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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two cases of idiopathic chondrolysis of the hip-joint in chinese boys were treated by the authors. By consulting medical literature, the etiology, diagnosis and treatment of this disease were discussed in this paper. The real cause of this disease is still unknown. When a preschool child, especially a girl, complains of pain and limitation of movement at one hip-joint without evident predisposing cause, plus narrowing of inter-articular space revealed by roentgenogram and normal values in hematology and ESR, this disease should be ruled out. Owing to lack of ideal therapy up to now, pain can be alleviated and ankylosis be prevented by performing active and passive functional exercises of the joint persistently under light load or no load conditions. Besides, immobilization of the joint by brace and plaster bandage are contraindications for this disease.
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PMID:[Idiopathic chondrolysis of the hip-joint: report of two cases and review of the literature]. 803 71

Of 44 patients (55 hips) with slipped upper femoral epiphysis treated from 1963 to 1989, 13 (14 hips) developed chondrolysis. Eight hips had chondrolysis at the time of presentation, all in female patients who were either coloured or black and who had moderate or severe slips. The other six hips had persistent pin penetration of the joint; in five of these the pin penetrated the anterosuperior quadrant of the head. Removal of penetrating pins resulted in improvement in pain in all six hips and in the range of movement in four. Chondrolysis did not develop in any of 11 hips with transient intraoperative pin penetration. In hips with chondrolysis maximum joint-space narrowing developed within the first year; improvement in joint space and range of movement continued for up to three years after maximal involvement. At an average follow-up of 13.3 years no patient had pain but five hips were stiff.
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PMID:Chondrolysis in slipped upper femoral epiphysis. Long-term study of the aetiology and natural history. 824 91

Joint distraction (arthrodiastasis) with a unilateral fixator was used to treat 9 patients with stiffness of the hip which had followed Perthes' disease (3), epiphysiolysis (2), congenital dysplasia (2), tuberculosis (1) and idiopathic chondrolysis (1). Their average age was 14 years, and they all had pain, limp and shortening of the leg. Distraction of 0.5 to 1 cm was maintained for an average of 94 days. The average range of movement subsequently was 65 degrees compared with 20 degrees before. The articular space was widened by an average of 2.8 mm, and only 3 patients had pain on follow up.
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PMID:Arthrodiastasis for stiff hips in young patients. 840 45

Chondrolysis, or acute cartilage necrosis, is a controversial and perplexing complication of slipped capital femoral epiphysis (SCFE) in adolescents. It usually leads to deformity, pain, limping, and limitation of motion in the affected extremity. Although several theories have been proposed, no agreement has been reached as to the etiology or the pathogenesis of chondrolysis. Furthermore, no treatment program has been completely successful, and the general prognosis and natural history of this condition are not clear. An overview of the latest knowledge of the matter is presented.
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PMID:Chondrolysis after slipped capital femoral epiphysis. 886 81

Twenty-five patients, 11 to 19 years in age, were treated with hip arthrodesis for an incapacitating painful and stiff hip. Clinical diagnoses included avascular necrosis (AVN) associated with slipped capital femoral epiphysis (SCFE) (7 patients), posttraumatic AVN (6), septic arthritis (4), complication of treatment of developmental dysplasia of the hip (DDH) (4), pathologic fracture of femoral neck through bone cyst with resulting AVN (2), Perthes disease (1), and idiopathic chondrolysis (1). Preoperative motion was minimal or absent in 13 patients, limited in 12, and very painful in 23 patients. A two-incision surgical approach was utilized, providing for an intra-articular fusion technique and internal fixation with precise positioning. The surgical technique described avoids any dissection of the hip abductor musculature or a deforming osteotomy of the proximal femur. Twelve complications occurred in 10 patients, 9 of which required additional operative treatment. At an average postoperative follow-up of 6 years, 10 months, the overall activity level was greatly increased over the preoperative activity level secondary to the relief of pain. Hip arthrodesis is the acceptable salvage procedure for the otherwise healthy, active adolescent or young adult with unilateral hip disease characterized by incapacitating pain and/or an unacceptable fixed position.
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PMID:Intra-articular hip arthrodesis without subtrochanteric osteotomy in adolescents: technique and short-term follow-up. 911 92

