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At least 433 records · Page 24Linked to original sources
PubMed2000

Enamel matrix-derived protein stimulates attachment of periodontal ligament fibroblasts and enhances alkaline phosphatase activity and transforming growth factor beta1 release of periodontal ligament and gingival fibroblasts.

BACKGROUND: Although it is claimed that enamel matrix-derived proteins (EMP) can be used to promote new attachment formation around periodontally involved teeth, the underlying biological mechanism is not understood. It was the aim of the present study to investigate the effects of EMP on the behavior of human periodontal ligament (HPLF) and gingival fibroblasts (HGF) in vitro, with special focus on their attachment properties, the expression of alkaline phosphatase (ALP) activity, the release of transforming growth factor (TGF)beta1, and their proliferative rate. METHODS: Fibroblast populations were obtained from 10 individuals with a healthy periodontium and cultured in chemically defined medium on culture plates coated with EMP, purified collagen type I, or their respective vehicles. Experiments were performed in the absence of serum for periods up to 48 hours. RESULTS: It was shown that HGF barely attached and spread on EMP-coated substrata, whereas HPLF attached and spread within 24 hours. However, when cultured on purified collagen type I, both cell types showed rapid attachment and spreading. Furthermore, the expression of ALP activity was significantly enhanced under the influence of EMP, especially in HPLF. HPLF and HGF both released significantly higher levels of TGFbeta1 in the presence of EMP. EMP did not influence 3H-thymidine incorporation by HPLF and HGF. CONCLUSIONS: Our results indicate that HPLF and HGF respond differently to EMP. A more rapid attachment of HPLF to this substratum might contribute, during the initial stages of periodontal healing, to selective outgrowth and colonization of exposed root surfaces in vivo.

Adolescent↗
PubMed1992

[Ligament repair with PDS (polydioxanone) in chronic insufficiency of the fibular ligament of the upper ankle joint: experimental and clinical experiences].

From September 1988 till February 1989, 14 patients with chronic ligamentous rupture of the ankle had been operated on using PDS-plasty. Of 12 patients checked in follow-up examination (mean postoperative period 45 weeks), only two showed good or very good results. Most patients had the same signs of chronic instability as preoperatively. Two patients had been reoperated on. Intraoperatively we did not find a biological substitute along the PDS guide line. In an experiment on the rat we examined histological changes and tensile strength at appointed times. Histological data showed no biological substitute of PDS. We also found residues of PDS even after 300 days. After a short time loss of tensile strength occurred. In view of an aseptical necrosis that occurred in our experiments, we must point out the risk of foreign body granulomas.

Adolescent↗
PubMed1992

[Reconstructive interventions of the posterior cruciate ligament--experimental studies of isometric aspects. Part II: Studies of the posterior cruciate ligament replacement model].

Isometric positioning of the posterior cruciate ligament (PCL) graft is important for successful reconstruction of the PCL-deficient knee. This study documents the relationship between graft placement and changes in intra-articular graft length during passive range of motion of the knee. In eight cadaveric knees the PCL was identified and cut. The specimens were mounted in a stabilizing rig. PCL reconstruction was performed using a 9-mm-thick synthetic cord that was passed through tunnels 10 mm in diameter. Three different femoral graft placement sites were evaluated: (1) in four specimens the tunnel was located around the femoral isometric point, (2) in two specimens the tunnel was positioned over the guide wire 5 mm anterior to the femoral isometric point, (3) in two specimens the tunnel was positioned over the guide wire 5 mm posterior to the isometric femoral point. In all knees only one tibial tunnel was created around the isometric tibial point. The location of the isometric points was described in part I of the study. The proximal end of the cord was fixed to the lateral aspect of the femur. Distally the cord was attached to a measuring unit. The knees were flexed from 0 degree to 110 degrees, and the changes in the graft distance between the femoral attachment sites were measured in 10 degrees steps. Over the entire range of motion measured the femoral tunnels positioned around the isometric point produced femorotibial distance changes of within 2 mm. The anteriorly placed tunnels produced considerable increases in femorotibial distance with knee flexion, e.g. about 8 mm at 110 degrees of flexion.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

[Postoperative continuous passive motion following augmentation of anterior cruciate ligament ruptures with polydioxanone ligaments. Early results of a prospective study].

During a period of six months 30 patients underwent surgery at the St. Vincenz and Elisabeth Hospital at Mainz (Germany) because of a rupture of the anterior cruciate ligament (ACL). 26 persons could be examined three and six months after surgery. The surgical technique was the PDS augmented suture or the PDS augmented central third of the patellar tendon depending on the age of the rupture. All patients were rehabilitated with early exercises including CPM during the stationary phase. The influence of CPM on swelling, effusion, mobility, muscle atrophy, stability and time of after-treatment will be presented. The findings lead to the conclusion that CPM has great influence on prevention of muscle atrophy and early, unlimited mobility.

Adult↗
PubMed1988

[A holding device for standardized roentgenologic detection of ulnar, palmar and radial capsule ligament lesions of the metacarpophalangeal joint of the thumb. Hyperextensometer for the index finger metacarpophalangeal joint for determining laxity of the ligament].

A device has been designed to hold the limb for standardized radiological demonstration of lesions of the ulnar and radial collateral and palmar ligaments of the metacarpophalangeal joint of the thumb. The device also serves as a hyperextensometer of the metacarpophalangeal joint of the index finger with which to measure joint laxity. The simple mechanism allows routine application. Standardized stressed roentgenograms allow exact quantification of the extent of all lesions and consequently leads to adequate treatment.

Finger Injuries↗
PubMed1985

[Muscle exercise after the anterior cruciate ligament reconstruction of the knee--Part I: The force given to the anterior cruciate ligament by separate isometric contraction of the quadriceps or the hamstrings].

