PURPOSE: This study examined the rate of degeneration of acetabular cartilage by the bipolar head according to time, and also which clinical factors are related to the degeneration of acetabular cartilage. MATERIALS AND METHODS: Among 192 patients (226 hip joints) who received bipolar hemiarthroplasty from August 1996 to August 2002, 61 patients (65 hip joints) were enrolled in this study, who were followed up for more than 2 years and showed no signs of dislocation, infection, or functional problems. A modified form of a computer assisted vector wear analysis program was used to measure the rate of degeneration of the acetabular cartilage. The factors that appeared to affect the rate of acetabular degeneration in the two groups was evaluated. RESULTS: The average linear degenerative change in the acetabular cartilage and the volumetric degenerative change were 0.23 +/- 0.107mm/year and 114 +/- 47.2mm3/year, respectively. The result showed significant differences in activity and HHS between the 2 groups. The HHS showed a reverse relationship with the linear degeneration and volumetric degeneration, and the activity showed a correlation with the linear and volumetric degeneration. CONCLUSION: The acetabular cartilage degenerates faster as the patient' activity increases, and slower with a higher HHS. When surgeons perform hip joint arthroplasty, it is strongly recommended that the life expectancy and the level of activity should be considered when deciding between a hemiarthroplasty and total hip arthroplasty.
Aged ; Arthroplasty, Replacement, Hip/*adverse effects ; Cartilage, Articular/*radiography ; Follow-Up Studies ; Humans ; Middle Aged ; Treatment Outcome

PURPOSE: To evaluate the characteristic MR findings of hemophilic arthropathy of the knee. MATERIALS & METHOD: Seven knees in six patients with hemophilia (five hemophilia A and one hemophilia B) were retrospectively studied with MR images and plain radiographs. Patients were aged between 2 and 20 years (mean, 11) and all had a clinical history of repeated hemarthrosis. MR images of the knee were analyzed with respect to intra- andextra-articular hemorrhage, the state of synovial tissue, articular cartilage, bone, menisci, and ligaments. RESULTS: Synovial hypertrophy and articular cartilage destruction were revealed in all seven knees ; pannus wasfound in four, and was seen as low signal intensity on T1-weighted image and high signal intensity on T2-weighted images. All five instances of synovial hypertrophy and pannus were enhanced. Joint effusion, presented in five ofseven knees, demonstrated slightly low signal intensity on T1-weighted image and high signal intensity on T2-weighted images, and was associated with peripheral low signal intensity of hemosiderin. Subchondral and marginal erosion was seen in six cases, patellar deformity in three, meniscal damage in four and cruciate ligament damage in one case. CONCLUSION: MR is superior to plain radiography in demonstrating chronic repeated hemarthrosis (manifested as thick intra-articular effusion), hemosiderin, synovial hypertrophy, erosion ordestruction of articular cartilage and bone, and meniscal or cruciate ligament injury of hemophilic arthropathy ofthe knee. MR is therefore thought to be a useful imaging study for accurate evaluation of hemophilic arthropathyof the knee.
Cartilage, Articular ; Congenital Abnormalities ; Hemarthrosis ; Hemophilia A ; Hemorrhage ; Hemosiderin ; Humans ; Hypertrophy ; Joints ; Knee* ; Ligaments ; Magnetic Resonance Imaging* ; Radiography* ; Sulindac

