Abstract:[Objective] To explore the factors related to anterior femoral cortical notching in total knee arthroplasty (TKA) with anterior referencing (AR) system. [Methods] A retrospective study was conducted on 86 consecutive patients (105 knees) who underwent TKA with AR for primary knee osteoarthritis in our hospital from October 2015 to December 2020. The patients were divided into notching group (the NT) and non-notching group (the NNT) according to whether anterior femoral cortical notching was seen on postoperative lateral X-ray of the knee. Univariate comparison and multivariate logistic regression analysis were performed to analyze the factors related to the anterior femoral cortical notching. [Results] Among 105 knees, 28 knees had anterior femoral cortical notching, accounting for 26.7%, while the re- maining 77 knee had non-notching of the femoral anterior cortex, accounting for 73.3%. Of the NT group, 13 knees (12.4%) were of grade I, 10 knees (9.5%) of grade II, 5 knees (4.8%) of grade III, and no grade IV according to Tayside classification. In term of univariate compari- son, there were no significant differences in age, BMI, gender, side, anterior condylar thickness, lateral distal femoral angle (LDFA) , mechan- ical axis deviation (MAD) , anterior cortical flexion angle, intercondylar fossa shape, anterior condylar osteophyte, opening point position, dis- tal femoral osteotomy, posterior condylar osteotomy, and condylar line identification between the two groups (P＞0.05) . However, the NT group had significantly greater posterior condylar thickness measured on the preoperative radiographs (P＜0.05) , in addition, the significant- ly higher ratio of smaller femoral component used intraoperatively than NNT group (P＜0.05) . In term of multivariate logistic regression analy- sis, the larger posterior condyle thickness measured on preoperative image (OR=1.124; P＜0.05) was a risk factor for anterior femoral cortical notching, whereas the larger femoral component selected during operation (OR=0.375; P＜0.05) was a protective factor for anterior femoral cortical notching. [Conclusion] In anterior referencing TKA, larger preoperative posterior condyle thickness is a risk factor for anterior corti- cal notching, while larger femoral prosthesis used intraoperatively is a protective factor for anterior cortical notching.

Abstract:[Objective] To compare the clinical outcomes of a novel hemispherical titanium augment (HTA) versus traditional orange slice-shaped tantalum augment (OSTA) for acetabular reconstruction in revision total hip arthroplasty (RTHA) . [Methods] A retrospective study was done on 67 patients (67 hips) who received RTHA for previous prosthetic loosening complicated with acetabular bone defect in our department from January 2018 to June 2019. According to the doctor-patient communication, 35 patients had HTA used, while the re- maining 32 patients had OSTA used to reconstruct the acetabulum. The perioperative, follow-up and imaging documents were compared between the two groups. [Results] All patients in both groups had RHTA performed smoothly without injures to nerve and vascular vessel, as well as other serious complications. The HAS group proved significantly superior to the OSTA group in terms of operation time and in- traoperative blood loss (P＜0.05) , although there were no significant differences in the total length of incisions, postoperative walking time and hospital stay between the two groups (P＞0.05) . All the patients were followed up for more than 2 years without a significant difference in the time to resume full weight-bearing activity between the two groups (P＞0.05) . The Harris score, hip extension-flexion ROM and VAS scores significantly improved over time in both groups (P＜0.05) , which were not significantly different between the two groups at any corresponding time points (P＞0.05) . Radiographically, there were no significant differences between the two groups in acetabular inclina- tion and anteversion postoperatively (P＜0.05) . Compared with those preoperatively, postoperative leg length discrepancy (LLD) and hip center of rotation (HCOR) displacement transversely and longitudinally significantly decreased postoperatively in both groups (P＜0.05) , which were not significant different between the two groups at any corresponding time points (P＞0.05) . [Conclusion] Although the clini- cal and imaging consequences are similar between the HTA and OSTA, the former is quick and convenient in term of operation manipula- tion over the latter.

