These results support earlier data indicating that osteoarthritis consistently develops in patients with pigmented villonodular synovitis of the hip. Complete synovectomy seems to be effective in preventing recurrence of the synovitis, but it does not appear to prevent the development of secondary osteoarthritis.
We studied the perioperative blood loss in 100 total hip arthroplasties performed for rapidly destructive coxarthrosis and compared it with the blood loss in 100 total hip arthroplasties for regular coxarthrosis. The treatment protocol was identical in both groups. Total blood loss was calculated as the compensated blood loss (volume transfused during and immediately after surgery) and the non-compensated blood loss using Nadler and Mercuriali formula. The mean blood loss calculated in milliliters of red blood cells (100% haematocrit) was 578 ml in regular coxarthrosis and 945 ml in rapidly destructive coxarthrosis. The blood loss after total hip arthroplasty is greater when surgery is performed for rapidly destructive coxarthrosis than for regular coxarthrosis (P<0.001).Résumé Nous avons étudié la perte sanguine dans 100 arthroplasties totales de hanche exécutées pour coxarthrose destructrice rapide et l'avons comparé avec la perte sanguine dans 100 arthroplasties pour coxarthrose habituelle. Le protocole du traitement était identique dans les deux groupes. La perte sanguine totale a été calculée comme la perte sanguine compensée (le volume à transfuser pendant et immédiatement après chirurgie) et la perte sanguine non -compensée en utilisant la formule de Nadler et Mercuriali. La perte moyenne, calculé en ml de cellules de sang rouge (100% d'hématocrite) était de 578 ml dans la coxarthrose habituelle et de 945 ml dans la coxarthrose destructrice rapide. La perte sanguine après arthroplastie de hanche est plus importante quand la chirurgie est exécutée pour coxarthrose destructrice rapide que pour coxarthrose habituelle (P<0.001).
Osteochondral transplantation requires a careful assessment of the location of donor plugs. A mismatch of cartilage thickness between the donor and recipient site may lead to abnormal stresses and poor function. The objective of this study was to characterize the recommended donor and recipient sites with respect to cartilage thickness in younger individuals. Nineteen arthro CT (13 men, 6 women), which had been carried out in a population of less than 50 years old were studied. Recommended donor sites have included the posterior femoral condyles, the medial and lateral aspect of the trochlea and central, medial and lateral sides of the intercondylar notch. Recipient sites were studied at four regions of interest on the medial femoral condyle usually involved in osteochondritis dissecans. Average cartilage thickness was calculated on the digital version of the reference cuts for each site and compared. The sensitivity of the precision of the measurements to observer variability was evaluated using intra- and inter-observer correlation coefficient tests. The femoral cartilage in the knee was thickest in the recipient sites (2.49 mm, SD 0.64) than in donor sites (1.79 mm, SD 0.43) (P<0.0001). There was no differences between the different donor sites, unless for the antero lateral intercondylar notch which was significantly thinner (1.3 mm, SD 0.29) than the other sites (P<0.05). The cartilage of the donor site was consistently thinner than the cartilage of the recipient sites. Between the different donor sites, the lateral side of the intercondylar notch was significantly thinner than the other donor sites and should not be harvested in priority.
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