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Biomedical subjects

P R Kurzweil

Publications and source records attributed to P R Kurzweil.

12 recordsLinked to original sources
PubMed1995

Tibial interference screw removal following anterior cruciate ligament reconstruction.

A small number of patients developed pain and tenderness at the tibial tunnel following anterior cruciate ligament reconstruction. Twenty-three knees in 22 patients underwent removal of the tibial interference screw. Ten knees had a preoperative flexion contracture and underwent a concomitant procedure to address the loss of motion at the time of hardware removal. In the 13 knees with full extension, the interval between ligament reconstruction and screw removal averaged 16 months. Eleven of these knees also underwent arthroscopy, but no intra-articular causes of pain were identified. Roentgenographic analysis showed protrusion of the interference screw above the tibial cortex in three cases. Follow-up after hardware removal averaged 2 years. Tibial tunnel tenderness resolved in 21 of 23 knees, including those of the two patients who underwent hardware removal alone. Although it cannot be stated with certainty that tibial interferences screws may cause pain, this review suggests an association. This is an uncommon problem and it is estimated to be a factor in less than 3% of the author's anterior cruciate ligament reconstructions. More common causes of knee pain should be sought before electing to remove the tibial interference screw.

Anterior Cruciate Ligament↗
PubMed1993

Endoscopic ACL reconstruction: a technical note on tunnel length for interference fixation.

The total length of bone-patella tendon-bone autografts can vary significantly between individuals. Grafts that are "too long" may protrude from the tibial tunnel site, precluding interference screw fixation. A simple calculation can be used to estimate the length of the tibial tunnel required to accommodate the graft. An intraoperative final check can be made with a calibrated drill. This distance should accommodate the total graft length. If necessary, minor adjustments that include trimming the bone plugs or deepening the femoral osseous tunnel can be made to prevent graft protrusion.

Anterior Cruciate Ligament↗
PubMed1993

Endoscopic ACL reconstruction.

The endoscopic technique offers the advantage of one incision and a femoral osseous tunnel trajectory that is more in line with the collagen fibers of the graft. Technically, it is more demanding to reproducibly obtain the interference fixation than using the two-incision technique. There is a tendency for screw and graft divergence in the femoral tunnel. The exact clinical significance of this screw and bone plug divergence has yet to be clarified. Surgeons must assess their ability to obtain the best results for the patient. There is a definite learning curve for the endoscopic technique. We believe that, with further advances in instrumentation, fixation, and alternative grafts, it will eventually be the approach of preference for ACL reconstructions.

Anterior Cruciate Ligament↗
PubMed1992

Survival of cells after intra-articular transplantation of fresh allografts of the patellar and anterior cruciate ligaments. DNA-probe analysis in a goat model.

The fate of donor cells in fresh allografts of the patellar and anterior cruciate ligaments was assessed after transplantation of the allografts as substitutes for the anterior cruciate ligament in goats. DNA-probe analysis was used to distinguish between the DNA of individual goats. Donor DNA was completely replaced by recipient DNA in both the transplanted patellar and anterior cruciate ligaments within a four-week period. Simultaneous full-thickness skin transplants in the same animals were not rejected during the interval of rapid loss of donor DNA from the allografts. The absence of rejection of the skin grafts at the one-week interval suggests that no pre-existing antibody associated with an immune reaction was responsible for the rapid loss of DNA in the allografts.

Animals↗
PubMed1984

Use of sodium chromate Cr51 in diagnosing childhood idiopathic pulmonary hemosiderosis.

The diagnosis of idiopathic pulmonary hemosiderosis (IPH) may be elusive. A 6-year-old boy had microcytic hypochromic anemia and a hemolytic component. Hemosiderin-laden macrophages were not found in the gastric aspirate. He had no pulmonary signs or symptoms. Extensive hematologic and roentgenologic investigations failed to reveal the cause of the anemia. Quantitative serial scintigraphic scanning showed significant (35%) pulmonary sequestration of autologous erythrocytes labeled with sodium chromate Cr51. The half-life of the RBCs was moderately decreased (half-life, 15 days; normal, 25 to 35 days). An open-lung biopsy specimen confirmed the diagnosis of IPH. A diagnosis of IPH should be considered when children have iron deficiency anemia and pulmonary signs or symptoms. Organ sequestration studies may be helpful in equivocal cases.

Anemia, Hypochromic↗
PubMedDate not supplied

Persistence of the olecranon physis: a cause of "little league elbow".

The elbow is one of the most common sites of overuse injuries in adolescent baseball players. The term "little league elbow" has been used to describe a number of entities. This article reports three cases of painful persistence of the olecranon epiphyseal plate in adolescent pitchers. Symptoms associated with this entity may improve with rest and avoidance of the aggravating activity. However, if symptoms persist and the contralateral growth plate has closed, internal fixation may be necessary and is effective in relieving the symptoms.

Adolescent↗
PubMedDate not supplied

A comparison of patellar tendon autograft and allograft used for anterior cruciate ligament reconstruction in the goat model.

Similar-sized patellar tendon autografts and fresh-frozen allografts were used to reconstruct the anterior cruciate ligament of one knee in 40 female goats. Evaluations of the reconstructions and contralateral controls at the 6-week and 6-month postoperative periods included anterior-posterior translation, mechanical properties determined during tensile failure tests, measurement of cross-sectional area, histology, collagen fibril size and area distribution, and associated articular cartilage degenerative changes. Six months after anterior cruciate ligament reconstruction, the autografts demonstrated a smaller increase in anterior-posterior displacement, values of maximum force to failure two times greater, a significant increase in cross-sectional area, a more rapid loss of large-diameter collagen fibrils, and an increased density and number of small-diameter collagen fibrils compared to the allografts. Clinical significance. More surgeons are allowing their patients to return to running and sports 6 months after anterior cruciate ligament reconstruction. While the structural and material properties of autografts and allografts at time zero are similar, in the goat model during the first 6 months they differ. The allografts demonstrate a greater decrease in their implantation structural properties, a slower rate of biologic incorporation, and the prolonged presence of an inflammatory response. At 6 months the autograft demonstrates a more robust biologic response, improved stability, and increased strength to failure values.

Animals↗
PubMedDate not supplied

Inferior capsular shift procedure for anterior-inferior shoulder instability in athletes.

Sixty-eight shoulders in 63 athletic patients with anterior-inferior glenohumeral instability underwent an anterior-inferior capsular shift procedure. Shoulders with glenoid fractures, predominantly posterior instability, or routine, unidirectional anterior instability were not included in this study. There were 42 men and 21 women, with an average age of 23 years. Forty-two repairs were performed on the dominant arm. All 31 overhead throwing athletes had their dominant arms repaired. Forty-six shoulders had histories of recurrent anterior dislocations, while 22 shoulders had recurrent subluxation. All 68 shoulders had an anterior-inferior capsular shift, tailored to the degree of laxity found; in addition, 21 had repair of a Bankart lesion. Forty-two patients were rated excellent (67%), 17 good (27%), 2 fair (3%), and 1 poor (3%). Fifty-eight of 63 (92%) patients returned to their major sports, 47 (75%) at the same competitive levels. Only 5 of 10 elite throwing athletes returned to their prior competitive levels. Loss of external rotation averaged 7 degrees. Two patients (2.9%) re-dislocated postoperatively, after violent falls.

Adult↗