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1.
目的探讨一种自拟中药配方制成的护膝治疗膝关节骨性关节炎(knee osteoarthritis,KOA)的临床疗效。方法本次研究选择2020年6月至12月于联勤保障部队临潼康复疗养中心进行治疗的160例确诊为KOA的患者作为研究对象,根据临床治疗方法将全部患者随机分成两组,每组80例,比较两组临床效果。结果比较后发现,总有效率观察组为61.25%;对照组为37.50%,差异有统计学意义;膝关节Lysholm评分对比显示,两组患者的膝关节功能都有明显改善,且观察组治疗效果明显优于对照组,差异有统计学意义。结论该自制护膝对于KOA患者有很好的治疗效果,能显著改善患者关节的各项功能。  相似文献   
2.
目的:观察mini-Swashbuckler入路联合股骨外侧微创内固定系统(LISS)治疗股骨远端骨折患者的效果。方法:选取80例股骨远端骨折患者为研究对象,按照随机数字表法分为对照组与观察组各40例。对照组采用传统Swashbuckler入路联合LISS治疗,观察组采用mini-Swashbuckler入路联合LISS治疗,比较两组临床相关指标水平、膝关节功能[美国特种外科医院膝关节功能(HSS)]评分、并发症发生率和生命质量[简明健康状况调查量表(SF-36)]评分。结果:观察组手术时间长于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);两组住院时间和骨折愈合时间比较,差异无统计学意义(P>0.05);术后3、6个月时,观察组HSS评分均高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为5.00%(2/40),与对照组的10.00%(4/40)比较,差异无统计学意义(P>0.05);术后6个月,两组SF-36评分均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:mini-Swashbuckler入路联合LISS治疗股骨远端骨折患者可减少术中出血量,提高HSS和SF-36评分,效果优于传统Swashbuckler入路联合LISS治疗,但手术时间长于传统Swashbuckler入路联合LISS治疗。  相似文献   
3.
目的探讨关节镜下半月板成形术(AMP)对膝关节半月板损伤患者血清疼痛因子、一氧化氮(NO)、透明质酸(HA)及关节活动度的影响。方法选取2019年5月—2020年12月收治的90例膝关节半月板损伤为研究对象,根据治疗方法不同分为对照组和治疗组,每组45例。对照组接受保守治疗,治疗组行AMP治疗。比较两组的临床疗效,治疗前后的血清前列腺素E2(PGE2)、5-羟色胺(5-HT)、NO、HA、疼痛视觉模拟评分法(VAS)评分和膝关节活动度。记录两组治疗并发症发生情况。结果治疗组疗效优良率高于对照组(P<0.05)。治疗后,两组血清PGE2、5-HT、NO、HA水平均较治疗前下降,且治疗组低于对照组(P<0.05)。治疗后1、2、3、4周,两组VAS评分均较治疗前降低,且治疗组低于对照组(P<0.05)。治疗后,两组膝关节屈伸活动度均较治疗前升高,且治疗组高于对照组(P<0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。结论AMP对膝关节半月板损伤疗效良好,可减少疼痛因子生成,控制NO、HA水平,提高关节活动度。  相似文献   
4.
目的观察温针灸推拿辅以中药治疗膝骨性关节炎的临床疗效。方法100例膝骨性关节炎患者,按照随机数字表法分为综合治疗组及对照组,每组50例。综合治疗组采取温针灸推拿辅以中药治疗,对照组采取常规西药治疗。比较两组治疗前后的膝关节疼痛评分、炎症指标[肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)]、生活质量评分,治疗效果。结果治疗1周后,综合治疗组患者的膝关节疼痛评分(2.01±0.12)分、TNF-α(1.52±0.24)ng/ml、hs-CRP(7.45±1.02)mg/L、IL-6(61.52±2.16)pg/ml均低于对照组的(3.56±0.45)分、(2.42±0.28)ng/ml、(9.18±1.56)mg/L、(121.25±2.11)pg/ml,生活质量评分(92.19±3.35)分高于对照组的(85.21±2.12)分,差异具有统计学意义(P<0.05)。综合治疗组患者的总有效率94.00%高于对照组的72.00%,差异具有统计学意义(P<0.05)。结论对膝骨性关节炎患者实行温针灸推拿辅以中药治疗的临床效果确切,可缓解症状及膝关节的疼痛程度,改善患者的生活质量,值得推广和应用。  相似文献   
5.
