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WANG Song-yi, TAN Xin-huan, LIU Shu-yan, JU Chang-jun, ZHAI Jian-guo, ZHOU Xin, JIN Hai-long, MAN Zhi-ying
2025,33(16):1441-1448, DOI: 10.20184/j.cnki.Issn1005-8478.120017
Abstract:
[Objective] To compare the clinical consequence of partial transplantation of the fifth carpometacarpal joint versus arthroplasty in the treatment of metacarpophalangeal defects. [Methods] A retrospective study was conducted on 32 patients who underwent surgical treatment for metacarpophalangeal defect due to trauma in our hospital from March 2016 to December 2022. According to preoperative surgeon-patients discussion, 16 patients were treated with partial transplantation of the fifth carpometacarpal joint, while other 16 patients were with then conventional arthroplasty. The documents regarding perioperative period, followup and imaging were compared between the two groups. [Results] All patients in both groups had corresponding surgical procedures performed successfully without serious complications such as neurovascular injuries. The transplantation group consumed significantly longer operative time [(137.0±16.4) min vs (102.5± 12.5) min, P＜0.005] and more intraoperative fluoroscopy times [(28.1±1.4) vs (23.1±0.8), P=0.006] than the arthroplasty group. However, there were no significant differences in intraoperative blood loss, total incision length, hospital stay, hospitalization cost and postoperative plaster fixation time between the two groups (P＞0.05). With time elapsed during the followup period lasted for (17.7±4.0) months in a mean, the VAS and DASH scores in both groups were significantly decreased (P＜0.05), while grip strength, metacarpophalangeal ROM and Carroll hand function test scores were significantly increased (P＜0.05). The transplantation group proved significantly superior to the arthroplasty group in terms DASH score [(83.2±3.9) vs (89.9±5.4), P=0.003; (55.3±6.2) vs (61.4±6.9), P=0.022] 1 and 3 months postoperatively, metacarpophalangeal ROM [(62.5±5.4)° vs (56.6±7.3)°, P=0.033; (82.2±4.3)° vs (76.9±5.2)°, P=0.004] and Carroll score [(77.8±4.0) vs (74.9±3.2), P=0.022; (92.6±3.6) vs (88.5±3.2), P=0.004] 3 months after operation and at the latest follow-up, as well as grip strength [(26.8±3.7) kg vs (22.9±3.5) kg, P=0.009; (48.9±5.8) kg vs (44.1±5.0) kg, P=0.009] 1 month after surgery and at the last follow-up. As for postoperative imaging, there was no significant difference in fracture healing time between the two groups (P＞0.05), whereas the transplantation group had significantly greater relative joint space than the arthroplasty group at the last follow-up [(1.03±0.68)% vs (0.86±0.11)%, P= 0.002]. [Conclusion] Partial transplantation of the fifth carpometacarpal joint for metacarpophalangeal partial defect, especially with tendon and ligament insertion defect, does better rebuild the integrity and stability of the joint, and is more conducive to the functional recovery of the metacarpophalangeal joint.
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ZHANG Sheng-zhi, ZHANG Gui-ping, WANG Wen-qing, SONG Jiang-run, MA Wei, SONG Xiao-dong, ZHAO Bao-bao, GONG Bo
2025,33(16):1449-1457, DOI: 10.20184/j.cnki.Issn1005-8478.110705
Abstract:
[Objective] To analyze the long-term clinical outcomes of knee arthroscopic surgeries for lateral meniscus injury by stratification. [Methods] A retrospective study was conducted on 326 patients (331 knee) who had the lateral meniscus injury treated arthroscopi-cally in our hospital from October 2008 to December 2018, involving 202 males and 124 females with a mean age of (39.3±11.3) years. The clinical data were compared by stratification based on gender, age, injury time, injury type and operation method. [Results] In term of gender, there were no significant differences in VAS, Lysholm, Tegner and Rasmussen scores, as well as maximum knee flexion ROM, loss of maximum knee extension and knee space tenderness between male and female (P＞0.05). In term of age, the patients aged ≤40 years proved significantly superior to those aged ＞40 years in Lysholm score [(88.5±1.6) vs (84.1±1.1), P＜0.001], Tegner score [(6.7±0.8) vs (5.5±0.9), P＜ 0.001], Rasmussen score [(27.6±1.3) vs (23.8±1.4), P＜0.001], maximum knee flexion ROM [(134.4±3.0)° vs (124.2±1.8)°, P＜0.001], whereas the