Histopathology in rabbit Achilles tendon after operative tenolysis (longitudinal fiber incisions).

The surgical treatment (tenolysis) of chronic Achilles tendinopathy is often successful. However, little is known about the postoperative intratendinous changes after this procedure. The study group consisted of 21 rabbits. Operative tenolysis was done in each case on one Achilles tendon (AT). The ATs of both legs were studied histologically and immunohistochemically using antibodies against collagen types I and III 2, 4 and 6 weeks postoperatively. Nine rabbits without operation served as controls. A significant uniform hypervascularization was noted in the entire operated tendon postoperatively, and this concurred with the contralateral nonoperated AT, but neither side showed changes in collagen fiber structure as judged by immunohistochemistry. We conclude that the tenolysis procedure triggers neoangiogenesis at the AT followed by increased blood flow and improved nutrition in the same. These changes could, at least partly, explain the often seen clinical success in surgically treated tendinopathy.

Oxaceprol is a well-tolerated therapy for osteoarthritis with efficacy equivalent to diclofenac.

The therapeutic equivalence and safety of treatment for 21 days with 400 mg t.i.d. oxaceprol (n = 132) and 50 mg t.i.d. diclofenac (n = 131) were assessed in a multicentre, randomised, double-blind study of a mixed population of patients with osteoarthritis of the knee and/or hip. In a per-protocol analysis of efficacy, the mean Lequesne index decreased by 2.5 points in the oxaceprol group (n = 109) and by 2.8 points in the diclofenac group (n = 109). The 95% confidence interval for the end-point difference revealed therapeutic equivalence. This was confirmed by assessments (visual analogue scale) of pain at rest, weight-bearing pain, pain on standing and pain on movement, all of which decreased to a similar extent under both treatments. The pain-free walking time increased in both groups from 10 min to 25 min by the end of the treatment period. Mobility was also increased to a similar extent by both drugs. The physicians assessed treatment as good or very good in 45-46% of patients in both groups. In all patients who received treatment, 28 and 37 adverse events were reported by 25 out of 132 (18.9%) and 33 out of 131 (25.2%) patients treated with oxaceprol and diclofenac, respectively. In 15 patients (11.4%) with 15 adverse events in the oxaceprol group and 25 patients (19.1%) with 27 adverse events in the diclofenac group, a relation to the medication was considered probable. The difference between the groups was statistically significant (p = 0.04106) for the number of these adverse events. Oxaceprol is therapeutically equivalent to diclofenac, but better tolerated than diclofenac in the treatment of osteoarthritis.

Synovial tissue implants from patients with rheumatoid arthritis cause cartilage destruction in knee joints of SCID.bg mice.

OBJECTIVE: To establish in SCID.bg mice a model in which joint destruction is initiated by human inflammatory cells from patients with rheumatoid arthritis (RA). METHODS: Development of a surgical technique and immunohistologic analysis. RESULTS: Initial experiments with single cell suspensions failed because more than 70% of the cells injected intraarticularly left the mouse knee joint within 16 h without causing destruction. This was observed with peripheral blood mononuclear cells, T cell lines reactive to mouse or rat collagen type II, and synovial mononuclear cells. Cell immigration was reduced but not prevented by preactivation with mitogens. In contrast, small tissue implants from human synovial membrane which were transferred by surgical intervention into mouse knee joints remained at the site of injection and could be easily localized within the mouse joint (observation period up to 8 weeks). The human synovial membrane implants induced pannus formation and erosion of cartilage and bone while only a mild and transient synovitis was observed with normal synovial membrane and control tissues like human thymus. The predominant cells at the site of destruction were human (CD68+) and murine (Mac-2+) monocytes/macrophages. CONCLUSION: The human/murine SCID arthritis is a useful model for studying pathogenetic aspects of joint destruction as well as effects of new drugs or novel treatment strategies.

[A new prosthetic smooth wall shaft]. / Ein neuer Prothesenweichwandschaft.

A report about our productions and experiences with the smooth wall of the body's bed from Polyurethanschaum EZ 7607 system. The material mark out trough permanent improvement of it's wear and economical properties. Recently useful technique will be further developed trough continuous improvements of the materials in addition to our experiences.

[Diagnosis and therapy of chondropathia patellae]. / Diagnostik und Therapie der Chondropathia patellae.

As a role the comprehensive compiling of the case history as well as the clinical and roentgenological examination give the correct diagnosis. But the variable conservative and/or operative treatment must be carried out without polypragmasy. Thus good up to very good results can be achieved in 80 per cent. The therapy must aim at making the patients free from symptoms, but it is not the aim to enable them to accomplish great physical performances.