[Objective]To evaluate the technique and outcome of arthroscopic reconstruction of anterior cruciate ligament (ACL) with preservation of the remnents.[Method]From June 2005 to May 2006, 28 knees with ACL tear in 28 patients were verified with arthroscopy in this department.Of them,8 knee were combined with lateral meniscus tear and 6 combined with medial meniscus tear. All the damaged ACLs were reconstructed with single bundle of autogenous quadrupled hamstring tendons under arthroscopy without remove of the remnants of ACL. Bioabsorbable interference screw was used for direct anatomic fixation of the reconstructed ligament.[Result]No severe complication occurred in early stage after operation in the 28 patients.All of them were followed up for 12 to 24 months with an average of 18 months. Lysholm score was remarkablely improved from 46～80 (mean 60.75?9.54) preoperatively to 85～100 (mean 95.89?6.24) at the latest follow up (P

[Objective] To investigate the treatment in the use of allograft bone grains combined with autograft bone grafting in giant cell tumor.[Method]From March 1996 to March 2006,24 cases of giant cell tumor closed to knee were verified by pathology in this department,including 11 on thighbone and others on tibia.Before operation allografts was sheared to grains after antigen extracted by repeat freeze thawing and mechanical methods.Giant cell tumor of bone was completely erased in surgical fringe and the defect was thoroughly closed-up with allograft grains combined with cancellous bone autografts.The knee joints exercise was made for 12 weeks with external orthosis fixation.[Result]No severe complication occurred in early stage after operation in the 24 patients.All of them were followed up for 1 to 6 years with an average of 2 years and 8 months.None of them recidivated after the operation,and no insert was taken off for severe rejection,one case showed tolerant pathologic fracture.All the transplantations showed ideal appearance in X-ray photograph and the motion of joints had no significant difference than before.Curative effects were evaluated by Mankin criteria.The outcome was excellent in 20 cases,good in 4 cases.[Conclusion]Bone allograft grains combined with autograft is an effective and few rejection in filling of giant bone defect in surgical operation of giant cell tumor near knee joints.

[Objective]To compare the clinical results between allograft and autograft for treatment of scoliosis in the adolescent.[Method]A retrospective study was made in 63 cases of adolescent patients with scoliosis who were operated on with posterior instrumentation from 1996~2006.These patients were divided into two groups.In group A,32 patients aged 10 to 15 years with an average of 12.2 years,had a mean Cobbs angle of 62?(ranged,38? to 113?),were received allograft bone grafting.The patients were followed up for at least 18 months with an average of 26 months.Clinical and radiographic evaluations were performed.[Results]Operating time and blood loss in group A were less than that in group B(P

[Objective]To observe the curative effect of ectogenic bone inductive factor in treating osteoporotic frature,and provide feasibility pathway and method for clinical treatment.[Method]Sixty cases of osteoporotic fracture from Febuary 2002 to May 2005 were randomly divided into experimental group(30 cases) and control group(30 cases).The experimental group were given 4 ml osteotide a day by intramuscular injection,and 15 days were a course of treatment.The second course of treatment went on after 15 days later when the first course ended.At the same time,no any medicine was given to the control group.The biochemical indicators were detected 2 months later.And after 2,4 and 6 months the union of fracture was observed through radiology.[Result]Four months after operation,radiology examination showed that the rate of union of fracture was 93% and 67% respectively.There was significant difference between the two groups(P