former was significantly inferior to the latter in VAS score [(2.1±0.5) vs (1.5±0.7), P＜0.001] and loss of maximum knee extension [(1.2±0.9)° vs (0.2±0.0)°, P＜0.001] at the latest follow-up. In term time interval from the injury to operation, patients with time ≤28 days were significantly better than those with ＞ 28 days regarding abovesaid scores and the maximal knee flexion ROM and loss of maximum knee extension before and at the last follow-up (P＜0.05). In term of injury extent, the patients with simple injury proved significantly superior to those with complex injuries in above scores, maximum knee flexion and loss of maximum knee extensions before and at the last followup (P＜0.05). In term of the surgical method, the patients received partial meniscectomy were significantly superior to those underwent meniscus suture and subtotal meniscectomy in abovementioned scores, maximum knee flexion ROM and loss of maximum knee extension before operation and at the last follow-up (P＜0.05). In addition, the patients received partial meniscectomy had significantly higher ratio of preoperative joint space tenderness than those received meniscus suture and subtotal meniscectomy (P＜0.05), although there was no a significant difference in the ratio of joint space tenderness among the three groups at the latest follow-up (P＞0.05). [Conclusion] The longterm consequence of arthroscopic treatment for lateral meniscus injury of the knee is good, especially for patients with young age, short interval from injury to surgery and simple injury type.
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LI Xu-dong, XU Boyong, HUA Long, LI Yi-cheng, MU Wen-bo, GUO Wen-tao
2025,33(16):1458-1463, DOI: 10.20184/j.cnki.Issn1005-8478.110500
Abstract:
[Objective] To explore the factors related to genu valgus (GV) of the affected side after total hip arthroplasty (THA) for Harto- filakids type III developmental dysplasia of the hip in adult. [Methods] A retrospective study was performed on 62 patients who received THA for Hartofilakids type III developmental dysplasia in our department from 2003 to 2013. According to Ranawat and Elkus et al.' s criteria, the GV was defined as the femorotibial angle (FTA) more than 10° at the latest follow-up. Univariate comparison and multiple logistic regression analysis were used to explore the related factors of postoperative GV. [Results] A total of 23 patients were determined as GV at the latest follow-up, accounting for 37.1%. There were no significant differences between the two groups in terms of gender, age, BMI, Harris score before and at the last follow-up, AKS score before surgery and medial proximal tibial angle (MPTA) before surgery, as well as the ratio of intraoperative iliotibial band release, incidence of hip dislocation and revision surgery during the followup (P＞0.05). The GV group proved significantly lower than the non-GV group in terms of AKS score at the latest follow-up [(65.1±9.5) vs (74.1±5.8), P＜0.001], mechanical lateral distal femoral angle (mLDFA) [(83.2±5.1)° vs (87.9±2.9)°, P＜0.001] preoperatively and [(77.1±4.4)° vs (82.6±2.6)°, P＜0.001] at the last follow-up, whereas the former was significantly greater than the latter in terms of FTA [(9.9±5.2)° vs (3.6±2.8)°, P＜0.001] preoperatively and [(17.2±3.7)° vs (6.8±3.3)°, P＜0.001] at the last follow-up, as well as MPTA [(87.2±4.3)° vs (84.4±3.1)°, P=0.010] at the last follow-up. In addition, the GV group was significantly higher in ratio of shortening osteotomy during THA [hip, yes/no, (19/4) vs (33/68), P= 0.014], while significantly less shortening length [(1.6±0.5) cm vs (2.1±0.9) cm, P=0.004] than the non-GV group. As results of multivariate logistic regression, the greater preoperative FTA (OR=1.654, P＜0.05) and preoperative mLDFA (OR=1.221, P＜0.05) were independent risk factors for postoperative GV. [Conclusion] There is a high risk of genu valgus after THA for high DDH in adult, despite of the fact that shortening osteotomy and iliotibial band release can alleviate it. The greater preoperative FTA and mLDFA are risk factors for postoperative genu valgus
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LI Wei, LIU Cheng-yao, YU Fu-bin, ZHANG Wenqiang
2025,33(16):1464-1469, DOI: 10.20184/j.cnki.Issn1005-8478.110658
Abstract:
