P365 REGENERATION OF ARTICULAR CARTILAGE AFTER PELVIC OSTEOTOMYIN OSTEOARTHRITIS HIPS DUE TO ACETABULAR DYSPLASIA

Summary. Hip dysplasia is the most common orthopedic problem in the practice of pediatric orthopedists. A significant problem with hip dysplasia is the divergence of nomenclature units, which is related to different points of view on the pathophysiology of the process. Contemporary conception defines hip dysplasia as a dynamic condition – “developmental dysplasia of the hip (DDH)”, which (in the absence of treatment) worsens with age and leads to the development of early hip osteoarthritis and requires hip replacement in young people. The leading macromorphological substrate of DDH is acetabular dysplasia, which is a spatial and structural change of acetabulum. For the treatment of acetabular dysplasia, conservative or surgical treatment (depending on the age of the child and the presence of previous treatment) is used. The most problematic solution is the treatment tactics for walking-age children. This is due to two factors: 1) increased loading on certain parts of the articular cartilage of the acetabulum during gait, which leads to the progression of deformity of the acetabulum and to progression of pathology; 2) changes in morphology of the intra-articular and extra-articular structures. However, better results with fewer complications are achieved after surgery. Biomechanically justified for acetabular dysplasia are pelvic osteotomies, which are divided into reconstructive and “salvage” procedures (preference is given to reconstructive procedures, which allows saving the native articular cartilage of acetabulum). Each osteotomy has its own advantages and disadvantages. When comparing three pelvic osteotomies commonly used in children (Salter, Pemberton and Dega), it is found that better results are achieved in children younger than 4 years after Salter’s osteotomy, results in older children are better after Dega’s osteotomy, and there is a high risk of femoroacetabular impingement following Pemberton’s osteotomy in the future.

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The Effect of Total Meniscectomy versus Caudal Pole Hemimeniscectomy on the Stifle Joint of the Sheep

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1632463 ◽

1999 ◽

Vol 12 (02) ◽

pp. 56-63 ◽

Cited By ~ 5

Author(s):

C. R. Bellenger ◽

P. Ghosh ◽

Y. Numata ◽

C. Little ◽

D. S. Simpson

Keyword(s):

Tissue Culture ◽

Articular Cartilage ◽

Fibrous Tissue ◽

Cartilage Degeneration ◽

Medial Compartment ◽

Proteoglycan Synthesis ◽

Stifle Joint ◽

Medial Meniscectomy ◽

Tibial Condyle ◽

Articular Cartilage Degeneration

SummaryTotal medial meniscectomy and caudal pole hemimeniscectomy were performed on the stifle joints of twelve sheep. The two forms of meniscectomy produced a comparable degree of postoperative lameness that resolved within two weeks of the operations. After six months the sheep were euthanatised and the stifle joints examined. Fibrous tissue that replaced the excised meniscus in the total meniscectomy group did not cover as much of the medial tibial condyle as the residual cranial pole and caudal fibrous tissue observed following hemimeniscectomy. The articular cartilage from different regions within the joints was examined for gross and histological evidence of degeneration. Analyses of the articular cartilage for water content, glycosaminoglycan composition and DNA content were performed. The proteoglycan synthesis and release from explanted articular cartilage samples in tissue culture were also measured. There were significant pathological changes in the medial compartment of all meniscectomised joints. The degree of articular cartilage degeneration that was observed following total meniscectomy and caudal pole meniscectomy was similar. Caudal pole hemimeniscectomy, involving transection of the meniscus, causes the same degree of degeneration of the stifle joint that occurs following total meniscectomy.The effect of total medial meniscectomy versus caudal pole hemimeniscectomy on the stifle joint of sheep was studied experimentally. Six months after the operations gross pathology, histopathology, cartilage biochemical analysis and the rate of proteoglycan synthesis in tissue culture were used to compare the articular cartilage harvested from the meniscectomised joints. Degeneration of the articular cartilage from the medial compartment of the joints was present in both of the groups. Caudal pole hemimeniscectomy induces a comparable degree of articular cartilage degeneration to total medial meniscectomy in the sheep stifle joint.

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