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At least 289 records · Page 16Linked to original sources
PubMed1996

Effects of 5-lipoxygenase inhibitors on interleukin production by human synovial tissues in organ culture: comparison with interleukin-1-synthesis inhibitors.

Prostaglandins and leukotrienes differentially regulate the production of interleukin-1 (IL-1) in monocytes. It was, therefore, decided to investigate the effects of some 5-lipoxygenase inhibitors compared with standard IL-1 synthesis inhibitors on the production of IL-1 by human synovial tissue explants in organ culture. Human synovial (from hip/knee arthroplasty) or porcine tibio-tarsal joint synovial explants were incubated in organ culture in Dulbecco's Modified Eagle's Medium + 5% foetal calf serum in the presence of the test compounds or solvents (controls), or media alone for 1-5 days. Total bioactive IL-1 was assayed in the medium (following serial dilution or with polyethylene glycol 8000 added in some assays to remove inhibitors) using the D-10 T-cell bioassay. Some assays of interleukins 1 alpha, 1 beta, 6 or 8 were performed by ELISA. Of the 5-lipoxygenase inhibitors investigated, MK-886(3-(1-(4-chlorobenzyl)-3-tert-butyl-thio-5-isopropylindol-2- yl)-2,2 -dimethyl propanoic acid), L-656,224 ((7-chloro-2-[4-methoxypenyl]methyl)-3 -methyl-5-propyl-4-benzofuranol), PF-5901 and tepoxalin were the most potent inhibitors of IL-1 production. While the PF-5901 was effective at 5-30 microM and tepoxalin was effective at 1-10 microM, the others were the most potent having minimal inhibitory activity in the range of 0.01-0.1 microM. The presumed IL-1-synthesis inhibitors, tenidap and IX-207,887, were inactive at concentrations of 30-50 microM. Leukotriene B4 (1-100 ng/mL-1) added to MK-886 (5 microM)-treated cultures reversed the inhibitory effects of the latter on IL-1, confirming the role of 5-lipoxygenase products in the regulation of IL-1 production. Addition of polyethylene glycol 8000 to MI-886-treated cultures eliminated the inhibitory effects of this drug, suggesting that this drug exerts its effects by promoting production of IL-1 inhibitors. MK-886 also inhibited synovial production of two other pleiotrophic cytokines which it regulates, IL-6 and IL-8. The results suggest that some 5-lipoxygenase inhibitors may be usefully employed in regulating production of those interleukins involved in joint cartilage destruction.

Animals↗
PubMed1994

Flavobacterium meningosepticum, a pathogen in birds.

Five bacterial isolates were recovered from various diseased birds (chickens, a pigeon, and a zebra finch) and were identified as Flavobacterium meningosepticum. Four of them were isolated in pure or nearly pure culture of samples from internal organs, and one strain was isolated in mixed culture of a tarsal joint fluid sample. Except for the last case, there was no evidence of other disease agents. By using phenotypic, chemotaxonomic, and genomic methods, the strains were taxonomically characterized and could not be differentiated from the human clinical reference strains of the species. Two avian strains were different in their phenotypic behaviors and constituted another genotypic subgroup. In general, all F. meningosepticum strains constituted a single species which was easily differentiated from biochemically similar species and phylogenetically closely related taxa.

Animals↗
PubMed2006

Sexual dimorphism, but not testosterone itself, is responsible for ankylosing enthesitis of the ankle in B10.BR (H-2k) male mice.

BACKGROUND: Ankylosing enthesopathy (ANKENT) with progressive stiffening of ankle and tarsal joints of the hind limbs is a naturally occurring arthropathy in B10.BR mice. Some features are similar to those of the spondyloarthropathies in humans. OBJECTIVE: To study the role of sexual dimorphism and testosterone in the development of ANKENT. METHODS: The incidence of ANKENT was observed in non-castrated, castrated, and testosterone substituted castrated male mice, and in control and testosterone treated female mice. RESULTS: ANKENT occurred only in males; it did not develop in males castrated at age 2-3 months but occurred in castrated males injected with testosterone. Females injected with testosterone did not develop ANKENT. CONCLUSION: Testosterone can replace what castration eliminates, at least in the postpubertally castrated males, but is itself not sufficient to induce joint disease.

