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At least 559 records · Page 31Linked to original sources
PubMed1990

Histological studies of the glenoid labrum from fetal life to old age.

To help to resolve the controversy regarding the composition of the glenoid labrum, thirty-eight shoulders from cadavera were examined grossly and histologically. We used specimens for individuals of different ages so that we could determine what changes occur as a result of aging. In children and adults, the labrum appeared to be fibrocartilaginous tissue. The labrum was a separate anatomical structure that could be distinguished from the fibrous capsule of the shoulder. Neonatal labra were composed of primitive mesenchymal tissue containing only few chondrocytes that modulated into fibrocartilage in the first few years of life. Neonatal labra contained no elastin, whereas specimens from adults had rare elastin fibers. The labrum was sparsely vascularized throughout its substance, with no particular pattern of distribution. Vascularity decreased with increasing age of the individual.

Adolescent↗
PubMed1989

[The technic of the Bankart operation. A modified reinsertion technic].

A modified technique of reinsertion of the capsule to the bony rim of the glenoid was developed and performed in 57 patients with recurrent anterior dislocation of the shoulder joint. The technique is described in detail. The principal idea of this modified technique is to suture the lateral flap of the capsule into a small sulcus, which is chiselled into the transition zone between the cartilage of the joint and the bony rim of the glenoid. From the bottom of the sulcus four holes are drilled just below the corticalis of the glenoid rim with a dental drill. The capsule is fixed by two U-sutures transosseously. The advantages of this technique are: (1) stable capsular barrier along the rim of the glenoid reinserted by two strong U-sutures; (2) no step between the cartilage of the joint and the reinserted capsule (a Hill-Sachs lesion cannot hook in at the Bankart lesion); (3) the sutures are extra-articular; (4) the lateral flap of the capsule must not be shortened, and therefore full shoulder motion can be obtained; (5) the tendon of the subscapularis muscle is restored to its original position on the lesser tuberosity; (6) a short period of postoperative immobilization. In accordance with the standard rating scale of Rowe, 31 patients were graded as having excellent results, 8 good, none fair, and none poor.

Adolescent↗
PubMed1979

[Diagnostic arthroscopy and arthroscopic surgery: experiences with 500 knee arthroscopies].

A diagnosis by clinical examination and arthrography was not possible in 160 out of 500 arthroscopically examined patients, most of them with post-traumatic knee disorders. In 157 cases the clinical diagnosis was wrong, and in another 58 cases incomplete. Only in 89 patients (18%) arthroscopy proved the clinical diagnosis to be correct. At arthroscopy, a meniscal injury was found in 156 patients (medial meniscus 57, lateral meniscus 64, both menisci 8). With regard to the menisci a previous arthrography was found correct only in 103 out of 213 cases, i.e. in 48%. Lesions of the articular cartilage were present in 210 patients, although they were expected clinically in only one third of these cases. Normal intraarticular structures were found in 95 examinations. The arthroscopic examination was insufficient three times because of a protruding fat pad, and wrong in 2 patients in whom an arthroscopically diagnosed meniscal tear could not be found at arthrotomy. The morbidity of arthroscopy is small. Only complications: A local allergic reaction because of a wound spray in four cases, bronchial asthma following general anesthesia in two patients. No infection occurred. Several therapeutic procedures may be carried out through the arthroscope. So loose bodies were removed from the joint in 39 and partial meniscectomy performed in 13 patients, all of them being treated as out-patients.

Cartilage, Articular↗
PubMed1994

Wrist problems in the tennis player.

