Abstract: [Objective] To compare the clinical efficacy of fixation with laminar hook versus pedicale screw for treatment of simple bilat- eral lumbar spondylolysis in children and adolescent. [Methods] A retrospective study was performed on 43 patients who received surgical treatment for simple bilateral spondylolysis in our department from January 2016 to January 2019. According to doctor-patient communica- tion, 20 patients underwent internal fixation with laminar hooks (LH), while the other 23 patients underwent fixation with pedicle screw (PS). The perioperative, follow-up and imaging data were compared between the two groups. [Results] All patients in both groups were successful- ly operated on. The LH group proved significantly superior to the PS group in terms of operation time [(79.9±7.8) min vs (103.9±8.6) min, P＜ 0.05], incision length [(6.2±0.9) cm vs (7.8±0.8) cm, P＜0.05] and intraoperative blood loss [(120.8±16.2) ml vs (177.0±12.8) ml, P＜0.05]. However, there was no statistical significance in the number of intraoperative fluoroscopy, postoperative walking time, incision healing scale and hospital stay between the two groups (P＞0.05). Patients in both groups were followed up for more than 24 months, and there was no statis- tical significance in the time to resume full weight-bearing activities between the two groups (P＞0.05). As time went on, the VAS and ODI scores significantly decreased in both groups (P＜0.05). The LH group was significantly better than the PS group in terms of VAS score [(2.0± 0.7) vs (2.4±0.5), P＜0.05], ODI score [(30.2±6.0) vs (38.7±2.5), P＜0.05] 3 months postoperatively, whereas which became not statistically sig- nificant at the latest follow-up (P＞0.05). Regarding to imaging, the isthmus was completely healed within 6 months postoperatively in all pa- tients of both groups. There were no statistically significant differences in intervertebral height and lumbar lordosis angle between the two groups at any corresponding time points (P＞0.05). [Conclusion] The laminar hook used for fixation of simple lumbar spondylolysis in chil- dren takes advantages of decreasing iatrogenic trauma and improving clinical outcomes over the pedicle screw fixation.

Abstract:[Objective] To explore the clinical outcomes of tibia transverse transport (TTT) for diabetic foot accompanied with sepsis or septic shock. [Methods] A retrospective study was conducted on 77 patients who received treatments for severe diabetic foot complicated with sepsis or septic shock in our hospital from April 2015 to August 2020. First of all, all the patients received treatments of anti-shock, im- provement of general condition with sensitive antibiotics, and local debridement. Subsequently, 45 patients were treated with TTT, while the remaining 32 patients were with traditional treatment according to the doctor-patient communication. The documents regarding clinical con- dition and auxiliary examination were compared between the two groups. [Results] The TTT group proved significantly superior to the tradi- tional group in terms of hospital stay [(21.8±7.6) days vs (28.6±12.0) days, P=0.007], debridement times [(2.1±0.5) times vs (3.5±1.0) times, P＜0.001], dressing change times [(19.7±7.5) times vs (25.1±11.1) times, P=0.013], wound area at discharge [(68.2±27.4) cm² vs (105.2±20.5) cm² , P=0.003], amputation rate during hospitalization [8(17.8%) vs 15(46.9%), P=0.006] and mortality in hospital [1(2.2%) vs 7 (21.9%), P= 0.005]. The follow-up period was 1~72 months with an average of (20.4±15.8) months. At the final follow-up, 8 (22.2%) patients in the TTT group and 6 (60%) patients in the traditional group died; the difference was statistically significant (P=0.022). And 26 (72.2%) patients in the TTT group while no patients (0%) in the traditional group were salvageable; the difference was statistically significant (P＜0.001). At the final follow-up, PCS score [(43.5±3.4) vs (40.6±2.1), P=0.043] and MCS score [(46.4±3.6) vs (36.5±2.4), P＜0.001] in the TTT group were sig- nificantly higher than those in the traditional group. As time went by, PCS score and MCS score in both groups were significantly higher than before treatment (P＜0.05). As for auxiliary examination, WBC, PCT, CRP, ESR, and IL-6 in both groups were significantly decreased over time (P＜0.05). At discharge, WBC, PCT, CRP, ESR, and IL-6 of limb salvage patients in TTT group were significantly lower than those in traditional group (P＜0.05). The CTA angiography in the TTT group at discharge was significantly better than that in the traditional group (P＜ 0.05), and the CTA angiography in the TTT group at the last follow-up was significantly better than that at discharge (P＜0.05). [Conclusion] Compared with traditional therapy, TTT treatment for severe diabetic foot complicated with sepsis or septic shock can significantly improve the wound healing rate, reduce the amputation rate and mortality, relieve pain, improve the function of affected limb, and improve the quality of life.

