On anormal nutrition in articular cartilages / by P. Redfern.

  • Redfern, Peter, 1821-1912.
Date:
1849-1850
Catalogue details

Licence: Public Domain Mark

Credit: On anormal nutrition in articular cartilages / by P. Redfern. Source: Wellcome Collection.

    39/88 (page 39)
    which have become converted into dense fibrous tissue. On opening- the cap¬ sule, the head is found to be separated from the bone, and lying in the acetabu¬ lum, presenting, towards the neck, a flattened but rough surface, the margins of which correspond precisely to the edge of the cartilaginous surface. The neck cannot be said to exist, having been almost wholly removed by absorption. Between the inter-trochanteric lines there is an extremely irregular surface di¬ rected towards the head. From this surface and its margins, several dense fibrous bands pass to be attached to the capsule near the head, and one or two to the irregular surface on the head itself. In the substance of these bands are several loose portions of bone, which appear to have been separated at the time of the accident. On withdrawing the head from the acetabulum, to which it is attached in the usual way by the round ligament, the latter brings away with it a dense white membrane, which covers the whole surface of the cartilage, and is reflected from it to the ligament. Where the membrane has been torn off, the bone at the bottom of the acetabulum is left rough and bare, and where the membrane has been withdrawn from the surface of the cartilage, the latter is roughened. At the upper part of the acetabulum, the cartilage, covered by the membrane, presents several depressions and irregularities, and similar ap¬ pearances are seen also at the lower part near to the edge of the cartilage. In the latter position there is one part, where the bone appears to be covered merely by a thin membrane, of the characters of the one described on the depressed patches on the condyles of the femur in Obs. IV. A thin fibrous membrane covers the fractured surface of the head of the fe¬ mur, and is continuous with a denser membrane, which can be traced over the whole cartilaginous surface to the round ligament. The membrane and round ligament can be readily stript off, and they expose bare bone near the attach¬ ment of the ligament, and at the very edge of the articular surface ; but, on the remaining parts, a layer of cartilage, of considerable density and granular on the surface, is found. A brownish-red patch, three-fourths of an inch long and half-an-inch broad, immediately above the round ligament, presents a very thin layer of cartilage, which atone spot is quite yellow; whilst another patch of half-an-inch in diameter, below the ligament* has an extremely thin cover¬ ing of reddish-brown cartilage. The bone, under these two patches, and at the irregular one near the round ligament, from which the cartilage has been alto¬ gether removed, has its texture completely opened out and softened, being in some parts a mere shell, which breaks down readily under the fingers. Knee-Joint.—The cartilage of the femur presents a deep depression, elongated from before backwards, on the inner condyle, near its junction with the troch¬ lea. Over a space of the size of a shilling, on the centre of the trochlear surface, there is a patch of fibres, many of which project half to three-fourths of an inch beyond the surface. The cartilage of the external glenoid surface of the tibia ^depressed in the centre, and furnished with projecting fibres, and that of the internal surface is slightly fibrous in the centre, but the cartilage of both surfaces is nearly healthy under the semilunar cartilages. The cartilage of the patella has a large and irregularly depressed patch in the centre, running to¬ wards the internal edge of the bone. Its whole surface appears thinly covered with fibres, and, in some places, is rough and granular. The cartilages of the ankle-joint, and of the articulations of the foot, appear healthy ; but a few are thinned at their edges, and the bones at such parts are excessively soft. The shaft of the femur of this side has a very large medullary canal, and very little compact tissue ; its lower end is considerably softened. The whole of the tibia consists of soft spongy substance, which admits of its being crushed in the hand or twisted in any direction. The fibula is similarly changed, and can be twisted round the fingers very readily. All the bones of the foot can be crushed between the finger and thumb with the greatest ease. The cancelli of these bones contain an unusual quantity of oik