Bioabsorbable Unsintered Hydroxyapatite/Poly-l-Lactic Acid Pin Fixation of Osteochondritis Dissecans in Adolescents: Initial Experiences

2020 ◽  
Author(s):  
Martin Georg Zeilinger ◽  
Christian Autenrieth ◽  
Kerstin Remmel ◽  
Alexander Schuh ◽  
Matthias Hammon ◽  
...  
Keyword(s):  
Lactic Acid ◽  
Osteochondritis Dissecans ◽  
Clinical Results ◽  
Resonance Imaging ◽  
Pin Fixation ◽  
Mri Scans ◽  
Harris Score ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri

Abstract Background This study sought to retrospectively evaluate the clinical and magnetic resonance imaging (MRI) outcomes of u-HA/PLLA pin (u-HA/PLLA: hydroxyapatite/poly-L-lactic acid) pin fixation of unstable osteochondritis dissecans (OCD) lesions of the knee. Methods Seven adolescent patients (four females and three males) with arthroscopically unstable OCD lesions of the knee were included. The mean age at diagnosis was 13.1 years. Clinical results were evaluated preoperatively and during follow-up using the Ogilvie-Harris score (0 – 15 points). MRI scans were performed preoperatively and during follow-up, with results evaluated using the Dipaola classification (grades 1 – 4). Mean follow-up time was 29 months. Results The median Ogilvie-Harris score improved from 13 points (range: 10 – 14 points) to 15 points (range: 13 – 15 points). Separately, the median Dipaola score improved from 3 points (range: 2 – 4 points) to 1 point (range: 1 – 4 points). No complications such as infection, synovitis, or intra-articular adhesion were observed. Conclusions Initial experiences using bioabsorbable u-HA/PLLA pins for the refixation of unstable OCD lesions in adolescents in the knee are promising, and MRI provides excellent monitoring of healing.

Magnetic Resonance Imaging After Arthroscopic Microfracture of Capitellar Osteochondritis Dissecans

2012 ◽  
Vol 40 (11) ◽  
pp. 2549-2556 ◽  
Author(s):  
Corey A. Wulf ◽  
Rebecca M. Stone ◽  
M. Russell Giveans ◽  
Gregory N. Lervick
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Osteochondritis Dissecans ◽  
Articular Surface ◽  
Resonance Imaging ◽  
Arthroscopic Microfracture ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Evaluation

Background: Osteochondritis dissecans (OCD) of the capitellum affects young athletes involved in elbow load-bearing activities. Unstable lesions are best managed surgically, although debate remains regarding the optimal method. Arthroscopic treatment allows rapid recovery, but the effect on the articular surface is undetermined. Hypothesis: The clinical outcome after arthroscopic microfracture of stage III/IV capitellum OCD would be successful in terms of return to sport and restoration of function, and there would be some evidence of articular restoration or repair. Study Design: Case series; Level of evidence, 4. Methods: We reviewed records of 10 consecutive adolescent patients (age ≤18 years) with stage III or IV OCD lesions of the capitellum managed with arthroscopic microfracture. The mean age at the time of surgery was 13.9 years (range, 10.8-18.5 years); 7 patients were skeletally immature and 3 were skeletally mature. Pre- and postoperative functional assessment included active range of motion, Mayo Elbow Performance Score (MEPS), and Timmerman/Andrews elbow score. All patients underwent plain radiographic and magnetic resonance imaging (MRI) evaluation at a minimum of 12 months (mean, 27 months; range, 12-49 months) and clinical evaluation at a minimum of 24 months (mean, 42 months; range, 27-54 months) after surgery. Results: The mean range of motion improved in both flexion (135.8°→140.7°, P = .112) and extension (20.4°→–2.2°, P = .005). The mean MEPS (70.5→97, P = .007) and Timmerman/Andrews elbow scores (116.4→193.0, P = .008) improved significantly. magnetic resonance imaging (MRI) evaluation demonstrated an improvement in overall joint congruence and the formation of a reparative articular surface in 8 of 10 (80%) patients. No reoperations or major complications were encountered. Six of 8 patients involved in competitive athletics returned to the same level of participation at an average of 5.1 months. Conclusion: Arthroscopic OCD fragment excision and capitellar microfracture demonstrates good to excellent functional results in short-term follow-up. Follow-up MRI suggests potential for a reparative fibrocartilaginous articular surface. Longer term follow-up is necessary to determine durability of the technique.

