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Bilic R, Simic P, Jelic M, Stern-Padovan R, Dodig D, van Meerdervoort HP, Martinovic S, Ivankovic D, Pecina M, Vukicevic S. Osteogenic protein-1 (BMP-7) accelerates healing of scaphoid non-union with proximal pole sclerosis. Int Orthop 2006; 30:128-34. [PMID: 16506027 PMCID: PMC2532081 DOI: 10.1007/s00264-005-0045-z] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2005] [Revised: 11/07/2005] [Accepted: 11/17/2005] [Indexed: 01/14/2023]
Abstract
We randomly assigned 17 patients with scaphoid non-union at the proximal pole to three treatment groups: (1) autologous iliac graft (n=6), (2) autologous iliac graft + osteogenic protein-1 (OP-1; n=6), and (3) allogenic iliac graft + OP-1 (n=5). Radiographic, scintigraphic, and clinical assessments were performed throughout the follow-up period of 24 months. OP-1 improved the performance of both autologous and allogenic bone implants and reduced radiographic healing time to 4 weeks compared with 9 weeks in group 1. Helical CT scans and scintigraphy showed that in OP-1-treated patients sclerotic bone was replaced by well-vascularised bone. The addition of OP-1 to allogenic bone implant equalised the clinical outcome with the autologous graft procedure. Consequently the harvesting of autologous graft can be avoided.
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Affiliation(s)
- R. Bilic
- Department of Orthopedic Surgery, School of Medicine, University of Zagreb, Salata 11, 10000 Zagreb, Croatia
| | - P. Simic
- Laboratory for Mineralized Tissues, Department of Anatomy, School of Medicine, University of Zagreb, Salata 11, 10000 Zagreb, Croatia
| | - M. Jelic
- Department of Orthopedic Surgery, School of Medicine, University of Zagreb, Salata 11, 10000 Zagreb, Croatia
- Laboratory for Mineralized Tissues, Department of Anatomy, School of Medicine, University of Zagreb, Salata 11, 10000 Zagreb, Croatia
| | - R. Stern-Padovan
- Department of Radiology, School of Medicine, University of Zagreb, Salata 11, 10000 Zagreb, Croatia
| | - D. Dodig
- Department of Nuclear Medicine, School of Medicine, University of Zagreb, Salata 11, 10000 Zagreb, Croatia
| | | | - S. Martinovic
- Laboratory for Mineralized Tissues, Department of Anatomy, School of Medicine, University of Zagreb, Salata 11, 10000 Zagreb, Croatia
| | - D. Ivankovic
- Department of Medical Statistics, Epidemiology and Medical Informatics, School of Medicine, University of Zagreb, Salata 11, 10000 Zagreb, Croatia
| | - M. Pecina
- Department of Orthopedic Surgery, School of Medicine, University of Zagreb, Salata 11, 10000 Zagreb, Croatia
| | - S. Vukicevic
- Laboratory for Mineralized Tissues, Department of Anatomy, School of Medicine, University of Zagreb, Salata 11, 10000 Zagreb, Croatia
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Affiliation(s)
- M Reljanovic
- Vuk Vrhovac Institute, Dugi dol 4a, Zagreb
- Orthopedic Clinic, Zagreb, Croatia
| | - A Barada
- Vuk Vrhovac Institute, Dugi dol 4a, Zagreb
- Orthopedic Clinic, Zagreb, Croatia
| | - R Bilic
- Vuk Vrhovac Institute, Dugi dol 4a, Zagreb
- Orthopedic Clinic, Zagreb, Croatia
| | - J. Kovijanic
- Vuk Vrhovac Institute, Dugi dol 4a, Zagreb
- Orthopedic Clinic, Zagreb, Croatia
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Abstract
The biplanar (Rippstein/Dunlop) technique is commonly used to radiographically determine the neck-shaft and anteversion angles of the hip. This method is unsuitable for certain groups of patients, such as those with fixed contracture of the hip joint. In these patients we have found the 'sinus wave' method to be preferable. We compared the neck shaft and anteversion angles of 30 hips determined by these two methods. Correlation was good for both the neck shaft (r = 0.972) and anteversion angles (0.69). We also used ultrasound to measure the anteversion but this correlated poorly with the Rippstein/Dunlop technique (r = 0.56). We believe that the sound wave technique is an accurate and practical way to determine the anteversion and neck-shaft angles of the hip.
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Affiliation(s)
- M Haspl
- Department of Orthopaedic Surgery, School of Medicine, University of Zagreb, Croatia
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Abstract
A computer-assisted method of preoperative planning was used to create virtual models of the deformed distal end of the radius after malunion of a fracture. By comparison with a similar model of the uninjured wrist, values were calculated for the angles and lengths to be corrected by osteotomy. Shifts of the distal fragment were analysed for 33 deformed wrists, 27 of which underwent corrective osteotomy and bone grafting. In more than half the cases there was dorsal or volar shift of 3 mm or more. The accuracy of the correction was measured by comparing the three-dimensional models before and after osteotomy with the model of the normal wrist. The volar and ulnar inclination angles of the articular surface of the radius and the radial length were regularly restored to normal.
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