Clinical Research Directory

Hemi-tibial Plateau Osteotomy Combined With Arthroscopic Repair for Medial Meniscus Posterior Root Tears in Varus Knees

This is a single-center clinical trial started by the study team. The goal is to compare two surgeries for people who have a varus knee alignment and a tear at the back attachment of the medial meniscus. Researchers want to learn how the newer bone-cut procedure with arthroscopic meniscus repair compares to the standard bone-cut procedure with arthroscopic meniscus repair. Researchers will also track safety and hospital-related costs. Main questions the study aims to answer: * At 12 months after surgery, how does the improvement in knee function compare between the newer-surgery group and the standard-surgery group? The study will evaluate preliminary trends in clinical efficacy using the Lysholm knee function score. * Do the two groups differ in pain relief, imaging findings, meniscus healing, complications, and hospital stay and preliminary cost-effectiveness? The study plans to enroll about 20 participants at Sun Yat-sen University Eighth Affiliated Hospital (Shenzhen Futian). Participants will be assigned by chance, like drawing lots, in a one-to-one ratio. This is an pilot study with a PROBE (Prospective Randomized Open-label Blinded-Endpoint) design. While participants and surgeons will know which surgery is performed, the research assistant responsible for collecting patient-reported outcomes will be blinded to group allocation to minimize observer bias. Study groups: * Experimental group: hemi-tibial plateau osteotomy plus arthroscopic meniscus repair. * Control group: high tibial osteotomy plus arthroscopic meniscus repair. Who may join: * Age 35 to 65 years, with no restriction on sex; * Diagnosed with a medial meniscus posterior root tear; * Presence of varus knee deformity; * Imaging findings support the diagnosis (e.g., knee MRI); * Failure of conservative treatment: no meaningful improvement after more than 1 month of non-surgical management (e.g., rest, medication, or physical therapy); * Varus alignment angle less than 10 degrees; * The deformity is predominantly tibial in origin; * Knee radiographs do not show the most severe osteoarthritis (Kellgren-Lawrence grade other than IV). Who cannot join: * A knee that is chronically "locked," meaning it cannot bend or straighten normally. * The most severe level of knee arthritis on knee X-ray. * Severe arthritis in the hip or ankle that could affect knee function testing. * Inflammatory or infectious conditions that can affect the knee, or abnormal inflammation blood tests that make participation unsafe. * Knee instability or poorly functioning prior ligament reconstruction, based on the study doctor's judgment. * Any prior surgery on the target knee, or on other joints of the same-side lower limb. * Serious heart, liver, or kidney disease, cancer, bleeding disorders, immune deficiency, or severe mental health conditions that make participation unsafe. * Body mass index of 30 or higher. * Pregnancy or breastfeeding, or not willing to use birth control during the study. * Participation in another clinical study within the past 3 months (except registry studies). * Any other reason the study doctor believes makes participation unsafe or not appropriate. What participants will do: * Complete screening and baseline assessments within about 30 days before surgery and sign informed consent. * Receive the assigned surgery during the hospital stay. * Return for follow-up visits at 3 months, 6 months, and 12 months after surgery. * Complete knee function and symptom questionnaires and rate pain at each follow-up visit. * Have standing knee X-rays and full-length leg X-rays at 3, 6, and 12 months. * Have an MRI of the operated knee at 3, 6, and 12 months to assess meniscus healing and meniscus extrusion. Outcomes: * Primary outcome: change from baseline to 12 months in the Lysholm knee function score. * Secondary outcomes: changes in the Lysholm score at 3 and 6 months; changes in the WOMAC knee arthritis symptom score at 3, 6, and 12 months; changes in pain rating on a standard pain scale at 3, 6, and 12 months; imaging measures and bone healing on X-rays; meniscus healing and extrusion on MRI; surgery time and blood loss; complications during and after surgery; length of hospital stay and hospital costs; and quality of life utility value from a standard health questionnaire.

Clinical Application Research of Combined Therapy in ERAS for Accelerated Orthopedic Rehabilitation

The double-blind method is adopted.Case selection Patients who underwent meniscus repair surgery under knee arthroscopy at Li Huili Hospital Affiliated to Ningbo University, the 906th Hospital of the People's Liberation Army (Joint Logistic Support Force of the Chinese People's Liberation Army), and Yangming Hospital Affiliated to Ningbo University (Yuyao People's Hospital), with ages set at 20 to 65 years old, are planned to be included in a sample size of 120 cases based on previous research experience, divided into 4 groups. They were respectively: the blank control group, the Henggu Bone Injury Healing Agent intervention group, the lower limb rehabilitation training system intervention group, and the Henggu Bone injury Healing agent combined with the lower limb rehabilitation training system intervention group, with 30 cases in each group. Grouping was conducted using a double-blind method, with random grouping carried out by a third-party organization. 1. Inclusion criteria: (1) The patient is conscious and aware of the content of this study; (2) Those with good compliance; (3) Possess good language communication skills. 2. Exclusion criteria: (1) Severely obese patients; (2) People with cognitive dysfunction; (3) Those with relevant serious complications; (4) Those with severe heart, liver or kidney insufficiency. 3. Exclusion criteria: Those who received intervention with other anti-inflammatory and analgesic drugs after the operation. Criteria for terminating the study: Postoperative complications such as joint infection and deep vein thrombosis of the lower extremities occur after the operation. Blank control group: No intervention measures Lower limb rehabilitation training system intervention group: Received rehabilitation system intervention after the operation Henggu Bone Injury Healing Agent Intervention Group: Take Henggu Bone Injury Healing Agent after the operation The combined intervention group: After the operation, they took Henggu bone injury Healing Agent and received rehabilitation system intervention The knee joint function and pain scores of each group, the implementation of the recovery plan, remote guidance of the rehabilitation system (applicable to the intervention group), and the duration of drug use: a total of 6 weeks of Henggu Bone Injury Healing Agent were evaluated at 1 day, 4 weeks, 3 months, and 6 months after the operation.

