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At least 577 records · Page 32Linked to original sources
PubMed2002

Impact of vocal cord paralysis on cricoarytenoid joint.

To demonstrate structural changes in the cricoarytenoid joint after recurrent laryngeal nerve paralysis, we performed a laboratory investigation of fixed arytenoid cartilages from adult humans obtained during laser surgical arytenoidectomy in cases of bilateral vocal fold paralysis, analyzing the articular cartilage, the joint capsule, and the attached laryngeal musculature. Ten arytenoid cartilages from adult humans were studied by means of histology, as well as scanning and transmission electron microscopy. After long-standing denervation (>6 months), all arytenoid cartilages showed degenerative changes in their joint surface structure at various levels of intensity. The articular surface revealed fibrillation in some places, demasking of collagen fibrils next to the joint surface, and formation of chondrocyte clusters near the joint surface. All specimens also showed muscle atrophy. We conclude that long-standing recurrent laryngeal nerve paralysis does not result in ankylosis of the cricoarytenoid joint, as assumed, but the articular cartilage undergoes structural changes comparable to those in osteoarthritis. Structural changes in the articular cartilage and in the surrounding musculature hamper efforts at joint function recovery, as do procedures aiming solely at either medialization or lateralization of the vocal fold.

Adolescent↗
PubMed1993

Anatomy of the human temporomandibular joint. An updated comprehensive review.

This article is an in-depth review of the current knowledge on human temporomandibular joints (TMJ's). All aspects of joint anatomy are described with emphasis on adaptability to biochemical stimuli throughout life. Each TMJ is a pressure-bearing compound double synovial joint. TMJ's are unique in having a movement not only controlled by the morphology of the joint per se but also by the dentition at the other end of the lever system. During life the temporal, condylar and discal articular surfaces undergo remodelling. The synovium is an important joint component which contributes to nourish and lubricate the avascular surfaces and has bactericidal properties. The joint capsule has privileged relationships anteriorly with the lateral pterygoid muscle. This muscle has two heads that show functionally reciprocal activation. The exact insertion and role of the superior head of the lateral pterygoid muscle remains controversial. The disc has a very low coefficient of friction and compensates for the lack of congruence between articular surfaces. Biomechanically it is stabilized between condyle and articular eminence by its thick rim which has special viscoelastic properties. Apart from the viscoelastic deformations the other important mechanism of disc stabilization seems to be related with the structure of some of the disc attachments.

Humans↗
PubMed1996

The attachments of the conus elasticus to the laryngeal skeleton: physiologic and clinical implications.

The attachments of the inferior and dorsal extensions of the lateral parts of the conus elasticus (CE) are not fully understood. A re-investigation was done in plastinated serial sections of 20 adult human larynges. The CE consists of a coherent sheet of connective tissue fibers dividing into two layers toward the inferior anchorage to the cricoid arch, and the posterior anchorage to the cricoid lamina. Caudally, the medial fiber layer is continuous with the submucous fibroelastic membrane of the trachea and is not connected to the cricoid cartilage. The lateral caudal fiber layer is attached to the superior rim of the cricoid arch. Dorsally, both layers of the CE are fixed to the cricoid lamina, the lateral sheet to the lateral edge of the cartilage, the medial sheet to its anterior perichondrium near the midline. Towards the cricoarytenoid joint, the dorsal extension of the CE divides into a caudal and a cranial sheet including a fold of adipose tissue at the base of the arytenoid cartilage. The cranial layer extends towards the vocal process, the caudal layer radiates into the joint capsule and may therefore influence the complicated joint mechanics. The firm attachments of the CE to the cricoid cartilage probably counteract deformations of the CE during phonation. An insufficient fixation of the CE may contribute to an obstruction of the airways causing sleep apnea.

Adult↗
PubMed2004

Tendon regeneration: an anatomical and histological study in sheep.

Utilization of the hamstring tendon in reconstruction of the anterior cruciate ligament (ACL) has become common in recent years. In MRI studies regeneration potential in harvested tendon has been observed. In the present study, 20 legs from ten sheep, which underwent 10 cm segment resection of tendon of musculus extensor digitalis lateralis (MEDL) were used. The sheep were killed 6 months after the operation and regenerated tendons were examined macroscopically and histologically. Dissection was performed in the tendon resection area and specimens were reharvested for histological examination. Regeneration of the tendon with normal anatomical topographies was found in all legs. Regeneration occurred on both sides of the resected tendon simultaneously. Regeneration was muscle-like in the proximal side but it was tendon-like in the distal side. The developed tendon was fused to the joint capsule and to the fascia at the joint line in all specimens. This study indicates that tendon has a potential for regeneration.

