Biomedical subjects

G Lajtai

Publications and source records attributed to G Lajtai.

7 recordsLinked to original sources

PubMed2001

Half pipe cannula for shoulder arthroscopy.

Shoulder arthroscopy makes it possible to diagnose and to reconstruct different pathologies. This article describes the use of a half pipe cannula for changing instruments in shoulder arthroscopy without using a closed cannula system. The use of this new device is not an alternative to standard cannula systems, but it is very helpful for changing different arthroscopic instruments without altering the soft tissues, thus minimizing postoperative swelling.

Arthroscopy↗

PubMed2000

[Arthroscopy of the upper ankle joint. A retrospective analysis of complications].

The purpose of this retrospective study was to analyse the complications of our arthroscopic procedures at the ankle joint. In all patients we evaluated the treatment protocols and in 111 patients (79.3%) we also evaluated the clinical and radiologic results. All in all we have found complications in 14 patients. In 4 cases we have seen a delayed wound healing, in 2 cases a superficial infection, in 3 cases a deep infection, in 3 cases a neural damage and in 2 cases a phlebothrombosis. Our study show, that the complication rate could be minimized by detailed knowledge of the anatomy, exact preoperative diagnostic and planing of the operation and careful preparation of the portals. The use of a laser also shows a tendency to a lower complication rate.

Adult↗

PubMed1999

[Results of reconstruction of anterior cruciate ligament ruptures. Use of resorbable interference screws (minimum follow-up of 2.5 years)].

The purpose of this study was to assess the effects of biodegradable interference screw use in ACL reconstruction beyond the usual clinical historical and physical findings. The use of this material for interference screws has potential benefits if the problems of inflammation are minimal and the fixation properties are sufficient. There is no need for a second operation for removal and no complicating factor if revision surgery is necessary. A prospective study was initiated in May, 1993 to evaluate the use of biodegradable interference screws (Instrument Makar). Our patients were evaluated with the aid of the common OAK-score. The overall evaluation showed 89.5% excellent and good results, 7% fair results and 3.5% poor results. The average score was 90.7 points (63-100 points). The measurement with the arthrometer (KT 1000) showed a difference of up to 3 mm as compared to the knee joint not operated on in 24 (93%) of the patients. Four patients showed a 3 to 6 mm difference. A tibia translation of more than 4 mm was not measured in any case. The biodegradable interference screw is a safe and effective interference screw for fixation of the bone blocks for ACL reconstruction.

Adult↗

PubMed1999

Serial magnetic resonance imaging evaluation of operative site after fixation of patellar tendon graft with bioabsorbable interference screws in anterior cruciate ligament reconstruction.

Magnetic resonance imaging (MRI) is accepted as the imaging procedure of choice for showing internal derangement of the knee. In contrast to metal implants, bioabsorbable interference screws do not produce an artifact and provide an opportunity to expand the evaluation of the postoperative anterior cruciate ligament (ACL) ligament repair. There is the potential to evaluate the implant, the graft, the adjacent tissue, and the surgically created bone tunnels. The purpose of this study was to evaluate with MRI the postoperative site of ACL patellar tendon autografts in which bioabsorbable screws were used for fixation. It was hypothesized that a time line of bone tissue changes resulting from this type of surgery could be developed based on the expanded evaluation of MRI. From January 1993 through October 1997, 270 patients underwent surgical repair of a disrupted native ACL. There were 173 men 97 women; the average age was 25.1 years, (range, 17 to 50 years). There were 155 right knees and 115 left knees. In addition to the conventional postoperative clinical assessment and plain film radiographs, opportunistic MRIs were obtained with the patient's permission. The examinations were performed at different postoperative intervals from the third postoperative day to 4 years postoperatively. A total 206 MRIs from various time intervals were available for study. The study protocol was designed to look for loss of integrity of the screws, adjacent fluid collection, tunnel widening, and tunnel healing or narrowing. The hypothesis was substantiated in this study. The use of MRI provided observations not available by other imaging methods. The absence of metal implants for fixation provided an opportunity to examine the adjacent tissue in detail and to form a time line of the tissue response in this type of surgery.

Absorbable Implants↗

PubMed1999

Conventional radiography, CT, and MR imaging in patients with hyperflexion injuries of the foot: diagnostic accuracy in the detection of bony and ligamentous changes.

