To avoid early osteoarthritis, surgery correction of residual subluxation is recommended when the RI >38% at the age of 3-4 years or the RI >33% with the sourcil upward at the age of 4-5 years.
Intraoperative arthrogram-determined FHC is an alternative predictor of residual hip dysplasia after CR of DDH and FHC ≤30% can be considered the criterion for unacceptable reduction.
Aims Eccentric reductions may become concentric through femoral head ‘docking’ (FHD) following closed reduction (CR) for developmental dysplasia of the hip (DDH). However, changes regarding position and morphology through FHD are not well understood. We aimed to assess these changes using serial MRI. Methods We reviewed 103 patients with DDH successfully treated by CR and spica casting in a single institution between January 2016 and December 2020. MRI was routinely performed immediately after CR and at the end of each cast. Using MRI, we described the labrum-acetabular cartilage complex (LACC) morphology, and measured the femoral head to triradiate cartilage distance (FTD) on the midcoronal section. A total of 13 hips with initial complete reduction (i.e. FTD < 1 mm) and ten hips with incomplete MRI follow-up were excluded. A total of 86 patients (92 hips) with a FTD > 1 mm were included in the analysis. Results At the end of the first cast period, 73 hips (79.3%) had a FTD < 1 mm. Multiple regression analysis showed that FTD (p = 0.011) and immobilization duration (p = 0.028) were associated with complete reduction. At the end of the second cast period, all 92 hips achieved complete reduction. The LACC on initial MRI was inverted in 69 hips (75.0%), partly inverted in 16 hips (17.4%), and everted in seven hips (7.6%). The LACC became everted-congruent in 45 hips (48.9%) and 92 hips (100%) at the end of the first and second cast period, respectively. However, a residual inverted labrum was present in 50/85 hips (58.8%) with an initial inverted or partly inverted LACC. Conclusion An eccentric reduction can become concentric after complete reduction and LACC remodelling following CR for DDH. Varying immobilization durations were required for achieving complete reduction. A residual inverted labrum was present in more than half of all hips after LACC remodelling. Cite this article: Bone Joint J 2023;105-B(2):140–147.
AIM To determine whether study on the carcinogenic potential of reflux juice from patients with remote gastrectomy could clarify the inherent relationship between duodenal reflux and gastric stump cancer. METHODS A total of 37 reflux juice samples (13 BillrothI, 24 BillrothII) were employed in the present study. A two-stage transformation assay using BALB/c 3T3 cells was carried out to test the initiating or promoting activity of these samples. RESULTS Two of 18 (11.1%) reflux samples exerted initiating activities, whereas 9/19 (47. 4%) samples enhanced the MNNG-initiating cell transformation, suggesting the duodenal reflux juice might more frequently possess the tumorpromoter activity (P = 0.029). In addition, there was no difference in initiating activities of the samples irrespective of surgical procedures (P = 0.488), while Billroth II samples exhibited stronger tumor-promoter activity than Billroth I samples (P = 0.027). Furthermore, the promoter activities were well correlated with the histological changes of the stomas (r s = 0.625, P = 0.004), but neither their cytotoxicities nor initiating activities had this correlation (Probabilities were 0.523 and 0.085, respectively
BackgroundKnee injury and osteoarthritis (OA) are common articular disorders that affect numerous people of different ages, particularly menopausal women. Epidemiological surveys conclude that ladies gain a higher prevalence of OA than men, the menopausal women even get higher morbidity. However, studies about OA animal models suggest that the animals could remain a good joint function regardless of aging and menopause; age and menopause seem to have little effect on joint function. Thus, the study aimed to explore whether age and menopause will influence the clinical recovery of a knee joint in OA and injury women and the relevant mechanism by analyzing the proteome profile of synovial tissue (ST) samples.MethodsThe routine blood test and hormone levels were detected before the surgery. The ST samples of participants were collected during the surgery and 8 ST samples were used for proteome analysis. Just the day before and one month after the surgery, scores of Visual Analogue Score (VAS), Lysholm, The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used for assessing the functions of the affected knee. The relationship among proteome data, aging, estrogen level, and affected knee function were analyzed. ResultsAge, menopause and disorders of the knee were related to the clinical outcomes of knee OA and injuries of female patients. Proteome data revealed that the abundance of 174 proteins in old women was statistically different from those of young women. Similarly, compared to the menopausal women, about 120 proteins were significantly changed in the samples taken from premenopausal women. 58 proteins were shown to be insignificant different amounts in ST from knee OA women compared to knee injury ones. The reactions and pathways of these proteins were analyzed and visualized.ConclusionsAge and menopause showed a certain correlation with the protein profile of ST from OA or knee injury female patients, which indicated that the protein components might be affected by age and menopause. Besides, age and menopause also influenced the clinical outcomes of these patients after surgery therapy. Aging and menopause might take part in the regulation of remaining knee joint functions via modeling the ST protein expression.
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