Our study was targeted to investigate the relationship between postoperative leg length discrepancy (LLD) and the outcomes of total hip arthroplasty (THA) including gait, hip function, and lower back pain (LBP). Ninety-two patients who underwent primary THA during Jan 2009 to Apr 2011 in our medical center were enrolled in this study. We measured postoperative LLD of the patients both directly and from the leg radiographs. Six months after the surgery, we evaluated the hip function with Harris Hip Score (HHS), analyzed the gait, and recorded the degree of LBP. Patients with LLD between 10 and 20 mm were given the block footbeds to correct the difference in the leg length. Then 1 year after the surgery, the above-mentioned parameters were evaluated again. (1) LLD: Patients were divided into three groups according to the magnitude: less than 10 mm were grouped as A, those between 10 and 20 mm as B, and more than 20 mm as C. (2) Gait analysis: patients with larger LLD showed slower gait speed (t = 6.527; p < 0.01), longer single support time (t = -2.665; p = 0.01), and shorter foot-off time (t = -8.502; p < 0.01). After half a year of the surgery, Group B patients showed recovery and their functional performance was not significantly different from that of the patients in Group A (t = -0.686; p = 0.49). (3) HHS: In the first half of the follow-up year, patients with smaller LLD showed an improved function (t = 6.56; p < 0.01). At the end of year one, the HHS of Group B patients was not significantly different from that of Group A (t = 1.4; p = 0.16), suggesting a good recovery, however, Group C patients showed no improvement in HHS scores. (4) LBP: Initially, Group B patients suffered from more severe LBP than Group A patients, however, the examination conducted in the end of year 1 exhibited no difference in the LBP levels of the two groups (t = 0.683; p = 0.01, t = -0.85; p = 0.40). After THA surgery, the outcome was found to be significantly associated with the degree of different length of lower limbs. The use of block such as footbed could partly relieve the symptoms of hip dysfunction and LBP. However, the recovery was less significant in patients with leg length difference more than 20 mm.
Background Intervertebral disc degeneration (IDD) was considered to be the pathological basis of intervertebral disc herniation (IDH). However, the plasma melatonin in the IDD cases and healthy controls remained unclear. Methods In this case–control study, a total of 71 IDD cases and 54 healthy controls were enrolled between April 2020 and August 2020. The diagnostic effect of plasma melatonin for IDD was detected using receiver operating characteristic curve. The correlations between two continuous variables were detected with the Pearson linear analyses. Results It was found that lower melatonin concentration was detected in the IDD cases (1.906 ± 1.041 vs 3.072 ± 0.511 pg/mL, P <0.001). Through receiver operating characteristic curve analyses, it was found that plasma melatonin could be used as a diagnostic biomarker for IDD (area under curve=0.808, P <0.001). In advanced correlation analyses, it was found that plasma melatonin concentration was negatively associated with the age, symptom durations, IDD disease severity and proinflammatory factors, including IL-6 and TNF-α concentrations ( P <0.05). Comparing with the higher melatonin groups, significantly increased IL-6 (0.601 ± 0.085 vs 0.507 ± 0.167 pg/mL, P =0.028) and TNF-α (3.022 ± 0.286 vs 2.353 ± 0.641, P <0.001) were detected in the patients with lower melatonin concentration. Conclusion The plasma melatonin concentration was significantly decreased in the IDD cases and plasma melatonin could be used as a diagnostic biomarker for IDD. Lower plasma melatonin was associated with longer disease durations, elevated disease severity and higher inflammatory cytokines levels in IDD patients.
The objective was to explore the curative effect of prolonged third generation of gamma nail (pTGN) and prolonged dynamic hip screw (pDHS) internal fixation in treating femoral intertrochanteric fracture, and analyze the incidence rate of infection for better clinical diagnosis and treatment. Sixty five patients with femoral intertrochanteric fracture during February, 2011-February, 2013 were selected and divided into two groups, with one receiving pTGN (control group) and the other one receiving pDHS internal fixation (observation group). The clinical effects of two groups were compared. In control group, the excellent and good rate was 78.13 %, the total effective rate was 87.5 %, and the total complication rate was 6.24 %; in observation group, the excellent and good rate was 78.79 %, the total effective rate was 90.91 %, the total complication rate was 6.06 %; there was no statistical difference between two groups (p > 0.05). The operation time, the intraoperative fluoroscopy time, and the total blood loss had statistically significant difference between two groups (p < 0.05); however, the differences of the total length of incision, the length of preoperative hospitalization, postoperative ambulatory episode, and the length of stay between two groups were not statistically significant (p > 0.05). Both pTGN and pDHS internal fixation were effective on femoral intertrochanteric fracture, with pDHS internal fixation having better overall efficiency.
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