THE VASCULAR SUPPLY TO BONE IN DISTRACTION OSTEONEOGENESIS: AN EXPERIMENTAL STUDY

VOL. 78-B, No. 3, MAY 1996 pain due to gross degenerative changes (Fig. 1). Mr W. Alexander Law at the London Hospital performed a vitallium mould arthroplasty in October 1949 (Fig. 2). She returned to work after eight months and enjoyed an active lifestyle until her retirement in 1984. When seen in January 1995 she walked with a limp but did not require a walking aid and was free from pain. There was true shortening of 6 cm on the left side and a positive Trendelenburg sign. There was no fixed-flexion deformity and she had an excellent range of movement. A radiograph showed settling of the prosthesis with considerable resorption of the neck (Fig. 3). Discussion. The first mould arthroplasty was made in 1923 from glass and inserted in an ankylosed hip by SmithPetersen at Massachusetts General Hospital. Over the next two decades, a number of different materials were used until vitallium was introduced in 1938. The Smith-Petersen cup arthroplasty was a standard method of hip reconstruction until the advent of total hip replacement (Charnley 1961). There have been other reports of prostheses with long survival times, but we could find no other record of a satisfactory result at 45 years.