Jian-Quan Wang

Peking University Third Hospital, Peping, Beijing, China

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Publications (17)13.07 Total impact

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    ABSTRACT: Clinical features of anterior cruciate ligament (ACL) injury are important for its prevention, diagnosis and treatment. However, few studies have reported such data, especially in China. The purpose of this study was to describe the clinical characteristics of ACL injury on a large cohort. Between 1993 and 2007, a total of 4355 ACL deficient inpatients (612 athletes and 3743 non-athletes) were registered. Data were collected using a special database system. And the distributions of characteristics in different groups were compared and analyzed statistically. All subjects were confirmed with ACL tear during surgery. Statistical analysis revealed that the percentage of females in Athlete Group was significantly higher than that in Non-athlete Group (56.05% vs. 24.95%, P < 0.001). This study also found that sports trauma was the main cause of ACL tears. Soccer, basketball, judo, wrestling and track and field were the five most responsible activities for athletes. The average injury time for athletes was significantly shorter than that for non-athletes (413.3 days vs. 717.5 days, P < 0.001). Three thousand nine hundred and eight cases were ordered ACL reconstruction (76.04% single-bundle, 18.30% double-bundle). Three hundred and forty-five patients (7.92%) were combined with other ligaments injuries, 2667 (61.24%) were found with various grades of cartilage lesions, and 3377 (77.54%) were found with meniscal injury. Sports trauma was the main cause of ACL tears in China, and reconstruction had become the principal surgical choice. In order to restore knee joint stability and reduce the incidence of cartilage and meniscal injury, patienttailored ACL reconstruction should be suggested at the right moment.
    Chinese medical journal 12/2013; 126(23):4487-92. · 0.90 Impact Factor
  • Jian Xiao, Guo-Qing Cui, Jian-Quan Wang
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    ABSTRACT: To evaluate the mid-term results of arthroscopic repair of full-thickness rotator cuff tears. From December 2002 to May 2007, 35 patients(35 shoulders) with full-thickness rotator cuff tears underwent arthroscopic treatment. Five patients were lost in the follow-up period, leaving 30 patients available for evaluation. There were 15 male and 15 female patients, the average age was 55.6 years(31-74 years). Three left shoulder and 27 right ones were involved. All the patients underwent subacromial bursectomy and acromioplasty, 19 cases were repaired by suture anchor. Eleven tears were repaired by suture anchor combined with side-to-side suture. Sixteen patients underwent single-row repair and 14 patients underwent dual-row repair. The follow-up was completed on June 2012. The University of California at Los Angeles (UCLA) scoring system was adopted before operation and at the final evaluation. Thirty patients were followed up for an average of 78.5 months(range 5-10 years). The average score increased from 14.2 ± 3.1 to 33.6 ± 2.1 (t = -37.154, P = 0.000) . The mean pain score was 2.5 ± 0.9 vs.9.5 ± 1.0(t = -24.466, P = 0.000) for preoperative vs. postoperative, the function score was 4.5 ± 1.5 vs. 9.4 ± 1.1 (t = -18.500, P = 0.000), the mean forward flexion score was 3.3 ± 1.6 vs. 4.9 ± 0.2(t = -5.614, P = 0.000), the mean forward flexion strength was 3.9 ± 0.5 vs. 4.7 ± 0.4 (t = -6.591, P = 0.000). The results were 19 excellent, 11 good. The average scores of single-row group and double-row group were 33.6 ± 1.7 and 33.6 ± 2.6 respectively. All patients were satisfied with the operation. This surgery has many advantages such as mini-invasion and rapid recovery. The clinical results of both single-row repair and dual-row repair are satisfactory. The key to the operation lies in accurate tear pattern recognition, enough tendon release and correct suturing method.
    Zhonghua wai ke za zhi [Chinese journal of surgery] 07/2013; 51(7):619-622.
