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Biomedical subjects

B Zarins

Publications and source records attributed to B Zarins.

At least 19 recordsLinked to original sources
PubMed2005

Injuries in women's professional soccer.

OBJECTIVE: The injury data from the first two seasons of the Women's United Soccer Association (WUSA) were analysed to determine the injury incidence, anatomic location of injuries, and relation of player position. METHODS: Injury data on 202 players from eight teams during the first two seasons of the WUSA were prospectively collected and analysed. RESULTS: A total of 173 injuries occurred in 110 players with an overall injury incidence rate of 1.93 injuries per 1000 player hours. The incidence of injury during practice and games was 1.17 and 12.63 per 1000 player hours, respectively. Of the injuries 82% were acute and 16% were chronic. Most of the injuries (60%) were located in the lower extremities. Strains (30.7%), sprains (19.1%), contusions (16.2%), and fractures (11.6%) were the most common diagnoses and the knee (31.8%) and head (10.9%) were the most common sites of injury. Anterior cruciate ligament (ACL) injuries accounted for 4.6% of all injuries and the incidence of ACL tears was 0.09 per 1000 player hours (practice 0.04, game 0.90). Midfielders suffered the most injuries (p<0.007). CONCLUSION: We conclude that the injury incidence in the WUSA is lower than the 6.2 injuries per 1000 player hours found in the corresponding male professional league (Major League Soccer); however, knee injuries predominate even in these elite female athletes.

Anterior Cruciate Ligament Injuries↗
PubMed2000

Practical considerations in anterior cruciate ligament replacement surgery.

The endoscopic method of anterior cruciate ligament (ACL) reconstruction using a patellar tendon graft that is secured with interference screws is a commonly performed procedure. It has many potential pitfalls, the majority of which are secondary to technical errors. Prevention of errors starts with a full knowledge of normal ACL anatomy and any discrepancies with the size and shape of the graft substitute. Accurate tibial and femoral tunnel placement is essential and involves using consistent intra-articular landmarks and achieving specific radiographic criteria. Accurate tunnel placement minimizes graft excursion and impingement against the roof of the intercondylar notch. This will result in maximum knee stability and motion. Much has been written about the principles of graft-tunnel mismatch and interference screw-bone plug divergence. The clinical implications of these potential sources of error remain somewhat controversial and are discussed in this article.

Anterior Cruciate Ligament↗
PubMed2000

Development of a virtual reality arthroscopic knee simulator.

The virtual reality arthroscopic knee simulator (VR-AKS) consists of a computer platform, a video display, and two force-feedback (haptic) interfaces which also monitor the position of the instruments in the user's hands. The forces that the user would normally apply to the lower limb during arthroscopy are directed through an instrumented surrogate leg. Proprietary software furnishes the mathematical representation of the physical world and replicates the visual, mechanical, and behavioral aspects of the knee while task-oriented programs monitor and record specific areas of user performance. A prototype has demonstrated the feasibility of the system and work on the first, fully functional simulator will begin soon.

Arthroscopy↗
PubMed1999

Photodynamic modulation of wound healing with BPD-MA and CASP.

BACKGROUND AND OBJECTIVE: Wound healing is an intricate process requiring the orchestration of cells, growth factors, cytokines, and the extracellular matrix. Cytokines, specifically TGF-beta, are believed to be instrumental in sustaining the fibrotic process, which leads to scarring. Photodynamic therapy (PDT) uses potent photosensitizers, which induce a wide range of effects on cells and the extracellular matrix. The influences of PDT on wound healing are not well known. STUDY DESIGN/MATERIALS AND METHODS: Seven full-thickness incisional wounds were placed on each of 24 hairless Sprague Dawly rats, three wounds on one flank serving as dark controls and four on the contralateral side treated with PDT. Wounds were created two days before, one hour before, or one hour after red light exposure with an argon ion pumped dye laser. Twelve rats were injected with 0.25 mg/kg or 0.5 mg/kg of the PDT drug, BPD-MA, and the other 12 with 5 mg/kg or 10 mg/kg of the PDT drug, CASP, 3 and 24 hours prior to irradiation of light, respectively. At low doses of both photosensitizers, animals were irradiated with 1, 5, 10, and 20 J/cm2. At higher doses of BPD-MA and CASP animals were treated with 10, 20, 50, and 100 J/cm2 of light. Wounds were examined each day for 14 days and noted for edema, erythema, inflammation, necrosis, and quality of scarring. Wounds were also photographed at day 0, 2, 5, 8, and 14 post-irradiation. All animals were sacrificed 14 days after irradiation and the wounds were evaluated by light microscopy. RESULTS: Grossly, animals treated with 0.25 mg/kg BPD-MA showed no effect with PDT. Animals treated with 0.5 mg/kg BPD, and 5 and 10 mg/kg CASP showed responses that varied with both light and drug dose. Erythema, edema, inflammation, and necrosis attributed to PDT were all observed, but there was no apparent influence of PDT on either the rate or final appearance of wound healing. Histologically, there were no apparent differences between treated and untreated sites, regardless of the drug, dose of light, or time of irradiation. CONCLUSION: A single PDT treatment given before or after skin wounds does not apparently alter wound healing even when PDT caused brisk inflammatory reactions. PDT may have effects that were not detected. We conclude that PDT does not greatly influence incisional skin wound healing in the rat model.

