Biomedical subjects

A B Sattel

Publications and source records attributed to A B Sattel.

4 recordsLinked to original sources

PubMed1991

Constrained total elbow arthroplasty.

In 1972, the senior author designed a condylar-sparing constrained hinge elbow prosthesis with a high-density polyethylene bushing. The condylar-sparing design allows both intercondylar and intramedullary fixation of the humeral component with methylmethacrylate cement. Reattachment of the muscles and collateral ligaments to the preserved condyles provides further stability. The clinical experience spans more than 16 years in 42 elbows with a relatively low loosening rate of 7%. The implant was removed and not replaced in three elbows: one for late infection, one for posttraumatic comminuted fracture of the distal humerus, and one for loosening of a humeral component. A series of 27 patients (31 elbows) with 24-204 months of follow-up study (average, 77 months) had excellent pain relief and an average range of motion of 129 degrees flexion, -44 degrees extension, 69 degrees pronation, and 61 degrees supination.

Bone Cements↗

PubMed1991

Collateral ligament reconstruction of the metacarpophalangeal and proximal interphalangeal joints using porous dacron tendon.

We are encouraged by the favorable preliminary results of ligamentous reconstruction using the porous Dacron tendon. It provides a stable construct in cases where there is insufficient local autogenous tissue, and obviates the need for a tendon graft. Early active range of motion is permitted. Current investigation for additional applications for the use of the porous Dacron tendon include volar plate reconstruction following disruption, capsuloligamentous reconstruction of the trapezial metacarpal joint (with trapezium implant arthroplasty as well as for isolated disruption of the volar oblique ligament), intercarpal ligament repair or augmentation, and distal radioulnar joint stabilization.

Arthritis↗

PubMed1991

Local hypothermia to prolong safe tourniquet time.

Local hypothermia was studied as a method to safely prolong tourniquet time for reconstructive procedures of the upper extremity. An ice blanket constructed of flannel cloth and cold gel packs was applied to the limb for 45 minutes preoperatively. Seventy-eight patients were evaluated for complications resulting from hypothermia and prolonged tourniquet application. The duration of continuous tourniquet ischemia averaged two hours and 25 minutes. Intraoperative muscle temperature recordings indicated that the iced limbs were an average of 12.9 degrees cooler than noniced limbs before tourniquet inflation. Electron microscopic studies of biopsied muscle showed no evidence of ischemic changes. There were no postoperative complications associated with prolonged tourniquet inflation or the hypothermia blanket technique. Local hypothermia appears to be a safe and effective method of decreasing the adverse effects of tourniquet ischemia and allowing continuous tourniquet inflation time to extend safely beyond the customary two-hour limit.

Adult↗

PubMed1989

Bipolar implant shoulder arthroplasty. Long-term results.

The bipolar shoulder implant (BSI), designed by the senior author in 1975, has an unfixed metal glenoid cup with a polyethylene liner that articulates with a cemented titanium humeral component. The BSI was inserted in 35 shoulders of 33 patients with severe rheumatoid arthritis (20 cases), degenerative arthritis (ten cases), and posttraumatic lesions (five cases). The follow-up period ranged from 24 to 140 months (average, 63 months). Pain relief was good to excellent in 31 shoulders; four experienced some pain during daily activities. After BSI, motion was greatly improved with 71 degrees average range of abduction, 23 degrees range of adduction, 79 degrees range of flexion, 45 degrees range of extension, 76 degrees range of internal rotation, and 28 degrees range of external rotation. BSI was well-tolerated by the bone and soft tissues, with no erosive changes at the coracoacromial arch. There was no evidence of loosening at the cement-bone interface. One patient with a postoperative subcoracoid dislocation maintained a good functional result for more than 11 years. One BSI had draining sinus tract with negative culture, which spontaneously healed following removal of the implants. There were 3.3 mm (range, -7 mm to 11 mm) of superior subluxation of the humeral head on the preoperative roentgenogram. This increased to 8.7 mm (range, -5 mm to 20 mm) in the long-term follow-up roentgenogram. The bipolar implant is specially indicated in the severely arthritic shoulders in patients with vertical humeral subluxation and complicated histories of multiple failed operations.

Adult↗