Objective:To assess the clinical outcomes of hip arthroscopy in patients with concurrent femoroacetabular impingement (FAI) and subspine impingement (SSI).Methods:Data were retrospectively reviewed for patients with both FAI and SSI who underwent hip arthroscopy surgery from August 2021 to May 2022. A total of 23 patients (23 hips) followed up for more than 1 year, including 10 males and 13 females, 9 left hips and 14 right hips, with an average age of 31.3±4.6 years (range, 25-45 years). Subspine decompression by anterior inferior spine (AIIS) shaping for SSI was performed during hip arthroscopy in addition to labral repair and bony correction for FAI in the patients with concurrent FAI and SSI. Clinical outcomes were evaluated using preoperative and 1-year postoperative measures: lateral center-edge (LCE) angle, α angle on 45° Dunn view X-rays, maximum hip flexion angle, hip flexion and knee extension strength, visual analogue scale (VAS) for pain, modified Harris Hip Scores (mHHS), and International Hip Outcome Tool-12 (iHOT-12).Results:Of the 23 patients, 20 had type 2 AIIS and 3 had type 3 AIIS. At 1-year follow-up after surgery, there were significant improvements: LCE angle decreased (33.3°±6.1° to 31.7°±4.1°, t=1.076, P=0.288), α angle reduced (63.7°±8.5° to 50.0°±6.6°, t=6.116, P<0.001), hip flexion angle increased (107.4°±6.0° to 120.2°±4.4°, t=8.269, P<0.001), VAS scores decreased (4.0±1.1 to 1.0±1.1, t=9.591, P<0.001), mHHS improved (62.6±4.9 to 87.5±8.1, t=12.700, P<0.001), and iHOT-12 scores rose (51.4±4.9 to 75.7±7.7, t=12.593, P<0.001). There was no significant difference in the strength of hip flexion and knee extension between preoperative and follow-up ( t=0.930, P=0.357 and t=0.050, P=0.960, respectively). There were no reports of traction-related complications (such as skin necrosis and nerve paralysis), severe adverse events (such as femoral neck fractures, deep vein thrombosis in the lower limbs, intra-articular infections, ectopic ossification and hip instability), or the need for revision surgery. Conclusion:Subspine decompression by anterior inferior spine (AIIS) shaping for SSI during conventional hip arthroscopy is safe and effective, enhancing hip function and alleviating pain at 1-year follow-up without significant complications.

Objective:To analyze the clinical efficacy of arthroscopic transverse release of the iliotibial band through peritrochanteric space for the treatment of external snapping hip.Methods:A total of 30 patients (12 males and 18 females) with bilateral external snapping hip underwent arthroscopic transverse release of the iliotibial band through peritrochanteric space in Department of Sports Medicine, Senior Department of Orthopaedics, the Fourth Medical Center, Chinese PLA General Hospital were retrospectively analyzed from May 2021 and June 2022. The average age was 32.5±8.2 years (range, 17-51 years). At the same time, 30 patients who underwent arthroscopic external release of the iliotibial band through the external surface of the iliotibial band (external iliotibial band group) were selected as control group, including 13 males and 17 females, aged 29.5±6.8 years (range, 11-45 years). The visual analogue scale (VAS), modified Harris hip score (mHHS), and gluteal muscle contracture disability scale (GDS) were compared between the two groups at preoperative, 6 months postoperative, and final follow-up.Results:All patients successfully completed the operation and were followed up for 17.5±3.3 months (range, 12-25 months). The VAS scores of the two groups at the last follow-up were lower than those before operation ( P<0.05). The mHHS scores before operation, 6 months after operation and at the last follow-up in the peritrochanteric space group were 76.5 (67.0, 85.5), 98.5 (94.8, 100.0) and 100.0 (97.0, 100.0), respectively, and those in the external iliotibial band group were 80.5 (70.0, 86.0), 100.0 (96.0, 100.0) and 100.0 (99.5, 100.0). The differences in mHHS scores between the two groups were statistically significant for intragroup comparisons ( P<0.05); of these, 6 months postoperatively and at the last follow-up were greater than preoperatively, with statistically significant differences ( P<0.05); the differences at 6 months postoperatively and at the last follow-up were not statistically significant ( P>0.05). There was no significant difference in mHHS scores between groups at different time points ( P>0.05). The GDS before operation, at 6 months after operation and at the last follow-up were 47.0 (35.8, 64.5), 90.0 (81.0, 94.0) and 93.5 (89.8, 98.0) in the peritrochanteric space group, and 51.0 (38.0, 64.5), 50.0 (81.0, 94.0) and 93.5 (89.8, 98.0) in the external iliotibial band group, respectively. The differences in GDS between the two groups were statistically significant for intragroup comparisons ( P< 0.05); of these, 6 months postoperatively and at the last follow-up were greater than preoperatively, with statistically significant differences ( P<0.05); the differences at 6 months postoperatively and at the last follow-up were not statistically significant ( P>0.05). There was no significant difference in GDS between groups at different time points ( P>0.05). Conclusion:Arthroscopic transverse release of the iliotibial band through peritrochanteric space for the treatment of external snapping hip can effectively reduce hip pain and improve hip function, with satisfactory clinical results, and can be used as an alternative treatment to transverse release through the external surface of the iliotibial band.

