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Objective:To analyze the effect of mucosal ligament preservation on the outcome of arthroscopic repair of meniscus injury.Methods:A total of 77 patients with knee meniscus tears caused by sports injuries who underwent arthroscopic meniscus repair or suture in Zhengzhou Orthopaedic Hospital from June 2022 to June 2023, were retrospectively analyzed. Including 45 males and 32 females, aged 38.57±13.54 years (range, 52-87 years), body mass index 24.72±4.01 kg/m 2 (range, 34.14-13.61 kg/m 2). All patients complained of knee pain, limited activity and walking weakness. The symptoms were not relieved after 1 month of conservative treatment, which seriously affected daily work and life. According to the intraoperative treatment of mucosal ligament, the patients were divided into mucosal ligament preservation group and mucosal ligament removal group. The visual analogue score (VAS), Lysholm score, and total blood loss were compared between the two groups. Results:All patients successfully completed the operation and were followed up for an average of 5.23±2.16 months (range, 3-9 months). The operation time was 47.59±16.81 min in mucosal ligament preservation group and 45.25±15.93 min in mucosal ligament removal group, and there was no significant difference between the two groups ( t=0.628, P=0.532). The total blood loss in the mucosal ligament preservation group was 246±193 ml, which was less than 343±211 ml in the mucosal ligament removal group, and the difference was statistically significant ( t=2.095, P=0.040). None of the patients received allogeneic blood transfusion. The hematocrit of the mucosal ligament preservation group was 42.48%±4.57% before operation and 39.42%±4.65% on the third day after operation, while that of the mucosal ligament removal group was 41.24%±4.16% and 38.95%±3.80%. The difference between the two groups was statistically significant ( t=0.016, P=0.004; t=0.004, P=0.016). There was no significant difference between the two groups before operation and on the third day after operation ( t=0.217, P=0.545; t=0.629, P=0.159). The preoperative VAS score of mucosal ligament preservation group was 7.25±1.10, which was higher than that of 3 months after operation (0.83±1.06), and the difference was statistically significant ( t=0.062, P<0.001). The preoperative VAS score of mucosal ligament removal group was 7.16±1.21, which was higher than that of 3 months after operation (1.05±1.13), and the difference was statistically significant ( t=0.017, P<0.001). There was no significant difference in VAS scores between the two groups before operation and at 3 months after operation ( t=0.144, P=0.740; t= 0.273, P=0.603). The preoperative Lysholm score of mucosal ligament preservation group was 31.76±7.54, which was significantly lower than that of 3 months after operation 87.30±4.12 ( t=-39.329, P<0.001); The Lysholm score of the mucosal ligament removal group was 34.13±7.32 before operation, which was lower than 89.05±4.45 at 3 months after operation, and the difference was statistically significant ( t=-40.172, P<0.001); There was no significant difference in Lysholm score between the two groups before operation and 3 months after operation ( t=1.395, P=0.167; t=1.766, P=0.081). Conclusion:The preservation of mucosal ligament in arthroscopic surgery for meniscus injury does not prolong the operation time. It can reduce the total intraoperative blood loss, and the postoperative knee function recovery is similar to that of mucosal ligament removal.
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Objective:To investigate the clinical effect of arthroscopic release through the peritrochanteric compartment from inside-out in the treatment of lateral snapping hip.Methods:A total of 38 patients (70 hips) with lateral snapping hip who underwent arthroscopic surgery in Department of Sports Medicine, Zhengzhou Orthopaedics Hospital Affiliated to Henan University from December 2016 to December 2022 were retrospectively analyzed. There were 13 males and 25 females, aged 27.8±7.6 years (range, 15-45 years). Among them 6 cases of unilateral and bilateral 32 cases. According to the different release approaches, they were divided into outside-in group (37 hips) and inside-out group (33 hips). Visual analogue scale (VAS) was used to evaluate postoperative hip pain, and gluteal muscle contracture disability scale (GDS) was used to evaluate postoperative effectiveness. Postoperative hip function was evaluated by modified Harris hip score (mHHS).Results:All patients in the two groups successfully completed the operation and were followed up for 8.23±1.25 months (range, 6-12.8 months). The hip VAS scores in the inside-out group were 4.0 (3.5, 6.0), 5.0 (4.0, 6.0), and 1.0 (0.5, 1.0) before surgery, 1 week after surgery, and 3 months after surgery, respectively, and those in the outside-in group were 4.0 (3.5, 6.0), 5.0 (4.0, 6.0), and 1.0 (0.5. 