[Objective] To compare the clinical consequences of robot-assisted total knee arthroplasty (RA-TKA) versus conventional total knee arthroplasty (C-TKA). [Methods] A retrospective study was conducted on 43 patients who received TKA from February 2023 to October 2023. According to the doctor-patient communication, 21 patients underwent RA-TKA, while other 22 patients received C-TKA. The documents regarding perioperative period, follow-up and imaging were compared between two groups. [Results] All patients in both groups had TKA performed successfully. The RA-TKA group proved significantly greater than the C-TKA group in terms of operative time [(99.8±15.2) min vs (82.4±11.5) min, P＜0.001] and the total incision length [(13.1±1.1) cm vs (12.3±0.7) cm, P=0.011]. All patients in both groups were followed up for (15.2±2.4) months in a mean. The VAS, HSS, KSS, WOMAC scores and knee extension-flexor ROM were significantly improved in both groups at the last follow-up compared with those before surgery (P＜0.05), which were not statistically significant between the two groups at any time points accordingly (P＞0.05). As for imaging, the RA-TKA proved significantly superior to the CTKA in terms of hip-knee-ankle angle (HKA) [(178.1±1.3)° vs (176.1±2.3)°, P＜0.001; (178.2±0.9)° vs (177.0±2.3)°, P=0.023], lateral tibia component (LTC) [(87.9±1.1)° vs (89.2±1.8)°, P=0.009; (88.0±0.9)° vs (89.1±1.6)°, P=0.006] immediately after surgery and at the last follow-up. However, there were no significant differences in frontal femoral component (FFC), lateral femoral component (LFC), and frontal tibia component (FTC) between the two group postoperatively (P＞0.05). [Conclusion] The RA-TKA has better lower limb alignment, more accurate osteotomy and implant position after operation, regardless of that no difference in short-term clinical efficacy is found compared with C-TKA.
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LIU Bao- shuai, ZHANG Zi- an, ZHOU Gui-zhen, LI Hai-feng, LI Qing-qi
2025,33(16):1470-1476, DOI: 10.20184/j.cnki.Issn1005-8478.110593
Abstract:
[Objective] To compare the clinical efficacy of low-profile loop plate (LP) versus hook plate (HP) for fixation of acromiocla- vicular dislocation. [Methods] A retrospective study was conducted on 46 patients who had Rockwood III-V acromioclavicular dislocation treated surgically in our hospitals from January 2020 to June 2023. According to the preoperative doctor-patient communication, 22 patients underwent LP, while other 24 patients underwent HP. The perioperative period, follow-up and imaging data of the two groups were compared. [Results] All patients in both groups had corresponding surgical procedures performed successfully without significant differences in operation time, hospital stay, healing grade between the two groups (P＞0.05). However, the LP group was significantly superior to the HP group in terms of incision length [(4.1±0.8) cm vs (6.0±0.6) cm, P＜0.001], blood loss, [(34.8±5.2) mL vs (55.4±7.8) mL, P＜0.001] and active activity time [(1.5±0.1) days vs (1.6±0.0) days, P＜0.001]. All patients in both groups were followed up for more than 12 months, and the LP group resumed full weight-bearing activity significantly earlier than the HP group [(46.1±3.0) days vs (53.9±4.7) days, P＜0.001]. As time went on, VAS score, Constant-Murley score, forward flexion elevation ROM and abduction elevation ROM were significantly improved in both groups (P＜0.05). At 3 months and the last follow-up, the LP group was significantly better than the HP group in terms of VAS score [(2.2±0.8) vs (2.9±0.8), P=0.007; (0.8±0.6) vs (1.9±0.8), P＜0.001], Constant-Murley score [(84.2±3.6) vs (79.0±2.7), P＜0.001; (93.9±2.0) vs (91.1±2.6), P=0.023], forward flexion elevation ROM [(142.1±6.5)° vs (113.3±11.1)°, P＜0.001; (170.2±5.9)° vs (151.7±9.6)°, P＜0.001], and abduction elevation ROM [(127.9±5.0)° vs (107.3±8.7)°, P＜0.001; (155.9±5.7)° vs (141.0±8.2)°, P＜0.001]. As for imaging, the acromiocla-vicular distance (ACD) and coracoclavicular distance (CCD) in both groups decreased significantly after surgery compared with those preoperatively (P＜0.05). At any corresponding time points, there were no significant differences in CCD and ACD between the two groups (P＞ 0.05). [Conclusion] The low-profile loop plate is superior to the hook plate for fixation of acromioclavicular dislocation.
