RESUMEN
We reviewed the results of a MacIntosh lateral-substitution over-the-top repair for chronic anterior cruciate-ligament insufficiency in thirty-four patients. This technique is a combined intra-articular and extra-articular repair using a strip of the tensor fasciae latae that is based at Gerdy's tubercle. We describe the operative procedure in detail. The patients were evaluated for both subjective and objective improvement. The average length of follow-up was thirty-seven months (range, twenty-four to fifty-nine months). Thirty-one patients (91 per cent) had a good or excellent result and in three patients (9 per cent) the result was rated as a failure. Ninety-seven per cent returned to their preoperative level of activity. There were no significant complications. We recommend this repair as a sound and effective method of treating chronic anterior cruciate-ligament insufficiency in the young to middle-aged symptomatic patient.
Asunto(s)
Inestabilidad de la Articulación/cirugía , Articulación de la Rodilla/cirugía , Ligamentos Articulares/cirugía , Transferencia Tendinosa/métodos , Adolescente , Adulto , Estudios de Evaluación como Asunto , Femenino , Estudios de Seguimiento , Humanos , Articulación de la Rodilla/fisiología , Masculino , MovimientoRESUMEN
Tuberculous dactylitis is rare musculoskeletal infection, but as emigration from developing countries increases it is likely to be seen more frequently. The author reports the case of a 23-year-old man with this condition. The radiologic features of tuberculous dactylitis include soft tissue swelling, periostitis with bone expansion and cortical destruction, diffuse uniform infiltration and localized osteitis. The major role of surgery is to provide tissue for diagnosis and to allow for the removal of caseous avascular tissue to promote distribution of drugs into surrounding tissues. An important aspect in the rehabilitation of these patients is early motion to prevent joint contracture and subsequent ankylosis.
Asunto(s)
Dedos/diagnóstico por imagen , Tuberculosis Osteoarticular/diagnóstico por imagen , Adulto , Cartílago Articular/diagnóstico por imagen , Dedos/patología , Tejido de Granulación/patología , Humanos , Masculino , Radiografía , Tuberculosis Osteoarticular/patologíaRESUMEN
The immunogenicity of a virus-induced rat osteosarcoma was studied utilizing the lymphocyte microcytoxicity test. Lymphocytes from "progressor" animals (in which the tumour progressed and metastasized) demonstrated an ability to kill osteosarcoma cells in vitro, while serum from these animals abrogated or blocked the cell-mediated cytotoxicity. Lymphocytes from "regressor" animals (in which tumours failed to develop or regressed spontaneously) also showed cytolytic activity against osteosarcoma cells in vitro, but their serum failed to block the lymphocyte-mediated cytolysis. Both progressor and regressor animals demonstrated the presence of humoral cytotoxic antibodies to tumour antigens on the basis of the ability of their serum to kill tumour cells in vitro. In an attempt to alter the fatal course of the disease in progressor animals, immunoprophylaxis and immunotherapy of the osteosarcoma in F1 hybrid rats war carried out by injecting them with parentalor, third party, allogeneic lymphoid cells. Injection of parental spleen lymphocytes into F1 hybrids produced a transient graft versus host reaction (GVHR), and prolonged the survival of the animals when lymphocytes were injected three days before, seven days after and on the day of tumour induction. Injection of allogeneic, third party lymphoid cells produced no detectable GVHR and prolonged the survival of F1 hybrids with osteosarcoma only when injected on the day of tumour induction. The prolonged survival of the groups treated with parental lymphoid cells was a result of stimulation of the host's immunological mechanisms during a transient GVHR, whereas the prolongation of survival in the group given allogeneic cells was most likely the result of a direct action of the donor lymphocytes on tumour cells, and not connected to a GVHR.
Asunto(s)
Virus de la Leucemia Murina de Moloney , Osteosarcoma/inmunología , Sarcoma Experimental/inmunología , Animales , Anticuerpos Antineoplásicos/inmunología , Citotoxicidad Celular Dependiente de Anticuerpos , Técnicas de Cultivo , Inmunidad Celular , Linfocitos/inmunología , Trasplante de Neoplasias , Osteosarcoma/patología , Ratas , Ratas Endogámicas ACI , Sarcoma Experimental/patología , Factores de TiempoRESUMEN
The biological behaviour and histopathology of an experimental osteosarcoma in rats are described as a model to study the human disease. The tumour was developed by injection of Moloney murine sarcoma virus into the tibial marrow space of three strains of inbred new-born rats. The resulting neoplasm was highly malignant and arose after a short latent period of only 10 days. It was readily maintained in tissue culture and was transplantable to adult rats. The virus induced tumour resembled human osteosarcoma in pattern of growth, tumour osteoid production, reaction of adjacent bony tissues and distribution of metastases, being an excellent model for the study of the interaction between oncogenic viruses and skeletal tissues. The analogies and differences between this and other virus-induced murine tumours and human osteosarcoma are discussed.
