WEIYong-cun , XIE Yan-chun , WANG Hong-wei , XUAN An-wu , GU Hong-wen , YU Hai-long
2024, 32(1):5-10. DOI: 10.3977/j.issn.1005-8478.2024.01.01
Abstract:[Objective] To explore the clinical outcomes of posterior lumbar interbody fusion (PLIF) with bone cement augmented pedi-cle screw by graduated or non-graduated pushrods for osteoporotic lumbar degenerative diseases. [Methods] A retrospective study was per-formed on 42 patients who underwent PLIF with bone cement augmented pedicle screw for osteoporotic lumbar degenerative diseases fromOctober 2021 to October 2022. According to doctor-patient communication, 22 patients had the graduated pushrod used for bone cementaugmentation of the pedicle screws, while the other 20 patients had the ungraduated rod used. The perioperative, follow-up and imaging dataof the two groups were compared. [Results] The graduated group proved significantly superior to the ungraduated group in terms of operationtime [(142.7±53.4) min vs (164.3±58.6) min, P<0.05], intraoperative fluoroscopy times [(10.2±2.3) times vs (15.3±1.8) times, P<0.05], intra-operative blood loss [(246.6±123.8) ml vs (324.1±113.8) ml, P<0.05], despite of insignificant differences in total incision length, incisionhealing grade, walking time and hospital stay between the two groups (P>0.05). In addition, the graduated group got significantly lower bonecement leakage rate than the ungraduated group (4.5% vs 11.3%, P<0.05). The follow-up period lasted for (13.9±3.2) months in a mean, andthere was no significant difference in time to resume full weight-bearing activities between the two groups (P>0.05). The VASs and ODIscores decreased significantly over time in both groups (P<0.05), which were not statistically significant between the two groups at any timepoints accordingly (P>0.05). Regarding imaging, the lumbar lordosis (LL) significantly improved in both groups 3 months after surgery and atthe last follow-up compared with those preoperatively (P<0.05). However, there were no significant differences in terms of LL angle andBridwell fusion grade between the two groups at any time points accordingly (P>0.05). [Conclusion] In the case of lumbar interbody fusionfor osteoporotic lumbar degenerative diseases, the bone cement augmented pedicle screw with the graduated pushrod does reduce the num-ber of fluoroscopy, shorten the operation time and reduce the risk of leakage of bone cement.
DONG Wei , WANG Xiao-ming , GU Yuan-lin , YAN Jun-yao , LI Xin-wei
2024, 32(1):11-17. DOI: 10.3977/j.issn.1005-8478.2024.01.02
Abstract:[Objective] To investigate clinical efficacy of high tibial osteotomy (HTO) combined with arthroscopic debridement (AD)and platelet-rich plasma (PRP) intraarticular injection for medial knee osteoarthritis (mKOA). [Methods] A retrospective study was conduct-ed on 33 patients who received HTO for mKOA in our hospital from November 2015 to July 2019. According to doctor-patient communica-tion, 17 patients received HTO+AD+PRP treatment (combination group), and the other 16 patients received HTO treatment only. The periop-erative, follow-up and imaging data of the two groups were compared. [Results] All patients in both groups were operated on smoothly, with-out significant differences in operation time, total incision length, intraoperative blood loss, incision healing grade, ambulation time and hos-pital stay between the two groups (P>0.05). All patients were followed up for more than 30 months, and the combined group resumed fullweight-bearing activities significantly earlier than the HTO group [(58.1±4.6) days vs (66.1±4.0) days, P<0.05]. The VAS and WOMACscores decreased significantly (P<0.05), while Lysholm and HSS scores significantly increased over time in both groups (P<0.05). Althoughthere was no significant differences in abovesaid scores between the two groups before operation (P>0.05), the combined group proved signifi-cantly superior to the HTO group in terms of VAS [(2.4±0.5) vs (2.8 ±0.5), P<0.05], WOMAC [(18.4± 2.0) vs (23.7±2.5), P<0.05], HSS [(80.8±3.0) vs (73.3±2.5), P<0.05] and Lysholm score [(79.1±3.6) vs (71.4±2.8), P<0.05] at the latest follow-up. Regarding imaging, the medial prox-imal tibial angle (MPTA) and femorotibial angle (FTA) significantly improved (P<0.05), whereas the K-L classification remained unchangedin both groups at 6 months and 1 year after surgery compared with those preoperatively (P>0.05). However, there were no statistically signifi-cant differences in the above imaging items between the two groups at any time points accordingly (P>0.05). [Conclusion] HTO combinedwith arthroscopic debridement and PRP does significantly improve knee joint function, relieve pain and improve patient satisfaction, andachieves clinical efficacy better than that of HTO only.