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DAI Sheng, FENG Meng, MAO Gen-wen, LIU Jun, WANG Xu, WANG Zhun, NI Jian-long, SHI Zhi-bin, LUI Rui-yu
2025,33(16):1477-1482, DOI: 10.20184/j.cnki.Issn1005-8478.110478
Abstract:
[Objective] To compare the clinical outcomes of open Brostrom-Gould procedure versus arthroscopic counterpart for repair of the anterior talofibular ligament (ATFL). [Methods] A retrospective study was conducted on 64 patients who received Brostrom-Gould procedure for chronic lateral ankle instability in our hospital from January 2019 to January 2022. According to preoperative doctor-patient communication, 26 patients were treated with conventional open technique, while other 38 patients were treated with arthroscopic technique. The document regarding perioperative period, followup and imaging were compared between the two groups. [Results] The open group proved significantly inferior to the arthroscopic group in terms of operation time [(64.5±10.1) min vs (57.8±6.4) min, P=0.005], incision length [(5.5±1.0) cm vs (2.9±0.7) cm, P＜0.001], intraoperative blood loss [(38.6±11.3) mL vs (20.1±4.0) mL, P＜0.001], and hospital stay [(7.2±1.4) days vs (4.1±1.5) days, P＜0.001]. The average follow-up time was of (30.6±5.0) months, and the open group resumed walking [(20.7±2.1) days vs (16.9±2.0) days, P＜0.001] and full weight-bearing activity [(83.7±4.1) days vs (64.2±3.7) days, P＜0.001] significantly latter than the arthroscopic group. The anterior drawer test, inversion test, VAS score, AOFAS score and ROM in both groups were significantly improved 1 month after surgery and at the last follow-up compared with those preoperatively (P＜0.05). The VAS [(4.6±1.5) vs (2.7±1.5), P＜ 0.001] and AOFAS score [(74.1±8.2) vs (80.0±7.6), P=0.005] in the open group was significantly inferior to those in the arthroscopic group 1 month after surgery, despite of the fact that no statistical significance was noted in the above indexes between the two groups at remaining time points (P＞0.05). As for imaging, the talar tilt (TT), anterior displacement (AD) and Kellgren-Lawrence (K-L) grades in both groups were significantly improved, immediately after surgery and 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 point accordingly (P＞0.05). [Conclusion] Arthroscopic Brostrom-Gould procedure for repair of ATFL has the advantages of short operation time, small incision, less blood loss, less pain in the early postoperative period, and faster functional recovery.
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SUN Qi-hui, LIU Yu-na, SHI Jiang-hua, TANG Sheng-bin, LIU Ning, YAN Jing
2025,33(16):1483-1489, DOI: 10.20184/j.cnki.Issn1005-8478.120373
Abstract:
[Objective] To search the factors related to social frailty (SF) in elderly patients with knee osteoarthritis (KOA). [Methods] A total of 202 patients with KOA who visited the orthopedic outpatient department of our hospitals from March 2024 to March 2025 were enrolled into this study. The patients were divided into the non-SF group and the SF group according to the HALFT scale. Univariate comparison and binary multivariate logistic regression analysis were used to explore the risk factors of SF. [Results] Among the 202 patients, 75 had no SF with HALFT score of 0, accounting for 37.1%, whereas 67 in the early stage of SF with HALFT score from 1 to 2 points, accounting for 33.2%; 60 in the SF stage with HALFT score from 3 to 5, accounting for 29.7%. Regarding univariate comparison, the SF group proved significantly greater than the non-SF group in terms of age [(72.2±6.3) years vs (67.8±5.8) years, P＜0.001], Kellgren-Lawrence (KL) scale [I/II/III/IV, (7/46/48/26) vs (19/31/20/5), P＜0.001], and living style [living alone/with others, (2/73) vs (21/106), P=0.010], score of yielding coping style [(13.7±2.3) vs (11.4±2.1), P＜0.001], avoidance coping style sore [(18.8±2.7) vs (16.5±2.8), P＜0.001]. However, the SF group was significantly less than the non-SF group in terms of the exercise frequency [never/occasionally/often, (50/52/25) vs (30/19/26), P= 0.006], two-way social support score [(38.1±7.7) vs (44.7±7.0), P＜0.001], positive psychological capital score [(101.7±19.1) vs (119.6± 20.7), P＜0.001] and coping style score [(19.0±3.6) vs (22.4±4.3), P＜0.001]. As results of binary multivariate logistic regression analysis, living with others (OR=0.105, P＜0.05), higher two- way social support score (OR=0.881, P＜0.05), and high positive psychological capital score (OR=0.952, P＜0.05) were protective factors for the SF in elderly with KOA. However, advanced age (OR=1.104, P＜0.05), advanced K-L stage (OR=7.685, P＜0.05), and high yielding coping style score (OR=1.398, P＜0.05) were the risk factors for SF. [Conclusion] The patients with advanced age, living alone, higher KOA stage, lower social support, lower psychological capital, and yield coping have a higher risk of developing SF. Clinically, targeted intervention measures should be taken to reduce the SF level of elderly with KOA.