Animals↗
PubMed1994

Three-dimensional motion of the arytenoid adduction procedure in cadaver larynges.

To determine whether variation in suture placement could improve the results of the arytenoid adduction procedure, a model was developed using fresh human cadaver larynges. Three-dimensional (3-D) motion of the arytenoid was determined by utilizing computed tomographic imaging with radiopaque markers on the apex and muscular and vocal processes. By utilizing principles previously applied to the study of rigid body mechanics for the carpal, knee, and tarsal joints, rotation and translation of the arytenoid about the axial, coronal, and sagittal axes were calculated. Subglottic airflow resistance was measured before and after the procedure. Posterior glottic closure was reproducibly achieved, as determined by computed tomographic imaging and airway resistance. Conflicting reports on cricoarytenoid joint mechanics can be attributed to reliance on trigonometric analysis of two-dimensional images, which results in errors in out-of-plane motion. This paper presents a useful model for obtaining detailed anatomic information describing arytenoid 3-D motion.

Arytenoid Cartilage↗
PubMed2004

The role of the interosseous talocalcaneal ligament in subtalar joint stability.

BACKGROUND: Injury of the interosseous talocalcaneal ligament (ITCL) has been recognized as a cause of subtalar instability, though lack of an accepted clinical test has limited the ability of clinicians to reliably make the diagnosis. Clinical effects of ITCL failure remain unclear because of insufficient understanding of the role of the ligament. METHODS: Load-displacement characteristics of the subtalar joint were studied in six cadaver specimens using an axial distraction test and a transverse multi-direction drawer test. In all tests, cyclic loading (+/-60 N) was applied, and load-displacement responses were collected before and after sectioning of the ITCL. Two parameters were used to analyze the data: neutral-zone laxity as a measure of joint play, and flexibility as a measure of resistance to applied force. RESULTS: In the axial distraction test, sectioning increased both neutral-zone laxity and flexibility (p =.01 and.02, respectively). In the transverse test, sectioning caused increase of both neutral-zone laxity and flexibility (p <.001, for each). Neutral-zone laxity increased most greatly along an axis defined roughly by the posterior aspect of the fibula and the central region of the medial malleolus. Flexibility increased most in the medial direction (p <.05, for each). CONCLUSIONS: Results confirmed the role of the ITCL in maintaining apposition of the subtalar joint, as well as suggested its role in stabilizing the subtalar joint against drawer forces applied to the calcaneus from lateral to medial. The dominant direction of increased neutral-zone laxity described above suggests the optimal direction for detecting subtalar instability involved with ITCL injury. CLINICAL RELEVANCE: ITCL failure may result in subtalar instability and should be examined with a drawer force along the preferential axis roughly from the posterior aspect of the fibula to the central region of the medial malleolus. Further clinical evaluation is required to determine whether ITCL failure is reliably detectable.

Adult↗
PubMed2006

Arthrodesis of the subtalar and talonavicular joints for correction of symptomatic hindfoot malalignment.

BACKGROUND: Triple arthrodesis has long been used for the treatment of painful malalignment or arthritis of the hindfoot. However, the effect of fusion on adjacent joints has sparked interest in a more limited arthrodesis in patients without involvement of the calcaneocuboid joint. METHOD: Results of 16 feet in 14 patients who had a modified double arthrodesis for symptomatic flatfoot, cavovarus deformity, or hindfoot arthritis were reviewed retrospectively with a minimum followup of 18 (range 18 to 93) months. The most common diagnosis contributing to the hindfoot deformity was pes planovalgus. All operations were done with a consistent technique using rigid internal fixation with screws. In 15 feet, a concomitant gastrocnemius recession for equinus contracture was done at the time of the primary surgery. Clinical evaluation was based on the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale in addition to subjective assessments of pain, function, shoewear, cosmesis, and overall satisfaction. Radiographic evaluation included measurements of the anterior-posterior talo-second metatarsal angle, lateral talocalcaneal angle, and lateral talo-first metatarsal angle, and notation of arthritic changes of the ankle, calcaneocuboid, and midfoot joints, as well as an assessment of time to union of all arthrodeses. RESULTS: The average AOFAS Ankle-Hindfoot Scale improved from 44.7 preoperatively to 77.0 postoperatively (p < 0.01). Subjectively, patients experienced improvements in pain, function, cosmesis, and shoewear. Overall, all patients were satisfied and would have the procedure again under similar circumstances. Radiographically, all parameters statistically improved. There was an increase in arthritic scores for six ankle, six calcaneocuboid, and five midfoot joints. One talonavicular joint nonunion occurred in a rheumatoid patient, requiring revision arthrodesis. CONCLUSIONS: We have concluded that simultaneous arthrodesis of the talonavicular and subtalar joints is a reasonable treatment in the subset of patients with symptomatic hindfoot malalignment whose calcaneocuboid joints are not involved in the primary disease.

