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At least 901 records · Page 50Linked to original sources
PubMed2006

Evaluation of ilial screw loosening after triple pelvic osteotomy in dogs: 227 cases (1991-1999).

OBJECTIVE: To investigate factors influencing screw loosening after triple pelvic osteotomy (TPO) and ischial wire stabilization of the acetabular segment. DESIGN: Retrospective case series. Animals-227 dogs with congenital hip dysplasia or subluxated hip joints. PROCEDURES: Medical records and radiographs of 227 dogs that underwent 332 TPO procedures were evaluated, and data pertaining to screw type, plate position, sacral screw engagement, use of ischial interfragmentary wires, and pelvic alignment were assessed for associations with screw loosening. RESULTS: Complications developed in 96 of the 332 (29%) procedures. Cancellous screws without sacral engagement were associated with the lowest frequency (6%) of loosening, compared with cancellous and cortical screws engaging the sacrum and cortical screws that did not engage the sacrum. Frequency of screw loosening increased when cortical or cancellous screws engaged the sacrum and when cortical screws were used. In dogs that had surgery bilaterally, the first limb on which TPO was performed had a higher frequency of screw loosening than the second limb. Pelvic alignment loss was greatest (5.4 degrees ) when the 3 most cranial screws were loosened. Loss of pelvic alignment was significantly different between dogs that underwent surgery and had complications and those that underwent surgery and did not have complications in association with loosening of 1, 2, and 3 screws. CONCLUSIONS AND CLINICAL RELEVANCE: TPO screw loosening was multifactorial and related to stability of the affected ilium, screw type, and screw position. Placing cancellous screws that do not engage the sacrum in pelvic osteotomy plate positions 1 through 3 may decrease the number of screws that loosen.

Animals↗
PubMed1998

Case report: can sacroiliac joint dysfunction cause chronic Achilles tendinitis?

This case study discusses the possible relationship between chronic Achilles tendinitis and sacroiliac joint dysfunction. The patient presented is an active pole jumper, competing at both the national and international levels. He suffered from chronic Achilles tendinitis during the 1994-95 season, and conservative treatment applied locally was not successful. The athlete discarded the possibility of operative debridement of the tendon. Instead, an evaluation of the kinetic chain of the lower extremity and pelvic-lumbar area was performed, and the athlete was diagnosed with sacroiliac joint dysfunction and Achilles tendinitis. Evaluation findings, treatment program, and treatment outcome are also presented. The literature regarding sacroiliac joint mechanics and biomechanics of the foot-knee-hip and pelvic area is discussed and used to support the author's thesis that sacroiliac joint dysfunction, in this case a backward rotation of the right ilium, may have changed the kinematic chain of the lower extremity and caused a tendinitis in the Achilles tendon of the affected leg. Sacroiliac joint function and dysfunction, the reliability of sacroiliac joint mobility tests, and the validity of treatment programs are still considered controversial, and more research is needed to understand these mechanisms.

Achilles Tendon↗
PubMed2004

Ultrasonographic examination of the equine sacroiliac region.

REASONS FOR PERFORMING STUDY: Little information exists about the normal ultrasonographic appearance of the equine sacroiliac region, but knowledge of the ultrasonographic anatomy is necessary to understand the possible pathological changes in sacroiliac diseases. OBJECTIVES: The normal ultrasonographic appearance of soft tissues and bony structures of the sacroiliac region in horses was studied in order to establish clinically relevant reference parameters. METHODS: Thirteen cadaver specimens were examined using a transcutaneous approach above the tubera sacrale to image the dorsal sacroiliac ligament and the tendon of the longissimus dorsi muscle. A rectal approach was used to outline the sacroiliac joint and its adjacent structures. Thirteen sound horses with no history of back pain were examined following the same protocol as for the post mortem examinations. RESULTS: The tendon of the longissimus dorsi muscle can clearly be distinguished from the dorsal sacroiliac ligament, especially in longitudinal images. Transrectal examination of the sacroiliac joint consists of evaluation of the bony surfaces of the sacrum and ilium in comparison with the contralateral side. CONCLUSIONS: Ultrasonographic examination of the sacroiliac region provided clear images of the caudomedial border of the sacroiliac joint and its adjacent structures and is a useful aid in the diagnosis of sacroiliac joint diseases and adjacent lesions. The study has shown ultrasonography to be a useful method for examining and differentiating the longissimus dorsi muscle and the dorsal sacroiliac ligament at the level of the tubera sacrale. POTENTIAL RELEVANCE: Diagnostic ultrasound is available to most practitioners. These reference ultrasound parameters may help to improve the diagnosis of sacroiliac diseases.

