[Cystic fibrosis primarily presenting with pseudo-Bartter syndrome: a report of three cases and literature review]. / 以假性Bartter综合征为主要表现的囊性纤维化患儿3ä¾‹å¹¶æ–‡çŒ®å¤ä¹ .

OBJECTIVES: To summarize the clinical characteristics and genetic variations in children with cystic fibrosis (CF) primarily presenting with pseudo-Bartter syndrome (CF-PBS), with the aim to enhance understanding of this disorder. METHODS: A retrospective analysis was performed on the clinical data of three children who were diagnosed with CF-PBS in Hunan Children's Hospital from January 2018 to August 2023, and a literature review was performed. RESULTS: All three children had the onset of the disease in infancy. Tests after admission showed hyponatremia, hypokalemia, hypochloremia, and metabolic alkalosis, and genetic testing showed the presence of compound heterozygous mutation in the CFTR gene. All three children were diagnosed with CF. Literature review obtained 33 Chinese children with CF-PBS, with an age of onset of 1-36 months and an age of diagnosis of 3-144 months. Among these children, there were 29 children with recurrent respiratory infection or persistent pneumonia (88%), 26 with malnutrition (79%), 23 with developmental retardation (70%), and 18 with pancreatitis or extrapancreatic insufficiency (55%). Genetic testing showed that c.2909G>A was the most common mutation site of the CFTR gene, with a frequency of allelic variation of 23% (15/66). CONCLUSIONS: CF may have no typical respiratory symptoms in the early stage. The possibility of CF-PBS should be considered for infants with recurrent hyponatremia, hypokalemia, hypochloremia, and metabolic alkalosis, especially those with malnutrition and developmental retardation. CFTR genetic testing should be performed as soon as possible to help with the diagnosis of CF.

Arthroscopic treatment of ankle impingement syndrome.

Arthroscopic treatment of ankle impingement syndrome (AIS) is a minimally invasive surgical procedure used to address symptoms caused by impingement in the ankle joint. This syndrome occurs when there is abnormal contact between certain bones or soft tissues in the ankle, leading to pain, swelling, or limited range of motion. Traditionally, open surgery was the standard approach for treating AIS. However, with advancements in technology and surgical techniques, arthroscopic treatment has become a preferred method for many patients and surgeons. With improved visualization and precise treatment of the arthroscopy, patients can experience reduced pain and improved functionality, allowing them to return to their daily activities sooner. In this paper, we reviewed the application and clinical efficacy the of arthroscopic approach for treating AIS, hoping to provide a reference for its future promotion.

lncRNA NEAT1 promotes hypoxia-induced inflammation and fibrosis of alveolar epithelial cells via targeting miR-29a/NFATc3 axis.

The objective of the present study was to explore the function and mechanism of long noncoding RNA (lncRNA) nuclear paraspeckle assembly transcript 1 (NEAT1) in pulmonary fibrosis (PF) progression. HPAEpic cells and A549 cells were exposed to hypoxic conditions to establish an in vitro model. Cell apoptosis was detected by TUNEL assay, and inflammatory cytokine levels were detected by ELISA. Gene and protein expression levels were identified by qRT-PCR and Western blot assays, respectively. The interaction among NEAT1, miR-29a, and NFATc3 was identified by dual-luciferase reporter and RNA pull-down assays. In hypoxia-treated cells, hypoxia markers (HIF-1α and HIF-2α), cytokines (TNF-α, IL-1ß, and IL-6) and fibrotic markers (α-SMA, collagen I and collagen III) were significantly enhanced. Consistently, the expression levels of NEAT1 and NFATc3 were increased, but miR-29a was decreased in hypoxia-stimulated cells. Knockdown of NEAT1 significantly decreased cell apoptosis and the releases of TNF-α, IL-1ß, and IL-6 as well as reduced the levels of α-SMA, collagen I, and collagen III. Moreover, NEAT1 positively regulated NFATc3 expression by directly targeting miR-29a. Functional experiments showed that the anti-apoptotic, anti-inflammatory, and anti-fibrotic effects mediated by NETA1 silencing were impeded by miR-29a inhibition or NFATc3 overexpression in hypoxia-stimulated HPAEpic and A549 cells. Collectively, these data demonstrated that NEAT1 knockdown inhibited hypoxia-induced cell apoptosis, inflammation, and fibrosis by targeting the miR-29a/NFATc3 axis in PF, suggesting that NEAT1 might be a potential therapeutic target for relieving PF progression.

