The Novel Application of Three-Dimensional Printing Assisted Patient-Specific Instrument Osteotomy Guide in the Precise Osteotomy of Adult Talipes Equinovarus

Objective. This current research is aimed at assessing clinical efficacy and prognosis of three-dimensional (3D) printing assisted patient-specific instrument (PSI) osteotomy guide in precise osteotomy of adult talipes equinovarus (ATE). Methods. We included a total of 27 patients of ATE malformation (including 12 males and 15 females) from June 2014 to June 2018 in the current research. The patients were divided into the routine group ( n = 12 ) and 3D printing group ( n = 15 ) based on different operative methods. The parameters, including the operative time, intraoperative blood loss, complications, time to obtain bony fusion, functional outcomes based on American Orthopedic Foot and Ankle Society (AOFAS), and International Congenital Clubfoot Study group (ICFSG) scoring systems between the two groups were observed and recorded regularly. Results. The 3D printing group exhibits superiorities in shorter operative time, less intraoperative blood loss, higher rate of excellent, and good outcomes presented by ICFSG score at last follow-up ( P < 0.001 , P < 0.001 , P = 0.019 ) than the routine group. However, there was no significant difference exhibited in the AOFAS score at the last follow-up and total rate of complications between the two groups ( P = 0.136 , P = 0.291 ). Conclusion. Operation assisted by 3D printing PSI osteotomy guide for correcting the ATE malformation is novel and feasible, which might be an effective method to polish up the precise osteotomy of ATE malformation and enhance the clinical efficacy.

Patient-Specific Instrument Guided Double Chevron-Cut Distal Femur Osteotomy

The risk of non-union and prolonged periods of protected weight-bearing still remain unsolved issues after distal femur osteotomy (DFO). To improve the stability, we developed the double chevron-cut technique, which is a modified medial closing-wedge DFO guided by a patient-specific instrument. The purpose of this study was to investigate the feasibility and outcome of this operative approach. Twenty-five knees in twenty-three consecutive patients with genu valgum and lateral compartment osteoarthritis that received double chevron-cut DFO were included. The target of correction was 50% on the weight-bearing line (WBL) ratio. Patient-reported outcomes included the Oxford Knee Score (OKS) and the 2011 Knee Society Score (KSS). The mean of the WBL ratio was corrected from 78.7% ± 12.0% to 48.7% ± 2.9% postoperatively. The mean time to full weight bearing was 3.7 ± 1.4 weeks. Union of the osteotomy was achieved at 11.3 ± 2.8 weeks. At a mean follow-up of 17 months, the OKS improved from a mean of 27.6 ± 11.7 to 39.1 ± 7.5 (p = 0.03), and the KSS from a mean of 92.1 ± 13.0 to 143.9 ± 10.2 (p < 0.001). Three patients developed complications, including one case of peri-implant fracture, one of loss of fixation, and one of non-union. The double chevron-cut DFO followed by immediate weight-bearing as tolerated is effective in treating genu valgum deformity and associated lateral compartment osteoarthritis.

FORMAL ASPECT OF EDUCATION: CONVERSION OF THE SOFT POWER TO THE SUPPORT OF SPIRITUAL SECURITY OF TRAINEE (PRACTICAL VIEW)

The aim of the article is to think over author’s personal teaching experience. The object is a formal aspect of education - its organization & its process - which are ruled by basic documents, for example, standards or programs. It’s clear that they are the essential part & aspect of education. But sometimes they are underestimated by the lecturers & by students as well. It becomes the case for growth of resentment & misunderstanding in them that finally triggers negative reactions & lowers the efficiency of the work of each part. These days the negative reactions are used by global players to get their own goals which are achieved in the course of the war of a new type that got a specific name & term. Today it is called informational war in which the Russian Federation is involved. The review and the reassess the potential of the formal aspect of education is considered as one of the ways & sources to resist in a serious rival struggle & the form as itself - all the documents - are taken as a specific instrument that helps to weaken the pressure on young contemporaries’ minds - students of colleges & universities. The key to improve the effectiveness of educational and pedagogical work is opening & clearing up the students the essential & fundamental role of the basic, common known terms that stay hidden & unnoticed. These ideas could be helpful to provide spiritual security of young contemporaries & Russian society in general.

