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At least 271 records · Page 15Linked to original sources
PubMed2000

Nitric oxide metabolite production in the cranial cruciate ligament, synovial membrane, and articular cartilage of dogs with cranial cruciate ligament rupture.

OBJECTIVE: To measure concentrations of nitric oxide metabolites (nitrite-nitrate [NOt]) in cartilage, synovial membrane, and cranial cruciate ligament (CCL) in dogs and evaluate associations with osteoarthritis in dogs with CCL rupture. ANIMALS: 46 dogs with CCL rupture and 54 control dogs without joint disease. PROCEDURE: Tissue specimens for histologic examination and explant culture were harvested during surgery in the CCL group or immediately after euthanasia in the control group; NOt concentrations were measured in supernatant of explant cultures and compared among dogs with various degrees of osteoarthritis and between dogs with and without CCL rupture. RESULTS: Osteoarthritic cartilage had significantly higher NOt concentration (1,171.6 nmol/g) than did healthy cartilage (491.0 nmol/g); NOt concentration was associated with severity of macroscopic and microscopic lesions. Synovial membrane NOt concentration did not differ between dogs with and without CCL rupture. Ruptured CCL produced less NOt than did intact ligaments. In control dogs, NOt concentrations were similar for intact ligaments (568.1 nmol/g) and articular cartilage (491.0 nmol/g). Synthesis of NOt was inhibited substantially by coincubation with inhibitors. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that NOt in canine joint tissues originates from the inducible nitric oxide synthase pathway. Nitric oxide metabolite production in cartilage was greater in dogs with osteoarthritis than in healthy dogs and was associated with lesion severity, suggesting that nitric oxide inhibitors may be considered as a treatment for osteoarthritis. The CCL produces substantial concentrations of NOt; the importance of this finding is unknown.

Animals↗
PubMed1999

Porcine anterior cruciate ligament fibroblasts are similar to cells derived from the ligamentum teres, another non-healing intra-articular ligament.

Porcine ligament fibroblasts were cultured from the anterior cruciate (ACL), medial collateral (MCL), and ligamentum teres (LT). There were no apparent differences in confluent cellular morphology among the ligament cell types as evaluated by phase contrast microscopy. The proliferation rate of MCL cells from 24-120 h was significantly higher (p < 0.05) than that of cells from either the LT or the ACL. MCL cells produced more collagen and less non-collagenous protein than the LT and ACL as determined by [3H]proline incorporation. This resulted in MCL cells producing a higher percentage (37%, p < 0.05) of collagen relative to total protein than either the ACL (28%) or the LT (32%). The MCL cells produced a significantly higher percentage (34.7%, p < 0.05) of type-III collagen relative to total type-I and III collagen than either the ACL (29.2%) or the LT (29.5%). The LT and MCL cells had similar and significantly greater coverage of in vitro wounds than the ACL. This study provides the first in vitro study of the LT and demonstrates that fibroblasts from the LT and ACL, two ligaments that heal poorly, have similar in vitro characteristics, with the exception of wound healing.

Animals↗
PubMed2002

Anterior cruciate ligament reconstruction using an alloplastic ligament of polyethylene terephthalate (PET -- Trevira -- hochfest). Follow-up study.

Between April 1989 and July 1996, 217 anterior cruciate ligament reconstructions using a synthetic ligament of polyethylene terephthalate (PET Trevira-- hochfest) were performed. 160 (74%) cases have been followed-up with a mean time of 4.8 years (1.0-8.3) and evaluated by the IKDC standard knee ligament evaluation form. Altogether 88% excellent and good results were found. The best outcomes involved isolated ACL tears and reconstruction within a few month. The amount and intensity of lasting symptoms depended mostly on osteoarthrotic changes (chondral and meniscal lesions) and correlated with the interval between injury and reconstruction. All findings are presented in detail and critically discussed.

Adolescent↗
PubMed1991

Patellar fracture and avulsion of the patellar ligament complicating arthroscopic anterior cruciate ligament reconstruction.

