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Biomedical subjects

E M Wojtys

Publications and source records attributed to E M Wojtys.

At least 19 recordsLinked to original sources
PubMed1996

Allograft meniscus transplantation.

At this time, meniscal allograft transplantation remains an investigational procedure with very limited indications. To date, no work has shown that the transplanted meniscus is capable of protecting and, preserving the hyaline cartilage of the knee joint. The technical aspects of the procedure have been established and are reproducible. Furthermore, it is apparent that a systemic rejection phenomenon does not seem to occur, and the transplanted meniscus is capable of healing. MR imaging appears to be the best method of assessing postoperative position of the transplanted meniscus in the knee. If the transplanted meniscus cannot be maintained in an anatomic position during weight bearing, it is unlikely to have any functional role. Questions remain with regard to the best way to preserve and sterilize the meniscus and whether the transplanted allograft meniscus is capable of assuming the multifaceted role of the normal meniscus in the knee. As more work is conducted, these questions will be answered, and a better understanding of the efficacy of this novel technique will be achieved.

Biomechanical Phenomena↗
PubMed1995

MRI versus arthroscopy in evaluating knee meniscal pathology.

The purpose of this project was to evaluate magnetic resonance imaging (MRI) accuracy for diagnosing and defining meniscal pathology. The charts of 45 patients who underwent both MRI and arthroscopy were viewed retrospectively. All cases were seen by one of two orthopedic surgeons. Magnetic resonance imaging scans were reviewed by staff radiologists at the University of Michigan Hospital Medical Center. Arthroscopy was used as the standard for comparing MRI results. Data were analyzed two ways with respect to questionable (code 3) MRI lesions. First, all code 3 lesions were interpreted as either true positives or negatives. Second, all code 3 lesions that corresponded with a negative arthroscopy finding were interpreted as false positives. The MRI accuracy was 87.8% when considering nonmatching code 3 lesions as true positives or negatives. The accuracy declined to 82.2% when considering code 3 lesions as false negatives. Magnetic resonance imaging sensitivity for medial meniscal and lateral meniscal tears was 84.6% and 87.5%, respectively, regardless of code 3 interpretation. The specificity for medial meniscal tears with and without the negative effect was 71.9% and 84.4%, respectively. The specificity with and without considering code 3 lesions as false positives was 89.2%, and 91.9%, respectively.

Adolescent↗
PubMed1994

Predictive value of meniscal and chondral injuries in conservatively treated anterior cruciate ligament injuries.

Some degree of uncertainty remains in the natural history of anterior cruciate ligament (ACL) tears treated conservatively with a supervised rehabilitation program, counseling, and activity modifications. Symptomatic ACL-deficient individuals usually present for treatment, whereas the asymptomatic may not, thus making the true outcome difficult to discern. The goal of this study was to identify which prognostic indicators available at the initial evaluation of an ACL-deficient knee could predict future disability. The hospital records of 107 individuals who presented with an ACL-deficient knee (confirmed by arthroscopy) were reviewed. Follow-up (mean 51.7 months) was obtained on 99 individuals (93%) by telephone interview. The study sample was composed of 72 males (67%), 83 acute injuries (78%), and 91 complete ACL tears (85%). Furthermore, 81 individuals presented initially with associated knee injuries (87%), whereas 73 injuries were sports related (68%). Associated injuries included 47 lateral meniscal tears (54%), 37 medial meniscal tears (42.5%), 52 hyaline cartilage injuries (59.8%), and 16 other ligament injuries (18.4%). Those individuals with associated injuries to the meniscus did not show a reduction in the ability to run, secondary to pain and/or swelling. However, those individuals with hyaline cartilage defects did decrease their running due to pain and swelling.(ABSTRACT TRUNCATED AT 250 WORDS)

Anterior Cruciate Ligament↗
PubMed1993

Substance P innervation of lumbar spine facet joints.

Sixteen adult human lumbar spine facet joints were harvested from patients undergoing various lumbar spine procedures. Diagnoses included degenerative disc disease, adult spinal deformity, facet joint degenerative arthritis, and degenerative spondylolisthesis. Facet joints were processed for routine hematoxylin and eosin staining. Immunohistochemical analysis was performed using a monoclonal antibody to substance P. All facets grossly exhibited evidence of degenerative disease, including cartilage surface irregularity and fibrillation. Histological examination of facets obtained from patients with degenerative spinal conditions demonstrated erosion channels extending through the subchondral bone and calcified cartilage into the articular cartilage. Immunostaining showed the presence of substance P-positive nerve fibers within these erosion channels, and also within marrow spaces. The presence of substance P nerve fibers within subchondral bone of degenerative lumbar facet joints implicates this type of joint in the etiology of low back pain.

Adult↗
PubMed1993

Electrical stimulation of soft tissues.

It is well-documented that electrical potentials normally are present in biologic soft tissues. The discovery of these has generated interest in effecting a change in the biology of these tissues by externally imposing an electrical field. There is experimental evidence that ligament and tendon repair can be affected by ES, but there have been no clinical studies to demonstrate its effectiveness in human ligament or tendon injuries. The only clinical support for use of ES to enhance soft-tissue healing is for its use in chronic, open dermal wounds. ES has been shown to be effective for these chronic wounds under certain conditions. There is currently insufficient justification for the use of ES for reduction of soft-tissue edema.

Electric Stimulation Therapy↗
PubMed1991

The early diagnosis and treatment of developmental patella infera syndrome.

