Abstract:[Objective] To compare the clinical efficiency of Ethibond suture versus steel wire tension band for fixation of patellar frac-ture. [Methods] A retrospective study was conducted on 41 patients who received open reduction and internal fixation of patellar fracture inour department from November 2015 to December 2021. According to the doctor-patient communication, 23 patients had the fracture fixedwith Ethibond suture tension band (the suture group), while the other 18 cases were with conventional steel wire tension band (the wiregroup). The perioperative period, follow-up results and imaging data of the two groups were compared. [Results] There were no significantdifferences between the two groups in terms of operation time [(58.0±2.0) min vs (57.2±2.3) min, P＞0.05], the total length of incision [(7.8±0.3) cm vs (8.0±0.5) cm, P＞0.05], intraoperative blood loss [(60.4±2.0) ml vs (55.6±2.4) ml, P＞0.05], incision healing grade [A/B/C, (22/1/0)vs (16/2/0), P＞0.05] and hospital stay [(11.0±0.6) days vs (12.5±0.7) day, P＞0.05]. All of them were followed up for (17.2±1.0) months on amean, and there was no significant difference in the time to return to full weight-bearing between the two groups (P＞0.05). The VAS scoresdecreased significantly (P＜0.05), while the Kujala, Lysholm and Bostman scores, as well as knee extensity-flexion ROM significantly in-creased over time in both groups (P＜0.05), whereas which proved not statistically significant between the two groups at any time points ac-cordingly (P＞0.05). In terms of imaging, there were no significant differences in the fracture reduction quality, Insall-Salvati index and frac-ture healing time between the two groups (P＞0.05). [Conclusion] The Ethibond suture tension band for fixation of patella fracture doesachieve the same clinical efficacy as steel wire tension band fixation, with good safety. Therefore, the suture tension band may replace thetraditional steel wire tension fixation.

Abstract:[Objective] To evaluate the clinical outcomes of antibiotic-loaded bone cement combined with vacuum-assisted closure(VAC) for Gustilo-Ⅲ tibiofibular fractures. [Methods] A retrospective study was conducted on 60 patients who received treatments forGustilo type Ⅲ tibiofibular fractures in our hospital from March 2020 to September 2021. According to preoperative doctor-patient commu-nication, 31 patients were treated with antibiotic-loaded bone cement combined with VAC (the combination group), while the remaining 29patients were treated with VAC only (the VAC group) after a thorough debridement and external fixation in the first stage. The documents re-garding perioperative period, laboratory tests and follow-up were compared between the two groups. [Results] All patients in both groupshad operations performed smoothly without serious complications. Although there were no significant differences in the first-stage operationtime and VAS scores between the two groups (P＞0.05), the combination group proved significantly superior to the VAC group in terms ofthe time elapsed prior to the second stage of preoperative time [(9.9±1.7) days vs (11.0±1.9) days, P=0.014], exudation scale [0/I/II/III/IV,(6/17/5/3/0) vs (2/11/10/4/2), P=0.017], granulation scale [I/II/III/IV, (18/8/4/1) vs (9/12/6/2), P=0.048], the bacterial culture before the sec-ond stage of surgery [positive/negative, (1/23) vs (6/17), P=0.035], wound closure mode [suture/skin graft/flap, (24/5/2) vs (13/11/5), P=0.034], wound healing time [(25.8±5.1) days vs (29.6±5.5) days, P=0.007], hospital stay [(29.6±4.5) days vs (33.0±5.5) days, P=0.011] andthe treatment costs [(6.3±0.5) ten thousand yuan vs (6.7 + 0.6) ten thousand yuan, P=0.003]. Regarding laboratory tests, the WBC, NEU,CRP and ESR were significantly decreased over time in both groups (P＜0.05), which in the combination group were significantly better thanthose in the VAC group just before the second stage of surgery (P＜0.05). In addition, the combination group was significantly better than theVAC group in terms of fracture healing time [(6.2±1.7) months vs (7.3±1.5) months, P=0.011] and fracture union state [good/delayed/non-union/osteomyelitis, (25/4/1/1) vs (17/6/2/4), P=0.016]. The local scar grade and limb function based on Johner-Wruh criteria significantlyimproved over time in both groups (P＜0.05), which in the combination group were significantly better than those in the VAC group at 3months after surgery (P＜0.05), but became not statistically significant between the two groups at 6 and 12 months after surgery (P＞0.05).Moreover, the combination group was also significantly superior to the VAC group in term of the patient satisfaction (P＜0.05). [Conclusion]The antibiotic-loaded bone cement combined with vacuum assisted closure has the advantages of shortening treatment period, reducing therisk of infection and promoting fracture healing over the VAC only.