Triple Hemisection Percutaneous Achilles Tendon Lengthening for Severe Ankle Joint Deformity.

OBJECTIVE: To investigate the efficacy of modified percutaneous Achilles tendon lengthening for severe ankle joint deformity. METHODS: This retrospective case series study included 33 patients with an average age of 25.2 years who underwent surgery in our hospital from April 1, 2010 to March 1, 2018. Triple hemisection percutaneous Achilles tendon lengthening was performed. One stage surgery, other soft tissue surgery or bone correction surgery could be performed. After surgery, a plaster cast was used to fix the functional position, and rehabilitation training was carried out as planned. Complications during the perioperative period were recorded. Statistical analysis of the patients' visual analogue scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) score before and at the last follow-up was performed. The recurrence rate of Achilles tendon contracture at the last follow-up and the patients' satisfaction rate were investigated. RESULTS: All patients were followed up, with an average follow-up period of 56.31 months (8-104 months). All achieved good ankle joint function and appearance improvement And there were no infection or skin necrosis complications. In two cases, the incision was poorly healed at non-Achilles tendon site and was cured by change of dressing. The average VAS score at the last follow-up was reduced from (2 ± 1.48) points before surgery to (0.26 ± 0.51) points (P = 0.001), and the average AOFAS score was increased from (64.97 ± 13.56) points before surgery to (90.06 ± 10.06) points (P = 0.001). During the follow-up period, there was no chronic rupture of Achilles tendon. There were two cases of recurrence of foot drop (5.7%), and the patients' satisfaction rate was 93.9%. CONCLUSION: In the surgical treatment of severe ankle joint deformity, the application of triple hemisection percutaneous Achilles tendon lengthening for Achilles tendon contracture has the advantages of less trauma, beautiful incision, and reliable efficacy. The satisfaction rate of patients with this treatment is high, and it is worth promoting in the clinic.

LncRNA NEAT1 regulates MMP-16 by targeting miR-200a/b to aggravate inflammation in asthma.

Asthma is a common respiratory disease which is characterized by persistent airway inflammation. Abnormal expression of long non-coding RNAs (lncRNAs) is observed in asthma. However, whether lncRNA nuclear-enriched abundant transcript 1 (NEAT1) regulates asthmatic inflammation and its mechanism still needs to be further investigated. The expression levels of inflammatory factors (tumour necrosis factor (TNF)-α, interleukin (IL)-4, IL-13, and IL-10) were detected using reverse transcription quantitative real-time PCR (RT-qPCR) and enzyme-linked immunosorbent assay (ELISA). MTT and flow cytometry assays were employed to determine cell proliferation and apoptosis, respectively. Dual luciferase reporter assay was performed to verify the relationship between miR-200a/b and MMP-16 or NEAT1. NEAT1 silencing markedly reduced TNF-α, IL-4, and IL-13 levels, while elevated IL-10 expression, suppressed cell proliferation, and promoted cell apoptosis. However, NEAT1 overexpression elicited the opposite effects on cell proliferation and inflammation cytokines secretion. What is more, NEAT1 negatively regulated miR-200a/b expression, and MMP16 was a target gene of miR-200a/b. miR-200a/b overexpression suppressed inflammation, cell proliferation, and enhanced cell apoptosis through regulation of MMP16. Moreover, MMP-16 overexpression or miR-200a/b inhibition abolished the regulatory effect of sh-NEAT1 on cell inflammation and apoptosis in BEAS-2B cells. NEAT1 acted as the role of sponge for miR-200a/b to regulate MMP-16 expression, thereby promoting asthma progression, suggesting that NEAT1 might have great potential as therapeutic target for asthma.

MiR-200a and miR-200b restrain inflammation by targeting ORMDL3 to regulate the ERK/MMP-9 pathway in asthma.

