The photo-Fenton degradation mechanism of CoFe 2 O 4 with H 2 O 2 and PMS as oxidants and some effective strategies to improve the catalytic performance.
Purpose: We developed an augmentation technique for PCL reconstruction with independent internal brace reinforcement and evaluated the functional outcome after PCL reconstruction employing autologous hamstrings augmented with an internal brace system for patients with isolated or combined grade 3 posterior instability who were treated with this technique. Methods: From January 2016 to January 2018, patients with isolated or combined grade 3 PCL tears who underwent single-bundle PCL reconstruction using autologous hamstrings augmented with independent internal braces were studied. The function of the operated knee was evaluated according to the International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner activity score. The patients were asked the level of returned to their previous sport. Posterior knee laxity was examined with a KT-1000 arthrometer, and data on range of motion (ROM), re-operation, and other complications were collected. Results: A total of 33 consecutive patients who received single-bundle PCL reconstruction using autologous hamstrings augmented with independent internal braces with a minimum two years follow-up were included in this study. Two patients had undergone this procedure during the study period and were not included in this study (one had combined bone fractures, and one patient had previous meniscus surgery). Thirty-one patients were available for final analysis. The mean follow-up was 45.35 ± 10.88 months (range 29–66 months). The average IKDC subjective knee evaluation scores from 51.65 ± 12.35 to 84.52 ± 6.42, the Lysholm score from 53.90 ± 11.86 to 85.68 ± 4.99, and the Tegner score from 2.81 ± 0.79 to 6.71 ± 1.83 (P < 0.05 for all). The mean total posterior side-to-side difference in knee laxity, assessed using a KT-1000 arthrometer, decreased from 12.13 ± 2.66 mm pre-operatively to 1.87 ± 0.56 mm post-operatively at 70° (P < 0.05). Most patients (29/31) had normal or near normal knee ROM post-operatively; two patients revealed a 6–15° loss of knee flexion compared with the contralateral knee. Twenty-nine patients (93.55%) returned to a normal daily exercise level. Twenty-three patients (74.19%) returned to competitive sports with high-level sports (Tegner score of 6 or above; eleven patients (35.48%) reported to be on the same level as well as the Tegner level); six patients (19.35%) returned to recreational sports (Tegner score of 4 or 5). Two patients had Tegner scores of 2 and 3, indicating poor function level. No patient needed PCL revision surgery during the follow-up period. Conclusion: Single-bundle PCL reconstruction with internal brace augmentation for PCL injury exhibited satisfactory posterior stability and clinical outcomes in patients with isolated or combined grade 3 PCL injuries at a minimum two year follow-up.
Due to the small scale, low technical level, and limited scope of application of artificial intelligence in the field of traditional Chinese medicine orthopedics, there are many problems in the development of this area. Driven by precise and minimally invasive medical concepts, the integration of artificial intelligence and data mining technologies (such as the Internet, cloud computing, and big data) will further profoundly change the face of smart healthcare in the future, which will bring great challenges to traditional Chinese medicine orthopedics, and Change opportunities for your own development. In order for artificial intelligence to provide good diagnosis and treatment services for a large number of patients with orthopaedic diseases, progress still needs to be made with the technology and joint efforts of many orthopaedic experts and scholars. This article uses data mining techniques to optimize orthopedic rehabilitation information. Test results show that the system is faster and more convenient. Artificial intelligence technology will be used for intelligent medical treatment of orthopedic diseases in the future. It will become an essential assistant for clinicians and make a significant contribution to the diagnosis of various orthopedic diseases.
1 February 2020 in Orthopaedic Journal of Sports Medicine
Several fixation methods have been introduced in medial patellofemoral ligament (MPFL) reconstruction. However, the optimal management of patients with recurrent patellar dislocation remains controversial. To present a case series with a minimum 2-year follow-up of 29 patients with recurrent patellar dislocation who underwent a new transosseous suture fixation technique for MPFL reconstruction. Case series; Level of evidence, 4. From January 2014 through February 2016, a total of 29 patients with recurrent patellar dislocation for which the MPFL was reconstructed with transosseous suture patellar fixation were studied. All patients were available for follow-up (mean, 37.52 months; range, 26-48 months). The patellar attachment was fixed by transosseous patellar sutures. The International Knee Documentation Committee (IKDC) subjective knee score, Kujala score, Tegner score, range of motion, congruence angle, patellar tilt angle, and complications were assessed both pre- and postoperatively. No recurrent dislocation was observed in any of the 29 patients for a minimum of 2 years. All outcome scores improved significantly from preoperatively to postoperatively: the average IKDC subjective knee evaluation score from 53 to 87, Kujala from 54 to 90, Lysholm from 50 to 89, and Tegner from 3 to 5 (P < .001 for all). The congruence angle significantly decreased from 22° preoperatively to –3° postoperatively, and the patellar tilt angle (Merchant) decreased from 23° preoperatively to 5° postoperatively (P < .001 for both). In total, 25 patients (25/29; 86.21%) were completely pain-free when performing activities of daily living at the last follow-up, and 27 patients (93.1%) rated themselves as very satisfied or satisfied with the results. In patients with chronic recurrent patellar dislocation, transosseous patellar suture fixation for MPFL reconstruction can significantly improve patellar stability and achieve good results at short-term follow-up.