scholarly journals Switching from branded to generic glatiramer acetate: 15-month GATE trial extension results

2017 ◽  
Vol 23 (14) ◽  
pp. 1909-1917 ◽  
Author(s):  
Krzysztof Selmaj ◽  
Frederik Barkhof ◽  
Anna N Belova ◽  
Christian Wolf ◽  
Evelyn RW van den Tweel ◽  
...  
Keyword(s):  
Glatiramer Acetate ◽  
Efficacy And Safety ◽  
Resonance Imaging ◽  
Open Label ◽  
Double Blind ◽  
Disability Status ◽  
Mri Scans ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri

Background: Open-label 15-month follow-up of the double-blind, placebo-controlled Glatiramer Acetate clinical Trial to assess Equivalence with Copaxone® (GATE) trial. Objective: To evaluate efficacy, safety, and tolerability of prolonged generic glatiramer acetate (GTR) treatment and to evaluate efficacy, safety, and tolerability of switching from brand glatiramer acetate (GA) to GTR treatment. Methods: A total of 729 patients received GTR 20 mg/mL daily. Safety was assessed at months 12, 15, 18, 21, and 24 and Expanded Disability Status Scale and magnetic resonance imaging (MRI) scans at months 12, 18, and 24. The presence of glatiramer anti-drug antibodies (ADAs) was tested at baseline and months 1, 3, 6, 9, 12, 18, and 24. Results: The mean number of gadolinium-enhancing lesions in the GTR/GTR and GA/GTR groups was similar at months 12, 18, and 24. The change in other MRI parameters was also similar in the GTR/GTR and GA/GTR groups. The annualized relapse rate (ARR) did not differ between the GTR/GTR and GA/GTR groups, 0.21 and 0.24, respectively. The incidence, spectrum, and severity of reported adverse events did not differ between the GTR/GTR and GA/GTR groups. Glatiramer ADA titers were similar in the GTR/GTR and GA/GTR groups. Conclusion: Efficacy and safety of GTR is maintained over 2 years. Additionally, switching from GA to GTR is safe and well tolerated.

scholarly journals Clinical Results and MRI Evaluation of Patellar Osteochondral Fracture Fixation following Patellar Dislocation

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Krzysztof Małecki ◽  
Kornelia Pruchnik–Witosławska ◽  
Dominika Gwizdała ◽  
Piotr Grzelak ◽  
Paweł Flont ◽  
...  
Keyword(s):  
Fracture Fixation ◽  
Patellar Dislocation ◽  
Articular Surface ◽  
Clinical Results ◽  
Suture Technique ◽  
Osteochondral Fracture ◽  
Mri Scans ◽  
The Mean ◽  
Reconstructed Surface

Aim. The aim of the study was to analyze the clinical results and MRI scans after transpatellar osteochondral fracture fixation following patellar dislocation. Methods. Our study group comprised 17 patients with patellar dislocation followed by osteochondral fracture of the articular surface of the patella. All patients underwent surgery where the fractured osteochondral fragments of the patella were attached using the transpatellar suture technique. The mean age at the time of surgery was 14.1 years, and the mean follow-up period was 7.5 years. Results. The results of the patellar compression test and the apprehension test were negative in all patients. The mean Lysholm and Kujala scores were 89.2 and 89.6, respectively. The MRI scan revealed healing of the fixed fragment and restoration of the articular surface in all patients. In 16 cases, subchondral bone of the fixed fragment area was described as irregular: its articular cartilage was narrowed and not homogenous. Progressive degenerative changes were observed in the patellofemoral joint at follow-up in three patients. Conclusions. By fixing osteochondral fragments, the patellar articular surface can be restored. The MRI scans show that the cartilage in the reconstructed surface is narrowed after a mean 7.5-year follow-up.