We performed a modified, rotational acetabular osteotomy through a lateral transtrochanteric approach on 19 hips in 18 patients with a dysplastic joint. Six hips in six patients were operated on using the original approach. The mean age at operation was 28 years (14 to 54) and the mean period of follow-up 2.3 years (1 to 4.4). Clinical evaluation using the Merle d'Aubigne score showed excellent or good results in 76%. Radiologically, 15 hips showed good acetabular remodelling and no signs of progressive osteoarthritis. In ten hips (40%) there was chondrolysis and collapse of the transferred acetabulum or both within one year, although this gave only mild pain in some patients. Factors which were significantly associated with the grade of outcome included age at the time of operation, the thickness of the transferred acetabulum, failure to use a bone graft, and a transtrochanteric approach.
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PMID:Early deterioration after modified rotational acetabular osteotomy for the dysplastic hip. 911 46

We describe six knees in five patients, referred to us after accidental irrigation with chlorhexidine 1% in aqueous solution during arthroscopy. All six knees developed persisting pain, swelling and crepitus with loss of range of movement. Radiographs showed loss of joint space in all three compartments due to extensive chondrolysis, with many loose bodies and synovitis. Histological examination showed partial necrosis of the cartilage, with slight non-specific inflammation and fibrosis of synovial specimens. Care is needed in checking irrigation fluids, and these should have a distinctive colour.
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PMID:Clinical and pathological changes in the knee after accidental chlorhexidine irrigation during arthroscopy. Case reports and review of the literature. 1085 96

The authors report 4 cases of rapid lateral femoro-tibial chondrolysis following arthroscopic lateral meniscectomy. All patients were young athletes. At the time of meniscectomy, the cartilage of the lateral compartment was normal. Only one meniscectomy was done with the Ho Yag laser. Clinical symptoms were always identical: pain and important swelling, persisting despite intra articular injections of corticosteroids. A second-look arthroscopy was performed after a mean delay of 6 months (5 to 8), showing numerous cartilaginous debris floating in the joint (like in a chondromatosis disease) and a severe cartilaginous damage in the lateral compartment (grade 3 or 4). Swelling disappeared after arthroscopic lavage followed in two cases by a non weight bearing period of one to two months. But X-rays always demonstrated a narrowing of the lateral joint line on flexion-full weight bearing AP views. Rapid chondrolysis is a rare and severe complication of lateral meniscectomy. The etiology, which is mechanical, is not known. It probably represents an acute form of chronic, slow chondrolysis which is frequent after lateral meniscectomy. Rapid chondrolysis should be treated urgently by the following protocol: arthroscopic lavage, intra articular injections of corticosteroids and non weight bearing period.
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PMID:[Rapid chondrolysis after arthroscopic external meniscectomy. Apropos of 4 cases]. 977 28

Nine patients with chondrolysis secondary to slipped capital femoral epiphysis of the hip were followed up from a minimum of 7 to a maximum of 19 years (average, 13.7 years) after the onset of the disease. The degree of slipping of the proximal epiphysis of the femur was severe in five patients and moderately severe in four patients. The nine patients were treated with non-weight bearing, antiinflammatory drugs, and physical therapy. The disease had a good resolution, with gradual regression of pain, and radiographs showed restoration of the joint space in an average of 10 months. At follow-up, mild coxalgia after prolonged activity was present in five patients, whereas in the one patient with concomitant avascular necrosis, pain was much more intense. All patients had some limitation of range of motion of the hip. It was most restricted in two patients, one with associated avascular necrosis and one with a severe slip. In all patients, radiographs showed restoration of the joint space. In the group with severe degrees of slipping, there were marginal osteophytes of the femoral head and the acetabulum. Significant arthrosis was present in the patient treated conservatively and in the patient with associated ischemic necrosis. In this long-term study of chondrolysis secondary to slipped capital femoral epiphysis, the overall prognosis was benign and was determined by the degree of slipping of the proximal epiphysis of the femur and concomitant aseptic necrosis. However, the authors believe that the patients with radiographic signs of degenerative joint disease may have a poor long-term prognosis.
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PMID:Chondrolysis of the hip complicating slipped capital femoral epiphysis: long-term follow-up of nine patients. 1021 71

Idiopathic chondrolysis of the hip is characterized by the destruction of the articular cartilage due to an unknown cause, principally affecting women during adolescence and producing premature degeneration of the hip. Twelve cases (11 patients) were reviewed at our hospital, with an average follow-up period of 13.2 years, during which a clinical and radiologic study was performed. Despite the treatment implemented, idiopathic chondrolysis of the hip causes progressive degeneration of the joint with the appearance of almost constant pain, stiffness, and anomalous positions. Radiologic studies show concentric narrowing of the articular space, decrease in the width of the femoral head and neck, and shortening of the affected member due to alteration in the growth physis of the upper extremity of the femur.
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PMID:Idiopathic chondrolysis of the hip: long-term evolution. 1041 92


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