accordingly (P＞0.05). Regard- ing imaging, the spinal canal occupying rate of the involved segment was significantly decreased in both groups after surgery and at the last follow-up compared with that preoperatively (P＜0.05), while the intervertebral height and the Cobb angle of lumbar lordosis remained un- changed (P＞0.05). There were no significant differences in the above imaging indexes between the two groups at any matching time point (P＞0.05). [Conclusion] Both surgical techniques are safe and effective minimally invasive methods for the treatment of lumbar disc herniation. Although UBED consumes longer operation time and more fluoroscopy times, it takes advantages of less trauma and faster postoperative re- covery over the QCD.

Abstract:[Objective] To evaluate the risk factors of traumatic arthritis after surgical treatment of tibial plateau fractures. [Methods] The data bases, including Wanfang、SinoMed、CNKI、PubMed、Embase and Cochrane Library were searched for the papers that met the criteria by computer from the creating to October 2022. The risk factors of traumatic arthritis after surgical treatment of tibial plateau frac- tures were analyzed by using RevMan 5.3. [Results] A total of 12 articles were included, including 1 prospective study and 11 retrospective studies, with 338 arthritic patients and 1 038 non-arthritic patients in the study. As results of the meta-analysis, the high-energy injury (OR=3.50, 95%CI 2.44~5.03, P＜0.001), fracture type ≥ IV (OR=3.86, 95%CI 2.60~5.73, P＜0.001), osteoporosis (OR=2.63, 95%CI 1.04~ 6.65, P=0.04), meniscus injury (OR=1.74, 95%CI 1.08~2.81, P=0.02), time elapsed between injury and surgery ＞7 days (OR=2.95, 95%CI 2.02~4.30, P＜0.001), non-anatomical reduction of the fractures intraoperatively (OR=5.92, 95%CI 2.73~12.84, P＜0.001), poor postopera- tive fracture reduction anatomical score (OR=10.67, 95%CI 2.12~53.77, P=0.004), and mechanical axis malalignment ≥ 5° (OR=2.85, 95% CI 1.12~7.26, P=0.03) were risk factors for postoperative traumatic arthritis of tibial plateau fractures. [Conclusion] The high energy injury, tibial plateau fracture type ≥ IV, osteoporosis, meniscus injury, time elapsed between injury and operation ＞7 days, non-anatomical reduc- tion intraoperatively, poor anatomical score of postoperative fracture reduction, and malalignment of mechanical axis ≥5° are risk factors for traumatic arthritis after tibial plateau fracture surgery. Patients with the above risk factors should be given high attention and early interven- tion to reduce the incidence of postoperative arthritis and improve the clinical prognosis of patients.

Abstract:Adolescent idiopathic scoliosis is a common spinal deformity with no obvious cause. If not treated in time, it will lead to a va- riety of complications such as aggravation of lateral curvature angle and cardiopulmonary dysfunction, which makes patients' quality of life decline and even threaten their lives. At present, the treatment of adolescent idiopathic scoliosis can be divided into non-surgical treatment and surgical treatment. Early detection, diagnosis and treatment are advocated to effectively prevent the progression of scoliosis. In this pa- per, the main non-surgical treatment methods, including exercise therapy and brace therapy, were reviewed to provide reference for the clini- cal non-surgical treatment of adolescent idiopathic scoliosis.

Abstract:With development of total hip arthroplasty (THA), the researches on different approaches for THA has been drawn more and more attention. With the rise of minimally invasive concept, direct anterior approach (DAA) for THA has also been widely used. The advan- tages of intermuscular approach include not cutting muscle, less intraoperative bleeding, less soft tissue injury, less risk of postoperative dis- location, and higher clinical satisfaction of patients. However, with the deepening of the research, many problems have emerged. Therefore, many improved techniques have been gradually applied in clinical practice. This paper summarizes and analyzes the improved techniques to provide a reference for clinicians

Abstract:Adjacent segment degeneration (ASD) refers degenerative disorder of the adjacent disc following spinal fusion, with many risk factors, such as advanced age, overweight, previous degeneration of the segment, osteoporosis, sagittal spine-pelvis imbalance, choice of surgical techniques, number of segments of intraoperative decompression and fusion, destruction extent of anatomical structure involved. The incidence and morbidity of ASDs after lumbar fusion remain relatively high at present, and how to effectively prevent and treat ASDs af- ter lumbar fusion is a hot and difficult topic in the research of spinal degenerative diseases. Therefore, we reviewed the literature reports on adjacent segment degeneration over the past 10 years, aiming to provide further theoretical reference for clinical practice and reduce the inci- dence of adjacent segment degeneration after lumbar fusion to improve the long-term clinical effect of lumbar fusion.