Abstract:[Objective] To compare the clinical outcomes of unilateral versus bilateral channel endoscopic decompression in minimally invasive transforaminal interbody fusion (MIS-TLIF) for lumbar spinal stenosis (LSS) . [Methods] A retrospective study was conducted on a total of 90 patients who received MIS-TLIF for LSS in our department from January 2018 to June 2021. According to preoperative doctorpatient communication, 47 patients underwent bilateral decompression through an unilateral channel, with the remained 43 cases received bilateral decompression through bilateral channels. The perioperative conditions, follow-up and imaging data of the two groups were com- pared. [Results] All patients in both groups were operated on successfully with no serious intraoperative complications. The incidence of early complications was of 10.64% in unilateral group, while 11.63% in bilateral group, which was not statistically significant (P=0.881) . The unilateral group proved significantly superior to the bilateral group in terms of operative time, intraoperative blood loss, intraoperative fluoroscopy times and postoperative walking time (P＜0.05) , although there was no significant difference in total incision length, incision healing grade and hospital stay between the two groups (P＞0.05) . All patients in both groups were followed up for more than 12 months, and there was no statistical significance in the time to resume full weight-bearing activities between the two groups (P＞0.05) . The VAS and ODI scores decreased significantly (P＜0.05) , while JOA score increased significantly over time in both groups (P＜0.05) . There were no sig- nificant differences in VAS, ODI and JOA scores between the two groups before surgery (P＞0.05) , however, the unilateral group proved sig- nificantly superior to the bilateral group in abovementioned clinical scores at discharge, 6 months and 12 months after surgery (P＜0.05) . Regarding imaging, the height of the intervertebral space, the minimum spinal canal area, and the lumbar lordosis angle significantly im- proved in both groups immediately after surgery and at the last follow-up compared with preoperative results (P＜0.05) , whereas no statisti-cal significance was found in the above indexes between the two groups at any corresponding time points (P＞0.05) . There was no statistical- ly significant difference in the Bridled fusion grade between two groups at any corresponding time points (P＞0.05) . At the last follow-up, all patients in both groups had no adverse imaging manifestations such as screw loosening, fracture, and interbody fusion cage displace- ment. [Conclusion] Both unilateral and bilateral channel decompression in MIS-TLIF do effectively treat LSS. By comparison, unilateral channel decompression achieve better clinical results than bilateral channel, with less intraoperative trauma, earlier postoperative ambula- tion, and faster recovery.

Abstract:[Objective] To search the morphological characteristics of lumbar pedicle in Tibetan adults by comparison of the morphologi- cal differences of lumbar pedicle between Tibetan and Han ethnic groups and between male and female to provide reliable anatomical data for lumbar pedicle screws fixation in Tibetan patients. [Methods] A total of 200 persons, including 100 Tibetan and 100 Han with 50 male and 50 female in each ethnic group were randomly selected based on the inclusion criteria. The pedicle width, axis length, sagittal diameter, cross-sectional angle and sagittal angle from L₁ to L₅ vertebrae were measured by CT examination, and compared between ethnic groups and gender groups. [Results] The lumbar pedicle width and cross-sectional angle increased from L₁ to L₅ in the 200 subjects (P＜0.05) , while the sagittal diameter of the pedicle decreased gradually from L₁ to L₅ (P＜0.05) , the axis length of lumbar pedicle was of the maximal value at L₃ levels (P＜0.05) , the lumbar pedicle sagittal angle was generally decreased up-down (P＜0.05) . The data in terms of some lumbar pedicle di- ameters were significantly different between Tibetan and Han ethnic groups, in addition, the male was significantly greater in terms of the width, axis length and sagittal diameter of lumbar than the female (P＜0.05) . [Conclusion] There are differences in the measurement of lum- bar pedicle morphology among different races and genders. Therefore, ethnic and gender differences should be considered in the selection of screw placement angle and screw type during lumbar pedicle internal fixation. In other words, it may be necessary to perform CT and other examinations on the involved vertebrae before operation.

Abstract:[Objective] To develop a conceptual model for lumbar disc herniation patient reported outcome, and to explore the structure of patient reported outcome scale preliminary, in order to provide the basis for scale compilation. [Methods] A conceptual model, initial di- mension and item pool were developed by literature review, expert consultation and patient interviews. A total of 200 patients with lumbar disc herniation in a general hospital were investigated and the items of initial questionnaire were screened by using classical test theory. Scale structure was explored using exploratory factor analysis and parallel analysis. [Results] A conceptual model for lumbar disc herniation patient reported outcome was constructed which consists of 4 first-level indicators and 9 second-level indicators. Six common factors were extracted according to the exploratory factor analysis and parallel analysis. The variance contribution rates were 13.4% , 12.5% , 11.0% , 9.9%, 7.7% and 4.5%, respectively, reflecting the social adaptation, psychological emotion, functional limitation, therapeutic effect, standing and walking, and somatic symptoms of patients. [Conclusion] The 6 common factors extracted were all covered in the constructed conceptu- al model, which could explain the impact of lumbar disc herniation on patients. The lumbar disc herniation patient reported outcome scale should be complied in 6 dimensions , including social adaptation, psychological emotion, functional limitation, therapeutic effect, standing and walking, and somatic symptoms of patients.

