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Dislocation is a leading cause of revision after total hip arthroplasty (THA). To address this risk, dual-ability technology was developed, which features a mobile polyethylene liner locked onto a femoral head and articulating in a metallic acetabular shell This study reports clinical outcome data after implantation of the third-generation POLARCUP Dual-Mobility Sys-ter (Smith & Nephew Orthopaedics AG, Rotkreuz, Switzerland). Primary THA procedures were performed in 150 patients. At 7.1 years, cumulative cup survival according to Kaplan-Meier was 97.4%. The mean Postel-Merle d'Aubigne score improved from 8.9 to 17.1 during the investigation. Two cups were revised at 5.4 and 6.4 years because of aseptic loosening. No dislocations were observed during follow-up; The current results confirm excellent early to midterm clinical outcomes for the POLARCUP Dual-Mobility System. [ABSTRACT FROM AUTHOR]

Background: The separate design concepts of dual-mobility cups and triple-taper femoral stems were developed to improve survivorship following total hip replacement (THR) by reducing instability/dislocation and enabling enhanced fixation. Successful outcomes at over two decades have been reported with earlier-generation devices based on these concepts. The current study aimed to provide the first long-term results with a unique pairing of later-generation dual-mobility cup and triple-taper cementless femoral stem after a decade of use in patients undergoing THR., Methods: In this retrospective analysis, records were reviewed for all subjects implanted with this dual-mobility cup/cementless femoral stem combination at three centers between 2002 and 2005. Any subject who had not already had follow-up visit beyond 10 years, was not previously revised, and still living were invited for a single follow-up visit consisting of Merle d'Aubgine Scores, the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, and standard radiographs., Results: There were 244 THRs available for analysis. At a mean follow-up of 11.9 years, the Kaplan-Meier survivorship (endpoint: revision for any reason) was 99.1% (95% CI, 97.6-99.7) for the stem and 95.9% (95% CI, 93.1-97.6) for the cup. Merle d'Aubigne Scores were significantly improved from baseline and WOMAC scores were in the satisfactory range at the final follow-up. Radiographic analysis revealed no cases of stem subsidence, no cases of bone hypertrophy, 1 (0.4%) case of bone atrophy, and 3 (1.2%) cases of osteolysis around the stem. No subjects had radiolucent lines greater than 1 mm in any femoral Gruen zone. Evidence of cup migration was seen in 1 (0.4%) subject and 1 (0.4%) subject had evidence of osteolysis that was seen in Gruen zones I, II, IV, and V., Conclusions: This combination of a later-generation dual-mobility cup and cementless triple-taper stem was associated with excellent survivorship and satisfactory functional outcomes at over 10 years follow-up., Trial Registration: ClinicalTrials.gov, NCT02648152. Date of registration: January 6, 2016. Retrospectively registered.

Introduction: Since 1962, the low friction arthroplasty developed by Sir John Charnley has given us very good long terms results at more than 40 years follow up, but dislocation remains a major complication. The dislocation rate is a permanent risk during the life of the patient and the prosthesis, defined by J. Caton and D. Berry in 2004 as a cumulative risk. History and concept development: The concept of dual mobility was thought up by G. Bousquet, A. Rambert and J. Rieu in the 1970s (1974-1979). The first one in 1979 was called NOVAE and combined two articulations: one large and one smaller by a recruitement phenomenon increasing the jumps distance and so decreasing dislocation forces. In 2003, D. Noyer published the first paper about the «third articulation»: a true metal/PE bearing. Since 1996, twenty years after the first patent, many dual mobility cups have been developed with various fixation ways and various designs., Conclusion: Today with the same principles there are many differences for the «third generation» with excellent results at more than ten years FU with less than 1% to 2% dislocation rate in primary, revision, recurrent THA dislocation and THA after femoral neck fractures.

In this prospective study, serum hyaluronate (SH) was assayed using a radiometric method (Pharmacia) in 73 osteoarthritis patients and 39 controls. All assays were performed between 8 h 00 and 9 h 00 a.m. because SH levels exhibit circadian variations. SH levels were significantly higher in patients with osteoarthritis than in controls (92 +/- 66 micrograms/l and 39 +/- 21 micrograms/l, respectively, p = 0.0001). Among 50 patients with osteoarthritis, including 29 with knee involvement and 21 with hip involvement, SH levels were not correlated with morning stiffness, duration of symptoms, Lequesne's algofunctional index, erythrocyte sedimentation rate, C-reactive protein, severity of roentgenographic changes in the affected knee or hip, disease extension, or severity. The lack of any relationship between changes in SH levels and Lequesne's is index values in 25 patients or between SH levels and joint space narrowing evaluated retrospectively in 16 patients, as well as the prompt return to high SH levels after arthroplasty and synovectomy in 14 patients with hip joint osteoarthritis, suggest that this potential marker is not useful for monitoring osteoarthritis in a single joint.

