Results: The mean kyphosis correction obtained was 62.5% with the mean post-operative kyphosis angle reducing to 24.1 (range 5 ± 60). At a mean follow-up of 5.8 years (4 ± 7 years) the mean kyphosis angle loss was 3.28 (range 0 ± 58). Of the 23 patients with neurological de®cit, recovery was seen in 21 cases (91.3%) while deterioration was seen in one case (4.3%). The remaining ®ve patients were neurologically intact pre-operatively. Bony fusion was seen in all cases at 9 months. One patient with subpulmonary function died post-operatively (mortality 3.5%).
Conclusion:The results of our series are encouraging. However single stage decompression with fusion and kyphosis correction is a very demanding surgery and should be performed after taking into account the risks and bene®ts involved. This surgery perhaps prevents progression of neurological de®cit and recurrence of late onset paraplegia in these complex cases in developing countries. Spinal Cord (2001) 39, 429 ± 436
Prophylactic stabilization with internal fixation of the asymptomatic hip in unilateral slipped upper femoral epiphysis is controversial. We present a retrospective analysis of 65 patients who had prophylactic fixation of the uninvolved hip at the same time as their opposite slipped femoral physis. None had an underlying systemic or endocrine abnormality and the average age was 12.5 years (range 11-15 years). A single 7.0 mm cannulated cancellous screw was used in all patients. The average time to fusion was 18 months (range 6-36 months) and duration of follow up ranged from 5 to 8 years (mean 6.5 years). None of the patients had implant removal and at latest review did not show any evidence of chondrolysis, avascular necrosis, premature physeal arrest or secondary arthrosis in the prophylactically fixed hip. One patient (1.5%) developed a superficial wound infection, which was successfully treated by antibiotics. This study demonstrates the safety of prophylactic fixation using a single cannulated cancellous screw and we recommend it for prevention of delayed slip and hence secondary osteoarthrosis.
In 170 total knee arthroplasties for osteoarthritis 71 did not receive a patellar replacement (group A), while 99 knees had a cemented polyethylene patella (group B). The mean follow-up time was 36 months (30-50 months). In group A 10 patients underwent second-stage patellar resurfacing and in group B 2 knees underwent revision of the patellar component. Radiologically the average patellar congruency was similar. In both groups there were 21 non-congruent knees. In group A 8 were symptomatic and had low scores compared to 2 in group B (P<0.05). The mean HSS score and patellar score were higher in group B than in group A (P<0.05).
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