Abstract:[Objective] To explore the clinical efficacy of 3D printing assisted small-incision open reduction and internal fixation (OR- IF) of ankle fractures. [Methods] A retrospective study was performed on 67 patients who had ankle fractures treated surgically from January 2021 to April 2023. According to the preoperative doctor-patient communication, 32 patients received 3D printing assisted small-incision ORIF, while the other 35 patients underwent conventional small-incision ORIF. The perioperative period, follow-up and imaging data of the two groups were compared. [Results] All the 67 patients had ORIF performed successfully. The 3D group proved significantly superior to the conventional group in terms of operation time [(100.6±12.4) min vs (124.5±14.8) min, P＜0.001], intraoperative blood loss [(89.4±10.2) mL vs (115.0±13.0) mL, P＜0.001], intraoperative fluoroscopy times [(12.5±3.7) times vs (14.7±4.3) times, P=0.029], hospital stay [(14.7±2.8) days vs (15.4±2.6) days, P＜0.001] and ambulation time [(17.0±3.2) days vs (19.0±4.0) days, P＜0.001]. In addition, the former resumed full weight-bearing activity significantly earlier than the latter [(115.3±20.4) days vs (129.8±21.7) days, P=0.007]. As time went on, the VAS and AOFAS scores, as well as dorsal-plantar flexion ROM and inversion-eversion ROM in both groups were significantly improved (P＜ 0.05). At 1 month after surgery and the last follow-up, the 3D group was significantly better than the conventional group in terms of VAS score [(4.0±0.) vs (4.8±1.0), P＜0.001; (0.9±0.3) vs (1.1±0.3), P=0.008], AOFAS score [(77.2±7.8) vs (73.4±6.7), P=0.036; (93.0±4.6) vs (90.6±5.0), P=0.046], dorsal-plantar flexion ROM and inversion-eversion ROM (P＜0.05). Regarding imaging, there was no significant difference in the quality of fracture reduction between the two groups (P＞0.05). The tibiocrural angle (TCA), medial clear space (MCS) and tib-iofibular clear space (TFCS) were significantly improved in both groups after surgery compared with those preoperatively (P＜0.05). The 3D group got significantly better TCA, MCS and TFCS than the conventional group immediately postoperatively (P＜0.05), whereas which became not statistically significant between the two groups at the last follow-up (P＞0.05). [Conclusion] 3D printing assisted small-incision open reduction and internal fixation of ankle fracture does improve surgical efficiency and is conducive to ankle functional recovery.

Abstract:[Objective] To compare the clinical consequence of the medial patellofemoral ligament (MPFL) reconstruction with the fiber tape (suture anchor) versus the semitendinous tendon autograft in the treatment of patella dislocation. [Methods] A retrospective study was conducted on 68 patients who received MPFL reconstruction for patellar dislocation from July 2021 to September 2022. According to the doctor-patient communication, 35 patients had MPFL reconstructed with fiber tape (the FT group), while other 33 patients were with semitendinosus tendon autograft (the TG group). The perioperative period, follow-up and imaging data of the two groups were compared. [Results] The FT group proved significantly superior to the TG group in terms of operative time [(63.5±6.0) min vs (88.9±6.6) min, P＜ 0.001], total incision length [(3.7±0.7) cm vs (10.0±1.4) cm, P＜0.001], intraoperative blood loss [(22.9±3.9) mL vs (53.2±13.3) mL, P＜ 0.001], ambulation time [(1.2±0.4) days vs (1.9±0.9) days, P＜0.001] and hospital stay [(2.4±1.0) days vs (4.9±2.1) days, P＜0.001]. All patients in both groups were followed up for a mean of (28.9±3.8) months, the FT group resumed full weight-bearing activity significantly earlier than TG group [(10.8±1.1) weeks vs (12.9±1.5) weeks, P＜0.001]. As time went on, Kujala, Lysholm and Tegner scores and ROM were significantly increased (P＜0.05), while VAS scores were significantly decreased in both groups (P＜0.05). At corresponding time points, there was no statistical significance in the above indexes between the two groups (P＞0.05). Radiographically, patellar congruence angle (PCA), patellar tilt angle (PTA), patellar displacement (PD) were significantly improved over time in both group (P＜0.05), whereas which were not significantly different between the two groups at any time point accordingly (P＞0.05). [Conclusion] MPFL reconstructions with both fiber tape and semitendinous tendon autograft do effectively restore patellar anatomic position and knee joint function. By comparison, the fiber tape takes advantages of no donor site sacrifice, little interference to soft tissue and better early clinical consequence over the semi-tendinous tendon autograft.

