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Biomedical subjects

A Finsterbush

Publications and source records attributed to A Finsterbush.

At least 19 recordsLinked to original sources
PubMed2001

Collapsing the tibial bone tunnel in hamstring autograft reconstruction of the anterior cruciate ligament.

The use of double staples is an accepted method for fixation of hamstring anterior cruciate ligament (ACL) grafts at the distal tibial site. In the last year, we have modified the 2-staple technique that we have been using for distal tibial fixation of our double loop hamstring ACL autografts. Previously, we had impacted the graft with 2 toothed staples onto the cortex distal to the opening of the tibial tunnel. The modification we report here involves driving the proximal staple into the tibial tunnel roof, thus collapsing the tunnel onto the tendon during fixation. The distal staple is introduced in the usual manner. Clinical follow-up including subjective and objective KT-1000 arthrometry has indicated no difference in the early results compared with the former staple technique. Radiologic follow-up showed tunnel obliteration and filling in the area of the proximal staple, suggesting early graft incorporation in callus. While early results are encouraging, long-term follow-up and pullout studies will be reported. It would appear that collapsing the bony tunnel by the proximal staple may be a simple method of providing fracture callus to increase the stiffness of the tibial graft fixation, with no major or minor complications. Animal experiments are being carried out to objectively define the mechanical advantage of the graft incorporation by callus.

Animals↗
PubMed1995

Histomorphometric analysis of innervation of the anterior cruciate ligament in osteoarthritis.

The aim of this study was to determine whether there are quantitative changes in the innervation of the anterior cruciate ligament in osteoarthritis. Eleven whole anterior cruciate ligaments were obtained at autopsy from cadavera of individuals with advanced osteoarthritis: five healthy ligaments were used as controls. The ligaments were transected and stained with hematoxylin and eosin, oil red O for fat, and a modification of Gairn's gold chloride method. The latter stain permits visualization of axons, mechanoreceptors, and free nerve endings that are not apparent on routine stains. The ratio of nerve tissue to periligamentous synovial tissue was determined histomorphometrically by the point-counting method. The nerve tissue was located almost exclusively in the periligamentous synovial tissue. There was a statistically significantly greater area of nerve tissue (as a percentage of the total area) around the anterior cruciate ligaments in the osteoarthritic group than around the ligaments in the control group (p < 0.02). The nerve tissue was distributed evenly throughout the periligamentous synovial tissue in the specimens in both groups. A neurological role has been proposed for the anterior cruciate ligament in osteoarthritis. This study provides morphological evidence for neural pathology of the anterior cruciate ligament in subjects with osteoarthritis.

Adipose Tissue↗
PubMed1991

[Pitfalls in the diagnosis of tuberculous arthritis].

Jewish immigrants from Russia, and Arabs added to the population register since 1967, have a relatively high incidence of bone and joint tuberculosis. These patients now account for most of this disease in Israel. Skeletal tuberculosis imitates various joint conditions, most commonly, rheumatoid arthritis, and therefore presents a diagnostic problem. Injections of corticosteroids and/or immunosuppressive therapy can reactivate quiescent tuberculous lesions. During a 12-year period 14 patients with tuberculous arthritis involving 16 joints were seen in this hospital. They included 9 males and 5 females, 14-70 years old, 4 of whom were known to have had previous skeletal tuberculosis: 3 had spinal and 1 had hip involvement. None of the other 10 had a clinical history of tuberculosis, nor X-ray evidence of active pulmonary disease. 7 patients were diagnosed postoperatively as having joint tuberculosis on histopathological and bacteriological examination; 3 had positive cultures from joint aspirations. Most commonly involved were the spine and knee--4 cases of each. The wrist and acromioclavicular joint were affected in 2 cases each, and the hip, sacroiliac joint, ankle and elbow joints in 1 case each. The youngest patient, 14 years old, had triple-joint involvement of the wrist and the acromioclavicular and sacroiliac joints; the others had single-joint disease. In 1 patient the disease was reactivated after 36 years by surgical conversion of a fused hip to a mobile artificial joint. 3, whose joints were injected with corticosteroids, developed active, destructive tuberculous arthritis. A patient with rheumatoid arthritis who underwent total knee replacement was found to have active tuberculous arthritis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Reflex sympathetic dystrophy of the patellofemoral joint.

Eighteen patients with a diagnosis of reflex sympathetic dystrophy (RSD) affecting the knee were reviewed. Minor isolated injuries and operations about the knee triggered the original episode. The symptoms, regardless of location and mechanism of injury, occurred in the patellofemoral joint. Roentgenographic features of patchy demineralization and abnormal uptake on a 99mTc scan were typically located in the patella and corresponding femoral articular surface. At the initial stage of the syndrome, pain, hypersensitivity to touch, and inhibition of the quadriceps muscle were the most prominent features. In the later stages of the syndrome, functional instability due to quadriceps weakness created dependence on a knee brace or crutch support. Six patients whose RSD was initially misdiagnosed underwent numerous unsuccessful surgical procedures. In three of these patients, the knee was ultimately fused. All patients had an initial isolated knee injury (usually after minor trauma), and prolonged periods of immobilization and a cast, and 12 of the 18 patients were involved with workers' compensation. Early diagnosis and prompt treatment with an epidural block, followed by intensive physiotherapy, are recommended. A personal doctor/patient relationship that offers guidance and encouragement is key to successful management of this syndrome.

Accidents, Occupational↗
PubMed1990

Myopathological findings in thalassemia major.

