Hip Arthroplasty with a Preceding Contralateral Pelvic Support Osteotomy: 7- and 21-Year Follow-up: A Case Report.

CASE: This is a case of 27-year-old woman with bilateral hip dysplasia who had been treated with a pelvic support osteotomy (PSO) on 1 side and a contralateral total hip replacement (THR). Good clinical outcomes for both hips were achieved after 21 and 7 years after PSO and THR, respectively. To the best of our knowledge, these 2 different methods have not been previously reported in 1 patient. CONCLUSION: Total hip arthroplasty in presence of contralateral PSO may be offered as a viable treatment option for advanced osteoarthritis to restore hip range of motion and achieve satisfactory clinical results.

Results of surgical treatment of unresolved Osgood-Schlatter disease in adults.

Osgood-Schlatter is a common disease with most cases resolving spontaneously with skeletal maturity. Adults with continued symptoms may need surgical treatment if they fail to respond to conservative measures. The purpose of this study is to describe the pathological lesions, our surgical technique, and the results of our surgical treatment of Osgood Schlatter disease in adults. Thirty-five adult patients (37 knees) had surgery for unresolved Osgood-Schlatter disease. Three patients were lost for follow-up. An incision over the anterolateral aspect of the patellar tendon was used. Direct anterior incisions were avoided to decrease postoperative pain with kneeling. The patellar tendon was reflected medially, and the ossicle was removed from the posterior surface of the tendon. A tibial tuberosity reduction osteotomy was done in 29 cases (85%). A beak of the distal part of the tibial tubercle was found in 24 cases (71%) with impingement of the patellar ligament. Thirty-one knees (91%) had complete resolution of preoperative pain. There was one case of painful scar. This surgical technique for treatment of Osgood-Schlatter disease in adults is effective and safe especially for those who have the habit of frequent kneeling.

Comparison between lengthening over nail and conventional Ilizarov lengthening: a prospective randomized clinical study.

The aim of this study is to compare lengthening over an intramedullary nail to the conventional Ilizarov method with regard to percentage length increase, external fixation index, consolidation index and incidence of complications. This is a prospective randomized controlled study. Thirty-one limbs in 28 patients were included in the study; 15 were lengthened over an intramedullary nail, and 16 limbs were lengthened conventionally. The mean duration of external fixation in the lengthening over nail group was 52.2 days compared to 180.4 days in the conventional group. There was higher incidence of complications in the conventional method group. In comparison with conventional Ilizarov lengthening, lengthening over an intramedullary nail offers a shorter period of external fixation and fewer complications overall, but there is a high incidence of deep intramedullary infection which is serious.