Abstract: [Objective] To investigate the role of preoperative 3D printing simulation in open reduction and internal fixation (ORIF) of complex tibial plateau fractures (TPF). [Methods] The patients who admitted to our hospital for complex TPF from May 2022 to November 2023 were randomly divided into the 3D group (22 cases) and the conventional group (22 cases) according to random number method. The 3D group received 3D printing simulation and then ORIF, while the conventional group underwent the traditional ORIF. The documents regarding perioperative period, follow-up and images were compared between the two groups. [Results] All patients in both groups had ORIF performed successfully. The 3D group proved significantly superior to the conventional group in terms of the operation time [(95.2±16.6) min vs (115.3± 20.7) min, P＜0.001], total incision length [(12.8±1.8) cm vs (15.1±2.4) cm, P＜0.001], intraoperative blood loss [(129.5±30.1) mL vs (161.2± 26.7) mL, P＜0.001] and intraoperative fluoroscopy times [(6.6±1.1) vs (11.0±1.7), P＜0.001]. The average follow-up time was of (14.0±1.5) months, and the 3D group regained full weight-bearing activity significantly earlier than the conventional group [(96.5±5.1) days vs (102.8± 6.8) days, P＜0.001]. Compared with those 3 months after surgery, pain VAS score, HSS score, knee ROM and Rasmussen clinical score in both groups were significantly improved 6 months after surgery and at the last follow-up (P＜0.05). The 3D group was significantly better than the conventional group in terms the pain VAS score [(1.5±0.9) vs (2.6±1.0), P＜0.001] 3 months after operation, HSS score [(62.8±2.7) vs (60.0± 3.5), P=0.005; (90.3±3.7) vs (86.8±3.4), P=0.002; (91.1±3.5) vs (88.1±4.2), P=0.014] and Rasmussen clinical score [(22.3±3.5) vs (19.5±3.0), P=0.007; (24.5±2.3) vs (21.6±2.8), P＜0.001; (26.2±2.3) vs (23.6±0.6), P＜0.001] at 3 months, 6 months postoperatively and the last follow-up. Regarding imaging, the 3D group was also significantly superior to the conventional group in Rasmussen imaging score [(14.7±1.5) vs (13.5± 1.8), P=0.021], medial proximal tibial angle (MPTA) [(87.0±1.2)° vs (89.6±1.6)°, P＜0.001] and posterior tibial slope (PTS) [(9.8±2.2)° vs (11.6±2.8)°, P=0.022] at the latest follow-up. [Conclusion] Preoperative 3D printing simulation does reduce the operation time of ORIF for complicated TPF, shorten the time to return full weight bearing after operation, and improve the quality of fracture reduction.

