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At least 757 records · Page 42Linked to original sources

PubMed1992

Calcitonin gene-related peptide, substance P and GAP-43/B-50 immunoreactivity in the normal and arthrotic knee joint of the mouse.

The aim of this study was to describe the normal distribution of calcitonin gene-related peptide (CGRP) and substance P (SP) containing fibres in the knee joint of the mouse and to obtain insight into the changes in innervation associated with degenerative processes in the joint. Arthrosis was induced by a single subpatellar intra-articular injection of bacterial collagenase. After decalcification in EDTA solutions, the CGRP and SP fibres were visualized by peroxidase-antiperoxidase pre-embedding immunocytochemistry for light microscopy. Control experiments on the mouse brain as a reference for the effect of EDTA on the immunostaining showed that the decalcification procedure with EDTA had not impaired the immunostaining. A rich innervation of thin varicose CGRP and SP immunoreactive fibres was found in most peri- and intra-articular tissue components. The periosteum, synovial tissues, the joint capsule and the intra-articular fat tissues were richly innervated. Less intense innervations were also found in the subchondral bone plates of the tibio-femoral joint and of the patella. Fibres were also found in the soft tissues between the patellar tendon and the femoral groove. No differences could be found between the location of CGRP and SP fibres with respect to the localization in the joint, but generally more CGRP fibres were found. The collagenase-induced osteoarthrosis was characterized by sclerosis of the subchondral bone, patellar dislocation, osteophyte formation, synovial proliferation and by severe cartilage abrasion, particularly on the medial side of the femoro-tibial joint. The overall distribution of CGRP and SP fibres was the same as in the control joints. However, major differences were found in all studied joints at specific locations around the cruciate ligaments, in the synovium around the patella, in the soft tissues lateral of the patella and in plica tissue between the patella and femoral groove. The CGRP and SP innervation was no longer detectable by immunolabelling with the antibodies. With a polyclonal antibody to the growth associated protein GAP-43/B-50, signs of degenerated axonal profiles were observed in these locations. At other peripheral locations, such as the muscles, the GAP-43/B-50 distribution was normal. In conclusion, the present study provides detailed information on the localization of CGRP and SP fibres, which may be involved in pain perception. Knowledge of the changes that occur during arthrosis may give more insight into the clinical symptoms.

Animals↗

PubMed2003

Intra-articular ganglion cysts of the cruciate ligaments: case report and review of the literature.

BACKGROUND: A ganglion can arise as a cystic lesion from a tendon sheath or a joint capsule and contain a glassy, clear, and jelly-like fluid. They can occur within muscles, menisci, and tendons. Intra-articular ganglion cysts of the knee joint are rare. We report on three ganglion cysts of the cruciate ligaments: Two were intercruciate, and one was located around the posterior cruciate ligament. METHODS: The clinical diagnosis was established using magnetic resonance imaging. All patients were treated successfully using arthroscopic debridement by basket punch and shaver. Subsequent histological examination confirmed the diagnosis. RESULTS: All three patients were asymptomatic at the postoperative follow-up of 16-36 months. CONCLUSION: A review of the literature reveals a controversial discussion about the clinical significance as well as the etiology of ganglion cysts arising from the cruciate ligaments. These case reports show that an intra-articular ganglion cyst of the cruciate ligaments is difficult to diagnose. A cyst does not necessarily have to be associated with specific clinical symptoms or a previous trauma. Preoperatively, MRI is essential when diagnosing ganglion cysts of the knee joint. An intra-articular ganglion cyst of the knee joint can be successfully treated by arthroscopy.

Adult↗

PubMed2005

Manual treatment effects to the upper cervical apophysial joints before, during, and after endotracheal anesthesia: a placebo-controlled comparison.

OBJECTIVES: In this preliminary, placebo-controlled clinical trial, two different manual treatments were compared, spinal manipulation and postisometric relaxation, for dysfunctional motion segments of the upper cervical spinal column. The influence of the muscular portion on the joint-play restriction of a motion segment can be ignored in anesthesia, and the manual evaluation of this joint-play restriction must be focused on nonmuscular structures. By retesting in anesthesia, it is possible to examine whether mobilization and manipulation affect exclusively the muscular structures or also affect the other parts of the motion segment. Conclusions can be drawn about the superiority of one or both treatments and about the structural basis of the restricted joint play and its palpation. DESIGN: A total of 26 inpatients at the surgical or orthopedic department of the University of Rostock were examined manually at four testing times: before and after manual treatment, in anesthesia, and within 24 hrs of completing anesthesia. They were randomized into three groups: postisometric relaxation (mobilization), spinal manipulation (thrust technique), and placebo. RESULTS: A highly significant effect for both treatments was found posttherapeutically (P < 0.01) but not for placebo. In anesthesia, the treatment effect of spinal manipulation was further significant (P < 0.01) when compared with placebo. For postisometric relaxation, however, it was not (P = 0.160). A significant difference between spinal manipulation and postisometric relaxation was not found in anesthesia (P = 0.137). The treatment effect postnarcotically was further significant when compared with placebo only for spinal manipulation (P = 0.011). CONCLUSIONS: Both treatments are superior to placebo. Postisometric relaxation seems to affect mainly the muscular parts of the treated segments and less so the other parts, such as the joint capsule or the segmental affiliated ligaments and fascia. Spinal manipulation seems to influence all other segmental parts more effectively, and the treatment effect persists longer. A joint-play restriction cannot be an exclusively muscular tension phenomenon. Segmental motion dysfunctions show a high variability in their spontaneous course.

