ObjectiveTo explore the effect of different drying conditions on the appearance and intrinsic quality indicators of Pinelliae Rhizoma for screening suitable drying conditions， so as to provide reference for its standardized production and quality evaluation. MethodsDifferent dried samples of Pinelliae Rhizoma were prepared by lime-assisted sweating method and intermittent drying method. Visual analysis was employed to measure the color brightness values（L^*） of the surface， cross-section and powder of the samples， texture analyzer was used to determine the hardness of the samples under different drying conditions. The total starch content was calculated by measuring the contents of amylose and amylopectin in the samples with ultraviolet-visible spectroscopy. High performance liquid chromatography（HPLC） was used to determine the contents of seven nucleoside components（uracil， hypoxanthine， uridine， inosine， guanosine， β-thymidine and adenosine） in the samples. Pearson correlation analysis was conducted to explore the correlation between the external characteristics and intrinsic indicators of the different dried samples. Principal component analysis（PCA） was used to comprehensively rank the data of various indicators， and partial least squares-discriminant analysis（PLS-DA） was used to screen differential components with variable importance in the projection（VIP） value>1. Furthermore， the difference between the optimal drying condition for Pinelliae Rhizoma and the traditional sun-drying method was explored by independent samples t-test. ResultsWith the increase of temperature， the color of the intermittently dried samples gradually deepened， while their hardness gradually decreased. Concurrently， the contents of extract， total starch， uridine and adenosine exhibited an upward trend， whereas the contents of uracil， hypoxanthine and inosine displayed a downward trajectory. Compared with the intermittent drying group， the content of extract in the samples subjected to lime-assisted sweating increased. With the increase of lime dose， the hardness and the total content of nucleoside components in the samples showed a downward trend， while the total starch content showed an upward trend. Correlation analysis showed that the comprehensive score of L^* was negatively correlated with the contents of uracil， hypoxanthine and inosine， and positively correlated with the contents of uridine， guanosine and adenosine. Hardness was negatively correlated with adenosine content， and positively correlated with the contents of inosine， uracil and hypoxanthine. Through comprehensive consideration and comprehensive score of principal components， the method of 5% lime-mixed sweating for 6 days emerged as the top-ranking approach. Except for the extract， the results of independent samples t-test showed that there was no significant difference between the 5% lime-mixed sweating for 6 days and the traditional sun-drying in terms of other content indicators. ConclusionThe whiteness and firmness of Pinelliae Rhizoma exhibit significant correlations with its chemical composition， while uridine， uracil， guanosine， adenosine and inosine are the key constituents responsible for the quality difference of Pinelliae Rhizoma under different drying conditions. The lime-assisted sweating method optimized in this study can be proposed as a viable alternative to the traditional sun-drying method. This method not only ensures the quality of the medicinal material but also effectively reduces the drying time and prevents mold contamination， which provides a valuable reference for the standardization of drying conditions and the establishment of quality evaluation criteria for Pinelliae Rhizoma.