Arthroscopic reconstruction of the anterior cruciate ligament-deficient knee using the middle third of the patellar tendon is an effective treatment for acute or chronic anterior cruciate ligament insufficiency. The strength of this bone-ligament-bone graft is superior to virtually all other autogenous tissue utilized. We report the complication of avulsion of one half of the remaining patellar tendon from the tibia associated with patellar fracture in the early postoperative period.

Adult↗
PubMed1994

[Reconstruction of the medial collateral ligament of the knee in rats using a free autogeneic transplant of fascia lata, ligament or tendon].

After resecting the lateral collateral ligament of the knee in 56 male mature rats, the authors replaced it by an autogenous transplant of the same size, made of fascia lata, ligament or patellar tendon. The authors then studied this transplant after an evolution of 2 days to 5 1/2 months. This lapse of time can be divided into three stages: an initial stage (first week), marked by transplant necrosis and acute inflammation--an early stage (from the second to the fourth week), which shows the migration of the cells from the host to the transplant and the rebuilding of collagen fibers. Tissues with a loose, extensible, but weak texture, such as the fascia lata, are totally colonized by the fibroblasts. Tissues with a dense, strong, but less extensible texture, as the patellar tendon, are soon destroyed and recolonized at the periphery, whereas their center is destroyed and recolonized by fibroblasts later and more irregularly--a late phase of consolidation (from the second to the fifth month), which shows the rebuilding of a dense collagen network and its reorientation. In fascia lata transplants, this new collagen is homogeneous and is made of parallel bundles. In tendon transplants, the network is not homogeneous. It has a persistent nodular aspect at the periphery and well-oriented bundles, separated by calcified or granulomatous foci at the center. In the case of ligament transplants, the new collagen network shows an intermediate aspect between the two described above. The weakest regular connective tissues are the best for ligamentoplasties, and tendons are the worst.

Animals↗
PubMed1993

[Gadolinium-DTPA enhanced MRT in the evaluation of the healing of autologous patellar ligament transplants for anterior cruciate ligament reconstruction].

Eighteen patients with autologous patellar tendon transplant for reconstruction of the anterior cruciate ligament were examined postoperatively. The time between operation and MR study was up to 3 weeks in ten patients, between 3 and 35 weeks in three patients and more than 35 weeks in five patients. In all patients, Gd-DTPA enhancement on the surface of the ligamentous transplant was visualized. This enhancement was between 1 and 10 mm thick. In all patients, complete stability of the knee joint was achieved, postoperatively. In 15 patients flexion and extension were normal at the postoperative investigation. Three patients had a limitation of knee movement. In these MR studies, significant hyperplasia of the synovial membrane of the entire joint was diagnosed, explaining the persisting problems. Gd-DTPA-enhanced MR of the knee joint allows non-invasive documentation of remodelling following a patellar ligament transplant and possible complications.

Adolescent↗
PubMed1997

[Effect of external extra-articular ligament plasty on the results of anterior cruciate ligament reconstruction with patellar tendon, a 4 years follow-up].

