OBJECTIVE: To explore the effectiveness of the modified Lemaire procedure in anterior cruciate ligament reconstruction (ACLR) in patients with a highly positive pivot shift test. METHODS: The clinical data of 18 patients with anterior cruciate ligament (ACL) rupture and highly positive pivot shift test between April 2020 and September 2022 were retrospectively analyzed. There were 13 males and 5 females with an average age of 28.3 years (range, 17-41 years). Causes of injury included 11 cases of direct violence injury, including 6 cases of traffic accident injury, 4 cases of sports injury, 1 case of falling injury; 7 cases of indirect violence injury, all sports injury. All patients had complete ACL rupture, including 15 acute injuries and 3 old injuries. The preoperative pivot shift test was grade Ⅱ in 9 cases and grade Ⅲ in 9 cases. All patients were treated with ACLR combined with modified Lemaire procedure. The International Knee Documentation Committee (IKDC) score and Lysholm score were used to evaluate the effectiveness before operation and at 3, 6, 12 months after operation. KT-2000 arthrometer was used to measure the anterior stability of the knee joint, and the difference between the healthy and affected sides was recorded. Pivot shift test was used to evaluate the rotational stability of the knee joint. During the follow-up, X-ray films were taken to observe the bone tunnel and internal fixation, and MRI was used to examine the healing of ACL, anterolateral collateral ligament and fibular collateral ligament grafts. RESULTS: All patients completed the operation successfully without complications such as knee joint infection, vascular and nerve injury. All patients were followed up 12-19 months (mean, 13.2 months). After operation, the rotational stability of the knee joint recovered satisfactorily, and there was no adverse symptom such as knee instability and locking at last follow-up. X-ray film and MRI showed that the bone tunnel was anatomically located and healed well, the internal fixation was in good position, and the reconstructed ACL and iliotibial band were continuous and in good tension. The IKDC score, Lysholm score, and the difference of KT-2000 between the healthy and the affected sides significantly improved at 3, 6, and 12 months after operation ( P<0.05). All the indicators further improved with time after operation, except that there was no significant difference in IKDC score between 3 and 6 months after operation and in the difference of KT-2000 between 3 months and 6, 12 months after operation ( P>0.05), and there were significant differences in other indicators between different time points ( P<0.05). Pivot shift test was negative immediately after operation and at last follow-up. CONCLUSION In ACL injuries with a highly positive pivot shift test, ACLR combined with the modified Lemaire procedure can effectively restore anterolateral knee stability, leading to satisfactory knee stability and function in the early postoperative period.
Humans ; Anterior Cruciate Ligament Reconstruction/methods* ; Male ; Female ; Anterior Cruciate Ligament Injuries/physiopathology* ; Adult ; Adolescent ; Retrospective Studies ; Young Adult ; Anterior Cruciate Ligament/surgery* ; Treatment Outcome ; Joint Instability/surgery* ; Knee Joint/physiopathology* ; Range of Motion, Articular

Objective To investigate the effect of solanine on radiosensitivity of osteosarcoma cells. Methods Osteosarcoma cells were treated with solanine, at the same time, radiation treatment was given, cell proliferation was measured by MTT assay, cell apoptosis was measured by flow cytometry, the protein levels of Ki-67, PCNA, Bax and Cleaved Caspase-3 were detected by Western blot and mitochondrial membrane potential was detected by JC-1 method, the ROS level in cells was detected by DCFH-DA method. Radiosensitivity was measured by plate cloning. Results Compared with cells that were not treated with solanine and radiation, the proliferation of osteosarcoma cells and the Ki-67 and PCNA protein levels were decreased after solanine or radiotherapy ( F=55. 165, 50. 667, 23. 389, P<0. 05) ,the apoptotic rate and the level of Bax and Cleaved Caspase-3 protein increased ( F=54. 588, 42. 924, 51. 541, P<0. 05), the mitochondrial membrane potential decreased (F=40. 762, P<0. 05), and the ROS level in the cells increased( F=79. 055, P<0. 05) . Compared with cells treated with solanine or radiotherapy, the proliferation of osteosarcoma cells and the levels of Ki-67 and PCNA proteins were decreased after solanine combined with radiation treatment ( F=55. 165, 50. 667, 23. 389, P<0. 05) , the apoptotic rate and the levels of Bax and Cleaved Caspase-3 were increased ( F=54. 588, 42. 924, 51. 541, P<0. 05), the mitochondrial membrane potential was decreased (F=40. 762, P<0. 05), and the ROS level was increased (F=79. 055, P<0. 05). The radiosensitization ratio of solanine to osteosarcoma cells was 1. 786. Conclusions Solanine inhibits proliferation and induces apoptosis of osteosarcoma cells, and improves radiosensitivity of osteosarcoma cells.

