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Biomedical subjects

Andreas H Gomoll

Publications and source records attributed to Andreas H Gomoll.

6 recordsLinked to original sources
PubMed2006

Biocompatibility of a polymer patch for rotator cuff repair.

Both mechanical and biological factors influence the high re-tear rate after rotator cuff repair. Mechanical factors have largely been addressed by the introduction of better implants and modification of suture configuration, but further improvements are needed to address the often poor tissue quality of the degenerated rotator cuff tendons. Current biological solutions provide only short-term reinforcement and have been associated with pseudo-infectious reactions. This pre-clinical animal study investigates the biological response to a novel polycarbonate polyurethane patch used for tissue augmentation in a rat rotator cuff repair model. Bilateral defects were created in the supraspinatus tendons of 12 Sprague Dawley rats. One side was repaired with a patch as a tissue augmentation device. The contralateral side acted as internal control without patch augmentation. After 6 weeks the tissues were harvested and underwent histologic and histomorphometric analyses. Histological evaluation demonstrated no inflammatory reaction; histomorphometry revealed tissue ingrowth of 79.9%. In conclusion, the polycarbonate polyurethane patch for tissue extension or augmentation in rotator cuff repair has demonstrated no inflammatory response and excellent tissue integration in a rat rotator cuff repair model.

Animals↗
PubMed2006

Chondrolysis after continuous intra-articular bupivacaine infusion: an experimental model investigating chondrotoxicity in the rabbit shoulder.

PURPOSE: Postoperative pain pumps are increasingly used to deliver a continuous infusion of local anesthetic into the surgical wound or the joint. Recently, there have been concerns that the use of such devices may be associated with chondrotoxicity and even cases of chondrolysis in the shoulder. An experimental model is presented that investigates potential chondrotoxic effects of a continuous intra-articular infusion of bupivacaine in the rabbit shoulder. METHODS: We divided 30 rabbits into 3 groups that received continuous infusions of either saline solution, bupivacaine, or bupivacaine with epinephrine into the glenohumeral joint over a period of 48 hours. Animals were killed after 1 week, and osteochondral and synovial samples from the glenohumeral joint underwent analyses with confocal microscopy for live/dead cell assay, metabolic sulfate uptake assessment, and conventional histologic analysis. RESULTS: Infusion of bupivacaine with epinephrine and without epinephrine decreased sulfate uptake by 56% (P = .009) and 50% (P = .02), respectively, when compared with saline solution; cell viability decreased by 20% (P = .08) and 32% (P = .02), respectively. Histologic analysis yielded significantly worse scores for bupivacaine infusion with epinephrine (P = .004) and without epinephrine (P = .02). The results for bupivacaine with or without epinephrine were not significantly different. CONCLUSIONS: Continuous intra-articular infusion of bupivacaine with and without epinephrine led to significant histopathologic and metabolic changes in articular cartilage. CLINICAL RELEVANCE: Bupivacaine showed profound chondrotoxic effects in an experimental model that closely followed the current clinical application of postoperative pain pumps. The results caution against the use of such devices in applications for smaller joints with minimal clearance or dilution as a result of hematoma, where continuous exposure of cartilage to bupivacaine is expected.

Analgesia, Patient-Controlled↗
PubMed2006

Treatment of chondral defects in the patellofemoral joint.

Patellofemoral disease is one of the most controversial management issues in orthopedic surgery. Nonoperative management as a prerequisite first line treatment is successful in the majority of cases. However, a small subset of patients with persistent pain after adequate rehabilitation will be potential candidates for surgical intervention. Careful assessment of the underlying pathomechanics is critical for a successful outcome; these include malalignment of the extensor mechanism, trochlear dysplasia, soft-tissue imbalance, and chondral damage. As the pathology is multifactorial, the planning and treatment must be multifaceted. With careful patient selection, the options of titrated limited lateral release, restoration of MPFL function, tibial tubercle osteotomy, cartilage repair, and patellofemoral resurfacing provide improved functionality and pain relief for the young patient suffering from patellofemoral pain.

Algorithms↗
PubMed2004

Image catalogs.

The advent of digital photography and radiography allows documentation of interesting clinical findings with unprecedented ease, and many orthopaedic surgeons have taken extensive advantage of this opportunity to create large digital libraries of clinical results. However, this leaves surgeons with a rapidly increasing volume of data to store and organize; therefore, a system for archiving, locating, and managing images, radiographs, and digital slide presentations has become a crucial need in most orthopaedic groups and practices. However, many surgical groups and practices are not familiar with the computer technology available to initiate such systems. In this review, we discuss several software solutions currently on the market to address the specific needs of orthopaedic surgeons, and as a practical example, discuss a system that is in place in the Department of Orthopaedic Surgery at our institution. Overall, depending on the individual circumstances of each institution, there are various options that meet different technologic and financial requirements.

Computer Storage Devices↗
PubMedDate not supplied

Incisional vacuum-assisted closure therapy.

Postoperative swelling and prolonged drainage from surgical incisions result in both practical and medical burdens, such as increased need for dressing changes and potentially higher rates of surgical wound infection. This article presents a technique to apply a vacuum-assisted closure therapy sponge as a postoperative dressing to provide a clean, dry wound environment in the immediate postoperative period.

Aged↗