ObjectiveTo evaluate the effectiveness of semitendinous and gracilis transfer for the treatment of medial collateral ligament (MCL) injury caused by total knee arthroplasty (TKA). MethodsBetween March 2009 and May 2014, 11 patients (11 knees) with MCL injuries caused by primary TKA were treated by semitendinous and gracilis transfer in primary TKA (injury group). Another 18 patients (21 knees) without MCL injury were included as the control group. There was no significant difference in gender, age, injury sides, disease duration, body mass index, knee varus deformity, and preoperative Knee Society Score (KSS) between 2 groups (P>0.05), with comparability. KSS score was used to evaluate the function after operation. ResultsPrimary healing of incision was obtained in all patients, and no complications of joint instability and pain occurred. The follow-up time was 6-29 months in injury group and was 7-34 months in control group. At last follow-up, the KSS clinical score and functional score were significantly increased to 89.82±3.76 and 89.54±3.50 in the injury group (P<0.05) and were significantly increased to 90.19±3.39 and 90.00±3.53 in the control group (P<0.05) respectively, but no significant difference was shown between 2 groups (t=0.158, P=0.877; t=0.820, P=0.432). X-ray films showed no prosthetic loosening or subsidence during follow-up. ConclusionThe semitendinous and gracilis transfer is reliable for the treatment of MCL injury caused by TKA. The insertions of semitendinous tendon and gracilis are close to that of the knee MCL, which can effectively improve knee function.
In the present investigation, we studied four methods of blind source separation/independent component analysis (BSS/ICA), AMUSE, SOBI, JADE, and FastICA. We did the feature extraction of electroencephalogram (EEG) signals of brain computer interface (BCI) for classifying spontaneous mental activities, which contained four mental tasks including imagination of left hand, right hand, foot and tongue movement. Different methods of extract physiological components were studied and achieved good performance. Then, three combined methods of SOBI and FastICA for extraction of EEG features of motor imagery were proposed. The results showed that combining of SOBI and ICA could not only reduce various artifacts and noise but also localize useful source and improve accuracy of BCI. It would improve further study of physiological mechanisms of motor imagery.
ObjectiveTo investigate the effect of medial 1/3 anatomical orientation of the tibial tubercle on the rotational alignment of Gemini MK-Ⅱ tibial components in total knee arthroplasty (TKA). MethodsBetween March 2011 and December 2012, 61 cases (67 knees) of varus knee osteoarthritis underwent Gemini MK-Ⅱ knee arthroplasty, and the clinical data were retrospectively analyzed. There were 12 males and 49 females, with an average age of 67.6 years (range, 50-82 years). The body mass index ranged from 20.9 to 33.7 kg/m2 (mean, 28.2 kg/m2). Unilateral TKA was performed in 55 cases and bilateral TKA in 6 cases. The duration of knee osteoarthritis ranged from 2 to 30 years (mean, 12.1 years). According to radiographic changes, 56 knees were rated as Kellgren-Lawrence grade Ⅲ and 11 knees as grade IV. During TKA, the tibial rotational alignment was determined by medial 1/3 anatomical orientation of the tibial tubercle. The anteroposterior and lateral X-ray films and CT scan were taken to measure the tibial rotational angle (TRA) at pre-and post-operation and to analyze the relative factors for TRA by Pearson correlation analysis. ResultsAll the patients were followed up 18-41 months (mean, 20.5 months). The range of motion (ROM) significantly increased from (98.806±16.969)° preoperatively to (116.806±11.458)° at last follow-up (t=-11.760, P=0.000). The knee society score (KSS) significantly increased from 111.239±20.344 to 160.522±17.872 at last follow-up (t=-27.271, P=0.000). The anatomical tibiofemoral angle (ATFA), posterior condylar angle (PCA), and TRA were all improved after TKA, showing significant differences when compared with preoperative ones (P<0.05). Rotational malalignment was observed in 11 knees (16.42%) before TKA, and in 14 knees (20.90%) at 1 week after TKA, showing no significant difference (χ2=0.443, P=0.506). There were 8 knees (11.94%) of internal rotation (>8°) and 6 knees (8.96%) of external rotation (>8°). The postoperative tibial prosthesis TRA had no correlation with the preoperative ATFA and tibial plateau TRA, the postoperative PCA and ATFA (r=-0.174, P=0.159; r=0.220, P=0.074; r=0.237, P=0.053; r=-0.095, P=0.442). ConclusionIn patients with varus knee osteoarthritis, medial 1/3 anatomical orientation of the tibial tubercle will contribute to the development of tibial rotational malalignment when TKA is performed by using Gemini MK-Ⅱ tibial components.
