[Show abstract][Hide abstract] ABSTRACT: We evaluated the clinical and radiological results of one-stage correction for cerebral palsy patients.
We reviewed clinical outcomes and radiologic indices of 32 dysplastic hips in 23 children with cerebral palsy (13 males, 10 females; mean age, 8.6 years). Ten hips had dislocation, while 22 had subluxation. Preoperative Gross Motor Function Classification System (GMFCS) scores of the patients were as follows; level V (13 patients), level IV (9), and level III (1). Acetabular deficiency was anterior in 5 hips, superolateral in 7, posterior in 11 and mixed in 9, according to 3 dimensional computed tomography. The combined surgery included open reduction of the femoral head, release of contracted muscles, femoral shortening varus derotation osteotomy and the modified Dega osteotomy. Hip range of motion, GMFCS level, acetabular index, center-edge angle and migration percentage were measured before and after surgery. The mean follow-up period was 28.1 months.
Hip abduction (median, 40°), sitting comfort and GMFCS level were improved after surgery, and pain was decreased. There were two cases of femoral head avascular necrosis, but no infection, nonunion, resubluxation or redislocation. All radiologic indices showed improvement after surgery.
A single event multilevel surgery including soft tissue, pelvic and femoral side correction is effective in treating spastic dislocation of the hip in cerebral palsy.
Clinics in orthopedic surgery 06/2012; 4(2):139-48.
[Show abstract][Hide abstract] ABSTRACT: To determine whether the marrow conversion index (MCI) in MRI is related to the total number of mononuclear and mesenchymal stem cells (MSCs) in proximal femoral metaphysis of patients with hip osteoarthritis.
Thirty-two hips of 32 consecutive patients who underwent total hip arthroplasty (THA) for hip osteoarthritis were included in this study. MRI of the hip was performed preoperatively and MCI was subsequently calculated. Three-milliliter bone marrow samples were obtained from the proximal femur during THA and the number of total mononuclear cells was determined using a hemocytometer. Colony forming unit-fibroblasts (CFU-Fs) assays of MSCs were performed by transferring a total of 2 × 10(4) mononuclear cells to each of five 60-mm plates. One week later, the numbers of colonies were counted.
The total number of mononuclear cells decreased with increasing MCI. Likewise, the prevalence and total number of CFU-Fs increased with increasing number of total mononuclear cells, and decreased with increasing MCI.
Our results suggest that measurement of MCI in MRI can be an objective and noninvasive method to predict marrow cellularity and the number of MSCs in patients with hip osteoarthritis.
Journal of Magnetic Resonance Imaging 01/2012; 35(1):218-22. · 2.57 Impact Factor