[Clinical application of percutaneous spinal endoscopy debridement and lavage in sacroiliac joint tuberculosis].

OBJECTIVE: To investigate the feasibility and clinical efficacy of percutaneous spinal endoscopic debridement and lavage for the treatment of sacroiliac joint tuberculosis. METHODS: The clinical data of 7 patients with sacroiliac joint tuberculosis treated with percutaneous spinal endoscopic debridement and lavage from January 2007 to April 2009 were retrospectively analyzed. There were 2 males and 5 females, aged from 29 to 69 years old, 4 cases on the right side of the lesion and 3 cases on the left side. The course ranged from 8 to 144 months. According to Kim classification, 5 cases were type Ⅲ and 2 cases were type Ⅳ. All patients were treated with HRZE quadruple anti tuberculosis drugs for 2 to 6 weeks beforeoperation. VAS, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Oswestry Disability Index (ODI) were compared before and after surgery. RESULTS: All the operations were successful, the intraoperative blood loss was less than 50 ml on average, and no complications such as hematoma and infection were occurred. The follow-up time of 7 cases ranged from 18 to 40 months. Pain relief was obvious, and there was a statistical result in the VAS, ESR, and ODI of the patients at 1, 3, 6, 12, 18 months after operation compared with before treatment. At the final follow-up, the patient's clinical, imaging and laboratory examinations showed that the infection had disappeared, and the patient returned to normal life and work. CONCLUSION: Percutaneous spine endoscopic debridement and lavage has less tissue trauma, targeted operation, definite curative effects, and quick postoperative recovery, which has explored new options for minimally invasive treatment of sacroiliac joint tuberculosis.

Core decompression combined with autologous bone marrow stem cells versus core decompression alone for patients with osteonecrosis of the femoral head: A meta-analysis.

BACKGROUND: The efficacy of core decompression plus autologous bone mesenchymal stem cells (BMSCs) for the treatment of osteonecrosis of the femoral head (ONFH) remains controversial. We conducted a systematic review and meta-analysis to explore the efficacy of core decompression combined with BMSCs for OFNH patients. METHODS: We searched PubMed, Embase, Web of Science, and the Cochrane library databases through October 2018 for randomized controlled trials (RCTs) assessing the effect of core decompression combined with BMSCs for OFNH patients. The primary outcome was the visual analog scale (VAS) score at 6 months, 12 months and 24 months. The pooled data were analyzed using Stata 12.0 software. RESULTS: Fourteen studies with 540 patients (core decompression + BMSCs = 275, core decompression alone = 265) were included in our meta-analysis. Compared with the core decompression alone group, the core decompression + BMSCs group showed a significant decrease in the VAS score at 6 months, 12 months and 24 months, and a decrease in the number of hips undergoing total hip arthroplasty (THA), the Western Ontario and McMaster Universities (WOMAC) score and the volume of the postoperative necrotic zone. Core decompression + autologous BMSCs was associated with an increase in HHS postoperatively. No significant difference existed in adverse events. CONCLUSIONS: Compared with core decompression alone in the treatment of ONFH, the combined utilization of core decompression and autologous BMSCs has better pain relief and clinical outcomes and can delay the collapse of the femoral head more effectively.

[Progress on research of Madelung's deformity].

Madelung deformity is a rare deformity of forearm and wrist caused by growth disorders of distal radius ulnar and palmar epiphyseal. Current studies showed that its incidence mainly associated with trauma, epiphyseal developmental abnormalities, nutritional disorders and genetic deletion or mutation. The early clinical presentation is not typical, in middle and late time, wrist deformity and weak can appear. Plain film considered as the main means of diagnosis is often lack of early diagnosis significance. Although wrist joint magnetic resonance imaging showing early soft tissue and skeletal abnormalities were used for the early diagnosis of the disease, current domestic study in magnetic resonance imaging of this deformity is less. According to the size of the distal ulnar inclination angle and palm angle, this deformity can be divided into different types. The patients with severe deformity and symptoms usually need surgical intervention including ulna revision and osteotomy of the distal radius at present. Although the two operation can achieve good clinical results, the surgical trauma, infection and postoperative risk of joint activities are more.