Objective:To evaluate the accuracy of the domestic "Skywalker" surgical robot in implementing personalized lower limb alignment reconstruction scheme in total knee arthroplasty (TKA) and the short-term clinical outcome of robotic assisted TKA.Methods:From September 2020 to January 2021, the data of patients who received surgical robot assisted TKA in 5 clinical centers in China (Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Southwest Hospital affiliated to Third Military Medical University, The Affiliated Hospital of Qingdao University, The First Affiliated Hospital of Chongqing Medical University and Yantai Yuhuangding Hospital, and Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine was the group leader) were prospectively collected and retrospectively analyzed. There were 24 males and 82 females with an average age of 67.6±7.3 years, (range 45-80 years); Average body mass index 26.42±4.31 kg/m 2, all the operation were performed by "Skywalker" surgical robot system according to preoperative design based on CT. The operation time, intraoperative blood loss, hospitalization days and postoperative complications were recorded, and the imaging indexes including hip-knee-ankle (HKA), lateral distal angle of femur (LDFA) and medial proximal angle of tibia (MPTA) measured before and after the operation, implant model indexes (preoperative planning implant model and postoperative implant model) and short-term clinical efficacy indexes [Western Ontario and McMaster Universities (WOMAC) osteoarthritis index] pain score, stiffness score, joint function score, total score and SF-12 score before and 3 months after the operation) were compared. Results:The average follow-up period was 109.60±9.80 d, (range 95-143 d). The average operation time of 106 patients was 105.30±23.22 min; The average intraoperative blood loss was 141.70±58.33 ml; The average length of hospitalization was 5.82±2.80 d. One patient had ischemic stroke after operation, and one patient had abnormal liver function after operation. According to the judgment of the investigator, all of them were not related to the operation. The actual angle error is the difference between the preoperative planning angle and the postoperative measurement angle. The absolute error of 99.1% (105/106) of the HKA angle was within 3°, 90.8% (69/76) of LDFA, 98.7% (75/76) of the MPTA. In 45 patients in one center where data were available, the actual implant models used in all patients were consistent with the preoperative planning size, and there were only differences in version selection such as Asian condyle. WOMAC pain score, joint function score, total score was improved from 7.34±2.85, 25.10±9.85, 34.75±13.02 to 3.34±2.66, 14.68±9.64, 18.66±13.49 before and after operation, respectively, which were statistically significant ( P<0.001) and SF-12 physiological score and psychological score were improved form 27.24±6.42, 30.68±8.26 to 38.83±5.74, 39.36±7.85 before and after operation, respectively, which were statistically significant ( t=7.33, P<0.001; t=4.53, P=0.043). Conclusion:Domestic surgical robot system "Skywalker" can assist the surgeon to achieve accurate and personalized reconstruction of lower limb alignment and achieve satisfactory short-term clinical outcomes. The long-term clinical outcomes of personalized reconstruction and survival rate of implant still need to be further studied.

Objective:To evaluate the role of transient receptor potential vanillic acid 4 (TRPV4) in dexmedetomidine-induced improvement in cognitive function in mice with mechanical ventilator-caused brain injury.Methods:Ninety clean-grade healthy male C57BL6 mice, weighing 20-25 g, aged 8-12 weeks, were divided into 5 groups ( n=18 each) using a random number table method: control group (group C), mechanical ventilation group (group V), HC-067047 group (group H), dexmedetomidine group (group D), and dexmedetomidine+ GSK1016790A group (group DG). In group C, the animals breathed air spontaneously for 6 h without mechanical ventilation. In group V, the animals were mechanically ventilated for 6 h. In group H, TRPV4 blocker HC-067047 10 mmol was injected into the cerebral ventricle at 3 and 6 h of mechanical ventilation. In D and DG groups, dexmedetomidine 50 μg/kg was intraperitoneally injected at 30 min before mechanical ventilation. In group DG, TRPV4 agonist GSK1016790A 5 μmol was injected into the cerebral ventricle at 60 min before mechanical ventilation. Morris water maze test was performed on 6 mice in each group at 1 day before mechanical ventilation and 3 and 7 days after mechanical ventilation. Six mice in each group were randomly selected and sacrificed at 1 day after mechanical ventilation, and the brain tissue was taken for determination of the neuronal apoptosis in hippocampal CA1 area by TUNEL method, and the apoptosis index was calculated. Six mice in each group were randomly selected and sacrificed at 1 day after mechanical ventilation, and the hippocampal tissues were taken for determination of the expression of TRPV4, serine-threonine protein kinase (Akt), phosphorylated Akt (p-Akt), Bcl-2, Bax and caspase-3 by Western blot. Results:Compared with group C, the escape latency was significantly prolonged and the number of crossing the original platform was reduced at 3 and 7 days after mechanical ventilation, the expression of TRPV4 and caspase-3 was up-regulated, the ratio of Bcl-2/Bax was decreased, and the apoptosis index of neurons was increased in group V and group DG ( P<0.05). Compared with group V, the escape latency was significantly shortened and the number of crossing the original platform was increased at 3 and 7 days after mechanical ventilation, the expression of TRPV4 and caspase-3 was down-regulated, the expression of p-Akt was up-regulated, the ratio of Bcl-2/Bax was increased, and the apoptosis index of neurons was decreased in group D and group H ( P<0.05). Compared with group D, the escape latency was significantly prolonged at 3 and 7 days after mechanical ventilation, the number of crossing the original platform was reduced, the expression of TRPV4 and caspase-3 was up-regulated, the expression of p-Akt was down-regulated, the ratio of Bcl-2/Bax was decreased, and the apoptosis index of neurons was increased in group DG ( P<0.05). Conclusions:TRPV 4 is involved in dexmedetomidine-induced improvement in cognitive function, which is related to up-regulation of p-Akt expression and inhibition of apoptosis in hippocampal neurons in mice with mechanical ventilation-caused brain injury.