Abstract:[Objective] To compare the clinical outcomes of the bridge combined fixation system (BCFS) used in hybrid fixation (HF)versus double-rod fixation (DRF) for distal femoral fractures. [Methods] A retrospective study was conducted on 36 patients who receiveBCFS internal fixation for distal femoral fractures in our hospital from January 2018 to December 2020. Based on doctor-patient communi-cation, 17 patients received HF, while the other 19 patients received DRF. The perioperative period, follow-up and imaging data of the twogroups were compared. [Results] Two groups of patients successfully completed the operations with no serious complications. Although theHF group proved significantly greater than the DRF group in terms of operation time [(110.8±16.6) min vs (97.5±13.4) min, P＜0.05] and in-cision length [(22.9±4.2) cm vs (19.6±3.0) cm, P＜0.05], there were no significant differences in intraoperative blood loss, fluoroscopy times,postoperative drainage volume, incision healing grade and hospital stay between the two groups (P＞0.05). All patients in both groups werefollowed up for more than 12 months, and the HF group resumed walking [(31.9±9.1) days vs (40.4±9.1) days, P＜0.05] and the full weightbearingactivity [(117.0±32.4) days vs (149.0±44.7) days, P＜0.05] significantly earlier than the DRF group. The knee ROM, HSS scores andSchatzker-Lambert (S-L) scale significantly increased in both groups over time (P＜0.05). Despite of the fact that there were no significantdifferences in the above indexes between the two groups before surgery (P＞0.05), and no significant differences in knee flexion-extensionROM between the two groups at any matching time point after surgery (P＞0.05), the HF group proved significantly superior to the DRFgroup in term of HSS score one month after surgery [(60.2±4.2) vs (56.5±5.1), P＜0.05], whereas which became not statistically significantbetween the two groups at 6 months after surgery and the latest follow-up (P＞0.05). In addition, the former was significantly better than the latter in term of S-L grade [excellent/good/fair/poor, 6 months postoperatively (7/9/1/0) vs (3/9/5/2), P＜0.05; the last follow-up (14/2/1/0) vs(9/8/1/1), P＜0.05]. Regarding to imaging, there was no significant difference in the quality of fracture reduction and the time of fracturehealing between the two groups (P＜0.05), while the HF group got significantly less the femorotibial angle than the DRF group (P＜0.05).[Conclusion] This BCFS used in HF configration might take advantages of avoiding the varus deformity of the distal femur, while achievingstable fixation over the DRF for distal femoral fractures, especially for the comminuted fractures.