1.0), and the differences between the two groups of patients in the within group comparison of hip VAS before and after surgery were statistically significant ( P<0.05). The hip VAS at 3 months postoperatively was smaller than that before surgery and at 1 week postoperatively, and the differences were statistically significant ( P<0.05). There were no significant differences between groups at different time points ( P>0.05). The GDS scores in the inside-out group were 52.30±8.19, 75.03±6.41, and 92.30±4.61 preoperatively, 1 week postoperatively, and 3 months postoperatively, respectively, and in the outside-in group were 51.97±6.64, 75.41±7.10, and 91.32±4.18, respectively, and the differences in the quantitative GDS function scores of the hips in the pre- and postoperative periods of the patients in both groups were statistically significant ( P<0.05). The differences in the quantitative GDS function scores within the groups were statistically significant ( P<0.05), and the quantitative GMC function scores of the hip joints at 3 months after surgery were greater than those of the preoperative period and 1 week after surgery, and the differences were statistically significant ( P<0.05). There were no significant differences between groups at different time points ( P>0.05). Differences in mHHS within group comparisons before and after surgery were statistically significant in both groups ( P<0.05), and mHHS at 3 months postoperatively was greater than preoperatively and 1 week postoperatively, with statistically significant differences ( P<0.05). The mHHS at 1 week postoperatively in the inside-out group was 79.03±7.37, which was greater than that in the outside-in group 71.32±10.02, and the difference was statistically significant ( t=3.63, P<0.001). Conclusion:Arthroscopic release through the peritrochanteric compartment from inside-out in the treatment of lateral snapping hip can effectively reduce hip pain and improve hip function, with satisfactory clinical results, and can be used as an alternative treatment to inward-to-outward release.
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Objective To discuss the clinical effect of surgical treatment for ankle osteoarthritis under arthroscopy.Methods Forty-eight cases with ankle osteoarthritis patients admitted at the Orthopaedic Hospital of Zhengzhou from January 2012 to June 2014 were selected and all of them were given the treatment of focal cleaning under arthroscopy.The clinical effect of surgical treatment were judged by modified McGuire ankle rating system,the United States after ankle surgery AOFAS ankle-full score and Mazur ankle rating system respectively.Results At the time of the last follow-up,modified McGuire ankle rating system((85.64±16.52)points vs.(52.46±10.25)points,t=-8.465),the United States after ankle surgery AOFAS ankle-full score [(85.24±11.46)points vs.(53.68±9.48)points,t=-7.548)and Mazur ankle rating system((86.45±12.57)points vs.(58.49±8.64)points,t=-6.596)all increased than that of pre-operation,the differences were statistically significant(P＜0.05).The modified McGuire ankle rating system of patients with low-grade lesion at pre-operation((62.45±7.63)points vs.(49.58±6.35)points,t=3.685)and the time of the last follow-up((93.68±11.54)points vs.(68.54±9.68)points,t=8.695)were all higher than that of patients with high-grade lesion,the differences were statistically significant(P＜0.05).The clinical effect of surgical treatment judged by modified McGuire ankle rating system,the United States after ankle surgery AOFAS ankle-full score and Mazur ankle rating system were respectively 91.67％(44/48),89.58％(43/48)and 89.58％(43/48),the differences were no statistically significant(x2=0.824,P＞0.05).Conclusion The clinical effect of surgical treatment for ankle osteoarthritis under arthroscopy is remarkable and it causes light damage to the body.It is especially suitable for patients with low-grade lesions and is worth popularization and application.
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Objective To research the surgical technique and curative effect of the posterior cruciate ligament(PCL) anatomical reconstruction with double-bundle hamstring tendons absorbable interference screw fixation via double-tunnel in femoral under arthroscopy. Methods 24 patients, average age of 32 years ranged from 17 to 42 years old, were treated with anatomical reconstruction of PCL through double-tunnel in femoral and one tunnel in tibia with double-bundle hamstring tendons fixed with absorbable interference screw under arthroscopic. The anterolateral bundle was reconstructed with multistranded autograft semitendinosus tendon grafts and was tightend and fixed, at knee flexion 15?-30?. The posteromedial bundle was reconstructed with multistranded autograft gracilis tendon grafts, and was tightened and fixed, at knee flexion 60?-70?. Results All the patients were followed up for a mean time of 9.4 months (6 months-19 months). All the knee joint motion were in normal range, no exhibition of pain and distinct trauma arthritis. The postoperative posterior drawer test, reverse Lachman test, tibia sags sign and reverse pivot shift test were all negative. The postoperative Lysholm score was (92.7?6.4) points, and the postoperative score increased significantly compared with the preoperative (t=3.12, P