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The role of PGE2 in the sensitization of mechanoreceptors in normal and inflamed ankle joints of the rat.

The role of PGE2 in the sensitization of high-threshold tarsal joint mechanoreceptors (putative nociceptors) has been investigated in 11 arthritic and 16 normal rats. Injections of a low dose of Freund's complete adjuvant at multiple sites into the tissues surrounding the ankle joint induced a chronic unilateral monoarthritis in the injected limb. Measurements of both spontaneous activity and responses of tarsal joint mechanoreceptors to repeated graded mechanical stimuli were made. All of the mechanoreceptors examined had afferent fibres with conduction velocities in the C- or A-delta range. Using this new model of joint inflammation we have shown that lysine acetylsalicylate reduces the mechanical sensitivity of these joint mechanoreceptors and reduces the spontaneous activity in afferent nerve fibres. Prostaglandin E2 is unable to restore either the spontaneous activity in the afferent axon or the mechanical sensitivity of tarsal joint mechanoreceptors after lysine acetylsalicylate in the arthritic rat. Similarly, PGE2 does not sensitize or excite tarsal joint mechanoreceptors in the normal rat. In the normal rat, however, PGE2 potentiates the excitatory action of bradykinin and enhances the sensitizing effect of bradykinin on the responses of joint mechanoreceptors to mechanical stimulation when both substances are injected simultaneously. These results indicate that PGE2 is not important in the sensitization of these joint mechanoreceptors in this model of chronic joint inflammation but that in other circumstances PGE2 may be able to contribute to a sensitization of joint mechanoreceptors by enhancing the action of bradykinin.

Action Potentials↗

[Reorientational arthrodesis of the ankle joint using four screws].

BACKGROUND: Arthrodesis of the ankle has gained wide acceptance as a first-line treatment option for painful posttraumatic osteoarthritis. The technique using four to five lag screws for internal osteosynthesis is a safe and biomechanically stable method to obtain a sound ankle fusion with good to excellent long-term results in the majority of patients. Malalignment hazards are minimized by preservation of the ankle mortise. METHODS: The meticulous resection of all cartilage and sclerotic bone as well as an atraumatic surgical technique are essential for preventing major complications. The need for revision surgery is minimized by correction of talar malalignment, fusion with the foot in a 90 degrees position and preoperative evaluation of the subtalar joint. In a series of 40 ankle fusions fixed with the lag screw technique, 82.5% good to excellent results were obtained after 5.6 (4.8-7.6) years. No infection, stress fracture or non-union was seen. RESULTS: In cases of osteitis, osteonecrosis, osteoporosis, and poor soft-tissue condition, external fixation techniques are preferred. In the presence of severe loss of bone stock at the distal tibia, stability can be achieved by using a compression nail for tibiotalar fusion without additional subtalar arthrodesis.

Adult↗

[Results of surgery of lesions of the ankle joint (author's transl)].

Ruptures of the ligaments are getting more and more frequent as a result of increased general sports activities and the increasingly high demands made on sportsmen in competitive events. From June 1975 to June 1980, surgery was performed in 76 patients of our hospital. 54 patients were followed up, corresponding to 71% of the total number. 50 patients considered the results of surgery to be very good to good. Four patients only were dissatisfied. This subjective result was confirmed by objective examination. Basing on these data, the conclusion is that surgical treatment of ruptures of the outer ligaments of the ankle joint is the method of choice.

Adolescent↗