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Objective: To explore the effectiveness of dynamic hip screw (DHS) and intralesional curettage via Watson-Jones approach in treatment of benign bone lesions of the proximal femur.
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Objective@#To investigate the operative method and clinical application of the BARD® Mesh in enhancing joint stability and function of endoprosthetic reconstruction for bone tumors.@*Methods@#From Jan 2013 to Jun 2015, the clinical data of 51 patients aged (44.75±23.18) years underwent wide resection of tumor and endoprosthetic reconstruction using the BARD® Mesh were collected. Among them, 27 were male and 24 were female. The surgical treatments received by these patients included 5 shoulder arthroplasties, 12 elbow replacements, 12 hip replacements and 32 knee replacements (including 24 femoral tumors and 8 tibial tumors). According to the pathologic type, there were 12 metastatic tumors, 20 osteosarcomas, 7 chondrosarcomas, 5 malignant fibrous histiocytomas, 4 giant cell tumors of bone, 1 Ewing sarcoma, 1 leiomyosarcoma and 1 pigmented villonodular synovitis (pvns). These patients received extensive tumor resection, tumorous prosthesis replacement, preserved articular capsule and muscles repair with artificial mesh and endoprosthesis wrapping. The curative effect including joints range of motion and Musculoskeletal Tumour Society Scores (MSTS) were evaluated.@*Results@#The median follow-up time was (19.75±8.17) months. The drainages were removed out on an average of 4 days after operation. The postoperative complications included 2 superficial incision infection, 1 deep incision infection and 1 osteofascial compartment syndrome, infection or dislocation of prosthesis wasn′t observed. The mean active flexion of shoulder joint after replacement was (34.00±10.84)°, mean active abduction was (20.00±9.35)° and the mean MSTS was 19.80±9.54. The superior rate of shoulder flexion function was 0. The mean active flexion of elbow joint after replacement was (75.00±7.07)°, mean active abduction was (-5.00±7.07)° and the mean MSTS was 25.00±2.83. The superior rate of elbow flexion function was 50.0% (1/2). The mean active flexion of hip joint after replacement was (86.67±20.60)°, mean active abduction was (2.08±4.98)° and the mean MSTS was 25.42±1.78. The superior rate of hip flexion function was 83.3% (10/12). The mean active flexion of knee joint after replacement was (89.69±22.39)°, mean active abduction was (-0.63±1.68)° and the mean MSTS was 23.31±2.09. The superior rate of knee flexion function was 50.0%(16/32). Among them, the superior rate of femoral flexion function was 66.7% (16/24), the superior rate of tibial flexion function was 0. All of patients were satisfied with the curative effect of operation at the end of follow-up time.@*Conclusions@#The BARD® Mesh may enhance the attachment of soft-tissue to endoprosthesis, improve the joint stability, decrease the endoprosthetic infection and dislocation, facilitate the attachment of tendon to endoprosthesis and recover the muscular motivation after endoprosthetic reconstruction. This plays an important role in joint stability and motivation reconstruction of soft-tissue impairment, effectively prevents surgical complications.
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[Objective]To study the repair of articular cartilage defects with combined bone morphogenetic protein(BMP)/basic fibroblast growth factor(bFGF)biomaterial in order to supply experimental basis for repairing cartilage defects biologically.[Method]Twenty-four 14-week-old rabbits were randomly divided into four groups,BMP/bFGF biomaterial gel(group A),BMP biomaterial gel(group B),bFGF biomaterial gel(group C)and simple fibrin glue treated group(group D).A couple of knees of each rabbit experienced 5 mm-diameter-full cartilage resection and drilling throuth of bone marrow.Gross appearance,histologicol section and electron microscope were axamined at 8,12,24 weeks after operation.[Result]In group A the cartilage defects were smoothly repaired by white translucent hard tissue at 8 and 12 weeks,and defect boundary was hard to be indentified with normal cartilage at 24 weks.No smooth repairing was observered in B,C and D groups.Group A got a better histological score than B,C and group D(P0.05).[Conclusion]Combined BMP/bFGF biomaterial is good for repair of articular cartilage defects and has better result than using BMP or bFGF alone.These results may provide a therapy for articular cartilage defects.