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ZHU Tian-hao, HUANG Chang-ming, FAN Hua-qiang, GAN Zhi-yong.
2025,33(16):1490-1494, DOI: 10.20184/j.cnki.Issn1005-8478.11079A
Abstract:
Prior research has indicated that injuries to the posteromedial corner of the knee joint are susceptible to misdiagnosis and missed diagnosis. Inadequate treatment may result in residual deformities and functional impairments, ultimately compromising the success of cruciate ligament reconstruction. Consequently, early diagnosis and intervention for posteromedial corner injuries are imperative. It is essential to comprehensively understand the anatomy, biomechanics, diagnosis, and treatment of injuries to the posteromedial corner of the knee. This article conducts a comprehensive literature review to elucidate the anatomy, biomechanics, diagnosis, and treatment of posterome-dial corner injuries of the knee, thereby advancing the understanding of these injuries.
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XU Fang-cheng-lin, MEI Yingxue, YU Yong-qin
2025,33(16):1495-1501, DOI: 10.20184/j.cnki.Issn1005-8478.110503
Abstract:
Venous thromboembolism (VTE) exhibits a high incidence among orthopedic diseases. Timely, standardized, and predictive risk assessment is crucial for adopting appropriate preventive measures. However, there is a diverse range of VTE risk assessment models currently available for orthopedics, lacking uniformity. This study aims to comprehensively and thoroughly explore and collect information on the development and practical application of VTE risk assessment models within the field of orthopedics, both domestically and internationally. It will meticulously review and summarize the applicable populations for these models and their version update history over time, aiming to provide a reference for clinical practice.
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HONG Li- hui, SHAN Fa- rong, LI Er- hu, LIU Ming-ming
2025,33(16):1502-1505, DOI: 10.20184/j.cnki.Issn1005-8478.110385
Abstract:
With lower limb disable for various reasons increasing, the lower limb rehabilitation robots are getting more and more sophisticated. Lower limb dysfunction seriously affects the daily life of patients, and the rational use of lower limb rehabilitation robots can effectively improve the symptoms of patients, achieve precise rehabilitation, and make the rehabilitation strategy more complete. This paper combines the current state of research at home and abroad respectively on the different types of lower limb robots; lower limb robots applied to the assessment method after the rehabilitation exercise are reviewed; finally, the lower limb rehabilitation robotic rehabilitation training and assessment system is summarized and outlooked.
