Abstract:[Objective] To compare the clinical efficacy of percutaneous reduction and fixation (PRF) versus conventional open reduction and internal fixation (ORIF) in the treatment of joint surface collapse-type calcaneal fractures. [Methods] A retrospective study was conducted on 59 patients who received surgical treatments for subtalar collapse-type calcaneal fractures (Sanders Ⅱ-Ⅲ type) from January 2022 to June 2023. According to the communication between doctors and patients, 30 patients were treated with PRF, while the other 29 patients underwent conventional ORIF. The perioperative, follow-up and imaging documents of the two groups were compared. [Results] All patients in both groups had corresponding surgical procedures performed successfully. The PRF group proved significantly superior to the ORIF group in terms of operation time [min, (20.5±9.1) vs (87.2±8.7), P<0.001], the total incision length [cm, (2.1±0.2) vs (13.8±1.4), P<0.001], the intraoperative blood loss [mL, (10.5±3.3) vs (61.2±7.4), P<0.001] and the hospital stay [d, (8.4±1.7) vs (16.7±2.9), P<0.001]. However, there was no statistically significant difference in the number of intraoperative fluoroscopy and the incision healing grade between the two groups (P>0.05). The average follow-up time of the patients was of (18.4 ± 4.3) months, and there was no a statistically significant difference in the time to resume ambulation and the full weight-bearing activities between the two groups (P>0.05). The VAS scores, AOFAS scores, and the inversion-eversion ROM significantly improved in both groups over time (P<0.05). The VAS score in PRF group was significantly less than that in the ORIF group 1 day postoperatively [points, (3.0±1.2) vs (7.8±1.5), P<0.001], regardless no difference between the two groups at 6 months and the last follow-up (P>0.05). There were no statistically significant differences in the AOFAS score, and ROM between the two groups at any other corresponding time points (P>0.05). As for imaging, the B?hler angle, Gissane angle, cartilage surface collapse, calcaneal length, calcaneal width, and calcaneal height in both groups were significantly improved at the last follow-up 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). [Conclusion] The percutaneous reduction and fixation technique for subtalar collapse-type (Sanders Ⅱ~Ⅲ type) calcaneal fractures has the advantages of satisfactory reduction, reliable fixation, small trauma and few complications.

Abstract:[Objective] To compare the clinical efficacy of long head of biceps tendon (LHBT) transposition with or without platelet-rich plasma (PRP) injection in the treatment of massive rotator cuff tears (MRCTs). [Methods] A retrospective study was conducted on 40 patients who underwent LHBT transposition for MRCTs at our hospitals from January 2020 to August 2024. According to the chronological order of the surgeries, 18 cases from January 2020 to June 2022 did not receive PRP injection during the operation, while 22 cases from July 2022 to August 2024 received PRP injection locally during the operation. The perioperative, follow-up, and imaging data of the two groups were compared. [Results] All patients in both groups had corresponding surgical procedures performed successfully without serious complications. The VAS score in both groups significantly decreased after surgery (P<0.05). The PRP group were significantly lower than the non-PRP group in VAS score 3, 7, and 14 days after surgery [points, (6.1±1.0) vs (6.8±1.1), P=0.039; (4.9±1.1) vs (6.0±1.3), P=0.005; (3.7±1.2) vs (4.6±1.4), P=0.016]. The patients were followed up from 12 to 16-month, and the UCLA, Constant-Murley, and ASES scores, as well as the flexion-elevation and abduction-elevation ROM in both groups significantly improved at 3 months and the last follow-up compared with those preoperatively (P<0.05). At 3 months after surgery, the PRP group were significantly better than the non-PRP group in terms of UCLA score [points, (25.1±4.3) vs (22.3±4.0), P=0.039], Constant- Murley score [points, (64.4±7.3) vs (58.8±8.3), P=0.029], and ASES score [points, (77.3±9.3) vs (70.6±8.3), P=0.024]. As for imaging, the acromiohumeral distance (AHD), Seebauer and Sugaya grades in both groups significantly improved at 3 months and the last follow-up 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). [Conclusion] PRP injection combined with LHBT transposition for MRCTs can accelerate the early pain relief and functional recovery after surgery with high safety.

