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.

Biochemical bone markers compared with bone density measurement by dual energy X-ray absorptiometry.

In contrast to medical imaging, the biochemical markers allow a more frequent determination and are not as invasive as histomorphometric methods. We investigated biochemical markers of type I collagen compared with bone density measurements in 85 females between 41 and 89 years of age (median: 57 years). The bone density measurements were performed by dual energy X-ray absorptiometry (DXA) on the lumbar spine (L1-4). The bone density measurements were stated as a percentage of the norm. All patients were divided into three groups: I = <80%; II = 80-130%; III = >120%. Based on this classification the median concentration of the I-carboxyterminal propeptide of type I collagen in serum (S-PICP) as an anabolic marker of type-I collagen increased significantly with rising bone density: I 65.0 micrograms/liter (interquartile range: 52.1-78.0 micrograms/liter); II 85.9 micrograms/liter (52.1-115.5 micrograms/liter); III 81.4 micrograms/liter (62.0-101.0 micrograms/liter);P < 0.05. The concentration of urinary pyridinolines (U-PYR) as a marker for degradation of type I collagen decreased. The I-carboxyterminal telopeptide (S-ICTP) and osteocalcin (S-BGP) did not change. The multivariate regression analysis showed no relationship between between bone density and biochemical bone markers. Only the age significantly correlated negatively with bone density measurement. For a better assessment of type I collagen metabolism we created a "b-quotient" by dividing the sum of S-PICP and S-BGP by U-PYR. The median b-quotient increased significantly: I 1.55 (0.97-2.04); II 2.09 (1.57-2.86): III 2.46 (1.58-3.22); P < 0.05. Changes in bone metabolism cannot be identified by the determination of a single marker. However, the improved biochemical diagnostic measurement using the b-quotient may provide early information about the progression of a metabolic disorder within the interval of imaging.

[Biomechanic and electromyography studies of gait in healthy subjects and patients with coxarthrosis]. / Biomechanische und elektromyographische Ganguntersuchungen an gesunden Probanden und Koxarthrose-Patienten.

This report deals with electromyographical-kinesiological examinations of 40 unimpaired subjects and 31 coxarthrosis patients before and 3 months after implantation of an artificial hip joint on a level gaitway 12 m in length with a newly developed computer-controlled measuring system. The accomplished gait analyses served the purpose of determining biomechanical and electromyographical norm values and tolerance levels of unimpaired test subjects and recognizing pathological aberrations as well as determining the success of therapeutical measures. The results showed that despite greater freedom of joint movements observable postoperatively, the muscle actions of the patients did not come to equal those of the unimpaired subject group.

[Problems associated with corrective osteotomy of the hip joint in spastic children (author's transl)]. / Zur Problematik der Korrekturosteotomie am Hüftgelenk spastisch behinderter Kinder.

The authors report on 85 adduction-derotation osteotomies and 13 operations on the acetabulum performed in 56 children with cerebral palsy. Such causes as were observed of an increased tendency toward reabduction are described, taking age at operation into consideration. Other postoperative complications, including fragment dislocations and fractures of the shaft of the femur following disuse osteoporosis, are pointed out. The problem of the "anti-Chiari effect", resulting from the negative function of the hypsiloid cartilage, is discussed with regard to the formation of the "Chiari roof".

[Tumour prosthesis in the treatment of metastases, loosening of prosthesis and fractures at the proximal femur (author's transl)]. / Die Tumorprothese zur Behandlung von Metastasen, Prothesenlockerungen und Frakturen am proximalen Femur.

19 patients were treated via a tumour prosthesis in the hip joint region. The indication resulted from osteolyses, loosening of prosthesis and subtrochanteric fractures in aged patients involving risk factors. The results show that application of a tumour prosthesis is a suitable method for bridging over major defects in the proximal femur to achieve early mobilisation of the patients associated with full load of the extremity on which the operation had been performed.