BACKGROUND:Oblique lumber interbody fusion has become a mature lumbar fusion method at present,and its method of assisting lateral screw-rod fixation under the same channel has attracted attention in recent years.However,there is currently no consensus on the optimal intraoperative placement of lateral screw-rod,and there is a lack of relevant biomechanical evidence.OBJECTIVE:To establish various oblique lumber interbody fusion combined with lateral screw-rod fixation models,evaluate their impact on lumbar spine biomechanics,and provide biomechanical foundations for the implantation of lateral screw-rod.METHODS:Using CT images of a healthy adult,the L4-L5 Stand-Alone oblique lumber interbody fusion model and lateral screw-rod fixation models with different screw placement positions were established by using Mimics,Geomagic and SolidWorks software,including nine double screw-rod fixation models and five single screw-rod fixation models.Ansys Workbench software was employed to analyze the range of motion,peak stress of internal fixation and cage under conditions of flexion,lateral bending,and rotation.RESULTS AND CONCLUSION:(1)The range of motion of all internal fixation models was less than Stand-Alone oblique lumber interbody fusion model.Both single screw-rod and double screw-rod showed the least range of motion when placed close to the upper endplates of L4 and L5,and the former had more restrictions on the motion.(2)The peak stress of cage in all internal fixation models was lower than Stand-Alone oblique lumber interbody fusion model.Except for right rotation condition,double screw-rod was minimal cage stress when placed anterior superior and posterior inferior quadrants of L4 and L5,which was similar to that when placed proximaly to L4 lower and L5 upper endplates;screw-rod showed minimal stress when placed proximally to L4 lower and L5 upper endplates.(3)Under flexion-extension condition,double rod-screw exhibited minimal internal fixation stress when positioned close to the upper endplates of L4 and L5;single-rod fixation showed minimal stress when placed proximally to L4 lower and L5 upper endplates.(4)It is indicated that the position of lateral screw-rod is one of the important factors that affect the biomechanical properties of oblique lumber interbody fusion,double screw-rod performs better biomechanical properties than single-rod fixation.The best biomechanical stability can be obtained when double screw-rod is placed close to the upper endplate of the vertebral body.The risk of cage subsidence is greatly reduced when the double screw-rod is placed in the anterior superior and posterior inferior quadrants of the upper and lower vertebrae or adjacent to the upper and lower endplates.

BACKGROUND:Oblique lumber interbody fusion has become a mature lumbar fusion method at present,and its method of assisting lateral screw-rod fixation under the same channel has attracted attention in recent years.However,there is currently no consensus on the optimal intraoperative placement of lateral screw-rod,and there is a lack of relevant biomechanical evidence.OBJECTIVE:To establish various oblique lumber interbody fusion combined with lateral screw-rod fixation models,evaluate their impact on lumbar spine biomechanics,and provide biomechanical foundations for the implantation of lateral screw-rod.METHODS:Using CT images of a healthy adult,the L4-L5 Stand-Alone oblique lumber interbody fusion model and lateral screw-rod fixation models with different screw placement positions were established by using Mimics,Geomagic and SolidWorks software,including nine double screw-rod fixation models and five single screw-rod fixation models.Ansys Workbench software was employed to analyze the range of motion,peak stress of internal fixation and cage under conditions of flexion,lateral bending,and rotation.RESULTS AND CONCLUSION:(1)The range of motion of all internal fixation models was less than Stand-Alone oblique lumber interbody fusion model.Both single screw-rod and double screw-rod showed the least range of motion when placed close to the upper endplates of L4 and L5,and the former had more restrictions on the motion.(2)The peak stress of cage in all internal fixation models was lower than Stand-Alone oblique lumber interbody fusion model.Except for right rotation condition,double screw-rod was minimal cage stress when placed anterior superior and posterior inferior quadrants of L4 and L5,which was similar to that when placed proximaly to L4 lower and L5 upper endplates;screw-rod showed minimal stress when placed proximally to L4 lower and L5 upper endplates.(3)Under flexion-extension condition,double rod-screw exhibited minimal internal fixation stress when positioned close to the upper endplates of L4 and L5;single-rod fixation showed minimal stress when placed proximally to L4 lower and L5 upper endplates.(4)It is indicated that the position of lateral screw-rod is one of the important factors that affect the biomechanical properties of oblique lumber interbody fusion,double screw-rod performs better biomechanical properties than single-rod fixation.The best biomechanical stability can be obtained when double screw-rod is placed close to the upper endplate of the vertebral body.The risk of cage subsidence is greatly reduced when the double screw-rod is placed in the anterior superior and posterior inferior quadrants of the upper and lower vertebrae or adjacent to the upper and lower endplates.