Animals↗
PubMed1989

Subcutaneous joint-mouse escape during knee-joint arthroscopy.

During arthroscopy of the knee, large volumes of fluid are required. Cadaver studies have indicated that flexion of the knee may cause rupture of the joint capsule during arthroscopy. To illustrate this, a rare case is presented with rupture of the posterior part of the capsule during arthroscopy with extrusion of a joint mouse. This possibility should be considered when the joint mouse cannot be found inside the joint during arthroscopy.

Adult↗
PubMed1990

Transfer of a composite island homodigital distal interphalangeal joint to replace the proximal interphalangeal joint. Technique and case report.

The authors present an original technique of PIP joint reconstruction by an homo-digital island compound DIP joint transfer. The transfer consists of joint, capsule, volar plate, and ligaments. The distal joint is fused and the islanded joint interposed at the PIP level. In our clinical case, a flexion of 80 degrees was obtained with an extension lack of 15 degrees. This salvage procedure can be useful in selected well motivated patients. It provides rapid bone healing, good lateral stability, potential for growth in children, long term preservation of cartilage and acceptable range of motion.

Adult↗
PubMedDate not supplied

Arthrography using perfluorocarbon compounds.

The neat liquid and an emulsion of two perfluorocarbon compounds were injected into the knee joints of dogs and a human cadaver to investigate their applicability for arthrography. Excellent delineation of joint structures was observed for as long as 24 hours, but after 24 hours each contrast agent leaked out of the joint capsule into surrounding tissue. Light microscopy of joint tissue revealed a synovial proliferative reaction and a foreign-body granuloma reaction in surrounding tissues. No clinically apparent adverse side effects were evident in the test animals.

Animals↗
PubMed1990

Cervical zygapophyseal joint pain patterns. I: A study in normal volunteers.

The pain patterns evoked by stimulation of normal cervical zygapophyseal joints were determined in five volunteers. Under fluoroscopic control, joints at segments C2-3 to C6-7 were stimulated by distending the joint capsule with injections of contrast medium. Each joint produced a clinically distinguishable, characteristic pattern of pain, which enabled the construction of pain charts that putatively could be of value in determining the segmental location of symptomatic joints in patients presenting with cervical zygapophyseal pain.

Cervical Vertebrae↗
PubMedDate not supplied

Arthroscopic approach and intra-articular anatomy of the palmaroproximal or plantaroproximal aspect of distal interphalangeal joints.

An arthroscopic approach to the palmaroproximal or plantaroproximal pouch of the distal interphalangeal joint was developed in six cadaver limbs and seven limbs of three clinically normal horses. The dorsal aspect of the proximal border and the proximal articular margin of the distal sesamoid (navicular) bone, the palmar aspect of the distal articular margin of the middle phalanx, the collateral sesamoidean ligaments of the distal sesamoid bone, and the joint capsule attachments were readily accessible. Distending the joints with fluid gave access to portions of the articular surface between the distal sesamoid bone and the middle phalanx in all joints, and to a small portion of the distal phalanx in two hind distal interphalangeal joints. Two horses allowed to recover from anesthesia were not lame on days 30 and 37, respectively. Problems encountered initially were difficulty entering the joint, hemarthrosis, and minimal iatrogenic cartilage damage.

Animals↗
PubMed1998

Midfoot fusion technique for neuroarthropathic feet: biomechanical analysis and rationale.

To test the hypothesis that a plate applied to the plantar (tension) side of the medial midfoot provides stronger fixation than midfoot fusion with screw fixation, we biomechanically compared the two constructs for midfoot fusion. We created a model of midfoot instability in eight matched pairs of cadaver legs by section of joint capsule, ligaments, and tendons about Lisfranc's joints, and then performed a load-to-failure study to compare the fixation provided by a plantarly applied third tubular plate with that by cortical screws. After an initial load deformation curve to 1000 N was obtained, specimens were cyclically loaded at 200 to 750 N for 3000 cycles and then loaded to failure (screw pullout, fracture, or deformation >3 mm). Comparing the plantar plate and midfoot fusion with screw fixation constructs, a plate applied to the plantar (tension) aspect of the medial midfoot provides a stronger, sturdier construct than does midfoot fusion with screw fixation.