Abstract:[Objective] To compare clinical outcomes of endoscopic posterior lumbar interbody fusion (Endo-PLIF) versus traditional open posterior lumbar interbody fusion (PLIF) for lumbar degenerative diseases [Methods] From January 2020 to June 2021, a total of 40 pa- tients received PLIF for lumbar degenerative diseases in our department. According to the results of preoperative doctor-patient communica- tion, 20 patients received Endo-PLIF, while the other 20 patients received traditional open PLIF. The document regarding perioperative peri- od, follow-up and images were compared between the two groups. [Results] All patients in both groups had corresponding PLIF performed smoothly without serious complications. Although the Endo group consumed significantly longer operation time and more intraoperative fluo- roscopy times than the open group (P＜0.05) , the former proved significantly superior to the latter in terms of intraoperative blood loss, post- operative walking time and hospital stay (P＜0.05) . However, there were no significant differences in the total incision length and incision healing grade between the two groups (P＞0.05) . All patients in both groups were followed up for more than 12 months, and the Endo group re- gained full weight-bearing activity significantly earlier than the open group (P＜0.05) . The VAS score for lower back pain and ODI score de- creased significantly (P＜0.05) , while the JOA scores increased significantly over time in both groups (P＜0.05) . At discharge, 6 months after surgery and at the last follow-up the Endo group was significantly better than the open group in abovesaid scores (P＜0.05) . Radiographical- ly, intervertebral height and lumbar lordosis significantly increased 6 months after surgery and at the latest follow-up in both groups com- pared with those before surgery (P＜0.05) , whereas which were not significantly different between the two groups at any corresponding time points (P＞0.05) . In addition, there was no significant difference in Bridwell fusion grades between the two groups at the corresponding time points (P＞0.05) . [Conclusion] he Endo-PLIF is effective treatment for lumbar degenerative diseases, with advantages of less trauma, less in- traoperative bleeding and faster postoperative recovery over the traditional open PLIF

Abstract:[Objective] To evaluate the clinical outcomes of 3D printing assisted osteotomy and instrumented correction of kyphosis sec- ondary to ankylosing spondylitis (AS) . [Methods] A retrospective study was done on 47 patients who received surgical correction of kyphosis secondary to AS kyphosis in our hospital from December 2015 to December 2020. According to the results of doctor-patient communication, 19 patients underwent 3D print- assisted surgery (3D group) , and 28 patients underwent conventional freehand surgery (conventional group) . The documents regarding to perioperative period, follow-up and radiographs were compared between the two groups. [Results] All patients in both groups had operation finished successfully without death, paraplegia and other serious complications. The 3D group proved significantly superior to the conventional group in terms of operation time, total incision length, intraoperative blood loss, intraoperative fluo- roscopy times, amount of allogenic blood transfusion, postoperative hemoglobin (Hb) at 2 days, and hospital stay (P＜0.05) , nevertheless there was no significant difference in incision healing grade between the two groups (P＞0.05) . All of them in both groups were followed up for (27.7±3.3) months, and the 3D group returned to full weight-bearing activity significantly earlier than the conventional group (P＜0.05) . The ADL, VAS, ODI and JOA scores improved significantly over time in both groups (P＜0.05) , which in the 3D group were significantly better than those in the conventional group at 3 months and the latest follow- up (P＜0.05) . Regarding imaging, the accuracy of pedicle screw placement in the 3D group was significantly better than that in the conventional group (P＜0.05) . The Cobb angles of the main curva- ture and balance deviations in both sagittal and coronal planes significantly improved at 3 months and the last follow-up in both groups com- pared with those preoperatively (P＜0.05) , which in the 3D group were significantly better than those in the conventional group at 3 months and the latest follow-up (P＜0.05) . [Conclusion] The 3D printing assisted osteotomy and instrumented correction of kyphosis secondary to ankylosing spondylitis do significantly improve the accuracy of screw placement, shorten operation time, reduce surgical trauma and improve clinical outcome.