2024, 32(1):18-23. DOI: 10.3977/j.issn.1005-8478.2024.01.03
Abstract:[Objective] To evaluate the clinical value of artificial intelligence hip (AIHIP) system used in preoperative planning for totalhip arthroplasty (THA). [Methods] A total of 112 patients who were undergoing unilateral primary THA from March 2020 to January 2022were selected. According to preoperative doctor-patient communication, AIHIP system was used in 74 cases (intelligent group) and 2D tem-plate measurement was used in 38 cases (conventional group) for preoperative planning. The documents of perioperative period, follow-upand imaging were compared between the two groups. [Results] The intelligent group proved significantly superior to the conventional groupin terms of operative time [(78.4±29.6) min vs (89.1±34.3) min, P<0.05], accordance rate of acetabular component (98.6% vs 78.9%, P<0.05)and accordance rate of femoral component (100.0% vs 84.2%, P<0.05), despite of insignificant differences in incision length, intraoperativeblood loss, incision healing grade, ambulation time, and hospital stay between the two groups (P>0.05). All patients were followed up formore than 12 months, and the intelligent group resumed full weight-bearing activities significantly earlier than the conventional group[(21.8±4.8) days vs (23.0±5.2) days, P<0.05]. The Harris hip score, flexion-extension ROM and VAS scores significantly improved in bothgroups over time (P<0.05). The intelligent group was significantly better than the conventional group in terms of Harris scores, extensionROM and VAS scores 1 and 6 months after operation (P<0.05), but there was no statistically significant difference in abovementioned itemsbetween the two groups 12 months after surgery (P>0.05). Radiographically, there were no statistically significant differences between thetwo groups in terms of acetabular abduction and anteversion, as well as leg length discrepancy (LLD), femoral stem size and its placement (P>0.05). However, the intelligent group was significantly superior to the conventional group in deviation values of longitudinal hip center of rota-tion [(1.0±0.0) mm vs (2.0±0.0) mm, P<0.05] and transverse hip center of rotation [(2.0±0.0) mm vs (3.0±0.0) mm, P<0.05] postoperatively.[Conclusion] The AIHIP system has high accuracy in preoperative planning for THA, which can effectively help to reconstruct hip rotation center, shorten operation time and restore hip function in early stage.
HU Yong-sheng , ZHANG Xiao-xuan , SONG Xing-hua , TIAN Hui-zhong , ZHENG Jun-tao , XIE Jiang
2024, 32(1):24-30. DOI: 10.3977/j.issn.1005-8478.2024.01.04
Abstract:[Objective] To compare the clinical outcomes of anterior versus posterior approach debridement and instrumented fusionsfor thoracolumbar tuberculosis. [Methods] A retrospective study was performed on 103 patients who received surgical treatment for thoraco-lumbar tuberculosis in our hospital from January 2015 to October 2020. According to doctor-patient communication, 39 patients underwentanterior-approach surgery (the anterior group), while the remaining 64 cases underwent posterior-approach surgery (the posterior group).The perioperative, follow-up and imaging data of the two groups were compared. [Results] All patients in both groups had corresponding sur-gical procedures performed successfully, the anterior group proved significantly greater than the posterior group in terms of operation time[(136.7±19.2) min vs (108.7±15.6) min, P<0.05], the total incision length [(23.0±3.8) cm vs (14.6±3.5) cm, P<0.05], intraoperative blood loss[(558.7±42.7) ml vs (408.8±35.8) ml, P<0.05], regardless of the fact thar the former had significantly less intraoperative fluoroscopy timesthan the latter [(3.5±1.5) times vs (6.7±2.1) times, P<0.05]. In addition, the incidence of early complications in the anterior group was signifi-cantly higher than that in the posterior group (15.4% vs 6.3%, P<0.05). The follow-up period lasted for a mean of (29.6±10.4) months , andthere was no significant difference in clinical healing time between the two groups (P>0.05). The VAS, ODI and JOA scores were significant-ly improved in 2 groups (P<0.05), while ASIA grade for neurological function remained unchanged over time in both groups (P>0.05), whichwere not statistically significant between the two groups at any time points accordingly (P>0.05). With respect of imaging, the spinal canal ar-ea, local kyphotic Cobb angle and lesion state were significantly improved in both groups at the last follow-up compared with those preopera-tively (P<0.05), whereas all which were not statistically significant between the two groups at any time points accordingly (P>0.05). [Conclu-sion] Both anterior and posterior debridement and instrumented fusions are effective options for the treatment of thoracolumbar tuberculosis,by comparison, the posterior surgery has certain advantages of less trauma over the anterior counterpart.
