Objective To discuss the diagnosis and treatment of partial-thickness rotator cuff tears.Methods A total of 14 cases of partial-thickness rotator cuff tears from April 1999 to January 2004 were surgically treated in this hospital.Before operation,X-ray examinations at anteroposterior view and at scapular outlet view were conducted in all cases,B-ultrasonography was conducted in 11 cases,and magnetic resonance imaging(MRI) or magnetic resonance arthrography(MRA),in 14 cases.Subacromial decompression and tear debridement was performed in 5 cases,while subacromial decompression and rotator cuff repair was performed in 9 cases.The University of California Los Angeles(UCLA) shoulder scoring system was used to evaluate the outcomes.Results The partial tears were identified at bursal-side in 7 cases and at articular-side in 7 cases.The 14 cases were followed for 1~6 years(mean,38 months).The UCLA scores were elevated from 15.9?3.9 preoperatively to 30.9?5.2 postoperatively(t=15.000,P=0.000).The curative results were classified as "good" in 13 cases and "poor" in 1 case.Conclusions Arthroscopy is a reliable method for the diagnosis of partial-thickness rotator cuff tears,which can be effectively treated with rotator cuff repairs.Arthroscopic repair gives little invasion and quick recovery.

Objective To assess the effectiveness of arthroscopic debridement techniques for osteoarthrosis of the elbow in nonathlete patients. Methods Twenty-six nonathlete patients with elbow osteoarthrosis were treated with arthroscopic debridement from January 1999 to January 2006.Of the 26 patients,23 were followed for 4～86 months (mean,23 months).All of the 23 patients had complained of pain and loss of elbow motion and 4 patients had symptoms of ulnar neuritis. The Mayo Elbow Performance Score was used as evaluation criteria of the efficacy. Results Twenty-three patients were followed for 4～86 months (mean, 23 months). Twenty elbows (87%) were not painful or were only mildly painful, and three (13%) were moderately painful. The mean arc of flexion-extension was improved from 99.6? (range, 65?～135?) preoperatively to 122.1? (range, 80?～150?) at the time of follow-up. According to the Mayo Elbow Performance Score, the result was excellent in 16 elbows, good in 4, and fair in 3, with a rate of excellent or good results of 87%. Symptoms of ulnar neuritis disappeared in the 3 patients and continued without aggravation in the remaining 1 patient. Fourteen patients were greatly satisfied with the results, 6 satisfied, and 3 unsatisfied, the satisfactory rate being 87%. One patient reported a delayed ulnar nerve symptoms after operation. Conclusions Arthroscopic debridement techniques for elbow osteoarthrosis in nonathlete patients can yield satisfactory pain relief, significant increase in the range of motion, and quick recovery.

Objective To report the diagnostic and therapeutic effects of arthroscopic surgery on elbow sports injuries. Methods Nineteen patients with elbow diseases were treated by arthroscopic methods from January 1996 to February 2000. The modified HSS elbow rating scale was used as criteria of the efficacy. All patients were followed up for 4.5 months to 4.5 years (an average 8.6 months). Results Among nineteen patients, eleven had an excellent results, seven good, one poor, and satisfactory rate was 94.7 percent. Ten patients were satisfied greatly with the results,eight patients satisfied, one unsatisfied, the satisfactory rate was up to 94.7 percent according to the responses of questionnaire from the patients. The time resuming daily was in a medium of 7 days, and that for sports was in an average of 2.5 months. All the 11 cases of athletes and actors(actresses) resumed their previous seats. Complications occurred in 3 earlier cases, one had radial nerve temporary paralysis, the other two had residue loose bodies. Conclusion Elbow arthroscopic treatment is a reliable method with the advantages of minor trauma, quicker recovery and less traumatic manipulation. Careful pre-operative examination, selection of a safer portal of entry, and standard manipulation are very important points for the attainment of better results and less complications.