Abstract:[Objective] To explore the efficacy and feasibility of the unilateral biportal endoscopic (UBE) decompression for thoracic os- sification of ligament flavum (TOLF) . [Methods] A retrospective study was performed on 29 patients who receiced surgical decompression for TOLF in our hospital from January 2018 to May 2021. Bases on preoperative doctor-patient communication, 12 patients underwent UBE, while the rmaining 17 patients were treated with the traditional open laminectomy. The documents regarding perioperative period, follow-up and radiographs were compared between the two groups. [Results] All patients in both groups had corresponding surgical procedures per- formed successfully without serious complications. The UBE group proved significantly superior to the open group in terms of total incision length, postoperative walking time and hospital stay (P＜0.05) , regardless of that the former took significantly more intraoperative fluoroscopy than the latter (P＜0.05) . However, there were no significant differences in terms of operation time and incision healing grade. All patinets in both group were followed up for (14.0±1.3) months on a mean, and the patients in the UBE group resumed full weight-bearing activity signifi- cantly earlier than those in the open group (P＜0.05) . The ODI and JOA scores, as well as pyramidal tract sign significantly improved over time in both groups (P＜0.05) , whereas which were not statistically significant between the two groups at any matching time points (P＞0.05) . Radiographically, the thoracic kyphosis angle, the spinal canal area and the sagittal diameter of the spinal canal were significantly increased in both groups after operation (P＜0.05) . Althogh no significant differences in aforesaid imaging data were found between the two groups pre- operatively (P＞0.05) , the UBE group had significantly less thoracic kyphosis angle and posterior bone loss than the open group postopera- tively (P＜0.05) , regardless of no significant differences in spinal canal area and canal sagittal diameter between them postoperatively (P＞ 0.05) . [Conclusion] Both UBE and open decompression are effective treatments for TOLF. By comparison, the UBE takes benefits of reduc- ing iatrogentic trauma with minimal bone structure and stability affected, facilitating postoperative recovery, declining the postoperative tho- racic kyphosis.

Abstract:Parvimonas micra (P. micra.) is a kind of Gram-positive anaerobic bacteria, widely existing in the skin, oral mucosa, gastroin- testinal tract and urogenital system. Although P. micra was common cause in odontogenic infections, there has not been a report about inter- vertebral space infection caused by P. micra in domestic literature, whereas which usually induced by Staphylococcus aureus, followed by streptococcus and enterococcus. We report a case of lumbar intervertebral space infection with epidural abscess caused by P micra con- firmed by next generation sequencing (NGS) and cured after one- stage posterior lumbar debridement combined with instrumented fusion with iliac bone autograft and allograft. Combined with a review of the literature, the epidemiological characteristics, pathogenesis and diagno- sis and treatment experience of lumbar intervertebral space infection caused by P. micra were summarized, in addition, suggestions were put forward for diagnosis and treatment of the disease.

Abstract:The total joint arthroplasty (TJA) is the most successful clinical surgical technique in the 20th century, and keeps increasing in number of cases. However, periprosthetic joint infection (PJI) is one of the most common and devastating complications after TJA, which mainly induced by Gram-positive bacteria, especially Staphylococcus aureus. Vancomycin may cover most of the pathogens causing PJI and plays an increasingly important role in the prevention of PJI with the increasing incidence of PJI caused by MRSA. The local administration of vancomycin to assist in the prevention of PJI is becoming more and more comprehensive with effectiveness and safety confirmed in animal experiments and/or retrospective trials, despite of lacking more robust evidence. Future studies should focus on large multicenter randomized trials to demonstrate effectiveness of vancomycin for PJI prevention further.

Abstract:Vertebral hemangiomas (VHs) are common benign tumors that are mostly asymptomatic. Only 0.9%~1.2% of invasive VHs have neurological symptoms due to compression of the spinal cord, nerve roots, or both due to bony swelling, cortical erosion, extension into the spinal canal, impaired blood flow, and epidural hemorrhage. In addition, VHs can lead to serious complications sometimes, such as patho- logical fractures of the spine. This article reports a case of multiple thoracic hemangiomas involving the spinous process complicated with pathological fractures of the involved segment and the adjacent segment, and summarizes the published literature on VHs involving the spi- nous process.