Adult↗

PubMed1985

Arthroscopic anatomy of the intercarpal and radiocarpal joints of the horse.

Arthroscopic anatomy of the equine intercarpal and radiocarpal joints was documented in six cadaver limbs and on observations made during surgical treatment of horses with carpal osteochondral fractures. Instrument positions and arthroscopic visualisation were recorded. The cadaver limbs were dissected and iatrogenic lesions recorded. A single arthroscopic portal examination was adequate in both joints; however, a second arthroscopic portal improved visualisation. The intercarpal joint was more easily examined than the radiocarpal joint because of anatomical differences. Iatrogenic lesions were associated with failure of joint capsule distention during penetration.

Animals↗

PubMed1976

A radiological sign of entrapment of the median nerve in the elbow joint after posterior dislocation. A report of two cases.

Two boys with entrapment of the median nerve in the elbow joint after closed reduction of a posterior dislocation with fracture of the medial epicondyle showed a characteristic radiological sign in the anteroposterior radiograph after two to three months. The sign was a depression in the cortex on the ulnar side of the distal humeral metaphysis, with interruption of the local periosteal reaction. At operation in both patients the depression was found to correspond with the place where the median nerve reached the posterior surface of the humerus. Radiographs taken after transverse section of the nerve above and below the joint capsule and end-to-end suture showed gradual disappearance of the cortical depression.

Child↗

PubMed1996

Mechanisms of joint destruction, pain and disability in osteoarthritis.

Osteoarthritis is characterised by progressive erosion of articular cartilage, and bony overgrowth at the joint margins. Cartilage integrity requires a balance between synthesis and degradation of matrix components, and the latter is augmented in osteoarthritis through the action of chondrocyte-derived metalloproteinases. Synthesis rates also increase but fail to keep pace with the losses. Synovial inflammation, a mild and inconstant feature of osteoarthritis, is more likely to be a consequence of cartilage breakdown than a cause, and its contribution to pain is uncertain. The origins of pain and disability are complex; pathological changes in the joint capsule and periarticular ligaments are a likely source, but nocturnal pain may be related to raised pressure in subchondral bone. In addition to structural damage in the joint, psychosocial factors, muscle weakness, and comorbidities may contribute.

Humans↗

PubMed1995

Salvage of extensor tendon function with tenolysis and joint release.

Extensor tendon adhesions following laceration, fracture, or crush injuries will prevent normal joint function. Tenolysis often will not address the resulting stiffness. A systematic release of the extensors, joint capsule, collateral ligaments, and occasionally the flexor tendons is needed to restore function.

Anesthesia↗

PubMed1996

Luxation of the radial carpal bone in a cat.

A case of radial carpal bone luxation in the cat and its management is described. Open reduction was performed and surgically maintained, in combination with repair of rupture of the short radial collateral ligament and joint capsule. The carpus was supported for one month following surgery by application of transarticular external fixation. Four months after treatment the cat was sound, despite evidence of degenerative joint disease. The mechanism of luxation appears to be analogous to that seen in the dog.

Animals↗

PubMed1991

[Ultrasonography in serous coxitis].

Ultrasonography is a rapid, reliable and painless technique for diagnosis of transient synovitis and other conditions with effusion of the hip joint. We therefore recommend ultrasonography as the primary imaging method in all patients with acute and subacute pain in the hip and thigh. The diagnostic criterion for intracapsular effusion is a side difference greater than or equal to 2.0 mm in the distance between the anterior joint capsule and the femoral neck. Ultrasonography is also useful in following the resorption of the effusion during the active stage of transient synovitis and in assessing the hip joint for possible development of coxa magna and Legg-Calvé-Perthes disease at later follow-up. Radiography and scintimetry may be omitted in uncomplicated cases but should be employed when Legg-Calvé-Perthes disease is suspected.

Diagnosis, Differential↗

PubMed1981

[Development of the human hip joint and its innervation].