Abstract:Adolescent lumbar disc herniation is now a growing concerned issue; more and more attention has been paid to the risk fac- tors of adolescent lumbar disc herniation. Scholars have found the main risk factors for adolescent lumbar disc herniation involving exercise and trauma, lumbosacral transition vertebra, the length of intercrestal line, the length of L5 transverse process, facet joint stability, lumbosa- cral angle, BMI and waist-hip ratio, smoking, gender and occupation, etc. However, how to use these risk factors to predict the probability of individual occurrence of lumbar disc herniation, and whether the risk factor scale can be used to predict the selection of special occupations remains a lot works to do. This article mainly reviews the research status of the main risk factors of adolescent lumbar disc herniation and rel- ative assessment.

Abstract:[Objective] To identify the potential long non-coding RNAs (lncRNAs) and signaling pathways involved in steroid-induced osteonecrosis of femoral head (SONFH), and investigate their molecular mechanisms. [Methods] Microarray data (GSE123568) were down- loaded from NCBI-GEO and analyzed using bioinformatics tools. By analyzing Differentially Expressed Genes (DEG), Kyoto Encyclopedia of Genes and Genomes (KEGG) amplification pathways, Gene Ontology (GO), and finally identified a protein-protein interaction (PPI) net- work and identified 3 key noncoding genes and 1 key mRNA. We further studied the co-expression profiles of mRNAs, miRNAs and ln- cRNAs in SONFH, established a specific competitive endogenous RNA (ceRNA) network for SONFH, analyzed immune infiltration, and ex- plored the relationship between DEG and immune cells, finally verified with GSE26316. [Results] A total of 374 mRNAs were obtained in the microarray, including 258 down-regulated and 116 up-regulated. Seven lncRNAs were obtained, among which C20orf197, MIR22HG and XIST were significantly different (P＜0.05). The results of biological process analysis showed that DEG was obviously enriched in in- flammatory response. Molecular function analysis showed that DEG was significantly enriched in ubiquitin- protein transferase activity, ubiquitin- protein ligase binding and receptor activity. Analysis of cell components showed that DEG was mainly enriched in cytoplasm. Genes in PPI network modules were mainly enriched in the structural components of GO^,s blood shadow protein-related cytoskeleton, plas- ma membrane and cytoskeleton, while in KEGG, they were mainly enriched in toll-like receptor signaling pathways. Six key genes were identified in this study. By analyzing the immune infiltration, it was found that SONFH tissues contained a higher proportion of CD4 primi- tive T cells (P＜0.05), and verified the expression level of FOXO3 in GSE26316 data set. [Conclusion] C20orf197, MIR22HG and XIST are potential markers in the pathogenesis of SONFH, and the gene axis XIST/Has-miR-217/FOXO3 plays an important role in the occurrence and development of SONFH.

