We studied cancellous bone loss in a 4000y BP population, using several methods designed to detect age-related changes, in order to investigate the pattern of cancellous bone loss in this ancient population and to compare the results deriving from different methods used on identical specimens. We used 10-mm sections of fourth lumbar vertebral bodies and left femoral necks of 18 individuals of both sexes with estimated ages from 20 to 60 years of a 4000y BP bronze-age population. Stereoscopic photographs were used for three-dimensional analysis and trabecular number (TN) counting. After embedding, the following parameters were measured in different image analysis systems using plane parallel block samples: bone mineral density (BMD) in water by DEXA, and by evaluation of standardized radiographic images; fractional bone volume (BV/TV) in backscattered electron images of the trabecular surface layer and in optical images of trabeculae in a surface-stained layer; and trabecular bone pattern factor (TBPf) in the latter images. There was a high correlation between the results of morphological methods for measuring fractional bone volume. Reasonable correlations were found between the x-ray photon methods and poor correlations between these and the morphological methods. These poor correlations may be due to the diagenetic substitution occurring in archaeological skeletons, which would strongly influence x-ray-based density measurements. However, all the methods demonstrated that the most dramatic loss of quantity and quality in cancellous bone occurred in females between 40 and 60 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Austria↗

PubMedDate not supplied

[5 years' experiences with the Gersthof polyethylene peg-anchored acetabulum].

The acetabular socket "Model Gersthof" is a spheric polyethylene component which can be anchored cement-free by means of three symmetrically arranged pegs at the outside. Between July 1979 and October 1986, 1316 implants of cement-free sockets were performed at our own department. The evaluation of the socket was based on the criterium of radiological instability (= aseptic loosening). After five years of observation, this design-oriented evaluation of success shows a survival of 92% +/- 2.9%.

Acetabulum↗

PubMedDate not supplied

Bone marrow edema of the hip: MR findings after core decompression.

Magnetic resonance imaging is an extremely sensitive technique for evaluation of bone marrow changes at an early stage of avascular necrosis (AVN) of the hip. We therefore examined 11 painful hips whose clinical symptoms led us to suspect idiopathic AVN. The radiographs of all of these either were normal or demonstrated a minimal decrease in radiodensity. Magnetic resonance demonstrated diffuse signal loss of the bone marrow at short TR/TE images of the femoral head in all hips, with various extensions in the head, neck, and intertrochanteric area. These regions turned iso- to hyperintense on long TR/TE images compatible with bone marrow edema (BME). Focal abnormalities characteristic for AVN were not seen in any of the cases. Radionuclide studies performed in six cases were positive. All patients underwent core decompression treatment. Hydrostatic bone marrow pressure measurement and intraosseous venography were positive in five cases when measured. Histology available in eight cases confirmed the presence of BME. Furthermore, the bone changes corresponded to those of early AVN. Follow-up examinations after core decompression with MR showed normal signal intensity in all cases. Magnetic resonance represents a viable diagnostic tool for BME and can monitor the therapeutic success of core decompression. Whether BME of the femoral head constitutes a distinct transient syndrome or represents an early form of AVN is controversial at present. Our findings support those who believe that BME may represent an initial stage of idiopathic AVN.

Adult↗

PubMedDate not supplied

[Fibrin adhesion of cartilage surfaces].

Basing on encouraging results with the fixation of pure articular cartilage with the fibrin sealant in animal experiments, pure cartilage fragments were replanted in human patients using fibrin sealant. From individual cases biopsies could be taken from macroscopically not well healed areas during arthroscopic examination. The histological results from these cases are presented together with overall clinical experiences. Six weeks after operation one side of the graft showed no union with the subchondral bone and was also separated from the cartilage bed. However, after three and six months, the grafted cartilage had fused with subchondral bone, but pannus-like tissue was covering the surface and filling the cleft at the border to the bed. After one and five years, complete fusion with the subchondral bone and the surrounding cartilage can be demonstrated. There is always covering pannus at the larger observation times. In the majority of the 73 cases treated so far excellent clinical results were obtained, enabling the patients to take up their sporting activities again.

Athletic Injuries↗