RESUMO
BACKGROUND: In high tibial osteotomy, planning is critical for achieving successful realignment. Any method selected needs to be reliable, with inter-observer and intra-observer correlation. A literature review demonstrated two distinct methods of planning for high tibial osteotomy. HYPOTHESIS: Both methods are precise and show excellent inter and intra-observer correlation. METHOD: Fifty consecutive weight-bearing long leg alignment antero-posterior (AP) radiographs were identified and planning undertaken on suitable radiographs using the methods of Puddu (method 1) and Miniaci (method 2). Two observers, one junior trainee and one Specialist Knee Fellow, recorded measurements to calculate inter and intra-observer correlation. RESULTS: Thirty-two radiographs were included. Inter-observer and intra-observer correlation, and correlation between the two methods were all greater than 0.97 (p<0.0001). CONCLUSION: Our results show excellent correlation between both methods and both observers. Both methods are reliable for planning and can be performed by both junior trainees and subspecialists. Further work should consider how planning can ensure adequate intraoperative correction.
Assuntos
Articulação do Joelho/diagnóstico por imagem , Osteotomia/métodos , Tíbia/cirurgia , Competência Clínica , Feminino , Humanos , Articulação do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Osteoartrite do Joelho/cirurgia , Reprodutibilidade dos Testes , Suporte de CargaRESUMO
BACKGROUND: Although a regular course of the conduction system is anticipated in hearts with pulmonary atresia and intact ventricular septum (PAIVS), it has never been demonstrated anatomically. In view of one of the surgical options in repair being debulking of the right ventricular wall, it is important to establish the location of the major conduction pathways. METHODS: Four hearts belonging to fetuses aged 18, 20, 22, and 29 weeks were examined. Entire hearts were serially sectioned and step sections were stained. The sinus node and atrioventricular conduction bundles were identified and their locations described. RESULTS: The conduction system in hearts with PAIVS is similar to that in normal hearts, although there was a minor variation in one of them. This was a heart affected by Ebstein malformation of the tricuspid valve. In this case, the right bundle branch terminated abruptly soon after its origin. CONCLUSIONS: Confirmation of the regular course of the cardiac conduction system is important to the development of strategies for surgical repair of PAIVS.
