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At least 19 recordsLinked to original sources

Bone-to-bone, joint-to-bone and joint-to-joint ratios in normal and diseased skeletal states using region-of-interest technique and bone-seeking radiopharmaceuticals.

Bone-to-bone, iliosacral joint-to-os sacrum and joint-to-joint ratios were computed using the region-of-interest technique 2 to 3 hrs. after injection of 99mTc Sn-methylene-diphosphonate or 99mTc Sn-pyrophosphate in 139 patients with skeletal diseases (bone tumours, degenerative changes of the spine and joints, inflammatory changes of joints) as well as in 123 patients with normal skeletal states. In the latter group, iliosacral joint-to-os sacrum ratios decreased with increasing age of the patients. In patients with osseous metastases of the spine ratios of 0.80 to 4.0 occurred ( reference area second vertebra below or above the affected vertebra). In degenerative changes of the spine values of 0.80 to 1.69 were computed. These results show, that 74% of the spine metastases could not be differentiated from benign changes of the spine by determining their relative amounts of bone uptake. In bone tumours of the extremities and in rheumatoid or gouty arthritis of the small joints (hands and feet) the highest ratios, i.e. contrasts, occurred referring to a contralateral reference area. Osteoarthritic and inflammatory alterations of the big joints could not be differentiated because of percentual distribution of the increased joint-to-joint ratios turned out to be nearly identical.

Adult

Relationship between radiographic signs in the temporomandibular joint and hand joints.

The temporomandibular joints of 64 patients and the hand joints of 62 patients with mandibular pain and/or dysfunction were exposed in oblique lateral transcranial, transmaxillary, and dorso-volar projections. The relationship between radiographic signs generally ascribed to osteoarthrosis was investigated. Indices were constructed to quantify the radiographic findings in the two joints. In the temporomandibular joint statistically significant age-independent correlations were found between flattening of the lateral part of the condyle, subcortical sclerosis of the condyle and reduced joint space. In the hand joints statistically significant age-independent correlations were found between osteophytes, subcortical sclerosis, eroded/absent cortical outlining, reduced/obliterated joint space and dislocations. No statistically significant correlation could be found between radiographic findings in the temporomandibular and hand joints. It is concluded that the radiographic signs in the temporomandibular joint of reduced joint space, subcortical sclerosis of the condyle and flattening of the lateral part of the condyle are interrelated and probably characteristic of osteoarthrosis, and that these relationships are similar to those that occur in the hand joints.

Adolescent

Temporomandibular joint meniscectomy--effects on joint structure and masticatory function in macaca fascicularis.

The postoperative effects of unilateral temporomandibular joint meniscectomy on joint structure and masticatory function were evaluated in four mature Macaca fascicularis and compared with one control. Mandibular movement during mastication was monitored objectively with an optoelectronic tracking system within four months and again within twelve months postmeniscectomy in each animal. Temporomandibular joint structure was documented radiographically and histologically. Results showed that degenerative joint disease was produced in the postsurgical joint, and that the morphological changes were location-dependent. Fibrous ankylosis was observed histologically in three animals. The contralateral joints were not affected morphologically, except for bony resorption of the articular eminence noted microscopically in one animal. Radiographically, however, the joint appeared normal. Variable alterations in masticatory patterns were observed following unilateral meniscectomy. While there appeared to be an association between temporomandibular joint structure and masticatory function, radiographic and microscopic observation of morphological alterations in the joint did not result in predictable functional limitations in chewing pattern.

Animals

Primary ACL Repair and Reconstruction in Isolated ACL Ruptures: Forgotten Joint Scores and the Association Between Residual Laxity and Joint Awareness.

