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Biomedical subjects

E Vignon

Publications and source records attributed to E Vignon.

At least 163 records · Page 9Linked to original sources
PubMed1975

[Study of the concentration of glycosaminoglycans in cartilage from normal and osteoarthritic femoral head].

The biochemical composition of cartilage was studied in relation to the site of the sample and the age on 20 normal femoral heads and in relation to the histological appearance of the tissues on 34 arthrosic femoral heads. The collagen and glycosaminoglycan content of normal cartilage is identical in the four poles of the femoral head but becomes reduced with age. The chondroitin sulphate content falls slightly but slowly during ageing. In arthrosis, the glycosaminogylcan content is reduced when the cartilage is eroded and remains roughly normal when the cartilage is macroscopically normal or osteophytic. The cartilage of the osteophyte differs, however, radically from normal articular cartilage by a very high water content and by the presence of glycosaminoglycans which are mainly dialysiable. Similar modifications, that are less marked, occur in the macroscopically normal cartilage of the arthrosic femoral head and suggest the role of a disorder of glycosaminoglycan synthesis in the etiology of certain cases of arthrosis.

Age Factors↗
PubMed1975

[Clinical, biological and histological effects of ethane-1-hydroxy 1, 1-diphosphonate (EDHP) in Paget's disease].

The diphosphonates are analogues of the pyrophosphates that are capable of resisting enzymatic destruction and they become fixed in the bone tissue where they have a powerful inhibitory action on osteoclastic resorption and on osteoid mineralization. Ethane-1-hydroxy-1, 1-diphosphonate (EDHP) was administered by mouth at the dose of 20 mg/kg/day over a period of 3 to 6 months to 11 patients with painful Paget's disease. A marked analgesic effect was noted in 7 of the 11 patients. Spectacular metabolic effects were noted with return to normal of the total hydroxyprolinuria/24 h and of the alkaline phosphatases 3 months after treatment in 6 of the 11 treated subjects and a marked improvement in these parameters in 4 other patients. Histologically, there was almost total disappearance of osteoclasia and of osteoblastosis in the affected areas. Clinically, the secondary effects presented in some cases as diarrhoea, and an early and marked rise in phosphoraemia was recorded. Histologically, hyperosteoidosis was seen, equally in the affected and nonaffected zones. This resulted from an almost complete stoppage in the calcification of the osteoid as indicated by the double labelling by tetracycline. The review of the literature shows that considerable therapeutic effects are obtained even with very small doses of EHDP, e.g., 10 mg/kg/day for 3 months, but that these are often accompanied by more marked secondary effects. The diphosphonates appear to be a promising treatment for Paget's disease.

Alkaline Phosphatase↗
PubMedDate not supplied

Intra-articular injections of hylan G-F 20 in patients with symptomatic hip osteoarthritis: an open-label, multicentre, pilot study.

OBJECTIVE: To obtain prospective data on feasibility and safety of intra-articular injections of hylan G-F20 in patients with symptomatic hip osteoarthritis (OA). METHODS: Fifty-seven patients with primary hip OA, Kellgren-Lawrence grade II-III, aged > or = 40 and walking pain 50-90 mm on a visual analogue scale (VAS) were enrolled in an open-label, multicentre pilot trial. Hylan G-F20 (2 ml) was injected intra-articularly (IA) in the hip under fluoroscopy at D0, and follow-up visits were performed at D7-30-60-90. The possibility of a second injection at D30-60 or 90 was considered if the reported pain level was equivalent to baseline. Adverse events, walking pain (VAS), WOMAC index, patient and physician's global assessment were recorded at each visit. RESULTS: Twenty-five patients 1 injection and 32 received 2 injections. Transient hip pain was reported following 10.1% of injections, but no patient withdrew from the study because of this. Two mild synovial fluid aseptic effusions occurred after the first injection. No systemic device-related adverse event was reported. Walking pain decreased from 69.3 mm at entry to 39.5 mm at the end point (p < 0.0001). All other outcome measures decreased significantly. CONCLUSION: Viscosupplementation with hylan G-F20 is feasible, easy to perform and well-tolerated in hip OA. A double-blind, controlled study should be performed to confirm data on its efficacy.