[Objective]To explore the incidence, causes, training courses at high risk and location of the body of training injury in a special force corps, provide evidence for effective prevention of the injury.[Method]A questionnaire on training injuries and relative situations, and review of medical records from Nov 2005 to Oct 2006 were performed in 823 soldiers and officers in a special force corps at Nov 2006. Data were input into computers after quantization, and descriptive analysis was conducted with SPSS 13.0 software. [Result]Of 823 soldiers and officers, 738 (89.67%) experienced one or more injuries in that year, 525 (63.79%) were affected in normal training, 221 (26.85%) lost more than one training day due to the injuries. Confirmed with the medical records, 213 (25.90%) lost more than one training day due to injuries. A total of 1696 injuries occurred in 823 soldiers and offices in that year, of them, 1263 injuries interfered with normal training. Injury rate was 12.78 per 100 per month. 24.12% of injuries were due to over-exertion, 15.86% due to accident and 13.33% due to environmental field. Injury occurred mainly in runing related training courses including 5km running (22.17%) and 400m obstacle running (20.87%), followed by weight lifting (9.67%). The most frequent site of injury was the lower extremities, accounted for 65.74 % of the inj urie s including the foot ( 18.75 %),the ankle (13.50%), the leg (13.56%) and the knee (14.39%), followed by low back (14.21%). [Conclusion]Persistent over-exertion basic training, the courses at high risk of injury, should be improved in focus. Lower extremities and low back, the most frequent locations of injury, should be taken as key points of prevention and treatment of training injury.

[Objective]To explore the clinical characteristic of combined posterior cruciate ligament (PCL) with posterolateral corner (PLC) injuries,and evaluate the technique and outcome of arthroscopic single bundle reconstruction of PCL and reconstruction of PLC with posterior half of biceps femoris tendon.[Method]From Dec. 2001 to Dec. 2004,14 patients (14 knees) with severe posterior and posterolateral rotatory instability were treated surgically in our department,all of them presented III degree positive results of posterior drawer test,positive varus stress test and more than 10 degree of external rotation of the affected knees compared with the intact knees.PCL tear and abnormal opening of posterolateral compartment were seen in all of the 14 knees under arthroscopy.Of them,2 knee were combined with common peroneal nerve injury.All the damaged PCLs were reconstructed with single bundle of autogenous quadrupled hamstring tendons under arthroscopy,and PLCs were reconstructed with the posterior half of biceps femoris tendon tenodesis.[Result]No severe complications occurred in early stage after operation in the 14 patients.All of them were followed up from 12 to 33 months with an average of 21.14?7.26 months.Posterior stabilities were recovered significantly,varus stress test was negative at 30 degree of flexion and full extension,less than 10 degree of external rotation compared with the intact knee in all of the patients.Lysholm score was remarkable improved from 40~60 (mean 47.1?8.25) preoperatively to 70~95 ( mean 86.79?7.23) at follow up(P

ObjectiveTo evaluate and compare long-term clinical outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction with remnant preservation versus remnant resection.MethodsFrom October 1999 to May 2005,standard ACL reconstruction with autogenous quadrupled hamstring tendons under arthroscopy using remnant resection with transtibial techniques was conducted in 87 patients.From June 2005 to May 2010,ACL reconstruction with autogenous quadrupled hamstring tendons using outside-in bone tunnel establishment and remnant preservation was performed in 221 patients.Only the patients who underwent simple ACL reconstruction together with more than three years follow-up records were enrolled in the study,including 66 patients in remnant preservation group and 39in remnant resection group.ResultsPatients of both groups were all followed up for 36-60 months,which showed insignificant difference between groups ( P ＞ 0.05).Compared with the preoperative data,the latest follow up data demonstrated satisfactory outcomes in both groups.The two groups showed no significant differences regarding the preoperative data including age and gender distribution,average time from injury to surgery,joint instability extent and functional score of the affected knee ( P ＞ 0.05 ).There was no statistical difference in regards of the thigh muscle atrophy and Lachman test between groups ( P ＞0.05).However,the remnant preservation group was superior to the remnant resection group in aspects of the range of motion of the affected knee,Lysholm score,stability in anterior drawer test,stability in pivot shift test and international knee documentation committee (IKDC) grade ( all P ＜ 0.05 ). ConclusionCompared with standard ACL reconstruction using remnant resection with transtibial techniques,the ACL reconstruction using outside-in bone tunnel establishment and remnant preservation has better longterm clinical outcomes including stability and function of the affected knee.