Abstract:[Objective] To compare the clinical efficacy of TightRope fixation versus tricortical screw fixation in the treatment of distal tibiofibular syndesmosis injury. [Methods] A retrospective study was conducted on 180 patients who had interior tibiofibular syndesmosis tear treated surgically from January 2019 to January 2023. According to the patients' selection, 90 of them had the syndesmosis tear fixed by TightRope, while other 90 were fixed by tricortical screws. The documents regarding to perioperative period, followup and imaging were compared between the two groups. [Results] There were no significant differences in operation time, intraoperative blood loss, incision length, walking time, incision healing time, hospital stay and complication rate between the two groups (P＞0.05). However, the TightRope group resumed full weight-bearing activity significantly earlier than the screw group [(10.4±2.4) weeks vs (12.0±2.6) weeks, P＜0.001]. The American Orthopedic Foot and Ankle Society (AOFAS) ankle and hindfoot score and plantar flexion-dorsal extension range of motion (ROM) were significantly increased (P＜0.05), whereas the visual analogues scale (VAS) for pain were significantly decreased over time in both groups (P＜0.05). The TightRope group proved significantly superior to the screw group in terms of AOFAS score [(70.8±6.6) vs (65.8±5.9), P＜ 0.001] and plantar flexion-dorsal-extension ROM [(24.7±3.8)° vs (18.7±3.4)°, P＜0.001] one month after surgery. As for imaging, the tibiofib-ular clear space (TFCS) decreased significantly (P＜0.05), while tibiofibular overlap (TFO) increased significantly in both groups postoperatively compared with those preoperatively (P＜0.05), whereas which were not statistically significant between the two groups at any time points accordingly (P＞0.05). In addition, there was no significant difference in the incidence of implant failure and distal tibiofibular syndesmosis re-separation between the two groups (P＞0.05). [Conclusion] The TightRope can achieve the same consequence as screw fixation in fixing distal tibiofibular syndesmosis injury, but the TightRope is beneficial to functional recovery, including earlier restoration of full weight bearing activity.

Abstract:[Objective] To evaluated the early clinical efficacy of hemiarthroplasty (HA) through posterolateral approach small incision with piriformis preservation by comparing with the conventional HA though the posterior lateral approach with piriformis cut off for femoral neck fractures in the elderly. [Methods] A retrospective study was performed on elderly 50 patients who underwent HA for femoral neck fractures. According to the doctor-patient communication, 25 patients had HA performed through posterolateral approach small incision with pir- iformis preservation (the preserved group), while other 25 patients received HA through the traditional posterolateral approach with pirifor-mis cut off (the cut-off group). The perioperative period, follow-up and imaging documents of the two groups were compared. [Results] The preserved groups proved significantly superior to the cut-off group in terms of operation time [(46.9±6.4) min vs (55.6±9.6) min, P＜0.001], incision length [(9.1±1.2) cm vs (15.5±2.0) cm, P＜0.001], intraoperative blood loss [(86.7±14.5) mL vs (121.9±19.4) mL, P＜0.001], ambulation time [(27.2±3.2) hours vs (41.1±2.8) hours, P＜0.001], blood CK 3 days postoperatively [(225.9±87.5) U/L vs (375.6±97.8) U/L, P＜0.001], VAS score 3 days postoperatively [(3.2±0.5) vs (5.2±1.0), P＜0.001], and hospital stay [(9.5±1.8) days vs (13.6±3.5) days, P＜0.001]. The mean follow-up time was of (27.2±2.1) months, and the Harris score, hip extension-flexion ROM and hip external rotation ROM were significantly improved in both groups at the last follow-up compared with those 1 month after surgery (P＜0.05). The preserved group was also significantly better than the cut-off group in Harris score 1 month after operation [(82.7±3.9) vs (76.3±4.9), P＜0.001]. As for imaging, the preserved group was significantly superior to the cut-off group regarding to the Sugaya scale of piriformis [1/2/3/4/5, (19/3/3/0/0) vs (0/0/0/13/12), P＜ 0.001; (15/5/4/1/0) vs (0/0/0/10/15), P＜0.001] and Fuchs grade of piriformis [0/1/2/3/4, (3/12/10/0/0) vs / 1/15/9 (0/0), P＜0.001; (1/14/9/1/0) vs (0/0/0/10/15), P＜0.001] 3 months after surgery and at the last follow-up. [Conclusion] The HA through posterolateral approach small incision with piriformis preservation is minimally invasive technique, more conducive to the early recovery of hip function compared with the HA through the traditional posterolateral approach for femoral neck fractures in the elderly.

