Incorporation and biodegradation of hydroxyapatite-tricalcium phosphate implanted in large metaphyseal defects--an animal study.

Incorporation and biodegradation of hydroxyapatite(HA)-tricalcium phosphate(TCP) granules implanted in 5 x 5 x 5 mm distal femoral metaphyseal defects created in 18 adult rabbits were studied. In two rabbits, the defects were left to heal spontaneously without any implant. Roentgenographic and histological study by light microscopy was done on silver nitrate stained undecalcified sections as well as haematoxylin-eosin stained decalcified sections. The synthetic HA-TCP was biocompatible and produced no adverse reactions. The implant was osteoconductive and allowed good new bone formation to occur, mainly from periphery to center, but mature trabeculae could be delineated only at 4-6 months. The HA-TCP biomaterial had very low biodegradability with marked amount of intact implant still present at final follow up. Bonding between implant and bone, though a close biological bond, was not uniformly strong. Rate of bone ingrowth was very slow and large areas of implant at center did not show new bone formation at 12 months.

Immunodiagnosis in bone and joint tuberculosis.

Fifty patients of bone and joint tuberculosis (age 15-70 years) and 30 healthy controls were studied for levels of immunoglobulin G (IgG), immunoglobulin A (IgA), immunoglobulin M (IgM), T cells and circulating immune complexes (CICs) in different stages of disease. Levels of IgG, IgA, IgM, T cells and CICs were significantly raised in fresh and healed tuberculosis patients, compared to control.

New observations on carrying angle.

Based on experiments on fresh cadaveric and accidentally amputated 8 upper limbs of children, study of ulnae for presence and absence of non articular strip on the trochlear notch, measurements of carrying angle, length of forearm bones, pronation-supination, height and weight in 2250 infants, children and adults of various age groups and clinical observations on 800 cases of injuries around elbow many new facts have been observed about the development of the carrying angle and its significance in the etiopathogenesis of various types of fractures seen around the elbow. The carrying angle develops in response to pronation of the forearm and is dependent on length of the forearm bones. Lesser the length of forearm bones greater is the carrying angle. So the carrying angle is more in shorter persons as compared to taller persons. It is abduction at the shoulder and not the carrying angle which keeps the swinging upper limbs away from the side of the pelvis during walking. Carrying angle is not a secondary sex character. The type of fracture a child sustains after fall on outstretched hand is also determined by the value of the carrying angle. A new type of fracture hitherto undescribed in the literature, T-Y fracture of the distal humeral epiphysis is also reported.

A probable explanation for mild extra-articular manifestations in Indian patients of rheumatoid arthritis: a preliminary study.

One hundred four Rheumatoid factor (RF) positive Rheumatoid Arthritis (RA) patients fulfilling ARA criteria were screened for extraarticular manifestations. Rheumatoid nodules were present in 2.8% cases. Other extraarticular manifestations such as pulmonary, cardiac, occular, renal or GI involvement were absent in these cases. However, circulating immune complexes (CICs) were highly significantly raised in all the RA patients (P < 0.001). From amongst these cases a limited number (8 cases) have been subjected to qualitative and quantitative analysis of CICs to look for whether there could be any relationship between these and mild extraarticular manifestations that were being noticed in our groups of patients. Finding showed IgG-IgG CICs in five, IgG-IgM in two and IgG-IgA in one case. Quantitative analysis revealed mean IgG 4.97 +/- 1.7 IU/ml, IgM 14.58 +/- 5.53 IU/ml and IgA 5.08 +/- 1.53 IU/ml on LD Solugen plates. Serum concentration of C3 was not reduced (94.1 +/- 8.9 mg/dl). Low IgM contents of CICs and no reduction in complement level is the likely explanation for less severe inflammatory manifestations seen in our study. The conclusion and findings have been discussed in the light of observation reported by the Western workers.

Allogenic decalbone in glenoplasty for recurrent anterior dislocation of shoulder.

31 patients of recurrent anterior dislocation of shoulder treated by anterior glenoplasty using allogenic decalbone had good results. It is proposed that generalised congenital or developmental disorder may be an important etiological factor in pathogenesis of recurrence of the dislocation.