local lumbar veins, and Nozoe concluded that both local trauma and a metabolic disturbance were necessary factors in causing a neuropathic CHIR-99021 CT99021 arthropathy. The work of Magnuson in dogs also emphasized a multiplicity of factors, including infection or chemical disturbance in addition to repeated trauma. Resection of Bone, Cartilage, or Synovia. In a study of the pathogenesis of degenerative joint disease, Kroh resected part of the articular surface of rabbit femoral condyles and concluded that the disease developed following an incongruity in the joint surface. This view, unsubstantiated by histological evidence, neglects the observation that a fibrillary change in superficial articular cartilage is the earliest detectable histological lesion in this disease.
The work of Wehner referred to above Bortezomib was followed by that of Key, who also resected parts of the articular cartilages in twenty rabbits. His conclusions were similar to those of Kroh . Unlike Axhausen, he did not agree that the presence of a nidus of dead cartilage was necessary for degenerative changes to develop. Dead cartilage placed in a joint is destroyed and removed without causing further damage. Barthels chose to excise the patella, and Arnulf, Benichoux, Desloux, and Morin used comparable methods in their study of the value of plastics in the treatment of chronic arthritis. Local Electrolysis. Axhausen was the principal proponent of the value of electrolysis in the study of degenerative joint lesions. A current was applied to the articular surfaces, degenerative changes followed use of the joint.
When a current of 2 5 milliamps alone was applied for 20 sec, aseptic cartilage and bone necrosis never occurred. Mannheim confirmed these observations. Deprivation of Nerve Supply. Nozoe made a series of interesting observations on the relationship between joint integrity and nerve function. He deprived rabbit knee joints of their innervation by cutting lumbar segments 4 to 7 and sacral segments 1 to 2. The local injection of potassium permanganate then caused degenerative changes. Similar changes were induced by feeding 2 g. sucrose per kg. body weight daily. Nozoe concluded that local trauma, neuropathy, and a metabolic factor appeared to be necessary for the evolution of degenerative joint disease. Local Cooling. Manteuffel approached the same problem by repeatedly cooling the lower legs of guinea pigs by means of an ether spray.
Vascular stasis was induced. Cartilaginous degeneration and an overgrowth of connective tissue followed. Schiavetti, Terzani, and Spitz Reduction in Blood Supply. It has always seemed likely that an alteration in the blood supply might explain the manner in which a noxious agent could cause arthritic lesions in rheumatoid arthritis as well as being an important accessory factor in the degenerative disease of elderly persons. Obliterative arterial disease near such joints is frequent, and the articular cartilage, dependent for its normal metabolism on the integrity of the synovia, is often the site of replacement fibrosis. Wollenberg was apparently the first to demonstrate joint changes following a mechanical reduction in blood supply to the joint. Axhausen and Pels repeated Wollenburg,s experiments, but concluded that the claim that an impaired blood supply was a fa