Thickening of mesenchyma at the place of the future coxofemoral joint (embryos 10.5--14 mm of parietal-coccygeal length) is defined in the area limited by the lumbar and sacral spinal nerves behind, by the femoral nerve in front and above and by the ischiatic nerve underneath and behind. The femoral head surrounded with anlages of the iliac, pubic and ischiatic bones is defined in 16 mm long embryos. The vascular canal ends blindly or penetrates through the wall of the cotyloid cavity at the place where lately fusion of the iliac and the pubic bones takes place. A special attention is paid, at the embryonic level, to variants of the iliolumbar muscle fixation and to participation of its tendons, in some cases, information of the femoral joint circular zone. The joint capsule, presented as a condensed mesenchyma is defined in prefetuses 18 mm of parietal-coccygeal length. To its inferior fragment, branches of the obturative and the accessory obturative nerves, to its superior fragment--branches of the superior gluteal nerve, to its posterior fragment--branches of the ischiatic nerve, and to its anterior fragment--branches of the femoral nerve grow out. Taking into account the time when these nerves grow into the innervated substrate, they should be considered as the most important for innervating the capsule, it being realized mainly by mixed, or more exactly by the musculo-articular branches. As the branches of the nerves mentioned above penetrate into the capsule thickness, the latter is differentiating into certain layers. Owing to the results obtained, it is possible to conclude that the anlage and further formation of the femoral joint elements is taking place simultaneously with the development and complication of its innervational connections.

Femur↗

PubMed1993

Dialysis arthropathy of the hip.

Beta 2-microglobulin amyloid deposition is associated with a destructive arthropathy in the hip of chronic hemodialysis patients. Twenty-five hips from 18 patients were assessed for the presence and immunohistochemical type of amyloid. The hemodialysis group was compared with an age- and disease-matched control group that had no evidence of renal failure. Beta 2-microglobulin amyloid deposits were present in all patients who had been on hemodialysis for 18 months or more. Beta 2-microglobulin amyloid deposits were not found in patients who had been on hemodialysis for less than 18 months. Amyloid deposits were seen first in the articular cartilage and later involved the synovial membrane, joint capsule, and subchondral bone as well. The presence and amount of amyloid deposition correlated to the duration of hemodialysis. Severely affected hip roentgenographically had a concentric loss of joint space, periarticular erosions, and cystic lesions in the femoral head and acetabulum. These pathologic and roentgenographic changes suggest that amyloid deposition leads directly to the erosive hip arthropathy occurring in hemodialysis patients.

Adult↗

PubMed1993

[Passive stabilizers of the glenohumeral joint. A biomechanical study].

Passive glenohumeral joint stability was tested in ten cadaveric shoulder specimens, before and after venting of the intra-articular space. Force-displacement diagrams were measured with anterior, posterior and inferior excursion, in the neutral position, in 90 degrees of abduction and in a combination of 90 degrees of abduction and 90 degrees of external rotation. Displacement at 50 N prior to venting averaged 11.17 +/- 6.48 mm posteriorly, 7.15 +/- 5.51 mm anteriorly and 3.41 +/- 3.73 mm inferiorly. Venting of the joint increased displacement by 47% anteriorly, 49% posteriorly and 61% inferiorly. In addition, mathematical model calculation was used to estimate the destabilizing force present at the glenohumeral joint capsule during physiological arm motion. This force approximated 970 N, clearly more than passive stabilizers alone can provide. It is therefore assumed that in addition to passive glenohumeral joint stabilization, significant active forces are effective during arm motion.

Adult↗

PubMed2001

Extra-articular origin of biceps brachii.

We report a clinically relevant anatomic variation of the tendon of the long head of biceps brachii muscle. The clinical and historically relevant data regarding an anatomic finding observed in 1 patient are reviewed. The clinical outcome of the patient's care was successful. Recognition of the described anatomic variant of the biceps tendon can aid the surgeon in focusing the treatment on the actual pathology and not on aberrant anatomy. Several anatomic variations in the origin of the long head of the biceps brachii have been observed. Some of these anomalies have been implicated as having a role in rotator cuff tendinopathy or in exposure for shoulder surgery. We are reporting the observation that the long head of the biceps tendon may have a mesotendon or be incorporated in the extra-articular side of the glenohumeral joint capsule, making arthroscopic visualization and assessment of the tendon difficult.

Adolescent↗

PubMed1978

[Epithelioid sarcoma].

The analysis of data from literature and of the author's own 3 observations suggests that epithelioid sarcoma of Enzinger should be separated from soft tissue tumors of obscure genesis. It has a peculiar morphological structure, affects predominantly distal parts of the extremities in the area of tendons and joint capsules, and has some features of the clinical course and prognosis.

Adult↗

PubMed2004

Pathology and clinico-pathologic correlations in spondyloarthropathies.

