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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]

BACKGROUND: Osteoporosis is a disease in which bone density and structure are destroyed and fractures are caused by increased bone fragility, leading to high clinical disability and mortality rates. OBJECTIVE: To review the research progress in the role of bone immunity in physiological and pathological processes related to bone metabolism, providing ideas for the research and clinical application of bone immunity in bone diseases. METHODS: The first author searched PubMed and CNKI databases in November 2022 for relevant literature using the keywords of “osteoimmunology, immuno-skeletal interface, bone metabolism, skeletal metabolism, lymphocyte, immune factor” in English and Chinese, respectively. The time range of retrieval was mainly from January 2010 to November 2022, and a small number of classical long-term literatures were included. After reading the topic and abstract for preliminary screening and excluding repetitive studies, low-quality journals and unrelated literature, 81 documents were finally included for review. RESULTS AND CONCLUSION: Osteoimmunology refers to that bone and immune cells share the same microenvironment and interact with each other to jointly perform the “bone immune system,” which includes all cells in the bone marrow. Immuno-skeletal interface has protective effects on bone under physiological conditions, but it may lead to bone destruction under pathological conditions. Osteoprotegerin is mainly derived from B cells and can inhibit osteoclast metabolism. However, when the body is in an inflammatory state, T cells and B cells work together to promote bone resorption. In addition, interleukin-1, interleukin-6 and tumor necrosis factor-α regulate the expression of receptor activator of nuclear factor-κB ligand in vivo and affect bone metabolism. In most clinical diseases (such as rheumatoid arthritis, estrogen deficiency, HIV infection, and hyperparathyroidism), the immuno-skeletal interface interacts with the bone immune system, resulting in the regulation of bone metabolism. In terms of clinical prospect, the interaction between bone immunity and bone metabolism should be studied in order to propose new strategies for therapeutic intervention to reduce the risk of fracture. [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: Previous studies have found that both high tibial osteotomy and high tibial osteotomy combined with arthroscopy can effectively treat medial compartment osteoarthritis with varus deformity of the knee, but there are few studies comparing the therapeutic effects of the two. OBJECTIVE: To compare the clinical outcome of high tibial osteotomy and high tibial osteotomy combined with arthroscopy to treat degenerative tear in the posterior horn of medial meniscus combined with varus deformity of knee joint. METHODS: From July 2015 to January 2019, data of 48 knee osteoarthritis patients with degenerative tear in the posterior horn of medial meniscus combined with varus deformity of knee joint in Affiliated Hospital of Zunyi Medical University were retrospectively analyzed. The 24 patients in the trial group were treated with high tibial osteotomy combined with arthroscopy. The 24 patients in the control group were treated with high tibial osteotomy. The knee joint function scores and imaging detection indexes at different time points after operation were compared between the two groups. RESULTS AND CONCLUSION: (1) The hospital for special surgery knee score and knee Lysholm score of patients in the trial group at 6 and 12 months after operation were higher than those in the control group (P < 0.05). There was no significant difference in the hospital for special surgery knee score and knee Lysholm score between the two groups at 24 and 36 months after operation (P > 0.05). The visual analogue scale score of patients in the trial group was lower than that in the control group at 6 months after surgery (P < 0.05). There was no significant difference in the visual analogue scale scores between the two groups at 12, 24, and 36 months after surgery (P > 0.05). (2) The imaging examination at 12 months after operation showed that the lower limb alignment and femoral tibial angle were effectively improved in both groups, and the relative positions of the femoral tibial angle and lower limb alignment passing through the tibial plateau and the posterior tibial slope of the tibial plateau were not significantly different between the two groups (P > 0.05). (3) It is concluded that high tibial osteotomy and high tibial osteotomy combined with arthroscopic surgery can effectively treat degenerative tear in the posterior horn of medial meniscus combined with varus deformity of knee joint, effectively improve joint function and relieve pain symptoms. High tibial osteotomy combined with arthroscopy exhibited good early clinical efficacy. [ABSTRACT FROM AUTHOR]

