简介：Objective:Toevaluatetheresultsoftotalkneearthroplasty(TKA)inpatientswithposttraumaticdegenerativearthritisduetoapreviousfracturearoundtheknee.Methods:Weanalyzedtheresultsof15TKAs,performedfrom1997to2003,in15patientswithpost-traumaticdegenerativearthritisduetoapreviousfracturearoundknee.Therewere3womenand12menwithanaverageageof58years(range,31-76years).Thetimefromfracturetoarthroplastyaveraged8.2years(range,2-27years).Internalfixationhadpreviouslybeenperformedin8patientsresultinginretainedhardware.Atthetimeofarthroplastyafemoralfracturemalunionwaspresentintwoknees.Lateralretinacularrelease(4knees),extensormechanismrealignment(1knee)ormedialcollateralligamentreconstruction(1knee)wereneededatthetimeofarthroplasty.Results:Follow-upaveraged35months(range,12-73months).Nopatientwaslostforfollow-up.AccordingtotheKneeSocietyScorescale,themeanpreoperativekneescorewas37(range,10-70)andfunctionalscorewas41(range,0-60).Theywereimprovedsignificantlytoameanof84(range,10-100)and76(range,20-100)points,respectivelyatthelatestfollow-up.Themeankneearcofmotionwereimprovedfrom84°preoperationto94°atthelatestfollow-up.Postoperativemanipulationunderanesthesiaforpoormotionwascarriedoutin4knees.Nokneehadasepticlooseningthatrequiredsubsequentrevision.Twokneesdevelopedsuperficialinfectionandweretreatedwithdebridement.Itsubsequentlyrecoveredwiththeretentionofcomponents.Conclusions:SignificantimprovementinfunctionandreliefofpainhasbeenachievedinpatientswithpreviousfracturesundergoingsubsequentTKA.However,thisprocedureistechnicallydemandingandpatientsareatincreasedriskforrestrictedmotionandneedmorecarefollowingTKA.ThisstudysuggeststhattheoutcomeofTKAmaybeimprovedfurtherbymakingspecialeffortstorestorelimbalignment,toensurecorrectcomponent

简介：客观：探索multiple-ligamentinjured膝的临床的特征并且为multiple-ligamentinjured膝评估处理的协议，技术和结果。方法：从2001年10月，到在9的2005年3月，有联合前面的十字形的系带(ACL)的9膝和以后的十字形的系带(打印机控制语言)眼泪，病人们被识别与临床并且arthroscopic考试。他们，5膝与破裂ofposteromedial角落(PMC)和中间的并行的系带(MCL)被相结合，4与混乱ofposterolateral角落(PLC)，2与腿弯部的脉管的损害并且1与小腿侧的神经损害。六个病人在损伤的尖锐阶段被就医，腿弯部的动脉and4的2个收到的修理举办了PMC和MCL的修理。有在arthroscope下面的自体移植的ACL和打印机控制语言的重建在损伤以后在4～10个星期在所有病人被执行，包括有在4个病人的二头肌femoris腱tenodesis的以后的一半的PLC的重建和PMC和MCLwith的重建在1个病人的大腿骨的扁带。结果：没有严重复杂并发症在9个病人在手术以后发生在早舞台。所有他们被跟随在上面为有23的一般水准的10-39月。00months±9。46个月。Lysholm分数是有85.00±的一般水准的70-958.29。InternationalKnee文档委员会(IKDC)分数从严重地反常(等级D)在在到在2膝的正常(等级A)的起始的检查的9膝，将近在6膝的正常(等级B)并且在在最后后续的1knee反常。9个病人，7在损害前回到了一样的活动水平，2在水平下面。结论：有严重不稳定性的多重系带的受伤的膝通常与另外的重要结构损坏被相结合。因此，对联合损害的小心的评价和治疗是必要的。在arthroscope下面的ACL和打印机控制语言的重建，同时或在阶段与额外的关节的系带的修理或重建结合了，在外科和令人满意的结果有最小的损伤的优点。

简介：AbstractPurpose:The treatment and outcome of tibial stress fractures concomitant with knee osteoarthritis (OA) are complicated. The aim of this study was to evaluate the functional and radiological outcome of total knee arthroplasty with long tibial stem as a treatment for patients having knee OA and tibial stress fracture.Methods:Patients who were diagnosed to have proximal tibia stress fracture along with knee OA at our institution between June 2013 and November 2018 were included in our study. All patients underwent total knee arthroplasty with long tibial stem. Preoperative and postoperative functional assessments were done according to range of movement of the knee joint, knee society score and knee injury and OA outcome score. Descriptive analysis was carried out by mean and standard deviation for quantitative variables, frequency and proportion for categorical variables.Results:Twelve patients were included in the study. All patients were found to have stress fractures in the proximal half of tibia and extra-arthrosis. Four patients had non-union/delayed union, and 8 patients had acute fractures. The average preoperative range of movement was 88.1°, which improved to 116.3° at 3 months following surgery. It was found that the fracture has healed in all cases. Mean knee society score improved from 32.9 preoperatively to 89.3 at 1 year follow-up. Knee injury and OA outcome score improved from a mean score of 28.3 preoperatively to 81.1 at 1 year follow-up.Conclusion:Stress fractures can occur in the proximal tibia in patients with knee OA. Total knee arthroplasty with tibial stem provides a suitable solution for both conditions. Additional plating or bone graft is unlikely to be required.

