[Cellular aspects of the aging of the articular cartilage. II. Condylar cartilage with fissured surface taken from normal and arthritic knees]. / Aspects cellulaires du vieillissement du cartilage articulaire. II. Cartilage condylien à surface fissurée prélevé dans les genoux "normaux" et "arthrosiques".

The authors studied the cellular density (number of cells per mm2) of cartilage taken from the femoral condyles of 46 cadavers (73 knees). In each case, the cartilage was taken from the summit of the condyle and, in 46 joints (27 subjects), a sample was also taken from the posterior surface (non weight-bearing zones). The fragments of non-calcified cartilage were sectioned with a cryostat and the sections (10 micrometers) were stained with hematein-eosin and solid red-Alcian blue. This study demonstrates: 1) a decrease in the cellular density of fissured cartilage compared to normal cartilage; this decrease appears to be proportional to the degree of fibrillation; 2) a decrease in the cellular density of apparently normal cartilage from arthrotic joints compared with normal cartilage from healthy joints; 3) with the age of the subjects, an increase in the density of the clones (number of clones per mm2) and the density of clonal cells (number of clonal cells per mm2) together with a decrease in the mean number of chondrocytes per clone. In fissured cartilage, the density of the clones, the density of the clonal cells and the number of chondrocytes per clone are slightly higher on the posterior surface of the condyles than on the summit of the condyles. These results emphasise the importance of the role that might be played by cellular phenomena in the mechanisms of deterioration of cartilage with aging and with arthrosis.

[Cellular aspects of the aging of articular cartilage. I. Condylar cartilage with a normal surface sampled from normal knees]. / Aspects cellulaires du vieillissement du cartilage articulaire. I. Cartilage condylien à surface normale, prèlevè dans les genoux normaux.

The authors studied the cellular density of articular cartilage taken from the femoral condyles of 77 autopsy subjects at Hôpital Lariboisière in Paris. This study showed a decrease in the cellular density (number of chondrocytes per mm2) going from the superficial zone towards the calcified zone of the cartilage in all layers, as a function of the age of the subjects. The decrease in cellular density is in the order of about 50% of the total chondrocyte number when subjects younger than 40 are compared with those older than 80. The demonstration of a regular increase in the number of empty lacunae per mm2 with the age of the subjects, i.e. lacunae without chondrocytes, suggest that the cause of this decrease in cellular density of the cartilage with age could be a physiological necrosis due to "exhaustion" of the chondrocytes. The metabolic activity of the chondrocytes may also decrease with age, as suggested by the increasing proportion of alcianophobic cells, cells which are weakly or not at all labeled by radioactive sulfates which indicate the sites of biosynthesis of proteoglycans. These cellular modifications could play a role of senile fibrillation of articular cartilage and in arthrosis.

[Anatomic incidence of meniscochondrocalcinosis of the knee]. / Fréquence anatomique de la ménisco-chondrocalcinose du genou.

The authors have studied the incidence of menisco-calcinosis (MC) and that of menisco-chondrocalcinosis (MCC) of knee joints of 108 non selected cadavera. The mean age of the subjects was 71.8 +/- 13.8 years. The study was performed by radiographic examination of the menisci and cartilagineous fragments of femoral condyles using high contrast films. The incidence of MC or MCC was found to be 18.5 per cent. It was slightly higher in females (21.5 p. cent) than in males (15.8 p. cent) subjects but this difference failed to reach the level of statistical significance. No positive case was detected before the age of 60 years. For the age groups of: 60-69, 70-79, 80-89 and over 90 years, its incidence was: 11.7; 26.9; 21.2 and 50 (4 subjects out of 8) per cent respectively. Approximately 40 per cent of all positive cases had meniscocalcinosis without associated chondrocalcinosis. No single case of chondrocalcinosis without meniscocalcinosis was observed. Six out of 8 cases with MC calcinosis and 2 out of 12 cases with MCC were unilateral. The external menisci were more frequently and more heavily affected than internal ones. Eighty per cent of the knees affected by either MC or MCC were at the same time associated to an osteoarthrotic lesion compared to 35 p. cent of the knees without MC or MCC matched for age: a result which appeared to be highly significant difference.

[History of sciatica]. / Histoire de la sciatique.

The long history of sciatica is recalled from the 18th century observations through the contributions of Lasègue (a philosopher who worked with Claude Bernard), Valleix, Brissaud, Dejerine, Sicard, Forestier, Alajouanine and Petit-Dutaillis. Two papers by professor de Sèze on the significance of herniations of lumbar disks were published in December 1939 and June 1940, a most unfavourable period in France. Since then many advances are to be recorded among which the use of metrizamide instead of the old lipiodol and, most of all, the advent of CT Scan.

Metabolism of human femoral head cartilage in osteoarthrosis and subcapital fracture.

The cell density and incorporation of 35SO4 and 3H-glycine into human articular cartilage from 8 osteoarthrotic and 7 normal (subcapital fracture) femoral heads were studied. It was found that osteoarthrotic cartilage incorporates on a per cell basis about twice as much 35SO4 and 2--5 times as much 3H-glycine as normal cartilage. There was no relationship between the intensity of incorporation and either the location of the cartilage (weight-bearing versus non weight-bearing areas) in normal cartilage or the degree of damage (normal-like, fibrillated, and ulcerated) in osteoarthrotic articular cartilage. In the latter tissue the increased synthetic capacity of the cells seems to be a diffuse rather than a localised process, for it was also found in cartilage from peripheral osteophytes. Histo-autoradiographic studies showed that the osteoarthrotic chondrocytes are metabolically hyperactive all over the femoral head, including wedge-shaped margins of the zone of exposed bone. These results support the hypothesis that much of the articular cartilage from osteoarthrotic femoral heads is of an immature chondroblastic type. It is suggested that de-novo synthesis of articular cartilage occurs during the process of regional remodelling of the femoral head, which would account for the observed hyperactivity.

[Our experience with surgery of the rheumatoid metatarsus. 150 cases]. / Notre expérience de la chirurgie de l'avant-pied rhumatoïde (150 interventions).

The authors report on the results of their experience with surgery of the rheumatoid metatarsus (95 patients operated on--150 operations). The operation most frequently performed was the Lelievre metatarsian resection-alignment. They confirm the advantage of this type of surgery, which provides very handicapped patients with substantial relief, both of pain and of the functional troubles, despite the nature of the disease involved. Out of 80 patients operated on and followed up over a period of 2 to 14 years, and considering the correction of the deformities, the effect on pain and functional troubles, the authors report 103 very good and good results, and 18 poor results and failures. The good results obtained deteriorate only very little in the long run: after 10 years, the very good and good results involving effect on pain, has gone from 96 to 90%. On the other hand, as far as functional troubles are concerned, very good and good results go from 90% to 70%. The authors underline the advantage of a very through examination, in order to look for post-operatory risk factors (peripheral circulatory deficiency and poor resistance to infection). They insist for exercising great prudence when advising an operation consisting of the interposition of an endoprosthesis (Swanson's implant). Indeed, in subjects who are in any way fragile, delays in scarification, related to hematomas complicated or not with skin necrosis appear with increased frequency after interposition of the implant.