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Biomedical subjects

P Gallinaro

Publications and source records attributed to P Gallinaro.

At least 19 recordsLinked to original sources
PubMed2006

Serum interleukin-6 response to elective total hip replacement surgery.

The focus of this work was to study the serum interleukin-6 (IL-6) response to total hip replacement. Twenty-one patients received an uncemented total hip prosthesis. Venous samples for IL-6 determination were drawn before and after surgery. The IL-6 response was significant, and a peculiar heterogeneity of response was apparent: the medians of peak levels (82.3 pg/ml) and of areas under the response curve (51.8 pg/ml) distinguished between IL-6 high responders (HR) and IL-6 low responders (LR; p<0.0001). No difference was found in the gender composition of these groups, whereas the HR patients were older than the LR patients (p<0.05). The amount of IL-6 increase was found to correlate with patient age, whereas its slope was found to correlate with the duration of the surgical procedure. Moreover, the HR group presented a higher degree of hyperthermia in the days after surgery compared with the LR patients, without evidence of differences in postoperative complications, time to mobilisation, or length of stay in hospital. The main finding of our study was the evidence of a remarkable variability between individuals in the IL-6 response to surgery. Future studies are needed to identify the factors involved in the regulation of the cytokine response to surgery.

Adult↗
PubMed2006

The judet quadricepsplasty: Long-term outcome of 21 cases.

BACKGROUND: The lack of knee flexion represents a possible complication in severe femur fractures. In 1956, Judet proposed a quadricepsplasty technique that allowed for a graded release without the disruption of the vastus medialis obliqus, vastus lateralis, or rectus femoris. METHODS: This article reports the clinical outcome of 21 cases of Judet quadricepsplasty after an average follow-up of 101.0 months (range, 21-204 months). The definitive flexion gain was classified as excellent, good, fair, or poor. Excellent when >100 degrees, good when >80 <99 degrees, fair when >50 degrees <79 degrees, poor when <50 degrees. The flexion and extension strength were graded from 0 to 5, according to the Daniel's scale. RESULTS: The average strength score was 4.71 in flexion, 4.81 in extension. The average definitive flexion was 95.67 degrees (range, 54-128 degrees) and the average definitive flexion gain was 72.43 degrees (range, 40-122 degrees). When the patients were grouped on the basis of the definitive flexion, excellent results were observed in eight cases (38.10%), were good in nine (42.86%), and fair in four (19.05) with zero poor results. CONCLUSIONS: Our experience has shown that, even if first proposed in 1956, the Judet procedure still gives a reproducible amount of good results.

Adolescent↗
PubMed2001

Flexion osteotomy in the treatment of avascular necrosis of the hip.

The natural history of untreated nontraumatic avascular necrosis of the femoral head has a very poor outcome because of the high percentage of collapse of the head. Among the more conservative surgical treatments available, flexion intertrochanteric osteotomy, aimed at rotating the intact posterior portion of the femoral head into the weightbearing portion of the acetabulum, gives satisfying long-term results when planned and performed carefully on selected patients. In general, this includes young and highly motivated patients who have a diagnosis of Ficat Stage II or Stage III idiopathic avascular necrosis. According to the Merle d'Aubignè hip score, avascular necrosis with a complete or slightly reduced range of motion represents the best indication. The results of this procedure on 24 patients at a mean followup of 122 months were satisfactory in 15 patients (62.5%). Nine patients (37.5%) had a conversion to total hip arthroplasty, none of which was associated with technical difficulties related to the initial surgical procedure. Pain and walking ability improved in all patients postoperatively compared with preoperatively, although improvement in range of motion was not observed.

Adult↗
PubMed2000

Prevention of pin track infection in external fixation with silver coated pins: clinical and microbiological results.

Pin tract infection is a frequent complication of external fixation; according to literature its frequency ranges from 2-30%. The recent introduction of silver coating of polymeric materials was found to decrease bacterial adhesion; its clinical use with Foley catheters and central venous catheters led to significant results. To verify the ability of the same silver coating to decrease the bacterial colonization on external fixation screws, a prospective randomized study was carried out on 24 male patients; a total of 106 screws were implanted in the lower limb to fix femoral or tibial diaphyseal fractures: 50 were coated with silver and 56 were commercially available stainless steel screws. Although the coated screws resulted in a lower rate of positive cultures (30.0%) than the uncoated screws (42.9%), this difference was not statistically significant (p = 0.243). The clinical behavior of the coated screws did not differ from that of the uncoated ones. Furthermore, the implant of silver-coated screws resulted in a significant increase in the silver serum level. These results led us to consider it ethically unacceptable to continue this investigation.

Adolescent↗
PubMed1998

In vivo UHMWPE biodegradation of retrieved prosthesis.

