Objective To compare the differences  of coronal lower limb  parameters between the patients with osteoarthritis secondary to developmental dysplasia of the hip（DDH） and normal young adults on the coronal plane.Methods The radiographic data of 62 patients with osteoarthritis secondary to DDH were retrospectively reviewed.The DDH group was divided into two subgroups including unilateral DDH group（46 cases）and bilateral DDH group（32 sides of 16 cases）.62 healthy individuals were recruited to form a control group.Full leg length standing anterior-posterior radiographs was collected and 7 parameters were measured in the coronal plane，including Hip-Knee-Ankle angle（HKA），Neck-shaft Angle（NSA），Mechanical Lateral Distal Femoral Angle（mLDFA），Anatomical Lateral Distal Femoral Angle（aLDFA），Medial Proximal Tibia Angle（MPTA），Femoral Bowing Angle（FBA），Joint Line Convergence Angle（JLCA）.Results The HKA angle（-1.78±3.4）° in DDH group may be more prone to presenting varus alignment than those in the control group（1.78±2.50）°（P＜0.05）.The incidence of valgus alignment in DDH group（50%）was significantly higher than that in control group（2%）（P＜0.05）.The mLDFA in DDH group（85.12±3.81）° was significantly smaller than that in control group（87.49±3.64）°（P＜0.05）.The aLDFA in DDH group（79.02±3.91）° was significantly smaller than that in the control group（83.34±2.59）°（P＜0.05）.The mMPTA and JLCA of DDH group was （86.34±3.24）°and（1.07±1.91）°，respectively，whilce in control group was（86.51±3.02）°and （0.95±1.64）°，respectively（both P>0.05）.The NSA and FBA of DDH group was （146.95±12.61）°and（5.30±4.09）°，respectively，whilce in control group was（131.40±5.51）°and （2.96±2.18）°，respectively（both P＜0.05）.Conclusion The patients with osteoarthritis secondary to DDH may be more apt to presenting varus alignment deformity，which may be related to morphological changes of distal femur and proximal femur，instead of intra-articular factors and anatomical changes of proximal tibia.

Objective To evaluate the therapeutic effects of early reconstruction of medial patellofemoral ligament（MPFL）in acute traumatic patellar dislocation of knee joint.Methods 15 acute traumatic patellar dislocation of knee joint patient underwent early MPFL reconstruction，and were regular follow-up after operation.At the final follow-up，evaluated the stability of patellar and compared the Lysholm score，Kujala score and Tegner score between pre-injury and last follow.Results The average follow up was 18.6 months.All the patient had no recurrent patellar dislocation，and showed negative apprehension test.The preinjury Lysholm score，Kujala score and Tegner score were 90.6±13.1，92.3±12.4 and 5.9±1.3，respectively；the postoperative Lysholm score，Kujala score and Tegner score were 91.2±12.5，95.1±13.2 and 6.2±1.6.There were no significant difference between before injury and postoperation on Lysholm score，Kujala score and Tegner score at last follow-up（P＞0.05）.Conclusion Early MPFL reconstruction for acute traumatic patellar dislocation can restore the stability and function of patellar.

Objective To study the short-and long-term effects of SuperPath minimally invasive arthroplasty for the treatment of femoral head necrosis.Methods The subjects were 50 patients with femoral head necrosis.Randomly divided into the control group and observation group with 25 cases in each group.The patients in the control group were treated with total hip replacement through anterolateral small incision.The patients in the observation group were treated with minimally invasive total hip replacement through SuperPath incision.Compared two groups of the perioperative indexes and the incidence of complications，and all patients were followed up for 6 months，compared before and after operation of the Harris hip function score and visual analogue method were evaluated.Results The observation group of the drainage flow[（211.83±23.76）ml]，intraoperative blood loss[（354.06±38.28）ml]，hospitalization time[（8.74±1.53）d]，the difference of leg length[（12.97±3.05）mm] and thigh circumference[（5.41±0.58）mm] was significantly lower than the control group[（150.49±18.61）ml，（213.95±30.24）ml，（4.52±1.06）d，（8.12±2.30）mm and（2.87±0.51）mm，respectively]（P<0.05）.1 year after operation，the Harris score（89.30±4.19）and Barthel index（90.63±4.95） in the observation group were significantly higher than the control group（81.86±5.24，79.47±5.36）（P<0.05）.VAS score was significantly lower in observation group（0.85±0.43） than that in control group（2.09±0.61）（P<0.05）.The incidence of complications in the two groups was not significantly different（P>0.05）.Conclusion SuperPath incision minimally invasive total hip arthroplasty for the treatment of avascular necrosis of the femoral head has advantages such as small trauma，low complication and significant effect.It can relieve pain and promote hip joint function and quality of life recovery.