XU Tao , WANG Shuang , LIU Hong-jun , ZHANG Wen-zhong , YUAN Chao-qun , WU Wen-jie , GU Jia-xiang
2024, 32(1):31-37. DOI: 10.3977/j.issn.1005-8478.2024.01.05
Abstract:[Objective] To compare the clinical efficacy of ulnar oblique shortening osteotomy versus the osteotomy combined with wristarthroscopic debridement and repair in the treatment of ulnar impaction syndrome. [Methods] A retrospective study was performed on 40 pa-tients who received surgical treatment for ulnar impaction syndrome in our hospital from June 2014 to June 2021. Based on doctor-patientcommunication, 20 patients underwent simple oblique-shortening osteotomy of ulna (shortening group), while the remaining 20 patients un-derwent oblique-shortening osteotomy of ulna combined with wrist arthroscopy (combination group). The perioperative, follow-up and imag-ing data were compared between the two groups. [Results] All patients in both groups had operation performed successfully. The shorteninggroup proved significant better than the combination group regarding operation time [(61.3±17.4) min vs (119.5±29.4) min, P<0.05], incisionlength [(6.2±1.6) cm vs (8.4±2.1) cm, P<0.05] and blood loss [(48.3±9.3) ml vs (61.3±10.2) ml, P<0.05], whereas no significant differences inintraoperative fluoroscopy times, length of stay, incision healing time and active activity time between the two groups (P>0.05). The followupperiod lasted for 12 to 30 months, and there was no significant difference in the time to resume full weight-bearing activities between thetwo groups (P>0.05). the VAS score, modified Mayo score, carpal palmar flexion-dorsalis extension, ulnar-radial deviation, and pronationsupinationrange of motion (ROM) significantly improved in both groups over time (P<0.05). The combination group was significantly betterthan the shortening group in terms of VAS [6 months postoperatively (1.9±0.9) vs (2.7±1.3), P<0.05; the last follow-up (1.5±1.1) vs (2.5±1.2),P<0.05], Mayo score [6 months postoperatively (86.2±10.3) vs (78.3±9.5), P<0.05; the last follow-up (87.5±7.0) vs (80.5±10.4), P<0.05].However, there was no significant differences in ROMs between the two groups at any time points accordingly (P>0.05). Radiographically, ul-nar variation length and lateral radioulnar space were significantly improved in both groups immediately after surgery (P<0.05), whereas which were not significantly different between the two groups at any corresponding time points (P>0.05). [Conclusion] Compared with thesimple oblique-shortening osteotomy of ulna, the osteotomy combined with wrist arthroscopic surgery does better relieve the pain and re-store the wrist function.
