Objective To determine the concentrations of lead (Pb) and cadmium (Cd) in three kinds of materials (cartilage, cortical bone, and cancellous bone) of the femur head obtained from patients in the process of operation....Objective To determine the concentrations of lead (Pb) and cadmium (Cd) in three kinds of materials (cartilage, cortical bone, and cancellous bone) of the femur head obtained from patients in the process of operation. Methods Concentrations of Pb and Cd were determined in selected parts of the femur head of 30 patients after total hip arthroplasty, using ICP-AES (atomic absorption spectrophotometry). Results Pb contained the highest concentration in cortical bone, while Cd did so in cancellous bone. There were statistically significant differences in the concentrations of both elements between the cartilage and cortical bone, and also differences in the concentration of Pb between the cartilage and cancellous bone. There were no significant differences in the concentrations of Pb or Cd between cortical and cancellous bone. Conclusion Comparative studies on toxic metals should take into account both analogous bones and their fragments, as even if they come from the same kind of bones (e.g. femur head), clear differences exist in concentrations of heavy metals related to the sampling site and type of tissue (cartilage, cortical bone, and cancellous bone).展开更多
To study the effect of titanium alloy cage on the treatment of the ischemic necrosis of femoral head in dog,the model of the ischemic necrosis of femoral head was made with the liquid ni-trogen in 15 hybrid adult dogs...To study the effect of titanium alloy cage on the treatment of the ischemic necrosis of femoral head in dog,the model of the ischemic necrosis of femoral head was made with the liquid ni-trogen in 15 hybrid adult dogs.The titanium alloy cage made of a hollow cylinder was driven into the subchondral bone of necrotic femoral head via central channel.The dogs were divided into 3 groups,each group was sacrificed 3,6,12 weeks after the operation respectively.No collapse of femoral head was observed after the operation.The position of the cages was good on radiograph.Microscopically,the cancellous bone of necrotic femoral head rebuilt gradually and grew into cage.After 12 weeks of creeping substitution,the cancellous bone filled up the hollow cavity and holes of the cages.It is concluded that the titanium alloy cage can provide structural support for the sub-chondral bone and prevent collapse and can be used for the treatment of the ischemic necrosis of femoral head.展开更多
Objective: To assess the curative effect of the stage II femoral head necrosis treated by arthroscopy assisted lesion clearance, bone graft and titanium rod support. Methods: All the patients (including 58 patients 74...Objective: To assess the curative effect of the stage II femoral head necrosis treated by arthroscopy assisted lesion clearance, bone graft and titanium rod support. Methods: All the patients (including 58 patients 74 hips) were diagnosed as stage II femoral head necrosis according to the ARCO staging system during 2003-2013. In these patients, 15 hips were stage IIA, 34 hips were stage IIB and 25 hips were stage IIC. Located by C-arm and assisted by arthroscopy, minimally-invasive percutaneous pulp core decompression and lesion clearance within the femoral head were accurately performed, and then, the OAM composite of autologous bone marrow was implanted and the femoral head was supported using the titanium rod. Follow-up including the pain score, the Harris hip score and X-ray observation for disease progression were achieved at 6, 12, 24 and 36 months postoperatively, Kaplan-Meier survival curve was used for the survival analysis. Result: The VAS score and the Harris score after operation were better THRAn THRAt of before the surgery, the difference had statistical significance (p Conclusion: Arthroscopy assisted lesion clearance, bone graft and titanium rod support to treat the stage II osteonecrosis of the femoral head are effective and can prevent the femoral head from collapsing. But for stage IIC patients who had a history of the use of hormone, this surgery should be chosen carefully because the outcome is always very poor.展开更多