Objective To comprehensively know clinical pathological change of recurrent anterior dislocation of shoulder joint by arthroscopy. Methods 52 patients with recurrent anterior shoulder dislocation were inspected by arthroscopy in our institute, 38 cases were male, 14 cases were female; the mean age were 24.7, from 16 to 49 years old. 2 epilepsy patients were excluded, the other 50 cases were divided into two groups, the first group included 32 shoulder dislocated patients accompanied with shoulder hyper-laxity. The other group included 18 purely traumatic shoulder dislocated patients. All patients were explored by arthroscopy and all pathological changes were recorded and the difference of pathological change between the two groups were contrasted. Results 51 cases showed anterior-inferior labrum injury, 50 cases showed Hill-Sachs injury, 32 cases showed biceps-tendon inflammation or injury, 30 cases showed bone or cartilage injury of anterior-inferior glenoid, 29 cases showed SLAP injury, 7 cases showed rotator cuff injury. Anterior-inferior labrum injury: labrum abraded disappear was more occurred in pure traumatic group(P=0.055) and ALPSA injury was more in hyper-laxity group (59.4% to 38.9%, P=0.164). Bone or cartilage injury of anterior-inferior glenoid were more occurred in purely traumatic group(P=0.083, P=0.052). Hill-Sachs injury was more superficial or only cartilage injury in hyper-laxity group but wider and deeper in purely traumatic group. Conclusion The general pathological changes of recurrent anterior shoulder dislocation sucessively are: anterior-inferior labrum injury, Hill-Sachs injury, biceps-tendon inflammation or injury, bone or cartilage injury of anterior-inferior glenoid, SLAP injury and rotator cuff injury. The pathological changes of the hyper-laxity group were lighter than purely traumatic group.

Objective To study clinical results of arthroscopically assisted mini-open rotator cuff repair.Methods Twenty-two patients with rotator cuff tears were treated with arthroscopically assisted mini-open rotator cuff repair from March 1999 to March 2004.Thirteen patients underwent arthroscopic inspection,mini-open subacromial decompression,and rotator cuff repair.Nine patients underwent arthroscopic subacromial decompression and mini-open repair.The UCLA scoring system was used for outcome assessment.Results The 22 patients were followed for 12-72 months(mean,47 months).The UCLA scores were increased from 14.8?3.8 preoperatively to 32.0?4.7 postoperatively(t=15.086,P=0.000).The results were classified as excellent in 7 patients,good in 13 patients,fair in 1 patient,and poor in 1.Twenty patients were satisfied with the operative outcomes.Conclusions Arthroscopically assisted mini-open rotator cuff repair is an effective procedure for rotator cuff tears,with simplicity of performance and little invasion.

[Objective]To study the accuracy of Helfet test in the diagnosis of the knee meniscus tear.[Method]From Apr.2007 to Oct.2007,52 cases of the lateral meniscus tear and 23 cases of the medial meniscus tear were checked-up with Helfet test,McMurray test ,KS test,and arthroscope comparatively.[Result]The Helfet Test was positive in most of the lateral meniscus tear cases.The consistency with McMurray test and arthroscope was lateral meniscus tear,especially to bucket-handle and Horizontal tear high respectively.The rate of accuracy to lateral menicus was 81.4%.The rate of accuracy to bucket-handle and Horizontal tear were 89.6% and 87.2% respectively.[Conclusion]The "Helfet" test is sensitive to the knee lateral meniscus tear.It is fast,simple,reliable,reproducible,positive for diagnose of lateral meniscus tear,and is worth of being used widely.

Objective To measure and determine the position of the tibial attachment of the anterior cruciate ligament (ACL)in relation to its anterior ridge on the magnetic resonance imaging (MRI)of normal knee joints,and to explore the clinical role of the anterior ridge in guiding tunnel positioning during ACL reconstruction as well as in facilitating postoperative radiographic evaluation.Methods The knee MRI of one hundred young adult patients with an intact ACL and normal knee joint (mean age:25.1 years,range:18-40 years)was retrospectively reviewed.All MR images were obtained at full extension of the knee on the same MRI machine.Using digital image software on MRI,the measurements in the sagittal view were taken,including the depth of the tibia,the distance from the anterior edge of the tibial plateau to the most anterior and posterior portions of the ACL insertion on the tibia and the anterior ridge according to Staubli and Rauschning's method.Results The center of the tibial insertion of the ACL is located between 28.43％ and 50.94％ of the total anterior-posterior depth of the tibia,which was less than 43.3％ in 58 patients.The average distance from the anterior edge of the tibial plateau to the anterior ridge was 13.61 ± 2.17 mm (ranging from 8.03 to 18.65 mm),26.80％ ±3.89％ (ranging from 17.74％ to 33.94％)across the tibial plateau.There were significant positive correlations between the distance from the anterior edge of the tibial plateau to the most anterior portion of the ACL insertion and that to the anterior ridge.The distance from the most anterior portion of the ACL insertion to the anterior ridge was averaged 0.56 ± 0.68 mm (ranging from-0.28 to 2.71 mm).During the ACL reconstruction,with the anterior edge of the tibial tunnel determined at posterior 0.5 mm to the anterior ridge,the graft size as 8 mm,and the tibial guider angle set as 55 degree,96of the patients (96％)would have the center of the tibial tunnel located before the center of their native ACL attachment.Conclusions On sagittal MR images,the location of the anterior ridge and the most anterior portion of the ACL insertion correlated well,with the average distance between them of 0.56 mm.The study indicates that during ACL reconstruction,tibial tunnel drilling with the anterior edge of the ACL graft positioned at the anterior ridge can achieve a more anterior position than the traditional methods to orientate according to the center of the bone tunnel.

