Purpose This study assessed whether avascular necrosis (AVN) is correlated with the presence or absence of the ossific nucleus (ON) at the initiation of conservative treatment for developmental dysplasia of the hip (DDH). To date, the correlation between the presence of the ON and AVN manifestations remains ambiguous. Methods The medical records of 148 patients with 234 dislocated hips who presented at our institution between January 2006 and December 2007 were reviewed. Based on ultrasound examination, the hips were classified according to Graf IIIa, IIIb, and IV criteria. Patients aged [6 months were simultaneously examined by standardized pelvis radiography. Results The ON was present in 84 hips (35.9 %) at the beginning of treatment. Treatment was begun at a mean age of 5 months, with overhead traction for 2 weeks followed by arthrography and a spica cast for 4 weeks. Afterwards, we used a Tübingen hip-flexion splint. The mean age at final follow-up was 87 months. Hips were radiographically evaluated at last follow-up according to the Ogden-Bucholz AVN classification scheme. There was no significant difference in AVN prevalence between ON -versus ON ? hips in children aged B10 months (P = 0.681), whereas when all age groups were analyzed together, AVN was significantly increased in ON ? hips (P = 0.002). Clinical examination revealed no differences in limping, leg length inequality, and range of motion of hips in the ON -versus ON ? groups. Conclusion We conclude that DDH treatment should be performed early without regard to the presence or absence of the ON. Reduction should not be delayed beyond [10 months of age because any delay in treatment increases the incidence of AVN.
The findings in this study indicate that ACLD knee may adapt functionally to prevent excessive anterior-posterior translation but they fail to avoid rotational instability.
Traumatic injuries of the peripheral nerves are very common. Surgical repair of the damaged nerve is often complicated by scar tissue formation around the damaged nerve itself. The main objective of this study is to present the recent data from animal experimental studies where pharmacological topical agents are used at the site of peripheral nerve repair. Some of the most commonly topical agents used are tacrolimus (FK506), hyaluronic acid and its derivatives, and melatonin, whereas methylprednisolone and vitamin B12 have been used less. These studies have shown that the abovementioned substances have neuroprotective and neuroregenerative properties though different mechanisms. The successes of the regenerative process of the nerve repair in experimental research, using topical agents, can be evaluated using variety of methods such as morphological, electrophysiologic, and functional evaluation. However, most authors agree that despite good microsurgical repair and topical application of these substances, full regeneration and functional recovery of the nerve injured are almost never achieved.
Following ACL reconstruction, patients have better clinical and kinematic parameters. Despite improvements, knee kinematics during gait in the ACLR group differed from the control group. These kinematic changes could lead to abnormal loading in the knee joint and initiate the process for future chondral degeneration.
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