BACKGROUND: Asthma is one of the most frequent and serious diseases worldwide. Inflammation has been reported to correlate with airway remodeling, which is critical for the progression of asthma. Better understanding of novel molecules modulating asthma and the underlying mechanism will benefit explorations of new treatments. Method: To explore the role of miR-200a and miR-200b in asthma, miR-200a mimics/inhibitor and miR-200b mimics/inhibitor were employed in A549 cells, respectively. Expression levels of inflammatory cytokines, including TNF-α, IL-4, IL-5, IL-13 and IL-1ß, were measured by quantitative real time polymerase chain reaction (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA). A dual luciferase reporter assay was performed to identify whether miR-200a/200b directly bound to Orosomucoid 1-like 3 (ORMDL3). ERK, p-ERK and MMP-9, involved in downstream pathways of ORMDL3, were detected using qRT-PCR and western blotting. Results: MiR-200a/200b silencing significantly increased the expression of inflammatory cytokines, including TNF-α, IL-4, IL-5, IL-13 and IL-1ß, in A549 cells. ORMDL3 was the target gene of miR-200a/200b, with high expression levels in miR-200a inhibitor and miR-200b inhibitor groups. MiR-200a and miR-200b played synergistic roles in the regulation of the inflammatory effect in A549 cells. Expression levels of p-ERK and MMP-9 were significantly increased in miR-200a inhibitor and miR-200b inhibitor groups and were rescued by ERK inhibitor and MMP-9 inhibitor, respectively. Conclusion: These findings suggest that miR-200a and miR-200b are required to regulate asthma inflammation. Reduction in miR-200a/200b promotes the development of asthma inflammation by targeting ORMDL3 to activate the ERK/MMP-9 pathway. Therefore, elevating miR-200a and miR-200b and decreasing ORMDL3 might be potential strategies for inhibition of the asthma process.

Application of 3D-printed Customized Guides in Subtalar Joint Arthrodesis.

OBJECTIVE: To explore the feasibility of 3D printed customized guides assisting the precise drilling of Kirschner wires in subtalar joint arthrodesis. METHODS: We retrospectively reviewed the data of 29 patients (30 subtalar joints) who underwent subtalar joint arthrodesis between 1 July 2013 and 31 December 2017. The customized guides were designed on a full-scale 3D polylactic acid model made from computed tomography (CT) data of patients by Model Intestinal Microflora in Computer Simulation (MIMICS) software, which were manufactured by 3D printing technology. A total of 14 joints used customized guides (experimental group); the remained 16 joints used the traditional method (control group). The time of drilling the Kirschner wires to the correct position, the time of subtalar fusion, American Orthopaedic Foot & Ankle Society (AOFAS) scores, and complications were evaluated in both groups. RESULTS: All customized guides were successfully manufactured. In the experimental group, it took 2.1 ± 0.7 min to drill the Kirschner wire to the satisfactory position, and 2 cases needed to be re-drilled; in the control group, it took 4.6 ± 1.9 min to drill the Kirschner wire to the satisfactory position (P < 0.05), and 8 cases needed to be re-drilled. No serious complications occurred in both groups during and after the surgery. Postoperative radiographic fusion was confirmed in all cases. No significant difference was observed in the fusion time and AOFAS scores 1 year postoperatively between the two groups (P > 0.05). CONCLUSION: It is safe to apply 3D-printed customized guides for subtalar joint arthrodesis, which can assist the accurate drilling of Kirschner wires into the appropriate position according to the preoperative plan, and reduce the operation time as well as intraoperative radiation.

V-Y Tendon Plasty for Reconstruction of Chronic Achilles Tendon Rupture: A Medium-term and Long-term Follow-up.