Abstract:[Objective] To compare the clinical results of open reduction and internal fixation (ORIF) with or without deltoid ligament(DL) repair by suture anchor for ankle fractures complicated with DL tear. [Methods] A retrospective study was done on 76 patients who re-ceived ORIF for closed ankle fractures accompanied with DL tear in our hospital from January 2015 to December 2020. According to preop-erative doctor-patient communication, 38 patients got DL repaired in ORIF, while the other 38 patients had DL unrepaired. The periopera-tive period, follow-up and imaging data were compared between the two groups. [Results] All the 76 patients had corresponding surgicalprocedures completed successfully without serious complications. The repaired group proved significantly inferior to the unrepaired groupin terms of operation time, total incision length and intraoperative blood loss (P＜0.05). All patients were followed up for 12~28 months, withan average of (18.7±4.6) months, and the repaired group returned to full weight-bearing activity significantly earlier than the unrepairedgroup (P＜0.05). The ankle dorsiflexion-plantarflexion range of motion (ROM), AOFAS scores, valgus test and VAS score significantly im-proved over time in both groups (P＜0.05). The repaired group proved significantly superior to the unrepaired group in terms of AOFASscore, ankle dorsiflexion-plantarflexion ROM, valgus test and VAS score at all time points postoperatively (P＜0.05), whereas the formerhad significantly less foot varus-valgus ROM than the latter (P＜0.05) . In terms of imaging, the repaired group got significantly better quali-ty of fracture reduction than the unrepaired group (P＜0.05). The medial clear space (MCS) and talus tilt (TT) were significantly reduced inboth groups at the latest follow-up compared with those before surgery (P＜0.05), while which in the repaired group were significantly lessthan those in the unrepaired group at the latest follow-up (P＜0.05). [Conclusion] Repairing DL with suture anchor during ORIF does im-prove the clinical outcomes of ankle fractures complicated with DL tear.

Abstract:[Objective] To compare the clinical outcomes of percutaneous repair with suture anchors versus open counterpart for treat-ment of acute Achilles tendon rupture. [Methods] A retrospective study was done on 35 patients who received surgical repair for acuteAchilles tendon rupture in our hospital from October 2017 to October 2021. According to the preoperative doctor-patient communication,16 patients underwent percutaneous repair of the tendon with suture anchor (the percutaneous group), while the remaining 19 patient under-went conventional open repair (open group). The perioperative and follow-up documents were compared between the two groups. [Results]All patients had corresponding surgical procedures performed successfully. The percutaneous group was significantly superior to the opengroup in terms of operation time [(56.6±10.4) min vs (81.7±28.7) min, P=0.003], incision length [(1.9±0.6) cm vs (7.7±3.5) cm, P＜0.001], in-traoperative blood loss [(10.6±6.0) ml vs (26.0±15.8) ml, P＜0.001], hospital stay [(8.2±1.6) days vs (11.1±3.5) days, P=0.015], but there wasno statistical significance in the walking time and incision healing grade between the two groups (P＞0.05). The follow-up period lasted for(21.8±7.1) months in a mean, and the percutaneous group resumed full weight-bearing activity significantly earlier than the open group[(8.4±1.0) weeks vs (12.8±3.1) weeks, P=0.005]. The VAS, AOFAS and ATRS scores, as well as plantar flexion-dorsal extension ROM weresignificantly improved in both groups over time (P＜0.05). Percutaneous group was significantly better than that of the open group in VASscore at 1 month [(1.6±0.4) vs (2.3±0.7), P=0.001] and 6 months postoperatively [(0.9±0.3) vs (1.3±0.4), P=0.005], despite of insignificantdifferences in terms of AOFAS, ATRS scores and plantar flexion-dorsal extension ROM between the two groups at any time points accord-ingly (P＞0.05). [Conclusion] Compared with traditional open repair, percutaneous repair with suture anchor is less invasive, and more ben-eficial to functional recovery.

