ObjectiveThis study aimed to explore the application and complications of high-flexion rotating platform (RPF) and standard rotating platform (RP) prostheses during total knee arthroplasty (TKA) for valgus knee.MethodsThe clinical data of 150 patients who underwent TKA for valgus knee in the hospital between January 2020 and January 2023 were retrospectively analyzed. Seventy-nine patients who received an RP prosthesis during TKA for valgus knee between January 2020 and June 2021 were included in the control group, and 71 patients who received RPF during TKA for valgus knee between July 2021 and January 2023 were enrolled in the observation group. The surgery-related indicators (surgical time, intraoperative blood loss, and the time required for 90° spontaneous knee flexion) were compared between the groups. Knee function was evaluated in the two groups using the American Knee Society Score (KSS) scale and the Hospital for Special Surgery (HSS) scale, and measuring the range of motion (ROM) of the knee joint and the ability to perform high-flexion activities. The differences in lower limb alignment [hip-knee angle (HKA), femorotibial angle (FTA)] were compared, and postoperative complications were recorded.ResultsThere were no statistically significant differences between the groups in terms of surgical time, intraoperative blood loss, time required for 90° spontaneous knee flexion, preoperative KSS, HSS score, ROM, preoperative HKA, and FTA (P>0.05). After surgery, the KSS and HSS scales in both groups were improved, the ROM angle was increased, and the HKA and FTA were reduced. However, there were no statistically significant differences in the change ranges and high-flexion activity ability between the groups (P>0.05). The incidence rate of patellar crepitus after surgery in the observation group was higher than in the control group (P<0.05).ConclusionRPF and RP prostheses during TKA for valgus knee effectively improved knee function and corrected lower limb alignment. There was no obvious difference in the treatment effect between the two kinds of prostheses. However, the incidence rate of patellar crepitus with the PRF prosthesis was relatively high. In clinical practice, doctors still need to determine the appropriate prosthesis for each patient’s specific situation.

ObjectiveThe aim of this study was to assess the clinical outcomes of C arm fluoroscopy-guided percutaneous kyphoplasty (PKP) in elderly patients with osteoporotic vertebral compression fractures (OVCF) and to explore how age, body mass index (BMI), and osteoporosis severity influence these outcomes.MethodsWe retrospectively reviewed 167 OVCF patients treated with PKP between January 2022 and December 2023. Pain intensity (VAS), functional disability (ODI), Cobb angle, anterior vertebral body height, overall response rate, patient satisfaction (5 point Likert scale), and health related quality of life (SF 36) were assessed before and after surgery. Logistic regression identified independent predictors of suboptimal clinical and satisfaction outcomes.ResultsCompared with baseline, postoperative VAS decreased from 7.83±1.27 to 1.31±1.53, ODI from 45.39±7.12 to 3.31±1.39, Cobb angle from 22.31°±3.87° to 17.91°±1.83°, and vertebral height from 22.39±9.12 mm to 30.31±3.79 mm (all P<0.001). The overall success rate was 100% (marked improvement in 60.5%, moderate in 39.5%). Multivariate analysis demonstrated that age≥76 years, BMI≥23.4 kg/m2, and severe osteoporosis significantly increased the risk of less favorable outcomes (P<0.05). The mean satisfaction score was 4.52±0.63, with 85% of patients reporting satisfaction. The SF 36 total score improved from 52.3±8.7 to 78.6±9.2 (P<0.001), most notably in the bodily pain domain (82.5 vs. 30.1).ConclusionC arm–guided PKP provides excellent pain relief, restores vertebral height and alignment, and enhances function and quality of life in elderly OVCF patients. Advanced age, higher BMI, and greater osteoporosis severity are key risk factors for suboptimal clinical and satisfaction outcomes, underscoring the importance of personalized preoperative evaluation and management.

