Graphene and its derivatives have good physical and chemical properties and biological properties, which can promote stem cell proliferation and osteogenic differentiation, and it has antibacterial properties and drug release property. Therefore, it has broad application prospects in the field of orthopedic biomaterials. This paper mainly introduces the research progress of graphene nanocomposite materials applied in the aspects of bone tissue engineering scaffold, bone repair, bone graft materials, etc. in order to provide desirable information for the future application basis and clinical research.
Objective To introduce the research update of microencapsulation and its application in orthopedics. Methods Recent articlesconcerned were extensively reviewed. Results Drugs and cells modified by genecould be encapsulated in different materials and be implanted in vivo avoiding a host immune system rejection. It act as a continuous source of desired medicine for enhancement of bone healing, the treatment of bone tumor and bone infection, and the regeneration of bone and cartilage. Conclusion Microencapsulation can be used asa carrier for drugs and cells modified gene to treat related disease in orthopedics.
Objective To review the research progress on the application of digital orthopedic technology in total hip arthroplasty (THA) for developmental dysplasia of the hip (DDH), thereby providing a reference for clinical decision-making. MethodsA comprehensive literature review was conducted to summarize the effectiveness of various emerging digital orthopedic technologies in the context of THA for DDH. Results Digital orthopedic technologies have significantly enhanced the precision and safety of THA for DDH. Specifically, artificial intelligence-based preoperative planning systems have demonstrated superior accuracy in prosthesis size matching and positioning compared to conventional methods. Additive manufacturing technologies have provided personalized solutions for reconstructing complex bone defects in DDH. Furthermore, robot-assisted and navigation-assisted techniques have effectively improved the accuracy of prosthesis placement and lower limb length restoration in THA. However, each of these digital orthopedic technologies still possesses its own limitations. ConclusionThrough the integration of multiple technologies, digital orthopedics effectively addresses the challenges of precise reconstruction in THA for DDH. Future efforts should focus on further integrating diverse intelligent technologies and equipment to establish a comprehensive digital diagnosis and treatment system, aiming to achieve superior long-term effectiveness.
ObjectiveTo review the current status and progress of locking plate for the treatment of distal femoral comminuted fractures.MethodsThe related literature was extensively reviewed to summarize the current status and progress in the treatment of distal femoral comminuted fracture with locking plate from four aspects: the current treatment situation, the shortcomings of locking plate and countermeasures, the progress of locking technology, locking plate and digital orthopedic technology.ResultsTreatment of distal femoral comminuted fractures is challenging. Locking plates, the most commonly used fixation for distal femoral comminuted fractures, still face a high rate of treatment failure. Double plates can improve the mechanical stability of comminuted fractures, but specific quantitative criteria are still lacking for when to choose double plates for fixation. The far cortial locking screw has shown good application value in improving the micro-movement and promoting the growth of callus. The biphasic plating is a development of the traditional locking plate, but needs further clinical examination. As an auxiliary means, digital orthopedic technology shows a good application prospect.ConclusionThe inherent defect of locking plate is a factor that affects the prognosis of distal femoral comminuted fracture. The optimization of locking technology combined with digital orthopedic technology is expected to reduce the failure rate of treatment of distal femoral comminuted fracture.
ObjectivesTo systematically review the efficacy and safety of direct oral anticoagulants (DOAC) on preventing venous thromboembolism (VTE) after major orthopedic surgery (MOS).MethodsThe Cochrane Library, PubMed, EMbase, CNKI, WanFang Data and CBM databases were electronically searched for randomized controlled trials (RCTs) on the efficacy and safety of DOAC on preventing VTE after MOS from inception to March 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 22 RCTs involving 41 244 patients were included. The results of meta-analysis showed that: the rate of symptomatic deep vein thrombosis (DVT) after MOS in rivaroxaban (Peto OR=0.54, 95%CI 0.35 to 0.82, P=0.004) and apixaban (Peto OR=0.49, 95%CI 0.26 to 0.92, P=0.03) were lower than enoxaparin. Additionally, the rate of symptomatic pulmonary embolism (PE) after MOS in rivaroxaban was lower than enoxaparin (Peto OR=0.53, 95%CI 0.29 to 0.96, P=0.04), however, in major bleeding after MOS rivaroxaban was significant higher than enoxaparin (Peto OR=1.98, 95%CI 1.30 to 3.01, P=0.001).ConclusionsCurrent evidence shows that rivaroxaban and apixaban is superior to enoxaparin on preventing symptomatic DVT after MOS. Rivaroxaban is superior to enoxaparin on preventing symptomatic PE, however, the risk of major bleeding is higher than enoxaparin. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusions.