Adult↗
PubMedDate not supplied

Epidemiological, clinical, biological and radiological differences between atrophic and hypertrophic patterns of hip osteoarthritis: a case-control study.

OBJECTIVE: Lack of osteophytes (atrophic form) has been shown to be a factor in the severity of hip osteoarthritis (OA). The aim of this study was to determine the epidemiological, radiological and biological differences between the hypertrophic and atrophic forms of hip osteoarthritis. METHODS: 25 patients with symptomatic hip OA (ACR criteria) and classified as having an atrophic form of OA based on the lack of osteophytes on standard radiograph of the pelvis, were matched for joint space width with 25 subjects with evidence of the hypertrophic form of hip OA. OA radiological severity was assessed using a scoring system and by computer measurement of the joint space width. Angles of hip dysplasia were measured. Serum hyaluronic acid, cartilage oligomeric matrix protein, collagenase, Type I procollagen, C-terminal crosslinking telopeptide of type I collagen and tissue inhibitor of métalloproteases-1 were assayed by immunoassay and C-reactive protein by ultrasensitive immunonephelemetry. Statistical analysis was performed using logistic regression, taking into account age, sex, body mass index, and bilaterality. RESULTS: Compared to hypertrophic OA, atrophic OA affected chiefly elderly women and was characterized by a smaller centre-edge angle and diffuse superior femoral head migration. It was less frequently bilateral. No statistically significant difference was found in the biological data between the two groups. CONCLUSION: An atrophic bone response in hip OA occurs chiefly in women and is associated with poor coverage of the femoral head. Serum biomarkers able to demonstrate differences between the atrophic and hypertrophic patterns of OA are lacking.

Aged↗
PubMedDate not supplied

Is there evidence to support the inclusion of viscosupplementation in the treatment paradigm for patients with hip osteoarthritis?

OBJECTIVE: Viscosupplementation with hyaluronic acid (HA) or its derivatives for the symptomatic relief of osteoarthritis (OA) of the hip joint has never been studied in placebo-controlled, double-blinded trials and conflicting results have been obtained from the published open trials. The aim of this study was to review the literature on viscosupplementation as a symptomatic treatment of hip OA. METHODS DATA SOURCES: Clinical trials in Medline (1966-2005) and Cochrane Controlled Trials Register using the key words: hip osteoarthritis AND hyaluronic acid or HA preparation trade name. All trials aimed to assess intra-articular hyaluronic acid injection for the treatment of hip OA were analyzed. In the absence of placebo-controlled trials, and because of the very wide variety of the study designs it was not possible to apply strictly the conventional rules of meta-analysis. RESULTS: Nine studies, including a total of 287 patients, were identified. Eight studies were uncontrolled-open trials. One was a randomized double blind study comparing two HA preparations. Five open-label prospective studies, including a total of 141 patients with symptomatic hip OA, assessed the safety and efficacy of 1 to 3 x 2mL intra-articular (IA) injections of hylan G-F 20 under fluoroscopic or ultrasound guidance. The overall success rate was about 50% at 3 to 12 month follow-up. In 31 subjects with symptomatic hip OA who received 1 x 3mL IA injection of non animal stabilized hyaluronic acid (NASHA) under fluoroscopy, pain and disability were reduced by 59% and 47% respectively at month 3. Six to 11 months after treatment the results remained satisfactory (42% and 39%). Hyaluronan injections, performed 3 to 5 times at weekly intervals in 44 patients, were effective in controlling pain in 68% of the patients over the 6 month follow-up period. In contrast, 1 to 3 ultrasound guided IA injections of HA preparations with 0.5-0.75 or 1.0 million MW induced only a very weak benefit in 28 patients. In all studies IA injections of HA were safe and well tolerated. Transient pain at the injection site and mild increase in hip pain for a few days was more frequent with NASHA. In the only double blind controlled trial no difference between hyaluronan and hylan was found regarding both efficacy and safety. CONCLUSION: To date, in the absence of placebo-controlled studies, the efficacy of IA injections of HA or its derivatives in the symptomatic treatment of hip OA cannot be determined conclusively. Nevertheless the published data suggest that viscosupplementation may be effective. Double-blind, controlled studies are required to confirm these data, before viscosupplementation should be included into the treatment paradigm for patients with hip osteoarthritis.

Humans↗