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Biomedical subjects

R J Pawluk

Publications and source records attributed to R J Pawluk.

17 recordsLinked to original sources

Tensile properties of the inferior glenohumeral ligament.

The tensile properties of the inferior glenohumeral ligament have been determined in 16 freshly frozen cadaver shoulders. The inferior glenohumeral ligament was divided into three anatomical regions: a superior band, an anterior axillary pouch, and a posterior axillary pouch. This yielded 48 bone-ligament-bone specimens, which were tested to failure in uniaxial tension. The superior band was consistently the thickest region, averaging 2.79 mm. The thickness of the inferior glenohumeral ligament decreased from antero-superiorly to postero-inferiorly. The resting length of all three anatomical regions was not statistically different. Total specimen strain to failure for all bone-ligament-bone specimens averaged 27%. Variations occurred between the three regions, with the anterior pouch specimens failing at a higher strain (34%) than those from the superior band (24%) or the posterior pouch (23%). Strain to failure for the ligament midsubstance (11%) was found to be significantly less than that for the entire specimen (27%). Thus, larger strain must occur near the insertion sites of the inferior glenohumeral ligament. Stress at failure was found to be nearly identical for the three regions of the ligament, averaging 5.5 MPa. These values are lower than those reported for other soft tissues, such as the anterior cruciate ligament and patellar tendon. The anterior pouch was found to be less stiff than the other two regions, perhaps suggesting that it is composed of more highly crimped collagen fibers. Three failure sites were seen for the inferior glenohumeral ligament: the glenoid insertion (40%), the ligament substance (35%), and the humeral insertion (25%). In addition, significant capsular stretching occurred before failure, regardless of the failure mode.

Aged

Quantitation of in situ contact areas at the glenohumeral joint: a biomechanical study.

Glenohumeral arthritis may result from abnormal articular mechanics, and shoulder reconstructive procedures often rely implicitly on the belief that the restoration of normal articular mechanics is required to obtain satisfactory clinical results. Despite this, limited knowledge of normal or pathologic glenohumeral joint articular mechanics and contact is available. This study uses a stereophotogrammetry technique to determine contact areas in normal cadaver glenohumeral joints with intact ligaments and capsule through a large range of motion using simulated forces of the four rotator cuff muscles and three deltoid heads. All shoulders were first elevated to their maximum elevation in the scapular plane at an external rotation (starting rotation = 40 +/- 8 degrees), which allowed each shoulder to attain its maximal elevation in the scapular plane, and then repeated at 20 degrees internal to this rotation. Contact areas consistently increased with increasing elevation until 120 degrees to an average of 5.07 cm2 before decreasing with further increased elevation to an average of 2.59 cm2 at 180 degrees of total arm elevation. At 20 degrees internal to the starting rotation, contact areas reached high values 60 degrees earlier (averaged 4.56 cm2 at 60 degrees of total arm elevation) and then remained fairly constant through 120 degrees before decreasing with further increased elevation to 2.51 cm2 at 180 degrees total arm elevation. With increasing elevation in the external starting rotation, humeral head contact dramatically migrates from an inferior region to a superocentral-posterior region while glenoid contact shifts posteriorly. When the humeral shaft is positioned 20 degrees internal to the starting rotation, humeral head contact shifts from inferocentral-anterior to superocentral-posterior regions. Simultaneously, a similar posterior shift in glenoid contact is observed. Furthermore, whereas only a small portion of the humeral head surface area is in contact in any given position, contact on the glenoid surface is much more uniformly distributed over its entire articulating surface.

Aged

Bioengineering activities at the New York Orthopaedic Hospital Research Laboratory.

The studies described above are representative of the Laboratory's long-standing dedication to the philosophy of multi-disciplinary research. Results from these studies will continue to provide new insights as to the function of diarthrodial joints, articular cartilage and other hydrated soft tissues. It appears reasonable to expect that in the years ahead we will have a better understanding of the mechanisms behind histomorphogenesis, growth, functional adaptation, regeneration, ageing and degeneration of connective tissues and osteoarthritis resulting from these investigations being conducted at the New York Orthopaedic Hospital Research Laboratory.

Biomechanical Phenomena

A non-operative salvage of surgically-resistant pseudarthroses and non-unions by pulsing electromagnetic fields. A preliminary report.

This report documents, for the first time, to the authors' knowledge, the therapeutic use in humans of low energy, electromagnetic fields pulsing in the extremely low frequency (E.L.F.) range. These fields, established outside the body, were used to treat congenital and acquired pseudarthroses and non-unions. Energy of this type appears to affect biological processes, not through heat production, but through electrically-induced changes in the environment of cells within the organism. Of the 29 patients included in the study, 17 had experienced at least one failure of surgical repair and, in each of these, amputation had been recommended. The overall success rate, including those patients treated with inadequate pulse characteristics and those who failed to follow the protocol, was in excess of 70 per cent. Improvements in the specificity of pulse characteristics hold promise for increasing the rate of success. The simple, clinical methodology, which is conducted on an out-patient basis, appears to be both safe and effective. It can be applied with or without surgery. This approach requires additional controlled investigations before it is ready for general use in the orthopaedic community. The indications for amputation of surgically-resistant pseudarthroses, however, should be reassessed. The principles and technology, which have been established during this endeavor, may have physiologic and practical significance for processes other than pseudarthrosis and non-union.

Adolescent

Augmentation of bone repair by inductively coupled electromagnetic fields.

Pulsing electromagnetic fields of low frequency and strength have been inductively coupled across skin, directly to bone, to enhance the repair of canine osteotomies. The induced voltage field in bone appears to increase the organization and strength of the repair process at 28 days after "fracture."

Animals

Electrical behavior of cartilage during loading.

When cartilage is deformed, it becomes electrically polarized. At least two mechanisms seem to underlie this phenomenon, namely, a short-duration, high-amplitude, piezoelectric-like response and a longer-duration, lower-amplitude response secondary to streaming potentials. The polarity of articular cartilage during loading could hypothetically facilitate joint lubrication.

Animals

In vivo effects of direct current in the mandible.

The application of low level direct current (3 to 5 mua in situ, that is, 50 mua/cm2), within the mandible of mature Beagle dogs results in an increased osteogenesis at the cathode (negative electrode) when compared to responses about nonactive (control) packs within the same dog. The increased osteogenesis suggests a stimulation of cellular activity rather than the electrophoretic migration of cells. Significant differences observed between platinum-iridium and stainless-steel electrodes seem to suggest that faradaic results play little or no role in the osteogenic response at the platinum-iridium cathode. Conversely, at all other electrodes, faradaic reactions compete to some extent with an osteogenic response. Careful consideration of current density and electrode composition must be taken into account when direct current stimulation is to be used.

Animals