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.

Objective:To investigate the effect of baicalin on cognitive function of mice with brain injury induced by mechanical ventilation and its mechanism.Methods:Seventy two C57BL6 mice, weighing 20-25 g, aged 8-12 weeks, were randomly divided into control group (group C), mechanical ventilation group (group V), baicalin group (group B), baicalin+ Akt inhibitor MK-2206 group (group BM) according to random number table method, with 18 in each group.Mice in group C did not have mechanical ventilation and breathed air independently for 6 hours.Mice in group V received mechanical ventilation for 6 hours.Mice in group B and group BM were intraperitoneally injected with baicalin 100 mg/kg 30 minutes before mechanical ventilation, and mice in group BM were injected intraventricular with Akt inhibitor MK-2206 300 μg/kg 60 minutes before mechanical ventilation.Six mice in each group were randomly selected to test their learning and memory abilities by Morris water maze test 1st day before mechanical ventilation and 3rd day and 7th day after mechanical ventilation.One day after mechanical ventilation, six mice in each group were killed, and the brain tissue was taken.TUNEL method was used to detect the neuronal apoptosis in hippocampal CA1 area, and the apoptosis index was calculated.One day after mechanical ventilation, six mice in each group were killed, and the hippocampus was taken, Western blot was used to detect the protein expressions of caspase-3, caspase-9, Akt, p-Akt, GSK-3β and p-GSK-3β.SPSS 22.0 software was used for statistical analysis of data, repeated measure ANOVA and one-way ANOVA were used for comparison between multiple groups.LSD- t test was used for further pairwise comparison. Results:The results of water maze test showed that the time and group interaction of the four groups were not significant ( F=1.14, P>0.05), the main effect of time and group were both significant ( F=47.36, 59.65, both P<0.05). At 3rd day and 7th day after mechanical ventilation, the escape latencies of mice in group V were higher than those in group C (both P<0.05), and the numbers of platform crossing were lower than those in group C (both P<0.05). And 3 days and 7 days after mechanical ventilation, the escape latencies of mice in group B were lower than those in group V (both P<0.05) and the numbers of platform crossing were higher than those in group V (both P<0.05). The escape latenies of mice in BM group on the 3rd and 7th day were higher than those in group B (both P<0.05), and the numbers of platform crossing were lower than those in group B on the 3rd day and 7th day after mechanical ventilation(both P<0.05). TUNEL and Western blot results showed that apoptosis index of hippocampal neurons and expression levels of apoptosis-related proteins caspase-3 and caspase-9 were significant different in the four groups ( F=51.42, 41.21, 40.19, all P<0.05). The apoptosis index of hippocampal neurons ((40.6±3.9)%), the expression levels of caspase-3 (4.93±0.92) and caspase-9 (4.81±0.88) in the hippocampus of mice in group V were higher than those in group C ((13.7±1.4)%, (1.87±0.27), (1.71±0.25), all P<0.05), the apoptosis index of hippocampal neurons ((15.6±1.6)%), the expression levels of caspase-3 (1.95±0.30) and caspase-9 (1.76±0.28) in group B were lower than those in group V ((40.6±3.9)%, (4.93±0.92), (4.81±0.88), all P<0.05), the apoptosis index of hippocampal neurons ((27.8±2.7)%), the expression levels of caspase-3 (3.58±0.61) and caspase-9 (3.49±0.57) in BM group were higher than those in group B ((15.6±1.6)%, (1.95±0.30), (1.76±0.28), all P<0.05). Expression level of p-Akt, p-GSK-3β in hippocampal tissues of the four group of mice were significantly different ( F=37.54, 43.23, both P<0.05). The expression level of p-Akt (0.51±0.06) and p-GSK-3β (0.47±0.05) of hippocampal tissues of mice in group V were lower than those of group C ((1.07±0.10), (1.11±0.12), both P<0.05), the expression level of p-Akt (0.99±0.10) and p-GSK-3β (1.08±0.09) of hippocampal tissues of mice in group B were higher than those of group V (both P<0.05), the expression level of p-Akt (0.83±0.08) and p-GSK-3β (0.81±0.07) of hippocampal tissues of mice in group BM were lower than those in group B (both P<0.05). Conclusion:Baicalin can improve the cognitive function of mice with brain injury induced by mechanical ventilation, which is related with activation of Akt/GSK-3β signaling pathway and inhibition of hippocampal neuron apoptosis.

