Objective:To observe therapeutic effect of sodium aescinate Tablets on knee osteoarthritis complicated with synovitis.Methods:86 patients with knee osteoarthritis combined with synovitis treated in the Honghui Hospita...Objective:To observe therapeutic effect of sodium aescinate Tablets on knee osteoarthritis complicated with synovitis.Methods:86 patients with knee osteoarthritis combined with synovitis treated in the Honghui Hospital Affiliated to Xi’an Jiaotong University from January 2018 to December 2019 were randomly divided into control group and intervention group,with 43 cases in each group.The control group was given routine treatment,and the intervention group was given sodium aescinate Tablets orally on the basis of routine treatment,twice a day,2 tablets each time.The curative effect was evaluated after 2 weeks of treatment.The knee pain and joint function of the two groups were evaluated by Visual Analogue Scale(VAS)and Western Ontario and McMaster Universities Arthritis Index(WOMAC),and the clinical effects of the two groups were compared.Results:Before treatment,there was no significant difference in general information,VAS and WOMAC scores between the two groups(P>0.05).After treatment,the VAS and WOMAC scores of the two groups were both lower than those before treatment,and the difference was statistically significant(P<0.05).The vas and WOMAC scores of the intervention group were lower than those of the control group(VAS,1.87±0.79 vs 3.38±0.81).In this study,sodium aescinate tablets were applied to the treatment of KOA combined with synovitis.The results showed that the intervention group was better than the control group in alleviating knee pain,improving joint function and improving clinical efficacy,and the difference was statistically significant.The total effective rate of the intervention group was higher than that of the control group(100%vs 86.05%),and the difference was statistically significant(P<0.05).Conclusion:Sodium aescinate tablet in the treatment of knee osteoarthritis combined with synovitis can effectively alleviate knee pain,improve joint function and improve clinical efficacy.展开更多
AIM To review and report functional outcomes, complications,and survivorship associated with total knee arthroplasty(TKA) in the treatment of post-traumatic arthritis(PTA).METHODS We conducted a systematic review acco...AIM To review and report functional outcomes, complications,and survivorship associated with total knee arthroplasty(TKA) in the treatment of post-traumatic arthritis(PTA).METHODS We conducted a systematic review according to the PRISMA guidelines. We searched PubMed, Cochrane Library, and SCOPUS in December 2015 for Englishlanguage clinical research studies, both prospective and retrospective, examining the use of TKA for the treatment of PTA. All relevant articles were accessed in full. The manual search included references of retrieved articles.We extracted data on patients' demographics and clinical outcomes, including preoperative diagnosis and pre- and post-operative functional scores. We summarized the data and reported the results in tables and text.RESULTS Sixteen studies, four prospective and ten retrospective,examined patients who underwent TKA for PTA due to fractures of the proximal tibia, patella, and/or distal femur. Eleven studies utilized the Knee Society Scores criteria to assess functional outcomes. All studies utilizing these criteria reported an improvement in functional and knee scores of patients following TKA. Further, studies reported an increased range of motion(ROM) and reduction of pain following surgery. The most commonly reported complications with TKA included infection, stiffness, wound complications, intraoperative rupture of tendons, and osteolysis/polyethylene wear. The overwhelming majority of these complications occurred within the first two years following surgery. Six studies examined the survivorship of TKA with subsequent revision for any reason as an endpoint. Compared to patients with osteoarthritis, patients with PTA required more revisions, the majority for polyethylene wear.CONCLUSION Although associated with higher complication rates,TKA is an effective treatment for PTA, as it improves ROM, pain and functional outcomes.展开更多
Objective:To evaluate the efficacy of synovectomy combined with postoperative radiotherapy in the treatment of pigmented villonodular synovitis compared with only synovectomy in knee. Methods:The related references we...Objective:To evaluate the efficacy of synovectomy combined with postoperative radiotherapy in the treatment of pigmented villonodular synovitis compared with only synovectomy in knee. Methods:The related references were searched from SinoMed,CNKI,Wanfang,VIP,PubMed,Embase,Cochrane Library and Web of Science from date of databases establishment to October 2020,and the studies of synovectomy combined with postoperative radiotherapy were screened. According to the type of research,the corresponding evaluation methods were selected for quality evaluation of the literature. RevMan 5.3 software was used for meta-analysis. The primary outcome was recurrence,while the secondary outcomes included complications,excellent and good rate of function of knee,range of motion of knee,Lysholm score,and IKDC score of knee etcetera. Results:A total of 11 articles were included in meta-analysis,with 510 cases,280 in the combined group and 230 in the control group. The results of meta-analysis showed that:(1)The recurrence rate in the combination group was significantly lower than that in the