Degenerative joint disease is a non-inflammatory disorder of movable joints characterized by deterioration and abrasion of articular cartilage, and also by formation of new bone at the joint surfaces. It is by far the most common form of arthritis in persons over the age of fifty, but manifestation of this disease do not appear as a rule until the fourth or fifth decade. Despite the frequent occurrence of osteoarthrosis in the adult population, many parameters of its pathogenesis have not yet been established. It is generally accepted that many types of injury, and prolonged strenous sporting activity are capable of producing the initial cartilage lesion that leads to the development of degenerative joint disease. But little information is available on its frequency in young athletes. The present study was designed to obtain more precise information about the effect of prolonged strenuous athletic activities on the development of osteoarthrosis in young women athletes. After a detailed clinical examination of the joints of 50 Korean young women volley ball players between 19 and 24 years of age, routine roentgenography was taken of hips, knees, ankles, shoulders, elbows, wrists and hands. The following results were obtained: 1. 23(46%) of 50 young women volley ball players had radiological evidence of osteoarthrosis in one or other of the joint X-rays, but there was no instance of apparent narrowing of the joint space. Nine(18%) of 50 young players had osteoarthrosis in more than 2 joints. Among 50 young volley ball players, 19(38%) athletes had symptomatic osteoarthrosis. 2. The knee joints were most commonly affected(34%). Less frequent sites were ankles(16%), elbow(8%), shoulders(8%) and hips(2%). But there was no involvement of the distal interphalangeal joints of the hand which are most frequently affected in the elderly. 3. 8(16%) of 50 athletes were found to have osteoarthrosis at the site of an injury. The knee joints showed this association most frequently. 4. It was found that body weight and occupation did not affect the incidence of the osteoarthrosis significantly.
Adult ; Aged ; Ankle ; Arthritis ; Athletes ; Body Weight ; Cartilage ; Cartilage, Articular ; Elbow ; Female ; Hand ; Hip ; Humans ; Incidence ; Joint Diseases ; Joints ; Knee ; Knee Joint ; Occupations ; Osteoarthritis ; Radiography ; Shoulder ; Sports ; Wrist

The role of acromioclavicular (A-C) arthritis in stage 2 and 3 impingement syndromes was investigated in this study. Twenty-seven patients with stage 2 and 3 impingement syndrome were evaluated both clinically and radiologically for the presence of A-C arthritis. Patients with A-C arthritis who were treated by conservative or surgical methods were rated before and after therapy according to the University of California at Los Angeles (UCLA) shoulder rating scale. The follow-up period ranged from 7 to 16 months, with an average of 13 months. A-C arthritis was diagnosed in 21 of 27 patients (one grade 2 and 20 grade 3, according to Kellegren). Clinical and radiological evaluation of these 21 patients revealed A-C joint pain and a positive lidocaine injection test in all (100%), a positive horizontal adduction test in 20 (95.2%), decreased joint space in 18 (85.75%) and osteophytes in 11 (52.4%). Surgical treatment was considered for 12 A-C arthritis patients; and distal clavicle resection was performed in 11 of these cases. The average score measured by the UCLA rating scale increased from 13 to 28 in the group treated with surgery (satisfactory result), and from 10 to 13 in the group treated with conservative therapy (unsatisfactory result). The results of this study may be interpreted as demonstrating that A-C arthritis is a common etiologic factor in chronic impingement syndromes and its co-existence has a strategic importance in the choice of treatment method. Surgical resection of the distal clavicle should be considered in the presence of this pathology since this technique provides excellent results in pain relief and appears to be superior to conservative therapy in these cases.
Acromioclavicular Joint*/radiography ; Acromioclavicular Joint*/pathology ; Adult ; Aged ; Arthritis/radiography ; Arthritis/pathology ; Arthritis/complications* ; Arthrography ; Cartilage, Articular ; Human ; Male ; Middle Age ; Shoulder Impingement Syndrome/complications*

OBJECTIVETo observe therapeutic efficacy of osteoarthritis treated by electroacupuncture, and explore its function of promoting cartilage restoration.

METHODSAccording to random digital table, sixty cases of knee osteoarthritis (60 knees) were randomly divided into an electroacupuncture group and a physiotherapy group, 15 cases (30 knees) in each one. The electroacupuncture was applied at Neixiyan (EX-LE 4), Dubi (ST 35), Heding (EX-LE 2) and Xuehai (SP 10) in the electroacupuncture group, once every other day. The physiotherapy group was treated by medium-frequency therapeutic apparatus every day. For both groups, 4 weeks of treatment were required. The Lysholm knee scoring scale (LKSS) was used to evaluate and compare the knee joints function before and after treatment. At the same time, the GE Signa EXCITE Twin Speed HD 1.5T was used to take MRI examination of knee joints, and measure the T2 values in 10 sub-regions of the cartilage of tibiofemoral joints.

RESULTSCompared before treatment, the LKSS score of both groups were improved with significant differences except item demands for support (P < 0.01, P < 0.05). Between the two groups after treatment, there were significant differences on total score, item instability and swelling (all P < 0.05), the electroacupuncture group was better than the physiotherapy group, but no significant difference on the other items (all P > 0.05). In the electroacupuncture group after treatment, T2 value in anterior lateral tibial sub-region (LTa) was significantly lowered (P < 0.05), but no significant difference in the other nine sub-regions (all P > 0.05). In the physiotherapy group, T2 value in any sub-region was not significantly different before and after treatment (all P > 0.05).

CONCLUSIONElectroacupuncture could effectively improve the symptom, sign and knee joint's function of patients with knee osteoarthritis. Compared with physiotherapy, it has more superior effect and considered as a better non-operative treatment for osteoarthritis. Electroacupuncture also has positive influence on T2 value in cartilage, indicating that electroacupuncture may have the function of promoting cartilage restoration.

Adult ; Aged ; Cartilage, Articular ; diagnostic imaging ; Electroacupuncture ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Osteoarthritis, Knee ; diagnostic imaging ; therapy ; Radiography ; Treatment Outcome

OBJECTIVETo observe the images of early lesions of condylar cartilage of osteoarthritic rats in synchrotron radiation diffraction enhanced imaging (DEI).

METHODSThe animal model of temporomandibular joint osteoarthrosis was established in rat following the method of partial resection of the joint disc. The changes of osteoarthritic condylar cartilage in different pathological stages were observed by DEI and compared with those in situ histopathological sections.

RESULTSWith DEI, straight and orbicular lines were detected in condylar cartilage 45 to 60 days after discs resection. The lines were confirmed by histopathology to be collagen degradation and tiny fissure formation inside the cartilage.

CONCLUSIONSDEI is capable of imaging the early stages of pathological changes of excised condylar cartilage such as collagen degradation and tiny fissure formation, and this technique is of potential value to clinical application.

Animals ; Cartilage, Articular ; diagnostic imaging ; pathology ; Male ; Mandibular Condyle ; diagnostic imaging ; pathology ; Radiography ; Rats ; Rats, Wistar ; Temporomandibular Joint Disorders ; diagnostic imaging ; pathology ; X-Ray Diffraction ; methods

Calcium Pyrophosphate ; metabolism ; Cartilage, Articular ; metabolism ; pathology ; Chondrocalcinosis ; diagnostic imaging ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Female ; Gout ; pathology ; Humans ; Knee Joint ; diagnostic imaging ; metabolism ; pathology ; Male ; Menisci, Tibial ; metabolism ; pathology ; Middle Aged ; Osteoarthritis ; etiology ; pathology ; Radiography

Osteoarthritis (OA) is a chronic joint disease that involves degeneration of articular cartilage, limited intra-articular inflammation manifested by synovitis and changes in the subchondral bone. After the articular cartilage's stability and complex structure in the framework of pressure-proof were destruct, the ability to repair by itself was weak. Therefore early diagnosis in the treatment of osteoarthritis is a focal ponit. This paper addressed on the characteristics of diagnosis of OA in the relevant objective diagnostic methods.
Adult ; Aged ; Bone Density ; physiology ; Bone and Bones ; diagnostic imaging ; pathology ; Calcification, Physiologic ; Cartilage, Articular ; diagnostic imaging ; pathology ; Female ; Humans ; Joints ; diagnostic imaging ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Osteoarthritis ; diagnosis ; epidemiology ; Osteoarthritis, Knee ; diagnosis ; diagnostic imaging ; Radiography ; Radionuclide Imaging ; Synovial Membrane ; diagnostic imaging ; pathology ; Ultrasonography