OBJECTIVE: To evaluate the surgical results of V-Y tendon plasty in the treatment of chronic Achilles tendon rupture during medium and long-term follow-up. METHODS: Between June 2005 and September 2017, 20 patients with chronic Achilles tendon rupture underwent V-Y tendon plasty in our hospital. The mean injury-to-surgery time was 20.4 weeks (range, 4-96 weeks). The Matles test and an improved Thompson test was used to examine Achilles tendon rupture. These patients were not able to stand on the tiptoes of the injured lower extremity. X-ray tests ruled out the chance of fracture and were used to examine the Kager triangle. MRI was used to confirm the final diagnosis. The function of the ankle and the foot was assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) score and the Achilles Tendon Total Rupture Score (ATRS). V-Y tendon plasty for Achilles tendon reconstruction was performed. A below-knee cast was used to keep the ankle in plantar flexion (up to 20°) for 4 weeks. Non-weight-bearing exercise was allowed with crutches. After 4 weeks, partial weight-bearing was allowed. Physical exercises were performed under rehabilitation guidelines. At 10-12 weeks postoperation, patients began to return to daily life activity levels without restrictions. Preoperative and postoperative MRI was obtained. RESULTS: The mean follow-up period was 32.8 months. The mean operative gap of the Achilles tendon after debridement was 5 cm (range, 4-9 cm), with 85% of the gap less than or equal to 6 cm. The mean AOFAS score increased from 59.25 ± 12.28 preoperatively to 96.55 ± 3.75 at final follow-up (P < 0.05). The mean ATRS score increased from 39.55 ± 14.21 preoperatively to 94.05 ± 4.89 at final follow-up (P < 0.05). All patients had no recurrent Achilles tendon rupture during the follow up. No patient had developed serious complications, such as sural nerve injury or deep vein thrombosis. Patients were able to return to daily life activity levels without restrictions. At the latest follow-up, all patients were able to perform repetitive single heel rise on the involved limb, and to walk without a visible limp. All of the postoperative MRI showed the continuity of the Achilles tendon with no signs of cysts or inflammation, indicating perfect healing at the final follow-up. CONCLUSIONS: V-Y tendon plasty can be used in most cases of chronic Achilles tendon rupture. It yields satisfactory functional results and low complication rates. The advantage of this procedure is that it is an easy and economic method without the need for expensive synthetic implants. V-Y tendon plasty should be considered an acceptable first-choice treatment.

Hemi-arthroplasty performed in a 109-year-old patient with intertrochanteric fracture: A case report.

The mortality of conservative treatment and the risk resulting from operation for elderly patients with femoral intertrochanteric fractures are high. Safety in the perioperative period and quicker recovery should be placed at the top priority for elderly patients with hip fractures. We reported a case of 109-year-old female patient with intertrochanteric fracture who has undergone the hemiarthroplasty in our center recently. With sciatic nerve and lateral cutaneous nerve block anesthesia, she was offered the artificial femoral head replacement in the lumbar plexus block after sufficient preoperative preparation. The surgery went well with minimally invasive cut, and the patient's recovery was satisfactory.

Total hip arthroplasty for patients with Crowe type IV developmental dysplasia of the hip: Ten years results.

BACKGROUND AND OBJECTIVES: The aim of this study was to determine the rate of union, functional results and complications in patients with Crowe IV developmental dysplasia of the hip (DDH) who underwent cementless total hip arthroplasty (THA) with S-ROM prostheses and subtrochanteric transverse shortening osteotomy. METHODS: Forty-five patients (52 hips) operated between January 2005 and May 2008, with a mean age of 40.6 years at surgery were followed. The mean follow-up period was 9.8 years. Clinical outcomes, radiographic outcomes and complications were evaluated. RESULTS: Osteotomy union occurred in 52 of 52 femurs (100%). Mean Harris hip score improved from 33.7 ± 4.7 preoperatively to 81.2 ± 6.3, 90.8 ± 5.3 and 89.8 ± 7.1 at 1, 5 and 10 years postoperatively. Two patients had temporary sciatic nerve paralysis postoperatively, and 2 patients experienced early postoperative dislocation. Two patients complained about mild longer limb length than the non-operated limb at the last follow-up. Three hips showed osteolysis in Gruen zone 1, and 1 hip showed osteolysis in zone 1 and 7. No implants were revised, and no signs of component loosening and migration were observed at the last follow-up visit. CONCLUSIONS: S-ROM stem combined with transverse subtrochanteric shortening osteotomy in THA for patients with Crowe type IV DDH has good clinical results with small risk of complications.

Three-dimensional printing in the surgical treatment of osteoid osteoma of the calcaneus: A case report.