Surgical Outcome After Displaced Bucket-handle Meniscal Lesions - Repair Versus Partial Meniscectomy

The menisci of the knee joint are structures composed of cartilage and connective tissue, whose primary functions are to stabilize the joint and distribute weight across joint surfaces. In doing so, it helps protect the joint from osteoarthritis - a form of joint failure commonly referred to as "joint wear". Meniscal surgeries are among the most common orthopaedic procedures performed both in Sweden and globally. Historically, damaged menisci were treated by removing the injured part. However, this approach is linked to early-onset osteoarthritis. Osteoarthritis affects approximately one-third of individuals over the age of 45 and ranks among the ten most common diagnoses in Europe based on years lived with disability. The knee is the most frequently affected joint, and the importance of the menisci in preserving knee function has become increasingly recognized. In recent years, advances in surgical techniques have led to a shift towards meniscus-preserving procedures. A typical injury is the displaced meniscus, in which a large portion of the meniscus becomes detached from the joint capsule and wedges itself inside the joint, causing mechanical locking and preventing full extension. A displaced meniscus often loses its blood supply and suffers mechanical damage from being compressed between the joint surfaces. To preserve the meniscus and prevent irreversible damage, early surgical intervention is required. If the injury is too old or the tissue too damaged, the injured part of the meniscus must be removed, which significantly increases the risk of developing early knee osteoarthritis. It remains unclear how soon surgery must be performed to successfully preserve the meniscus, and this likely depends on various other factors, including patient age, presence of additional joint injuries, and surgical technique. There is currently no reliable data on the proportion of displaced menisci that heal after meniscus-preserving surgery. However, studies suggest that 20-30% of repaired menisci require reoperation due to failed healing. Given that displaced menisci are considered surgical emergencies, they pose a significant burden on healthcare systems already strained by limited access to urgent surgery. Meanwhile, ongoing development of surgical techniques raise ethical and logistical questions for health providers - especially as the scientific evidence for the benefits of some advanced treatments remains inconclusive. Therefore, more research is needed to guide the optimal management of displaced bucket-handle lesions across a diverse patient population, taking into account age, activity level, and concurrent injuries. A key priority is to identify predictors of healing potential, particularly the time window during which surgical repair remains a viable option. With better knowledge, more menisci could potentially be preserved - reducing both the number of unnecessary re-operations and the long-term incidence of knee osteoarthritis.

Transtibial Pull Out Method Versus Suture Anchor Method for Meniscus Extrusion

The concept of meniscal extrusion has recently been recognized as an important pathological condition associated with meniscal dysfunction. Meniscal extrusion is the medial or lateral displacement of the meniscus beyond the edges of the tibial plateau. Some meniscal extrusions are physiologic, but large degrees of extrusion are thought to be pathologic. Meniscal extrusion can vary in extent from minimal physiological extrusion to extrusions exceeding 10 mm. The generally accepted threshold value is considered to be 3 mm. To date, the gold standard for measuring meniscal extrusion is T2-weighted MRI. MRI is valuable not only due to its ability to define other meniscal or knee pathologies but also because it provides good sensitivity and specificity. Surgical treatment of meniscal extrusion is preferred in young, active, symptomatic patients and individuals with acute injuries. The treatment approach may vary depending on the underlying cause. One of these methods is centralization surgery, which aims to achieve the anatomical reduction of the extruded meniscus. The aim of this study is to compare the functional outcomes of transtibial pull-out and suture anchor techniques used in centralization surgery and to contribute to standardization.

Assessment of Quadriceps Femoris Muscle Function in Patients After Arthroscopic Knee Surgery in Outpatient Rehabilitation

The goal of this clinical trial is to learn if a high intensity magnetic field is an effective way to treat quadriceps muscle atrophy after knee arthroscopic surgery in adult patients. The main questions it aims to answer are: Is high intensity magnetic field muscle stimulation is an effective way to treat quadriceps muscle atrophy Is high intensity magnetic field muscle stimulation is more effective and more tolerable option for quadriceps muscle stimulation than transcutaneous muscle electrical stimulation Researchers will compare high intensity magnetic field muscle stimulation to transcutaneous muscle electrical stimulation and control group, to see if high intensity magnetic field muscle stimulation works to treat quadriceps muscle atrophy. Participants will: receive high intensity magnetic field or transcutaneous muscle electrical stimulation 1 time/day for 14 days, Visit the rehabilitation department for testing before/after and 1 month after rehabilitation.