  • Yan Xu, Yu Yin, Jian-quan Wang, Ying-fang Ao
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    ABSTRACT: To determine if double bundle hamstring autograft posterior cruciate ligament (PCL) reconstruction could bring better outcomes than single bundle. From June 2007 to June 2009, there were 22 subjects, including 16 male and 6 female patients with an average (37 ± 13) years old (16-54 years old) were reconstructed with single bundle PCL reconstruction (single bundle group), 24 subjects, including 18 male and 6 female patients with an average (37 ± 10) years old (17 - 52 years old) were reconstructed with double bundle PCL reconstruction (double bundle group). There were no differences between the two groups on patients' demographics and the duration from the injury to the operation (P > 0.05). Clinical outcomes, KT2000 and tunnel placements of all the patients were measured and analyzed. The two groups were retrospectively studied and compared with a (29 ± 9) months (24 - 55 months) follow-up. Operation duration of double bundle group was (92 ± 8) minutes which was significantly longer than the single bundle group (78 ± 13) minutes (t = 2.474, P < 0.05). IKDC, Lysholm and Tegner scores were all significantly improved at the last follow-up of both groups (single bundle group: t = 9.578, 13.115 and 8.165, P < 0.01; double bundle group: t = 4.390, 5.522 and 4.313, P < 0.05). Post operative KT2000 side-to-side difference of the double bundle group was significantly smaller than that of the single bundle group under maximum posterior force with the knee in 90° flexion ((1.5 ± 1.5) mm vs. (4.0 ± 2.9) mm, t = 2.538, P = 0.019). There were 66.7% of the patients of double bundle group were normal which was significantly higher than 31.8% of the single bundle group on the IKDC knee examination form (χ² = 5.576, P = 0.018). Single or double bundle PCL reconstruction could restore the knee's stability and function satisfied. There are no differences between two groups in clinical scores, but double group manifestes a better anterior-posterior stability.
    Zhonghua wai ke za zhi [Chinese journal of surgery] 03/2013; 51(3):247-51.
  • Yan Xu, Ying-Fang Ao, Jian-Quan Wang, Guo-Qing Cui
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    ABSTRACT: PURPOSE: To determine if anatomic double-bundle anterior cruciate ligament (ACL) reconstruction is superior to anatomic single-bundle reconstruction in restoring the stabilities and functions of the knee joint. METHODS: A prospective randomized clinical study was done to compare the results of 32 cases of anatomic single-bundle ACL reconstruction and 34 cases of anatomic double-bundle ACL reconstruction with average follow-up of 16.3 ± 3.1 months. Tunnel placements of all the cases were measured on 3D CT. Clinical results were collected after reconstruction; graft's appearance, meniscus status and cartilage state under arthroscopy were compared and analysed too. RESULTS: Tunnel placements, confirmed with 3D CT, were in the anatomic positions as described in literature both in SB and DB group. No differences were found between SB and DB groups in clinical outcome scores, pivot shift test and KT 1000 measurements (average side-to-side difference for anterior tibial translation was 0.7 mm in SB group and 1.0 mm in DB group). More than 70 % of the single-bundle graft and AM bundle graft in DB group appeared excellent, but only 44.1 % of PL bundle grafts in DB group were excellent and 11.8 % were in poor state. No new menisci tear was found either in SB or DB group, however, in DB group cartilage damages in medial patella-femoral joint occurred in 38.2 % cases. This rate was significantly higher than in the SB group which is only 9.3 %. CONCLUSION: Both single- and double-bundle anatomic ACL reconstruction can restore the knee's stability and functions very well. However, more incidences of poor PL status and medial patellar-femoral cartilage damage may occur in double-bundle ACL reconstruction. LEVEL OF EVIDENCE: Randomized controlled trial, Level I.
