Recovery Of Knee Joint Function Research Articles

Treatment of degenerative medial meniscus injury of knee joint by arthroscopy combined with small needle knife to release superficial medial collateral ligament of knee joint

To explore the clinical effect of arthroscopic combined with small needle knife in the treatment of degenerative medial meniscus (MM) injury of knee joint by releasing the superficial layer of medial collateral ligament (SMCL). From February 2016 to November 2018, 56 patients (56 knees) with limited pain, strangulation and flexion in medial knee joint space were selected. X-ray Kellgren-Lawrence grading was I-II. MRI showed medial meniscus injury(III degree) of knee joint. There were 30 males(30 knees) and 26 females(26 knees). Arthroscopic MM plasty and small needle knife were used to release SMCL. The Lysholm knee score was used to evaluate the effect of operation. All 56 patients were followed up, and the duration ranged from 3 to 24 months, with an average of 10 months. According to the Lysholm knee score standard, the final follow-up was compared with that of before operation. The results showed that the preoperative knee score was 37.24±1.32, the latest follow-up knee score was 85.72±5.28, the knee score was higher than that before the operation(P<0.05). Arthroscopy combined with small needle knife release of superficial medial collateral ligament in the treatment of degenerative medial knee meniscus injury can effectively improve the mechanical balance of the knee joint, improve Lysholm knee score in patients with knee meniscus injury, and promote the recovery of knee joint function, which has clinical value.

Comparison of analgesic effect, knee joint function recovery, and safety profiles between pre-operative and post-operative administrations of meloxicam in knee osteoarthritis patients who underwent total knee arthroplasty.

This study aimed to compare the efficacy and safety of pre-operative and post-operative meloxicam administration regarding post-operative pain control and knee joint function recovery in knee osteoarthritis (KOA) patients who underwent total knee arthroplasty (TKA). Totally, 196 KOA patients who underwent TKA were consecutively enrolled and randomly assigned into pre-operative (N = 98) and post-operative administration group (N = 98) as 1:1 ratio. Pre-operative administration group received meloxicam 15 mg at 24 h pre-operation and 7.5 mg at 4 h, 24 h, 48 h, and 72 h post-operation, respectively. Post-operative administration group received meloxicam 15 mg at 4 h post-operation and 7.5 mg at 24 h, 48 h, and 72 h post-operation, respectively. Pain visual analog scale (VAS) at rest and at flexion, patient's global assessment (PGA), patient-controlled analgesia (PCA) consumption, hospital for special surgery (HSS), knee score, and adverse events were assessed. Pre-operative meloxicam administration attenuated pain VAS score at rest at 6 h, 12 h, and 24 h; and pain VAS score at flexion at 6 h, 12 h, 24 h, and 48 h; as well as PGA score at 6 h, 12 h, 48 h post-TKA compared with post-operative meloxicam administration. Additional and total consumption of PCA were both decreased in pre-operative meloxicam administration group than post-operative meloxicam administration group, while HSS knee score at 3 months post-TKA was similar between pre-operative and post-operative meloxicam administration groups. Regarding safety, the incidence of adverse events was of no difference between the two groups. Pre-operative administration of meloxicam might assist the post-operative pain management and care in KOA patients who underwent TKA.

Early effectiveness of mini-Swashbuckler approach for distal femoral type C fractures

