Bone and Arthrosurgery Science

Clinical Observation of Anterolateral Thigh Perforator Flap for Reconstruction of Head and Facial Soft Tissue Defects

Yuanguo Luo — 2025-10-31

Objective: To evaluate the efficacy of the anterolateral thigh perforator flap in repairing head and face skin defects. Methods: Nineteen patients with head and facial skin defects, admitted to the 303rd Hospital and the 89th Hospital of the People’s Liberation Army from May 2012 to May 2020, were selected as research subjects and underwent repair surgery. The primary method employed was free transplantation of the anterolateral thigh perforator flap. Following the operation, patients were closely monitored for 5 to 7 days. The viability of the blood vessels was assessed based on the healing, color, and vascular filling of the flaps. Patients were followed up for 6 to 18 months post-operation to evaluate the donor and recipient sites. Results: Out of the 19 transplanted flaps, 18 survived completely, yielding a survival rate of 94.73%. The recurrence rate of the original lesion post-operation was 10.52%. 94.44% of patients reported no impact on lower limb movement on the side where the flap was harvested, and only 16.66% of patients experienced noticeable numbness in the donor site skin after the operation. All 19 patients reported that initially, the flaps were stiff and had limited movement. However, after 6 months, they gradually softened and adhered more closely to the original skin tissue. Conclusion: The free anterolateral femoral perforator flap is an ideal option for repairing head and facial defects. It offers a reliable blood supply, a large harvestable area, and minimal impact on both donor and recipient sites. Its abundant blood supply remains unaffected by the repair surgery, resulting in a relatively high survival rate. It demonstrates good adaptability and is more readily accepted by patients.

Effects of Aquatic Exercise Therapy on Joint Mobility and Inflammatory Markers in Patients with Rheumatoid Arthritis

Xiaoge Wang — 2025-10-31

This study aimed to investigate the effects of aquatic exercise therapy on joint mobility and inflammatory markers in patients with rheumatoid arthritis. Through a randomized controlled trial, patients in the experimental group underwent aquatic exercise therapy, with pre- and post-treatment data on joint mobility and inflammatory markers compared. Results demonstrated that aquatic exercise therapy significantly improved joint range of motion and reduced inflammation levels, indicating positive therapeutic effects for rheumatoid arthritis.

The Effect of Ultrasound-Mediated Drug Delivery Combined with Core Muscle Group Training on the Lumbar Spine of Patients with Chronic Low Back Pain

Huiping Zhang — 2025-10-31

Objective: To investigate the effects of ultrasound-mediated drug delivery combined with core muscle group training on lumbar spine function, pain intensity, and muscle function in patients with chronic low back pain (CLBP), providing evidence-based support for clinical treatment. Methods: A total of 120 CLBP patients admitted to the Department of Orthopedics in our hospital from January 2023 to December 2024 were selected as research subjects. They were randomly divided into a control group (n = 60) and an observation group (n = 60) using a random number table method. The control group received ultrasound-mediated drug delivery treatment alone, while the observation group received a combination of ultrasound-mediated drug delivery and core muscle group training. Both groups underwent continuous treatment for 8 weeks. The Visual Analogue Scale (VAS) scores, Oswestry Disability Index (ODI), and clinical efficacy were compared between the two groups before treatment, at 4 weeks, and at 8 weeks after treatment. Results: Before treatment, there were no statistically significant differences in VAS scores, ODI, or lumbar spine range of motion between the two groups (p > 0.05). After 4 and 8 weeks of treatment, both groups showed a significant decrease in VAS scores and ODI compared to before treatment (p < 0.05), with the observation group having lower scores than the control group (p < 0.05). The total effective rate in the observation group after 8 weeks of treatment was 93.33% (56/60), which was higher than the 78.33% (47/60) in the control group, with a statistically significant difference (p < 0.05). Conclusion: Ultrasound-mediated drug delivery combined with core muscle group training can effectively alleviate pain intensity, improve lumbar spine function and range of motion, enhance core muscle strength, and demonstrate good safety in CLBP patients. It is worthy of clinical promotion and application.

Clinical Study on Minimally Invasive Sling Technique Fixation for the Treatment of Acromioclavicular Joint Dislocation with Double Endobutton by Bare-handed

Jikui Guan — 2025-11-06

Objective: To evaluate the clinical efficacy of minimally invasive, fluoroscopy-free, arthroscopy-free, coracoid tunnel-free double Endobutton plate sling technique for the treatment of acromioclavicular joint dislocation. Methods: A total of 60 patients with acromioclavicular joint dislocation admitted to our hospital between January 2021 and December 2023 were divided into two groups according to the treatment method. The control group underwent open reduction and internal fixation with a clavicular hook plate, while the study group received minimally invasive, fluoroscopy-free, coracoid tunnel-free double Endobutton plate sling fixation. The therapeutic outcomes were compared between the two groups. Results: All surgical outcome measures in the study group were superior to those in the control group (p < 0.05). The improvement in Constant scores and the reduction in visual analog scale (VAS) pain scores was significantly greater in the study group compared to the control group (p < 0.05). Conclusion: The minimally invasive, fluoroscopy-free, arthroscopy-free, coracoid tunnel-free double Endobutton plate sling technique for the treatment of acromioclavicular joint dislocation offers significant advantages, including minimal invasiveness, reduced trauma, reliable fixation, fewer complications, accelerated recovery, and improved joint function.

