简介：在这个工作，在有表面精力的效果的一半空间的边脱臼的有弹性的领域被获得了。有弹性的地然后被用来在脱臼上学习图象力量，为在有紧张失配和底层上的薄电影的让步的力量的取向附生的薄电影的脱臼产生的批评厚度。当从免费表面的脱臼的距离比小时，脱臼上的图象力量从常规答案背离的结果表演若干次典型长度。另外由于表面精力的效果，为脱臼产生的批评厚度比由常规有弹性的答案预言了的小，偏差的程度取决于失配紧张的大小。相反，为许多实际薄电影的让步的力量上的表面精力的效果能除了典型长度比得上厚度的一些软的被忽视。

简介：目的将创造膝系带并且到压力在不同的膝屈曲侧面的并行的系带(LCL)改变与或没有代替的运动的分析的有限元素模型调节的3-dimensional。four-major-ligament从一个成年人包含了膝标本的方法死于颅骨损害为与精确预先标记的可检测的系带插入脚印，地点和取向扫描的CT作好准备。扫描图象的CT与3-dimensional重建技术被变换成膝的一个3-dimensional模型并且由ANSYS的软件转变了成有限元素模型。模型用另外的科学家获得的试验性、数字的结果被验证。在五个不同的膝屈曲角度的LCL的自然压力变化(0

简介：AbstractIntracapsular fractures of the proximal femur are one of the most common fractures of the lower limbs. Most cases require osteosynthesis with suitable implants, and intraoperative positioning of the patient on the fracture table is a prerequisite to facilitate fracture manipulation, traction, reduction and fluoroscopy assessment. However, positioning the limbs of bilateral above-knee amputees for internal fixation of related proximal femoral fractures is a difficult task, which requires customized inventory for effective limb positioning and fracture manipulation. This study reported a rare case following a crush injury of bilateral lower limb in a road traffic accident, and described some technical tips of acute femoral neck fractures in bilateral above-knee amputation. The patient was managed with immediate guillotine amputation and later secondary wound closure followed by internal fixation of the right-sided femoral neck fracture with multiple cancellous cannulated screws.

简介：AbstractBackground:Physical therapy is regarded as an essential aspect in achieving optimal outcomes following total knee arthroplasty (TKA). The coronavirus disease 2019 (COVID-19) pandemic has made face-to-face rehabilitation inaccessible. Virtual reality (VR) is increasingly regarded as a potentially effective option for offering health care interventions. This systematic review and meta-analysis investigate VR-based rehabilitation’s effectiveness on outcomes following TKA.Methods:From inception to May 22, 2021, PubMed/Medline, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, Scopus, PsycINFO, Physiotherapy Evidence Database, China National Knowledge Infrastructure, and Wanfang were comprehensively searched to identify randomized controlled trials (RCTs) evaluating the effect of VR-based rehabilitation on patients following TKA according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and the Cochrane Handbook for Systematic Reviews of Interventions.Results:Eight studies were included in the systematic review, and seven studies were included in the meta-analysis. VR-based rehabilitation significantly improved visual analog scale (VAS) scores within 1 month (standardized mean difference [SMD]: -0.44; 95% confidence interval [CI]: -0.79 to -0.08, P = 0.02), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) within 1 month (SMD: -0.71; 95% CI: -1.03 to -0.40, P < 0.01), and the Hospital for Special Surgery Knee Score (HSS) within 1 month and between 2 months and 3 months (MD: 7.62; 95% CI: 5.77 to 9.47, P < 0.01; MD: 10.15; 95% CI: 8.03 to 12.27, P < 0.01; respectively) following TKA compared to conventional rehabilitation. No significant difference was found in terms of the Timed Up and Go (TUG) test.Conclusions:VR-based rehabilitation improved pain and function but not postural control following TKA compared to conventional rehabilitation. More high-quality RCTs are needed to prove the advantage of VR-based rehabilitation. As the COVID-19 pandemic continues, it is necessary to promote this rehabilitation model.

