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 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The first 100 cases of the 135 THARIES surface replacement procedures with 4--32 months follow-up, are evaluated in terms of clinical results, radiographic information and complications. The short but detailed follow-up suggests that this procedure was an excellent alternative for the younger and more active population. The overall hip ratings (pain, walking and function) and range of motion are comparable to that of stem-type total hip replacements. When the THARIES and conventional hip results are further compared in 34 patients matched by sex and age for 3 major etiological groups (osteoarthritis, osteonecrosis and congenital hip dysplasia), the interim results are essentially comparable for both types. Three cases in the first 100 have required revision. One patient (no. 1) with osteoporosis, chondrolysis and arthrofibrosis following slipped capital femoral epiphysis had loose femoral and acetabular components 24 months postoperatively. He was revised to a T-28 hip replacement. The polyethylene socket in another patient (no. 4), the first dysplastic hip in this series, was 20 nm uncovered superiorly, became loose and was revised 9 months postoperatively. Now 15 months postoperative with a more medial THARIES acetabulum, the patient continues to have a good result. Another patient (no. 12) with bilateral dysplastic hips became progressively more disabled due to heterotopic bone, which was then excised 18 months postoperatively. Radiographic studies of the THARIES sockets demonstrate radiolucent zones at the cement-bone interfaces of the acetabulum in 88 cases, partial in 51 and complete in 37. Three hips were currently considered to have evidence of progressive socket loosening but are active and asymptomatic. There have been no femoral neck fractures in this series which we attribute to the custom fitting ability inherent in the range of components, the reaming protocol and the various remodelling guides. There have been no prosthetic breakages, subluxations, dislocations or sepsis. The complications observed in this series are minor and comparable to that of many other total hip arthroplasty operations. Nerve palsy and trochanteric separation have not been major problems although one existing peroneal nerve dysfunction and one trochanteric migration emphasize the need to minimize these complications by careful handling of the operative leg, and an accurate trochanteric reattachment technique.
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PMID:THARIES surface replacements: a review of the first 100 cases. 10 70

Coxopathies with rapid chondrolysis: Comparison of clinical and anatomical findings. Clinical, radiological, laboratory, and antomical data concerning 14 coxopathies with rapid chodrolysis are presented with reference to 12 patients aged from 37 to 77 years. Three criteria define this affection: reduction of the joint space by at least 50 per cent, in one year or less; chondrolysis completed in 1 to 3 years; complete narrowing in the superior part of the joint; isolated narrowing, exceptionally with a discrete osteophytosis. The pain rapidly becomes very severe. Such symptoms are, at first, indicative of coxitis, but the establishment of a radio-clinical picture of coxopathy rapid chrondrolysis is more indicative of an arthrosic origin. This could represent a particular evolutive stage of coxarthrosis related to the initial chondrolytic phase of rapid destructive coxarthrosis. From an early stage, the anatomical facts indicate an association between the degenerative lesions and the non-specific inflammatory lesions of the synovial membrane. These facts are interpreted, on the basis of data in the literature, as an indication of synovial lesions caused by the liberation of osteocartilaginous fragments. The problem of the pathogenesis of this rapid chondrolysis is then discussed.
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PMID:Hip diseases with rapid chondrolysis. Clinical and anatomical comparison. 114 87

Idiopathic chondrolysis of the hip is characterized by pain and limp in adolescence, with progressive loss of articular cartilage space and stiffness of the hip. In our five cases, the best results were obtained in those patients immobilized in a position of function. Those cases in which range-of-motion exercises were carried out resulted in ankylosis in a position of excessive flexion.
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PMID:The bizarre stiff hip. Possible idiopathic chondrolysis. 117 5

Fourteen patients (16 hips) with idiopathic chondrolysis of the hip were retrospectively studied at the Shriners Hospital from 1973 to 1986. Follow up averaged 84 months (range 13-180 months). All 14 patients were female. All but one were premenstrual. Each patient presented with an insidious onset of pain in the hip, thigh, or knee and radiographic symmetrical joint space narrowing. Three of the 16 hips required fusions, and only five regained a full range of motion. Partial restoration of the joint space occurred in eight hips. Essential treatment consists of unloading the hip joint while maintaining motion.
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PMID:Idiopathic chondrolysis of the hip. 273 19

SCFE is one of the most potentially damaging conditions of the adolescent hip. The onset may be associated with minor trauma but is often insidious and may present as vague thigh or knee pain. The lateral radiograph is the most sensitive view for detection of a low-grade slip. The contralateral hip must be examined carefully as there may be bilateral disease with the pain and disability of the presenting side masking the symptoms of less involved hip. SCFE is occasionally associated with other metabolic and endocrinologic disease, and these should be screened for in the history and physical examination. Once a slip begins, the hip remains at jeopardy for acute progression until the physeal plate closes. We recommend immediate surgical stabilization and prefer a cannulated screw system. Proper technique is critical to safe and reliable surgery. The most common complications, AVN and chondrolysis, are often related to technical errors and should be minimized with attention to detail.
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PMID:Slipped capital femoral epiphysis. 331 66