Abstract:[Objective] To evaluate the clinical significance of digital virtual planning (DVP) before primary total hip arthroplasty (THA). [Methods] A total of 60 patients who were undergoing primary THA in our hospital from August 2017 to June 2021 were included in this study. According to the doctor- patient communication, 30 patients received the DVP THA, while the remaining 30 patients received conventional THA. The perioperative period, follow-up and imaging data were compared between the two groups. [Results] All patients in both groups had THA performed successfully with no serious complications. The DVP group proved significantly superior to the conventional group in terms of operative time [(97.3±20.5) min vs (131.2±19.3) min, P＜0.05], intraoperative blood loss [(245.2±20.4) ml vs (322.1±25.6) ml, P＜0.05] and postoperative ambulation [(5.2±4.4) days vs (9.2±3.7) days, P＜0.05]. All of them were followed up for (14.2± 3.6) months on a mean, the DVP group resumed full weight-bearing activities significantly earlier than the conventional group [(10.3±2.2) weeks vs (14.2± 4.2) weeks, P＜0.05]. The Harris score and hip flexion- extension range of motion (ROM) significantly increased (P＜0.05), while the VAS score significantly decreased in both groups over time (P＜0.05). The DVP group proved significantly better than the conventional group at the latest follow-up in terms of Harris score [(93.2±10.9) vs (81.2±8.5), P＜0.05] and hip ROM [(84.5±11.2)° vs (71.6±11.4)°, P＜0.05]. Radio- graphically, the DVP group got significantly more proper postoperative acetabular abduction [(45.6±3.6)° vs (40.1±3.3)°, P＜0.05] and ante- version of the acetabular component [(14.1±2.5)° vs (10.1±2.1)°, P＜0.05], with significantly less deviations of hip center of rotation (HCOR) longitudinally [(2.2±1.7) mm vs (5.2±3.1) mm, P＜0.05] and transversely [(3.3±1.6) mm vs (4.9±3.1) mm, P＜0.05] than the conventional group. In addition, the DVP group gained significantly accurate femoral component in position [medium/displaced, (28/2) vs (21/9), P＜0.05] and size [appropriate/small, (29/1) vs (23/7), P＜0.05] than the conventional group, despite that there was no statistical significance in leglength discrepancy (LLD) between the two groups (P＞0.05). [Conclusion] Preoperative digital image virtual planning does reduce the trau-ma of THA, effectively improve the accuracy of prosthesis matching, and promote the early hip functional recovery.

