Objective To evaluate the feasibility and significance of problem-based learning (PBL) in orthopedic internship. Methods A total of 315 students in grade 2002 were involved in PBL during their internship in the Department of Orthopedics at the First Affiliated Hospital of China Medical University, Shenyang, China. Teaching effectiveness was evaluated with a questionnaire and an ability examination. The results of PBL teaching during different semesters were compared, and the feasibil ity and significance of PBL were analyzed. Results Students who participated in PBL were in a dominant position and were more active in the learning process. The PBL pattern could improve students’ ability to identify, analyze and solve problems, and also contribute to fostering and enhancing their clinical thinking. This could help them solve the problems that emerged from the theory curriculum.Conclusions The PBL pattern used in the orthopedics internship has advantages and practical significance, which are applicable in modern medical teaching practice.
Objective To explore the timing of indwelling urinary catheter removal in male patients undergoing orthopedic surgery under general anesthesia by a prospective randomized controlled study. Methods Male patients who underwent orthopedic surgery under general anesthesia in the First People’s Hospital of Shuangliu District between September 2019 and January 2021 were selected prospectively. The patients were randomly assigned to group A (pull out the catheter before anesthesia) and group B (pull out the catheter within 24 hours after anesthesia) at a ratio of 1∶1 by sortition. The age, operation duration, operation site, heart rate when pulling out the catheter, first urination, urinary tract infection, patient comfort score, nursing satisfaction score and patient satisfaction related indicators of the two groups were recorded and analyzed. Results A total of 120 patients were included in the study. All patients successfully completed the trial without dropping out or quitting. There was no significant difference between the two groups in terms of age, operation duration and operation site (P>0.05). No urinary tract infection occurred in both groups. There was no significant difference in the first urination between the two groups (P>0.05). The heart rate of patients in group A when pulling out the catheter was slower than that of group B [(74.62 ± 11.38) vs. (84.52 ± 8.98) times/min], and the satisfaction of patients in group A (group A: 46 cases were satisfied, 11 cases were relatively satisfied, 3 cases were dissatisfied; group B: 17 cases were satisfied, 25 cases were relatively satisfied, 18 cases were dissatisfied), comfort score (17.82±2.73 vs. 16.68±2.13), and nursing satisfaction score (19.62±1.59 vs. 16.32±2.05) were better than those in group B (P<0.05). Conclusions For male patients who need catheterization before orthopedic surgery under general anesthesia, pulling out the catheter before waking up after anesthesia can effectively reduce the physiological stress reaction of patients, reduce discomfort, improve patient satisfaction, and reduce the workload of nurses after surgery, which is conducive to early rehabilitation exercise of patients.
Objective To explore the application of robot-assisted pedicle screw fixation combined with total endoscopic decompression and interbody fusion in single segment lumbar decompression and fusion. Methods A total of 27 cases undergoing single segment lumbar decompression and fusion between August 2020 and May 2021 in the People’s Hospital of Deyang City were retrospectively collected. They were divided into group A and B according to their surgery method. The patients in group A underwent robot-assisted pedicle screw fixation combined with total endoscopic decompression and interbody fusion surgery, while the ones in group B underwent traditional posterior decompression and fusion. The operation time, amount of bleeding, Visual Analogue Scale (VAS) score and Oswestry Disability Index (ODI) score before operation and one month and three months after operation, and success rate of screw placement were compared. Results There were 12 patients in group A, 5 males and 7 females, aged (59.83±6.79) years, and 15 patients in group B, 6 males and 9 females, aged (53.73±14.87) years. The amount of intraoperative bleeding [(195.00±45.23) vs. (240.00±47.06) mL] and postoperative hospital stay [(5.92±1.56) vs. (8.33±3.62) d] in group A were less than those in group B (P<0.05), while the operation time [(185.80±52.13) vs. (160.70±21.37) min] and the success rate of screw placement [100.0% (48/48) vs. 96.7% (58/60)] had no statistical difference between the two groups (P>0.05). The VAS score and ODI score of the two groups decreased significantly over time (P<0.05), but there was no significant difference in VAS score between the two groups at the same time point before operation, one month after operation, or three months after operation (P>0.05). The ODI score of group A was better than that of group B one month after operation (P=0.010), but there was no significant difference between the two groups before operation or three months after operation (P>0.05). Conclusion Compared with traditional open surgery, the application of robot-assisted total endoscopic lumbar decompression and fusion technology in single segment lumbar fusion has good early clinical outcome, high success rate of screw placement, and small trauma, which is beneficial to early functional recovery and has the significance of further exploring its application prospect.