Objective To study the feasibility and accuracy of the femur internal and external condyle notch line as the femoral intramedullary localization point used in total knee arthroplasty（TKA）.Methods 64 patients with TKA were randomly divided into the observation group and the control group，32 cases（32 knees）in each group.The observation group was positioned according to the interlocking point between the internal and external condyle notch line and the extension line of the medial lateral condyle of femur.The control group was positioned with traditional technique.The distance between the location points and the anatomical axis of the femur，the femoral external rotation angle and the lower limb force line deviation were observed.Results The average distance between the anatomical axis of femur and the highest point of the intercondylar notch ceiling was（14.27±2.48）mm.The average distance in the observation group was（1.1±0.37）mm，and the distance in the control group was（3.22±1.45）mm，and there was significant difference between the two groups（P<0.05）.The deviation of lower extremity force line and femoral prosthesis valgus angle were measured.In the observation group the deviation was（2.49±1.27）°，and the control group was（3.81±1.74）°，and there was significant difference between the two groups（P<0.05）.In the observation group，the femur prosthesis valgus angle was（88.6±2.71）°，and the control group was（86.7±4.17）°.there was significant difference between the two groups（P<0.05）.Conclusion The interlocking point between the internal and external condyle notch line and the extension line of the medial lateral condyle of femur was a more accurate position for the femoral intramedullary localization point used in total knee arthroplasty，it could provide a satisfactory postoperative femoral prosthesis alignment.

Objective To investigate the analysis of Clinical efficacy，serum and joint fluid indexes of sodium hyaluronate injection and ACL reconstruction surgery in the treatment of ACL injury patients.Methods To screening 91 cases of ACL injury patients as research subjects，it will be divided into study group with 46 cases and control group with 45 cases，patients in control group were given ACL reconstruction surgery and patients in study group were given sodium hyaluronate injection and ACL reconstruction surgery，then the two groups were compared in terms of clinical efficacy and so on.Results After treatment，the total clinical effective rate（95.7%）was significantly higher in the study group than in the control group（82.2%）（P<0.05）.There was no difference in the relevant joint fluid indexes between the two groups before surgery（P>0.05）.The relevant joint fluid indexes of the study group were significantly improved compared with the control group at 10 weeks after operation（P<0.05）.There was no difference in the serum indexes between the two groups before operation（P>0.05），the relevant serum indexes of the study group were significantly improved compared with the control group at 10 weeks after operation（P<0.05）.There was no difference in knee function and pain score between the two groups before operation（P>0.05），The knee function and pain scores of the study group were significantly improved compared with the control group at 10 weeks after operation（P<0.05）.Conclusion The sodium hyaluronate injection and ACL reconstruction surgery in the treatment of ACL injury patients is significant，it is worthy of popularization and application.

Objective To investigate the effect of arthroscopic debridement combined with microfracture on joint function in the treatment of knee osteoarthritis（KOA）.Methods The clinical data of 180 cases of KOA treated were retrospectively analyzed，and patients were divided into two groups according to different treatment methods.88 patients in the control group received arthroscopic joint debridement，while 92 patients in observation group received arthroscopic debridement combined with microfracture.Then the knee joint function，pain degree，inflammatory factor levels，and clinical efficacy were compared between the two groups.Results The preoperative Lysholm score between the two groups had no difference（P>0.05），which was increased at the postoperative 1 month and 6 month，and the score was higher in the observation group（70.59±3.29，84.57±10.22）than in the control group（65.14±3.24，78.54±10.24）（P<0.05）.The preoperative VAS score had no difference（P>0.05），which was decreased at the postoperative 1 month and 6 month，and the score was lower in the observation group（21.88±5.54，12.57±8.55）than in the control group（30.19±5.59，24.50±8.59）（P<0.05）.The preoperative CRP and IL-6 levels had no difference（P>0.05），while the CRP was increased and the IL-6 was decreased at the postoperative 1mon and 6mon，moreover，both levels in the observation group[（13.69±6.18）mg/L，（20.31±10.42）ng/L] were higher than those in the control group[（23.51±6.71）mg/L，（26.51±10.41）ng/L]（P<0.05）.The clinical total effective rate in the observation group（97.83%）was significantly higher than that in the control group（89.78%，P<0.05）.Conclusion Compared with the arthroscopic joint debridement alone，the combination with the microfracture has a better effect on the improvement of knee joint function and decrease of pain degree for KOA patients.