Objective:To analyze the clinic effects of arthroscopic partial trapeziectomy and suture button suspensionplasty in the treatment of first carpometacarpal joint (CMCJ) Eaton stage II/III arthrosis.Methods:A retrospective study was conducted on a total of 15 cases (16 hands) of patients including 5 males (1 bilateral) and 10 females with CMCJ stage II/III arthrosis who underwent surgical treatment at the first affiliated hospital of Shenzhen university from January 2020 to June 2022, with mean age of 56.7±6.4 years (range, 46-75 years). The duration from pain to treatment was 7.8±3.2 months (range, 4-14 months). X-ray showed narrowing of CMCJ with osteophytes and distal radial subluxation. All the patients were treated with arthroscopic partial trapeziectomy and suture button suspensionplasty. The preoperative and last postoperative follow-up radiographs, visual analogue scale (VAS), thumb's Kapandji scores, disabilies of the arm, shoulder, and hand (DASH) scores, grip and pinch strength and time to return to work were compared.Results:All cases were followed up for 19.6±6.3 months (range, 11-36 months). The postoperative X-ray showed all the CMCJs were reduced with a normal height of first metacarpal. The mean time for patients to return to their daily activities was 18.69±3.70 d and the mean time to return to work was 24.63±4.91 d. The average VAS score decreased from 6.56±1.15 preoperatively to 1.00 (0.75, 1.25). The preoperative Kapandji's score was 8.00±0.82 and the postoperative Kapandji's score was 8.00 (7.25, 9.00). The average DASH values improved from 24.06±3.19 to 4.00 (3.00, 5.00). The were significant differences except for Kapandji score ( Z=-4.905, P<0.001; Z=-0.121, P=0.905; Z=-4.846, P<0.001). The mean grip and pinch strength showed improvement from an average of 16.4 (14.13, 18.68) kg and 1.70±0.35 kg to 26.14±3.27 kg and 3.58±0.91 kg with significant difference ( Z=-4.617, P<0.001; t=-7.669, P<0.001). Conclusion:Arthroscopic partial trapeziectomy and suture button suspensionplasty is a minimally invasive surgery for the treatment of first CMCJ Eaton stage II/III arthrosis. By this technique, the patients' existing instability and pain problems can be solved.

