Abstract:Recently, the traditional classification of adult acquired flatfoot deformity (AAFD) based on posterior tibial tendon dysfunc-tion (PTTD) has been questioned. The expert consensus published in 2020 proposed a new classification and recommended that the progres-sive collapsing foot deformity (PCFD) be used instead of the previous PTTD. The new classification system classifies PCFD based on flexibili-ty, location and type of deformity, which can more comprehensively elucidate the status of such deformity. This paper will interpret the newclassification consensus.

Abstract:[Objective] To investigate the clinical diagnostic value of lumbar bone marrow fat fraction (FF) measured by MRI IDEALIQsequence for osteoporosis (OP), and to search the correlation between FF and bone mineral density, or bone metabolism markers. [Meth-ods] From January 2022 to February 2023, 91 inpatients or outpatients of the Orthopedic Department of our hospital were enrolled in thisstudy. Dual-energy X-ray bone mineral density (BMD) examination, lumbar routine MRI sequence and IDEAL-IQ sequence scanning, andblood bone metabolism markers detection were performed. The patients were divided into three groups according to the T value measured byBMD, 15 patients fall in the normal group, 33 patients were in osteomalacia group and 43 patients were in the OP group. The detection re-sults among the three groups were compared, the correlation between FF and related parameters was analyzed, and the efficiency of theabove detections in diagnosing OP was analyzed by ROC. [Results] The BMD [(1.1±0.1) g/cm² vs (0.9±0.1) g/cm² vs (0.7±0.1) g/cm², P＜0.001], FF [(82.9±10.2)% vs (75.0±6.8)% vs (75.8±9.2)%, P＜0.05], β-CTX [(345.7±113.0) ng/ml vs (547.7±236.7) ng/ml vs (617.5±165.3)ng/ml, P＜0.05] were significantly different among the normal group, osteomalacia group and OP group, despite insignificant difference inP1NP among the three groups (P＞0.05). In term of correlation analysis, the FF value was significantly negatively correlated with BMD (r=-0.396, P＜0.05), whereas significantly positively correlated with β-CTX (r=0.238, P＜0.05), and had no significant correlation with P1NP (r=0.081, P＞0.05). In term of ROC analysis, the area under cure (AUC) was ranked up-down as FF (0.786) ＞ β-CTX (0.652) ＞ P1NP (0.622) ＞BMD (0.033). When the diagnostic threshold of FF was of 78.0%, its specificity was of 67.8% and sensitivity of 86.0%. [Conclusion] TheFF value of MRI IDEAL-IQ sequence is significantly negatively correlated with BMD, while significantly positively correlated with β-CTX,can provide valuable information for the clinical diagnosis of osteoporosis.

Abstract:[Objective] To investigate the clinical efficacy and safety of arthroscopic debridement and microfracture combined withplatelet-rich plasma (PRP) for post-traumatic osteoarthritis (PTOA) of the ankle. [Methods] A retrospective study was done on 41 patientswho received surgical treatment for PTOA from February 2019 to February 2021. According to doctor-patient communication, 23 patients re-ceived PRP injection intraarticularly following the arthroscopic procedure, while the remaining 18 patients had hyaluronic acid (HA) inject-ed intraarticularly after surgery. The document regarding perioperative period, follow-up and auxiliary examination were compared betweenthe two groups. [Results] There were no significant differences in operation time, intraoperative blood loss, total incision length, incisionhealing grade, deep venous thrombosis of lower limbs and hospital stay between the two groups (P＞0.05). All patients in both groups were fol-lowed up for more than 12 months, without a significant difference in the time to resume full weight-bearing activity between the two groups(P＞0.05). The VAS and AOFAS scores improved significantly (P＜0.05), while the ankle dorsal-plantar flexion range of motion (ROM) re-mained unchanged over time in both groups (P＞0.05). At 12 months after surgery, the PRP group proved significantly superior to the HAgroup in terms of VAS score [(1.3±0.6) vs (2.7±1.1), P＜0.05] and AOFAS score [(80.9±6.5) vs (71.0±5.6), P＜0.05]. Regarding laboratory test-ing, the Hs-CRP, IL-6 and TNF-α significantly decreased in both groups over time (P＜0.05). The PRP group was significantly better thanthe HA group in terms of Hs-CRP [(3.1±0.3) mg/L vs (6.7± 0.1) mg/L, P＜0.05], IL-6 [(3.0±0.3) ng/L vs (4.0±0.3) ng/L, P＜0.05] and TNF-α[(4.2±0.6) ng/L vs (5.2±0.6) ng/L, P＜0.05] 12 months postoperatively. Radiographically, there were no significant changes in TT and mLDTAin both groups 6 and 12 months postoperatively compared with those preoperatively (P＞0.05). However, the Kellgren-Lawrence (K-L) classi-fication for osteoarthritis in the PRP group significantly improved 12 months after surgery (P＜0.05), which in the HA group remained not sig-nificantly changed (P＞0.05). At 12 months after surgery, the PRP group proved significantly superior to the HA group in K-L stage [I/II/IIIa/IIIb/IV, (0/16/6/1/0) vs (0/7/7/4/0), P＜0.05]. [Conclusion] Arthroscopic debridement and microfracture combined with PRP does signifi-cantly improve the clinical efficacy for post-traumatic osteoarthritis of the ankle with high safety.

