Objective To study the magnetic resonance imaging (MRI) characteristic of bone bruises associated with acute anterior cruciate ligament (ACL) ruptures and to investigate the correlation between bone bruises and cartilage lesions. Methods The MRI findings of 37 cases of acute ACL ruptures associated with bone bruises were studied retrospestively. The classification and distribution of bone bruises were analyzed and the cartilage lesions were also observed under arthroscopy. Results A total of 57 independent bone bruises(type Ⅰ:14, type Ⅱ:32, type Ⅲ:3, type Ⅳ:6 and type Ⅴ:2) were documented by MRI in the 37 patients. 54 (94.7%) bone bruises located in lateral joint compartment with involvement of lateral femoral condyle in 31 and lateral tibial plateau in 23. Nine cases (15.8%) of articular cartilage lesions were found under arthroscopy in the area overlying bone bruises. Conclusion Bone bruises associated with acute ACL ruptures mainly located in the lateral compartment of knee, especially in anterior portion of lateral femoral condyle and posterior portion of lateral tibial plateau. Arthroscopic cartilage lesions were not corresponding to bone bruises.

Objective To study the outcomes of autologous osteo-periosteal cylinder graft transplantation for Hepple V osteochondral lesions of the talus (OLT) with large subchondral cyst.Methods The data of 27 consecutive patients of OLT with subchondral cyst was retrospectively analyzed who were treated by autologous osteo-periosteal cylinder graft transplantation from October 2007 to September 2011.There were 26 males and 1 female with an average age of 35.8 years (range,22-53 years).Visual analogue score (VAS) for pain during daily activities,the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score,and subjective satisfaction were investigated.The plain radiographs,magnetic resonance imaging (MRI) of the ankle,and second look arthroscopy were analyzed.Results All the 26 patients were followed up for 22.4 months.At the last follow-up,the VAS score decreased from 5.4±1.0 points preoperatively to 0.8±0.8 points postoperatively,and the mean (50％) AOFAS score improved from 73.9±3.1 points preoperatively to 93.0±6.5 points postoperatively.In 26 cases,the radiolucent area of cysts disappeared on plain radiographs.The mean magnetic resonance observation of cartilage repair tissue (MOCART) score was 57.2,though small subchondral bone cyst was still found in 3 cases on postoperative MRI.The mean (50％) ICRS arthroscopic score of cartilage repair was 9.2 points according to second look arthroscopy of 18 cases.There were 16 cases receiving excellent effect,8 good and 2 fair.The excellent and good rate was 92.3％ (24/26).There were no major complications.Conclusion Autologous osteo-periosteal cylinder graft transplantation could repair the osteochondral defects.It yields satisfactory results,and is suitable for treating OLT with large subchondral cyst.

Objective: To investigate clinical outcomes of modified reattachment of superior peroneal retinaculum (SPR) for patients with recurrent peroneal tendon dislocation. Methods: A total of 24 cases with recurrent peroneal tendon dislocation from December 2012 to June 2017 were treated with modified reattachment of SPR. There were 20 males and 4 females. The average age was 24.9±9.3 years (14-48 years). The average BMI was 23.18±3.50 kg/m² (15.8-32.2 kg/m²). A 4-5 cm incision was made along the lateral margin of the fibula and curved distally around the fibular tip in line with the peroneal excursion. The superior peroneal retinaculum, peroneus longus and peroneus brevis were exposed. The periosteum and SPR were stripped from the fibula. The false pouch was formed. Two suture anchors were inserted into the postero-lateral ridge of the lateral malleolus without damaging the cartilaginous ridge, after which the SPR was reattached to the lateral malleolus with the anchored suture. The inner layer of the false pouch was incised, while the outer layer (periosteum) was sutured with the SPR in a pants-over-vest style. The following items, including American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS), rate of return to previous sports level, time to return to sports activity, complication, and patients satisfaction were evaluated preoperatively and at the final follow-up. Results: The average operation duration was 36.1±8.8 min (20-51 min). The blood loss was 1-10 ml, average 4.1±2.7 ml. The follow-up was carried out in 22 cases for mean 33.9±15.7 months (13-61 months). AOFAS score was improved from 77.8±7.8 points to 95.5±4.3 points significantly (t=-11.89, P<0.001). VAS score was reduced from 4.2±2.4 to 0.3±0.8 significantly (t=7.69, P<0.001). Mean duration return to sports activity was 5.0±1.9 months (3-10 months). A total of 20 patients (91%) returned to their previous sports level. Only one patient (5%) was found with limitation of range of motion, while two patients (9%) reported pain at the scar site without recurrence. The satisfaction rate was 91%. Conclusion Clinical outcomes of modified reattachment of SPR for patients with recurrent peroneal tendon dislocation was safe and effective.

