PubMed Health⌕ Search

Biomedical subjects

Elly Trepman

Publications and source records attributed to Elly Trepman.

5 recordsLinked to original sources
PubMed2002

Microscopic metallic wear and tissue response in failed titanium hallux metatarsophalangeal implants: two cases.

The membranes present at the implant-bone interface were retrieved from two patients with titanium single stem hallux implants that had failed. Both patients had pain and valgus deformity of the hallux, and radiographs showed a radiolucent shadow around the implant stem, with thinning of the dorsal cortex of the proximal phalanx in one patient. After removal of the implants, arthrodesis of the first metatarsophalangeal (MP) joint was performed. Histologic analysis of the membrane tissue at the implant-bone interface showed a synovial-like appearance. There was a fibrous tissue stroma adjacent to the bone surface, with multiple regions of scalloping covered by mononuclear cells. Fine metallic debris was seen throughout the fibrous tissue. Multinucleated foreign body giant cells were sparsely observed associated with fine particulate metallic wear debris similar to observations from failed total hip arthroplasties. The histologic appearance is evidence that foreign-body granulomatous infiltration associated with metallic wear debris may be a causative factor of peri-implant osteolysis leading to aseptic loosening and failure of titanium single stem hallux implants.

Aged↗
PubMed2002

Patellar tendon-bearing, patten-bottom caliper suspension orthosis in active Charcot arthropathy: crutch-free ambulation with no weight bearing in the foot.

A custom, patellar-tendon bearing (PTB), patten-bottom, caliper suspension orthosis was constructed for six patients with severe, active (Eichenholtz stage I) Charcot arthropathy of the ankle and hindfoot. With the orthosis, the suspended foot and ankle remained completely non-weight-bearing, and the lower extremity supported full weight bearing along the posterior and anterior leg shells and PTB crest. Four of the six patients used the orthosis to ambulate without crutches, leaving the upper extremities free for functional use. Frequent adjustment of the orthosis and skin examination were required. Minor problems with the orthosis included superficial skin breakdown and downward pistoning of the leg associated with improper, loose donning. Patient compliance was poor in four of the six patients because of general debility, difficulty with balance, and discomfort. However, in the other two patients, the absence of mechanical forces on the foot and ankle in the orthosis allowed the swelling and erythema of the active phase of Charcot arthropathy to resolve within several weeks, with maintenance of functional ambulation during the months required for healing of the Charcot process.

Adult↗
PubMed2002

Toe flexor forces in dancers and non-dancers.

Toe flexor force (hallux and second toe) was determined in the right and left feet of 24 dancers and 29 non-dancers (sitting and standing positions) using a commercially-available pressure sensor connected to a voltmeter. For the hallux and second toe combined (all trials combined), average toe flexor force was slightly greater for dancers than non-dancers (dancers, 7 +/- 4 N; non-dancers, 6 +/- 4 N; P<0.049). For dancers and non-dancers combined (all trials), the average toe flexor force of the hallux was more than twice that of the second toe (hallux, 9 +/- 4 N; 2nd toe, 4 +/- 1 N; P<0.0001); average toe flexor force was slightly greater in standing than sitting positions (standing, 7 +/- 4 N; sitting, 6 +/- 3 N; P<0.0001); and the average toe flexor force was slightly greater for the right than left foot (right, 7 +/- 4 N; left, 6 +/- 4 N; P<0.012). The average toe flexor force was greatest for the first repetition and slightly decreased for the second and third repetitions (first repetition, 7 +/- 4 N; second and third repetitions each, 6 +/- 4 N; P<0.0013). Toe flexor force measurement may potentially be applicable to clinical practice as a guide to rehabilitation after injury or as a screening parameter for readiness to advance dance or other athletic training, performance, or competition.

Adult↗
PubMed1998

Subtalar Joint Arthrography.

The purpose of this study was to determine the accuracy and the specificity of an optimum technique of posterior talocalcaneal/posterior subtalar (PST) joint arthrography and anesthetic injection in patients with hindfoot pain. Fifty-five PST joints were studied in 55 patients. The posteromedial approach was used in the first 24 patients, followed by an anterolateral approach in 31 patients. The ease of performance, success of confirming PST needle position, and adverse effects were noted. After contrast injection, a combination of 1% lidocaine and 0.5% bupivacaine was injected. Results consisted of 47 arthrographically confirmed PST injections. The posteromedial approach was deemed more difficult; three patients had tendon sheath opacification and four had unwanted anesthesia of the toes. The anterolateral approach was technically easier and no extra-articular structures were visualized or anesthetized. Therefore, PST arthrography with anesthetic injection is optimized with an anterolateral approach.

Journal Article↗