Abstract:[Objective] To observe the relationship among epiphysis ring, cervical nerve and uncinate process to guide the decompres- sion of cervical nerve by one-hole split endoscope. [Methods] Three dimensional models were established based on CT data of 33 patients with cervical spondylotic radiculopathy, the anteroposterior distance of anterior margin of cervical nerve (APDACN), vertical distance of in- ferior margin of cervical nerve (VDIMCN), left and right distance of lateral border of dure mater (LRDLDM), vertical distance of superior mar- gin of cervical nerve start point (VDSCNP), vertical distance of inferior margin of cervical nerve start point, (VDICNP), anterior and posterior distance of lateral border of isthmus of pedicle (APDLIP), abductor angle of cervical nerve (AACN) and anterior inclination angle of cervical nerve (AICN） were measured and compared between genders and sides. [Results] As cervical segment declining, the APDACN remained unchanged significanty (P＞0.05), while the VDIMCN, VDSCNP, VDICNP, AACN and AICN significantly increased (P＜0.05), the LRDLDM and APDLIP significantly decreased (P＜0.05). There was no significant difference between male and female in APDACN, VDIMCN, LRDLDM, VDSCNP, VDICNP, APDLIP, AACN and AICN (P＞0.05), additionally, there was no statistical significance in the above indexes between the left and right sides at any corresponding segments (P＞0.05). The APDACN, VDIMCN, LRDLDM, VDSCNP, VDICNP, APDLIP, AACN and AICN in the main segment (C_5/6) were not significantly correlated with age and BMI (P＞0.05). [Conclusion] With the descending of cervical segment, VDIMCN, VDSCNP, VDICNP, AACN and AICN marked by the lowest point of the epiphyseal ring posterior margin in- creased gradually, while LRDLDM and APDLIP decreased. There was no significant difference in the above indexes between male and fe- male at the same segment, and between left and right.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical effect of modified Zadek dorsal closed wedge calca-neus osteotomy for Haglund syndrome.[Methods] From May 2019 to August 2021, 12 patients received modified dorsal closed wedge calca-neal osteotomy for Haglund syndrome.The patient was placed in the healthy side lateral position, a longitudinal incision on the anterolateralside of the Achilles tendon was made to expose the insertion of the Achilles tendon.After debridement of pathology bursa, osteotomies wereconducted beginning from posterior superior calcaneal tubercle and wedging into the calcaneal body according to the preoperative design.Subsequently, the wedge- shaped bone block was removed, the wedge was closed by rotating and displacing the Achilles tendon insertionbone fragment forward and upward to correct the deformity.[Results] All the 12 patients had operation completed successfully without seri-ous complications, and followed up for 9~24 months.Compared with those before operation, the VAS score, AOFAS ankle and hindfoot scoreand Fowler-Philip angle measured on images were significantly improved at the last follow-up (P＜0.05).According to Arner Lindholm crite-ria, 10 cases were excellent, 2 cases were good, with the excellent and good rate of 100% (12/12).[Conclusion] This modified Zadek dorsalclosed wedge calcaneus osteotomy for Haglund syndrome does effectively relieve heel pain, correct calcaneal tubercle retrogression deformi-ty to restore ankle function.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of enhanced percutaneous vertebroplasty (PVP) via cannulated pedicle screw for Kümmell?s disease. [Methods] From May 2021 to December 2022, 23 patients received abovemen- tioned surgical treatment for Kümmell?s disease. As the patient was placed in prone position for fracture reduction, the puncture needle was inserted into the diseased vertebra after local infiltration anesthesia. After pulling out the needle core, the guide wire was inserted along the needle channel, and then the cannulated pedicle screw was inserted into the vertebral body over the guide wire. Using a 2.5 ml syringe at- tached with the tail of the cannulated screw, the bone cement was injected into the vertebral body under fluoroscopy. The injection was stopped as the void in the vertebral body was filled with bone cement, which was anchored together with the thread in front of the screw. [Results] All patients were successfully operated without serious complications, and followed up for more than 3 months. As time elapsed preop- eratively, 2 days postoperatively and 3 months postoperatively, the VAS score [(5.6±0.2), (1.1±0.2), (1.2±0.2), P＜0.05] and ODI scores [(37.8±0.6), (15.1±0.5), (14.0±0.7), P＜0.05] improved significantly. Regarding imaging, no intravertebral cement leakage was observed in all patients, and the center height of the vertebral body significantly increased after surgery [(12.3± 0.4), (17.3±0.4), (16.9±0.3), P＜0.05], where- as the distance between the anterior and posterior edges of the vertebral body was not significantly changed (P＞0.05). [Conclusion] This en- hanced PVP via cannulated pedicle screw for Kümmell?s disease is a simple surgical technique, which might increase the anchoring force between the anterior and posterior columns and improve the long-term clinical outcomes.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of vascularized ulnar nerve transposition un- der myofascia for cubital tunnel syndrome. [Methods] The nutritional vessels and the length of the ulnar nerve were measured on 6 adult up- per limbs with red latex perfusion in the artery, and then the operation was designed. A total of 20 patients with mild cubital tunnel syndrome were divided into two groups with 10 cases in each group. The patients in the two groups received vascularized ulnar nerve transposition un- der myofascia, or traditional ulnar nerve transposition, respectively. In the vascularized group, the ulnar nerve and its associated vessels were freed and protected during the operation, and the ulnar nerve with associated vessels were moved to the anterior position under myofascial. [Results] All the patients had operation performed in 30~45 min, with good incisions healing. All patients were followed up for more than 6 months, with a mean of recovery of sensation about 3.6 months, while a mean of recovery of hand muscle strength about 4.2 months. Regard- ing electrophysiological tests, the sensory nerve conduction velocity (SCV) and motor nerve conduction velocity (MCV) significantly im- proved in both groups 6 months postoperatively compared with those preoperatively (P＜0.05). Although there was no significant difference in SCV and MCV between the two groups before surgery (P＞0.05), the vascularized group proved significantly superior to the traditional group in terms of SCV [(50.7±6.7) m/s vs (47.6±5.3) m/s, P=0.049] and the MCV [(52.5±3.8) m/s vs (48.4±3.1) m/s, P＜0.001]. [Conclusion] The technique of vascularized ulnar nerve transposition under myofascia is simple and feasible, which can improve the clinical outcomes.

