What is Protrusio acetabuli?

Protrusio acetabuli is a defect of the central acetabulum resulting from migration of the femoral head medial to the Ilio-ischial (Kohler's) line. There are a number of causes, the common ones being secondary to inflammatory cause and others including metabolic, post traumatic, osteogenesis imperfecta, Paget's disease.

The common factor is a metabolic or mechanical alteration of the peri-acetabular bone. Central migration occurs along the resultant joint-reaction force vector. Total hip arthroplasty has been the traditional surgical treatment and requires reconstruction of the contained central bony defect with bone graft. Lateralization of the cup is necessary to a successful outcome.

Careful pre-operative planning is required to assess limb length, implant choice, size and position. The outcome of THR with bone grafting for protrusion has been favorable with success rates comparable to primary THR.

Total Knee Replacement Part 1: Preoperative Considerations

Total Knee Replacement

Garlic helps prevent hip osteoarthritis

A compound called diallyl disulphide in garlic limits the amount of cartilage-damaging enzymes. A new study shows that women who consume allium vegetables, such as garlic, onions and leeks, have lower levels of hip osteoarthritis.

Reference:
Frances MK Williams, Jane Skinner, Tim D Spector, Aedin Cassidy, Ian M Clark, Rose M Davidson, Alex J MacGregor. Dietary garlic and hip osteoarthritis: evidence of a protective effect and putative mechanism of action. BMC Musculoskeletal Disorders, 2010

Do you have healthy vimentin?

Vimentin helps a cell handle mechanical stress in cartilage. Osteoarthritis is the most common joint disease in the United States. A degeneration of cartilage due to chondrocytes from osteoarthritic joints that have weaker vimentin structures than chondrocytes from normal joints causes the joint to be susceptible to fractures. Healthy vimentin is necessary to maintain cartilage’s vitality.

Reference:
Haudenschild, D. R., Chen, J., Pang, N., Steklov, N., Grogan, S. P., Lotz, M. K. and D'Lima, D. D. (2011), Vimentin contributes to changes in chondrocyte stiffness in osteoarthritis. Journal of Orthopaedic Research, 29: 20–25. doi: 10.1002/jor.21198

Reducing atherosclerosis progression for patients with rheumatoid arthritis

Inflammation and rheumatoid arthritis disease (a chronic disease that causes pain, stiffness, swelling, and limitation in the motion and function of multiple joints) activity may contribute to the progression of atherosclerosis in people with rheumatoid arthritis . Limiting inflammation would mean patients have fewer cardiovascular events like myocardial infarction and stroke. Patients who used anti-TNF treatment had lower rate of progression of intima thickness, a marker for atherosclerosis. Physicians found that prednisone is associated with progression of atherosclerosis. Therefore medications like TNF inhibitors and statins can be taken to lower cholesterol and atherosclerosis progression. A high c-reactive protein may suggest more risk for cholesterol plaque.

Study:
Longitudinal Predictors of Progression of Subclinical Carotid Atherosclerosis in Rheumatoid Arthritis.
http://www.jrheum.org/content/37/4/730.abstract