BACKGROUND: Primary anterior cruciate ligament (ACL) repair has recently reemerged as a treatment option for carefully selected proximal ACL tears. However, evidence regarding patient-reported joint awareness and the relationship between postoperative laxity and joint awareness remains limited. PURPOSE: To compare joint awareness, clinical outcomes, and postoperative laxity between primary ACL repair and hamstring tendon autograft reconstruction in carefully selected patients with isolated ACL rupture, and to explore the association between residual laxity and postoperative joint awareness. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: This retrospective cohort study included 85 patients with isolated ACL rupture treated with either primary ACL repair (n = 26) or hamstring autograft reconstruction (n = 59), with a minimum follow-up of 24 months. Clinical outcomes, including visual analog scale score, Lysholm score, International Knee Documentation Committee (IKDC) score, Tegner activity scale score, postoperative knee laxity, return to sport, and rerupture rates, were evaluated. The authors also used the Forgotten Joint Score-12 (FJS-12), a measure of joint awareness, to evaluate patients. A higher score reflects lower joint awareness, suggesting function more similar to a native knee. Multivariable regression analyses were performed to evaluate variables associated with postoperative FJS-12 values. RESULTS: No differences were observed between groups in postoperative Lysholm, IKDC, and Tegner activity scale scores; Lachman- and pivot-shift-assessed postoperative laxity; and return-to-sport rates. However, postoperative FJS-12 values were significantly higher in the repair group compared with the reconstruction group (87.0 &#xb1; 15.0 vs 77.5 &#xb1; 14.2; mean difference, 9.5 points [95% CI, 2.8-16.3]; P = .006), corresponding to a moderate effect size (Cohen d = 0.66). Secondary exploratory regression analyses demonstrated that residual postoperative laxity was associated with lower postoperative FJS-12 values in both Lachman- and pivot-shift-based models (R2 = 0.649 and 0.680, respectively; P < .001 for both). CONCLUSION: In carefully selected patients with proximal ACL tears and adequate tissue quality, no significant between-group differences were detected in conventional clinical outcomes, postoperative laxity, return-to-sport rates, or rerupture rates between primary ACL repair and reconstruction. Primary ACL repair was associated with higher postoperative FJS-12 values at short- to midterm follow-up, suggesting function more similar to that of a native knee. Residual postoperative laxity was associated with lower FJS-12 values in secondary exploratory analyses.

Humans

[The pathology of temporomandibular joint luxations--anatomical studies on temporomandibular joint preparations].

After a description of the published hypothesis of luxation and subluxation in the temporomandibular joint the preparations of five temporomandibular joints is described. The results refer to the movement of the discus and the capitulum mandibulae and to the effects of the musculus temporalis and of the facies articularis ossis temporalis. In addition a hypothesis is established according to which the temporomandibular-joint-luxation may be considered to occur in the menisco-condylar part of the joint.

Humans

Synovectomy and total joint arthroplasty for recurrent hemarthroses in the arthropathic joint in hemophilia.

Severe hemophiliacs with intractable bleeding into one or more joints despite adequate clotting factor replacement therapy are difficult management problems. Synovectomy has controlled bleeding only in joints without significant arthritis destruction. Total joint replacements have been performed in arthropathic joints, but not when uncontrolled bleeding was a concurrent problem. This report describes a hemophiliac with uncontrolled bleeding into an arthritic knee who was successfully managed by combining synvectomy with total knee replacement.

Adult

[Model investigations on the static abnormal strain on the homolateral knee joint following arthrodesis or ankylosis of the hip joint in the frontal plane (author's transl)].

The static abnormal load on the homolateral knee joint after stiffening of the hip in the frontal plane (abnormal load associated with abduction or adduction) is examined via a simplified pelvis and leg model. Besides the direct impairment of the homolateral knee joint, it has also been possible to demonstrate the indirect impairment of the ankle joint and of the foot.

Ankle Joint

[Systematy of artificial knee joints considering constructional characteristics of the natural knee joint (author's transl)].

The subject of this investigation is to spezify artifical knee joints. For this purpose the most important constructional peculiarities and functions of the natural knee joints are to be opposed to them of the artificial ones. This analysis is based on the kinematic and theory of construction. The systematy distinguishs the various artificial knee joints considering the characteristics that are thought to be substantial.

