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Zoe H Dailiana

Publications and source records attributed to Zoe H Dailiana.

10 recordsLinked to original sources
PubMed2006

Arthroscopic meniscal repair: a comparative study between three different surgical techniques.

The purpose of this prospective study was to evaluate and compare the results of arthroscopic meniscal repair using three different techniques. Between January 2002 and March 2004, 57 patients who met the inclusion criteria underwent an arthroscopic meniscal repair. The outside-in technique was used in 17 patients (group A), the inside-out in 20 patients (group B), while the rest of the 20 patients (group C) were managed by the all-inside technique using the Mitek RapidLoc soft tissue anchor (Mitek Surgical Products, Westwood, MA, USA). Anterior cruciate ligament (ACL) reconstruction was performed in 29 patients (51%). The criteria for clinical success included absence of joint line tenderness, locking, swelling, and a negative McMurray test. The minimum follow-up was one year for all groups. The mean follow-up was 23 months for group A, 22 months for group B, and 22 months for group C. All meniscal repairs were considered healed according to our criteria in group A, while 19 out of 20 repairs (95%) healed in group B. Finally 7 of 20 repairs (35%) were considered failures in group C and this difference was statistically significant in comparison with other groups. The time required for meniscal repair averaged 38.5 min for group A, 18.1 min for group B, and 13.6 min for group C. Operation time for meniscal repair in group A was statistically longer in comparison with other groups. There were no significant differences among the three groups concerning complications. According to our results, arhtroscopic meniscal repair with the inside-out technique seems to be superior in comparison with the other methods because it offers a high rate of meniscus healing without prolonged operation time.

Adult↗
PubMed2006

Vascularized bone grafts from the palmar radius for the treatment of waist nonunions of the scaphoid.

PURPOSE: With their intrinsic vascularity vascularized bone grafts provide an alternative solution to the challenging problem of scaphoid nonunions. The union rate (after imaging evaluation including magnetic resonance imaging [MRI]) and functional outcome of using vascularized bone grafts pedicled on the palmar carpal epiphyseal artery for waist nonunions of the scaphoid are reported in this prospective case series. METHODS: The technique was applied to 9 waist nonunions resulting from fractures. The mean time elapsed from the initial injury to the procedure was 22 months and the mean follow-up time was 24 months. The graft was pedicled on the artery running at the distal edge of the pronator quadratus and was inserted in the nonunion as an intercalary graft. Six patients had postoperative MRIs to evaluate fracture healing and graft incorporation. RESULTS: Union was accomplished in all cases between 6 and 12 weeks. Postoperative MRI showed the viability of the graft (contrast-enhanced images) and confirmed union and graft incorporation. Complete absence of pain was noted in all patients. The Mayo modified wrist score increased from 63 to 92 after surgery and according to this score results were excellent in 5 patients and good in 4. CONCLUSIONS: Vascularized bone grafts from the anterior radius lead to rapid union and consolidation in cases of waist nonunion. Postoperative MRI confirms viability of the graft, union, and graft incorporation. The approach is limited to the distal radius and wrist and lacks donor site morbidity. The interposition of the graft from the palmar side allows correction of the humpback deformity and patients regain carpal height, grip strength, and painless motion. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic, Level IV.

Adolescent↗
PubMed2006

A capsular-based vascularized distal radius graft for proximal pole scaphoid pseudarthrosis.

PURPOSE: To evaluate the clinical results of the application of a capsular-based dorsal distal radius vascularized bone graft in scaphoid proximal pole nonunions. METHODS: Thirteen patients with symptomatic nonunion at the proximal pole of the scaphoid (10 with avascular necrosis) were treated and reviewed retrospectively. The vascularized bone graft was harvested from the distal aspect of the dorsal radius and was attached to a wide distally based strip of the dorsal wrist capsule. It was inserted press-fit into a dorsal trough across the nonunion site after scaphoid fixation with a Herbert screw. RESULTS: After a mean follow-up period of 19 months 10 of the 13 nonunions (8 of the 10 with avascular necrosis) achieved solid bone union. No complications other than the 3 persistent nonunions occurred. CONCLUSIONS: Results of the use of a capsular-based vascularized bone graft from the distal radius for proximal pole scaphoid nonunions compare favorably with the results of pedicled or free vascularized grafts. It is a simple technique that eliminates the need for dissection of small-caliber pedicle or microsurgical anastomoses. No donor site morbidity was observed. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic, Level IV.

Adult↗
PubMed2005

Vascularized periosteal flaps of distal forearm and hand.