Abstract:[Objective] To compare the clinical results of three methods for fixation of displaced distal radius fractures. [Methods] A retrospective study was done on 115 patients who received treatment for displaced distal radial fractures in our hospital from January 2019 to May 2021. According to the doctor-patient communication, 35 patients were treated with closed reduction and external fixation with trac- tion splint (the TS group), 45 patients were with closed reduction and external fixation with plaster cast (the PC group), while the remaining 35 patients received open reduction and internal fixation (ORIF) with plate and screws. The perioperative, follow-up and imaging data of the three groups were compared. [Results] The TS, PC and ORIF group were recorded in terms of operation time [(60.7±6.1) min vs (40.4± 4.0) min vs (73.3±7.1) min, P＜0.05], treatment fee [(1 288.9±158.5) yuan vs (830.7±146.8) yuan vs (12 351.7±1 645.4) yuan, P＜0.05] and external fixation time [(7.1±0.7) weeks vs (7.1±0.7) weeks vs (1.8±1.4) weeks, P＜0.05], with statistically significant differences among them. The VAS score for pain and swelling extent of the three groups significantly improved with time after treatment (P＜0.05), which were not sta- tistically significant among the three groups at any time points accordingly (P＞0.05). All patients in the three groups were followed up for (13.6±2.1) months on a mean, and there was no significant difference in the time to resume full weight-bearing activity among the three groups (P＞0.05). During the follow-up, the TS group proved significantly superior to the PC group in term of revision surgery rate (2.9% vs 17.8%, P＜0.05). The PRWE score, Gartland-Werley score and flexion-extention ROM significantly improved in all three groups over time after operation (P＜0.05), which in ORIF group were significantly better than those in the TS group and PC group at 3 months after surgery (P＜0.05), whereas became not statistically significant among the three groups at the latest follow-up (P＞0.05). Radiographically, fracture alignment, PT, RI, and RH significantly improved in all three groups immediately after treatment and at the last follow-up compared with those preoperatively (P＜0.05). At the last follow- up, the ORIF group was ranked as the best, the TS group as the middle, while the PC group as poorest in terms of abovementioned imaging items, with statistical significances (P＜0.05). [Conclusion] All three methods are ef- fective for the treatment of displaced distal radius fractures, and each has its own advantages and disadvantages. The clinical outcome of TS is intermediate between PC and ORIF, and the treatment should be selected on a case-specific basis.

Abstract:[Objective] To explore the factors affecting function after wide resection and modular megaprosthetic replacement for ag- gressive bone tumors around the knee. [Methods] A retrospective study was performed on 31 patients who underwent wide resection and modular megaprosthetic replacement for aggressive bone tumor around the knee. The clinical consequences were observed by follow up, and radiographical measurements, including the osteotomy length ratio (OLR), internal- external medulla ratio (IEMR) and bilateral leg length discrepancy (LLD), and femorotibial mechanical axis angle (MAA) were recorded. The patients grouped according to tumor site, con- stitution and tumor feature were compared, and the correlation analysis was performed between clinical and imaging data. [Results] All the 31 patients were successfully operated on without serious intraoperative complications, whereas with operation time of (174.0±54.7) min, the intraoperative blood loss of (388.7±260.6) ml, and the incision length of (28.1±4.3) cm. During the follow-up period lasted for an aver- age of (39.3±18.9) months, 2 cases of lung metastasis, 1 case of multiple systemic metastasis and 2 cases of local recurrence were found and treated respectively. At the last follow-up, the clinical scores were recorded as SF-36 score of (129.3±29.0), MSTS score of (22.3±4.7), TESS score of (112.1±14.9), and KSS functional score of (64.0±19.4), additionally, the radiographical parameters were measured as OLR of (38.0±8.1)%, IEMR of (112.4±29.1)%, LLD of (35.5±132.6) mm and MAA of (178.3±1.3)°. At the latest follow-up, the tumor free survival rate was of 87.1%, while the prosthetic survival rate was of 96.8%. In term of grouping comparison, there was no significant difference re- garding of SF-36, MSTS, TESS, and KSS scores among groups by tumor site, patient constitution, and tumor feature (P＞0.05). As results of Pearson correlation analysis, significantly negative correlation were noticed between the SF-36 score and OLR (r=-0.596, P＜0.001), TESS score and LLD (r=-0.495, P=0.005), MSTS score and OLR (r=-0.568, P=0.001), MSTS and LLD (r=-0.368, P=0.044), as well as KSS score and LLD (r=-0.457, P=0.010). However, all the clinical scores were not correlated with IEMR and MAA (P＞0.05). [Conclusion] This wide resection and modular megaprosthetic replacement do effectively treated aggressive bone tumors around the knee with benefits of improving patients' quality of life and functional recovery. However, the OLR and LLD were significantly correlated with postoperative qual- ity of life and function.