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ZHANG Yun-feng, YANG Xiao-hui, LAO Ke-cheng, FAN Xiao
2025,33(16):1506-1511, DOI: 10.20184/j.cnki.Issn1005-8478.110801
Abstract:
[Objective] To investigate the effects of salidroside on the spinal cord tissue expressions of aquaporin 1 (AQP-1) and aquaporin 4 (AQP-4) after acute spinal cord injury in rats. [Methods] Thirty-six rats were randomly divided into the sham operation group, the model group and the salidroside group, with 12 rats in each group. In the sham operation group, only laminectomy was performed, and normal saline was injected intraperitoneally after the operation. In the model group and the salidroside group, spinal cord injury models were established, and normal saline and salidroside were injected intraperitoneally after the operation, respectively. Samples were harvested 3 days after the operation to detect the moisture content of spinal cord tissues. In addition, Nissl, immunohistochemistry and TUNEL staining, as well as western blot and RT-PCR assay were carried out for detection. [Results] Compared with the sham operation group, the moisture contents of spinal cord tissues in the model group and the salidroside group were significantly increased, while compared with the model group, the moisture content of spinal cord tissues in the salidroside group was significantly decreased [(85.3±5.6)% vs (72.2±7.6)%, P＜ 0.001]. In term of Nissl staining, the morphology of nerve cells in the sham operation group was normal, while that in the model group was disordered, and that in the salidroside group was significantly improved compared with the model group. In term of immunohistochemistry, compared with the sham operation group, the positive expressions of NeuN in the model group and the salidroside group were significantly decreased, whereas compared with the model group, the positive expression of NeuN in the salidroside group was significantly increased [(0.4±0.4) vs (0.9±0.4), P＜0.001]. In term of Tunel staining, compared with the sham operation group, the positive Tunel staining in the model group and the salidroside group was significantly increased, while compared with the model group, the positive staining in the salidroside group was significantly decreased [(0.8±0.1) vs (0.6±0.0), P＜0.001]. In term of western blot assay, compared with the sham operation group, the relative protein expression levels of AQP-1 and AQP-4 in the model group and the salidroside group were significantly increased (P＜0.05), while compared with the model group, the AQP-1 and AQP-4 expression in the salidroside group were significantly decreased (P＜ 0.05). As results of RT-PCR, compared with the sham operation group, the relative mRNA expression of AQP-1 and AQP-4 in the model group and the salidroside group were significantly increased (P＜0.05), whereas compared with the model group, the AQP-1 and AQP-4 expression in the salidroside group were significantly decreased (P＜0.05). [Conclusion] The salidroside down- regulates the expressions of AQP-1 and AQP-4 during the process of acute spinal cord injury, reduce edema and inhibit cell apoptosis.
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MA Bo-wen, SUN Jia-hao, XIA Tian-wei, SHEN Ji-Rong.
2025,33(16):1512-1515, DOI: 10.20184/j.cnki.Issn1005-8478.110105
Abstract:
[Objective] To introduce the surgical technique and preliminary clinical results of implants removal and total hip arthroplasty in lateral position through direct anterior approach (DAA). [Methods] A patient who suffered from bone nonunion after open reduction and internal fixation of the left femoral neck fracture admitted to our hospital in 2023 underwent abovesaid surgical treatment after artificial intelligence preoperative planning. The patient was placed in lateral position, the DAA incision was used to expose the femoral neck. After the previous screws and plate were removed, the femoral head was extracted by osteotomy. As the acetabulum and proximal femoral medullary cavity were prepared, the acetabular cup and ceramic lining, as well as femoral stem and ceramic short head components selected according to the preoperative design were placed sequentially. Checking prosthetic components in proper position and no dislocation in motion, the wound was irrigated and closed in layers. [Results] The patient had operation perfored successfully with operation time of 135 min and intraoperative blood loss about 240 mL. The X-ray and CT showed that the prosthetic components was in place, without significantly widened or narrowed joint space 1 day postoperatively. The patient resumed walking independently 3 days after surgery, were marked Harris score of 94.3, with the affected hip range of motion of 110° in flexion, 20° in abduction, 10° in external rotation, and 10° in adduction 2 months after operation. The anterolateral and lateral radiographs of the affected hip showed the prosthetic components in good position, no local bone sclerosis observed. [Conclusion] The direct anterior approach used for implant removal and total hip arthroplasty in same stage is less invasive, safe and effective, and does accelerate early postoperative recovery.