Objective:This study aimed to explore the status of radiological Kashin-Beck disease (KBD) among school-aged children in Chamdo City, Tibet, through a 3-year monitoring survey, providing epidemiological evidence for prevention and control strategies.Methods:The target areas for this study were Luolong, Bianba, and Basu counties in Chamdo City, Tibet Autonomous Region, identified as having the most severe historical cases of KBD. Children aged 7-12 years attending school were enrolled as study subjects. Anteroposterior X-ray films of the right-hand were taken, and radiological diagnoses were made based on the "Diagnosis of Kashin-Beck Disease" criteria (WS/T 207-2010). Two experienced researchers independently reviewed the X-rays, and intra- and inter-group consistency were assessed using weighted Kappa values and percentage agreement. Cross-sectional surveys were conducted in 2017 and 2020 to describe the X-ray detection rates of KBD, and logistic regression analysis was employed to construct a predictive model of risk factors for radiological KBD cases.Results:In 2017, a total of 5,711 children aged 7-12 years in Chamdo City, Tibet, participated in the baseline cross-sectional survey (average age 9.2 years, 48.0% female), with 28 cases of radiological KBD. The age- and gender-standardized prevalence rate was 0.527%. In 2020, 6,771 participants (average age 9.3 years, 49.5% female) underwent a second cross-sectional survey, with 9 cases of radiological KBD and a standardized prevalence rate of 0.134%. Logistic regression analysis indicated that older age [ OR=2.439, 95% CI(1.299, 4.580), P=0.006] and female gender [ OR=8.157, 95% CI(1.016, 65.528), P=0.048] were independent risk factors for radiological KBD cases. Conversely, higher residential altitude, under the premise of Tibet's high altitude, was a protective factor [ OR=0.995, 95% CI(0.990, 0.999), P=0.032). Conclusion:The radiographically positive detection rate of KBD among school-aged children in Chamdo City, Tibet Autonomous Region, is at an extremely low level and showing a declining trend, reaching the historical standard in 2020. Considering the absence of positive signs in affected children, it suggests that local KBD has been effectively eliminated.

This study reports a case of pachydermoperiostosis combined with posterior cruciate ligament femoral insertion avulsion fracture. The avulsion fracture was treated by arthroscopic surgery of suspension fixation. The symptom of the pachydermoperiostosis was relieved by non-steroidal anti-inflammatory drugs. Literature search and review were carried out by searching the key words of ("pachydermoperiostosis" OR "primary hypertrophic osteoarthropathy" OR "Touraine-solente-gole syndrome") OR ("posterior cruciate ligament" AND "avulsion fracture"). This patient was confirmed to be the first case reported suffering both diseases mentioned above. For the search results, there were 14 articles on posterior cruciate ligament femoral insertion avulsion fracture and 7 articles on pachydermoperiostosis. This study focused on the impact of pachydermoperiostosis on bone quality, possible factors for the avulsion fracture, and the advantages of arthroscopic surgery. Pachydermoperiostosis is a rare autosomal recessive disease. The incidence of posterior cruciate ligament femoral insertion avulsion fracture is extremely low. It is a seriously sports injury affecting the stability of the knee joint. Standardized surgical treatment can help patients obtain a satisfactory clinical outcome.

A rare instance of an aneurysmal bone cyst (ABC) in the wrist hamate of a 30-year-old male were reported in this case report. The patient exhibited a 1.5 cm mass on the dorsal ulnar side of the right wrist, which was non-tender, with normal overlying skin temperature and preserved wrist flexion. Radiographic evaluation revealed a deformed hamate with extensive cystic degeneration and minimal subchondral bone. Computed tomography (CT) scans highlighted clear osteolytic changes, including a visible bony crest. Magnetic resonance imaging (MRI) depicted mixed signal intensity on T1 and T2 weighted images. A biopsy indicated thinning and softening of the hamate's dorsal cortex, revealing eroded bone and dark red soft tissue. Histopathological analysis confirmed the diagnosis of an aneurysmal bone cyst. The patient underwent resection of the right wrist hamate, bone grafting from the iliac crest, and stabilization with Kirschner wire, resulting in fusion of the capitate-hamate and fourth and fifth carpometacarpal joints. The postoperative course involved immobilization with plaster for six weeks, and a 15-month follow-up indicated no recurrence. A review of the literature revealed that ABCs involving carpal bones are rare, predominantly occurring in individuals under 30 years of age. Clinical manifestations typically include wrist pain, occasional mild swelling, limited wrist mobility, and reduced hand strength. Radiological findings are characterized by osteolytic changes with MRI showing low T1WI and high T2WI signal intensity, and liquid levels on axial images. Treatment predominantly involves osteotomy or curettage with bone grafting. Diagnostic hallmarks include osteoclast-like multinucleated giant cells, ossified areas, and cystic cavities partitioned by fibrous septa. Our findings, consistent with the literature, suggest a favorable prognosis for carpal bone ABCs when treated appropriately.