Objective To exoplore the causes in healing difficulties of osteoporotic fracture, and to study the feasible approaches and methods for clinical treatment of osteoporotic fracture. Methods Forty female Sprague-Dawley rats, used as donor animals, were divided randomly into ovariectomized (OVX) group and control (CON) group, with each group of 20 animals. OVX group was subjected to bilateral ovariectomy and CON group was subjected to sham operation. Four months after surgery, the rats were sacrificed, and long bones of the extremities were harvested respectively for preparation of bone matrix gelatin (BMG) in terms of Urist's method. BMG implants obtained from OVX and CON rats were implanted into left and right femoral muscle pouches respectively of 17 female SD rats. The host rats were killed after 14-day feeding, and tissue block of BMG implants were removed for histologic study, alkaline phosphatase (ALP) activity, and calcium content (CA) determination, respectively. Results ALP activity of BMG tissue block from OVX group was (7.22? 2.59)U/g, and that from CON group was (12.01?6.18)U/g. Significant difference was found between the two groups (P

Objective To investigate the effects of echocardiography-guided pacemaker parameters optimization in order to enhance the efficacy of cardiac resynchronization therapy(CRT).Methods Seventeen patients with chronic heart failure received biventricular resynchronous pacing therapy.A-V delay and V-V delay was optimized under the guiding of spectral Doppler echocardiography and tissue Doppler imaging.Results The indices of heart function in all patients were significantly improved after the treatment.The NYHA class of the patients was improved from class Ⅲ～Ⅳ to class Ⅱ～Ⅲ.Since PAV/SAV was optimized to 130-180/100-150 ms,left ventricular filling time(LVFT) was increased from (354±147)ms to (420±112)ms,mitral reflux (MR) was decreased from (8.41±4.55)cm2 to (5.36±4.71)cm2.After VV delay was optimized to 4-40ms,standard deviation of time to regional peak systolic velocity (Ts-SD-12) was decreased from (48.4±17.9)ms to (30.2±18.6)ms,left ventricular outflow tract velocity time integral(VTI LVOT) was increased from (20.6±9.0)cm/s to (26.1±3.1)cm/s.Conclusions Echocardiography-guided optimization of the pacemaker parameters is necessary in order to enhance the efficacy of CRT.

Objective To evaluate the skill and outcome of arthroscopic reconstruction of posterior cruciate ligament (PCL) with retention of PCL remnant. Methods From April 2004 to June 2006, 38 patients (38 knees) with PCL deficiency were verified by clinical and arthroscopic examinations. Of them, there were 9 knees combined with disruption of the posterolateral comer, 6 with rupture of the posteromedial corner, 8 with lateral meniscus tear and 4 with medial meniscus tear. With reservation of PCL remnant and synovium, all the impaired PCLs were reconstructed with single bundle of autogenous quadrupled hamstring tendons under arthroscopy. Interference screws were used for direct anatomic fixation of the reconstructed ligament. Results No severe comphcations occurred at early stage after operation in all 38 patients who were followed up for 12-37 months (average 20.79 months). Lysholm score was improved significandy from 40-70 points (mean 51.32 pints) before operation to 70-100 pints (mean 92.37 points) at the latest follow up (t=-30.14, P<0.01). According to International Knee Documentation Committee (IKDC) score, there was a remarkable improvement from 16 abnormal knees (grade C) and 22 severely abnormal knees (grade D) preoperatively to 18 normal knees ( grade A), 18 nearly normal knees (grade B) and 2 abnormal knees at the latest follow up (Z=-6.00, P <0.01). Of 38 patients, 36 returned to normal sports level but 2 degraded level of sports. Conclusions Arthroscopic PCL reconstruction with retention of PCL remnants is a feasible technique, with satisfactory outcome. Preservation of PCL remnants and synovium may be beneficial to biological incorporation and reinnervation of the reconstructed ligament.