[Objective]To evaluate the clinical and radiological results of a curettage of granulation tissue,the exchange of polyethylene liner and morselized bone grafting for the treatment of osteolysis around a stable cementless acetabular cup.[Method]From Apr.1996 to Jul.2000,26 patients underwent revision of curettage of granulation tissue,the exchange of polyethylene liner and morselized allografting,which were followed up for an average of 5.5 years.The Harris Hip Score was used to evaluate the clinical result.The size of osteolysis of periacetabular cup was measured in AP and lateral view of X-rays.The allograft union was evaluated with the bone graft incorporation scale.[Result]Clinically,the average HHS increased from 82 to 88 points postoperatively.Radiologically,the size of osteolysis of peraacetabular cup changed from average 23.8 mm?24.9 mm to 11.5 mm?8.2 mm in the AP view,and from 11.1 mm?11.6 mm to 5.3 mm?4.5 mm in the lateral view.The bone graft incorporation scales were Grade Ⅰ and Ⅱ in 12 and 14 cases,respectively.[Conclusion]The Curettage of granulation tissues,morselized bone grafting and exchange of polyethylene liner and femoral head is an effective therapy in osteolysis around a stable cementless acetabular cup and could preserve the bone stock for the further revision THA.

BACKGROUND: The aim of this study was to evaluate the safety and analgesic efficacy of polmacoxib 2 mg versus placebo in a superiority comparison or versus celecoxib 200 mg in a noninferiority comparison in patients with osteoarthritis (OA). METHODS: This study was a 6-week, phase III, randomized, double-blind, and parallel-group trial followed by an 18-week, single arm, open-label extension. Of the 441 patients with knee or hip OA screened, 362 were randomized; 324 completed 6 weeks of treatment and 220 completed the extension. Patients were randomized to receive oral polmacoxib 2 mg (n = 146), celecoxib 200 mg (n = 145), or placebo (n = 71) once daily for 6 weeks. During the extension, all participants received open-label polmacoxib 2 mg. The primary endpoint was the change in Western Ontario and McMaster Universities (WOMAC)-pain subscale score from baseline to week 6. Secondary endpoints included WOMAC-OA Index, OA subscales (pain, stiffness, and physical function) and Physician's and Subject's Global Assessments at weeks 3 and 6. Other outcome measures included adverse events (AEs), laboratory tests, vital signs, electrocardiograms, and physical examinations. RESULTS: After 6 weeks, the polmacoxib-placebo treatment difference was −2.5 (95% confidence interval [CI], −4.4 to −0.6; p = 0.011) and the polmacoxib-celecoxib treatment difference was 0.6 (CI, −0.9 to 2.2; p = 0.425). According to Physician's Global Assessments, more subjects were “much improved” at week 3 with polmacoxib than with celecoxib or placebo. Gastrointestinal and general disorder AEs occurred with a greater frequency with polmacoxib or celecoxib than with placebo. CONCLUSIONS: Polmacoxib 2 mg was relatively well tolerated and demonstrated efficacy superior to placebo and noninferior to celecoxib after 6 weeks of treatment in patients with OA. The results obtained during the 18-week trial extension with polmacoxib 2 mg were consistent with those observed during the 6-week treatment period, indicating that polmacoxib can be considered safe for long-term use based on this relatively small scale of study in a Korean population. More importantly, the results of this study showed that polmacoxib has the potential to be used as a pain relief drug with reduced gastrointestinal side effects compared to traditional nonsteroidal anti-inflammatory drugs for OA.
Arm ; Celecoxib* ; Electrocardiography ; Hip ; Humans ; Knee ; Ontario ; Osteoarthritis* ; Outcome Assessment (Health Care) ; Physical Examination ; Vital Signs