ObjectiveTo compare the biomechanical difference of 4 kinds of internal fixations for acetabular fracture in quadrilateral area. MethodsThe transverse fracture models were created in 16 hemipelves specimens from 8 adult males, and were randomly divided into 4 groups according to different internal fixation methods (n=4): infrapectineal buttress reconstruction plate (group A), infrapectineal buttress locking reconstruction plate (group B), reconstruction plate combined with trans-plate quadrilateral screws (group C), and anterior reconstruction plate-lag screw (group D). Then the horizontal displacement, longitudinal displacement of fractures, and axial stiffness were measured and counted to compare the stability after continuous vertical loading. ResultsUnder the same loading, the horizontal and longitudinal displacements of groups A, B, C, and D were decreased gradually; when the loading reached 1 800 N, the longitudinal displacement of group A was more than 3.00 mm, indicating the failure criterion, while the axial stiffness increased gradually. Under 200 N loading, there was no significant difference (P>0.05) in horizontal displacement, longitudinal displacement, and axial stiffness among 4 groups. When the loading reached 600-1 800 N, significant differences were found in horizontal displacement, longitudinal displacement, and axial stiffness among 4 groups (P<0.05) except the horizontal displacement between groups C and D (P>0.05). ConclusionFor acetabular fracture in the quadrilateral area, anterior reconstruction plate-lag screw for internal fixation has highest stability, followed by reconstruction plate combined with trans-plate quadrilateral screws, and they are better than infrapectineal buttress reconstruction plate and infrapectineal buttress locking reconstruction plate.
ObjectiveTo investigate the efficiency of total knee arthroplasty (TKA) for varus osteoarthritic knees with tibial bone resection determined by lateral tibiofemoral joint 90° flexional gap measurement. MethodsBetween March and June 2013, 60 patients (60 knees) with varus osteoarthritic knees underwent TKA. All patients were randomly divided into traditional osteotomy group (control group, 30 cases) and lateral tibiofemoral joint 90° flexional gap measurement resection group (trial group, 30 cases). There was no significant difference in gender, age, affected side, body mass index and preoperative knee society score (KSS), range of motion (ROM) of the knee, anatomic tibiofemoral angle (ATFA), patellar tilt angle, posterior condylar offset (PCO), and joint line height between 2 groups (P>0.05). The bone resection thickness of the distal femoral lateral condyle, femoral posterior lateral condyle, and lateral tibial plateau were measured; and the X-ray films were taken to measure and compare ATFA, patellar tilt angle, PCO, and joint line height after TKA. The knee function recovery was evaluated with KSS score and ROM of the knee. ResultsThe bone resection thickness of the lateral tibial plateau and distal femoral lateral condyle in trial group was significantly smaller than that in control group (P<0.05); while the bone resection thickness of the femoral posterior lateral condyle was significantly bigger than that in control group (P<0.05). The 10 mm polyethylene insert was used in 19 cases of the trial group and in 8 cases of the control group, showing significant difference (Z=-4.040, P=0.003). All the patients were followed up 13-16 months (mean, 14.5 months). Radiography at 6 weeks after TKA indicated that the ATFA, patellar tilt angle, and joint line height had no significant difference between 2 groups (P>0.05); the PCO of trial group was significantly lower than that of control group (P<0.05). The KSS score and ROM of the knee at 12 months after operation were significantly improved when compared with preoperative ones in 2 groups (P<0.05), and trial group was significantly better than control group (P<0.05). ConclusionIt was an effective method to determine bone resection thickness using lateral tibiofemoral joint 90° flexional gap measurement in TKA for varus osteoarthritic knees, which can reduce the bone resection thickness of the tibial plateau and distal femoral lateral condyle and restore the joint line and PCO with better early recovery of the knee function.
ObjectiveTo investigate the surgical methods and effectiveness to use the iliac flap combined with anterolateral thigh flap for repair of the first metatarsal bone and large skin defect. MethodsBetween January 2013 and January 2016, iliac flap combined with anterolateral thigh flap was used to repair the first metatarsal bone and large skin defect in 9 patients. There were 5 males and 4 females, with a median age of 15 years (range, 10 to 60 years). The causes included traffic accident injury in 6 cases and crush injury of machine in 3 cases. The average time from injury to operation was 3 hours to 14 days (mean, 7 days). The size of skin soft tissue defect ranged from 10 cm×6 cm to 20 cm×10 cm. The size of first metatarsal bone defect ranged from 2 cm×1 cm to 5 cm×1 cm. The size of iliac flap was 3.0 cm×1.5 cm to 6.0 cm×1.5 cm, and the size of anterolateral thigh flap was 10 cm×6 cm to 20 cm×10 cm. The donor site was directly sutured or repaired by free skin graft. ResultsAfter operation, the composite flaps survived with primary healing of wound; the skin grafts at donor site survived and the incision healed by first intention. All patients were followed up 6 months to 2 years (mean, 1.6 years). X-ray examination showed that the bone healing time was 3.5-5.0 months (mean, 4 months). The flap had soft texture, good color and appearance. All patients could normally walk. According to the American Orthopaedic Foot and Ankle Society (AOFAS) standard, the foot function was excellent in 6 cases and good in 3 cases, and the excellent and good rate was 100% at last follow-up. ConclusionThe iliac flap combined with anterolateral thigh flap for repair of the first metatarsal bone and large skin defect is a practical way with good shape at one stage.