Abstract:[Objective] To systematically evaluate the clinical efficacy and safety of high tibial osteotomy (HTO) combined with plateletrich plasma (PRP) in the treatment of knee osteoarthritis. [Methods] PubMed, Embase, Web of science, CNKI, Wanfang and VIP databases were searched for the control studies of HTO combined with PRP in the treatment of knee osteoarthritis, and RevMan 5.4 was used for analysis. [Results] A total of 11 studies involving 617 patients were included. As results of the meta-analysis on the whole, the HTO+PRP was significantly better than the control group in terms of VAS score (MD=-0.58, 95%CI: -0.78~-0.38, P＜0.001), range of motion (ROM) (MD= 7.24, 95%CI: 2.79~11.69, P＜0.001), WOMAC score (MD=-5.78, 95%CI: -7.71~-3.86, P＜0.001), HSS score (MD=3.15, 95%CI: 0.64~ 5.66, P=0.01), Lysholm score (MD=6.67, 95%CI: 5.49~7.84, P＜0.001). [Conclusion] The HTO combined with PRP does achieve considerably better consequence for the KOA over other controls, with certain safety.

Abstract:Multiple osteonecrosis is relatively rare in clinical practice, and is even rarer in major joints. With the advancement of medical imaging technology and molecular biology, the diagnostic methods and treatment strategies for this disease have been continuously improved. In this review, literature was collected from the China National Knowledge Infrastructure (CNKI), Wanfang Data, and PubMed databases using the Chinese and English keywords "multiple osteonecrosis", "femoral head necrosis", and "necrosis of humeral head". Additionally, a secondary search was conducted using the keywords "bilateral" and "combination" to further refine the results. The aim is to explore the latest research findings and potential future directions on study of osteonecrosis of multiple major joins.

Abstract:Rotator cuff injury is one of the most common diseases causing shoulder pain and functional impairment in middle-aged and elderly individuals. With the development of arthroscopic techniques, arthroscopic surgery has become the main treatment for rotator cuff injuries, and generally achieves favorable clinical outcomes. However, it is challenging to achieve the formation of tissue structure in the tendon-bone interface similar to normal tendon insertion, and restore the original biomechanical properties after rotator cuff repair. Efforts to effectively enhance the healing rate of the tendon-bone interface might ensure the formation of tissue structures similar to normal tendon insertion, thus restoring their original biomechanical properties. This article provides a comprehensive review of the factors influencing tendonbone healing at the rotator cuff footprint and intervention methods to promote tendon-bone healing.

Abstract: [Objective] To explore the role of quercetin (Quer) regulating nuclear factor erythroid 2 related factor (NRF2) by heme oxygenase1 (HO1) signaling pathway on mouse ADTC- 5 cells. [Methods] Mouse ADTC- 5 cells were cultured in vitro and divided into 3 groups. Control group (Contr group) had no special treatment, while the IL-1β group was treated with 10 ng/ MLL-1β for 24 hours, and the IL-1β+Quer group was treated with 10 ng/mL IL-1β for 24 hours and then treated with 100 μmol/L Quer for 24 hours. Colorimetry, western blot and qRT-PCR assays were performed to detect ferrousion (Fe2+ ), protein and mRNA expressions of the factors. [Results] In term of colorimetric detection, compared with the contr group, the IL-1β and IL-1β+Quer groups measured Fe2+ [(6.6±0.2) μmol/L vs (13.9±0.2) μmol/L vs (9.2±0.2) μmol/L, P＜0.001], malondialdehyde (MDA) [(2.2±0.1) nmol/mL vs (6.1±0.0) nmol/mL vs (3.6±0.1) nmol/mL, P＜0.001] was significantly increased. However, compared with the contr group, the latter two groups measured superoxide dismutase (SOD) significantly decreased [(58.0±0.7) U/mL vs (26.1±0.8) U/mL vs (47.8±1.0) U/mL, P＜0.001]. As results of western blot and qRT-PCR assays, the protein and mRNA expression levels of glutathione peroxidase 4 (GPX4), NRF2 and HO1 in mouse ADTC-5 cells were ranked up-down as the contr group ＞the IL-1β+Quer group＞the IL-1β group, whereas the protein and mRNA expressions in the supernatant IL-1β and MMP-13 in mouse ADTC-5 cells were all ranked as the IL-1β group ＞the IL-1β+Quer group ＞the contr group. [Conclusion] The quercetin up-regulates NRF2-HO1 signaling pathway to inhibit iron death in mouse ADTC-5 cells.

