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Biomedical subjects

M Salai

Publications and source records attributed to M Salai.

At least 55 records · Page 3Linked to original sources
PubMed1997

Fresh osteochondral allografts at the knee joint: good functional results in a follow-up study of more than 15 years.

The treatment of deep chondral defects at the knee joint poses major difficulties and challenges to the orthopaedic surgeon, particularly in young patients for whom solutions like total or hemi-joint arthroplasty are not recommended, because of their limited durability. Biological resurfacing with materials such as perichondrium, periosteal allografts, and cultured chondrocytes is still at the experimental stage and there has been limited clinical validation. Since 1978, we have successfully used fresh osteochondral ('shell') allografts for the treatment of selected patients with a chondral defect at the knee joint. These grafts, implanted mainly in young patients, have proved durable and have provided good functional results for more than 15 years, as shown by an average of 84.6 in the Hospital for Special Surgery (HSS) Knee Score. The operative technique and results of long-term follow-up of patients receiving fresh, osteochondral ('shell') allografts are presented and discussed.

Adult↗
PubMed1997

Resection arthrodesis of the knee in the treatment of tumours--a long-term follow-up.

Limb salvage operations using large custom-made prostheses have become the treatment of choice for juxta-articular tumours at the knee. Resection-arthrodesis has been used since the 1920s and offers a satisfactory long term solution for young active patients. The good functional results after this procedure in 9 patients is presented here. This method should still be considered in selected cases.

Adolescent↗
PubMed1997

Chronic massive knee effusion in familial Mediterranean fever.

OBJECTIVE: To document the occurrence of chronic massive knee effusions in patients with familial Mediterranean fever (FMF). PATIENTS: Three cases of chronic massive knee effusion of young FMF patients requiring open synovectomy are presented. RESULTS: Open synovectomy necessitated protracted rehabilitation, eventually with good results. CONCLUSIONS: FMF should be considered in the differential diagnosis of chronic massive knee effusion. Early diagnosis and daily colchicine treatment generally result in a good clinical outcome and may eliminate the need for open synovectomy in favor of arthroscopic surgery.

Adult↗
PubMed1997

Orthopaedic long term aspects of bladder exstrophy.

This study evaluates long term orthopaedic aspects of children with bladder exstrophy who were operated on using different techniques and at different ages. Data were accumulated from 20 patients with an age range of 2 to 29 years (average, 13 years). Fourteen patients underwent pelvic osteotomy. Interviews and physical examinations confirmed that, in the long term, children with classical bladder exstrophy do not have significant orthopaedic problems or disability, whether or not they underwent pelvic osteotomy. Radiographic imaging showed normal hip joint configuration with marked pubic diastasis. There were no clinical problems associated with the diastasis. Pelvic computed tomography studies in 7 patients showed marked remodeling of the femora and acetabula. Radiographs of the spine showed a curve in 7 (47%) of the patients, but in only 3 cases was the curve larger than 10 degrees. Pelvic osteotomy is indicated during surgical correction of bladder exstrophy to facilitate closure of the abdominal wall to prevent postoperative wound dehiscence and possibly achieve better urinary control in older age. However, there is no clear indication for pelvic osteotomy from an orthopaedic point of view.

Adolescent↗
PubMed1997

Electron microscopic study on the effects of different preservation methods for meniscal cartilage.

OBJECTIVES: The study was conducted to evaluate different methods for preservation of meniscal cartilage. During the last decade, the use of allografts containing cartilage in various forms, such as: small osteochondral grafts, osteoarticular grafts, or whole joints, has gained popularity. Meniscal allografts in particular, can be used in cases of post-menisectomy syndrome, or in uni-compartmental osteoarthritis of the knee. The preservation methods used for the cartilaginous components of allografts would appear to influence the success rates, which vary between 30% and 85% according to different reports. Some of the methods of preservation currently in use include: deep-freezing in liquid nitrogen, freezing to -80 degrees C, gamma irradiation, and immersion in ethylene oxide. METHODS: In an attempt to find the best technique for cartilage preservation (in terms of preserving the ultra-structural properties prior to implantation), bovine meniscal cartilage was examined after preservation by: a) freezing to-80 degrees C; b) exposure to 2.5 Mrad gamma irradiation; or c) a combination of both. RESULTS: Electron microscopic studies were performed, with fresh menisci serving as controls. Our tests demonstrated that in all techniques, severe cellular damage was caused, whereas the collagen network retained its properties. CONCLUSION: The optimal method for the preservation of cartilage remains to be established.

Animals↗
PubMed1997

Human immunodeficiency virus (HIV) inactivation of banked bone by gamma irradiation.

OBJECTIVE: The increasing number of patients with acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus(HIV)-positive carriers, poses difficulties when musculo-skeletal tissues are considered for banking in readiness for future clinical application. This study was conducted to test the actual yield of gamma irradiation on HIV infectivity, within HIV-infected bones. METHODS: The effect of gamma irradiation on bones containing T-cells chronically infected with HIV type I (HIV-I) was studied, in respect to inactivation of the virus. RESULTS: After exposure of the cell-free virus or infected T-cells to 2.5 megarads of gamma irradiation, the authors were able to demonstrate complete inactivation of the virus. CONCLUSIONS: It would appear from this study that gamma irradiation at this dose is sufficient to achieve clinical sterilisation of bones and facilitate their use for reconstructive procedures by eliminating the risk of HIV transmission to the recipient. Furthermore, when preparing bones for banking, this would also seem to be the method of choice in preventing the transmission of various strains of bacteria, fungi and other viruses.

