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Biomedical subjects

O Engkvist

Publications and source records attributed to O Engkvist.

At least 37 records · Page 2Linked to original sources

Regeneration of peripheral nerve through a polyglactin tube.

Polyglactin 910, a resorbable synthetic material, was used as a mesh-tube to bridge defects (7 to 9 mm in length) in a sectioned rabbit tibial nerve. After absorption of the mesh a new nerve sheath was formed which enclosed numerous minute fascicles of regenerating axons. The polyglactin tube influenced the direction taken by the regenerating axons and guided them into the distal segment. The tube also reduced the formation of neuromas and the growth of scar tissue from surrounding structures.

Animals↗

Thumb injuries in downhill skiing.

Thumb injuries are next to knee injuries the most common injury in downhill skiing today. In this material they constituted 17% of all skiing injuries. Three-fourths of the thumb injuries were lesions of the ulnar collateral ligament of the metacarpophalangeal joint. Compared to a control population consisting of 1619 randomly chosen uninjured skiers, we found that no type of ski pole handle in common use today eliminated the risk of thumb injury, but the injury frequency was higher when using a ski pole with a big plate on the top of the handle. It was, however, of no importance how the skier gripped the ski pole in relation to the strap. It is suggested that the skier during a fall holds on to the ski pole until the very last moment before the hand hits the ground. The ski pole handle then remains in the hand and constitutes the hypomochlium that forces the thumb into abduction and extension, which causes the typical ulnar collateral ligament injury.

Adolescent↗

Results from resection of the distal end of the ulna after fractures of the lower end of the radius.

Pain, impaired mobility and weakness in the wrist are common complications after fractures of the lower end of the radius. When these symptoms persist, resection of the distal end of the ulna has been the surgical treatment of choice. 24 patients who had undergone this procedure were reviewed. 50% stated they were not improved by the operation. Of 11 patients with degenerative changes in the distal radio-ulnar joint on preoperative X-ray, 8 stated they were helped by the operation, while of 13 patients without any signs of arthrosis in the distal radio-ulnar joint, only 4 experienced relief of their discomfort. A more discriminating approach to the treatment of the sequelae of fractures to the lower end of the radius is required. Resection of the distal end of the ulna is probably only indicated when the distal radio-ulnar joint shows sings of arthrosis.

Adult↗

Joint cartilage formation induced by silastic sheet spacer.

In an experimental study in rabbits the effect on articular cartilage regeneration from subchondral bone induced by a temporary interposed silicone rubber sheet has been analyzed. The normal articular cartilage of the medial condyle of the femur was resected and the subchondral bone surface covered by a 2 mm thick Silastic sheet which was removed after 2 months. At that time cartilaginous tissue of a hyalin appearance was found to cover the resected surface. As early as one month after removal of the sheet this cartilage showed obvious signs of degeneration and a few months later no regenerating cartilage was left. It is concluded that in this study there is no experimental evidence supporting the idea that temporary interposition of a silicone rubber sheet is beneficial in the treatment of degenerative arthritis.

Animals↗

Perichondrial arthroplasty. A clinical study in twenty-six patients.

26 patients with painful and/or rigid small joints of the extremities have undergone surgery by a new arthroplasty method, utilizing the cartilaginous potential of the perichondrium demonstrated earlier in animal experiments. Perichondrium from the rib has been grafted to the articular surfaces of the affected joint after removal of the remaining ordinary articular cartilage. In 12 cases the joint disease was a sequela after trauma--either fracture involving the joint surfaces, or an open joint injury complicated by a purulent arthritis. In 6 cases there was an idiopathic degenerative joint disease and in 5 the arthritis was of rheumatic origin. In a further 3 cases the indications for operation were various. The follow-up period varied between 3 and 41 months. 13 patients classified as excellent regained range of motion and power and had no pain either at rest or at work. In 3 cases range of motion and power improved, but there was still some pain in the affected joint at work. Ten cases were not improved by the perichondrial arthroplasty and possible reasons for this are discussed. The results indicate that it is possible to restore joint function using free autologous perichondrial grafts from the rib.

Adolescent↗

Rupture of the extensor pollicis longus tendon after fracture of the lower end of the radius--a clinical and microangiographic study.

The pathogenesis of the late post-traumatic rupture of the extensor pollicis longus tendon has never been satisfactorily explained. In the present series of fifty-nine ruptures two were partial, making possible an exact localization of the rupture. Microangiographic studies performed on amputated arms showed that this part of the tendon was poorly vascularized. Our study confirms earlier observations that ruptures most commonly occur after undisplaced fractures. It is suggested that increased pressure within the non-ruptured tendon sheath jeopardizes the blood flow in the already poorly vascularized parts of the tendon, leading to degeneration and rupture, usually within eight weeks. An haematoma inside the sheath interfering with the production of synovial fluid, could deprive the tendon of an alternative nutrition via diffusional pathways.