Abstract:Aseptic loosening (AL) is the main clinical complication of artificial joint replacement. Currently, it is believed that the main mechanism of the AL is related to the wear debris produced by the prosthetic components with the long-term mechanical and biological ef- fects, which regulate the immune environment of the bone-implant interface by inducing the change of the function of macrophages. In addi- tion, wear debris and inflammatory cytokines regulate the process of bone remodeling by stimulating osteoblasts, osteoclasts, and their pre- cursors, ultimately leading to increased bone resorption and the occurrence of AL. In this paper, literature review is conducted to provide ref- erence for clinicians.

Abstract:Palmar fascial contracture, also termed as Dupuytren’s contracture, is a fibrous hyperplastic disease of the palmar fascia char- acterized by progressive flexion deformity of the fingers with unknown etiology. Medication, physical therapy and some other interventions in the early stages may limit further progression of the disease to prevent flexion deformity, whereas without strong objective evidence. The most common treatment in the late stages is surgical excision. In this paper, we report a case of palmar fascial contracture who underwent partial palmar fasciotomy with good results and review the relevant literature.

Abstract:[Objective] To introduce the preoperative design, surgical technique and preliminary clinical outcome of oblique single-cut rotation osteotomy for correction of multiplanar deformity of the femoral shaft. [Methods] A patient received abovementioned surgical treat- ment for malunion of femoral shaft fracture. Preoperative design was conducted to determine the osteotomy angle and rotation angle by com- puter, and then the operation was simulated on Mimics software, and the osteotomy guider was made by 3D printing. A longitudinal incision was made on the lateral side of the femur to expose the malunion part of the femur. The osteotomy guider was placed, and the osteotomy and rotation of the bone ends were completed according to the preoperative design, subsequently, an interlocking intramedullary nail was used to fix the osteotomy in corrected alignment with bone autograft harvesting from the iliac create around the osteotomy site. [Results] The opera- tion was performed smoothly without adverse reaction and complications. After 6 months of follow-up, the patient had no longer limping, and no pain in the knee. The CT images confirmed that the osteotomized site healed completely. [Conclusion] This oblique single-cut rotation osteotomy is feasible to correct the angulations in the coronal and sagittal planes and rotational deformities in transverse plane of the femur si- multaneously, with satisfactory short-term clinical outcome.

Abstract:[Objective] To evaluate the efficacy and surgical safety of transforaminal endoscopic debridement of the lesion of brucellosis spondylitis in the lower lumbar spine (L4/5, L5 S1) . [Methods] A retrospective study was conducted on 16 patients who underwent transforami- nal endoscopic debridement of the lesion of brucellosis spondylitis in the lower lumbar spine from January 2014 to August 2022. Clinical and laboratory data of patients were summarized. [Results] All the patients had operation performed successfully with no complications such as nerve and dural injury, got significantly relief of lumbago and nerve symptoms of lower extremity and well incision healing postoperatively. The body temperature decreased from (38.6±1.2)℃ before surgery to (37.6±0.7)℃ 2 days after surgery and (36.5±0.4)℃ at the last follow-up (P＜0.05); the VAS score for pain significantly decreased [(6.3±1.3), (3.7±1.2), (1.1±0.9), P＜0.05]; the ODI score significantly decreased [(67.4±9.5)%, (36.1±6.1)%, (12.3±4.1)%, P＜0.05] . However, the JOA score significantly increased from (8.9±3.0) to (14.5±3.9) and (25.6± 1.6) (P＜0.05) . In terms of laboratory test, the ESR significantly decreased from (51.9±33.3) mm/h preoperatively to (34.3±16.0) mm/h 2 days postoperatively, and (10.6±4.2) mm/h at the latest follow-up (P＜0.05) . CRP decreased significantly from (46.6±34.0) mg/L to (30.2±18.9) mg/L and postoperative (3.0±1.4) mg/L accordingly (P＜0.05) . [Conclusion] This transforaminal endoscopic debridement of the lesion of brucellosis spondylitis in the lower lumbar spine is less invasive, safer and has satisfactory clinical results.