Objective: To explore the effect of tumor necrosis factor-α（TNF-α）on the occurrence of steroid-induced avascular necrosis of femoral head（SANFH）. Methods: Twenty-four rabbits were firstly divided into void group...Objective: To explore the effect of tumor necrosis factor-α（TNF-α）on the occurrence of steroid-induced avascular necrosis of femoral head（SANFH）. Methods: Twenty-four rabbits were firstly divided into void group （n=12） and model group （n=12） at random. Prednisone Acetate was injected to the model group(0.32 mg·kg-1·d-1). In the 6 th and 8 th week, two rabbits of the two groups were killed respectively to observe whether the model was successful. The level of TNF-α in serum of the residual rabbits of the two groups was examined in Radioimmunoassay method. Results: The level of TNF-α in model group is significantly higher than that in void group（P<0.001） under the premise of the model of SANFH success by histological observation. Conclusion: The rise of level of TNF-α may be one of the most important factors in the occurrence of SANFH.展开更多
Nonunion neck of femur can be a difficult problem to treat, particularly in the young, and is associated with high complication rates of avascular necrosis due to the precarious blood supply and poor biomechanics.The ...Nonunion neck of femur can be a difficult problem to treat, particularly in the young, and is associated with high complication rates of avascular necrosis due to the precarious blood supply and poor biomechanics.The various treatment options that have been described can be broadly divided according to the aim of improving either biology or biomechanics. Surgeries aimed at improving the biology, such as vascularized fibula grafting, have good success rates but require high levels of expertise and substantial resources. A popular surgical treatment aimed at improving the biomechanics-valgus intertrochanteric osteotomyoptimizes conditions for fracture healing by converting shear forces across the fracture site into compressive forces. Numerous variations of this surgical procedure have been developed and successfully applied in clinical practice. As a result, the proximal femoral orientation for obtaining a good functional outcome has evolved over the years, and the present concept of altering the proximal femoral anatomy as little as possible has arisen. This technical objective supports attaining union as well as a good functional outcome, since excessive valgus can lead to increased joint reaction forces. This review summarizes the historical and current literature on valgus intertrochanteric osteotomy treatment of nonunion neck of femur, with a focus on factors predictive of good functional outcome and potential pitfalls to be avoided as well as controversies surrounding this procedure.展开更多
发育性髋关节发育不良(developmental dysplasia of the hip,DDH)是常见的儿童肢体畸形,早期筛查和诊断非常重要,延误治疗或治疗不当将导致严重后果。股骨头缺血性坏死(avascular necrosis,AVN)是DDH闭合复位后严重且常见的并发症,如何...发育性髋关节发育不良(developmental dysplasia of the hip,DDH)是常见的儿童肢体畸形,早期筛查和诊断非常重要,延误治疗或治疗不当将导致严重后果。股骨头缺血性坏死(avascular necrosis,AVN)是DDH闭合复位后严重且常见的并发症,如何预防及避免AVN的发生一直困扰着小儿骨科医师。闭合复位前骨化核的存在似乎有助于降低AVN发生率,避免AVN的发生与DDH早诊断、早治疗关系密切。本文就骨化核与DDH闭合复位后AVN相关性的研究进展进行综述。展开更多
目的探究对老年股骨颈骨折患者应用人工股骨头置换术与人工全髋关节置换术的效果。方法回顾性选取2017年1月—2022年5月高邮市中医医院收治的238例股骨颈骨折患者的临床资料,依据治疗方案不同分为对照组(n=132)和观察组(n=106)。对照组...目的探究对老年股骨颈骨折患者应用人工股骨头置换术与人工全髋关节置换术的效果。方法回顾性选取2017年1月—2022年5月高邮市中医医院收治的238例股骨颈骨折患者的临床资料,依据治疗方案不同分为对照组(n=132)和观察组(n=106)。对照组实施人工股骨头置换术治疗,观察组实施人工全髋关节置换术治疗,比较两组治疗效果、临床相关指标、髋关节功能评分(Harris Hip Score,HHS)、髋关节疼痛程度评分(Visual Analogue Scale,VAS)、并发症。结果观察组治疗效果(96.23%)高于对照组(89.39%),差异有统计学意义(χ^(2)=3.926,P<0.05)。与对照组相比,观察组手术时间、住院时间较长,术中出血量、术后引流量较多,差异有统计学意义(P<0.05)。术后1年,观察组HHS评分高于对照组,差异有统计学意义(P<0.05)。和对照组比较,观察组各时间点VAS评分以及并发症发生率均较低,差异有统计学意义(P<0.05)。结论采用人工股骨头置换术治疗老年股骨颈骨折患者,有着手术时间短等优点,但其远期效果较差。虽然人工全髋关节置换术的手术时间等较长,但远期效果较好,疼痛感低,并发症少,可依据患者实际情况而选择手术方案。展开更多
