In this paper, we evaluated the long-term results of uncemented total hip arthroplasties using tapered fully porous-coated cobalt-chrome stems (Autophor 900S). The average follow-up was 206 months in 127 hips (113 patients). The articulations of the joints were ceramic-on-polyethylene in 43 hips and ceramic-onceramic in 84. The survival rate of the stems at 17 years was 94.5%. A stable stem with bony ingrowth was identified in all 120 hips, excluding femoral revision cases (seven hips). The causes of the seven femoral revisions were aseptic loosening in four, infection in two, and stem fracture in one. No surgical intervention was performed for osteolysis or stress shielding. The Autophor 900S tapered fully porous-coated cobalt-chrome femoral stem revealed encouraging radiographic longterm stability.
To investigate the developmental pattern of femoral shortening in Legg-Calve-Perthes disease, the authors made an experimental model of the disease in piglets by devascularizing the capital femoral epiphysis and following the piglets to skeletal maturity. The discrepancy first increased in the postoperative 0 to 8 weeks (1.2-1.9 mm of shortening per week), then decelerated for a considerable period during the postoperative 8 to 16 weeks (0.2-0.6 mm per week), and then increased again toward the end of the growth period of the postoperative 20 weeks (1.2 mm per week). The developmental pattern of femoral shortening showed an upward slope/plateau/upward slope pattern, as in type IV of the Shapiro classification. As the mechanism of the observed pattern, the authors presumed reduced epiphyseal height and growth retardation in the physis during the initial upward slope, a repair process at the plateau phase, and premature physeal closure during the second upward slope.
Exogenous administration of gangliosides induced neuronal differentiation with prominent neuritogenesis in human neuroblastoma SH-SY5Y cells in vitro. Neuritogenesis was characterized by ruffling of the cell membrane, the development of lamellipodia and filopodia, and the subsequent elongation and branching of the neurites ultrastructurally. Both axons and neurites were identified. Increased numbers of cell organelles in the neurites and cell bodies were noted. Nonsynaptic contacts and gap junctions formed between neurites or between each neurite and cell body. These findings could be implicated in histopathologic changes from neuroblastoma to ganglioneuroblastoma.
Residual shortening of the affected limb was measured at skeletal maturity by teleoroentgenograms in 68 patients with Legg-Calve-Perthes disease (LCPD); special attention was paid to the length of the ipsilateral tibia. Of these 68 patients, 38 were treated by abduction orthosis (AO) and 30 by femoral varus osteotomy (FVO). Residual shortening in AO group was significantly greater than that in FVO group. The femoral lengths in both of these groups were similar (12.5 mm in the AO group and 10.1 mm in the FVO group), but the tibial lengths were significantly different (2.5 mm shortening in the AO group and 0.9 mm lengthening in the FVO group). Residual shortening in the patients treated by FVO was less than that in patients treated by AO. The difference is speculated to be caused by the overgrowth of the ipsilateral tibia.
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