To explore the early effectiveness and advantages of mini-Swashbuckler approach in treatment of distal femoral type C fractures by comparing with Swashbuckler approach. A retrospective analysis was made on 43 patients with distal femoral type C fractures between January 2014 and June 2018. Twenty-two patients were treated with open reduction via mini-Swashbuckler approach and internal fixation with less invasive stabilization system (LISS) plate in modified group; and 21 patients were treated with open reduction via Swashbuckler approach and internal fixation with LISS plate in traditional group. There was no significant difference in age, gender, cause of trauma, fracture classification, fracture side, interval between injury and operation, and complications between the two groups ( P>0.05). The operation time, intraoperative blood loss, intraoperative fluoroscopy times, hospitalization time, fracture healing time, Hospital for Special Surgery (HSS) scores of the knee, and postoperative complications were recorded and compared between the two groups. The operation successfully completed in both groups. The operation time of the modified group was significantly longer than that of the traditional group, the fluoroscopy times was increased and the blood loss was reduced, the differences were significant ( P<0.05). There was no significant difference in hospitalization time between the two groups ( t=0.277, P=0.783). All patients in the two groups were followed up 6-8 months, with an average of 7.2 months. Fractures healed in both groups, there was no significant difference in healing time between the two groups ( t=0.861, P=0.394). The HSS scores of the modified group were 82.91±2.88 and 89.28±3.63 at 3 and 6 months after operation, respectively, which were superior to those of the traditional group (74.62±3.64) and (81.48±4.55) ( t=8.306, P=0.000; t=6.231, P=0.000). There was 1 case of incision infection, 1 case of deep vein thrombosis, and 2 cases of knee flexion and extension dysfunction in traditional group, and 1 case of deep vein thrombosis, 1 case of varus deformity, and 1 case of internal fixation loosening in modified group. There was no significant difference in the incidences of complications between the two groups ( P>0.05). Compared with Swashbuckler approach, mini-Swashbuckler approach has limited visual field exposure, which leads to prolonged operation time and increased fluoroscopy times, but the risks of complications do not increase. Because of its small soft tissue injury and less blood loss, it is conducive to the recovery of knee joint function after operation.

Effect of EndoButton double-bundle reconstruction of medial patellofemoral ligament in the treatment of recurrent patellar dislocation

Objective To investigate the recovery of knee joint function in patients with recurrent patellar dislocation treated by reconstruction of medial patellofemoral ligament with EndoButton double bundles. Methods A retrospective analysis was performed for 26 patients with recurrent patellar islocation who were treated in The Second Hospital of Tangshan from February 2014 to July 2016, with a total of 26 knees, aged 14-29 years.All patients underwent medial patellofemoral ligament reconstruction with autologous semitendinosus muscle.Double tunnel technique was used in medial patella and single tunnel technique was used in femoral side.Twenty-four patients were followed up for 12 to 24 months.The recovery of knee joint function was evaluated by Kujala score, Lysholm score, patellar fitness angle and patellar tilt angle before and after treatment. Results None of the follow-up patients had dislocation again, and the fear test was negative.The preoperative Kujala score and Lysholm score were (59.67±5.28) and (61.75±5.45) respectively.The corresponding scores at the last follow-up were (87.21±4.21) and (90.13±2.47). There were significant differences between the two scores (t=-19.98, -23.24, all P <0.01). The patellar fit angle changed from (23.17±3.63)degrees before operation to (14.17±2.01)degrees after operation.There was significant difference between the two scores.(t=10.62, P<0.01); Patellar tilt angle changed from preoperative (18.33±3.92)degree to postoperative (2.45±1.10)degree, the difference was significant (t=19.10, <0.01). Conclusion EndoButton double-bundle reconstruction of medial patellofemoral ligament is effective in the treatment of patellar dislocation with satisfactory recovery of knee joint function. Key words: Recurrent patellar dislocation; Medial patellofemoral ligament; Reconstruction; Knee joint function

Treatment for depression fractures of posterolateral tibial plateau through superior fibular head approach

