Objective To evaluate the clinical effects of the treatment of recurrent anterior dislocation of shoulder in soldiers with bipolar lesions by arthroscopic Bankart repair and Remplissage surgery.Methods From February 2019 to March 2022,15 patients with recurrent anterior dislocation of shoulder in our hospital were selected,all of whom were male;The age ranged from 18～33(23.07±4.39)years,Beighton score was(4.40±1.89).4 cases of left shoulder and 11 cases of right shoulder.Preoperative CT evaluation of Hill-Sachs injury was(16.93±2.17)%.The range of motion was recorded,and the function and stability of the shoulder was evaluated by the American Shoulder and Elbow Surgeons(ASES)score and Constant-Murley score.Results All patients were followed up for 10～28(18.47±6.46)months.No patient had clinical complications such as infections,neurovascular injuries and redislocation.Shoulder flexion and lifting increased from(152.41±14.28)° pre-operatively to(167.48±10.23)° at the latest follow-up,and internal rotation,preoperative spinous process levels were T5 1 cases,T6 2 cases,T7 6 cases,T8 3 cases,T9 2 cases,T10 1 cases,postoperative spinous process levels were T5 1 cases,T6 1 cases,T7 3 cases,T8 6 cases,T9 4 cases,the average lateral external rotation and abduction 90° external rotation decreased from(60.31±13.43)°and(97.41±13.17)° pre-operatively to(51.23±14.27)° and(89.47±14.15)° at the latest follow-up,respectively.The ASES score and Constant-Murley score were significantly improved.Conclusion The clinical effect of rehabilitation of Bankart repair combined with Remplissage under arthroscopy in the treatment of recurrent dislocation of shoulder in soldiers with Bipolar lesions is satisfactory.Although the external rotation angle of shoulder is slightly decreased after operation,it can significantly reduce the recurrence rate of shoulder dislocations and return to the training.

Objective To investigate therapeutic effects of β-TCP/PLGA scaffolds seeded bone marrow mesenchymal stem cells (BMSCs) combing with hyperbaric oxygen (HBO) on bone defect with seawater immersing in rabbit radius.Methods BMSCs were seeded into the β-TCP/PLGA scaffolds to construct tissue engineering bone.60 New Zealand rabbits were created 1.5 cm bone defect in bilateral radius,and then bilateral wound limbs were immersed in seawater for 3 h.After debridement,all rabbits were randomly divided into 4 groups.In group A nothing was implanted into the bone defect.Only BMSCs was implanted in group B.BMSCs + HBO was given in group C.β-TCP/PLGA BMSCs + HBO was given in group D.At postoperative 4,8,12 weeks rabbits were sacrificed after radiography radius.X-ray radiography,HE staining,immunohistochemical observation were used to evaluate repairing effect of bone defect with seawater immersing.Results Radiographic analysis demonstrated that the bone defects were completely repaired with recanalization of the medullary cavity in group D,bone defects were partially repaired with partal recanalization of the medullary cavity in group C,bone defects were incompletely repaired in group B;bone defect repair unfinished and the broken ends were sclerous in group A.Each time point group D＞group C＞group B＞group A in callus grey value (P＜0.05).HE staining indicated after 12 weeks,a small amount of lainellar bone formated in group A;a small amount of lamellar bone formated in group B;a large amount of lamellar bone formated in group C;a large amount of lamellar bone formated in group D.Immunohistoehemical result indicated at postoperative 4 weeks,the expressions of osteocalcin(OCN) in each group were at high levels,the expressions decreased significantly at Postoperative 8 weeks,the expressions were at a low level at postoperative 12 weeks.At postoperative 4 and 8 weeks,the expression levels of OCN were group D＞ group C＞ group B＞group A (P＜0.05),there was no significant difference at postoperative 12 weeks between the 4 groups (P＞0.05).Conelusion the β-TCP/PLGA composite BMSCs combined hyperbaric oxygen is the effective method to repair seawater immersed bone defect in rabbit.