Although wrist injuries in tennis may occur from acute direct trauma, most injuries occur due to chronic overuse. Wrist biomechanics in tennis indicate that a wide range of wrist motion may not be necessary for effective play. The nature of the injury should be established as early as possible with the goals of restoring the wrist to a pain-free stable unit with normal range of motion. A secondary goal is to return the athlete to play as quickly as possible. Key points of the athlete's history are acute or chronic onset, progressive symptoms, and severity of symptoms, i.e., limitation of play. Key points of the physical examination include localization of maximal tenderness, edema, loss of range of motion, and bilateral grip strength. Plain roentgenograms should always be obtained. Specific imaging studies may be indicated and include bone scan, computed tomography, and arthrography. Specific and common wrist tennis injuries are discussed and treatment recommendations are given. Wrist problems in tennis are no uncommon and are responsible for a significant amount of lost playing time. Familiarity with the more common problems will enhance the physician's ability to evaluate and treat these athletes.

Acute Disease↗
PubMed1994

[Evaluation of MRI of knee by arthroscopy].

Between August 1989 and April 1993, 61 patients (68 knees) suspected of having intraarticular knee pathology underwent magnetic resonance imaging (MRI) before arthroscopy. In order to evaluate the diagnostic value of the MRI of knee joints, a retrospective study was undertaken. The analysis of the correlation between the arthroscopic findings and the results of MRI indicated the high sensitivity and specificity of MRI in diagnosing disorders of the knee joint. Also the characteristics of MRI of knee and the affecting factors have been discussed in this paper.

Adult↗
PubMed1997

Ultrasound of the elbow.

Ultrasound examination of the elbow should be performed in a comparative way, exploring joint spaces and fossas. Ultrasound is the method of choice for the detection of joint fluid and loose bodies. Tendinitis and microfissures can be demonstrated in case of tennis and golfer elbow. On the posterior aspect of the elbow, ultrasound shows the different types of bursitis, and allows evaluation of the ulnar nerve in cases of impingement.

Bursitis↗
PubMed1976

Pathology of the limbus in untreated teratologic congenital dislocation of the hip. A case report of a ten-month-old- infant.

A dislocated hip in a 10-month-old infant with multiple congenital anomalies was examined postmortem. The true acetabulum was filled with areolar tissue and the acetabular articular cartilage was covered by fibrous pannus. The secondary acetabulum consisted of fibrous capsular tissue lined by synovial cells. A lip of new fibrous tissue, the limbus, grew over the cartilaginous labrum of the true acetabulum in juxtaposition to the dislocated femoral head.

Abnormalities, Multiple↗
PubMed2004

3-D anatomically based dynamic modeling of the human knee to include tibio-femoral and patello-femoral joints.

An anatomical dynamic model consisting of three body segments, femur, tibia and patella, has been developed in order to determine the three-dimensional dynamic response of the human knee. Deformable contact was allowed at all articular surfaces, which were mathematically represented using Coons' bicubic surface patches. Nonlinear elastic springs were used to model all ligamentous structures. Two joint coordinate systems were employed to describe the six-degrees-of-freedom tibio-femoral (TF) and patello-femoral (PF) joint motions using twelve kinematic parameters. Two versions of the model were developed to account for wrapping and nonwrapping of the quadriceps tendon around the femur. Model equations consist of twelve nonlinear second-order ordinary differential equations coupled with nonlinear algebraic constraint equations resulting in a Differential-Algebraic Equations (DAE) system that was solved using the Differential/Algebraic System Solver (DASSL) developed at Lawrence Livermore National Laboratory. Model calculations were performed to simulate the knee extension exercise by applying non-linear forcing functions to the quadriceps tendon. Under the conditions tested, both "screw home mechanism" and patellar flexion lagging were predicted. Throughout the entire range of motion, the medial component of the TF contact force was found to be larger than the lateral one while the lateral component of the PF contact force was found to be larger than the medial one. The anterior and posterior fibers of both anterior and posterior cruciate ligaments, ACL and PCL, respectively, had opposite force patterns: the posterior fibers were most taut at full extension while the anterior fibers were most taut near 90 degrees of flexion. The ACL was found to carry a larger total force than the PCL at full extension, while the PCL carried a larger total force than the ACL in the range of 75 degrees to 90 degrees of flexion.