Observation on the Clinical Efficacy of Electroacupuncture in Treating Medial Proliferative Scar of the Patella after Surgery for Patellar Instability

Huwei Bian — 2025-11-06

Objective: To observe the clinical efficacy of electroacupuncture in treating medial proliferative scar of the patella after surgery for patellar instability. Methods: A total of 38 patients with medial proliferative scar of the patella after surgery for patellar instability were selected from the outpatient follow-up clinic of the Sports Medicine Department at Changzhou Traditional Chinese Medicine Hospital from March 2022 to December 2024. They were randomly divided into an observation group and a control group, with 19 patients in each group. The control group was treated with simple acupuncture, targeting the Ashi points around the medial scar of the patella, as well as Xuehai, Liangqiu, Zusanli, and Yanglingquan. The technique of even reinforcement and reduction was applied, with the needles retained for 30 minutes, twice a week for 4 consecutive weeks. The observation group, in addition to the acupuncture treatment used in the control group, had two pairs of adjacent acupoints in the scar area connected to an electroacupuncture device, with electrical stimulation applied for 30 minutes. The treatment frequency was the same as that of the control group. The Vancouver Scar Scale (VSS) score, Kujala patellofemoral joint function score, and clinical efficacy were compared between the two groups before and after treatment. Results: After 4 weeks of treatment, both groups showed a significant decrease in the total VSS score and scores in each dimension compared to before treatment (p < 0.05), along with a significant increase in the Kujala score (p < 0.05). The degree of improvement in the observation group was superior to that in the control group (p < 0.05). The total effective rate in the observation group was significantly higher than that in the control group (p < 0.05). Conclusion: Electroacupuncture is significantly effective in treating medial proliferative scar of the patella after surgery for patellar instability. It can synergistically improve the appearance of the scar and the function of the knee joint, outperforming simple acupuncture.

Musculoskeletal Ultrasound to Evaluate the Effect of 4D PRO Suspension Rope Training Combined with Mulligan Technique on Non-specific Low Back Pain: A Single-blind Randomized Controlled Trial

Cong Wang — 2025-11-10

This trial was designed to evaluate the effects of 4D PRO suspension rope exercise combined with the Mulligan technique in non-specific low back pain (NLBP) patients by musculoskeletal ultrasound and clinical indicators. Sixty patients were randomly divided into the suspension group and the control group for eight weeks. The two groups were also treated with the Mulligan manipulation. The suspension group was treated combined with suspension rope training, while the control group was treated combined with traditional rehabilitation training. Pain, lumbar function and spinal range of motion were measured by a specialist before and after treatment. In addition, musculoskeletal ultrasound was used to measure the thickness of bilateral transversalis and multifidus muscles. After eight weeks, muscle thickness of bilateral transversalis and multifidus muscles, NRS, ODI and spinal range of motion in two groups were significantly better than those before treatment (P<0.05)). The suspension group showed significantly improvement compared to the control group regarding pain, lumbar function, spinal range of motion and the thickness of bilateral transversalis and multifidus muscles(P<0.05). 4D PRO Suspension rope training may be an effective exercise as an adjunctive therapy with Mulligan technology in non-specific low back pain.

Observation on the Clinical Efficacy of Platelet-rich Plasma Combined with Intra-articular Injection of Sodium Hyaluronate in the Treatment of Mild to Moderate Knee Osteoarthritis

Songchao Bi — 2025-11-06

Objective: To explore the clinical efficacy of platelet-rich plasma (PRP) combined with intra-articular injection of sodium hyaluronate in the treatment of mild to moderate knee osteoarthritis (KOA) and its effects on cartilage metabolism, oxidative stress status and cartilage structure. Methods: A total of 120 patients diagnosed with mild to moderate KOA in the orthopedics department of the hospital from January 2023 to October 2024 were selected and randomly divided into a control group and a study group, with 60 cases in each group. The control group was treated with intra-articular injection of sodium hyaluronate, while the study group was treated with PRP in combination on this basis. The treatment course was 4 weeks. The clinical efficacy, serum matrix metalloproteinase-13 (MMP-13), type II collagen degradation products (CTX-II), superoxide dismutase (SOD), malondialdehyde (MDA) levels and MRI-T2 mapping results of the two groups after 12 months of treatment were compared. Result: The total effective rate of the study group was 91.67%, which was higher than 75.00% of the control group (p < 0.05). After 12 months of treatment, the levels of serum MMP-13, CTX-II and MDA in the study group were all lower than those in the control group, and the level of SOD was higher than that in the control group (p < 0.01). MRI-T2 mapping showed that the average T2 value of cartilage in the study group was significantly lower than that in the control group, while the cartilage thickness increased significantly (p < 0.05). No serious adverse reactions occurred in either group. Conclusion: Intra-articular injection of PRP combined with sodium hyaluronate can significantly relieve pain in patients with KOA, improve joint function, inhibit cartilage degradation, reduce oxidative stress levels and promote cartilage repair. Its therapeutic effect is superior to that of sodium hyaluronate alone, and it has good safety.