Abstract:[Objective] To compare the clinical efficacy of two kinds of endoscopic decompression in the treatment of lumbar spinal ste- nosis. [Methods] A retrospective study was conducted on 213 patients who received endoscopic surgery for lumbar spinal stenosis in The Second Affiliated Hospital of Anhui Medical University and the Third People's Hospital of Hefei City from May 2018 to May 2021. Accord- ing to doctor-patient communication, 132 patients underwent unilateral biportal endoscopy (UBE), while the other 81 patients were treated with endoscopic foraminoplasty and decompression (EFD). The perioperative period, follow- up and imaging data of the two groups were compared. [Results] All the patients in both groups were operated on successfully. The UBE group proved significantly superior to the EFD group in terms of dural tear [1 (0.8%) vs 5 (6.2%), P＜0.05] and nerve root injury [2 (1.5%) vs 6 (7.4%), P＜0.05], as well as intraoperative ra- diation exposure time [(1.1±0.1) min vs (3.3±0.6) min, P＜0.05], nevertheless, there were no significant differences in operation time, postop- erative infection rate, postoperative walking time and hospital stay between the two groups (P＞0.05). All of them in both groups were fol- lowed up for more than 12 months, without a significant difference in the time to return to full weight-bearing activities between the two groups (P＞0.05). The VAS scores for both low back pain and leg pain, and ODI score significantly decreased in both groups at the latest fol- low-up compared with those preoperatively (P＜0.05), which proved not significantly different between the two groups at any corresponding time points (P＞0.05). Radiographically, compared with those preoperatively the height of involved vertebral space, sagittal diameter of later- al recess, sagittal diameter of central spinal canal and lumbar lordosis angle (L₁~S₁ Cobb angle) were significantly increased in both groups 3 months after surgery and at the last follow-up (P＜0.05). Although there was no significant difference in the abovesaid imaging indexes be- tween the two groups before surgery (P＞0.05), the UBE group got significantly greater sagittal diameter of lateral recess [(12.0±3.7) mm vs (9.8±2.8) mm, P＜0.001] and sagittal diameter of central spinal canal [(15.7±3.8) mm vs (9.8±2.1) mm, P＜0.001] than the EFD group post- operatively. However, there were no statistically significant differences in the height of intervertebral space and lumbar lordosis angle be- tween the two groups at any time points accordingly (P＞0.05). [Conclusion] The UBE does improve the symptoms of patients with lumbar spinal stenosis and achieve satisfactory clinical outcomes, especially for bilateral and severe lumbar spinal stenosis, which is superior to unilateral transforaminal endoscopies.

Abstract:[Objective] To compare clinical efficacy of unilateral biportal endoscopic discectomy (UBE) versus minimally invasive tubu- lar discectomy (MITD) for single-segment intervertebral disc herniation. [Methods] A retrospective study was done on 166 patients who un- derwent minimally invasive lumbar discectomy for single-level disc protrusion in our hospital from August 2020 to August 2021. According to preoperative doctor-patient communication, 50 patients were treated with UBE, while the remaining 116 patients received MITD. Periop- erative, follow-up and imaging data were compared between the two groups. [Results] Although the UBE consumed significantly longer oper- ation time than the MITD group [(107.9±19.0) min vs (63.2±11.0) min, P＜0.05], the former proved significantly less than the latter in terms of incision length [(2.0±0.2) cm vs (2.8 ± 0.3) cm, P＜0.05], intraoperative fluoroscopy times [(2.7±0.8) vs (3.2±1.1) times, P＜0.05], intraopera- tive blood loss [(30.8±15.6) ml vs (42.0±22.3) ml, P＜0.05], and hospital stay [(8.7±2.1) days vs (10.2±3.9) days, P＜0.05]. There was no signif- icant difference in postoperative ambulation time and incision healing grade between the two groups (P＞0.05). All the patients in both groups were followed up for (15.7±3.5) months on a mean, and there was no significant difference in the time to resume full weight-bearing activities between the two groups (P＞0.05). The VAS scores both for lower back pain and leg pain, as well as ODI score decreased significantly in both groups with time (P＜0.05), which was not statistically significant between the two groups at any time points accordingly (P＞0.05). With re- gard to imaging, the height of intervertebral space and the percentage of vertebral canal occupying area significantly reduced in both groups at 1 month, 6 months and the last follow-up after surgery compared with those preoperatively (P＜0.05), whereas which proved not significant- ly different between the two groups at the corresponding time points (P＞0.05). [Conclusion] The UBE used in the treatment of single-level lumbar disc disease does achieve similar clinical efficacy as MITD. By contrast, the UBE has less trauma, fewer intraoperative fluoroscopy, and further shortened hospital stay.