Abstract: [Objective] To evaluate the efficacy of arthroscopic double-loop suture bridge with knotless anchors in the treatment of large and medium-sized rotator cuff tears (RCTs) in the elderly. [Methods] A retrospective study was conducted on 102 elderly patients who underwent arthroscopic repair of large and medium-sized RCTs in our hospitals from March 2021 to December 2023. According to preoperative doctor-patient communication, 52 patients received double-loop suture bridge with knotless anchors, while the other 50 patients underwent the traditional suture bridge with knotted anchors. The perioperative, followup, and imaging data were compared between the two groups. [Results] The knotless group consumed significantly shorter operation time than the knotted group [min, (80.0±11.3) vs (86.2±10.5), P=0.005], but there were no statistically significant differences between the two groups in terms of total incision length, intraoperative blood loss, number of anchors used, time to return active movement, incision healing grade, and hospital stay (P＞0.05). The average follow-up time was of (20.0 ± 3.6) months, and the knotless group achieved full weight-bearing activity significantly earlier than the knotted group [weeks, (17.4±2.0) vs (18.5±2.4), P=0.013]. The VAS, UCLA, Constant-Murley, and ASES scores, as well as forward elevation, abduction elevation, and internal-external rotation range of motions (ROMs) in both groups improved significantly over time (P＜0.05). The knotless group proved significantly superior to the knotted group in terms of UCLA [points, (25.6±2.8) vs (23.8±3.0), P=0.002], Constant-Murley [points, (83.6± 4.2) vs (81.0±4.7), P=0.004], and ASES scores [points, (78.5±4.5) vs (75.6±4.8), P=0.002] 6 months postoperatively, whereas which became not statistically significant between the two groups at the last follow-up (P＞0.05). As for imaging, the knotless group were also significantly better than the knotted group regarding to acromiohumeral distance (AHD) [mm, (12.6±1.5) vs (11.9±1.6), P=0.025] and acromion index (AI) [(0.68±0.06) vs (0.71±0.07), P=0.022] 6 months postoperatively, but no statistically significant differences between the two groups at the last followup (P＞0.05). In addition, there was no statistically significant difference in rotator cuff integrity between the two groups (P＞0.05). [Conclusion] The knotless double-loop suture bridge does shorten the operation time and full weight-bearing activity time, and has obvious advantages in mid-term shoulder joint function and AHD and AI improvement over the knotted counterpart.

Abstract:[Objective] To explore the efficacy differences of arthroscopic repair of rotator cuff injury with or without platelet-rich plasma (PRP). [Methods] A retrospective research was conducted on 118 patients with rotator cuff injury from April 2022 to May 2024. According to the communication between doctors and patients, 60 patients were treated with arthroscopic repair combined with PRP (the PRP group), while the other 58 patients were treated with arthroscopic repair alone (the non-PRP group). The perioperative, follow-up and imaging data were compared between the two groups. [Results] The PRP group was significantly greater than the non-PRP group in terms of operation time [min, (70.3±7.8) vs (65.9±7.3), P=0.002] and intraoperative blood loss [mL, (24.3±4.6) vs (13.8±2.9), P<0.001], however, there were no statistically significant differences in hospital stay, incision length, incision healing grade, and active joint movement time between the two groups (P>0.05). The PRP group resumed full weight-bearing activity earlier than the non-PRP group [d, (60.4±7.4) vs (64.8±9.5), P=0.006]. The VAS scores significantly decreased, while the UCLA, Constant-Murley and ASES scores, as well as forward flexion ROM, and abduction ROM significantly increased over time in both groups (P<0.05). The PRP group proved significantly superior to the non-PRP group in terms of UCLA [points, (29.4±2.2) vs (28.2±2.0), P=0.003; (31.5±2.1) vs (30.2±2.0), P=0.001], Constant-Murley [points, (69.4±4.9) vs (64.5±4.6), P<0.001; (31.5±2.1) vs (30.2±2.0), P<0.001], ASES [points, (80.4±5.3) vs (76.5±4.9), P<0.001; (85.3±4.6) vs (81.0±4.5), P<0.001], forward flexion ROM [°, (150.4±13.4) vs (145.8±10.4), P=0.040; (154.4±10.8) vs (150.6±9.6), P=0.046], and abduction ROM [°, (132.8±9.6) vs (126.5±8.3), P<0.001; (138.5±8.7) vs (133.5±8.0), P=0.002] 3 months postoperatively and at the last follow-up. As for imaging, the acromiohumeral distance (AHD) significantly increased, and the tendon integrity significantly improved over time in both groups (P<0.05), which were not statistically significant between the two groups at any time points accordingly (P>0.05), and there was no a statistically significant difference in the re-tear rate between the two groups (P>0.05). [Conclusion] Although arthroscopic repair of rotator cuff injury combined with PRP prolongs the operation time and increases the intraoperative blood loss, the PRP injection can promote the recovery of shoulder function.

