Calcified cartilage differs in patients with end-stage primary osteoarthritis and secondary osteoarthritis due to rheumatoid arthritis of the hip joint.

OBJECTIVES: Despite distinct aetiologies, the end-stages of primary osteoarthritis (OA) and secondary OA are described by common radiological features. However, the morphology of the bone-cartilage unit may differ depending on the pathogenesis. In this cross-sectional study, we aimed to investigate the histological differences in the bone-cartilage unit of the femoral head between patients with primary OA and secondary OA due to rheumatoid arthritis (RA). METHOD: Femoral heads were obtained from 12 patients with primary OA, six patients with secondary OA due to RA, and 12 control subjects. The femoral heads were investigated using stereological methods to ensure unbiased quantification. RESULTS: The volume (mean difference [95% confidence interval]) (2.1 [0.5;3.8] cm3, p = 0.016) and thickness (413 [78.9;747] µm, p = 0.029) of the articular cartilage and the thickness of the calcified cartilage (56.4 [0.4;113] µm, p = 0.017) were larger in patients with primary OA than in patients with secondary OA due to RA. Femoral head volume (1.2 [-3.6;6.1] cm3, p = 0.598), bone volume fraction (-1.1 [-2.8;5.1] cm3, p = 0.553), subchondral bone thickness (-2.5 [-212;207] µm, p = 0.980), and osteophyte area (25.3 [-53.6;104] cm2, p = 0.506) did not differ between patients. CONCLUSION: The thicker calcified cartilage in primary OA preceding the loss of articular cartilage can be attributed to endochondral ossification. Patients with secondary OA due to RA had severely thinner calcified cartilage as the pathogenesis is driven by inflammation and is characterized by a generalized and more severe loss of articular cartilage.

[Intramedullary tuberculous abscess in a patient with liver transplantation]. / Intramedullaer tuberkuløs absces hos levertransplanteret patient.

Recipients of solid-organ transplants are, due to immunosuppressive treatment, disposed to opportunistic infections including tuberculosis. We report a rare case of acute intramedullary tuberculous abscess in a Danish male recipient of a liver transplant. The problems in diagnostics, medical and surgical treatment are discussed.

Progressive Osteolysis after Porous-Coated Anatomic (PCA) Uncemented Total Hip Arthroplasty Ten-Year Results in 32 Consecutive Cases

ABSTRACT: Thirty-two primary non-cemented first generation Porous-Coated Anatomic (PCA) total hip prostheses in 31 patients were followed prospectively. The average follow-up period was 10.3 years. The median age at surgery was 53 years (range 21-65). All operations were performed by one surgeon. Preoperatively, all cases had a poor Harris Hip Score. Ten years after surgery, 95% were rated good or excellent. Progressive roentgenographical changes were observed. In particular there was severe femoral osteolysis in zones 1, 2 and 7, and extensive wear of the polyethylene liner at the two latest follow-up examinations. Wear of the polyethylene liner, up to 0.4 mm/year, was significantly correlated with osteolysis after seven years (p=0.003). Aseptic cup loosening was the reason for six of the eight failures. At 10.3 years after surgery the survival with revision as end-point was 72%. We stopped using the 1st generation PCA prosthesis after five years due to worrying roentgenographic changes. The seven and ten years results have confirmed that this prosthesis cannot be recommended for implantation. (Hip International 1999; 9: 214-20)