Arthrosis Deformans Research Articles

Electrophysiological patterns of sciatic nerve in patients with arthrosis deformans of the hip

BACKGROUND: Neurological complications in sciatic nerve (SN) after a total hip replacement (THR) are observed in 0.93.2% of cases in patients with arthrosis deformans and age-related morphologic changes in SN. These cause the need for SN evaluation before THR. This research was aimed at the evaluation of the initial SN capacity with electrophysiological findings in patients with arthrosis deformans of the hip.
 MATERIALS AND METHODS: Electroneuromyography (ENMG) was used to evaluate fibular and tibial nerves M-responses as well as F-waves in 66 patients with dysplastic coxarthrosis and 12 patients with posttraumatic coxarthrosis. The findings were compared to those of the controls.
 RESULTS: Changes in ENMG findings for fibular nerve in 49 patients with dysplastic coxarthrosis were bilateral and showed significant difference only from the norm. In 19 of 66 cases (27.9%) low M-responses (р 0.02) were found in the side subject to THR. In 87.3% of cases, the signs of a decrease in the conductivity of proximal segments of the tibial nerve were revealed. In patients with posttraumatic coxarthrosis, the significant decrease in ENMG findings from both fibular and tibial nerves was observed in the affected side, they made up just 42-50% of those in the opposite side. Asymptomatic progress of denervation damage in hip and tibia muscles sometimes required needle EMG to fund the signs of motor innervation disorder. A-waves revealed in 65% of patients suggested local damage to one or both portions of SN.
 CONCLUSION: ENMG findings in patients with dysplastic arthrosis of the hip enabled revealing of the signs of neuropathy before surgeries and decreasing the risk of neurologic post-surgery complications.

What Role Does Synovitis Play in Craniomandibular Dysfunction (CMD)? A 3T-MRI Study.

The purpose of the present study was to investigate the degree and clinical relevance of synovitis in craniomandibular dysfunction. In total, 140 temporomandibular joints were examined using a 3 T MRI scanner. Quantitative analysis of synovial enhancement was performed and interrelated with arthrosis deformans, degenerative disc disease, joint effusion, bone marrow edema and restriction of motion. We found a statistically high and significant correlation between the degenerative changes as mentioned above and the intensity of synovial enhancement. The study shows that typical MRI findings in CMD patients are often combined with signs of synovitis. Presumably joint inflammation has an effect on the clinical signs and symptoms and also the prognosis of CMD. These results should be taken into consideration when selecting treatment. · 3T-MRI using a dedicated coil is the method of first choice in the examination of CMD syndrome.. · MR imaging allows quantification of increased synovial enhancement.. · There is a highly significant correlation between degenerative changes of the disc or cartilage and synovitis.. · Results of the study are relevant for the clinical assessment and therapy of CMD syndrome.. · Stimmer H, Ritschl L, Goetz C et al. What Role Does Synovitis Play in Craniomandibular Dysfunction (CMD)? A3T-MRI Study. Fortschr Röntgenstr 2019; 191: 924 - 931.

A case of arthrosis deformans coxae

A case of arthrosis deformans coxae

Verschiedene Autoaggressionskrankheiten in einer Familie

By the example of a family with arthrosis deformans, Crohn’s disease and autoimmunhemolytic anemia manifestations of the syphilitic miasm are demonstrated as well as their evocation by the initial prescription of remedies acting too superficially.

Boering's Arthrosis: Review and Analysis of Progression in 6 Cases

Background: In 1966 Boering described a degenerative condition of the mandibular condyle occurring in children. This condition alters the normal appearing condyle into an abnormal ‘mushroom form’ and with loss in the vertical height and abnormal backward bend to the condylar head and neck. He documented these changes by sequential tracings of the panoramic images from normal to abnormal appearance. Terms used to describe this condition are Boering's arthrosis, juvenile arthrosis and arthrosis deformans juvenilis.

Standardization of roentgen diagnosis in coxarthrosis and gonarthrosis in clinical studies. Recommendations of the 1st Working Circle of the DGOT (Connective Tissue Research and Arthrosis Deformans)

Recommendations of standardized radiographic assessment in clinical and epidemiological studies on patients with hip and knee osteoarthritis. Survey of published studies and results of consensus conferences regarding reproducibility of radiographic assessment and standardization procedures. With the proposed guidelines a standardized and reproducible radiographic assessment of patients with hip and ankle osteoarthritis in clinical and epidemiological studies is possible. The recommended procedures can be supplemented by additional techniques.