Abstract:[Objective] To explore the factors related to poor clinical consequence of arthroscopic rotator cuff repair. [Methods] A retrospective analysis was conducted on 158 patients who had rotator cuff tear repaired under arthroscopy in our hospital from January 2022 to June 2024. According to the UCLA shoulder score at the last follow-up, the patients with a score <29 were classified as the poor group, and those with a score ≥29 were classified as the good group. Univariate comparison and multivariate logistic regression analysis were used to explore the factors related the clinical outcomes of arthroscopic rotator cuff repair. [Results] Based on the UCLA score at the last follow-up, 36 were included in the poor group among the 158 patients, accounting for 22.8%. As results of univariate comparisons, the poor group proved significantly greater than the good group in terms of age [years, (67.4±9.5) vs (57.9±10.2), P<0.001], the Cofield classification [n, small/medium/large/giant, (5/13/10/8) vs (37/62/14/9), P=0.002], the of critical shoulder angle (CSA) [°, ≤38/>38, (11/25) vs (75/47), P<0.001], retraction distance of the rotator cuff ends [cm, 3.00 (2.00, 3.00) vs 2.00 (1.00, 2.00), P<0.001], operation time [min, (73.9±10.2) vs (61.4±12.6), P<0.001], the preoperative VAS score [score, (8.00 (6.00, 9.00) vs 6.00 (5.00, 7.00), P<0.001], and the VAS score at the last follow-up [points, (1.3±0.4) vs (0.9±0.3), P<0.001]. Regarding multivariate logistic regression analysis, the CSA (OR=3.627, P=0.002), the retraction distance of the rotator cuff ends (OR=3.216, P<0.001), the Cofield classification (OR=2.065, P=0.001), preoperative VAS score (OR=1.788, P<0.001), age (OR=1.110, P<0.001), and operation time (OR=1.090, P<0.001) were independent risk factors for poor clinical outcomes of rotator cuff repaired under arthroscopy. [Conclusion] The age, operation time, Cofield classification, preoperative VAS score, CSA, and retraction of the torn ends are all risk factors for poor clinical outcomes of rotator cuff repaired under arthroscopy.

Abstract:[Objective] To evaluate the clinical efficacy of dynamic intraligamentary stabilization (DIS) repair versus anterior cruciate ligament reconstruction with tendon autograft (ACLR) in the treatment of anterior cruciate ligament injury by a meta-analysis. [Methods] The databases of China National Knowledge Infrastructure (CNKI), Wanfang, PubMed, Cochrane Library, and Web of Science (2015—2024) were searched. The effect sizes were extracted from the full texts, and a meta-analysis was conducted using RevMan 5.4 software. [Results] A total of 5 studies involving 344 patients were enrolled into this study, including 165 patients in the DIS group and 179 patients in the ACLR group. As consequence of the meta-analysis, there was no statistically significant difference in the postoperative failure rate, revision rate, and functional score between the two groups (P>0.05). However, the DIS had significantly higher implant removal rate than the ACLR group (OR=10.26, 95%CI 3.13~33.62, P<0.001). Although there was no statistically significant difference in the IKDC score and Tegner score between the two groups (P>0.05), the DIS group had significantly higher Lysholm score than the ACLR group (WMD=1.50, 95%CI 0.10~2.90, P=0.04). [Conclusion] For the acute femur-side anterior cruciate ligament tears (interval from injury to surgery time <21 days), DIS achieves comparable failure rate, revision rate, and functional score with ACLR, with advantage of preserving proprioception, while disadvantage of significantly increased risk for implant removal.

