2025 Issue 1

• (Open Access) Fenestration versus core decompression and bone grafting for medium-term femoral head necrosis

  ZHA Yang-xiao-zhi, CHEN Yan-xiong, ZHANG Jun, LIAN Xing-ye, MENG Zeng-dong.

  2025,33(1):5-11, DOI: 10.20184/j.cnki.Issn1005-8478.110357

  Abstract: (56) PDF (2.15 MKB)(247)

  Abstract:

  [Objective] To compare the clinical efficacy of fenstration at femoral head-neck interface for decompression and impacting

  bone grafting (the FDBG) versus core decompression, and impacting bone grafting with a strut graft (the CDBG) for medium-term osteonecro-

  sis of the femoral head (ONFH). [Methods] A retrospective study was conduted on 100 patients who underwent surgical treatment for medi-

  um-term ONFH in our hospital from June 2014 to April 2022. According to the preoperative doctor-patient communication, 50 patients re-

  ceived the FDBG, while other 50 patients underwent the CDBG. The perioperative, follow-up and imaging data of the two groups were com-

  pared. [Results] The FDBG group proved significantly greater than the CDBG group in term of operation time [(54.4±7.2) min vs (46.3±6.8)

  min, P<0.001], total length of incision [(4.2±0.8) cm vs (3.5±0.6) cm, P<0.001], intraoperative blood loss [(100.5±12.0) ml vs (50.8±7.4) ml,

  P<0.001], whereas the former was significantly less than the latter regarding volume of bone graft [(2.5±0.5) g vs (4.3±0.6) g, P<0.001], ambu-

  lation time [(96.0±5.2) days vs (106.3±10.6) days, P<0.001] and hospitalization days [(5.5±0.7) days vs (7.0±1.2) days, P<0.001]. All patients

  in both groups were followed up for a mean of (30.0±3.5) months, and the FDBG group resumed full weight-bearing activity significantly ear-

  lier than the CDBG group [(180.8±26.5) days vs (200.0±35.0) days, P=0.003]. The VAS score, HHS score, iHOT-33 score, hip extensionflexion

  range of motion (ROM) and hip internal-external rotation ROM significantly improved in both groups over time (P<0.05). The FDBG

  group was significantly superior to the CDBG group in terms of VAS score [(2.8±0.6) vs (3.1± 0.8), P=0.036], HHS score [(76.7±5.6) vs (72.4±6.5), P<0.001] and iHOT-33 score [(64.8±6.0) vs (60.5±5.6), P<0.001] 3 months postoperatively. At the last follow-up, there was no statisti-

  cally significant difference in the survival rate of the femoral head between the FDBG and CDBG groups [42/50 (84.0%) vs 37/50 (74.0%),

  P=0.220]. Among the 21 patients who failed hip preservation, 10 patients (47.6%) underwent revision hip arthroplasty. As for imaging, there

  were no significant changes in ARCO grade and Tonnis stage in both groups 6 months after surgery and at the last follow-up, compared with

  those before operation (P>0.05), but the signs of lesions and joint effusion significantly improved in the two groups over time (P<0.05). At cor-

  responding time points, there were no statistically significant differences in the abovesaid imaging indicators between the two groups (P>

  0.05). [Conclusion] The fenstration decompression and impacting bone grafting for ONFH is superior to the core decompression bone graft-

  ing in time to regain full weight-bearing activity and hip function 3 months after surgery.

• (Open Access) A prospective random comparison of personalized guide versus conventional counterpart for unicompartmental knee arthroplasty

  DENG Yu, JIANG Qi-long, CAO Lin-hu, BAI Xin-wen.

  2025,33(1):12-18, DOI: 10.20184/j.cnki.Issn1005-8478.100932

  Abstract: (27) PDF (1.66 MKB)(230)

  Abstract:

