Many techniques of the internal fixation have resulted in these years from the new concept of biomechanical osteosynthesis (BO). LISS (less invasive stabilization system) is a typical representative of BO in minimally invasive surgery. The clinical results have been greatly improved by LISS in the operative treatment of distal humerus fractures, the proximal tibia fractures, periprosthetic supracondylar fractures and osteoporotic fracture, but skills of using LISS should be improved, indications of using LISS explored, and the mechanism that LISS improves the healing of fracture studied further.

BACKGROUND:So far there is not an ideal animal model for clinical research of osteonecrosis of the femoral head, which hinders its development. OBJECTIVE:To compare the merits and characteristics of different methods and various animal models, and to provide a reference for selection of models of osteonecrosis of the femoral head. METHODS:Literature search was performed in databases of PubMed, EMBASE, Wanfang, and China National Knowledge Infrastructure, published from 2006 to 2014 by computers. The key words were“Osteonecrosis of the Femoral Head, Animal model, Vivo Experiment, Legg Calve Perthes disease, Osteoarthritis, Col apse of the Femoral Head, Trauma, Corticosteroid, Alcohol, Liquid Nitrogen”in English and Chinese, respectively. Final y, 48 articles were included. RESULTS AND CONCLUSION:Traumatic osteonecrosis of the femoral head models simulates the most common clinical type, which is more effective in Legg Calve Perthes disease. Glucocorticoid-induced osteonecrosis of the femoral head models is more suitable for etiology, pathology and comprehensive research. Physical osteonecrosis of the femoral head models could be used for evaluating treatment methods, such as surgery. The ideal animal models should be similar with human in anatomy, histology and biomechanics;pathology, pathophysiology, and radiographic progression of osteonecrosis of the femoral head can simulate the whole process of human osteonecrosis of the femoral head, and it is easy to be obtained, cost-effective and good repeatable.

Calcium sensing receptors (CaSR) is a member of super-family of G-protein coupling receptors. This review first introduced the concept, construction features, distribution, functions, decision methods, moderators, genetic locus of CaSR and its relationship with some diseases concisely. Then this article described the investigation progress of CaSR in cardiovascular system intensively, including the expression pattern, role and signal pathways of CaSR in rat myocardium in normal, ischemia-reperfusion injury, apoptosis and cardiac hypertrophy;the role and mechanism of CaSR in calcium homostasis regulation of rat myocardium, endoplasmic reticulum (ER) stress and cardiac ischemic preconditioning and postconditioning. The metabolism rule, physiological significance and pathological action of polyamine in cardiac cells;the increase of CaSR expression in cardiac tissue of artherosclerosic rat and its effect on sensitivity to acute myocardial infarction are also discussed. In the end, the research perspective of CaSR in cardiovascular system was anticipated.

Platelet-rich plasma(PRP) is a highly-concentrated plasma enriched in platelets and various growth factors. These growth factors will be released abundantly by platelets when PRP is activated by thrombin, which plays a key role in accelerating wound healing, bone repair, and meanwhile, in controlling of inflammatory process. Biocompatibility and versatility of PRP have been confirmed in clinical studies as well as its excellent effects on tissue reparation. These have lead to the extensive use of PRP in many medical fields as a therapeutic alternative. Mechanism of PRP in bone and tissue repair the application of PRP in the field of orthopedics is reviewed in this article. In addition, attempt is made to discuss about some problems still existing in the clinical application of PRP.

ObjectiveTo analyze complications following the treatment of peri-knee fracture or nonunion by locking plates.Methods From January 2005 to May 2009, we used internal fixation with a locking plate to treat 106 closed peri-knee fractures in 97 patients (46 distal femoral fractures and 60 proximal tibia fractures). There were 85 cases of fresh fracture and 21 cases of nonunion. They were 62 males and 35 females, with an average of 34.8 years (from 18 to 54 years). The patients were followed up monthly for The Hospital for Special Surgery (HSS) scores and complications. Analyses were done to find associations between complications and gender,injury cause,injury type,facture type and operation time. ResultsThe follow-ups averaged 23.8 months (from 10 to 32 months ). The 46 distal femoral fractures obtained an average HSS score of 83.4 points one year after operation and had a complication rate of 32.6 ％ ( 15 cases); the 60 proximal tibia fractures obtained an average HSS score of 86. 4 points one year after operation and had a complication rate of 16.7 ％ (10 cases). There were no significant associations between complication rate and gender, injury cause, injury type and fracture type ( P ＞ 0. 05). There was a significant association between complication rate and operation time(x2 = 5.440, P = 0. 015).Conclusions Although locking plates are a new and effective treatment for peri-knee fracture or nonunion, they still have drawbacks. Indications should be strictly followed and care should be taken to avoid postoperative complications as much as possible.

Bioglass is one of the most important inorganic biomedical materials and is widely used in clinic. Orthopedists and researchers pay more and more attentions to bioglass due to its excellent biocompatibility and bioactivity. This paper introduces the current research status and development of bioglass in bone repairing,bone tissue engineering, anti-infection drug delivery material and interventional therapy. Brief review is given to the potential application of bioglass in orthopaedics.

