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Biomedical subjects

Richard L Uhl

Publications and source records attributed to Richard L Uhl.

12 recordsLinked to original sources
PubMed2004

Antibiotic-loaded articulating cement spacer in the 2-stage exchange of infected total knee arthroplasty.

An antibiotic-loaded articulating cement spacer (ALACS) was used in the 2-stage exchange of infected total knee arthroplasty. Specially designed molds produced articulating femoral and tibial spacer components. Twenty-four consecutive patients were followed for an average of 33 months (range, 28-51 months). Two patients (8%) had a persistent infection after the first stage. Twenty-two patients (92%) underwent a successful 2-stage exchange. Minimal soft-tissue contracture and minimal bone loss were encountered during reimplantation. None of these patients developed a recurrent or persistent infection. The average postoperative knee flexion was 104 degrees (range, 89 degrees-122 degrees). The average Hospital for Special Surgery score was 82 (range, 63-96). The ALACS spacer preserved knee function between stages, resulting in effective treatment of infection, facilitation of reimplantation, and improved patient satisfaction.

Aged↗
PubMed2004

Spacer endoprosthesis for the treatment of infected total hip arthroplasty.

We reviewed the treatment of infected total hip arthroplasty with a temporary spacer endoprosthesis. To fabricate the spacer, antibiotic-loaded cement was inserted into a specially designed mold. A central rod pin was superficially imbedded as an endoskeleton once the cement reached a doughy state. After polymerization, the final product was removed from the mold and inserted as an articulating spacer. Twenty patients were followed for an average of 38 months (range, 26-67 months). There were no recurrent or persistent infections. Eighteen patients underwent a successful 2-stage exchange. Two patients retained the spacer as a definitive treatment method. Complications with the spacer included 2 fractures and 2 dislocations. Overall, this cost-effective technique provided efficient local antibiotic delivery, early mobilization, facilitation of reimplantation, and improved patient satisfaction.

Aged↗
PubMed2004

Complications of thermal ablation in wrist arthroscopy.

Wrist arthroscopy is a valuable diagnostic and therapeutic tool. Thermal ablation can be used concomitantly to treat partial ligamentous tears, triangular fibrocartilage cartilage complex tears, and to perform partial synovectomy. We reviewed 47 consecutive patients who underwent wrist arthroscopy with concomitant thermal ablation between 1997 and 2001. Three patients sustained serious complications. The serious complications included, in all three patients, tendon ruptures and in one case, a 5 x 10-mm full-thickness skin burn. Thermal treatment of collagenous tissues has recently gained popularity in the orthopedic literature, but there is little information on the potential complications. The arthroscopist of large and small joints must be aware of the risks involved when using thermal ablation.

Adult↗
PubMed2004

Functional outcome following anterior submuscular transposition of the ulnar nerve with V-Y lengthening of the flexor-pronator origin.

Functional outcome after V-Y musculofascial lengthening of the flexor-pronator musculotendinous origin was assessed in conjunction with submuscular transposition of the ulnar nerve for cubital tunnel syndrome. We retrospectively evaluated 38 submuscular transpositions with V-Y lengthening in 35 patients. A functional score was calculated on a 100-point scale both preoperatively and at latest follow-up, and pain and numbness scores were assessed using visual analog scales. Mean length of follow-up was 4.9 years (range, 2.5-7.9 years). Mean functional score improved from 33.5 preoperatively to 62.7 at latest follow-up (P<.001), pain improved from 7.4 to 3.5 (P<.001), and numbness improved from 7.0 to 4.1 (P<.001). V-Y lengthening of the flexor-pronator origin is an effective alternative to musculofascial lengthening in combination with submuscular transposition for treatment of cubital tunnel syndrome.

Adolescent↗
PubMedDate not supplied

Direct real-time measurement of in vivo forces in the lumbar spine.

BACKGROUND CONTEXT: Accurate knowledge of the mechanical loads in the lumbar spine is critical to understanding the causes of degenerative disc disease and to developing suitable treatment options and functional disc replacements. To date, only indirect methods have been used to measure the forces developed in the spine in vivo. These methods are fraught with error, and results have never been validated using direct experimental measurements. PURPOSE: The major aims of this study were to develop a methodology to directly measure, in real time, the in vivo loading in the lumbar spine, to determine if the forces developed in the lumbar spine are dependent on activity and/or posture and to assess the baboon as an animal model for human lumbar spine research based on in vivo mechanical loading. STUDY DESIGN: Real-time telemetered data were collected from sensor-imbedded implants that were placed in the interbody space of the lumbar spines of two baboons. METHODS: An interbody spinal implant was designed and instrumented with strain gauges to be used as a load cell. The implant was placed anteriorly in the lumbar spine of the baboon. Strain data were collected in vivo during normal activities and transmitted by means of a telemetry system to a receiver. The forces transmitted through the implant were calculated from the measured strain based on precalibration of the load cell. Measured forces were correlated to videotaped activities to elucidate trends in force level as a function of activity and posture over a 6-week period. The procedure was repeated in a second baboon, and data were recorded for similar activities. RESULTS: Implants measured in vivo forces developed in the lumbar spine with less than 10% error. Loads in the lumbar spine are dependent on activity and posture. The maximum loads developed in the lumbar spine during normal (baboon) activities exceeded four times body weight and were recorded while animals were sitting flexed. Force data indicate similar trends between the human lumbar spine and the baboon lumbar spine. CONCLUSIONS: It is possible to monitor the real-time forces present in the lumbar spine. Force data correlate well to trends previously reported for in vivo pressure data. Results also indicate that the baboon may be an appropriate animal model for study of the human lumbar spine.

Animals↗