To evaluate surgical method and clinical efficacy for the treatment of depression fractures of posterolateral tibial plateau through superior fibular head approach. Eleven patients with depression fractures of posterolateral tibial plateau through superior fibular head approach were treated from October 2013 to December 2016, including 9 males and 2 females with an average age of 39.7 years old ranged from 25 to 60 years old. The time from injure to operation ranged from 4 to 10 days with an average of 6.5 days. All fractures were closed fracture. Incision healing, tibial plateau varus angles and posterior slope angle were measured through X-rays immediately after operation and latest follow-up. At final follow-up, HSS score of knee joint were used to evaluate clinical effects. Eleven patients were followed up ranged from 11 to 13 months ranged from 55 to 90 min. All incisions were healed at stage I. Fracture healing time ranged from 7 to 12 weeks. There were no significant differences of tibial plateau varus angles and posterior slope angles comparing between immediately opertaion and latest follow-up (P<0.05). At the final follow up, HSS scores ranged from 80 to 93 points, 6 cases were excellent and 5 moderate. Depression fractures of posterolateral tibial plateau through superior fibular head approach has advantages of simple operation, less invasive, benefit for recovery of knee joint function, and could receive clinical effects.

Manual Lymphatic Drainage Therapy in the Knee Joint Functional Rehabilitation After TKA in Diabetic Knee Osteoarthritis Patients: A Randomized Clinical Trial

To investigate the clinical effect of manual lymphatic drainage on functional rehabilitation of patients with diabetic knee osteoarthritis. A total of 199 patients with diabetic osteoarthritis who underwent total knee arthroplasty (TKA) were enrolled in the hospital and there were 72 males and 127 females in these patients. They were randomly divided into manual lymphatic drainage group (103 cases) and routine care group (96 cases). The manual lymphatic drainage group was treated with manual lymphatic drainage on the basis of routine functional rehabilitation nursing in March, while the routine nursing group only received perioperative nursing for conventional knee replacement. The patients with manual lymphatic drainage and routine nursing were studied before and 1 week, 1 month, 1 month, 3 months, and 6 months after operation to get the results of the changes of knee active flexion and extension, limb swelling degree, VAS pain score and preoperative group, the difference of HSS score and AKS score of knee joint in 6 months after operation. The active knee flexion activity of patients in the manual lymphatic drainage group was better than that of the routine care group (<i>P</i> < 0.05). The active knee extension and knee swelling were better in the manual lymphatic drainage group than that in the routine nursing group 1 week and 1 month after operation (<i>P</i> < 0.05); there was no significant difference in knee active activity and knee swelling between the two groups in March and June (<i>P</i> > 0.05); The scores of HSS in patients with manual lymphatic drainage in each stage after operation were better than that in the routine care group (<i>P</i> < 0.05). The AKS pain scores of the manual lymphatic drainage group were better than those of the routine care group (<i>P</i> < 0.05). There was no statistical difference (<i>P</i> > 0.05) in the AKS pain scores of the two groups in March and June. The AKS clinical score and AKS function score of patients in the manual lymphatic drainage group were better than that in the routine care group (<i>P</i> < 0.05). In general, manual lymphatic drainage treatment for patients with diabetes after total knee surgery can not only effectively alleviate postoperative knee swelling and pain but can also accelerate knee joint function recovery and improve postoperative satisfaction.

Role of Parecoxib Sodium in the Multimodal Analgesia after Total Knee Arthroplasty: A Randomized Double-blinded Controlled Trial.

