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Da E Maso - One of the best experts on this subject based on the ideXlab platform.
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factors influencing the development of Osteonecrosis in patients treated for slipped capital femoral epiphysis
Journal of Bone and Joint Surgery American Volume, 2003Co-Authors: Keti P Tokmakova, Robe P Stanto, Da E MasoAbstract:Background: Osteonecrosis is a serious complication of the treatment of slipped capital femoral epiphysis. The purpose of the present study was to identify factors influencing the development of Osteonecrosis. Methods: Two hundred and forty patients who had been treated for slipped capital femoral epiphysis between 1965 and 1999 were retrospectively evaluated. Treatment included stabilization with a spica cast or fixation with one to four pins or screws. Radiographs that had been made at the time of presentation, before and after the operation, and at consecutive follow-up examinations were reviewed. Osteonecrosis was defined retrospectively on the basis of radiographic evidence of sclerosis and collapse of the femoral head. The risk of development of Osteonecrosis was correlated with various clinical and radiographic parameters. Results: All twenty-one patients in whom Osteonecrosis developed had presented with an unstable slipped capital femoral epiphysis. None of the 204 patients who had presented with a stable slipped capital femoral epiphysis, regardless of grade, had development of Osteonecrosis. In the group of patients who had presented with an unstable slipped capital femoral epiphysis, the risk of development of Osteonecrosis increased with the severity (grade) of the slip. Osteonecrosis was more likely to develop in patients who had been treated with multiple pins than in those who had been treated with a single cannulated screw. Conclusions: Patients who have a stable slipped capital femoral epiphysis are not at risk for the development of Osteonecrosis when treated with pinning in situ. Patients who have an unstable slipped capital femoral epiphysis have a decreased risk of Osteonecrosis when treated with pinning in situ. Complete or partial reduction of an unstable slipped capital femoral epiphysis increases the risk of development of Osteonecrosis. Pinning in situ without reduction with a single cannulated screw is the method of choice for the treatment of a slipped capital femoral epiphysis. Level of Evidence: Therapeutic study, Level III-2 (retrospective cohort study). See Instructions to Authors for a complete description of levels of evidence.
Keti P Tokmakova - One of the best experts on this subject based on the ideXlab platform.
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factors influencing the development of Osteonecrosis in patients treated for slipped capital femoral epiphysis
Journal of Bone and Joint Surgery American Volume, 2003Co-Authors: Keti P Tokmakova, Robe P Stanto, Da E MasoAbstract:Background: Osteonecrosis is a serious complication of the treatment of slipped capital femoral epiphysis. The purpose of the present study was to identify factors influencing the development of Osteonecrosis. Methods: Two hundred and forty patients who had been treated for slipped capital femoral epiphysis between 1965 and 1999 were retrospectively evaluated. Treatment included stabilization with a spica cast or fixation with one to four pins or screws. Radiographs that had been made at the time of presentation, before and after the operation, and at consecutive follow-up examinations were reviewed. Osteonecrosis was defined retrospectively on the basis of radiographic evidence of sclerosis and collapse of the femoral head. The risk of development of Osteonecrosis was correlated with various clinical and radiographic parameters. Results: All twenty-one patients in whom Osteonecrosis developed had presented with an unstable slipped capital femoral epiphysis. None of the 204 patients who had presented with a stable slipped capital femoral epiphysis, regardless of grade, had development of Osteonecrosis. In the group of patients who had presented with an unstable slipped capital femoral epiphysis, the risk of development of Osteonecrosis increased with the severity (grade) of the slip. Osteonecrosis was more likely to develop in patients who had been treated with multiple pins than in those who had been treated with a single cannulated screw. Conclusions: Patients who have a stable slipped capital femoral epiphysis are not at risk for the development of Osteonecrosis when treated with pinning in situ. Patients who have an unstable slipped capital femoral epiphysis have a decreased risk of Osteonecrosis when treated with pinning in situ. Complete or partial reduction of an unstable slipped capital femoral epiphysis increases the risk of development of Osteonecrosis. Pinning in situ without reduction with a single cannulated screw is the method of choice for the treatment of a slipped capital femoral epiphysis. Level of Evidence: Therapeutic study, Level III-2 (retrospective cohort study). See Instructions to Authors for a complete description of levels of evidence.
Robe P Stanto - One of the best experts on this subject based on the ideXlab platform.