Aged↗
PubMed1991

[Surgical treatment of anterior instability of the shoulder joint].

In the article are presented data on the operative treatment of 52 patients (54 operations) with anterior instability of the arm joints. Patients have been distributed into 4 groups depending upon the character of intra-articular damages, revealed in the process of arthrotomy. Each group of patients was subjected to adequate operative intervention, based upon Bankart's method. The authors proceeded from the principle that the arm joint instability treatment should be aimed at removal of intra-articular damages. There have been restored integrity of the damaged cartilage cushion and the joint capsule, the capsule plasty and blocking of the anteroinferior joint sinus. The treatment tactics of the kind allowed to achieve the maximum stability of the arm joint and prevent postoperative recurrencies. Long-term results have been studied with 41 patient, no recurrencies have been noted. The operated limb function has been restored with the majority of the patients.

Arthrodesis↗
PubMed1997

Intracapsular pressure and loosening of hip prostheses. Preoperative measurements in 18 hips.

We measured the intracapsular pressure preoperatively in 18 hips (17 patients) before revision of a total hip arthroplasty because of aseptic loosening. Distension of the joint capsule was measured with sonography in 13 cases. In extension, the mean intracapsular pressure was 26 (0-60) mmHg, in extension and inward rotation it was 159 (24-280) mmHg, in extension and outward rotation it was 30 (3-67) mmHg and in 45 degrees of flexion it was 12 (0-28) mmHg. A mean of 6 (0.5-20) mL of joint fluid was aspirated after the pressure measurements. Sonography showed increased joint fluid/synovial edema and/or increased capsular thickness, as compared to 34 unrevised, radiographically not loose prosthetic hips, and that the capsular distension correlated to intracapsular pressure during extension and inward rotation. We conclude that the intracapsular pressure usually is elevated in a hip joint with loose prosthetic components, that the intracapsular pressure varies with the position of the hip and that capsular distension reflects increased intracapsular pressure. The increased and often very high pressure, varying during gait, may pump debris away from the joint along the interfaces and even by itself cause osteolysis and loosening.

Aged↗
PubMed2002

[Technique and diagnostic value of musculoskeletal ultrasonography in rheumatology. Part 6: ultrasonography of the wrist/hand].

Sonography of the hands is especially helpful in the diagnosis of early arthritis. Sonography allows for a very sensitive detection of small joint-effusion, tenosynovitis and small erosive bone lesions earlier than conventional radiography. Musculoskeletal sonography is also helpful in morphological analysis of changes of the median nerve in patients with carpal tunnel syndrome. The following standard scans are suggested for the sonographic evaluation of the wrist: 1. dorsal longitudinal scan along the radio-carpal joint, 2) along the ulno-carpal joint, and 3) dorsal transverse scan along the wrist to detect joint fluid collection, synovitis, tenosynovitis, ganglia, irregularities of the bone surface in osteoarthritis, and erosions due to inflammatory disease, 4) volar longitudinal scan along the radio-carpal joint, and 5) along the ulno-carpal joint, and 6) volar transverse scan along the wrist to diagnose the same objective as the above mentioned scans and to evaluate the median nerve in cases of carpal tunnel syndrome. Optional scans are the following: 7) ulnar longitudinal 8) transverse scan along the ulnar joint space and the extensor carpi ulnaris muscle to detect tenosynovitis and caput ulnae syndrome, 9) radial longitudinal, and 10). transverse scan along the joint space to diagnose synovitis and tenosynovitis. The following standard scans are suggested for the sonographic evaluation of the fingers: 1) volar longitudinal, 2) volar transverse scan in extension along the finger joints to detect effusion and synovial proliferation, tenosynovitis, irregularities of the bone surface (osteophytes, erosions), 3) dorsal longitudinal scans in extension and flexion >70 degrees along the CMC I, MCP, PIP and DIP joints to evaluate effusion and synovial proliferation, tenosynovitis or tendinitis, irregularities of the bone surface (osteophytes, erosions), and 4) dorsal transverse scans along the finger joints to evaluate these structures in an additional dimension. Optional 5) scans include the following: medial longitudinal scan along the MCP I, II, PIP and DIP joints, and 6) lateral longitudinal scan along the MCP V, PIP and DIP joints to evaluate the erosive bone process and joint instability. A linear transducer with a frequency of between 7.5 and 12 MHz is recommendable. The anterior distance between the bone and the joint-capsule of the wrist is > or = 3 mm in probable and > or = 4 mm in definite synovitis or effusions. Synovitis or effusions are probable if the difference between right and left wrist is > or = 1 mm, and they are definite if the difference is > or = 2 mm. A carpal tunnel syndrome is probable with a cross-sectional area of the median nerve of > or = 12 mm(2).

