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At least 181 records · Page 10Linked to original sources
PubMed1994

Midcarpal arthroscopy: anatomy and portals.

Arthroscopy of the midcarpal joint of the wrist is a relatively new procedure made possible by the advances and miniaturization of arthroscopic instrumentation. Only recently has even the basic variability in the normal anatomy of the midcarpal joint been delineated. Midcarpal arthroscopy is becoming a routine part of a complete diagnostic wrist arthroscopy and is offering good views of midcarpal anatomy and new opportunities for arthroscopic treatment of midcarpal and proximal wrist joint traumatic and degenerative pathology.

Arthroscopy↗
PubMed1993

[Alloplastic augmentation in reconstruction of the knee joint ligaments].

Alloplastic augmentation of crucial ligaments of the knee is made with absorbable or non-absorbable grafts. Surgical technics is an important factor having a decisive influence on the final result. Encouraging remote results after reconstructions of the crucial ligaments with a graft taken from the ligament of the patella and allogenic augmentation show that progress in this kind of surgery should be seen in the improvement of the quality of allogenic grafts, their biocompatibility and in perfecting of the surgical technic.

Animals↗
PubMed1997

Arthroscopic repairs of triangular fibrocartilage complex tears.

Technical advancements in arthroscopic wrist procedures have improved our knowledge of normal and abnormal intraarticular wrist function. Triangular fibrocartilage complex (TFCC) tears from trauma injuries are a common source of ulnar-sided wrist pain. Fortunately, the TFCC is a structure that can be evaluated and treated arthroscopically with results that are comparable to open surgical procedures. Successful arthroscopic repairs of TFCC tears depend on a coordinated team effort between perioperative nurses, orthopedic surgeons, nurse practitioners, and occupational hand therapists, as well as cooperation from patients and family members. This article reviews the anatomy and physiology of the TFCC, the biomechanics of the wrist and mechanisms of injury, and arthroscopic repairs of TFCC tears.

Arthroscopy↗
PubMedDate not supplied

Stability of the loaded ankle. Relation between articular restraint and primary and secondary static restraints.

The stabilizing capacity of the ligaments and articular surface in the ankle was determined under defined physiologic loading conditions. The concept of primary and secondary constraints was adapted to the ankle. With physiologic loading, the articular surface accounted for 30% and 100% of stability in rotation and version, respectively. That the articular surface was the sole source of inversion and eversion stability under the prescribed physiologic loading conditions has not been previously reported. The demonstration that the articular surface resists inversion displacement in the loaded ankle supports the conclusion of previous studies that rotation, rather than inversion, may account for a type of clinically symptomatic ankle instability. Further, ankle instability may occur during loading and unloading but not once the ankle is fully loaded. The results of our study confirm the importance of the anterior talofibular and calcaneofibular ligaments and suggest an important role for the deltoid ligament.

Adult↗
PubMed2004

When to inject analgesic agents intra-articularly in anterior cruciate ligament reconstruction: before or after tourniquet releasing.

PURPOSE: To evaluate 2 different applications of an intra-articular (IA) mixture composed of 40 mL 0.25% bupivacaine and 2 mg morphine in anterior cruciate ligament (ACL) reconstructions, before and after tourniquet release. TYPE OF STUDY: Prospective, double-blind, randomized, clinical trial. METHODS: Forty patients who underwent ACL reconstruction were prospectively randomized into 2 groups. Group 1 was injected with IA morphine with bupivacaine 10 minutes before tourniquet release. Group 2 was injected with IA morphine with bupivacaine injection after tourniquet release, after a 30-minute period of waiting with closed drainage. Visual analog scale scores were recorded at 10 and 30 minutes and at 1, 2, 4, 8, 12, and 24 hours after surgery. Detailed records were kept of the amount of analgesic drug required. RESULTS: In pain scores, there was no difference between the 2 groups except for 30 minutes postoperatively (P = .005). The first analgesic requirement time was significantly lower in group 2 (P < .001) and the total amount of opioid used was lower in group 2 (P = .037) than those in group 1. There was no difference between the 2 groups in terms of operation time (P = .484), although there was a significant difference between groups in terms of tourniquet time (P = .024). CONCLUSIONS: We conclude that IA analgesic injection after tourniquet release is more beneficial to obtain postoperative analgesia in ACL reconstructions than the same injection before tourniquet release. LEVEL OF EVIDENCE: Level I.

Analgesia↗
PubMed1992

Survival of cells after intra-articular transplantation of fresh allografts of the patellar and anterior cruciate ligaments. DNA-probe analysis in a goat model.