ZHANG Si-ping , MA Peng-cheng , ZHANG Wen-hao , LIU Wei , HUANG Yi-fei
2024, 32(1):38-43. DOI: 10.3977/j.issn.1005-8478.2024.01.06
Abstract:[Objective] To determine whether posterior stabilized (PS) prosthesis can obtain better clinical efficacy, kinematic functionand knee stability than ultracongruent (UC) prosthesis in primary total knee arthroplasty (TKA). [Methods] The databases, includingPubMed, EMBASE, Cochrane Library, Wanfang, CNKI, and China Biology Medicine Disc database, were searched for relevant studies onthe comparison of PS and UC prosthesis in primary TKA from the establishment of the database to December 2021. Two reviewers indepen-dently screened literature and extracted data. The quality of the studies was evaluated according to the Newcastle-Ottawa Scale (NOS) andthe Cochrane risk of bias assessment tool. Review Manager 5.4 was used for a meta-analysis. [Results] A total of 22 studies were included inthis meta-analysis, including 11 randomized controlled trials, 9 retrospective studies, and 2 prospective studies, with a total of 2 904 kneesinvolved. The results of meta-analysis showed that the UC group were less than PS group the in terms of femoral rollback (WMD=-5.20, 95%CI -5.85~-4.54, P<0.001) and the maximal flexion (WMD=-2.27, 95%CI -3.75~-0.79, P=0.003), whereas the UC group was significantlygreater than the PS group in term of the tibial sagittal laxity (WMD=5.10, 95%CI 3.45~6.76, P<0.001). There were no significant differencesin function score (SMD=-0.08, 95% CI- 0.30~0.13, P=0.43), pain score (WMD=1.88, 95% CI-2.32~6.08, P=0.38), ROM (WMD=-0.82,95%CI -2.38~0.75, P=0.31), flexion contracture (SMD=-0.05, 95%CI -0.25~0.14, P=0.59), and peak torque (WMD=0.26, 95%CI -2.91~3.43, P=0.87) between the two groups. [Conclusion] In the primary TKA, the PS prosthesis has better kinematics and knee stability, and isstill the best choice of posterior cruciate ligament replacement prosthesis.
ZHANG Cang-xu , DU Wen-hao , ZHANG Dahai , XIE Shi-cheng
2024, 32(1):44-49. DOI: 10.3977/j.issn.1005-8478.2024.01.07
Abstract:Periprosthetic joint infection (PJI) is a catastrophic complication after arthroplasty. Once it happens, it will bring great psy-chological and economic burden to patients, so timely and correct diagnosis is crucial. At present, the commonly used diagnostic methods areformulated according to clinical manifestations, imaging manifestations, serum and synovial biomarkers, etc. With the discovery and experi-ment of more serum and synovial biomarkers, the examination of biochemical indicators become increasingly important, regardless of somesynovial biomarkers easily affected by inflammation. In recent years, leukocyte esterase has been paid more and more attention, which hashigh sensitivity and specificity for diagnosis of PJI, despite of that other clinical evaluations and auxiliary examinations should be combinedin the diagnosis. Effectiveness of leukocyte esterase for diagnosis of PJI need further research. This article comprehensively analyzes the cur-rent clinical research on synovial leucocyte esterase, and reviews its research status and clinical value in the diagnosis of PJI.
SUN Jia-hao , ZHU Jia-qing , XIA Tian-wei , SHEN Ji-rong
2024, 32(1):50-55. DOI: 10.3977/j.issn.1005-8478.2024.01.08
Abstract:This paper reports a case of inflammatory pseudotumor (IP) complicated with posterior dislocation of the hip after ceramic onceramic (CoC) total hip arthroplasty (THA). Eight years after CoC THA, the patient had left hip prosthesis dislocated due to squatting, and re-ceived open reduction finally following 7 failed closed reduction. The linear wear of ceramic ball was found after open exposure, and then thehip was reduced successfully after dozens of IP lesions were removed around the acetabular components. Through the analysis of this case,we believe that although the wear rate of CoC prosthesis is low with very low biological activity of the ceramic particles, which rarely causescell reaction and inflammation, they are not completely inert, and may cause adverse local tissue reaction (ALTR) and IP. In addition, by lit-erature review, this paper focuses on the causes, early diagnosis and treatment of IP after CoC THA in order to provide clinical reference.
TIAN Zhi-kang , CHENShang , YANG Tao , MENG Chun-yang
2024, 32(1):56-60. DOI: 10.3977/j.issn.1005-8478.2024.01.09
Abstract:Pain involving neck, shoulder, waist and leg is a common condition that deteriorate quality of life and health, which is usuallyinduced by intervertebral disc degeneration (IVDD), such as cervical and lumbar disc herniation. In recent years, mesenchymal stem cellsand their extracellular vesicles have shown potential role in delaying and treating IVDD, which not only have the capacity to improve differ-entiation of nucleus pulposus cells, but also promote nucleus pulposus cell proliferation, inhibit apoptosis, and inflammatory reactions. How-ever, considering that the microenvironment of degenerative intervertebral discs is not suitable for cell growth, the non-cellular therapy rep-resented by exocrine body is expected to become an alternative to cell therapy. This article summarizes the latest research results of severalcommon mesenchymal stem cells and extracellular vesicles in the treatment of IVDD, in order to better understand the current clinical appli-cation status and prospects of mesenchymal stem cells and extracellular vesicles in this field.