Seven cases of pyogenic arthritis of the sacro-iliac joint in children were observed between 1968 and 1981. Their analysis is discussed with the conclusions of the too much rare publications in the recent literature. Taking in to account the anatomic particularities the necessity of very precise roentgenographic technics in order to assess the sacro-iliac joint, especially in children because of incomplete ossification, the authors replace this pathology into the osteomyelitis in children. From the clinical aspects of the disease, with its typically localized pain, and its acute clinical and biological septicemic syndrome, the authors attempt to demonstrate that the classical idea of a delayed diagnosis, is not absolute. Even in this particular localization, an early "up to date" diagnosis is possible allowing rapid treatment with efficient antibiotherapy directed towards the responsible germ after their isolation (especially staphylococcus aureus). Indubitable progress has been gained with systematic radio-nuclide bone scanning in emergency.

Progressive radial deviation after epiphyseal separation in children is a rare complication. It is related to an imbalance of residual growth potential of the lower ends of the radius and ulna together. The functional disability is generally moderate. 5 cases were observed by the authors, all of which were treated surgically. The mechanism of the deformity and the surgical techniques are described. These are lengthening of the radius, angulation osteotomy of the radius, shortening of the ulna or epiphysiodeses. In some cases, operative excision of a partial epiphyseal closure can be done provided that there has been a close follow up after the trauma and an early diagnosis.

An anatomical study has been achieved on 42 upper extremities of adult rabbit's thigh bones. Three types of prostheses have been perfected in order to analyse the reactions of the cartilage and of the subchondral bone when confronted with these implants. The animals were sacrificed at different intervals. The state of the acetabulum surface has been studied according to macroscopic and microscopic criteria. Three methods converge and agree in showing an arthrosis type of reaction with regard to the non operated controlateral articulation.

The authors present an experimental study of the rabbit femoral prosthesis compatibility : macroscopical aspect, proteoglycan content and metabolism of the acetabular cartilage.

The micro-hardness and the density of fixed negative charges in cartilage of the shoulders, hips and knees of 6 subjects were studied. These two parameters were narrowly correlated. The resistance and proteoglycan concentration of the cartilage of the femoral head were greater than those of the knee and of the shoulder. They did not vary on each side. There is a significant correlation between the hardness of the cartilage of the femoral head and of the external femoral condyle. The histologically normal cartilage of the femoral head in arthrosis is at the lower limit of control values for hardness.

The authors present a new equipment for orthopaedic assesment of club-foot. This "dynamic splint" aims to produce a self-correction of the deformity by the infant at time of each movement of his lower limb. With regard to 72 such deformities, concerning 47 children, they record the results after an average follow-up of more than 2 years. Criterions of results, clinical and chiefly radiological, more objectives, are classified into 3 parts : correction of varus of the foot, correction of adduction of the hind-foot, correction of equinus.

A macroscopic and microscopic anatomical study of the knees of 10 Beagles showed that thin osteo-chondral autografts taken from another joint healed perfectly macroscopically and almost perfectly histologically, if they fitted very well (figure 2). Rib cartilage grafts fitted perfectly to a dog's knee were not successful unless the perichondrium was turned towards the bone, in which case cartilage proliferated on the surface (figure 4). There was very little loss of substance but trans-chondro-osseus perforation also revealed a chondrogenic mode (figure 4). No trace was found in the literature of work concerning a comparison of these two types of grafts in the same experiment.

Study of the arterial vascularization of the coxal bone by microangiographic methods. Nutritive and periosteal blood-vessels come from Iliaca interna and Iliaca externa arteries. The ilium is vascularized by the Ilio-lumbalis artery which is a nutritive blood vessel. A eriosteal vascularization also exists. Ischium and pubis have a periosteal vascularization. Blood vessels are oriented toward the sus-acetabulum area where many anastomoses exist.