Abstract:[Objective] To evaluate the clinical outcomes of endoscopic decompression combined with internal treatment of traditional Chinese medicine (TCM) for lumbar spinal stenosis. [Methods] A retrospective study was conducted on 45 patients who received endoscopic surgery for lumbar spinal stenosis in our hospital from January 2021 to December 2021. According to the results of preoperative doctor-pa- tient communication, 22 patients were treated with endoscopic decompression combined with traditional Chinese medicine (combination group), while the other 23 patients were treated with endoscopic decompression alone (simple group). The perioperative, follow-up and imag- ing data were compared between the two groups. [Results] The operation was successfully completed in both groups, without significant differ- ences in operation time, incision length, intraoperative fluoroscopy times, intraoperative blood loss, time to resume ambulation postoperative- ly, incision healing grade and hospital stay between the two groups (P＞0.05). At the latest follow-up lasted for more than 12 months the TCM symptom scores, VAS for lumbago and leg pain scores, as well as ODI score in both groups significantly improved compared with those before surgery (P＜0.05). Although there were no statistically significant differences in the above parameters between the two groups before surgery (P＞0.05), the combination group proved significantly superior to the simple group in terms of TCM symptom score [(6.2±2.4) vs (11.5± 4.2), P＜ 0.05], low back pain VAS [(0.9±0.7) vs (1.8±1.4), P＜0.05] and leg pain VAS [(0.9± 0.7) vs (1.0±0.9), P＜0.05] and ODI score [(4.3±3.15) vs (6.9±4.2), P＜0.05] at last follow-up. Radiographically, there were no significant changes in intervertebral height or lumbar lordotic angle be- tween the two groups at the last follow-up compared to the preoperative period (P＜0.05), whereas the spinal canal area was significantly en- larged in both groups (P＜0.05). At any corresponding time points, there was no significant difference in the above image indexes between the two groups (P＞0.05). [Conclusion] This endoscopic decompression combined with internal treatment of traditional Chinese medicine does re- lieve nerve compression and dredge the blockage of supervision vessel, significantly improve nerve function, and promote rapid recovery.

Abstract:[Objective] To compare the clinical efficacy of open reduction and cannulated screw fixation versus arthroscopic resection of painful Saupe type III bipartite patella. [Methods] A retrospective study was conducted on 19 patients who receive surgical treatment for painful bipartite patella in our hospital from January 2008 to January 2020. According to doctor-patient communication, 10 patients under- went open reduction and cannulated screw fixation (the fixation group), while the remaining 9 patients underwent arthroscopic resection (the resection group). The perioperative, follow-up and imaging data of the two groups were compared. [Results] Although the fixation group had significantly longer incision than the resection group [(3.5±0.4) cm vs (1.8±0.3) cm, P＜0.05], the former proved significantly superior to the latter in terms of pain VAS score 5 days after operation [(2.6±0.2) vs (3.6±0.1), P＜0.05] and ambulation time [(3.5±1.3) days vs (6.7±1.0) days, P＜0.05], despite of insignificant differences in incision healing and hospital stay between the two groups (P＞0.05). With time of the fol- low-up lasted for (36.1±2.5) months on a mean, the pain VAS score significantly reduced (P＜0.05), whereas Kujala and Hungerford scores, as well as knee extension-flexion ROM significantly increased in both groups (P＜0.05). There were no statistically significant differences in the above indexes between the two groups before operation (P＞0.05), but the fixation group was significantly better than the resection group in terms of VAS score [(1.6±0.5) vs (2.9±0.8), P＜0.05], Kujala score [(92.1±3.2) vs (85.8±4.4), P＜0.05], Hungerford score (95.1±4.3) vs (87.5± 5.4), P＜0.05] and knee ROM [(139.4± 4.7)° vs (131.6± 3.3)°, P＜0.05] 12 months postoperatively. Regarding to imaging, the patello- femoral K-L classification and Insall index remained unchanged significantly in both groups at 6 and 12 months after surgery compared with those preoperatively (P＞0.05), which were not statistically significant between the two groups at any time points correspondingly (P＞0.05). [Conclusion] The open reduction and cannulated screw fixation take the advantages of less trauma, direct vision reduction and reliable fixa- tion, do achieve better clinical outcome over the arthroscopic resection for painful bipartite patella.

