ABSTRACT
BACKGROUND: The purpose of this study was to analyze patients with adolescent idiopathic scoliosis (AIS) treated with bracing at The Royal Children's Hospital in Melbourne Australia according to the Scoliosis Research Society (SRS) criteria and evaluate the effectiveness of this treatment method. PATIENTS AND METHODS: During the 1 year survey 125 patients with AIS were treated with bracing and 52 (42 %) of those fulfilled the SRS criteria. Measurements were performed according to the follow-up visits at 6 and 12 months. RESULTS: The mean age of the patients was 13.1 years and the mean Cobb angle at the start of therapy was 31.8°. Thirtynine (76 %) patients were treated successfully and an improvement of the Cobb angle was achieved in 26 (51 %) patients. A further 6 patients (12 %) required surgery and 7 (14 %) showed a Cobb angle of more than 45° after reaching skeletal maturity. CONCLUSION: The results show the effectiveness of bracing as a treatment method for patients with AIS. The SRS criteria provide good guidance to classify patients who are likely to benefit from this treatment. A better comparison of the outcome with other studies can be achieved by using these criteria.
Subject(s)
Braces/statistics & numerical data , Braces/standards , Practice Guidelines as Topic , Scoliosis/epidemiology , Scoliosis/rehabilitation , Adolescent , Female , Guideline Adherence/statistics & numerical data , Humans , Male , Prevalence , Radiography , Retrospective Studies , Risk Factors , Scoliosis/diagnostic imaging , Treatment Outcome , Victoria/epidemiologyABSTRACT
BACKGROUND: The Bernese periacetabular osteotomy (PAO) is a popular option for treating symptomatic acetabular dysplasia. We noted symptomatic impingement after PAO in several male patients. QUESTIONS/PURPOSES: We therefore determined (1) the incidence of clinical signs of FAI after PAO in the male population; and (2) whether any factors were associated with the positive impingement signs after PAO in males. PATIENTS AND METHODS: We retrospectively reviewed 38 males who underwent 46 periacetabular osteotomies (PAO) between 2000 and 2007. Clinical and radiographic data were analyzed with the focus on pre- and postoperative incidence of femoroacetabular impingement. Minimum followup was 12 months (average, 43 months; range, 12-90 months). RESULTS: We found a positive impingement sign in 19 of the 46 hips during the preoperative examination compared to 22 (47.8%) hips postoperatively. The ROM (flexion and internal rotation) decreased postoperatively compared to preoperatively. Radiographic parameters of coverage LCE-, ACE- and Tönnis angle improved into the normal range. Twenty hips had postoperative heterotopic ossification to varying degrees, mostly minor. WOMAC scores improved in the function and pain domains postoperatively. CONCLUSIONS: Despite normalization of coverage we found a high postoperative rate of clinical signs of FAI after PAO in males. LEVEL OF EVIDENCE: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