LIN Shun , LIU Jin-tao , JIANG Hong , YU Pengfei
2024, 32(1):61-66. DOI: 10.3977/j.issn.1005-8478.2024.01.10
Abstract:Lumbar disc herniation (LDH) is one of the common orthopedic diseases in the clinic. In recent years, with the developmentof minimally invasive spinal surgery, the transforaminal endoscopic surgery system (TESSYS) is widely used in the treatment of lumbar discherniation due to its small incision, minimizing injury and rapid postoperative recovery. However, some patients have developed postopera-tive residual symptoms in varying degrees after endoscopic treatment, and the specific mechanism of their occurrence is not fully understood,and the choice of the best treatment mode remains controversial. This article reviews the research on postoperative residual symptoms in re-cent years, analyzes the causes and related treatment measures to provide a reference for the clinical management of postoperative residualsymptoms.
WANG Zhen-jun , XU Hong-sheng , JI?AO Shao-feng , ZHANG Hai-tao , LIU Zhi-jie , GUO Yue , CHEN Jian-wen
2024, 32(1):67-70. DOI: 10.3977/j.issn.1005-8478.2024.01.11
Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of proximal tibiofibular osteotomy with exter-nal fixator for medial knee osteoarthritis. [Methods] From April 2018 to December 2021, 10 patients with medial knee osteoarthritis weretreated with the above method. The osteotomy site was determined according to the preoperative full-length X-ray film of both lower limbs.An incision was made about 3cm below the head of the fibula to remove a fibular segment 1 cm in length after drilling and osteotomy throughthe intermuscular space between the peroneus longus, brevis and the gastrocnemius. After that, the tibial osteotomy below the tibial tuberclewas conducted in the same way, and a suitable fixation ring was selected according to the diameter of the patient's lower leg, and an Ilizarov’s external frame was installed. The external frame with rings above and below the osteotomy sites fixed with Kirshner wires and threaded pinswas gradually adjusted beginning 7 days after surgery to correct the deformity. [Results] All patients had operation performed successfullywithout vascular and nerve injury during the operation, with the external fixator to be continued adjust to correct the deformity within 21 daysafter the operation. The patients wore the external fixator for (101.9±9.5) days in a mean, and got the alignment of lower limb force satisfacto-rily corrected. At the latest follow-up lasted for (2.0±0.6) years, the VAS for pain, KSS score, mechanical axis deviation (MAD) of lower ex-tremity, and medial proximal tibial angle (MPTA) significantly improved in the patients (P<0.05). [Conclusion] Proximal tibiofibular osteot-omy with Ilizarov’s external fixator for medial knee osteoarthritis does correct the deformity effectively, and achieves satisfactory clinical con-sequences.
JIN Wen , SUN Liang-ye , GAO Qing , ZHENG Quan , LIU Xiao-feng
2024, 32(1):71-74. DOI: 10.3977/j.issn.1005-8478.2024.01.12
Abstract:[Objective] To investigate the efficacy of local injection of dexamethasone combined with ropivacaine (DR) in the preven-tion of incision-related complications of open reduction and internal fixation (ORIF) of calcaneal fractures. [Methods] A retrospectivestudy was conducted on 136 patients (137 feet) who underwent ORIF for calcaneal fractures in our hospital from January 2019 to October2022. According to doctor-patient communication, 68 patients (68 feet) received intraoperative DR injection around the incision (the DRgroup), while the other 68 patients (69 feet) had no DR injected (the routine group). The perioperative data of the two groups were compared.[Results] Although there were no significant differences in operation time, incision length and intraoperative blood loss between the twogroups (P>0.05), the DR group proved significantly superior to the routine group in terms of incision swelling time [(4.7±1.1) days vs (6.8±2.9) days, P<0.001], exudation time [(3.6±1.6) days vs (6.4±1.2) days, P<0.001], postoperative hospitalization time [(7.3±1.2) days vs (8.5±2.1) days, P<0.001] and postoperative pain VAS score [1 day postoperatively, (5.2±1.2) vs (8.4±1.1), P<0.001; 2 days postoperatively, (4.8±1.3) vs (6.6±1.8), P<0.001; 3 days postoperatively, (3.4±1.8) vs (4.3±1.6), P<0.001]. In addition, the former was significantly better than thelatter in incision healing grade [A/B/C, (66/0/2) vs (58/2/9), P=0.010], howerve, there was no statistically significant difference in postopera-tive stitches removal time between the two groups (P>0.05). [Conclusion] Local injection of dexamethasone combined with ropivacainearound the incision does effectively reduce postoperative pain and incision-related complications in ORIF of calcaneal fracture.