    Knee Surgery Sports Traumatology Arthroscopy 01/2013; · 2.68 Impact Factor
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    ABSTRACT: Arthroscopic debridement is an appropriate procedure for osteoarthritic elbow in general populations. However, the results of arthroscopic debridement in the professional athletes, a younger and highly active patient cohort is unclear. The purposes of this study were to assess the clinical outcomes of arthroscopic debridement of osteoarthritic elbow in professional athletes and to evaluate the effect of prognostic factors on the clinical outcomes. From January 1999 to January 2006, 35 professional athletes with osteoarthritc elbow (36 elbows) were treated with arthroscopic debridement, consisted of osteophytes removal, loose bodies removal and fenestration of the olecranon fossa as necessary. Average patient age was (23 ± 5) years (range 7 - 34 years). Average follow-up was (43 ± 23) months (range 16 - 98 months). Athletic activities consisted mainly of wrestling, judo and weightlifting. Patients were evaluated preoperatively and postoperatively with the modified Hospital for Special Surgery (HSS) elbow scoring system. According to the modified HSS elbow scoring system, the result was excellent for 16 elbows, good for 14 and poor for 6. No case had got worse after surgery. All athletes reported an improvement in pain. After athletic training, 15 elbows were not painful, 16 mildly painful, 3 moderately painful and 2 severely painful. The arc of flexion-extension improved from 111° preoperatively to 127° postoperatively. All of the athletes were able to return to their previous level of training. Five athletes won national-level championships. At follow-up, 17 athletes (18 elbows) were greatly satisfied with the results, 12 satisfied and 6 unsatisfied. Postoperatively, one athlete reported ulnar nerve symptoms and two others had residual loose bodies. The fenestration of the olecranon fossa was associated with a significantly increased chance of a poor outcome. The nature of the osteoarthritis, duration of symptoms, osteophytes removal and loose bodies removal did not predict the outcomes. Arthroscopic debridement of osteoarthritic elbow in professional athletes can yield significant short-term pain relief, as well as restoration of elbow range of motion and resuming their athletic training. The long-term durability of this procedure with regard to preservation of range of motion and radiographic progression of arthritis remains unknown.
    Chinese medical journal 12/2011; 124(24):4223-8. · 0.90 Impact Factor
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    ABSTRACT: The purpose was to find a simple guideline to help establish accurate positioning of the posterolateral bundle (PLB) femoral bone tunnel during double-bundle anterior cruciate ligament reconstruction by measuring the distance between the center of the PLB femoral footprint to the shallow and the deep articular cartilage borders of the lateral wall of the intercondylar notch. The femoral insertions of the anteromedial bundle and PLB of the anterior cruciate ligament were dissected in 22 male cadaveric knees, aged 25 to 45 years. By use of the intercondylar notch as the landmark, the distances between the center of the PLB femoral footprint and the shallow and the deep articular cartilage borders of the lateral wall of the intercondylar notch were measured with the knees flexed at 90°. The measured data (mean ± standard deviation) were evaluated and compared. The center of the PLB was positioned 8.60 ± 1.52 mm and 8.65 ± 1.54 mm from the shallow and the deep cartilage borders of the lateral wall of the intercondylar notch, respectively (P = .95). The distance between the center of the PLB footprint to the low cartilage border of the lateral intercondylar wall was 5.05 ± 0.76 mm. The findings suggest that the position of the center of the PLB femoral footprint is at the middle of the line joining the shallow and the deep borders of the femoral cartilage. Surgeons can use our results as a guideline and use the PLB footprint remnant as a reference at the same time to locate the femoral PLB tunnel in a simple, easy, and repeatable way.
