- Discussion:
- osteoarthritis represents a gradual processes of destruction & regeneration;
- early in dz, articular cartilage loses its glistening appearance;
- later on surface layers flake off while deeper layers develop longitudinal fissures, process termed fibrillation;
- cartilage becomes thin and sometimes denuded;
-
subchondral bone:
- becomes thickened, sclerotic, & polished (eburnation);
- subchondral bone displays thickened trabeculae and microfractures;
- tidemark is disrupted by vessels from the subchondral layer;
-
cysts:
- may be seen in subchondral bone;
- cysts may arises from increases in intrasynovial pressure;
-
osteophytes:
- spurlike bony outgrowths covered by hyaline cartilage, may develop at margins of joint & progressively enlarge;
- small bits of cartilage-covered bone, known as joint mice, may actually break off into the joint;
- Histology:
- see:
articular cartilage:
- superficial zone demonstrates earliest changes;
- there is a diminution of chondrocytes in superficial zones;
- cartilage matrix loses its ability to stain for proteoglycans with alcian blue or safranin-O;
- deeper chondrocytes demonstrate proliferation in clusters (brood capsules);
- capillary buds penetrate the layer of calcified cartilage;
- newly formed sements of cartilage push up from below;
- tidemark:
- demarcation between calcified and noncalcified cartilage;
- becomes split & reduplicating tidemark;
-
synovium: becomes hypertrophied and thrown into villose folds;
- may see infiltration with plasma cells, and lymphocytes;
- syovial hypertrophy may be involved in producing joint pain by increased synovial fluid production and increased intra-articular pressure;
Instructional Course Lectures, The American Academy of Orthopaedic Surgeons. Osteotomies about the Hip for the Prevention and Treatment of Osteoarthrosis.
The coexistence and characteristics of osteoarthritis and osteoporosis.
Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study.
Proximal tibial varus osteotomy for osteoarthritis of the lateral compartment of the knee.
Miyakawa patellectomy
High tibial osteotomy compared with high tibial and Maquet procedures in medial and patellofemoral compartment osteoarthritis.
High tibial osteotomy. A prospective clinical and roentgenographic review.
Bipolar hemiarthroplasty in degenerative arthritis of the hip. 100 consecutive cases.
Long-term results of bipolar arthroplasty in osteoarthritis of the hip.
Valgus high tibial osteotomy. A long-term follow-up study.
Late recurrence of varus deformity after proximal tibial osteotomy.
Total hip and knee arthroplasty in juvenile rheumatoid arthritis.
High tibial osteotomy. Use of an osteotomy jig, rigid fixation, and early motion versus conventional surgical technique and cast immobilization.
Original Articles: Comparison Of An Antiinflammatory Dose Of Ibuprofen, An Analgesic Dose Of Ibuprofen, And Acetaminophen In The Treatment Of Patients With Osteoarthritis Of The Knee.
The incidence of fabellae in osteoarthrosis of the knee.
High tibial osteotomy for varus gonarthrosis. A long-term follow-up study.
Medial-displacement intertrochanteric osteotomy in the treatment of osteoarthritis of the hip. A long-term follow-up study.
Comparison of an antiinflammatory dose of ibuprofen, an analgesic dose of ibuprofen, and acetaminophen in the treatment of patients with osteoarthritis of the knee [see comments
Osteoarthritis of the hip treated by intertrochanteric osteotomy. A long-term follow-up.
Tibial osteotomy for osteoarthritis of the knee. A five to ten-year follow-up study.
Results of surgical treatment for non-union after high tibial osteotomy in osteoarthritis of the knee.
Acne arthralgia.
Intraarticular corticosteroids in treatment of osteoarthritis.
Osteotomy for osteoarthritis of the hip. A survivorship analysis.
Does
Does osteoarthrosis depend on growth of the mineralized layer of
Gait analysis study on patients with varus osteoarthrosis of the knee.
Tibial torsion in patients with medial-type osteoarthrotic knees.
Periacetabular and intertrochanteric osteotomy for the treatment of osteoarthrosis in dysplastic hips.