Abstract:[Objective] To compare the clinical outcomes of modified Ma-Griffith percutaneous repair (PR) versus conventional openrepair (OR) of acute closed Achilles tendon rupture. [Methods] A retrospective study was conducted on 72 patients who received surgicaltreatment for acute closed Achilles tendon rupture in our hospital from July 2015 to February 2020. Based on the results of doctor-patientcommunication, 38 patients underwent PR, while the other 34 patients received conventional open repair (OR). The perioperative periodand follow-up data of the two groups were compared. [Results] The PR group proved significantly superior the OR group in terms of opera-tion time [(45.5±5.9) min vs (49.0±7.0) min, P＜0.05], the total length of incision [(5.5±0.8) cm vs (7.9±0.9) cm, P＜0.05], intraoperativeblood loss [(16.1±4.1) ml vs (25.9±4.9) ml, P＜0.05], postoperative ambulation time [(4.0±1.6) days vs (7.0±1.7) days, P＜0.05], incision heal-ing grade [A/B/C, (38/0/0) vs (30/4/0), P＜0.05] and hospital stay [(8.2±1.9) days vs (12.0±2.5) days, P＜0.05]. The PR group got significantlyhigher incidence of sural nerve injury than the OR group (20.1% vs 2.9%, P＜0.05), whereas the former had significantly lower incidence ofpostoperative incision infection than the latter (0.0% vs 11.8%, P＜0.05). All patients were followed up for a mean of (15.9±2.8) months, andthe PR group resumed full weight-bearing activity significantly earlier than the OR group [(59.3±4.7) days vs (87.8±4.4) days, P＜0.05]. TheVAS score decreased significantly (P＜0.05), while AOFAS score and ankle range of motion (ROM) increased significantly in both groupsover time postoperatively (P＜0.05). The PR group proved significantly superior to the OR group in terms of VAS score [(1.9±0.6) vs (3.9±0.8), P＜0.05], AOFAS [(86.0±3.4) vs (74.7±5.0), P＜0.05], ATRS score [(89.2±4.0) vs (77.2±4.0), P＜0.05] and ankle ROM [(48.7±3.6)° vs(39.7±4.1)°, P＜0.05] 1 month postoperatively, whereas which became not statistically significant between the two groups at the latest followup (P＞0.05). [Conclusion] Compared with open repair, the percutaneous repair, a minimally invasive surgery, does significantly reduce theinfection rate after Achilles tendon rupture and improve the early postoperative functional recovery, despite of higher risk of sural nerve in-jury.

Abstract:Osseointegrated prostheses refer to prostheses that are directly integrated with the amputated bone tissue. In the past 30years, osseointegrated prosthesis technique has developed rapidly, up to now, dozens of treatment centers have been established, and morethan 1 000 patients have used osseointegrated prostheses around the world. Compared with traditional prostheses, osseointegrated prosthe-ses have obvious advantages in their function and comfort. Although osseointegrated prostheses have been developed into different types,fixation methods and surgical methods, they still face complications and risks, such as infection and periprosthetic fractures. Therefore, os-seointegrated prosthesis techniques still need to be continuously improved. This article mainly discusses various types and characteristicsof osseointegrated prostheses, summarizes the advantages and disadvantages of them in clinical application to provides a reference for fur-ther development in the future.

Abstract:Far-out syndrome (FOS) is a disorder characterized by pain caused by compression of the L5 nerve root outside the foramina,which is different from the nerve root in the common position of compression, for its unique anatomical characteristics. In order to clarify thediagnosis of FOS, CT and MRI are better diagnostic methods. For patients who are irresponsive to standard conservative treatment, surgicalmanagement, with complete decompression and with or without fusion, is indicated. This disease is rarely reported, there is no consensus onthe best treatment, and there is a lack of efficacy analysis and controlled studies with large samples. Further research should be carried out tobetter diagnose and treat the disease.

Abstract:Sciatic nerve injury is one of the rare complications secondary to total hip arthroplasty, which might be caused by direct in-traoperative nerve injury, limb elongation, bone cement-related heat injury, and postoperative hematoma. Despite abovementioned commoncauses, half cases of the nerve injuries might have no clear reason. Although a number of risk factors have been reported, no single one isconsidered the most significant risk factor. Active surgical exploration and neurolysis can improve nerve function, and conservative treat-ment is suitable for some patients with no definite organic cause. The prognosis of sciatic nerve injury is often unpredictable, and there is noconsensus on what factors can determine the evolution of this injury. This paper reports a case of sciatic nerve injury secondary to total hiparthroplasty, and reviews the literatures regarding its etiology, risk factor, treatment and prognosis.

Abstract:Ovarian cancer G protein-coupled receptor 1 (OGR1) subfamily was widely distributed in human tissues, which has protonsensitiveproperties and can sense changes in extracellular pH through the receptor of histidine residues, thereby regulating the functions ofvarious human cells. Proton-sensing receptors not only closely related to tumorigenesis, immune system, nervous system, and vascular sys-tem, but also to regulate osteoblast bone formation and osteoclast bone resorption affecting bone metabolism by the changes of extracellularpH value. As the bone metabolic balance is disrupted, it leads to abnormal bone mass and related bone disease. This article reviews the re-search progress on the role of proton-sensitive ovarian cancer G protein-coupled receptor 1 in bone metabolism.