Adolescent↗

Perichondrial wrist arthroplasty in rheumatoid patients.

A new method is proposed for reconstruction of the wrist joint in rheumatoid arthritis. Perichondrial arthroplasty done in four patients with severe deformity of the wrist from rheumatoid arthritis gave functionally improved results. In one case biopsy of the reconstructed joint showed newly formed cartilaginous tissue four months after initial surgery.

Arthritis, Rheumatoid↗

Radiography in joint reconstruction with perichondrial grafts.

The radiographic findings in 13 joints successfully reconstructed with free perichondrial grafts from the rib are reported. Radiography was performed during a period of 13 to 40 months postoperatively. Definite cortical demarcation occurred after 8 to 11 months and had increased 11 to 16 months following surgery. In 3 cases the final examination of 2 metacarpophalangeal joints and one proximal interphalangeal joint was completed with arthrography which demonstrated that the articular surfaces appeared even although the cortical bone contours were somewhat irregular. The extent of the joint spaces largely resembled that in healthy controls.

Adult↗

Reconstruction of articular cartilage with free autologous perichondrial grafts. An experimental study in rabbits.

An experimental study in adult rabbits has been performed to find out whether the cartilage forming capacity of the perichondrium could be utilized in reconstruction of articular cartilage. The normal articular cartilage of the glenoid surface of the humero-scapular joint was completely removed. Auricular perichondrium was grafted to cover the exposed bony surface with the active chondrogenic layer of the perichondrial graft facing the joint cavity. The joint was not immobilized but the operated limb was amputated at wrist level to avoid weight bearing. The animals were sacrificed at different time intervals ranging from 1 to 17 weeks. In 12 out of 14 grafted rabbits regeneration of cartilage occurred. In 6 of 10 control cases where no perichondrium was grafted to cover the resected surface no cartilage was found. In the other 4, only small areas of mature cartilage were seen, probably remnants of the original articular cartilage.

Amputation, Surgical↗

The cartilaginous potential of the perichondrium in rabbit ear and rib. A comparative study in vivo and in vitro.

In an experimental study the cartilaginous protential of the rabbit ear perichondrium has been compared with that of the rib in vivo and in vitro. Perichondrium was transferred as free autologous grafts to the subcutaneous tissue on the scalp and as loose bodies into the knee joint. The presence of cartilage in the grafts was examined after six weeks. In vitro explants of rabbit perichondrium from the ear and the rib were maintained in an organ culture system. The presence of cartilage was analyzed after one to three weeks. Rabbit perichondrium from the rib appeared to have a greater cartilaginous potential than that from the ear both in vivo and in vitro. Chondrogenesis in perichondrium was demonstrated in vitro.

Animals↗

Reconstruction of patellar articular cartilage with free autologous perichondrial grafts. An experimental study in dogs.

The cartilaginous potential of the perichondrium has earlier been utilized to reconstruct articular cartilage in unloaded joints in adult rabbits. The present work in adult dogs has been performed to find out if the perichondrium can be used for the same purpose in joints subjected to pressure. In 13 knee joints the articular cartilage of the patella was excised completely and the resected surface was covered with an autologous perichondrial graft taken from the rib cartilage. After 3 weeks of immobilization the dogs were allowed to run freely until sacrifice 2 to 17 months later. In all 13 cases regeneration of cartilage took place. Within 8 months the regenerated cartilage showed no or only very slight degenerative signs but from 12 months and later such changes were common. In control cases where the resected surface was left without any graft no cartilage at all was found. Conclusively cartilage formation from grafted rib perichondrium is achieved in the knee joints of adult dogs, but it does not resist considerable pressure forces.

Animals↗

Formation of cartilage from rib perichondrium grafted to an articular defect in the femur condyle of the rabbit.

In immature and adult rabbits perichondrium from the rib was autologously grafted to a surgically created defect of the articular surface of the femur condyles exposing the subchondral bone. After one week of immobilization the animals were allowed to move freely until sacrifice after 7 and 13 weeks. In all grafted cases newly formed cartilage of a hyalin appearance filled the defect. Using the technique of intraarticular administration of tritiated thymidine, mitotic activity was found in the superficial zone of the regenerated cartilage indicating that the proliferation of cells is initiated from the perichondrium. In control cases where no graft covered the defect no cartilage was found.

Animals↗

Reconstruction of articular cartilage using autologous perichondrial grafts. A preliminary report.

In a pilot study of grown-up rabbits perichondrium from the ear was grafted to the joint surface of cavitas glenoidalis from which the normal articular cartilage had been resected. in all cases regeneration of new cartilage occurred. Five clinical cases of arthritis are reported in which, following removal of the degenerated cartilage and grafting of rib perichondrium, articular cartilage regeneration took place

Adult↗