ObjectiveTo explore the effectiveness of total hip arthroplasty (THA) for non-functional bony ankylosed hip in young and middle-aged patients. MethodsBetween January 2010 and March 2013, 14 cases (19 hips) of non-functional bony ankylosed hip were treated by THA. There were 9 males and 5 females, aged 37.5 years on average (range, 23-58 years). The left hip was involved in 6 cases, the right hip in 3 cases, and bilateral hips in 5 cases. The causes were tuberculosis in 2 patients, ankylosing spondylitis in 5 patients, traumatic arthritis in 5 patients, osteoarthritis in 1 patient, and suppurative infection in 1 patient. The disease duration was 7-18 years with an average of 8.9 years. Flexion stiffness was observed in 10 hips, flexion abduction stiffness in 6 hips, and flexion adduction shortening stiffness in 3 hips. Only 5 patients could walk with a crutch before operation. Harris hip score was 24.368±7.625. ResultsThe average operation time was 63.4 minutes (range, 50-90 minutes). The average intraoperative blood loss was 196.8 mL (range, 100-400 mL). Patients obtained primary healing of incision; no complication of neurovascular injury, fracture, joint dislocation, or infection occurred. All patients were followed up 2.2 years on average (range, 1 year to 4 years and 3 months). The Harris score was 86.837±7.742 at last follow-up, showing significant difference when compared with preoperative score (t=-41.956, P=0.000). The results were excellent in 5 hips, good in 11 hips, fair in 2 hips, and poor in 1 hip, with an excellent and good rate of 84.2%. All patients could basically take care of themselves; 2 patients could walk with crutch, and the other patients could walk without crutch. X-ray films showed that prosthesis was in good position; no shifting, loosening, or sinking was found. Heterotopic ossification occurred in 2 hips. ConclusionTHA is an effective surgical approach to treat non-functional bony ankylosed hip in young and middle-aged patients.
ObjectiveTo systematically evaluate the efficacy and safety of intra-articular injection of hyaluronic acid for knee osteoarthritis. MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 1, 2016), WanFang Data, CBM, and CNKI were searched to collect randomized controlled trials (RCTs) about intra-articular injection of hyaluronic acid for knee osteoarthritis from inception to February 2016. The meta-analysis was conducted using RevMan 5.3 software. ResultsA total of 17 RCTs involving 4 070 patients were included. The results of metaanalysis showed that: there were no significant differences in WOMAC pain scores (7 weeks: MD=-0.01, 95%CI -0.46 to 0.44, P=0.98; 13 weeks: MD=-0.01, 95%CI -0.46to 0.43, P=0.95; 26 weeks: MD=0.32, 95%CI -0.04 to 0.67, P=0.08), stiffness scores (7 weeks: MD=0.10, 95%CI -0.26 to 0.45, P=0.59; 13 weeks: MD=0.24, 95%CI -0.11 to 0.60, P=0.17; 26 weeks: MD=0.06, 95%CI -0.09 to 0.22, P=0.42), and life function scores (7 weeks: MD=-0.20, 95%CI -0.75to 0.36, P=0.49; 13 weeks: MD=-0.02, 95%CI -0.57 to 0.52, P=0.93; 26 weeks: MD=0.30, 95%CI -0.07 to 0.67, P=0.11) between the hyaluronic acid group and the control group in 7-, 13- and 26 weeks. However, the hyaluronic acid group was superior to the control group in 50-step test (MD=-0.49，95%CI -7.36 to -3.61，P<0.000 01). ConclusionCurrent evidence suggests that intra-articular injection of hyaluronic acid has better effect than control treatment for pain at movement. However, due to the limited quantity of the included studies, the above conclusion still need to be verified by more high quality studies．
ObjectiveTo systematically evaluate the effectiveness of arthroscopic debridement versus non-operative treatment for degenerative meniscal tear. MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 7, 2015), WanFang Data, CBM, and CNKI were searched to collect randomized controlled trials (RCTs) about arthroscopic debridement versus non-operative treatment for degenerative meniscal tear from inception to July 2015. The meta-analysis was conducted using RevMan 5.3 software. ResultsA total of nine RCTs involving 1 023 patients were included. The results of meta-analysis showed that:there were no significant differences between two groups at different follow-up time points in knee scoring scale (less than 6 months:SMD=0.12, 95%CI -0.11 to 0.35, P=0.30; 1 year:SMD=-0.03, 95%CI -0.18 to 0.11, P=0.65; 2 years:SMD=-0.07, 95%CI -0.32 to 0.19, P=0.61) and pain score (less than 6 months:MD=0.30, 95%CI -0.10 to 0.70, P=0.14; 1 year:MD=0.10, 95%CI -0.40 to 0.60, P=0.70; 2 years:MD=0.02, 95%CI -0.52 to 0.92, P=0.90). ConclusionCurrent evidence suggests that arthroscopic debridement hasn't better effective than non-operative treatment for degenerative meniscal tear, however, due to the limited quantity of the included studies, the above conclusion still need more high quality research to be verified.