Objective To compare the effectiveness of anatomical single-bundle (ASB) and over-the-top singlebundle (OSB) reconstruction of the anterior cruciate l igament (ACL). Methods Between January 2008 and June 2008, 64 patients with ACL injury underwent arthroscopic ACL reconstruction. ASB ACL reconstruction was performed in 28 cases (ASB group) and OSB ACL reconstruction in 36 cases (OSB group). There was no significant difference in gender, age, diseaseduration, International Knee Documentation Committee (IKDC) score, Lysholm score, and side-to-side difference between 2 groups (P gt; 0.05). Results All incisions healed by first intention; no infection or other compl ications occurred. All cases were followed up 20-24 months (mean, 21.5 months). There were significant differences in the IKDC score, Lysholm score, and the side-to-side difference between last follow-up and preoperation in 2 groups (P lt; 0.05), but there was no significant difference between 2 groups at last follow-up (P gt; 0.05). Significant differences were found in negative rate of the pivot shift test between last follow-up and preoperation in ASB group and between 2 groups at last follow-up (P lt; 0.05), but there was no significant difference between last follow-up and preoperation in OSB group (P gt; 0.05). Conclusion The effectiveness of arthroscopic ASB ACL reconstruction is better than that of arthroscopic OSB ACL reconstruction, especially in controll ing rotational stabil ity.
To analyze the effectiveness of anterior cruciate l igament (ACL) reconstruction with preserving the remnant ACL by allograft l igament. Methods Between January and July in 2008, 97 patients underwent ACL reconstruction with the allograft l igament. On the basis of the ACL’s condition, patients were divided into 2 groups. In the trial group (patients having remnant ACL, n=38), there were 27 males and 11 females with an average age of 24.3 years (range, 16-43 years); of them, 8 cases compl icated by menicus injury and 13 cases by Outbridge I degree cartilage injury; the time from injuryto operation was 3-20 weeks (mean, 8.6 weeks). In the control group (patients having no remnant ACL, n=59), there were 35 males and 24 females with an average age of 27.8 years (range, 18-48 years); of them, 16 cases compl icated by menicus injury and 23 cases by Outbridge I degree cartilage injury; the time from injury to operation was 4-44 weeks (mean, 12.7 weeks). All injuries were caused by sports in 2 groups. All patients had positive anterior drawer test and positive Lackman test. Before operation and 3, 8, 9, 15 months after operation, the function of the knee joint was evaluated by the International Knee Documentation Committee (IKDC) scale and Lysholm score. KT-2000 arthrometer was used to evaluate knee laxity. Results All incisions healed primarily, and no intraarticular infection occurred. Thirty-seven cases and 57 cases were followed up 15 months in the trial group and the control group, respectively. Knee instabil ity disappeared; the patients showed negative anterior drawer test and negative Lackman test. By the evaluation of KT-2000, the joint sl ippage of 2 groups were less than 2 mm at 3 and 6 months after operation, but it was more than 2 mm in 2 cases of the trial group and in 3 cases of the control group at 9 months after operation; and it was no change in the trial group and 2.5-4.0 mm (mean, 3.4 mm) in the control group at 15 months after operation. Both the IKDC scale and Lysholm score were higher in the trial group than in the control group 3 months after operation, but the differences were not significant (P gt; 0.05). Both the IKDC scale and Lysholm score were
ObjectiveTo explore the prognostic value of serum cystatin C (Cys C) in patients with congenital heart disease-associated pulmonary arterial hypertension (PAH-CHD).MethodsA retrospective cohort study was conducted on adult PAH-CHD patients who were hospitalized for the first time in the First Affiliated Hospital of Xinjiang Medical University from January 2010 to January 2020. The serum Cys C and other related data of patients were collected. The median follow-up time was 57 months. The main end event was all-cause death. According to the prognosis, the patients were divided into a survival group and a death group. Cox regression was used to analyze the risk factors for all-cause death in patients with PAH-CHD.ResultsA total of 456 patients were enrolled, including 160 males and 296 females, aged 38.99±14.72 years. The baseline data showed that there were statistical differences in resting heart rate, serum Cys C, creatinine, NT-proB-type natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin T (hs-cTnT), high-sensitivity C reactive protein (hs-CRP), New York Heart Association (NYHA) cardiac function classification and serum potassium between the survival group and the death group. Univariate Cox regression analysis showed that serum Cys C, NT-proBNP, hs-cTnT, creatinine and NYHA cardiac function classification were related risk factors for all-cause death in patients with PAH-CHD. Multivariate Cox regression analysis showed that serum Cys C (HR=3.820, 95%CI 2.053-7.108, P<0.001), NYHA grade Ⅲ (HR=2.234, 95%CI 1.316-3.521, P=0.010), NYHA grade Ⅳ (HR=4.037, 95%CI 1.899-7.810, P=0.002) and NT-proBNP (HR=1.026, 95%CI 1.013-1.039, P<0.001) were independent risk factors for all-cause death in patients with PAH-CHD and had a good predictive value.ConclusionAs a new cardiac marker, serum Cys C can predict all-cause death in patients with PAH-CHD and is an independent risk factor.