Objective To investigate the effect of absorbable membrane on prevention of tendon adhesion after the ruptured tendon is repaired. Methods In our experiment, 30 12-weeks-old Leghorn cocks were divided into 2 groups randomly. Group A was the blank group, and Group B was the absorbable membrane group. Each group had 15 cocks. The flexor tendon of third phalanx was made ruptured. After repairing, histological observation, failure mode test and functional recovery test were performed regularly. Results In Group B, there was little adhesion between tendon and normal tissue under gross observation. There was no significant tissue necrosis or scar tissue under microscope. There was no difference in the failure mode test between the 2 groups 6 weeks after repairing. The functions of movement of interphalangeal and metacarpophalangeal joints in group B were better than those in group A. Conclusion The absorbable membrane can be a kind of material or method used to prevent tendon adhesion.

Objective To explore diagnosis of nonunion following intramedullary nailing of femoral and tibial fractures and the treatment of nonunion of femoral and tibial fractures with Less Invasive Stabilization System (LISS) or locking compression plate (LCP). Methods From February 2003 to December 2004, 7 cases of nonunion after intramedullary nailing of femoral and tibial fractures were diagnosed by X-ray or CT scanning or CT-3D. LISS or LCP fixation and bone grafting were employed to treat the 7 cases of nonunion in the femur and tibia. Their case histories ranged from 10 to 49 (mean 23.3) months. Results All the 7 patients were followed up for a mean of 9.1 (4 to 16) months. The bone union time for all the fractures averaged 4.7 months (ranging from 4 to 6 months). No loosening or breakage of the implants occurred in this series. Conclusions The operation should be done for the patients who feel pain in the lower extremities or the fracture line still exists at the fracture ends long time after intramedullary nailing. In order to improve the healing of bone fractures, micromovement and bone defects at the fracture site should be eliminated. Because of its merits in design, the LISS can be used to effectively treat nonunion at the distal femur or the proximal tibia.

Fractures of the femoral head (FFH) are mainly seen in young adults,and the majority mechanism is due to dashboard injury in crushing vehicles.FFH can be present with or without posterior dislocation of the hip joint.Except for periarticular pain and hip dysfunction,the typical signs include flexion,adduction and internal rotation of the hip and shortening of involved limb.CT and MRI get their popularity as diagnostic methods for FFH.An emergency open reduction should be indicated in the scenario of failed closed reduction in FFH with posterior dislocation,of FFH with femoral neck fractures,of unmatched head and acetabulum following closed reduction and of deteriorating sciatic nerve damage.Pipkin as well as Brumback classification is still the most popularly used methods,which have great significance for establishment of surgical strategy and prediction of prognosis.More and more clinical evidences show conservative care of FFH should only be indicated for non-displaced fractures or displacement less than 2 mm.These cases must meet the following criteria simultaneously,including stable hip joint,concentric head and acetabulum,no free fractured fragments in the joint space and no labrum entrapment.Operative care is naturally the treatment of choice.Surgical approaches for FFH are hot topics in recent years.In previous control studies to compare Kocher-Langenbeck (K-L) and Smith-Peterson (S-P) approach,it is revealed less operative time,less blood loss and better operative field you can get in S-P approach,however,the incidence of ectopic ossification is higher.Ganz approach,which is characterized by osteotomy of great trochanter,hip capsulotomy and surgical dislocation of the hip,is a novel pattern for operative care of FFH.Ganz approach can show the entire femoral head,while can not damage medial femoral circumflex artery (MFCA) and induce iatrogenic osteonecrosis of the femoral head (ONFH).Various screws are the main implants for the fixation of fractured femoral head.Osteoarthritis and ONFH are two principal complications following FFH,which not only closely associate with severity and mechanism of primary injury,but also correlate with reduction quality and iatrogenic factors.Artificial hip joint replacement is a rational choice for extremely comminuted femoral head and these FFH in the elderly.

BACKGROUND:It is unclearwhat kind of material for rotator cuff repair augmentation is the safest or most effective. OBJECTIVE:To review the basic research, clinical application and prospects of materials for rotator cuff repair augmentation. METHODS:Eligible studies were identified from electronic databases including EMbase, Medline, PubMed, OVID, Cochrane Library, Springerlink, CNKI, WanFang, and VIP. RESULTS AND CONCLUSION:There are four kinds of patches used for rotator cuff augmentation: tendon patches, non-degradable patches, extracelular matrix-based patches and degradable synthetic patches. Tendon patches have good mechanical strength, but postoperative foreign body reactions and increasing risk of infection and unable to recover the normal structure are problems to be solved. Non-degradable patches also have good mechanical strength, but the long-term safety is unclear. Extracelular matrix-based patches remain a lower mechanical strength and have a higher failure rate. Degradable synthetic patches are proposed to overcome these previous issues by combining wel-adjusted mechanical properties with biological additives and minimize risk of infection by completely absorbing in a time-dependent manner. However, migration of bioactive cels, regulation of degradation rate and suppression of acidic degradation products is are existing problems to be solved.