    Arthroscopy The Journal of Arthroscopic and Related Surgery 07/2011; 27(7):959-64. · 3.10 Impact Factor
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    ABSTRACT: To evaluate retrospectively the results of arthroscopic Bankart repair using suture anchors for recurrent anterior shoulder dislocation with a minimum 1-year follow-up and to assess risk factors for recurrence. From March 2002 to March 2010, 259 patients with recurrent anterior shoulder dislocation underwent arthroscopic Bankart repair with suture anchors. And 188 patients (50 athletes, 138 nonathletes) were available for follow-up. The mean age at the time of surgery was 25.3 years (range, 13 - 58 years). The mean follow-up was 38.6 months (range, 12 - 110 months). All of the 188 patients were evaluated preoperatively and postoperatively with the American Shoulder and Elbow Society (ASES) shoulder score and Rowe score system. The rate of recurrent instability, range of motion, and risk factors for postoperative recurrence were evaluated. The ASES score was 72.6 preoperatively, and Rowe score was 33.4. The ASES scores improved significantly to 91.9 postoperatively (P < 0.001). The Rowe scores improved to 81.9 postoperatively (P < 0.001). And 152 patients were greatly satisfied with the results, 16 satisfied and 20 unsatisfied. The satisfactory rate was 89.4%. 24 patients (12.8%) suffered a recurrence after surgery, 14 athletes and 10 nonathletes. The recurrence rates were 28.0% in the athlete group and 7.2% in the nonathlete group. On average there was no significant loss of external rotation postoperatively (average, 75.2° preoperatively and 67.2° postoperatively). Patients under age 20, and athlete patients were associated with recurrence (P < 0.05). Other factors including length of time until surgery, type of anchors, number of anchors, presence of bony Bankart lesion, presence of a superior labrum, anterior and posterior tear, presence of posterior or inferior labrum lesion, presence of rotator cuff tear, ligamentous laxity and rotator interval closure did not influence the recurrence rate (P > 0.05). Arthroscopic Bankart repair is a good option for the treatment of recurrent anterior shoulder dislocation. Identification of risk factors for recurrence allows for consideration of open stabilization. In the series, patients under age 20 and athlete patients are the most important risk factors for recurrence.
    Zhonghua wai ke za zhi [Chinese journal of surgery] 07/2011; 49(7):597-602.
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    ABSTRACT: Ligusticum wallichi Franchat (chuanxiong) is a very common traditional Chinese herbal medicine in China. Tetramethylpyrazine (TMP) is a major active ingredient extracted from Ligusticum wallichi Franchat. We investigated the protective effect of TMP on interleukin-1β (IL-1β) induced proteoglycan (PG) degradation and apoptosis in rabbit articular cartilage and chondrocytes. Rabbit articular cartilage explants and chondrocytes were cultured with 10 ng/ml IL-1β for 72 h in the absence or presence of various concentrations of TMP (50, 100 or 200 μM). Cartilage and chondroprotective effects of TMP were determined by evaluating (1) the degree of PG degradation by measuring the amount of glycosaminoglycan (GAG) released into the culture media with 1,9-dimethylmethylene blue (DMMB) assay in cartilage explants; (2) gene expression of MMP-3 and TIMP-1 by real-time quantitative reverse transcription-polymerase chain reaction analysis in cartilage explants; (3) chondrocytes viability with MTT assay; (4) the production of intracellular reactive oxygen species (ROS) with laser scanning confocal microscopy (LSCM). Anti-apoptotic effects of TMP were determined by measuring (1) apoptosis with flow cytometric analysis; (2) mitochondrial membrane potential assay with LSCM; (3) caspase-3 activity with special assay kit. IL-1β treatment increased the level of GAG released into the culture media, and induced the gene expression of MMP-3 and inhibited the gene expression of TIMP-1 in cartilage explants. Moreover, IL-1β treatment decreased the cell viability and mitochondrial membrane potential, and enhanced the level of intracellular ROS, apoptosis rate, and caspase-3 activity in chondrocytes. However, simultaneous treatment with TMP attenuated the IL-1β-induced cartilage and chondrocyte destruction in a dose-dependent manner. TMP showed the decrease of GAG degradation and MMP-3 mRNA production, and the enhancement of TIMP-1 mRNA production in cartilage explants. TMP also increased the cell viability in chondrocytes. Furthermore, TMP inhibited the chondrocytes apoptosis through suppression of ROS production, maintaining of mitochondrial membrane potential and downregulation of caspase-3 activity. These results demonstrate that TMP has the cartilage and chondroprotective effect, which suggest that TMP could act as an agent for pharmacological intervention in the progress of OA.