Total knee arthroplasty (TKA) is an established surgical technique and is the standard treatment for degenerative knee joint diseases. However, severe pain after TKA makes it difficult for many patients to perform early postoperative rehabilitation and functional exercise, which might result in subsequent unsatisfactory recovery of knee joint function and great reduction in patients' satisfaction and quality of life. Orthopaedic surgeons have tried a large variety of analgesics and analgesic modes to relieve patients' pain after TKA. There are many analgesic regimens available in clinical practice but all have some deficiencies. Parecoxib sodium, a highly selective inhibitor of cyclooxygenase-2 (COX-2), can reduce the synthesis of peripheral prostaglandin to exert the effect of analgesia, and relieve inflammation and prevent central sensitization through inhibition of peripheral and central COX-2 expression. In addition, it can be used as a preemptive analgesic without affecting platelet aggregation. However, there does seem to be conflicting evidence in the current research as to whether parecoxib sodium can be used successfully as a preemptive analgesic; the effect of preemptive analgesia with parecoxib sodium in multimodal analgesia is still controversial. This research investigated the effects of parecoxib sodium in a preemptive multimodal analgesic regimen. Eighty-eight patients were randomized into two groups. The experimental group received parecoxib (46 patients) and the control group received saline (42 patients), administered 30 min before the initiation of the surgical procedure. A patient-controlled analgesia (PCA) pump was applied within 48 h after surgery. The visual analogue scale (VAS), drug consumption through the PCA pump, use of salvaging analgesia, range of motion (ROM) of the knee joints, and postoperative complications were observed. The VAS score in the post-anesthesia care unit (PACU) of the parecoxib group was significantly lower than that of the control group (P = 0.039). There was no significant difference in the demographic profiles, duration of operation, hemorrhage in surgery, postoperative hemorrhage, postoperative drainage, VAS at different time points, function of knee joints, length of hospital stay, use of salvaging analgesia, and postoperative drug consumption through the PCA between the two groups (P > 0.05). In preemptive multimodal analgesia regimens, parecoxib sodium can significantly decrease the VAS score in the short term, relieve pain shortly after surgery, and does not increase the incidence of complications. Parecoxib sodium is a safe and effective drug in the perioperative analgesic management for TKA.

Clinical effects of arthroscopic reconstruction of anterior cruciate ligament with LARS artifical ligamennt

Objective To explore the operating methods and clinical effects of reconstruction of anterior cruciate ligament with LARS artifical ligament. Methods From October 2012 to June 2015, the clinical data of twenty-four patients with arthroscopic reconstruction of anterior cruciate ligament with LARS artifical ligamennt in Capital Medical University Beijing Friendship Hospital Pinggu Hospital were analyzed retrospectively.All patients underwent anatomical and isometric reconstruction of anterior cruciate ligament to drill femoral and tibial tunnel.The recovery of knee joint function was evaluated by Lysholm scoring system, and the clinical effect was observed. Results All 24 patients were available for follow-up with an average of (22.5±1.5) months.No wound infection occurred during the period.Joint instability and weak leg symptoms and knee pain were obviously improved, the scope of joint activities was increasing.The Lysholm scores improved from a preoperative score of (40.20±1.26) points to postoperative (92.20±2.18)points, and the difference between the two groups was statistically significant (t=2.156, P<0.05). According to the modified Lysholm scoring standard, among 24 cases, 15 cases were excellent, 7 cases were good, 2 cases were fair, and the excellent and good rate was 91.6% (22/24). Conclusion The reconstruction of the anterior cruciate ligament with LARS artificial ligament has the advantages of small trauma, definite curative effect and less complications.It can achieve the purpose of anatomic reconstruction of the anterior cruciate ligament and can effectively restore the stability of the knee joint. Key words: Arthroscopic; LARS; artifical ligament; anterior cruciate ligament(ACL)

Do Nonsteroidal Anti-Inflammatory Drugs Affect Tissue Healing After Arthroscopic Anterior Cruciate Ligament Reconstruction?

BackgroundExperimental studies have reported nonsteroidal anti-inflammatory drugs (NSAIDs) could impair tendon healing. The purpose of this study was to investigate whether NSAIDs could affect recovery of knee joint function in patients after anterior cruciate ligament (ACL) reconstruction.Material/MethodsWe enrolled 40 patients treated with celecoxib and 40 patients treated with tramadol, who underwent ACL reconstruction from January 2011 to December 2017. Visual analogue scale (VAS) and functional outcomes were collected and evaluated. The follow-up period was 12 months.ResultsIn both groups, all patients obtained pain release after surgery, compared with that before surgery. But no significant differences were observed between the 2 groups in VAS scores. We also did not find any differences between the 2 groups at 1 year of follow-up, in terms of anterior drawer test, Lachman test, side-to-side laxity assessed by KT-2000, IKDC score, Lysholm score, and Tegner scale. However, the celecoxib group showed a reduced incidence of nausea compared to the tramadol group (P=0.048).ConclusionsThe use of NSAIDs after ACL reconstruction is relatively safe and could decrease adverse side effects which were caused by opioid drugs.