Surgical excision is the traditional treatment for osteoid osteoma. However, the complexity of the foot anatomy makes a satisfactory outcome challenging. Difficulty in localizing the lesion intraoperatively may result in either incomplete tumor resection or excessive bone loss. To date, no published report has described the use of three-dimensional printing in the surgical treatment of osteoid osteoma of the calcaneus. In this case, we printed a three-dimensional model of the calcaneus of a 17-year-old female patient with a 2-year history of night pain in the lateral aspect of the hindfoot and ankle, evaluated the lesion as an osteoid osteoma, and designed a surgical guiding plate. Intraoperatively, we had no difficulty achieving complete resection of the lesion from the lateral calcaneus bone window, autogenous bone grafting, and subtalar arthrodesis. At the 2-year follow-up examination, the patient remained asymptomatic with no recurrence of the osteoid osteoma.

Angiogenesis-related genes may be a more important factor than matrix metalloproteinases in bronchopulmonary dysplasia development.

We characterized the expression profile of angiogenesis-related genes (ARG) and matrix metalloproteinase (MMP) genes in preterm infants, with and without bronchopulmonary dysplasia (BPD). We reanalyzed a gene expression dataset for preterm infants from the Gene Expression Omnibus database using the Gene-Cloud of Biotechnology Information platform. A total of 1,652 genes were differentially (1.2-fold change) expressed: 811 were highly expressed in infants with BPD, and 841 were highly expressed in those without BPD. Twenty-eight and 11 ARGs were upregulated in infants with and without BPD, respectively. Among 27 detected MMPs and TIMPs, MMP8, MMP9, MMP25, TIMP2 and TIMP3 were differently expressed. Levels of THBS1, MMP8, MMP9, MMP25, TIMP2 and TIMP3 increased as severity of BPD and retinopathy of prematurity (ROP) increased, whereas ETS1, LEF1 and SPOCK2 exhibited the opposite trend. Expression of ETS1 and LEF1 had a fitting rate of R2 = 0.849 and P < 0.001. ELISAs showed a positive correlation between THBS1 and CD36 (receptor of THBS1) levels in serum samples from preterm infants. Our study indicates that the upregulation of THBS1 and downregulation of ETS1, LEF1 promotes BPD in preterm infants by disrupting blood vessel formation rather than by dysregulation of MMPs and TIMPs.

Removal of osteoblastoma of the talar neck using standard anterior ankle Arthroscopy：A case report.

INTRODUCTION: Osteoblastoma of the talus, a benign tumor, is rare in orthopedics. The choice of treatment is usually open surgery for excision of tumor. Limited data is available concerning arthroscopic approaches. PRESENTATION OF CASE: A 36-year-old male patient was evaluated for pain and swelling of the left ankle joint. Based on the findings of physical examination, X-rays and MRI investigations, the tumor was isolated. Standard anterior arthroscopic surgery was performed due to ankle pain. A diagnosis of osteoblastoma of the talar neck was made following the pathological survey. He had no recurrent pain and normal joint mobility 5 years postoperatively during he was regularly followed up. DISCUSSION: Osteoblastoma of the talar neck is slowly progressive and it is a palpable painful mass. Open or arthroscopic surgery can be performed. Treatment strategies are decided on according to the tumor's location, extent and size. Some advantages of arthroscopic surgery are wide visualization areas, minimally invasion, low morbidity, no necessity for casting and immobilization, early rehabilitation and quick recovery. CONCLUSION: In conclusion, arthroscopic management can be successful in selected patients with small benign tumor localized to the ankle joint.

[Clinical features of tracheobronchial foreign bodies in children].

OBJECTIVE: To investigate the clinical features of tracheobronchial foreign bodies in children and to provide a basis for feasible preventive measures. METHODS: A retrospective analysis was performed on the clinical data of 114 children with tracheobronchial foreign bodies confirmed by fiberoptic bronchoscopy between February 2012 and February 2013. RESULTS: The majority (71.9%) of children with tracheobronchial foreign bodies were younger than three years old, and the male-to-female ratio was 2:l. The proportion of cases in winter was higher than that in summer. The incidence of tracheobronchial foreign bodies was significantly higher among rural children than among urban children. The positive rate of CT varied significantly for tracheobronchial foreign bodies at different sites, and the patients with tracheal foreign bodies had a significantly lower positive rate of chest CT than patients with foreign bodies in the left and right main bronchi (P<0.01). The misdiagnosis rate in children with a history of aspiration of foreign bodies was significantly lower than in children without one (P<0.01). CONCLUSIONS: Health education related to the prevention of tracheobronchial foreign bodies in children should be conducted primarily in rural areas. Tracheobronchial foreign bodies are common in children younger than three years old. Bronchoscopy should be performed early for suspected cases of tracheobronchial foreign bodies.