Abstract:[Objective] To investigate the clinical efficacy of proximal femoral osteotomy combined with Steel pelvic osteotomy in thetreatment of severe Legg-Calvé-Perthes disease (LCPD). [Methods] A retrospective study was conducted on 38 patients who received surgi-cal treatments for severe LCPD in our hospitals from January 2013 to June 2021. According to doctor-patient communication, 17 patientswere treated with simple proximal femoral varus osteotomy (the femoral group), while the other 21 patients were treated with proximal femoralvarus osteotomy combined with Steel pelvic osteotomy (the combined group). The perioperative period, follow-up and imaging data of the twogroups were compared. [Results] The femoral group proved significantly less than the combined group in terms of operation time, incisionlength, intraoperative blood loss, postoperative drainage volume and hospital stay (P＜0.05). All patients in both groups were followed up for(33.0±9.6) months in a mean, and the femoral group resumed ambulation [(73.5±3.5) days vs (79.9±5.1) days, P＜0.05] and the full weightbearingactivity [(108.9±6.8) days vs (119.4±8.6) days, P＜0.05] significantly earlier than the combined group. Compared with those preopera-tively, the Harris score, hip flexion-extension range of motion (ROM) and internal-external rotation ROM significantly increased in bothgroups at the latest follow-up (P＜0.05), which proved not statistically significant between the two groups at any time points accordingly (P＞0.05). Radiographically, the acetabular index (AI), lateral center edge angle (LCEA), femoral head extrusion index (FHEI) and Sharp anglesignificantly improved at the last follow-up compared with those before surgery in both groups (P＜0.05). Although there was no statistical sig-nificance in the above radiographic parameters between the two groups before surgery (P＞0.05), the combined group was significantly superi-or to the femoral group in terms of AI [(11.3±2.0)° vs (16.7±1.7)°, P＜0.05], LCEA [(33.4±2.1)° vs (25.2±2.8)°, P＜0.05], FHEI [(12.2±3.3)%vs (17.8±3.0)%, P＜0.05], Sharp angle [(27.9±4.4)° vs (35.4±3.1)°, P＜0.05], whereas there was no statistical significance in Stulberg classifi-cation between the two groups (P＞0.05). [Conclusion] Compared with the femoral osteotomy alone, the femoral varus osteotomy combined with Steel pelvic osteotomy does achieve better femoral head containment that facilitate the recovery of femoral head, despite of greater surgi-cal trauma.