OBJECTIVE: The goal of this study was to compare the capabilities of conventional radiography, CT, and MR imaging in revealing ligamentous and bony changes in patients after hyperflexion injuries. SUBJECTS AND METHODS: Forty-nine patients with hyperflexion injuries of the foot were included in our study. Conventional radiography, weight-bearing radiography, CT, and MR imaging were performed. All images were reviewed with respect to ligamentous and bony abnormalities and alignment alterations. Eleven patients with joint malalignment underwent surgery, which is considered the gold standard in these patients. Five patients with joint malalignment refused surgery. RESULTS: For all 49 patients, conventional radiographs revealed 33 metatarsal and 20 tarsal fractures. Eight patients presented with tarsometatarsal joint (Lisfranc's joint) malalignment. Weight-bearing radiographs showed joint malalignment in the same eight patients only. CT showed 41 tarsal fractures and 53 metatarsal fractures. Joint malalignment was evident in 16 patients. MR imaging revealed 41 metatarsal fractures and 18 metatarsal bone bruises. Tarsal bones were fractured at 39 sites and there were nine tarsal bone bruises. Metatarsal fractures were mostly localized in the second metatarsal bone; tarsal fractures, in the cuboid. Joint malalignment was evident in 16 patients; in 11 of these 16 patients, Lisfranc's ligament was disrupted. Surgery confirmed bony and ligamentous changes and joint malalignment in 11 patients. CONCLUSION: Conventional radiographs including weight-bearing images are not sufficient for routine diagnostic workup of patients with acute hyperflexion injuries of the foot. CT should serve as the primary imaging technique for such patients.

Adolescent↗

PubMed1998

[Resorbable interference screws. Histologic study 4.5 years postoperative].

The use of degradable implants in recent years has brought not only good results. Foreign body reactions to implantation of degradable polymers clearly curtailed the initial expectations. Bioabsorbable polymers have been used for sutures, vascular clips, and fixation implants for both intra-articular fractures and malleolar fractures. In the literature these implants are controversial. Potential benefits remain for the use of this material for interference screws if the problems of inflammation are minimal and the fixation properties are sufficient. There is no need for a second operation for removal. In one patient, 4,5 years after to implantation of an degradable interference screw (Copolymer 85/15 D,L lactide glycolide; Biologically Quiet, Instrument Makar, Inc. Mount Hope, MI 48864, USA) we took an biopsy and made histological examinations. No foreign body reaction or inflammation signs could be detected.

Absorbable Implants↗

PubMedDate not supplied

Serial magnetic resonance imaging evaluation of a bioabsorbable interference screw and the adjacent bone.

The purpose of this prospective study was to review, using expanded clinical assessment tools, the initial use of a bioabsorbable interference screw (copolymer 85/15 D, L lactide/glycolide) in anterior cruciate ligament (ACL) reconstruction at the Wels Hospital, Austria. The study enlisted 32 patients of whom 28 were available for follow-up at minimum of 2.5 years. Since the implant material was new and the screw would not show on plain film radiographs, the clinical assessment was expanded beyond the usual historical and physical findings. The evaluation included opportunistic knee joint aspiration and repeat magnetic resonance imaging (MRI) studies to investigate the longevity of the implant and potential adverse effects of this new bioabsorbable material. The knee joint aspirations showed no infection. Serial MRIs showed the physical presence of the screw to remain intact for 4 months and disappear in 6 months. The MRIs showed minimal collection of edema around the bone tunnels that resolved by 12 months. There were no symptoms or adverse clinical result correlated with the MRI evidence of edema. There was temporary bone tunnel expansion. The clinical results were good. The OAK-score (Orthopädische Arbeitsgruppe Knie) showed 89.5% excellent and good results, 7% fair results and 3.5% poor results. The average score was 90.7 points (range, 63 to 100 points). The knee joint stability measured with the KT-1000 arthrometer showed 93% to have a 3-mm or less difference compared with the unoperated knee. This bioabsorbable interference screw appeared safe and effective for fixation of bone blocks during ACL reconstruction while producing no occult infection or adverse clinical response during the degradation process.

Absorbable Implants↗