Adolescent↗
PubMed1988

Subtalar and intertarsal joint involvement in hemophilia and juvenile chronic arthritis: frequency and diagnostic significance of radiographic abnormalities.

Because radiological distinction between hemophilia and juvenile chronic arthritis can be difficult, the ankle and foot radiographs of patients affected by these two disorders were evaluated to compare the frequency and pattern of joint involvement. No statistical difference was noted between the frequency of posterior subtalar joint involvement in the two disorders, but, in the juvenile chronic arthritis group, more than 90% of the abnormal posterior subtalar joints were associated with intertarsal involvement. This association was never found in patients with hemophilia. Isolated tibiotalar joint involvement without subtalar abnormalities was significantly more frequent in hemophilia than in juvenile chronic arthritis. Although clinical differentiation between the two disorders is easily made, intertarsal joint involvement could be a useful feature in the radiological distinction of hemophilia and juvenile chronic arthritis.

Adolescent↗
PubMed1989

Kinematics of the ankle/foot complex: plantarflexion and dorsiflexion.

In an in vivo investigation of eight healthy volunteers, three dimensional ankle/foot kinematics were analyzed by roentgen stereophotogrammetry in 10 degrees steps of motion from 30 degrees of plantar flexion to 30 degrees of dorsiflexion of the foot. The study included all of the joints between the tibia and the first metatarsal, as well as the talocalcaneal joint, and was performed under full body load. Although the talocrural joint was found to account for most of the rotation around the transverse axis occurring from 30 degrees of plantar flexion to 30 degrees of dorsiflexion, there was a substantial contribution from the joints of the arch. This was seen particularly in the input arc from 30 degrees of plantar flexion to the neutral position, where the dorsiflexion motion of these joints amounted to 10% to 41% of the total transverse axis rotation.

Adult↗
PubMed1990

Tarsometatarsal involvement in juvenile spondyloarthropathy.

Patients with juvenile spondyloarthropathy who carry HLA B27 antigen or have a family history of ankylosing spondylitis may have marked tarsometatarsal arthritis. This may be associated with hindfoot involvement and result in a supination deformity. Spontaneous fusion with complete obliteration of the tarsometatarsal joints may occur.

Adolescent↗
PubMed1995

Lateral column lengthening with calcaneocuboid fusion: range of motion in the triple joint complex.

Lengthening the lateral column of the foot has been shown to correct flatfoot deformity. In adults, however, lengthening leads to calcaneocuboid arthritis. Lateral column lengthening with calcaneocuboid fusion, which lengthens the lateral column of the foot and prevents calcaneocuboid arthritis, was investigated in a cadaver model to determine the remaining range of motion in the talonavicular and subtalar joints. Inversion/eversion motion was produced by tendon pulls and the range of motion was measured in three dimensions using a magnetic space tracker. After lateral column lengthening with calcaneocuboid fusion, 48% of talonavicular and 70% of subtalar joint range of motion were preserved. Analysis of the inversion and eversion ranges of motion suggests that the lengthening fusion limits eversion more than inversion. These findings demonstrate the need for clinical investigation of this procedure, which could preserve motion in the talonavicular and subtalar joints, correct deformity, and obviate calcaneocuboid arthritis.

Adult↗
PubMed1996

Results of distal tibial bone grafting in hindfoot arthrodeses.