EFFICIENCY AND SAFETY OF TOURNIQUET DURING TOTAL KNEE ARTHROPLASTY: WHEN TO PERFORM RELEASE?

Use of a pneumatic tourniquet during total knee arthroplasty is an effective option allowing reduction of the time of surgery and intraoperative blood loss. At the same time, there are a lot of researchers who advocate differing tactical approaches to the duration of the tourniquet application — the so-called “early” and “late” releases.Purpose of the study. To assess the effectiveness and safety of various methods of tourniquet use during primary total knee arthroplasty.Material and methods. 72 patients with end-stage knee osteoarthritis were randomly divided into two equal prospective groups: 1) keeping the tourniquet throughout the surgery, including wound closure (late release); 2) performing knee arthroplasty using the tourniquet until after implantation of the prosthesis component and implementation of hemostasis after the release of the tourniquet (early release). Such aspects as perioperative blood loss and changes in blood counts, blood transfusion volume, and severity of pain on the VAS scale, the rate of recovery of the knee joint function and number of postoperative complications were assessed during hospital stay of patients.Results. The duration of procedures was 70±15,4 min for the Group I with tourniquet throughout surgery (late release) and 95±27,5 for the Group II with early release (p = 0,001). On the 7th day after the arthroplasty the authors observed statistically significant differences (p0,05) in the dynamics of reducing the level of hemoglobin, red blood cells and hematocrit in patients of compared groups — in patients who underwent late release of the tourniquet, these indicators were higher. When assessing the rate of recovery of knee joint function according to the KSS -and the intensity of the pain syndrome no significant statistical differences were found in the patients of both groups.Conclusion. Application of the tourniquet throughout the surgery to release after closure of the surgical wound does not lead to a sharp increase in the number of ischemic and thromboembolic complications, while at the same time, the application of this methodology to a large extent maintains hemoglobin indicators, red blood cells and hematocrit at a high level without a critical decrease.

Curative effect of knee arthroplasty on patients with osteoarthritis and analysis of long-term joint function of these patients.

The aim of this study was to explore the curative effect of knee arthroplasty on patients with osteoarthritis and analysis of their long-term joint function. Ninety-six cases of osteoarthritis patients, collected in our hospital from June 2010 to May 2011, were divided into control group and observation group (N.=48 in each group). Patients in observation group were treated by knee replacement, and patients in control group were treated by arthroscopic debridement. Bleeding during operation of patients and the operation time in both groups were comparable during their followed up for 6~60 months, with an average of 52 months. Neer score was used to compare the curative effect of patients after 6 months; knee society score (KSS) was used to compare knee joint function and knee joint of motion (ROM) of patients several days prior to surgery and after 6 months, 12 months, 24 months, and 48 months. Visual analogue scale (VAS) was used to compare pain degrees of patients at the last follow-up. By Neer score comparison, after 6 months excellent and good rate of patients in observation group (91.67%) was obviously higher than that of control group 70.83% (P<0.05); ROM of patients in observation group was obviously higher than that in control group (P<0.05); After six months, KSS score of patients in both groups greatly improved. As well, with the extension of time, their knee joint function showed a better trend, and KSS score of patients in observation group was obviously higher than that of control group (P<0.05). Pain of patients in observation group was significantly lower than that in control group (P<0.05). Both arthroscopy debridement and knee replacement have good curative effect. The curative effect of knee replacement was better, postoperative knee joint activity was obviously improved, the long-term recovery of knee joint function was good, and knee replacement can reduce the pain of the patients.