Objective To explore the therapeutic efficacy of automatic peritoneal dialysis on elderly patients with cardiorenal syndrome(CRS).Methods A total of 260 elderly CRS patients treated at our hospital from January 2019 to January 2022 were recruited,and then randomly divided into an observation group and a control group,with 130 cases in each group.The control group received conventional basic treatment and symptomatic treatment,while the observation group received automated peritoneal dialysis treatment on this basis.Cardiac function indicators,renal function indicators,inflammatory factors,MAP and heart rate were compared between the two groups.Re-sults After treatment,significantly lower LVESD(26.29±1.19 mm vs 29.59±1.84 mm),LVEDD(47.43±1.39 mm vs 51.81±1.34 mm),LAD(30.74±1.15 mm vs 33.11±0.88 mm),and levels of NT-proBNP(1034.74±313.61 ng/L vs 2634.02±853.67 ng/L),urea(16.69±3.57 mmol/L vs 32.67±4.54 mmol/L),cystatin C(0.47±0.13 mg/L vs 0.61±0.15 mg/L),creatinine(254.74±41.15 mmol/L vs 394.09±38.61 mmol/L),TNF-α(144.14±23.16 mg/L vs 183.97± 23.37 mg/L)and hs-CRP(4.09±1.03 μg/L vs 5.45±1.17 μg/L),and higher LVEF(39.14± 4.48％vs 35.64±5.27％)were observed in the observation group than the control group(all P＜0.01).There were no significant differences in heart rate and MAP between the two groups before and after treatment(P＞0.05).Conclusion Automatic peritoneal dialysis can improve the cardiac and renal function and reduce inflammatory response in elderly CRS patients,and show positive significance for improving prognosis.

Objective:To explore the short-term effectiveness of arthroscopic combined with dual-plane high tibial osteotomy in the treatment of anterior cruciate ligament injury combined with varus deformity of knee joint.Methods:A retrospective study was performed on 17 patients with anterior cruciate ligament injury combined with varus deformity of knee joint who underwent arthroscopic combined with dual-plane high tibial osteotomy at Department of Bone and Joint, the Affiliated Hospital of Southwest Medical University from January 2017 to June 2018.There were 11 males (11 knees) and 6 females (6 knees), aged 41.3 years (range: 32 to 49 years) .During the surgery, the weight bearing line of lower extremity was set to 62.5% position of the tibial plateau on coronal plane. The tibial slope was adjusted to the normal range on sagittal plane, and anterior cruciate ligament was reconstructed to improve the stability of knee joint.At final follow up, full length weight bearing X ray was used to evaluate the position of weight bearing line, femoral tibial angle and tibial slope pre- and post-operatively.The Lysholm scores, Hospital for Special Surgery score, Tegner knee activity scores and International Knee Documentation Committee (IKDC) scores were used to estimate knee joint function, while the Lachman test, KT-1000 side-to-side difference and pivot-shift test were used to estimate the knee joint stability.Results:The patients were followed up for 1.8 years(range:1.2 to 2.5 years). No complication such as infection, deep vein thrombosis, graft failure, nonunion or delayed union was observed.The weight bearing line was corrected from (28.48±2.24)% preoperatively to (57.43±1.02)% postoperatively ( t=46.80, P=0.00) .The femoral tibial angle was improved from (172.31±3.37) ° preoperatively to (178.91±1.34) ° postoperatively( t=10.46, P=0.00). The tibial slope was decreased from (14.29±1.26) ° preoperatively to (9.31±0.79) ° postoperatively ( t=24.59, P=0.00) . The KT-1000 side-to-side difference decreased from (7.95±1.19) mm preoperatively to (1.79±0.49)mm postoperatively( t=18.34, P=0.00). At the last follow-up, Lysholm score, Hospital for Special Surgery score, Tegner score, and the IKDC knee evaluation score of patients showed significant improvement from preoperative( P<0.05). Conclusion:Arthroscopic combined with dual-plane high tibial osteotomy can get a good short term efficacy in the treatment of anterior cruciate ligament injury combined with varus deformity of knee joint which can significantly improve the alignment of lower extremity and knee joint stability.