Objective Based on the principle of uncemented stem design, the femoral anteversion in different CT planes before total hip arthroplasty (THA) and stem anteversion after THA was compared, so as to find out the preoperative measurement to estimate stem anteversion in patients with developmental dysplasia of the hip(DDH) after THA. Methods Twenty-one primary THA patients (28 hips) who were diagnosed with DDH between September 2007 and May 2013 in Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were selected. Preoperative and postoperative CT scans were performed on all patients. The femoral anteversion angle was defined as the angle between the midcortical line between the anterior and posterior cortical line in five CT slices and the posterior condylar axis. The slice levels for the 4 femoral sites were selected，including the area just distal to the femoral head, the center of the lesser trochanter，1 cm height above center of the lesser trochanter, 2 cm height above center of the lesser trochanter (marked as femoral anteversion 1-4). Femoral anteversion 5 was defined as the midcortical line of the anterior cortical line in the slice of 2 cm height above center of the lesser trochanter and the posterior cortical line in the slice of 50% of the distance from the top of greater trochanter to the center of the lesser trochanter above the center of the lesser trochanter. The stem anteversion angle was defined as the angle formed by the stem neck major axis and the posterior aspect of the femoral condylar line. The cup version and stem alignment were also calculated. The difference value and correlation coefficients of femoral anteversion 1-5 and stem anteversion were compared. Results Femoral anteversion 1-5 was 17.70°±10.54°, 35.59°±7.21°, 31.09°±7.98°, 24.71°±9.11°, 21.94°±10.10°, respectively。Stem anteversion was 20.52°±10.90°. The difference value between stem anteversion and femoral anteversion 1-5 was 2.82°±6.27°, -15.08°±7.99°, -13.80°±15.68°, -4.19°±5.69°, -1.42°±4.07°, respectively. Cup anteversion was 25.60°±11.65°, and combined antevertion was 46.11°±13.28°，sagittal stem tilt was 1.13°±1.53°. There were statistically significant differences between femoral anteversion 1-4 and stem anteversion (P＜0.05), and no statistical difference was found between femoral anteversion 5 and stem anteversion. The correlation coefficients of femoral anteversion 1-5 and stem anteversion were 0.829, 0.681, 0.689, 0.853, 0.928, respectively. Conclusions Femoral anteversion 5 had a highly positive correlation with stem anteversion, which was an effective a substitute of stem anteversion before THA.

