To observe the clinical effect of pinknife release guided by visual ultrasound in the treatment of stenotenosynovitis.

A total of 43 patients with stenotenosynovitis were selected from the acupuncture clinic of the First Affiliated Hospital of Guangzhou Medical University from May 2020 to July 2023. The patients with history of chronic strain of the hand, poor flexion and extension of the fingers and localized soreness were included. The patients with stenotenosynovitis combiningpathological changes between the tenosynovitis membrane and the tendon under ultrasound imaging, and severe underlying diseases (i.e. hypertension, diabetes, coronary disease and severecardial, hepatic, renal dysfunctions, history ofhemorrahge tendency, open surgery, and allergic to anesthesia drugs) were excluded.The changes of pain grading index, visual analogue scale, pain intensity evaluation, joint range of motion and treatment satisfaction of the patients undergoing ultrasound-guided pinknife release were compared before treatment, two weeks and three months after treatment. The changes of tendon sheath thickness before and after treatment were observed and compared with the healthy group. The anastomosis between ultrasonic fixed point and pain point was observed and the changes of ultrasonic imagingbefore and after treatment were compared.T test was used to compare pain indices and tendon sheath thickness before and after treatment, chi square test was used to compare the degree of joint mobility limitation and satisfaction.

The study found that patients chose acupotomy after they were not satisfied with the effect of the previous treatment. The score of McGill pain questionnaire showed that there was statistical significance after two weeks of treatment compared with before treatment (t =9.700, 13.824, Z=-6.698, all P<0.05). Patients′ tolerance to pain intensity, nature of pain and fear of pain were significantly improved compared with before treatment. The normal rate of joint mobility disorders reached 60.4% two weeks after treatment and 100% three months after treatment. Patient satisfaction was 62.8% after two weeks and 100% after three months. Before treatment, the tender point of the lesion was consistent with the positive image marks of the lesion under ultrasound. The ultrasonic image of the lesion showed decreased echo and abundant blood flow signal, and the thickness of tendon sheath before treatment was statistically different from that of the healthy group (t=11.473, P<0.05). Three months after treatment, the tender point of the lesion disappeared. The local hypoechoic area disappeared, the signal of rich blood flow decreased, and the thickness of tendon sheath decreased compared with that before treatment (t=1.742, P<0.05), and was similar to that of healthy group (t=1.742, P>0.05), suggesting that the tendon sheath improved with the improvement of circulation after treatment, and the soft tissue environment around the tendon improved.

Ultrasound guided pinknife therapy can directly reflect the changes of tendon and tendon sheath in the internal level, display the precise image of tendon and tendon sheath adhesion, and provide a clear vision for pinknife operation. It can improve the clinical effect of acupotomy in the treatment of stenotendinitis, and provide a new treatment options for the clinical precision treatment of stenotenosynovitis.

To investigate the long-term effects of meniscoplasty on the progression of knee osteoarthritis (OA) after anterior cruciate ligament reconstruction (ACLR).

Patients with anterior cruciate ligament (ACL) injuries in affiliated provincial hospital of Anhui medical university from January 2010 to June 2013 were retrospectively analyzed.Inclusion criteria: initial ACLR with autologous tendon graft, minimum follow-up time of 10 years and complete clinical data, age at operation between 18 and 45 years, preoperative examination suggested that Kellgren-Lawrence (KL) grade of the knee <2. Exclusion criteria: intra-operative meniscus suture, obvious articular cartilage injury (Outerbridge grade Ⅲ to Ⅳ) , presence of varus or vagus deformity, and other knee joint injuries or surgical history. A total of 68 patients (53 males and 15 females) were included according to the criteria. According to whether meniscoplasty was performed during anterior cruciate ligament reconstruction, the patients were divided into two groups: the meniscoplasty group (n=32) and the control group (n=36). Criteria for the evaluation of OA included: radiographic osteoarthritis (ROA) was defined using KL grade, and ROA combined with the knee ostheoarthritis outcome score (KOOS) defined radiographic symptomatic osteoarthritis (RSOA). The incidence of ROA and RSOA were compared by chi square test, the scores of KOOS, International Knee Documentation Committee (IKDC) and Lysholm score, and the effect of RSOA on the function of meniscoplasty were analyzed by Mann-Whitney U test.

The median follow-up period was 11.0 (10.5, 12.0) years. The incidence of postoperative ROA was significantly higher in the meniscoplasty group (75.0%) than in the control group (44.4%)(χ²=6.530, P=0.011). The incidence of postoperative RSOA was also significantly higher in the meniscoplasty group (65.6%) than in the control group (30.6%)(χ²=8.363, P=0.004). In terms of functional scores, the meniscoplasty group had significantly lower quality of life related to the knee (QOL)(Z=3.657, P<0.001), pain (Z=3.719, P<0.001), sports and recreation function (S/R) (Z=3.447, P=0.001), IKDC (Z=2.899, P=0.004), and Lysholm (Z=3.031, P=0.002) scores than the control group. All the functional scores were significantly lower in the meniscoplasty group of RSOA-positive patients than in the negative patients (all P<0.001).

