Natural course of osteochondritis dissecans in children.

Results are reported from an absence of physiotherapic, orthopaedic, or surgical treatment in 31 cases of osteochondritis dissecans in 24 children. The mean age at diagnosis was 11 years and 4 months, and all the children were suffering from pain for an average of 3 months. None of these children were treated, except for instructions to discontinue involvement in sports activities until their pain had disappeared.

Isolation of translactone-containing triterpenes with thrombin inhibitory activities from the leaves of Lantana camara.

Methanolic extracts prepared from the leaves of Lantana camara have been found to inhibit human thrombin. An assay, in which thrombin activity is measured as a function of clot formation from fibrinogen, was used to guide the fractionation and purification of five principal active constituents (1-5), which were all characterized as 5,5-trans-fused cyclic lactone-containing euphane triterpenes.

Prevention of postoperative venous thrombosis: a randomized trial comparing unfractionated heparin with low molecular weight heparin in patients undergoing total hip replacement.

A double blind randomized trial comparing subcutaneous enoxaparin (40 mg once daily) with standard unfractionated calcium heparin administered at a dose of 5,000 units every 8 hours in patients undergoing elective hip replacement has been performed. Treatment regimens began 12 hours preoperatively with enoxaparin, 2 hours preoperatively with standard unfractionated calcium heparin, and were continued for 15 days or until discharge. Venography was performed in all patients.

[Double-blind randomized comparative study of enoxaparin and standard heparin in the prevention of thromboembolic disease during insertion of total hip replacement].

237 patients with a non-traumatic disease of the hip requiring total hip replacement entered a multicentre trial. Treatments were allocated at random in a double-blind manner: 113 patients received 5000 IU of standard heparin t.d.

The three-dimensional active rotary stabilization of the knee.

The careful examination of insertions and directions of the tendons of the knee peri-articular muscles permits a global conception of the action of the 29 couples in rotatory stabilization. First, an analytic study of the tibial and femoral rotatory stabilization is considered. Second, the three-dimensional rotatory mechanical coupling between femur and tibia is developed.

[Osteochondritis dissecans of the knee].

For more than 10 years the authors have had a rather differentiated attitude to osteochondritis dissecans. The indication depends on the age, topography of the lesion, its volume and stage of evolution. The results of three techniques are discussed: simple ablation of the sequestrum, re-implantation of the sequestrum after treatment of the niche and cortico-spongiosa grafting.

[Patellar imbalance and external rotary instability of the knee].

The importance of external hyperrotation and external rotary instability in patellar imbalance is examined. In view of the progressive nature of patellar imbalance and of the predominant part played by the muscular and capsulo-ligamentous elements in the stability of the extensor apparatus, the authors advocate an earlier and more radical surgical approach with a view to improving the patellar medialization forces (transplantation of the intermediate great muscle and retension of the lateral patellar retinaculum) as well as the elements of active internal rotation of the tibia (modified version of Slocum's operation and transfer of the internal third of the patellar tendon).

[Surgical treatment of long-standing anterio-internal instability of the knee. Personal experience].

The authors have reviewed 139 surgical procedures performed in the treatment of antero-medial instability of the knee, including 71 Slocum procedures, 54 Nicholas, procedures and 14 miscellaneous procedures. The clinical signs and surgical techniques are described in detail. The results show that Slocum's procedure was always satisfactory and that it can be done either in isolation or in association with Nicholas' procedure and medial transfer of part of the patellar tendon.