Abstract:[Objective] To compare the clinical outcomes of percutaneous endoscopic interlaminar discectomy (PEID) versus percutane- ous endoscopic transforaminal discectomy (PETD) for huge lumbar disc herniation. [Methods] A retrospective study was conducted on 159 patients who received endoscopic discectomy for huge lumbar disc herniation from September 2016 to September 2019 in our department. Among them, 84 patients received PEID, while the other 75 patients received PETD. The clinical consequences were compared between the two groups. [Results] All the patients in both groups had operation completed successfully, without significant differences in terms of opera- tive time, intraoperative blood loss, fluoroscopic times, ambulation time and hospital stay between the two groups (P＞0.05). At the last followup, both VAS and ODI scores in the two groups were significantly decreased compared with those before surgery (P＜0.05). However, there were no statistical significantly differences in VAS and ODI scores between 2 groups at any corresponding time points (P＞0.05). [Conclusion] Both the endoscopic discectomies do effectively treat huge lumbar disc herniation in this study.

Abstract:[Objective] To investigate the causes and clinical outcomes of revision total hip arthroplasty (THA) for failed hemiarthroplas- ty (HA) for femoral neck fractures. [Methods] A retrospective study was performed on 39 patients who underwent revision THA for failed HA for femoral neck fracture in our department from January 2010 to December 2019. The causes of revision, clinical and imaging results were analyzed statistically. [Results] Of the 39 patients, 59.0% had acetabular wear, while 46.2% had problems related to femoral stem. In addi- tion, 82.1% of patients had revision THA involving all components, while 17.9% had the acetabular component replaced only. Compared with those before revision, the hip extension-flexion range of motion (ROM) and Harris scores significantly increased (P＜0.05), whereas the VAS scores significantly decreased at the latest follow up (P＜0.05). Radiographically, the positions of acetabular and femoral components significantly improved after revision (P＜0.05). [Conclusion] Acetabular wear and femoral component loosening are the main causes of revi-sion THA for the failed HA, while the joint function does still be significantly improved after revision

Abstract:[Objective] To investigate the clinical outcomes of breathing training combined with routine exercise therapy for neck pain due to the pinched extraforaminal nerve. [Methods] From September 2021 to June 2022, a total of 60 patients received exercise therapy for neck pain induced by the pinched extraforaminal nerve. Of them, 30 patients received conventional exercise therapy (the conventional group), while the other 30 patients underwent breathing training on the basis of conventional exercise therapy (the combined group). The treatment period and follow-up documents of the two groups were compared. [Results] At the end of treatment, there was no significant differ- ence in the compliance VAS score between the two groups (P＞0.05), but the combined group was marked significantly higher satisfaction VAS score than the conventional group [(8.5±1.1) vs (7.5±1.1), P=0.027]. The mean follow-up time was of (7.4±1.6) months in all patients of both groups. Compared with those before treatment, the VAS and NDI scores significantly decreased (P＜0.05), while cervical flexion-exten- sion, left-right bending and left-right rotation range of motion (ROM) significantly increased in both groups after treatment and at the latest follow-up (P＜0.05). At the time of the last follow-up, the combined group proved significantly superior to the conventional group in terms of pain VAS score [(1.3±1.0) vs (2.3±1.5), P＜0.05], NDI score [(3.5±1.5) vs (4.8±2.0), P＜0.05], cervical flexion-extension ROM [(86.9±3.1)° vs (83.9±3.9)°, P＜0.05], and cervical left-right rotation ROM [(115.3±5.1)° vs (108.5±4.7)°, P＜0.05]. [Conclusion] This breathing training combined with conventional exercise therapy does significantly improve the clinical outcomes for neck pain induced by pinched extraforami- nal nerves.