Abstract:[Objective] To investigate the effect of continuous low-intensity ultrasound (cLIUS) on the preservation of osteochondral tis-sue in vitro. [Methods] Sixty osteochondral specimens were harvested from a 6-month-old pig femur condyles and were randomly dividedinto two groups, which were stored in DMEM medium at 4℃, those in the static group was not treated with ultrasound, while the samples inthe ultrasonic group was stimulated for 20 min every day at a frequency of 42 kHz and an electric power of 50W. The survival rate, proteo-glycan expression, histomorphology and biomechanical properties were detected at the 14 th and 28 th days. The expression of extracellularregulatory protein kinase (ERK) was detected 2 hours after cLIUS stimulation. [Results] The ultrasound group got significantly higher cellsurvival rate than the static group at 14 days [(75.5±1.8)% vs (65.6±1.5)%, P＜0.05], whereas which became not statistically significant be-tween the two group at 28 days. As time went by, the cell survival rate in both groups decreased significantly (P＜0.05). Histological stainingshowed that the ultrasound group was better than the static group, the former had higher the saffron O staining IOD [(224.7±4.1) vs (166.5±3.7), P＜0.05], toluidine blue staining IOD [(223.7±6.0) vs (166.7±5.0), P＜0.05] than the latter at 14 days, while which returned to be not sig-nificant difference between the two groups at 28 days (P＞0.05). The tissue morphology and structure of the two groups were disordered andproteoglycan was significantly lost over time (P＜0.05). In addition, the ultrasound group got significantly higher Young's modulus than thestatic group 14 days [(8.7±0.3) MPa vs (7.0±0.0) MPa, P＜0.05], which became not significantly different either at 28 days between the twogroups (P＞0.05). The Young's modulus of the two groups decreased significantly with time (P＜0.05). At 2 hours after ultrasonic stimulation,the ultrasonic group had significantly higher expression of ERK protein than the static group [(0.9±0.1) vs (0.5±0.2), P＜0.05]. [Conclusion]The cLIUS improves the preservation quality of porcine bone cartilage in vitro, prolong the preservation time and up-regulate the expres-sion of ERK protein.

Abstract:[Objective] To test a domestic visual electromagnetic navigation system by observing its effect on distal locking screw place-ment of intramedullary nail in the femur model. [Method] Based on the measurement principle of coordinate position of the object measur-ing the change rate of three mutually perpendicular magnetic fields, this visual electromagnetic navigation system was developed by combin-ing positioning coil and reluctance sensor. Thirty artificial femur models were randomly divided into navigation group and conventionalgroup, with 15 in each group. In both groups, intramedullary nail with handles were inserted into the femur model. In the navigation group,the visual electromagnetic navigation system was used to assist the 3 locking screws placement at the distal end of the intramedullary nail,while in the conventional group, a conventional mechanical guider was used to assist the 3 locking screws placement at the distal end. Thecontinuous insertion time of 3 screws in two groups and the success rate at the first placement were recorded and compared. [Results] Theinsertion time of the first, second and third screws in the two groups increased in sequence, with statistical significance (P＜0.05). The navi-gation group proved significantly superior to the conventional group in terms of continuous insertion time of the first screw [(156.3±14.8) secvs (266.8±31.2) sec, P＜0.05], the second screw [(230.7±17.1) sec vs (318.1±32.2) sec, P＜0.05], and the third screw [(306.5±20.8) sec vs(408.6±27.7) sec, P＜0.05]. However, there was no significant difference in the success rate at the first placement between the two groups(P＞0.05). [Conclusion] This visual electromagnetic navigation system is accurate in positioning, and does significantly shorten the time ofdistal locking screw placement of intramedullary nail in femur model compared with the mechanical guider.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical consequences of arthroscopic assisted small-inci-sion repair of pectoralis major tear. [Methods] From March 2020 to August 2022, 4 patients underwent abovementioned operation for oldpectoralis major tear near the humeral insertion. After preoperative ultrasonography and MRI were used to show the exact location of the in-jury, the torn pectoralis major was identified under arthroscopy, and then the free end of the pectoralis major tendon was sutured with inter-locking suture by suture hook. The tendon end was released under traction with the suture loop and removing the scar tissue around the inju-ry site under arthroscope. A small incision was made on the deltopectoral groove to expose the anatomic insertion of pectoralis major, holeswere drilled at the humerus, and the tendon was reduced to the lateral margin of the biceps tendon groove of the humerus, and fixed with afootprint anchor. [Results] All the 4 patients were successfully operated on without neurovascular injury, infection and other complications,and were followed up for 10~14 months with an average of (11.8±1.5) months. At the last follow-up, all patients had no pain, regained nor-mal range of motion in terms of abduction-adduction and internal-external rotation, with significantly improved function and appearance ofthe pectorals major, and resumed sports 6 months after surgery with grade 5 pectoral muscle strength. Based on Bak's criteria, all 4 patientsachieved excellent results. The postoperative MR showed that the pectoral major muscle was in normal appearance. [Conclusion] Preopera-tive MRI and musculoskeletal ultrasonography can help to reveal the retraction and quality of the torn pectoralis major. Arthroscopic assist-ed small-incision repair of old pectoralis major muscle tear is feasible and minimally invasive, and does achieve satisfactory preliminaryclinical results.