Evaluación del Desempeño Docente en el Aula desde la Perspectiva del Estudiante de la Licenciatura en Sistemas Computacionales de la Universidad Autónoma de Nayarit

En este trabajo se exponen resultados de dos evaluaciones del desempeño docente en el aula de los profesores de la Licenciatura en Sistemas Computacionales de la Universidad Autónoma de Nayarit. La evaluación tuvo como propósito el diseño y aplicación de un instrumento específico dirigido a recuperar información para la mejora continua de la práctica docente en el aula. El instrumento de recolección de datos se integró por 4 categorías correspondientes a indicadores de calidad del quehacer docente en el aula. Los resultados muestran que la mayoría de los docentes se ajustan a los criterios de las 4 categorías evaluadas, pero los hallazgos también indican que algunos profesores trabajan aún con un modelo tradicional que va desde criterios unilaterales de evaluación hasta pocas o nulas oportunidades que permitan potenciar el rendimiento de los estudiantes. This paper presents results of two evaluations of teacher performance in the classroom of teachers of the Degree in Computer Systems of the Universidad Autónoma de Nayarit. The purpose of the evaluation was to design and implement a specific instrument aimed at retrieving information for the continuous improvement of teaching practice in the classroom. The instrument was integrated by 4 categories corresponding to indicators of quality of the teaching task in the classroom. The results showed that most teachers meet the criteria of the four categories evaluated, but the findings also indicate that some teachers still work with a traditional model that ranges from unilateral evaluation criteria to few or no opportunities to enhance the performance of students.

The Results of Patient-Specific Instrument Guided Chevron-cut Distal Femur Osteotomy: A Retrospective Analysis

BackgroundDistal femur osteotomy (DFO) has been gaining popularity in treating subjects with genu valgum and the associated lateral compartment osteoarthritis. However, the risk of non-union and a period of protective weight bearing still remain unsolved even with the advent of locking plates. To improve the inherent stability of medial close-wedge DFO, we create bone cut in chevron shape with the guidance of a patient-specific instrument (PSI). The patients were allowed immediate weight-bearing as tolerated. The objective of the study was to assess the results of this technique.MethodsTwenty-five knees in twenty-three consecutive patients with genu valgum and lateral compartment osteoarthritis received chevron-cut medial close-wedge DFO. The alignment parameters of the knee, including the weight-bearing line (WBL) ratio, hip-knee-ankle angle (HKA), and mechanical lateral distal femoral angle (mLDFA) were assessed. We defined outliers as those with a difference of more than 10% from the targeted 50% WBL ratio. Patient-reported evaluation included the Oxford Knee Score (OKS), Knee Society Score (KSS), and a visual analog scale (VAS) pain scale.ResultsThe WBL ratio, HKA, and mLDFA were corrected from a mean of 78.7% ± 12.0%, 9.3° ± 2.8° valgus, and 83.6° ± 1.9° to 48.7% ± 2.9%, 0.5° ± 1.1° varus, and 91.4° ± 3.5° (respectively) postoperatively. A mean operative time of 58.8 ± 18.3 minutes, and 6.2 ± 1.3 intraoperative radiographs were taken. A mean Hb drop of 1.4 g/dl was found, while no patient required transfusion. Only one knee (4%) postoperatively fell in the defined range of correction outliers. Consolidation of the osteotomy was achieved at 11.3 ± 2.8 weeks. The OKS, KSS, and VAS pain scale were significantly improved compared with the pre-operative data. Complications developed in three patients, including one periprosthetic fracture, one loss of fixation, and a case of non-union.ConclusionThe PSI-guided chevron-cut close-wedge DFO, followed by immediate weight-bearing as tolerated is accurate, safe, and effective in the correction of genu valgum deformity and the associated lateral compartment osteoarthritis.Level of evidence IV