Abstract: [Objective] To introduce the surgical technique and preliminary clinical results of arthroscopic triangular fibrocartilage complex (TFCC) reconstruction with palmaris longus tendon autograft for distal radioulnar instability complicated with TFCC injury . [Methods] As an incision was made on the volar side of the wrist, the palmaris longus tendon was harvested with a tendon extractor. The distal radius was exposed, and a bone tunnel was created with a 4.5mm cannulated drill. Under arthroscopic vision, an ulnar tunnel was made with the tibial guide for anterior cruciate ligament reconstruction, and then the braided tendon graft was introduced through the distal radial tunnel, and then the ulnar tunnel. Finally, the graft ends were tighten in proper tension and secured with anchor sutures. [Results] All patients underwent the abovementioned surgery successfully without severe complications. Compared with those before surgery, the modified Mayo score was significantly improved [(61.0±3.1), (90.5±8.2), P＜0.05] at the latest follow-up lasted from 9 months to 1.5 years. No patients required revision or secondary surgery. [Conclusion] Arthroscopic TFCC reconstruction with palmaris longus tendon autograft does restore the morphology of TFCC anatomically and the stability of the distal radioulnar joint, and achieves satisfactory initial clinical outcome.

Abstract: [Objective] To introduce the development, application and preliminary clinical results of a new-type external fixator for high tibial osteotomy. [Methods] The device was composed of threaded rod and lockable hinge as the main frame, attached with 8 pin for bone fixation. After installation, the postoperative correction could be optimized by adjusting the nuts on the external fixer. As appropriate patients were selected for high tibial osteotomy with the adjustable external fixator, the osteotomy angle was adjusted according to reexamination X-ray films after surgery until the target alignment was reached. The external fixator could be removed after osteotomy site healed. [Results] All the 12 patients were successfully operated on and followed up for 6~12 months, with an average recovery time of knee function of (3.2±0.2) months. Radiographically, all patients showed the osteotomy site healed, with medial proximal tibial angle (MPTA) significantly increased from (79.2±3.4)° preoperatively to (87.1±2.5)° postoperatively (P＜0.001), while the joint line convergence angle (JLCA) corrected from 2°~4° preoperatively to ＜2° postoperatively (P＜0.001). [Conclusion] The high tibial osteotomy with this new-type external fixator for knee osteoarthritis does effectively improve knee function and quality of life, however, it still needs to be further verified by relevant control studies.

Abstract:[Objective] To compare the accuracy of the new "shoulder-shoulder" (SS) anatomical marker versus the artificial intelligence assisted planning system (AIHIP system) for femoral stem placement in total hip arthroplasty (THA) to prevent of leg length discrepancy. [Methods] From August 2020 to December 2022, 94 patients who were undergoing initial THA were divided into two groups by random number table method. Of them, 47 patients had femoral stem placed by SS method, while other 47 patient were by AIHIP. The clinical and imaging documents of the two groups were compared. [Results] There were no significant differences in operation time, total blood loss and postoperative ambulation time between the two groups (P＞0.05). As for imaging, there were no significant differences in acetabular prosthesis matching, femoral stem prosthesis matching, leg length discrepancy and joint eccentricity between the two groups (P＞0.05). However, the SS group proved significantly less than the AIHIP group in terms of tip-shoulder distance [(15.9±3.0) mm, (17.7±3.4) mm, P＜0.001], bone cutting [(7.8±2.7) mm, (9.2±4.1) mm, P=0.003]. [Conclusion] The new "shoulder-shoulder" anatomical marker for femoral stem positioning can accurately insert the femoral component during THA and prevent leg length discrepancy after surgery.

