AIM: To explore the way and therapeutic effect of one stage total hip replacement (THR) in treating rheumatoid arthritis-induced ischemic necrosis of the femoral head combined with intertrochanteric fracture. METHODS: From July 1998 to September 2006, one stage THR was performed in 12 cases with ischemic necrosis of the femoral head combined with the fresh intertrochanteric fracture in Department of Orthopedics, Henan Provincial Traditional Chinese Medicine Hospital, including 8 males and 4 females aged 28-65 years with disease course of 5-20 years. The prosthesis of biology was provided by Pu Lusi (Switzerland). RESULTS: All cases were followed up for 2 to 9 years. The fracture ends well healed, showing good form and position of prosthesis postoperatively 4 month by X-ray reexamination. No acetabulum wear or prosthesis dislocation was found. They could walk without help and take care of themselves after 5 months. The results were excellent in 7 cases, good in 3, fair in 1, and bad in 1 according to Harris evaluation standard of THR. The average value of Harris evaluation was 90.8 two years postoperatively, and the excellent and good rate was 83.3%. CONCLUSION: One stage THR for rheumatoid arthritis-caused ischemic necrosis of the femoral head combined with intertrochanteric fracture is an ideal method to restore function of the hip joint.

[Objective]To describe a new way of arthroscopic posterior cruciate ligament reconstruction and evaluate the early stage of follow up results.[Method]Twenty four consecutive cases of isolated and combined posterior cruciate ligament deficiency were studied.Quadriceps tendon patellar bone was used for preparation of "Y" shaped autograft.Double-tunnel of femur were drilled and tibia was inlayed at their anatomical footprint.[Result]All cases were followed up for 24 months to 30months,averaging 24.5 months.Lysholm rating scales were used to make clinical subjective evaluations.Lysholm scores raised from 49.20?1.44 before operation to 87.91?1.52 after operation.Finial Lysholm evaluation showed 7 patients were excellent,16 good,and 1 poor.The good to excellent rate was 95.8%.Anteroposterior translation as clinical objective evaluations was measured with KT-1000.KT1000 arthrometer measurement showed that the average posterior translation improved from 12.85?1.10mm preoperatively to 3.98?1.99mm postoperatively.One patient was graded as failure.[Conclusion]Arthrosopy assisted prodedure of double bundle posterior cruciate ligament reconsruction using quadriceps tendon patellar bone autograft by double-tunnel of femur and inlaying of tibia is effective and reproducible.The short follow up clinical results are encouraging.

OBJECTIVE: To explore the clinical effect of total hip arthroplasty (THA) in the treatment of old central dislocation of the hip joint. METHODS: Between January 2010 and June 2014, 21 patients (21 hips) with old central dislocation of the hip joint underwent THA and autologous bone graft for acetabulum reconstruction. There were 13 males and 8 females, aged 60-75 years (mean, 67.4 years). The left hip was involved in 12 cases and the right hip in 9 cases, with a disease course of 1-20 years (mean, 9.6 years). The causes were falling from height in 6 cases, traffic accident in 9 cases, crushing in 4 cases, and others in 2 cases. Hip pain, limited activity, and lameness were the main clinical symptoms. Preoperative Harris score was 32.95±2.06 and visual analogue scale (VAS) was 8.14±0.73. RESULTS: Primary healing of incision was obtained in all patients. The patients were followed up 1.9-6.4 years (mean, 4.6 years). The X-ray films showed bone graft fusion at 4-24 months (mean, 12.5 months); there were no complications of grafted bone absorption, osteolysis, and infection. During follow-up, no prosthetic loosening or sinking, and no translucent zones around the prosthesis were observed. Harris score was significantly improved to 87.67±2.01 at 1 week and 92.10±1.95 at 1 year; and VAS score was significantly decreased to 2.57±0.81 at 1 week and 0.19 ±0.51 at 1 year (P<0.05). CONCLUSIONS: THA is an effective surgical treatment for old central dislocation of the hip joint, because it can restore normal hip rotation center and reconstruct the hip joint function.

Objective To investigate the effect of solanine on radiosensitivity of osteosarcoma cells. Methods Osteosarcoma cells were treated with solanine, at the same time, radiation treatment was given, cell proliferation was measured by MTT assay, cell apoptosis was measured by flow cytometry, the protein levels of Ki-67, PCNA, Bax and Cleaved Caspase-3 were detected by Western blot and mitochondrial membrane potential was detected by JC-1 method, the ROS level in cells was detected by DCFH-DA method. Radiosensitivity was measured by plate cloning. Results Compared with cells that were not treated with solanine and radiation, the proliferation of osteosarcoma cells and the Ki-67 and PCNA protein levels were decreased after solanine or radiotherapy ( F=55. 165, 50. 667, 23. 389, P<0. 05) ,the apoptotic rate and the level of Bax and Cleaved Caspase-3 protein increased ( F=54. 588, 42. 924, 51. 541, P<0. 05), the mitochondrial membrane potential decreased (F=40. 762, P<0. 05), and the ROS level in the cells increased( F=79. 055, P<0. 05) . Compared with cells treated with solanine or radiotherapy, the proliferation of osteosarcoma cells and the levels of Ki-67 and PCNA proteins were decreased after solanine combined with radiation treatment ( F=55. 165, 50. 667, 23. 389, P<0. 05) , the apoptotic rate and the levels of Bax and Cleaved Caspase-3 were increased ( F=54. 588, 42. 924, 51. 541, P<0. 05), the mitochondrial membrane potential was decreased (F=40. 762, P<0. 05), and the ROS level was increased (F=79. 055, P<0. 05). The radiosensitization ratio of solanine to osteosarcoma cells was 1. 786. Conclusions Solanine inhibits proliferation and induces apoptosis of osteosarcoma cells, and improves radiosensitivity of osteosarcoma cells.