Objective To introduce the technique of OCM hospital (Orthopadische Chirurgie Munchen) in total hip arthroplasty (THA). Methods From January 2005 to January 2006, 20 cases of THA were done in our department with the technique of OCM hospital. The operative approach was through the anterior interval of gluteus medius, and a "V" shaped capsulatomy and a twice-osteotomy of femoral neck were conducted. Specialized acetabular saws and positioners of cup were applied to fix the prosthesis and a table was used to allow the posterior part to be removed. The affected femur was then further externally rotated so that the lower extremity could be placed in the sterilized bag beside the table. In order to achieve better position of the femoral stem, an extensive capsule release was done. Results BMI (body mass index) averaged 27. 4% , the length of skin incision 9. 3 cm, and blood transfusion two units for all the patients. The blood loss and the drainage were 130 mL and 80 mL respectively. In the mean follow up of 4. 3 months, 15 cases recovered completely but five still needed crutches. The mean VAS (visual analog scale) evaluation decreased from the preoperative 5. 1 to 3. 6 (one month later), 1. 7 (three months later ) and 0. 8 (six months later). The mean Harris scores of hip for all the cases increased from the 45. 4 to 88. 4 postoperatively. Conclusions OCM THA owns many advantages, such as small skin incision, less injury to gluteus medius and rapid recovery of patients, but compared with a conventional THA it needs a long learning and special instruments. Its indications are patients who are not over-weighted and have their first THA. Therefore, it is suggested that only qualified hospital and surgeons are allowed to perform the operation.

Objective To evaluate the effects of Burch-Schneider(BS) acetabular reinforcement ring applied in primary or revision total hip arthroplasties in 9 patients with combined or cavitary acetabular bone defects. Methods A retrospective follow up that averaged 3.8 years was performed with a special scoring system comprising the patients symptoms, signs and function. Results The excellent and good function were achieved in 89% of all cases. Conclusion 1)BS reinforcement ring could be effectively and reliably applied in primary or revision total hip arthroplasty or in patients with severe acetabular bone defects. 2)BS reinforcement ring shows the biological fixation feature, so as to provide good foundation for long-term satisfactory function of hip. 3)The lower ear of BS ring need not to be fixed to ischium with screws as usual, but be inserted in obturator foramen above transverse ligament, thus imparting some elastic resilience to it. 4)The upper ear should be folded through such a curve that its curvature was in compliance with that of ilium, which would be better performed in one session. 5)The appropriate amount of 0.8 cm?0.8 cm?0.8 cm morcellized allografting bone was used to snugly fill the space, which would be conducive to desirable incorporation between prosthesis and bone, and the authors propose that the patients should be allowed weight-bearing earlier.

Objective To discuss the treatment efficacy of the femoral-head osteonecrosis by umbrella strut bone grafting and bone marrow mesenchymal stem cells. Methods The femoral-head osteonecrosis models on one side were established in forty-two goats using liquid nitrogen, which were randomly classified into three groups after 8 weeks. Group A were conducted umbrella strut bone grafting and bone marrow mesenchymal stem cells transplantation, group B were conducted simple unit side muscle bone flap grafting, and group C were conducted umbrella strut bone grafting and Cancellous bone grafting transplantation. The health side of three groups was treated as self-control. The radiological and histology examination were made at 3,6treated lateral femoral-head shape restored,cystic cnlow-density area disappeared, the original collapse had repaired, and no further collapse of the femoral-head shaped for both group A and B. Bone fusion was good and bone column shadow had been vague for group A, while the bone fusion healed somewhat less and bone column shadow still clear for group B. Group C had irregular contour of femoral head, flat collapse, uneven density, and fracture cracks could be seen at weight-bearing area of femoral head, obviously was the poorest bone had different states: mature and arranged ruled for group A, childish and irregular arrangement for group B, thinning, sparse and fracture for group C. The percentage of empty lacunae counts decreased, while the percentage of trabecular bone area fraction increased for group A. In contrast with group B, and C, the difference was statistically significant (P ＜ 0.05), but the difference was no longer statistically significant when contrast with healthy sides (P ＞ 0.05). 6 months later, the radiological and histology examination showed that:group A and group B had been no significant difference comparing to normal femoral heads, while the femoral head of group C collapsed and disappeared completely. Group A and group B were no difference comparing the healthy side (P ＞ 0.05)in the area fraction of trabecualr bone and percentage of empty lacunae counts, neither it was between group A and group B(P ＞ 0. 05). Conclusion The treatment efficacy of the femoral-head osteonecrosis by umbrella strut bone grafting and bone marrow mesenchymal stem cells was good and was better than cancellous bone grafting transplantation and simple unit side muscle bone flap grafting.

Objective To explore the effectiveness of ipsilateral autologous semitendinosus ten don graft in treatment of lateral ankle ligament injuries and ankle instability. Methods Two patients including one male (25 years old) and one female (17 years old) with chronic lateral instability of the ankle were enrolled in the study. Both patients had the history of repeated ankle sprain in supination position and had grade Ⅲ injury of the lateral ankle ligament according to the American College of Foot and Ankle Surgeons Grading System. Anterior drawer test and talar tilt test were all positive. The stress-inversion radiograph demonstrated the average inclination of the talus for 21 ° and the lateral radiograph demonstrated anterior dislocation of the talus. The chronic ankle instabilities in two patients were treated by using the ipsilateral autologous semitendinosus tendon graft to reconstruct the lateral ankle ligament. Results The two patients were followed up for mean eight months, which revealed that the active and passive range of motion was good, with no pain or swelling. The anterior drawer test and talar tilt test were all negative. The stress-inversion radiograph demonstrated that the average inclination of the talus was less than 5°, with no anterior dislocation of the talus. According to the Mazur grading system, the clinical outcome was excellent in one patient and good in one. The two patients were satisfied with the stability of the ankle. Conclusions ( 1 ) Lateral ankle ligament injury is a common cause of chronic ankle instability,even the ankle osteoarthritis. ( 2 ) Brostr(o)m method can attain satisfactory result for fresh lateral injury of the ankle, but not for the old injuries. ( 3 ) Ipsilateral autologous semitendinosus tendon graft is simpleand effective for treatment of lateral ankle ligament injuries and chronic ankle instability and may play an important role in the treatment of lateral ankle instability and prevention of the occurrence of ankle osteoarthritis.

Objective To explore the feasibility and evaluate the teaching effect of case-based multidisciplinary team teaching mode in clinical practice teaching of gynecology.Method According to different grade,120 students were divided into experimental group and control group (60 students per group).The teaching content contained three malignant tumor cases,which were cervical cancer,endometrial cancer and ovarian cancer.The course needed 12 periods totally.The experimental group received multidisciplinary team (MDT) teaching mode,and the control group received traditional lecture-based learning teaching mode (LBL).Teaching effect evaluation and test scores would be analyzed at the end of teaching.SPSS19.0 was used for t test and chi-square test.Results Our results showed that the theory test scores,practical skills test scores,the paperwork scores and the total scores of the students in MDT group were significantly higher than those in the traditional group (P＜0.05).At the same time,the students' self-evaluation scores in the ability of information retrieval,acquisition,understanding,comprehensive and the ability of self-learning,learning interest,enthusiasm and teamwork were significantly higher than the traditional group (P＜0.05).Conclusion MDT teaching mode is feasible,which can improve teaching effect and students' quality,and is worthy of advocating and popularization.