Albert B. Ferguson

The Pathological Changes in Degenerative Arthritis of the Hip and Treatment by Rotational Osteotomy

Close scrutiny of the pathological changes involved imi dcgemmcrativc arthritis of time hip leads immevitably to the comiclusion that the various mnammifcstatiomms of time disease rcpm-csent changes in the balance betsveeum localized abmmormmmal stress and the capacity of the joimit tissues to i-epair. This comicept explains the periods of lessened symmmptommms during the steady progression of this disease. That it is a progressive disease beconmes evident uvhemm large series of cases are studied. Thus Pearson amid Riddell found in 400 cases of degenerative arthritis of the hip that seveim hips became painless spontaneously. It is also imimportant to ummderstand the pathological processes involved in order to have somne basis for the selection of conservative and surgical immeasures uvhich uvill distribute mmmore uvidely the stresses associated svith uveight-bearing and proummote tissue repair. The study of pathological changes described here is based omi four autopsies and seventy-six surgical operations, thus providing a total of eighty-foui specimumens. All time various etiological factors uvhich mmiay lead to degenerative changes are represented. The principal one, houvever, mumight be termumed idiopathic and forty-mime specimimens fall immto this category. 1mmtemi cases, there was a history of defimmite, severe trauimma without fracture, dislocatiomm, or subsequent developmmmemmt of avascular mmecmosis. Time patients imi time idiopatimic group had had symimptommis fomami average of 4.3 ycam’s. 1mmgemucral, paticmmts uvimose imip lesiomms amc the icsult of rheumimatoid disease or comigemuital defom-ummity sucim as dysplasia seek ummedical advice for commsideratiomm of possible sum-gical mmiammagcmmment uvhemi they are sevem-al decades youuigcr than timose iii time idiopathic gi-oup, uvimo om-dimiam-ily seek such tm-eatmmmemmt iii the sixtim decade. Lloyd-Ilohcits ium imis sttmdy of 124 osteotonmies listed time etiology of the disease as fohlosvs: idiopathic ium scvemmty-three ; dysplasia, tsvemity-six ; adolescemmt coxa u’ama, cigimt ; Pcrtimcs’ disease, thu-ce ; septic ai’thritis, three ; rheuummatoid artimmitis, tsvo ; Otto pelvis, tsvo ; traummiatic dislocatiomm, tsvo ; and immiscellaneous diseases, five. Iii time immaterial prescmited here, traummia (ten cases) amid rheummmatoid arthritis (tss’elve cases) are mmmore prommminemmtly represemmted. A dysplastic hip dating frommm childhood is a possible cause of osteo-am-thritis, but timere us’cre omuly miimmc cases of imip dysplasia iii this seu’ies. Ofteum time late appearance of osteo-aithmitis immiummics timat of aim old dysplastic hip joimit amid mmmaybe misimmterpm-cted as time mcsult of dysplasia.

The Influence of Immobilization and Motion on the Formation of Fibrocartilage in the Repair Granuloma after Joint Resection in the Rabbit

1. Arthroplasties of the first metatarsophalangeal joints in rabbits have been examined histologically after varying periods of immobilization and subsequent motion. 2. In this laboratory model, motion started one week after surgery consistently produced the best joint as evidenced by histological examination. 3. The proposition is presented that wound repair should be looked upon as an inflammatory response and that by proper control of local factors at the wound site it should be possible to direct the tissue response into channels leading to the formation of the desired mature tissue.

A STUDY OF THE ACTION AT VARYING LENGTHS OF TWO MUSCLES OF OPPOSING FUNCTION, TIBIALIS ANTERIOR AND GASTROCNEMIUS, IN THE RAT

The length-tension diagram for the tibialis anterior and gastrocnemius muscles of the rat reveals differences in the range of maximum developed tension in relation to the resting tension of the muscle at the time of stimulation. It is felt that the standard configuration noted by Blix in the gastrocnemius of the frog cannot be applied to all length-tension diagrams and that the point of maximum developed tension of a muscle will vary with structure and function.