Objective To explore the effect of arthroscopic release combined with suture bridge treatment of old supraspinatus tendon tear with shoulder dysfunction.Methods 40 patients with old supraspinatus tendon tear were analyzed retrospectively.According to the operation method，the patients were divided into control group and experimental group with 20 cases each.Treatment of single row of loose strip anchor nails under arthroscope in control group，the experimental group was treated with the technique of loosening suture bridge under arthroscope.VAS score and ASES score were assessed before operation and after 1 month，3 months，6 months，and 12 months.Range of motion（ROM）was evaluated before operation and after 12 months.The analysis of complication was also preceded.Results All patients completed 12 months of follow-up.There were no difference between experimental group and control group in ASES score（27.6±5.5 vs 27.5±3.6），VAS score（7.6±0.5 vs 7.5±0.7）and shoulder bends forward[（83.6±12.4）°vs（80.6±14.5）°]，abduction[（75.6±8.4）°vs（72.8±9.3）°]，intorsion[（20.1±3.7）°vs（21.2±2.9）°] at preoperation（P＞0.05）.At 1 month，3 months，6 months，and 12 months postoperation，VAS scores were 5.8±0.6，4.2±0.5，3.0±0.2 and 1.8±0.4 in experiment group and were 6.1±0.3，4.4±0.6，3.5±0.4 and 2.2±0.3 in control group，the difference was significant（P＜0.05）.ASES scores were 35.8±3.6，54.2±4.7，73.1±3.2 and 85.8±2.6 in experiment group and were 34.1±3.3，49.4±3.6，69.5±2.4 and 72.2±3.1 in control group，the difference was significant（P＜0.05）.After 12 months，there was a significant improvement in joint flexion，abduction，and lateral internal rotation in experimental group[（160.4±10.2）°，（158.7±9.7）°，（48.1±5.9）°] than the control group[（138.4±7.2）°，（128.7±6.5）°，（30.1±4.2）°].No complications occurred in two groups，such as anchor loosening，pain，swelling and other complications.Conclusion Arthroscopic release combined with Suture Bridge can effectively improve the function of shoulder in patients with old supraspinatus tendon tear.

Objective To investigate the lamina windowing small gap and the vertebrae pedicle bone graft in the treatment of thoracolumbar burst fractures of the curative effect.Methods 132 patients with thoracolumbar burst fracture of were selecteds，the average random divided into open the window and pedicle group，open a window line set of lamina windowing small gap vertebral body bone graft and pedicle group through pedicle vertebral body bone graft，through intraoperative records，hospital records and postoperative follow-up of collecting morphological index，operation index，JOA score and Frankel classification of spinal cord injury in order to evaluate the clinical curative effect of two kinds of operative methods.Results The operation time in the pedicle group was（103.58±14.37）min，which was more than that of the fenestration group [（85.72±12.96）min]，the incision drainage rate in the pedicle group [（100.96±5.29）ml] was less than that in the fenestration group [（178.52±12.41）ml]，and the postoperative pain score in the pedicle group [（15.37±2.86）] was higher than that in the fenestration group [（8.26±4.52）]，the healing time of fractures in the pedicle group [（20.85±0.60）weeks ]was less than that of the fenestration group [（24.29±1.06）weeks].The difference was all statistically significant （P<0.05）.After treatment，the intervertebral space height of the pedicle group [（11.55±1.94）mm] was significantly higher than that of the fenestration group [（9.53±1.92）mm]，and the difference was statistically significant（P<0.05）.After treatment，the JOA scores of patients in the pedicle group[7.78±1.39，4.93±0.92，13.84±2.74] were significantly higher than those in the open window group[6.24±1.20，4.50±0.83，12.43±2.52]（P<0.05）.The difference between the composition of Frankel spinal cord injury in the pedicle group and the fenestration group was statistically significant （P<0.05）.Conclusion Compared with small fenestration through the intervertebral space，this surgical method can promote the fracture healing and improve the symptoms of patients more rapidly，and is more suitable for the surgical treatment of thoracolumbar burst fracture patients.