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ZHANG Dao-jian, Jimi Gesang, MA Xiaogang, YANG Ti-min
2025,33(16):1516-1519, DOI: 10.20184/j.cnki.Issn1005-8478.110874
Abstract:
[Objective] To investigate preliminary results of direct anterior approach (DAA) hip arthroplasty in Xizang area. [Methods] A retrospective study was done on 23 patients who received DAA hip arthroplasty from August 2023 to August 2024. The Clinical and imaging data were evaluated. [Results] The 23 patients were operated on successfully without serious complications, with the average operation time of (109.4±32.5) min, the average incision length of (12.9±1.5) cm, the average intraoperative blood loss of (317.4±148.9) mL. All the patients were followed up for a mean of (13.5±1.2) months. With time preoperatively, 3 months postoperatively and the latest follow-up, the VAS score was significantly decreased [(9.1±0.6), (3.4±0.8), (2.1±0.5), P＜0.001], while the hip flexion-extension range of motion (ROM) [(58.2±29.7)°, (117.0±8.6)°, (127.0±5.2)°, P＜0.001] and Harris score [(31.5±18.2), (96.4±1.4), (96.7±2.1), P=0.010] were significantly increased. As for imaging, there were no significant changes in the leg length discrepancy, femoral neck-shaft angle, acetabular abduction angle and acetabular anteversion after surgery compared with those before surgery (P＞0.05). [Conclusion] In Xizang, the DAA hip arthroplasty does achieve good initial clinical consequence, with advantages of less risk of dislocation, faster recovery, higher satisfaction, and better hip function recovery.
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CHEN Jun, XIE Fang, ZOU Feng, ZHANG Nan-nan
2025,33(16):1520-1523, DOI: 10.20184/j.cnki.Issn1005-8478.110635
Abstract:
[Objective] To investigate the effect of esketamine (ESK) on fatigue syndrome after total hip arthroplasty (THA) in the elderly. [Methods] A total of 183 elderly patients who were undergoing THA were randomly divided into ESK group (92 cases) and control group (91 cases). The clinical and laboratory results of the two groups were compared. [Results] The ESK group proved significantly lower incidence of intraoperative hypotension than the control group (8.7% vs 19.8%, P=0.039). The occurrence of postoperative fatigue syndrome (POFS) and pain NRS score in both groups were significantly improved over time postoperatively (P＜0.05). The ESK group was significantly superior to the control group in terms of incidence of POFS 1 day (13.0% vs 28.6%, P=0.008) and 3 days postoperatively (8.7% vs 19.6%, P=0.026), as well as bed rest time [(7.6±1.3) hours vs (8.2±1.6) hours, P=0.006] and the number of awakening within 7 days after the operation [(82.6±9.2) times vs (90.2±9.3) times, P＜0.001]. As for blood test, the interleukin-1β (IL-1β), hypersensitive C-reactive protein (hsCRP), cortisol, serum interleukin-6 (IL-6) were significantly increased in both groups immediately after surgery, 1 and 3 days after surgery compared with those preoperatively (P＜0.05). There were no statistical significances in the above test indexes between the two groups before surgery (P＞0.05). However, the ESK group had significantly lower levels of the aforesaid test parameters than the control group at all corresponding time points after surgery (P＜0.05). [Conclusion] Esketamine reduces the incidence of POFS after THA in the elderly, which may be related to inhibiting inflammatory response, reducing intraoperative hypotension, shortening bed rest time and improving sleep quality.
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WANG Ming-youa, WANG Hong-pin? ga, TAO Qi-fenga, YANG Xiao-qinb, CHEN Chun-yua, LAN Yu-pinga
2025,33(16):1524-1528, DOI: 10.20184/j.cnki.Issn1005-8478.110146
Abstract:
[Objective] To evaluate the early clinical consequences of robot-assisted total knee arthroplasty (TKA). [Methods] From June to November 2023, 130 patients who admitted to our hospital for knee osteoarthritis were divided into two groups according to the ratio of 1:1 using random number table method. Of them, 65 patients received robot-assisted TKA, while other 65 patients received conventional TKA. The documents regarding to perioperative period, follow-up and images of the two groups were compared. [Results] The robot group consumed significantly longer operative time [(95.1±9.1) min vs (81.8±8.1) min, P＜0.001], associated with significantly longer incision length [(14.9 ± 0.5) cm vs (14.1 ± 0.8) cm, P＜0.001] than the conventional group. Compared with those preoperatively, the VAS, KSS, WOMAC scores and knee range of motion (ROM) were significantly improved in both groups at the last follow-up (P＜0.05), which proved not statistically significant between the two groups at any corresponding time points (P＞0.05). As for auxiliary examinations, there were no statistically significant differences in Hb, HCT, WBC, NLR, ESR and CRP between the two groups 3 days after surgery (P＞0.05). However, the robot group was significantly superior to the conventional group in terms of postoperative frontal femoral component (FFC) angle [(89.1± 1.0)° vs (87.6±1.9)°, P＜0.001], lateral tibia component (LTC) angle [(86.8±0.9)° vs (85.9±2.3)°, P=0.006], hip-knee-ankle (HKA) angle [(179.1±1.0)° vs (176.7±1.7)°, P＜0.001], despite of the fact that there was no significant difference in frontal tibial component (FTC) angle and lateral femoral component (LFC) angle between the two groups (P＞0.05). [Conclusion] Robot-assisted total knee arthroplasty is a safe and effective surgical method, which can achieve good reconstruction of lower limb alignment and precise placement of prosthetic components.
