ObjectiveTo investigate the effectiveness of arthroscopic treatment of pigmented villonodular synovitis (PVNS) of the ankle. MethodsTwelve patients who were initially diagnosed as having PVNS of the ankle were treated between January 2005 and May 2012.There were 6 males and 6 females,aged 20-50 years (mean,35.4 years).Disease duration ranged from 6 months to 12 years (median,3.6 years).One case of recurrence was included.The preoperative American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was 55.5±7.6.According to degree and range of the PVNS lesions,4 cases of local PVNS were treated with arthroscopic debridement,and 8 cases of diffuse PVNS were treated with arthroscopically assisted arthrotomy;and local radiotherapy was given in all patients after operation. ResultsPrimary healing of incision was obtained in all patients.The mean follow-up time was 2.8 years (range,1-6 years).At 12 months after operation,no obvious pain,swelling,and limited range of motion of the ankle were observed.The AOFAS score was increased to 84.3±3.4 at 12 months,and it was significantly higher than that at preoperation (P<0.05) and at 3 months after operation (82.8±3.8)(P<0.05).There was no recurrence during follow-up. ConclusionArthroscopic arthrotomy combined with postoperative radiotherapy are recommended for PVNS of the ankle according to the PVNS lesion degree and range.And arthroscopically assisted surgery has many advantages of less traumas and hemorrhage,fast recovery,and less complications.
ObjectiveTo introduce the application of Photoshop CS16.0 (PS) software in preoperative osteotomy design of ankylosing spondylitis kyphosis (ASK), and to investigate applied values of the preoperative design. MethodsBetween March 2009 and March 2013, 21 cases of ASK were treated through preoperative osteotomy design by using PS software. There were 16 males and 5 females, aged from 23 to 50 years (mean, 34.2 years). The deformity included thoracolumbar kyphosis in 14 cases, thoracic kyphosis in 2 cases, and lumbar kyphosis in 5 cases. The ultimate osteotomy angle of preoperative plans and the location and extent of osteotomy were determined by the osteotomy design, which guided operation procedures of the surgeon. The actual osteotomy angle was obtained by measuring Cobb angle of osteotomy segment before and after operation. The sagittal parameters of spine and pelvis including global kyphosis (GK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT), and chin brow-vertical angle (CBVA) were measured at preoperation, at 1 week after operation, and last follow-up. The clinical outcomes were assessed by simplified Chinese Scoliosis Research Society-22 (SRS-22) questionnaire and Oswestry disability index (ODI). ResultsNo complications occurred in the other cases except 1 case of dural tear during operation and 1 case of nerve injury after operation, and primary healing of incision was obtained. All patients were followed up 14 to 45 months (mean, 26.3 months). The SRS-22 and ODI scores at 1 week after operation and last follow-up were significantly improved when compared with preoperative scores (P<0.05), but no significant difference was found between at 1 week and last follow-up (P>0.05). The preoperative planned osteotomy angle and the postoperative actual osteotomy angle were (34.2±10.5)° and (33.7±9.7)° respectively, showing no significant difference (t=0.84, P=0.42). The CBVA, GK, SVA, PT, and LL were significantly improved when compared with the preoperative values (P<0.05), but no significant difference was found between at 1 week and last follow-up (P>0.05). At last follow-up, no failures of internal fixation was found, and bony fusion was obtained. ConclusionThe preoperative osteotomy design by using PS software can precisely recover the spinal sagittal balance and horizontal angle of view, so it can effectively avoid excessive correction and insufficient correction of the deformity and obtain good effectiveness in treating ASK.