Abstract:[Objective] To compare the clinical outcomes of selective anterior cervical corpectomy fusion versus posterior unilateral open-door laminectomy and lateral mass fixation for multilevel cervical spondylotic myelopathy (MCSM). [Methods] A retrospective study was conducted on 62 patients who underwent surgical treatment for MCSM from April 2013 to March 2017. Based on preoperative doctor-pa- tient communication, 32 patients underwent anterior cervical corpectomy fusion (anterior group), while the remaining 30 patients underwent posterior unilateral open-door laminoplasty and lateral mass fixation (posterior group). Perioperative period, follow-up and imaging data of the two groups were compared. [Results] Although the anterior group spent significantly longer operative time [(168.4±36.4) min vs (118.5± 33.8) min, P＜0.05], with more intraoperative blood loss [(686.5±133.6) ml vs (387.0±99.6) ml, P＜0.05] than the posterior group, the former proved significantly superior to the latter in terms of incision length [(7.1±0.7) cm vs (10.7±0.7) cm, P＜0.05] and complication rate [(7/32) vs (24/30), P＜0.05]. All patients in both groups were followed up for (34.9±12.6) months on an average, with no a significant difference in the time to resume full weight- bearing activities between the two groups (P＞0.05). The ASIA neurological functional grade, NDI score, JOA score and pyramidal tract sign significantly improved over time in both groups (P＜0.05), which proved not statistically significant between the two groups at anyone of time points accordingly (P＞0.05). Radiographically, cervical lordosis was significantly improved at the latest fol- low-up compared to that preoperatively in the anterior group (P＜0.05), whereas remained unchanged in the posterior group (P＞0.05). Al- though there was no significant difference in the cervical lordosis angle between the two groups before surgery (P＞0.05), the anterior group was significantly superior to the posterior group at the last follow-up [(13.6±5.5)° vs (9.4±5.0)°, P＜0.05]. At the last follow-up the minimum sagittal diameter of the cervical canal significantly increased in both groups compared with those preoperatively (P＜0.05), which were not sig- nificantly different between the 2 groups at corresponding time points (P＞0.05). [Conclusion] Both surgical procedures do effectively re- lieve the pain, improve neurological function and obtain satisfactory clinical efficacy for MCSM. By contrast, the anterior surgery improve the cervical lordosis with low complication rate, while the posterior technique consumes short operation time with relatively less intraoperative blood loss.

