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BACKGROUND: Although traditional plain scan and enhanced magnetic resonance imaging has been used for skeletal muscle imaging for many years, it is not enough to evaluate the microscopic changes of diseased tissue or the activity of diseased tissue. Dynamic contrast-enhanced magnetic resonance imaging can capture this information and advantages are shown in orthopedic imaging examination. OBJECTIVE: To review the progress of dynamic contrast-enhanced magnetic resonance imaging in orthopedics clinics. METHODS: The relevant documents from January 1900 to February 2020 were retrieved in the CNKI database, PubMed database, Web of Science and Wanfang database by computer. The search terms were “dynamic contrast-enhanced magnetic resonance imaging; skeletal muscle tumor; arthritis; spine; fracture” in Chinese, and “dynamic contrast enhanced magnetic resonance imaging (DCE-MRI); osteomuscular tumor; arthritis; spinal surgery; fracture” in English. RESULTS AND CONCLUSION: (1) At present, there is a general lack of consensus on the best scanning method for acquiring dynamic contrast-enhanced magnetic resonance imaging images and the ideal method for analyzing such images in clinical applications. The parameter analysis methods are mainly qualitative, semi-quantitative and quantitative analysis. (2) Dynamic contrast-enhanced magnetic resonance imaging has been widely used in non-invasive detection, qualitative and therapeutic monitoring of different diseases such as heart failure, breast cancer, prostate cancer, renal rejection and liver tumors. The clinical application in orthopedics is not mature enough, but has unlimited potential: It can be used to assess the blood flow after femoral neck fracture and to predict the viability of the femoral head, the regional perfusion of nonunion after fracture, bone perfusion of arthritis and other entities, and detection of deformed blood vessels. Compared with conventional imaging, in contrast, dynamic contrast-enhanced magnetic resonance imaging can also better assess the relationship between changes in lumbar spine perfusion, disc degeneration, and endplate perfusion at different stages. [ABSTRACT FROM AUTHOR]

Total knee replacement is one of the most effective methods for the treatment of end-stage knee osteoarthritis. At present, the method of mechanical alignment is mainly used in the lower limb alignment of the knee replacement, which can improve the function of the knee joint, but some patients can also produce the postoperative knee joint pain, limited activity and other complications, resulting in poor satisfaction after operation. In recent years, more and more studies have begun to focus on moving mechanics alignment techniques and applied it to clinical practice. The kinematic alignment technique is aimed at the reconstruction of the anatomical structure of patients, keeping the motion axis of the knee joint prosthesis in line with the physiological motion axis of the knee joint, reducing the release of soft tissues and ligaments around the knee joint, and realizing the physiological kinematics of the knee joint. In this paper, the study of the method of dynamic mechanical alignment in total knee arthroplasty is reviewed. [ABSTRACT FROM AUTHOR]

BACKGROUND: Studies have shown that the femoral bowing angle is strongly associated with the distal femoral valgus angle, so the distal femoral valgus angle can vary with the angle of the femoral bowing. If the preoperative plan is inadequate or not aware of the problem, it will affect the postoperative lower limb alignment and the position of femoral prosthesis and affect clinical outcomes. Either conventional or computer-assisted navigation surgery can often be used in patients with total knee arthroplasty for this type of end-stage knee osteoarthritis. OBJECTIVE: To review the causes, definitions and effects of the presence of the femoral bowing, and compare the intraoperative osteotomy and postoperative outcomes in the two surgical methods for knee osteoarthritis with femoral bowing in total knee arthroplasty. METHODS: A computer-based search of CNKI, PubMed, and WanFang was performed for retrieving articles concerning the application of arthroplasty in the end-stage knee arthritis with femoral bowing published from August 1997 to May 2018. The keywords were “knee arthritis, femoral bowing, total knee arthroplasty/replacement, computer-assisted navigation, limb alignment” in Chinese and English, respectively. After initial screening of titles and abstracts and exclusion of irrelevant articles, 51 eligible articles were included in final analysis according to the inclusion and exclusion criteria. RESULTS AND CONCLUSION: (1) The incidence of femoral bowing in Asians is higher than that of Western Europeans and other Westerners, and vitamin D and calcium intake should be strengthened. (2) There is a strong correlation between the femoral bowing and the distal femoral valgus angle. Conventional cutting angle may affect the lower limb alignment and prosthesis placement. (3) Compared with the conventional method, computer-assisted navigation total knee arthroplasty can more accurately reconstruct the postoperative lower limb alignment and accurately place the position the prosthesis. (4) In the two surgical procedures, navigation has more advantages in rebuilding the coronal lower limb alignment, but it cannot bring satisfactory clinical outcomes. Before degeneration, it has its own deformity, and then it returns to the neutral position, and may not get satisfied clinical outcomes. [ABSTRACT FROM AUTHOR]