BACKGROUND: To establish an animal osteomyelitis model is the basis and key to explore the treatment of osteomyelitis. In the past, direct addition of bacteria was used to make the osteomyelitis model, which is significantly different from clinical pathogenic factors. Moreover, it is difficult to control the amount of bacterial suspension dripped, which can easily lead to the death of model animals. Osteomyelitis caused by bacterial biofilms is the most common in clinical practice. OBJECTIVE: To prepare a rat model of osteomyelitis by inserting Kirschner wires with bacterial biofilms into the rat bone marrow cavity. METHOD: Bacterium-bearing Kirschner wires were prepared using Staphylococcus aureus. Eighteen healthy Sprague-Dawley rats were enrolled. Kirschner wires with Staphylococcus aureus biofilms were inserted into the rat tibia, and the borehole was sealed with sterile paraffin. Rats’ behaviors and incision healing were observed after modeling. Bone infection was observed through imaging and pathological examinations at 4 weeks after modeling. Secretions at the model site were aseptically taken for bacterial culture, and mass spectrometry was used to identify whether they were the bacteria inoculated during the production of bacterial biofilms, and the serum inflammatory factors of rats before and after modeling were detected as indicators for evaluating the success of the osteomyelitis model. RESULTS AND CONCLUSION: All the 18 rats presented with the characteristics of osteomyelitis. They all showed different degrees of pus, dead bone, dead space and new bone formation. After modeling, the levels of serum inflammatory factors, such as procalcitonin, tumor necrosis factor alpha and interleukin-10, increased significantly (P < 0.05). The bacteria that formed after secretion culture were identified as Staphylococcus aureus. To conclude, the rat osteomyelitis model can be successfully made by inserting the Kirschner wire into the rat tibia through the Staphylococcus aureus biofilm, which is closer to osteomyelitis in clinic. [ABSTRACT FROM AUTHOR]

股骨旋转对线为影响全膝关节置换术后膝关节功能极为重要的因素，常用的股骨旋转对线参照轴有股骨内外上髁轴、股骨后髁轴、前后轴线、股骨前轴、股骨滑车轴等。积极探讨股骨旋转对线的术中参照轴对有效地降低膝关节并发症的发生有重要意义。 [ABSTRACT FROM AUTHOR]

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]

Objective To observe the curative effect of anti-osteoporotic drugs on osteoporotic intertrochanteric fractures after internal fixation in the elderly. Methods Fifty-seven elderly patients, who were over 60 years old and diagnosed with osteoporotic intertrochanteric fractures from July 2013 to June 2014 in our hospital, were selected. They were divided into group A (30 cases, with the use of anti-osteoporotic drugs) and group B (27 cases, without the use of anti-osteoporotic drugs). Oral D-Cal and alendronate were administered on the fifth day after the surgery. The healing time of the fracture, complications, Harris hip score, and bone mineral density (BMD) were observed. Results Twenty-six cases in group A and 24 cases in group B were completely followed-up. There was no statistical difference in the fracture healing time and complications (P > 0. 05) between the two groups. After 12 months of surgery, the score of Harris in group A was higher than that in group B,with statistical significance (P < 0. 05). The serum calcium and vitamin D levels was lower in two groups three days after surgery than those before the surgery, with statistical significance (P < 0. 05). After 6 months of the surgery, the serum calcium and vitamin D levels in group A increased comparing to those before the surgery and three days after surgery,with statistical significance (P < 0. 05). BMD in group A and group B was not different in 6 months of the surgery. After 12 months of the surgery, BMD increased in group A, but did not increase in group B, comparing to that before the surgery. Conclusion The use of anti-osteoporotic treatment increases BMD in the elderly patients with osteoporotic intertrochanteric fractures, and obtains better curative effect. [ABSTRACT FROM AUTHOR]