WEN Yong-li?ang , QIN Hai-biao , QIN Hao-ran , CHEN Yong-xi , SONG Quan-sheng , LIANG Jian , YANG Jian , CHEN Li-xian
2024, 32(1):75-79. DOI: 10.3977/j.issn.1005-8478.2024.01.13
Abstract:[Objective] To compare the clinical outcomes of endoscopic versus open bone grafting and pedicle screw fixation for lumbaristhmic spondylolysis in the youth. [Methods] A retrospective study was conducted on 22 patients who received surgical treatment for lum-bar isthmic spondylolysis in our department from June 2017 to January 2021. According to the preoperative doctor-patient communication,12 patients underwent the endoscopic surgery, while other 10 patients underwent the open surgery. The clinical and imaging consequencesof the two groups were compared. [Results] The endoscopic group proved significantly superior to the open group in terms of intraoperativeblood loss [(115.8±13.1) ml vs (195.0±27.2) ml, P<0.05], postoperative ambulation time [(1.3±0.5) days vs (2.3±0.5) days, P<0.05] and hospi-tal stay [(10.1±1.2) days vs (14.1±1.8) days, P<0.05], but the former consumed significantly longer operation time than the latter [(115.1±11.2) min vs (100.6±7.3) min, P<0.05]. With time of the follow-up period lasted for (14.8±2.2) months on a mean, the VAS score and ODI sig-nificantly decreased in both groups (P<0.05), which was not statistically significant between the two groups before surgery (P>0.05), whilethose in the endoscopic group were significantly better than the open group 1 and 3 months after surgery (P<0.05), and then became not sta-tistically significant again between the two groups at the latest follow-up (P>0.05). Radiographically, the isthmic healing rate increased sig-nificantly over time in both groups (P<0.05), with no significant differences in isthmic healing quality and isthmic healing time between thetwo groups at any time points accordingly (P>0.05). By the time of last follow-up, all patients achieved isthmic bone healing. [Conclusion]The posterior endoscopic isthmic bone grafting and pedicle screw fixation is considerably better than the traditional open counterpart for lum-bar isthmic spondylolysis.
XIAO Shou- yun , SHEN Si- yuan , LIANG Feng , TIAN Ji-wei , ZHANG Yun-peng , DING Hui-min
2024, 32(1):80-83. DOI: 10.3977/j.issn.1005-8478.2024.01.14
Abstract:[Objective] To analyze the clinical outcome of total hip arthroplasty (THA) through direct anterior approach (DAA) for femo-ral neck fractures, and to explore its learning curve. [Methods] A retrospective analysis was performed on 58 patients who received DAATHAfor femoral neck fracture in our hospital from January 2020 to December 2021. The learning curve was analyzed by cumulative sum(CUSUM) analysis, and the clinical data of patients at different learning stages were compared. [Results] According to CUSUM learningcurve, the initial stage was sequence of 1~22 cases, the growth stage was sequence 23~32 cases, and the maturity stage was sequence 33~58cases. With the accumulation of operation cases, operation time [(165.1±16.5) min, (139.8±7.2) min, (120.4±8.2) min, P<0.001], intraopera-tive blood loss [(187.6±16.4) ml, (147.3±19.0) ml, (118.9±11.4) ml, P<0.001] and hospital stay [(8.6±1.7) days, (6.5±0.9) days, (5.0±0.7)days, P<0.001] were significantly reduced, the complications were significantly decreased (P<0.05), and the imaging significant prostheticposition was significantly improved (P<0.05). Harris scores in the mature stage were significantly better than those in the initial stage andgrowth stage 1 and 3 months after surgery (P<0.05), but there was no significant difference in Harris scores among the three groups 6 monthsafter surgery (P>0.05). [Conclusion] DAA-THA has the advantages of less intraoperative injury and faster recovery, but it has a long learn-ing curve, requiring 23~32 cases to reach technical maturity.