Adolescent Disc Degeneration - No Headache Association

Cephalalgia ◽  
2007 ◽  
Vol 27 (1) ◽  
pp. 14-21 ◽  
Author(s):  
K Laimi ◽  
M Erkintalo ◽  
L Metsähonkala ◽  
T Vahlberg ◽  
M Mikkelsson ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Disc Degeneration ◽  
Population Based ◽  
Degenerative Changes ◽  
Resonance Imaging ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Study

The objective of the study was to determine whether adolescents with headache have more disc degeneration in the cervical spine than headache-free controls. This study is part of a population-based follow-up study of adolescents with and without headache. At the age of 17 years, adolescents with headache at least three times a month ( N = 47) and adolescents with no headache ( N = 22) participated in a magnetic resonance imaging (MRI) study of the cervical spine. Of the 47 headache sufferers, 17 also had weekly neck pain and 30 had neck pain less than once a month. MRI scans were interpreted independently by three neuroradiologists. Disc degeneration was found in 67% of participants, with no difference between adolescents with and without headache. Most of the degenerative changes were located in the lower cervical spine. In adolescence, mild degenerative changes of the cervical spine are surprisingly common but do not contribute to headache.

CLOSED RADIAL WEDGE OSTEOTOMY FOR PREISER'S DISEASE: A REPORT OF FOUR CASES

Hand Surgery ◽  
2011 ◽  
Vol 16 (03) ◽  
pp. 347-352 ◽  
Author(s):  
Ousuke Hayashi ◽  
Takuya Sawaizumi ◽  
Hiromoto Ito
Keyword(s):  
Clinical Score ◽  
Clinical Results ◽  
Wrist Pain ◽  
Wedge Osteotomy ◽  
Wrist Movement ◽  
Wrist Arthrodesis ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
Preiser’S Disease

Purpose: To investigate the clinical outcome of closed radial wedge osteotomy (CRWO) for Preiser's disease. Methods: CRWO was performed for four patients with Preiser's disease between 2000 and 2005. All patients were diagnosed by X-ray and magnetic resonance imaging (MRI) scans. Separation gaps in the radioscaphoid joint were observed to evaluate the decompression in the area. Clinical evaluation was performed using Cooney's scoring system. Results: Although wrist pain persisted in patients with radioscaphoid arthritis change, marked mitigation of wrist pain was confirmed in three patients. The average clinical score was 66, with good in one, fair in two, and poor in one. Restriction of wrist movement by CRWO caused lower clinical scores. No patients had wrist arthrodesis at the last follow-up evaluation. Conclusions: Short-term observation showed disappointing clinical results; however, for relief of wrist pain, this method is a potential surgical procedure for Preiser's disease under limited conditions.

Does MRI lesion activity regress in secondary progressive multiple sclerosis?

2010 ◽  
Vol 16 (4) ◽  
pp. 434-442 ◽  
Author(s):  
Y. Zhao ◽  
AJ Petkau ◽  
A. Traboulsee ◽  
A. Riddehough ◽  
DKB Li
Keyword(s):  
Multiple Sclerosis ◽  
Progressive Multiple Sclerosis ◽  
Resonance Imaging ◽  
Short Term ◽  
Secondary Progressive ◽  
Relapsing Remitting ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
Short Term Trend