  [Objective] To compare the clinical outcomes of unicompartmental knee arthroplasty (UKA) by the beginners with the pa-tient-specific instrumentation (PSI) guide versus the experienced physicians with conventional guide. [Methods] From January 2022 to No-vember 2022, a total of 44 patients who were undergoing unilateral UKA were included in this study and randomly divided into two groups.Of them, 22 patients had UKA performed by the beginners with the personalized osteotomy guides (PSI group), while other 22 patients weretreated by experienced physicians with commercially provided conventional osteotomy guides (Oxford Microplasty) (OMP group). The docu-ments regarding perioperative period, follow-up and images were compared between the two groups. [Results] Although the PIS group con-sumed significantly longer operative time than the OMP group [(65.2±6.1) min vs (58.1±3.9) min, P＜0.001], there were no significant differ-ences in total incision length, intraoperative blood loss, insert thickness, walking time, incision healing grade and hospital stay between thetwo groups (P＞0.05). The mean follow-up time was of (18.0±3.2) months, and there was no significant difference in the total weight-bearingactivity time between the two groups (P＞0.05). The VAS score, HSS score, KSS score, FJS score and ROM were significantly improved inboth groups over time (P＜0.05). At corresponding time points, there was no statistical significance in the above indexes between the twogroups (P＞0.05). Radiographically, the femoral component varus/valgus angle (FVVA), femoral component flexion/extension angle (FVVA),femoral component flexion/extension angle (FFEA), tibial component varus/valgus angle (TVVA), tibial component posterior slope angle (TP-SA) and hip knee ankle angle (HKAA) remained unchanged significantly in both groups at the latest follow-up compared with those immedi-ately after operation (P＞0.05), additionally, which were not significantly different between the two groups at any time points accordingly (P＞0.05). [Conclusion] Compared with experienced doctors using OMP for UKA, the beginners using PSI spend a relatively longer operationtime, but the consequences of the two groups are comparable in perioperative damage control, functional scores and imaging indicators.Therefore, PSI might be used as an alternative tool for UKA beginners to shorten the learning curve.

• (Open Access) Comparison of three arthroscopic techniques for repair of wrist triangular fibrocartilage complex tear

  WEI Ben- lei, ZHANG Yu, ZHAO Tong-lin, LI Wei

  2025,33(1):19-24, DOI: 10.20184/j.cnki.Issn1005-8478.110103

  Abstract: (24) PDF (1.11 MKB)(232)

  Abstract:

  [Objective] To compare the clinical consequence of capsular suture (CS), single bone tunnel repair (SBT) and Y-shaped dou-ble bone tunnels repair (DBT) of Palmer type IB wrist triangular fibrocartilage complex (TFCC) tear. [Methods] A retrospective researchwas conducted on 49 patients who had Palmer type IB TFCC tear repaired arthroscopically in our hospital from June 2014 to September2023. According to the preoperative doctor-patient communication, the patients were divided into three groups. Of them, 14 patients re-ceived CS, 19 received SBT, and 16 cases received DBT. The perioperative period, follow-up and imaging data of the three groups were com-pared. [Results] All patients in the 3 groups were operated on successfully. The CS group was significantly superior to the SBT and DBTgroups in terms of operation time [(106.5±15.4) min vs (170.6±15.7) min vs (163.1±19.2) min, P＜0.001] and intraoperative blood loss [(14.0±3.5) ml vs (50.1±15.8) ml vs (46.7±13.4) ml, P＜0.001], whereas the CS group took significantly longer external fixation time than the SBTgroup and DBT group [(50.1±6.1) days vs (33.6±7.2) days vs (31.9±4.8) days, P＜0.001]. All of them were followed up for (14.0±5.6) monthsin a mean, and the CS group resumed full weight-bearing activity significantly later than the SBT and DBT groups [(55.8±3.1) days vs (45.1±3.3) days vs (37.5±5.5) days, P＜0.001]. The VAS score, Mayo score, extension-flexion ROM, ulnar-radial deviation ROM and pronation-su-pination ROM were significantly improved in three groups over time (P＜0.05). At the last follow-up, the SBT group were significantly betterthan the DBT group in VAS score and ulnar-radial deviation ROM (P＜0.05), while the DBT group was significantly superior to the SBTgroup in terms of Mayo score, extension-flexion ROM and pronation-supination ROM (P＜0.05). Moreover, both DBT and SBT groups weresignificantly better than CS group regarding abovesaid items (P＜0.05). As for imaging, the radioulnar distance, TFCC continuity and radioul-nar recess edema were significantly improved in all the three groups at the last follow-up compared with those preoperatively (P＜0.05),which in the DBT group were significantly better than those of SBT group (P＜0.05), while in SBT group was significantly better than in CSgroup (P＜0.05). [Conclusion] Wrist arthroscope-assisted double-transosseous fixation for type IB TFCC tear was safe and effective, and su-perior to single-transosseous and capsule suture techniques.