ObjectiveTo evaluate the effectiveness of pedicle subtraction osteotomy (PSO) assisted with anterior column reconstruction in the treatment of chronic osteoporotic vertebral compression fracture (OVCF). MethodsBetween January 2008 and October 2014, 11 cases of chronic OVCF were treated. There were 2 males and 9 females, aged 65-76 years (mean, 72.3 years). The vertebral compression fracture segment involved T11 in 2 cases, T12 in 2 cases, L1 in 4 cases, L2 in 2 cases, and L3 in 1 case. At preoperation, the Oswestry disability index (ODI) score was 31.1±10.2; kyphosis Cobb angle of fractured vertebrae was (36.5±10.2)° on the lateral X-ray films of the spine; and distance between C7 plumb vertical line (C7 PL) and sagittal vertical axis (SVA) of the S1 superior border was (5.2±2.5) cm. Six cases had spinal cord injury (SCI), including 4 cases of Frankel grade C and 2 cases of grade D. At last follow-up, ODI score, kyphosis Cobb angle of fractured vertebrae, and distance between C7 PL and SVA were recorded and compared with preoperative values. Postoperative Frankle scores were recorded in SCI cases. X-ray film and CT scan were taken to evaluate bone fusion at 12 months after operation. ResultsThe operation was completed successfully without serious complications. Nerve root radiation symptoms occurred in 2 cases undergoing lumbar PSO, which was relieved after conservative treatment. Cerebrospinal fluid leakage occurred in 1 case and was cured after 2 weeks. All cases were followed up 12-24 months (mean, 15.6 months). No internal fixation failure or pseudarthrosis was found postoperatively.Screw loosening was found in 1 case (2 screws of the upper level) and titanium Cage cutting vertebral body was found in 1 case. Bone fusion was obtained in all cases at 12 months after operation. At last follow-up, ODI score was significantly improved to 13.7±5.7(t=4.417, P=0.018), kyphosis Cobb angle of fractured vertebrae to (7.0±15.2)° (t=5.113, P=0.009), and the distance between C7 PL and SVA to (2.8±2.2) cm (t=3.285, P=0.032). In 6 SCI cases, Frankle grade was recovered to E (1 case), to D (1 case), and no improvement (2 cases) from C, and to E from D (2 cases). ConclusionPSO assisted anterior column reconstruction was an effective method in treatment of chronic OVCF.
ObjectiveTo discuss the effects of coix seed extract injection on rate of tumor of C57 mice liver cancer model, tumor size, and serum IL-6. MethodsUsing chemical carcinogens diethyl nitrosamine (DEN) to establish the mice model of liver cancer, liver cancer mouse model to coix seed extract was given observation of C57 mice liver cancer model come tumor formation rate, tumor growth, and the change of serum IL-6. ResultsC57 mice after intraperitoneal injection of coix seed extract injection model of liver cancer tumor rate (55.6%) significantly lower than the DEN group (87.5%), P < 0.01; tumor diameter[(0.3±0.05) cm] was lower than that in group DEN[(0.8±0.06) cm], P < 0.01. The serum level of IL-6 in C57 mice after treated with coix seed extract significantly lower than that in group DEN (P < 0.01). ConclusionCoix seed extract can effectively inhibit the tumor rate and the growth of tumor in hepatocellular carcinoma model of C57 mice, and decrease the level of serum IL-6.
Objective To review the research background, biomechanical characteristics, and clinical application of fenestrated pedicle screw (FPS). Methods The recent literature about the study and application of FPS was reviewed, analyzed, and summarized. Results Compared with the technique of conventional pedicle screw augmentation, FPS can be augmented with polymethyl methacrylate (PMMA) through inner central pore and side holes. Hence, the augmentation process of FPS is more convenient during operation. The biomechanics of PMMA augmented FPS is strong enough for instrumentation in osteoporotic vertebra body and the way of FPS PMMA augmentation can reduce the risk of PMMA leakage. Conclusion FPS is an innovation in the technology of spinal instrumentation, which is expected to improve the clinical outcome of PMMA augmented pedicle screw in osteoporotic vertebra body fixation.