Abstract:[Objective] To compare the clinical and imaging consequences of three puncture techniques used in percutaneous vertebro- plasty (PVP) for osteoporotic compression fracture (OVCF). [Methods] A total of 83 patients with OVCF admitted to our department from March 2019 to March 2020 were enrolled into this study and randomly divided into 3 groups. Of them, 27 patients received unilateral PVP (the uPVP group), 28 cases underwent bilateral PVP (the bPVP group) and 28 cases had percutaneous curved vertebroplasty performed (the PCVP group). The documents regarding to perioperative period follow-up and radiographs were compared among the three groups. [Results] All patients were successfully operated on without serious complications. The bPVP group consumed significantly longer operation time, with more times of fluoroscopy and greater hospitalization cost than the uPVP and PCVP groups (P＜0.05). The PCVP group had significantly more bone cement injected [(4.1±0.6 ) ml vs (3.4±0.3) ml vs (3.5±0.3) ml, P=0.029], whereas significantly lower incidence of cement leakage [0.0% vs 22.2% vs 10.7%, P=0.029] than the uPVP and bPVP groups. As time went during the follow-up lasted for (13.7±1.2) months, the VAS and ODI scores significantly decreased in all the three groups (P＜0.05). Although there were no statistically significant differences in VAS and ODI scores among the three groups before surgery (P＞0.05), the PCVP and bPVP groups proved significantly superior to the uPVP group in ODI score [(23.7±3.8) vs (23.7±3.6) vs (26.0±3.6), P=0.029] at the latest follow-up (P＜0.05). Radiographically, PCVP and bPVP groups proved significantly superior to the uPVP group in term of excellent rate of bone cement distribution in vertebral body [85.7% vs 82.1% vs 59.3%, P=0.045]. Compared with those preoperatively, the anterior vertebral height was significantly increased (P＜0.05), while Cobb angle was significantly decreased in all the three groups postoperatively (P＜0.05). At the latest follow-up, the PCVP group had less loss in term of anterior vertebral height and correction of local kyphosis in term of Cobb's angle than the bPVP and uPVP groups, despite of no statistically significant differences among them (P＞0.05). [Conclusion] The PCVP does highlight accuracy of cement injection, reduce the risk of cement leakage, and improve long-term function of OVCF patients.

Abstract:[Objective] To compare the clinical efficacy of tibial transverse transport (TTT) combined with endovascular intervention (EVI) versus EVI only for severe arteriosclerosis obliterans (ASO) of the lower extremity. [Methods] A retrospective study was performed on 86 patients who received surgical treatment for severe ASO in our hospital from May 2018 to January 2021. According to doctor-patient com- munication, 46 cases received TTT combined EVI (the combined group), while the remaining 40 patients received EVI only (the EVI group). The documents regarding treatment period, follow-up and imaging were compared between the two groups. [Results] Although the combined group consumed significantly longer operation time than the EVI group [(116.4±11.1) min vs (88.1±13.4) min, P＜0.05], the former proved sig- nificantly superior to the latter in terms of hospital stay [(21.5±4.0) days vs (24.7±4.5) days, P＜0.05], local debridement times [(1.4±0.5) times vs (2.3±0.9) times, P＜0.05] and longevity of antibiotic use [(14.5±3.7) days vs (21.2±3.4) days, P＜0.05]. All patients in both groups were followed up for (18.8±4.3) months on a mean. The combined group was significantly better than the EVI group in terms of time to re- sume full weight- bearing activity [(5.0 ± 1.6) months vs (6.6 ± 2.2) months, P＜0.05], wound healing time [(4.2 ± 1.8) months vs (5.6 ± 2.7) months, P＜0.05], wound healing rate (92.9% vs 76.3%, P＜0.05) and final amputation rate (13.0% vs 35.0%, P＜0.05). The pain VAS score, self-perceived VAS score and local lesion grade significantly improved in both group over time (P＜0.05), which were not statistically signifi-cant between the two groups before surgery and one month after surgery (P＞0.05), while became statistically significant between the two group 3 months after surgery and at the last follow-up (P＜0.05). As for imaging, vascular imaging presentations in both groups was signifi- cantly improved over time (P＜0.05), which was no significant difference between the two groups preoperatively (P＞0.05), whereas in the com- bined group was significantly better than that in the EVI group at all corresponding time points after surgery (P＜0.05). [Conclusion] This tibial transverse transport combined with endovascular intervention does considerably improve the therapeutic effect, is an effective and safe treatment for severe arteriosclerosis obliterans of the lower extremity.