Developmental patella infera and associated arthrofibrosis after knee surgery require prompt recognition and treatment. The condition develops because of contracture of peripatellar tissues, fatpad tissues, and quadriceps weakness, and may rapidly progress to permanent patella infera and disabling patellofemoral arthrosis. Case studies for five patients with acute developmental patella infera are described. All patients required an early arthroscopic release of contracted tissues. To establish normal right to left patellar, vertical-height ratios, lateral roentgenograms were obtained in 202 normal knees (101 pairs). The data showed that although essentially no difference existed between right and left sides, large variations existed in the ratios from one individual to another (range, 0.75-1.46). Thus, the diagnosis of developmental patella infera requires comparison of patellar height ratios in the same knee or between knees in the same individual. A decrease in the vertical-height ratio of 11%-15%, depending on the method used, indicates developmental patella infera.

Adolescent↗
PubMed1991

Conservative treatment of Grade III acromioclavicular dislocations.

Twenty-two patients with Grade III acromioclavicular (AC) joint dislocations were treated nonoperatively and evaluated by questionnaire, physical exam, and isokinetic strength and endurance testing. The mean follow-up time was 2.6 years (range, six months to 7.7 years). Patients returned to work an average of 2.1 weeks after injury. All of the patients were right-handed; 14 injured their dominant right AC joint whereas eight injured their nondominant left side. Isokinetic muscle testing was used to evaluate the strength and endurance of both shoulders in all 22 patients. Strength was measured as peak torque for shoulder flexion, extension, internal and external rotation, abduction, and adduction at 400 degrees per second. Internal and external rotation testing was also evaluated at 60 degrees per second. Endurance was measured at 400 degrees per second for flexion, extension, and internal and external rotation. The strength and endurance levels of the injured shoulders were comparable to the noninjured side. Although discomfort levels were low, long range follow-up reports reveal discomfort appearing with increased intensity of activity.

Acromioclavicular Joint↗
PubMed1990

Innervation of the human knee joint by substance-P fibers.

Anterior knee pain is a frequent musculoskeletal complaint affecting all ages, both sexes, athletes, and nonathletes alike. Numerous theories have been proposed regarding its etiology including patellar malalignment, quadriceps insufficiency, subluxation, quadriceps muscle tightness, and chondral defects. However, the mechanism by which these factors produce this pain is not clear. Knowledge of the distribution of nociceptive nerve fibers around the knee would seem to provide insight in treating these painful conditions. Eleven human patellae--eight specimens from patients with degenerative patellofemoral disease and three normals--were evaluated. Immunohistochemical techniques using monoclonal antibody to substance-P were employed to identify nociceptive fibers. Substance-P is a nociceptive neurotransmitter found in afferent nerve fibers. Substance-P fibers were isolated in the retinaculum, fat pad, periosteum, and subchondral plate of patellae affected with degenerative disease. This study demonstrates that selective tracting of nociceptive pain fibers is possible around the knee both in soft tissue and, in some circumstances, bone. The subchondral plate of normal patellae did not demonstrate erosion channels, but those with chondral defects from degenerative disease did. Nociceptive fibers found in these defects may explain the origin of symptoms in some patients. The distribution of substance-P nerve fibers in the soft tissues around the knee suggests that denervation may be the mechanism by which surgical procedures for anterior knee pain produce favorable results.

Humans↗
PubMed1990

Use of a knee-brace for control of tibial translation and rotation. A comparison, in cadavera, of available models.

We assessed the relative restraints that are provided by fourteen currently available functional knee-braces, using six limbs in cadavera. The tests were made at 30 and 60 degrees of flexion of the knee, and a mechanical loading system applied loads that caused anterior-posterior translation and internal-external rotation. The braces limited abnormal tibiofemoral displacements by 10 to 75 per cent in translation; there was more variation in rotation. This study demonstrated that functional knee-braces provide a restraining influence that may be beneficial in the control of abnormal displacements of the knee, but that the degree of restraint varies considerably.

Braces↗
PubMed1990

Pyarthrosis of the knee. Treatment considerations.

Patients with pyarthrosis of the knee can be effectively managed by several different methods. A retrospective review of patients with the diagnosis of septic arthritis of the knee was undertaken to determine the efficacy of two different treatment programs. Multiple-needle arthrocentesis was contrasted with formal arthrotomy drainage. In this series, patients with a longer than three-day history of a knee pyarthrosis and those with Staphylococcus aureus or enteric gram-negative organisms on culture benefited from open drainage procedures in lieu of repeated aspiration techniques.

Adolescent↗
PubMed1988

Softball sliding injuries. A prospective study comparing standard and modified bases.

In a previous retrospective study, base sliding was found to be responsible for 71% of recreational softball injuries. As most injuries occurred following rapid deceleration impact against stationary bases, quick-release (breakaway) bases were evaluated as a means to modify this mechanism of injury. Six hundred thirty-three softball games were played on breakaway-base fields and 627 games were played on stationary-base fields. Forty-five sliding injuries (7%) occurred on the stationary-base diamonds and only two sliding injuries (less than 1%) occurred on the breakaway-base fields. Implementing the use of breakaway bases in recreational softball leagues could potentially achieve a significant, cost-effective reduction of injuries.

Adult↗
PubMed1987

Sports injuries in the immature athlete.

The care of the pediatric athlete should not be viewed as caring for small adults. Growing bones, tendons, ligaments, and muscles respond differently to stress. Proper training and conditioning can remedy most problems in the immature athlete.

Adolescent↗