Animals↗
PubMed2006

The effect of conformation on orthopaedic health and performance in a cohort of National Hunt racehorses: preliminary results.

REASONS FOR PERFORMING STUDY: There is a lack of scientific data and studies on the effect of conformation on performance or on orthopaedic health. OBJECTIVES: To investigate the relationship between conformation, injury and performance in racehorses used for racing over fences. METHODS: Over 2 years, 108 National Hunt racehorses were followed and their medical and performance data recorded. Conformation was measured in 3D with a computerised motion analysis system. Linear multiple regression models were used to evaluate the effect of conformation on measures of race performance and stepwise forward logistic regression models to assess the effect on risk of injury. RESULTS: An increase in intermandibular width, flexor angle of the shoulder joint and coxal angle (the angle between the ilium and ischium) was demonstrated to have a positive effect on performance. Performance decreased with increasing girth, length of the hind digit and valgus conformation of the metacarpophalangeal joint. The risk of suffering from superficial digital flexor tendon injury increased with increasing metacarpophalangeal joint angle and with carpus valgus conformation. The risk of pelvic fracture increased with valgus conformation of the tarsus and decreased with an increasing coxal angle. CONCLUSION: Valgus deformation was demonstrated to be detrimental to performance or increased risk of injury, perhaps resulting in higher loads on musculoskeletal structures. The coxal angle was the only parameter to have an effect on both risk of injury and performance. An alignment of the muscles with the axis of the pelvis may be beneficial for force transmission and decrease the bending moment of the muscles on the bones. The statistical power of this study is limited, however it provides preliminary data necessary for the planning of a larger scale study on the effect of conformation on performance and risk of injury. CLINICAL RELEVANCE: Studies of the effects of conformation on performance and risk of injury may aid in identifying individuals likely to perform well on the racecourse and avoid risks of injury.

Animals↗
PubMedDate not supplied

Canine bone marrow as a potential thermal sanctuary during the plateau phase of 41.8 degrees C whole body hyperthermia.

Whole body hyperthermia (WBH) is currently being evaluated as an adjunct to various forms of antineoplastic therapy. In this regard, the uniformity of temperature in an individual subject, induced by any given WBH system, is a significant factor. Preliminary animal investigations suggested that the bone marrow temperature may differ from core temperature during 41.8 degrees C WBH. To quantitatively evaluate this possible phenomena, dogs were utilized in conjunction with a radiant heat WBH system. It was found that mean bone marrow temperature was significantly less than core (i.e. rectal) temperature (p < 0.001), i.e. 0.27 degree C for the ilium 0.40 degree C for the humerus and 0.95 degree C for the tibia. The implications of these results to current clinical trials are discussed.

Animals↗
PubMed1988

Schilling test: physiologic basis for and use as a diagnostic test.

With the advent of binding assays for vitamin B12 in blood, the Schilling test, which involves administration of radioactive B12 to a patient and subsequent urine collection for 24 to 48 h, fell into disuse in many laboratories. However, the test is still the only way to actually measure whether vitamin B12 is being absorbed through the terminal ilium. By administering radioactive vitamin B12, along with a preparation of intrinsic factor (IF), lack of functional IF may also be demonstrated. The Schilling test requires that attention be paid to a number of parameters, including the amount of radioactive vitamin B12 administered and the completeness of the urine collection. These factors, and others required for correct performance of the test, are discussed in this article.

Anemia, Pernicious↗
PubMed1989

Stress analysis of a total hip acetabular component: an FEM study.