Sixty-two ultra high molecular weight polyethylene prosthetic components (PEs) (31 tibial plateaux and 31 cups), sterilised by gamma rays or ethylene oxide (EtO), were retrieved after 1-12 years depending on different medical reasons and were studied by FTIR spectroscopy with derivatisation of oxidised species. Esters, acids and hydroperoxides were found under the surface of the EtO sterilised PEs up to 2 mm depth. The behaviour of gamma ray sterilised PEs is more complex due to the oxidation following the sterilisation process. Ester and acid formation might arise from the diffusion of components of synovial liquid or from the oxidation process, whereas hydroperoxide formation is thought to be due to the oxidation. Abrasion and delamination process is discussed considering the topological distribution of degradation products.

Aged↗
PubMed1996

Unacceptable biodegradation of polyethylene in vivo.

The chemical characterization of 19 retrieved ultra-high-molecular-weight polyethylene tibial plateaux, six new ones and one raw bar was performed by means of infrared spectroscopy. The surface and bulk oxidation and biodegradation indexes were calculated. The raw bar has a measurable oxidation, which increases on the bulk and on the surfaces of the new plateaux. In the retrieved plateaux, the average oxidation index increases further both on the bulk and on the surfaces; the worse values were present on the worn area. Similar results were found for the biodegradation index. The data show that the biotic in vivo degradation is promoted by the oxidation present on the new plateaux and that it occurs through a different mechanism, abiotic thermal-, photo-, gamma-radiation oxidation, evaluated by the oxidation index.

Aged↗
PubMed1993

Screw sockets: survivorship analysis after eight years.

A comparative analysis of the radiographic results of 111 screw sockets (65 tapered and 46 hemispherical cup sectors) was made to evaluate both their behaviour over a period of time and the validity of their use today. The follow-up was performed on average 42 months after the implant. Overall survivorship shows a high risk of failure during the fourth year and a greatly increased rate of failure after the sixth year. Comparison of the survival curves of the two types of acetabular component revealed no significant differences. The two types considered were, however, of different sizes: the implanted taper sockets were on average 6.6 mm larger than the comparable hemispherical cup sector acetabular components, thus involving a greater loss of acetabular bone.

Bone Screws↗
PubMed1991

Biocompatibility and osteogenetic characteristics of new biocompatible glasses.

A fibre-shaped glass with qualities of biocompatibility and biodegradation could be promising for reconstructive bone surgery in orthopaedics and neurosurgery. New highly biocompatible glasses, originally made by the Italian Group of Study on Biocompatible Glass, are obtained both in cylinder and fibre shapes due to their original chemical composition (Glassfiber). This is the only glass which is also available as a continuous filament. Hydrolytic in vitro and in vivo tests demonstrate that these glasses present both good biocompatibility and adjustable biodegradation in relation to their chemical composition. The advantages of bioactive glass also being available as a continuous filament are suggested.

Animals↗
PubMed1991

Total knee replacement: surgical technique and instrumentation.

The surgical technique and instrumentation of four systems of total knee replacement, two with intramedullary and two with extramedullary alignment systems, are discussed. The differences between the instrumentations, their advantages and disadvantages, and the basic "philosophy" of each technique are compared in four "crucial" operative stages, determinant for the final result: the anteroposterior and distal femoral osteotomies, the tibial osteotomy, and the mechanical axis. In expert hands the two systems are equally reliable. In our experience, the extramedullary system with the tensor is more versatile. The stages are more dependent on the surgeon than on the instruments, and the tensor enables the surgeon to control and balance the level of osteotomy and the soft-tissue release every time. The intramedullary femoral alignment system seems simpler: each step is a direct consequence of the previous one, except the first step, which is, of course, entrusted to the experience of the surgeon. The fact that each stage is predetermined may reduce the chances of error in less skilled hands.

Femur↗
PubMed1990

Experience with bipolar prosthesis in femoral neck fractures in the elderly and debilitated.

Eighty-eight bipolar Bateman hip endoprostheses for medial femoral neck fractures were implanted. The average age of the patients was 75 years. Intrahospital results proved the morbidity and mortality rates to be well within acceptable limits. Thirty patients were followed during periods of 12-74 months (median, 33 months). According to Charnley evaluation, mobility was excellent and very good in 20 patients (86%). Good function was present in 63% of patients. The majority of patients belonged to category C as defined by Charnley. Mild pain was present in 19 patients (63%); in only two cases, involving severe rheumatoid arthritis, pain was clearly related to sinkage. Radiographically, no visible protrusion or socket wear was present. Periarticular ossification occurred in 19 patients, but this did not impair function.

Aged↗
PubMed1977

Etiology, pathogenesis and classifications of knee fractures.

Fractures of the knee include fractures of the lower end of the femur, upper end of tibia, and patella. The term articular fractures has been avoided in this text because it would exclude supracondylar fractures of the femur, fractures of the tibial spines, and epiphyseal separations in which the articular surfaces remain uninjured. By agreement with the other rapporteurs to this Congress, we excluded from our review separation of the apophysis of the tibial tubercle, fractures of the tibial spines, and osteochondral lesions.

Accidents, Traffic↗