• (Open Access) Arthroscopic reduction and titanium cable fixation versus open counterpart for patellar fractures

  DU Hao, WANG Sicheng, HOU Jun-ye, LI Guang-feng, YIN Zhi-feng, ZHANG Wen-ru, YANG Xiao-yu, LI Wang, CAO Zhong-hua

  2025,33(1):25-31, DOI: 10.20184/j.cnki.Issn1005-8478.110176

  Abstract: (26) PDF (1.97 MKB)(230)

  Abstract:

  [Objective] To compare the clinical efficacy of arthroscopic reduction and titanium cable internal fixation versus traditionalopen counterpart for patellar fractures. [Methods] A retrospective study was conducted on 59 patients had closed unilateral patellar frac-tures treated surgically in our department from January 2022 to December 2022. According to doctor-patient communication, 31 patients un-derwent arthroscopic reduction and titanium cable internal fixation (the arthroscopic group), while other 28 patients received open reductionand titanium cable internal fixation (the open group). The perioperative, follow-up and imaging data of the two groups were compared. [Re-sults] All the patients in both groups were successfully operated on. The arthroscopic group proved significantly superior to the open group interms of total incision length [(3.5±0.3) cm vs (8.5±0.6) cm, P＜0.001], intraoperative blood loss [(73.5±16.4) ml vs (94.6±21.5) ml, P＜0.001],intraoperative fluoroscopy times [(2.8±0.9) times vs (3.4±1.0) times, P=0.035], hospital stay [(4.3±1.5) day vs (8.3±2.1) days, P＜0.001]. Themean follow-up period was of (15.3±4.4) months, and there was no significant difference in time to resume full weight-bearing activities be-tween the two groups (P＞0.05). The VAS, Kujala and Lysholm scores, as well as knee extension-flexion range of motion (ROM) were signifi-cantly improved in both groups over time postoperatively (P＜0.05). At 12 weeks and the last follow-up, the arthroscopic group was signifi-cantly better than the open group in terms of knee extension-flexion ROM [(105.0±3.9)° vs (100.5±3.9)°, P＜0.001; (117.9±4.8)° vs (112.3±4.4)°, P＜0.001]. Regarding to imaging, the joint surface congruity was significantly improved in both groups at the last follow-up comparedwith that preoperatively (P＜0.05). However, there were no statistically significant differences in the joint face congruity between the twogroups at and corresponding time points (P＞0.05), and fracture healing time between the two groups (P＞0.05). [Conclusion] The arthroscop-ic reduction and titanium cable internal fixation for patellar fractures has the advantages of better safety, less bleeding, shorter operation time, smaller incision, shorter hospital stay and better functional recovery over the open counterpart.

• Movable bearing versus fixed bearing prostheses in unicompartmental knee arthroplasty for medial compartment osteoarthritis of the knee

  WANG Hai-bo, FENG Xiao, WANG Long, JIANG Jian, LIN Su-bin, WANG Ye-hua

  2025,33(1):32-37, DOI: 10.20184/j.cnki.Issn1005-8478.110290

  Abstract: (22) PDF (1.69 MKB)(149)

  Abstract:

  [Objective] To compared the clinical outcome of mobile bearing (MB) and fixed bearing (FB) platforms in unicompartmentalknee arthroplasty (UKA) in the treatment of medial compartment osteoarthritis of the knee. [Methods] A retrospective study was conductedon 102 patients who received UKA for medial compartment osteoarthritis of the knee in our hospital from January 2020 to January 2023. Ac-cording to preoperative doctor-patient communication, 54 patients received MB prosthesis and 48 patients received FB prosthesis. The peri-operative period, follow-up and imaging data of the two groups were compared. [Results] All patients in both groups had UKA performed suc-cessfully with no significant differences in operation time, incision length, intraoperative blood loss, postoperative drainage volume, walkingtime and hospital stay between the two groups (P＞0.05). However, the treatment cost in MB group was significantly lower than that in FBgroup [(5.1±0.2) 10k yuan vs (5.5±0.3) 10k yuan, P＜0.001]. The mean follow-up time was of (26.5±3.0) months, and there was no significantdifference in the time to regain full weight-bearing activities between the two groups (P＞0.05). The VAS score, WOMAC score, HSS scoreand extension-flexion range of motion (ROM) were significantly improved in both groups over time postoperatively (P＜0.05), whereas whichwere not statistically significant between the two groups at any corresponding time points (P＞0.05). As for imaging, femorotibial angle (FTA),hip-knee-ankle (HKA) and medial proximal tibial angle (MPTA) were significantly improved in both groups at the latest follow-up com-pared with those preoperatively (P＜0.05), whereas there were no significant changes in posterior tibial slope (PTS) (P＞0.05). At any timepoints accordingly, there were no significant differences in the above image indicators between the two groups (P＞0.05). [Conclusion] TheMB UKA and FB UKA achieve comparable clinical consequences for medial compartment osteoarthritis of the knee.