Abstract:[Objective] To investigate the technique notes and clinical outcome of hip arthroscopy for cam-type femoroacetabular im- pingement (FAI). [Methods] A total of 102 patients who underwent hip arthroscopy for the cam-type FAI in our department from September 2016 to October 2020 were enrolled into this study, including 67 males and 35 females, aged from 18 to 50 years old with an average age of (30.9±9.6) years. Based on the intraoperative pathological findings, corresponding managements were conducted. The documents regarding to intraoperative findings and treatments, as well as follow-up and images were summarized in this paper. [Results] All the 102 patients had hip arthroscopic procedures performed successfully without serious complications. In terms of intraoperative pathological findings, the cam deformity presenting femoral head-neck junction osteophyte was observed in all patients. In addition, the incidence of labral tear was 100%, of which Seldes grade 2 accounted for 45.1%, and the incidence of acetabular cartilage injury was 50.0%, with Outerbridge grades 1~2 inju- ry of 47.1% and Outerbridge grades 3~4 damage of 2.9%, while the incidence of femoral head cartilage injury with Outerbridge grade 1~2 was of 27.5%, and incidence of ligamentum teres tear was 22.6%, of which the Domb grade 1 was dominant. All the patients were followed up for 25 to 74 months, with a mean of (44.7±10.0) months. Compared with those preoperatively, the HHS score [(43.1±12.5), (83.8±8.0), P＜ 0.001], iHOT-12 score [(48.7±10.9), (85.4±10.0), P＜0.001] and VAS score [(5.8±1.8), (2.2±1.6), P＜0.001] significantly improved at the lat- est follow-up. Radiographically, the postoperative images showed that the femoral head-neck junction cam-like osteophytes were effectively removed in all patients. Compared with those preoperatively the lateral center-edge angle (LCEA) [(32.3±3.1)°, (30.5±3.2)°, P＜0.001] and α angle [(64.2±5.5)°, (43.2±4.6)°, P＜0.001] significantly decreased, while the joint space [(3.6±0.6) mm, (3.5±0.6) mm, P=0.122], and T?nnis classification for hip osteoarthritis [0/1/2, (69/33/0), (58/42/2), P=0.135] remained unchanged. [Conclusion] The cam-type FAI is usually associated with other structural pathologies involving the labrum and articular cartilage. Based on the intraoperative findings, other lesions should be treated on the basis of the removal of the cam-like osteophyte, and suture of the joint capsule should be conducted, in order to ob- tain satisfactory clinical results.

Abstract:[Objective] To evaluate the clinical efficacy and safety of Huamoyan granules in the treatment of knee osteoarthritis. [Meth-ods] A total of 467 patients with unilateral osteoarthritis were included in this study and randomly divided into two groups. Among them, 350 patients in the trial group were given Huamoyan granules orally 1 bag/time and 3 times/day, which contained 13 medicinal herbs including Prunella, Ligustrum, Herba leaf, Astragalus, tetrandrhexis, Coix seed, Tuckahoe, loofah, Zeilan, Salvia miltiorrhiza, Angelica sinensis, Achy- ranthes Herba Siegesbeckiae, while the 117 patients in the control group received the granule simulation agent orally 1 bag/time and 3 times/ day, which was similar with the Huamoyan granules in appearance, character and odor without any active ingredients. The treatment course was lasted for 24 weeks in both groups, and the clinical, ultrasonic and blood test data were compared between the two groups. [Results] The adverse reaction rate during the treatment was 2.0% in the trial group, while 2.6% in the control group, which was not statistically significant (P＞0.05). The knee circumference, WOMAC score and VAS score for pain decreased significantly (P＜0.05), while the comprehensive effec- tive rates were significantly increased in both groups over time (P＜0.05). Although there were no significant differences in the abovesaid items between the two groups before treatment (P＞0.05), the trial group proved significantly superior to the control group in terms of knee cir- cumference [(36.6±2.8) mm vs (37.4±2.9) mm, P＜0.001], WOMAC score [(27.0±21.5) vs (46.5±28.9), P＜0.001] and VAS score [(3.0±2.4) vs (4.9±2.9), P＜0.001] and comprehensive efficiency (92.2% vs 60.4%, P＜0.001) 12 weeks after treatment. During the follow-up period, the rate of symptom aggravation was 7.1% in the trial group, whereas 29.1% in the control group, which was statistically significant (P＜0.05). Re- garding ultrasound, the trial group was significantly better than the control group in terms of depth of effusion in suprapatellar bursae [(4.0± 2.5) mm vs (4.9±2.7) mm, P＜0.001] and suprapatellar synovial thickness [(1.6±1.7) mm vs (1.9±1.8) mm, P＜0.001] 12 weeks after treatment. As results of blood test, the trial group also proved significantly superior to the control group in CTX-Ⅱ [(6.9±2.2) μg/L vs (8.2±4.0) μg/L, P=0.001] and IL-6 [(32.8±2.7) pg/ml vs (50.0±5.6) pg/ml, P＜0.001] 12 weeks after treatment. [Conclusion] This Huamoyan granule does relive the joint swelling and pain of knee osteoarthritis, improve the motor dysfunction with less adverse reactions, while good safety.

