Basal Joint Arthritis A Review of Pathology, History, and Treatment.

The basal joint is a collection of articulations at the base of thumb that serve an important function in the overall dexterity of the hand. The unique anatomy of the basal joint provided many evolutionary advantages to the human hand, but also made this joint susceptible to arthrosis and degenerative changes. Surgical treatment of basal joint arthritis has continued to evolve since it was first described in 1949, including excisional arthroplasty, tendon interposition, ligament reconstruction, implant arthroplasty, and arthroscopy. A review of the pathoanatomy, history, and surgical treatments are assessed including a critical review of the literature.

Espondiloartritis axiales: ¿se pueden clasificar todas? / Axial spondyloarthritis: can all be classified?

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Queen Anne (1665-1714) and her health.

The contemporary records of Queen Anne's health and disease are reviewed, including the strange diagnoses made and the treatments prescribed. A correct diagnosis is suggested.

The classic: Radiography of the trapeziometacarpal joint. Degenerative changes of this joint. 1936.

This classic article is a translation and reprint (Appendix 1. Supplemental material is available with the online version of CORR.) from the French of the original article by M. Robert, entitled La radiographie de l'articulation trapézo-métacarpienne. Les arthroses de cette jointure. The original article was published in Société de Radiologie Méd de France, Bulletins.1936;24:687-689. (Reproduced with kind permission of the SFR.).

Surgical treatment of trapeziometacarpal joint arthritis: a historical perspective.

BACKGROUND: The trapeziometacarpal (TMC) joint's unique anatomy and biomechanics render it susceptible to degeneration. For 60 years, treatment of the painful joint has been surgical when nonoperative modalities have failed. Dozens of different operations have been proposed, including total or subtotal resection of the trapezium or resection and implant arthroplasty. Proponents initially report high levels of patient satisfaction, but longer-term reports sometimes fail to support initial good results. To date, no one procedure has been shown to be superior to another. QUESTIONS/PURPOSES: This review sought to identify factors responsible for the development of many different procedures to treat the same pathology and factors influencing whether procedures remain in the armamentarium or are abandoned. METHODS: I performed a nonsystematic historical review of English-language surgical journals using the key words "carpometacarpal arthritis", or "trapeziometacarpal arthritis", and "surgery" in combination with "history" using the PubMed database. In addition, bibliographies of pertinent articles were reviewed. RESULTS: The factors that led to many surgical innovations appear to be primarily theoretical concerns about the shortcomings of previously described procedures, especially about proximal migration of the thumb metacarpal after trapezial resection. Longevity of a particular procedure seems to be related to simplicity of design, especially for prosthetic arthroplasty. The evolution of surgery for TMC joint arthritis both parallels and diverges from that in other joints. For example, for most degenerated joints (even many in the hand), treatment evolved from resection arthroplasty to implant arthroplasty. In contrast, for the TMC joint, the 60-year-old procedure of trapezial resection continues to be performed by a majority of surgeons; many modifications of that procedure have been offered, but none have shown better pain reduction or increased function over the original procedure. In parallel, many differently designed prosthetic total or hemijoint arthroplasties have been proposed and performed, again with as yet unconvincing evidence that this technology improves results over those obtained by simple resection arthroplasty. CONCLUSIONS: Many procedures have been described to treat TMC joint arthritis, from simple trapezial resection to complex soft tissue arthroplasty to prosthetic arthroplasty. In the absence of evidence for the superiority of any one procedure, surgeons should consider using established procedures rather than adopting novel ones, though novel procedures can and should be tested in properly designed clinical trials. Tissue-engineered solutions are an important area of current research but have not yet reached the clinical trial stage.

The rise of the metal elbow.

Painful arthritis of the elbow joint has long been a challenging problem. Elbow arthroplasty has emerged as viable treatment method for many patients. Implant design and surgical technique have evolved to provide more predict-able symptom relief without compromising function. Elbow arthroplasty can now be used to treat a wide variety of conditions, including osteoarthritis, rheumatoid arthritis, and fractures. This review article presents historical and contemporary perspectives on elbow arthroplasty. A thorough discussion of implant design, surgical technique, and clinical outcomes is presented.

[History of corticotherapy]. / Histoire de la corticothérapie.

Corticosteroids emerged in the late 1940s, at a time when steroid chemistry began to offer new therapeutic approaches. Extractive chemistry (T. Reichstein), chemical synthesis (E.C. Kendall) and clinical investigations (P. Hench) were combined to result in the discovery of cortisone in 1948, leading to a long series of related derivatives. Besides their first applications to treat Addison's disease and rheumatic or inflammatory diseases, corticosteroids could easily correct many metabolic and functional symptoms. Fluoridation of the steroid skeleton allowed the development of more active and better tolerated molecules. Corticosteroids have revolutionized the treatment of allergic diseases or immunity troubles, graft rejection, many dermatological, respiratory, digestive, eye diseases, etc. It is used today in all areas of therapeutic.

A history of reverse total shoulder arthroplasty.