Objective: To examine the surgical method and clinical outcome of primary repair of chronic Achilles tendon rupture. Methods: From March 2012 to August 2017, clinical data of 35 consecutive patients with chronic Achilles tendon rupture who were treated with primary repair by the same group of doctors at Department of Sports Medicine, Peking University Third Hospital were retrospectively analyzed.There were 29 males and 6 females with age of (41.0±9.3)years(range:29-65 years). All the patients had unilateral tendon rupture with 22 cases on the left and 13 cases on the right. The preoperative and postoperative Visual Analogue Scale(VAS), American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score(AOFAS), the Victorian Institute of Sport Assessment-Achilles(VISA-A), the Achilles tendon Total Rupture Score(ATRS) and the Tegner Activity Score of patients were collected and compared by paired-t test. Results: The patients were followed up for (45.6±17.2) months (range:17-28 months).No serious postoperative complications such as infection or nerve damage and rerupture outcomes were reported. At the last follow-up,the VAS decreased from 1.0(2.0) (M(Q_R) preoperative to 0.0(0.8)(Z=-3.586, P=0.00), AOFAS increased from 64.3±12.5 to 97.0±5.0(t=-14.359, P=0.00), VISA-A increased from 51.3±9.8 to 87.8±18.0(t=-17.656, P=0.00), Tegner increased from 0.9±0.3 to 4.6±1.7(t=-12.524, P=0.00) and ATRS increased from 40.0±3.5 to 97.9±3.9(t=-64.133, P=0.00). Twenty-eight patients (80.0%) had returned to their preinjury activity levels, and 7 patients (20.0%) no longer participate in recreational sports. According to Arner-Lindholm curative effect evaluation criteria, 32 cases(91.4%) gained the excellent results, 1 case (2.9%) of good and 2 cases(5.7%) bad, and the percentage of the cases with the excellent or good results was 94.3%.All except 2 patients with bad results could perform a single-limb heel rise painlessly. Conclusions Primary repair is an efficient approach for chronic Achilles tendon rupture.The mid-and-long curative effect is satisfactory and stable. Compared with other surgical techniques, operation is relatively simple and economical.The primary repair is considerably safe, with few serious complications such as infection or nerve damage and reruptures.

Objective To examine the surgical method and clinical outcome of primary repair of chronic Achilles tendon rupture. Methods From March 2012 to August 2017, clinical data of 35 consecutive patients with chronic Achilles tendon rupture who were treated with primary repair by the same group of doctors at Department of Sports Medicine, Peking University Third Hospital were retrospectively analyzed.There were 29 males and 6 females with age of (41.0±9.3)years(range:29-65 years). All the patients had unilateral tendon rupture with 22 cases on the left and 13 cases on the right. The preoperative and postoperative Visual Analogue Scale(VAS), American Orthopaedic Foot and Ankle Society Ankle?Hindfoot Score(AOFAS), the Victorian Institute of Sport Assessment?Achilles(VISA?A), the Achilles tendon Total Rupture Score(ATRS) and the Tegner Activity Score of patients were collected and compared by paired?t test.Results The patients were followed up for (45.6±17.2)months(range:17-28 months).No serious postoperative complications such as infection or nerve damage and rerupture outcomes were reported. At the last follow?up, the VAS decreased from 1.0(2.0) (M(QR) preoperative to 0.0(0.8) (Z=-3.586, P=0.00), AOFAS increased from 64.3±12.5 to 97.0±5.0(t=-14.359, P=0.00), VISA?A increased from 51.3±9.8 to 87.8±18.0(t=-17.656,P=0.00), Tegner increased from 0.9±0.3 to 4.6±1.7(t=-12.524,P=0.00) and ATRS increased from 40.0 ± 3.5 to 97.9 ± 3.9(t=-64.133, P=0.00). Twenty?eight patients (80.0%) had returned to their preinjury activity levels, and 7 patients (20.0%) no longer participate in recreational sports. According to Arner?Lindholm curative effect evaluation criteria, 32 cases(91.4%) gained the excellent results, 1 case (2.9%) of good and 2 cases(5.7%) bad, and the percentage of the cases with the excellent or good results was 94.3%.All except 2 patients with bad results could perform a single?limb heel rise painlessly.Conclusions Primary repair is an efficient approach for chronic Achilles tendon rupture.The mid?and?long curative effect is satisfactory and stable. Compared with other surgical techniques, operation is relatively simple and economical.The primary repair is considerably safe, with few serious complications such as infection or nerve damage and reruptures.

