Biomedical subjects

J Glutting

Publications and source records attributed to J Glutting.

4 recordsLinked to original sources

PubMed1995

An evaluation of various methods of treatment for Legg-Calvé-Perthes disease.

An analysis of 5 methods of treatment for Legg-Calvé-Perthes disease was done on 124 patients with 141 affected hips. Before treatment, all groups were statistically similar concerning initial Mose measurement, age at onset of the disease, gender, and Catterall class. Treatments included the Scottish Rite orthosis (41 hips), nonweight bearing and exercises (41 hips), Petrie cast (29 hips), femoral varus osteotomy (15 hips), or Salter osteotomy (15 hips). Hips treated by the Scottish Rite orthosis had a significantly worse Mose measurement across time interaction (repeated measures analysis of variance, post hoc analyses, p < 0.05). For the other 4 treatment methods, there was no statistically different change. At followup, the Mose measurements for hips treated with the Scottish Rite orthosis were significantly worse than those for hips treated by nonweight bearing and exercises, Petrie cast, varus osteotomy, or Salter osteotomy (repeated measures analysis of variance, post hoc analyses, p < 0.05). There was, however, no significant difference in the distribution of hips according to the Stulberg et al classification at the last followup.

Analysis of Variance↗

PubMed1992

Prognostic factors in congenital dislocation of the hip treated with closed reduction. The importance of arthrographic evaluation.

We reviewed the clinical records, arthrograms, and roentgenograms of sixty-one children who had seventy-two congenitally dislocated hips in an effort to identify factors that can be used to predict the outcome of treatment. Only patients who had been followed clinically and roentgenographically for a minimum of two years after the initial closed reduction were included in the study. The mean age at the time of closed reduction was thirteen months (range, three to forty-one months). The mean age at the time of the most recent follow-up was six years (range, two to fifteen years). The mean duration of follow-up after the initial closed reduction was five years (range, two to thirteen years). There was no statistical difference between the good, fair, and poor-result groups with regard to sex, the age at the initial reduction, the traction station, the side of involvement, the initial acetabular index, the initial grade of displacement, the effect of adductor tenotomy, and several of the arthrographic measurements. The medialization ratio (the percentage of the horizontal radius of the cartilaginous femoral head that lay medial to the Perkins line), measured at the time of the reduction, was significantly different (p < 0.04) between the hips for which the result was good or fair and those for which the result was poor. The medialization ratio averaged 75 per cent in the hips for which the result was good, 66 per cent in those for which the result was fair, and 57 per cent in those for which the result was poor. Limbus shapes 5 through 8 were associated with avascular necrosis (p < 0.05) and a poor result (p < 0.03).

Acetabulum↗

PubMedDate not supplied

Management of dislocated hips with Pavlik harness treatment and ultrasound monitoring.

We studied the outcome of ultrasound-monitored Pavlik harness treatment of 47 infants (nine boys and 38 girls) with 55 frankly dislocated hips documented by dynamic ultrasonography. The success and failure groups were of similar ultrasound status (hip-status score) at the time of initial examination, but a significant difference emerged at the 7- and 14-day examinations. Detection of frank dislocation and institution of treatment with the Pavlik harness within 3 weeks of birth increased the probability of a successful result. Of 33 infants (27 girls and six boys) with 41 dislocated hips who were seen before the age of 21 days, 26 (63%) hips were reducible in the Pavlik harness alone, and 15 (37%) hips were irreducible and required a subsequent procedure to achieve reduction. Fourteen infants (three boys and 11 girls) with 14 dislocated hips were first seen after the age of 21 days. Three (20%) were successfully treated in the Pavlik harness alone, and 11 (80%) required further treatment. In our opinion, persistent dislocation without improvement after 3 weeks of treatment in the Pavlik harness mandates discontinuation of use of this device. No anatomic factors were seen at the time of the initial ultrasound examination that permitted prediction of those hips likely to succeed or fail treatment with the Pavlik harness.

Acetabulum↗

PubMedDate not supplied

Acetabular volume.

Reconstructive acetabular osteotomies can affect the acetabular volume. Volume mismatch between the femoral head and the acetabulum should be an important consideration but is rarely evaluated before hip reconstruction. Accurate measurement of the volume of the acetabulum is difficult because of the unusual shape and spatial orientation of the acetabulum. In this study, we used three techniques (physical, two-dimensional computed tomography, and three-dimensional computed tomography reconstruction) to determine the volume of 18 pig, four sheep, and 15 model acetabulae. A comparison of pre- and post-Pemberton osteotomy volumes of three dysplastic acetabulae models and two patients with developmental dysplasia of the hip also was performed. The results indicate that accurate, reproducible volume determinations can be made by using all three techniques, and that certain data-selection modes can reduce the patient's exposure to radiation. In addition, we observed an increase in the volume of the acetabulum after the Pemberton osteotomy.

Acetabulum↗