    Journal of ethnopharmacology 11/2010; 132(2):414-20. · 2.32 Impact Factor
  • Jian Xiao, Guo-Qing Cui, Jian-Quan Wang
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    ABSTRACT: To study the clinical features and diagnosis of bursal-side partial-thickness rotator cuff tears. From August 1999 to June 2006, 38 patients with bursal-side partial-thickness rotator cuff tear were evaluated. Twenty-eight men and ten women of average age 45.7 years (range, 18-69 years) with 11 left and 27 right shoulders were studied. According to the Ellman classification, 6 cases were classified as grade I, 7 as II and 25 as III. Physical and X-ray examination, including anteroposterior and supraspinatus outlet views, were performed on both shoulders of all patients. Ultrasonography and MR examination were performed in 27 and 35 patients, respectively. Thirteen patients underwent arthroscopic subacromial decompression and debridement of the rotator cuff. Twenty five patients underwent arthroscopic or mini-open subacromial decompression and rotator cuff repair. All patients had shoulder pain, with 18 cases of night pain. No statistical difference in the incidence of night pain was found between the three groups. Strength of forward flexion and abduction of the affected shoulder was decreased in 25 patients. The Neer impingement sign was found in 35 cases (92.1%), Hawkins impingement sign in 27 (71.1%), tenderness of the greater tuberosity in 34 (89.5%), painful arc in 26 (68.4%), and traction test in 26 (68.4%). The positive rates for ultrasonography and MR were 48.1% and 74.3%, respectively. Long-standing motion pain, impingement sign, painful arc, lock and crepitus in the subacromial space are suggestive of bursal-side tears. MRI is much more accurate than ultrasonography. Fat-suppressed T2-weighted images must be included. Arthroscopy is still the gold standard for making the diagnosis.
    Orthopaedic Surgery 11/2010; 2(4):260-5.
  • Jian Xiao, Guo-qing Cui, Jian-quan Wang
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    ABSTRACT: To study the surgical techniques and results of arthroscopic treatment of bursal-side partial-thickness rotator cuff tears. From June 2002 to December 2007, 57 patients with bursal-side partial-thickness rotator cuff tears underwent arthroscopic treatment. There were 34 male and 15 female patients, the average age was 49.7 years (25 - 71 years). Fifteen left shoulder and 34 right ones were involved. Seven cases were classified as degree I, 6 as II and 36 as III according to Ellman classification. The anterior-posterior and the supraspinatus outlet projection of the X-rays were obtained before surgery. Twenty-nine patients had been received by sonography and 36 patients had undergone MRI examinations. All the patients underwent subacromial bursectomy and acromioplasty, 13 cases underwent cuff debridement, 36 cases underwent cuff repair. Among them, 3 cases were treated by side to side suture of rotator cuff, 26 cases were treated by suture anchor, 7 cases were treated by side to side suture combined with suture anchor. UCLA scoring system was adopted before operation and at the final evaluation. Forty-nine patients had been reviewed at least 2 years after the operation with an average of 48 months (2 to 7 years). The average score was 32.1 ± 3.8 postoperatively, and the mean pain score was 2.9 ± 1.0 vs 8.4 ± 1.7 (P = 0.000) for pre- vs. post-operation, the function score was 5.4 ± 1.2 vs. 9.1 ± 1.4 (P = 0.000), the mean forward flexion score was 4.3 ± 1.1 vs. 4.9 ± 0.2 (P = 0.000), the mean forward flexion strength was 4.0 ± 0.4 vs. 4.8 ± 0.4 (P = 0.000), the results were 16 excellent, 31 good and 2 bad. Forty-seven patients were satisfied with the operation. Arthroscopy is an effective method for the treatment of bursal-side partial-thickness rotator cuff tears. The key to the operation lies in bleeding control, proper acromioplasty and correct suturing method. This surgery has many advantages such as mini-invasion and rapid recovery.
    Zhonghua wai ke za zhi [Chinese journal of surgery] 10/2010; 48(19):1492-5.