Occipitocervical fusion (OCF) is used to treat the instability of the cranio-cervical junction due to various reasons (such as trauma, rheumatoid arthritis, infection, tumor, congenital malformations and degeneration). A satisfactory fusion rate can be obtained and the stability of the occipital neck can be reconstructed by OCF. Dysphagia is one of the most common complications after OCF, which seriously affects the quality of life of patients after surgery. This article mainly focuses on the evaluation and prediction methods of dysphagia after OCF, and summarizes related research in the past 16 years, and provides guidance and direction for how to predict the occurrence of dysphagia during OCF and the evaluation of postoperative dysphagia. The evaluation of dysphagia is mainly conducted using the Bazaz dysphagia score, swallowing quality of life scale (SWAL-QOL) and eating assessment tool-10 (EAT-10) score. However, the clinical prediction of dysphagia is mainly based on the changes of cervical curvature parameters (O-C 2 angle, O-EA angle, Oc-Ax angle, PI angle). At present, there are many methods for clinical evaluation and prediction of dysphagia, but the best evaluation method is still uncertain. We reviews the evaluation and prediction methods of postoperative dysphagia of OCF, showing that the Bazaz dysphagia score, SWAL-QOL score and EAT-10 score scale are suitable for evaluating postoperative dysphagia of OCF. During OCF operation, adjustment of O-C 2 Angle >-5°, O-EA Angle >100°, Oc-Ax Angle >65°, and increase of postoperative PI Angle from preoperative PI Angle (that is, dPI Angle) ≥0° can reduce the probability of dysphagia to a certain extent.

Magnesium and its alloys have been widely studied in the field of orthopaedics for their desirable mechanical properties, biodegradability and biocompatibility. However, the rapid degradation rate of magnesium and its alloys cannot match the healing process of bone itself, and may adversely affect the adhesion, growth and differentiation of surrounding cells, resulting in early loosening of implants, thus limiting their wide clinical application. Surface coating modification is a feasible and promising anti-corrosion solution to solve the problem of uncontrollable corrosion rate of magnesium implants. The surface coating modification technology can optimize the integration of the bone-implant interface by improving the bone induction ability of the implant surface (such as the bio-mimetic coating based on phosphate ceramics) or improving the corrosion resistance (such as the micro-arc oxidation coating with wear resistance and corrosion resistance, and the phytic acid coating with self-healing potential). While optimizing the degradation rate of magnesium implant, it can also realize multiple functions such as promoting osseointegration, drug delivery and photothermal therapy through composite component modification. In this paper, the advantages and disadvantages of different coating modification method on the surface of orthopaedic magnesium implants are comprehensively illustrated, and the key technologies in each preparation process are summarized and the composite modification methods are further discussed, so as to provide references for the preparation of multifunctional magnesium implants that meet the requirements of orthopaedic applications.