Objective To explore the risk factors related to the development and progression of lumbar degenerative spondylolisthesis（LDS）.Methods A total of 71 patients with LDS or degenerative spinal stenosis（DSS）were retrospectively.Thirty-six patients with LDS（group LDS） and 35 patients with DSS（group DSS）were enrolled.Spinopelvic parameters including pelvic incidence（PI），pelvic tilt（PT），sacral slope（SS），lumbar lordosis（LL），thoracic kyphosis（TK），regional lumbopelvic lordosis angles（PR-LI，PR-L2，PR-L3，PR-L4，PR-L5），pelvic morphology（PR-S1），lumbar 4 slope（L4S）and lumbar 5 slope（L5S）were assessed on whole spine lateral radiographs in a standing position.All the parameters from LDS will compared with those of DSS and normal population respectively，Student’s t-test was used to compare each parameter among the LDS，DSS and normal population.Results PI [（57.67±11.78）°]，SS [（37.83±9.17）°] and LL [（54.65±11.45）°] in group LDS were significantly greater than those of group DSS [（44.47±8.75）°，（28.18±9.02）°，（38.97±15.59）°] and normal reference value [（44.75±9.01）°，（33.57±7.64）°，（48.75±10.03）°]（P<0.05）.L4S [（8.18±9.98）°] and L5S [（19.96±8.33）°] in group LDS were greater than the group DSS[（3.32±7.95）°，（10.87±8.02）°]（P<0.05）.The PR-L4 [（57.63±13.44）°]，PR-L5 [（45.76±10.92）°] and PR-S1 [（27.91±10.41）°] in group LDS were significantly smaller than those of group DSS [（65.48±10.70）°，（56.33±9.15）°，（38.63±7.29）°]（P<0.05）.Conclusion Greater PI may lead to the development and progression of lumbar degenerative spondylolisthesis.L5S is a parameter that can be used to predict the risk of LDS.The lower regional lumbopelvic lordosis angles in LDS were smaller than those of DSS.

Objective To investigate the changes of Caprini score，plasma D-D and FIB levels in patients with post-fracture DVT and its diagnostic significance.Methods Sixty patients with postfracture DVT（DVT group）and 120 patients without DVT after fracture were selected（control group）.The Caprini score，plasma D-D and FIB levels were compared between the two groups.The relationship between Caprini score and plasma D-D and FIB in the DVT group was analyzed.Results The Caprini score，D-D and FIB levels in the DVT group[7.26±1.88，（3.31±1.52）mg/L，（4.48±0.72）g/L] were significantly higher than those in the control group[3.39±0.80，（0.46±0.11）mg/L，（3.60±0.68）g/L]，and the difference was statistically significant（P<0.05）.There was a significant positive correlation between Caprini score and D-D and FIB levels in patients with DVT（P<0.05）.There was a positive correlation between Caprini score and level of D-D and FIB（r=0.748、r=0.662，P<0.05）.The sensitivity of Caprini score combined with D-D and FIB levels in the diagnosis of DVT in fracture patients was 97.83%，specificity was 92.00%，missed diagnosis rate was 2.17%，misdiagnosis rate was 8.00，and area under ROC curve was 0.947（P<0.05）.Conclusion Caprini score，D-D and FIB levels in patients with lower limb fracture have certain clinical value for the diagnosis of DVT.

Objective To observe the expression of stromal interaction molecule-1（STIM1）and other osteogenetic differentiation related factors （such as ALP，OCN，OPN） in bone marrow stromal stem cells（BMSCs）of postmenopausal osteoporosis patients.Methods BMSCs were cultured in the presence of osteogenic induction for 14d after obtained from postmenopausal osteoporosis patients.We analyzed the Ca²⁺ concentration and Ca²⁺ release activated Ca²⁺channel（CRAC）by Fluo-3 staining before and after osteogenic induction respectively.The expressions of STIM1 and other osteogenic differentiation related factors（ALP，OPN and OCN）were further measured and evaluated by quantitative real time PCR.Mineralization was evaluated by the calcium chelating dye alizarin red at the start of osteogenic induction and after 7 and 14 days.BMSCs were stained for alkaline phosphatase（ALP）at 14d.Results BMSCs were successfully cultured after osteogenic induction for 14d.The expressions of STIM1 and other osteogenic differentiation related factors（ALP，OPN，and OCN）in observation group were lower than the control group by RT-PCR（P<0.05）.Similarly，ALP staining was significantly reduced in observation group compared with the normal control cells（P<0.05）.Besides，the expression of STIM1 in observation group after osteogenic induction for 14d was reducing，but less than control group.Ca²⁺ concentration was reduced in observation group than control group（P<0.05）.The numbers of calcium chelating dye alizarin red in observation group were less than control group.Conclusion There are significant evidences that STIM1 in BMSCs would be contributed to the postmenopausal osteoporosis，which could provide a new research direction and therapeutic strategy for osteoporosis.