Abstract:Injuries to bone cartilage, tendon and other tissues are common health problems worldwide. There are many problems in traditional treatment. The autologous transplantation faces donor shortage and secondary trauma, while the allogeneic transplantation has the risk of immune rejection and the metal implants may cause stress shielding effect or require a second operation to remove. The self-repair capacity of cartilage, nerve and other tissues is extremely weak, with difficult to achieve functional reconstruction. Therefore, there is an urgent need for safer and long-lasting regenerative repair programs. Biological materials, especially chiral biomimetic biomaterials, can be construct chiral biomimetic scaffolds, can simulate the chiral microstructure and mechanical properties of natural tissues, provide a directional growth microenvironment for cells, and provide excellent biological adaptability for tissue repair. This article reviews the application progress of chiral biomimetic biomaterials in the repair of bone and other tissues, and provides new ideas for the repair of bone and other tissues.

Abstract:The number of patients undergoing anterior cruciate ligament (ACL) reconstruction (ACLR) has been steadily increasing, and approximately 20% of these patients develop moderate to severe osteoarthritis within 10 years, with some eventually requiring total knee arthroplasty (TKA). TKA is a well-established and effective surgical treatment for end-stage knee osteoarthritis. However, ACLR alters the knee's anatomical structure and increases the technical complexity of TKA, including challenges such as difficult anatomical exposure, prolonged surgery time, residual ACL fixation devices, soft tissue imbalance, and the need for highly constrained prostheses. This paper reviews studies on TKA following ACLR, highlights the complexity in such cases, which necessitate experienced management approaches that involve meticulous planning, specialized techniques, and the use of modular components. As more cases of this nature are expected to arise, clinicians need to be adequately prepared to manage them.

Abstract:Spinal tumors represent a prevalent clinical entity, characterized by distinct clinical manifestations including spinal instability due to structural compromise, severe pain resulting from nerve root and spinal cord compression, nocturnal exacerbation of pain, and potential paraplegia in advanced cases. In clinical practice, it is imperative to ascertain the tumor's origin, pathological nature, and pain mechanisms. The therapeutic approach to spinal tumor-related pain primarily encompasses pharmacological interventions, surgical procedures, and physical therapy. While pharmacological management has limited efficacy, surgical interventions demonstrate superior outcomes in improving both therapeutic efficacy and patients' quality of life. Current mainstream surgical modalities include transpedicular corpectomy, radiofrequency ablation, brachytherapy with radioactive particle implantation, endoscopic surgery, and intraoperative auxiliary techniques based on individual patient characteristics and clinical requirements. This article provides a comprehensive review of the current clinical applications of these five surgical treatment modalities, offering valuable insights for clinical reference.

Abstract:Cerium (Ce) is recognized as the most abundant rare element within the Earth's crust. In the nanoscale, the reversible inter-conversion between Ce³⁺ and Ce⁴⁺ is associated with the generation and elimination of oxygen vacancies in its lattice structure, which results in dual redox properties that facilitate the scavenging of excess reactive oxygen species (ROS) from living organisms. An overabundance of ROS can disrupt the microenvironment of bone remodeling, potentially leading to the development of various pathological bone conditions, including rheumatoid arthritis, osteoporosis, osteoarthritis, and delayed fracture healing. Due to its diverse biological activities, such as anti-oxidative, anti-inflammatory, osteogenic, and angiogenic properties, Ce has been extensively utilized in the treatment of orthopedic diseases. This article review the biological activities of Ce and the advancements in Ce-based materials in the clinical orthopedic practise to provide innovative perspectives for the development of Ce-based materials targeting various orthopedic diseases while also addressing the challenges that lie ahead in this field.

Abstract:Spinal cord injury (SCI) seriously affects the motor, sensory, and autonomic nerve functions of patients. Due to its high incidence, high treatment cost, high disability rate, and younger age of onset, the treatment situation is becoming increasingly considered. Currently, a large number of studies have shown that in the process of SCI occurrence and development, multiple programmed cell deaths (PCD), such as apoptosis, pyroptosis, autophagy, ferroptosis, and necroptosis, act in concert to exacerbate nerve damage. Traditional Chinese medicine (TCM) has demonstrated significant therapeutic effects in promoting nerve regeneration, inhibiting inflammatory responses and oxidative stress, and eliminating damaged organelles through multi-target regulation of the above PCD pathways. Based on this, this article systematically expounds the molecular mechanisms of PCD in SCI and reviews the relevant research on the regulation of PCD by TCM in the treatment of SCI in recent years, aiming to provide ideas and references for the clinical diagnosis and treatment and in-depth research of SCI.