PURPOSE OF THE STUDY: The purpose of this study was to compare the functional results obtained when an external extra-articular plasty was added to an anterior cruciate ligament (ACL) reconstruction using an autologous bone tendon-bone patellar tendon graft. MATERIAL AND METHODS: The authors analyzed two consecutive series of 60 and 50 patients operated by the same surgeon for a chronic rupture of the anterior cruciate ligament, one by reconstruction of the cruciate ligament with a free graft of the patellar tendon supplemented by an external extra-articular plasty made with a quadriceps tendon graft and the second with an isolated free patellar tendon graft. Anterior laxity was measured before and after surgery, by dynamic X-rays and by the Medmetric KT-1000 arthrometer. Functional results were evaluated four years after operation, with the French A.R.P.E.GE score based on sport activity level and intensity. RESULTS: Anterior laxity was not different before operation in both groups and there was no difference between males and females. Medmetric KT-1000 arthrometer showed the same negative differential laxity immediately after surgery in both groups and the same evolution during the first 4 years, without any significant difference on laxity on the middle aspect of the knee. Radiological results were different. After a 4 years follow-up, anterior laxity did not show significant difference on the medial compartment of the knee (5.3 +/- 2.3 mm and 5.5 +/- 1.7 mm), but there was a significant minor laxity in the lateral compartment for the lateral extra-articular plasty group (11.0 +/- 2.3 mm against 14.8 +/- 3.8 mm)(p = 0.002). Functional results and sport activity were similar in both groups. Examination showed 4 positive pivot shift tests (2 "sliding" and 2 positive) in the group with extra-articular plasty, even though 8 positive pivot shift tests in the isolated ACL group (5 "sliding" and 3 positive) were found. DISCUSSION: This study, as well as five others studies found in literature, was not randomized. In all these series, the surgical techniques, the rehabilitation programs and the functional score evaluation were too different to allow any pertinent comparison. Extra-articular plasty helps to control the laxity of the lateral compartment of the knee which is incompletely controlled by ACL reconstruction, particularly in chronic cases. This is proved by radiological measurements and pivot shift tests. Jensen in 1983, about 205 patients with a 4 year follow-up and Noyes, which used an allograft patellar tendon, found an advantage to do extra-articular plasty. But Strum (in 1989), as O'Brien (in 1991) and Roth (in 1987), did not found any advantage with extra-articular plasty. CONCLUSION: It is therefore obvious, after a four-year follow-up, that extra-articular supplementation presents an advantage for reconstruction of the ACL. by a free graft of the patellar tendon in chronic cases. Further randomized study will confirm that isolated ACL reconstruction is possible in some well defined categories of anterior laxity.

Adolescent↗
PubMed1986

The phenomenon of "ligamentization": anterior cruciate ligament reconstruction with autogenous patellar tendon.

Reconstruction of the anterior cruciate ligament (ACL) with patellar tendon (PT) is a common procedure for the symptomatic ACL-deficient knee. Questions regarding graft incorporation, viability, and nutrition of the transplanted tissue are of concern. This relates to the graft's response to its new intrasynovial milieu and new physical forces. These factors were studied in a rabbit model of ACL reconstruction using PT and were evaluated with histological and biochemical parameters with respect to time. A histological and biochemical metamorphosis of the grafted PT occurred in this study. Autografts demonstrated a gradual assumption of the microscopic properties of normal ACL; by 30 weeks postoperatively, cell morphology was ligamentous in appearance. Normally, type III collagen is not observed in PT, however, a gradual increase in its concentration was seen in the grafts; by 30 weeks its concentration (10%) was the same as in normal ACL. Similarly, glycosaminoglycans content increased from its normally low level in PT to that found in native ACL. Collagen-reducible crosslink analysis demonstrated that grafted tissue changed from the normal PT pattern of low dihydroxylysinonorleucine (DHLNL) and high histidinohydroxymerodesmosine (HHMD) to the pattern seen in normal ACL (high DHLNL and low HHMD) by 30 weeks. These data suggest that when PT is placed in the anatomic and environmental milieu of the ACL, a "ligamentization" of the grafted tissue results; also the autograft initially depends on synovial fluid nutrition, as revascularization occurs after 6 weeks.

Animals↗
PubMed1986

[Management of ligament injuries of the anterior ankle joint with ligament suture and a joint plaster cast].

Treatment of ligamentous injuries of the ankle joint by sutures functionplaster. 139 patients had been checked up after treatment by suturing and functionplaster because of ruptures of ligaments of the ankle joint. Four days after a funktionplaster has been applied the leg has been fully loaded. Four weeks later the plaster was taken off. At this time the ankle joint can be fully loaded and is mobile. 127 patients were absolutely restored, ten patients had slight complaints, in one case a slight instability has been remaining. One patient showed a ligament rupture of the ankle joint following newer distorsion. Twelve persons had superficial wound necroses. In one case there was an infection of the wound, the time of treatment was 78 days. This patient complains of pains by loading.

Adolescent↗
PubMed1997

[Replacement of the anterior cruciate ligament by cold preserved bone-cruciate ligament-bone allotransplants. An experimental study in the sheep].