• A meta-analysis on high tibial osteotomy with or without arthroscopic debridement for knee osteoarthritis

  SHEN Xiang, LI Yao, LIAN Hong-yu, LI Zi-tao

  2025,33(1):38-43, DOI: 10.20184/j.cnki.Issn1005-8478.110171

  Abstract: (28) PDF (1.01 MKB)(149)

  Abstract:

  [Objective] To evaluate clinical efficacy of high tibial osteotomy with arthroscopic debridement (HTO-A) verusus high tibialosteotomy without arthroscopic debridement (HTO) by a meta-analysis. [Methods] The related literatures were searched in PubMed, Web ofScience, Embase, Cochrane Library, CNKI, Wanfang and PP databases from January 2024, and a meta-analysis of the included literatureswas performed using Revman 5.4 software. [Results] A total of 8 literatures were enrolled into this study, including 3 randomized controlledtrials and 5 retrospective cohort studies, with 547 patients included, involving 290 in the HTO-A group and 257 in the HTO group. As re-sults of the meta-analysis, the HTO-A group was significantly superior to the HTO group in terms of postoperative knee range of motion(MD=4.61, 95%CI 1.28-7.94, P=0.007), VAS score (MD=-0.97, 95%CI -1.79~0.15, P=0.02) 1 month, (MD=-0.51, 95%CI -0.62~0.40, P＜0.001) 3 months, (MD=-0.38, 95%CI -0.46~-0.31, P＜0.001) 6 months postoperatively, and HSS score (MD=4.94, 95%CI 3.15~6.73, P＜0.001) 1 month, (MD=4.30, 95%CI 1.07~7.54, P=0.009) 3 months, (MD=3.54, 95%CI 2.47~4.61, P＜0.001) 6 months and (MD=4.26, 95%CI 3.30~5.21, P＜0.001) 12 months postoperatively. However, there were no significant differences in postoperative complication rate (OR=0.58, 95%CI 0.24-1.43, P=0.24) and VAS score 12 months after surgery (MD=0.00, 95%CI -0.23~0.22, P=0.98) between the two groups.[Conclusion] Compared with HTO alone, the HTO combined arthroscopic debridement has greater knee range of motion, better knee jointfunction and less pain symptoms in the short term, but there is no significant difference in the incidence of postoperative complications andlong-term pain symptoms.

• (Open Access) Analysis of highly cited papers in Orthopedic Journal of China from 2016 to 2021

  FENG Chun-lei, SUN Lei, NING Hua, YAN Cheng-jie, ZOU Xue-lian, HAN Bing, GUO Xiu-ting

  2025,33(1):44-51, DOI: 10.20184/j.cnki.Issn1005-8478.11066A

  Abstract: (26) PDF (1.50 MKB)(232)

  Abstract:

