Læknablaðið - 15.10.1982, Page 4

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LÆKNABLADID
NÝR DOKTOR í LÆKNISFRÆDI BRYNJÓLFUR MOGENSEN
í júni síðastliðnum, varði dr. Brynjólfur Mo-
gensen doktorsritgerð vid háskólann í Lundi.
Efni hennar er Hip Surgery in'Juvenile Chro-
nic Arthritis við Medicinska Fakulteten i
Lundi.
Útdráttur úr efni ritgerðarinnar fer hér á
eftir:
Juvenile chronic arthritis (JCA) is an uncom-
mon disease with a favourable prognosis in
about three fourths of the patients. Hip
involvement is often the major cause of
disability and limited locomotion.
During the 10-year from 1970 through 1979,
150 hip operations were performed in 73
patients at the JCA Center in Lund and the
results were evaluated.
Arthroscopy of the hip with a traction
technique was found to give valuable informa-
tion about the synovia and the cartilage
surface. It should be performed early on in the
course of the hip symptoms to decide about
further treatment.
Synovectomy was found to give long-last-
ing pain relief in three fourths of the patients
even if performed after long-standing hip
disability with narrowing of the joint space.
The range of movement was not improved.
Synovectomy may postpone total hip arthro-
plasty for several years.
The outcome of soft tissue releasing opera-
tions was disappointing due to the shortlasting
effect. A more extensive release combined
with synovectomy might give better results.
The early clinical results of surface replace-
ment were promising but the 2-year radio-
graphic follow-up revealed loosening in half
of the hips and roentgen stereophotogramme-
try showed migration in three fourths.
The long-term clinical results after total hip
replacement were satisfactory. However there
was an actual or potential loosening in one
third of the hips at an average follow-up of 6.5
years. The radiographic loose total hip arthro-
plasty had a slightly lower pain score. At least
one revision will be necessary in most of the
hip arthroplasties.