Objective:To explore the short-term effectiveness of arthroscopic combined with dual-plane high tibial osteotomy in the treatment of anterior cruciate ligament injury combined with varus deformity of knee joint.Methods:A retrospective study was performed on 17 patients with anterior cruciate ligament injury combined with varus deformity of knee joint who underwent arthroscopic combined with dual-plane high tibial osteotomy at Department of Bone and Joint, the Affiliated Hospital of Southwest Medical University from January 2017 to June 2018.There were 11 males (11 knees) and 6 females (6 knees), aged 41.3 years (range: 32 to 49 years) .During the surgery, the weight bearing line of lower extremity was set to 62.5% position of the tibial plateau on coronal plane. The tibial slope was adjusted to the normal range on sagittal plane, and anterior cruciate ligament was reconstructed to improve the stability of knee joint.At final follow up, full length weight bearing X ray was used to evaluate the position of weight bearing line, femoral tibial angle and tibial slope pre- and post-operatively.The Lysholm scores, Hospital for Special Surgery score, Tegner knee activity scores and International Knee Documentation Committee (IKDC) scores were used to estimate knee joint function, while the Lachman test, KT-1000 side-to-side difference and pivot-shift test were used to estimate the knee joint stability.Results:The patients were followed up for 1.8 years(range:1.2 to 2.5 years). No complication such as infection, deep vein thrombosis, graft failure, nonunion or delayed union was observed.The weight bearing line was corrected from (28.48±2.24)% preoperatively to (57.43±1.02)% postoperatively ( t=46.80, P=0.00) .The femoral tibial angle was improved from (172.31±3.37) ° preoperatively to (178.91±1.34) ° postoperatively( t=10.46, P=0.00). The tibial slope was decreased from (14.29±1.26) ° preoperatively to (9.31±0.79) ° postoperatively ( t=24.59, P=0.00) . The KT-1000 side-to-side difference decreased from (7.95±1.19) mm preoperatively to (1.79±0.49)mm postoperatively( t=18.34, P=0.00). At the last follow-up, Lysholm score, Hospital for Special Surgery score, Tegner score, and the IKDC knee evaluation score of patients showed significant improvement from preoperative( P<0.05). Conclusion:Arthroscopic combined with dual-plane high tibial osteotomy can get a good short term efficacy in the treatment of anterior cruciate ligament injury combined with varus deformity of knee joint which can significantly improve the alignment of lower extremity and knee joint stability.

This paper describes the biological characteristics of the metal tantalum (Ts) and the application status of tantalum in artificial joints, bone necrosis, spine, defects of bone and other aspects of bone. The early clinical application results of tantalum in bone diseases were satisfactory, but it is necessary to do further study of tantalum in a deep going way, and further detailed comparison between the tantalum with other metals as orthopedics implants. The advantage of tantalum materials as orthopedic implants still needs to be verified by a great deal of clinical cases for a long period of time.
Biocompatible Materials ; therapeutic use ; Bone Diseases ; surgery ; Humans ; Orthopedic Fixation Devices ; Orthopedic Procedures ; instrumentation ; Prostheses and Implants ; Tantalum ; therapeutic use