  [Objective] To analyze the highly cited papers in the Orthopedic Journal of China, so as to provide references for topic se-lection and submission, and further enhance the academic quality and influence of the journal. [Methods] The citation numbers of all pa-pers published in this journal from January 2016 to December 2021 were retrieved and counted based on the China National Knowledge In-frastructure (CNKI) China Citation Database, in order to determine the highly cited papers, and literature type distribution, topic distribu-tion, and keyword analysis. [Results] From January 2016 to December 2021, a total of 3 363 articles were published, including 3 135 validpapers. Of them, 2 973 theses were cited, with the top 5% of cited papers of 152. These highly cited papers had a total citation frequency of6 708 times, with an average citation frequency of 44.1 times per paper, while the papers cited ≥50 times were 41 articles. Among the 41theses, 24 were from affiliated hospitals of universities, accounting for 58.5%. In terms of topic distribution, the first one was 12 articles re-lated to spine, the second was 11 articles related to joints, and the third was 10 articles related to trauma (including ankle), and the fourthwas 9 papers on other topics. In term of type distribution of the 41 theses, 21 were clinical original articles, 9 reviews, 4 clinical studies,and 2 experience exchanges, as well as 1 expert consensus, 1 diagnosis and treatment norms, 1 meta-analysis, 1 basic research, and 1 nurs-ing conference report respectively. The most frequently used keywords were "knee " (8 times), "percutaneous transforaminal endoscope" (7times), and "osteoarthritis" (6 times). [Conclusion] The highly cited articles in this journal focuses are characterized on spine in topics, clin-ical original article in published type. The main content of Orthopaedic Journal of China is cutting-edge orthopedic hot field, and unique re-search.

• Research status of cytokines related to osteoarthritis pathogenesis

  HUANG Peng-fei, ZHAO Jun-jie, ZHANG Zhao-kun, ZHAO Hai- yan

  2025,33(1):52-57, DOI: 10.20184/j.cnki.Issn1005-8478.100841

  Abstract: (30) PDF (676.83 KKB)(149)

  Abstract:

  Osteoarthritis is the most common chronic degenerative disease in the elderly population. In recent years, the global inci-dence of osteoarthritis has been increasing, but there is still no complete cure for osteoarthritis, partly because of the lack of a comprehensiveunderstanding of the mechanism of osteoarthritis and its development. Therefore, this article introduced in detail the pathogenic factors relat-ed to the pathogenesis of osteoarthritis, such as cytokines, matrix metalloproteinases, inflammatory mediators and other pathogenic factors,and reviewed their roles and mechanisms in osteoarthritis.

• Research progress of human umbilical cord blood stem cells in the treatment of osteoarthritis

  TIAN Si- man, NIU Yingzhen, MA Jun, DONG Jiang-tao

  2025,33(1):58-63, DOI: 10.20184/j.cnki.Issn1005-8478.100696

  Abstract: (23) PDF (668.99 KKB)(150)

  Abstract:

  Osteoarthritis (OA) is a chronic degenerative joint disease characterized by cartilage damage, which seriously affects thequality of life of patients, and none of the available clinical treatments can halt the progression of OA. Mesenchymal stem cells (MSCs) andtheir exosomes show promising applications in the treatment of OA due to their ability to regenerate cartilage. Among them, human umbilicalcord blood-derived mesenchymal stem cells (hUCB-MSCs) have the advantages of non-invasive collection method, high proliferation, andlow immunogenicity, which is considered to be a more effective cell source for the treatment of OA. Exosomes secreted by hUCB-MSCs (huc-MSCs-EXOs) act as intercellular messengers that can treat OA through the bioactive factors they carry. In this paper, we reviewed the prog-ress of hUCB-MSCs and their exosomes in OA treatment to provide new ideas for OA treatment.

• (Open Access) Advances in the study of exosomes and autophagy crosstalk in spine and joint degenerations

  YAN Bing-han, QIU Dao-di, XU Zhan- wang, TAN Guo- qing

  2025,33(1):64-69, DOI: 10.20184/j.cnki.Issn1005-8478.100399

  Abstract: (22) PDF (1.01 MKB)(230)

  Abstract:

  Intervertebral disc degeneration (IDD) and osteoarthritis (OA) are common spine and joint degenerative diseases, which seri-ously affect people's quality of life. Currently, there is no effective radical treatment. The crosstalk between exosomes and autophagy of differ-ent origin can delay the progression of IDD and OA, and its mechanism involves inhibiting apoptosis and protecting extracellular matrix. Byreviewing relevant literature in recent years, this paper described the application status of exosomes and autophagy in the diagnosis and treat-ment of spinal and articular degenerative diseases, and found that autophagy might be an emerging target for the treatment of osteoarticulardegenerative diseases. Exosomes contain a variety of bioactive substances required for bone reconstruction, and the mutual interference ofthe two can further improve the efficacy of IDD and OA. It is expected to provide reference for future research in this field.