Objective:To explore the inhaled allergen sensitization status of children with allergic rhinitis in Beijing City, and to provide evidence for diagnosis and treatment, allergen avoidance and disease management.Methods:In this cross-sectional study, data from 8 741 children with allergic rhinitis treated in Children′s Hospital affiliated to Capital Institute of Pediatrics from January 2020 to December 2021 were retrospectively analyzed. The subjects were divided into toddlers (1 y-≤3 y), preschool children (3 y-≤6 y), school aged children (6 y-≤12 y) and adolescents (12 y-≤18 y) and according to season the subjects were divided 4 groups: spring, summer, autumn, winter. The ImmunoCAP system was used to detect serum allergens sIgE.Results:The positive rates of inhaled allergens among subjects in sequence from high to low were: mx2 [molds (penicillium speciosum/mycosporum multiflorum/aspergillus fumigatus/alternatia/demodex longum)], w6 (artemisiaargyi), wx5[weeds pollen combination (ragweed/artemisia argyi/marguerite/dandelion/goldenrod)], w1(ragweed), tx5[trees pollen combination (populus tomentosa/hazel/elm/willow)], d2(dermatophagoides farina), d1(dermatophagoides pteronyssinus), ex1[animal dander combination (catdander/dogdander/horsedander/cowdander)], i6(blattella germanica). Boys have higher positive rates of sIgE responses than girls (54.20% vs. 47.96%, χ 2= 8 923.000, P<0. 001). The primacy inhaled allergen in toddlers, preschool children and school aged children was mx2 (37.75%, 39.99% and 42.46%), and in adolescents w6 (45.45%), d2 (41.51%) and d1 (37.74%) were the largest categories. Except for mold, the positive detection rate of inhaled allergens increased gradually with age. In different seasons, the positive rates of ex1 (24.77% vs. 18.26% vs. 17.10% vs. 12.39%, χ 2= 31.469, P<0.001), wx5 (20.18% vs. 28.62% vs. 39.96% vs. 12.53%, χ 2= 155.788, P<0.001), mx2 (31.79% vs. 50.96% vs. 36.99 vs. 28.81, χ 2= 208.444, P<0.001), tx5 (28.14% vs. 27.01% vs. 26.77% vs. 9.64%, χ 2= 60.613, P<0.001) and w6 (26.57% vs. 34.39% vs. 52.11% vs. 25.35%, χ 2= 17.710, P<0.001) were statistically different among groups. Mx2 in spring and summer was the highest categories (31.79%, 50.96%), and w6 in autumn was the highest (52.11%). Conclusions:In this study, mx2 was the most important allergen in children (≤12 y) and w6 was the highest in adolescents treated in Children′s Hospital affiliated to Capital Institute of Pediatrics from January 2020 to December 2021 in Beijing City. The types of allergens and positivity rates were different for different sexes, ages and seasons.

