Aims

After a few passages of in vitro culture, primary human articular chondrocytes undergo senescence and loss of their phenotype. Most of the available chondrocyte cell lines have been obtained from cartilage tissues different from diarthrodial joints, and their utility for osteoarthritis (OA) research is reduced. Thus, the goal of this research was the development of immortalized chondrocyte cell lines proceeded from the articular cartilage of patients with and without OA.

Introduction and purpose: Talar fractures are infrequent but are an important cause of morbidity.

Materials and methods: This is a retrospective study of talar fractures treated in our Hospital between 1997 and 2006 (10 years).

Results: We collected 44 fractures in 42 patients (37 men and 5 women), with a mean age of 33 years (range: 8–67 years). The cause of the fractures in 40 cases was high-energy trauma and in 4 cases low-energy trauma. The most frequent causes were traffic accidents (29) and falls (8). Mean hospital stay was 14 days. We found 22 neck fractures, which were classified accoding to Hawkins’ scale (10 type I, 9 type II and 3 type III), 19 fractures of the body (7 due to crushing, 5 coronal, 4 osteochondral, 2 sagittal and 1 of the lateral process), and 3 combined neck and body fractures. We did not see any head fractures. We found 5 fracture-dislocations, 2 subtalar fractures associated to a neck fracture and 2 complete dislocations. Nine of the 44 fractures were open (1 grade I, 5 grade II, 2 grade IIIA, 1 grade IIIB). Only 9 of the 42 patients did not have associated lesions. Of those that did have associated lesions, 52% had adjacent lesions and 57% had distant lesions. Twenty-six fractures underwent surgery, 20 with cannulated screws (6 anterograde and 14 retrograde) and 6 with Kirschner wires. Follow-up was carried out in 24 of these patients and the complications seen were 2 osteonecrosis, 5 skin necroses, 12 cases of posttraumatic arthritis, 3 infections, 2 malunions, and 8 cases of intolerance of osteosynthesis material. Hawkins’ sign was assessed in the neck fractures, and osteopenia was found in 6 fractures, none of which developed osteonecrosis. In the 3 patients who did not have osteopenia, 2 ischemic necroses were seen.

Conclusions: The rate of osteonecrosis was 13% in the patients followed up, less than that seen in published series. A positive Hawkins’s sign is reassuring as none of the patients with subchondral osteopenia at 6–8 weeks subsequently developed osteonecrosis.

Introduction and purpose: The purpose of the study is to look at the progress of fixed implants with osteolysis and bone defects treated and to set ground rules for treatment guidelines.

Materials and methods: We reviewed 204 hips between March 1996 and March 2003, in 40 of which femoral osteolysis was treated with fixed prostheses.

The reasons for the revisions were 20 aseptic cup loosenings and 20 cases of worn polyethylene, with presence of femoral osteolysis. Thirty of the stems were biological, nine mini-madreporic and one cemented.

The mean follow-up was 5 years and 2 months.

We used morsellised impacted bone graft held in place with cement, metal laminas or bone stock.

Results: Clinically the outcome was excellent or good in 92.5% of the cases, with no migration or revision of the stem.

All the grafts took. There was very limited partial resorption in 20% of the cases and radiolucent lines in 20.6%.

Among the complications were two new cases of wear with osteolysis and a fractured femur caused by a fall, with no infection or dislocation.

Conclusions: Femoral osteolysis must be watched and treated surgically if it progresses, even though the implant is fixed.

Impacted morsellised bone grafts in the femoral canal with a fixed stem, even with extensive, unchecked osteolysis, held in place with metal cages are a reliable means of recovering bone stock and holding the femoral component firmly in place for the long term, with good clinical and radiological outcome, minimal risk and shorter surgery.

Introduction and Objectives: This study reviews the results of osteoarticular ultrasound of the hip in infants using the Graf method between 1992 and 2002 for the diagnosis and treatment of congenital hip dysplasia (CHD) and congenital hip dislocation in the province of Santa Cruz de Tenerife, Canary Islands, Spain. The objective of this study is to evaluate the impact of early diagnosis and treatment of infant hip pathologies related to CHD using a non-invasive, reproducible, and relatively easy-to-use method of clinical evaluation.

Materials and Methods: Between 1992 and 2002, 5,760 (18%) of a total 32,000 newborns in our province received an ultrasound examination using the Graf technique due to the presence of one or more risk factors. Graf methods and ultrasonographic criteria were used to conduct a systematic study with static ultrasonograms, dynamic studies, and/or stress studies of the hips. During the 10-year period, only 4 hips required surgical intervention after one year of age when orthopaedic treatment was not an option. This represents a significant reduction in the rate of surgery due to earlier treatment after ultrasonographic diagnosis.

Results: Risk factors associated with the appearance of congenital hip deformities diagnosed by ultrasound in the infant population of Santa Cruz de Tenerife, in order of frequency, were as follows: female newborn, first pregnancy, first birth (36%), lax hip (30%), asymmetry (25%), positive Ortolani hip clunk (15%), family history (15%), reduced abduction (6%), associated osteoarticular pathology (5%), prematurity (3%), and others. Ultrasound made it possible to initiate early treatment and control. The wide pillow (including the Frejka abduction pillow) was used in 31.63% of cases, Pavlik harness in 10.87%, a DSS splint in one case, and the Kramer extension/repositioning technique requiring hospitalisation was used in 1.92% of cases. Average age to maturity of dysplastic hips (reaching type I) was 4 months.

Discussion and Conclusions: There are no significant differences between the results obtained in our study and those reported in the literature of other populations on the use of ultrasonographic hip screening using the Graf technique.