Objective To conduct a systematic bibliometric analysis of recent research on robot-assisted orthopedic surgery, in order to reveal the research trends, hotspots, main contributors, and future development directions in this field. Methods On August 27, 2024, WoSCC (Web of Science Core Collection Database) was searched and relevant literature on robot-assisted orthopedic surgery from 2003 to 2023 was included. Excel 2016, VOSviewer (version 1.6.10), and CiteSpace (version 6.2.R6) were used for data collection and analysis. Results The total citation frequency of 1718 retrieved literature was 28978 times, with an average citation frequency of 16.87 times per article. The total citation frequency of articles in 2019 was the highest (4330 times), and the publication volume in 2023 was the highest (315 articles). Among the top 5 countries in terms of publication volume, the United States had the highest publication volume and total citation frequency, while China ranked second in terms of publication volume, but had the lowest average citation frequency per article. Analysis of cooperation between countries showed that the United States, China, Germany, and other countries had the most cooperation. Babar Kayani’s articles were cited the most frequently. Among the top 10 institutions in terms of publication volume, the Hospital for Special Surgery (United States) had the highest publication volume, the Pennsylvania State System of Higher Education (United States) had the highest total citation frequency for publications, and the average citation frequency of each article published by the University of Pittsburgh (United States) was the highest. The dynamic evolution of research hotspots suggested that early research mainly focused on the combination of traditional surgical techniques and navigation, while in recent years, research had mainly focused on computer-aided surgery, augmented reality, and medical robotics technology. Conclusions In recent years, significant progress has been made in the research of robot-assisted orthopedic surgery, with the United States taking a leading position in this field and having extensive global cooperation. Research hotspots show that with the continuous development of computer-aided surgery, augmented reality, and robotics technology, the field of orthopedic surgery is evolving towards more precise, individualized, and minimally invasive directions.
Systems-based integrated course is a advanced and mainstream educational mode in western medical education, and also it is a hotspot of current medical education reform in China. In this article, we introduce our practice and the students' feedback of the orthopedic module of 8-year clinical medicine systems-based integrated course. During practice, we follow the integral curriculum design of Sichuan University, establish a team of teachers, integrate the curriculum of relevant disciplines, and improve teaching methods, ameliorate evaluation forms, etc. Through the implementation of this course, we recognize that this new course system aims to cultivate excellent clinical doctors, which focuses on the bilateral permeation and reconstruction among disciplines, especially between basic curriculums and clinical curriculums, changes traditional teaching methods, and strengthens the ability of practice and lifelong learning.
Objective To explore the impact of moxibustion combined with Shenque acupoint patching on postoperative gastrointestinal function in patients undergoing major orthopedic surgery. Methods Convenience sampling method was used to select patients undergoing major orthopedic surgery from Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital) between October and December 2024 as the research subjects. The trial group received intervention with moxibustion combined with Shenque acupoint patching on the basis of routine care, while the control group only received routine care. The time of first flatus/defecation, frequency of defecation within 7 days, incidence/degree of abdominal distension at 72 hours, and adverse events were compared between the two groups after surgery. Results Finally, 94 subjects were included, including 51 in the trial group and 43 in the control group. There was no statistically significant difference in the general condition between the two groups of patients (P>0.05). Compared with the control group, patients in the trial group had a shorter first flatus time [6.00 (5.00, 9.00) vs. 14.00 (6.83, 19.13) h] and spontaneous defecation time [26.00 (21.00, 52.10) vs. 50.20 (26.42, 69.35) h], and an increase in spontaneous defecation frequency [6.00 (4.00, 7.00) vs. 4.00 (3.00, 5.00)] within 7 days after surgery, with statistically significant differences (P<0.05). Neither the trial group nor the control group experienced any adverse events. Conclusion Moxibustion combined with Shenque acupoint patching can safely and effectively promote the recovery of gastrointestinal function in patients undergoing major orthopedic surgery, and is worthy of clinical promotion.
Objective To investigate the clinical efficacy of computer-assisted cannulated screw internal fixation system based on error correction method for femoral neck fractures. Methods A retrospective analysis was made on the clinical data of 20 femoral neck fracture patients treated by computer-assisted cannulated screw internal fixation system based on error correction method between January 2014 and October 2015 (trial group), and 36 femoral neck fracture patients undergoing traditional manual surgery with closed reduction by cannulated screw fixation in the same period (the control group). There was no significant difference in gender, age, injury cause, side of fracture, types of fracture, and time from injury to operation between 2 groups (P>0.05). The operation time, intraoperative blood loss, intraoperative frequency of fluoroscopy and guide pin insertion, fracture healing time, fracture healing rate, and Harris hip score were compared between 2 groups. Results All incisions healed by first intention after operation, and no complication of blood vessel and nerve injury occurred. The operation time of trial group was significantly longer than that of control group (t=2.290,P=0.026), however, the intraoperative blood loss, intraoperative frequency of fluoroscopy and guide pin insertion of trial group were significantly less than those of control group (t=–10.650,P=0.000;t=18.320,P=0.000;t=–16.625,P=0.000). All patients were followed up 12-18 months (mean, 14.7 months). X-ray films showed that fracture healing was obtained in 2 groups, showing no significant difference in fracture healing time between 2 groups (t=0.208,P=0.836). No complication of ischemic necrosis of femoral head occurred during follow-up period. At last follow-up, the Harris hip score was 87.05±3.12 in trial group and was 86.78±2.83 in control group, showing no significant difference (t=0.333,P=0.741). Conclusion Computer-assisted cannulated screw internal fixation surgery based on error correction method for femoral neck fractures is better than traditional manual surgery in decreasing intraoperative radiation and surgical trauma during operation.
Evidencebased medicine (EBM) is different fromtraditional medicine in that the practice of EBM comes from evidence and experience of the doctors. The objective evidence plays a key role in clinical practice. During the clinical teaching process, the following steps should be taken: firstly, the students should find a problem in their clinical practice; then, theyshould search for the evidence with the help of their teachers, evaluate the evidence, apply the evidence to the clinical practice, and solve the problem; finally, they should evaluate the effectiveness. An introduction of the principles and methods of EBM to the clinical practice can greatly improve the students’ ability to analyze and solve a clinical problem.