Abstract:[Objective] To evaluate the clinical efficacy of posterior arthroscopic subtalar arthrodesis for the end- stage arthropathy. [Methods] A retrospective study was conducted on 31 patients who underwent posterior arthroscopic subtalar arthrodesis for severe subtalar arthritis in our hospitals from August 2016 to June 2019. The perioperative, follow-up and imaging data were summarized. [Results] All the patients had operation performed successfully without intraoperative complications, and followed up for (19.1±2.9) months on an average. The VAS scores of 31 patients significantly decreased (P＜0.05) , whereas the AOFAS scores significantly increased over time (P＜0.05) . In terms of imaging examination, 30 patients had normal hindfoot alignment, whereas the remaining one patient got mild varus (＜5°) , which did not impact the joint function. By the time of the latest follow-up, all the 31 patients got solid subtalar fusion with fusion rate of 100%. [Conclusion] This posterior arthroscopic subtalar arthrodesis is effective treatment for end-stage subtalar arthropathy with a high fusion rate.

Abstract:[Objective] To evaluate the clinical outcomes of minimally invasive decompression and interspinous dynamic stabilization for lumbar degenerative diseases. [Methods] A retrospective study was conducted on 42 patients who received microdiscectomy and Intra- SPINE implantation through minimally invasive Quadrant channel under general anesthesia for lumbar degenerative diseases from January 2015 to October 2017. The perioperative, follow-up and radiographic documents were evaluated. [Results] All patients had operation per- formed successfully with operation time of (76.4±16.8) minutes, and blood loss of (59.1±14.5) ml, and were followed up for more than 3 years. The VAS and ODI scores significantly improved at 3 months postoperatively and the latest follow-up compared with those before operation (P＜0.05) . In addition, the excellent and good rate of clinical outcomes were marked as 95.2% based on the MacNab’s criteria at the latest fol- low-up. In terms of radiographic assessment, the intervertebral disc height (DH) and intervertebral foraminal height (FH) significantly in- creased postoperatively compared with those before operation (P＜0.05) . During the follow-up, only 1 case of them developed adjacent seg- ment degeneration, without other complications. [Conclusion] The minimally invasive decompression and interspinous dynamic stabiliza- tion does achieve satisfactory clinical outcomes in the treatment of lumbar degenerative diseases.

Abstract:[Objective] To explore the clinical outcomes of single open-door laminoplasty for ossification of the posterior longitudinal ligament (OPLL) in cervical and upper-thoracic spine. [Methods] From May 2017 to February 2019, a total of 21 patients underwent single open- door laminoplasty for continuous OPLL in cervical and upper- thoracic spine. [Results] All the patients had operation completed smoothly without serious complications, such as cerebrospinal fluid leakage and epidural hematoma. As time went during the follow-up last- ed for 9~24 months, the pyramidal tract sign, JOA, VAS and NDI scores significantly improved (P＜0.05) . One patient developed severe C5 nerve palsy, which was relieved after symptomatic treatment. In terms of imaging, the cervical lordosis angle decreased at 6 months after op- eration and at the latest follow-up compared with that preoperatively, but the difference was not statistically significant (P＞0.05) , while the sagittal diameter of the spinal canal increased significantly (P＜0.05) . During the follow-up period, no reclosing and the shaft fracture were noted in anyone of them. [Conclusion] Single posterior open-door extended laminoplasty does achieve sufficient spinal cord decompression, satisfactory neurological function improvement with low complications and satisfactory clinical efficacy for continuous OPLL in cervical and upper-thoracic spine.

Abstract:[Objective] To investigate the clinical efficacy of staged Ilizarov technique and tendon transfer in the treatment of severe tali- pes equinovarus deformity secondary to poliomyelitis. [Methods] A retrospective study was conducted on 24 patients who received Achilles tendon lengthening combined with Ilizarov technique to correct the deformities in the first stage, followed by transfer of posterior tibialis to maintain muscle balance in the second stage for talipes equinovarus deformity secondary to poliomyelitis in our department from June 2012 to June 2018. [Results] All patients had two-stage surgical procedures and relative interoperative management performed successfully with no serious complications such as nerve and vascular injury during the preoperative period. As time went in the follow-up period lasted for (2.6±0.8) years on an average, the range of motion of ankle dorsi flexion and metatarsal flexion joint significantly improved (P＜0.05) ，the AOFAS ankle-hindfoot score significantly improved (P＜0.05) . In term of radiograph, Morrey-Wiedeman classification of ankle degenera- tion were significantly improved at 8 months after operation and at the last follow-up compared with those before operation (P＜0.05) . [Conclusion] The staged Ilizarov technique and tendon transfer are effective treatment for correction of severe talipes equinovarus deformity sec- ondary to poliomyelitis.