Biomechanical Phenomena

[Electromyographic examination of the femoral muscles in hemophilic effusion in the knee-joint and in irritated conditions of the knee-joint (author's transl)].

In ten patients with acute effusion in the knee-joint due to hemophilia, or with chronic knee-joint affection, the maximal isometric contraction of the M. vastus medialis and lateralis and of the M. rectus femoris was measured by electromyography. Measurements were taken before and after puncture of the effusion, or before and after intraarticular injection of a local anesthetic. In all examined patients, the contraction tests were performed below the pain threshold. The proportionate share of energy of the quadriceps muscle was considerably enhanced by reducing the intraarticular pressure and injecting a local anesthetic. This increase differs, depending on the state of the knee-joint affection.

Acute Disease

Response of primate joint afferent neurons to mechanical stimulation of knee joint.

1. One hundred thirty-eight knee joint afferents from posterior articular nerve (PAN), in primates, were recorded in dorsal root filaments. Responses of afferents were studied in relation to both passive manipulations of the knee and active contractions of quadriceps, semimembranosus, and gastrocnemius muscles. 2. When the knee was passively rotated, most neurons discharged only when extreme angular displacements were achieved. Response of neurons responding to passive extensions was linearly related to the torque applied to the knee. With maintained extensions, discharge in extension neurons adapted slowly. Some of the time constants of adaptation were similar to those for simultaneously recorded torque relaxation. 3. Contractions of quadriceps, semimembranosus, or gastrocnemius muscles could activate many neurons in the absence of changes in joint angle. For quadriceps-activated neurons, rather high torques (mean = 2,450 g with cm) were required. 4. The results support the hypothesis that joint afferents function as capsullar stretch receptors, responding to those mechanical events which result in loading of the capsule.

Adaptation, Physiological

Gastrocnemio-semimembranosus bursa and its relation to the knee joint. III. Pressure measurements in joint and bursa.

Pressure measurements in the knee joint and gastrocnemio-semimembranosus bursa were performed on patients and autopsy cases. A normally occurring closure mechanism between the joint and the bursa was demonstrated and analysed. Two patients were also found to have a partial valvular mechanism in the form of a hindrance to spontaneous passage of fluid from the bursa to the joint but no hindrance in the other direction.

Autopsy

Functional anatomy of the elbow joint and three-dimensional quantitative motion analysis of the elbow joint.

This work consists of two parts. Part One is a three-dimensional study of the passive motion of the elbow joint and revealed that the elbow joint was not a true hinge joint. Part Two is a three-dimensional quantitative motion analysis which was undertaken to compare shoulder and trunk motion in normal subjects with those with contracted elbows. This analysis revealed that shoulder rotation, shoulder abduction, trunk flexion and trunk rotation compensates for a contracted elbow.

Elbow Joint

Deformation of the articular cartilage and joint space of the human knee joint under static load.

In order to define the deformation of articular cartilage and the joint space under statically loaded knee joints, we studied serial sections in the frontal plane of knee joints which were frozen under the application of a load. Normal articular cartilage surfaces did not make contact even under loads of 100kg or more, leaving always a space between. The compressive deformation of articular cartilage mainly occurred at the central area near to the intercondylar notch or prominence, but the deformation of cartilage in the area covered by menisci was negligible.

Adult

[Periarticular ossification following replacement of the hip-joint. Clinical and radiologic examination of 697 hip-joints (author's transl)].

Systematic examination of 733 cases of replacement of the hip-joint, operated on with an identical technique and method of post-operative treatment. Frequency and severity of periarticular ossification, their relationship to pre-operative arthrosis and their effect on joint function are described. Development and localization of periarticular ossification, their higher incidence after tearing off of the trochanter, removal of osteophytes and occurrence of hematomata hint at surgical trauma as one of the causes. Preliminary operations on the proximal end of femur did not influence ectopic ossification. Ossification of grade I did not interfere with function, grades II and III limited movement in varying degrees.

Follow-Up Studies