Aluminum↗
PubMed1998

Lipoma arborescens of the knee.

Lipoma arborescens is a rare intra-articular lesion, characterised by diffuse replacement of the subsynovial tissue by mature fat cells, producing prominent villous transformation of the synovium. The aetiology of this benign condition is unknown. We describe six cases involving the knee, discussing the symptoms, diagnosis and treatment.

Adipocytes↗
PubMed1993

Diagnosis and treatment of traumatic anterior instability of the shoulder.

Traumatic anterior glenohumeral joint dislocation is the most common type of shoulder instability. Lesions that usually result are avulsion of the anterior capsule and glenoid labrum from the glenoid rim (Bankart lesion), compression fracture of the posterosuperior humeral head (Hill-Sachs lesion), and laxity of the joint capsule. Another common lesion is a lengthwise disruption of the rotator cuff at the interval between the subcapularis and supraspinatus tendons. The shoulder that dislocates repeatedly after trauma has an excellent success rate when treated by surgical repair. The aim of the Bankart procedure is to restore stability to the shoulder by repairing the traumatic lesion of the anterior glenoid rim without altering normal anatomy.

Acute Disease↗
PubMed1991

Low conductivity irrigating solutions for arthroscopy.

The purpose of this study was to find a nonconductive physiologic solution to use for arthroscopy when electrosurgery is performed. We studied the effect of several solutions on proteoglycan synthesis in bovine articular cartilage slices, and the effect of using an electrosurgical instrument in various solutions in bovine knee joints. Both HEPES buffer 0.3 M (N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid) (Sigma Chemical Company, St. Louis, Missouri) and glycerol 2.6% gave good results in both categories. The glycerol solution appears to be the best from those tested since it supported cartilage metabolism somewhat better and is far less expensive than HEPES solution. Thus, in the use of electrosurgery during arthroscopic procedures, solutions such as Ringer's lactate and saline are too conductive to be effective or safe. Distilled water is nonphysiologic. Glycerol 2.6% is safe and effective and supports articular cartilage metabolism reasonably well for up to 2 h.

Animals↗
PubMed1990

Measurement of anterior-posterior displacement of the knee. A comparison of the results with instrumented devices and with clinical examination.

Thirteen subjects who had normal knees and fifteen patients who had a chronic rupture of the anterior cruciate ligament were tested in order to compare the measurements of tibiofemoral displacement as recorded by four commercial devices: the Acufex knee-signature system, the Genucom knee-analysis system, the Medmetric KT-1000 arthrometer, and the Stryker knee-laxity tester. Anterior and posterior displacement were measured at forces of eighty-nine newtons (twenty pounds) and 133 newtons (thirty pounds). We found significant differences in reproducibility of measurement among the devices. The Acufex, Medmetric, and Stryker devices had more reproducible measurements, and they could be used to identify 80 to 90 per cent of the normal subjects and anterior cruciate-deficient patients. The Genucom device had poorer reproducibility of measurement, and it tended to register greater differences in displacement between the right and left knees of normal subjects.

Adult↗
PubMed1990

Histological studies of the glenoid labrum from fetal life to old age.

To help to resolve the controversy regarding the composition of the glenoid labrum, thirty-eight shoulders from cadavera were examined grossly and histologically. We used specimens for individuals of different ages so that we could determine what changes occur as a result of aging. In children and adults, the labrum appeared to be fibrocartilaginous tissue. The labrum was a separate anatomical structure that could be distinguished from the fibrous capsule of the shoulder. Neonatal labra were composed of primitive mesenchymal tissue containing only few chondrocytes that modulated into fibrocartilage in the first few years of life. Neonatal labra contained no elastin, whereas specimens from adults had rare elastin fibers. The labrum was sparsely vascularized throughout its substance, with no particular pattern of distribution. Vascularity decreased with increasing age of the individual.

