Objective To explore the reliability and accuracy of the arbitrary point method for measuring the anteversion angle of acetabular prosthesis after total hip arthroplasty (THA) based on pelvic X-ray films. Methods The clinical data of 23 patients (25 hips) who underwent THA between December 2018 and September 2023 and met the selection criteria were retrospectively analyzed. Among them, there were 16 males and 7 females, with an average age of 57.6 years (range, 34-81 years); 13 hips had THA on the left side and 12 on the right side. There were 19 cases (21 hips) of osteonecrosis of the femoral head, 2 cases (2 hips) of femoral neck fractures, 1 case (1 hip) of developmental dysplasia of the hip, and 1 case (1 hip) of osteoarthritis. After THA, all patients underwent X-ray examination and CT scan. Three physicians measured the anteversion angle of acetabular prosthesis using the arbitrary point method and the CT measurement method respectively, and repeated the measurements three times. The results of the two measurement methods were compared, and the intraclass correlation coefficient (ICC) was employed to assess the reproducibility of the methods. Results The anteversion angles of acetabular prosthesis were (15.87±7.73)° measured by the arbitrary point method, and (15.31±7.89)° measured by CT measurement method. There was no significant difference between the two methods (t=1.515, P=0.143). The ICC of the measurement results by the arbitrary point method for the three physicians were 0.97 (P<0.001), 0.96 (P<0.001), and 0.96 (P<0.001), respectively; and the ICC of the measurement results by CT method were 0.93 (P<0.001), 0.93 (P<0.001), and 0.94 (P<0.001), respectively. Conclusion The arbitrary point method for measuring the anteversion angle of acetabular prosthesis after THA based on pelvic X-ray film is easy to operate, accurate, and has high reproducibility.
ObjectiveTo explore the surgical treatment of deep chest wall infection, improve the cure rate and reduce the recurrence rate.MethodsThe clinical data of 655 patients with deep chest wall infection treated in Yanda Hospital and Beijing Royal Integrative Medicine Hospital from June 2015 to June 2020 were retrospectively analyzed. There were 450 males and 205 females, aged 55.6±12.8 years. There were 8 patients with chest wall infection after tumor necrosis, 15 patients after radiotherapy and 632 patients after thoracotomy (612 patients after cardiovascular surgery and 20 patients after general thoracic surgery). Among them, 649 patients underwent debridement and reconstruction of chest wall defect with muscle flap.ResultsThe average operation time was 95±65 min, the average intraoperative blood loss was 180±100 mL, and the average postoperative hospital stay was 13±6 d. Of the 649 patients who underwent muscle flap reconstruction after debridement, 597 patients recovered within 2 weeks, and the primary wound healing rate was 94.4%. Twenty-three (3.5%) patients died. The median follow-up time was 25 (2-40) months. Among the remaining 632 patients, 20 recurred, with a recurrence rate of 3.1% (20/632).ConclusionPedicled muscle flap after thorough debridement of deep chest wall infection is one of the best methods to repair chest wall defect with pedicled muscle flap.