Abstract:Knee osteoarthritis (KOA) is a common joint disease that significantly affects individual health and places a heavy burden on the healthcare system. Exercise is an important method for preventing and treating KOA. However, factors such as individual physical differ- ences, exercise methods and intensity can lead to the exacerbation of KOA when exercise is not conducted scientifically. By contrast, exer- cise prescription can harness the therapeutic advantages of exercise while ensuring safety. An exercise prescription is a personalized exer- cise plan based on patient condition and physical assessment, combined with individual lifestyle considerations. It plays a role in KOA treat- ment by alleviating pain, improving knee joint function, and more. Nonetheless, there are still some contentious aspects within its content. This article provides a review of recent domestic and international literature, summarizing the progress of exercise prescription application in KOA treatment.

Abstract:Osteoimmunology demonstrates that the interaction between macrophages and osteoclasts is involved in regulating bone state, in other word, the macrophage-osteoclast axis plays an important role in bone immunity. The wear particles produced by prosthesis stimulate osteoclasts to dissolve bone, while macrophages devours wear particles to produce chronic inflammation, leading to aseptic loosen- ing. Macrophages promote fracture healing through anti-inflammatory effect and osteoclast differentiation. However, osteoclast activity is the main cause of osteoporosis, in which macrophages play an important role. Macrophages are also considered to be an important cause of exces- sive osteoclast activity in patients with rheumatoid arthritis. This paper reviews the role of the interaction between macrophages and osteo- clasts in bone immunity in related bone disorders.

Abstract:Open wedge high tibial osteotomy (OWHTO) is a reliable option for the treatment of medial unicompartmental osteoarthritis with varus deformity in relatively younger patients, but there is still the risk of nonunion, collapse and loss of correction in the osteotomy space. Various bone grafts have been used to fill the osteotomy gap, however, the ideal bone graft remains to be looked for. This article pres- ents various bone grafts available for OWHTO in order to make the appropriate selection in each specific clinical situation.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of autologous rib structural bone grafting in instrumented fusion of craniocervical junction zone in children. [Methods] Two children received atlantoaxial, or occipitocervical instru- mented fusion with rib autografts for congenital craniocervical junction disorders. A posterior cervical median incision was made, and the at- lantoaxial pedicle screw-rod, or occipitocervical plate-screw-rod system was routinely placed for internal fixation. A high-speed burr was used to grind the bone graft groove at the posterior inferior edge of the atlantoaxial arch, or occipital and the superior edge of the cardinal ver- tebral plate. Then, an oblique incision was made along the direction of the ribs under the subscapular angle of the posterior chest wall to ex- pose the rib, a rib segment was harvested and trimmed into columns in proper length, and placed on the bone bed on the craniocervical junc- tion zone. [Results] The surgical procedure was successfully performed in both patients, without hemopneumothorax and postoperative com- plications in the rib donor site, and were followed up for 6 months and 12 months, respectively. Both patients got significantly symptom im- provement postoperatively in terms of JOA and VAS scores. Solid atlantoaxial or craniocervical fusion was noted with bony rib healing in the donor site 3 months postoperatively. [Conclusion] The autologous rib structural bone grafting is a safe and effective instrumented fusion of the craniocervical junction area in children.