The term "spondyloarthritis" encompasses a variety of conditions that manifest as inflammation of the synovial membranes and entheses. The synovial inflammation lacks specificity and shares many features with rheumatoid synovitis. The hallmark of spondyloarthritis is inflammation of the entheses, which manifests as a combination of hyperostosis, osteitis, and periostitis. The entheses include not only the sites where tendons, ligaments, and joint capsules attach to bone, but also other fibrous structures such as the amphiarthroses (pubic symphysis, manubriosternal symphysis, and discovertebral junctions) and the diarthro-amphiarthroses (sacroiliac area, chest wall joints, and tips of the fingers and toes). This vast entheseal territory is the target selectively involved in patients with spondyloarthropathy.

Humans↗

PubMed2005

A novel total knee arthroplasty infection model in rabbits.

Infection of biomaterial implants is an expensive and devastating complication of orthopaedic surgery historically ranging from less than 1% in primary total knee arthroplasty (TKA) to 10% in revision TKA. An in vivo animal model was developed to test the efficacy of innovative therapies for the prevention of biomaterial centered infections caused by methicillin-resistant Staphylococcus aureus bacteria (MRSA). Twenty-two New Zealand White rabbits were used in this study. After proper anesthesia, a stainless-steel screw with a high molecular weight polyethylene (UHMWPE) washer was cemented in a defect created in the intra-articular, non-articulating portion of the lateral femoral condyle of each knee. After closure of the joint capsule, each knee was inoculated with 0, 10(2), 10(3), or 10(4) colony forming units (CFU) of MRSA. Animals were sacrificed after 7 days at which time joint aspirate, tissues and biomaterial samples were examined for evidence of infection. A total of 42 knees were used for analysis. When saline was injected into the knee, 0/10 of the knees demonstrated evidence of biomaterial centered infection (with the contralateral knee receiving 10(4)CFU MRSA). Four of 10 knees developed a biomaterial centered infection when 10(2)CFU MRSA was introduced. Seven out of 10 knees developed a biomaterial centered infection when either 10(3) or 10(4)CFU MRSA was injected. No evidence of septicemia (positive blood cultures) was found in any animal. This rabbit knee model utilizes commonly employed inexpensive orthopaedic implant materials in an in vivo milieu and provides an effective method for the evaluation of treatments for biomaterial centered infections.

Animals↗

PubMed2001

Estimation of genetic population variables for six radiographic criteria of hip dysplasia in a colony of Labrador Retrievers.

OBJECTIVE: To estimate genetic population variables for 6 radiographic criteria of canine hip dysplasia (CHD). ANIMALS: 664 full- and half-siblings from a colony of Labrador Retrievers. PROCEDURE: Heritability estimates and genetic correlations were calculated for 6 radiographic criteria of CHD. Two evaluation protocols were compared: the grade of the most severely affected hip joint and the sum of the scores for both hip joints. The predictive performance of estimated breeding values was also evaluated. RESULTS: The overall prevalence of CHD (Federation Cynologique Internationale grades C, D, and E) was 29.6%. Median age at radiographic examination was 377 days. Heritability for the total CHD grade, Norberg angle (NA), coverage of the femoral head (COV), craniodorsal acetabular rim (ACR), subchondral bone sclerosis (SUBCH), shape of the femoral head and neck (FHN), and osteoarthritic changes at the insertion site of the joint capsule (JC) was estimated as follows: 0.44, 0.43, 0.46, 0.37, 0.32, 0.21, and 0.05, respectively. Heritability estimates were slightly higher for the sum of the scores for both hip joints. If NA and COV were included as fixed effects in the model for the dependent variables ACR, SUBCH, FHN, and JC , then heritability of these traits significantly decreased (0.08 to 0.15). High scores of NA and COV lead to a significant increase of the scores of the remaining criteria. CONCLUSIONS AND CLINICAL RELEVANCE: Canine hip dysplasia is heritable to a moderate degree. Signs of subluxation revealed the highest heritability estimates. The criteria ACR, SUBCH, FHN, and JC were strongly influenced by NA and COV.

Animals↗

PubMed1986

Hip joint pressure after femoral neck fracture.

The hip joint pressure in 40 patients with intracapsular femoral neck fractures was measured on the fracture table prior to surgery. All but 1 patient had pressures well below 20 mmHg with the hip unreduced. When the hip was extended and internally rotated, the pressure rose to values exceeding the normal arteriolar pressure in most patients, with a peak pressure of 135 mmHg. In nine of 22 Garden IV fractures, the pressure remained low despite extension and inward rotation. Injection of contrast medium in three of these hips indicated a rupture of the joint capsule. The pressure response to extension and internal rotation was less marked in fractures older than 72 hours. The findings do not support the hypothesis that a hip-joint tamponade is a common etiologic factor for the development of femoral head necrosis following fracture. However, prolonged reduction maneuvers with the hip joint in extension and internal rotation can create intracapsular pressures high enough to temporarily jeopardize the circulation of the femoral head.

Aged↗