Abstract:[Objective] To evaluate the clinical efficacy of cannulated screws and retrograde intramedullary nail for femoral neck frac-ture accompanied with femoral shaft fractures. [Methods] A retrospective study was conducted on 22 patients who received cannulatedscrews for femoral neck fractur and retrograde femoral intramedullary nail for the same-side femoral shaft fractures in our hospital from Jan-uary 2017 to January 2020. The clinical and imaging data were evaluated. [Results] All patients were successfully operated on, with no neu-rovascular injury and other serious complications, and followed up for (28.4±8.5) months. Compared to those 3 months after surgery, theHarris scores [(54.4±2.1), (77.8±3.1), P＜0.05], HSS score [(80.4±2.4), (94.8±2.4), P＜0.05], hip internal- external rotation range of motion(ROM) [(50.4±2.1)°, (74.6±1.9)°, P＜0.05], hip flexion-extension ROM [(60.7±4.8)°, (90.23±2.9)°, P＜0.05], the knee flexion-extensionROM [(100.3±2.5) °, (120.8±2.1) °, P＜0.05] significantly increased at the latest follow-up. Radiographically, all patients got femoral neckfracture and femoral shaft fractures reduced well after surgery. The healing time of femoral neck fractures was of (6.1±2.0) months, while thefemoral shaft fractures was of (6.8±2.2) months. There was no significant change in Tonnis hip osteoarthritis grade at the last follow-up com-pared with that 3 months after surgery (P＞0.05). [Conclusion] The cannulated screws and retrograde intramedullary nail for femoral neckfracture accompanied with femoral shaft fractures have good flexibility in operation, do achieve satisfactory clinical results.