Objective:To explore the feasibility and effect of applying spherical fitting technology in CT three-dimensional reconstruction in preoperative planning of the resection range of Cam-type femoral acetabular impingement (FAI).Methods:46 Cam-type FAI patients who underwent arthroscopic femoroplasty in the Department of Sports Medicine in the Third Affiliated Hospital of Southern Medical University from July 2020 to June 2022 were enrolled in the spherical fitting group, including 26 females and 20 males, with an average age of 38.4±15.2 years (range of 24-53 years). The preoperative planning was performed using spherical fitting technology in CT three-dimensional reconstruction. Another 42 Cam-type FAI patients who underwent arthroscopic femoroplasty from July 2018 to June 2020 were enrolled in the observation group, including 25 females and 17 males, with an average age of 43.6±18.4 years (range 24-61 years). The preoperative planning was performed using CT three-dimensional reconstruction observation method. This study evaluated the impact of femoroplasty planned by spherical fitting technique on patients' prognosis though comparing the differences of postoperative α angle, femoral head-neck offset ratio, modified Harris hip score (mHHS), and visual analog score (VAS) at 3, 6, 9, and 12 months between two groups.Results:The average follow-up time was 11.8±0.6 months in spherical fitting group and 11.3±0.8 months in observation group. There was no significant difference regarding α angle, femoral head-neck offset ratio, mHHS, and VAS between two groups preoperatively ( P>0.05). The mHHS in two groups increased gradually, while VAS decreased sequentially at 3, 6, 9, and 12 months postoperatively. The postoperative mHHS and VAS were significantly better than those before surgery ( P<0.05). The mHHS was 83.2±14.8 vs. 70.5±11.2 in spherical fitting group and observation group at the followup of 9 months with significant difference ( t=4.471, P=0.007). It was 85.7±13.3 vs. 73.2±12.5 at the followup of 12 months with significant difference ( t=4.596, P=0.008). No significant difference was found in α angle, femoral head-neck offset ratio or mHHS at 3 and 6 months postoperatively ( P>0.05), and no significant difference was found in VAS at 3, 6, 9, and 12 months postoperatively between two groups. Conclusion:The spherical fitting technology in CT three-dimensional reconstruction could assist surgeons with planning of the resection range of Cam deformity preoperatively, and achieve a smooth progress of arthroscopic femoroplasty intraoperatively; after short term follow-up, we found that patients who underwent femoroplasty using this technology achieved satisfactory outcomes.

Objective:To investigate the clinical efficacy of arthroscopic surgery for the treatment of femoral acetabular impingement (FAI) in athletes.Methods:A total of 18 FAI athletes (athlete group) who underwent hip arthroscopy in the Department of Sports Medicine, Peking University Third Hospital from April 2014 to June 2021 were retrospectively analyzed, including 12 males and 6 females, aged 20.44±3.45 years (range, 15-27 years). According to gender, age, body mass index and follow-up time, 36 non-athlete FAI patients (non-athlete group) were matched at a ratio of 1∶2 by propensity score matching method. There were 18 males and 18 females, aged 20.81±4.68 years (range 14-31 years). The hip pain visual analogue scale (VAS), modified Harris hip score (mHHS), hip outcome score-activity of daily living scale (HOS-ADL) and hip outcome score-sports scale (HOS-SS) scores were compared between the two groups before and after surgery. The minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) were also compared between the two groups.Results:All patients successfully completed the surgery and were followed up for 33.56±19.20 months (range, 24-77 months). The VAS score at the last follow-up decreased from 6.22±1.52 points before surgery to 1.28±1.67 points in the athletes group, and decreased from 6.28±1.37 points before surgery to 1.67±1.69 points in the non-athletes group. There was no significant difference between the two groups ( P>0.05). The mHHS score at the last follow-up increased from 65.53±12.90 points before surgery to 92.28±13.59 points in the athletes group, and increased from 61.01±11.96 points before surgery to 86.82±11.98 points in the non-athletes group. There was no significant difference between the two groups ( P>0.05). The HOS-ADL score at the last follow-up increased from 72.77±18.86 points before surgery to 94.00±11.36 points in the athletes group, and increased from 70.35±13.12 points before surgery to 90.78±9.36 points in non-athletes group. There was no significant difference between the two groups ( P>0.05). The HOS-SS score at the last follow-up increased from 49.77±22.93 points before surgery to 87.28±17.62 points in the athletes group, and increased from 44.08±19.66 before surgery to 72.57±20.16 in the non-athletes group. The HOS-SS scores in the athletes group at the last follow-up were higher than those in the non-athletes group ( P<0.05). Furthermore, 61% (11/18) in the athletes group achieved MCID in HOS-ADL after surgery, which was lower than the non-athletes group's 81% (31/36), with a statistically significant difference (χ 2=4.339, P=0.037). Conclusion:Hip arthroscopy in the treatment of FAI in athletes can achieve satisfactory pain relief and motor function.