ObjectiveTo compare the short-term effectiveness of unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO) in the treatment of medial compartment osteoarthritis (OA) of the knee so as to provide a reference for clinical selection of appropriate treatment. MethodsBetween January 2010 and June 2011, 28 cases of medial compartment OA of the knee underwent UKA in 16 cases (UKA group) and HTO in 12 cases (HTO group). Biomet Oxford phase Ⅲ unicompartmental knee prosthesis was used in UKA group, and closing wedge osteotomy in HTO group. There was no significant difference in gender, age, course of disease, side, body mass index, articular cartilage degeneration classification, preoperative knee range of motion (ROM), Lysholm knee score, Tegner activity score, and femorotibial angle (FTA) between the 2 groups (P>0.05). The patients of UKA group began weight-bearing walking with walking aids within 48 hours after operation, and the patients of HTO group began weight-bearing walking with walking aids at 6 weeks after operation, and gradually began full weight-bearing walking at 8-12 weeks. ResultsThere was no significant difference in operation time and intraoperative blood loss between 2 groups (t=0.406, P=0.688; t=-1.552, P=0.133). All incision healed primarily in both groups. No complications occurred in 2 groups. All patients were followed up 3.5 years on average (range, 3.0-4.5 years) in UKA group and 3.6 years on average (range, 3-4 years) in HTO group. There were significant differences in Lysholm knee score, Tegner activity score, and FTA in the 2 groups between before and after operation (P<0.05), but there was no significant difference in knee ROM (P>0.05). At last follow-up, there was no significant difference in all above indexes between 2 groups (P>0.05). The postoperative X-ray showed that all force lines of the lower limbs were corrected, and the prosthesis and internal fixation were fixed reliably. During follow-up, Kellgren-Lawrence Ⅱ degeneration of the lateral compartment was observed in 1 case of 2 groups respectively; Kellgren-Lawrence Ⅱ degeneration of the patellofemoral joint was observed in 1 case of the HTO group, there was no significant difference between the 2 groups (χ2=0.778, P=0.378). ConclusionBoth UKA and HTO have good short-term effectiveness for treating unicompartmental OA; however, the long-term effectiveness need further study and follow-up.
ObjectiveTo compare the effectiveness of locking compression plate and elastic intramedullary nail for the treatment of benign long bone pathological fractures in children, so as to provide the evidence for clinical treatment. MethodsSeventy-two children with long bone pathological fractures who accorded with the inclusion criteria between January 2005 and July 2013 were randomly divided into 2 groups. Fracture was fixed with elastic intramedullary nail in 33 cases (group A) and with locking compression plate in 39 cases (group B). There was no significant difference in sex, age, body mass index, primary lesion, location of fracture, side of fracture, and interval between injury and operation between 2 groups (P>0.05). ResultsGroup A had shorter operation time, less intraoperative blood loss, and less overall costs than group B, showing significant differences (P<0.05). Primary healing of incision was obtained. All the patients were followed up 1-7 years (mean, 3.4 years). Tumor lesions disappeared and the pathological fracture healed after operation by X-ray film observation, and group A had faster fracture healing time than group B (P<0.05). There was no loosening and displacement of internal fixation, bone resorption, and bone defect nonunion in 2 groups. Recurrence was found in 2 cases (6.1%) of group A and 3 cases (7.7%) of group B, showing no significant difference (χ2=0.074, P=0.580). Re-fracture was found in 1 patient with tibial bone cyst of group B after 3 months of operation, and healed after 1 year of open reduction and internal fixation. According to X-ray film and comprehensive function evaluation of shoulder, elbow, hip, knee, and ankle, the results were all excellent in 2 groups at last follow-up. ConclusionElastic intramedullary nail fixation should be the first choice, and locking compression plate should be the second choice for children with benign long bone pathological fractures.
In order to enhance the anticoagulant properties of decellularized biological materials as scaffolds for tissue engineering research via heparinized process, the decellularized porcine liver scaffolds were respectively immobilized with heparin through layer-by-layer self-assembly technique (LBL), multi-point attachment (MPA) or end-point attachment (EPA). The effects of heparinization and anticoagulant ability were tested. The results showed that the three different scaffolds had different contents of heparin. All the three kinds of heparinized scaffolds gained better performance of anticoagulant than that of the control scaffold. The thrombin time (TT), prothrombin time (PT) and activated partial thromboplastin time (APTT) of EPA scaffold group were longest in all the groups, and all the three times exceeded the measurement limit of the instrument. In addition, EPA scaffolds group showed the shortest prepared time, the slowest speed for heparin release and the longest recalcification time among all the groups. The decellularized biological materials for tissue engineering acquire the best effect of anticoagulant ability in vitro via EPA heparinized technique.