Objective To investigate the effect of daily soft brace wearing on plantar dynamics during walking in patients with chronic ankle instability(CAI). Methods A total of 52 patients with unilateral chronic ankle instability(CAI)in Beijing Rehabilitation Hospital from February,2021 to January,2023 were randomly divided into control group(n=26)and experimental group(n=26).Both groups underwent an eight-week exercise training program.The control group wore placebo brace dur-ing daily activities,while the experimental group wore soft ankle brace.Plantar dynamic parameters were mea-sured using a pressure plate system during walking,including peak plantar pressure and plantar impulse before and after intervention. Results Six participants dropped out in the control group and five in the experimental group,resulting in a final inclu-sion of 41 participants.After intervention,there was no significant difference in peak plantar pressure and im-pulse on the affected side in the control group among different areas(P＞0.05).In the experimental group,the peak pressure and impulse in the heel medial,heel lateral and forefoot medial areas increased(|t|＞4.192,P＜0.001),while the peak pressure and impulse in the midfoot and lateral forefoot areas decreased(t＞2.984,P＜0.05);the peak pressure and impulse in the heel medial,heel lateral and forefoot medial areas were higher in the experimental group than in the control group(|t|＞2.126,P＜0.05),and the peak pressure and impulse were low-er in the midfoot and forefoot lateral areas(t＞2.133,P＜0.05). Conclusion Wearing a soft brace during daily activities may optimize the distribution of peak plantar pressure and plan-tar impulse on the affected side in patients with CAI,which may prevent recurrence of sprains.

Objective:To document any effect of combining kinesiotaping (KT) with Monitored Rehab Systems biofeedback training (MRS training) on the recovery of knee function after anterior cruciate ligament reconstruction (ACLR).Methods:Twenty-two patients after ACLR were randomly divided into an MRS group and a combined group, each of 11. In addition to conventional rehabilitation training, the MRS group had placebo taping in place during their MRS training, while the combined group had KT applied. Each training session lasted 45 minutes, with three sessions per week. Before the experiment and after 8 weeks of treatment, the affected foot support phase, impulse of each area of the affected foot′s sole, and lower limb reaction time were measured.Results:Significant improvement in the affected foot′s support phase and lower limb reaction time was documented in both groups, as well as in the average impulse percentage of the affected foot′s plantar forefoot area (F area), mid-foot area (MF area), and heel area (H area). All were significantly better in the combined group than in the MRS group, on average.Conclusion:Supplementing MRS biofeedback training with kinesiotaping can more effectively improve the knee joint functioning and postural control of patients after ACLR surgery. The combination is worthy of clinical promotion and application.

Objective:To characterize the severe sports injuries related to alpine skiing during the 2022 Beijing Winter Olympics and Paralympics so as to provide information for the prevention and treatment of sports injuries in the Yanqing National Alpine Skiing Center tracks.Methods:The medical data were collected of all the alpine skiing athletes and related staff who had sought medical treatment in Peking University Third Hospital Yanqing Hospital during January 20, 2022 to March 26, 2022. Descriptive statistical analyses were conducted for body part, type, occurrence place, and severity of the injuries.Results:There were 49 patients who had suffered severe injuries related to alpine skiing events during this Olympic Games, with 68 injuries by body parts and 72 injuries by types. The most common injury part was the knee (25.0%, 17/68), followed by the head (14.7%, 10/68), and the shoulder (8.8%, 6/68). The most common types of injury were contusion (including hematoma and abrasion, 30.6%, 22/72), followed by sprain (including dislocation, subluxation, and ligament injury, 22.2%, 16/72), and fracture (20.8%, 15/72). The most common occurrence place in the tracks for athletes was the "Haituo Bowl" area (41.7%, 10/24). In terms of severity, the injuries led to an absence from training or competition in 48 athletes [98.0% (48/49)], of whom 33 were severely injured [67.3% (33/49)].Conclusions:The most vulnerable part for severe sports injuries in the alpine skiing events of the 2022 Beijing Winter Olympics and Paralympics was the knee, mostly with ligament injuries, which is consistent with the findings of previous events. The high proportion of severe injuries indicated the difficulty of this track. The place where injuries mostly occurred was the "Haituo Bowl" area of the racing track, also the most challenging part of this track, indicating a necessity of more medical resources in this area.

