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T Conrozier

Publications and source records attributed to T Conrozier.

53 records · Page 3Linked to original sources
PubMed1995

Progression of digital osteoarthritis: a sequential scintigraphic and radiographic study.

Hand radiographs and scintigraphy were obtained initially and at the 4-year follow-up in 15 patients with symptomatic osteoarthritis (OA) of distal and/or proximal interphalangeal joints. For each joint, a 0-15 score was obtained for the OA radiographic lesions read blind by the same observer. An abnormal isotope retention over a bone reference area was assessed and quantified. The predictive value of scintigraphy for the OA radiographic progression was confirmed and shown to be improved by a second investigation. During the study period, the percentage of radiographic OA joints increased from 66.3 to 76.6%, but joints showing an abnormal scan decreased from 40 to 22.5%. Progression of the OA radiographic score was closely related to scintigraphic changes. The mean difference between the final and initial OA score was -0.08 in joints with two normal scans (N = 115), +0.73 in joints showing a first abnormal and a second normal scan (N = 94) and +1.8 in joints with two abnormal scans (N = 14) or a scan becoming abnormal (N = 47). An abnormal scan appears to represent a transient event, and this event is associated with a period of progression of digital OA. Potentially, anti-OA therapies that suppress joint isotope retention might slow down OA progression. The magnitude of joint isotope retention was positively correlated with the OA radiographic score established at the same time (R = 0.61 and P < 0.001), but showed no predictive value for progression of the latter.

Adult↗
PubMed1995

Quantitative assessment of radiographic normal and osteoarthritic hip joint space.

Radiographic joint space narrowing (JSN) is the hallmark of progression in osteoarthritis (OA). We developed a technique of measuring joint space of the hip by computer analysis of digitally stored pelvic radiographs. The interobserver coefficient of variation was 3.3%. Mean joint space width (MJSW) and joint space surface were more sensitive to change than interbone distance. In a retrospective analysis of 69 OA hips, MJSW decreased 0.43 +/- 0.43 mm per year and was lower in patients with the hypertrophic form of OA. Limitations were due to radiograph quality. This computerized measurement method is applicable to monitor progression of hip OA and appears to be of value in the evaluation of disease-modifying therapies for OA.

Adolescent↗
PubMed1994

[Rate of joint space pinching in coxarthrosis].

Accurate measures of cartilage destruction are needed to evaluate the effects of chondroprotective agents in human osteoarthritis. Use of a digitalized image analyzer (HOLOGIC, ICMS software) to measure mean joint space width on roentgenograms of the hip is a simple, reliable method with a coefficient of variation of 3.3%. To determine the rate of joint space loss and to identify factors associated with this parameter, we retrospectively studied 56 hips with osteoarthritis in 39 patients (mean age at baseline 55.5 +/- 12 years; mean roentgenographic follow-up 5.2 +/- 3.6 years, mean number of roentgenograms per patient 3.7 +/- 1.1). Mean annual joint space loss was 13.5 +/- 16.6%, i.e., 0.42 +/- 0.38 mm, and was negatively correlated with the duration of roentgenographic follow-up (r = 0.95 and 0.97, p < 0.01). When only those subjects who were followed up for two to eight years were studied, mean joint space loss was only 6.7% with a considerably smaller standard deviation of 4.2%, i.e., 0.29 +/- 0.21 mm. No influence on the rate of joint space loss was found for age at onset of symptoms, age at the first roentgenographic study, side, gender, or location of the joint space narrowing. The roentgenographic stage or joint space width at baseline were positively correlated with the rate of joint space loss expressed as a percentage but not in mm. These data suggest that the absolute amount of cartilage lost is not influenced by the roentgenographic stage of the osteoarthritis at inclusion of the patient in the study.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

[Serum phospholipase A2 activity in osteoarthritis].