Objective To investigate the effects of HBO on open tibial fracture coupled with seawater immersion in rabbits and the possible mechanism involved.Methods Forty-eight New Zealand rabbits were selected and randomly divided into the HBO group and the control group,each consisting of 24 animals.The animals of both groups were inflicted with unilateral open tibial fracture.The injured limbs were immersed in artificial seawater for 3 hours,and then had wound suture and internal fracture fixation after debridement.The animals in the HBO group was immediately treated with HBO,once a day for a succession of 2 weeks,whereas the animals in the Control group were left there untreated.At week 4,8 and 12 after injury,the animals were sacrificed and samples (8 limbs from each group) were collected for further study.The repair of the fractured tissues of both groups was compared by radiography,histology and immunohistochemistry.Results (1)Histopathology was performed by HE staining.At week 12 after injury,for the animals in the HBO group,osseous callus could universally be seen in the fracture zone,cell components were basically mature bone cells,and the infiltration of inflammatory cells could scarcely be seen,while for the animals in the Control group,mixed bone callus could mainly be noted in the fracture zone,but cartilage cells were still visible,and a small scale of inflammatory cell infiltration could also be observed.(2) Immunohistochemistry revealed that vascular endothelial growth factor (VEGF) was mainly expressed in the cytoplasm of osteoblast,chondrocytes and osteocyte,and significant changes could be seen at different time points.At week 4 after injury,the expression levels of the two groups were the highest.At week 8 and 12 after injury,the expression levels all gradually dropped to a relatively low level.At week 4 and 8 after injury,the expression level of the HBO group was obviously stronger than that of the Control group(P ＜0.01).However,at week 12 after injury,no significant differences could be noted in the expression levels between the 2 groups (P ＞ 0.05).(3) Radiographic imaging was performed for the detection of callus grayscale in the fracture zone.At week 12 after injury,the average value of callus grayscale in the fracture zone for the animals of the HBO group was (190.58 ± 7.52),while that of the Control group was (144 ± 8.11).Statistically significance was shown,when comparisons were made between the 2 groups (P ＜0.01).(4)At week 4 after injury,the content of malondialdehyde (MDA) in the soft tissue around the fracture zone in the animals of the HBO group was significantly lower than that of the Control group,and the activity of superoxide dismutase (SOD) in the animals of the HBO group was higher than that of the Control group.Statistical significance could be seen,when comparisons were made between the 2 groups (P ＜ 0.01).However,at week 8 and 12 after injury,there were no significant differences in the content of MDA and activity of SOD between the 2 groups (P ＞ 0.05).Conclusions In the treatment of open bone fracture coupled with seawater immersion,HBO could alleviate inflammatory reaction and reperfusion injury,enhance the proliferation of tissue cells,and was beneficial to the healing of bone fracture.For this reason,this regimen was a practical method for the repair of open bone fracture coupled with seawater immersion.

Objective To investigate the effects of HBO on open tibial fracture coupled with seawater immersion in rabbits and the possible mechanism involved.Methods Forty-eight New Zealand rabbits were selected and randomly divided into the HBO group and the control group,each consisting of 24 animals.The animals of both groups were inflicted with unilateral open tibial fracture.The injured limbs were immersed in artificial seawater for 3 hours,and then had wound suture and internal fracture fixation after debridement.The animals in the HBO group was immediately treated with HBO,once a day for a succession of 2 weeks,whereas the animals in the Control group were left there untreated.At week 4,8 and 12 after injury,the animals were sacrificed and samples (8 limbs from each group) were collected for further study.The repair of the fractured tissues of both groups was compared by radiography,histology and immunohistochemistry.Results (1)Histopathology was performed by HE staining.At week 12 after injury,for the animals in the HBO group,osseous callus could universally be seen in the fracture zone,cell components were basically mature bone cells,and the infiltration of inflammatory cells could scarcely be seen,while for the animals in the Control group,mixed bone callus could mainly be noted in the fracture zone,but cartilage cells were still visible,and a small scale of inflammatory cell infiltration could also be observed.(2) Immunohistochemistry revealed that vascular endothelial growth factor (VEGF) was mainly expressed in the cytoplasm of osteoblast,chondrocytes and osteocyte,and significant changes could be seen at different time points.At week 4 after injury,the expression levels of the two groups were the highest.At week 8 and 12 after injury,the expression levels all gradually dropped to a relatively low level.At week 4 and 8 after injury,the expression level of the HBO group was obviously stronger than that of the Control group(P ＜0.01).However,at week 12 after injury,no significant differences could be noted in the expression levels between the 2 groups (P ＞ 0.05).(3) Radiographic imaging was performed for the detection of callus grayscale in the fracture zone.At week 12 after injury,the average value of callus grayscale in the fracture zone for the animals of the HBO group was (190.58 ± 7.52),while that of the Control group was (144 ± 8.11).Statistically significance was shown,when comparisons were made between the 2 groups (P ＜0.01).(4)At week 4 after injury,the content of malondialdehyde (MDA) in the soft tissue around the fracture zone in the animals of the HBO group was significantly lower than that of the Control group,and the activity of superoxide dismutase (SOD) in the animals of the HBO group was higher than that of the Control group.Statistical significance could be seen,when comparisons were made between the 2 groups (P ＜ 0.01).However,at week 8 and 12 after injury,there were no significant differences in the content of MDA and activity of SOD between the 2 groups (P ＞ 0.05).Conclusions In the treatment of open bone fracture coupled with seawater immersion,HBO could alleviate inflammatory reaction and reperfusion injury,enhance the proliferation of tissue cells,and was beneficial to the healing of bone fracture.For this reason,this regimen was a practical method for the repair of open bone fracture coupled with seawater immersion.