Objective: To compare the clinical effects of endoscopic laminectomy with traditional hemilaminectomy for lumbar spinal stenosis. Methods: From January 2016 to April 2017, 61 patients with lumbar spinal stenosis were treated surgi-cally. Percutaneous endoscopic laminectomy was performed in 32 patients (minimally invasive group), including 13 males and 19 females, aged 38-76 years, with an average age of 58.47±7.51 years. Twenty-nine patients (open group) underwent hemilaminecto-my, including 11 males and 18 females, aged 38-75 years, with an average age of 57.17±9.99 years. The operation time, bleeding, incision length, bedridden time and hospitalization time were recorded. Visual analogue scale(VAS), Oswestry disability index (ODI), dural sac cross-sectional area (DSCA), ventral intervertebral space height (VH), dorsal intervertebral space height (DH) and lumbar mobility (range of motion, ROM) were compared between the two groups. Results: All of 61 patients were followed up for 14 to 27 months, with an average of 19.2±2.95 months. The operation time was 60.88±6.49 min in the minimally invasive group, and 52.07±9.45 min in the open group (t=4.277, P=0.000). The blood loss of minimally invasive group was 55.63±10.14 ml, and that of open group was 78.79±12.58 ml (t=7.952, P=0.000). The incision length of minimally invasive group was 23.31±4.56 mm, and open group 82.59±7.66 mm (t=12.047, P=0.000). Bed rest time was 21.97±6.42 h in minimally invasive group and 78.79±12.58 h in open group (t=12.047, P=0.000). The hospitalization time of the minimally invasive group was 8.53±2.75 d and the open group 11.34±3.12 d (t=3.745, P=0.000). All these parameters had statistical significance (P<0.05). At the last follow-up, the VAS score of minimally invasive group was 1.06±0.56, and the open group was 1.14±0.74 (t=0.469, P=0.634). ROM of open group was 5.66±1.12 degree, and ROM of minimally invasive group was 5.56±1.13 degree (t=0.140, P=0.710), VH of minimally invasive group was 14.75±2.81 mm, and open group was 14.44±2.89 mm (t=0.181, P=0.672). There was no significant difference between the two groups for these parameters. At the last follow-up, ODI score was 13.25%±1.08% in the minimally invasive group and 14.28%±2.10% in open group (t=5.911, P=0.018). DSCA score was 108.56±8.69 mm² in the minimally invasive group, and 117.28±11.09 mm² in open group (t=11.774, P=0.001). There were significant differences between the two groups for ODI and DS-CA. Conclusion Both endoscopic and open laminectomy have excellent clinical effects on lumbar spinal stenosis. Endoscop-ic laminectomy has the advantages of less local trauma, less damage to the stability of the lumbar spine and faster recovery. However, there's a higher technical requirement for endoscopic spine surgery.