6.
BackgroundProximal tibia vara has drawn interest since the concept of constitutional varus was introduced. Proximal tibia vara is a condition where the knee varus tilt the tibia condyle medially and shift the tibial articular surface medially. This condition affects medial proximal tibial angle measurements and the placement of the tibial implant in knee replacement surgery. Thus, it challenged the neutral knee arthroplasty alignment target because some people may present a proximal tibia vara. This study assesses the prevalence of the proximal tibia vara and the correlation to knee osteoarthritis grade.MethodsThis retrospective study was carried out from January 2021 to June 2021. Eighty-five limbs were included with the following inclusion criteria: knee osteoarthritis patients who received a long view lower extremity radiograph. The exclusions criteria were (1) patients who had undergone arthroplasty and lower extremity surgery before and (2) valgus knee deformity. The outcomes in this study were HKAA, MAD, TAD, MPTA, PTRP, LDFA, and PTS. Intraclass correlation (ICC) using two-way mixed was used to assess the reproducibility of the radiographic parameters. Multiple logistic regression was used to evaluate the correlation between knee osteoarthritis grade and radiographs parameters (MAD and TAD).ResultA total 85 limbs from 52 patients were assessed in this study. Proximal tibia vara was found in 18 knees (21%.). The logistic regression was performed to assess the correlation between the severity of the knee osteoarthritis and radiographic parameters (MAD, TAD, LDFA, and PTS) with an overall p-value < 0.001 and pseudo-R2 = 0.29.ConclusionA significant portion of patients with knee osteoarthritis have proximal tibia vara, and it is a pre-existing condition. Since the pre-existing proximal tibia vara affects preoperative measurements, a long-standing lower extremity x-ray is recommended to be obtained as part of knee replacement preparation.  相似文献   
7.
Background and aimsIn this cross-sectional study we investigate the association between handgrip strength (HGS) and muscle function of the lower limbs and the predictors of the appendicular lean mass index (ALMI) in older adults with obesity of both sexes.Methods and resultsEighty-four older (67 ± 5 years) men (N = 44) and women (N = 40) with obesity (body mass index (BMI) 33 ± 4 kg/m2) performed: the HGS, isokinetic knee extensors (KE) and flexors (KF) muscle strength and power and Short Physical Performance Battery (SPPB). The correlation between HGS and lower limbs muscle function was evaluated, and four multiple hierarchical linear models were built to assess the contribution of each ALMI predictor (i.e., HGS, BMI, SPPB, muscle strength and power).In men, HGS was weakly-to-moderately associated (p < 0.05) with KE, KF muscle function and physical performance. In women, HGS showed a weak association (p < 0.05) with KE muscle function. The significant predictors of ALMI were only the BMI in women, whereas in the group of men BMI, KE maximal strength and power better explain the variance in ALMI than HGS alone.ConclusionOur results suggest that HGS should not be used alone as a marker of lower muscle nor physical function. Sex differences exist with the BMI that is a contributor of ALMI both in men and women. However, at least in the group of men, markers related to strength and power of the lower limbs can better describe variations in ALMI compared to HGS in this kind of population.Clinical trial registrationNA.  相似文献   
8.
《Radiography》2022,28(3):663-667
IntroductionAnti-scatter grids efficiently reduce scatter radiation from reaching the imaging receptor, enhancing image quality; however, the patient radiation dose increases in the process. There is disagreement regarding the thickness thresholds for which anti-scatter grids are beneficial. This study aims to establish a thickness threshold for the use of anti-scatter grids to optimise adult knee radiography.MethodsThe study consisted of two phases. In Phase 1 phantom knee radiographs were acquired at varying thicknesses (10–16 cm) and tube voltages (60–80 kV). For each thickness and tube voltage, images with and without an anti-scatter grid were obtained. In Phase 2, two radiologists and three radiographers, evaluated the image quality of these images. Visual Grading Analysis (VGA) scores were analysed using Visual Grading Characteristics (VGC) based on the visualisation of five anatomic criteria.ResultsThe average DAP decreased by 72.1% and mAs by 73.1% when removing the anti-scatter grid. The VGC revealed that overall images taken with an anti-scatter grid have better image quality (AUC ≥0.5 for all comparisons). However, the anti-scatter grids could be removed for thicknesses 10, 12 and 14 cm in conjunction with using 80 kVp,.ConclusionAnti-scatter grids can be removed when imaging adult knees between 10 and 12 cm using any kVp setting since the radiation dose is reduced without significantly affecting image quality. For thicknesses >12 cm, the use of anti-scatter grids significantly improves image quality; however, the radiation dose to the patient is increased. The exception is at 14 cm used with 80 kVp, where changes in image quality were insignificant.Implications for practiceOptimisation by removing anti-scatter grids in adult knee radiography seems beneficial below 12 cm thickness with any kVp value. Since the average knee thickness ranges between 10 and 13 cm, anti-scatter grid can be removed for most patients. Nevertheless, further studies are recommended to test if this phantom-based threshold applies to human subjects.  相似文献   
9.
