Objective To investigate the early clinical effect of resurfacing arthroplasty on the treatment of avascular necrosis of the femoral head in the young and middle-aged patients. Methods Eleven patients with avascular necrosis of the femoral head in Ficat Stages Ⅲ -Ⅳ(14 hips)were treated by femoral head resurfacing operations. Of 11 cases, there were 7 males and 4 females. With an age range of 35 to 49 years.While 13 patients with avascular necrosis of the femoral head in Ficat Satges Ⅲ-Ⅳ (16 hips) were treated by total hip resurfacing arthroplasty of 13 cases there were 8 males and 5females. With an age range of 23 to 48 years. The prostheses were improved in light of the anatomic features of the Chinese. Results These patients treated by femoral head resurfacing operations were followed up for 1 to 5 years. The average Harris hip score was increased from 39 points preoperatively to 91 points postoperatively. These patients treated by total hip resurfacing operations were followed up for 6 to 40 months. The average Harris hip score wasincreased from 30 points preoperatively to 93 points postoperatively. Conclusion Hip resurfacing operations may be the most effective treatment for avascular necrosis of the femoral head in the young and middle aged patients.
Objective To compare the treatment effect of patellar resurfacing versus patellar non-resurfacing in total knee arthroplasty. Methods We identified eligible studies in PubMed (1950 to 2008.6), OVID MEDLINE (1950 to 2008.6), OVID CINAHL (1950 to 2008.6), OVID EBM (2nd Quarter 2008), CBMdisk (1978 to 2008.6), and CNKI (1981 to 2008.6), and handsearched some Chinese orthopedic journals to identified randomize controlled trials (RCTs) comparing patellar resurfacing versus patellar non-resurfacing in total knee arthroplasty. Data were extracted and methodological quality was critically assessed by two reviewers independently. Meta-analyses were performed using Stata 10.0 software. Outcomes of interest included the number of reoperations for patellofemoral problems, the prevalence of postoperative anterior knee pain, and the improvement in HSS knee score. Results Thirteen RCTs involving 1 566 patients were included. The scores of methodological quality respectively were more than 13. The results of meta-analyses showed that patellar resurfacing could decrease the re-operation rate for patellofemoral problems (RR=0.30, 95%CI 0.14 to 0.62, Plt;0.01). The rate of postoperative anterior knee pain and the improvement in HSS knee score were comparable between patellar resurfacing and patellar non-resurfacing. Conclusion The outcome identified is re-operations for patellofemoral problems. The resurfaced patella performs better, and we find an increased relative risk for re-operation when the patella is left un-resurfaced. No differences are observed between the two groups for the prevalence of postoperative anterior knee pain, and the improvement in HSS knee score. Further well-designed and large-scale RCTs are required to determine the effects of patellar resurfacing and non-resurfacing on these outcomes.
Objective To observe the tendency of serum cobalt (Co), chromium (Cr), and molybdenum (Mo) ions concentration level after resurfacing arthroplasty of the hip (RSAH) by inductively coupled plasma mass spectrometer (ICP-MS), and analyze the influence factors. Methods Forty-seven patients (55 hips) underwent RSAH between June 2005 and November 2014 who had good joint function (Harris score were >85) at every review time were selected in the study. There were 25 males and 22 females, with the mean age of 49.7 years (range, 18-64 years). The disease causes included developmental dysplasia of the hip (DDH) in 18 cases (22 hips) and non-DDH in 29 cases (33 hips). The follow-up time was 6 months to 5 years (mean, 3.2 years). The concentrations of Co, Cr, and Mo ions were measured by ICP-MS, and were compared with those of 6 normal controls. Based on the analysis of the measured results, patients were chosen and grouped according to prosthesis position and femoral head prosthesis diameter. A correlative analysis was made between serum metal ions concentration and various factors (age, body mass index, pre- and post-operative Harris scores, neck-shaft angle, and stem-shaft angle). Results The concentration of serum Co ion reached the peak at 1 year after operation (P<0.05), and then slowly decreased, increased again at 4 years after operation and was close to the 2nd-year level at 5 years. The concentration of serum Cr ion reached its peak at 9 months after operation (P<0.05), and then gradually decreased, and was close to normal level at 5 years. The concentration of serum Mo ion kept increase trend and reached the peak at 5 years (P<0.05). Thirty-five hips of 29 patients followed up 9 months and 1 year were grouped. For DDH and non-DDH patients, Co and Cr ion concentrations of 40-45° abduction angle of acetabular component were significantly lower than those of <40 and="">45° (P<0.05), but there was no significant difference in Mo ion concentration (P>0.05). For all patients, Co, Cr, and Mo ion concentrations of 15-20° anteversion angle of acetabular component were significantly lower than those of <15 and="">20° (P<0.05). Co, Cr, and Mo ion concentrations of ≥48 mm diameter of the femoral component were significantly lower than those of <48 mm (P<0.05). There was a negative correlation between Co ion and postoperative Harris score (r=–0.486,P=0.041). Conclusion The serum Co and Cr ions concentrations increase obviously at 1 year and 9 months after RSAH operation, and Mo ion concentration displays an increase trend. The metal ions concentrations have close relationship with the position of acetabular component.