Læknablaðið : fylgirit - 01.06.1996, Blaðsíða 59

53
I'amily members > 35 years of age
■ Doeumented knee OA
» Symptoms suggesting knee OA
4 Unaffected
hip OA have been reported. We present an Ice-
landic family with a high prevalence of knee OA in
four generations.
Results were obtained by interview and clinical
examination and, where available, retrospective
analysis of radiographic and arthroscopic results. No
visible mechanical factors, hypermobility or obesity
can explain the high prevalence, and OA of other
joints is not very common. Furthermore the male to
female ratio of 1:1 is unexpected for knee O A where
women usually dominate.
There are problems in defining affected as well as
unaffected members with such a common disorder
where disease onset may be late in life, but the
results point to an intrinsic defect in the knee inher-
ited as a dominant trait.
V-5. An open study on the effect of
pentosan polysulfate (Cartrophen®)
treatment on "mTc-diphosphonate
uptake in hand osteoarthritis
Helgi Jónsson*, Cuðrún Aspelund*, Eysteinn Pét-
ursson**, David Cullis-Hill***
Frá Dpts of*Rlieumatology and **Nuclear Medicine
Landspítalinn University Hospital, Reykjavík,
***Arthropharm, Australia
"Tc-diphosphonate uptake in joints reflects ost-
eocyte activity and bony remodeling. Uptake in ost-
eoarthritic hand joints is associated with radiogra-
phic progression. Pentosan polysulphate is a pleio-
tropic ostearthritis drug shown to have symptomatic
effect on osteoarthritis of the knee and is registered
for veterinary use.
Methods: Twelve patients with severe symptoma-
tic hand osteoarthritis were treated with four weekly
intramuscular injections of pentosan polysulphate
(3mg/kg) after having stopped NSAID treatment.
Bone scans of hands and wrists were done before
and 10 days after treatment. Four patients with a
clinical response to pentosan polysulphate had a
repeat course of treatment four weeks later and a
third bone scan.
Results: Despite improvement in all secondary
variables (subjective evaluation, pain (VAS), grip
strength, ISHOA hand disability scale), no consist-
ent changes in "mTc-diphosphonate uptake were
registered after either one or two courses of pentos-
an polysulphate.
Conclusions: One or two treatment courses with
pentosan polysulphate (Cartrophen®) do not affect
short term isotope uptake in patients with hand
osteoarthritis.
V-6. Hypermobility features in
patients operated for thumb base
osteoarthritis (OA)
Magnús Páll Albertsson*, Helgi Jónsson**
Frá *Dpt of Orthopedic Surgery, Reykjavík Hospi-
tal, **Dpt of Rheumatology , Landspítalinn Uni-
versity Hospital, Reykjavík
Hypermobility has recently been implicated in the
pathogenesis of CMC 1 OA in Icelandic patients.
The objective of the present study was two-fold, to
investigate the impact of „hypermobility associated
hand OA“ in Swedish patients with severe CMC 1
OA, and to evaluate operation results in this sub-
group of patients.
Material and methods: Forty two consecutive
female patients who had been operated with tra-
pezectomy and fascioplasty during 1992-1994 at the
Department of Hand Surgery in Malmö, Sweden,
were examined with regard to hypermobility featur-
es according to the Beighton criteria. Forty eight age
matched Swedish females constituted the control
group.
Rcsults: Hypermobility features, both >2 Beigh-
ton criteria (n=27, p<0.01) and 2^4 criteria (n=12,
p<0.05) were significantly more prevalent in the
operated group. Patients with hypermobility featur-
es had fewer and less severely involved interphalan-
geal joints, and tended to be younger at operation,
particularly those fulfilling 2=4 Beighton criteria
(median age 59 compared with 65 in the remainder,
p<0.05). Pinch and grip strength was comparable in
lax and non-lax patients, as was pain, but the lax
group tended to report more subjective improve-
ment postoperatively (p=0.07).
Conclusions: The prevalence and clinical picture
of hypermobility associated hand OA is similar in
Swedish and Icelandic patients with severe thumb
base OA, with the majority of such patients fulfilling
5=2 Beighton criteria. Patients with hypermobility
features seem to be younger when operated and
report excellent operation results in this short fol-
low-up. Larger prospective studies are needed to
evaluate long term results and the merits of opera-
tion methods.