基金financed as research project no.NN404507738 by the Polish Ministry of Education from the resources for years 2010-2011
文摘Objective To determine the concentrations of lead (Pb) and cadmium (Cd) in three kinds of materials (cartilage, cortical bone, and cancellous bone) of the femur head obtained from patients in the process of operation. Methods Concentrations of Pb and Cd were determined in selected parts of the femur head of 30 patients after total hip arthroplasty, using ICP-AES (atomic absorption spectrophotometry). Results Pb contained the highest concentration in cortical bone, while Cd did so in cancellous bone. There were statistically significant differences in the concentrations of both elements between the cartilage and cortical bone, and also differences in the concentration of Pb between the cartilage and cancellous bone. There were no significant differences in the concentrations of Pb or Cd between cortical and cancellous bone. Conclusion Comparative studies on toxic metals should take into account both analogous bones and their fragments, as even if they come from the same kind of bones (e.g. femur head), clear differences exist in concentrations of heavy metals related to the sampling site and type of tissue (cartilage, cortical bone, and cancellous bone).
基金a grant from the National Natural Sciences Foundation of China (No. 30170945)
文摘To study the effect of titanium alloy cage on the treatment of the ischemic necrosis of femoral head in dog,the model of the ischemic necrosis of femoral head was made with the liquid ni-trogen in 15 hybrid adult dogs.The titanium alloy cage made of a hollow cylinder was driven into the subchondral bone of necrotic femoral head via central channel.The dogs were divided into 3 groups,each group was sacrificed 3,6,12 weeks after the operation respectively.No collapse of femoral head was observed after the operation.The position of the cages was good on radiograph.Microscopically,the cancellous bone of necrotic femoral head rebuilt gradually and grew into cage.After 12 weeks of creeping substitution,the cancellous bone filled up the hollow cavity and holes of the cages.It is concluded that the titanium alloy cage can provide structural support for the sub-chondral bone and prevent collapse and can be used for the treatment of the ischemic necrosis of femoral head.
文摘Objective: To assess the curative effect of the stage II femoral head necrosis treated by arthroscopy assisted lesion clearance, bone graft and titanium rod support. Methods: All the patients (including 58 patients 74 hips) were diagnosed as stage II femoral head necrosis according to the ARCO staging system during 2003-2013. In these patients, 15 hips were stage IIA, 34 hips were stage IIB and 25 hips were stage IIC. Located by C-arm and assisted by arthroscopy, minimally-invasive percutaneous pulp core decompression and lesion clearance within the femoral head were accurately performed, and then, the OAM composite of autologous bone marrow was implanted and the femoral head was supported using the titanium rod. Follow-up including the pain score, the Harris hip score and X-ray observation for disease progression were achieved at 6, 12, 24 and 36 months postoperatively, Kaplan-Meier survival curve was used for the survival analysis. Result: The VAS score and the Harris score after operation were better THRAn THRAt of before the surgery, the difference had statistical significance (p Conclusion: Arthroscopy assisted lesion clearance, bone graft and titanium rod support to treat the stage II osteonecrosis of the femoral head are effective and can prevent the femoral head from collapsing. But for stage IIC patients who had a history of the use of hormone, this surgery should be chosen carefully because the outcome is always very poor.
