Objective To compare the effectiveness of arthroscopic and open ankle arthrodeses. Methods The clinical data were retrospectively analyzed from 30 patients undergoing unilateral ankle arthrodesis between January 2008 and January 2011. Of 30 patients, 14 underwent arthroscopic ankle arthrodesis (arthroscopic group), and 16 underwent open ankle arthrodesis (open group). There was no significant difference in gender, age, lesion type, disease duration, and preoperative American Orthopaedic Foot and Ankle Society (AOFAS) score between 2 groups (P gt; 0.05). The operation time, intraoperative blood loss, postoperative hospitalization days, postoperative AOFAS score, and bony union rate were observed to evaluate the effectiveness. Results The operation time of arthroscopic group was significantly longer than that of open group (P lt; 0.05); the intraoperative blood loss and postoperative hospitalization days of arthroscopic group were significantly less than those of open group (P lt; 0.05). Superficial infection of incision occurred in 1 case of open group, and healing of incision by first intention was obtained in the other patients. All patients were followed up 12 months. No screw breakage was observed. The X-ray films showed bony fusion in 13 cases (92.86%) of arthroscopic group and in 10 cases (62.50%) of open group at 3 months after operation, showing significant difference (χ2=3.850, P=0.049); but no significant difference was found (χ2=0.910, P=0.341) in bony fusion rate between the arthroscopic group (14/14, 100%) and open group (15/16, 93.75%) at 12 months after operation. The AOFAS scores at 1, 3, 6, and 12 months after operation were significantly higher than preoperative score in 2 groups (P lt; 0.05). There was no significant difference in AOFAS score between 2 groups at 1 and 3 months (P gt; 0.05), but significant differences were found at 6 and 12 months (P lt; 0.05). Conclusion The overall effectiveness of arthroscopic ankle arthrodesis is better than that of open ankle arthrodesis, which can decrease intraoperative blood loss, shorten hospitalization days, get higher bony fusion rate, and obtain good ankle function recovery.
Objective To compare the short-term effectiveness between primary cemented and uncemented total hip arthroplasty (THA) for osteonecrosis of the femoral head (ONFH) after renal transplantation. Methods The clinical data were retrospectively analyzed from 18 patients (21 hips) with ONFH after renal transplantation undergoing cemented THA in 11 cases (13 hips) (cemented group) and uncemented THA in 7 cases (8 hips) (uncemented group) between February 2005 and February 2012. There was no significant difference in gender, age, disease duration, ONFH stage, preoperative Harris score, and bone density between 2 groups (P gt; 0.05). Postoperative complications were observed in 2 groups; the hip function was assessed based on Harris scores; X-ray film was used to observe the prosthetic situation. Results All the wounds healed by first intention. The patients were followed up 6-77 months (mean, 46 months) in the cemented group, and 4-71 months (mean, 42 months) in the uncemented group. Femoral prosthesis infection occurred in 1 case (1 hip) respectively in each group; hip dislocation, femoral prosthesis loosening, and acetabular prosthesis loosening occurred in 1 case (1 hip) of the cemented group, respectively. At last follow-up, the incidences of postoperative complications and revision rate of the cemented group were 30.7% (4/13) and 23.1% (3/13) respectively, which were significantly higher than those of the uncemented group [12.5% (1/8) and 0 (0/8)] (P=0.047, P=0.040). Harris score was significantly increased to 94.1 ± 3.7 in the uncemented group and 90.0 ± 4.2 in the cemented group, showing significant differences compared with the preoperative scores in 2 groups (P lt; 0.05), but there was no significant difference between 2 groups (t=1.815, P=0.062). Postoperative X-ray films showed that the initial position of the prosthesis was satisfactory. At last follow-up, the bone fixation, fibrous stability, and loosening of the femoral prosthesis and loosening of acetabular prosthesis occurred in 9 hips, 3 hips, 1 hip, and 1 hip of the cemented group, respectively; bone fixation of the femoral prosthesis and stability of acetabular prosthesis were observed in all hips of the uncemented group. There was no heterotopic ossification in 2 groups. Conclusion Uncemented THA after renal transplantation can obtain satisfactory short-term effectiveness, and uncemented THA is better than the cemented THA; however, the middle- and long-term effectivenesses need further observation．