Abstract:[Objective] To compare the clinical efficacy of arthroscopic versus open reduction and internal fixation of lateral humeruscondylar fracture in children. [Methods] A retrospective study was conduced on 101 children who received surgical treatment for lateral hu-meral condylar fracture in Qingdao Women and Children's Hospital from December 2019 to December 2021. According to doctor-patientcommunication, 70 children received arthroscopic reduction and internal fixation (ARIF), while the other 31 children received open reduc-tion and internal fixation (ORIF). The perioperative, follow-up and imaging data of the two groups were compared. [Results] All patients inboth group had corresponding surgical operations performed successfully. The ARIF group proved significantly superior to the ORIF groupin terms of operation time [(45.6±8.6) min vs (53.7±10.6) min, P＜0.001], total length of incision, [(1.5±0.3) cm vs (4.7±0.6) cm, P＜0.001]and hospital stay [(5.1±0.8) days vs (6.8±1.0) days, P＜0.001], whereas the former consumed significantly greater number of intraoperativefluoroscopy than the latter [(12.0±2.0) times vs (10.5±2.5) times, P=0.002], and there was no statistically significant difference in incisionhealing grade between the two groups (P＞0.05). All patients in both groups were followed up for more than 12 months, and the ARIF grouphad K-wire removed significantly earlier than the ORIF group [(67.3±8.2) days vs (80.5±12.5) days, P＜0.001]. Compared with those 3months after K-wire removed, MEPS remained unchanged (P＞0.05), while VAS scores significantly decreased in both groups at the latestfollow up (P＜0.05), but there were no statistically significant differences in the above scores between the two groups at any correspondingtime points (P＞0.05). In addition, the ARIF group was significantly better than the ORIF in forearm pronation-supination ROM 3 months af-ter K-wire removed [(173.6±10.0)° vs (166.6±10.1)°, P=0.002]. Regarding imaging, the ARIF group got significant better quality of fracturereduction than the ORIF group (P＜0.05). At the last follow-up the Baumann angle (BA) increased significantly in both groups (P＜0.05),while the carrying angle (CA) and anterior angulation of distal humerus (ADH) were not significantly changed in both groups (P＞0.05).[Conclusion] Arthroscopic reduction and internal fixation have advantages of less incision and less serious complications, and could be a

Abstract:[Objective] To compare the clinical outcomes of unicompartmental knee arthroplasty (UKA) versus high tibial osteotomy(HTO) for spontaneous osteonecrosis of the knee (SONK). [Methods] A retrospective study was conducted on 39 patients who received surgi-cal treatment for SONK treated from January 2015 to October 2021. According to preoperative doctor-patient communication, 22 patients re-ceived UKA, while the other 17 patients received HTO. The perioperative, follow-up and imaging data were compared between the twogroups. [Results] The UKA group proved significantly superior to the HTO group in terms of operating time [(53.0±6.3) min vs (60.5±8.0)min, P＜0.05] and postoperative walking time [(3.5±0.9) days vs (5.7±0.7) days, P＜0.05], despite of the fact that the former had significantlylonger total incision length than the latter [(9.2±1.1) cm vs (6.7±0.9) cm, P＜0.05]. However, there were no significant differences in intraoper-ative blood loss, incision healing grade and hospital stay between the two groups (P＞0.05). All patients in both groups were followed up for(24.7±10.0) months on an average, and the UKA group returned to full weight-bearing activity significantly earlier than HTO group [(7.1±2.0) days vs (34.5±3.6) days, P＜0.05]. The VAS, WOMAC and KSS scores were significantly improved in both groups over time (P＜0.05),whereas the knee range of motion (ROM) was not significantly changed (P＞0.05). Although there were no statistically significant differencesin the above indexes between the two groups before surgery (P＞0.05), the UKA group was significantly better than the HTO group in terms ofVAS score, WOMAC score and KSS scores at all time points postoperatively accordingly (P＜0.05), while without statistically significant dif-ferences in knee ROM between the two groups (P＞0.05). Radiographically, the UKA group had significantly better femorotibial angle (FTA)than the HTO group immediate postoperatively [(182.0±1.9)° vs (173.8±2.1)°, P＜0.05] and at the last follow-up [(182.0±1.7)° vs (173.0±2.0)°, P＜0.05]. In addition, the UKA group proved significantly superior to the HTO group at the latest follow-up in terms of the lateral com-partment Kellgren and Lawrence (K-L) classification [0/I/II/III/IV, (17/4/1/0/0) vs (6/7/4/0/0), P＜0.05] and patellofemoral K-L classification [0/I/II/III/IV, (15/5/2/0/0) vs (4/8/4/1/0), P＜0.05]. [Conclusion] Both UKA and HTO do achieve good clinical outcomes for treatment of SONK. By comparison, the UKA has considerably better early clinical consequence than the HTO.