目的:"从虚从瘀从毒"三个角度,采用网络药理学和分子对接技术探讨补肾活血汤治疗膝骨关节炎的内在分子机理。方法:将补肾活血汤中的药物在TCMSP、TCM Database@Taiwan数据库查询相关化学成分及作用靶点,然后对靶点进行基因注释;在PharmGkb、OMIM、DrugBank、GeneCards、TTD 5个数据库中进行疾病相关靶点检索,获取其对应靶点;然后通过Cytoscape 3.8.2软件将药物成分、疾病及靶点的对应关系构建"中药-成分-靶点-疾病"网络可视化,并从String数据库获取交集靶点数据,构建PPI蛋白互作网络;利用R语言软件对基因进行GO和KEGG富集分析;最后对核心化合物及核心靶点进行分子对接。结果:共获取补肾活血汤活性化合物163种,共筛选出10个核心成分,预测出对应靶点244个,KOA相关靶点1921个,两者的交集基因共129个;利用PPI蛋白互作网络共筛选到3个核心靶点蛋白;GO和KEGG富集分析分别得到2604个、159个富集结果;分子对接结果显示补肾活血汤治疗骨质疏松过程中,其核心化合物quercetin、luteolin、kaempferol与核心靶点TP53、JUN、RELA具有良好的结合性能。结论:补肾活血汤在促进细胞增殖、抗黏附及维持血管内稳定、抗炎等方面发挥其重要作用,并通过网络药理学和分子对接阐释了其"从虚从瘀从毒"治疗膝骨关节炎的内在分子机制。  相似文献   
10.
BackgroundPatellofemoral joint cartilage defects are difficult to treat due to their unique thickness and topography.PurposeTo report the postoperative outcomes of patients age 21 and younger treated with particulated juvenile allograft cartilage (PJAC) for full-thickness cartilaginous defects of the patellofemoral joint. The primary aim was to report surgical outcomes and complication rates, as well as return to sport activity. A secondary aim was to provide objective scores of defect restoration by magnetic resonance imaging (MRI) assessment.MethodsA retrospective review of all PJAC cases conducted between 2012 and 2019 at a single tertiary care urban musculoskeletal institution was conducted. Patients 21 years old or younger with minimum clinical follow up of 1 year and postoperative MRI at a minimum of 6 months were included. Cartilage restoration by MRI was independently assessed using the International Cartilage Repair Society’s (ICRS) standardized system.ResultsThirty four patients, 36 knees, were included, with mean age 16.1 ± 3.1 years old. Return to sport rate among patients who participated in a sport preoperatively was 100%. On independent MRI assessment, two thirds of defects achieved an overall grade of normal or nearly normal, while 28 patients (78%) had majority defect fill. Primary graft failure occurred in two cases and one patient experienced a surgical complication.ConclusionRestoration of patellofemoral chondral defects in young patients with particulated juvenile allograft results in satisfactory short-term outcomes and postoperative MRI appearance, along with high rates of return to sport and low rate of complications and graft failure.What is known about the subject: Patellofemoral joint cartilage defects are difficult to treat due to their unique thickness and topography. Several cartilage restoration techniques are available, but these rarely achieve the same mechanical properties as native hyaline cartilage. PJAC is a cell-based technique that has demonstrated promise since its introduction in 2007.What this study adds to existing knowledge: This series of patients adds the largest single cohort of pediatric and adolescent patients who receive PJAC for defects of the patellofemoral joint. Surgeons treating patients in this age group should be aware of every technique, and their respective outcomes.  相似文献   
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