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简介：针刺膝关节周围的4个穴位,犊鼻、内膝眼、梁丘和血海,得气后接电针,并用TDP照射膝关节,治疗了78例膝关节骨性关节炎患者.治疗2个疗程后,临床治愈26例,显效18例,好转31例,无效3例,总有效率96.2%.

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简介：由使随机化的控制试用为膝骨关节炎(洋槐的一种)观察温暖的刺破的艾灸的临床的效果。

简介：客观：到从膝系带的文化成纤维细胞房间并且到学习这些房间的生物特征。方法：前面的十字形的系带(ACL)和从新西兰白兔子的中间的并行的系带(MCL)的房间在vitro是有教养的。骨胶原的细胞的生长和表示被分析。而且，一在里面vitro创伤闭合模型被建立，ACL和MCL房间愈合被比较。结果：为所有这些房间的最大的生长与Dulbecco的家被获得修改的鹰与10%胎儿的牛的浆液补充的媒介，而是RPMI1640和火腿是媒介不是合适的维持这些房间的F12。从新西兰白兔子的ACL和MCL房间的形态学在vitro是相似的，但是MCL房间变得比ACL房间快。两种房间类型在我由ACL房间生产了打III的大杂烩类型的文化，而是比率生产了骨胶原的类似的数量比由MCL房间生产了高。创伤闭合试金证明在在损害以后的36个小时，在ACL文化创造的没有房间的地区被ACL房间部分占据；相反，在MCL文化的受伤地区被房间几乎完全盖住。结论：尽管从新西兰白兔子的ACL细胞和MCL细胞在文化在形态学显示出类似的外观，细胞的生长和象在vitro愈合一样的骨胶原的生物化学的合成是显著地不同的。在在vitro的房间的二种类型的内在的性质的这些差别可能在vivo贡献这些系带的微分愈合潜力。

简介：ArthritisistheleadingcauseofdisabilityinolderadultsintheUnitedStates.1Osteoarthritis(OA)isthemostcommonformofarthritis,andkneeandhipthemostaffectedjoints.SomeofthecommonriskfactorsareassociatedwithkneeandhipOAincludingage,bodyweight,pastjointinjuries,andsportparticipation.Participationinstrenuoussportsincreasestherisksofinjuries.However,itisnotclearifparticipationindifferentsportspresentsdifferentrisksforOA.2Forexample,itiswellknownthatrunningincreasestheriskforkneeinjuries,butitremainsunknownifrunningisassociatedwithan

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简介：由于mediopatellar襞的眼泪胀大和前面的痛苦的膝的一个案例被报导。锁住的patellofemoral关节和膝的耐心的也感到的笨蛋。在arthroscopic检查下面，厚、含纤维的襞被发现中间到膝盖骨，并且沿着到infrapatellar脂肪的从中间的膝盖骨的支持带的襞的桶眼泪垫。极化的显微镜的检查显示出骨胶原纤维碎片和轻思考性质的损失。Neuroimmunohistology在裂缝附近在区域建议了synovial襞神经分布的起来规定。这可能与疼痛有关。mediopatellarplicacaused疼痛的桶眼泪和膝的锁比以前报导是更普通的。

简介：AbstractPurpose:Common peroneal nerve palsy is quite disabling and every effort should be made to prevent its injury during the treatment.Methods:We retrospectively reviewed the prospectively collected data of 7 cases of tibial plateau fractures in association with proximal fibula fracture from January 2019 to September 2019 who presented to emergency room of our hospital.Results:In addition to fibular neck fracture, the first case had type 6 tibial plateau displaced fracture and the second case had displaced acetabular fracture with instability of knee with tibial tuberosity avulsion. common peroneal nerve palsy developed following application of distal tibial skeletal traction in both the cases. Other 6 such cases remained neurologically intact as traction was not applied to them.Conclusion:Such iatrogenic complication could have been prevented if the injury pattern of "concomitant medial and lateral columns" of the proximal leg is kept in mind by the treating surgeon before applying skeletal traction.