ObjectiveThis study aimed to explore the effect of the femoral elliptical tunnel technique on gait after anterior cruciate ligament reconstruction of the knee joint.MethodsA total of 115 patients undergoing anterior cruciate ligament reconstruction of the knee joint between June 2022 and July 2024 were selected. The patients were divided into a control group and an observation group according to the random number table method. The control group was treated with the circular tunnel technique during the surgery, while the observation group was treated with the femoral elliptical tunnel technique. The impulse and foot angle deviation of each area on the affected foot sole were recorded. The muscle strength of both legs, including the peak moment (PT), total work (TW), average power (AP) of the flexor/extensor muscles of the knee joint, and the maximum single work done by the flexor/extensor muscles (MRTW) was recorded. Knee joint function was evaluated using the Lysholm knee joint function score.ResultsNo significant differences were found in the preoperative deviations in the foot angles and Lysholm knee joint function scores between the two groups (P>0.05). After the surgery, the deviations in the angle of the affected foot in the observation group were significantly smaller than in the control group, and the Lysholm knee joint function score was significantly higher than in the control group (P<0.05). No significant difference was observed in the percentage of impulses in the forefoot and midfoot areas between the two groups before surgery (P>0.05). After surgery, the impulses in each area of the foot sole on the affected side were significantly improved in the observation group compared with the control group (P<0.05). There were no statistically significant differences in PT, TW, AP, and MRTW before surgery between the two groups (P>0.05). After surgery, PT, TW, AP, and MRTW in both groups were significantly improved (P<0.05), with PT, TW, AP, and MRTW in the observation group being significantly better than the control group (P<0.05).ConclusionThe femoral elliptical tunnel technique can improve impulses, PT, TW, and foot angle deviations of each area on the affected foot after anterior cruciate ligament reconstruction of the knee joint, and accelerate recovery of the knee joint.

ObjectiveThe aim of this study was to explore the diagnostic value of 64-slice spiral CT and its reconstruction techniques for thoracolumbar compression fractures.MethodsA retrospective analysis was performed on the clinical data of 98 patients with thoracolumbar compression fractures who were admitted to the hospital between May 2018 and December 2020. All patients received 64-slice spiral CT and digital radiography (DR) examinations. Using surgical results as the gold standard, the examination results of 64-slice spiral CT and its reconstruction techniques were compared with those of DR.ResultsDR examination found that all patients had vertebral compression fractures. Lumbar spine orthotopic films showed different degrees of decline in the vertebral height. Lumbar spine lateral films showed that the vertebral body was compressed or biconcave. The images of hyperflexion and hyperextension showed openings. Some patients’ images showed signs of vacuum in the intervertebral disc. Examination of the 64-slice spiral CT scans found that the patients’ fracture lines were clear and sharp, with paravertebral soft tissue shadows. Some patients’ images showed signs of vacuum in the intervertebral disc, contusion and bleeding of the spinal cord, contusion and laceration of the perivertebral organs, and trabecular structure disorder and sclerosis of the vertebrae. For all patients with thoracolumbar compression fractures, 137 fractured vertebral bodies were confirmed by surgery, 122 fractured vertebral bodies (89.05%) were detected by DR, and 131 fractured vertebral bodies (95.62%) were detected by multi-slice spiral CT. The detection rates of fractured vertebral bodies by the two methods showed a significant difference (P<0.05). A total of 195 fractures occurred in 137 fractured vertebral bodies. The detection rate of the fracture sites by DR was significantly lower than by multi-slice spiral CT (P<0.05). The detection rates of transverse process and lamina fractures by DR were lower than by multi-slice spiral CT (P<0.05). There were no significant differences in the detection rates of spinous process, facet joint, and pedicle fractures between the two methods (P>0.05).Conclusion64-slice spiral CT and its reconstruction techniques exhibit good diagnostic value for thoracolumbar compression fractures. This technique can significantly improve the diagnostic accuracy for thoracolumbar compression fractures.