Abstract:Hypophosphatemic rickets is a kind of rare genetic diseases which manifests abnormal bone mineralization caused by hypo-phosphatemia due to renal phosphorus loss. Multiple gene mutations may lead to hypophosphatemic rickets. However, patients from the samefamily may have different clinical presentation and severity, which need we have to make individualized diagnosis and treatment. Limb defor-mities seriously affects the quality of life in the patients with hypophosphatemic rickets, which might be needed surgical treatment appropri-ately by orthopedists. Drug treatment is the cornerstone of the treatment of hypophosphatemic rickets, however, even if the most ideal drugscheme and medical management were accepted, limb deformities progress in some children or adults. For this scenario, surgical interven-tion will be the ultimate method to solve the problem. Drug therapy is essential before and after orthopedic surgery for hypophosphatemicrickets. Drug combines with careful surgical planning and rigorous surgical techniques can correct the complex deformity in patients with hy-pophosphatemic rickets successfully.

Abstract:Calcified thoracic disc herniation is a rare disease in clinical practice, and its clinical manifestations are usually asymptomat-ic or painful in the early stage. However, as conservative treatment failed, or spinal cord and nerve dysfunction occurred, surgical interven-tion must be conducted. There are many approaches for surgical treatment, including transthoracic approach, posterior approach, posterolat-eral approach, etc. The application of minimally invasive endoscopic techniques in clinical practice has also gradually increased andachieved good clinical outcomes. For different positions and sizes of calcified intervertebral discs, the approach is very important, and thesurgeon should formulate appropriate treatment strategies according to the perfect imaging examination, select the appropriate approach, im-prove the surgical outcomes and reduce the incidence of postoperative complications. This article reviews the surgical approach for calcifiedthoracic disc herniation, and provides reference for the selection of surgical approach for calcified thoracic disc herniation.

Abstract:Unicompartmental knee arthroplasty (UKA) is an important option in the staged treatment of osteoarthritis of the knee, withthe advantages of small incisions, minimal trauma, less bleeding, shorter operative time and shorter hospital stay. However, due to the uniquenature of UKA in preserving the healthy side of the tissue, post-operative periprosthetic joint infection (PJI) should be managed more careful-ly and as early as possible to avoid the destruction of the healthy side of the bone by inflammatory factors, accelerating the process of osteoar-thritis. Gram-negative and conditionally pathogenic infections are rare and poorly detected after UKA. Metagenomic next-generation se-quencing (mNGS) is an effective tool to identify the pathogenic organisms of infection and can guide the clinical use of targeted drugs. In thispaper, we report a case of acute infection with stenotrophomonas maltophilia after UKA with a literature review to provide a reference for cli-nicians.

Abstract:Skeletal muscle injury (SMI), as the most common event in human sports training, seriously affects the quality of life of pa-tients and brings a huge burden to the social medical security system. Microwave hyperthermia is widely used in a variety of clinical andsports rehabilitation environments, and has obvious therapeutic effect on skeletal muscle injury, but the therapeutic mechanism of micro-wave hyperthermia on skeletal injury has not been fully understood. Current studies have shown that microwave hyperthermia plays role inthe expression of heat shock proteins in skeletal muscle, involving the molecular mechanism of skeletal muscle growth and development andoxidative stress after skeletal muscle injury, despite lack of quantitative standard about microwave hyperthermia effect. This article reviewsthe protein, cellular and molecular mechanisms of microwave treatment for skeletal muscle injury, in order to provide a theoretical basis forclinicians to better implement microwave hyperthermia.