Objectives To explore the application effect of orthopedic psychological sleep management mode based on enhanced recovery after surgery (ERAS) in orthopedic patients. Methods A non-synchronous clinical controlled study was conducted. The intervention group enrolled 118 orthopedic patients who admitted to our hospital between April and June 2017, and the control group enrolled 111 orthopedic patients who admitted to our hospital between January and March 2017. The control group used routine nursing measures during hospitalization, while the intervention group implemented an ERAS-based orthopedic psychological sleep management mode based on routine nursing measures, which included carrying out a new mode of multidisciplinary collaborative management, implementing the normative path of orthopedic psychological sleep management, and implementing the comprehensive psychological sleep management. The mood, sleep quality and satisfaction of the two groups within 24 hours after admission and before discharge were compared. Results Before the intervention, there was no statistically significant difference in general data, mood or sleep quality between the two groups (P>0.05). After the intervention, the median score (the lower and upper quartiles) of the Huaxi Emotional Index of the intervention group was 1 (0, 5), while the score of the control group was 2 (0, 6); the median score (the lower and upper quartiles) of the Pittsburgh Sleep Quality Index was 4 (3, 7) in the intervention group and 6 (4, 9) in the control group; the satisfaction score in the intervention group was better than that in the control group (96.47±2.72vs. 95.52±2.79); the differences between the two groups were statistically significant (P<0.05). Conclusions The ERAS-based orthopedic psychological sleep management mode is beneficial to improve the patients’ emotional disorder, sleep quality and satisfaction. It facilitates the patients’ accelerated recovery.
Graphene and its derivatives have good physical and chemical properties and biological properties, which can promote stem cell proliferation and osteogenic differentiation, and it has antibacterial properties and drug release property. Therefore, it has broad application prospects in the field of orthopedic biomaterials. This paper mainly introduces the research progress of graphene nanocomposite materials applied in the aspects of bone tissue engineering scaffold, bone repair, bone graft materials, etc. in order to provide desirable information for the future application basis and clinical research.
ObjectiveTo evaluate the effectiveness of TiRobot-assisted surgery by O-arm navigation system for percutaneous minimally invasive treatment of posterior pelvic ring injury. Methods The clinical data of 76 patients with posterior pelvic ring injury between January 2016 and June 2021 were retrospectively analyzed. Among them, 45 cases were treated with minimally invasive percutaneous sacroiliac screw fixation assisted by TiRobot and O-arm navigation system (study group), 31 cases were treated with minimally invasive percutaneous sacroiliac screw fixation under the guidance of C-arm X-ray machine (control group). There was no significant difference in gender, age, cause of injury, Tile classification, time from injury to operation between the two groups (P>0.05). The operation time, intraoperative blood loss, the times of nail track adjustment, and intraoperative fluoroscopy times were recorded. The quality of fracture reduction was evaluated by Matta score. At last follow-up, Majeed score was used to evaluate the recovery of pelvic function. ResultsA total of 72 screws were implanted in the study group, with a median of 1 (1, 2) screws per patient. In the control group, 47 screws were implanted, with a median of 1 (1, 2) screws per patient. There was no significant difference in the number of screws between the two groups (Z=−0.392, P=0.695). The operation time, intraoperative blood loss, times of nail track adjustment, and intraoperative fluoroscopy times in the study group were significantly less than those in the control group (P<0.05). All patients were followed up 6-24 months (mean, 14 months). No serious complications was found after operation and during follow-up. Matta score was used to evaluate the quality of fracture reduction at 1 week after operation, and there was no significant difference between the two groups (Z=−1.135, P=0.256). At last follow-up, there was no significant difference of Majeed score between the two groups (Z=−1.279, P=0.201). ConclusionTiRobot-assisted surgery by O-arm navigation system is a reliable surgical method for the treatment of posterior pelvic ring injury, which can reduce the operation time and fluoroscopy times when compared with the traditional operation under the guidance of C-arm X-ray machine. The safety, accuracy, and efficiency of the operation were improved.