A stress analysis of a total hip acetabular component was performed using three-dimensional finite element modeling. The model consisted of 548 four-noded quadrilateral shell elements with 582 nodes. A worst-case support condition was assumed in which bony contact with small areas of the ilium, ischium, and pubis was represented by three-point support. Loads corresponding to the peak pressures developed in the hip when rising from a seated position--the activity contributing most to the fatigue of a prosthesis--were applied to the model. Peak stresses of 490 MPa are predicted around a screw hole in the region of greatest loading; according to the fatigue curve for porous-coated Ti-6Al-4V alloy, this translates into a component life of three years. When the area of bony support for the prosthesis is increased by a factor of 1.5, the fatigue life is more than doubled to seven years. The addition of restraints around the loaded hole to represent the placement of a screw extends the lifetime dramatically to 65 years. Substituting the material properties of cobalt-chromium alloy increases the predicted lifetime of the component to twelve years. We conclude that poor bone support can compromise the service life of titanium alloy acetabular components. Furthermore, we suggest that screw fixation be used to secure the prosthesis in the anterior-superior region if the prosthesis is not well supported by bone in the acetabulum.

Acetabulum↗
PubMed1978

Fixation of pelvic fractures and dislocations. An experimental study on the loading of pelvic fractures and sacro-iliac dislocations after external compression fixation.

A trapezoid external compression fixation frame, assembled with the Hoffman instruments, was used for stabilizing experimental injuries to the pelvic skeleton of ten cadaver specimens. The resistance to loading in a position corresponding to upright standing was tested in 17 experiments and related to the calculated load in vivo. The results indicated that ipsilateral injuries, either presenting as dislocations of the sacro-iliac joint and symphysis or as unilateral fractures of the sacrum or ilium in combination with fractures of the pubic rami could be stabilized by the external compression frame well enough to permit weight-bearing in the upright standing position. Bilateral injuries to the pelvic skeleton, vertical or oblique, could not, however, be stabilized enough to resist more than a fraction of the normal load in the upright standing position.

Aged↗
PubMed1979

Effect of chlorpromazine on skeletogenesis. The result of maternal administration of the drug in experimental rats.

Chlorpromazine hydrochloride (CPZ) is known to induce intrauterine and extrauterine growth retardation. A single dose of CPZ (100 mg/kg) was administered to pregnant CF rats on the 14th day of gestation (sperm positive=day 0). Fetuses were collected from the 16th to the 20th day of gestation and processed for alizarin red-S stain. Ossification was delayed by 1 to 3 days in the long bones of the extremities, by 1 day in the scapulae and by 2 to 3 days in the ilium. Ischium and pubis remained unossified until the 20th day of gestation. Ossification of the skull bones was also delayed as manifested by the presence of wide sutures in the treated cases. The number and range of ossified vertebral bodies and arches in the treated group were always less than those in the control group. The sternebrae were most affected. The ribs also showed a significant delay in maturity.

Animals↗
PubMed1991

Immobilization increases bone prostaglandin E. Effect of acetylsalicylic acid on disuse osteoporosis studied in dogs.

The effect of acetylsalicylic acid (aspirin) on bone mass and bone prostaglandin E (PGE) in immobilization osteoporosis was studied in 12 growing dogs using a unilateral hind limb cast-fixation model. Osteoporosis was induced by fiberglass-cast immobilization of the right hind limb for 4 weeks, with the left hind limb as a control. Six dogs received buffered aspirin at 25 mg/kg body weight per os every 8 hours; 6 dogs received no treatment. All the dogs were killed after 4 weeks, and bone samples were collected. Bone mineral content of the distal tibial metaphysis was measured by single-photon absorptiometry. In vitro release of PGE from the calcaneus, tibial cortical bone, tibial cancellous bone, and ilium were measured using a specific radioimmunoassay for PGE. Compared with the controls, the casted limb of untreated dogs had half the bone mass and a twofold increase in bone PGE. Aspirin treatment was associated with a 65 percent reduction in bone PGE and a 13 percent bone mass sparing effect. These results provide indirect evidence that PGE plays a role in immobilization osteoporosis.

Absorptiometry, Photon↗
PubMed1996

High complication rates with pelvic allografts. Experience of 22 sarcoma resections.

We performed 22 reconstructions by allografts in patients with pelvic sarcoma: 14 Ewing's sarcomas, 7 chondrosarcomas, and 1 osteosarcoma. All patients with Ewing's sarcoma and osteosarcoma received chemotherapy. No patients with chondrosarcoma had adjuvant treatment. 12 reconstructions were iliosacral arthrodesis after resection of an ilium tumor, 1 was iliofemoral arthrodesis and 9 were pelvic reconstructions with total hip prosthesis after resection of an acetabulum tumor. In the surviving patients, the mean length of follow-up was 4 (2-6) years. 2 allografts fractured and 8 allografts developed an infection. The infection was commoner in patients who had chondrosarcomas, large tumors, and a long operation time. Neither chemotherapy nor radiotherapy increased the infection rate. All infected allografts had to be removed.