Abstract:[Objective] To quantitatively evaluate the surface electromyography (sEMG) changes in multi-exercises for facet disorder before and after lumbar oblique wrench manipulation. [Methods] From September 2020 to December 2021, 15 patients with facet disorder and 10 matched normal subjects were included in this study in the Department of Tuina, Ruijin Hospital affiliated to Shanghai Jiao Tong Uni- versity. The clinical score evaluation and sEMG under several exercise states were conducted before and after lumbar oblique wrench manip- ulation. The difference in clinical state and the myoelectric activity of lumbar muscles were compared before and after lumbar oblique wrench manipulation in the patient with the normal subject. [Results] Compared with those before treatment, the VAS score for pain signifi- cantly reduced [(6.2±0.9), (1.5±0.6), P＜0.05], while the JOA score significantly increased [(11.9±1.4), (22.7±3.3), P＜0.05] 1 month after treatment in the patients. In terms of sEMG, the mean amplitude and median frequency of the right and left erector, as well as the left and right multifidus significantly decreased 1 month after treatment compared with those before treatment under different exercise modes, includ- ing normal walking, right foot over obstacle, left foot over obstacle, bending and bending load (P＜0.05). After treatment, the mean sEMG am- plitude and median frequency of right and left erector and left and right multifidus were not significantly different from those of normal peo- ple (P＞0.05). [Conclusion] Lumbar oblique wrench manipulation does relieve pain and reduce the abnormal electrical activity of erector and multifidus muscles in patients with facet disorders.

Abstract:[Objective] To evaluate the diagnostic value of iliac-lower extremity line in hip ultrasound for developmental dysplasia of the hip (DDH) in infants. [Methods] The hip ultrasound examination was conducted in 863 infants by Graf method, and the relationships be- tween iliac-lower extremity line and femoral head in different Graf types of the hip were determined. The age, sex, α angle, β angle and Graf types of the hip were compared between the positive and negative groups of the iliac-lower extremity line. [Results] At the primary ultra- sound examination of the 863 infants, the iliac-lower extremity line positive group was significantly younger than the negative group in age [(53.2±25.3) days vs (67.7±34.0) days, P＜0.001], and the positive groups had significantly higher ratio of female than the negative group [male/female, (69/108) vs (340/346), P＜0.001]. In addition, the positive group got significantly less alpha angle [(53.7±4.6)° vs (60.1±4.5)°, P＜0.001], while significantly greater β angle [(77.5±6.0)° vs (71.9±6.0)°, P＜0.001] than the negative group, despite of no statistically signifi- cant difference in Graf type of the hips between the two groups (P＞0.05). [Conclusion] As Graf method is used to detect the hip in infants, the iliac-lower extremity line might be helpful for judging whether the femoral head is displaced related to the acetabulum.

Abstract:[Objective] To investigate the clinical outcomes of debridement, antibiotics, and implant retention (DAIR) for periprosthetic joint infection (PJI) after primary total knee arthroplasty (TKA). [Methods] A retrospective study was conducted on 33 patients who received DAIR for PJI in our hospital from January 2016 to June 2020, including 28 patients suffered from PJI within 3 months after TKA, and 5 pa- tients in 4~6 months after surgery. The clinical and laboratory results were evaluated. [Results] All patients had DAIR performed successful- ly with operation time of (113.5±12.4) min, and intraoperative blood loss of (43.5±7.4) ml, and were followed up for (44.1±11.7) months. Of them, 28 cases were successful with the success rate of 84.8%, whereas 5 cases were of surgical failure, including 2 cases infected within 3 months after the initial replacement, 3 cases infected in 4 to 6 months after the operation, with the failure rate of 15.2%. Compared with those before DAIR, the VAS score for pain [(5.1±1.4), (1.4±0.9), P＜0.001] significantly reduced, while the KSS functional score [(43.0±9.9), (81.8± 11.3), P＜0.001] and KSS clinical score [(37.8±14.9), (84.0±7.0), P＜0.001] significantly increased at the latest follow-up. In term of lab test, bacterial culture were negative in 15 cases (45.5%), whereas positive in 18 cases (54.5%). The WBC, CRP and ESR were significantly de- creased over time (P＜0.05). [Conclusion] The DAIR does achieve satisfactory early clinical consequences for PJI. However, its failure rate for PJI in 4 to 6 months after primary TKA is relatively higher than that within 3 months after the surgery.