Abstract:[Objective] To explore the main causes and characteristics of limb deformity in high altitude area to provide data support for the formulation of feasible prevention and treatment strategies. [Methods] From May to December 2021, based on 7 rounds of medical service tour, 1 free medical checking and 1 screening, involving personal interview, questionnaire survey and on-site physical examination, the data regarding various physical disabilities and limb deformities in Litang County, Sichuan Province, were collected and analyzed pri- marily to present the characteristics of the limb deformities. [Results] Among the 530 persons who were investigated in this study, 364 cas- es were found disabled extremity with limb deformity, accounting for 68.7%. Of them, 29 (8.5%) were of congenital deformity, 15 (4.4%) of post-traumatic deformity, 253 (74.0%) of degenerative deformity, 45 (13.1%) neurological sequelae deformity, and 22 (6.0%) other malfor- mations. Among all persons who had deformities, 363 were Tibetan and 1 was Han. The incidence of lower extremity deformity was higher than that of upper extremity, and knee was the most common deformity site, with an incidence of 49.8% (264/530). Knee deformities were mostly osteoarthritis, with bilateral involvement and severe severity, most of which had not been treated surgically. [Conclusion] The inci- dence of limb deformity is high in Litang County, mainly affected the Tibetan nationality. The causes of deformity are osteoarthritis, sequel- ae of neurological disorders and congenital limb deformity, etc., which may be related to the high altitude and hypoxia environment, the working methods of herdsmen in Tibetan areas and the limited local medical conditions, etc., which should be paid attention to.

Abstract:[Objective] To analyze the global research status of cervical spondylotic radiculopathy (CSR). [Methods] The Wed of Sci- ence Core Collection database was used to retrieve literature on CSR from 1994 to 2021. Retrieval data were statistically analyzed by biblio- metrics method and two bibliometric tools were used to conduct visualization and knowledge maps, including the bibliometrics online site and VOS viewer software. Annual trends of publications, contributions of countries, institutions, authors and journals, and clustering of key- words were analyzed. [Results] A total of 2 748 publications were included. The number of annual publications has shown an increasing trend worldwide. The United States has made the greatest contribution, with the largest number of publications and the highest H-index. Chi- na ranked second in the number of publications, but its H-index was relatively low. The most prolific institutions was University of Pennsyl- vania, and Professors Winkelstein BA, Olmarker K and Kikuchi S have made great achievements in this field. However, the collaboration be- tween international institutions or researchers was relatively low. Publications in Spine, World Neurosurgery and European Spine Journal ranked top three in terms of journals. Among them, Spine not only published the largest number of articles, but also had a far higher H-index than other journals. Through the analysis of hotspots, it was found that diffusion tensor imaging, anterior discectomy and prognosis score may be the current research hotspots. [Conclusion] There will be an increasing number of publications on cervical spondylotic radiculopathy re- search, and the United States stay ahead in this field. International collaboration needs to be further strengthened.

Abstract:Knee osteoarthritis (KOA) is a common orthopedic disease in the middle-aged and elderly. The joint damage caused by im- mune inflammation plays an important role in its pathogenesis, so modifying inflammatory reaction is of great significance for the prevention and treatment of knee osteoarthritis. Activating or inhibiting expression of inflammatory signaling pathways might be potential approaches for prevention and treatment of KOA. Among them, the NF-κB, an important inflammatory signaling pathway, can improve the inflammatory re- sponse of knee joint by regulating the expression of target gene, thus achieving the role of preventing and treating KOA. In this paper, the ef- fects of the NF-κB signal pathway on KOA by influencing cartilage metabolic balance and synovitis are reviewed. By regulating the up- stream and downstream factors such as inflammatory factors, Toll-like receptors and matrix metalloproteinases, the pathology of cartilage and synovium might be improved, thus this paper aims to provide some reference for clinicians.

