The effect of ibuprofen on the thickening, stiffening and development of degenerative changes in the rabbit knee following immobilization

The right knee of adult rabbits was immobilized in extension for 5 weeks. The rabbits were then allowed to move freely for 8 weeks. Some rabbits were given 100 mg of ibuprofen (Brufen) daily per os during the immobilization and remobilization periods. The controls were not given any drug. The development of the thickness, stiffness and degenerative changes in the knees as a result of immobilization was observed. The thickening was significantly less and the radiological changes were significantly smaller in the knees of those rabbits given ibuprofen than in the controls. There were no significant differences between the groups regarding the mobility of the immobilized knees. In the study the anti-inflammatory drug ibuprofen had a prophylactic effect on some of the pathological processes in the rabbit knee (following immobilization and resulting in progressive osteoarthritis.

Early posterior subtalar fusion in the treatment of fractures of the os calcis

Displaced fractures of the os calcis involving the subtalar joint frequently cause chronic disability due to subsequent osteoarthritis. Early posterior subtalar fusion may prevent this outcome. We have reviewed forty-seven fractures in forty-three patients at an average of seven years after operation. Over 90 per cent of patients had an excellent, good or satisfactory result.

[Late results of Imhäuser's osteotomy for slipped capital femoral epiphysis (author's transl)]

The author has reviewed the clinical and radiological results of 55 patients 11 to 22 years following an Imhäuser three dimensional intertrochanteric osteotomy for slipped capital femoral epiphysis. 13 additional patients responded by questionnaire. Of these 68 hips 66 were painfree and functional. One patient complained of pain (due to coxarthrosis proven by x-ray). A second patient was dissatisfied with the functional range of his hip. 40 of the 55 hips which were examined clinically and radiologically had full range of motion, 10 hips showed minimal and 5 hips significant limitation of motion. Radiologically 73% of the 55 hips examined were rated excellent or good, 27% showed beginning degenerative changes (including one patient with marked coxarthrosis). The results were greatly influenced by the severity and direction of slipping, preoperative treatment and the accuracy of operative correction. This study permits the conclusion that three dimensional intertrochanteric osteotomy prevented or at least delayed the development of degenerative changes in the majority of cases. It is possible that many of these patients will not develop coxarthrosis.

[Osteotomy of the pelvis (Chiari) (author's transl)]

Judging by 203 cases the pelvic displacement osteotomie by Chiari has proven to be a very effective method to correct the deficient femoral head cover of the dysplastic acetabulum, in many cases however it is difficult to normalize the roof angle. We examined 51-joints in which the pelvic osteotomie by Chiari had been performed just before and particularily after growth had come to an end, in view of the prophylaxis of arthrosis of this operation. Hereby we observed that development or increase of anthrotic signs on an average of 10 1/2 years was less frequent than could be expected without the osteotomy, the clinical condition remaining approximately the same as before the operation, but nevertheless did not deteriorate.

[Corrective osteotomies at posttraumatic deformities of the femur (author's transl)]

The importance of the posttraumatic deformities is apart from the aesthetic point of view also due to the "praearthrotic deformity" according to Hackenbroch. Certain cases require operative correction, the indication of which being corresponding to the diagnosis possibilities. On account of examples the technique of osteotomies at the femur has been pointed out which should always be done in combination with a Compressionosteosynthesis.

A clinical and stress radiographical follow-up investigation after Jones' operation for replacing the anterior cruciate ligament

Measurements have been made on knee radiographs exposed during stress displacement by controlled hydraulic forces using a specially designed apparatus. This accurately records the amount of anterior and posterior tibial displacement (drawer sign) and the degree of medial and lateral collateral ligament laxity on radiographs. The findings in 25 patients have been analysed following the Jones' procedure for the repair of the anterior cruciate ligaments. The operative results were judged to be completely successful in 72% of patients and the value of stress radiographic measurements is discussed.

[To discharge one compartment of the knee without a varisation or valgisation osteotomy in the knee region (author's transl)]

The correction of a varus or valgus deformity around the knee joint as prophylaxis or as a therapy of monocompartmental osteoarthritis of the knee is limited in its indication and of the amount of correction. The experiments have shown a possibility of discharging one compartment by a translocation of the knee to lateral or medial side after a supracondylar osteotomy. The method and its indication have been discussed.

[The effect of correction of the varus or valgus deformity of the knee (author's transl)]

The distribution of pressure force (load) on the tibia-plateau in a normal knee as well as varus or valgus deformity has been measured electronically and also studied by photoelastic experiments. The translocation of it by changing the knee axis has been demonstrated. The significance of the pressure force causing monocompartmental gonarthritis has been shown. The causal therapy is a correction of the valgus or varus deformity. The effect of this operation lies in the biomechanical discharge of the damaged compartment.

Suitability of the C57 black mouse as an experimental animal for the study of skeletal changes due to ageing, with special reference to osteo-arthrosis and its response to tribenoside

Histological studies in male C57 black mice revealed a high incidence (39-61%) of osteo-arthrotic changes in the knee joint from about the 17th month of life. In animals of the same strain aged 15 1/2 months the incidence was only 19%. The incidence of gonarthroses in 16-month-old female mice was considerably lower (4%). In male mice aged 17-20 months, the oral administration of tribenoside in doses of 500 and 1,200 mg/kg weekly led to a significant (p less than 0.05) reduction in the overall arthrotic involvement. A possible relation between the effect of tribenoside and other anti-inflammatory agents on osteo-arthroses in the mouse and their influence on mucopolysaccharide metabolism in connective tissue is discussed. The incidence of the formation of gaps in the epiphyseal growth zones and of osteoporosis of the femur and tibia in the same strain increases distinctly with advancing age. Except in animals treated with the highest dosage tested, in which there was a significant decrease in the development of osteoporosis, tribenoside in the range of doses used had no influence on these skeletal changes.

Late results of transfer of the tibial tubercle for recurrent dislocation of the patella

The authors wished to determine the late results of the Hauser operation, with special reference to the development of osteoarthritis. Predisposing factors associated with recurrent dislocation of the patella were also investigated. Thirty-five patients with forty-four surgically treated knees attended for review, ten to twenty-five (average sixteen) years after operation. Two patients had subsequently undergone excision of the patella. Ten patients gave a family history of recurrent dislocation of the patella and seven patients showed generalised joint laxity. Pain was present in eight knees before operation and was present in thirty-three knees (75 per cent) at the time of review. Patella crepitus was present in thirty-seven out of forty-two knees (88 per cent) at review. Osteoarthritis was present in thirty out of forty-two knees (70 per cent). The incidence increases with time since operation and the present age of the patient. It is concluded that the Hauser operation prevents further dislocation but does not prevent the development of osteoarthritis. It is possible that a simple soft-tissue operation which effectively prevents dislocation might achieve the same results.

Effect of sympathectomy on development of chronic osteoarthritis: case report

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