Background: The rate of new contrast-enhancing lesions (CELs) on monthly magnetic resonance imaging (MRI) scans has been shown to decrease over a 9-month period in placebo-treated patients with relapsing—remitting (RR) multiple sclerosis (RRMS). Objective: We examined this phenomenon in placebo-treated secondary progressive MS (SPMS) patients. Methods: Patients were chosen from two clinical trials. Monthly scans were taken at screening, baseline and months 1—9 for Cohort-1 and months 1—6 for Cohort-2. We examined the monthly new CEL rates according to initial CEL level: 0, 1—3, >3 CELs at screening, and presence and absence of pre-study relapses. Results: Respectively, 59, 21 and 14 of the 94 Cohort-1 patients, and 36, 17 and 9 of the 62 Cohort-2 patients had 0, 1—3 and >3 initial CELs. For Cohort-1, the monthly new CEL rates did not change during follow-up, regardless of initial CEL level. For Cohort-2, the monthly rate was unchanged in the 0 initial CEL subgroup, but decreased 33% (95% confidence interval: 8%, 52%) from months 1—3 to months 4—6 in the other two subgroups. For the combined cohorts, a decreasing rate was observed in the 12 patients with >3 initial CELs and pre-study relapses. Conclusions: The short-term trend of new CEL activity in placebo-treated SPMS patients may vary across cohorts.

scholarly journals Early MRI outcomes in participants with a first clinical demyelinating event at risk of multiple sclerosis in the ORACLE-MS study

2021 ◽  
Vol 7 (1) ◽  
pp. 205521732199085
Author(s):  
Mark S Freedman ◽  
Patricia K Coyle ◽  
Giancarlo Comi ◽  
Susan L Scarberry ◽  
Doris Damian ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Resonance Imaging ◽  
Phase 3 ◽  
Post Hoc Analysis ◽  
T2 Lesions ◽  
Mri Scans ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri ◽  
Post Hoc

Background In the Phase 3, 96-week ORACLE-MS study, cladribine tablets 10 mg (3.5 or 5.25 mg/kg cumulative dosage over two years) significantly reduced lesions associated with multiple sclerosis versus placebo in participants following a first clinical demyelinating event (FCDE). Objective To determine the timing of effects of cladribine tablets on lesion activity assessed by magnetic resonance imaging (MRI). Methods This post hoc analysis assessed the effect of cladribine tablets versus placebo in ORACLE-MS on secondary MRI endpoints including T1 gadolinium-enhancing (Gd+), new or enlarging T2 lesions, and combined unique active lesions assessed on MRI scans performed at screening and every 3 months thereafter. Results Compared to placebo, cladribine tablets 3.5 mg/kg treatment appeared to lead to a trend of reductions in the mean number of T1 Gd+ lesions by Week 13 (first post-baseline scan: 0.37 vs. 1.00), new or enlarging T2 (0.20 vs. 1.01) and combined unique active (0.29 vs. 1.91) lesions by Week 24. Low lesion counts were maintained with cladribine tablets throughout 96 weeks. Similar results were observed with the 5.25 mg/kg dosage. Conclusion In participants with an FCDE, cladribine tablets appeared to reduce lesion numbers within 13 weeks (time of first evaluation).

Maximum one-handed pull force and its relation to shoulder geometry

2005 ◽  
Vol 4 (3) ◽  
pp. 143-155
Author(s):  
Krystyna Gielo-Perczak
Keyword(s):  
Maximum Voluntary Contraction ◽  
Frontal Plane ◽  
Voluntary Contraction ◽  
Resonance Imaging ◽  
Upper Arm ◽  
Shoulder Joints ◽  
Mri Scans ◽  
The Mean ◽  
Shoulder Geometry ◽  
Magnetic Resonance Imaging Mri

The current study proposes a method of geometrical description of the shoulder articulating surfaces in order to deduce an unrecognized relationship between shoulder geometry and strength during a one-handed pulling task. The paper reports the results of a study of the strength of 12 participants during one-handed pulling correlated with the geometries of their shoulder joints derived from magnetic resonance imaging (MRI) scans. The measurements of a mean force during pulling were recorded when an upper arm was adducted in the frontal plane from 5 to 30 degrees during maximum voluntary contraction (MVC). It was observed in the study that an area determined by the height and width of the glenoid fossa closely relates to the mean force during pulling.

