Acta Orthop Belg
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Spondylotic degeneration can manifest as tandem (concurrent) cervical and lumbar spinal stenosis. The primary manifestations include neurogenic claudication, gait disturbance and a mixture of findings of myelopathy and polyradiculopathy in both the upper and lower extremities. The purpose of this retrospective study was to report the existence and management of tandem (concurrent) cervical and lumbar spinal stenosis. ⋯ All the patients had excellent or good results and none deteriorated neurologically. Although tandem spinal stenosis occurred relatively infrequently, we concluded that its possible presence should not be overlooked. The treatment plan must be designed according to the chief complaints and symptoms of the patient.
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Case Reports
Osteonecrosis of the femoral head following medullary nailing of the femur in an adult.
The femoral head receives the majority of its blood supply via branches of the medial femoral circumflex artery, whose course runs across the piriformis fossa and along the superior aspect of the femoral neck. Cadaveric studies have demonstrated damage to the medial femoral circumflex artery in cases where the piriformis fossa was the entry point for intramedullary nailing. Although well recognised in children, osteonecrosis of the femoral head after intramedullary nailing has exceptionally been reported in adults. We present a case of osteonecrosis of the femoral head post-epiphyseal closure following IM nailing for a femoral fracture in a 22-year-old Caucasian adult.
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Comparative Study
Autologous chondrocyte implantation: a comparison between an open periosteal-covered and an arthroscopic matrix-guided technique.
In this prospective study, the authors compared the Carticel method of autologous chondrocyte implantation with the Hyalograft C technique. The aim of the study was to compare the clinical outcomes of the two methods, to identify any complications and to analyse MRI images of the repair process. Seventeen patients who had received autologous chondrocyte implantation with the Carticel technique and ten treated with Hyalograft C were assessed. ⋯ Molecular analysis was performed to assess mRNA levels of the various collagen molecules and proliferation and differentiation factors: the results showed that the implanted material undergoes progressive remodelling to regenerate hyaline cartilage. Both Carticel and Hyalograft C implantation techniques seem to lead to comparable short- and medium-term results. Moreover, this study confirmed that MRI is a valid tool in the follow-up evaluation of autologous chondrocyte implantation.