PubMed Health⌕ Search

Biomedical subjects

Anthony Miniaci

Publications and source records attributed to Anthony Miniaci.

8 recordsLinked to original sources
PubMed2004

Manual punch versus power harvesting of osteochondral grafts.

PURPOSE: The purpose of the study was to analyze the effect on chondrocyte viability of 2 existing methods of harvesting osteochondral grafts used for articular cartilage resurfacing. TYPE OF STUDY: Acute animal experiment. METHODS: Power (P) trephine versus manual (M) punch harvesting was tested; 2.7-mm and 4.5-mm dowels were harvested from 8 femoral trochlea from 4 sheep using the Acufex MosaicPlasty system (Andover, MA). Grafts were harvested perpendicular to the articular surface to a depth of 10 mm under constant saline irrigation. Power trephine grafts (n = 46, 2.7 P; n = 45, 4.5 P) were harvested by coupling the serrated trephine to a standard orthopaedic nitrogen powered drill. Manual punch grafts (n = 41, 2.7 M; n=33, 4.5 M) were harvested by malleting the punch to the required depth, minimizing rocking, and only slightly turning the punch on removal. Five 40-microm-thick fresh cartilage sections oriented perpendicular to the articular surface were obtained from each graft and then stained with Syto 13 and ethidium bromide vital stains, and the proportion of live cells per field and physical damage were compared between groups. Masson's trichrome stain was used on paraffin-embedded histologic sections. RESULTS: Power harvesting was technically more difficult and resulted in more gross and light microscopic damage to the osteochondral grafts. Chondrocyte viability was significantly greater for manual punch versus power harvesting of both graft sizes (P <.005). Chondrocyte viability was greater for 4.5 P versus 2.7 P grafts (P <.005), but no difference was found between the 2.7 M and 4.5 M groups (P =.357). CONCLUSIONS: Chondrocyte viability is significantly greater using manual punch versus serrated power trephines when harvesting osteochondral grafts for cartilage resurfacing procedures. Power trephines should not be used for this procedure. CLINICAL RELEVANCE: This study shows that the original method (power trephine) of harvesting osteochondral grafts results in great loss of chondrocyte viability versus manual punch harvesting and should no longer be used.

Animals↗
PubMed2004

Cruciate and posterolateral corner injuries in the athlete: clinical and magnetic resonance imaging features.

With an increasing number of people participating in recreational and competitive sporting activities, sports-related injuries of the knee and knee ligaments have increased in incidence. The extent and severity of such injuries may have important implications with regard to potential return to athletic pursuits as well as impacting upon activities of daily life. This article discusses the MR imaging and clinical features of sports-related injuries of the cruciate ligaments and posterolateral corner of the knee, highlighting the implications of such injuries on joint function. MR imaging has the potential to accurately identify these ligamentous injuries, as well as other potential associated combined injuries of the knee, with information from MR imaging examination assisting in decision-making and planning with regard to potential clinical and/or surgical patient management.

Anterior Cruciate Ligament Injuries↗
PubMed2004

Multidirectional instability: surgical decision making.

Although previous authors have described multidirectional instability of the shoulder, it was not until 1980 that Neer and associates solidified the current understanding and treatment of inferior and multidirectional instability. They emphasized the importance of differentiating this condition from the more common unidirectional instabilities and introduced the concept of an inferior capsular shift to globally tension the capsule anteriorly, inferiorly, and posteriorly, while thickening and reinforcing it on the side of greatest instability (i.e., anterior or posterior). Since the time of this initial description, the diagnosis and treatment of multidirectional instability has been fraught with difficulty and confusion. More recently, the advent of shoulder arthroscopy has blazed the trail for minimally invasive techniques to correct multidirectional instability, including arthroscopic thermal capsulorrhaphy and suture plication. However, despite strong opinions regarding these surgical techniques, when comparing open approaches to arthroscopic techniques for the treatment of multidirectional instability, long-term outcomes of arthroscopic techniques have yet to replicate those of open surgery.

Arthroscopy↗
PubMed2003

MR imaging of cartilage repair procedures.