Arthritis, Rheumatoid↗
PubMed1994

[The role of computed tomography and magnetic resonance in assessing degenerative arthropathy of the lumbar articular facets].

Degenerative arthropathy of the lumbar facet joints remains a debated issue relative to both its etiopathogenesis and its clinical significance. The authors studied 9 autoptic specimens by means of CT and MRI: the diagnostic value of the two methods was assessed taking the histopathologic findings of the relative specimens as the gold standard. The following signs of degenerative arthropathy were investigated in each specimen: cartilaginous wears, hypertrophy of the articular processes, osteophytosis, subchondral sclerosis and geodes and capsular and ligamentous calcifications. CT clearly demonstrated the characteristic signs of arthropathy, although failing to assess the cartilaginous wears in the early degeneration phases. Cartilaginous surface tears were directly depicted by MRI in the specimens showing medium and advanced degeneration. In our opinion, CT represents the examination of choice in the diagnosis of degenerative arthropathy of the lumbar apophyseal joints. Nevertheless, human trials are needed to assess MR capabilities in better detailing subchondral bone structure and in depicting the joint capsule and the synovial membrane and fluid as a major MR potential to diagnose back pain syndromes arising from the posterior arch.

Aged↗
PubMed2006

Nerve endings of the wrist joint: a preliminary report of the dorsal radiocarpal ligament.

As part of an investigation of the articular nerve ending populations in the wrist joint capsule associated with the anterior and posterior interosseous nerves, this study addresses the nerve ending population in the dorsal radiocarpal ligament. The ligaments were harvested from four wrists of two fresh cadavers within 12 h of death. Tissues were fixed, cryostat sectioned, and processed for fluorescence immunohistochemistry using antibody to protein gene product 9.5 (PGP 9.5), a general or pan neuronal marker, and a secondary antibody conjugated to a fluorescent tag (Alexa Fluor 488). The sections were evaluated with a confocal laser microscope and an image analyzer. Labeled nerve endings were mapped, measured, and categorized. Type I (Ruffini-like ending), Type III (Golgi-like tendon organ) and Type IV (noncorpuscular) nerve endings could be identified in all four DRC ligaments, with Types I and IV dominating. These receptors were distributed primarily over the superficial two thirds of the ligament (>80%), and near the bony attachments (>70%). The dorsal radiocarpal ligament has a rich sensory innervation from the posterior interosseous nerve terminating in nerve endings located in the superficial two-thirds of the ligaments, primarily near bony attachment sites.

Aged↗
PubMed2005

Endoscopic distal soft tissue procedure in hallux valgus surgery.

The distal soft tissue procedure is the basis of surgical hallux valgus correction. It involves release of the transverse metatarsal ligament, adductor hallucis, and lateral joint capsule, which permits the proximal phalanx to be realigned on the metatarsal head. The attenuated medial capsule is plicated after the medial bony prominence has been excised. We describe a new endoscopic approach for the distal soft tissue procedure with better cosmetic results.

Arthroscopy↗
PubMed1998

Morphological characteristics of primary sensory and post-synaptic sympathetic neurones supplying the temporomandibular joint in the cat.

The cells of origin of peripheral nerves that supply the temporomandibular joint were investigated by examining the centripetal transport of wheat germ agglutinin-horseradish peroxidase (WGA-HRP). Following WGA-HRP injection into the temporomandibular joint capsule of the cat, a large number of labelled neurones were observed in the trigeminal and superior cervical ganglia ipsilateral to the injection site, while no labelled neurones were detected in the cervical dorsal-root ganglia. Only one labelled neurone was seen in the stellate ganglion. Labelled neurones were primarily located in the posterolateral and dorsal regions of the trigeminal ganglion, but their distribution in the superior cervical ganglion was not localized to specific regions. The labelled neurones in the trigeminal ganglion were significantly larger than those in the superior cervical ganglion but the sizes of smaller neurones overlapped, suggesting that trigeminal ganglion neurones send both myelinated and unmyelinated fibres to the temporomandibular joint. The innervation of the temporomandibular joint by somatosensory and sympathetic fibres suggests that sympathetic nerves could be responsible for allodynia or neuropathic pain caused by temporomandibular disorders.

Animals↗