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By Mark D. Miller
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Extra info for Review of Orthopaedics, 5th Edition
Example text
It results in increased osteoclastic resorption and failure of repair attempts (poor mineralization due to low phosphate). Diagnosis is based on signs and symptoms of hypercalcemia (described earlier) and characteristic laboratory results (increased serum calcium, PTH, urinary phosphate; decreased serum phosphate). Bony changes include osteopenia, osteitis fibrosa cystica (fibrous replacement of marrow), “brown tumors” (Fig. 1–21) (increased giant cells, extravasation of red blood cells (RBCs), hemosiderin staining, fibrous tissue hemosiderin), and chondrocalcinosis.
Used for structural defects. b. Cancellous grafts—Revascularize and incorporate quickly; osteoblasts lay down new bone on old trabeculae, which are later remodeled (“creeping substitution”). Allografts must be harvested with a sterile technique, and donors must be screened for potential transmissible diseases. The major factors influencing bone graft incorporation are 33 c. shown in Figure 1–17. Synthetic bone grafts—Composed of calcium, silicon, or aluminum. (1) Silicate-based grafts—Incorporate the element silicon (Si) as silicate (silicon dioxide): bioactive glasses and glass-ionomer cement.
3) Idiopathic transient osteoporosis of the hip—Uncommon; diagnosis of exclusion; most common during the third trimester of pregnancy in women but can also occur in men. Presents with groin pain, limited range of motion (ROM), and localized osteopenia (without a history of trauma). Treatment includes limited weight bearing and analgesics. The disease is generally self-limiting and tends to resolve spontaneously after 6-8 months (distinguishes it from ON, in which the symptoms are progressive and do not resolve spontaneously).