Objective:To explore the inhaled allergen sensitization status of children with allergic rhinitis in Beijing City, and to provide evidence for diagnosis and treatment, allergen avoidance and disease management.Methods:In this cross-sectional study, data from 8 741 children with allergic rhinitis treated in Children′s Hospital affiliated to Capital Institute of Pediatrics from January 2020 to December 2021 were retrospectively analyzed. The subjects were divided into toddlers (1 y-≤3 y), preschool children (3 y-≤6 y), school aged children (6 y-≤12 y) and adolescents (12 y-≤18 y) and according to season the subjects were divided 4 groups: spring, summer, autumn, winter. The ImmunoCAP system was used to detect serum allergens sIgE.Results:The positive rates of inhaled allergens among subjects in sequence from high to low were: mx2 [molds (penicillium speciosum/mycosporum multiflorum/aspergillus fumigatus/alternatia/demodex longum)], w6 (artemisiaargyi), wx5[weeds pollen combination (ragweed/artemisia argyi/marguerite/dandelion/goldenrod)], w1(ragweed), tx5[trees pollen combination (populus tomentosa/hazel/elm/willow)], d2(dermatophagoides farina), d1(dermatophagoides pteronyssinus), ex1[animal dander combination (catdander/dogdander/horsedander/cowdander)], i6(blattella germanica). Boys have higher positive rates of sIgE responses than girls (54.20% vs. 47.96%, χ 2= 8 923.000, P<0. 001). The primacy inhaled allergen in toddlers, preschool children and school aged children was mx2 (37.75%, 39.99% and 42.46%), and in adolescents w6 (45.45%), d2 (41.51%) and d1 (37.74%) were the largest categories. Except for mold, the positive detection rate of inhaled allergens increased gradually with age. In different seasons, the positive rates of ex1 (24.77% vs. 18.26% vs. 17.10% vs. 12.39%, χ 2= 31.469, P<0.001), wx5 (20.18% vs. 28.62% vs. 39.96% vs. 12.53%, χ 2= 155.788, P<0.001), mx2 (31.79% vs. 50.96% vs. 36.99 vs. 28.81, χ 2= 208.444, P<0.001), tx5 (28.14% vs. 27.01% vs. 26.77% vs. 9.64%, χ 2= 60.613, P<0.001) and w6 (26.57% vs. 34.39% vs. 52.11% vs. 25.35%, χ 2= 17.710, P<0.001) were statistically different among groups. Mx2 in spring and summer was the highest categories (31.79%, 50.96%), and w6 in autumn was the highest (52.11%). Conclusions:In this study, mx2 was the most important allergen in children (≤12 y) and w6 was the highest in adolescents treated in Children′s Hospital affiliated to Capital Institute of Pediatrics from January 2020 to December 2021 in Beijing City. The types of allergens and positivity rates were different for different sexes, ages and seasons.

Objective To examine the surgical method and clinical outcome of primary repair of chronic Achilles tendon rupture. Methods From March 2012 to August 2017, clinical data of 35 consecutive patients with chronic Achilles tendon rupture who were treated with primary repair by the same group of doctors at Department of Sports Medicine, Peking University Third Hospital were retrospectively analyzed.There were 29 males and 6 females with age of (41.0±9.3)years(range:29-65 years). All the patients had unilateral tendon rupture with 22 cases on the left and 13 cases on the right. The preoperative and postoperative Visual Analogue Scale(VAS), American Orthopaedic Foot and Ankle Society Ankle?Hindfoot Score(AOFAS), the Victorian Institute of Sport Assessment?Achilles(VISA?A), the Achilles tendon Total Rupture Score(ATRS) and the Tegner Activity Score of patients were collected and compared by paired?t test.Results The patients were followed up for (45.6±17.2)months(range:17-28 months).No serious postoperative complications such as infection or nerve damage and rerupture outcomes were reported. At the last follow?up, the VAS decreased from 1.0(2.0) (M(QR) preoperative to 0.0(0.8) (Z=-3.586, P=0.00), AOFAS increased from 64.3±12.5 to 97.0±5.0(t=-14.359, P=0.00), VISA?A increased from 51.3±9.8 to 87.8±18.0(t=-17.656,P=0.00), Tegner increased from 0.9±0.3 to 4.6±1.7(t=-12.524,P=0.00) and ATRS increased from 40.0 ± 3.5 to 97.9 ± 3.9(t=-64.133, P=0.00). Twenty?eight patients (80.0%) had returned to their preinjury activity levels, and 7 patients (20.0%) no longer participate in recreational sports. According to Arner?Lindholm curative effect evaluation criteria, 32 cases(91.4%) gained the excellent results, 1 case (2.9%) of good and 2 cases(5.7%) bad, and the percentage of the cases with the excellent or good results was 94.3%.All except 2 patients with bad results could perform a single?limb heel rise painlessly.Conclusions Primary repair is an efficient approach for chronic Achilles tendon rupture.The mid?and?long curative effect is satisfactory and stable. Compared with other surgical techniques, operation is relatively simple and economical.The primary repair is considerably safe, with few serious complications such as infection or nerve damage and reruptures.