Patellar changes during long-term observations on the Blauth knee joint endoprosthesis

Changes in the position and structure of the patella and their importance with regard to pain patterns are described on the basis of long-term observation of the Blauth prosthesis. Examinations were performed on 206 knee prostheses on average 37.6 months (min. 12, max. 120 months) after implantation. Axial roentgenograms showed the patella to be laterally subluxated in 12% of the cases, and luxated in one. Also in 12% of the cases, osteolytic destruction of the posterior surface of the patella was found; there was a statistically significant correlation between the two groups, but they were not identical. In cases with changes in the patellar structure, initial pain on walking was significantly more frequent, though this was not so in cases where the kneecap had shifted from its normal position. The authors discuss possible connections with curvature radii and with the distances between the center of rotation and the sliding support on the femoral part of the prosthesis as causes of increased complaints in low kneecaps and for the increased incidence of structural changes in high kneecaps. The term "retropatellar pain syndrome" is applied to patients who experience pain when climbing stairs, rising from chairs and when starting to walk, in whom at least 2 of these complaints are positive: A total of 10.2% of the patients complained of considerable retropatellar pain. A patellectomy was performed in 8 of these patients. The radiological and histological analyses of 3 of the patellae removed showed evidence of arthrosis deformans at different stages, with concomitant synovitis.

Replacement of the Meniscus with a Collagen Implant (CMI).

Replacement of an almost completely absent medial meniscus with a collagen implant (CMI), reconstruction of form and function of the medial meniscus, delay of the development of arthrosis deformans. Subtotal degenerative or traumatic loss of the medial meniscus, stable meniscal periphery, stable anterior and posterior meniscal insertions, joint with stable ligaments. Complete loss of the medial meniscus. Untreated knee ligament instability. Extreme varus deformity. Extensive cartilaginous damage, i.e., levels IV and VI as described by Bauer and Jackson. Advanced unicompartmental or generalized arthrosis. Replacement of the lateral meniscus. Standard anterior arthroscopy portals. Resection of the medial meniscus leaving a complete and stable outer rim. Revitalization of the periphery to promote healing. Measurement of defect size. Insertion and fixation of the CMI with nonresorbable suture material in inside-out technique. Postoperative knee brace with limited motion in extension/flexion of 0/0/60° until week 4, 0/0/90° until week 6. Coutinuous passive motion within the limits of motion from the 1st postoperative day, actively assisted physiotherapy. No weight bearing for 6 weeks, then increased weight bearing for 2 weeks until full weight bearing is achieved. Cycling can commence from 3 months postoperatively. Full sporting activity after 6 months. 60 patients (19-68 years, average 41.6 years) with subtotal loss of the medial meniscus and varus morphotype were treated from January 2001 to May 2004 as part of a prospective, randomized, arthroscopically controlled study. The sample consisted of 30 patients with high tibial valgus osteotomy combined with implantation of a CMI, and 30 patients with valgization correction osteotomy only. The CMI had to be removed from one patient because of a dislocation. Evaluation on the Lysholm Score, IKDC (International Knee Documentation Committee), and subjective pain data revealed only slight, nonsignificant differences for 39 patients after 24 months (CMI and correction n = 23; correction only n = 16). The chondroprotective effect of the CMI in the long term remains to be seen.

General symptoms of cornea Salzmann-type degeneration

After a brief review of the symptoms of Salzmann's nodular corneal dystrophy the authors report on 28 patients. As found by radiological examination, arthrosis deformans was present in all of the patients and, in nearly all cases, osteoporosis has been diagnosed. Histological examination revealed a regressive change in 3 patients' costal cartilage of identical macular character. 22 patients had cataracta and 20 an impaired hearing. Therefore, the disease belongs to the keratochondrosises. 1. The regressive change of the corneal stroma, the hyaline cartilage and the bones relies assumably on an abnormality of their mutual component, the mucopolysaccharides. 2. Experimental and therapeutic experiences have shown that prolonged mucopolysaccharide administration (heparin) will induce osteoporosis. This explains the relationship between osteoporosis and metabolic disorder of mucopolysaccharides. 3. The remarkably high occurrence of cataracta, in comparison to a normal population of the same age, is presumably related to the metabolic disorder of mucopolysaccharides. 4. The aforesaid seem to confirm that Salzmann's nodular corneal dystrophy, corneal dystrophy is not induced by repeated inflammations but conversely, pathological metabolism of the cornea in consequence of dystrophy is responsible for serial keratitis.

