The range of motion increased significantly in all patients. Flexion improved from a mean of 51° preoperation to a mean of 100° at discharge, and the average extension loss improved from 10° to 3° (p < 0.000). The average knee score, according to the Hospital for Special Surgery system, improved from 62 points preoperatively to 77 points at discharge, and 91 points at final follow-up (p < 0.000). All the patients were satisfied with the final ROM gain.
Abstract. The present study aimed to explore the potential diagnostic role of diffusion tensor magnetic resonance imaging (DTI) in the early stage of modified corticosteroid-induced osteonecrosis of the femoral head (ONFH). A total of 20 beagles were randomly classified (1:1) into either an experimental group (LM), which were intramuscularly injected with lipopolysaccharide (LPS) and methylprednisolone (MPS) on three consecutive days, or control (CON) group, which were injected with saline. Magnetic resonance imaging (MRI) and DTI were performed at pre-induction and 8 and 12 weeks post-induction. Apparent diffusion coefficient (ADC) values in the range of interest in the femoral head were quantified using DTI. Proximal femora were examined for ONFH at 8 and 12 weeks. The results demonstrated that ONFH developed in four beagles at 8 weeks and in six beagles at 12 weeks, whereas no ONFH was detected in the CON group. No abnormalities were detected by MRI and DTI, and no mortality occurred. In beagles with ONFH in the LM group, the ADC values were 4.7±0.2x10 -4 and 4.8±0.3x10 -4 mm 2 /sec at 8 and 12 weeks, respectively, which were significantly increased compared with the CON group (2.5±0.3x10 -4 and 2.4±0.3x10 -4 mm 2 , respectively) and the LM group without ONFH (2.6±0.4x10 -4 and 2.4±0.3x10 -4 mm 2 , respectively) (P<0.05). The results of the present study indicated that intramuscular injection of LPS and MPS may lead to early-stage ONFH in beagles. As such, the detection of locally elevated ADC values in the femoral head may aid in the early diagnosis of ONFH.
Abstract-The management of heterotopic ossification (HO) is controversial. Although some reports have investigated assessment and surgical resection techniques for HO affecting one or more joints, the cases of multijoint stiffness secondary to HO are rare. This article describes a rare case of HO affecting both upper limbs of a 32-year-old man that severely interfered with activities of daily living. We present the rehabilitation management of this case and the functional outcome 1 to 2 yr after excision of the ossific masses.
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