简介：Objective:Tocomparethetherapeuticeffectofpointpenetrationmethodoflongneedleandthatofwesterndruginthetreatmentofkneeosteoarthritis.Methods:Thesimpleandrandomizedgroupingmethodwasusedinpresentstudy.Results:Theeffectiverateintheacupuncturegroupwas87.5%,andinthewesterndruggroupwas55.6%,thesignificantdifferencewasfoundbetweentwogroupsinthetherapeuticeffect(P＜0.01).Conclusions:Thetherapeuticeffectofpointthroughpointwithlongneedleinthetreatmentofkneeosteoarthritiswasbetterthanthatofwesterndrug.

简介：Background:NostudieshavecomparedeffectivenessofresistancetrainingandTaiJiexerciseonrelievingsymptomsofkneeosteoarthritis(OA).Thepurposeofthestudywastoevaluateeffectsofa10-weekTaiJiandresistancetraininginterventiononimprovingOAsymptomsandmobilityinseniorswithkneeOA.Methods:Thirty-oneseniors(60-85years)wererandomlyassignedtoaTaiJiprogram(n=12),aresistancetrainingprogram(n=13),andacontrolgroup(n=6).AllparticipantscompletedtheWesternOntarioandMcMaster(WOMAC)OsteoarthritisIndexandperformedthreephysicalperformancetests(6-minwalk,timed-up-and-go,andtimedstairclimbanddescent)beforeandafterthe10-weekintervention.Results:Theparticipantsintheresistancetraininggroupsignificantlyimprovedonthetimed-up-and-gotest(p<0.001),theWOMACpainsubscore(p=0.006),WOMACstiffnesssub-score(p<0.001),andWOMACphysicalfunctionsub-score(p=0.011).TheTaiJigroupsignificantlyimprovedonthetimed-up-and-gotest(p<0.001),butnotontheWOMACscores.Conclusion:ResistancetrainingwaseffectiveforimprovingmobilityandimprovingthesymptomsofkneeOA.TaiJiwasalsoeffectiveforimprovingmobility,butdidnotimprovekneeOAsymptoms.

简介：AbstractAnterior tibiofemoral dislocation after total knee arthroplasty is an extremely rare and serious event. Amongst English-published papers, we found only 15 relevant cases, 3 of which presented vascular complications. This manuscript aims to present a 77-year-old woman with a TC-Plus (Smith & Nephew) cruciate-retaining type in first time of knee prosthesis, who suffered an anterior tibiofemoral dislocation and were admitted to our hospital. The clinical management and outcome were evaluated. Furthermore, a review of literature was performed. We concluded that early detection and surgical intervention of vascular injury is the key in the survival of the limbs. If there is still knee instability after acute recovery, it seems that revision surgery with constrained total knee arthroplasty can bring about good clinical and functional results.

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简介：AbstractPurpose:The poor prognosis in patients with floating knee injuries is mainly contributed to articular involvement (Fraser's type II). This study aims to evaluate and compare the functional outcomes among different Fraser's type II floating knee injuries after surgical management.Methods:Twenty-seven patients with Fraser's type II floating knee injuries (54 fractures) between September 2014 and December 2015 were enrolled prospectively in this study and were distributed according to Fraser's floating knee classification into three different groups as type IIA (ipsilateral femoral shaft and tibial intra-articular involvement, n = 11), type IIB (ipsilateral tibial shaft and femoral intra-articular involvement, n = 9) and type IIC (both femoral and tibial intra-articular involvement, n = 7). The differences among the groups were evaluated and compared. The functional outcomes of these injuries at one year were analyzed using Knee Injury and Osteoarthritis Outcome Score (KOOS) which covers 5 subscales of pain, other symptoms, activities of daily living, sports and recreation, and quality of life. The result was also compared with standardized age-sex matched healthy population using paired samples t-test.Results:All the patients were male, and the injury mechanism was solely roadside accident. The mean age was 29.8 years and injury severity score 17.9 (comparable in all the three groups). Most injuries were observed on the right side (20 cases, 74.1%). Based on paired samples t-test, the KOOS score of patients with Fraser's type IIA was found to be better than that of type IIB and type IIC. Compared with the reference age-sex matched control group, patients with Fraser's type IIB and IIC fractures had significantly lower mean score in all KOOS subscales (all p < 0.01). However, Fraser's type IIA only revealed significant difference regarding the subscales of activities of daily living (p < 0.0001), sports and recreation (p < 0.0001), and quality of life (p < 0.0001).Conclusion:The results of this study show that patients with Fraser's type IIA fractures had a better functional outcome as compared to those with type IIB and IIC fractures. This might be due to the open intra-articular involvement of the distal femur of the latter two fracture types.

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