Abstract: [Objective] To investigate the clinical outcome of one-stage internal fixation of open pronation ankle fractures. [Methods] A retrospective study was conducted on of 26 patients who had open pronation external rotation ankle fracture (IV degree), pronation abduction ankle fracture (III degree) and log splitter fractures treated by one-stage internal fixation in our hospital from January 2014 to December 2022. The clinical and imaging documents were evaluated. [Results] All patients were successfully operated on, without complications such as nerve and vascular injury during the operation. All the 26 patients were followed up for an average of (16.8±3.4) months. Compared with those preoperatively, VAS score [(8.8±0.7), (4.1±0.5), (1.1±0.5), P＜0.001], AOFAS score [(0), (74.6±4.1), (92.9±5.1), P＜0.001], Baird Jackson score [(0), (71.9±4.3), (97.1±4.8), P＜0.001] were significantly improved 3 months after surgery and at the last follow-up. In terms of imaging, compared with those preoperatively, talocrural angle (TCA) [(100.7±14.4)°, (82.3±2.7)°, (82.3±2.6)°, P＜0.001], medial clear space (MCS) [(15.1±6.5) mm (3.3±0.5) mm, (3.3±0.4) mm, P＜0.001], tibiofibular clear space (TFCS) [(17.4±5.7) mm, (4.1±0.5) mm, (4.1± 0.4) mm, P＜0.001], and tibiofibular overlap (TFO) [(0) mm, (7.5±0.9) mm, (7.6±0.8) mm, P＜0.001] were significantly improved 3 months after surgery and at the last follow-up. [Conclusion] For patients with open pronation ankle fracture, one-stage internal fixation is beneficial to restore normal anatomical structure and ankle function, accelerate the recovery of patients, and does achieve satisfactory clinical consequence.

Abstract: [Objective] To investigate the clinical outcome of tibiofibular osteotomy combined with Taylor frame for correction of external rotation deformity of the leg. [Methods] A retrospective study was performed on 30 patients who had external rotation deformity of the leg corrected by tibiofibular osteotomy combined with Taylor frame from February 2019 to August 2022. The clinical and imaging data were evaluated. [Results] All patients had operation done successfully with adjustment time of the external fixator of (24.1±7.3) days, and wearing the external fixator time of (124.3±12.2) days. All patients were followed up for an average of (2.3±0.6) years. Compared with those preoperatively, the VAS score significantly decreased [(3.2±0.4), (0.4±0.2), P＜0.001], while the KSS clinical score [(63.3±3.3), (85.0±2.5), P＜0.001], KSS functional score [(64.8±5.2), (84.0±5.1), P＜0.001] significantly increased, and the knee extension-flexion ROM remained unchanged significantly (P＞0.05) at the latest follow-up. As for images, the external tibial torsion (ETT) [(38.9±13.8)°, (8.3±1.6)°, P＜0.001], hip-kneeankle angle (HKA) [(4.1±1.19)°, (0.7±0.7)°, P＜0.001] were significantly reduced at the last follow-up compared with those before operation. [Conclusion] Tibiofibular osteotomy combined with Taylor frame is minimally invasive, safe, accurate and reliable technique, and achieves satisfactory short-term clinical consequence for leg external rotation deformity.

Abstract:[Objective] To compare the early effects of pericapsular nerve group (PENG) block versus fascia iliaca compartment (FIC) block on total hip arthroplasty (THA) under general anesthesia. [Methods] A total of 109 patients who planned to undergo THA in the Department of Joint Surgery of our hospital from June 2020 to September 2021 were included in this study and randomly divided into two groups. Of them, 54 patients receiving PENG block, while other 55 patients receiving FIC block. The clinical and analgesic data of the two groups were compared. [Results] There were no significant differences in operation time, intraoperative blood loss and intraoperative infusion volume between the two groups (P＞0.05). As time elapsed postoperatively, quadriceps muscle strength was significantly increased (P＜ 0.05), whereas postoperative nausea and vomiting (PONV) score was decreased significantly in both groups (P＜0.05). The PENG group proved significantly superior to the FIC group 12 hours after surgery in terms of muscle strength [(4.1±0.7) vs (3.3±0.5), P＜0.001], PONV score [(2.7±0.4) vs (4.6±0.5), P＜0.001], pain VAS score [(2.5±0.6) vs (3.7±0.9), P＜0.001] and patient- controlled intravenous analgesia (PCIA) press times [(10.1±2.4) vs (15.2±1.9), P＜0.001]. [Conclusion] Periarticular capsular nerve block does effectively relieve pain, reduce the dosage of opioids, give better analgesic effect over the fascia iliaca compartment block block in THA.

