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Background Part of patients undergoing TKA did not achieve the expected physiological function results. The purpose of this study was to investigate whether preoperative balance training can reduce pain and improve joint function after TKA.Methods 100 patients with knee osteoarthritis (OA) prepared for TKA, according to the inclusion and exclusion criteria, were randomly divided into balance training group (50 patients) and control group (50 patients). The main evaluation outcomes of the study included early functional milestones, ROM, WOMAC score, keen society score (KSS), KOOS score, and complications at 1 month (baseline) and 1 day before surgery, 6 weeks (main endpoint) and 52 weeks (1 year) after surgery.Results 4 patients lost to follow-up at 1 month before surgery, 96 received planned surgery and 86 underwent a complete postoperative evaluation. After TKA, many indicators of the two groups, including WOMAC score, KSS, KOOS score, were significantly improved compared with before surgery. At 52 weeks after TKA, no statistically significant difference between the balance training group and control group in attain early functional milestones, ROM, WOMAC score, KSS, KOOS score, and complications; however, at 6 weeks after surgery, balance training group had better early benefits in stopping all narcotics (P = 0.045), relieving pain (P = 0.037), improving function (P = 0.017) and quality of life (QOL) (P = 0.028).Conclusions Although there were no difference between preoperative balance training group and control group at the 52 weeks after surgery, however, preoperative balance training can relieve pain and improve function in the early stage (6 weeks), but adequately statistically powered trials are needed to confrm the accuracy of the study resultsTrial Registration ChiCTR2000032789.

Background To evaluate the survival rate of porous tantalum rod implantation in the treatment of avascular necrosis of the femoral head, to evaluate its clinical effect and imaging results, and to analyze the reasons for its failure to return to total hip arthroplasty (THA). Methods From January 2008 to December 2013, tantalum rod implantation for avascular necrosis of the femoral head was performed in two institutions. Statistical analysis of operation data, including operation time, blood loss and blood transfusion. Harris hip score and imaging results were evaluated. Kaplan Meier survival analysis was performed with THA as the end point. Histopathological observations were performed on femoral head specimens with the tantalum rods that failed THA after tantalum rod implantation. Results 42 patients (52 hips) were followed up completely, the average follow-up time was 74.3 months (60-120 months). 24 hips turned to THA at the end of follow-up (46.2%), the average time was (44 ± 32) months, and the average Harris score before THA was (57 ± 10). The follow-up time of 28 patients without THA was 78.6 ± 13.8 months, and the average Harris score was 80.6 ± 2.8. Histopathological examination revealed the implant surface is in contact with sparse Island bone. There is limited bone tissue extending inward from the implant. In the living bone area, there was “on-growth” of new bone but no “in-growth”. In the necrotic area, there was no obvious new bone regeneration. Conclusion The mid-and-long term clinical effect of tantalum rod implantation in the treatment of avascular necrosis of the femoral head is not good, and the osteogenic activity of tantalum rod in the femoral head is limited. ARCO stage, age and bone marrow edema were risk factors for the failure of tantalum rod implantation to THA.

Background: Many previous studies have compared the effects of preoperative balance training and non-balance training on daily performance and knee functional outcomes after surgery, however, whether preoperative balance training is more beneficial to patients is still a big debate. Comparing the postoperative joint and daily function of balance training and non-balance training is the main purpose of our study.Methods: Cochrane library, Pubmed and Web of Science databases searched by us, and searched again before submitting our submission. This mete-analysis included 22 studies that directly compared postoperative performance and functional outcomes after training group (TG) and control group (CG). We used the software endnote X9 for data selection, and the software Review Manager 5.3 for data analysis to make funnel plots and forest plots.Results: The pooled data indicated that balance training significantly improved 2/6 MWT (2/6-min walk test) (weighted mean difference (WMD) = 25.17, 95% confidence interval (CI) 12.88 to 37.46, P < 0.0001), gait speed (WMD = 0.15, 95% CI 0.10 to 0.19, P < 0.00001), TUG (timed up and go) (WMD = 1.02, 95% CI 0.75 to 1.29, P < 0.00001), BBS (berg balance scale) (WMD = 1.79, 95% CI 0.50 to 3.08, P = 0.006), FHR (ratio of functional reach distance to body height) (WMD = 9.34, 95% CI 6.69 to 11.98, P < 0.00001), TCS (WMD = 1.20, 95% CI 0.86 to 1.53, P < 0.00001), early stage vitality (WMD = 14.41, 95% CI 13.53 to 15.30, P < 0.00001) and KOOS (Knee Injury and Osteoarthritis Score) sysptoms (WMD = 6.34, 95% CI 2.07 to 10.60, P = 0.004), middle stage function (WMD = 5.85, 95% CI 0.13 to 11.56, P = 0.04).Conclusion: Preoperative balance training improved partial postoperative daily performance and knee functional outcomes in patients with total knee arthroplasty.