Abstract:As an extremely high-frequency electromagnetic wave, millimeter wave has been widely used in traditional fields, such as communication and radar, and its application prospect in the medical field has become increasingly prominent in recent years. Millimeter wave has been applied in diagnosis of skin diseases, regulation of immune system diseases, nervous system diseases, analgesia, telemedicine and intelligent detection, in addition, some in-depth studies have been carried out on millimeter waves in cells and microorganisms. However, the mechanism and theoretical basis of millimeter wave have not been fully elucidated, and further in-depth research is still needed. This article reviews the action mechanism and clinical application of millimeter waves, and summarizes the research progress of millimeter waves in clinical diseases in recent years, in order to provide a reference for the further clinical application of millimeter waves.

Abstract:Rotator cuff injury is a common musculoskeletal disorder, and the repair outcome directly affects the recovery of shoulder function. Platelet-rich plasma (PRP), as a biological treatment method, demonstrates various regulatory effects in promoting rotator cuff healing. Through regulating local inflammatory responses, promoting tendon cell proliferation and migration, improving collagen synthesis, remodeling and so on, it accelerates rotator cuff healing after repair. Although PRP has significant clinical application prospects in rotator cuff repair, its standardized preparation, optimal treatment strategies, and long-term safety still need further research to clarify. This article summarizes relevant domestic and foreign literature in recent years and reviews the mechanism of PRP promoting rotator cuff healing after repair.

Abstract:[Objective] To introduce the surgical technique and the preliminary clinical consequence of single needle outside-in suture of the meniscus. [Methods] Using a single injection needle with side hole on the tip, a single-strand suture was introduced outside-in. Under arthroscope, it was observed that the suture needle emerged from the inner edge of the torn meniscus in the joint cavity. The suture loop was drawn out the anterior portal and the needle was pulled back to the subcutaneous layer, then passed through again from the outside to the meniscus tear site. Then, following the principle of a sewing machine, another suture was introduced through each suture loop sequentially outside the anterior portal, with this manipulation repeated to complete the continuous meniscus suture. The first stitch drawn back outside and induced the intra-articular suture thread out to be knotted, then the suture was gradually tightened successively, finally, a knot was made on the inner side of the joint cavity. [Results] All patients had operation performed successfully without nerve injury, while with the average operation time of (45.1±11.8) minutes. No complications such as infection occurred after the operation in anyone of them. The Lysholm score significantly increased from (55.1±4.1) preoperatively to (85.6±9.7) at 6 months after the operation (P<0.001). At 12 months after the operation, the patient satisfaction score (out of 10) was of (9.2±2.6). [Conclusion] The single-needle outside-in suture of meniscus is a safe and effective minimally invasive surgical method, which significantly reduces surgical trauma and costs, shortens the operation time, and improves the knee functional recovery.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of suture combined with internal reinforcement repair for Sherman Ⅱ type acute anterior cruciate ligament (ACL) femoral side rupture. [Methods] From January 2024 to June 2025, 5 patients received above-mentioned arthroscopic repair of acute ACL femoral side rupture. Microfractures were made around the femoral insertion point, and one 4.5 mm anchor was slightly anteriorly and downwardly inserted into the ACL femoral insertion area. The two Johnson sutures were used to suture the residual ACL, and then one 4.75 mm anchor was inserted into the ACL femoral insertion point at a 90° flexion position of the knee joint. The sutures were tightened to restore and fix the residual ACL to the femoral insertion. After a tibial tunnel was established, and the tail sutures of the 4.75 mm anchor were drawn out from the tibial tunnel, tightened and tied to form an enhanced stable structure. [Results] All patients had wounds healed in the first stage after surgery. At the last follow-up, all patients had negative Lachman test and a negative anterior drawer test, except a patient who had a grade Ⅰ positive Lachman test and a negative anterior drawer test. The Lysholm score was improved from 50.7 before surgery to 92.6 at the last follow-up, while the IKDC score improved from 47.3 before surgery to 89.7 at the latest follow-up. The overall patient satisfaction rate reached 100%. [Conclusion] Arthroscopic ACL suture combined with internal augmentation provides a superior treatment option for the Sherman type Ⅱ rupture with acceptable tendon quality.

