The Kingston periacetabular osteotomy utilizing computer enhancement: a new technique.

OBJECTIVE: To develop a new periacetabular osteotomy technique that can be performed safely and reliably using computer-enhanced technology. MATERIALS AND METHODS: This technique uses a modified posterior approach with a trochanteric osteotomy. A 3D surface model is generated from CT data. The osteotomy is planned using custom software developed by our team. A dynamic reference body is fixed to the iliac crest and the pelvis is registered using an optically tracked probe (Optotrak, Northern Digital, Ontario, Canada). A tracked probe is used to mark the osteotomies in three dimensions. The posterior column is osteotomized between the sciatic notch and hip joint. The pubic ramus is osteotomized under fluoroscopic guidance. The acetabular fragment is rotated into a more appropriate position and fixed with pelvic reconstruction plates. Subjective and objective data are collected pre- and postoperatively. RESULTS: This procedure has been performed on eight patients. Average center-edge angle correction has been 17 degrees. The computer and optical guidance system has provided accurate information in seven of eight cases, and there have been no complications. CONCLUSIONS: This technique has enabled us to perform periacetabular osteotomies with safety and predictability. Using this computer-enhanced technique, periacetabular osteotomy may become a more common procedure in the practice of hip reconstruction surgeons.     

Genetic variation in Brac, Croatia.

A serological survey of the Dalmatian island of Brac (Croatia), based on a total sample of 747 subjects, shows considerable local genetic variation. While the overall gene frequencies are much as expected from the island's geographical position, the local genetic heterogeneity is made up of differences between the inland and coastal villages, differences between the two coastal areas, and variation among the older inland villages. This heterogeneity is interpreted as deriving from the settlement process (founder effect), random differentiation, and the essentially local marriage pattern.     

High tibial osteotomy compared with high tibial and Maquet procedures in medial and patellofemoral compartment osteoarthritis

The effect of adding the Maquet tibial tubercle elevating procedure to a valgus high tibial osteotomy (HTO) in combined medial and patellofemoral disease had not been established. This prospective study evaluates clinically and roentgenographically the use of this osteotomy combination versus HTO alone in dual-compartment arthritis. Forty-four patients (46 knees) with dual-compartment disease from 1979 to 1984 were evaluated. Twenty-two patients were treated with 23 HTOs by a senior surgeon, and 22 were treated with 23 combined procedures by another surgeon. The two groups were matched according to age, sex, and preoperative clinical and roentgenographic disability. The minimum follow-up period was two years. All had more than 5 degrees valgus alignment at the follow-up evaluation, with an average of 11.2 degrees in the HTO group and 10.2 degrees in the combined osteotomy group. A modified Hospital for Special Surgery assessment (maximum, 100 points) was used with an optimum pain score of 30 points. All were followed roentgenographically with grading of the three knee compartments. In both groups, the total and pain scores improved significantly postoperatively. There was no statistical difference between the two groups in terms of mean postoperative femorotibial shaft alignment or clinical and roentgenologic outcome. Although HTO was a good procedure for pain relief for dual-compartment disease, the addition of Maquet procedure did not improve the results.     

Revision total hip arthroplasty with osseous allograft reconstruction. A clinical and roentgenographic analysis

One hundred twelve irradiation-sterilized, -70 degrees frozen allografts have been used in 72 patients who were available for follow-up study in a prospective analysis of allograft revision total hip arthroplasty. Clinical objectives were achieved in 85% of patients with a follow-up period ranging from six to 72 months. Based on clinical and roentgenographic analysis, specific recommendations are made to further improve the success rate of revision total hip arthroplasty associated with protrusio, shelf, acetabular, calcar, and large fragment femoral allografts.     

Genes predict village of origin in rural Europe

The genetic structure of human populations is important in population genetics, forensics and medicine. Using genome-wide scans and individuals with all four grandparents born in the same settlement, we here demonstrate remarkable geographical structure across 8–30 km in three different parts of rural Europe. After excluding close kin and inbreeding, village of origin could still be predicted correctly on the basis of genetic data for 89–100% of individuals.