QUANTIFICATION OF NEURAL ELEMENTS IN POSTERIOR CRUCIATE LIGAMENT: COMPARISON BETWEEN HEALTHY KNEES AND WITH PRIMARY OSTEOARTHROSIS

ABSTRACT Objective: To quantify the neural elements in the posterior cruciate ligament (PCL) in healthy knees and with primary osteoarthrosis (OA). Methods: In two groups with OA, one of cadavers and another of individuals, the area of neural elements identified in histological sections of PCL with anti-S100 immunohistochemistry was quantified. Results: The overall mean area of the neural elements was 0.96% ± 0.67%, with the value in the cadaver group of 1.02% ± 0.67% and in the OA group of 0.80% ± 0.64%, with a significant statistically difference (p = 0.001). No correlation was observed between neural element quantification and the age of the individuals (p > 0.05). There was no difference in the quantification of neural elements between the sexes in the cadaver group (p = 0.766), but in the OA group there was a statistically significant reduction in males (p = 0.003). Also, in the osteoarthrosis group there was no difference in the quantification of neural elements in the knees with varus or valgus alignment (p = 0.847). Conclusion: There was a decrease in neural element quantification in PCL of individuals affected by OA in relation to non-arthritic individuals, with this quantification not related to age or with the axis of the lower limb. However, this quantification is not related to age or the axis of the lower limb. Level of Evidence III, Case control study.

Primary hip arthroplasty for the treatment of alkaptonuric hip arthritis: 3- to 24-year follow-ups

Background The objective of this study is to share our experience in total hip replacement for the treatment of ochronotic hip arthritis, in particular to report how to establish the diagnosis and some tips to limit complications. Method A cohort comprised of 10 patients (12 hips) with alkaptonuric hip arthritis. There were six men and four women with the mean age of 62.80 ± 7.57 years. All patients had a stiff spine, grossly restricted movements of hip joints, and severely limited daily routine activities. Total hip replacement was performed in all patients. The patients were evaluated at 6, 12, and 24 months after surgery, as well as every 4 years thereafter. Harris hip score was used to assess the functional outcome. The level of significance was set at p < 0.05. Results The mean follow-up lasted 16.70 ± 6.82 years (3 to 24 years). At the final available follow-up, nine patients returned to work, ambulate without an orthosis, and achieve complete pain relief. Harris hip score was improved from poor to excellent. One patient died 16 years after surgery due to breast cancer. No complication relating to prosthetic failures was detected. Conclusion Total hip replacement gives long-term satisfactory results in patients with alkaptonuric hip arthritis, resulting in comparable function of the hips in patients who undergo primary osteoarthrosis.

Sex differences in anatomical parameters of acetabulum among asymptomatic Serbian population

Background/Aim. Anatomical parameters of the bony components of the hip joint are essential for better understanding of etiopathogenesis of diseases like primary osteoarthrosis of the hip joint. The aim of this reserch was to examine the normal acetabular morphometry in Serbian population and to determine whether there are sex differences in anatomical parameters of the acetabulum among asymptomatic subjects. Methods. Pelvic radiographics of 320 adult asymptomatic patients (640 hips) were analyzed in 170 men and 150 women to determine the morphology of the acetabulum in Serbian population. For each hip the center edge angle of Wiberg (CEA), the acetabular angle of Sharp (AA), acetabular depth (AD), acetabular roof obliquity (ARO) and roof angle (RA) were measured. Results. The following average measurements for acetabulum geometry were obtained (X ? SD): CEA - 33.5 ? 6.5? (33.6 ? 5.8? in male, 33.3 ? 6.9? in female), AA - 38.0 ? 3.8? (37.5 ? 3.6? in male, 38.5 ? 3.9? in female), AD - 11.9 ? 2.8 mm (12.5 ? 2.7 mm in male, 11.2 ? 2.7 mm in female), ARO - 7.6 ? 5.7? (6.2 ? 4.9? in male, 9.0 ? 6.0? in female) and RA - 18.4 ? 10.0? (19.6 ? 8.5? in male, 17.1 ? 9.5? in female). There were significant differences in the CEA, AA, AD, ARO and RA related to gender (p < 0.01, t-test). Conclusion. There are significant gender differences in Serbian population for all the examined anatomical parameters of acetabulum. We found sex-related differences in acetabular morphology, female acetabulum being marginally more dysplastic than male acetabulum. There is also a clear tendency of female hips to be more dysplastic than male ones.

Detection of bone erosions in knee osteoarthrosis by serum biomarkers

Introduction. Osteoarthrosis (OA) is a degenerative chronic disease characterized by destruction of joint articular cartilage and subchondral bone with formation of osteophytes and usuries on joint surface. Quantitative and dynamic changes in remodeling of joint tissue reflect matrix molecules that dismiss as fragments in joint liquid, blood and urine where they can be detected. Human cartilage glycoprotein (YKL-40) is synthesised by chondrocytes and synovial cells and plays a significant role in remodel tissue. Objective. The aim of the paper was the parallel analysis and determination of the degree of correlation between ultrasound indicators destruction of joints, bone erosion (usuries), and serum YKL-40 concentrations in patients with primary osteoarthrosis of the knee. Methods. The analysis included 88 patients with the diagnosis of knee OA. Ultrasound review of knees was done by two rheumatologists. The analysis of serum samples determined the concentration of YKL40 by ELISA method. Results. The average age of patients was 69.97?9.37 years, duration of knee OA 6.46?6.73 years. The mean value of age in 59 patients with usuries was 72.05?7.74, at 29 without usuries 65.75?11.00 (p=0.003). The average value (median) thickness cartilage in medial condyl femur (front access) in patients with usuries was 1.25 mm (1.12-1.36 mm), without usuries 1.35 mm (1.20-1.51 mm) (p=0.016). The central YKL40 value of biomarkers in the patients without usuries was 81 ng/ml (46.5-120.5 ng/ml), with usuries the medial condyil 138 ng/ml (89.5-175.0 ng/ml), the lateral 106 ng/ml (63.0-201.5 ng/ml) and both condyl 86 ng/ ml (69.75-140.5 ng/ml) (p=0.004). The central value YKL40 after 5 year-duration of disease was 83.68?33.65 ng/ml, after 10 years 138.22?48.88 ng/ml, after 15 years 209.30?79.36 ng/ml, and after 20 years 218.50?106.51 ng/ml (p=0.000). The biomarker YKL 40 may be a marker for usuries (area 0.691, p=0.004; confidence interval 0.574-0.808). If you took the optimal cut-off of 84.5 ng/ml, then YKL40 sensitivity to the usuries was 69.5%, and specificity 51.7%. Conclusion. Increased concentrations of biomarkers YKL40 may be an indicator of the degree of destructive changes in the knee osteoarthrosis.