Abstract:[Objective] To investigate the effect of mTOR protein on tendon repair ability of tendon stem cells in aged rats. [Methods]Young and old rat tendon stem cells were cultured in vitro, and mTOR expression was regulated by adenovirus transfection, and mTOR andrelated proteins were detected by Western blot. Aged rat patellar tendon injury models were made, and divided into mTOR expression,mTOR interference, green fluorescent protein (GFP) and blank groups. The repaired tendon tissues of the rats were harvested at 2 and 4weeks for histological, tissue immunochemical and biomechanical assays. [Results] In vitro test, the western blot results showed that theaged rats presented significantly higher level of mTOR [(1.8±0.1) vs (0.9±0.1), P＜0.05], Raptor [(4.1±0.3) vs (2.2±0.3), P＜0.05] and P-Rap-tor [(1.8±0.1) vs (0.9±0.1), P＜0.05] than the young group, despite of insignificant differences in Akt, p-Akt, S6k and P-S6K between the twogroups (P＞0.05). The expression sequence of mTOR, Raptor and P-Raptor after transfection of TSCs in aged rats ranked from high to low:mTOR expression group ＞ GFP Group ＞mTOR interference group (P＜0.05). In vivo test, HE tissue scores significantly increased in all the 4groups 4 weeks after surgery group compared with those 2 weeks after surgery (P＜0.05), which ranked from high to low as the mTOR interfer-ence group ＞GFP Group ＞mTOR expression group ＞ blank control group at time points accordingly with statistically significant differences(P＜0.05). Compared with those 2 weeks after surgery, the Col1 and SCX expressions remained unchanged at 4 weeks after surgery (P＞0.05),which ranked among the 4 groups from high to low as the mTOR interference group ＞GFP Group ＞Blank group ＞mTOR expression group,with statistical significance (P＜0.05). Compared with those 2 weeks after surgery, the maximum failure strength in biomechanical test signifi-cantly increased in 4 weeks after surgery (P＜0.05), which ranked up-down as mTOR interference group ＞GFP Group ＞ blank group ＞mTORexpression group with statistical significances at time points accordingly (P＜0.05). [Conclusion] Inhibition of mTOR protein does enhancethe repair capacity of tendon stem cells in aged rats in this study.

Abstract:[Objective] To introduce the surgical techniques and preliminary clinical results of staged external fixation and percutane-ous plate fixation for open double shaft fractures of the forearm. [Methods] A total of 12 patients were treated with staged external fixationand percutaneous plate internal fixation for open forearm double shaft fractures. In the first stage an external fixator was applied to maintainfixation and forearm alignment, while in the second stage, two minimally invasive percutaneous "windows" were made on each end of the ul-nar fracture and the radial fracture along the long axis of bone, separating the muscle and tendon to the periosteum. The periosteum stripperwas used to separate extra-periosteum to make a "tunnel" and the plates were inserted from the distal "window" to the proximal "window"respectively. After further reduction under fluoroscopy, drilling and screw placement were carried out. Early postoperative rehabilitation offorearm rotation function was performed. [Results] All the 12 patients had two stages of surgical procedures performed successfully withoutserious complications with an average interval between the first and second stages of (21.1±6.1) days. All patients were followed up for 12 to26 months. The radius got healing in (4.3±1.1) months, while the ulna was of (4.0±1.4) months on a mean. According to the Grace-Evers-mann criteria, the clinical outcomes at the latest follow-up were marked as excellent in 9 cases, good in 2 cases, and fair in 1 case, with ex-cellent and good rate of 91.7%. [Conclusion] Using the initial external fixator to assist indirect reduction, the percutaneous plate fixation issafe and reliable, and does achieve satisfactory clinical efficacy for double shaft fractures of the forearm.

Abstract:[Objective] To present the surgical technique and preliminary clinical results of percutaneous drug-loaded calcium sulfateand pedicle screw fixation for lumbar brucellosis. [Methods] A total of 19 patients received abovementioned surgical treatment for lumbarbrulellosis from July 2017 to July 2021. After percutaneous pedicle screws were placed on the contralateral side, a MAST Quadrant channelsystem was installed on the affected side to expose the facet and the infected intervertebral space. The lesion was completely debrided, andthen the drug-loaded calcium sulfate particles were prepared and implanted through the channel into the affected intervertebral space,which finally covered with a gelatin sponge immersed with rifomycin. The pedicle screws were placed on the same side, and the screw-rodsystem was adjusted and fasten. After the operation, rehabilitation function exercise was conducted under protection with a brace. [Results]All the 19 patients were successfully operated on without serious complications, and followed up for (18.3±8.7) months in a mean. At the lat-est follow-up, all the patients got bony fusion of the affected space without infection recurrence and implant failure, associated with signifi-cant decrease of ESR, CRP and VAS score (P＜0.05), whereas significant improvement in term of ASIA neurological function grade. [Con-clusion] On the basis of standardized antimicrobial therapy, percutaneous drug-loaded calcium sulfate and pedicle screw fixation are mini-mally invasive treatment, with continuous and slow release of antimicrobial drugs, which is conducive to infection control and has definiteclinical efficacy for lumbar brucella spondylitis.