• Perioperative anticoagulation practices in unicompartmental knee arthroplasty

  JIANG Yun-fei, CAO Guang-lei.

  2025,33(1):70-74, DOI: 10.20184/j.cnki.Issn1005-8478.100900

  Abstract: (23) PDF (656.06 KKB)(149)

  Abstract:

  Both unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) are essential approaches for treating endstageknee osteoarthritis. It is a now clinical consensus to administer anticoagulation in TKA to prevent thromboembolism and mitigate seri-ous clinical consequences. However, there currently is no established guideline for perioperative prophylactic anticoagulation in UKA, andclinical practices often reference those used in TKA. In comparison to TKA, UKA involves smaller trauma and faster recovery. Simply adopt-ing the anticoagulation strategy from TKA appears outdated. This review systematically examines the perioperative anticoagulation approach-es for UKA, summarizes the current trends in perioperative anticoagulation, and provides insights to guide the formulation of perioperativeanticoagulation plans for patients undergoing UKA. Additionally, it offers considerations for the future development directions of anticoagula-tion.

• Current application of SPECT/CT in the diagnosis of osteomyelitis

  LI Fu-lin, ZHANG Yong-hong, WANG Dong, LI Yan

  2025,33(1):75-79, DOI: 10.20184/j.cnki.Issn1005-8478.100717

  Abstract: (19) PDF (660.74 KKB)(148)

  Abstract:

  Osteomyelitis is a serious bone disease in clinical practice, which can be caused by aerobic or anaerobic bacteria, mycobacte-ria and fungi, resulting in bone infection and destruction, seriously affecting the physical and mental health and working ability of patients.Early diagnosis and treatment are very important for good prognosis of osteomyelitis. However, conventional imaging examination or singlenuclear medicine functional imaging can not diagnose osteomyelitis early and accurately due to various factors. Single photon emission com-puted tomography (SPECT/CT) fusion imaging is helpful to overcome the shortcomings of routine examination, and can be used for early diag-nosis of osteomyelitis, accurate location of osteomyelitis lesions, provide a guidance of treatment and prognosis analysis, and is a new methodfor the diagnosis of osteomyelitis.

• (Open Access) Neurovascular pedicle flap combined with antibiotic calcium sulfate in treatment of infectious wounds around the ankle

  WANG Huia, DAI Jiang-pinga, ZHOU Tonga, LIU Yu-jiea, MA Tie-penga, LIU Yingb, ZHANG Yi-hana

  2025,33(1):80-84, DOI: 10.20184/j.cnki.Issn1005-8478.100934

  Abstract: (22) PDF (2.01 MKB)(229)

  Abstract:

  [Objective] To introduce the surgical technique and preliminary clinical results of neurovascular pedicle flap combinedwith antibiotic calcium sulfate in treatment of infectious wounds around the ankle. [Methods] From April 2016 to June 2022, a total of 21patients with infectious wounds around the ankle were treated by neurovascular pedicle flap combined with antibiotic calcium sulfate. Thesaphenous nerve and posterior tibial artery perforators around the wound was marked by high-frequency color doppler ultrasound preopera-tively. After debridement, the skin margin on one side of the flap was firstly cut to expose the saphenous nerve and posterior tibial arteryperforators near the flap axis and rotation point. After that, the flap was freed with subcutaneous fascia tissue about 1.5~2.0 cm in wide onboth sides of the flap axis retained. The flap was transferred to cover the wound by an open tunnel. The prepared antibiotic calcium sulfateparticles were filled into the cavity below the flap. Subsequently, the saphenous nerve was anastomosed end-to-end with the nerve stumpsat donor site under microscope. The flap donor site was sutured directly or repaired by intermediate split thickness skin graft harvested fromthe thigh. [Results] All 21 patients had flaps and skin grafts at donor site survived uneventfully with the incisions at the donor site healed inexcellent grade, and were followed up for (15.2±4.9) months in a mean. All patients returned to normal life without infection recurrence, hadappearance of the flaps looked good with a wear-resistant and soft texture. At the latest follow-up, the function of the affected ankle andfoot was marked as excellent in 10, good in 10, and fair in 1, with excellent and good rate of 95.2%. [Conclusion] This neurovascular pedi-cle flap combined with antibiotic calcium sulfate is a good option for treating infectious wounds at the distal leg and the ankle and foot withadvantages of simple procedure and good outcome.

