Biomedical subjects

J C Tauro

Publications and source records attributed to J C Tauro.

6 recordsLinked to original sources

PubMed1997

Completing arthroscopic knots with a broken suture limb.

Arthroscopically inserted sutures may become damaged during insertion. This can lead to breakage of one limb of the suture before sufficient knots have been delivered to prevent slippage. We present a clinical example and a simple technique to arthroscopically deliver half-hitch knots with a broken suture limb. The technique utilizes a grasper which is attached to the broken suture limb. The grasper acts as a new post over which additional half hitches can be delivered, completing the knot. We have found this technique very useful in shoulder capsular reconstruction and rotator cuff repair.

Adult↗

PubMed1994

Arthroscopic capsular advancement for anterior and anterior-inferior shoulder instability: a preliminary report.

The arthroscopic treatment of anterior and anterior-inferior shoulder instability has been limited by the surgeon's ability to adequately advance the glenohumeral ligament complex medially and superiorly. We describe a modification of the arthroscopic Bankart repair that includes an inferior capsular split. This technique allows up to 2 cm of additional capsular advancement, thus providing greater reduction of the stretched or redundant capsule if necessary. The short-term results in four cases are presented.

Adolescent↗

PubMed1991

Comparison of bovine collagen xenografts to autografts in the rabbit.

The use of bovine tendon as a xenograft material in humans is attractive because of its ready availability and favorable mechanical characteristics. Previous research has shown that the fibroblasts and some extracellular proteoglycans and glycoproteins, not the collagen matrix itself, in bovine tendon are primarily responsible for its antigenicity. Various attempts have been made to decrease the antigenicity of these grafts. A chloroform/methanol (CM) extraction procedure has been developed that selectively removes the fibroblasts from bovine tendon without destroying the collagen matrix. The mechanical, immunologic, and local host tissue responses to these grafts were compared to autografts and to untreated and glutaraldehyde-treated bovine tendon xenografts. The humoral immune response to a purified bovine Type I collagen product was also studied. The central two-thirds of a rabbit Achilles tendon were replaced with a reversed autograft or an experimental graft. Histologic examination of one- and two- week specimens showed an acute inflammatory response to all grafts. Untreated grafts stimulated a severe inflammatory response and were almost completely resorbed by two weeks. Glutaraldehyde-treated grafts were encapsulated. Cellular repopulation was minimal and inflammatory response was more persistent than in the autograft and CM groups. Inflammatory response to CM-treated grafts was similar to that of autografts. The CM grafts repopulated rapidly with host cells. The mechanical strength of CM grafts was equal to autograft controls at 12 weeks. The mechanical strength of untreated and glutaraldehyde-treated grafts was significantly lower. Measurement of the humoral immune response to these grafts was conducted in an independent group of animals using an enzyme-linked immunosorbent assay. A significant antibody response to untreated, glutaraldehyde-fixed, and CM-treated grafts was detected at 30 days. Antibody titers to glutaraldehyde-fixed and untreated grafts remained elevated at 60 and 90 days. In the CM group, antibody titers decreased to the level of autograft controls by 90 days. No significant antibody response was detected toward purified bovine Type I collagen.

Achilles Tendon↗

PubMedDate not supplied

Arthroscopic rotator cuff repair: analysis of technique and results at 2- and 3-year follow-up.

We present 53 patients who underwent arthroscopic rotator cuff repair and had a minimum of 2-year follow-up. Most tears were avulsions of the supraspinatus from the greater tuberosity, some with associated longitudinal tears. Longitudinal tears were repaired with a side-to-side suturing technique. Avulsion tears from the tuberosity were repaired using nonretrievable suture anchors. Traditional open-mobilization techniques, such as elevating the cuff off the glenoid neck and scapular fossa, and cutting the coraco-humeral ligament, were performed arthroscopically as needed. All repairs were performed using O-PDS or 1-PDS suture and a 7-mm suture punch for suture delivery. Both simple and mattress suture configurations were used. An anterolateral operative portal was used in most cases. A modified UCLA rating system that included additional points for abduction range of motion and strength was adapted for clinical evaluation in this study (maximum score, 45 points). The average preoperative rating was 17 (range, 9 to 26). The average postoperative rating was 41 (range, 16 to 45). There were 36 excellent (41 to 45 points), 13 good (36 to 40 points), 1 fair (30 to 35 points), and 3 poor (< 30 points) results. We have seen intraoperative but no cases of postoperative anchor pullout. The simple sutures performed as well as, and in some ways better than, mattress configurations. All fair and good results were with O-PDS. To perform an arthroscopic repair, the tear must be well visualized and mobilizable back to the tuberosity with only moderate tension. The anterolateral operative portal has been very useful because it allows better angle of entry for instruments and anchors and improved visualization in the subacromial space. The use of PDS and simple suture configurations has made the repair technically easier to perform with the instruments that are currently available. We do recommend 1-PDS suture because it breaks less easily even though it is slightly more difficult to deliver and tie. Arthroscopic cuff mobilization is relatively simple and has allowed us to repair larger tears. Based on our experience, arthroscopic rotator cuff repair is technically achievable and a superior alternative in selected cases for an experienced shoulder arthroscopist. Patients who underwent arthroscopic repairs had less scarring and shorter hospital stays and, we believe, less postoperative pain and easier rehabilitation compared with open repairs.

Adult↗

PubMedDate not supplied

Arthroscopic "interval slide" in the repair of large rotator cuff tears.

An arthroscopic technique for coracohumeral ligament release from a retracted supraspinatus tendon is presented. The procedure is technically simple and can greatly improve the mobility of retracted rotator cuff tears, thus expanding the application of arthroscopic repair to larger tears.

Aged↗

PubMedDate not supplied

Arthroscopic inferior capsular split and advancement for anterior and inferior shoulder instability: technique and results at 2- to 5-year follow-up.

We present a modification of the arthroscopic Bankart repair that includes an inferior capsular split. This technique allows up to 2 cm of additional capsular advancement, restoring more normal capsular tension by addressing plastic elongation of the capsule. Prospective evaluations of 34 patients with 2- to 5-year follow-up are included in this report. Average patient age was 25.1 years (range, 16 to 40 years). Twenty-two patients had experienced at least 1 anterior/inferior dislocation. Ten patients had chronic anterior/inferior subluxation. Two patients were considered multidirectional. Time from dislocation or the duration of symptoms to the repair ranged from 1 month to 13 years. The first 5 repairs were performed using transglenoid suture fixation, the last 29 with suture/anchor technique. There were no neurological complications. The average postoperative Bankart score was 91.6 (range, 40-100). In 30 of 34 patients, there has been no recurrence of subluxation or dislocation. Two of the 5 transglenoid repairs had a recurrence (40% recurrence rate). Two of 29 patients in the suture anchor group had a recurrence (6.9% recurrence rate). We believe that the addition of an inferior capsular split, used in conjunction with a suture/anchor repair, restores more normal capsular tension and especially addresses the inferior component of anterior/inferior shoulder instability. We include an inferior capsular split and advancement routinely when performing arthroscopic Bankart repairs.

Adolescent↗