Gesundheitserziehung und Gesundheitstraining bei Arthrose

Osteoarthrosis is one of the most prevalent diseases in orthopedics. Its impact for the individual patient as well as for the socio-economic system is enormous. An increasing loss of function and pain progress of disease leads to chronic handicap, which severely restricts freedom of a self-determined life and reduces quality of life. Besides conservative and later surgical treatment, health-inducing offers to patients with arthrosis deformans have gained more importance in the process of coping with the illness similar to other chronic diseases. Health education and exercise are supposed to help patients gain more theoretical and practical knowledge of the disease and foster a more positive attitude in order to improve self management. The effect of patient educating programs with respect to self-help activities and socio-economic savings (return to work, days of hospital treatment) could be verified during recent years in many cases of chronic disease, such as rheumatic disease, diabetes and asthma through prospective multicenter studies. Whether special health training in osteoarthrosis leads to similar effects is subject of current studies.

Retro-Odontoid Mass in High Elderly Patients-Genesis, Therapeutic Strategies and Post-Operative Care-

It has been controversial whether surgical treatment for retro-odontoid mass including disc hernia is indicated. We surgically treated 8 patients with retro-odontoid mass. We discuss clinical characteristics, therapeutic strategies, the genesis based on histological findings, and problems of post-operative care in this lesion.Age distribution of the patients was from 77 to 86 years old (mean: 81.0 years). Male/female ratio was 6/2. All patients showed neurological deficits due to myelopathy. Pre-operative magnetic resonance (MR) imaging showed an isointensity mass at the retro-odontoid space. Only marginal enhancement was seen in 2, and heterogenous enhancement in 6 patients.All patients underwent surgery via postero-lateral transdural approach for removal of the extradural retro-odontoid mass. All patients showed neurological improvement, however, severe neurological deficits still remained in 2 patients who had been in bed-ridden pre-operatively. The surgical specimens consisted of degenerative cartilaginous tissue and reactive fiborvascular tissue.As the retro-odontoid mass contains various pathological lesions, histological confirmation is necessary. Among reported surgical approaches, the postero-lateral transdural approach is less invasive, especially for high elderly patients. A source of cartilaginous tissue is probably derived from the herniated disc penetrated posterior longitudinal ligament at C2/3, which has migrated upward to the retro-odontoid space. Not only such migration, but also some proliferative change might come to form the retro-odontoid mass.Retro-odontoid mass is characteristic in very elderly patients. Elderly patient-specific problems such as disuse atrophy due to less movement and painful arthrosis deformans in the lower extremities prevent successful rehabilitation. Earlier planning to advance rehabilitation in cooperation with neurosurgeons, orthopedists, and rehabilitation physicians is necessary for very elderly patients' quality of life.

Osteoclastic finger arthrosis--a subtype of hand polyarthrosis

Description of a subtype of arthrosis deformans of the hand which is characterised as osteoclastic arthrosis. Retrospective analysis of radiographs of the hands of 150 women and 100 men with radiological findings of arthrosis deformans. 5% of women and 2% of men showed at least one digital joint with subchondral osteolysis of one or both articulating bones involving at least a third of the phalanx. This subchondral osteolysis far exceeds the cysts which are situated in the epiphyseal part of the articular region. It may develop within a year. Osteoclastic arthrosis of the finger is a subtype of polyarthrosis of the hand. Serial observations suggest that an osteoclast stimulating substance is produced by the cysts or arises directly from the synovial fluid; this enters the subchondral part of the bone through clefts which may or may not be visible radiologically and that this produces osteoclastic activity. The most important differential diagnoses are chronic tophaceous gout and a benign tumor.

純チタン製下顎頭キャップによる下顎頭形成術について

We have developed a pure titanium mandibular head cap and applied it to the orthopedic site of the mandibular head in condyloplasty and arthroplasty.It is shaped to cover the mandibular head so that natural head form and structure can be restored when the cap is worn and stabilized.In addition, this mandibular head cap has tiny holes in its margin to accomodate the expected bone infiltration and has holes for screws at the parietolateral part so that it can be secured with bone-marrow screws that match the mandibular head and neck.The titanium cap comes in three sizes-large, medium, and small-that can be chosen according to the size of the mandibular head.The surgical procedure involving this titanium mandibular head cap follows condyloplasty. The coarse surfaces and bony lumps of the mandibular head are ground and eliminated with a surgical bur.Next, the cap is placed on the mandibular head to be stabilized diagnally or vertically with screws.In some cases, the articular tubercle is removed to facilitate forward movement of the mandibular head.In our practice, this procedure was indicated for temporomandibular arthrosis that was unresponsive to longterm conservative therapy (disc displacement without reduction), temporomandibular arthrosis deformans, and ankylosis of the temporomandibular joint.This paper primarily addresses, in summary, the procedures and application methods.