Abstract: [Objective] To explore the diagnostic value of MRI based subscapular tendon morphology for frozen shoulder. [Methods] A retrospective analysis was conducted on data of patients with shoulder pain in our hospital from January 2020 to June 2023. According to the diagnostic criteria of frozen shoulder, 48 patients were diagnosed with frozen shoulder (FS), while other 50 patients were of non-frozen shoulder (NFS). The image measurement data were compared between the two groups. The diagnostic significances of image indexes to frozen shoulder was analyzed by receiver operating characteristic (ROC). [Results] The FS group proved significantly greater than the NFS group in terms of subscapularis tendon thickness (SScTT) [(4.9±0.6) mm vs (3.8±0.4) mm, P＜0.001], the cross sectional area of subscapularis tendon (SScT-CSA) [(69.3±27.8) mm² vs (37.9±12.5) mm² , P＜0.001], and the SScT CSA/SSc-CSA [(0.3±0.1) vs (0.1±0.0), P＜0.001], whereas the former had significantly lower signal value of subscapularis than the latter [(59.5±8.3) vs (74.7±7.4), P=0.040]. Regarding ROC analysis, both SScTT (AUC=0.900) and SScT-CSA/SSc-CSA (AUC=0.915) have high diagnostic value for frozen shoulder. [Conclusion] The thickness of subscapularis and the ratio of tendon-muscle cross-sectional area does indirectly reflect the fibrosis of subscapular tendon, and can be used as a new parameter for MRI diagnosis of frozen shoulder.

Abstract: [Objective] To evaluate the clinical efficacy of 3D-printed guide- assisted percutaneous minimally invasive metatarsal transverse osteotomy (PMIMTO) in the treatment of mild to moderate hallux valgus deformity. [Methods] A retrospective research was conducted on 21 patients (22 feet) who received the 3D-printed guide-assisted PMIMTO for mild to moderate hallux valgus deformity between June 2022 and April 2023. The therapeutic consequence and function of the patients were evaluated by using the forefoot score of the American Orthopaedic Foot and Ankle Society (AOFAS) and the visual analogue scale (VAS) for pain. As imaging taken, the hallux valgus angle (HVA) and the intermetatarsal angle (IMA) between the first and second metatarsals were measured, as well as the extents of the first metatarsal shortened were recorded. [Results] All the patinets had PMIMTO performed smoothly, with wounds healed in the first stage and no complications. The average follow-up time was of (15.1±2.2) months. With time elapsed preoperatively, 3 months postoperatively and the the last follow-up, AOFAS forefoot score [(59.7±3.6), (86.7±1.6), (89.8±4.3), P＜0.001] and pain VAS score [(6.1±1.3), (2.1±0.7), (0.7±0.6), P＜0.001] were significantly improved. At the last follow-up, no complications such as metatarsal head necrosis, nonunion of bones, or recurrence of deformity occurred in anyone of the patients. In terms of imaging, the HVA [(32.2±5.0)°, (11.9±1.1)°, (11.2±2.6)°, P＜0.001] and IMA [(12.6±1.6)°, (9.0±0.6)°, (8.1±1.4)°, P＜0.001] were significantly improved 3 months postoperatively and at the latest follow-up compared with those before the operation. [Conclusion] This 3D-printed guide does effectively improve the safety and effectiveness of PMIM-TO and shorten the operation time, is a safe and effective method.

Abstract:

Abstract: