Charcot arthropathy is a progressive, chronic and degenerative destruction of one or several joints caused by a central or peripheral neurological disorder. Approximately 25 % of the patients with syringomyelia develop this arthropathy located in the upper limb in 80 % of the cases. An early etiological diagnosis is essential to begin the treatment of the underlying neurological disorder. Afterwards, a conservative treatment of the arthropathy is preferred. We report the story of a patient with an arthropathy of the left shoulder due to Arnold-Chiari's malformation of type I with syringomyelia.
Arnold-Chiari Malformation/complications , Arthropathy, Neurogenic/etiology , Arthropathy, Neurogenic/physiopathology , Shoulder Joint/physiopathology , Syringomyelia/complications , Adult , Female , Humans
Ossification of the ligamentum flavum (OLF) is a rare cause of thoracic myelopathy. Mostly described in Japan and East Asia, a number of cases have recently been reported in western subjects. We present the case of a patient, an asymptomatic carrier of lumbar canal stenosis, presenting with a slowly progressive posterior cord compression and a T12 sensitive level. The diagnosis of thoracic OLF was retrospectively made thanks to medical imaging. We reviewed the literature and focused on the epidemiology, physiopathology, presentation, treatment and prognosis of the thoracic OLJ with or without lumbar spinal stenosis.
Ligamentum Flavum/pathology , Ossification, Heterotopic/complications , Spinal Cord Compression/etiology , Spinal Cord Diseases/etiology , Humans , Male , Middle Aged , Ossification, Heterotopic/pathology , Prognosis , Spinal Stenosis/pathology , Thoracic Vertebrae
Metal-on-metal total hip arthroplasty (MOM THA) fuels debate in the orthopedic community after statistics showed higher-than-expected short-term failures in comparison with metal-on-polyethylene THA. The problem of early failure in the young, active patient with a metal-on-polyethylene implant has prompted the research of another couple. Multiple studies showed the advantages of MOM THA. The results of MOM resurfacing and MOM THA in our hospital did not show concerning results. Nonetheless, the data in the literature shows divergent opinions. The most recent statistics indicate that the results are disappointing, particularly with specific types of implants. Several institutions, in the USA and in Europe, are developing protocols for the follow-up of patients with MOM hip implants. Today, we are headed towards imposing a moratorium on using MOM THA.
Arthroplasty, Replacement, Hip , Hip Prosthesis/adverse effects , Metals/adverse effects , Prosthesis Design/trends , Prosthesis Failure , Arthroplasty, Replacement, Hip/adverse effects , Arthroplasty, Replacement, Hip/methods , Hip Joint/surgery , Humans , Ions/metabolism , Metals/chemistry , Metals/metabolism , Prosthesis Design/methods , Prosthesis Failure/trends
OBJECTIVE: To assess health-related quality of life (HRQOL) in a prospective study with 7 years of follow-up in 49 consecutive patients who underwent a total joint replacement because of osteoarthritis. METHODS: Generic HRQOL was assessed with the short-form 36 (SF-36) and specific HRQOL with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). RESULTS: Out of the 39 subjects who have completed the 7 years of follow-up of this study, 22 (56.4 %) underwent a hip replacement surgery and the other 17 (43.6 %) a knee replacement. Six months after surgery, a significant improvement, compared to preoperative scores, was observed in two of the eight dimensions of the SF-36 (i.e. physical function and pain). The same dimensions, pain and physical function, at the same time, 6 months after surgery, measured by the WOMAC, showed a significant improvement as well, but there was no significant change in the stiffness score. From 6 months to the end of follow-up, changes in SF-36 scores showed a significant improvement in physical function (p = 0.008), role-physical (p = 0.004) and role-emotional (p = 0.01) while all scores of the WOMAC improved (p < 0.001 for pain, p < 0.001 for stiffness and p < 0.01 for physical function). CONCLUSION: The improvements observed in HRQOL at short term after surgery, are at least maintained over a 7-year follow-up period.
Arthroplasty, Replacement, Hip , Arthroplasty, Replacement, Knee , Osteoarthritis, Hip/surgery , Osteoarthritis, Knee/surgery , Quality of Life , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prospective Studies
The accretion of the terrestrial planets from asteroid collisions and the delivery to the Earth of martian and lunar meteorites has been modelled extensively. Meteorites that have experienced shock waves from such collisions can potentially be used to reveal the accretion process at different stages of evolution within the Solar System. Here we have determined the peak pressure experienced and the duration of impact in a chondrite and a martian meteorite, and have combined the data with impact scaling laws to infer the sizes of the impactors and the associated craters on the meteorite parent bodies. The duration of shock events is inferred from trace element distributions between coexisting high-pressure minerals in the shear melt veins of the meteorites. The shock duration and the associated sizes of the impactor are found to be much greater in the chondrite (approximately 1 s and 5 km, respectively) than in the martian meteorite (approximately 10 ms and 100 m). The latter result compares well with numerical modelling studies of cratering on Mars, and we suggest that martian meteorites with similar, recent ejection ages (10(5) to 10(7) years ago) may have originated from the same few square kilometres on Mars.
