Cartilage Necrosis Due to Pin Penetration

Aprin, Hormozan; Goodman, Steven; Kahn, Leonard B.

doi:10.1097/01241398-199111050-00012

Cited by 2 publications

(3 citation statements)

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“…Its overall incidence is reported to be 7% (range 1.1-28%) [6,16], but the aetiology is still unknown. Risk factors for development of chondrolysis are pin penetration [2,16], cast immobilisation, male gender, black racial origin, severe SCFE, and instability [4,24]. It is thought that chondrolysis may be due to an immune response (autoimmune disease) [16].…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome after transfixation of the epiphysis with Kirschner wires in unstable slipped capital femoral epiphysis

Seller

Wild

Westhoff

et al. 2006

International Orthopaedics (SICOT)

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Treatment of slipped capital femoral epiphysis (SCFE) is still controversial. Agreement has not yet been reached on the appropriate time to perform surgery, the necessity of repositioning manoeuvres, the type of implants for stabilisation, or the need for prophylactic treatment of the contralateral side. In this retrospective study, we present 29 patients with unstable (acute and acute-on-chronic) SCFE treated by internal fixation of the epiphysis with three or four Kirschner wires both therapeutically on the affected side and prophylactically on the not (yet) affected side. After hardware removal and mean follow-up of 3.5 years, radiological and clinical examination of hip function was carried out. X-ray in two planes showed no incidence of any slip progression. Applying the score used by Heyman and Herndon, 18 results (62.1%) were classified as excellent, nine (31.1%) as good, one (3.4%) as fair, and one (3.4%) as poor. The rate of severe complications such as chondrolysis and avascular necrosis of the femoral head was low in our series (0% and 6.8%, respectively). This form of therapeutic management shows good clinical results with low complication rates. The slip can be efficiently stabilised, progression is reliably prevented, and remodelling of the joint gives the patient good overall hip function. We see no indication for emergency surgery.

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Section: Discussionmentioning

confidence: 99%

Clinical outcome after transfixation of the epiphysis with Kirschner wires in unstable slipped capital femoral epiphysis

Seller

Wild

Westhoff

et al. 2006

International Orthopaedics (SICOT)

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“…The patient, once discharged from the hospital, would not complain of symptoms regarding the hip joint, and the implant penetration should remain unrecognized for some period of time. Our failed attempts to use a rabbit model 13 were due to the extensive and variable joint lesions produced which we believe is related with the implant/hip size ratio. We used a 2.4-mm Kirschner wire in beagles weighing 7 kg; immature rabbits weight less than 2 kg and a 3/16 Steinman pin is approximately 4.8 mm in diameter.…”

Section: Discussionmentioning

confidence: 99%

“…The amount of implant penetration into the joint was not documented in these studies. 5,8,10,12 To date, no experimental model of in situ pinning 13 was able to reproduce the situation above described.…”

Section: Introductionmentioning

confidence: 99%

Effect of oral diacerein (DAR) in an experimental hip chondrolysis model

Kitadai

Takahashi

Straus

et al. 2006

Journal Orthopaedic Research

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We aimed to reproduce the articular cartilage structural changes in a joint exposed to a metallic implant as in the adolescent pinned hip with persistent joint penetration and secondly, to test the effect of an interleukin inhibitor, diacerein (DAR) in the ensuing articular cartilage lesion. Twenty immature beagles were submitted to a surgical K-wire implantation in the hip with the material left in the joint space for 6 months. Twelve animals were sacrificed for histological and biochemical tests. Eight animals were sacrificed at 10 months (half of them treated with DAR) and analyzed by scanning electron microscopy (SEM) and biochemistry of the articular cartilage. Preoperative and monthly C3 and C4 complement and immunoglobulins serum levels were determined. The histological and the electrophoretic profile changes were significative at 6 months. At 10 months the migration profile (CaCl 2 ) recovered to normal levels in the operated hip and the SEM scores for the acetabulum were similar to the non operated control hip after treatment. The serum level of IgA was elevated at the 4th and 6th month postoperatively. The persistence of a metallic implant resulted in degenerative changes parallel to that described for hip chondrolysis as a complication of in-situ pinning; and the cartilage lesion improved with DAR treatment. ß

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Cartilage Necrosis Due to Pin Penetration

Cited by 2 publications

References 0 publications

Clinical outcome after transfixation of the epiphysis with Kirschner wires in unstable slipped capital femoral epiphysis

Clinical outcome after transfixation of the epiphysis with Kirschner wires in unstable slipped capital femoral epiphysis

Effect of oral diacerein (DAR) in an experimental hip chondrolysis model

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