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简介：AbstractBackground:Hypothermia is associated with many adverse clinical outcomes in pediatric patients, and thus, it is important to find an effective and safe method for preventing peri-operative hypothermia and its associated adverse outcomes in pediatric patients. This study aimed to investigate the effect of forced-air warming blankets with different temperatures on changes in the transforming growth factor-β (TGF-β), tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-10 levels in children undergoing surgical treatment for developmental displacement of the hip (DDH).Methods:The study included 123 children undergoing surgery for DDH under general anesthesia. The patients were randomly assigned to three groups, using a random number table: the 32, 38, and 43°C groups according to the temperature setting of the forced-air warming blankets. For each patient, body temperature was recorded immediately after anesthesia induction and intubation (T0), at initial incision (T1), at 1 h after incision (T2), at 2 h after incision (T3), at the end of surgery (T4), immediately upon return to the ward after surgery (T5), and then at 12 h (T6), 24 h (T7), 36 h (T8), and 48 h (T9) after the surgery. The serum levels of TGF-β, TNF-α, IL-1β, and IL-10 were measured at T0 and T4 for all groups.Results:The number of patients with fever in the 38°C group was significantly less than those in the 32 and 43°C groups (χ2 = 6.630, P= 0.036). At T0, the body temperatures in the 38 and 43°C groups were significantly higher than that in the 32°C group (F = 17.992, P < 0.001). At T2, the body temperature was significantly higher in the 43°C group than those in the 32 and 38°C groups (F= 12.776, P < 0.001). Moreover, at T4, the serum levels of TGF-β (F = 3286.548, P < 0.001) and IL-10 (F = 4628.983, P < 0.001) were significantly increased in the 38°C group, and the serum levels of TNF-α (F= 911.415, P < 0.001) and IL-1β (F = 322.191, P < 0.001) were significantly decreased in the 38°C group, compared with the levels in the 32 and 43°C groups.Conclusion:Force-air warming blankets set at 38°C maintained stable body temperature with less adverse outcome and effectively inhibited the inflammatory response in pediatric patients undergoing surgery for DDH.Clinical trial registration:ChiCTR1800014820; http://www.chictr.org.cn/showproj.aspx?proj=25240.

简介：Background:Preventinganteriorcruciateligament(ACL)injuriesisveryimportantforathletes,anddynamickneevalgusisconsideredariskfactorfornon-contactACLinjury.However,littleisknownaboutwhetherthefunctionsofthehipabductorandrear-footincreasedynamickneevalgus.Atwo-dimensional(2D)video-basedscreeningtestfocusedonhipabductorandrear-footfunctionsamongfactorsinvolvedindynamickneevalgus.Thepresentstudydeterminedassociationsbetweenhipandrear-footdynamicalignmentanddynamickneevalgus.Methods:Thiscross-sectionalstudyrecruited130femalebasketballplayers(258legs)fromninehigh-schoolteams.Theplayersperformedsingle-legsquatsandsingle-legdroplandingstoprovideknee-in(KID)andhip-out(HOD)distanceson2Dvideoimages.Hipandrear-footdynamicalignmentwasevaluatedusingadynamicTrendelenburgtest(DTT)andadynamicheel-floortest(HFT).Results:TheChi-squaretestrevealednosignificantdifferenceintheprevalenceofDTT-positivitybetweensingle-legsquats(28.7%)andsinglelegdroplandings(23.3%).TheprevalenceofHFT-positivitywassignificantlygreaterduringlandings(51.4%)thanduringsingle-legsquats(31.0%,p<0.01).TheKIDvaluesforbothsingle-legsquatsandsingle-legdroplandingsweregreaterintheDTT-positivethanintheDTTnegativegroup(15.15.4cmand20.27.5cm,p<0.001).TheHODvaluesweresimilarlygreaterintheDTT-positivegroup(15.21.9cmand17.62.8cm,p<0.001).TheKIDvaluesforbothsingle-legsquatsandsingle-legdroplandingsweregreaterintheHFT-positivethanintheHFT-negativegroup(12.25.1cm,p<0.01;14.77.2cm,p<0.001),whereasHODvaluesforthesetasksdidnotsignificantlydifferbetweenthetwogroups.Conclusion:Dynamichipmal-alignmentmightbeassociatedwithbothgreaterKIDandHOD,whereasrear-footeversionisassociatedonlywithgreaterKID.Hipabductorandrear-footdysfunctionareimportantfactorsfordynamickneevalgusandthusevaluatingDTTandHFTwi