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NING Bo, SONG Yan-lei, SUI Shu-xiang, GONG Xiao-nan
2025,33(16):1529-1532, DOI: 10.20184/j.cnki.Issn1005-8478.110636
Abstract:
[Objective] To evaluate the clinical efficacy of combined reconstruction of medial patellotibial ligament (MPFL) and medial patellotibial ligament (MPTL) in the treatment of recurrent patellar dislocation. [Methods] A total of 27 patients underwent MPFL and MPTL combined reconstruction using autogenous semitendinous tendon with tibial insertion preserved for recurrent patellar dislocation from May 2018 to September 27, 2021. Clinical and imaging results were evaluated. [Results] All 27 patients had operation performed successfully without serious complications such as blood vessel, nerve injury and lower limb venous thrombosis. As time elapsed preoperatively, 3 months postoperatively and the latest follow-up, the VAS score [(6.3±1.1), (1.6±0.5), (0.5±0.5), P＜0.001] significantly reduced, Kujala score [(51.9±3.0), (84.0±1.2), (93.2±1.1), P＜0.001], Lysholm score[(52.1±3.9), (83.1±2.6), (88.0±2.9), P＜0.001], knee extension-flexion ROM [(111.9±3.1)°, (122.6±1.7)°, (127.8±1.6)°, P＜0.001] significantly increased. As for image, the patellar tilt angle [(21.4±1.8)°, (8.1± 0.8)°, (7.3±0.6)°, P＜0.001], lateral patellar displacement [positive/negative, (13/14), (2/25), (2/25), P＜0.001] were significantly improved over time, whereas the TT-TG remained unchanged significantly (P＞0.05). [Conclusion] MPFL and MPTL combined reconstructions do effectively treat recurrent patellar dislocation, improve knee joint function, reduce pain, and are safe and effective treatment technique.
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LU Yao, LU Yu-feng, YAN Xiu-qin, FANG Ying- lei, WANG Shao- hua
2025,33(16):1533-1536, DOI: 10.20184/j.cnki.Issn1005-8478.110453
Abstract:
[Objective] To explore the outcome of the zero-defect all-round nursing in total hip arthroplasty (THA). [Methods] A total of 105 patients who were receiving THA from January 2022 to December 2023 were included into this study and divided into two groups by the random number table method. Among them, 53 cases received zero-defect full-perspective care (the combined group), and the other 52 cases received conventional care (the conventional group). The perioperative relevant data were compared between the two groups. [Results] The combined group proved significantly superior to the conventional group in term of the operation time [(82.5±7.6) min vs (86.4± 8.3) min, P=0.014], intraoperative blood loss [(201.4±28.7) mL vs (250.5±31.2) mL, P＜0.001], postoperative ambulation time [(2.0±0.3) days vs (4.0±0.5) days, P＜0.001], hospital stay [(8.5±1.1) days vs (10.0±1.7) days, P＜0.001] and total incidence of nursing defect events (1.9% vs 17.3%, P=0.018). Three days postoperatively, the combined group was significantly better than the conventional group regarding pain VAS score [(2.1±0.6) vs (2.6±0.8), P＜0.001], depression DASS-21 score [(3.8±1.5) vs (4.8±1.7), P=0.002], anxiety DASS-21score [(5.3±1.9) vs (6.5±2.4), P=0.005] and QoR-15 score [(128.0±20.3) vs (115.8±21.0), P=0.003]. In addition, the combined group also proved significnatly superior to the conventional group in Harris score at discharge [(56.0±6.4) vs (52.5±6.2), P=0.005]. [Conclusion] The zero-defect all-round nursing intervention can significantly reduce the operation time and blood loss in THA, alleviate pain and negative emotions, facilitate postoperative recovery of patients, and improve the quality of recovery and hip joint function.