Objective To investigate the correlation of spinal mechanical imbalance and thoraco-dorsal pain of ankylosing spondylitis (AS). Methods The clinical data of 90 patients with AS were collected. Patients were divided into two groups according to the presence of thoracodorsal pain: the AS with thoraco-dorsal pain group (30 cases) and the AS without thoraco-dorsal pain group (60 cases). Clinical symptoms, Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis function index (BASFI), Bath ankylosing spondylitis measurement index (BASMI), ankylosing spondylitis disease activity (ASDAS), and spinal mechanical function and nuclear myocardial force test were compared using t-test, one-way analysis of variance (ANOVA) analysis and Spearman correlation analysis. Results ① There were differences between thoraco-dorsal pain group and patients without thoracodorsal pain group at the time of back muscle strength [(0.82±0.41) min vs (1.33±0.74) min, F=12.372, P=0.001]; ②Thoraco-dorsal pain in the AS group was mainly the middle and lower thoracic vertebrae, such as the inflammation of rib head and rib transverse process, facial arthritis, and spinous ligaments, etc. And the missed diagnosis rate of magnetic resonance imagin (MRI) was high. ③ In healthy control group, the anterior flexion strength of thoracodorsal pain group was signific-antly different from that of patients without thoracodorsal pain [(92.1 ±46.3) Nm vs (126.6±35.7) Nm, F=6.440, P=0.002]. ④ There was significant difference in spinal strength as well as left and right rotation strength between the thoracodorsal pain group and patients without thoracodorsal pain [(1.18 ±0.22) vs (1.05 ±0.17), F=10.044, P<0.01];⑤In the thoraco-dorsal pain group, the right/left index was related to BASDAI (r=-0.522, P=0.004). For spinal mobility, the right/left index was related to cross cutting faces to right ( r=0.435, P=0.021), cross cutting faces to left (r=0.528, P=0.004). In spinal strength, the right/left index was related to left turn (r=0.57, P=0.001); right lateral flexion (r=0.368, P=0.049) and left lateral flexion (r=0.369, P=0.049). Conclusion The thoracodorsal pain of AS is dominated by the middle and lower thoracic vertebrae, and the missed diagnosis rate of MRI is high. The imbalance of the left and right side of the spine is one of the factors of the thoracic back pain in AS.

OBJECTIVETo synthesize a biodegradable and minimally cytotoxic amphiphilic block copolymer of PLGA-b-(PEI-co- PEG) and study its micellization behavior.

METHODSPLGA was synthesized by ring-opening polymerization. The cross-linked copolymer of PEI-co-PEG was synthesized from the low-molecular-weight polyethyleneimine (PEI, 1800 D) and hydrophilic poly(ethylene glycol) (PEG, 2000 D). PLGA-b-(PEI-co-PEG) was synthesized by dehydration condensation reaction of PLGA and water soluble PEI-co-PEG. The biodegradability of PEI-co-PEG was evaluated according to the molecular weight change after incubation at 37 ℃ for different time. The cytotoxicity of PLGA- b-(PEI-co-PEG) and PEI-co-PEG in MCF-7 cells was determined by MTT assay. The cationic PLGA-b-(PEI-co-PEG) micelles were prepared by standard dialysis method. The particle size and Zeta potential of the micelles were measured by a Malvern laser particle size analyzer. Micelle/insulin complexes were prepared by simple mixing method and their morphology were characterized by transmission electron microscopy (TEM). The fluorescence quenching method was used to determine the stability of the micelle/insulin complexes at different salt concentrations.

RESULTSAmphiphilic block copolymer of PLGA-b-(PEI-co-PEG) was successfully synthesized. The half-life of PEI-co-PEG degradation in PBS at 37 ℃ was about 48 h. The 50% cell inhibiting concentration (IC) of PLGA-b-(PEIco- PEG) and PEI-co-PEG in MCF-7 cells were 1375.7 μg/mL and 425.1 μg/mL, respectively. The micelles of PLGA-b-(PEI-co- PEG) (particle size: 99.5±2.61 nm, Zeta potential: 52.9±2.38 mV) were complexed with insulin electrostatic interaction and formed nanoscale micelle/insulin complexes. The dissociation rate of micelle/insulin complexes in 150 mmol/L NaCl solution was 27.6%.

CONCLUSIONSThe synthesized PEI-co-PEG shows good degradability . The cytotoxicity of PLGA-b-(PEI-co- PEG) is significantly lower than PEI-co-PEG, and PLGA-b-(PEI-co-PEG) micelle/insulin complexes have good salt- resistant stability in physiological condition.