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factors influencing the development of Osteonecrosis in patients treated for slipped capital femoral epiphysis
Journal of Bone and Joint Surgery American Volume, 2003Co-Authors: Keti P Tokmakova, Robe P Stanto, Da E MasoAbstract:Background: Osteonecrosis is a serious complication of the treatment of slipped capital femoral epiphysis. The purpose of the present study was to identify factors influencing the development of Osteonecrosis. Methods: Two hundred and forty patients who had been treated for slipped capital femoral epiphysis between 1965 and 1999 were retrospectively evaluated. Treatment included stabilization with a spica cast or fixation with one to four pins or screws. Radiographs that had been made at the time of presentation, before and after the operation, and at consecutive follow-up examinations were reviewed. Osteonecrosis was defined retrospectively on the basis of radiographic evidence of sclerosis and collapse of the femoral head. The risk of development of Osteonecrosis was correlated with various clinical and radiographic parameters. Results: All twenty-one patients in whom Osteonecrosis developed had presented with an unstable slipped capital femoral epiphysis. None of the 204 patients who had presented with a stable slipped capital femoral epiphysis, regardless of grade, had development of Osteonecrosis. In the group of patients who had presented with an unstable slipped capital femoral epiphysis, the risk of development of Osteonecrosis increased with the severity (grade) of the slip. Osteonecrosis was more likely to develop in patients who had been treated with multiple pins than in those who had been treated with a single cannulated screw. Conclusions: Patients who have a stable slipped capital femoral epiphysis are not at risk for the development of Osteonecrosis when treated with pinning in situ. Patients who have an unstable slipped capital femoral epiphysis have a decreased risk of Osteonecrosis when treated with pinning in situ. Complete or partial reduction of an unstable slipped capital femoral epiphysis increases the risk of development of Osteonecrosis. Pinning in situ without reduction with a single cannulated screw is the method of choice for the treatment of a slipped capital femoral epiphysis. Level of Evidence: Therapeutic study, Level III-2 (retrospective cohort study). See Instructions to Authors for a complete description of levels of evidence.
N Athanasou - One of the best experts on this subject based on the ideXlab platform.
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Osteonecrosis in retrieved femoral heads after failed resurfacing arthroplasty of the hip
Journal of Bone and Joint Surgery-british Volume, 2005Co-Authors: C P Little, A Ruiz, I J Harding, P Mclardysmith, R Gundle, D W Murray, N AthanasouAbstract:We present the histological findings of bone retrieved from beneath the femoral components of failed metal-on-metal hip resurfacing arthroplasties. Of a total of 377 patients who underwent resurfacing arthroplasty, 13 required revision; for fracture of the femoral neck in eight, loosening of a component in three and for other reasons in two. None of these cases had shown histological evidence of Osteonecrosis in the femoral bone at the time of the initial implantation. Bone from the remnant of the femoral head showed changes of Osteonecrosis in all but one case at revision. In two cases of fracture which occurred within a week of implantation, the changes were compatible with early necrosis of the edge of the fracture. In the remaining six fractures, there were changes of established Osteonecrosis. In all but one of the non-fracture cases, patchy Osteonecrosis was seen. We conclude that histological evidence of Osteonecrosis is a common finding in failed resurfaced hips. Given that Osteonecrosis is extensive in resurfaced femoral heads which fail by fracture, it is likely to play a role in the causation of these fractures.
J Narvaez - One of the best experts on this subject based on the ideXlab platform.
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spontaneous Osteonecrosis of the knee associated with tibial plateau and femoral condyle insufficiency stress fracture
European Radiology, 2003Co-Authors: J Narvaez, E De Lama, A SanchezAbstract:The purpose of this article is to describe the association between spontaneous Osteonecrosis and insufficiency stress fractures of the knee. To determine whether insufficiency stress fracture is associated with spontaneous Osteonecrosis of the knee, we retrospectively reviewed the medical charts and imaging studies of all patients with spontaneous Osteonecrosis of the knee, studied by MR imaging, seen in a tertiary hospital over an 8-year period. Four women (age range 66–84 years) presented spontaneous Osteonecrosis of the knee associated with insufficiency stress fracture of the medial tibial plateau. One of these patients also presented a concomitant insufficiency stress fracture of the medial femoral condyle. Radiographs were diagnostic of spontaneous Osteonecrosis of the medial femoral condyle in three cases, and insufficiency stress fracture of the medial tibial plateau was detected in one case. Magnetic resonance imaging allows the diagnosis of both conditions in all four cases. Spontaneous Osteonecrosis of the knee may be associated with insufficiency stress fracture of the medial femoral condyle and the medial tibial plateau. This association provides additional arguments in favor of the traumatic etiology of spontaneous Osteonecrosis of knee.