Objective To conduct a systematic bibliometric analysis of recent research on robot-assisted orthopedic surgery, in order to reveal the research trends, hotspots, main contributors, and future development directions in this field. Methods On August 27, 2024, WoSCC (Web of Science Core Collection Database) was searched and relevant literature on robot-assisted orthopedic surgery from 2003 to 2023 was included. Excel 2016, VOSviewer (version 1.6.10), and CiteSpace (version 6.2.R6) were used for data collection and analysis. Results The total citation frequency of 1718 retrieved literature was 28978 times, with an average citation frequency of 16.87 times per article. The total citation frequency of articles in 2019 was the highest (4330 times), and the publication volume in 2023 was the highest (315 articles). Among the top 5 countries in terms of publication volume, the United States had the highest publication volume and total citation frequency, while China ranked second in terms of publication volume, but had the lowest average citation frequency per article. Analysis of cooperation between countries showed that the United States, China, Germany, and other countries had the most cooperation. Babar Kayani’s articles were cited the most frequently. Among the top 10 institutions in terms of publication volume, the Hospital for Special Surgery (United States) had the highest publication volume, the Pennsylvania State System of Higher Education (United States) had the highest total citation frequency for publications, and the average citation frequency of each article published by the University of Pittsburgh (United States) was the highest. The dynamic evolution of research hotspots suggested that early research mainly focused on the combination of traditional surgical techniques and navigation, while in recent years, research had mainly focused on computer-aided surgery, augmented reality, and medical robotics technology. Conclusions In recent years, significant progress has been made in the research of robot-assisted orthopedic surgery, with the United States taking a leading position in this field and having extensive global cooperation. Research hotspots show that with the continuous development of computer-aided surgery, augmented reality, and robotics technology, the field of orthopedic surgery is evolving towards more precise, individualized, and minimally invasive directions.
Artificial intelligence (AI) technologies, encompassing virtual reality, augmented reality and adaptive learning platforms, offer immersive and personalised opportunities for undergraduate orthopaedic education. However, their adoption is hindered by limited faculty acceptance, data privacy and ethical risks, and disparities in educational resources. This study examines the opportunities and challenges of AI integration in orthopaedic teaching and proposes strategies including systematic AI training, strengthened data protection, resource sharing, and blended learning models. These measures aim to enhance the quality of learning for students and educators while fostering innovation and progress in medical education.
Day surgery is an important diagnosis and treatment modality to promote hierarchical diagnosis and treatment and form a “surgery in hospital, recovery in community” diagnosis and treatment mode. At the same time, the promotion and implementation of hierarchical diagnosis and treatment provides institutional support and promotion for the perfection of day surgery management. Based on the experience from the Day Surgery Centre of General Hospital of Eastern Theater Command, this paper investigates the role of “gate-keepers” and recovery guidance in community and secondary hospitals in the perfection of day surgery in tertiary hospitals. Taking orthopedic day surgery as an example, which accounts for the largest proportion in day surgery in General Hospital of Eastern Theater Command, this paper aims to explore a feasible model of hierarchical diagnosis and treatment of day surgery, which specifies the responsibilities and works of hospitals at all levels.