Objective:To evaluate the feasibility, accuracy, effectiveness and safety of a novel manual placement of cervical 7 pedicle screws via the posterior approach of cervicothoracic junction.Methods:A retrospective case series study was conducted to analyze the 35 patients with injury to the lower cervical spine or cervicothoracic junction who had been treated by a novel manual placement of cervical 7 pedicle screws at Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University from March 2015 to July 2021. There were 16 males and 19 females, with an age of (52.7±13.2) years. The core of this placement was to determine the entry point of cervical 7 pedicle screws. After the intersection of the upper edge of the cervical 7 lamina and the medial edge of the superior articular process was recorded as point A while the intersection of the lateral edge of the inferior articular process and the lower edge of the transverse process as point B, the intersection of the outer and middle 1/3 of the AB line was taken as the screw entry point, with the screw placement angle perpendicular to the lamina line or slightly inclined from 30° to 40° to the head side and outward. The length, diameter and placement angle of the cervical 7 pedicle screws were recorded and compared postoperatively between the left and right sides to explore the feasibility of this novel manual placement. According to the Rampersaud method, the screw positions were graded 1 week and 6 months after operation to evaluate the accuracy of this manual placement. The visual analogue scale (VAS) and the Japanese Orthopaedic Association (JOA) score were compared between preoperation, 1 week and 6 months after operation to evaluate the effectiveness of this placement. The postoperative complications were counted to evaluate the safety of this method. Loosening, displacement and breakage of the screws were observed by CT scanning at 6 months after operation.Results:This case series was followed up for (9.8±1.7) months. There was no significant difference in the length, diameter or placement angle of the screws between the left and right sides ( P>0.05). A total of 66 cervical 7 pedicle screws were placed. There was no change in the screw position grading at 1 week or 6 months after surgery. Grade A was achieved in 64 screws, Grade B in 2 screws, and Grade C or D in none. The VAS scores before operation, 1 week and 6 months after operation were respectively 4.4±1.7, 3.8±1.0 and 1.1±1.1, and the JOA scores respectively 6.7±2.2, 13.2±1.5 and 15.3±1.2. The VAS and JOA scores at 1 week and 6 months after operation were significantly improved compared with the preoperative values ( P<0.05). The improvement rates in JOA at 1 week and 6 months after operation were 62.7%±13.3 % and 83.9%±11.6%, respectively. There were no complications related to the placement of cervical 7 pedicle screws; there was no wound hematoma or infection. No loosening, displacement or breakage of the screws was observed by the 6-month follow-up. Conclusion:The novel manual placement of cervical 7 pedicle screws via the posterior approach of cervicothoracic junction is feasible, accurate, effective and safe.

Objective: To compare the morphological variation of the fibular malleolar groove and fibrocartilaginous ridge injury in those with and without peroneal tendon dislocation using MRI. Methods: Data of 45 patients (40 males, 5 females; average age 23.4±7.7 years, 11-44 years) with recurrent peroneal tendon dislocation treated from April 2010 to July 2017 and 45 patients (33 males, 12 females; average age 41.6±11.8 years, 17-67 years) without dislocation treated from June 2015 to Septem-ber 2017 were retrospectively analyzed. The morphological variation of the fibular malleolar groove and fibrocartilaginous ridge in-jury were compared between the two groups according to Rosenberg’s classification (convex, the posterior cortex of the fibula bulg-es outward; concave, the posterior fibular surface has a shallow-to-deep depression; flat, neither concavity nor convexity is found). Results: In group of patients with recurrent peroneal tendon dislocation: concave, 10 patients (22.2%, 10/45); flat, 27 patients (60.0%, 27/45); convex, 8 patients (17.8%, 8/45); fibrocartilaginous ridge injury, 44 patients (97.8%, 44/45). In group of patients without peroneal tendon dislocation: concave, 16 patients (35.6%, 16/45); flat, 18 patients (40.0%, 18/45); convex,11 patients (24.4%, 11/45); fibrocartilaginous ridge injury, 13 patients (28.9%, 13/45). Conclusion According the results, significant differ-ence has not been found in morphologic variations of the fibular malleolar groove between patients with and without recurrent pero-neal tendon dislocation. Fibrocartilaginous ridge injury is common in MRI of patients with recurrent peroneal tendon dislocation.