ABSTRACT
OBJECTIVE@#To explore the clinical effect of knee denervation combined with micro-fracture under arthroscope in the treatment of patellofemoral arthritis.@*METHODS@#From May 2015 to May 2018, 60 patients with knee joint degenerative patellofemoral arthritis were treated, including 28 males and 32 females, aged from 24 to 56(40.5±3.35) years old. Among them, 30 cases underwent arthroscopic debridement alone(control group), 30 cases underwent arthroscopic debridement, peripatellar denervation combined with cartilage cone and patellofemoral articular surface microfracture treatment (treatment group). VAS, Lysholm and Kujala scores were used to evaluate the therapeutic effect.@*RESULTS@#No complications such as wound infection, vascular nerve injury and deep venous thrombosis occurred in all patients. The patients were followed up for 7 to 36 months with an average of 12.5 months. The VAS scores of the two groups were improved 4 weeks after operation, and the improvement of the treatment group was significantly better than that of the control group, the difference was statistically significant (<0.05). Lysholm and Kujala scores were compared at the last follow-up of the two groups, the improvement of the treatment group was significantly better than that of the control group.@*CONCLUSIONS@#The treatment of patellofemoral arthritis with patellar denervation combined with microfracture can better relieve pain and improve knee function.
Subject(s)
Adult , Aged , Female , Humans , Male , Young Adult , Arthritis , Denervation , Femur , Fractures, Stress , Knee Joint , Patella , Patellofemoral Joint , Treatment OutcomeABSTRACT
BACKGROUND: Core decompression for early adult ischemic necrosis of femoral head gets the identity of most scholars, but the postoperative femoral head easily experiences collapse. How to prevent collapse is still a problem to be solved currently. OBJECTIVE: To perform biomechanical analysis of femoral head ischemic necrosis by using the finite element method and to provide biomechanical basis for the treatment of early adult femoral head necrosis. METHODS: One fresh femur specimen died of accidental death in youth and young adults was obtained, and no deformity or fracture was found. X-ray confirmed that it did not have tumor or osteoporosis. Spiral CT was used to scan normal femoral head and neck, pulp core decompression of femoral head and neck, brace device placement and bone-graft of femoral head and neck for acquiring image data from the proximal to distal vertical longitudinal axis. Scanning data were input in the Mimics software. Finite element method was utilized for biomechanical analysis of femoral head and neck of three models. RESULTS AND CONCLUSION: (1) The stress dispersal and downward conduction of normal femoral head was concentrated in the shaft of the femur and the tensile stress was concentrated in the rotor socket. (2) After pulp core decompression, the stress concentration, displacement and strain increased in the weight-bearing area of femoral head. (3) The stress of the internal bracing was similar to that of normal femoral head. (4) The stress of weight bearing area of femoral head is concentrated, and the strain is increased, so that weight bearing area is easy to collapse after pulp core decompression. The more stress distribution, more bearing load and less strain of implant and bone graft model, are conformed to the normal mechanical properties of the normal femoral head and neck.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the clinical effect of the anterior debridement,bone fusion, single screw-rod fixation for the treatment of lumbosacral tuberculosis.</p><p><b>METHODS</b>From March 2005 to February 2011,18 patients with lumbosacral (L3-S1) tuberculosis (including 13 males and 5 females with an average age of 38.5 years old ranging from 24 to 61 years) were treated with removing focus completely, large piece of iliac bone strut grafting, single screw-rod vertebral lateral anterior internal fixation through anterior extraperitoneal approach. The process segment was L3,4 in 2 cases, L4,5 in 5, L4 in 2, L5S1 in 6, L4-S1 in 3. All patients were routinely treated with antituberculous druy for 12-18 months after operation, erythrocyte sedimentation rate and liver function, X-ray films, CT examination, were statedly rechecked, and condition of antituberculosis treatment and bone grafting fusion were detected.</p><p><b>RESULTS</b>Intraoperative focus were exposed clearly, debrided thoroughly. There were no large blood vessels, nerves, ureteral injury and other serious complications during operation. All patients were followed up form 6 to 42 months with an average of 13 months. Internal fixations were not loosening,breaking; bone of grafting was not displacement and obtained good healing; erythrocyte sedimentation rate and C-reactive protein were normal; tuberculosis lesions were not recurrence.</p><p><b>CONCLUSION</b>Through anterior extraperitoneal approach to remove focus, bone fusion, single screw-rod fixation in treating lumbosacral tuberculosis can complete cut lesion and rebuild the stability of lumbosacral vertebrae,in this area with a single screw and rod fixation is a feasible method.</p>