Objective To evaluate the outcome of arthroscopic fixation with suture-bridge technique for greater tuberosity fractures.Methods Between September 2014 to April 2016,data of 20 cases with greater tuberosity fractures who were treated with arthroscopic suture-bridge technique were retrospectively analyzed.There were 12 males and 8 females,with an average age of 51.2 years old (range,28-76 years).The average period from injury to surgery was 6 days (range,2-18 days).The postoperative X-ray of shoulder was collected.The active mobilization and strength rehabilitation were gradually introduced depended on patients' status.The preoperative and postoperative shoulder function were evaluated by Constant-Murley score,American Shoulder & Elbow Surgeons (ASES) score,visual analogue scale (VAS) pain score and UCLA score.Results All 20 patients were followed up for 15 months (range,12-30 months).There was no postoperative complication,including re-fracture,re-displacement,implant failure and wound infection.Shoulder joint activity at the last follow-up:lift on the proneness of motion 168°±7.54° (range,150°-180°),outer spin 65.5°±6.71° (range,50°-70°),and internal rotation averaged T6 (range,T4-T10).At the last follow-up,the mean Constant-Murley score was 93.50±3.24,mean ASES score 90.80±4.72,mean VAS pain score 0.30±0.57 and mean UCLA score was 32.40±1.90.At the last follow-up,the anterior flexion in the side of the shoulder joint,the external rotation and internal rota tion were compared with the healthy side,and no statistical difference was found,and the function of the shoulder joint was satisfactory.There were two cases of Bankart injury,and the Bankart restoration was fixed by the arthroscope.Conclusion The arthroscopic suture-bridge technique can achieve less trauma,more reliable fixation for fractures of greater tuberosity of humerus.The arthroscopic suture-bridge technique can effectively spread the shear force and torsion force,increase the fixed area,and promote fracture healing.The arthroscopic fixation with suture-bridge technique is an effective treatment for fractures of greater tuberosity of humerus.

Objective To investigate the clinical and MRI outcomes of the arthroscopic rotator cuff repair for massive ro tator cuff tear at minimum 2 years after surgery.Methods From October,2010 to March,2013,data of 79 shoulders in 77 patients with massive rotator cuff tear who were treated with arthroscopic rotator cuff repair were retrospectively analyzed.There were 42 male (44 shoulders) and 35 female (35 shoulders).The average age before surgery was 57.4 years (43.1-80.4 years).There were 64 right shoulders and 15 left shoulders.The dominate side were involved in 70 cases.A trauma history was documented in 52 shoulders.The symptoms persisted less than 3 months in 42 shoulders,between 3 and 6 months in 11 shoulders,between 6 and 12 months in 11 shoulders and more than 1 year in 15 shoulders.No revision case was included.The clinical results (range of motion,forward elevation strength,external rotation strength and American Shoulder & Elbow Surgeons (ASES) score and MRI results were collected.Results All 77 cases were followed up more than 2 years.The forward elevation (156.9°±20.0° to 103.2°± 54.5°),external rotation (40.6°±15.5° to 32.0°±21.4°),internal rotation (L1 to ~),forward elevation strength (9.7±4.7 lb to 4.6±4.9 lb),external rotation strength (11.1±5.1 lb to 8.3±5.4 lb) and ASES score (82.7±14.6 to 45.2± 17.4) were all improved significantly at the latest follow-up.During the surgery,complete repair were achieved in 68 shoulders.The forward elevation (146.4°±31.4° to 110.0°±56.7°),external rotation (45.0°± 14.8° to 34.1°±20.8°) and ASES score (78.6± 14.9 to 54.5± 13.9) were all improved signifi cantly at the latest follow-up in patients with partial repair during the surgery.But the forward elevation strength (10.5±4.9 lb to 6.2±3.2 lb) and external rotation strength (11.5±5.1 lb to 8.3±3.8 lb) were significantly better improved in patients who had complete repair.In 68 shoulders with complete repair during the surgery,20 shoulders were found to have rotator cuff re-tear.The retear rate was 29.4％.But none of the patient with postoperative re-tear received revision surgery.The forward elevation (152.0± 23.3 to 103.5±60.5),forward elevation strength (8.5±4.7 lb to 5.0±4.7 lb) and ASES score (76.9±16.5 to 40.8±18.6) were all improved significantly at the latest follow-up in patients with postoperative re-tear of the rotator cuff tendon.But the forward elevation (161.4°± 13.4° to 152.0°±23.3°),forward elevation strength (11.3±4.7 lb to 8.5±4.7 lb),external rotation strength (12.4±4.8 lb to 9.6±5.3 lb) and ASES score (86.0±13.0 to 76.9±16.5) were significantly better in patients with complete healed rotator cuff tendon comparing with the re-tear group.Conclusion The rotator cuff repair can significantly improve the shoulder function of massive rotator cuff tear even when the rotator cuff tendon can only be partially repaired or re-tear after the surgery.The shoulder function is significantly better in patients with complete healed rotator cuff tendon comparing with the partial repair group and the re-tear group.