control group,[OR=0.33,95%CI(0.20,0.55),P<0.000 1];(2)The complications in the combined group were higher than that in the control group[OR=2.70,95%CI(1.16,6.31),P=0.02];(3)The excellent and good rate of the combined group was significantly better than that of the control group[OR=2.86,95%CI(1.23,6.64),P=0.01],and it also may be the result of different evaluation criteria of each study;(4)There was no significant difference range of motion[MD=2.96,95%CI(-0.54,6.47),P=0.10],Lysholm score[MD=3.22,95%CI(-0.51,6.96),P=0.09],or IKDC score[MD=2.88,95%CI(-1.07,6.82),P=0.15]in knee between the two groups. Conclusion:The meta-analysis shows that synovectomy combined with radiotherapy can reduce the recurrence rate of pigmented villonodular synovitis in knee,but compared with only operation,there are higher complications. However,the above conclusions need to be verified by long-term follow-up of more high-quality clinical studies.展开更多
Background Diffusion-weighted imaging(DWI)of synovitis has been suggested as a possible non-invasive alternative to contrast-enhanced T1w imaging(ce-T1w).We aimed to study DWI for diagnosing synovitis in the knee join...Background Diffusion-weighted imaging(DWI)of synovitis has been suggested as a possible non-invasive alternative to contrast-enhanced T1w imaging(ce-T1w).We aimed to study DWI for diagnosing synovitis in the knee joint of pediatric patients,to quantify inter-observer agreement on DWI and ce-T1w and to calculate quantitative measures of synovial diffusivity and conspicuity.Methods Forty consecutive patients with known or suspected arthritis of the knee(25 girls,median age 12 years)underwent routine 1.5T MRI with ce-T1w and transverse DWI with b values 50 and 800 s/mm2.Mean apparent diffusion coefficient(ADC)values and signal intensity of inflamed synovium,joint effusion and muscle were measured with regions of interest retrospectively.Post-contrast T1 w images(diagnostic standard)and diffusion-weighted images at b=800 s/mm2 with ADC map were separately rated by three independent and blinded readers with different levels of expertise for the presence and degree of synovitis along with the level of diagnostic confidence.Results Thirty-one(78%)patients showed at least some synovial contrast enhancement,17(43%)children were diagnosed with synovitis on ce-T1w.Ratings by the 1st reader on ce-T1w and on DWI for synovitis showed very good agreement(kappa=0.90).Inter-observer agreement on DWI ranged from moderate to substantial with kappa values between 0.68 and 0.79(all P<0.001).Agreement and diagnostic confidence were generally lower in patients with mild and without synovial enhancement,compared to patients with synovitis.DWI yielded higher signal of inflamed synovium vs.muscle tissue,but lower signal vs.joint effusion,compared to ce-T1 w(all P<0.001).Conclusions Diffusion-weighted imaging is a promising,though reader-dependent alternative to contrast-enhanced imaging in patients with arthritis of the knee,based on our preliminary findings.It holds potential for increasing patient safety and comfort.展开更多
BACKGROUND Computed tomography(CT)has become a routine preoperative examination for tibial plateau fractures(TPFs).Assessing the location of the fragment and intercondylar eminence fracture can provide clinicians with...BACKGROUND Computed tomography(CT)has become a routine preoperative examination for tibial plateau fractures(TPFs).Assessing the location of the fragment and intercondylar eminence fracture can provide clinicians with valuable information;however,the evaluation of traumatic meniscal lesion(TML)and arthroscopic management are controversial.AIM To predict TML by three-dimensional skeletal anatomy changes in unilateral TPF and bilateral TPF on preoperative thin layer CT.METHODS Acute fracture of tibial plateau patients undergoing arthroscopic surgery between December 2017 and December 2019 were included in this retrospective study.The type,zone,and location of TMLs were diagnosed based on the operation records and/or arthroscopic videos.Measurement of three-dimensional fracture morphology included the following:Frontal fragment width of plateau,sagittal fragment subsiding distance(FSD),sagittal fracture line distance,sagittal posterior tibial slope,and transversal area ratio of fragment area)on preoperative CT three-dimensional plane.The correlation of TML with skeletal values was calculated according to unicondylar TPFs and bicondylar TPFs.RESULTS A total of 67 patients were enrolled in this study,among which 30 patients had TMLs,lateral/medial(23/7).FSD was a particularly positive factor to predict TML,with odds ratio of 2.31(1.26-5.63).On sagittal view of CT,FSD degree of 8 mm and posterior tibial slope exceeding 11.74°implied enhanced risk of TML in bicondylar TPFs.On coronal view,once fragment width of plateau surpassed 3 cm,incidence of TML reached 100%.On transverse view,area ratio of fragment as enhanced risk of 5.5%and FSD>4.3 mm for predicting TML were observed in unicondylar TPFs.CONCLUSION TML can be predicted by different parameters on preoperative CT views according to unicondylar fractures and bicondylar TPFs.展开更多