Intramedullary nailing combined with cannulated screw in treating femoral condyles fractures

To observe the clinical effects of retrograde intramedullary nailing and cannulated screws in the treatment of femoral condylar fracture. From June 2009 to June 2015, 13 patients with femoral condyles fracture were treated by retrograde intramedullary nailing and cannulated screws including 6 males and 7 females with an average age of 46.1 years old ranging from 16 to 76 years old. There were 10 cases of closed fractures, 3 cases of open fraetures. According to AO classification criteriam, 4 cases were type C1, 7 cases were type C2, 2 cases were type C3. Postoperative reduction of fracture and the knee joint function recovery were observed. All patients were followed up for 12 to 36 months with a mean of 24 months. X-ray examination showed that the union time of fracture was 18 to 24 weeks, 21 weeks on average. There were no cases of loosening, breakage of internal fixators and re-fracture. Hospital for Special Surgery(HSS) knee score was 90.07±4.99 at 1 year after the operation. The clinical efficacy for retrograde intramedullary nailing and cannulated screw for the treatment of femoral condyles fracture was excellent. It can improve the anatomical reattachment rate and reduce the complications and promote the knee functional recovery.

Effect analysis of surgical treatment for meniscus injury under arthroscopy

Objective To discuss the clinical effect of surgical treatment for meniscus injury under arthroscopy. Methods One hundred and four cases patients with meniscus injury admitted at the Orthopaedic Hospital of Zhengzhou from January 2012 to June 2015 were selected, and all of them were given surgical treatment for meniscus injury under arthroscopy.All patients were followed-up after operation and the clinical effect of surgical treatment were judged by Lysholm marking system.The range of motion changes before and after knee surgery were compared.The knee joint function recovery were evaluated by international commission on knee score(IKDC) function of the knee joint subjective assessment.The clinical effect of different gender were compared. Results Lysholm marking scores of patients with different meniscus injury types all increased after treatment, the level of damage by (43.8±4.1) points increased to (76.8±10.5) points, radiation injury by (41.5±2.4) points increased to (75.6±9.4) points, longitudinal (39.6±4.2) points injury by increased to (76.8±10.5) points, degenerative disease by (41.2±2.6) points increased to (85.6±10.4) points and mixed type injury by (45.7±3.6) points increased to (85.9±8.5) points respectively, the differences were statistically significant between the preoperative and postoperative(t=-4.265, -4.135, -4.955, -4.563, -4.213, P 0.05). Conclusion The clinical effect of surgical treatment for meniscus injury under arthroscopy is remarkable and it causes light damage to the body.It is worth popularization and application. Key words: Meniscus injury; Arthroscopy; Minimally invasive surgery; Effect

Effects of people oriented nursing on meniscus injury treated by arthroscopic treatment

Objective To observe and analyze the clinical effects of people oriented nursing on recovery of meniscus injury treated by arthroscopic treatment and then give comments. Methods From December 2012 to December 2014, 98 kidney disease patients were selected as study objects by convenient sampling method according to inclusion and exclusion criteria, and were divided into experimental group (people oriented nursing) and control group (routine care). The clinical nursing effects of two groups were compared and analyzed, and the value of clinical application was evaluated. After the treatment, patients and families were investigated their satisfaction to medical staffs by our hospital self-designed questionnaire. Results The goodrate of knee joint function scores in the experimental group was better than that of the control group (P<0.01). The patients and their families had a higher satisfaction with medical staffs compared with that of the control group (P<0.01). Conclusions People oriented nursing has a better effects for knee joint function recovery treated by arthroscopic treatment, placate patients′ mood, promote knee joint recovery prognosis, and improve patients and their families′ nursing satisfaction. It has a high value to promote in clinical. Key words: Meniscus, tibia; Knee injury; Nursing; Under the arthroscope inspection

Effect of sodium hyaluronate combined with glucosamine in the treatment of knee osteoarthritis and its influence on knee joint function