Adolescent↗
PubMed1997

Transarticular invasion of iliopelvic sarcomas into the sacrum. Radiological analysis of 47 cases.

Joint cartilage functions as a barrier against the extension of bone tumors. However, transarticular invasion by iliopelvic sarcomas across the sacroiliac (SI) joints into the sacrum sometimes occurs. We made a radiological analysis (CT and/or MRI) of 47 bone sarcomas which originated in the ilium and extended nearly to the SI joint 8 of 17 chondrosarcomas and 3 of 30 other sarcomas (2 of 23 Ewing's sarcomas and 1 of 7 osteosarcomas) invaded the sacrum through the SI joint.

Adolescent↗
PubMed1998

Hydatid disease of bones and joints. 8 cases followed for 4-16 years.

Hydatid disease is a rare parasitic disease that seldom involves the skeleton. Treatment is difficult because of problems with the preoperative diagnosis, the invasive nature of the bony involvement and the variable anaphylactic reaction to the cyst fluid antigen. We present 8 cases with osseous hydatidosis who were treated over a period of 11 years. The spine was involved in 2 cases, the ilium in 2, the hip in 2, the tibia in 1 and the humerus in 1. We point out that diagnosis is difficult and the prognosis is often poor.

Adult↗
PubMed2003

Surgical techniques for total sacrectomy and spinopelvic reconstruction.

The surgical management of sacral tumors requires partial or total sacrectomy and spinopelvic reconstruction. These lesions present a great surgical challenge, because most spine surgeons are unfamiliar with the techniques required for these procedures. The authors describe a step-by-step operative technique and provide several illustrations. Total sacrectomy is performed by sequential anterior and posterior approaches that involve a rectus abdominis pullthrough pedicle flap reconstruction. The anterior procedure is an intraperitoneal approach used to expose the anterior aspect of the tumor, to ligate the main tumor vessels, and to conduct an anterior partial sacrectomy. After this, the rectus abdominis myocutaneous flap, based on the inferior epigastric vessel, is prepared, and a posterior sacrectomy is performed, dividing all sacral nerve roots in the thecal sac. After complete en bloc extirpation of the sacrum with tumor, spinopelvic reconstruction and closure with a myocutaneous flap are performed. Spinopelvic reconstruction is undertaken using a modified Galveston technique or double iliac screw fixation combined with posterior lumbar segmental fixation. These provide a long lever arm within the ilium to counteract the forces exerted by the lumbar spine. Understanding the nature of the disease as well as the biomechanics of the lumbosacral pelvic area and spinopelvic fixation will help surgeons select the appropriate treatment for sacral tumors.

Biomechanical Phenomena↗
PubMed1981

Anterior decompression for ossification of the posterior longitudinal ligament of the cervical spine.

Anterior decompression and fusion for treating ossification of the posterior longitudinal ligament of the cervical spine was performed in 12 patients. The central part of the vertebral body and the ossified area of the posterior longitudinal ligament were removed by means of a microrongeur and an air drill. The defect was filled with a long bone graft taken from the ilium. The operative results were excellent. Marked improvement of radicular and spinal cord signs was seen in all 12 cases. Three vertebral bodies were fused in one case, four in nine cases, and five in two cases. The highest level of fusion was C-2 and the lowest was T-1. It is considered that any ossification of the ligament below the C-2 level can be removed via an anterior approach as long as no more than five vertebral bodies are involved. Spinal computerized tomography was valuable in providing more detailed information about the stenotic spinal canal and the shape of the ossified ligament.

Adult↗
PubMed2000

Spinal-pelvic fixation in patients with lumbosacral neoplasms.