Atypical infectious spondylitis with reduced bone marrow enhancement: “black vertebra sign”

2020 ◽  
Vol 61 (11) ◽  
pp. 1553-1561
Author(s):  
Sung Eun Park ◽  
Hye Jin Yoo ◽  
Sung Hwan Hong ◽  
Ja-Young Choi ◽  
Hee Dong Chae
Keyword(s):  
Bone Marrow ◽  
Early Stage ◽  
Air Bubbles ◽  
Resonance Imaging ◽  
Enhancement Pattern ◽  
Mri Scans ◽  
Vertebral Bodies ◽  
Magnetic Resonance Imaging Mri ◽  
Infectious Spondylitis

Background A few patients suspected of having infectious spondylitis exhibited a reduced enhancement pattern on postcontrast T1-weighted (T1W) magnetic resonance imaging (MRI). Purpose To investigate the characteristics of infectious spondylitis patients who exhibited reduced vertebral enhancement. Material and Methods From January 2010 to November 2017, 456 patients with findings suspicious for infectious spondylitis on 706 postcontrast T1W imaging were retrospectively evaluated. When an affected vertebra exhibited markedly reduced enhancement compared to normal bone marrow (BM), the vertebra was termed a “black vertebra.” MRI and computed tomography (CT) imaging findings within two-week intervals and the patients’ clinical characteristics were reviewed. Results Ten patients (5 men, 5 women; mean age 66.4 years) whose MRI scans revealed the black vertebra sign were included. Among the 10 patients with black vertebrae, six patients exhibited signal voids in or around the affected vertebral bodies on T2-weighted (T2W) images. Eight patients showed air bubbles on CT images, suggestive of emphysematous infection. However, the typical image findings of infectious spondylitis were uncommon, namely, low BM signal intensity (SI) on T1W images (n=1) and intradiscal fluid-equivalent SI on T2W images (n=5) at an early stage. On follow-up MRI (average interval 7.2 weeks from initial MRI), available for five patients, marked progression of infection was evidenced by increased numbers of affected segments (n=3), low T1 SIs of the affected vertebrae (n=5), and increased contrast enhancement (n=3). Five patients underwent surgery to treat infections not controlled by antibiotics. Conclusion A black vertebra sign on postcontrast T1W imaging seems to reflect an early emphysematous infection.

scholarly journals Fetal subependymal giant cell astrocytoma: A case report and review of the literature

2020 ◽  
Vol 11 ◽  
pp. 26
Author(s):  
Aikaterini Karagianni ◽  
Ploutarchos Karydakis ◽  
Dimitrios Giakoumettis ◽  
Ioannis Nikas ◽  
George Sfakianos ◽  
...  
Keyword(s):  
Giant Cell ◽  
Mammalian Target Of Rapamycin ◽  
Subependymal Giant Cell Astrocytoma ◽  
Childhood And Adolescence ◽  
High Morbidity ◽  
Resonance Imaging ◽  
Fetal Magnetic Resonance Imaging ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri

Background: Subependymal giant cell astrocytomas (SEGAs) appear approximately in 10% of patients with tuberous sclerosis. These tumors are most commonly diagnosed in childhood and adolescence, with in utero diagnosed SEGAs being an extremely rare entity. Case Description: We present the case of a congenital SEGA detected in an antenatal ultrasound and further investigated with fetal magnetic resonance imaging (MRI) scans at 22 and 32 weeks of gestational age. At 9 days of age, the child underwent craniotomy and partial excision of the tumor, followed by a second more extensive operation 13 days later. The patient was subsequently administered mammalian target of rapamycin inhibitor (everolimus). Conclusion: In the latest follow-up MRI, at the age of two, the SEGA remained unchanged. Management of these tumors in neonates is challenging, mainly due to high morbidity and mortality of surgical treatment in these ages.

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