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    ABSTRACT: Sinomenine (SIN), an alkaloid extracted from the stem of the Chinese medicinal plant sinomenium acutum, has been used for treating rheumatoid arthritis. But little is known whether SIN has a protective effect on osteoarthritis (OA). In this study, we investigated the protective effect of SIN on IL-1beta-induced proteoglycan degradation and apoptosis in rabbit articular cartilage and chondrocytes. Treatment with 10 ng/ml IL-1beta increased the level of glycosaminoglycan (GAG) released into the culture media, and up-regulated the activity and mRNA expression of matrix metalloproteinase 13 (MMP-13) and down-regulated the activity and mRNA expression of tissue inhibitor of metalloproteinase 1 (TIMP-1) in cartilage explants, as confirmed by the methods of GAG quantitation, MMP-13/TIMP-1 enzyme-linked immunosorbent assay (ELISA) and real-time quantitative RT-PCR. Treatment with 10 ng/ml IL-1beta resulted in marked apoptosis in chondrocytes, as demonstrated by decreased cell viability, occurrence of DNA laddering and increased caspase-3 activity and annexin V binding of phosphatidylserine. However, simultaneous treatment with SIN (10, 50 or 250 microM) inhibited the GAG release and the activity and mRNA expression of MMP-13, and enhanced the activity and mRNA expression of TIMP-1 in a dose-dependent manner in cartilage explants. Furthermore, DNA fragment, caspase-3 activity and apoptosis rate were down-regulated, and cell viability was up-regulated dose-dependently in chondrocytes. Thus, SIN has the protective capacity to antagonize cartilage degradation and chondrocyte apoptosis, which suggest that SIN may act as an agent for pharmacological intervention in the progress of OA.
    Yakugaku zasshi journal of the Pharmaceutical Society of Japan 08/2010; 130(8):1053-60. · 0.46 Impact Factor
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    ABSTRACT: Pectoralis major tendon rupture is a relatively rare injury leading to both functional and cosmetic deficiency. The peak torque of the pectoralis major is significantly decreased after conservational treatment of a total rupture. We suppose that surgical intervention is better choice. We retrospectively evaluated 12 patients who were diagnosed with distal pectoralis major muscle rupture and underwent operation in our institute from 1993 to 2007. All patients were male with a mean age of 32 (19 - 54) years. In 4 patients, tendon reconstruction was accomplished by fixing the tendon to the humerus using sutures passed through predrilled humeral bone tunnels. In 8 patients, tendon reconstruction was accomplished by directly suturing the muscle to the tendon. All patients followed an accelerated rehabilitation protocol. Treatment results were evaluated according to the following criteria: (1) visual analogue pain scale, (2) isokinetic strength measurements, (3) range of motion of shoulder joint, (4) cosmetic result, and (5) postoperative sports activity performance. In this study, we aimed to describe our surgical technique of reconstruction of the rupture of pectoralis major muscle and to summarize the clinical results of the operative treatment. At the final follow-up examination (6.5 years postoperatively), only nine patients were available for evaluation. Three of them had excellent results, and five had good results, while one had poor results. Eight of the patients were able to return to their preinjury level of sporting activity. In summary, 89% of the patients achieved excellent or good results. Surgical treatment by anatomic tendon repair and accelerated rehabilitation can make recovery of strength and function of the pectoralis major muscle.