• Comparison of CT and Xray image planning before total knee arthroplasty

  WANG Xiao- hua, YUAN Liang, SUN Bin, ZHANG Ke, YANG Bin.

  2025,33(1):85-88, DOI: 10.20184/j.cnki.Issn1005-8478.100871

  Abstract: (23) PDF (1.06 MKB)(149)

  Abstract:

  [Objective] To compare the three-dimensional planning before total knee arthroplasty with full-length CT versus knee jointCT combined with full-length weight-bearing X ray. [Methods] Clinical data of 20 patients with knee osteoarthritis admitted to our hospitalfrom October 2021 to June 2022 were retrospectively analyzed. For each patient, preoperative three-dimensional planning was performed byfull-length lower extremity CT, and knee joint CT combined with full-length weight-bearing X ray. The difference between the two measure-ment methods and the actual value and the difference between the two image planning and the actual prosthesis size were compared. [Re-sults] There were no statistically significant differences in femoral eversion angle, cutting amounts of anterior condyle, distal medial bone,medial posterior condyle and lateral posterior condylebetween the two methods (P＞0.05). The bone cutting amount of medial tibial plateaumeasured by CT was significantly greater than that measured by X-ray [(4.1±1.3) mm vs (3.7±1.3) mm, P＜0.05]. The femoral component sizeplanned by the two methods was completely consistent in 13 cases (65.0%), while inconsistent in 7 cases (35.0%). There were 8 cases(40.0%) with identical tibia component and 12 cases (60.0%) with inconsistent tibia component. [Conclusion] Comparing the two imagetechniques used for the three dimensional planning of total knee arthroplasty, the planning parameters are similar in the femur, while differ-ent in the tibia.

• Comparison of different pressures of tourniquet in unicompartmental knee arthroplasty

  ZHAO Jin-wei, LIU Gui-yu, YANGWen-jiang, GAO Guang-ling, JIANG Hong-jiang, JU Chang-jun

  2025,33(1):89-93, DOI: 10.20184/j.cnki.Issn1005-8478.100734

  Abstract: (24) PDF (1.21 MKB)(148)

  Abstract:

  [Objective] To compare the consequence of different pressure strategies of tourniquet in fixed bearing unicompartmentalknee arthroplasty (FB-UKA). [Methods] A prospective single-blind randomized controlled study was conducted on 60 patients who were un-dergoing FB-UKA for knee osteoarthritis in our hospital from July 2022 to July 2023. The patients were randomly divided into the fixed pres-sure(FP) group, limb occlusion pressure (LOP) group and systolic blood pressure (SBP) group, with 20 patients in each group. The clinicaland blood test data were compared among the 3 groups. [Results] All patients in the 3 group had FB-UKA performed successfully. The FPgroup had significantly higher tourniquet pressure than the LOP and SBP groups [(300.0±0.0) mmHg vs (241.2±35.7) mmHg vs (273.1±12.3)mmHg, P＜0.001], but the FP group consumed significantly less preparation time of tourniquet than that the LOP group and SBP group [(0)min vs (3.9±0.8) min vs (1.5±0.5) min, P＜0.001]. Compared with those 1 day after surgery, the VAS score significantly decreased (P＜0.05),whereas the HSS score significantly increased 3 days and 7 days after surgery in all the 3 groups (P＜0.05). Compared with that 1 day aftersurgery, the swelling rate of the three groups was significantly increased 3 days after surgery (P＜0.05), whereas which significantly decreased7 days after surgery (P＜0.05). The FP group proved significantly inferior to the LOP group and SBP group in terms of the VAS score andswelling rate at all corresponding time point after surgery, as well as HSS score 1 and 3 days after surgery, with significant differences (P＜0.05). Regarding blood test, the Hb decreased significantly (P＜0.05), while Hct remained unchanged significantly 2 days after surgery com-pared with those before surgery (P＞0.05). At any corresponding time points, there were no significant differences in Hb value and Hct amongthe three groups (P＞0.05). [Conclusion] The strategy of establishing tourniquet pressure based on systolic blood pressure (SBP) and limb oc-clusion pressure (LOP) does achieve more satisfactory outcomesthe than conventional fixed tourniquet pressure in FB-UKA.