Objective To review the progress in influence of bony structure of glenohumeral joint on the shoulder joint stabil ity. Methods Recent l iterature, concerning the influence factors of the shoulder joint stabil ity and the action of bony structure of the glenohumeral joint in the stabil ity of shoulder joint, was extensively reviewed and summarized. Results The specific factors which the bony structure of the glenohumeral joint influences the stabil ity of the shoulder joint are the conformity index, the shape of the glenohumeral joint, version angle, incl ination angle, and head shaft angle, etc. Conclusion Although the predecessor’s research experience and cl inical reports have prel iminarily determined therelationship between the bony structure of the glenohumeral joint and the stabil ity of the shoulder joint, it is necessary to further study in various aspects (including anatomy, biomechanics, and cl inical practice).
ObjectiveTo evaluate the efficacy and safety of knee joint stability training in treating patients with knee osteoarthritis. MethodsSixty-one patients with knee osteoarthritis treated between April 2014 and April 2015 were randomly divided into 2 groups:rehabilitation group (n=30) and control group (n=31).Patients in the rehabilitation group received knee joint stability training (30-40 minutes once, once every day); the control group received diclofenac sodium orally at 75 mg/d (25 mg per time, 3 times every day).The Western Ontario and McMaster Universities Arthritis index (WOMAC) and short-form health survey (SF-36) were used before and after treatment.Patients' and physicians' assessment of the total efficacy rate was also analyzed. ResultsAfter 5 weeks of treatment, the total efficacy rate assessed by the patients for the rehabilitation group and the control group was respectively 93.33% and 87.10%, and those two numbers assessed by physicians were respectively 86.67% and 80.65%;the differences were not statistically significant (P > 0.05).Significant improvement was observed in the results of WOMAC and SF-36 in both two groups (P < 0.05).There was no significant difference in the clinical efficacy between the two groups (P > 0.05).No incidence of related adverse events occurred in the rehabilitation group, while the incidence of adverse events was 16.13% in the control group (P < 0.05). ConclusionThe knee joint stability training is as effective as diclofenac sodium in treating patients with knee osteoarthritis, but the joint stability training is better tolerated than the latter.
ObjectiveTo compare the effectiveness of partial versus intact posterior cruciate ligament (PCL)-retaining in total knee arthroplasty (TKA) with cruciate-retaining (CR) prosthesis.MethodsA total of 200 patients with osteoarthritis, who met the selection criteria and proposed unilateral TKA with CR prosthesis, were included in the study and randomly assigned into two groups (n=100). The patients were treated with intact retention of the double bundles of PCL in intact group and with partial resection of the anterior lateral bundle of PCL and the anterior bone island at the time of intraoperative tibial osteotomy in partial group. Patients with lost follow-up and re-fracture were excluded, and 84 cases in partial group and 88 cases in intact group were included in the final study. There was no significant difference between the two groups (P>0.05) in terms of gender, age, body mass index, course and grade of osteoarthritis, preoperative varus deformity of knee joint, flexion contracture, range of motion, clinical and functional scores of Knee Society Score (KSS). The operation time, wound drainage volume during 24 hours after operation, visual analogue scale (VAS) score at 24 hours after operation, range of motion of knee joint, clinical and functional scores of KSS, and the anteroposterior displacement of knee joint at 30° and 90° flexion positions were compared between the two groups.ResultsThere was no significant difference between the two groups in operation time, wound drainage volume during 24 hours after operation, and VAS score at 24 hours after operation (P>0.05). Patients in both groups were followed up after operation. The follow-up time was 25-40 months (mean, 30.2 months) in intact group and 24-40 months (mean, 31.8 months) in partial group. There was no significant difference in the range of motion and clinical scores of KSS between the two groups at 6, 12, and 24 months after operation (P>0.05). The functional scores of KSS were significantly higher in intact group than in partial group (P<0.05). There was no significant difference between the two groups in the anteroposterior displacement of knee joints at 30° flexion position at 6, 12, and 24 months after operation (P>0.05). When the knee was at 90° flexion position, there was no significant difference between the two groups at 6 and 12 months after operation (P>0.05), but the intact group was significantly smaller than partial group at 24 months after operation (P<0.05). Postoperative incision continued exudation in 4 patients (2 cases of partial group and 2 cases of intact group), and incision debridement in 2 patients (1 case of partial group and 1 case of intact group). No prosthesis loosening, excessive wear, or dislocation of gasket was found during follow-up.ConclusionThe double bundle of PCL plays an equally important role in maintaining the stability of the knee joint, and the integrity of PCL should be kept as much as possible when TKA is performed with CR prosthesis.
ObjectiveTo investigate the correlation between glenohumeral joint congruence and stability in recurrent shoulder dislocations. Methods Eighty-nine patients (89 sides) with recurrent shoulder dislocation admitted between June 2022 and June 2023 and met the selection criteria were included as study subjects. There were 36 males and 53 females with an average age of 44 years (range, 20-79 years). There were 40 cases of left shoulder and 49 cases of right shoulder. The shoulder joints dislocated 2-6 times, with an average of 3 times. The three-dimensional models of the humeral head and scapular glenoid were reconstructed using Mimics 20.0 software based on CT scanning images. The glenoid track (GT), inclusion index, chimerism index, fit index, and Hill-Sachs interval (HSI) were measured, and the degree of on/off track was judged (K value, the difference between HSI and GT). Multiple linear regression was used to analyze the correlation between the degree of on/off track (K value) and inclusion index, chimerism index, and fit index. ResultsMultiple linear regression analysis showed that the K value had no correlation with the inclusion index (P>0.05), and was positively correlated with the chimerism index and the fit index (P<0.05). Regression equation was K=–24.898+35.982×inclusion index+8.280×fit index, R2=0.084. ConclusionHumeral head and scapular glenoid bony area and curvature are associated with shoulder joint stability in recurrent shoulder dislocations. Increased humeral head bony area, decreased scapular glenoid bony area, increased humeral head curvature, and decreased scapular glenoid curvature are risk factors for glenohumeral joint stability.