Bone and Arthrosurgery Science

Clinical Guidelines for the Use of Platelet-Rich Plasma (PRP) for Osteoarthritis

Ying Zhang, Feng Shuang, Dongfa Liao, Xiaohui Li — Fri, 16 May 2025 00:00:00 +0800

This document specifies the requirements for institutions and personnel involved in the treatment of osteoarthritis with platelet-rich plasma (PRP), including the acquisition of PRP, the process of local injection therapy, and post-treatment patient examination and follow-up. This document is applicable to the treatment of osteoarthritis patients caused by degenerative diseases in orthopedic and joint surgery departments of general hospitals using PRP.

Analysis of the Efficacy of Arthroscopy-Assisted Treatment for Tibial Plateau Fractures

Jun Ge — Fri, 11 Jul 2025 15:01:40 +0800

Objective: To explore the efficacy of arthroscopy-assisted treatment for patients with tibial plateau fractures. Methods: A total of 80 patients with tibial plateau fractures in our hospital from January 2024 to January 2025 were selected as the research subjects. The patients were divided into an observation group and a control group based on their admission numbers, with 40 patients in each group. Relevant treatment indicators were compared between the two groups. Results: The total effective rate of the observation group was higher than that of the control group, and the incidence of complications was lower than that of the control group (P < 0.05). The surgical indicators (incision length, time to ambulate, fracture healing time, hospital stay) of the observation group were all better than those of the control group (P < 0.05). After treatment, the HSS score and modified Lysholm score of the observation group were higher than those of the control group (P < 0.05). The maximum angles of knee extension and flexion in the observation group were greater than those in the control group after treatment (P < 0.05). The GQOL-74 scores (material living status, physical, psychological, and social) of the observation group were significantly higher than those of the control group (P < 0.05). Conclusion: Arthroscopy-assisted minimally invasive surgery is effective in the treatment of tibial plateau fractures. It can not only optimize surgical indicators but also improve knee function and range of motion, which is beneficial for improving patients’ postoperative quality of life. The promotion of this treatment is feasible.

Analysis of the Therapeutic Effect and Influencing Factors of PFNA Internal Fixation Using Improved Needle Insertion Method in Treating Intertrochanteric Fractures of the Femur

Lei Wang, Junxing Ye, Zheng Feng — Fri, 11 Jul 2025 15:26:24 +0800

Objective: Exploring the therapeutic effect of implementing an improved needle insertion method in the treatment of proximal femoral nail anti-rotation (PFNA) internal fixation in patients with intertrochanteric fractures of the femur, and exploring the influencing factors of postoperative efficacy. Method: 100 patients with intertrochanteric fractures of the femur admitted to our hospital from January 2020 to December 2023 were randomly divided into two groups, both receiving PFNA internal fixation treatment. The control group received conventional method of inserting guide pins during surgery, while the study group received improved method of inserting guide pins. The efficacy, clinical indicators, and complications were compared between the two groups. Then, those with excellent and poor postoperative efficacy were included in the excellent group and the poor group, respectively. Univariate and multivariate logistic regression analyses were conducted on the factors that affect postoperative efficacy. Results: The proportion of age in the excellent group was generally younger than that in the poor group. The proportions of preoperative and postoperative complications and anemia in the excellent group were lower than those in the poor group. The proportion of early postoperative functional exercise in the excellent group was higher than that in the poor group. The proportion of improved needle insertion method in the excellent group was higher than that in the poor group (P < 0.05). After multiple logistic regression analysis, age, postoperative complications, preoperative complications, anemia, and intraoperative needle insertion method were risk factors affecting postoperative efficacy (P < 0.05). Conclusion: The implementation of improved needle insertion method in PFNA internal fixation treatment for patients with intertrochanteric fractures of the femur has a definite therapeutic effect and high safety. Age, preoperative complications and postoperative complications, anemia, and intraoperative needle insertion methods are risk factors that affect the therapeutic effect.

Study on the Application of Refined Management of Foreign Medical Devices and Implants in Infection Control of Orthopedic Implant Surgery

Chen Chen, Zifeng Li — Fri, 11 Jul 2025 15:29:36 +0800

Objective: To analyze the application effect of refined management of foreign medical devices and implants in infection control of orthopedic implant surgery. Methods: 252 patients who underwent orthopedic implant surgery in a hospital from May 2023 to April 2024 were selected and grouped according to the time node of the introduction of the refined management method. 126 patients before the introduction of the refined management method were included in the control group, and the surgical operation was completed by 20 doctors, with a total of 1,204 pieces of medical devices and implants. The 126 patients after the introduction of the refined management method were included in the observation group, and the surgical operations were performed by 21 doctors, using a total of 1,207 medical devices and implants. The two groups were compared in terms of the qualification rate of foreign medical devices and implants, satisfaction with their use, and the rate of infection of surgical incisions in the hospital. Results: The qualified rate of foreign medical devices and implants in the observation group was 96.93%, which was significantly higher than that of 83.97% in the control group (P < 0.05). Satisfaction scores for the observation group in the dimensions of the quality of foreign medical device and implant items, device distribution, timeliness of supply, and improvement of the problem were respectively 85.27 ± 6.78, 86.69 ± 6.73, 85.92 ± 6.47, 86.79 ± 5.83, which were significantly higher than the control group’s 80.42 ± 6.26, 82.24 ± 6.29, 81.19 ± 5.83, 82.14 ± 5.72, and the difference was statistically significant (P < 0.05); the rate of nosocomial surgical incision infection in the observation group was 0.79%, which was significantly lower than that of the control group (6.34%) (P < 0.05). Conclusion: The application of refined management in the infection control of orthopedic implant surgery can obtain ideal results, significantly reducing the risk of nosocomial incision infection and further improving the qualification rate of foreign medical devices and implants, and ultimately, obtaining a higher degree of satisfaction with the use.