Abstract:Osteoarthritis is a common group of chronic, high-teratogenic, and degenerative arthritis, which brings an economic burden on global healthcare systems. Activation of oxidative stress and excess of reactive oxygen species play an important role in the occurrence of osteoarthritis and are also important targets for the treatment of osteoarthritis. This paper reviews the pathophysiological mechanism of oxi- dative stress and reactive oxygen species as well as the research progress of related therapeutic interventions, for the sake of providing a ref- erence for further research.

Abstract:Cerebral palsy is the most common cause of motor dysfunction in children. In this paper, the relationship among central ner- vous system impairments, neuromuscular developmental defects and gait abnormalities in cerebral palsy is discussed. The cranial MRI is the gold standard for judging the brain impairment, while three-dimensional gait analysis is the gold standard for describing gait abnormalities in cerebral palsy, additionally recent studies have found that genetic analysis is increasingly important in the study of cerebral palsy. This ar- ticle also summarizes the surgical treatment methods and the curative effect of spastic cerebral palsy. Specific analysis and summary of treat- ment for muscle development defects, including muscle weakness, shortened tendon, spasm and disorderin selective motor control (SMC) were conducted in microcosmic and functional perspectives.

Abstract:The concept that torn anterior cruciate ligament (ACL) cannot heal is changing with the comprehensive understanding the basic biology in recent years. There has been a renewed interest in repair of acute ACL tear with newer internal brace technique, which had been proven to reduce relaxation and micromotion by sharing the load of ACL after repair, and provides a stable environment for ACL tissue healing. The ACL repair with internal brace technique is a promising treatment for acute proximal ACL tear, which not only lead almost the equivalent efficacy to standard anterior cruciate ligament reconstruction (ACLR), but also reduce the pain and speed up the rehabilitation. However, there still is a lack in terms of quantitative standards of age, level of sports participation and timing of treating while patient select- ed. In this paper, research progress in anterior cruciate ligament repair with internal brace is reviewed to evaluate the practical significance of this technique.