2024, 32(1):84-86. DOI: 10.3977/j.issn.1005-8478.2024.01.15
Abstract:[Objective] To investigate the effect of body temperature control on intraoperative blood loss in lumbar surgery. [Methods]A total of 80 patients undergoing posterior lumbar interbody fusion (PLIF) were divided into two groups by random number table method. Ofthem, 40 patients in the routine group (RG) received conventional intraoperative body temperature management, while other 40 patients inthe temperature control group (TCG) underwent intraoperative dynamic temperature control. Perioperative core body temperature and intra-operative blood loss were observed and recorded. [Results] All patients in both groups were operated successfully without serious complica-tions. All patients in the TCG maintained normal body temperature during operation, instead, 24/40 (60%) patients in the RG experiencedhypothermia during operation. The RG got significantly greater intraoperative blood loss than the TCG [(355.3±86.4) ml vs (230.3±49.2) ml,P<0.001]. As result of Pearson correlation, the core body temperature was significantly negatively correlated to intraoperative blood loss 1hour intraoperatively (r= -0.837, P<0.001) and after anesthesia resuscitation (r=-0.839, P<0.001). [Conclusion] Body temperature controlcan avoid the occurrence of intraoperative hypothermia in lumbar surgery, reduce the amount of intraoperative blood loss, and reduce theneed for blood transfusion.
LIU Wei , LU Zhi-kai , DUAN Tian-dong , WANG Ling- hai , XU Xuan- ming
2024, 32(1):87-90. DOI: 10.3977/j.issn.1005-8478.2024.01.16
Abstract:[Objective] To investigate the relationship between preoperative activity and postoperative lower extremity function after to-tal hip arthroplasty. [Methods] A total of 66 patients who underwent total hip replacement were selected as the study objects. The activitylevel of the week before surgery was assessed according to the international physical activity questionnaire. Forty-four patients with activitylevel ≥1 000 kcal were classified as the activity group, and the other 22 patients with activity level <1 000 kcal were classified as the low ac-tivity group. The preoperative and postoperative data of the two groups were compared. [Results] The activity group demonstrated significant-ly higher levels of physical activity one week prior to surgery [(3 513.0±2 840.0) kcal vs (429.0±312.0) kcal, P<0.001], shorter time to walk10 meters preoperatively [(7.7±2.4) s vs (10.4±8.3) s, P=0.049], lower VAS scores at 2 months postoperatively [(1.6±0.8) vs (2.2±1.1), P=0.014], greater hip abduction strength at 2 months postoperatively [(82.1±29.5)% vs (67.1±25.9)%, P=0.047], higher Harris scores preopera-tively [(54.7±10.2) vs (47.8±10.3), P=0.012], and higher Harris scores at 2 months postoperatively [(75.0±7.3) vs (65.7±8.1), P<0.001] com-pared to the less active group. There were no significant differences between the two groups in terms of age, gender, disease duration, BMI,10-meter walk time at 2 months postoperatively, preoperative VAS pain score, preoperative abduction strength, preoperative and postopera-tive 2-months hip flexion-extension range of motion (ROM), and hip internal-external rotation ROM (P>0.05). In terms of correlation analy-sis, the activity level 1 week before surgery was significantly negatively correlated with the 10 m walking time before surgery (r=-0.223, P=0.032), but had no correlation with the 10 m walking time after surgery (P>0.05); not correlated with the preoperative VAS scores (P>0.05),but there was a significant negative correlation with postoperative VAS score (r=-0.291, P=0.021). The activity level 1 week before surgerywas not correlation with preoperative hip abduction muscle strength (P>0.05), but was significantly positively correlated with postoperativehip abductor muscle strength (r=0.337, P=0.012); nor correlated with the preoperative and postoperative hip extension ROM and the inter-nal-external rotation ROM (P>0.05), but significantly positively correlated with Harris scores before surgery (r=0.293, P=0.019) and 2months after surgery (r= 0.389, P=0.003). [Conclusion] Preoperative activity of THA patients is correlated with Harris hip function, VASscore and abductor muscle strength. High preoperative activity is conducive to postoperative recovery.
2024, 32(1):91-93. DOI: 10.3977/j.issn.1005-8478.2024.01.17
Abstract: