ObjectiveTo investigate evaluation and treatment of osteochondral injury of knee joint and its effectiveness.MethodsBetween January 2010 and January 2016, 17 patients with osteochondral injury of knee joint were admitted. There were 2 males and 15 females, with an average age of 19.3 years (range, 15-33 years). The causes of injury included the sprain in 14 cases and knee hyper-extension and varus due to violence in 3 cases. The osteochondral injury located at patella in 8 cases, lateral femoral condyle in 4 cases, medial femoral condyle in 1 case, and tibial plateau in 4 cases. There were 15 cases of fresh fractures and 2 cases of old fractures. The Lysholm score of the knee joint was 31.6±2.3. After open reduction of osteochondral fractures of 14 cases, the absorbable rods (9 cases), absorbable cartilage nail (3 cases), or absorbable sutures (2 cases) were selected for fixation. The osteochondral fractures at the medial tibial plateau margin (non-weight-bearing area) in 3 cases were removed.ResultsThe incision fat liquefaction occurred in 1 case after operation and healed after debridement. The other incisions had primary healing. All 17 patients were followed up 6 months to 2 years (mean, 13 months). Thirteen of 14 patients with internal fixation had good fractures healing without traumatic arthritis; 1 case of patella osteochondral fracture did not heal. Three patients with non-weight-bearing osteochondral removal had no narrowing of the medial joint space and traumatic arthritis during the follow-up. The Lysholm score of knee joint at 1 year after operation was 91.3±1.1, which significantly improved when compared with preoperative score (t=7.136, P=0.001).ConclusionFor the osteochondral injury of the knee joint, the osteochondral block with full-layer cancellous bone can be treated with open reduction and internal fixation; while osteochondral block with punctate cancellous bone can be directly remove.
Objective To investigate the clinical efficacy of endoscopy-assisted anterior cervical discectomy and fusion for cervical spondylosis. Methods The clinical data of patients treated with water medium endoscopy-assisted anterior cervical discectomy and fusion for cervical spondylosis at Mianyang Orthopedic Hospital between September 2021 and September 2023 were retrospectively collected. The surgical efficacy and nerve injury recovery were evaluated based on the Neck Disabilitv Index (NDI), Japanese Orthopaedic Association (JOA) score, improvement rate of JOA score, Cobb angle and height changes of the affected intervertebral space before surgery and at the last follow-up, as well as the occurrence of surgical complications. Results A total of 29 patients were included, including 18 males and 11 females. The average age was (52.34±8.96) years, and the average duration of illness was (17.31±6.60) months. The average follow-up time was (11.69±3.41) months. At the last follow-up, the patients’ NDI (3.55±3.09 vs. 17.28±5.51), Cobb angle [(15.25±4.83) vs. (−1.34±7.50)°], intervertebral height [(8.04±0.82) vs. (4.67±0.95) mm], and JOA score (15.90±1.11 vs. 11.17±1.65) improved compared to preoperative levels (P<0.05). The JOA score improvement rate assessment showed that 16 cases were excellent, 11 cases were fine, 2 cases were moderate, and the excellent and fine rate was 93.10%. All patients did not experience serious complications after surgery. Conclusion Water medium endoscopy-assisted anterior cervical discectomy and fusion for cervical spondylosis has good clinical efficacy and safety.