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Biomedical subjects

R B Salter

Publications and source records attributed to R B Salter.

At least 19 recordsLinked to original sources
PubMed1998

The effects of postoperative continuous passive motion on peripheral nerve repair and regeneration. An experimental investigation in rabbits.

The effects of continuous passive motion (CPM) on nerve regeneration following nerve repair were investigated. In 26 rabbits, the medial popliteal nerve was transected and microsurgically repaired. Half of the animals were treated with cast immobilization and the rest with 70 degrees arc CPM. Both treatments were discontinued on day 14. After sacrifice on day 100, no animal showed separation at the suture line. Mean nerve conduction velocity was slightly slower in the CPM than in the immobilization group. Mean fibre density was also slightly less in the CPM group but the difference was not significant. Mean fibre diameters, fibre diameter distributions, and soleus-muscle wet weights were similar in the two groups.

Action Potentials↗
PubMed1996

Orthopedic conditions of the cervical spine and shoulder.

Orthopedic conditions of the cervical spine and shoulder can range from benign to life threatening. A careful history and examination are crucial to evaluate these children, and additional investigations may be necessary. The signs and symptoms in these conditions and the indications for referral are discussed.

Atlanto-Axial Joint↗
PubMed1996

Traumatic heterotopic bone formation in the quadriceps muscle. No progression by continuous passive motion in rabbits.

One hind limb in each of 20 New Zealand White rabbits was immobilized for 3 weeks together with daily forcible manipulation to induce heterotopic bone formation in the quadriceps muscle. The rabbits were then divided equally into a control group and a group treated with continuous passive motion (CPM). The effect of CPM on the development of heterotopic bone formation was assessed by radiographs of the femur and by histology. Treatment with CPM did not lead to increased heterotopic bone formation, as compared to the control group.

Animals↗
PubMed1995

Effects of continuous passive motion and immobilization on synovitis and cartilage degradation in antigen induced arthritis.

OBJECTIVE: To determine the effects of continuous passive motion (CPM) and immobilization on synovitis and cartilage degradation in an experimental model of chronic inflammatory, antigen-induced arthritis. METHODS: After bilateral arthritis induction of knee joints in 22 NZW rabbits, one knee was immobilized with a flexion splint while the opposite knee received CPM. RESULTS: After 2 weeks (n = 10), the CPM treated knees had significantly greater joint swelling, synovial effusion, and histologic synovitis scores compared to its opposite immobilized knees. However, the total cartilage degradation score showed no statistically significant difference between the two treatments. When the treatments were discontinued after 2 weeks and animals were allowed intermittent active motion of both knees in cages for 4 weeks (n = 12), no statistically significant difference in joint swelling, synovial effusion, and histologic synovitis score was observed between the 2 treatments. The articular cartilage degradation, however, was significantly greater in the immobilized knees compared to its opposite CPM treated knees. Five of 12 immobilized knees had articular surface erosion compared to none in the CPM treated knees. Loss of cellularity was also significantly greater in the immobilized knees. CONCLUSION: Although CPM produced greater synovitis at 2 weeks, articular cartilage was better preserved in the knees treated with CPM than immobilization at 6 weeks.

Animals↗
PubMed1994

Continuous passive motion stimulates repair of rabbit knee articular cartilage after matrix proteoglycan loss.

Continuous passive motion facilitates repair of full-thickness defects in the articular cartilage in rabbits. Studies were conducted to determine whether continuous passive motion would similarly affect the repair process after injection of chymopapain into the rabbit knee. Adolescent rabbits were injected with chymopapain and then given intermittent active motion in the form of free cage activity or continuous passive motion of the injected knee. After injection of either 0.2 or 2 mg chymopapain into the knee, serum keratan sulfate levels rose sharply, indicating proteoglycan loss, and, in all cases, peaked at 24 hours between 200-800% of preinjection levels. Importantly, serum keratan sulfate levels were significantly elevated within 1 hour when joints were submitted to immediate continuous passive motion after the injection. As shown previously, injection of either 0.2 or 2 mg chymopapain into the knee, followed by intermittent active motion, resulted in a pronounced loss of proteoglycans by Day 2, partial restoration of proteoglycans by Day 9, continued proteoglycan synthesis by Day 21 in animals receiving the lower dose, and severe degenerative changes by Day 21 in animals receiving the higher dose. In all animals that received either high or low doses of chymopapain, as well as 2 days of intermittent active motion and then continuous passive motion, the articular cartilage surface was intact by Day 9, and replenishment of proteoglycans had occurred in pericellular and interterritorial areas. By Day 21, the surface of the articular cartilage was still intact, and replenishment of proteoglycans in loaded regions continued in all animals receiving either dose of chymopapain. These results indicate that a period of intermittent active motion followed by continuous passive motion of a chymopapain injected knee may protect and stimulate repair of the articular cartilage matrix after chymopapain-induced injury.