文摘Objective: To explore the effect of tumor necrosis factor-α（TNF-α）on the occurrence of steroid-induced avascular necrosis of femoral head（SANFH）. Methods: Twenty-four rabbits were firstly divided into void group （n=12） and model group （n=12） at random. Prednisone Acetate was injected to the model group(0.32 mg·kg-1·d-1). In the 6 th and 8 th week, two rabbits of the two groups were killed respectively to observe whether the model was successful. The level of TNF-α in serum of the residual rabbits of the two groups was examined in Radioimmunoassay method. Results: The level of TNF-α in model group is significantly higher than that in void group（P<0.001） under the premise of the model of SANFH success by histological observation. Conclusion: The rise of level of TNF-α may be one of the most important factors in the occurrence of SANFH.
文摘Nonunion neck of femur can be a difficult problem to treat, particularly in the young, and is associated with high complication rates of avascular necrosis due to the precarious blood supply and poor biomechanics.The various treatment options that have been described can be broadly divided according to the aim of improving either biology or biomechanics. Surgeries aimed at improving the biology, such as vascularized fibula grafting, have good success rates but require high levels of expertise and substantial resources. A popular surgical treatment aimed at improving the biomechanics-valgus intertrochanteric osteotomyoptimizes conditions for fracture healing by converting shear forces across the fracture site into compressive forces. Numerous variations of this surgical procedure have been developed and successfully applied in clinical practice. As a result, the proximal femoral orientation for obtaining a good functional outcome has evolved over the years, and the present concept of altering the proximal femoral anatomy as little as possible has arisen. This technical objective supports attaining union as well as a good functional outcome, since excessive valgus can lead to increased joint reaction forces. This review summarizes the historical and current literature on valgus intertrochanteric osteotomy treatment of nonunion neck of femur, with a focus on factors predictive of good functional outcome and potential pitfalls to be avoided as well as controversies surrounding this procedure.
文摘发育性髋关节发育不良(developmental dysplasia of the hip,DDH)是常见的儿童肢体畸形,早期筛查和诊断非常重要,延误治疗或治疗不当将导致严重后果。股骨头缺血性坏死(avascular necrosis,AVN)是DDH闭合复位后严重且常见的并发症,如何预防及避免AVN的发生一直困扰着小儿骨科医师。闭合复位前骨化核的存在似乎有助于降低AVN发生率,避免AVN的发生与DDH早诊断、早治疗关系密切。本文就骨化核与DDH闭合复位后AVN相关性的研究进展进行综述。
文摘目的探究对老年股骨颈骨折患者应用人工股骨头置换术与人工全髋关节置换术的效果。方法回顾性选取2017年1月—2022年5月高邮市中医医院收治的238例股骨颈骨折患者的临床资料,依据治疗方案不同分为对照组(n=132)和观察组(n=106)。对照组实施人工股骨头置换术治疗,观察组实施人工全髋关节置换术治疗,比较两组治疗效果、临床相关指标、髋关节功能评分(Harris Hip Score,HHS)、髋关节疼痛程度评分(Visual Analogue Scale,VAS)、并发症。结果观察组治疗效果(96.23%)高于对照组(89.39%),差异有统计学意义(χ^(2)=3.926,P<0.05)。与对照组相比,观察组手术时间、住院时间较长,术中出血量、术后引流量较多,差异有统计学意义(P<0.05)。术后1年,观察组HHS评分高于对照组,差异有统计学意义(P<0.05)。和对照组比较,观察组各时间点VAS评分以及并发症发生率均较低,差异有统计学意义(P<0.05)。结论采用人工股骨头置换术治疗老年股骨颈骨折患者,有着手术时间短等优点,但其远期效果较差。虽然人工全髋关节置换术的手术时间等较长,但远期效果较好,疼痛感低,并发症少,可依据患者实际情况而选择手术方案。