Objective To evaluate the results of computer-aid customized acetabular cages for patients with severe defects.Methods Twenty-three patients (8 males and 15 females) with a massive acetabular defects were involved in the present study from January 2005 to September 2014.The average age was 64.2 years (range,46-79 years).According to the American Academy of Orthopaedic Surgeons (AAOS) classification,20 had AAOS type Ⅲ defects and three had AAOS type Ⅳ defects.The customized cages were individualized to each patient's bone defects based on the rapid prototype three-dimensional printed models.The mean follow-up duration was 66.3 months (range,24-120 months).The clinical and radiographic outcomes of all patients were assessed at 6 and 12 weeks after surgery and at once yearly thereafter.Harris hip scores were assessed before surgery and at each follow-up.Postoperative radiographs were evaluated for cage position,migration,and graft incorporation.Complications and reoperations were assessed by chart review.Results The mean Harris hip score improved from 36.2±7.9 (range,20-49) to 81.8± 8.4 (range,60-96),and there is a significant difference between pre-and post-operation (t=23.23,P＜0.001).Individualized custom cages resulted in generally reliable restoration of the hip center.The difference of horizontal distance (between the center of each hip and pubic symphysis) between bilateral sides was-3.0±6.4 mm (range,-19-8 mm).The difference of vertical distance (between the center of each hip and the line connecting the inferior border of the bilateral tear drop) between bilateral sides was 0.4±2.8 mm (range,-4.5-5 mm).No re-revisions had been conducted.None of the cups showed radiographic migration,while one cage was suspected to be loose based on a circumferential 2-mm radiolucent line.Cancellous allografts appeared to be incorporated in 22 of 23 patients.One deep infection and one superficial infection were observed and were treated with irrigation,debridement,and vacuum sealing drainage.One dislocation and one suspected injury of the superior gluteal nerve also were observed and were treated conservatively.Conclusion Individualized customized cages appears to provide stable fixation and improve hip scores at short or mid-term follow-up.

Objective To assess the functional restoration in patients with developmental dysplasia of the hip (DDH) who underwent hip resurfacing arthroplasty and to determine whether greater abduction angle of the acetabular component is relat?ed to larger diameter of femoral head component. Methods We reviewed 34 DDH cases (9 hips of 8 males and 25 hips of 24 fe?males, mean age 44.6±11.85 years at the time of surgery) on whom we performed hip resurfacing arthroplasty (HRA) from October 2006 to September 2009. The total hip Arthroplasty (THA) group was consisted of 35 DDH cases (8 hips of 8 males and 27 hips of 25 females, mean age 43.7±10.4 years at the time of surgery). All operations were performed by the same doctor over the same peri?od. Assessment of the functional hip scores was conducted by Harris Hip Scores. A radiographic study was also performed to evalu?ate the implants stability and abduction angle of the acetabular components. All the data was analyzed with Kolmogorov?Smirnov method. Results The mean follow?up was 6.2 years in the HRA group. The Harris Hip Score improved from 54.9±13.2 to 97.3± 6.2 after the surgery. The mean abduction angle of the acetabular component was 51.6° ± 5.33°, hip flexion was 127° ± 6.9° and mean diameter of femoral head was 46.5±1.5 mm. The mean follow?up was 5.9 years in the THA group. The Harris Hip Score im?proved from 51.6±19.7 to 95.6±7.9 after the surgery. The mean abduction angle of the acetabular component was 43.9°±4.90°, hip flexion was 117°±4.2°. There was no failure of the prosthesis, peri?prosthetic fracture and infection in either group. There was sig?nificant difference in the abduction angle of the acetabular component (P<0.05) and flexion of the hip between the two groups (P<0.05). Conclusion Patients in the HRA group had a better functional restoration and larger range of motion. Furthermore, a larger diameter of femoral head component could be achieved by placing the acetabular component in a greater abduction angle, which may contribute to a better long?term stability.