ABSTRACT
AIMS: The influence of identifiable pre-operative factors on the outcome of eccentric rotational acetabular osteotomy (ERAO) is unknown. We aimed to determine the factors that might influence the outcome, in order to develop a scoring system for predicting the prognosis for patients undergoing this procedure. PATIENTS AND METHODS: We reviewed 700 consecutive ERAOs in 54 men and 646 women with symptomatic acetabular dysplasia or early onset osteoarthritis (OA) of the hip, which were undertaken between September 1989 and March 2013. The patients' pre-operative background, clinical and radiological findings were examined retrospectively. Multivariate Cox regression analysis was performed using the time from the day of surgery to a conversion to total hip arthroplasty (THA) as an endpoint. A risk score was calculated to predict the prognosis for conversion to THA, and its predictive capacity was investigated. RESULTS: The congruity of the hip, age, the pre-operative minimum width of the joint space and range of abduction were identified as factors predicting conversion to THA. For three groups of patients (scoring 0 to 5, 6 to 7, and 8 to 9 points), the Kaplan-Meier event-free rates of survival at 15 years post-operatively for conversion to THA were 99.6%, 85.2% and 67.3%, respectively. CONCLUSION: These four pre-operative factors are easily measured and predict the prognosis for patients following ERAO. They may be used for decision making when offering surgical treatment to patients with acetabular dysplasia and early onset osteoarthritis. Cite this article: Bone Joint J 2016;98-B:1326-32.
Subject(s)
Acetabulum/surgery , Hip Dislocation, Congenital/surgery , Hip Joint/surgery , Osteoarthritis, Hip/surgery , Osteotomy/methods , Range of Motion, Articular/physiology , Acetabulum/diagnostic imaging , Adolescent , Adult , Child , Female , Follow-Up Studies , Hip Dislocation, Congenital/diagnosis , Hip Dislocation, Congenital/physiopathology , Hip Joint/diagnostic imaging , Hip Joint/physiopathology , Humans , Male , Middle Aged , Osteoarthritis, Hip/diagnosis , Osteoarthritis, Hip/physiopathology , Preoperative Period , Prognosis , Radiography , Retrospective Studies , Time Factors , Young AdultABSTRACT
The reversion-inducing cysteine-rich protein with Kazal motifs (RECK) gene had been isolated as an antagonist to RAS signaling; however, the mechanism of its action is not clear. In this study, the effect of loss of RECK function was assessed in various ways and cell systems. Successive cell cultivation of mouse embryonic fibroblasts (MEFs) according to 3T3 protocol revealed that the germline knockout of RECK confers accelerated cell proliferation and early escape from cellular senescence associated with downregulation of p19(Arf), Trp53 and p21(Cdkn1a). In contrast, short hairpin RNA-mediated depletion of RECK induced irreversible growth arrest along with several features of the Arf, Trp53 and Cdkn1a-dependent cellular senescence. Within 2 days of RECK depletion, we observed a transient increase in protein kinase B (AKT) and extracellular signal-regulated kinase (ERK) phosphorylation associated with an upregulated expression of cyclin D1, p19(Arf), Trp53, p21(Cdkn1a) and Sprouty 2. On further cultivation, RAS, AKT and ERK activities were then downregulated to a level lower than control, indicating that RECK depletion leads to a negative feedback to RAS signaling and subsequent cellular senescence. In addition, we observed that epidermal growth factor receptor (EGFR) activity was transiently upregulated by RECK depletion in MEFs, and continuously downregulated by RECK overexpression in colon cancer cells. These findings indicate that RECK is a novel modulator of EGFR signaling.
Subject(s)
Cellular Senescence/genetics , ErbB Receptors/metabolism , GPI-Linked Proteins/metabolism , Animals , Cell Proliferation , Cells, Cultured , Colonic Neoplasms/genetics , Cyclin D1/metabolism , Cyclin-Dependent Kinase Inhibitor p16/metabolism , Down-Regulation , Extracellular Signal-Regulated MAP Kinases/metabolism , Fibroblasts/metabolism , GPI-Linked Proteins/genetics , Mice , Mice, Inbred C57BL , Mice, Knockout , Nerve Tissue Proteins/metabolism , Proto-Oncogene Proteins c-akt/metabolism , RNA, Small Interfering/metabolism , Signal Transduction , Tumor Suppressor Protein p53/metabolism , p21-Activated Kinases/metabolismABSTRACT
Dysplasia epiphysealis hemimelica (DEH) on bilateral medial malleoli occurred in a boy who had polydactylies and syndactylies of all four limbs. Cases with both bilateral and symmetrical DEH affection as in this case seem not to have been reported previously in the literature. Dysplasia epiphysealis hemimelica complicated by congenital anomalies is extremely rare. A one-month-old boy of normal delivery had polydactylies of thumbs, small fingers, and great toes, and had symmetrical syndactylies of fingers and toes. At age eight, the patient reported swelling and tenderness on bilateral medial malleoli. Radiographs showed small blotches of radiopacity. Two years later, the radiopacities had enlarged to become typical of DEH.
Subject(s)
Abnormalities, Multiple , Chondrodysplasia Punctata/complications , Polydactyly/complications , Syndactyly/complications , Humans , Infant , Male , SyndromeABSTRACT
We studied the free gait of children by analyzing the wave pattern of the ground reaction force (GRF) and measuring time and distance parameters using large force plates. Two hundred and forty-one normal children, age 4-10 years, were included. Normalized waves of each subject were obtained by computer. Waves are composed of fore-aft, medial-lateral, and vertical components. We took nine specific points on these waves and analyzed the values of specific points and time and distance measurements. We found significant changes of these parameters up to approximately 8 years of age. These findings serve as GRF control data and are useful in evaluating pathological gaits.
