RESUMO
BACKGROUND: This study examined the results of open wedge high tibial osteotomy with using an Aescula open wedge plate and an allogenic bone graft as a surgical technique for the patients who suffer from osteoarthritis of the knee with a genu varum deformity. METHODS: From March 2007 to August 2007, 33 patients (37 cases) with osteoarthritis of the knee and a genu varum deformity underwent a high tibial osteotomy with using an Aescula open wedge plate and an allogenic bone graft. The patients were followed up for more than 1 year. Before and after surgery, the correction angle of the genu varum was measured by the lower extremity scannogram and the posterior tibial slope, the joint space distance and the time to bone union were evaluated. The functional factors were evaluated using the Knee Society Score. RESULTS: The average knee score and function score improved from 52.19 +/- 11.82 to 92.49 +/- 5.10 and 52.84 +/- 6.23 to 89.05 +/- 5.53, respectively (p < 0.001). According to the lower extremity scannogram, the mean preoperative varus angle was -1.86 +/- 2.76degrees, and the average correction angle at the last follow-up was 10.93 +/- 2.50degrees (p < 0.001). The tibial posterior slope before surgery and at the last follow-up were 8.20 +/- 1.80degrees and 8.04 +/- 1.30degrees, respectively (p = 0.437). The joint space distance increased from 4.05 +/- 1.30 mm to 4.83 +/- 1.33 mm (p < 0.001). The average time to complete bone union was 12.69 +/- 1.5 weeks. CONCLUSIONS: An open wedge high tibial osteotomy using an Aescula open wedge plate and an allogeneic bone graft to treat osteoarthritis of the knee with a genu varum deformity showed good results for the precision of the correction angle, the time to bone union and the functional improvement.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Artroscopia , Placas Ósseas , Transplante Ósseo , Deformidades Articulares Adquiridas/diagnóstico , Articulação do Joelho , Procedimentos Ortopédicos/métodos , Osteoartrite do Joelho/complicações , Osteotomia/métodos , Tíbia/diagnóstico por imagem , Transplante HomólogoRESUMO
A 7-yr-old girl presented with progressive shortening of the right upper arm and limitation of shoulder motion. Pseudohypoparathyroidism associated with Albright's hereditary osteodystrophy was diagnosed by biochemical, hormonal and radiographic studies. Her condition was complicated by severe humerus varus on the right side. Proximal humeral valgization osteotomy and concomitant humeral lengthening resulted in an improvement of the shoulder joint motion and activity in daily life.
Assuntos
Criança , Feminino , Humanos , Doenças Ósseas/complicações , Doenças do Desenvolvimento Ósseo/diagnóstico , Alongamento Ósseo , Pé/diagnóstico por imagem , Mãos/diagnóstico por imagem , Úmero/diagnóstico por imagem , Deformidades Articulares Adquiridas/diagnóstico , Osteotomia , Pseudo-Hipoparatireoidismo/complicações , Fatores de TempoRESUMO
La melorreostosis es considerada una enfermedad poco frecuente, que se caracteriza por lesiones en forma de escurrimientos de cera o sea imágenes de osteoesclerosis distribuidas a lo largo del eje mayor de los huesos. Puede involucrar articulaciones, tener invasión a tejidos blandos, produciendo fibrosis y dando como resultado contracturas y angulaciones de las extremidades afectadas. Presentamos el caso de una paciente de 17 aÏos de edad la cual sufre lumbalgia ocasional, acortamiento del miembro pélvico derecho y genu valgus del mismo, todo esto progresivo desde su infancia.Los estudios radiográficos muestran una imagen de escurrimiento de cera sugestiva de esta enfermedad en cadera y fémur derecho. Discutimos el origen de esta lesión y revisamos la literatura médica disponible.