Abstract: [Objective] To compare the clinical efficacy of low-frequency electrical stimulation (LFES) versus dispersive extracorporeal shock wave therapy (ESWT) for patellar chondromalacia. [Methods] From February 2021 to June 2022, 78 patients received non-surgical treatment for patellar chondromalacia. On the basis of routine exercise therapy, 39 patients received LFES, while the remaining 39 received ESWT. The treatment period and follow-up data were compared between the two groups. [Results] All patients in both groups had the corre- sponding therapies completed without obvious complications. Although there were no significant differences in the frequency of treatment, time interval, adverse reactions and VAS scores for treatment tolerance between the two groups (P＞0.05), the ESWT group proved significant- ly better than the LFES group in term of VAS score for treatment satisfaction [(6.5±1.0) vs (5.8±1.1), P＜0.05]. As time went during the followup period lasted for more than 6 months, the VAS scores for anterior knee pain significantly reduced (P＜0.05), whereas the Kujala score sig- nificantly increased in both groups (P＜0.05). The ESWT group proved significantly superior to the LFES group in terms of VAS score for an- terior knee pain [(0.8±0.8) vs (1.3±1.0), P＜0.05] and Kujala score [(85.8±9.9) vs (70.7±9.4), P＜0.05] 6 months after treatment. [Conclusion] The ESWT combined with exercise therapy does significantly relieve anterior knee pain, improve knee movement ability and improve longterm curative effect for patellar chondromalacia.

Abstract:[Objective] To evaluate the outcomes of the video-assisted discharge education (VADE) program for intervention of kinesio- phobia after total knee arthroplasty (TKA). [Methods] One hundred and twenty patients who were undergoing TKA in our hospital from Octo- ber 2022 to May 2023 were included into this study, and divided into two groups using the random number table method, including 60 pa- tients in the video-assisted discharge education program (the video group) and 60 patients in the conventional discharge education program (the conventional group). The clinical data of the two groups were compared. [Results] All patients in both groups received corresponding dis- charge educations completely without statistically significant differences in age, sex, disease duration, and BMI between the two groups (P＞ 0.05). The VAS and Tampa scale for kinesiophobia significantly decreased (P＜0.05), while the knee extension- flexion range of motion (ROM) and HSS score significantly increased in both groups over time (P＜0.05). Th video group proved significantly superior to the conven- tional group in terms of VAS score [(0.9±0.9) vs (1.4±0.6), P＜0.05], ROM [(119.5±7.0)° vs (115.5±7.5)°, P＜0.05], HSS score [(85.7±3.3) vs (84.4±3.3), P＜0.05], and Tampa score [(31.8±3.5) vs (33.3±3.2), P＜0.05] one month postoperatively, despite of insignificant differences in abovementioned items before operation and 24 hours postoperatively between the two groups (P＞0.05). [Conclusion] The video-assisted dis- charge education program does effectively reduce the degree of postoperative TKA kinesiophobia, relieve pain during the rehabilitation peri- od, improve knee function and knee extension-flexion mobility, and enhance patients' postoperative satisfaction.