It is becoming increasingly important for the radiologist to evaluate the appearance and outcome of cartilage repair procedures. MR imaging is currently the best method for such evaluation but it is necessary to use cartilage-specific sequences and to modify those sequences when necessary to minimize artifacts from retained metal within the joint. This article reviews the surgical technique of the more commonly performed cartilage repair procedures, currently recommended techniques for the MR imaging evaluation of articular cartilage and cartilage repair procedures, and the MR imaging appearance of cartilage repair procedures and of the most frequently encountered complications following such procedures.

Arthroplasty↗
PubMed2003

Thermal capsular shrinkage for treatment of multidirectional instability of the shoulder.

BACKGROUND: Capsular laxity is the main pathology in patients with multidirectional instability, and thermal shrinkage has been commonly employed to treat this condition. The objective of this study was to evaluate thermal capsular shrinkage as a treatment of multidirectional instability of the shoulder. METHODS: Nineteen consecutive patients with multidirectional instability were treated with thermal shrinkage. Fifteen patients had involuntary instability, and four had voluntary instability. The predominant direction of the instability was anteroinferior in ten patients and posterior in five; four patients had instability in multiple directions. Patients were followed for a minimum of two years or until surgical failure and recurrence of symptoms. Postoperatively, the patients wore a sling for three weeks, and they were evaluated regularly at three, six, and twelve months. The Western Ontario Shoulder Instability Index as well as subjective and objective evaluations of the patient's function, range of motion, pain, and instability were used as clinical outcome measures. RESULTS: Nine patients had recurrence of the instability at an average of nine months (range, seven to fourteen months) following the surgical procedure. Four patients had sensory dysesthesias in the axillary nerve distribution, and one of them had deltoid weakness. All neurological symptoms resolved within nine months. The surgical procedure failed in the five patients with predominantly posterior instability. It failed in only two of the ten patients with predominantly anteroinferior instability, and overall this group had objective improvement. CONCLUSIONS: Thermal capsular shrinkage used to treat multidirectional instability had a substantial failure rate with associated postoperative complications, including recurrence of instability (nine of the nineteen patients), stiffness (five patients), and neurological symptoms (four patients).

Adolescent↗
PubMed2002

Update on advanced surgical techniques in the treatment of traumatic focal articular cartilage lesions in the knee.

Considerable interest has been developed over the past several years in expanding the treatment of symptomatic femoral condylar articular cartilage lesions in active patients. Multiple surgical techniques have been reported and evolving technologies, equipment and approaches continue to expand. The purpose of this paper is to review the presentation of focal articular cartilage lesions including treatment indications, current surgical options and postoperative protocols emphasizing advanced techniques used to preserve or restore hyaline cartilage tissue. The various surgical options are discussed and the advantages and disadvantages are reviewed and highlighted in a clinical practice guideline algorithm.

Adolescent↗
PubMedDate not supplied

Magnetic resonance imaging of the shoulder in asymptomatic professional baseball pitchers.

The purpose of this study was to evaluate the magnetic resonance imaging findings in both shoulders of asymptomatic professional baseball pitchers. Fourteen pitchers who were without significant prior injury underwent a blinded clinical assessment and magnetic resonance imaging of both shoulders. All images were interpreted by two experienced musculoskeletal radiologists. The appearance of the rotator cuff tendons was graded, with additional evaluation of the biceps, labrum, and osseous structures. Ten athletes were found to have stable shoulders and painless full range of motion. Clinically, four athletes had at least a 40 degrees loss in internal rotation as compared with the nonthrowing arm. There were no significant differences in magnetic resonance imaging findings of the supraspinatus and infraspinatus tendons between the throwing and nonthrowing shoulders. The labrum was abnormal in 79% of the 28 shoulders. Enthesopathic changes of the posterior glenoid labrum were identified in the four pitchers who had loss of internal rotation. We conclude that unenhanced magnetic resonance imaging of the shoulder in asymptomatic high performance throwing athletes reveals abnormalities that may encompass a spectrum of "nonclinical" findings. These data can be useful in separating symptomatic pathologic findings from these variants. Enthesopathic changes of the posterior glenoid labrum in the throwing arm may represent an early Bennett-type lesion. The cause may be excessive traction on the posterior capsule during the pitching motion, with subclinical injury to this area.

Acromion↗