Serum phospholipase A2 activity in 67 osteoarthritis patients and 17 controls was determined using a radiolabeled specific substrate. Serum phospholipase A2 activity was significantly higher in osteoarthritis patients (115 +/- 73.6 dpm/h/ml) than in controls (45 +/- 25 dpm/h/ml) (p = 0.002). In 41 osteoarthritis patients, serum phospholipase A2 activity was unrelated to age, time since onset of osteoarthritis symptoms, duration of morning stiffness, Lequesne's index, roentgenographic stage of osteoarthritis, number of joints with osteoarthritis, erythrocyte sedimentation rate, or serum C-reactive protein levels. In 12 osteoarthritis patients who were evaluated twice at a mean interval of 46 days, changes in serum phospholipase A2 activity were unrelated to changes in Lequesne's index. Blind evaluation of long-term joint space loss was performed in 14 patients; serum phospholipase A2 activity increased only in those patients with progressive joint space loss, but the difference was not statistically significant as compared with the controls. These data suggest that serum phospholipase A2 activity is not useful in practice as a marker for osteoarthritis.

Adult↗
PubMed1993

[Measurement of the hip joint space using automatic digital image analysis].

Joint surface area (JSA) and mean joint space width (MJSW) at the hip were measured using a ICMS-Techline computer program to analyze digitalised frontal weight-bearing roentgenograms of the pelvis. With this technique, the portion of joint space studied is always the same in a given patient and is enclosed within an acute ECS angle whose apex C is the center of the head of the femur and whose ends E and S are the lateral rim of the acetabulum and the highest point of the homolateral sacral wing respectively. ECS varies across individuals but remains constant in a given hip. Twenty hips were included in the first part of the study. For each hip, three roentgenograms were taken at five-minute intervals by three different radiologists who used their own constants (settings, position of the subject). JSA and MJSW are determined five times on each film by two different observers who had no information on the films under study. The interobserver coefficient of variation (CV) was 4.7% for JSA and 3.3% for MJSW. Intra-observer CVs were 2.97 and 3.54% for MJSW and 4.32% and 5.13% for JSA. There was a very close correlation between MJSW and JSA (r = 0.87, p < 0.0001). MJSW was then determined for roentgenograms of 30 hips with osteoarthritis. Results were compared with the values obtained using Lequesne's method of joint space measurement at the site of maximum narrowing. Measurements were performed in a double-blind fashion by two observers. The correlation coefficient was r = 0.89 (p < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Serum hyaluronic acid in osteoarthritis].

In this prospective study, serum hyaluronate (SH) was assayed using a radiometric method (Pharmacia) in 73 osteoarthritis patients and 39 controls. All assays were performed between 8 h 00 and 9 h 00 a.m. because SH levels exhibit circadian variations. SH levels were significantly higher in patients with osteoarthritis than in controls (92 +/- 66 micrograms/l and 39 +/- 21 micrograms/l, respectively, p = 0.0001). Among 50 patients with osteoarthritis, including 29 with knee involvement and 21 with hip involvement, SH levels were not correlated with morning stiffness, duration of symptoms, Lequesne's algofunctional index, erythrocyte sedimentation rate, C-reactive protein, severity of roentgenographic changes in the affected knee or hip, disease extension, or severity. The lack of any relationship between changes in SH levels and Lequesne's is index values in 25 patients or between SH levels and joint space narrowing evaluated retrospectively in 16 patients, as well as the prompt return to high SH levels after arthroplasty and synovectomy in 14 patients with hip joint osteoarthritis, suggest that this potential marker is not useful for monitoring osteoarthritis in a single joint.

Adult↗
PubMed1991

[Serum hyaluronic acid and phospholipase A2 in an arthritic population].

Serum hyaluronic acid (HA) and A2 phospholipase (A2PL) activity were measured by radioimmunoassay (Pharmacia) and using a specific phospholipid substrate respectively, as potential markers of osteoarthritic synovitis. With neither age, treatment nor sample time taken into consideration, the concentration of HA (micrograms/ml) was 585 +/- 1,054 in rheumatoid arthritis, 379 +/- 409 in knee osteoarthrosis, 272 +/- 384 in hip osteoarthrosis, 131 +/- 144 in low back pain and 44 +/- 23 in osteoporosis, with no significant difference between the groups. HA was nevertheless found to be significantly higher in knee osteoarthrosis patients than in normal controls, when samples were drawn at the same time of day. Physical exercise (pedalling), as well as 20 hours lying flat and an intra-articular injection of corticosteroids did not cause any significant variation in serum HA levels in knee osteoarthrosis patients, in contrast to 20 hours of rest in the controls. A2PL activity was significantly higher in osteoarthrosis patients than in the controls, decreased with rest and corticosteroids and was not dependent upon sample time.