Bone Banks↗
PubMed1996

[3-Dimensional computerized imaging in complex pelvic fractures].

3-dimensional computerized imaging is a relatively new radiologic modality. The transformation of bi-plane CT images into 3-dimensions, enables the physician to rotate the desired region to any viewing angle. In complex anatomic regions such as the pelvis, it offers better visualization of lesions, avoids having to rotate the patient, and reduces the need for X-rays and exposure to radiation. Our preliminary results with this modality in 3 cases of complex fractures of the pelvis are presented.

Fractures, Bone↗
PubMed1995

Primary psoas abscess due to methicillin-resistant Staphylococcus aureus concurrent with septic arthritis of the hip joint.

We report an unusual case of a primary psoas abscess due to community acquired methicillin-resistant Staphylococcus aureus in an immunocompetent man. The course of the disease was indolent, expressed as septic arthritis of the hip joint. When the diagnosis was made, 3 months after symptoms began, the patient was treated by surgical evacuation of the abscess and appropriate antibiotics. Full recovery and return to his usual activity followed total hip replacement.

Arthritis, Infectious↗
PubMed1993

The operative results of tibial plateau fractures in older patients: a long-term follow-up and review.

A retrospective review of 19 elderly patients (65 years of age or older) with operatively managed tibial plateau fractures demonstrated that most patients had acceptable functional results, based on Rasmussen's criteria. The follow-up period was of 8-14 years (average 11 years). Seventy-nine percent of the patients (15/19) had excellent or good results. They regained their preinjury walking capacity and suffered only occasional pain. Four patients had fair results with limitation of walking capacity, pain on certain positions, and/or pain after activity. One of these 4 patients had significant medial instability. In this age group, internal fixation of tibial plateau fractures and early mobilization appeared to be beneficial in achieving good functional results.

Aged↗
PubMed1993

Total hip replacement in familial Mediterranean fever.

Familial Mediterranean fever (FMF) is a hereditary disorder affecting people of Mediterranean stock, mainly Sephardic Jews and Armenians. It is characterized by attacks of arthritis, either short, self-limited episodes typically lasting 72 hours or protracted attacks lasting from two weeks to one year. The latter form affects mainly the large joints of the lower limb. The hip joint is the most vulnerable and likely to be affected by the protracted attacks, which may result in destruction of the articular cartilage and, in some cases, aseptic necrosis of the femoral head. Eighteen FMF patients (19-52 years) underwent 22 total hip replacements between 1971 and 1985 at our hospital. Six of the 18 initial prostheses experienced aseptic loosening. This relatively high incidence led us to recommend implantation of cementless hip prostheses following meticulous synovectomy as the treatment of choice. The results of these surgeries and the uniqueness of total hip replacement in FMF patients are presented here and discussed.

Adult↗
PubMed1990

Massive bone allograft: a salvage procedure for complex bone loss due to high-velocity missiles--a long-term follow-up.

The treatment of high-velocity missile injury to the limbs is often associated with segmental bone loss, as well as damage to neurovascular and soft tissue. In such "limb threatening" cases, massive bone allograft can fill the bone defect and offer stability to the soft tissue reconstruction. The return of function in the affected limb is relatively rapid when using this method as a primary procedure. The indications for use of this technique and illustrative case reports are presented and discussed.

Adult↗
PubMed1987

The role of three dimension computerized imaging in hand surgery.

Three-dimensional computerized imaging is a new modality of radiological imaging. This new technique transforms the two-dimensional slices of bi-plane CT into a three-dimensional picture by a computer's monitor adjusted to the system. This system enables the physician to rotate the angle of viewing of the desired region to any desired angle. Moreover, this system can delete certain features of different densities from the picture, such as silicone implants, thus improving visualization. Our preliminary results using this technique are presented. The advantages, pitfalls, and suggested future applications of this new technique in hand surgery are discussed.

Adolescent↗
PubMed1985

Ski injuries in 1976-1982: Ybrig region, Switzerland.

An analysis is presented of 1763 consecutive injuries that occurred in the Ybrig region in Switzerland, a ski resort, during the 1976-1982 ski seasons. The study included all persons injured while skiing and treated at the emergency care facility at the base of the Ybrig region. Fractures were the most frequent injury. Over the years, a decrease in the total number of injuries was noticed. The severity of the injuries was increased. More attention should be paid to the individual preparation of the skier.

Adolescent↗
PubMed1985

Isolated anterior inguinal dislocation of the hip joint.

Anterior dislocation of the hip joint is rare, accompanied usually by a fracture of adjacent bony structures. A case of isolated anterior inguinal dislocation of the hip joint is hereby presented with 22 months of followup. The mechanism of this rare injury is usually forcible abduction and extension of the hip joint. Early diagnosis and reduction, with immediate post-reduction roentgenograms to discover any fragments in the joint space, should be done. In this patient, X-rays 11 and 22 months after reduction appeared normal.

Aged↗