Abstract:[Objective] To explore the effect of hydrogen -oxygen mixture inhalation on early consequences of arthroscopic repair of ro-tator cuff tear. [Methods] A retrospective study was performed on 60 patients who underwent unilateral arthroscopic rotator cuff repair fromFebruary 2020 to October 2021. According to the preoperative doctor-patient communication, 30 patients were inhaled hydrogen and oxy-gen mixture (the HOM group), while other 30 patients were inhaled pure oxygen (the PO group). The clinical and blood test data of the twogroups were compared. [Results] All patients were operated on successfully, without significant differences in the operation time, mean arte-rial pressure and heart rate 30min after intubation between the two groups (P＞0.05). As all patients were followed up for 12-weeks, theVAS score for pain, Constant-Murley and UCLA scores in both groups were significantly improved over time (P＜0.05). Although there wasno statistical significance in the above scores between the two groups before surgery (P＞0.05), the HOM group proved significantly superiorto the PO group 12 weeks after surgery in terms of VAS score [(1.7±0.6) vs (2.2±0.7), P＜0.05], UCLA [(29.1±0.8) vs (28.3±1.5), P＜0.05] andConstant-Murley score [(93.7±2.1) vs (91.4±3.9), P＜0.05]. Regarding blood test, the levels of serum IL-6 and TNF-a in both groups weresignificantly decreased after surgery (P＜0.05). The HOM group was significantly lower than the PO group in terms of IL-6 [(1.5±0.8) pg/mlvs (2.2±0.3) pg/ml, P=0.040] and TNF-alpha [(2.0±0.9) pg/ml vs (2.6± 0.9) pg/ml, P=0.026] 12 weeks postoperatively. [Conclusion] Inhala-tion of hydrogen and oxygen mixture does relieve pain and improve function after arthroscopic repair of rotator cuff tear.

Abstract:[Objective] To compare the clinical efficacy of Ganz approach versus Kocher-Langenbeck (K-L) approach for open reduc-tion and internal fixation (ORIF) of Pipkin type I and II femoral head fractures. [Methods] A retrospective study was conducted on 24 pa-tients who receive ORIF of femoral head fractures in our hospital from April 2017 to February 2022. According to the results of doctor-pa-tient communication, 12 patients had ORIF performed through the Ganz approach, while the other 12 patients were through K-L approach.The clinical and imaging documents of the two groups were compared. [Results] All patients in both groups were successfully operated on.The Ganz group proved significantly superior to the K-L group in terms of operative time [(94.6±15.1) min vs (109.2±14.6) min, P=0.025]and intraoperative blood loss [(254.2±78.2) ml vs (316.7±65.1) ml, P=0.045], despite of insignificant differences in incision length and inci-sion healing grade between the two groups (P＞0.05). As time went during follow-up period lasted for (17.1±8.4) months in a mean, the visu-al analogue scale (VAS) for pain and Harris score of the two groups were significantly increased (P＜0.05). The Ganz group was significantlybetter than the K-L group regarding Harris score one month after surgery [(44.1±2.5) vs (40.2±3.0), P=0.002], regardless of the fact thatthere were no significant differences in VAS score, and Harris score at other corresponding time points between the two groups (P＞0.05).Radiographically, there was no significant difference in fracture reduction quality between the two groups (P＞0.05). At the last follow-up,there were no significant differences in Brooker grade, Ficat stage and Tonnis grade between the two groups (P＞0.05). [Conclusion] TheGanz approach has the advantages of shortening operation time, reducing intraoperative bleeding, and improving recovery of hip function af-ter operation over the K-L approach for femoral head fractures.

Abstract:[Objective] To compare the early clinical consequences of percutaneous endoscopic interlaminar discectomy (PEID) versusunilateral biportal endoscopy (UBE) for lumbar disc herniation. [Methods] A retrospective study was done on 60 patients who underwentendoscopic discectomy for lumbar disc herniation from June 2016 to December 2022. According to the technology developed in different pe-riods, 30 patients underwent PEID and 30 patients underwent UBE. The perioperative and follow-up results were compared between thetwo groups. Clinical outcomes were assessed by the visual analogue scale (VAS), Oswestry disability index (ODI) score, and modifiedMacnab criteria at different follow-up times. [Results] All patients were successfully operated, with no complications of severe nerve injuryduring the operation. The PEID group proved significantly superior to UBE group in terms of operation time [(42.4±14.2) min vs (118.5±23.8) min, P＜0.001], incision length [(1.1±0.2) cm vs (2.4±0.3) cm, P＜0.001], intraoperative blood loss [(16.2±11.0) ml vs (39.8± 6.5) ml, P＜0.001], intraoperative fluoroscopy times [(3.8±0.9) times vs (7.2±2.0) times, P＜0.001], postoperative walking time [(1.2±0.3) days vs (2.3±0.6) days, P＜0.001] and hospital stay [(4.8±0.3) days vs (6.2±2.1) days, P=0.016]. In addition, the PEID was also significantly superior tothe UBE group in VAS score for pain 3 days after surgery [(1.8±0.8) vs (2.4±1.1), P=0.021]. The VAS scores for lower back and leg pain, aswell as ODI score significantly decreased in both groups over time (P＜0.05), whereas which were not significant between the two groups at 1month, 6 months postoperatively and the latest follow-up (P＞0.05). According to the modified Macnab's criteria, the excellent and good rateof clinical outcome was 90.0% in the PEID group, whereas 86.6% in the UBE group, which was not statistically significant between the twogroups (P＞0.05). [Conclusion] The PEID takes an advantage of less surgical trauma, while the UBE has a benefit of wider field of view to fa-cilitate fine operation under the endoscope.