The cognitive impairment of type 2 diabetes patients caused by long-term metabolic disorders has been the current focus of attention. In order to find the related electroencephalogram (EEG) characteristics to the mild cognitive impairment (MCI) of diabetes patients, this study analyses the EEG synchronization with the method of multi-channel synchronization analysis--S estimator based on phase synchronization. The results showed that the S estimator values in each frequency band of diabetes patients with MCI were almost lower than that of control group. Especially, the S estimator values decreased significantly in the delta and alpha band, which indicated the EEG synchronization decrease. The MoCA scores and S value had a significant positive correlation in alpha band.
ObjectiveTo analyze the causes of meniscal root tears (MRTs), and to review the progress in its diagnosis and therapy. MethodsThe published literature about MRTs was extensively reviewed and summarized. ResultsMRTs can be divided into acute traumatic injuries and chronic degenerative injuries; MRI examination is an effective way to diagnose according to meniscal extrusion, ghost sign, and meniscal root linear defects. Conservative treatments are mainly performed for chronic MRTs; partial meniscectomy can obtain predictable improvement in symptoms. Acute MRTs can be treated by arthroscopic meniscus repair and reconstruction which can effectively restore meniscal root anatomy and function, and knee joint degeneration can be postponed. ConclusionMRTs diagnosis relies on MRI, appropriate treatment plan should be made based on the specific circumstances of the patient after accurate diagnosis. Usually the satisfied short-term clinical results can be obtained, while the long-term results need more clinical evaluation.
Based on force sensing resistor(FSR) sensor, we designed insoles for pressure measurement, which were stable and reliable with a simple structure, and easy to wear and to do outdoor experiments with. So the insoles could be used for gait detection system. The hardware includes plantar pressure sensor array, signal conditioning unit and main circuit unit. The software has the function of data acquisition, signal processing, feature extraction and classification function. We collected 27 groups of gait data of a healthy person based on this system to analyze the data and study pressure distribution under various gait features, i.e. walking on the flat ground, uphill, downhill, up the stairs, and down the stairs. These five gait patterns for pattern recognition and classification by K-nearest neighbors (KNN) recognition algorithm reached up to 90% accuracy. This preliminarily verified the usefulness of the system.
ObjectiveTo study the possibility of the C17.2 neural stem cells (NSCs) differentiating into neural cells induced by serum-free condition medium of olfactory ensheathing cells (OECs) and to detect the cell viability of the differentiated cells. MethodsOECs were isloated and cultured from the olfactory bulbs of 3-day-old postnatal mouse to prepare serum-free condition medium of OECs. After C17.2 NSCs were cultured with H-DMEM/F12 medium containing 15% FBS and the cell fusion reached 80%, the 3rd passage cells were induced by serum-free condition medium of OECs in the experimental group, by H-DMEM/F12 in the control group, and non-induced C17.2 NSCs served as the blank control group. The growth condition of cells was observed with inverted microscope. After 5 days, the immunofluorescence staining[microtubule-associated protein 2 (MAP-2) and β-tubulin-Ⅲ] and Western blot (Nestin, β-tubulin-Ⅲ, and MAP-2) were carried out to identify the neural cells derived from NSCs. The cell viabilities were measured by MTT assay and the quantity of lactate dehydrogenase (LDH) release in the medium. ResultsIn the experimental group, the C17.2 NSCs bodies began to contract at 24 hours after induction, and the differentiated cells increased obviously with long synapse at 3 days after induction; in the control group, the cell morphology showed no obvious change at 24 hours, cell body shrinkage, condensation of nuclear chromatin, and lysis were observed at 3 days. The immunofluorescence staining showed that β-tubulin-Ⅲ and MAP-2 of C17.2 NSCs were positive at 5 days after induction, and Western blot suggested that the expression of Nestin protein declined significantly and the expressions of β-tubulin-Ⅲ and MAP-2 protein were increased in the experimental group, showing significant differences when compared with those in the control group and blank control group (P<0.05). The LDH release and the cell viability were 130.60%±6.86% and 62.20%±3.82% in the experimental group, and were 178.20%±5.44% and 18.00%±3.83% in the control group respectively, showing significant differences between 2 groups (P<0.05). The LDH release and the cell viability of experimental group and control group were significantly lower than those of blank control group (100%) (P<0.05). ConclusionNeurotrophic factors from OECs play an important role in inducing C17.2 NSCs differentiation into neural cells and keeping the viability of differentiated cells after induction.