One ACL in each of 17 mature sheep was replaced with a deep-frozen bone-an ACL bone allograft. Allografts were obtained from skeletally mature sheep using a standard aseptic technique and stored deep frozen for at least 6 days (mean 21 days). Macroscopical, biomechanical, and histological changes were evaluated 12, 24, and 52 weeks following implantation. At autopsy all allograft ligaments were present and demonstrated no evidence of infection or immune reaction. We found slight arthrotic changes in 3 knees after 12 weeks, in 4 knees after 24 weeks, and in 3 knees after 52 weeks. Twelve weeks after the operation the maximum load of the allografts was 17.5% of the contralateral controls and increased to 20.9% after 24 weeks and to 32% of controls after 52 weeks. Ligament stiffness in the linear region also increased from 18.9% of control (12 weeks) to 32.5% after 52 weeks, whereas maximum load decreased from 112.2% of controls (12 weeks) to 98% of controls (52 weeks). Histologically, the allografts progressively matured with time, becoming nearly identical to normal ligaments at 52 weeks.

Animals↗
PubMed1998

Ligament-muscle reflex arc after anterior cruciate ligament reconstruction: electromyographic evaluation.

The purpose of this study was to determine if a ligament-muscle reflex arc exists between the bone-patellar tendon-bone autograft after anterior cruciate ligament (ACL) reconstruction and the hamstring muscle group. We studied four patients, average age 34.2 years (range 32-36 years). The mean time between the ACL reconstruction and the study examination was 56.2 months (range 5-108 months). All patients underwent a second-look arthroscopy for meniscal injuries, cyclops lesions, or adhesions. Five patients with a normal ACL served as a control group before we performed an arthroscopic meniscectomy. Electromyographic (EMG) activity was measured using fine wire electrodes under two different testing conditions. No unequivocal EMG activity could be detected in the ACL-reconstructed knees when we pulled on the graft or in the controls. Three of four patients and all controls felt pain when we touched the graft or normal ACL or applied strain on it with the hook. In conclusion, the ACL autograft presents a noxious sensory innervation, the Lachman test maneuver stimulates a reflex arc with hamstrings activation, and an unequivocal ligament-muscle reflex arc from the graft to the hamstring muscle group could not be demonstrated.

Adult↗
PubMed1995

Effects of a delayed steroid injection on ligament healing using a rabbit medial collateral ligament model.

Corticosteroids are known to inhibit collagen synthesis in vitro as well as having a deleterious effect on ligament healing when applied immediately following injury. An acute injection of betamethasone into a transected rabbit medial collateral ligament significantly impaired the biomechanical and histological properties compared to non-injected transected ligaments. Differences in mechanical, histological and biochemical properties were observed up to 3 months following injury and an acute steroid injection. The present study explored the effects of a corticosteroid (betamethasone) injection 7 days following the initial injury. Biomechanical and histomorphometric analyses were carried determine if the previously observed deleterious effects of a corticosteroid injection immediately following injury can be linked to an interference in the inflammatory phase of healing due to the presence of the corticosteroid.

Analysis of Variance↗
PubMed1993

The distal ligamentous complex of the scaphoid and the scapho-lunate ligament. An anatomic, histological and biomechanical study.

22 fresh cadaver specimens have been examined to study the anatomy, histology and biomechanical features of the ligaments of the proximal and distal poles of the scaphoid. The biomechanical study was carried out by two methods: an analytical one on an Instron machine, and a global one in situ. The different experiments show the predominant rôle of the distal ligamentous complex of the scaphoid over the scapho-lunate ligament. This contrasts with the generally accepted concept and modifies the management of lateral carpal instability.

Biomechanical Phenomena↗
PubMed1993

Ligament replacement for chronic instability of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb.

Static and dynamic procedures have been described for reconstruction of chronic instability of the ulnar collateral ligament of the thumb metacarpophalangeal joint. This study presents a technique of ligament replacement utilizing a free tendon graft passed through two gouge tracks in the proximal phalanx and one in the metacarpal in a manner that closely approximates normal anatomy. We retrospectively reviewed 26 patients who underwent replacement. The follow-up period averaged 4.5 years. In 24 of 26 cases the joint was rendered stable by the replacement and the patient was relieved of pain. Eighty-five percent of the arc of motion was maintained. Postoperative key pinch measured 20 lb. on the operated side compared to 21 lb. on the unoperated side. Results were excellent in 20 patients, good in 4, and fair in 2. This technique successfully restores stability to the ulnar collateral ligament of the thumb metacarpophalangeal joint, diminishes pain and weakness with minimal loss of motion, and holds up over time.