Adolescent↗
PubMed1988

Knee injuries in sports.

Many knee injuries that previously caused disability can now be diagnosed accurately and treated successfully. Arthroscopy has been instrumental in this progress. The anterior cruciate ligament, which is an important stabilizer of the knee, is commonly injured. Disruption of the restraint provided by the ligament results in an unstable knee that can give way during pivoting motions. Early reconstruction is usually effective in restoring stability and improving function. Considerable progress has been made in knee bracing. However, prophylactic bracing has not been demonstrated to be effective in preventing knee injuries.

Athletic Injuries↗
PubMed1986

Combined anterior cruciate-ligament reconstruction using semitendinosus tendon and iliotibial tract.

We are reporting the results of a reconstructive procedure designed to decrease anterior tibial subluxation due to disruption of the anterior cruciate ligament. The operation combines both intra-articular and extra-articular methods. The semitendinosus tendon and the iliotibial tract are both routed from opposite directions over the top of the lateral femoral condyle and through the same oblique drill-hole in the proximal part of the tibia: the semitendinosus tendon is passed up through the tibial drill-hole, across the knee joint, over the top of the lateral femoral condyle, and deep to the fibular collateral ligament, and the iliotibial tract is passed deep to the fibular collateral ligament, over the top of the lateral femoral condyle, across the knee joint, and down through the drill-hole. Both grafts are simultaneously pulled tight while the semitendinosus tendon is sutured to the iliotibial tract laterally and the iliotibial tract is sutured to the semitendinosus tendon medially below the drill-hole. The posteromedial and lateral parts of the capsule are advanced to tighten the secondary restraints. One hundred of the first 106 consecutive patients with chronic instability who had this procedure were evaluated using subjective and objective criteria at three to seven and one-half years after surgery. The positive anterior-drawer sign tested at 25 degrees of flexion was eliminated or reduced to 1+ in eighty knees, and the positive pivot shift was reduced to zero or 1+ in ninety-one knees. The objective assessment of isokinetic muscle performance and passive tibial rotation showed significant improvements in strength and normalization of tibial rotation.

Adolescent↗
PubMed1985

Calcium pyrophosphate and pseudogout.

Calcium pyrophosphate deposition disease (CPDD) is a condition in which calcium pyrophosphate dihydrate crystals are deposited in joint articular cartilage, menisci, and synovium. The main clinical presentations of CPDD are chondrocalcinosis--calcification of cartilage, pseudogout--acute joint inflammation due to crystal-induced synovitis, and pyrophosphate arthropathy--degenerative joint disease similar to osteoarthritis associated with calcium pyrophosphate crystal deposition. The clinical importance of CPDD for the arthroscopist is the ability to recognize the condition so that appropriate treatment can be instituted. Arthroscopy is valuable for diagnosis as well as lavage and intraarticular debridement or meniscectomy. Tissue removed for microscopic examination should be sent to the laboratory in saline, since formalin dissolves the crystals. Postarthroscopy treatment of CPDD should include oral antiinflammatory medication. Asymptomatic chondrocalcinosis does not require treatment.

Aged↗
PubMed1985

Anterior portal selection for shoulder arthroscopy.

A posterior portal site has become the accepted standard for introduction of the arthroscope for routine diagnostic procedures of the shoulder. Few published guidelines exist, however, on the optimum and safe positions of accessory portals for introduction of a probe or surgical instruments during shoulder arthroscopy. The relatively thick surrounding muscle layers and the close proximity of vital neurovascular structures would make guidelines for safer and more reproducible accessory portal selection helpful to minimize the risk of injury to these structures. The "intraarticular triangle" bounded by the humeral head, the glenoid rim, and the biceps tendon has been found to be an excellent intraarticular landmark for placement of an accessory anterior portal for shoulder arthroscopy. Anatomical dissections on 20 cadaver shoulders have confirmed that instruments passed through this location are at little risk to injure adjacent neurovascular structures about the shoulder. Clinical data in 30 shoulder arthroscopies performed utilizing this landmark for placement of an anterior portal have confirmed this position to be a safe and useful location for portal placement if proper precautions are followed.

Arthroscopy↗