[Knee arthroscopic resection of articular capsule valvular treat popliteal cysts].

OBJECTIVE: To retrospective study the results of arthroscopic resection of articular capsule valvular treated popliteal cysts and examined the incidence of complication. METHODS: From July 2007 to July 2010, 45 patients with symptomatic popliteal cysts such as knee pain and limitation of motion were treated with arthroscopic technique to resect the connecting valvular mechanism at posteromedial compartment of articular capsule. Through the posteromedial viewing portal and cyst resection working portal, resected the valvular mechanism by shaver and plasma cutter, associated intra-articular pathology was treated simultaneously. The functional outcome was evaluated by employed Rauschning and Lindgren score before the surgery and the last follow-up. By using of Wilcoxon rank sum test to statistics analyze the clinic outcome. RESULT: In all cases, 40 patients were found the associated intra-articular pathology, the incidence was 88.9%.The intra-articular pathology was medial meniscus tear (27 cases, 60.0%), lateral meniscus tear (20 cases, 44.4%), cartilage lesion (28 cases, 62.2%), which composed with patellofemoral joint (12 cases, 26.7%),medial condyles of femur (10 cases, 22.2%),lateral condyles of femur (6 cases, 13.3%). The anterior cruciate ligment injury was found in 2 cases, the incidence was 4.4%. All the patients achieved symptoms relief postoperative, such as posterior knee discomfort and swelling after activities.The Rauschning and Lindgren score was improved 1-2 grade in average (Z = -6.092, P = 0.00). The recurrence rate was 2.2%. All the incision healed good. No major complications were encountered such as saphenous nerve, great saphenous vein, blood vessel in popliteal injury. CONCLUSIONS: Arthroscopic resection of articular capsule valvular treatment of popliteal cyst and treatment of associated intra-articular pathology are effective and safe. This surgery technique has more minimally trauma and lower recurrence rate.The clinic results in short term are excellent.

Anterior cruciate ligament reconstruction with bone-patellar tendon-bone graft: comparison of autograft, fresh-frozen allograft, and γ-irradiated allograft.

PURPOSE: To compare clinical follow-up results of anterior cruciate ligament (ACL) reconstruction using (1) autologous, (2) fresh-frozen allogeneic, and (3) γ-irradiated allogeneic bone-patellar tendon-bone (BPTB). METHODS: From February 2002 to January 2006, 187 patients received BPTB ACL reconstruction at our center. One hundred forty-two consecutive patients who had received single-bundle BPTB ACL reconstruction were included in this study. Of these patients, 41 had autografts, 33 had fresh-frozen allografts, and 68 had γ-irradiated allografts. Clinical results were evaluated with the KT-1000 maximum displacement test (MEDmetric, San Diego, CA), Lachman test, and Lysholm, Irrgang, and Larson activity scales. RESULTS: The mean duration of follow-up was 6.7 ± 1.5 years (range, 4.2 to 8.2 years). There were 3 cases of acute synovitis due to immunologic rejection (fresh-frozen allografts) and 6 cases of failure (γ-irradiated allografts). KT-1000 examination showed more anterior laxity in the γ-irradiated allograft group compared with the autograft and fresh-frozen allograft groups (P < .05). The Lysholm, Irrgang, and Larson activity scales showed no difference among the 3 groups (P > .05). CONCLUSIONS: The study showed a statistically poorer KT-1000 result and higher failure rate in the γ-irradiated allograft group compared with the autograft and fresh-frozen allograft groups. This may suggest that γ-irradiated allograft is not a good candidate graft for ACL reconstruction. Power analysis showed that the study was underpowered, so further research and longer follow-up study are needed to make this point clearer. LEVEL OF EVIDENCE: Level III, retrospective comparative study.

Long-term survival analysis of posterior cruciate-retaining total knee arthroplasty.