Meniscoplasty increases the risk of ROA and RSOA after ACLR, resulting in worse postoperative functional scores, the prevention and treatment of OA should mainly focu on those patients who have undergone meniscoplasty and postoperative RSOA.

To investigate the safety, early effectiveness and return-to-sport outcomes of all-inside peroneus longus tendon reconstruction and compare with anatomic single-bundle reconstruction of hamstring tendon in the treatment of anterior cruciate ligament (ACL).

From January 2021 to December 2022, 110 patients who were diagnosed with ACL injury and operated by the same surgeon in Changhai Hospital were prospectively analyzed. Inclusion criteria: ACL injury and no previous knee surgery history, willing to undergo all-inside peroneus longus tendon reconstruction or anatomical single-bundle hamstring tendon reconstruction, and able to be followed up regularly. According to the random number table method, they were divided into two groups. Fifty-five patients underwent total internal reconstruction of peroneus longus tendon (experimental group), aged from 24 to 40 years. Fifty-five patients underwent traditional hamstring tendon reconstruction (conventional group), with age from 27 to 40 years.The time of tendon harvesting, diameter of graft, and operation time were recorded. Lysholm score, International Knee Documentation Committee (IKDC) score, Tegner score, visual analogue scale (VAS) score, and American Foot and Ankle Society (AOFAS) score were evaluated before operation and at three, six, nine months, andone year after operation. Ligs knee relaxation test and return-to-sport evaluation were performed at one year after surgery. Independent sample t test was used for comparison of normal measurement data between groups, and repeated measurement variance was used for comparison within multiple time points. Mann-Whitney U rank sum test was used for comparison of non-normal measurement data between groups, Friedman test was used for comparison of multiple time points, and Wilcoxon rank sum test was used for comparison of two time points. Chi square test was used to compare count data between groups, and Mann-Whitney U rank sum test was used to compare rank data between groups.

The diameter of grafts in the experimental group was significantly larger than that in the conventional group(Z=-6.636, P<0.001), and the time of tendon harvesting was significantly shorter (Z=-9.304, P<0.001). At one year after operation, IKDC score(H=115.018, 105.664, both P<0.001), Lysholm score(H=120.783, 136.202, both P<0.001), Tegner score(H=98.690, 105.467, both P<0.001), and knee relaxation test(F=304.276, 373.941, both P<0.001) of the two groups were significantly improved when compared with those before operation, there was no statistically significant difference between the two groups (all P>0.05). At three and six months after operation, VAS in the experimental group was lower than that in the conventional group(Z=-2.358, -2.007, both P<0.05), but there was no statistically significant difference between the two groups at one year after operation(P>0.05). At one year after operation, the proportion of patients who passed the return-to-sport test in the experimental group was higher than that in the conventional group, and the difference was statistically significant (χ²=4.406, P=0.036).

Both all-inside peroneus longus tendon reconstruction and conventional hamstring tendon reconstruction can restore knee stability and significantly improve knee function at one year after operation. But the all-inside reconstruction graft of peroneus longus tendon has larger diameter, shorter time for harvesting tendon, milder early postoperative pain, it may be more beneficial for patients returning to sports after surgery.

To summarize and analyze the surgical effect of lateral retinacular release combined with lateral patellafemoplasty in the treatment of lateral patella compression syndrome.

This study was a retrospective clinical trial. The clinical data of 34 patients who underwent arthroscopic combined surgery to treat lateral patella compression syndrome from July 2015 to October 2019 by the same surgeon team from the Department of Sports Medicine of Peking University Third Hospital were included. Patients with anterior knee pain who had failed conservative treatment, tension of the lateral support band, and imaging findings indicating outward patellar tilting with lateral patellar osteophyte, Wiberg type III or IV patella, and arthroscopic lateral space stenosis were included. Patients with patellar instability, patellar dislocation, rheumatoid joint inflammation, patellofemoral joint development abnormalities, and patellofemoral osteoarthritis were excluded.The surgical method was L-shaped release of the lateral retinaculum combined with lateral patellafemoplasty. Paired t test was used to compare the Lysholm knee score, International Knee Documentation Committee knee subjective score (IKDC), visual analogue score (VAS), and patellar lateral curvature angle (LPCA) on 30° axial knee X-rays and lateral patellar tilt angle (PTA) before surgery and at the last follow-up. The paired t test and Wilcoxon signed rank test were used to compare the medial and lateral patellar cartilage damage seen under the intraoperative microscope in the same patient.