Abstract:[Objective] To explore the effect of hyperoside on dexamethasone (Dex)-induced inhibition of proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) and the potential molecular mechanism. [Methods] The BMSCs were isolat- ed from mice and cultured in vitro, and were divided into blank control group (BC), Dex group, Dex + hyperoside 1 μM group (DH-1), Dex + hyperoside 2 μM group (DH-2) and Dex + hyperoside 5 μM group (DH-5). After the osteogenic differentiation of BMSCs was induced, the cell viability was measured by CCK8 assay, the activity of alkaline phosphatase (ALP) was detected using ALP activity kit, and the mineral- ization level was observed by Alizarin Red S staining. In addition, the mRNA expressions of ALP, Runx2, and Osterix were measured by qRT-PCR, while protein expressions of PI3K, p-PI3K, AKT, and p-AKT in BMSCs were determine by western blot assay. [Results] The cell vitality of BMSCs was ranked from high to low as follows: BC group ＞ every hyperoside groups (DH- 1 group, DH- 2 group, DH- 5 group) ＞ Dex group, which was statistically significant (P＜0.05), despite that there was no significant difference in cell vitality among DH-1 group, DH-2 group and DH-5 group (P＞0.05). The ALP activity was up-down as BC group ＞DH-5＞DH-2＞DH-1＞Dex, with a statistically significant overall difference (P＜0.05). After 14 days of osteogenic induction, the formation of mineralized nodules in Dex group was the least, while which gradually increased with the increase of Hyperoside concentration in a certain dose dependence manner. The mRNA ex- pressions of ALP, Runx2 and Osterix were ranked up-down as the BC＞DH-5＞DH-2＞DH-1＞Dex, with a statistically significant overall dif- ference among groups (P＜0.05). Compared with those in the BC group, the p-PI3K/PI3K ratio [(1.0±0.2) vs (0.4±0.1), P＜0.05] and p-AKT/ AKT ratio [(1.0±0.1) vs (0.6±0.1), P＜0.05] in the Dex group significantly reduced. However, compared with those in Dex group, the p-PI3K/ PI3K ratio [(0.4±0.1) vs (0.8±0.1), P＜0.05] and p-AKT/AKT [(0.6±0.1) vs (0.9± 0.1), P＜0.05] in the hyperoside group significantly in-creased. [Conclusion] The hyperoside might alleviates Dex- induced inhibition of proliferation and osteogenic differentiation of BMSCs through PI3K/AKT signaling pathway.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical outcomes of unicondylar knee arthroplasty (UKA) with tibial precise osteotomy by the mechanical arm guided by celestial eye computer surgery system. [Methods] A total of 20 patients with medial-compartment osteoarthritis of the knee received the abovesaid surgery. The CT data of patients were collected before operation, and then imported into the celestial eye system to select appropriate prosthesis and plan the position of prosthesis. During the operation, a com- puter guided mechanical arm was used to insert 3 Kirschner wires into the proximal tibia, perform precise osteotomy along the direction of the Kirschner wires, place matching tibial component to finish the computer guided UKA surgery. The postoperative knee function and imag- ing data were followed up 6 months after operation to evaluate the surgical outcomes. [Results] All 20 patients were successfully operated on, with operation time of (48.5±8.6) min and blood loss of (47.5±10.1) ml, whereas without serious complications. Compared with those preoper- atively, 6 months after operation the knee range of motion (ROM) [(88.9±12.3)° vs (102.8±8.4)°, P＜0.05], KSS clinical score [(51.4±10.3) vs (89.7±3.0), P＜0.05] and KSS functional scores [(41.7±14.4) vs (83.3±6.9), P＜0.05] significantly improved. In addition, the posterior tibial slope, varus and varus, internal and external rotation angles of tibial component placed, as well as the tibial osteotomy thickness proved high- ly consistent with those of preoperative planning (P＞0.05). [Conclusion] The UKA with tibial precise osteotomy by the mechanical arm guid- ed by celestial eye computer surgery system is considerably effective and convenient, with shortening learning curve of this procedure.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical consequences of calcaneal osteotomy fixed with locking plate through a modified lateral “L”-shaped incision. [Methods] From January 2019 to October 2021, a total of 21 patients re- ceived abovementioned surgical operation for calcaneal varus and valgus deformities. The modified lateral “L”-shaped incision was made with doute turning angle parallel to the lateral malleolus and foot bottom respectively to expose the lateral well of the calcaneous. As calcane- ous osteotomy was conducted, the distal fragment of osteotomy was moved according to the need to correct the deformity, and then fixed with locking plate with trimming the step of the osteotomy site. The affected limb was immobilized with plaster cast for 3 weeks, and functional ex- ercises was encouraged 6 weeks postoperatively. [Results] All patients had operation performed successfully without serious complications, whereas with time of osteotomy range from 10 min to 19 min, with an average of (15.0±2.7) min. All the patients were followed up for 6~10 months, with an average of (8.5±1.3) months, and got osteotomy clinical healing 4~6 weeks, with an average of (4.9±0.8) weeks postoperative- ly. The AOFAS score increased significantly from (34.6±7.0) preoperatively to (85.2±4.6) at the latest follow-up (P＜0.05), while the VAS score decreased significantly from (7.9±0.9) preoperatively to (2.1±1.0) at the last follow-up (P＜0.05). [Conclusion] The modified lateral “L” incision with locking plate fixation for calcaneal osteotomy is easy to perform, and achieve satisfactory clinical outcome.

