【Abstract】 Objective To explore the effect of recurrent anterior shoulder dislocation on the secondary intra-articular injuries through analyzing the correlation between the number of dislocation, disease duration, and the secondary intra-articular injuries. Methods The clinical data were analyzed retrospectively from 59 patients with recurrent anterior shoulder dislocation who underwent arthroscopic Bankart reconstruction using suture anchor between January 2005 and June 2009. There were 48 males and 11 females, and the average age was 27.6 years (range, 15-42 years). The causes of first dislocation included contact sports (21 cases), non-contact sports (13 cases), daily activities (11 cases), and trauma (14 cases). The average number of preoperative dislocations was 10.6 times (range, 3-32 times). The time between first dislocation and surgery was 11 months to 12 years (median, 5.9 years). The results of apprehension test and relocation test were positive in all patients. The University of California Los Angeles (UCLA) score was 22.3 ± 2.4, and Constant-Murley score was 73.1 ± 5.8 preoperatively. According to the arthroscopic findings, the effect of recurrent anterior shoulder dislocation on the secondary intra-articular injuries was analyzed. Results All incisions healed by first intention, and no early complication occurred. All 59 patients were followed up 37.3 months on average (range, 16-58 months). At last follow-up, UCLA score was 34.6 ± 1.7 and Constant-Murley score was 86.7 ± 6.1, showing significant differences when compared with preoperative scores (P lt; 0.05). The number of preoperative dislocations was positively correlated with the severity of secondary articular cartilage injury (rs=0.345, P=0.007) and the severity of Hill-Sachs injury (rs=0.708, P=0.000). The time between first dislocation and surgery had a positive correlation with the severity of secondary articular cartilage injury (rs=0.498, P=0.000), but it had no correlation with the severity of Hill-Sachs injury (rs=0.021, P=0.874). Conclusion For patients with recurrent anterior shoulder dislocation, early Bankart reconstruction is benefit to functional recovery of shoulder and can avoid or delay the occurrence or development of secondary intra-articular injuries.
Objective To investigate the effectiveness of total hip arthroplasty with double-tapered cementless femoral stem for hip bony fusion by comparing with anatomical cementless femoral stem. Methods A retrospective analysis was made on clinical data of 50 cases (80 hips) of hip bony fusion undergoing total hip arthroplasty between October 1999 and January 2008. The patients were divided into 2 groups: 31 cases (49 hips) using BetaCone double-tapered cementless femoral stem (trial group), and 19 cases (31 hips) using Ribbed anatomical cementless femoral stem (control group). There was no significant difference in gender, age, disease duration, preoperative Harris score, and abduction angle of the hip between 2 groups (P gt; 0.05). After operation, X-ray films were used to calculate the ratio of force arm of abductor (a) to the force arm of gravity (b) and analyze the stability of the prosthesis. The abduction angle of the hip and Harris score were measured during follow-up. Results Fracture occurred during operation in 9 hips of 9 cases (5 in trial group and 4 in control group), and was cured after fixation. The mean follow-up time was 49 months (range, 12-98 months) in trial group and was 53 months (range, 6-105 months) in control group. The ratio of a/b was 0.65 ± 0.25 in trial group and was 0.56 ± 0.37 in control group, showing significant difference (t=2.19, P=0.03). The abduction angle of hip was (34.49 ± 7.58)° in trial group and was (30.97 ± 7.24)° in control group at 6 months after operation, which was significantly improved when compared with preoperative value in 2 groups (P lt; 0.05), and significant difference was found between 2 groups (t=2.06, P=0.04). Postoperative Harris score was significantly improved in 2 groups when compared with preoperative score (P lt; 0.05); trial group was better than control group in Harris score at 1 month after operation (t=3.62, P=0.01), but no significant difference was found between 2 groups at last follow-up (t=1.61, P=0.11). At last follow-up, X-ray films showed stabilized prosthesis in 2 groups. Grade I or II ectopic ossification occurred in 12 cases (14 hips) of trial group and 8 cases (9 hips) of control group at 2 years after operation. Conclusion The total hip arthroplasty with both double-tapered and anatomical cementless femoral stems for hip bony fusion can obtain satisfactory effectiveness, while the double-tapered cementless femoral stem has better abduction angle of hip.