Asunto(s)
Virus de la Leucemia Murina de Moloney , Osteosarcoma/patología , Sarcoma Experimental/patología , Animales , Técnicas de Cultivo , Modelos Animales de Enfermedad , Trasplante de Neoplasias , Osteosarcoma/diagnóstico por imagen , Radiografía , Ratas , Ratas Endogámicas ACI , Ratas Endogámicas F344 , Ratas EndogámicasRESUMEN
Recently, on the basis of in vitro experiments, a number of workers have suggested that degenerative disk desease may have an autoimmune basis. In order to corroborate these findings, a histopathologic study was undertaken on 218 specimens. A series of 108 Schmorl's nodes and 110 intervertebral disks obtained at laminectomy were examined for an immune-reaction type of inflammatory cellular infiltrate. While no inflammatory cellular infiltrates were found in any of the specimens, there were granulation tissue ingrowths and vascular invasion. these pathologic findings may represent the body's response to mechanical injury rather than in inflammatory response to a thus far undefined antigen.
Asunto(s)
Enfermedades Autoinmunes , Inmunidad Celular , Disco Intervertebral/inmunología , Enfermedades de la Columna Vertebral/inmunología , Humanos , Disco Intervertebral/patología , Enfermedades de la Columna Vertebral/patologíaRESUMEN
Joint allotransplantation has been employed in the management of osteoarthritis affecting primarily one compartment of the knee. Biological resurfacing and realignment of the knee has been the goal. The immunological results of six patients posttransplant were studied with the lymphocyte microcytotoxicity test. Definite immunogenicity was demonstrated at an early stage. The sera from the recipients posttransplant was noted to abrogate the in vitro cytotoxicity suggesting the presence of blocking factors. The actual clinical significance of this phenomenon was difficult to judge insofar as no evidence of allograft joint rejection was seen.
Asunto(s)
Articulación de la Rodilla/trasplante , Inmunología del Trasplante , Femenino , Marcha , Humanos , Articulación de la Rodilla/diagnóstico por imagen , Osteoartritis/diagnóstico por imagen , Osteoartritis/inmunología , Osteoartritis/cirugía , Radiografía , Trasplante HomólogoRESUMEN
A review of 839 necropsies revealed 415 cases of malignant neoplasm, 63 of which were found to have evidence of metastatic spread to the sternum. Nineteen of these metastases resulted in pathological sternal fractures. Fine detail radiography proved a quick and accurate technique for detecting these lesions post mortem. The characteristics of pathological sternal fractures were compared with traumatic sternal fractures with respect to deformity and healing. Pathological fractures of the sternum demonstrate a tendency to greater deformity and slower healing than traumatic sternal fractures.
Asunto(s)
Neoplasias Óseas/complicaciones , Fracturas Espontáneas/etiología , Esternón/lesiones , Fracturas Espontáneas/diagnóstico , Humanos , Metástasis de la Neoplasia , Esternón/patología , Cicatrización de HeridasRESUMEN
Detailed histological evaluation of 72 femoral heads in terms of bone density, cartilagenous integrity and number of stress fractures in 3 different clinical groups of patients suggest that femoral trabecular fatigue fractures are largely determined by the degree of osteoporosis in all clinical states. The state of the hyaline cartilage also contibutes to the development of these fractures but only when the cartilage is degenerated to a severe degree as seen in rheumatoid arthritis. Both bone density and cartilage viability may be determining factors in the pathogenesis of trabecular stress fractures in rheumatoid hips.
Asunto(s)
Fracturas del Fémur/etiología , Cabeza Femoral/lesiones , Estrés Mecánico , Huesos/patología , Fracturas del Fémur/patología , Humanos , Análisis de RegresiónRESUMEN
The immunogenicity of a virus-induced rat osteosarcoma was studied utilizing the lymphocyte microcytotoxicity test. Intratibial injection of murine sarcoma virus (Moloney) resulted in the development of palpable tumors at the injection site which on histopathological examination appeared to be osteosarcomas. In 73 per cent of animals injected these tumors progressed and metastasized to the lungs. Lymphocytes from these "progressor" animals demonstrated an ability to kill osteosarcoma cells in vitro (as quantitated in the microcytotoxicity test) while serum from these animals abrogated or blocked the cell-mediated cytotoxicity. In the remaining animals the tumors either failed to develop or regressed spontaneously. Lymphocytes from these "regressor" animals also demonstrated cytolytic activity against osteosarcoma cells in vitro, but serum failed to block the lymphocyte-mediated cytolysis. Both regressor and progressor groups demonstrated humoral cytotoxic antibodies to tumor antigen on the basis of the ability of their serum to kill tumor cells in vitro.