PURPOSE: Clinical factors related to cruciate-retaining knee arthroplasty failure in a long-term follow-up are yet unclear. The study was designed to evaluate the long-term survival rate of cruciate-retaining arthroplasty and clinical factors that may contribute to its failure. METHODS: A total of 162 patients (188 knees) who received cruciate-retaining press-fit condylar arthroplasty from June 1993 to May 1994 were followed up. All patients were assessed clinically and radiographically. Revision for any reason was regarded as failure of arthroplasty. RESULTS: A total of 120 patients (138 knees) were successfully followed up. Survivorship over 17 years was 92.5%. Fourteen knees were revised. Tibial varus angle of the operated knee in the unrevised patient group was greater than in revised group. There was statistical difference between these two groups (P < 0.05). CONCLUSION: Long-term survivorship of cruciate-retaining arthroplasty was fair. Varus and valgus deformity of the unoperated contralateral knee and tibial varus deformity of the operated knee could be important factors related to arthroplasty failure. CLINICAL RELEVANCE: This long-term follow-up result of Press-Fit Condylar cruciate-retaining arthroplasty was good considering it was an old design. The alignment of the operated knee and deformity of the unoperated contralateral knee are important clinical factors that should be paid attention to avoid unexpected arthroplasty failure. LEVEL OF EVIDENCE: IV.

[Treatment of elbow dysfunction under elbow arthroscopy].

OBJECTIVE: To evaluate early clinical outcome after arthroscopic treatment of elbow dysfunction. METHODS: From September 2007 to December 2009, 21 patients with elbow dysfunction were treated with an arthroscopic procedure. All patients had chronic history of elbow dysfunction. Extension lag was 18.2° (10° - 25°) combined with pain. All patients underwent five-portals arthroscopic release and debridement. Postoperative care including anti-infection, rehabilitation and prophylaxis of myositis ossificans were prescribed. All elbows were assessed for increase in ROM and Mayo assessment before and after surgery. Mayo score assessment: ≥ 90 points, excellent; 75 - 89 points, good; 60 - 74 points, common; < 60, bad. Complications were evaluated. RESULTS: At an average follow-up of 19.7 months (6 - 29 months), all patients had improvement of extension and relief of pain. The average lag of extension was 2.4° (0° - 5°). Pre-operative Mayo assessment: good, 13 patients; common, 5 patients; bad, 3 patients. Post-operation Mayo assessment: excellent, 17 patients; good, 4 patients; common, 0 patients; bad, 0 patient. There was no complication in this case serial. CONCLUSIONS: Arthroscopic surgery can minimize trauma and bleeding, and reduce complications. Combined with reasonable rehabilitation, arthroscopic surgery can improve elbow function and appears to be satisfactory management.

WITHDRAWN: 15-year follow-up of PFC posterior cruciate retaining total knee arthroplasty.

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Arthroscopically assisted treatment of adolescent knee joint tuberculosis.

OBJECTIVE: To evaluate the role of knee arthroscopy in diagnosis and treatment of knee joint synovitis and total joint tuberculosis (TB) of adolescence. METHODS: Forty-one patients with knee TB, aged 7-16 years, were treated using knee arthroscopy from June 2002 to December 2006. Clinical data were reviewed at followed up and evaluated using the Lysholm score. RESULTS: Among the 41 patients, 36 were diagnosed as having TB on the basis of preoperative clinical manifestations and laboratory results, and the remaining 5 as synovitis preoperatively, TB being confirmed postoperatively by arthroscopy and pathological examination. Specimens from 37 patients were confirmed as tuberculosis by pathological examination, while the other 4 were reported as chronic synovitis and necrotic tissue. Patients were followed-up for 6-58 months postoperatively (average, 43.5 months). All patients were treated with knee arthroscopy surgery and postoperative medication and no relapses occurred over the duration of follow-up. The mean Lysholm score was 91.4 points. The range of movement of the knee joint in 6 patients remained at 70°-110°. Two patients retained an extension lag of 10° and 25°, respectively. CONCLUSION: Diagnosis and treatment of adolescent TB is different from that of other TB patients. Arthroscopically assisted treatment of adolescent knee joint TB has the advantages of early diagnosis, minimization of trauma, thorough clearance and rapid recovery. Early treatment with arthroscopically assisted debridement, early rehabilitation and postoperative medication can preserve maximal function of knee joint and avoid arthrodesis. This is an ideal method for the treatment of adolescent knee TB.