Abstract:[Objective] To evaluate the early clinical results of percutaneous cannulated screw and bone cement osteoplasty for periace-tabular metastases. [Methods] A retrospective study was performed on 36 patients who received surgical treatment for periacetabular metas-tases in our hospital from May 2020 to June 2022. According to doctor-patient communication, 16 patients were treated with percutaneousscrew combined with bone cement osteoplasty (the combined group), while the remaining 20 patients were treated with simple percutaneousbone cement osteoplasty (the simple group). Clinical and imaging data were compared between the two groups. [Results] Although the com-bined group was significantly greater than the simple group in terms of operation time [(70.4±7.4) min vs (39.8±7.2) min, P＜0.05], fluorosco-py times [(23.1±5.7) times vs (13.3±5.1) times, P＜0.05], there was no significant difference in terms of the amount of bone cement injectedand postoperative ambulation time (P＞0.05). With time of the follow-up lasted for (10.4±2.5) months on a mean, the VAS, Harris and SF-36scores significantly improved in both groups (P＜0.05), which was not statistically significant between the two groups before surgery (P＞0.05).However, the combined group was significantly superior to the simple group in terms of VAS score 1 week postoperatively [(2.4± 0.6) vs (3.3 ±1.2), P＜0.05], 3 months postoperatively [(2.1±1.2) vs (3.2±1.6), P＜0.05], despite of the fact that there was no significant difference in Harrisscore and SF-36 score between the two groups (P＞0.05). Regarding imaging, the pathological fracture and lesion size remained unchangedin both groups postoperatively compared with those the preoperatively (P＞0.05), which were not of significant differences between the twogroups at any time points accordingly (P＞0.05). [Conclusion] Percutaneous hollow screw combined with bone cement in the treatment ofperiacetabular metastases can effectively relieve pain, improve hip function and improve patients' quality of life.

Abstract:[Objective] To explore the significance of computer aided design (CAD)/rapid prototyping (RP) personalized guide in percu-taneous transforaminal endoscopic discectomy (PTED) for lumbar disc herniation (LDH). [Methods] From October 2021 to September 2022,a total of 80 patients who were undergoing PTED in our hospital were randomly divided into two groups. Of them, 40 patients received person-alized guide aided PTED, while other 40 patients received conventional PTED. The clinical and imaging data of the two groups were com-pared. [Results] The guide group proved significantly superior to the conventional group in terms of operation time [(53.3±8.8) min vs (74.8±13.4) min, P＜0.05], intraoperative fluoroscopy times [(2.9±0.7) times vs (8.3±2.6) times, P＜0.05], puncture times [(1.9±0.7) times vs (4.5±1.3) times, P＜0.05], postoperative ambulation time [(1.4±0.2) days vs (2.6±0.5) days, P＜0.05]. The VAS and RMDQ scores significantly re-duced in both groups over time (P＜0.05). Although there were not statistically significant difference in above 2 scores between the two groupsbefore surgery (P＞0.05), the guide group was marked significantly lower than the conventional group 1 week postoperatively in terms of VASscore [(1.0±0.3) vs (1.9±0.5), P＜0.05] and RMDQ [(2.2±0.8) vs (4.0±1.5), P＜0.05], despite of the fact that the difference became not statisti-cally significant between the two groups 1 month after surgery (P＞0.05). Regarding imaging, the canal occupancy rate significantly decreasedin both groups postoperatively compared with that preoperatively in both groups (P＜0.05), whereas which was not significantly different be-tween the two groups at any time points accordingly. [Conclusion] The CAD/RP made personalized guide does improve the success rate ofpuncture, and has considerable advantages in short-term postoperative pain relief and lumbar function improvement.