文摘Objective:To observe therapeutic effect of sodium aescinate Tablets on knee osteoarthritis complicated with synovitis.Methods:86 patients with knee osteoarthritis combined with synovitis treated in the Honghui Hospital Affiliated to Xi’an Jiaotong University from January 2018 to December 2019 were randomly divided into control group and intervention group,with 43 cases in each group.The control group was given routine treatment,and the intervention group was given sodium aescinate Tablets orally on the basis of routine treatment,twice a day,2 tablets each time.The curative effect was evaluated after 2 weeks of treatment.The knee pain and joint function of the two groups were evaluated by Visual Analogue Scale(VAS)and Western Ontario and McMaster Universities Arthritis Index(WOMAC),and the clinical effects of the two groups were compared.Results:Before treatment,there was no significant difference in general information,VAS and WOMAC scores between the two groups(P>0.05).After treatment,the VAS and WOMAC scores of the two groups were both lower than those before treatment,and the difference was statistically significant(P<0.05).The vas and WOMAC scores of the intervention group were lower than those of the control group(VAS,1.87±0.79 vs 3.38±0.81).In this study,sodium aescinate tablets were applied to the treatment of KOA combined with synovitis.The results showed that the intervention group was better than the control group in alleviating knee pain,improving joint function and improving clinical efficacy,and the difference was statistically significant.The total effective rate of the intervention group was higher than that of the control group(100%vs 86.05%),and the difference was statistically significant(P<0.05).Conclusion:Sodium aescinate tablet in the treatment of knee osteoarthritis combined with synovitis can effectively alleviate knee pain,improve joint function and improve clinical efficacy.
文摘AIM To review and report functional outcomes, complications,and survivorship associated with total knee arthroplasty(TKA) in the treatment of post-traumatic arthritis(PTA).METHODS We conducted a systematic review according to the PRISMA guidelines. We searched PubMed, Cochrane Library, and SCOPUS in December 2015 for Englishlanguage clinical research studies, both prospective and retrospective, examining the use of TKA for the treatment of PTA. All relevant articles were accessed in full. The manual search included references of retrieved articles.We extracted data on patients' demographics and clinical outcomes, including preoperative diagnosis and pre- and post-operative functional scores. We summarized the data and reported the results in tables and text.RESULTS Sixteen studies, four prospective and ten retrospective,examined patients who underwent TKA for PTA due to fractures of the proximal tibia, patella, and/or distal femur. Eleven studies utilized the Knee Society Scores criteria to assess functional outcomes. All studies utilizing these criteria reported an improvement in functional and knee scores of patients following TKA. Further, studies reported an increased range of motion(ROM) and reduction of pain following surgery. The most commonly reported complications with TKA included infection, stiffness, wound complications, intraoperative rupture of tendons, and osteolysis/polyethylene wear. The overwhelming majority of these complications occurred within the first two years following surgery. Six studies examined the survivorship of TKA with subsequent revision for any reason as an endpoint. Compared to patients with osteoarthritis, patients with PTA required more revisions, the majority for polyethylene wear.CONCLUSION Although associated with higher complication rates,TKA is an effective treatment for PTA, as it improves ROM, pain and functional outcomes.
基金General Project of National Natural Science Foundation of China(No.81873327)Youth Project of National Natural Science Foundation of China(No.81904226)。
文摘Objective:To evaluate the efficacy of synovectomy combined with postoperative radiotherapy in the treatment of pigmented villonodular synovitis compared with only synovectomy in knee. Methods:The related references were searched from SinoMed,CNKI,Wanfang,VIP,PubMed,Embase,Cochrane Library and Web of Science from date of databases establishment to October 2020,and the studies of synovectomy combined with postoperative radiotherapy were screened. According to the type of research,the corresponding evaluation methods were selected for quality evaluation of the literature. RevMan 5.3 software was used for meta-analysis. The primary outcome was recurrence,while the secondary outcomes included complications,excellent and good rate of function of knee,range of motion of knee,Lysholm score,and IKDC score of knee etcetera. Results:A total of 11 articles were included in meta-analysis,with 510 cases,280 in the combined group and 230 in the control group. The results of meta-analysis showed that:(1)The recurrence rate in the combination group was significantly lower than that in the control group,[OR=0.33,95%CI(0.20,0.55),P<0.000 1];(2)The complications in the combined group were higher than that in the control group[OR=2.70,95%CI(1.16,6.31),P=0.02];(3)The excellent and good rate of the combined group was significantly better than that of the control group[OR=2.86,95%CI(1.23,6.64),P=0.01],and it also may be the result of different evaluation criteria of each study;(4)There was no significant difference range of motion[MD=2.96,95%CI(-0.54,6.47),P=0.10],Lysholm score[MD=3.22,95%CI(-0.51,6.96),P=0.09],or IKDC score[MD=2.88,95%CI(-1.07,6.82),P=0.15]in knee between the two groups. Conclusion:The meta-analysis shows that synovectomy combined with radiotherapy can reduce the recurrence rate of pigmented villonodular synovitis in knee,but compared with only operation,there are higher complications. However,the above conclusions need to be verified by long-term follow-up of more high-quality clinical studies.
