Degeneration of Acetabular Articular Cartilage to Bipolar Hemiarthroplasty

PURPOSE: This study examined the rate of degeneration of acetabular cartilage by the bipolar head according to time, and also which clinical factors are related to the degeneration of acetabular cartilage. MATERIALS AND METHODS: Among 192 patients (226 hip joints) who received bipolar hemiarthroplasty from August 1996 to August 2002, 61 patients (65 hip joints) were enrolled in this study, who were followed up for more than 2 years and showed no signs of dislocation, infection, or functional problems. A modified form of a computer assisted vector wear analysis program was used to measure the rate of degeneration of the acetabular cartilage. The factors that appeared to affect the rate of acetabular degeneration in the two groups was evaluated. RESULTS: The average linear degenerative change in the acetabular cartilage and the volumetric degenerative change were 0.23 +/- 0.107mm/year and 114 +/- 47.2mm3/year, respectively. The result showed significant differences in activity and HHS between the 2 groups. The HHS showed a reverse relationship with the linear degeneration and volumetric degeneration, and the activity showed a correlation with the linear and volumetric degeneration. CONCLUSION: The acetabular cartilage degenerates faster as the patient' activity increases, and slower with a higher HHS. When surgeons perform hip joint arthroplasty, it is strongly recommended that the life expectancy and the level of activity should be considered when deciding between a hemiarthroplasty and total hip arthroplasty.

Junctional Epidermolysis Bullosa (JEB) with Pyloric Atresia

Epidermolysis bullosa (EB) has three distinctive types, of which junctional EB has been known to be associated with pyloric atresia (PA) usaually. PA is a congenital disease of gastric outlet obstruction, known to occur at a rate of 1 per million live-births. It may occur independently or in combination with other congenital disorders such as EB. Dozens of cases of this combined disease have been reported since 1972 and autosomal recessive patterns have recently been revealed. This, junctional epidermolysis bullosa with pyloric atresia, has poor prognosis. Bullous, erupted cutaneous manifestations have recurrent, persistent characteristics and causes extracutaneous manifestations such as electrolyte imbalance, protein-loosing enteropathy, failure to thrive, and sepsis. In some cases, this syndrome may have obstructive uropathy and give it bad results also. For these reasons, physicians should be careful to avoid minor trauma on the skin and need to make meticulous decisions in operative correction about obstrutive gastrointestinal lesion or uropathy. We report a case of 3-day-old male baby, junctional epidermolysis bullosa with pyloric atresia.