Abstract:[Objective] To investigate the feasibility and reliability of fibular inclination angles of proximal tibiofibular joint (PTFJ) mea- sured by magnetic resonance imaging (MRI) reconstruction of the knee. [Methods] A total of 35 patients (35 knees) with medial knee osteoar- thritis were included in this study. The MRI measured fibular inclination angle (M-FIA) and X-ray measured fibular inclination angle (XFIA) were conducted to present the inclination of PTFJ. The reliability of M-FIA and the differences between M-FIA and X-FIA were evalu- ated, and the consistency of the two measures was assessed by Bland-Altmann analysis. [Results] The intraclass correlation coefficient (ICC) of intra-observer and inter-observer reliability measured by M-FIA were of 0.97 and 0.90, respectively, indicating excellent consistency re- liability. There was no significant difference between the measured values of X-FIA and M-FIA [(26.9±7.6)° vs (26.6±7.5)°, P=0.244]. In term of Bland-Altmann analysis, the 95% agreement limit between M-FIA and X-FIA was of (-0.3±2.8)°. [Conclusion] The knee MRI re- construction used to measure PTFJ inclination is a reproducible technique. M-FIA and X-FIA can be substituted for each other.

Abstract:[Objective] To evaluate the effect of targeted nursing during the perioperative period of lumbar decompression and fusion on postoperative abdominal distension and constipation. [Methods] From January 2022 to January 2023, 120 patients who were undergoing lumbar decompression and fusion for lumbar degenerative diseases in our hospital were included in this study, and were divided into the tar- geted group and conventional group by random number table method, with 60 cases in each group. The postoperative abdominal distension and constipation, anxiety and satisfaction with nursing work were compared between the two groups. [Results] All patients in both groups were successfully operated on without serious perioperative complications. The targeted group proved significantly superior to the convention- al group in terms of abdominal distension incidence (25.0% vs 58.3%, P=0.003), abdominal distension score [(0.5±0.3) vs (1.3±0.4), P= 0.001], constipation incidence (35.0% vs 63.3%, P=0.014), constipation score [(0.6±0.2) vs (1.4±0.9), P=0.002], anxiety score [(50.7±2.3) vs (57.7±7.6), P=0.002] and nursing satisfaction score [(9.0±1.0) vs (8.1±1.6), P=0.006]. [Conclusion] The targeted nursing does effectively reduce the occurrence of postoperative abdominal distension and constipation, relieve patients' anxiety status, improve patient satisfaction.

Abstract: [Objective] To investigate the clinical effect of enhanced recovery after surgery (ERAS) nursing in perioperative period of re- section of intraspinal tumor. [Methods] From March 2020 to October 2022, a total of 48 patients who underwent surgical resection of intra- spinal tumors in our hospital were randomly divided into two groups. Of them, 24 patients received perioperative ERAS nursing, while the other 24 patients received perioperative routine nursing. The early postoperative clinical data of the two groups were compared. [Results] All patients in both groups were successfully operated on, without death, nerve injury and other serious complications. Incision pain VAS scores in both groups were significantly decreased over time (P＜0.05). The ERAS group proved significantly lower VAS scores for incision pain than the routine group at 12 hours (h), 24 h, 48 h and 72 h postoperatively [(2.7±0.6) vs (5.2±1.2), P＜0.001; (2.9±0.4) vs (4.4±1.3), P＜0.001; (2.3±0.5) vs (3.3±1.0), P＜0.001; (1.6±0.4) vs (2.1±0.3), P＜0.001]. In addition, the ERAS group resumed ambulation postoperatively signifi- cantly earlier than the routine group [(1.4±0.5) days vs (3.0±1.2) days, P＜0.001], moreover, the former proved significantly shorter postopera- tive hospital stay than the routine group [(6.5±1.5) days vs (10.3±2.1) days, P＜0.001], furthermore, the ERAS group had significantly lower overall postoperative complication rate than the routine group (8.3% vs 29.2%, P=0.036). [Conclusion] The enhanced recovery after surgery (ERAS) nursing is safe and effective for perioperative period of resection of intraspinal tumor, and does effectively relieve postoperative pain and reduce the occurrence of postoperative complications.