基金This study was supported by the German Research Foundation(DFG)(No.NE1953/1-1).
文摘Background Diffusion-weighted imaging(DWI)of synovitis has been suggested as a possible non-invasive alternative to contrast-enhanced T1w imaging(ce-T1w).We aimed to study DWI for diagnosing synovitis in the knee joint of pediatric patients,to quantify inter-observer agreement on DWI and ce-T1w and to calculate quantitative measures of synovial diffusivity and conspicuity.Methods Forty consecutive patients with known or suspected arthritis of the knee(25 girls,median age 12 years)underwent routine 1.5T MRI with ce-T1w and transverse DWI with b values 50 and 800 s/mm2.Mean apparent diffusion coefficient(ADC)values and signal intensity of inflamed synovium,joint effusion and muscle were measured with regions of interest retrospectively.Post-contrast T1 w images(diagnostic standard)and diffusion-weighted images at b=800 s/mm2 with ADC map were separately rated by three independent and blinded readers with different levels of expertise for the presence and degree of synovitis along with the level of diagnostic confidence.Results Thirty-one(78%)patients showed at least some synovial contrast enhancement,17(43%)children were diagnosed with synovitis on ce-T1w.Ratings by the 1st reader on ce-T1w and on DWI for synovitis showed very good agreement(kappa=0.90).Inter-observer agreement on DWI ranged from moderate to substantial with kappa values between 0.68 and 0.79(all P<0.001).Agreement and diagnostic confidence were generally lower in patients with mild and without synovial enhancement,compared to patients with synovitis.DWI yielded higher signal of inflamed synovium vs.muscle tissue,but lower signal vs.joint effusion,compared to ce-T1 w(all P<0.001).Conclusions Diffusion-weighted imaging is a promising,though reader-dependent alternative to contrast-enhanced imaging in patients with arthritis of the knee,based on our preliminary findings.It holds potential for increasing patient safety and comfort.
基金The Jiangmen Science and Technology Project,No.2017A2018.
文摘BACKGROUND Computed tomography(CT)has become a routine preoperative examination for tibial plateau fractures(TPFs).Assessing the location of the fragment and intercondylar eminence fracture can provide clinicians with valuable information;however,the evaluation of traumatic meniscal lesion(TML)and arthroscopic management are controversial.AIM To predict TML by three-dimensional skeletal anatomy changes in unilateral TPF and bilateral TPF on preoperative thin layer CT.METHODS Acute fracture of tibial plateau patients undergoing arthroscopic surgery between December 2017 and December 2019 were included in this retrospective study.The type,zone,and location of TMLs were diagnosed based on the operation records and/or arthroscopic videos.Measurement of three-dimensional fracture morphology included the following:Frontal fragment width of plateau,sagittal fragment subsiding distance(FSD),sagittal fracture line distance,sagittal posterior tibial slope,and transversal area ratio of fragment area)on preoperative CT three-dimensional plane.The correlation of TML with skeletal values was calculated according to unicondylar TPFs and bicondylar TPFs.RESULTS A total of 67 patients were enrolled in this study,among which 30 patients had TMLs,lateral/medial(23/7).FSD was a particularly positive factor to predict TML,with odds ratio of 2.31(1.26-5.63).On sagittal view of CT,FSD degree of 8 mm and posterior tibial slope exceeding 11.74°implied enhanced risk of TML in bicondylar TPFs.On coronal view,once fragment width of plateau surpassed 3 cm,incidence of TML reached 100%.On transverse view,area ratio of fragment as enhanced risk of 5.5%and FSD>4.3 mm for predicting TML were observed in unicondylar TPFs.CONCLUSION TML can be predicted by different parameters on preoperative CT views according to unicondylar fractures and bicondylar TPFs.