BACKGROUND:During artificial knee replacement for al kinds of severe knee disease or conservative treatment for end-stage knee disease, Deluxe-PS knee prosthesis and PFC Sigma RP knee prosthesis have their advantages.
OBJECTIVE: To compare and analyze the matching of the Deluxe-PS and PFC Sigma RP knee prostheses with bone cross section.
METHODS:According to the use of the knee prosthesis, 87 gonarthritis patients undergoing bilateral knee replacement were divided into two groups. 46 cases in the test group received Deluxe-PS knee prosthesis replacement. 41 cases in the control group received PFC Sigma RP knee prosthesis replacement. Operation time and intraoperative blood loss were compared between the two groups. American Knee Society score, knee score of American Special Surgical Hospital and knee joint range of motion were used to evaluate knee joint function before replacement, 3 months after replacement and during final folow-up. Anteroposterior X-ray films were obtained after replacement to measure valgus angle and flexion angle of femoral prosthesis.
RESULTS AND CONCLUSION: (1) Operation time and intraoperative blood loss were significantly better in the test group than in the control group (P< 0.05). (2) No significant difference in American Knee Society score, knee score of American Special Surgical Hospital and knee joint motion was detected between the two groups before replacement and 3 months after replacement (P > 0.05). Above indexes were significantly improved in both groups at 3 months after replacement and during final follow-up (P < 0.05). (3) No significant difference in valgus angle and flexion angle of femoral prosthesis was identified between test and control groups during final follow-up (P > 0.05). (4) These findings indicate that effect of Deluxe-PS type artificial knee prosthesis was identical to that of PFC Sigma RP knee prosthesis in knee osteoarthritis patients receiving bilateral knee joint replacement. Deluxe-PS type artificial knee prosthesis can perfectly realize high-accuracy combination of the prosthesis and the bone cross section, and enhance the fusion suitability of the prosthesis and the bone surface. Deluxe-PS type artificial knee prosthesis has the advantage of operation. This advantage is possibly because Deluxe-PS type artificial knee prosthesis is more in line with the anatomical structure of the knee joint of Chinese.

Objective:To evaluate the clinical results of two-stage reverse total shoulder arthroplasty for treating postoperative deep infection after surgeries for proximal humeral fractures.Methods:From January 2013 to December 2014,8 consecutive patients with postoperative deep infection after surgeries for proximal humeral fractures who were treated with two-stage reverse total shoulder arthroplasty were ret-rospectively reviewed after the final follow-up.There were 1 man and 7 women with a mean age of (58.5 ±6.4)years,of whom 3 left shoulders and 5 right shoulders were involved.There were 2 patients with periprosthetic infection after hemiarthroplasty for proximal humeral fractures,and 6 patients with hu-meral head necrosis as well as implant-associated infection after open reduction internal fixation for proxi-mal humeral fractures with the locking plate.The diagnosis of postoperative deep infection was confirmed by either the preoperative cultures or the intraoperative biopsies during the first-stage surgery.At the first-stage surgery,all the patients underwent a thorough debridement,and then an antibiotic-impregnated bone cement spacer was placed after the removal of prosthesis or locking plate.During the second-stage surgery,the cement spacer was removed,and then a revision shoulder arthroplasty with the reverse shoul-der prosthesis was performed in all the patients who were routinely followed up after the second-stage sur-gery.The visual analogue score (VAS ),Constant score and University of California Los Angeles (UCLA)score were employed to evaluate the postoperative shoulder function.Results:The mean follow-up time was (19.9 ±8.0)months (range 12 to 35 months).At the end of the follow-up,the median forward elevation [100°(60°,140°)vs.25°(0°,90°),P=0.011],the median external rotation [15°(0°,50°)vs.5°(0°,20°),P=0.048],and the median internal rotation [L4 (buttock,T12) vs.buttock (buttock,L3 ),P =0.041 ]were all significantly improved postoperatively.The median Constant score [53.5 (32,74)vs.29.0 (10,57),P=0.012],the median UCLA score [20.5 (9, 26)vs.9.5 (5,15),P=0.012],and the median VAS score [1.5 (0,5)vs.5.0 (0,8),P=0.018]were all significantly improved after the surgery.No recurrence of infection,prosthetic loosening or neurovascular injury was noted by the last follow-up.Conclusion:Two-stage reverse total shoulder arthroplasty was an effective treatment for the postoperative deep infection after surgeries for proximal humeral fractures.The shoulder function was postoperatively improved to a certain degree.