Arthroscopy of the temporomandibular joint: Examination of 2 patients with suspected disk derangement

2 patients with a history of reciprocal temporomandibular joint (TMJ) clicking were visually examined with arthroscopy of their right side TMJs. Clinical and radiographic examination revealed no signs of arthrosis deformans. One patient with significantly reduced opening ability combined with occasional disappearance of TMJ clicks showed advanced arthrotic changes of cartilage which were not visible radiographically. The other patient with unimpaired function also had a severe arthrotic lesion in the clicking joint. In neither case did the disk appear to be displaced. It is concluded that arthroscopy yields additional information for TMJ diagnosis which cannot be achieved by clinical and radiographic examination alone.

Clinical Study of the Intra-articular Injection of Arteparon for Osteoarthritis of the Knee Joint

The drug arteparon (mucopolysaccharide polysulfuric acid esters) was developed in West Germany and its effects have been reported by Dettmer, Greiling, Greiling and Stuhlsatz, Platt, and Binzus and Holzer. To test this drug, a double-blind clinical study was conducted by authors using saline as the control (placebo). Although a total of 72 patients were studied, an evaluation of the effects was made on 27 patients in the arteparon group and on 31 patients in the placebo group.It was found that the arteparon group was significantly superior to the placebo group-in terms of total effectiveness and usefulness. Arteparon was more effective than the placebo especially for the alleviation of pain specific to arthropathy of the knee. However, no other significant difference between either group was observed regarding other symptoms. Although the only drug now available for intraarticular injection for arthrosis deformans of the knee is adrenocortical hormones, this hormone causes serious adverse reactions. This study indicates that arteparon can be a useful drug for the treatment of arthropathy of the knee.

Treatment of arthrosis deformans of temporomandibular joint with correct movement and muscle conditioning exercises

Treatment of arthrosis deformans of temporomandibular joint with correct movement and muscle conditioning exercises

"Plica disease" (synovial folds) of the knee-joint: arthroscopic and histological findings, with suggestions for treatment (author's transl)

A mediopatellar plica (synovial fold) of the knee-joint may develop without recognisable cause in adolescents or young adults, predominantly females. It leads to pain on pressure over the medial knee compartment, sudden or "springing" intraarticular movements and pseudolocking of the joint. Similar plicae occur after traumatic joint contusion, with meniscus disease, or more rarely with arthrosis deformans. Histologically they are characterized by band-like fibrosed evaginations of the synovial membrane and of the synovial fat and connective tissue into the joint spaces. The following therapeutic suggestions, based on the personal experience of 15 cases, are made in the knowledge that significant inflammatory or proliferative arthritic changes can be excluded: the plica can be cut through under arthroscopy; chondromalacial defects, directly or indirectly caused by plical rubbing, of the medial femoral condyle and the medial patella can be removed, also under arthroscopic control, with an electric razor. Arthrotomy is no longer needed in most cases.

Ankle fractures treated by fixation of the medial malleolus alone. Late results in 29 patients.

A review of 29 patients with unstable ankle fractures treated by fixation of the medial malleolus alone is presented. At follow-up the result in 16 patients was classified as unsatisfactory or a failure and all of these patients showed radiological signs of posttraumatic arthrosis deformans. The importance of the position of the lateral malleolus in order to prevent joint incongruity and subsequent arthrosis is emphasized.

Treatment of rheumatoid and degenerative diseases with copper complexes

This review presents a historical account of the treatment of rheumatoid and other degenerative diseases with copper complexes. Clinical data obtained from 1940 to 1971 are provided for about 1,500 patients with rheumatoid arthritis (acute or chronic), rheumatic fever, ankylosing spondylitis, staphlococcal spondylitis, gonococcal arthritis, chronic gouty arthritis, polyarticular synovitis, coxitis, disseminated spondylitis, arthritis with psoriasis, Reiter's syndrome, lupus erythematosus, sarcoidosis, arthrosis deformans, erythema nodosum, sciatica (with and without lumbar involvement), cervical spine-shoulder syndrome or lumbar spine syndrome. The drugs used in these studies were Dicuprene, Alcuprin, Cuprimyl, and Permalon, a copper-salicylate preparation. A detailed presentation of toxicities associated with the use of these copper complexes is included.

Operative treatment of arthrosis deformans of the temporomandibular joint: a preliminary report

If patients with arthrosis deformans of the temporomandibular joint are treated without success by conservative means, operative therapy may be indicated. The type of operation depends on the complaints: a) resection of the auriculotemporal nerve and superficial temporal artery; or b) the same operation in combination with condylar shaving. Twenty-four joints in 14 patients underwent a denervation. Thirty joints in 19 patients were also shaved. The results were very satisfactory.