BACKGROUND: Vascularized periosteal flaps (VPFs) are flexible osteogenic flaps, suitable for the reconstruction of small skeletal defects. Pedicled VPFs, harvested near the recipient site, minimize donor-site morbidity and procedure duration. The donor sites and the potential recipient sites for pedicled VPFs of the distal forearm-hand were identified in this study. METHODS: In 16 fresh cadaver upper extremities, the dimensions and arcs of rotation of the VPF pedicle(s) were studied. RESULTS: Pedicled VPFs with mean dimensions ranging between 0.5 x 3 cm and 2.5 x 4 cm could cover, after adequate mobilization, the distal half of the forearm, wrist, and hand to the proximal interphalangeal joints. CONCLUSION: The VPFs identified in this study can be used for the reconstruction of small skeletal defects and for the treatment of osteonecrotic lesions and nonunions of the distal forearm, wrist, and hand. The choice of the most suitable VPF will be based on the anatomic location and the dimensions of the recipient site.

Cadaver↗
PubMed2004

Analysis of failures after vascularized fibular grafting in femoral head necrosis.

Evaluation of graft-host bone interactions after failed vascularized fibular grafting of femoral head necrosis may elucidate the reasons for failure of the procedure. According to the authors' study, the vascularized fibula implanted into the femoral head before collapse has the potential for restructuring the major segment of the affected head and delaying joint degeneration for many years if circumferential graft-host union is established. Asymmetric bone healing and non-union between the graft and the necrotic subchondral bone in the weight-bearing area lead to failure, progression of symptoms, and subsequent early hip replacement.

Adult↗
PubMed2004

Drug therapy increases bone density in osteonecrosis of the femoral head in canines.

Although many different pathogenetic mechanisms have been proposed for osteonecrosis of the femoral head, the repair process leads to structural collapse when bone resorption exceeds production. The purpose of the current study was to determine the effects of two agents with known bone-altering qualities, alendronate and simvastatin, on the healing response of a cryosurgically induced necrotic lesion of the femoral head in canines. Eighteen beagles had cryosurgical necrosis of the right femoral head. After 2 weeks, in a blinded, placebo-controlled, randomized fashion, a 10-mg dose of oral alendronate (n = 6), a 40 mg dose of simvastatin (n = 6), or a placebo (n = 6) was administered daily for 12 weeks. At sacrifice, bone densitometry and histomorphometry quantified bone in the femoral head. In the alendronate-treated animals, a 16% increase in bone mineral density of the femoral head with induced osteonecrosis was found compared with the placebo group. Increases in bone volume and trabecular thickness also were detected in the alendronate and simvastatin groups, with alendronate having the greatest effect. Clinically, increasing the amount of bone in the femoral head may forestall mechanisms leading to joint collapse characteristic of advanced osteonecrosis of the femoral head.

Alendronate↗
PubMed2003

Heterotopic ossification after treatment of femoral head osteonecrosis with free vascularized fibular graft.

This study evaluated patients with heterotopic ossification after implantation of a free vascularized fibular graft for the treatment of femoral head osteonecrosis. We hypothesized that the osteogenic tendency of these patients might enhance the graft-host union and new bone formation in the femoral head, although the presence of heterotopic ossification might influence adversely the clinical result. Of patients with femoral head osteonecrosis, 32% developed heterotopic ossification after treatment with free vascularized fibular graft. Heterotopic bone formation did not influence the efficacy of the procedure to preserve the hip joint. The radiographic and clinical results and the rate of subsequent total hip arthroplasty were not affected by the heterotopic bone, but local trochanteric tenderness was associated with large heterotopic lesions.

Adolescent↗
PubMed2002

Heterotopic neo-osteogenesis from vascularized periosteum and bone grafts.

BACKGROUND: Periosteum is an osteogenic, flexible tissue. This study investigated the osteogenic potential of vascularized periosteal flaps in heterotopic conditions and compared it to the neo-osteogenesis from vascularized periosteal flaps combined with bone grafts with different properties (autologous and xenograft). METHODS: Vascularized periosteal flaps from the hindlimbs of 48 rabbits formed cylindrical pouches that were buried in muscles. The pouches were filled with autologous bone grafts (P/A group, n = 16), xenograft (P/X group, n = 16), or left empty (P/E group, n = 16). Specimens were harvested between 1 and 4 months and underwent radiographic, histologic, and histomorphometric evaluation. RESULTS: The total surface area was larger in the groups combined with bone grafts. Osseous apposition did not differ significantly in the P/A and P/X groups (p > 0.05). The central cavity contained hematopoietic cells (P/A), xenograft (P/X), or was absent (P/E). CONCLUSION: Vascularized periosteal flaps presented strong osteogenic capacity in heterotopic conditions. Combination with bone grafts resulted in larger specimens. The quality of neo-osteogenesis was not influenced by the different properties of combined bone grafts.

Animals↗