Two cases of acute chondrolysis of the upper femoral epiphysis associated with protrusio acetabuli are reported in two girls respectively 13 and 12 Y.O. The disease was unilateral in one patient and bilateral in other. Acute chondrolysis is characterized by onset of pain, restricted movements of the hip and evolution to an hip ankylosis within a few months. As usual no evidence of inflammatory disease could be shown at biology or at pathology of synovial membrane or of femoral head. CT and MR studies proved to be contributive in the first case. It's the author's opinion that in these 2 cases, chondrolysis appears as a complication of preexistent Protrusio Acetabuli.
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PMID:[Acute chondrolysis on primary protrusio acetabuli in children]. 343 Apr 48

The cases of nine patients (eleven hips) with idiopathic chondrolysis of the hip were studied. Seven of the patients were white and two were Hispanic. The age at onset ranged from eight to sixteen years (mean, 11.5 years). Four patients were boys and five were girls. All patients had a decreased passive range of motion of the hip, and radiographic examination showed regional osteoporosis, premature closure of the femoral capital physis, narrowing of the joint space, and lateral overgrowth of the femoral head on the neck. All laboratory examinations were negative for evidence of infection or rheumatoid arthritis. An arthrotomy was done in seven patients. Specimens of the synovial tissue showed no growth on culture, and the histological studies revealed only minimum signs of inflammation. Histological studies of the articular cartilage were normal. Treatment consisted of administration of acetylsalicylic acid in therapeutic dosages to maintain a blood salicylate level of fifteen to twenty-five milligrams per cent, active non-loading exercise of the hip, protected weight-bearing with crutches, short-term traction to overcome or relieve contractures after biopsy, iliopsoas tenotomy or lengthening in three patients, and an adductor myotomy in one patient. At follow-up, 2.3 to 9.4 years after onset (mean, 6.2 years), six patients had either no symptoms or only minor intermittent discomfort in the hip. On radiographic examination, although these six patients had restoration of the joint space they did have lateral overgrowth of the femoral head (lateral buttressing) and overgrowth of the lateral acetabular margin (lateral osteophyte). In three patients who had disabling pain, joint deterioration was evident on the radiographic examination. One of these patients had a resurfacing arthroplasty to relieve pain.
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PMID:Idiopathic chondrolysis of the hip. 665 40

Three cases of unilateral atloido-axis arthropathy are described in women aged 39 to 69 years. The initial diagnosis of arthritis made in view of the severity of the clinical (severe pain and stiffness) and radiological (marked chondrolysis, subchondral erosions), manifestations was contested in the absence of any laboratory abnormality of an inflammatory nature, as well as any bacterial, inflammatory rheumatic or metabolic cause. The final diagnosis made at the time of hospitalisation after 8 to 9 month progression of the disease was osteoarthritis, no subject to any doubt on the basis of the subsequent course. C2-C3 block present in 2 cases was a local factor of joint wear-and-tear. Other severe manifestations of osteoarthritis were seen in 2 patients. By analogy with certain forms of destructive osteoarthritis of the fingers, the term erosive osteoarthritis of the atloido-axis joint is suggested to describe this joint lesion.
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PMID:[Atloido-axoid erosive osteoarthritis. Apropos of 3 cases]. 710 Aug 5

The writers describe one case of idiopathic chondrolysis of the hip and four cases of chondrolysis secondary to slipped upper femoral epiphysis, all followed up from two to six years. So far as the writers know, idiopathic chondrolysis has not previously been reported in the literature in a male of the white race after the end of skeletal growth. In this case biopsy disclosed necrosis and fibrosis of the articular cartilage with extensive infiltration of lymphocytes and plasma cells in the synovial membrane and in the subchondral medullary spaces. In all the cases described there was gradual regression of pain and improvement in the radiographic appearances within about one year. Moderate limitation of movement persisted, however, especially internal and external rotation. In all cases the treatment consisted of protected weight bearing and physiotherapy.
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PMID:Chondrolysis of the hip (idiopathic and secondary forms). 734 30

Idiopathic chondrolysis of the hip is characterized by pain, limping and a progressive restriction in the range of motion of the hip. The paper describes the case of two female patients, age 28 and 37, who were referred to our hospital in October 1985 and May 1991 for pain and limitation of movement in the right hip. Neither patient had a previous history of systemic illness or trauma or medication such as steroids. On admission they underwent clinical and X-ray examinations. Both required an open biopsy to confirm the diagnosis. They have been followed for 4 years and 8 years, respectively.
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PMID:Adult idiopathic chondrolysis of the hip--report of two cases. 756 63


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