. Electron microscopy; proceedings of the Stockholm Conference, September, 1956. Electron microscopy. Osteoarthritis of the Hip Joint K. ; and L. H. Pimm The Nuffield Orthopaedic Centre, Oxford, and The Atomic Energy Research Estahlishincnt, Harwell With the increasing longevity of the population as a whole the degenerative wear and tear changes which occur in the joints are becoming one of the greatest problems facing modern orthopaedics. These changes, which we term "Osteoarthritis'", aflfect principally the main weight-bearing joints, and thus the head of the femur in the h
. Electron microscopy; proceedings of the Stockholm Conference, September, 1956. Electron microscopy. Osteoarthritis of the Hip Joint K. ; and L. H. Pimm The Nuffield Orthopaedic Centre, Oxford, and The Atomic Energy Research Estahlishincnt, Harwell With the increasing longevity of the population as a whole the degenerative wear and tear changes which occur in the joints are becoming one of the greatest problems facing modern orthopaedics. These changes, which we term "Osteoarthritis'", aflfect principally the main weight-bearing joints, and thus the head of the femur in the hip joint is most often involved. The gross and microscopic changes of the established condition have been studied for many years, but little is known of the pathology underlying the origin of the lesion. In an attempt to elucidate the problem a con- siderable amount of work has been carried out at the Nuffield Orthopaedic Centre, Oxford, and studies of the histological changes and vascular patterns have been published by Trueta, Harrison and Schajowicz (3, 9). One of their fundamental discov- eries was that the initial lesion is in the hyaline articular cartilage covering the head of the femur and in the «o«-pressure area, contrary to what might be expected. The light microscope shows disruption of the superficial layer of cartilage, followed by the appear- ance of collagen bundles, lissuration and an altera- tion in staining properties, leading ultimately to ulceration and destruction of the cartilage and its replacement by fibrocartilage. The bony changes occur later and are secondary. This study and the work carried out in Sweden by Ingelmark and Saaf (5), Tngelmark (4), Ekholm (1) and Ekholm and Norbiick (2) suggests that mechanical forces are concerned with the nutrition of the cartilage from vessels lying immediately below it in the bone and probably also from the synovial fluid as there are never any vessels in hya- line cartilage itself. It seems possible that there i
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