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PubMed1987

[Old age and joint disease].

The seriousness of articular diseases in old persons is related to the loss of function and the rapid way this can lead to them being bed ridden. Rheumatoid polyarthritis is often difficult to distinguish from rhizomelic pseudopolyarthritis, these two diseases resemble each other at this age with the asthenia and loss of general health, the inflammatory pains which are peripheral and of nerve root origin. Among the metabolic arthropathies, articular chondrocalcinosis is frequent, and often latent, but sometimes it is destructive in particular in the hips and knees; septic arthritis today mainly occurs in the elderly, and the algoneurodystrophies are more frequent in old persons than in young subjects, following trauma or a hemiplegia. Arthrosis is obviously the main articular disease of senescence especially involving the joints of the lower limb, hip disease being less incapacitating than knee disease where surgical treatment is less often considered. The arthroses of the upper limbs especially of the shoulder are well tolerated. Osteochondromatosis, osteonecrosis of the internal condyle of the knee, the rapidly destructive arthropathies and hemarthrosis can develop as a complication of a simple arthrosis. In the spine vertebral hyperostosis is especially a disease of the elderly, it can occur alone or with an arthrosis of the posterior vertebral joints, a narrow spinal canal straight or narrowed. Medical treatment, physiotherapy, and finally surgery can give very satisfactory results in an old patient, avoiding loss of function, a miserable existence and becoming bed ridden.

Aged↗
PubMedDate not supplied

[Resection of the acromial end of clavicula in acromioclavicular joint arthrosis].

Arthroses of the acromioclavicular joint mainly occur after trauma and may be the cause of pain in the shoulder region which is difficult to treat. Other possible causes are metastases, hyperparathyroidism, tuberculosis and osteolysis whose pathogenetic mechanism is still unknown. If all conservative treatment methods have been tried without success, lateral resection of the clavicula, first described in 1941 by Gurd and Mumford, is the method of choice. Some of the results obtained by the present authors with 15 patients (of whom 11 were followed up) are presented and compared with those obtained by other authors. Since the results are altogether very good, this operation, which is technically simple to perform, is recommended for arthroses of the acromioclavicular joint of any etiology. In cases with Tossy III ruptures of the joint the procedure described by Weaver and Dunn can be performed in addition.

Acromioclavicular Joint↗