Effects of Goal-Directed Fluid Therapy on MAP, NTproBNP, and hs-CRP in Elderly Patients with Lower Extremity Fractures Undergoing Open Reduction and Internal Fixation

Hongquan Ren, Yabo Hao — Fri, 11 Jul 2025 15:45:42 +0800

Objective: To investigate the effects of goal-directed fluid therapy on mean arterial pressure (MAP), N-terminal pro-brain natriuretic peptide (NT-proBNP), and high-sensitivity C-reactive protein (hs-CRP) levels in elderly patients with lower limb fracture undergoing open reduction and internal fixation surgery 24 hours after surgery. Methods: Sixty elderly patients admitted to our hospital from June 2022 to February 2023 for open reduction and internal fixation of lower limb fractures were randomly divided into two groups: 30 cases in the observation group and 30 cases in the control group. The patients in the control group were treated with conventional fluid therapy, and the observation group received goal-directed fluid therapy on the basis of the control group. The patients in the two groups were observed to monitor the changes of mean arterial pressure (MAP) and heart rate (HR), as well as the preoperative and 24-hour postoperative levels of NT-proBNP and hs-CRP. Results: The NT-proBNP level in the control group was 608.37 ± 180.46 ng/ml and the hs-CRP level was 510.09 ± 190.21 pg/ml during the operation, and the NT-proBNP and hs-CRP levels in the observation group were 608.74 ± 180.26 ng/ml and 514.12 ± 180.63 pg/ml, respectively, and the difference between the two groups was not statistically significant (P > 0.05). The levels of NT-proBNP and hs-CRP in the control group were 369.74 ± 77.11 ng/ml and 298.41 ± 72.14 pg/ml respectively at 24-hour postoperatively, and those in the observation group were 324.74 ± 71.26 ng/ml and 245.12 ± 77.63 pg/ml, the difference between the two groups was statistically significant (P < 0.05). In the control group, the preoperative MAP and heart rate were 14.12 ± 3.92 mmHg and 47.18 ± 15.42 beats/min respectively; in the intraoperative period, the MAP and heart rate were 54.81 ± 14.41 mmHg and 60.65 ± 14.11 beats/min. In the observation group, the preoperative MAP and heart rate were 15.12 ± 3.48 mmHg and 48.21 ± 15.36 beats/min, and the intraoperative MAP and heart rate were 50.16 ± 14.03 mmHg and 57.65 ± 14.10 beats/min, the difference was statistically significant (P < 0.05). Conclusion: Compared with traditional fluid therapy, goal-directed fluid therapy can reduce MAP, NT-proBNP, and hs-CRP levels in elderly patients with lower limb fractures undergoing open reduction and internal fixation surgery, and reduce the incidence of postoperative complications.

Clinical Application of “Three-in-One” Bone Repair Strategy in the Perioperative Period of Elderly Intertrochanteric Femoral Fractures

Fri, 11 Jul 2025 15:55:15 +0800

Objective: To investigate the clinical value of the “three-in-one” bone repair strategy (perioperative anti-osteoporosis therapy, optimization of minimally invasive intramedullary fixation technology, and postoperative intervention of Shenqi Hexue Decoction) in the treatment of elderly intertrochanteric femoral fractures. Methods: We retrospectively analyzed the elderly patients with intertrochanteric femoral fracture and intramedullary nail fixation admitted from January 2022 to December 2024, and divided the patients into two groups according to the method of this study: control group (63 cases, routine intramedullary fixation and basic anti-osteoporosis therapy) and trinity group (63 cases, using the “three-in-one” strategy). The perioperative indexes, bone metabolism indexes (BALP, BGP, PICP, PINP), Harris hip score, complications, and 1-year survival rate were compared between the two groups. Results: The intraoperative blood loss (95.3 ± 15.2 mL) and hospital stay (9.8 ± 2.1 days) in the trinity group were significantly lower than those in the control group (128.7 ± 20.1 mL and 14.5 ± 3.6 days, respectively) (P < 0.01). Six weeks after surgery, the levels of bone formation markers BALP (25.1 ± 3.8 U/L) and PICP (125.6 ± 18.3 μg/L) in the trinity group were significantly higher than those in the control group (P < 0.05). At 12 weeks after operation, the Harris score (86.7 ± 6.4) was significantly better than that of the control group (78.2 ± 7.1) (P < 0.01). Compared with the control group (14.7 ± 2.3 weeks), the fracture healing time in the trinity group (11.2 ± 1.8 weeks) was shortened by 23.8%, and the incidence of deep vein thrombosis (4.8% vs 15.9%) was significantly reduced (P < 0.05). Conclusion: The “three-in-one” strategy optimizes perioperative management, promotes bone metabolism and fracture healing, rapidly improves hip joint function, and reduces complications through multi-target intervention. It is a safe and effective solution for intertrochanteric fractures in the elderly, and is worthy of clinical application.