Animals↗
PubMed1994

The physiologic basis of continuous passive motion for articular cartilage healing and regeneration.

This article historically reviews the limited potential of articular cartilage to heal or regenerate, past emphasis on rest as opposed to motion, and the reasoning that led the author to create the biologic concept of continuous passive motion (CPM) in 1970. The basic premises and hypotheses of CPM are stated. A brief summary is provided of 19 scientific investigations of CPM in rabbits, with particular emphasis on the beneficial short-term and long-term effects of CPM in intra-articular fractures. The conclusions from the basic research are summarized. The clinical applications of CPM to the care of patients are discussed with respect to the indications and the results.

Animals↗
PubMed1994

Biologic resurfacing of a major joint defect with cryopreserved allogeneic periosteum under the influence of continuous passive motion in a rabbit model.

Periosteal autografts have been widely used for biologic resurfacing of full-thickness articular cartilage defects in rabbits. This study examined the effect of donor and recipient age on biologic joint resurfacing using fresh and cryopreserved periosteal allografts in a rabbit model. The study also assessed the ability of cryopreserved periosteal allografts to undergo neochondrogenesis. Eighty New Zealand rabbits were divided into six groups receiving combinations of fresh or cryopreserved allografts. After all the grafts were secured with fibrin glue, the animals were subjected to two weeks of continuous passive motion followed by four weeks of cage activity or intermittent active motion. The rabbit knees were analyzed at six weeks by gross examination, histochemical staining, and collagen typing. No significant difference in chondrogenic potential between fresh and cryopreserved periosteal allografts was observed. Grafts obtained from adult donors were much less chondrogenic than those from adolescents, but adults recipients experienced reasonably good results when they received allografts from young donors. No evidence of rejection was found in any of the samples as late as six weeks after transplantation.

Aging↗
PubMed1992

Biological resurfacing of full-thickness defects in patellar articular cartilage of the rabbit. Investigation of autogenous periosteal grafts subjected to continuous passive motion.

We compared the effects of continuous passive motion with those of intermittent active motion on the results of the resurfacing with autogenous periosteal grafts of full-thickness defects on the articular surface of rabbit patellae. Of 45 rabbits with defects, 30 received grafts. Fifteen of these had continuous passive motion for two weeks and intermittent active motion for four weeks; the other 15 had intermittent active motion for six weeks. In 15 the defects were not grafted (control group) and they had intermittent active motion for six weeks. Ten more rabbits had a sham operation. Six weeks after surgery, the results were assessed by the gross appearance, histology, histochemistry, immunohistochemistry and electron microscopy. By all assessments the quality of neochondrogenesis produced by periosteal grafts was superior to that in ungrafted defects (p less than 0.05) and the results in continuous passive motion treated animals were superior to those in intermittent active motion treated animals (p less than 0.05). The periosteal grafts produced hyaline cartilage containing type II collagen but the organisation of its fibres was irregular.

Animals↗
PubMed1991

Penile deformity in bladder exstrophy: correlation with closure of pelvic defect.

In the exstrophy-epispadias complex of anomalies, penile deformity represents one of the factors that causes long-term disability in males. In order to define the extent to which the separation of the bony elements may contribute to the final penile length and configuration, an in vitro model was devised using an adult male pelvis and an inflatable penile prosthesis. This model was used to study the relationship of interpubic distance to penile length. Closure of the "open book" deformity of the bony pelvis resulted in an increase in penile length. Closure of the pubic diastasis is best accomplished by iliac osteotomies. This study supports clinical evidence that iliac osteotomies, when performed in conjunction with closure of the exstrophic urinary bladder, may contribute to an increase in effective penile length.

Bladder Exstrophy↗
PubMed1991

The effect of continuous passive motion on knee ligament reconstruction with carbon fibre. An experimental investigation.

Our purpose was to determine whether continuous passive motion enhanced the quality of knee ligament reconstruction using carbon fibre. In 46 rabbits the medial collateral ligaments were excised and replaced with carbon fibre prostheses. The animals were treated postoperatively by either continuous passive motion, cast immobilisation or cage activity, termed intermittent active motion. At six weeks, the ligaments were compared histologically and biomechanically with normal (control) medial collateral ligaments and with sham-operated controls. The ligaments treated with continuous passive motion were superior to those in the other two treatment groups. There were no ligament failures in any of the groups. This study suggests that continuous passive motion, initiated immediately postoperatively, enhances the biomechanical properties of carbon fibre ligament replacement of the medial collateral ligament while preventing the harmful effects of joint immobilisation.

