[Congenital dislocation of knee: results of the treatment in 29 cases between 1970 and 2010 years at Shafa Yahyaian Hospital in Tehran]

There are not many reports regarding the treatment approaches of congenital dislocation of the knee in the literature. Therefore, the preferred method of treatment of this rare congenital disease is still controversial. Hereby, we report the treatment outcome of 29 patients admitted in Shafa Yahyaian Hospital during 40 years. In this retrospective study done in Shafa Yahyaian Hospital in Tehran, Iran during 2010, we retrospectively reviewed the medical records of 29 patients treated conservatively or surgically for congenital dislocation of the knee. Patients had been evaluated for an average follow-up of 8.5 years. Overall, 54 knee dislocations had been treated surgically [58%] or conservatively [42%]. Range of knee motion, persistent recurvatum, instability, valgus deformity after treatment and limping were the more important factors reported in the two surgically or conservatively treated groups. Knee function was satisfactory in patients with conservative treatment. Despite 80% of instability in the operated knees, patients could ambulate with or without braces and had a range of motion equal to 80 degrees. Knee function was also good after quadricepsplasty with transarticular pins in selected cases. We recommend a conservative approach to the disease, regardless of the patient's age at the time of treatment and subsequent surgery in patients with dissatisfactory recovery. Quadricepsplasty with transarticular fixation is recommended as a good option in treating these patients. Posterior capsulorrhaphy for patients with CDK and ligamentous laxity is also recommended

[Bone mineral density of girls with idiopathic scoliosis: a comparative study]

Several studies have suggested higher incidence of osteoporosis in patients with idiopathic scoliosis in comparison with the normal population. The aim of this study was to assess the prevalence of low bone mass among adolescent girls with idiopathic scoliosis. In this cross-sectional study performed in shafa Hospital in Tehran, Iran during 2011-2012, we recruited fifty-seven 12- to-20-year old girls with idiopathic scoliosis and compared them with 100 age-matched healthy girls. The patients had no other diseases including neuromuscular disorders, congenital vertebral anomalies or a history of spinal surgery. Bone mineral densities [BMD] of the hip and spine were evaluated and compared in all 157 participants using dual X-ray absorptiometry [DXA]. Standard BMD [sBMD] was also calculated at the lumbar spine. Analysis of the data revealed that hip BMD was significantly [P=0.004] lower in patients with idiopathic scoliosis versus the controls. Moreover, BMD and sBMD of the Spine were also significantly lower in the patients [respectively, P=0.030 and P=0.030]. Curve location had no effect on the values of hip BMD, spine BMD or spine sBMD [respectively, P=0.061 and P=0.274 and P=0.208]. Finally, with more severe curves a lower bone mass was detected for sBMD and spine BMD [respectively, P=0.017 and P=0.016], but it was not significant for hip BMD [P=0.069]. Adolescent girls with idiopathic scoliosis had lower bone mass compared with their healthy peers. The lower bone mass was correlated with the severity of the curve but not its location.