Background Pain control after total knee arthroplasty (TKA) is important for early postoperative experience and knee rehabilitation. However, there is no consensus on the Pain management after TKA. Whether early analgesic effect and patient satisfaction can reach or even exceed the femoral nerve block has been controversial. The aim of our study was to compare the early analgesia effect with multimodal cocktail periarticular injection (MCPI) and Femoral nerve block (FNB) during simultaneous knee arthroplasty. Methods Our study was a prospective randomized, double-blind controlled trial. From December 2018 to August 2019, 85 patients (170 knees) who underwent bilateral total knee arthroplasty at our institution were randomly treated with MICP and FNB. Randomization was done via a computerized randomization list. The visual analogue scores for pain, bilateral knee range of motion (ROM), postoperative adverse events, and patients satisfaction were assessed preoperatively and two weeks postoperatively. This trial is registered at ClinicalTrials.gov, number ChiCTR1800020003. Results A total of 85 patients (170 knees) were enrolled for bilateral TKA. Finally, 80 (160 knees) patients were included for analysis and comparison. The operation time of the MCPI group was significantly lower than the FNB group (66.5±8.7 min compared with 72.8±9.5 min, P

BackgroundTotal knee arthroplasty (TKA) is performed by gap balance (GB) and measured resection (MR) techniques for femoral rotation resection to achieve knee flexion balance and knee stability. It is still controversial to choose which technique is more advantageous. The purpose of this study was to compare the early clinical efficacy of GB and MR in TKA.MethodsThis study was a prospective randomized, double-blind controlled trial. From March 2018 to March 2019, 99 patients (99 knees) who underwent TKA at our institution were randomly treated with GB and MR. The cutting thickness of posterior condyle, radiographic findings, medial and lateral compartment pressure, gait analysis, and patients satisfaction were recorded. ResultsA total of 110 patients were enrolled for unilateral THA. Finally, 99 patients were included for analysis and comparison at 12 months follow-up. In GB group, the angle of Cutting Block to PCA was significantly lower than in the MR group (P0.05).ConclusionIn TKA, GB or MR techniques for femoral external resection has little effect on daily walking. However, the GB technique has advantages in early postoperative knee stability and knee flexion function improvement.

Effective porosity is a key factor in subsurface fluid flow. However, lignite is soft, may swell in water (depending on saturation state), and is friable. Thus the conventional saturated water NMR method has challenges when applied to lignite (coal swelling, and fragmentation during the centrification process to remove the pore water. Here an improved experimental method for effective porosity is demonstrated for lignite. To prevent sample breakage, the cores were wrapped with a heat shrinkable plastic and kerosene replaced water as the saturated fluid. The kerosene low-field NMR signal and porosity relationship was established and demonstrated for lignites from the Lower Cretaceous Saihantala Formation in the Shengli coalbed reservoirs in the Erlian Basin of Inner Mongolia, China. The lignite had a relatively high total porosity of 37.2–47.0% and an effective porosity of 25.0–34.6%. Thus, from this and additional reservoir considerations, this area is likely conducive to the production of coalbed methane.