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Biomedical subjects

M Marcacci

Publications and source records attributed to M Marcacci.

16 recordsLinked to original sources
PubMed1992

Functional evaluation of patients fitted with total knee prostheses.

Degenerative or inflammatory diseases of the knee joint account for a large proportion of diseases affecting the elderly. Treatment aims to eliminate pain, correct the deformity and maintain complete joint mobility. In cases of total joint degeneration, fitting of a joint prosthesis is the technique currently favoured since elimination of pain and correction of the deformity, accompanied by recovery of joint mobility (the fundamental requirements for normal everyday life) can only be obtained if the knee joint is completely replaced. With the discovery of new materials and increasingly sophisticated knowledge about articular mechanics, the knee prosthesis, although more recent than the hip prosthesis, has become ever more widespread to the point that it now represents an irreplaceable aid in the treatment of this common disease. The clinical results obtained are already stable and particularly encouraging and prosthesis design is sophisticated and accurate. There is, however, still the suspicion that current prostheses can be considered "rudimentary" in comparison with the physiological and biomechanical behaviour of the human joint. We therefore wanted to begin an evaluation using a gait analysis system to assess patients fitted with knee prostheses. The first impressions gained in this study are the subject of this article.

Activities of Daily Living↗
PubMed1992

The human anterior cruciate ligament: histological and ultrastructural observations.

In transverse and longitudinal paraffin-embedded sections, the human anterior cruciate ligament (ACL) is made up of wavy bundles of collagen fibres arrayed in various directions, the majority around the axis of the ligament with a few running parallel to it. The fascicles making up the larger bundles are also characterised by this undulating appearance. In thin sections 2 types of collagen fibrils are observed: small (with a single diameter peak at 45 nm) and large (3 peaks at 35, 50 and 75 nm respectively), organised into distinct areas made up of either large or small bundles of fibrils. The numerous fibroblasts that are present appear elongated in the direction of the bundles with branches and short cytoplasmic processes. The elastic system is made up of both elastic and oxytalan fibres. The varied orientation of the bundles in the ACL, the complex ultrastructural organisation and the abundant elastic system make it very different from other ligaments and tendons, providing a structure able to withstand the multiaxial stresses and varying tensile strains imposed upon it.

Anterior Cruciate Ligament↗
PubMed1991

Histologic and ultrastructural findings of tissue ingrowth. The Leeds-Keio prosthetic anterior cruciate ligament.

A light and electron microscopy investigation was performed on a Leeds-Keio ligament removed because of rupture 18 months after implantation to repair an anterior cruciate ligament. The investigation showed fibrous connective tissue on the plane of the main stress force. There was elastin and adequate vascularization interspersed with Type I collagen fibrils in the area most distant from the ligament. The tissue near the Dacron fibers was highly cellular with a matrix of infrequent, thin collagen fibrils and abundant fine granular material. The growth of the host tissue occurred in and around a Leeds-Keio ligament in response to tensile stresses.

Adult↗
PubMed1989

[Our experience in the treatment of idiopathic osteonecrosis of the femur head by évidement and filling with bone grafts].

UNLABELLED: The authors relate their experience in treating idiopathic osteonecrosis of the femoral head with bone grafting. CASES: 18 hips under control for a period varying from 8 to 3 years. Radiographic and clinical assessment before and after surgery according to Ficat, Arlet and Merle D'Aubigné. Four patients were affected with idiopathic osteonecrosis of the femoral head. Results were very good in 4 cases and quite good in 2 cases. Only one third of the results could be regarded as positive. This modest achievement is partly due to the method employed. In order to obtain better results, however, an early diagnosis is required and patients who are operated on should have quite a good bone mineralization.

Adult↗
PubMed1989

[Antero-lateral laxity or a combination of anterior and postero-lateral laxity? Therapeutic considerations].

The study involves a group of patients affected with inveterate lesion of the A.C.L. for at least 18 months. Homogeneous two-staged surgical treatment was carried out: 1) reconstruction of the A.C.L. according to Kenneth-Jones; 2) retention of the popliteus according to Bousquet. Results were: excellent: 18; good: 10; fair: 2. Follow-up was obtained after an average of 18 months.

Adolescent↗
PubMed1976

[A so-called adamantinoma of the right femur (author's transl)].

Report on a so-called adamantinoma of a right femur (fourth case from available publications) with remarks on the histogenesis of these tumors, which show correlating properties with malignant synovialomas. In other words, the so-called adamantinoma of long bones represents the osseous form of a malignant synovialoma, whereby an intraosseous ganglion has to be considered as a histogenetic criterion (matrix).

Diagnosis, Differential↗
PubMedDate not supplied

Ultrastructural modifications of patellar tendon fibres used as anterior cruciate ligament (ACL) replacement.

Using transmission electron microscopy, patellar tendons that had been autografted to replace the ACL were studied. Follow-up biopsies, performed at 6, 12 and 24 months after reconstructive surgery demonstrated that the autograft patellar tendons had undergone considerable change. After 6 months, the large collagen fibrils were less numerous and more widely spaced. The spaces were occupied by dense colonies of very small, newly-formed collagen fibrils and were rich in glycosaminoglycans. Small elastic fibres, fibrocytes, round cells with abundant rough endoplasmic reticulum and macrophage-like cells were scattered among the collagen fibrils. At 12 months, sporadic clumps of large collagen fibrils were seen between the compact bundles of small, uniform collagen fibrils. Both elastic and oxytalan fibres were observed; round cells with abundant rough endoplasmic reticulum were the most prevalent cell type. At 24 months, the tissue had the appearance of a normal ligament. The small uniform collagen fibrils had formed large, compact bundles that were prevalently arrayed parallel to the long axis. Both elastic and oxytalan fibres were observed and the numerous cells present exhibited the same morphological features as those observed at 12 months after surgery. The appearance of compact collagen bundles, the abundant elastic system and the abundance of active cells observed in the patellar tendon autograft 24 months after implantation, suggest that this type of tissue is a valid functional ACL substitute of a knee required to perform normal mechanical activity.

Adolescent↗