BACKGROUND: Management of the cuff-deficient arthritic shoulder has long been challenging. Early unconstrained shoulder arthroplasty systems were associated with high complication and implant failure rates. The evolution toward the modern reverse shoulder arthroplasty includes many variables of constrained shoulder arthroplasty designs. QUESTIONS/PURPOSES: This review explores the development of reverse shoulder arthroplasty, specifically describing (1) the evolution of reverse shoulder arthroplasty designs, (2) the biomechanical variations in the evolution of this arthroplasty, and (3) the current issues relevant to reverse shoulder arthroplasty today. METHODS: Using a PubMed search, the literature was explored for articles addressing reverse shoulder arthroplasty, focusing on those papers with historical context. RESULTS: Results of the early designs were apparently poor, although they were not subjected to rigorous clinical research and usually reported only in secondary literature. We identified a trend of glenoid component failure in the early reverse designs. This trend was recognized and reported by authors as the reverse shoulder evolved. Authors reported greater pain relief and better function in reverse shoulder arthroplasty with the fundamental change of Grammont's design (moving the center of rotation medially and distally). However, current reports suggest lingering concerns and challenges with today's designs. CONCLUSIONS: The history of reverse shoulder arthroplasty involves the designs of many forward-thinking surgeons. Many of these highly constrained systems failed, although more recent designs have demonstrated improved longevity and implant performance. Reverse shoulder arthroplasty requires ongoing study, with challenges and controversies remaining around present-day designs.

[The evolution of related names of Bi syndrome and the theory of etiology and pathogenesis].

In the Traditional Chinese medical literature of ancient times, Bi referred to the pathogenesis, or the symptoms as well as the name of the disease. As the name of a disease, Bi has the different meanings of broad and narrow., joint-running, joint-running wind, white tiger joint-running, gout etc. referring to the narrow meaning of Bi disease. The theory of etiology and pathogenesis of the narrow meaning of Bi disease developed from damp-impediment, wind-cold-damp impediment to damp-hot impediment, stasis-hot impediment, which reflected the constant deepening of cognition.

A health assessment for imperial Roman burials recovered from the necropolis of San Donato and Bivio CH, Urbino, Italy.

Imperial Roman burials recovered from the sites of San Donato and Bivio CH, located in the city of Urbino, Italy were examined for skeletal lesions. Observed pathologies include arthritis, trauma, periostitis, cranial pitting and enamel hypoplasia. All of the adults exhibited at least one enamel hypoplasia. In general, the adult males exhibit greater rates of skeletal pathologies than the females. Clearly, chronic health problems appear to be common among all adults; nearly 89% of them exhibit at least one form of skeletal lesion. This is in stark contrast to what is seen for the sub-adults. Only one sub-adult showed skeletal lesions. Acute health problems may have been the primary contributing factors for the death of the children recovered from the site. Despite previous research and attention to malaria as a critical health problem of Roman sub-adults, it does not seem to be an issue for this burial sample. We compare the frequency of cranial pitting and periostitis for the Urbino burials to several other Imperial Roman skeletal samples as a means to assess the potential for malaria and other casual factors for the observed lesions. In conclusion, we see the extreme rate of skeletal lesions for this community as indication of an extremely poor quality of life for these Romans.

Theodore Roosevelt's inflammatory rheumatism.

Theodore Roosevelt's death at age 60 was probably caused by a pulmonary embolus, but it was preceded by a 2 1/2-month illness described as inflammatory rheumatism. He had intermittent fever and acute arthritis in several joints leading to hospitalization and enforced bed rest for 6 weeks. The details of his illness and its possible etiology are reviewed. Inflammatory rheumatism was a descriptive term within which several modern diagnoses might be included. Although it is not possible to identify Roosevelt's illness with any certainty, it was most compatible with polyarticular gout, although reactive arthritis, rheumatic fever, and several other diagnoses cannot be ruled out.

[The former knackers yard in Zurich-Albisrieden: pathological findings in excavated animal bones]. / Wasenplatz am Letzigraben in Zürich-Albisrieden: pathologische Befunde am Tierknochenfundgut.

During archaeological excavations in the former knackers yard in Zurich-Albisrieden bones and joints of 8 horses and 1 mule were found and examinedfor pathological lesions. Degenerative changes (arthropathies, spondylosis and spondylarthrosis) as well as tooth irregularities were most often seen. One horse had a discospondylitis and spondylitis of C7 and Th1.

Death of the first white resident of North Queensland.

The first white resident of North Queensland's death certificate gives the final illness as 'arthritis'. This examination of contemporary records and more recent reports, together with the results of discussion with colleagues interested in medicine and history, attempts to suggest the reasons for his various symptoms and his final demise. This life story is reminiscent of a 'Boy's own' adventure with shipwrecks, survival at sea, coexistence with Aboriginal tribesmen before returning to 'white society', marriage and the start of a family. Are there lessons here for the twenty-first century physician and rheumatologist? Would the commonplace illnesses of mid nineteenth-century Queensland be very different to the problems seen in our outpatient clinics today?