Distal tibial bone grafting is a safe and effective means of obtaining cancellous bone for hindfoot arthrodesis procedures, providing a sufficient quantity and quality of cancellous bone graft. Fusion rates using this bone graft are no less than those reported in the literature using autologous bone obtained from other sites. The 1% significant complication rate (fracture) of the donor site is low. Relative contraindications to the procedure include concomitant clinically significant peripheral neuropathy and severe osteopenia. Since cortical bone is not available from the distal tibia, procedures requiring corticocancellous strut or block grafts cannot rely solely on distal tibial grafting, although this procedure can be used to supplement iliac crest grafting when necessary.

Adult↗
PubMed1996

Subtalar arthrodesis using interposition iliac crest bone graft after calcaneal fracture.

Fifteen consecutive patients with hindfoot pain after calcaneal fracture underwent subtalar arthrodesis using interposition iliac crest bone graft. Outcome and correction of calcaneal collapse were assessed before and after surgery with clinical examination, visual analogue scores, and standard x-rays while weightbearing. Eleven of the 15 patients were satisfied with the procedure. There were four failures due to transverse tarsal joint arthritis, overcorrection, and reflex sympathetic dystrophy. Radiographic examination revealed restoration of heel height, with 100% union rate of the arthrodesis. The described technique allows arthrodesis and correction of calcaneal collapse after calcaneal fracture.

Adult↗
PubMed1997

Stress radiography and stress examination of the talocrural and subtalar joint on helical computed tomography.

The main objective of this study was to compare subtalar inversion stress views using the Brodén view with inversion stress views on helical computed tomography (CT). One of the drawbacks of routine radiography is the imaging of three-dimensional structures in a two-dimensional plane. We investigated whether the use of helical CT would lead to a more objective and clearer measurable method to determine the amount of tilt in the subtalar joint. A group of 15 patients with unilateral chronic instability complaints and clinically suspected subtalar instability was examined. The contralateral asymptomatic foot was used as control. A variable amount of subtalar tilt (range, 4 degrees to 18 degrees) was demonstrated in all cases on stress radiographs, without finding significant difference between the symptomatic and asymptomatic feet. However, contrary to the findings at the talocrural level, subtalar tilt was found in none of the patients using helical CT. Thus, we now doubt that the tilt seen during stress examination using the Brodén view is the true amount of tilt. It may be that the lateral opening, seen on these radiographs, largely results from imaging two planes that have made a translatory and rotary movement relative to each other in an oblique direction. It is concluded that the Brodén stress examination might not be useful for screening patients with subtalar instability. Associated anomalies not visible on the radiographs were detected by helical CT. In four cases, narrowing of the articular cartilage and irregular and hypertrophic bone formation at the middle facet joint of the subtalar joints were found. It is likely that these changes cause disturbance of function of this joint and it is suggested that the subjective complaint of instability with "giving way" is not only caused by hypermobility, but can be caused by other disturbance of normal motion.

Adolescent↗
PubMed1997

The effect of tibiotalar fixation on foot biomechanics.

Contact areas and peak pressures in the posterior facet of the subtalar and the talonavicular joints were measured in cadaver lower limbs for both the normal limb and after fixation of the tibiotalar joint. Six joints were fixed in neutral, in 5-7 degrees of varus and of valgus. Ten degrees of equinus angulation was also studied. Each position of fixation was tested independently. Neutral was defined as fixation without coronal or sagittal plane angulation compared with prefixation alignment of the specimen. When compared with normal unfused condition, peak pressures increased, and contact areas decreased in the subtalar joint for specimens fixed in neutral, varus, and valgus. However, the change in peak pressure for neutral fusion compared with normal control was not statistically significant (P > 0.07). Peak pressures for varus and valgus fixation were significantly different from normal (P < 0.001). Contact areas for all positions of fixation were significantly different from normal (P < 0.001). Coronal plane angulation, however, also resulted in significantly lower contact areas compared with neutral fixation (P < 0.001). Contact areas and peak pressures in the talonavicular joint did not appear to be substantially affected by tibiotalar fixation with coronal plane angulation. Equinus fixation qualitatively increased contact areas and peak pressures in the talonavicular and posterior facet of the subtalar joint. Neutral alignment of the tibiotalar joint in the coronal and sagittal planes altered subtalar and talonavicular joint contact characteristics the least compared with normal controls. Therefore, ankle fusion in the neutral position would be expected to most closely preserve normal joint biomechanics and may limit the progression of degenerative arthrosis of the subtalar joint.

