Results of arthroscopic debridement for osteochondritis dissecans of the elbow.

Objective: To determine the clinical outcome of arthroscopic debridement for osteochondritis dissecans of the elbow.

Methods: A prospective cohort study was started in 2000; between 2000 and 2005, 15 patients (six male, nine female, mean age 28 years (range 16-49)) were treated for osteochondritis dissecans of the elbow with arthroscopic debridement. The lesion was graded during surgery using the classification of Baumgarten.

Postero-medial elbow problems in the adult athlete.

The ligamentous, osseous, musculotendinous, and neural structures at the postero-medial side of the elbow are at risk for various injuries in overhead athletes. The combination of valgus and extension overload during overhead activities results in tensile forces along the medial stabilising structures, with compression on the lateral compartment and shear stress posteriorly. The combination of tensile forces medially and shear forces posteriorly can result in ulnar collateral ligament (UCL) tears, flexor-pronator mass injuries, neuritis of the ulnar nerve, posterior impingement, and olecranon stress fractures.

Treatment of sequelae of radial head fractures with a bipolar radial head prosthesis: good outcome after 1-4 years follow-up in 11 patients.

Background: In the presence of additional disruption of the distal radioulnar ligaments, the interosseous membrane, or the lateral- and/or medial collateral ligament, radial head fractures treated by resection will result in valgus elbow instability, proximal radial migration and/or posterolateral rotatory instability. Radial head replacement has been used to treat or prevent this. We report our experience with the Judet CRF II radial head prosthesis.

Ligamentous reconstruction around the elbow using triceps tendon.

Posttraumatic instability of the elbow joint can be osseous or ligamentous. Ligamentous instability can be in valgus or in posterolateral rotatory direction. Rupture of both the lateral and medial collateral ligament of the elbow can be seen as an isolated injury, or it can be part of a more complex injury such as a dislocation.

Total elbow arthroplasty with the Kudo prosthesis.

Between 1990 and 1997 we undertook 57 Kudo type-4 total elbow replacements in 45 patients with rheumatoid arthritis. A total of 34 patients (44 elbows) were evaluated at an average of 7 (4.4-11.

Comparative prospective trial of 3 intramedullary plugs in cemented total hip arthroplasty.

We assessed the occlusion and stability of 3 intramedullary plugs used to restrict the femoral canal before primary cemented arthroplasty. In a prospective, randomized trial the Biosem (SEM, Montrouge, France), Cemlock (Sulzer Orthopaedic Ltd, Baar, Switzerland), and Thackray (DePuy International Ltd, Leeds, England) plug were compared in 93 hip joints replaced by the Stanmore hip prosthesis. We considered a range of 1 cm on the postoperative radiograph a measuring fault.

Biomechanical evaluation of the elbow using roentgen stereophotogrammetric analysis.

The medial collateral ligament complex is the primary constraint of the elbow to valgus forces and is composed of the anterior bundle, the posterior bundle, and a transverse part. Total and partial ruptures have been described. Clinical and radiologic examinations of medial or valgus instability of the elbow are difficult.

Functional anatomy of the lateral collateral ligament complex of the elbow: configuration of Y and its role.

A previous anatomic study has revealed that the lateral collateral ligament (LCL) complex of the elbow has a Y-shaped configuration, which consists of a superior, an anterior, and a posterior band. The LCL complex, including the annular ligament, functions as a 3-dimensional (3D) Y-shaped structure. On the basis of this concept, joint laxity after transection of the anterior band was studied in 5 normal, fresh-frozen cadaver elbows with a 3D kinematic testing apparatus.

Medial instability of the elbow: findings on valgus load radiography and MRI in 16 athletes.

Medial discomfort of the elbow in athletes can be due to valgus instability after acute ligament rupture or attenuation of the medial collateral ligament caused by repetitive microtrauma during overhead throwing. We studied 16 athletes with medial instability of the elbow due to insufficiency of the medial collateral ligament. 4 patients had sensory ulnar nerve symptoms, of whom 2 had abnormalities of the ulnar nerve on electromyography.

Posterolateral dislocation of the elbow joint. Relationship to medial instability.

Background: Dislocation of the elbow joint is the second most common dislocation in the upper extremity, dislocation of the shoulder being the most common. It has been reported that uncomplicated dislocation of the elbow joint may be associated with a decreased range of motion, degenerative changes in the elbow joint, ectopic calcification, or neurological deficits. As the medial collateral ligament complex can be completely disrupted during dislocation, we evaluated the association between the long-term results of treatment of simple posterolateral dislocation of the elbow and the presence of persistent medial or valgus elbow instability.

Kinematics of partial and total ruptures of the medial collateral ligament of the elbow.

In this study the kinematics of partial and total ruptures of the medial collateral ligament of the elbow are investigated. After selective transection of the medial collateral ligament of 8 osteoligamentous intact elbow preparations was performed, 3-dimensional measurements of angular displacement, increase in medial joint opening, and translation of the radial head were examined during application of relevant stress. Increase in joint opening was significant only after complete transection of the anterior part of the medial collateral ligament was performed.

Clinical reliability and validity of elbow functional assessment in rheumatoid arthritis.

Objectives: (1) To investigate the measurement characteristics of the Hospital for Special Surgery (HSS) and Mayo Clinic elbow assessment instruments, utilizing methodological criteria including feasibility, reliability, validity, and discriminative ability; and (2) to develop an efficient and disease-specific rating system for elbow function assessment (EFA) in adult patients with RA, using a combination of self-reported subjective items and objective measures, and comparing its characteristics with the HSS and Mayo Clinic scales.

Methods: (1) Selection of elbow-specific items. (2) Investigation of reliability and validity of all separate items, as well as the total HSS and Mayo Clinic scores, in 42 patients with RA (mean age 60 yrs).

Anterior cruciate ligament reconstruction with alternative tibial tunnel: early results after accelerated weight-bearing.

In this study an autologous graft of 50%-60% of the patellar tendon (mid portion) was used for anterior cruciate ligament (ACL) reconstruction in 50 patients (19 women, 31 men; mean age 26 years). The distal part of the graft was fixed in a tunnel running from the centre of the anatomical tibial attachment of the ACL to the place where the bone block of the graft was removed from the tibial tubercle. A rehabilitation programme with accelerated weight-bearing postoperatively without external protection was followed.

Melanogenesis in transfected fibroblasts induces lysosomal activation.

Normal melanosome biogenesis requires the association of structural proteins with tyrosinase. 3T3 Swiss fibroblasts transfected with mouse tyrosinase cDNA (line 13.4, clone c) are a unique system in which melanogenesis takes place in the absence of melanosomal structural proteins.