Abstract:[Objective] To explore the clinical outcomes of trephine used in anterior endoscopic cervical transcorporeal discectomy (AECTcD) for cervical disc herniation. [Methods] From Sep. 2018 to Sep. 2019, 29 patients received AECTcD with trephine used for creat- ing a bone tunnel for central cervical disc herniation (CDH) in our departments. The clinical and imaging consequences were evaluated. [Re- sults] All the patients had operation performed smoothly without injuries to blood vessel, nerves and esophagus, whereas with operation time of (86.0±9.3) min on an average, well incision healing and hospital stay of (5.6±1.8) days. The VAS score significantly decreased, while JOA score significantly increased at the latest follow-up lasted for (29.2±3.7) months on an average compared with those preoperatively (P＜0.05). Radiographically, the intervertebral disc height decreased significantly (P＜0.05), whereas the cross-section area of spinal canal increased significantly (P＜0.05), and the involved vertebral body height remained unchanged (P＜0.05) at the latest follow up compared with those pre- operatively. [Conclusion] The trephine used in AECTcD takes the advantages of higher controllability and accuracy for the establishment of bony channel.

Abstract:[Objective] To compare the early clinical outcomes of same-day (SD) and next-day (ND) ambulation after hip and knee re- placement. [Methods] The patients who underwent total hip arthroplasty (THA) and total knee arthroplasty (TKA) in our hospital from No- vember 2020 to May 2021 were randomly divided into two groups. Of them, 66 patients in the SD group resumed ambulation in the same day of operation, while the other 74 patients in the ND group carried out ambulation next day after surgery. The documents regarding periopera- tive period and follow-up were compared between the two groups. [Results] The SD group got out of bed and excreting stool first time after operation significantly earlier than the ND group (P＜0.05), additionally, the former had significantly lower incidence of nausea and vomiting than the latter (P＜0.05). Compared with those preoperatively, Harris and KSS scores in both groups were significantly increased 3 and 6 weeks after surgery (P＜0.05). The SD group proved significantly superior to the ND group in terms of Harris hip score at 6 weeks after sur- gery and KSS score at 3 weeks after surgery (P＜0.05). [Conclusion] The same-day ambulation after HTA/TKA does promote the recovery of intestinal function and joint function without remarkably increasing complications.

Abstract:[Objective] To compare the anti-cement-leakage efficacy of three percutaneous vertebral augmentations (PVA) in the treat- ment of osteoporotic vertebral compression fracture (OVCF) in the elderly. [Methods] A retrospective study was done on 80 patients who re- ceived PVA for OVCF from January 2020 to December 2022. Of them, 20 patients received percutaneous kyphoplasty (PKP), 30 patients re- ceived PVP with fractionated cement injection (FCI), while the remaining 30 patients received PVP following sealing by gelatin sponge (SGS). Clinical and imaging data of the three groups were compared. [Results] All patients in the three groups were operated on successfully, with a case of bone cement leakage occurred in the SGS group. The operative time was ranked from high to low as PKP group ＞ FCI group ＞ SGS group with statistically significant differences [(42.2±4.5) min vs (35.4±4.0) min vs (28.9±3.2) min, P＜0.001]. The injection amount of bone cement was arranged up-down as PKP group ＞ FCI group ＞ SGS group with statistically significant differences [(5.8±0.4) ml vs (5.4± 0.5) ml vs (4.9±0.6) ml, P=0.001]. The PKP group had the highest hospital expense, which was significantly higher than that of the other two groups (P＜0.05). The VAS and ODI scores significantly decreased over time in all the 3 groups (P＞0.05), of which the VAS scores 1 day after surgery were of PKP group ＞FCI group＞SGS group with statistically significant differences [(2.0±0.8) vs (1.2±0.8) vs (1.0±0.6), P＜0.001]. Ra- diographically, PKP group got significantly better kyphotic correction than the other two groups [(7.4±0.9)° vs (5.3±1.0)° vs (5.1±0.5)°, P＜ 0.001]. However, the anterior height of the affected vertebrae increased significantly in all three groups after surgery (P＜0.05). [Conclusion] The three surgical techniques have their own advantages and disadvantages. PKP is suitable for patients who need to correct kyphosis with high financial cost, the PVP with fractioned injection is more balanced in all data among the three groups of operations, while the PVP with sealing by gelatin sponge is simple in operation with short operation time, but a certain risk of cement leakage.