Adult↗
PubMed1998

Isolated subtalar arthrodesis.

Forty-eight isolated subtalar arthrodeses in 44 patients with an average follow-up of 59.5 months were retrospectively reviewed. Original diagnoses included talocalcaneal coalition, healed calcaneal fracture with subtalar arthrosis, acquired flatfoot because of posterior tibial tendon dysfunction, degenerative subtalar arthrosis, subtalar instability, and psoriatic arthritis. Ninety-three percent of patients were very satisfied or satisfied with their treatment. Pain and function improved significantly, and the American Orthopaedic Foot and Ankle Society ankle-hindfoot score at follow-up was 89. There were six unsatisfactory results: three feet had calcaneal fractures and three were malpositioned. Union was achieved in all cases. Transverse tarsal motion was diminished by 40%, dorsiflexion by 30%, and plantarflexion by 9%. There was a 36% and 41% incidence of mild radiographic progression of arthrosis in the ankle and transverse tarsal joint, respectively. Isolated subtalar arthrodesis provided a highly successful result in the disease presented, and this study provides support for the use of a selected hindfoot fusion procedure for specific indications.

Adolescent↗
PubMed1998

Effects of tarsal tunnel release and stabilization procedures on tibial nerve tension in a surgically created pes planus foot.

An in vitro study was performed on 11 cadaver legs to study the effects of tarsal tunnel release, distraction calcaneocuboid arthrodesis, and triple arthrodesis on tibial nerve tension in surgically created pes planus feet. Baseline tibial nerve tension was measured during maximal dorsiflexion, eversion, combined dorsiflexion-eversion, and cyclical load with varying degrees of internal rotation. These measurements were repeated on the same leg after each surgical procedure. This study demonstrated that a tarsal tunnel release significantly increased nerve tension during eversion, dorsiflexion-eversion, and cyclical load compared with the pes planus foot. Both triple arthrodesis and distraction calcaneocuboid arthrodesis were effective at decreasing tibial nerve tension; the former was more effective than the latter. Procedures producing skeletal instability, such as ligament release producing a pes planus deformity and a tarsal tunnel release, increased tibial nerve tension. Procedures that corrected deformity and increased stability decreased tibial nerve tension. If increased tibial nerve tension plays a role in the pathophysiology of tarsal tunnel syndrome, then this needs to be considered for treatment of patients with this syndrome.

Arthrodesis↗
PubMed2005

A monoclonal antibody against kininogen reduces inflammation in the HLA-B27 transgenic rat.

The human leukocyte antigen B27 (HLA-B27) transgenic rat is a model of human inflammatory bowel disease, rheumatoid arthritis and psoriasis. Studies of chronic inflammation in other rat models have demonstrated activation of the kallikrein-kinin system as well as modulation by a plasma kallikrein inhibitor initiated before the onset of clinicopathologic changes or a deficiency in high-molecular-mass kininogen. Here we study the effects of monoclonal antibody C11C1, an antibody against high-molecular-mass kininogen that inhibits the binding of high-molecular-mass kininogen to leukocytes and endothelial cells in the HLA-B27 rat, which was administered after the onset of the inflammatory changes. Thrice-weekly intraperitoneal injections of monoclonal antibody C11C1 or isotype IgG1 were given to male 23-week-old rats for 16 days. Stool character as a measure of intestinal inflammation, and the rear limbs for clinical signs of arthritis (tarsal joint swelling and erythema) were scored daily. The animals were killed and the histology sections were assigned a numerical score for colonic inflammation, synovitis, and cartilage damage. Administration of monoclonal C11C1 rapidly decreased the clinical scores of pre-existing inflammatory bowel disease (P < 0.005) and arthritis (P < 0.001). Histological analyses confirmed significant reductions in colonic lesions (P = 0.004) and synovitis (P = 0.009). Decreased concentrations of plasma prekallikrein and high-molecular-mass kininogen were found, providing evidence of activation of the kallikrein-kinin system. The levels of these biomarkers were reversed by monoclonal antibody C11C1, which may have therapeutic potential in human inflammatory bowel disease and arthritis.

Animals↗