Objective To investigate the effects of artificial femoral head replacement and total hip arthroplasty on the bone mineral density and bone metabolism during the perioperative period in elderly patients with osteoporotic hip fracture.Methods The clinical data of 95 patients with senile osteoporotic hip fracture were retrospectively analyzed.The patients were divided into control group and observation group according to different surgical methods.Artificial femoral head replacement was performed in the control group，and total hip replacement was performed in the observation group.The perioperative bone mineral density and bone metabolism index were compared.Results The bone density of the control group was（829.71 ±21.45）mg/cm³，Wards triangle area was（826.52±19.87）mg/cm³ and femoral neck was（794.26±27.25）mg/cm³.The bone density of the patients in the observation group was（848.52±22.32）mg/cm³，Wards triangle area（849.57±21.98）mg/cm

³，femoral neck（815.23±28.64）mg/cm³.The difference of degree was statistically significant（P<0.05）.The patients in the control group were BGP（3.14±0.27）ng/mL，ALP（73.26±7.07）U/L，BALP（71.71±1.07）U/L，TRACP5b（3.26±1.07）U/L，in the observation group was（3.61±0.56）ng/mL，（69.94±7.67）U/L，（76.61±1.16）U/L and（3.94±1.61）U/L .The difference was statistically significant（P<0.05）.The incidence of complications in the control group was 10.8% The incidence of complications in the observation group was 14.3%.There was significant difference between the two groups in the incidence of complications（P<0.05）.Conclusion Artificial femoral head replacement and total hip arthroplasty have different clinical effects in the treatment of elderly patients with osteoporotic hip fracture.Total hip arthroplasty can improve bone mineral density and bone metabolism better，but with higher Postoperative complications.

Objective To analyzed the clinical efficacy of transurethral ureteroscopic holmium laser lithotripsy combined with renal cyst excision and drainage for simultaneous treatment of renal cysts and renal stones.Methods We retrospectively analyzed the clinical data of 12 patients who underwent simultaneous ureteroscopic soft lens simultaneous nephrolithiasis and peritoneal plexus surgery.We observed the effect of treatment on patients，complications and postoperative follow-up results.Results We successfully completed 12 cases of surgery，no transit open surgery.The operative time was 69～205 min（mean 103.6±41.7 min）.Very little bleeding.No serious surgical complications.The hospital stay was 8 to 18 days[mean（12.3±2.9）d].The postoperative hospital stay was 4 to 14 days[mean（7.4±3.3）d].Postoperative follow-up of 1 to 12 months，postoperative CT or B-scan prompt renal stone completely broken，disappearance of renal cysts or diameter was significantly reduced.Conclusion Transurethral ureteroscopic holmium laser lithotripsy combined with renal cyst drainage and drainage is a safe and effective surgical approach.It has minimally invasive，safe and effective features.It deserves to be widely used in clinical practice.

Objective To analysis of the effect of composite dorsalis pedis free skin flap to repair pollex of large area skin wounds.Methods 12 patients with extensive skin lesions of the thumb and skin were selected.The anterior tibial artery or the dorsal arteries and veins were designed as the pedicle.Leaf flaps，which repair large areas of the thumb with a single defect.Observe the survival of the flap and the healing of the wound.Results 11 cases（91.67%）of the flap survived in the first stage，1 case（8.33%）showed vascular crisis necrosis，and the second stage of skin graft repair after dressing change；11 cases（91.67%）of the wound healed in the first stage.1 case（8.33%）showed subcutaneous flap hematoma on the second day after operation，which led to necrosis of the skin flap and healed after the second stage of skin grafting.1 case of necrosis of the skin graft in the donor site was healed after dressing change.After 4 to 14 months of followed-up，the skin color of the flap recovered well，and the two-point resolution felt an average of 5 to 8 mm.The function of finger flexion and extension is satisfactory.Conclusion The free flap of the dorsal dorsum flap can repair the large area of the skin defect of the thumb.The survival rate of the flap and the wound healing rate are high.The two flaps share a set of blood vessels，simplify the operation and improve the success rate of the operation.The flexion and sensory function of the thumb can achieve “functional repair”，which is worthy of promotion in the clinic.