A total of 34 patients were followed up for 12 to 53 months, (23±11)months on average. No postoperative complication such as infection or nerve damage occurred. Scores and angles were better than those before surgery, and the differences were statistically significant (t=7.08, 5.77, 10.08, 10.80, Z=13.28, all P <0.05).

Arthroscopic lateral retinacular release combined with lateral patella molding has good surgical results and can improve pain symptoms and joint motion function.

To study the morphological differences of knee joints by analyzing the use of two knee prosthesis systems and determine which factors are related to the use of prosthesis width.

From January 2019 to January 2021, 616 patients who underwent primary total knee arthroplasty in PLA General Hospital were retrospectively collected. Among them, 348 patients used Legion knee prosthesis system (Smith&Nephew Company, USA) and 268 patients used Unique knee prosthesis system (Zhengtian Company, Tianjin). Only patients with primary knee osteoarthritis were included, and patients with any history of surgery or knee joint trauma, a large number of bone defects requiring bone grafting and varus/valgus deformity greater than 15° were excluded. Statistics of gender, height, prosthesis type and other information were made. Pearson correlation analysis and binary logistic regression analysis were used to analyze the relationship between sex, height, femur size and prosthesis width selection.

The two most frequently used femoral prostheses in the Unique group were both narrower in size than those in the Legion group (58/60 vs 58/62; 61/63 vs 61/66). Women in both groups had smaller and narrower femurs. The medial-lateral/anterior-posterior(ML/AP) ratio was (1.08±0.03) in men and (1.07±0.03) in women. There was statistically significant difference between male and female (t=-4.75, P<0.05). Binary logistic regression analysis was used to evaluate the influence of gender, height, and femur size on the use of narrow prosthesis, and it was found that gender was the most relevant factor. In Legion group, women were 4.41 times more likely to use narrow prosthesis than men [OR=4.41, 95%CI (1.97, 9.85), P<0.01]. In the Unique prosthesis, women were 7.11 times more than men [OR=7.11, 95%CI (2.71, 18.61), P<0.01]. The second is the size of the femur. The larger the size of the femur, the higher the utilization rate of narrow prosthesis.

There are differences in knee joint morphology between males and females, but there are quite a number of women and men who use narrow prosthesis. Ethnic differences should be taken into account to design components for Asian populations and the femoral component size options should be increased with lesser increments in between sizes.

To use support vector machine (SVM) in machine learning algorithms to classify the features of gait map dataset and build a recognition model, and to explore the classification performance of the model in distinguishing between patients with osteoarthritis or ligament injuries of the knee and the healthy population.

A total of 135 cases of samples were included in this study from Shanghai University of Sports and other units. Among them, 55 cases were healthy people, and 80 cases were patients with confirmed knee injuries (13 cases of osteoarthritis of the knee, 51 cases of simple anterior cruciate ligament injuries, and 16 cases of multiple ligament injuries), and patients with other tissues and systems injuries that affect walking were excluded. A three-dimensional motion capture system was used to collect knee kinematic data and construct the gait map data set. After preprocessing methods such as data dimensionality reduction, an SVM classifier was used to classify the sample features of each case in terms of class- the relationship between high-dimensional spatial position and hyperplane to establish an identification ification model. One-way ANOVA was used to compare the basic information of the included patients and to validate the model classification performance using metrics such as accuracy and precision.

No significant differences were seen in the basic information of the included sample except for age (all P>0.05). The accuracy of the classification model based on SVM for determining whether a person was healthy or not was 91.4% [95% CI (87.9, 94.7)%]; the accuracy for classifying patients with knee osteoarthritis was 98.5% [95% CI (93.0, 99.1)%], patients with anterior cruciate ligament injuries was 90.6% [95% CI (81.9 , 99.4)%] and 91.5% [95% CI (83.4, 99.6)%] for patients with multiple ligament injuries.

The use of machine learning algorithms to classify the gait map feature datasets established based on portable motion capture devices for healthy people, patients with osteoarthritis of the knee and ligament injuries has a high accuracy and provides a new idea for clinical aid diagnosis based on gait analysis.

To retrospectively assess the clinical efficacy of compound Danshen tablets with conventional regimen in the treatment of frozen shoulder (FS).

Patients with primary FS who attended the outpatient clinic of Sun Yat-sen Memorial Hospital, Sun Yat-sen University from April 2022 to July 2023 were reviewed. All the patients were treated with functional exercises, oral celecoxib and a single shoulder injection. Those who needed to take oral compound Danshen tablets during treatment for other reasons were included in the compound Danshen tablets group, and the other patients were matched and included in the control group based on baseline data in the 2 ∶1 ratio of control group : compound Danshe tablets group. The independent Student’s t test and repeated measures ANOVA were used to analyze the difference of visual analog scale (VAS), shoulder range of motion(ROM), the American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley shoulder scale (CSS) and University of California, Los Angeles (UCLA) score before treatment, and at one, three months after treatment.

