[Serum hyaluronic acid in osteoarthritis]. / L'acide hyaluronique sérique dans l'arthrose.

In this prospective study, serum hyaluronate (SH) was assayed using a radiometric method (Pharmacia) in 73 osteoarthritis patients and 39 controls. All assays were performed between 8 h 00 and 9 h 00 a.m. because SH levels exhibit circadian variations. SH levels were significantly higher in patients with osteoarthritis than in controls (92 +/- 66 micrograms/l and 39 +/- 21 micrograms/l, respectively, p = 0.0001). Among 50 patients with osteoarthritis, including 29 with knee involvement and 21 with hip involvement, SH levels were not correlated with morning stiffness, duration of symptoms, Lequesne's algofunctional index, erythrocyte sedimentation rate, C-reactive protein, severity of roentgenographic changes in the affected knee or hip, disease extension, or severity. The lack of any relationship between changes in SH levels and Lequesne's is index values in 25 patients or between SH levels and joint space narrowing evaluated retrospectively in 16 patients, as well as the prompt return to high SH levels after arthroplasty and synovectomy in 14 patients with hip joint osteoarthritis, suggest that this potential marker is not useful for monitoring osteoarthritis in a single joint.

Massive bone allografts in children.

A group of ten children and adolescents with malignant bone tumours (eight osteosarcomas, two Ewing's tumours) were treated with chemotherapy and resection with allograft reconstruction. Intercalary grafts were used in three cases and terminal osteoarticular grafts at the knee in seven. The mean follow up was 22 months. Functional results were satisfactory, but there were some complications related to the graft. Although these are early results, we believe that the method is justified and is preferable to the use of an endoprosthesis, particularly in children.

[Pyogenic sacroiliac arthritis in children. Analysis and commentary apropos of 7 cases]. / Les arthrites sacro-iliaques à pyogènes chez l'enfant. Analyse et commentaires à propos de 7 observations.

Seven cases of pyogenic arthritis of the sacro-iliac joint in children were observed between 1968 and 1981. Their analysis is discussed with the conclusions of the too much rare publications in the recent literature. Taking in to account the anatomic particularities the necessity of very precise roentgenographic technics in order to assess the sacro-iliac joint, especially in children because of incomplete ossification, the authors replace this pathology into the osteomyelitis in children. From the clinical aspects of the disease, with its typically localized pain, and its acute clinical and biological septicemic syndrome, the authors attempt to demonstrate that the classical idea of a delayed diagnosis, is not absolute. Even in this particular localization, an early "up to date" diagnosis is possible allowing rapid treatment with efficient antibiotherapy directed towards the responsible germ after their isolation (especially staphylococcus aureus). Indubitable progress has been gained with systematic radio-nuclide bone scanning in emergency.

[Posttraumatic club-hand. Therapeutic problems (apropos of 5 cases)]. / Main bote post-traumatique. Problèmes thérapeutiques (à propos de 5 cas).

Progressive radial deviation after epiphyseal separation in children is a rare complication. It is related to an imbalance of residual growth potential of the lower ends of the radius and ulna together. The functional disability is generally moderate. 5 cases were observed by the authors, all of which were treated surgically. The mechanism of the deformity and the surgical techniques are described. These are lengthening of the radius, angulation osteotomy of the radius, shortening of the ulna or epiphysiodeses. In some cases, operative excision of a partial epiphyseal closure can be done provided that there has been a close follow up after the trauma and an early diagnosis.

[Anatomical and histological study of osteochondral and costal cartilage autografts in the dog]. / Etude anatomique et histologique d'autogreffes ostéochondrales et de cartilages costaux chez le chien.

A macroscopic and microscopic anatomical study of the knees of 10 Beagles showed that thin osteo-chondral autografts taken from another joint healed perfectly macroscopically and almost perfectly histologically, if they fitted very well (figure 2). Rib cartilage grafts fitted perfectly to a dog's knee were not successful unless the perichondrium was turned towards the bone, in which case cartilage proliferated on the surface (figure 4). There was very little loss of substance but trans-chondro-osseus perforation also revealed a chondrogenic mode (figure 4). No trace was found in the literature of work concerning a comparison of these two types of grafts in the same experiment.

[Microdurimetric and biochemical study of human articular cartilage. Comparison of different joints]. / Etude microdurimétrique et biochimique du cartilage articulaire humain. Comparaisons de diverses jointures.

The micro-hardness and the density of fixed negative charges in cartilage of the shoulders, hips and knees of 6 subjects were studied. These two parameters were narrowly correlated. The resistance and proteoglycan concentration of the cartilage of the femoral head were greater than those of the knee and of the shoulder. They did not vary on each side. There is a significant correlation between the hardness of the cartilage of the femoral head and of the external femoral condyle. The histologically normal cartilage of the femoral head in arthrosis is at the lower limit of control values for hardness.

[Morphometry of the femoral head in the rabbit. Surface appearance of the acetabulum after femoral prosthesis]. / Morphométrie de la Tête fémorale chez le lapin. Aspect de surface de l'acetabulum après prothèse fémorale.

An anatomical study has been achieved on 42 upper extremities of adult rabbit's thigh bones. Three types of prostheses have been perfected in order to analyse the reactions of the cartilage and of the subchondral bone when confronted with these implants. The animals were sacrificed at different intervals. The state of the acetabulum surface has been studied according to macroscopic and microscopic criteria. Three methods converge and agree in showing an arthrosis type of reaction with regard to the non operated controlateral articulation.

[Chemical study on acetabular cartilage adjoining a prosthetic implant: experimental study in the rabbit]. / Etude chimique du cartilage cotyloïdien en regard d'un implant prothétique: étude expérimentale chez le lapin.

The authors present an experimental study of the rabbit femoral prosthesis compatibility : macroscopical aspect, proteoglycan content and metabolism of the acetabular cartilage.

[A new orthopedic apparatus for the treatment of congenital equinovarus clubfoot. The active-passive articulated splint. Critical study propos of 72 cases treated in our department]. / Un nouvel appareillage orthopédique de traitement du pied bot varus équin congénital. L'attelle articulée activo-passive. Etude critique à propos de 72 cas traités dans le service.

The authors present a new equipment for orthopaedic assesment of club-foot. This "dynamic splint" aims to produce a self-correction of the deformity by the infant at time of each movement of his lower limb. With regard to 72 such deformities, concerning 47 children, they record the results after an average follow-up of more than 2 years. Criterions of results, clinical and chiefly radiological, more objectives, are classified into 3 parts : correction of varus of the foot, correction of adduction of the hind-foot, correction of equinus.

[Arterial vascularization of the os coxae]. / Vascularisation artérielle de l'os coxal.

Study of the arterial vascularization of the coxal bone by microangiographic methods. Nutritive and periosteal blood-vessels come from Iliaca interna and Iliaca externa arteries. The ilium is vascularized by the Ilio-lumbalis artery which is a nutritive blood vessel. A eriosteal vascularization also exists. Ischium and pubis have a periosteal vascularization. Blood vessels are oriented toward the sus-acetabulum area where many anastomoses exist.