BACKGROUND:Bone graft for acetabular reconstruction includes morselized bone graft, structural bone graft and hybrid bone graft, and the morselized bone has been widely used because of the advantages of simple
production and short healing time.
OBJECTIVE:To explore the key technologies and clinical effect of impaction bone grafting with morselized bone in total hip revision for AAOS Ⅲ acetabular deficiency.
METHODS:Sixteen cases of AAOS Ⅲ acetabular deficiency were treated with impaction bone grafting with morselized bone combined with metal devicesor constructive bone grafting. The hip Harris scores and
radiographic data were compared before and after treatment. The effect of impaction bone grafting with morselized bone on acetabular deficiency was assessed.
RESULTS AND CONCLUSION:Al the patients were fol owed-up at 3, 6, 12 months after surgery and every half a year successively. The pain of hip joints after operation was relieved significantly and the walking function was
restored. The hip Harris score was improved from 48.00 points before surgery to 84.94 points after surgery (P<0.01). Five cases were graded as excel ent, eight cases as good, two cases as average, and one case as poor. The excel ent and good rate was 81%, and the satisfying rate of the patients was 94%. The post-operative X-ray films of al the 16 patients showed that the acetabular rotation centers were recovered (near) to normal and the acetabular cups were covered wel by bone. The grafting bone particles got radiological osseointegration and the
acetabular cup prosthesis did not displaced, and no displacement and breakage happened to the metal devices.
Impaction bone grafting with morselized bone in total hip revision for AAOS Ⅲ acetabular deficiency can effectively reconstruct the acetabular bone structure, retain and restore the acetabular bone mass, and it has good technical advantages and good clinical effects.

Objective To investigate the related mechanism of ligamentum flavum (LF) hypertrophy in diabetic pa-tients with lumbar spinal canal stenosis ( LSCS ) .Methods Twenty-four diabetes mellitus patients [ DM (+) ] and twenty normoglycemic patients [ DM (-) ] with LSCS were enrolled in this study .Sorbitol in LF was analyzed using D-Sorbitol/Xylitol test kit .The thickness of LF was measured by CT .The structure of LF was observed after HE and Masson's trichrome staining .The cell cycle and proliferation of fibroblastic cell NIH 3T3 line cultured in high glucose were analyzed .Sorbitol of NIH3T3 was detected under different backgrounds in vitro, normal glucose , high glucose and high glucose burdened with aldose reductase inhibitor ( ARI) , Epalrestat .The expression of inflammatory factors was detected by qPCR and Western blot under above different backgrounds .Results LF of diabetic patients exhibi-ted significantly higher level of sorbitol and pro-inflammatory cytokines , TGF-βand of CD68-positive staining than that of the normoglycemic subjects ( P<0.01 ) .The diabetic LF was significantly thicker than that of the controls , and showed evidence of degeneration .The high glucose-cultured fibroblasts exhibited significantly higher levels of sorbitol , pro-inflammatory factors , and TGF-βcompared to the low glucose-cultured cells , and these levels were dose-dependently reduced by treatment with the aldose reductase inhibitor (P<0.05).Conclusions Sorbitol level of the LF is significantly increased in the DM patients with LSCS .Increased sorbitol recruites inflammatory factors and fibrogenic-related factor TGF-βin LF of DM patients with LSCS which may contributes to the LF hypertrophy .

Objective To evaluate the effects of SLAP repair and biceps tendon tenotomy and fixation in treating type Ⅱ superior labrum from anterior to posterior in shoulder arthroscopy.Methods PubMed,CNKI,VIP,and Wanfang database were searched electronically to screen randomized controlled trials and non randomized controlled trials that comparing two surgical methods for type Ⅱ SLAP lesions.In addition,we also retrieved the domestic orthopedic magazine and searches references that we had included in the present study.According to the criterion,screening literatures,data extraction and quality assessment were conducted by two reviewers independently.Meta-analysis was performed by using RevMan 5.3 software to evaluate UCLA scores,ASES scores,VAS scores and SST scores.Results A total of 7 articles were included in the present study,including 3 literatures in Chinese and 4 in English.There were 2 randomized controlled trials and 5 non randomized controlled trials.Two hundred and fifty-six patients were enrolled in the present study,including one hundred and twenty-five patients with SLAP repair and one hundred and thirty-one patients with biceps tendon tenotomy and fixation.Meta-analysis showed that there was significant difference in total score of UCLA [MD=2.55,95％CI(0.57,4.53),P=0.01] and shoulder function in the UCLA scoring system [MD=0.62,95％ CI(0.21,1.02),P=0.003] compared with SLAP repair.There was no difference in the UCLA scoring system,including pain [MD=0.99,95％CI(-0.15,2.14),P=0.09],flexion [MD=0.16,95％CI(0.01,0.32),P=0.06],strength [MD=0.03,95％CI(-0.15,0.22),P=0.74],satisfaction [SMD=0.18,95％ CI(-0.57,0.93),P=0.64] compared with SLAP repair.There was significant difference in ASES scores [MD=6.32,95％CI(2.55,10.08),P=0.001] between two groups.There was no difference in VAS scores [MD=0.54,95％CI (-0.64,1.72),P=0.37] and SST scores [MD=0.81,95％CI(-0.23,1.86),P=0.13] between two groups.Conclusion The UCLA scores,ASES scores and surgical results of biceps tendon tenotomy and fixation are superior to SLAP repair in treating type Ⅱ SLAP lesions.However,there is no significant advantage in pain,flexion,strength and satisfaction between the two groups.

Objective To conduct a comparative study of the biomechanical characteristics of anatomical and vertical reconstruction for the coracoclavicular ligament. Methods Thirty fresh adult cadaveric specimens of the shoulder joint were dissected, whereas other soft tissues of the shoulder joint were resected, and only the clavicle-coracoclavicular ligament-scapula structures were retained. All the specimens were randomly divided into three groups, with ten specimens in each group. In Group 1, the coracoclavicular ligament was retained; in Group 2, the cone ligament was reconstructed vertically based on the classical Steven technique; and in Group 3, the conical ligament was reconstructed anatomically based on the central site of the original ligament. Biomechanical tests under vertical tensile resistances were conducted separately on the three groups, and the tensile forces that caused the rupture of the coracoclavicular ligament or reconstruction failure were recorded. Results In Group 1, clavicle and coracoid fractures were not found, and the tensile force that caused the coracoclavicular ligament rupture was (650.41 + 35.88) N. In Group 2, clavicle fracture (two cases), endobutton pull-out from the clavicle (two cases) or coracoid (five cases), and coracoid fracture (one case) occurred, and the tensile force that caused the failure of the coracoclavicular reconstruction was (725.68 + 35.37) N. In Group 3, clavicle fracture (three cases ), endobutton pull-out from the clavicle (one case) or coracoid (five cases), and coracoid fracture (one case) occurred, and the tensile force that caused the failure of the coracoclavicular reconstruction was (765.15+13.68) N. Conclusions The tensile forces in the anatomical and vertical reconstruction of the coracoclavicular ligament were both superior to those of the primary ligament, with the anatomical reconstruction being superior to vertical reconstruction under a tensile effect.