UNLABELLED: An attempt was made to investigate the force of the anterior cruciate ligament (ACL) in separate isometric contraction (IMC) of the quadriceps and the hamstrings by means of the analysis of two-dimensional models. In IMC of the quadriceps, the average value of the anterior drawer force (ADF) was equal to 14% of the quadriceps tension at the knee flexion of 5 degrees. The ADF decreased as the flexion angle increased. The average value of the angles, where the ADF became zero, was 45.3 degrees, and the standard deviation was 12.5 degrees. In IMC of the hamstrings, the posterior drawer force was given at the every flexion angle. CLINICAL RELEVANCE: In the early stage of the rehabilitation after the ACL reconstruction, the quadriceps exercise by IMC should be performed at the knee flexion of more than 70 degrees (average + 1.96 X S.D.). The hamstrings exercise by IMC can be carried out regardless of flexion angle.

Adult↗
PubMed2005

Treatment of acute and chronic anterior cruciate ligament-posterior cruciate ligament-lateral side knee injuries.

Knee dislocations are rare but devastating injuries. The ACL-PCL-lateral side injury combination is representative of the challenges these injuries present. Early management is focused on vascular integrity. When possible, acute repair and reconstruction within 3 weeks from injury is preferred. Chronically deficient knees generally will require lateral side reconstruction rather than repair and may require limb realignment. Addressing all injured structures is imperative to afford the best chance at a reasonable outcome. Good results with surgery are possible, but some degree of persistent disability is to be expected.

Anterior Cruciate Ligament↗
PubMed1995

[Clinical relevance of tunnel position and interference screw location after replacement-plasty of the anterior cruciate ligament with a patellar ligament transplant].

Fifty-eight patients had a prospective follow-up examination 1 year after arthroscopic ACL replacement. Stability measurement was done using a KT-1000 arthrometer. The side-to-side difference was less than 2 mm in 40 patients, 2-4 mm in 11 patients and more than 4 mm in 7 patients. The position of the tibial and femoral tunnels and interference screw was measured from the postoperative X-ray. The positions of screws and tunnels were highly variable. However, there was no statistical correlation between the position of the femoral interference screw and stability measurement or between the position of the femoral interference screw and flexion contracture or between the position of the tibial interference screw and the extension contracture. However, out of six patients with the femoral tunnel in an extremely anterior position (> 20 mm anterior of the over the top position), only one patient had a stable joint (< 2 mm difference in KT 1000 with 89 N anterior shear load) at follow-up. A screw divergence of more than 10 degrees was found in 18 patients. A tibial interference screw with more than 30 degrees of divergence was seen in seven patients. The primary fixation strength of the bone block could be diminished in these cases. This may have an impact on the early rehabilitation protocol.

Adolescent↗
PubMed1996

High tibial osteotomy alone or combined with ligament reconstruction in anterior cruciate ligament-deficient knees.

UNLABELLED: High tibial osteotomy (HTO) is widely accepted as a treatment option in patients with medial unicompartimental osteoarthritis (OA) and varus morphotype of the knee. We increasingly see younger patients with a chronic anterior instability, an additional varus morphotype and beginning medial OA. Treatment options for these patients are not clear up to now. In this clinical study we compare for the first time three different treatment rationales and introduce a concept of symptom-oriented surgery in young patients with medial OA and chronic anterior instability. MATERIALS/METHODS: Between 1984 and 1994 30 patients were treated with a medical unicompartimental OA and chronic anterior instability of the knee. Patients were grouped into three different groups according to treatment. 1) only HTO was performed. 2) HTO and simultaneously an ACL-reconstruction and 3) HTO and 6-12 months later an ACL-reconstruction was performed. 27/30 patients were available for follow-up. All patients had an arthroscopy before surgery. Evaluation was done according to the IKDC-protocol and X-ray documentation. RESULTS: Pain was a major problem in all patients. None of them was completely pain-free. 8/27 patients had pain even with light activities. This included 1/11 patients of group 1, 3/8 of group 2 and 4/8 of group 3. 9/27 patients had stable knee joints with a Lachman-test of 3-5 mm. No patient had a Lachman test < 3 mm. 3/11 patients of group 1, 3/8 of group 2 and 2/8 of group 3 had a Lachman test of 5-10 mm. A positive pivot-shift could be found in 9/27 patients. 2/11 of group 1, 4/8 in group 2 and 3/8 in group 3. The overall IKDC-score improved in 23/27 patients, one patient remained unchanged, two deteriorated. Radiologically a slight progression of OA could be seen in all patients. Radiological signs of OA and pain did not show any correlation. There was, however, a significant rate of postoperative complications involving 4/11 patients of group 1 and 3/8 of group 3. There were 6 major complications in 5/8 patients in group 2. Nevertheless overall patient satisfaction was high. 25/27 patients would undergo the procedure again. CONCLUSION: HTO is a good treatment option for younger patients with medial OA and chronic anterior instability of the knee. These patients pose a high challenge to diagnostic and operative skills of the surgeon. Main symptoms of these patients have to be analysed clearly in terms of instability and pain. In patients aged 40 and older an HTO alone is an excellent treatment option with reproducibly good results. In younger patients we advise an HTO first. If instability persists, an ACL-reconstruction can be done 6-12 months later. One has to be aware that a simultaneous combined procedure has a significant complication rate. Hence if a simultaneous combined treatment is planned the surroundings including surgical technique, rehabilitation and patient compliance have to be ideal. These young patients need an activity counselling in order to realise that their knee joint has suffered significantly from the injury and ongoing high physical demands on their knee joint.

Adult↗