ObjectiveTo investigate the effectiveness of arthroscopic bipolar radiofrequency energy (bRFE) and lateral partial meniscectomy for lateral meniscus tear and cartilage lesion. MethodsBetween January 2011 and December 2012, 40 eligible patients with lateral meniscus tear and cartilage injury in the lateral knee compartment underwent arthroscopic treatment, and the clinical data were analysed retrospectively. There were 21 males and 19 females, aged 15-65 years (mean, 42.1 years). The left knee was involved in 22 cases and the right knee in 18 cases. The causes of injury included sport injuries in 5 cases and sprain of knee joints in 8 cases, the remaining patients had no history of trauma. The disease duration ranged from 1 month to 10 years (median, 10 months). The Lysholm score and Japanese Orthopaedic Association (JOA) score of the knee were 59.9±8.2 and 69.6±5.3. According to the Outerbridge classification, 2 cases were rated as grade I, 21 cases as grade II, 17 cases as grade III, and 10 cases as grade IV. The scores described by Noyes were 1-16 (mean, 6.52). The Noyes scores were from 1 to 6 points in 20 patients (group A) and 7 to 16 points in 20 patients (group B). During surgery, all patients underwent partial meniscectomy, and radiofrequency-based chondroplasty was used. Knee joint function was assessed using the Lysholm score and JOA score of the knee, and the clinical outcomes between different degrees of cartilage lesions were also compared. ResultsAll incisions healed primarily without complication. All the patients were followed up 8-31 months (mean, 18.1 months). The Lysholm and JOA scores of the knee at last follow-up (92.2±7.2 and 92.9±7.9, respectively) were significantly higher than those at preoperation (P<0.05). There was no significant difference in preoperative Lysholm and JOA scores of the knee between groups A and B (P>0.05), but significance difference was found between 2 groups at last follow-up (P<0.05). ConclusionArthroscopic bRFE and lateral partial meniscectomy have good effectiveness in treating lateral meniscus tear and cartilage lesion. The effectiveness is better in patients with mild cartilage lesion than in patients with severe cartilage lesion.
ObjectiveTo summarize the application status of three-dimensional (3-D) printing technique in joint surgery and look forward to the future research directions. MethodsThe recent original articles about the application and research of 3-D printing technique in joint surgery were extensively reviewed and analyzed. ResultsIn clinical applications, 3-D printing technique can provide "tailored" treatment and custom implants for patients, which helps doctors to perform the complex operations easier and more safely; in fundamental research, tissue engineered scaffolds with desirable external shape and internal organization are easily fabricated with 3-D printing technique, which can meet the demand of cell adherence and proliferation. Even more, cells may be deposited with the biomaterials during the printing. ConclusionWith the development of medical imaging, digital medicine and new materials, 3-D printing technique will have a wider range of applications in joint surgery.
ObjectiveTo systematically review clinical efficacy and safety of bone marrow stem cells transplantation in treating primary dilated cardiomyopathy (DCM). MethodsSuch databases as PubMed, CENTRAL, EMbase, Web of Knowledge, VIP, CNKI, CBM and WanFang Data were searched from inception to March 2014 for the randomized controlled trials (RCTs) about bone marrow stem cells transplantation for DCM. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2.0 software. ResultsA total of ten RCTs involving 374 patients were included. The results of meta-analysis showed that, a) for safety, after 3 months there was no significant difference in the incidence of malignant arrhythmia events between bone marrow stem cell transplantation group and routine treatment group (RR=0.81, 95%CI 0.38 to 1.72, P=0.58); and b) for efficacy, compared with the control group, left ventricular ejection fraction (LVEF) increased in the bone marrow stem cell transplantation group after 3 months (WMD=3.86, 95% CI 2.53 to 5.20, P<0.000 01) and after 6 months (WMD=5.54, 95%CI 3.02 to 8.06, P<0.000 1). The bone marrow stem cell transplantation group were better in increased 6-minute walking distance after 3 months (WMD=22.12, 95%CI 7.78 to 36.46, P=0.003), increased 6-minute walking distance after 6 months (WMD=102.79, 95%CI 50.16 to 155.41, P=0.000 1), decreased perfusion defect of myocardium percentage after 3 months (WMD=-4.00, 95%CI -5.87 to -2.13, P<0.000 1). However, there was no significant difference in left ventricular end-diastolic diameter (LVEDD) between two groups after 3 months (WMD=-0.37, 95%CI -1.67 to 0.93, P=0.57) and after 6 months (WMD=-0.70, 95%CI -2.76 to 1.36, P=0.51). ConclusionBone marrow stem cells transplantation for dilated cardiomyopathy is effective in improve patients' heart function with good safety, with significant difference. Due to limited quantity and quality of the included studies, more high quality and large-scale RCTs are needed to verify the above conclusion.
In order to establish the best procedure to store the femur samples from the biomechanical viewpoint, we compared the effects of different storage methods on the mechanical properties of mouse femurs. We obtained femurs surgically from twenty C57BL/6J female mice, 12 weeks old, and randomly divided them into 5 groups, i.e. fresh control group, 4% paraformaldehyde fixation group, 4℃ storage group, -20℃ storage group and -80℃ storage group, respectively, with five mice in each group. For the three low-temperature storage groups, each group was stored for 1 week, 2 months, 6 months at their respective temperatures. After rewarming, three-point bending test was performed to test the load and deflection changes. The results showed that both the elastic modulus and deflection decreased significantly in the 4% paraformaldehyde group. The maximum load and elastic modulus of the samples in the 4℃ group after one week storage was significantly reduced; The mechanical properties were close to the fresh control group in the -20℃ group stored for 2 months but the maximum load was also reduced after 6 months. However, mechanical properties, such as elastic load, maximum load and elastic modulus, were not changed obviously in the -80℃ storage group. Accordingly, -80℃ cryopreservation had little influence on the mechanical properties of bone tissues, which proved that the temperature -80℃ is a suitable one for long-term preservation.
ObjectiveTo investigate the value of cementless total hip arthroplasty (THA) for the treatment of Crowe type Ⅲ developmental dysplasia of hip (DDH) in adults. MethodsBetween September 2013 and September 2015, 50 patients (51 hips) with Crowe type Ⅲ DDH were treated. There were 20 males (20 hips) and 30 females (31 hips), with the average age of 39 years (range, 19-55 years). The left side was involved in 34 cases, the right side in 15 cases, and both sides in 1 case. All patients had the symptoms of limp walking and hip pain. The disease duration was 10-47 months (mean, 26 months). The sign of "4" number test and Trendenleburg sign were positive; the Harris score was 38.9±7.1. The bilateral lower extremities discrepancy was 2.5-4.0 cm (mean, 3.3 cm) before operation. All the patients underwent cementless THA, and acetabulum by structural femoral head autograft was performed in 28 cases (28 hips). ResultsAfter operation, the incision healed by first intention. Only 2 patients (2 hips) had femoral nerve palsy, and 7 patients (7 hips) had leg swelling, which were cured after symptomatic treatment. All the patients were followed up 6-18 months (mean, 10 months). The sign of limp walking was improved after operation, hip pain was relieved in 46 patients (46 hips) and only 4 patients (5 hips) still had mild pain. The X-ray films showed bony healing at 3-6 months (mean, 5 months) after operation. At last follow-up, the patients had equal limb length with the discrepancy less than 1 cm (mean, 0.4 cm). At last follow-up, the Harris score was significantly increased to 91.2±2.8 (t=-79.77, P=0.00). ConclusionThe cementless THA is an effective method to treat Crowe type Ⅲ DDH in adults.