Objective To explore the effects of HBO combined with percutaneous allogeneic bone marrow mesenchymal stem cells (BMSCs) grafting on the repair of rabbit radius open bone defect following seawater immersion.Methods Forty-eight New Zealand rabbits were randomly divided into 4 groups:the blank control group (group A),the(BMSCs) grafting group (group B),the HBO group (group C),and the HBO combined with BMSCs group (group D).A fifteen-millimeter bone defect was made in the mid-section of radius and then was immersed in the artificial seawater for 3 hours,then the wound was closed with debridement.The animals received HBO therapy the moment after completion of debridement.BMSCs grafting was administered 72 hours after debridement.The animals were sacrificed at week 4,8 and 12 to collect the samples (there were 4 rabbits from each batch of the group,and there were altogether 8 limbs).Repairs of the defect areas were compared between groups by means of radiographic scanning,histologic and immunohistochemical analyses.Results HE staining revealed that osteogenesis in the animals of group D at week 4 and 8 was the best,and group C was superior to group B.In the animals of group A,bone repair was not detected in the defect area,which was filled with scar tissue.At week 12 after injury,osteogenesis in the defect areas for the animals of group D was the best,which was mostly mature bone tissue.(2)Immunohistochemical detection indicated that VEGF and TGF-β1 were mostly expressed in the osteoblastic cells,cartilage cells and bone cell cytoplasm,and significant changes could be noted at different time points.At week 4 after injury,the expressions of VEGF and TGF-β1 all reached peak levels.At week 8,their expressions all decreased significantly,as compared with those at week 4 and 12,their expressions all decreased further to a low level.At week 4 and 8 after injury,the expression levels of VEGF and TGF-β1 for the 4 groups were in the following order:group D ＞ group C ＞ group B ＞ group A.Statistical significance could be seen,when comparisons were made between the groups (P ＜0.05).However,at week 12,no significant differences could detected when comparisons were made between the 4 groups (P ＞ 0.05).(3) Osteotylus measurement revealed that osteotylus grayness for the animals of group D,group C,group B and group A at week 12 after injury was 211.84 ± 4.31,200.31 ± 3.08,152.79 ± 4.43 and 80.88 ± 3.31 respectively,and statistical significance could be noted,when comparisons were made between the groups (P ＜ 0.05).Conclusions The effects of simple percutaneous allogeneic bone marrow mesenchymal stem cells grafting or simple HBO therapy on the repair of open bone defect following seawater immersion were not ideal.However,combined applications of these 2 treatment methods could produce synergistic effects,which could promote osteogenetic process of the affected bone and was an applicable method for the repair of open bone defect following seawater immersion.

Objective To explore the effects of HBO combined with percutaneous allogeneic bone marrow mesenchymal stem cells (BMSCs) grafting on the repair of rabbit radius open bone defect following seawater immersion.Methods Forty-eight New Zealand rabbits were randomly divided into 4 groups:the blank control group (group A),the(BMSCs) grafting group (group B),the HBO group (group C),and the HBO combined with BMSCs group (group D).A fifteen-millimeter bone defect was made in the mid-section of radius and then was immersed in the artificial seawater for 3 hours,then the wound was closed with debridement.The animals received HBO therapy the moment after completion of debridement.BMSCs grafting was administered 72 hours after debridement.The animals were sacrificed at week 4,8 and 12 to collect the samples (there were 4 rabbits from each batch of the group,and there were altogether 8 limbs).Repairs of the defect areas were compared between groups by means of radiographic scanning,histologic and immunohistochemical analyses.Results HE staining revealed that osteogenesis in the animals of group D at week 4 and 8 was the best,and group C was superior to group B.In the animals of group A,bone repair was not detected in the defect area,which was filled with scar tissue.At week 12 after injury,osteogenesis in the defect areas for the animals of group D was the best,which was mostly mature bone tissue.(2)Immunohistochemical detection indicated that VEGF and TGF-β1 were mostly expressed in the osteoblastic cells,cartilage cells and bone cell cytoplasm,and significant changes could be noted at different time points.At week 4 after injury,the expressions of VEGF and TGF-β1 all reached peak levels.At week 8,their expressions all decreased significantly,as compared with those at week 4 and 12,their expressions all decreased further to a low level.At week 4 and 8 after injury,the expression levels of VEGF and TGF-β1 for the 4 groups were in the following order:group D ＞ group C ＞ group B ＞ group A.Statistical significance could be seen,when comparisons were made between the groups (P ＜0.05).However,at week 12,no significant differences could detected when comparisons were made between the 4 groups (P ＞ 0.05).(3) Osteotylus measurement revealed that osteotylus grayness for the animals of group D,group C,group B and group A at week 12 after injury was 211.84 ± 4.31,200.31 ± 3.08,152.79 ± 4.43 and 80.88 ± 3.31 respectively,and statistical significance could be noted,when comparisons were made between the groups (P ＜ 0.05).Conclusions The effects of simple percutaneous allogeneic bone marrow mesenchymal stem cells grafting or simple HBO therapy on the repair of open bone defect following seawater immersion were not ideal.However,combined applications of these 2 treatment methods could produce synergistic effects,which could promote osteogenetic process of the affected bone and was an applicable method for the repair of open bone defect following seawater immersion.