Abstract:[Objective] To explore the clinical efficacy of suture anchor on the talus for repairing deep deltoid ligament rupture combined with ankle fractures. [Methods] A retrospective study was conducted on 32 patients who received the above surgical treatment from January 2022 to February 2024. The clinical and imaging data were evaluated. [Results] All the patients had the operations performed successfully, with the average operation time of (98.5±21.4) min, and the average intraoperative blood loss of (43.1±10.3) mL, whereas without intraoperative or postoperative complications. All patients were followed up for a mean of (15.3±2.6) months. Compared with those preoperatively, the VAS [points, (7.6±1.2), (3.2±0.4), (1.0±0.3), P<0.001], AOFAS [points, (42.3±3.6), (83.4±7.7), (92.3±3.4), P<0.001], and ankle dorsiflexion-plantar flexion ROM [°, (22.3±3.1), (41.2±3.6), (52.3±2.8), P<0.001] were significantly improved 3 months postoperatively and at the last follow-up. As for imaging, the medial clear space (MCS) [mm, (5.2±0.4), (2.6±0.3), (2.4±0.2), P<0.001], tibiofibular clear space (TFCS) [mm, (8.1±0.3), (1.7±0.5), (1.7±0.6), P<0.001], and talocrural angle (TCA) [°, (87.5±1.2), (83.2±1.6), (83.5±1.7), P<0.001] were significantly improved 3 months after operation and at the last follow-up compared with those before operation. [Conclusion] The suture anchor on the talus for repairing deep deltoid ligament rupture combined with ankle fractures achieves satisfactory clinical consequence with good recovery of joint function.

Abstract:[Objective] To explore the clinical consequence of oral Guwei Kang granules on femoral neck fractures after cannulated screw fixation in the elderly, and to provide a traditional Chinese medicine intervention plan. [Methods] A total of 76 patients who had femoral neck fractures treated by closed reduction and cannulated screw fixation from June 2022 to December 2024 were selected, and divided into the traditional Chinese medicine (TCM) group and the conventional group by the random number table method, with 38 cases in each group. The conventional group received conventional Western medicine treatments such as anticoagulation, analgesia, and rehabilitation training, while the TCM group was given oral Guwei Kang granules in addition to the conventional treatment for 6 months. The clinical and imaging data of the two groups were compared. [Results] The TCM group proved significantly earlier than the conventional group in terms of postoperative ambulation time [days, (27.8±2.8) vs (34.3±3.7), P<0.001] and the time to resume weight-bearing activities [days, (39.3±2.0) vs (45.7±2.9), P<0.001]. At 3 months after surgery and the last follow-up, the TCM group was also significantly superior to the conventional group in terms of VAS score [points, (3.5±0.5) vs (4.5±0.5), P<0.001; (1.1±0.4) vs (2.5±0.5), P<0.001], Harris score [points, (79.7±3.9) vs (72.1±3.0), P<0.001; (94.3±2.7) vs (89.8±4.9), P<0.001], hip flexion-extension ROM [°, (106.6±6.9) vs (95.9±7.3), P<0.001; (125.7±4.2) vs (116.6±4.4), P<0.001] and hip internal-external rotation ROM [°, (45.0±2.4) vs (39.6±2.7), P<0.001; (60.3±2.2) vs (50.9±4.6), P<0.001]. On imaging, there were no statistically significant differences in the ARCO staging, fracture healing, and femoral head collapse between the two groups at 3 months after surgery and the last follow-up (P>0.05), but the tip-apex distance in the TCM group was significantly smaller than that in the conventional group accordingly [mm, (22.7±1.1) vs (23.4±1.1), P<0.001; (23.5±1.0) vs (24.2±0.8), P<0.001]. [Conclusion] Adding oral Guwei Kang granules after cannulated screw fixation of femoral neck fractures can shorten the rehabilitation process, relieve pain, improve hip function, reduce the loosening of internal fixation devices, and may have a positive effect on preventing femoral head necrosis.