Abstract:[Objective] To evaluate the early-stage consequences of kinesio taping and resistance-balance training after arthroscopicanterior talofibular ligament (ATFL) repair. [Methods] From January 2020 to December 2021, 47 patients with ATFL injury were includedin this study, and underwent endoscopic ATFL enhanced repair. They were randomly divided into two groups, 24 patients in the trial groupwere given kinesio taping and resistance-balance training after surgery, while other 23 patients in the traditional group were given routine re-habilitation training. The early clinical data of the two groups were compared. [Results] All patients in both groups were successfully operat-ed on without serious complications. Over time of follow-up lasted for (11.6±1.2) weeks on a mean, the VAS, AOFAS and CAIT scores, aswell as single leg calf raise and peroneal muscle strength significantly improved in both groups (P＜0.05). At 10 weeks postoperatively, the tri-al group proved significantly superior to the traditional group in terms of VAS [(2.9±1.5) vs (4.1±2.1), P＜0.05], CAIT [(24.0±1.4) vs (22.1±1.4), P＜0.05], the single leg heel raise [(5.5±0.7) cm vs (4.5±0.6) cm, P＜0.05], AOFAS [(76.8±1.9) vs (75.2±1.8), P＜0.05] and peronealstrength [2/3/4/5, (0/1/10/13) vs (0/4/14/4), P＜0.05]. [Conclusion] The kinesio taping and resistance-balance training after arthroscopic an-terior talofibular ligament (ATFL) repair do relieve pain, increase muscle strength around ankle, improve ankle stability and function.

Abstract:[Objective] To observe the outcomes of denosumab as neoadjuvant therapy in the surgical treatment of refractory giant celltumor of bone. [Methods] A retrospective study was conducted on 12 patients who received treatment for refractory giant cell tumor of bonein our department from September 2020 to September 2022. Denosumab injection was injected subcutaneously once a week for 4 weeks be-fore surgery, followed by surgical treatment, and clinical and imaging results were observed. [Results] All patients were successfully operat-ed, with no nerve, vascular injury and other serious complications. After treatment, the tumor tissue became fibrotic and toughened to grayishwhite with clear boundaries, and histological staining showed a small number of osteoclast-like multinucleated giant cells in the local area.Compared to those before medication, the VAS score [(4.5±0.6), (2.1±0.8), (0.8±0.6), (0.3±0.4), P＜0.001] decreased significantly, whereasthe SF-36 score [(50.8 ±3.3), (53.6±4.2), (65.4±5.0), (81.7±3.7), P＜0.001] increased significantly 3 months after operation, and at the timeof the last follow-up. In terms of imaging, compared with those before medication, the maximum CT diameter of the lesion significantly de-creased [(65.3±15.1) mm, (52.3±14.0) mm, P＜0.001], whereas the lesion edge CT value [(98.2±30.5) HU, (276.1±79.1) HU, P＜0.001] andthe focal CT value [(38.4±10.4) HU, (97.1±20.0) HU, P＜0.001] significantly increased after denosumab therapy. [Conclusion] Denosumabcan be used as a neoadjuvant therapy to achieve surgical degradation, promote the complete curettage of tumor lesions, and preserve the nor-mal bone structure to the maximum extent to meet the postoperative functional rehabilitation.

Abstract:[Objective] To investigate the relationship between bone mineral density and cognitive impairment in type II diabetes melli-tus. [Methods] From July 2020 to September 2021, 45 patients with type II diabetes mellitus (T2DM) were enrolled in this study. Blood glu-cose, glycated hemoglobin A1c (HbA1c), serum osteocalcin (OC) and bone mineral density (BMD) were detected, while the Montreal Cogni-tive Assessment (MoCA) was used to evaluate the cognitive level of the patients. [Results] According to the results of BMD, 16 cases were os-teoporosis, 17 cases were bone mass reduction, and 12 cases were normal bone mass. The incidence of cognitive impairment was 15/16(93.8%) in the osteoporosis group, whereas 13/17 (76.5%) in the bone mass reduction group, and 3/12 (25.0%) in the normal bone massgroup. The patients were divided into two groups according to whether they had cognitive impairment. There were no significant differencesin age, gender composition, weight, height, BMI, HbA1c and years of education between the two groups (P＜0.05), the cognitive impairmentgroup had significantly lower MoCA score, OC and BMD than the normal cognition group (P＜0.05). [Conclusion] The incidence of cogni-tive impairment is significantly increased with the decrease of BMD in T2DM.