The fate of donor cells in fresh allografts of the patellar and anterior cruciate ligaments was assessed after transplantation of the allografts as substitutes for the anterior cruciate ligament in goats. DNA-probe analysis was used to distinguish between the DNA of individual goats. Donor DNA was completely replaced by recipient DNA in both the transplanted patellar and anterior cruciate ligaments within a four-week period. Simultaneous full-thickness skin transplants in the same animals were not rejected during the interval of rapid loss of donor DNA from the allografts. The absence of rejection of the skin grafts at the one-week interval suggests that no pre-existing antibody associated with an immune reaction was responsible for the rapid loss of DNA in the allografts.

Animals↗
PubMed1984

Intra-articular reconstruction of the anterior cruciate ligament. An experimental study of length changes in different ligament reconstructions.

An anatomic model was developed to test different types of intra-articular anterior cruciate ligament reconstructions. Four cadaver knees were tested in an identical fashion. In each knee 12 different positions were tested. The results indicate that over-the-top repair is not suitable for anterior cruciate ligament reconstruction from a mechanical standpoint. It is likely that this type of repair in human knees will lead to excessive stretching and insufficiency of the reconstructed tissue. A posterior approach through the lateral femoral condyle is more desirable. The position of the tibial tunnel is less crucial, but a more anterior tunnel is preferable. When the tunnels are properly drilled, fixation of the reconstructed ligament is advocated with the knee in 45 degrees-90 degrees of flexion. Postoperative immobilization in 45 degrees of flexion is suggested.

Adult↗
PubMed1985

Intra-articular reconstruction of the anterior cruciate ligament.

In this article, the author provides criteria for the recommendation of surgical intervention in acute and chronic anterior cruciate ligament insufficiency and describes various intra-articular procedures for both conditions. Intra-articular reconstruction of the anterior cruciate ligament with a vascularized patellar tendon graft is described in detail, as are the excellent results achieved with this procedure over the past 8 years.

Acute Disease↗
PubMed1987

In situ mechanical behavior of posterior spinal ligaments in the lumbar region. An in vitro study.

The posterior ligaments: ligamentum flavum, articular, interspinous and supraspinous ligaments of twenty five fresh cadaveric intervertebral segments, from T11-T12 to L4-L5, extracted from fourteen spines were tested in tension. A progressive dissection method was used, that is, each segment was tested after first resecting the disk with the ligaments intact and a force-elongation curve obtained. Then one ligament was cut and the test repeated, and so on. The most restrictive ligament was found to be the ligamentum flavum followed by the articular, interspinous, and supraspinous ligaments.

Aged↗
PubMed1992

[Extra-articular fractures near the knee and concomitant knee damage].

While the prognosis of intra-articular fractures of the knee joint is determined by the reconstruction of the articular surfaces, ligamentous damage and resulting joint instability is a main problem with extra-articular fractures neighbouring the knee. In a follow-up of 43 cases of A 1-3 fractures according to the AO/ASIF classification, 37.2% of the patients revealed concomitant ligamentous damage. Especially supracondylar femoral fractures and the avulsion fractures of the posterior cruciate and lateral collateral ligament are at higher risk.--Ligamentous ruptures accompanying avulsion fractures should be treated primarily according to the rules of knee joint surgery. In cases of supracondylar femoral fractures after open reduction and internal fixation the recovery of knee joint motion is more important than joint stability. Therefore ligamentous repair has to be performed secondarily if necessary.

Adolescent↗
PubMed1990

The radiologic assessment of post-traumatic vertebral stability.

The stability of the vertebral column depends upon the integrity of the bones, ligaments, and joints. The vertebral column can be divided into three distinct anatomic zones: anterior, middle, and posterior. Disruption of any single zone does not produce instability. Disruption of two contiguous zones will, however, significantly decrease the load-carrying capability of the spine and result in instability. Five radiographic signs indicative of vertebral instability have been identified: (1) displacement implies injury to major ligamentous and articular structures; (2) a wide interlaminar space implies injury to the posterior ligamentous structures and the facet joints; (3) wide facet joints imply injury to the posterior ligamentous structures; (4) a disrupted posterior vertebral body line implies burst injury with disruption of anterior bony and posterior ligamentous structures; (5) a wide vertebral canal implies injury to the entire vertebra in the sagittal plane. Each of these signs indicates disruption of a major skeletal, ligamentous, or articular structure and the presence of only one is sufficient to establish a diagnosis of instability. These conclusions are based upon a study of 138 injuries observed in 125 patients.

Fractures, Bone↗
PubMed1999

Intra-articular detachment of the Endobutton more than 18 months after anterior cruciate ligament reconstruction.

We report a case of detachment of an Endobutton (Acufex Microsurgical, Mansfield MA) used for femoral fixation of a reconstructed anterior cruciate ligament. The Endobutton, which was confirmed to be in place on the suprapatellar space of the femur by radiograph 18 months postoperatively, was found in the popliteal space by radiograph 25 months after surgery. This is a rare complication, but our case suggests that the Endobutton should not be fixed too distal close to the femoral groove.

Adult↗