RESUMO
Radiation therapy is used for the palliative treatment of malignant tumors and the radiation induced osteonecrosis is one of the well documented complications. Especially, in pelvic region, there are a few reports for osteonecrosis of the femoral head and acetabulum after the radiation therapy for the the malignant tumors such as cervical carcinoma or prostatic cancer. Roentgenographic changes that are caused by radiation include the rarefaction of bone and coarsening of the trabeculae. The radiolucencies tend to coalesce and patchy sclerosis appears. In acetabular region, this Pagetoid appearance mimics the findings of other malignant bone tumors, the recurrence of preexisting malignant peivic tumors and other infectious condition. After the diagnosis is confirmed, the treatment for the femoral head and acetabulum is also difficult. The authors report one case of osteonecrosis of the femoral head and acetabulum following radiation therapy which had many difficulties in its diagnosis and treatment.
Assuntos
Acetábulo , Diagnóstico , Cabeça , Osteonecrose , Cuidados Paliativos , Pelve , Neoplasias da Próstata , Recidiva , EscleroseRESUMO
We analyzed the factors of importance for nonunion in series of 91 open fractures of tibial diaphysis which were treated with external fixation. Factors analyzed included, age and sex of the patients, the mechanism of injury, the amount of soft tissue damage, the grade of comminution, the level at which the tibia was fractured, the presence of an intact fibula, the presence of the multiple injuries, the type of the external fixation used(AO external fixator, EXTOR; monotube external fixator, Ilizarov), and the need to supplement the stability of the reduction. We found that the amount of soft tissue damage and comminution of the fracture played a role in the development of the nonunion.
Assuntos
Humanos , Diáfises , Fixadores Externos , Fíbula , Fraturas Expostas , Traumatismo Múltiplo , Tíbia , Fraturas da TíbiaRESUMO
The aim of the present study was to investigate the mRNA expression of several cytokines which were not reported previously from interface tissues around loose cemented acetabulum to obtain better understanding of the biological mechanisms connected with aseptic loosening and osteolysis of THA. We investigated mRNA expression for several cytokines (interleukin-1 alpha [IL-l~a], IL-lp, IL-2, IL-2 receptor[2R], IL-4, IL-5, IL-8, IL-10, transforming growth factor-beta [TGF-p], and interferon- gamma [IFN-y]) by reverse transcription-polymerase chain reaction (RT-PCR) and release of metalloproteinase (MMP)-2 and MMP-9 from the cement-bone interface tissues around five loose polyethylene acetabular components. We did not include TNF-a and IL-6 because the biologic effect of the former is so similar to that of IL-1, and the latter fails to stimulate prostaglandin E, or collagenase production by fibroblsts or synovial cells. Expression of mRNA for IL-1p was detected in four, IL-2R and IL-8 in three, IL-10 and TGF-p in two of five interface tissues .No expression of mRNA for IL-la, IL-2, IL-4, IL-5, and IFN-p was detected. Zymographic analysis for gelatinase/type IV collagenase revealed gelatinolytic bands corresponding to metalloproteinase(MMP)-2 and MMP-9 in cemenl-bone interface tissues. Activated cells phagocytose particles in cement-bone interface tissues expressed more cytokines mRNA than previously known to be related to periprosthetic bone resorption, and secreted metalloproteinases associated with extracellular matrix degradation and fibrosis.
Assuntos
Acetábulo , Artroplastia de Quadril , Reabsorção Óssea , Colagenases , Citocinas , Matriz Extracelular , Fibrose , Interleucina-1 , Interleucina-10 , Interleucina-2 , Interleucina-4 , Interleucina-5 , Interleucina-6 , Interleucina-8 , Metaloproteases , Osteólise , Polietileno , RNA MensageiroRESUMO
The aim of investigation is to calculate the mean value of the acetabular anteversion of normal Korean adult after closure of growth according to different gender and sex age group, to find out any significant difference of the value of acetabular anteversion to some other variables such as age, height, weight and radiographic inclination(abduction angle) of acetabulum. Transverse pelvic computed tomography(CT) scans of 360 right hips with no known pathology were examined. The study population consisted of 12 groups by gender (male and female) and age(from third to eighth decade). The number of each group was thirty. The scanning slice nearest the middle region of the acetabulum (nearest through the center of the femoral head) on the scout film was chosen. A measuring point was assigned at the anterior edge of the acetabulum and second at the posterior edge. The line connecting these points was drawn. The angle formed by this line and the plane sagittal to the pelvis was determined as acetabular anteversion. The data analysis was run on a statistical analysis system(SAS). The mean value of acetabular anteversion 19.8±5.4 degrees(17.1±5.6 in males, 22.2±5.4 in females), it was greater significantly in females than in males (p=0.0001). The mean value of acetabular anteversion in third decade male group than the third, fourth and fifth decade group significantly(p < 0.05). The mean value of acetabular anteversion of Koreans was similar to Caucasians value. The value of acetabular anteversion was relatively releated to age. In conclusion, the acetabular anteversion of Korean females was larger than the Korean males. It was increased with aging. When we perform the total hip arthroplasty and pelvic osteotomy or reorientation procedure, we must consider the acetabular anteversion by different gender and age group.