Langzeitbehandlung der Coxarthrose mit Rumalon®

Role of internal and external fixation in ankle fusion

Between August 1980 and September 1993, 35 tibiotalar arthrodeses in 34 patients with primary and secondary osteoarthritis of the ankle were performed. Two different surgical techniques were employed. Internal screw fixation according to Wagner and Pock [20] and an external fixation method according to the resection compression arthrodesis by Charnley and Muller [14]. Twenty patients with 21 fusions could be investigated retrospectively. For evaluation we used self-assessment, clinical examination and radiographic analysis in combination with the score described by McGuire et al. [12]. In 80% the results were good and satisfactory with a median improvement of 23 score points on a scale of 100% 95 points, respectively. The most important advantages were pain relief and increase of walking distance. The fusion rate was 95%. We found osteoarthritis in the neighbouring joints did not have any influence on the surgical result. With respect to the two surgical techniques, the internal screw fixation method achieved fusion earlier with fewer complications and better improvement according to the McGuire score. Tibiotalar fusion is a safe therapy with reproducible good results involving pain relief, full weight-bearing and increase of walking distance.

Clinical trials of anti-osteoarthritic agents

Two long-term studies of chondroprotective agents in the treatment of osteoarthritis (OA) have been the subject of considerable interest. The studies included large numbers of patients with OA of the hip and of the knee followed for ten and five years. A range of criteria were chosen as parameters for monitoring the progression of disease, and statistical analysis of the results showed that GP-C modified positively the progression of OA. In view of the large number of criteria assessed, and the complexity of the results, it was decided that a reevaluation of the gonarthritis study would be appropriate using a range of indices in the statistical analysis. The statistical re-analysis of data confirmed that long-term treatment with GP-C positively modifies the progression of OA.

Effects of peptidic glycosaminoglycans complex on human chondrocytes cultivated in three dimensions

Human chondrocytes from the pelvic joint were cultivated in suspension; under these conditions, after a few days, cells aggregated. These chondrocytes were morphologically differentiated (round shape, situated inside cavities and surrounded by a matrix synthesized during cultivation) and biosynthetically differentiated (synthesis of type II collagen and cartilage proteoglycans (PG) (Bassleer et al. In vitro 22, 115-120, 1986). In this work, we present the metabolic and cellular effects of a peptidic-glycosaminoglycan (P-GAG) complex isolated from calf cartilage and bone marrow. We analyzed the effects of P-GAG on DNA synthesis (appreciated by 3H-thymidine incorporation into DNA), on type II collagen and on PG synthesis analyzed by specific radioimmunoassays. According to its final concentration in culture medium, P-GAG was able to stimulate proliferation or to favor the production of specific components of cartilage matrix, type II collagen and PG.

The mode of action of a glycosaminoglycan-peptide-complex (Rumalon) on articular cartilage of the rat in vivo

Quantitative ultrastructural morphometry and autoradiography of articular cartilage were used to assess in 3 months old rats the effects of in vivo administration of dexamethasone alone or in combination with a glycosaminglycan-peptide-complex (GAGPC). Dexamethasone treatment (3 mg/kg week for three weeks) induced a decrease of 35S-sulphate incorporation in cartilage and ultrastructural changes of articular chondrocytes, mainly characterized by an increase in cell mortality rate, a decrease in length of endoplasmic reticulum, in the number of Golgi bodies and in mitochondrial pool and size. These autoradiographic and ultrastructural changes were reversed or prevented when GAGPC was administered concomitantly with dexamethasone. These results show that the modifications measured by quantitative ultrastructural morphometry of chondrocytes are consistent with changes in biosynthetic functions and that the GAGPC protects cartilage from the inhibitory effects of corticoids.