Objective To explore the clinical results of arthroscopic subacromial decompression (ASD) for treatment of subacromial impingement syndrome. Methods Twelve cases with subacromial impingement syndrome from October 1998 to November 2003 were retrospectively studied. There was one case at degree Ⅰ, five at degree Ⅱ and six at degree Ⅲ according to Neer classification. Preoperative X-ray of obverse shoulder joint and outlet supraspinatus muscle was made. Seven cases was examined with ultrasonography and 10 with MRI or MRA. All cases were treated with arthroscopic subacromial decompression and arthroscopic acromioplasty and six cases underwent simultaneously arthroscopic suture of the rotator cuff. Results The follow up for 1-6 years (average 26 months) showed significant statistical difference upon preoperative UCLA score and postoperative UCLA score that were 16.9?4.0 and 32.5?1.4, respectively (t=-14.027,P﹤0.01). The results were excellent in two cases and good in ten. All cases were satisfied with the operation. Conclusions ASD is shown to be an effective procedure for subacromial impingement syndrome and has the advantages of minimal trauma and rapid postoperative recovery.

Objective:To study the proliferation promotion effect of very low density lipoprotein(VLDL) on mesangial cells(MCs) of SD rats. Methods:MTT method was used to measure the proliferation promotion effect of VLDL with different concentrations and treatment times. Flow cytometry was employed to observe the apoptosis of MCs for studying the toxicity of VLDL. Results:The optical density of MTT was linearly correlated with VLDL concentration(10 500 ?g/ml)and treatment tims(6 48 h),with r being 0.911( P

Objective To assess the diagnostic value of MRI for the long head of the biceps brachii tendon tear,and to compare the diagnostic efficiency between routing MRI and MR arthrography. Methods A retrospective study was conducted in 215 cases with shoulder MR examination (107 with MR arthrography, and 108 with routing MRI) and subsequent shoulder arthrescopy and surgery. Two radiologists analyzed all MR examinations independently, and the results were compared with those of arthroscopy and surgery. Sensitivity, specificity, and accuracy were calculated. Kappa values were used to quantify the interobserver agreement. Results Based on the results of arthroacopy and surgery, 215 patients comprised 7 cases of complete tear of the long head of the biceps brachii tendon, 29 cases of partial tear, and 179 cases without tear. The overall sensitivity, specificity, and accuracy for the diagnosis of tears (complete and partial tear) of the long head of the biceps brachii tendon were 72.2% (26/36), 91.6% (164/179), and 88.4% (190/215) respectively for observer 1, 80.6% (29/36), 93.8% (168/179), and 91.6% (197/215) respectively for observer 2. The interobserver agreement was good (Kappa value=0.681). For the complete tear of the biceps brachii tendon, the sensitivity, specificity, and accuracy were all 100% (7/7), 100% (208/208), and 100% (215/215) for both observers. For the tear of the long head of the biceps brachii tendon, the accuracy of MR arthrography were 93.4% (100/107) for observer 1 and 96.3% (103/107) for observer 2. They were higher than the Accuracy of routing MRI, which were 83.3% (90/108)and 87.0% (94/108) respectively for two observers (P<0.05). Conclusion Shoulder MRI is a moderate reliable method for evaluating the tear of the long head of the biceps brachii tendon, and the accuracy of MR arthrography is found to be superior to that of routine MRI.