Aged↗
PubMed1991

[Cytokines, prostaglandin E2, phospholipase A and metalloproteases in synovial fluid in osteoarthritis].

Concentrations of prostaglandin E2, interleukin 1 beta, interleukin 6 and tumor necrosis factor alpha, phospholipase A2, collagenase and proteoglycanase activity were determined in synovial fluid from 26 patients with osteoarthrosis of the knee and 10 with rheumatoid arthritis. Osteoarthrosis synovial fluid was characterised by the absence of interleukin 1 beta while tumour necrosis factor alpha and interleukin 6 were present in relatively large amounts, by a very high phospholipase A2 activity contrasting with a very low concentration of prostaglandin E2, and by a collagenase/proteoglycanase activity only slightly less constant and high as in rheumatoid arthritis. In osteoarthrosis patients, the interleukin 6 concentration, but not that of tumor necrosis factor alpha, was correlated with the collagenase and proteoglycanase activity of synovial fluid.

Adult↗
PubMed1990

[Effects of non-steroidal anti-inflammatory drugs on the enzymatic degradation of osteoarthritic cartilage].

The proteoglycannasic and collagenolytic activity the fissured, osteoarthritic human cartilage has been studied in vitro, using proteoglycannases and collagen type II respectively as marked substrates. The effect of various NSAIDs, used at a concentration corresponding to that of the synovial fluid, on these enzymatic activities has been measured in vitro. Naproxen decreases in a significant and dose-dependent way the enzymatic degradation of the cartilage, but only an inhibition of the proteoglycannase can be hoped for in vivo. Not all NSAIDs seem to have inhibitory effects on the enzymatic degradation of the osteoarthritic cartilage.

Aged↗
PubMed1990

Study of the effect of a glycosaminoglycan-peptide complex on the degradative enzyme activities in human osteoarthritic cartilage.

The in vitro collagenolytic and proteoglycanasic activity from human fibrillated osteoarthritic cartilage was determined using labelled proteoglycans and type II collagen as substrates. In vitro, a glycosaminoglycan-peptide complex (GP-C Rumalon) induced a dose-dependent inhibition of both collagenolytic and proteoglycanasic activities while sodium salicylate and indomethacin had only a weak suppressive effect on proteoglycanase. Phospholipase A2 activity was unmodified by GP-C suggesting that the effect of the drug on degradative enzymes was unrelated to prostaglandin formation.

Aged↗
PubMed1990

[Incidence of vertebral hyperostosis in patients with calcified tendinitis of the shoulder. Prospective study].

A vertebral hyperostosis was reported in 54.3 p. cent of the cases in 46 patients with calcified tendinitis of the shoulder, in 12.5 p. cent of the cases in 32 patients with a simple tendinitis of the shoulder and in 9.6 p. cent of the cases in 62 control patients without any scapular symptoms nor shoulder calcifications. The possible explanations of this significant association between vertebral hyperostosis and calcified tendinitis are considered.

Adult↗
PubMed1989

[Inflammation and cartilage].

The integrity of the collagen network and the proteoglycans is essential for the maintenance of the mechanical properties of cartilage. In spite of a slow turnover, cartilage is able to modify the synthesis of its matrix and has reparative powers. Chondrocytes also possess the enzymes necessary for degrading the matrix. Most substances which are mediators in the inflammatory process act on cartilage, either by inhibiting synthesis, or by stimulating the enzymes involved in degradation. The multiplicity of the mediators (kinin, histamine, serotonin, complement, free oxygen radicals, pharmacologically active lipids, cytokinin) and the interactions among the various systems that are called into play account for the difficulties encountered in treatment.

Arthritis↗
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

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↗