Animals↗
PubMed1991

The potential for regeneration of articular cartilage in defects created by chondral shaving and subchondral abrasion. An experimental investigation in rabbits.

Animal models for chondral shaving and subchondral abrasion were created to resolve the controversy about the nature of the repair tissue after these procedures and to determine the effect of continuous passive motion on the quality of the repair tissue. Chondral shaving was performed on the patella in forty adolescent rabbits, and subchondral abrasion was performed on the patella in another forty rabbits. In both procedures, a three-millimeter-diameter defect was created. After the operation, twenty animals from each group were allowed intermittent active motion; the remainder were treated by continuous passive motion for two weeks, followed by intermittent active motion. Half of the animals from each group were killed at four weeks and the other half, at twelve weeks. There was no evidence of repair tissue in the defects at either four or twelve weeks after chondral shaving, regardless of the postoperative treatment. The remaining underlying cartilage, however, had degenerated. After abrasion of subchondral bone, the defects in animals that were treated with only intermittent active motion healed at twelve weeks, although the quality of the repair tissue varied. All ten of the animals that were treated with continuous passive motion, however, had mature, hyaline-like cartilage as the predominant repair tissue at twelve weeks, compared with six of the ten animals that were treated with intermittent active motion (p less than 0.05). We concluded that, in this model, partial-thickness defects created by chondral shaving do not heal; rather, the remaining underlying cartilage degenerates. Full-thickness defects created by subchondral abrasion can heal by regeneration of hyaline-like cartilage. Such healing is enhanced by continuous passive motion for two weeks postoperatively.

Animals↗
PubMed1989

Congenital shortness of the costocoracoid ligament.

We report a large kindred in which individuals presented with fixation of the scapula to the first rib by a congenitally short costocoracoid ligament. Cosmetic deformity with rounding of the shoulder and loss of the anterior clavicular contour was the main concern of the affected individuals. Movements requiring rotation or retraction of the scapula were limited, although this did not interfere with normal activities. Surgical treatment consists of excision of the costocoracoid ligament and resulted in some correction of the cosmetic deformity. The pedigree supports an autosomal dominant mode of inheritance with variable expression. The abnormality results in a pectoral girdle which is reminiscent of that seen in the monotremes.

Adult↗
PubMed1989

The biologic concept of continuous passive motion of synovial joints. The first 18 years of basic research and its clinical application.

The notoriously limited capacity of articular cartilage to heal or to regenerate plus the author's clinical observations and research on the deleterious effects of immobilization on joints led him to the biologic concept of continuous passive motion (CPM) of synovial joints in 1970. The hypothesis that CPM should stimulate pluripotential mesenchymal cells to differentiate into articular cartilage and should accelerate the healing of articular tissues has been validated by numerous scientific investigations of a variety of experimental models of the knee joint. These models have included full-thickness defects, intraarticular fractures, acute septic arthritis, partial thickness lacerations of the patellar tendon, semitendinosus tenodesis to replace the medial collateral ligament, autogeneic osteoperiosteal grafts in major defects, free autogeneic periosteal grafts, and periosteal allografts. In 1978, the author collaborated with Saringer, an engineer, to develop CPM devices for humans. CPM is clinically indicated following such procedures as open reduction of fractures, arthrolysis for posttraumatic arthritis, synovectomy, drainage of septic arthritis, release of joint contractures, total arthroplasty, tendon repair, and ligament reconstruction. Clinically, CPM is an important stimulus to joint regeneration processes.

Animals↗
PubMed1989

Periosteal neochondrogenesis for biologically resurfacing joints: its cellular origin.

The purpose of this study was to determine if the hyaline-like cartilage produced in major full-thickness defects of a joint surface, treated by a free periosteal graft and subjected to continuous passive motion (CPM), originated exclusively from the progenitor cells of the cambium of the graft. Free periosteal grafts were raised from the tibia of both hind legs of eight male New Zealand rabbits and transplanted into full-thickness defects across the entire width of the patellar groove of 15 female rabbits. Postoperatively, CPM was instituted and the animals were sacrificed after 3 weeks. Cells from the regenerated tissue were grown from tissue explants and their karyotypes determined. In 33% of the rabbits, all cells contained a Y (male) chromosome, indicating that regenerated tissue originated exclusively from the progenitor cell of the periosteal graft. Karyotypes of the cells from the other 67% were mosaics (both female and male); thus, their cellular origin was from both the periosteal allograft and the pluripotential mesenchymal cells in the subchondral tissues.

Animals↗