Adult↗
PubMed2006

Medial patellofemoral ligament reconstruction: a novel technique using the patellar ligament.

In patients with chronic patellofemoral instability, more than 2 episodes of dislocation, and an anterior tuberosity trochlear groove of less than 20 mm as measured on computed tomography or nuclear magnetic resonance imaging, we have developed a technique for medial patellofemoral ligament reconstruction that uses a medial strip of the patellar ligament (PL). The incision started proximally at the level of the superior margin of the patella, centrally between the patellar medial margin and the medial epicondyle. A descending incision was then made, directed toward the superomedial margin of the tibial tubercle. We performed a plane-by-plane dissection up to the peritenon of the PL. With an osteotome, we could remove a 2-cm bone fragment concerning the medial third of the distal insertion of the PL or keep the distal end free. Using a No. 11 scalpel blade, we carefully detached the PL from the patella up to the transition between the proximal third and medial third of the patella. We placed the stitches between the periosteum and the ligament using FiberWire absorbable threads (Arthrex, Naples, FL) to safely rotate the graft. After that, we dissected the medial capsule and approached the femoral medial epicondyle. Then we placed a Krackow suture in the free tendon end using absorbable threads or anchored the threads into 2 holes that were previously drilled, and we secured the end with an absorbable interference screw or anchors. The fixation should be performed with the knee at 15 degrees to 30 degrees of flexion. Then we sutured the distal edge of the vastus medialis muscle to the graft, which bestows a dynamic component upon the reconstruction, and we immobilized the knee with a removable brace.

Arthroscopy↗
PubMed1986

Ligamentous avulsion of the ulnar collateral ligament of the thumb of a child.

Ulnar collateral ligament ruptures of the metacarpophalangeal joint of the thumb in children are usually associated with epiphyseal fractures of the proximal phalanx and, less frequently, cartilaginous fragments from the metacarpal. Radiographs are often normal. We describe an isolated ligamentous avulsion of the ulnar collateral ligament from the thumb metacarpal, without a bony or cartilaginous fragment, in a skeletally immature 12-year-old boy.

Child↗
PubMed2005

Immunohistochemistry of symptomatic hypertrophy of the posterior longitudinal ligament with special reference to ligamentous ossification.

STUDY DESIGN: Immnunohistochemical staining of the thickened posterior longitudinal ligament of the cervical spine. OBJECTIVES: To clarify the histological characteristics of hypertrophy of the posterior longitudinal ligament (HPLL) of the cervical spine and the relationship between HPLL and ossification of the posterior longitudinal ligament (OPLL). SETTING: Aichi Medical University, Aichi, Japan. METHODS: Eight specimens of HPLL and two of OPLL were obtained during anterior decompressive surgery on the cervical spine from patients with myelopathy. Hematoxylin and eosin staining, alcian blue staining and immunohistochemical staining with antibodies against bone morphogenetic protein (BMP), transforming growth factor (TGF)-beta, proliferating cell nuclear antigen (PCNA), alkaline phosphatase (ALP) and osteopontin (OPN) were carried out on the specimens. RESULTS: HPLL showed hyalinoid degeneration, the proliferation of chondrocytes and fibroblast-like spindle cells, infiltration of vessels and small ossification. In four cases, chondroid tissue was prominent with chondrocytes, which were expressed by ALP and OPN. The cells in HPLL were weakly or moderately stained by BMP, TGF-beta and PCNA. Their expression was similar to that of OPLL. Immunohistochemical staining was negative for all cells in the control cases. CONCLUSIONS: Histological and biochemical evidence supports the hypothesis that HPLL transforms into OPLL. The positive expression of BMP and TGF-beta in HPLL cells of myelopathic patients, and their similarity to OPLL, suggest that these cells have the potential to differentiate into osteogenic cells. Of note, neither BMP nor TGF-beta was demonstrated in the PLL of control subjects. Furthermore, the expression of chondrocytes by ALP and OPN in cartilage-prominent HPLL suggests that the cartilage can be replaced by new bone.

Aged↗