RESUMEN
Transplantation of 25 fresh-frozen medial menisci was studied in 15 adult dogs. Before implantation, the allografts were deep-frozen and stored at -70 degrees C for 6 weeks to 18 months. The animals were killed 2 to 8 months postoperatively, and their knees and transplants were examined macroscopically and histologically. Complete healing of the allografts was found in 19 knees, incomplete in 3, and healing by massive fibrovascular tissue in 3 knees. Some shrinkage of the transplants taken 2 to 4 months after the surgery was observed; however, the 6- and 8-month specimens appeared grossly normal. Histologically, all transplants displayed a characteristic decrease in the number of cells, but this was significantly less pronounced in the 6- and 8-month specimens. Some degenerative alterations were found in all transplanted knees, but was obviously less pronounced in areas covered by the allografts and in the 6- and 8-month specimens. It is concluded that the transplantation of the fresh-frozen menisci could be successful; although the transplants are subjected to a remodeling process, they appear to function normally and protect the articular cartilage. The technique of conservation by freezing at -70 degrees C offers the advantage of an effective meniscal banking.
Asunto(s)
Criopreservación , Meniscos Tibiales/trasplante , Animales , Perros , Femenino , Miembro Posterior , Masculino , Meniscos Tibiales/citología , Meniscos Tibiales/fisiología , Trasplante HomólogoRESUMEN
One hundred thirty patients who had an injury of the triangular fibrocartilage complex (TFCC) with distal radioulnar joint (DRU) instability were treated operatively. The TFCC injury with DRUJ instability occurred as an isolated lesion in 20. After appropriate fracture stabilization, 86 patients were treated with closed reduction of the DRUJ and radioulnar transfixation with one to two Kirschner wires with the forearm in neutral rotation. In 19 patients the avulsed ulnar styloid was internally fixed, and the DRUJ supplemented with radioulnar transfixation. In 13 patients the ulnar styloid was internally fixed. In 12 patients with radial avulsion fractures the displaced bony fragment was percutaneously fixed with a Kirschner-wire. Postoperatively all the patients were immobilized in a long arm cast in neutral rotation for 6 weeks. The results were excellent in 95%, fair in 30, and poor in 5.
Asunto(s)
Cartílago Articular/lesiones , Cartílago Articular/cirugía , Luxaciones Articulares/cirugía , Inestabilidad de la Articulación/cirugía , Fracturas del Radio/cirugía , Fracturas del Cúbito/cirugía , Traumatismos de la Muñeca/cirugía , Accidentes por Caídas , Accidentes de Tránsito , Enfermedad Aguda , Adolescente , Adulto , Hilos Ortopédicos , Femenino , Fijación Interna de Fracturas/métodos , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
We studied transplantation of a fresh meniscus in 25 knees in 15 adult dogs. On 2 tables and with 2 surgical teams the medial menisci were explanted, exchanged and implanted into the opposite dog's knee. The animals were killed 4-12 months postoperatively, and the transplants were studied histologically. Complete healing in the host's capsular tissues was found in 18 knees, incomplete healing in 3, and healing by massive fibrovascular scar tissue in 4 knees. In the 4- and 5-month specimens the transplants were found to be narrower, thinner, and of changed color and consistency, while in the 8- and 12-month specimens most of the allografts appeared grossly normal. Histologically, the allografts had normal general microarchitecture, but a marked decrease in the number of cells. In the 8- and 12-month specimens the cells had increased but the number of cells in general was still less than in the controls. Although some degenerative changes of the medial tibial articular cartilage were noted in most knees, there were less changes beneath the allografted meniscus.
Asunto(s)
Supervivencia de Injerto/fisiología , Meniscos Tibiales/trasplante , Animales , Perros , Femenino , Estudios de Seguimiento , Masculino , Trasplante HomólogoRESUMEN
The normal vascular anatomy of the articular disc of 48 antebrachiocarpal joints was studied in 24 dogs (12 puppies and 12 adult animals) using an India ink vascular injection technique. It was found that the articular disc receives its blood supply mainly from the palmar and dorsal branches of the palmar interosseous artery. Branches of these 2 arteries arborise and give direct peridiscal vessels to the dorsal, proximal and palmar sides of the articular disc. The peridiscal vessels ramify and anastomose with one another to form a cup-shaped terminal peridiscal capillary plexus around the disc which ends at the peripheral parts of the disc in a series of terminal capillary loops. This leaves the major central segment of the disc without blood vessels. The proportion of vascularised to nonvascularised areas of the disc depends upon the age of the animals. In young puppies, the degree of vascular penetration into the disc is quite extensive, while in adult animals it ranges from 15 to 25% of the discal width; the considerably larger central area of the articular disc is thus avascular.