    Chinese medical journal 01/2010; 123(1):57-60. · 0.90 Impact Factor
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    ABSTRACT: To evaluate the 4- to 10-year results of arthroscopic reconstruction of the posterior cruciate ligament (PCL) using single-bundle bone-patella tendon-bone graft, and to find out the principle and influential factor of the isolated PCL reconstruction. From May 1998 to July 2004 the data of 29 patients with isolated PCL reconstruction retrospectively investigated, using single-bundle bone-patella tendon-bone graft. Twenty-two cases were followed up with average 7.1 years (5 - 10 years). Follow-up included the subjective knee function evaluation, KT2000, Biodex and the radiographic assessment. The mean final follow-up IKDC score, Lysholm score, and Tegner score of the 22 cases were 89.4 +/- 8.1, 94.5 +/- 9.2, and 6.9 +/- 2.6 respectively. There were statistically significant improvements in them when compared with preoperative data respectively (P < 0.01). The average posterior displacement measured with KT2000 was (4.9 +/- 1.1) mm (90 degrees flexion) and (4.3 +/- 1.2) mm (30 degrees flexion) respectively. At the final follow-up, KT2000 examination revealed >or= 6 mm of posterior laxity in 6 patients (group A), and <or= 5 mm posterior laxity in 16 patients (group A). A statistically significant improvement was noted in comparing the mean final follow-up IKDC score, Lysholm score, and Tegner score between the group A and B (P < 0.01). The average time from injury to surgery of group A and B was (17.6 +/- 3.9) months and (2.9 +/- 2.1) months respectively, the difference was statistically significant (P < 0.01). The data was received from the Biodex dynamometer for the 22 patients who were followed up in clinic service. Patients achieved (90 +/- 22)% (60 degrees /s) and (87 +/- 19)% (120 degrees /s) recovery of the extensor peak torque respectively, for the flexor peak torque patients achieved (93 +/- 16)% (60 degrees /s) and (92 +/- 20)% (120 degrees /s) respectively, the difference between the peak torque of extensor and flexor in the same condition was statistically significant (P < 0.01). X-ray findings: 8 of the 22 patients (36.4%) were assessed as mild grade change (3 case in medial compartment isolated, 1 case in patellofemoral joint isolated, and 4 case in both compartments) and 2 patients (9.1%) as moderate grading in final follow-up radiographs (in both anterior and medial compartments), and 12 of the 22 patients (54.5%) revealed normal X-ray findings. The average time from injury to surgery of patients who revealed joint degeneration and patients who revealed normal X-ray findings was (16.6 +/- 2.7) months and (3.3 +/- 1.7) months respectively, the difference was statistically significant (P < 0.01). Arthroscopic reconstruction of the posterior cruciate ligament using single-bundle bone-patella tendon-bone graft produces well results with moderate to long term follow-up. For the patients with III or IV PCL injury, PCL reconstruction should be done as soon as possible.
    Zhonghua wai ke za zhi [Chinese journal of surgery] 06/2009; 47(10):778-82.
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    Yu Yin, Jian-Quan Wang, Zhen-Ming He
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    ABSTRACT: The medial plica may be caused by direct trauma or joint degeneration, which also could be iatrogenic. There have been few reports in the literature discussing incidence of the medial plica caused by an operation on the knee joint, specifically after the reconstruction of anterior cruciate ligament (ACL). In this study, we aimed to evaluate and analyze the relationship between the incidence of the medial plica and reconstruction of the ACL. A retrospective case series study was conducted to review the findings of 1085 patients between 2003 and 2007, who underwent second-look arthroscopy after reconstruction of the ACL (between 2002 and 2006). The correlation of the incidence of medial plica with the stability of the knee joint, the time from onset of injury to reconstruction surgery, the associated injuries, and the rate of progress during postoperative rehabilitation were analyzed. We found that 722 patients had the structure of a medial plica. The incidence after reconstruction of the anterior cruciate ligament (66.5%) was significantly higher than usually reported. All these medial plica had avascular fibrotic and thickened edges. An excision of pathologic medial plica and fat pad synovial fringes were done. The incidences were significantly different between the two groups with their reconstruction operation time, from onset of injury to surgery (less than one month or over 2 years), and the progress rate of postoperative rehabilitation (knee flexion could not be over 90 degrees in four weeks). The incidence was not different between the groups with knee stable conditions. Medial plica is more common in patients after reconstruction of ACL. More associated injuries and more rehabilitation difficulties can increase the medial plica incidence.