In thalassemia major (TM) one third of patients suffers from muscle wasting, weakness and cramps. Six patients with TM were studied. All had muscle wasting and proximal weakness; serum levels of vitamin E were low (0.6-7.0 micrograms/dl) while CPK, LDH and aldolase were normal. EMG revealed low-amplitude short-duration polyphasic potentials in 3 patients and normal activity in 3 others. Nerve conduction velocities were normal in 3 patients studied. On muscle biopsies, moderate variation in fiber size with fiber atrophy and preponderance of type 1 fibers were discovered. Our findings confirm the existence of nonspecific myopathic changes in TM. Chronic vitamin E deficiency should be considered in the pathogenesis of the myopathy in TM.

Adolescent↗
PubMed1988

Joint surgery in severe ankylosing spondylitis.

Twenty-three patients with ankylosing spondylitis with severe deformities of hips, knees, and ankles were treated by a variety of surgical procedures followed by a comprehensive rehabilitation program. The surgery included 35 total hip replacements, six knee arthroplasties, and seven femoral osteotomies. Elongation of the Achilles tendon (eight procedures) was done on 6 patients. Shortening of the femur was performed in patients with long-standing flexion contractures when straightening of the limb during the operation caused traction on the vessels and the nerves. When there was both hip and knee involvement, hip arthroplasty was performed first. Preoperative planning aimed at obtaining plantigrade position of the feet and lower limb-length equality. Availability of custom-made and miniaturized components was essential. Positioning of patients on the operating table necessitated special supports. Six patients were completely bedridden before surgery and 17 were severely disabled or deformed. All the patients but 2 improved markedly, became mobile, independent, and self-supporting. Revision arthroplasty was performed in 4 patients; 3 others deteriorated functionally, but refused further treatment. Heterotopic bone formation was observed after operation in 6 patients. Surgery for severe ankylosing spondyloarthritis requires highly specialized and well-equipped centers.

Activities of Daily Living↗
PubMed1987

Extent of fiber regeneration after peripheral nerve repair: silicone splint vs. suture, gap repair vs. graft.

The degree of regeneration in surgically repaired sciatic nerves in rats was measured using a simple new electrophysiologic method: comparison of the size of nerve responses evoked by stimulation distal and proximal to the anastomosis. Five different repair procedures were evaluated. After simple end-to-end suture anastomosis, about 40% of the severed parent fibers regenerated past the suture line. The result was substantially improved when the anastomosis was covered with a newly designed thinwall silicone sheath which incorporated a narrow longitudinal slit. The presence of suture material at the point of anastomosis had no effect. Finally, regeneration across a 5-mm gap ensheathed in silicone (67%) was better than regeneration through a 5-mm autograft (45%).

Action Potentials↗
PubMed1985

Lower limb pain in thalassemia.

A group of 67 homozygous beta thalassemic patients was investigated for disturbances related to their lower limbs. Thirty-six patients presented a variety of complaints. Four distinct types of pain were found. Ischemic crampy muscle pain in 12 patients. Postural pulsating pain after activity or prolonged standing was described by 18 patients. High intraosseous pressure was found in a significant number of these patients. Post transfusion hemosiderosis producing synovitis was diagnosed in 2 patients. Four additional patients presented acute self-limiting episodes of pain. This pain was probably due to microfractures. Some patients presented a combination of various pain patterns.

Adolescent↗
PubMed1983

Quantitative power measurement of extensor hallucis longus. A simple objective test in evaluation of low-back pain with neurological involvement.

Clinical evaluation of a patient with low-back problem is based mainly upon the subjective impressions of the physician. Accuracy in neurologic evaluation and follow-up of these patients depends upon objective and quantitative procedures. A handy instrument, simple to use by the clinician in his office, was developed in our laboratory and tested on healthy volunteers and patients with low-back problems. The instrument measures or records the power of the extensor hallucis longus. Weakness of this muscle represents the vast majority of root involvement in discogenic lesions. The measurement is compared with the result obtained on the contralateral side. The instrument includes a mobile mechanical spring gauge of 100-2000-gr range and a leg splint. A single channel polygraph can be connected to record the measurement. The technique was tested on healthy volunteers and good reproducibility and accuracy were found. Seventy-five patients were examined and the power of EHL measured. The patients were divided into three groups according to the nature of their back problems: 1) acute discogenic; 2) chronic low back problems with acute exacerbations; and 3) acute trauma. The quantitative measurements of EHL were of great help in evaluating and following treatment of patients with discogenic lesions and in deciding further surgical treatments. The test was valuable in evaluating malingeres and compensation cases. Eight of the patients with chronic, recurrent low-back problems were found to have weakness of EHL; further investigations showed root pressure mostly due to osteophytes pressing on the nerve roots. After acute trauma, the EHL power test also revealed weakness in patients with higher lumbar injuries, probably because of spreading.

Adult↗
PubMed1982

Healing and tensile strength of CO2 laser incisions and scalpel wounds in rabbits.

An experimental model was designed in order to compare the results of wound healing after skin incision by CO2 laser and scalpel. The skin of 36 rabbits was incised by a CO2 laser with a 15-W current output and by scalpel. The wounds were tested for tensile strength and histology after healing up to 4 weeks to determine if scalpel wounds differed from those made by the laser beam. Tensile strength tests showed that the wound incised by the laser beam was initially stronger up to 3 weeks; thereafter, the strength of both types of wounds was equal. Histologic preparations showed partial necrosis of the wound edges and a more extensive inflammation response in laser beam incisions which disappeared gradually from 2 weeks after incision. Because of initial stronger scar following laser beam incision as compared with scalpel incision, early mobilization of the operated limb is possible.

Animals↗