Data from 18 cases in the compound Danshen tablets group and 36 cases in the control group were available for retrospective analysis. At one month after treatment, the flexion mobility of the patients in the compound Danshen tablet group were significantly greater than those of the control group (147±22)° vs(134±32)°(t=1.558, P=0.003). At the third month, the ROM in flexion, abduction, lateral external rotation, and posterior extension internal rotation of the compound Danshen tablet group were(169±11)°, (160±23)°, (59±14)°, and(11±3) respectively, while the data of the control group were (146±22)°, (131±29)°, (41±13)°, and (13±3). The compound Danshen tablet group achieved superior ROM than the control group (t=4.147, 3.675, 4.662, -1.693, all P< 0.05). At the final follow-up, the ASES and CSS scores of the compound Danshen tablet group were significantly better than those of the control group (t=2.361, 2.088, both P<0.05).

On the basis of the conventional treatment program, the use of compound Danshen tablets can provide faster pain relief and promote functional recovery of the shoulder joint in patients with FS.

To compare the application effect of cementless femoral prosthesis and cemented femoral prosthesis in hip replacement for femoral neck fracture of elderly patients with osteoporosis (OP).

The clinical data of 91 elderly patients with femoral neck fracture with OP from Foshan Hospital of Traditional Chinese Medicine were retrospectively analyzed. They were all treated with hip replacement, and 42 cases were treated with non cemented femoral prosthesis (the non-cemented group) and 49 cases were treated with cemented femoral prosthesis (the cemented group). The operation related indexes, hip function of affected side and complications were compared between the two groups. Measurement data were analyzed using t tests, while count data were analyzed using chi square tests.

The ambulance time and full weight-bearing in the cemented group was shorter than the non-cemented group (t=9.484, 3.646, both P <0.05). The hip function scores of the cemented group after operation were higher than those in the non-cemented group (t=7.626, 6.891, both P<0.05). The incidence of complications in the cemented group was lower than that in the non-cemented group (corrected χ²=4.623, P<0.05).

The use of bone cement femoral prosthesis for hip replacement is more advantageous than non bone cement femoral prosthesis for elderly patients with femoral neck fracture accompanied by OP.

Explore the early efficacy analysis of the Lasso-loop Gould procedure under total arthroscopy for repairing the ATFL in the treatment of lateral ankle instability.

A prospective case study analysis was performed on the patients with lateral instability of the ankle joint who underwent arthroscopic surgery in Jinjiang Hospital From January 2022 to January 2023, were treated with a total arthroscopic Lasso-loop Gould procedure to repair the ATFL. The efficacy and pain before and after surgery were evaluated using AOFAS and VAS scores by Wilcoxon rank sum test.

A total of 25 patients, including 13 males and 12 females, were enrolled, with age of 31(19, 40)years, and the time from injury to surgery was 9(7, 18)months. All the patients were followed up for 6(3, 10)months. The AOFAS score increased from 59.0(48.0, 66.0)before surgery, to 98.0(85.0, 100.0)at the last follow-up, with a statistically significant difference (Z=4.38, P<0.001). The VAS score increased from 4.0(3.0, 5.0)before surgery, to 1.0(0, 2.5) at the last follow-up , with a statistically significant difference (Z=4.33, P<0.001). There were 19 postoperative excellent cases, two good cases, and four fair cases.

Under total arthroscope, the Lasso-loop Gould procedure for repairing the ATFL can restore the stability of the ankle joint in the treatment of lateral instability, it can also handle intra-articular injuries and achieve good therapeutic effects at early stage.

To observe the effect of pain management model led by responsibility nurse in knee replacement patients.

A total of 70 patients who underwent primary unilateral knee joint replacement in Guangdong Second Provincial General Hosipital from October 2019 to August 2021 were selected and divided into the experimental group and the control group according to simplerandom sampling, 35 patients in each group. The experimental group was given pain management mode led by responsible nurses, and the control group was given routine pain care. Postoperative pain scores and satisfaction with pain management were compared between the two groups using two independent-sample ttest.

At 24, 48 and 72 h after operation, VAS score of the experimental group were lower than those of the control group, and the differences were statistically significant (t=11.068, 8.278, 9.030, all P<0.05). The satisfaction score of pain management in experimental group was higher than that in control group, and the difference was statistically significant (t=-14.852, P<0.05).

The pain management model led by the responsible nurse can reduce the pain score of patients with artificial knee replacement within 72h after surgery, and improve the satisfaction of patients with postoperative pain management.