Asunto(s)
Cartílago Articular/irrigación sanguínea , Perros/anatomía & histología , Factores de Edad , Animales , Femenino , Miembro Anterior , Masculino , Radio (Anatomía) , CúbitoRESUMEN
A comparative study of the anatomy of the antebrachiocarpal (AC) articulation was carried out in 30 adult dogs with 60 joints. Although a considerable degree of similarity was found between the AC joint in dogs and the corresponding wrist joint in humans, a number of differences between these two homologous joints were also noted. The distal end of the ulna in dogs directly articulates with the ulnar carpal and accessory carpal bones forming a specialized antebrachiocarpal arrangement more adapted to running. The accessory carpal bone in dogs is a massive, long bone and is strikingly different from its homologue in humans, the pisiform bone. The joint between the accessory and ulnar carpal bones, which corresponds to the piso-triquetral joint in humans, is always connected with the AC joint, whereas in humans this communication could be found occasionally. The large radial carpal bone in dogs, characteristic for carnivores, corresponds to the fused scaphoid and lunate bones in humans, in whom this type of fusion is very rarely found. The palmar ulnocarpal and radiocarpal ligaments in dogs are distinctly intra-articular, whereas in humans these ligaments are intracapsular. One of the controversies of the AC joint in dogs is a structure located between the distal-most parts of the radius and ulna forming a strong bond between these two bones and a part of the antebrachial articular surface. It is cartilage-like and is composed of typical fibrocartilaginous tissue.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Carpo Animal/anatomía & histología , Perros/anatomía & histología , Animales , Cartílago Articular/anatomía & histología , Femenino , Masculino , Especificidad de la Especie , Articulación de la Muñeca/anatomía & histologíaRESUMEN
A study of the large subcutaneous haematoma or bursa was carried out in 85 adult patients who were mostly injured in traffic accidents as pedestrians hit by automobiles or in motocycle accidents. The lesions, mostly located at trochanteric and lumbosacral regions, were produced by direct, tangential traumatic forces splitting the subcutaneous fat from the fascia and creating a massive haematoma which was subsequently transformed into a real bursal cyst, resistant to the conventional methods of treatment. As the results of conservative measures were unsatisfactory in 74 per cent of cases, a simple operation has been developed, consisting of excision of the bursal wall and inserting cutaneofascial sutures to allow complete elimination of any dead spaces where tissue fluids could re-accumulate. As the results of this operation were favourable in 95 per cent of cases, it is recommended for the management of this condition.
Asunto(s)
Enfermedades del Tejido Conjuntivo/cirugía , Tejido Conectivo/cirugía , Hematoma/cirugía , Heridas y Lesiones/complicaciones , Adulto , Anciano , Tejido Conectivo/patología , Enfermedades del Tejido Conjuntivo/etiología , Enfermedades del Tejido Conjuntivo/patología , Femenino , Hematoma/etiología , Hematoma/patología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The articular disc of the distal radioulnar joint anatomy was studied in 109 wrist joints from 64 fresh adult cadavers. The disc is a strong fibrocartilaginous semicircular biconcave structure well adapted to its various functional roles. The length of the disc at its radial attachment varied between 12 and 20 mm (in most cases, 14-16 mm), and the width, measured between the apex and the radial base, varied from 7 to 14 mm, (in most cases, 9-11 mm). The thickness of the dorsal and palmar margins and the ulnar apex varied from 3 to 6 mm (in most cases, 4-5 mm), whereas the thickness of the central part varied from 0.5 to 3 mm (in most cases, 1 mm) and in a number of cases was perforated. Because the incidence of perforations increases progressively with the age of the subjects, the perforations were assumed to be degenerative in nature. Although the articular disc is a definable anatomic entity, it is intimately attached to surrounding elements to form a complex anatomic and functional structure.