Computer Simulation↗
PubMedDate not supplied

Results of anterior cruciate ligament reconstruction based on meniscus and articular cartilage status at the time of surgery. Five- to fifteen-year evaluations.

We sought to determine how the status of the meniscus and articular cartilage observed at the time of anterior cruciate ligament reconstruction affects results at 5 to 15 years after surgery. Objective follow-up was obtained on 482 patients at a mean of 7.6 years after surgery. Subjective follow-up was obtained on 928 patients at a mean of 8.6 years after surgery. Patients with both menisci present had significantly better KT-1,000 arthrometer scores than did patients with any part of the medial or both menisci removed. Stepwise regression analyses determined that a partial or total medial or lateral meniscectomy and damaged articular cartilage significantly lowered the final subjective total score. Patients with both menisci present and normal articular cartilage had a mean subjective total score of 94, and 97% had normal or near normal radiographic ratings on a weightbearing 45 degrees posteroanterior radiographs. The overall International Knee Documentation Committee rating was normal or nearly normal for 204 of 235 patients (87%) with both menisci present, 52 of 74 patients (70%) with partial or total lateral meniscectomies, 71 of 113 patients (63%) with partial or total medial meniscectomies, and 36 of 60 patients (60%) with both menisci removed. We concluded that the long-term subjective and objective results of a successful anterior cruciate ligament reconstruction are affected by the status of the menisci and articular surface.

Adolescent↗
PubMed1986

Minor articular fractures of the knee: an update.

Early management of minor articular fractures of the knee results in the best possible prognosis with the least period of disability. The authors stress the need for early arthroscopic examination when history, physical examination and x-ray suggest possibility of minor intra-articular fracture.

Arthroscopy↗
PubMed1992

MRI of the knee joint with a 3-D gradient echo sequence. Equivalent to diagnostic arthroscopy?

Three-dimensional (3-D) gradient echo sequences offer the advantage of volume imaging within a few minutes scanning time and creating thin contiguous slices. An optimized sequence (FISP 3D 40) was evaluated for its potential to detect lesions of the menisci, cruciate ligaments, and articular cartilage in 80 patients compared to arthroscopy as the standard. Magnetic resonance imaging showed a sensitivity of 97.9%, a specificity of 97.3%, and an accuracy of 97.5% for meniscal lesions, and a sensitivity of 100%, a specificity of 97.1%, and an accuracy of 97.5% for lesions of the cruciate ligaments. Based upon morphological criteria normal cartilage was identified in 91.5%, but fibrillation of different depths (grades 1-3) was poorly recognized. All full-thickness defects (grade 4) were recognized. Measurement of mean signal intensity (95% confidence intervals) was more useful to discriminate normal from abnormal cartilage (grades 1-3). This method promises the capability to detect early stages of oestoarthritis in future. The present results show MRI of the knee joint with a 3-D fast imaging technique to be a noninvasive alternative to diagnostic arthroscopy.

Adolescent↗
PubMed2000

Free nerve endings in the medial and posteromedial capsuloligamentous complexes: occurrence and distribution.

Free nerve endings (FNEs) of type IVa play a distinctive role in the articular nociceptive and sensorimotor system of the knee. This study qualitatively and quantitatively analyzed FNEs in the medial and posteromedial capsuloligamentous complexes. Biopsy specimens from ten precisely defined anatomical locations were taken from seven fresh cadaver knee joints. The specimens were fixed with 4% formaldehyde solution and stained with hematoxylin-eosin. The results were examined using immunohistochemistry. The occurrence of FNEs is described in combination with their specific pattern of distribution. A high number of FNEs were found in all investigated elements with a maximum relative density in the insertion of the semimembranosus muscle in the direct attachment on the tibial margin. The number was lowest in the superficial medial collateral ligament. The results were correlated with anatomical and biomechanical functions of the stabilizing effect of the medial capsuloligamentous complex. Our findings indicate that lesions and surgical procedures can alter normal sensory feedback and coordination by modifying the use of muscle fiber during specific movements.

Humans↗