1 May 2020 in Orthopaedic Journal of Sports Medicine
Background: Patellar instability remains a challenging problem for orthopaedic surgeons. Recurrent patellar instability is traditionally treated with medial patellofemoral ligament (MPFL) reconstruction using a suture anchor or bone tunnel technique. Although the use of transosseous sutures was recently described for MPFL reconstruction, relevant clinical data have not been reported. Purpose/Hypothesis: The purpose of this study was to compare a new transosseous suture fixation technique with the suture anchor technique for MPFL reconstruction. The hypothesis was that reconstruction with transosseous sutures would show similar clinical results to reconstruction with suture anchors. Study Design: Cohort study; Level of evidence, 2. Methods: There were 65 patients with recurrent lateral patellar dislocations from January 2014 to December 2016 who were included in this prospective nonrandomized controlled trial. In total, 31 patients underwent MPFL reconstruction with suture anchors at the patella site (suture anchor group), while the other 34 patients underwent MPFL reconstruction with transosseous sutures (transosseous suture group). The main outcome variable (patellar redislocation) was recorded at follow-up (range, 25-60 months). The International Knee Documentation Committee (IKDC) score, Kujala score, range of motion, congruence angle, patellar tilt, redislocation rate, and complications were collected preoperatively and/or postoperatively. Results: No recurrent dislocations or other complications were observed in any of the patients. No significant differences were found at follow-up between the suture anchor and transosseous suture groups for subjective IKDC score, Kujala score, congruence angle, patellar tilt, redislocation rate, or range of motion. Conclusion: This short-term study showed that after MPFL reconstruction (suture anchors or transosseous sutures), patellar stability could be restored. With the numbers available, no significant differences in outcome scores were observed between patients in the transosseous suture and suture anchor groups.
Purpose: To assess whether posterior cruciate ligament reconstruction (PCLR) with suture tape augmentation can yield more stability after isolated PCLR. Methods: A prospective database was retrospectively reviewed to identify patients who underwent primary isolated PCLR (control group) or isolated PCLR with suture tape augmentation (study group) from January 2016 to September 2020. We analyzed subjective International Knee Documentation Committee (IKDC), Lysholm, and Tegner knee scores; posterior drawer test findings; posterior stress radiographs; and return–to–sports activity rates. The minimal clinically important difference (MCID) was used to evaluate clinical relevance (subjective IKDC, Lysholm, and Tegner scores). Results: A total of 59 patients were included in this analysis (28 in control group and 31 in study group). The average length of follow‐up was similar between the study and control groups (48.6 months vs 47.9 months, P = .800). Knee function was significantly improved in the study group in terms of subjective IKDC scores (85.1 ± 6.4 in study group vs 79.8 ± 6.4 in control group, P = .002), Lysholm scores (86.3 ± 7.4 vs 80.8 ± 7.4, P = .005), and Tegner scores (7.0 ± 1.4 vs 5.6 ± 1.7, P = .006). However, the differences between the control and study groups were less than the MCID for the subjective IKDC score and Lysholm score. In the control and study groups, 21.4% of patients (6 of 28) and 48.4% of patients (15 of 31), respectively, returned to their preinjury sports activity levels ( P = .031). At last follow‐up, the mean side‐to‐side difference in posterior laxity was significantly improved in the study group compared with the control group (1.52 ± 0.70 mm in study group vs 3.17 ± 2.01 mm in control group, P < .01). Conclusions: Primary isolated PCLR with suture tape augmentation provides better posterior stability than PCLR without suture tape augmentation at a minimum of 2 years’ follow‐up. No differences between the groups were observed in the percentage of patients who met or exceeded the MCID for the subjective IKDC and Lysholm scores. Level of Evidence: Level III, retrospective comparative study.