Abstract:[Objective] To investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) on the early response after to-tal knee arthroplasty (TKA). [Methods] From May 2022 to June 2023, a total of 91 patients who were undergoing TKA for knee osteoarthri-tis were divided into two groups according to the random number table method. Of them, 46 cases in the TEAS group received TEAS treat-ment on the basis of conventional treatment, while other 45 patients in the routine group received the conventional treatment only. The clini-cal and blood test indexes of the two groups were compared. [Results] There were no significant differences in operation time, total bloodloss and incidence of adverse events between the two groups (P＞0.05). The TEAS group proved significantly superior to the routine group interm of dynamic pain VAS score at 7 days [(4.5±1.4) vs (5.1±1.3), P=0.018] and 14 days [(2.4±1.1) vs (3.9±1.5), P＜0.001], static pain VASscore at 7 days [(2.0±1.1) vs (2.6±1.5), P=0.043] and 14 days after surgery [(1.0±0.9) vs (1.4±1.1), P=0.033]. The TEAS group was also sig-nificantly better than the routine group regarding suprapatellar 10 cm circumference [(45.3±2.9) cm vs (48.1±4.3) cm, P=0.038] and theknee ROM [(122.3±9.3)° vs (115.6±7.4)°, P＜0.001] 14 days postoperatively. With respect of blood test, the TEAS group was also significant-ly superior to the routine group in Fib [(3.8±0.9) s vs (4.3±1.0) s, P=0.027], D-D [(7.1±15.8) mg/L vs (14.7±23.1) mg/L, P=0.048] and PT[(11.5±0.6) s vs (11.2±0.6) s, P=0.026] 7 days postoperatively. [Conclusion] TEAS might effectively reduce the early reaction after TKAand promote postoperative recovery.

Abstract:[Objective] To investigate the capacity of different bacteria-culture samplings in debridement to determine the pathogenicbacteria of foot chronic osteomyelitis. [Methods] Clinical data of 105 patients with chronic osteomyelitis of the foot from October 2017 toFebruary 2022 were retrospectively analyzed. A total of 105 bacterial cultures were sent for examination, including 29 (1 set), 36 (3 sets) and40 (5 sets). The number of bacteria detected and the ability to detect pathogenic bacteria were compared. [Results] Bacteria were detected in82 of 105 patients with chronic osteomyelitis, among which Staphylococcus aureus accounted for 34.2% of the total detected bacteria, fol-lowed by Staphylococcus epidermidis accounted for 12.2%. In the 105 samples, the detection rate of each set of bacteria was 65.5% (1 set),75.0% (3 sets), and 90.5% (5 sets). The capacity to identify pathogenic bacteria was 85.0% (5 sets), 55.6% (3 sets), which were statisticallysignificant between 1 set and 5 sets, as well as 3 sets and 5 sets (P＜0.05), whereas not significant between 1 set and 3 sets (P＞0.05). [Con-clusion] In the detection of pathogenic bacteria, the ability of sending 5 sets of specimens for intraoperative detection is the strongest, whilesending 1 set of specimens for intraoperative detection is the worst. Therefore, when determining pathogenic bacteria, it is recommended totake multi-site samples during debridement and send at least 5 sets of bacterial samples for examination.