BACKGROUND:Pro-kin balance system guidance has a relatively excellent rehabilitation effect on lower extremity proprioception and trunk control in stroke patients,but its effect on knee proprioception and balance function in patients after anterior cruciate ligament reconstruction has been less reported. OBJECTIVE:To investigate the effect of rehabilitation training guided by Pro-kin balance system on proprioception and balance function of the affected knee after anterior cruciate ligament reconstruction. METHODS:A total of 84 patients who underwent anterior cruciate ligament rupture reconstruction surgery were randomly divided into observation group and control group,with 42 patients in each group.The patients in the control group received routine rehabilitation intervention after surgery,and those in the observation group were given rehabilitation training based on the guidance of Pro-kin balance system.The training in each group lasted for 8 weeks.Lysholm score and International Knee Documentation Committee score were used to evaluate the change of knee joint function before and after the intervention.Average weight-bearing strength difference,trajectory error,swing value and 30°,45° and 60° passive angulation errors of the affected knee joint were used to evaluate the changes in the proprioception of the affected knee.The area and length of motion trajectory under open and closed eyes were used to evaluate the change of balance function.The satisfaction of patients in both groups with this rehabilitation training was investigated. RESULTS AND CONCLUSION:After training,Lysholm score and International Knee Documentation Committee score of patients in both groups were significantly higher than those before training(P<0.01),and the above scores in the observation group were significantly higher than those in the control group(P<0.01).After training,the average weight-bearing strength difference,trajectory error and swing value of the two groups were significantly lower than those before training(P<0.01),and the above scores in the observation group were significantly lower than those in the control group(P<0.01).After training,the passive angulation errors of 30°,45° and 60° of the affected knee joints in both groups were significantly lower than those before training(P<0.01),and those in the observation group were significantly lower than those in the control group(P<0.05,P<0.01).After training,the area and length of motion trajectory in both groups with eyes open were significantly smaller than those before training(P<0.01),and the above indicators in the observation group were significantly smaller than those in the control group(P<0.05,P<0.01).After training,the area and length of the movement track of the patients in both groups with eyes closed were significantly smaller than those before training(P<0.01),and the above indicators in the observation group were significantly smaller than those in the control group(P<0.01).The satisfaction of patients in the observation group was 95,which was significantly higher than 81%in the control group(P<0.05).To conclude,compared with the conventional rehabilitation training,the rehabilitation training based on Pro-kin balance system is more effective in improving the function,proprioception and balance function of the affected knee joints of patients undergoing anterior cruciate ligament rupture reconstruction,and the patients'satisfaction is higher.

Objective:To analyze the related factors that affect the occurrence of femoral head necrosis in patients with femoral neck fracture after surgery, and to build a nomogram predictive model.Methods:Using a retrospective study method, 180 patients with femoral neck fracture who were admitted to Hainan Provincial Hospital of Traditional Chinese Medicine from June 2019 to October 2021 were selected as the study objects. According to whether the patients had femoral head necrosis, they were divided into the occurrence group (75 cases) and the non occurrence group (105 cases). The receiver operating characteristic (ROC) curve was used to analyze the predictive value; Logistic regression was used to analyze the risk factors of postoperative femoral head necrosis; internal data were used to verify the clinical efficacy of nomogram model.Results:There was no significant difference in age, sex, body mass index and other general data between the two groups ( P>0.05); compared with the non occurrence group, Garden fracture in the occurrence group was mostly classified as type Ⅲ or Ⅳ, and more patients with preoperative traction, fracture displacement and unsatisfactory reduction quality, and the time from trauma to surgery was longer ( P>0.05). The area under curve of the time from trauma to surgery was 0.766 (95% CI 0.697 to 0.826), and the optimal cutoff value was 42 h; Garden fracture classification (type Ⅲ or Ⅳ), preoperative traction (yes), fracture displacement (yes), reduction quality (unsatisfactory) and time from trauma to surgery (>42 h) were the risk factors affecting the postoperative femoral head necrosis in patients with femoral neck fracture ( P<0.05). The risk of femoral head necrosis predicted by nomogram model was 0.802 (95% CI 0.692 to 0.873). The risk threshold of femoral head necrosis predicted by the model was >0.09, and nomogram model provides clinical net income. Conclusions:Garden fracture classification (type Ⅲ or Ⅳ), preoperative traction (yes), fracture displacement (yes), reduction quality (unsatisfactory) and time from trauma to surgery (>42 h) are the risk factors affecting the postoperative femoral head necrosis in patients with femoral neck fracture, and the nomogram model based on variables has a better predictive ability.