Clinical and radiological studies were performed on 25 hips of 25 patients with rapidly destructive coxopathy within 3 years after the onset. The mean age at the time of onset was 68.3 years. Two patients were males, and the other 23 were females; many patients were aged females. The mean Japanese Orthopaedic Association hip score for pain was 13/40 while that for the range of motion (flexion) was 9.4/12. Inspite of marked pain, the motion range was relatively good. The mean disease duration was 10.3 months in the group showing an increased blood sedimentation rate and 20.8 months in the group with a normal sedimentation rate, being shorter in the former showing positive inflammatory reactios. Hypertension was observed in 44%. Radiographic examination showed osteoporosis in all patients. According to Singh's classification, the disease duration was shorter in patients with advanced osteoporosis. The Center-Edge angle and Acetabular-Head Index as the acetabular covering rate were below the mean value in 65%, showing slight dysplasia of hip joint. Histopathological examination revealed exposure of eburnated bone on the surface of the capital lesion in many patients, but only slight proliferative changes. In the synovial membrane, villous hyperplasia and cell proliferation were observed in the surface layer in most of patients. Free fragments of the cartilage and bone were phagositized with nonspecific inflammatory findings in the deep layer.
The purpose of this study was to elucidate the factors of subjective quality of life (QOL) for the patients with cerebrovascular diseases and to investigate the usefulness of path analysis as an analystic method for the subjective QOL. A separate factor analysis was carried out for the 67 patients using the questionnaire developed by a research team of the Ministry of Health and Welfare in 1992. As a result, three fectors could be confirmed. They were feeling of satisfaction, sense of psychological security, and volision and vitality. In addition, the internal consistency of scaling observed suggests the validity of the evaluation, using these three factors, of subjective QOL of those patients. As a result of effect of extended ADL on the feeling of satisfaction, the sense of psychological security and the volision and vitality, the degree of the direct effects and that of the indirect effects through depressive state could be clarified on these three factors. These results suggest the usefulness of path analysis as the analystic method for the subjectice QOL of patients with cerebrovascular diseases at home.