Asunto(s)
Cartílago Articular/anatomía & histología , Radio (Anatomía) , Cúbito , Adulto , Anciano , Anciano de 80 o más Años , Envejecimiento/fisiología , Humanos , Articulaciones/anatomía & histología , Persona de Mediana EdadRESUMEN
Arthrography using 60 per cent Urografin was done on twenty fresh cadaver wrist joints. The wrists were then dissected and the arthrographic picture was correlated with the anatomical findings. The study showed that the contrast solution exactly delineated the radiocarpal joint cavity. It passed through all apertures into the adjacent joints. the arthrographic picture accurately corresponded to the anatomical observations. The pattern of a normal arthrogram was thus established. The preliminary results of a parallel clinical study in forty-nine patients are briefly described. I concluded that contrast arthrography can be helpful in the diagnosis of several conditions that show no findings on plain radiographs.
Asunto(s)
Articulación de la Muñeca/diagnóstico por imagen , Adulto , Anciano , Diatrizoato , Diatrizoato de Meglumina , Femenino , Humanos , Masculino , Persona de Mediana Edad , Radiografía , Articulación de la Muñeca/anatomía & histologíaRESUMEN
Late results of radial head excision were studied in 60 patients who had isolated fractures of the radial head. Symptomatic elbows were found in 43% of the patients, osteoarthritis in 52%, and valgus deformity in 30%. Elbow motion was restricted in 63%, and new bone formation at the surgical site was noted in 57% of the patients. Forearm rotation was limited in 58%. A proximal radioulnar synostosis was found in 7%, and proximal migration of the radius was present in 47%. A definite and symptomatic subluxation of the distal radioulnar joint was found in 25%. Overall results were unsatisfactory (fair and poor) in 50% of the patients. Excision of the radial head is a serious operation and is followed by a high proportion of complications. The indications for this operation should be relatively limited.
Asunto(s)
Complicaciones Posoperatorias/etiología , Fracturas del Radio/cirugía , Radio (Anatomía)/cirugía , Adolescente , Adulto , Anciano , Articulación del Codo/fisiopatología , Femenino , Estudios de Seguimiento , Antebrazo/fisiopatología , Humanos , Luxaciones Articulares/etiología , Masculino , Persona de Mediana Edad , Osificación Heterotópica/etiología , Factores de TiempoRESUMEN
On the basis of a study of 180 wrist joints from 100 fresh cadavers of individuals ranging in age from fetuses to 94 years, it is concluded that the triangular fibro-cartilage is very liable to degenerative alterations associated with ageing. Degeneration begins in the third decade and progressively increases in frequency and severity in subsequent decades. The changes comprise reduced cellularity, loss of elastic fibres, mucoid degeneration of the ground substance, exposure of collagen fibres, fibrillation, erosion, ulceration, abnormal thinning, and, ultimately, disc perforation. The changes are more frequent and more intense on the ulnar surface, and they are always situated in the central part of the disc. It appears that disc perforation is degenerative and age-related: thus there were no perforations in the first two decades of life; in the third there were 7.6%, in the fourth 18.1%, in the fifth 40.0%, in the sixth 42.8%, and in the over sixties 53.1%. There was an associated pattern of degenerative changes in the wrist joint as a whole. The structures adjacent to the articular disc (discal surface of the ulnar head, discal part of the lunate) were much more often involved, and the changes were much more advanced, than on non-discal surfaces. It is argued that this is because of more intensive biomechanical forces, particularly rotational forces, in the disc compartment of the joint.
Asunto(s)
Envejecimiento , Cartílago Articular/anatomía & histología , Adolescente , Adulto , Anciano , Cartílago Articular/embriología , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Articulación de la MuñecaAsunto(s)
Artritis Reumatoide/cirugía , Artrodesis/métodos , Muñeca/cirugía , Adolescente , Adulto , Anciano , Artritis Reumatoide/diagnóstico por imagen , Artritis Reumatoide/fisiopatología , Huesos del Carpo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Movimiento , Complicaciones Posoperatorias , Radiografía , Sinovectomía , Tendones/cirugía , Cúbito/cirugía , Muñeca/fisiopatología , Articulación de la Muñeca/diagnóstico por imagenRESUMEN
Among 125 patients with the Galeazzi-type fracture-dislocation of the forearm, there were fourteen children and eighty-six adults with the classic Galeazzi lesion, and twenty-five patients with a special type -- fracture of both bones and dislocation of the distal radio-ulnar joint. Conservative management was successful only in children. In adults this method resulted in failure in 80 per cent of cases. The results of operative treatment were much better. The fracture fragments of the radius and the dislocation of the radio-ulnar joint in this complex injury are very unstable, especially in the lesion with fractures of the radius and ulna, and it appears that rigid internal fixation is necessary for the dislocation as well as the fracture. With combined fixation over half of the results were excellent.