OBJECTIVE: To explore the clinical effect of total hip arthroplasty (THA) in the treatment of old central dislocation of the hip joint. METHODS: Between January 2010 and June 2014, 21 patients (21 hips) with old central dislocation of the hip joint underwent THA and autologous bone graft for acetabulum reconstruction. There were 13 males and 8 females, aged 60-75 years (mean, 67.4 years). The left hip was involved in 12 cases and the right hip in 9 cases, with a disease course of 1-20 years (mean, 9.6 years). The causes were falling from height in 6 cases, traffic accident in 9 cases, crushing in 4 cases, and others in 2 cases. Hip pain, limited activity, and lameness were the main clinical symptoms. Preoperative Harris score was 32.95±2.06 and visual analogue scale (VAS) was 8.14±0.73. RESULTS: Primary healing of incision was obtained in all patients. The patients were followed up 1.9-6.4 years (mean, 4.6 years). The X-ray films showed bone graft fusion at 4-24 months (mean, 12.5 months); there were no complications of grafted bone absorption, osteolysis, and infection. During follow-up, no prosthetic loosening or sinking, and no translucent zones around the prosthesis were observed. Harris score was significantly improved to 87.67±2.01 at 1 week and 92.10±1.95 at 1 year; and VAS score was significantly decreased to 2.57±0.81 at 1 week and 0.19 ±0.51 at 1 year (P<0.05). CONCLUSIONS: THA is an effective surgical treatment for old central dislocation of the hip joint, because it can restore normal hip rotation center and reconstruct the hip joint function.

AIM: To explore the way and therapeutic effect of one stage total hip replacement (THR) in treating rheumatoid arthritis-induced ischemic necrosis of the femoral head combined with intertrochanteric fracture. METHODS: From July 1998 to September 2006, one stage THR was performed in 12 cases with ischemic necrosis of the femoral head combined with the fresh intertrochanteric fracture in Department of Orthopedics, Henan Provincial Traditional Chinese Medicine Hospital, including 8 males and 4 females aged 28-65 years with disease course of 5-20 years. The prosthesis of biology was provided by Pu Lusi (Switzerland). RESULTS: All cases were followed up for 2 to 9 years. The fracture ends well healed, showing good form and position of prosthesis postoperatively 4 month by X-ray reexamination. No acetabulum wear or prosthesis dislocation was found. They could walk without help and take care of themselves after 5 months. The results were excellent in 7 cases, good in 3, fair in 1, and bad in 1 according to Harris evaluation standard of THR. The average value of Harris evaluation was 90.8 two years postoperatively, and the excellent and good rate was 83.3%. CONCLUSION: One stage THR for rheumatoid arthritis-caused ischemic necrosis of the femoral head combined with intertrochanteric fracture is an ideal method to restore function of the hip joint.

[Objective]To describe a new way of arthroscopic posterior cruciate ligament reconstruction and evaluate the early stage of follow up results.[Method]Twenty four consecutive cases of isolated and combined posterior cruciate ligament deficiency were studied.Quadriceps tendon patellar bone was used for preparation of "Y" shaped autograft.Double-tunnel of femur were drilled and tibia was inlayed at their anatomical footprint.[Result]All cases were followed up for 24 months to 30months,averaging 24.5 months.Lysholm rating scales were used to make clinical subjective evaluations.Lysholm scores raised from 49.20?1.44 before operation to 87.91?1.52 after operation.Finial Lysholm evaluation showed 7 patients were excellent,16 good,and 1 poor.The good to excellent rate was 95.8%.Anteroposterior translation as clinical objective evaluations was measured with KT-1000.KT1000 arthrometer measurement showed that the average posterior translation improved from 12.85?1.10mm preoperatively to 3.98?1.99mm postoperatively.One patient was graded as failure.[Conclusion]Arthrosopy assisted prodedure of double bundle posterior cruciate ligament reconsruction using quadriceps tendon patellar bone autograft by double-tunnel of femur and inlaying of tibia is effective and reproducible.The short follow up clinical results are encouraging.