ObjectiveTo investigate the effectiveness of open reduction by mini incision and absorbable screw internal fixation for the treatment of anterior cruciate ligament (ACL) tibial eminence avulsion fracture. MethodsBetween January 2006 and July 2012, 90 patients (90 knees) with ACL tibial eminence avulsion fracture were treated. There were 58 males and 32 females, aged from 10 to 58 years with an average of 33.7 years. The causes of injury were traffic accident injury in 60 cases, sports injury in 22 cases, and falling injury in 8 cases. The disease duration was 1-365 days with a median of 106 days. Combined injuries included 14 cases of meniscus injury, 5 cases of medial collateral ligament injury, and 3 cases of avulsion fracture of the anterior horn of the lateral meniscus. All patients underwent open reduction by mini incision and internal fixation with absorbable screw. Postoperative rehabilitation exercise was performed. ResultsTwo patients had delayed healing of incision, and others obtained primary healing. All the patients were followed up 6-72 months (mean, 40.1 months). X-ray examination showed that bone union was achieved in all patients at 3-12 months after operation; nail tail came off in 7 cases at 4-13 months after operation, and the nail tail was taken out under arthroscopy. At 6-12 months after operation, the range of motion (ROM), Tegner score, Lysholm score, and International Knee Documentation Committee (IKDC) score were significantly increased when compared with preoperative ones (P < 0.05). ConclusionA combination of open reduction by mini incision and absorbable screw internal fixation for the treatment of ACL tibial eminence avulsion fracture has the advantages of easy operation, firm fixation, and satisfactory functional rehabilitation, so it is a safe and effective method for the treatment of ACL tibial eminence avulsion fracture.
ObjectiveTo summarize the experience of 4 patients with a great saphenous venous graft patency after 15 years of postoperitive great saphenous venous sequential aortic coronary artery bypass grafting. MethodWe retrospectively analyzed the clinical data of 4 patients accepted great saphenous vein aortic coronary artery bypass graft under moderate hypothermia cardiopulmonary bypass from November 1989 to December 1992 year. There were 3 males and 1 female with a mean age of 48.3 years ranging from 40-58 years. We harvested great saphenous vein under groin 45-50 cm. The proximal and distal anastomoses were performed with parachute technique under two clamps technique. Coronary artery bypass graft was performed by two sequential grafts routinely. Aspirin was given through nasal tube 6 hours after operation. The risk factors of arteriosclerosis were controlled by patients themselves after discharge. ResultFour patients received coronary angiography in 15, 16, 18, and 21 years after surgery and the grafts and both proximal and distal anastomoses were patent. The patients lived about 20 years without angina. Conclusioncarefully dealing with the vein graft, taking sequential bypass grafting to guarantee parabolic curve and meticulous anastomosis are preconditional and necessary for long-term patency.
ObjectiveTo investigate the current status of systematic reviews/meta-analyses (SRs/MAs) registered in PROSPERO by Chinese authors, in order to provide references for improving the registration rate and quality, and finally improve the quality of SRs/MAs. MethodsWe searched PROSPERO (http://www.crd.york.ac.uk/crdweb/) from inception to December 31, 2014, to identify SRs/MAs registered by Chinese authors. Two reviewers independently screened records and extracted data. Excel 2013 was used for data input and management, and Stata 12.0 software was used for statistical analysis (Stata Corp., College Station, TX, USA). ResultsA total of 322 SRs/MAs were included. There was an increasing trend in registration number by year, and 60.6% was registered in 2014. The type of SRs/MAs was mainly the interventional (n=247, 76.7%). These SRs/MAs were related to 21 systematic diseases, and cancer ranked the top one (65, 20.2%). The authors distributed in 26 provinces, and majority of authors' institutes were "Evidence-Based Medicine Center". More than half (56.2%) of SRs/MAs were supported by fundings, but only 39.8% of SRs/MAs were performed cooperatively by two or more institutes. ConclusionThere is a rapid increase in numbers of SRs/MAs registered in PROSPERO by Chinese authors, but the absolute number is still small. The problems include the weakness of cooperative consciousness and lake of awareness in registering SRs/MAs.