简介：AbstractPurpose:Antibiotic-loaded bone cement (ALBC) was usually used to prevent periprosthetic joint infection (PJI) in primary total knee arthroplasty (PTKA), but whether to use ALBC or plain bone cement in PTKA remains unclear. We aimed to compare the occurrence rate of PJI using two different cements, and to investigate the efficacy of different antibiotic types and doses administered in preventing surgical site infection (SSI) with ALBC.Methods:The availability of ALBC for preventing PJI was evaluated by using a systematic review and meta-analysis referring to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Existing articles until December 2021 involving PTKA patients with both ALBC and plain bone cement cohorts were scanned by searching "total knee arthroplasty" , "antibiotic-loaded cement" , "antibiotic prophylaxis" , "antibiotic-impregnated cement" and "antibiotic-laden cement" in the database of PubMed/MEDLINE, Embase, Web of Science and the Cochrane Library. Subgroup analysis included the effectiveness of different antibiotic types and doses in preventing SSI with ALBC. The modified Jadad scale was employed to score the qualities of included articles.Results:Eleven quantitative studies were enrolled, including 34,159 knees undergoing PTKA. The meta-analysis results demonstrated that the use of prophylactic ALBC could significantly reduce the prevalence of deep incisional SSI after PTKA, whereas there was no significant reduction in the rate of superficial incisional SSI. Moreover, gentamicin-loaded cement was effective in preventing deep incisional SSI, and the use of high-dose ALBC significantly reduced the rate of deep incisional SSI after PTKA. Besides, no significant adverse reactions and complications were stated during the use of ALBC in PTKA.Conclusion:The preventive application of ALBC during PTKA could reduce the rates of deep PJI. Furthermore, bone cement containing gentamicin and high-dose ALBC could even better prevent deep infection after PTKA. However, the existing related articles are mostly single-center and retrospective studies, and further high-quality ones are needed for confirmation.

简介：【摘要】目的：分析在人工膝关节置换术（total knee arthroplasty,TKA）康复训练中，采用健康教育路径的效果。方法：实验对象30例为人工膝关节置换术患者，入院后随机分为两组，分别为干预组与对照组，每组各15例，在康复训练中，分别给予健康教育路径和常规健康教育，对比两组患者干预后的康复知识掌握情况、膝关节功能评分以及护理工作满意度，研究起止时间为2020年1月-2023年1月。结果：干预组较对照组康复知识掌握情况以及护理工作满意度，具有明显优势，差异存在统计学意义（P＜0.05）。结论：在人工膝关节置换术康复训练中，采用健康教育路径，可提升患者对康复知识的掌握程度以及对护理工作的满意度，值得推广。

简介：[摘要]目的： 探究分析膝关节半月板损伤患者个性化护理的应用有效性及作用研究。方法：选取2018年6月～2021年1月在本院进行治疗的膝关节半月板损伤患者80例进行研究分析，将患者分为两组，一组为实验组患者有40例，一组为对照组患者有40例。其中，对照组患者进行常规的护理，实验组在常规护理基础上进行个性化护理，对两组患者的恢复状况进行研究分析。结果 ：护理后实验组膝关节半月板损伤患者的SAS、SDS评分低于对照组，p﹤0.05有统计学意义。实验组膝关节半月板损伤患者的满意度高于对照组，P＜0.05有统计学意义。结论 ：临床开展个性化护理管理质量可以缓解患者的身体状况，降低患者并发症概率，使得手术的安全性更高，进一步促进患者的身体康复，是值得临床进行推广的。