Patellar instability can significantly influence the locomotor function in children with Down's syndrome. The aim of this study was to evaluate the mid-term results of the operative treatment of patellar instability in children with Down's syndrome. The study included eight children (10 operated knees) with Down's syndrome and associated patellar instability. The children's age ranged from 6 to 11 years (the mean age was 7 years 9 months). The operative treatment involved Green's quadricepsplasty in six cases (eight knees) and Green's quadricepsplasty augmented with a modified Galeazzi procedure - semitendinosus tenodesis - in two cases. The mean follow-up period was 3 years and 3 months. We achieved a stabilization of the patellofemoral joint and a correction of the position of the patella in seven knees (five of these were treated with Green's procedure and in two cases Green quadricepsplasty was combined with the Galeazzi procedure). We did not observe any recurrence of patellar dislocation in this group during the follow-up period. We noted two failures, defined as a recurrence of dislocation, during the mean of 9 months postoperatively. Green's quadricepsplasty provides satisfactory results in younger children with Down's syndrome. In older children, we recommend the modified Galeazzi procedure.
For children with DDH, the abduction brace is a safe and effective method of treatment and, although the infants begin to walk about 3 weeks later compared to healthy children, this practice does not seriously affect the child's locomotor development.
The aim of the study was to evaluate the relation between the activity of collagenase in the subchondral bone of the femoral head and the age of patients with hip osteoarthritis. Thirty-two patients were enrolled into the study. The mean age was 66 (range from 37 to 80 years). Bone samples of the femoral head were harvested during total hip replacement. The activity of collagenase was measured through spectrofluorimetry. We found statistically a significant correlation between collagenase activity in the bone and age. The mean activity of collagenase in younger patients (37-68 years) was 64.17 IU/microg. In older patients (69-80 years), the mean collagenase activity was 52.26 IU/microg. In patients with hip osteoarthritis the activity of collagenase in the subchondral bone of the femoral head tended to decrease with an increase in age.
In the XML version of the online publication the family name of the second author was incorrectly given as Pczek. In fact, the correct family name is Pączek.
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