OBJECT: Primary and metastatic neoplasms of the lumbosacral junction frequently pose a complex problem for the surgical management and stabilization of the spine because of the anatomical and biomechanical factors of this transition zone between spine and pelvis. The authors have used a modification of the Galveston technique, originally described by Allen and Ferguson in the treatment of scoliosis, to achieve rigid spinal-pelvic fixation in patients with lumbosacral neoplasms. The authors retrospectively reviewed their experience, with particular attention to method, pain relief, and neurological status. METHODS: From July 1994 through December 1998, 13 patients at the authors' institution have required spinal-pelvic fixation secondary to instability caused by primary (eight cases) or metastatic (five cases) neoplasms. Previous treatment included spinal surgery in 10 (77%), radiation therapy in seven (54%), and/or chemotherapy in six (46%). Following tumor resection, fixation was achieved by intraoperative placement of contoured titanium rods bilaterally into the ilium. These rods were attached to the lumbar spine with pedicle screws and subsequently crosslinked. Arthrodesis was performed. In the follow-up period of 3 to 50 months (average 20 months), nine (69%) of 13 patients were still alive. There were no cases of surgery-related death. Seven weeks postoperatively instrumentation failure occurred in one patient and was corrected by performing double L-rod spinal-pelvic fixation. Two patients experienced neurological dysfunction (ankle weakness and neurogenic bladder) that was thought to be related to tumor resection rather than the fixation procedure. Neurological status improved in four patients and remained unchanged in seven patients. Ambulatory status improved in 62% (eight patients), remained unchanged in 23% (three patients), and worsened in 15% (two patients). Spinal pain, as measured by a visual analog pain scale and determined by medication consumption was significantly reduced in 85% (11 cases). CONCLUSIONS: In selected patients with primary or metastatic lumbosacral tumors, resection followed by modified Galveston L-rod spinal-pelvic fixation is an effective means of achieving stabilization that can provide significant pain relief and preserve ambulatory capacity.

Adult↗
PubMed1985

Age-related osteopenia: evidence for an intrinsic defect of bone resorbing cells and a possible treatment.

B6D2F1 and B6AF1 mice of various ages were given sublethal or lethal doses of X radiation and injected with marrow and/or spleen cells from young, mature, or old syngeneic donors. Four to five months later they were killed and ash weights were determined on femurs, sacrum, and ilium. It was found that large numbers of marrow cells (i.e., greater than 25 X 10(6] and/or spleen cells (greater than 50 X 10(6] from old mice retarded the growth of bone in young hosts and induce loss of bone mass in mature recipients, spleen cells from young donors consistently prevented the loss of bone mass normally seen in aging mice, and the thymus and T cells did not appear to play a significant role in bone resorption and remodeling. These observations suggested that in aging mice loss of bone mass is caused by an intrinsic defect in a hematopoietic cell population, perhaps the macrophage/osteoclast or their common precursor, which results directly or indirectly in increased bone resorption. On this basis, promethazine HCl, an inhibitor of macrophage metabolism and phagocytosis, was added to the drinking water (1.0 to 4.0 mg/dl) of aging mice. Four to five months later it was found that bone mass was significantly greater in the groups given promethazine than in the age and weight matched controls.

Aging↗
PubMedDate not supplied

Radioactive iodine therapy: effect on functioning metastases of adenocarcinoma of the thyroid.

A case of metastatic adenocarcinoma of the thyroid is reported in which treatment by means of radioactive iodine has been successful. The patient was completely thyroidectomized for "malignant adenoma" in 1923, with neither thyrotoxicosis then nor hypothyroidism postoperatively; 15 years later there developed classic symptoms of hyperthyroidism and severe pain in the lower back. In October 1939 a pulsating tumor removed from the level of the 12th thoracic vertebra proved to be metastatic thyroid adenocarcinoma (histologically well differentiated, with small follicles and colloid). In the next two years hyperthyroidism increased and roentgenograms revealed new metastases in the lungs, upper part of the right femur, second rib on the left side, left ilium, and skull. Roentgenologic irradiation of the metastases proved ineffectual. In March 1943 a tracer dose of radioactive iodine revealed iodine retention by all the known lesions and no evidence of residual thyroid tissue in the neck. Therapeutic amounts of radioactive iodine were administered orally between May and October 1943. Definite and lasting clinical improvement followed. In April 1944 and March 1945 additional I* was administered with a resultant disappearance of pain, increase in weight, and progressive change in all clinical criteria in the direction of hypothyroidism. Roentgenographic evidence pointed to an arrest if not a regression of the disease. No untoward effects followed this therapy. Radioactive iodine seems to be an effective therapeutic agent in the control of this type of tumor.

Adenocarcinoma↗