    Chinese medical journal 05/2009; 122(7):818-22. · 0.90 Impact Factor
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    ABSTRACT: In clinical studies there is still a lot of controversy about the increased anterior and rotational stability between double-bundle (DB) and single-bundle (SB) anterior cruciate ligament (ACL) reconstruction. The aim of this study was to evaluate the clinical results of four-tunnel DB ACL reconstruction. Sixty-four consecutive patients with ACL ruptures from May 2005 to May 2006 were randomly assigned into two groups: 32 cases for SB ACL reconstruction and 32 cases for DB ACL reconstruction. Clinical data, including KT 2000, Biodex test, Lysholm score, Tegner score and IKDC score, were prospectively collected until at least 10 months post-operative. The average values of KT 2000 were (1.47 +/- 1.17) mm and (1.68 +/- 1.14) mm for the SB and DB ACL reconstruction groups at 30 degrees of knee flexion (P > 0.05), and were (1.04 +/- 0.98) mm and (1.13 +/- 0.98) mm at 90 degrees of knee flexion (P > 0.05). There were also no significant differences in Lysholm score, Tegner score, IKDC score and Biodex test scores between the two groups (P > 0.05). The operation time of DB ACL reconstruction was 20 minutes longer than the SB ACL reconstruction (P < 0.05). Double bundle ACL reconstructions have no obvious clinical advantages over single bundle ACL reconstructions.
    Chinese medical journal 04/2009; 122(6):706-11. · 0.90 Impact Factor
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    ABSTRACT: To summary the experience in the diagnosis and management of septic arthritis after anterior cruciate ligament (ACL) reconstruction. The knee joint infections after arthroscopic anterior cruciate ligament reconstruction were retrospectively studied. From January 1997 to July 2007, 16 of 3638 patients undergoing anterior cruciate ligament reconstructions experienced postoperative septic arthritis. The incidence, cause, presentation, laboratory results, treatment, and outcome of all infected patients were analyzed. The experiences of diagnosis and management of septic arthritis after anterior cruciate ligament reconstruction were summarized. The incidence of septic arthritis after ACL reconstruction was 0.44%. The most common symptoms of the infected patients were fever, swelling, severe pain, tenderness, restricted motion. Eleven (68.8%) patients were positive for bacteria cultures, and Staphylococcus epidermidis was the most common bacteria. Nine of the 16 patients were performed arthroscopic debridement, and the other 7 patients were conservatively treated. All patients regained full range of motion and normal stability at the 19.7 months follow-up. Septic arthritis, which could bring the dysfunction of the joint, is subsequent with cartilage injury and the failure of the ACL grafts. Early diagnosis and treatment of arthroscopic debridement in time are essential to the ultimate clinical outcome.
    Zhonghua wai ke za zhi [Chinese journal of surgery] 06/2008; 46(10):745-8.
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    ABSTRACT: To investigate the effect of the arthroscopic procedure on the patients with recurrent anterior shoulder dislocation. From January 2001 to March 2006,52 patients with recurrent anterior shoulder dislocation were treated by arthroscopy. Among them 44 patients were followed up for 12 to 54 months(on average of 26 months). The data of the 44 patients was reviewed. Three evaluation systems, University of California at Los Angeles Shoulder Scores (UCLA), Simple Shoulder Test (SST) and Dawson, were used. The study evaluated the effect based on the Dawson system by the factors as: age, course of the disease, frequency of dislocation and relocation methods and the range of shoulder movement. The ratio of recurrent dislocation after operation was 4.5%. Assessing through 3 evaluation systems, UCLA, SST and Dawson, results were similar: the follow-up evaluation were extraordinarily different from preoperative assessment, and the rating of good or excellent at the time of the final follow-up reached 91% higher. Based on the Dawson system, the evaluation results had no statistic diversity according to such factors as: age, course of the disease, frequency of dislocation and relocation methods. The effects of arthroscopic surgery to the recurrent anterior shoulder dislocation are satisfied and evidence-proved. It is a good option for both common patients and athletes.
    Zhonghua wai ke za zhi [Chinese journal of surgery] 05/2008; 46(8):581-3.