ABSTRACT: The aims of the present study were to describe the technique of hip arthroscopy for osteochondral loose body removal after posterior hip dislocation and report its preliminary results.
We reported consecutive patients undergoing hip arthroscopy for osteochondral fragment after sustaining fracture-dislocations. Seven patients who sustained traumatic hip dislocation with incarcerated osteochondral were included in this study. All patients had standard AP pelvis x-rays and 3D-CT scans. After closed reduction, all patients underwent hip arthroscopy in which loose bodies were removed and labral pathology debrided.
The mean follow-up was 15.7 months. The average Harris Hip Score was 89.8. No patient developed any of the complications commonly associated with arthrotomy including avascular necrosis, heterotopic ossification, and nerve injury.
Arthroscopic treatment of intra-articular loose bodies after hip fracture-dislocations allows excellent visualization of the joint and facilitated straightforward removal of the fragment.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 12/2009; 92 Suppl 6:S161-4.
ABSTRACT: The undercarboxylated osteocalcin (ucOC) level is increased in the elderly and postmenopausal women compared with the young, healthy, and reproductive women. The high level of serum UcOC reflects the vitamin K2 deficiency which not only results in high skeletal turnover, low bone quality, and low bone density, but also increases a risk of fracture. The objective of the study is to measure the ucOC level, the 25-hydroxy vitamin D (25(OH)D) levels, and the prevalence of vitamin K2 and vitamin D deficiency in Thai female patients with hip fracture. The serum UcOC and 25(OH)D levels of the 40 female patients with hip fracture (the mean age 77.2 +/- 9.7 years) were measured and compared to the control group of the 47 randomly selected female volunteers (the mean age 75.2 +/- 8.1 years) without osteoporosis-related problems. The serum level of UcOC (median) in the female patients with hip fracture was significantly higher than the control group (p = 0.0001). Fifty-three percent had the serum UcOC level above the cut-off point at 2.314 ng/ml and 83% had lower serum 25(OH)D than the cut-off point at 30 ng/ml. The serum UcOC levels; however, were not correlated with 25(OH)D levels (r = 0.191, p = 0.237). The high prevalence of vitamin K2 and vitamin D deficiency was found in the Thai female patients with hip fracture. The additional treatment with vitamin K2 supplement besides calcium and vitamin D is a beneficial effect for osteoporosis.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 09/2009; 92 Suppl5:S7-11.
ABSTRACT: Radiographic templates have been developed to assist with the preoperative planning process. However, the clinical usefulness of preoperative templating in total knee replacement is still lacking. The present study aims to evaluate the accuracy of preoperative templating in primary total knee replacement.
A retrospective study of 98 patients and 113 knees was carried out. Both the anteroposterior and lateral radiographic views were templated using the templates for DePuy Sigma PFC, fixed bearing total knee system and the template size was documented for each patient pre-operatively. The operative records were then reviewed to determine the size of the implant used during the operation.
The overall accuracy between the preoperative template size and the final implant size was 50.4% for the femoral component and 55.8% for the tibial component. The highest prediction for tibial assessment was the anteroposterior view and the lateral intercondylar view for femoral assessment.
Approximately 50% of the patients had a preoperative template size that matched the actual implant used. Many factors influence the final choice of the prosthesis used during total knee replacement; therefore, the preoperative template size can only be used as a rough guide.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 12/2007; 90(11):2338-43.