Objective To explore the clinical effect of sodium hyaluronate combined with glucosamine in the treatment of knee osteoarthritis and its improving for knee joint function. Methods 127 patients with knee osteoarthritis who were treated in our hospital from March 2011 to September 2013 were divided two groups according to the random number table method,the control group was intra-articular injected with sodium hyaluronate,while the observation group was treated with oral glucosamine on the basis of control group therapy.Compared the clinical effect, the keen joint pain by the visual analogue score(VAS)method were evaluated,and the improving of knee joint function and adverse reaction status in two groups after treatment was analyzed. Results Patients were followed up for 3 months,observed in 42 cases,17 cases markedly effective group,progress in 4 cases,invalid 1 cases,in the control group 31 cases were markedly effective,effective in 20 cases,progress in 7 cases,5 cases were ineffective,with a significant difference between he ttwo groups(Z=-2.120,P=0.034).VAS scores in the two groups after treatment were reduced than before treatment,and the reduced extent in the observation group was bigger than the control group[(2.7±0.8)vs(4.2±1.0)],the difference was statistically significant(t=3.832,P=0.039).Knee joint function score of the two groups after treatment were increased than before treatment,and increased extent in the observation group was bigger than the control group[(88.9±11.8)vs(75.2±12.0)],the difference was statistically significant(t=3.261,P=0.016).There were adverse reactions in the two groups after treatment,but the difference was no statistically significant(P>0.05). Conclusion Sodium hyaluronate combined with glucosamine can significantly promote the clinical effect in the treatment of knee osteoarthritis,it can relieve pain,improve the recovery of knee joint function and will not increased the risk of adverse reaction of patients after treatment,which has an important value to be popularized in clinical field. Key words: Sodium hyaluronate; Glucosamine; Osteoarthritis of the knee; Injection,intra-articular

Effect of early rehabilitation training on the recovery of knee joint function and life quality in tibial plateau fracture

Objective To explore the effect of early rehabilitation training on the recovery of knee joint function and life quality in tibial plateau fracture.Methods A total of 120 cases of tibial plateau fracture patients were divided into the observation group and the control group,the control group was given the conventional nursing,the observation group was given early rehabilitation training,the two groups were compared with the recovery of knee joint function and quality of life.Results The excellent and good rate of knee joint function was 90％ in the observation group,that was higher than that 75％ in the control group (P ＜0.05).the score of physical function,mental function,social function,the material living state in the observation group were all significantly higher than those of the control group (P ＜0.05).Conclusions Early rehabilitation training is conducive to the promotion the recovery of knee joint function in patients with tibial plateau fractures,and can improve the quality of life. Key words: Early rehabilitation training; Tibial plateau; Knee joint function; Life quality

Surgical treatment of the complicated fractures of the tibial plateau

Objective To investigate the therapeutic effect of the complicated fracture of tibial plateau treated by open reduction and internal fixation. Methods Surgical treatment in 68 cases with complicated fractures of the tibial plateau were analyzed retrospectively, T type plate, L type buttress plate, double plates, anatomical plate,locking plate and less invasive stabization system were adopted for different fractures,iliac or artificial bone grafted in the reconstruction of bone defect after the depression replaced. The time of operation and the effect of functional exercise in the postoperative patients to recover the function of the knees were analyzed at the same time. Results 52 patients of 68 cases were followed-up. Based on Rasmussen rating system,the recovery of knee joint function were excellent in 42cases(67%) ,good in 12 cases(19%) ,fair in 6 cases(10%) and poor in 2 cases(4%) ,the excellent-and-good rate was 86%. Conclusion Surgical treatment of the complicated fractures of the tibial plateau depended on the kind of fracture, therapeutic principles by stages. Moreover, bone grafte after the depression replaced in bone defect was neeassary,good internal fixtion oould meet functional exercise,soft tissue injuries like ligament and meniscus should be well treated,follow the principles of early exercise and delay weightbearing. Key words: Tibial fractures; Knee joint; Fracture fixation,internal; Bone plates