Does Patellar Denervation with Electrocautery Benefits for Total Knee Arthroplasty without Patellar Resurfacing: A Meta-analysis of Randomized Controlled Trails.

To investigate the effects of patellar denervation (PD) and non-patellar denervation (NPD) after primary total knee arthroplasty (TKA) without patellar resurfacing, this study conducted systematic electronic searches in November 2023 using PubMed, Embase, Web of Science, Cochrane, and Scopus, adhering to Cochrane Collaboration recommendations. Only randomized controlled trials (RCTs) were included. Additionally, a manual search was performed to identify potentially eligible studies from the reference lists of review articles. Two researchers independently conducted literature reviews, data extraction, and risk of bias assessments. The outcome analysis encompassed the incidence of anterior knee pain (AKP), visual analogue scale (VAS), range of motion (ROM), American Knee Society Score (KSS), Oxford Knee Score (OKS), patellar score (PS), complications, and reoperations. Meta-analysis was executed using RevMan 5.3 software. To enhance the credibility of the study, TSA v0.9 software was utilized to perform power analysis on the overall efficacy of primary and secondary outcomes. Twelve studies involving 1745 patients (1587 knees) were included, with 852 undergoing PD and 893 undergoing NPD. Results indicated a superior reduction in AKP incidence in the PD group compared to the NPD group. Statistically significant differences were observed between PD and NPD in KSS, OKS, and PS. However, the upper limit of the 95% confidence interval for each outcome fell below the minimal clinically important difference (MCID). No significant differences were found in VAS and ROM between PD and NPD. Additionally, PD was not associated with an increased incidence of complications or reoperations. Within 12 months and beyond, PD was proven to be a beneficial intervention in reducing AKP following TKA without patellar resurfacing, achieved without an increase in complications or reoperations. Regarding KSS, OKS, and PS, the minimal advantage achievable through PD may not be clinically significant.

Comparison of the clinical outcomes between proximal femoral nail anti-rotation with cement enhancement and hemiarthroplasty among elderly osteoporotic patients with intertrochanteric fracture.

BACKGROUND: The proximal femoral nail anti-rotation (PFNA) with cement enhancement enhances the anchorage ability of internal fixation in elderly with osteoporotic intertrochanteric fracture. However, whether it is superior to hemiarthroplasty is still controversial. The present study aimed to determine which treatment has better clinical outcomes among older patients. METHODS: We retrospectively analyzed 102 elderly patients with osteoporosis who developed intertrochanteric fractures and underwent PFNA combined with cement-enhanced internal fixation (n = 52, CE group), and hemiarthroplasty (n = 50, HA group) from September 2012 to October 2018. All the intertrochanteric fractures were classified according to the AO/OTA classification. Additionally, the operative time, intraoperative blood loss, intraoperative and postoperative blood transfusion rates, postoperative weight-bearing time, hospitalization time, Barthel Index of Activities Daily Living, Harris score of hip function, visual analog (VAS) pain score, and postoperative complications were compared between the two groups. RESULTS: The CE group had significantly shorter operative time, lesser intraoperative blood loss, lower blood transfusion rate, and longer postoperative weight-bearing time than the HA group. The CE group had lower Barthel's Index of Activities of Daily Living, lower Harris' score, and higher VAS scores in the first and third months after surgery than the HA group, but no difference was observed between the two groups from 6 months to 12 months. There was no significant difference in the total post-operative complications between the two groups. CONCLUSION: The use of PFNA combined with a cement-enhanced internal fixation technique led to shorter operative time and lesser intraoperative blood loss and trauma in elderly patients as compared to HA.

[Distribution and influencing factors of magnoflorine in Epimedium].

Eighty samples of Epimedium from 29 species and were determined in this study. The content of magnoflorine in leaves range between 0. 003% and 2. 603%. The results showed that the content of magnoflorine was quite stable within species except E. wushanense, E. acuminatum, E. hunanense. Genetic factors might be the main influencing ones. The contents of different parts and different collecting time of the medicinal materials were variable.

Preparation and visible light photocatalytic activity of N-doped titania.

N-doped titania powders were prepared with titanium tetraisopropoxide (TTIP) as the titanium source and urea as the nitrogen source by the sol-gel method. The samples were characterized using X-ray diffraction (XRD), diffuse reflectance spectrum (DRS), X-ray photoelectron spectroscopy (XPS), and transmission electron microscopy (TEM). The XRD and TEM results indicated that urea played an important role in controlling the size and aggregation process of titania nanoparticles. As an appropriate amount of urea was added into the titania sol, the size of the particles decreased. However, the excess urea reduced the dispersion of the particles and resulted in the aggregation. At the same time, the size of particle increased, and the size distribution broadened. The XPS and DRS results showed that the nitrogen was incorporated into titania lattice successfully, which brought about the redshift of the absorption edge and induced the photocatalytic activity in the visible light region. The photocatalytic experiments showed that the N-doped titania nanoparticles could effectively photodegrade methyl orange (MO) aqueous solution under visible light irradiation. The photocatalytic activity increased with the increase of the nitrogen doping level in the titania lattice, but decreased with the increase of the particle size and the organic surface residues caused by excess urea.