Objective:To present the surgical technique and to evaluate the results of the modified ar-throscopic Latarjet procedure.Methods: Arthroscopic Latarjet procedure has proven to be a reliable method of treatment for difficult anteroinferior instability of the shoulder joint.However, there is no ante-rior capsule reattachment and too much subscapularis damage for the classic procedure.From February 2013 , we modified the classic procedure with reattachment of anterior joint capsule and muscle-tendon junction splitting of subscapularis.Coracoid graft position was evaluated using CT scanning.Results:From March 2012 to August 2014, 51 modified Latarjet procedures were successfully performed arthro-scopically for patients with anterior shoulder instability.According to the CT scanning at the final follow up, the graft was flush with the glenoid in 94.1%, and medially placed in 5.9%.Vertical positioning was perfect in 96.0%(2 to 5 o’clock), too high in 2.0%, and too low in 2.0%.There were no cases of recurrent dislocation or subluxation.Conclusion: The modified arthroscopic Latarjet procedure has shown satisfactory results with good graft positioning.It is a minimal invasive and accurate approach, which combines the advantages of the open procedure.

Objective: To investigate the results of treating patients with recurrent anterior shoulder dislocation using open Latarjet technique in a retrospective study, and to discuss the detail of the surgical technique and the results of the procedure.Methods: In the study, 22 patients with recurrent anterior shoulder dislocation treated with open Latarjet technique were followed up.The average duration of the follow-up was 66.0 months.An X-ray film and a CT scan were performed before the surgery to evaluate the degenerative change of the gleno-humeral joint and the bony defect of the glenoid.An X-ray film and a CT scan were repeated at the end of the final follow-up to find out if there was any progression of the de-generative change of the gleno-humeral joint and if the transferred coracoid process united.Physical ex-aminations, American Shoulder & Elbow Surgeons ( ASES ) score, Constant-Murley score and Rowe questionnaire were used to evaluate the patients’ shoulder function before the surgery and at the end of the final follow-up.Results:Before the surgery the average forward elevation, external rotation and inter-nal rotation were 158.2°±28.7°, 55.3°±15.2°and T10 ( T3 -buttock) respectively.The average ASES score, Constant-Murley score and Rowe score were 77.6 ±17.5, 88.3 ±12.5 and 40.2 ±12.0, respectively.At the end of the final follow-up, no redislocation happened.The average forward eleva-tion, external rotation and internal rotation were 167.7°±12.7°, 54.3°±16.5°and T10 (T3-L3), respectively(P=0.138, P=0.765, P=0.439).No sigificant restriction was detected after the surgery regarding forward elevation,external rotation and internal rotation.The mean ASES score, Constant-Mur-ley score, and Rowe score significantly improved to 93.7 ±9.1 (P=0.001), 95.6 ±5.6 (P=0.008) and 96.4 ±4.4 (P<0.001) respectively after the surgery.A progression of the degenerative change of the gleno-humeral joint was detected in 3 patients.A non-union of the transferred coarcoid was detected in 1 patient.Conclusion:Open Latarjet procedure is effective in treating the recurrent anterior shoulder dislocation patient with severe glenoid defect.No significant progression of the degenerative change of the gleno-humeral joint is detected in average 5-year follow-up.