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21.
Arthroscopic reconstruction of the anterior cruciate ligament with Leeds-Keio ligament in non-professional athletes 总被引:2,自引:0,他引:2
M. Marcacci S. Zaffagnini A. Visani F. Iacono M. P. Neri A. Petitto 《Knee surgery, sports traumatology, arthroscopy》1996,4(1):9-13
We report our experience using the Leeds-Keio artificial ligament for anterior cruciate ligament (ACL) reconstruction. The study relates the results of the first 40 patients subjected to arthroscopic reconstruction of the ACL with a Leeds-Keio ligament, with a mean follow-up of 73 months. No associated peripheral procedures were carried out on any patient. The average age of the patients at the time of the operation was 31 years (range 26–35 years). The rehabilitation protocol followed by all patients aimed at resumption of sport 4 months after the operation. Clinical assessment included IKDC and the Lysholm scoring scale. The KT-2000 system was used for instrumented evaluation of joint laxity. All patients underwent a radiographic check-up. Clinically there were 55% excellent or good results when using the IKDC scale, while with the Lysholm score, satisfactory results were obtained in 80%. Complete post-traumatic rupture of the ligament was observed in three patients. No patient suffered an episode of either hydrarthrosis or reactive synovitis, which indicates good tolerance to the ligament. The radiographic evaluation of the operated knees showed a close correlation between the appearance of degenerative phenomena and performance of arthroscopic meniscectomy. The results achieved with the Leeds-Keio artificial ligament 5 years after application, although not completely satisfactory and inferior to those obtained with autologous biological ligaments, should be considered an encouragement to promote new efforts in this interesting research field. 相似文献
22.
Ramacciotti CE Paoli RA Marcacci G Piccinni A Burgalassi A Dell'Osso L Garfinkel PE 《Psychiatry research》2005,135(2):165-170
In this study we describe the frequency of eating disorders (EDs) in a group of bipolar (BP) patients. We evaluated a sample of 51 outpatients, diagnosed as having BP I disorder on the basis of the Structured Clinical Interview for DSM-IV (SCID). Each of these subjects was administered the Binge Eating Disorder Clinical Interview (BEDCI) to determine the presence of binge eating disorder (BED) or bulimia nervosa (BN). Of the 51 BP patients, 14 (9 BED, 5 BN) met criteria for an ED. Most patients developed binge eating coincident with the first episode of BP disorder or after the onset of it. This was true for those who developed BED as well as BN, and involved both manic and depressive phases. All BN patients were women (5/5), and family history of binge eating was present in 80% of BN subjects, but only in 22.2% of BED and 29.7% of non-ED BP patients. We found a high frequency of concordance between BP illness and binge eating problems in our sample of BP patients. Given the temporal sequence of the mood disorder, which generally preceded the ED, we suggest a model in which the ED evolves due to modulation of emotions with food, as well as use of medications to treat BP disorder that disrupt hunger and satiety mechanisms. Given differences in gender distribution and family history, cultural and familial influences may also be significant in the minority of BP binge-eating patients who develop BN. 相似文献
23.
24.
Giuseppe Filardo Elizaveta Kon Roberto Buda Antonio Timoncini Alessandro Di Martino Annarita Cenacchi Pier Maria Fornasari Sandro Giannini Maurilio Marcacci 《Knee surgery, sports traumatology, arthroscopy》2011,19(4):528-535
Purpose
Platelet-rich plasma (PRP) therapy is a simple, low-cost and minimally invasive method that provides a natural concentrate of autologous blood growth factors (GFs) that can be used to enhance tissue regeneration. In a previous analysis of a 12-month follow-up study, promising results were obtained when treating patients affected by knee degeneration with PRP intra-articular injections. The main purpose of this study was to investigate the persistence of the beneficial effects observed. 相似文献25.
Stem cells associated with macroporous bioceramics for long bone repair: 6- to 7-year outcome of a pilot clinical study 总被引:4,自引:0,他引:4
Marcacci M Kon E Moukhachev V Lavroukov A Kutepov S Quarto R Mastrogiacomo M Cancedda R 《Tissue engineering》2007,13(5):947-955
Extensive bone loss is still a major problem in orthopedics. A number of different therapeutic approaches have been developed and proposed, but so far none have proven to be fully satisfactory. We used a new tissue engineering approach to treat four patients with large bone diaphysis defects and poor therapeutic alternatives. To obtain implantable three-dimensional (3D) living constructs, cells isolated from the patients' bone marrow stroma were expanded in culture and seeded onto porous hydroxyapatite (HA) ceramic scaffolds designed to match the bone deficit in terms of size and shape. During the surgical session, an Ilizarov apparatus or a monoaxial external fixator was positioned on the patient's affected limb and the ceramic cylinder seeded with cells was placed in the bone defect. Patients were evaluated at different postsurgery time intervals by conventional radiographs and computed tomography (CT) scans. In one patient, an angiographic evaluation was performed at 6.5 years follow-up. In this study we analyze the long-term outcome of these patients following therapy. No major complications occurred in the early or late postoperative periods, nor were major complaints reported by the patients. No signs of pain, swelling, or infection were observed at the implantation site. Complete fusion between the implant and the host bone occurred 5 to 7 months after surgery. In all patients at the last follow-up (6 to 7 years postsurgery in patients 1 to 3), a good integration of the implants was maintained. No late fractures in the implant zone were observed. The present study shows the long-term durability of bone regeneration achieved by a bone engineering approach. We consider the obtained results very promising and propose the use of culture-expanded osteoprogenitor cells in conjunction with porous bioceramics as a real and significant improvement in the repair of critical-sized long bone defects. 相似文献
26.
Zaffagnini S De Pasquale V Marchesini Reggiani L Russo A Agati P Bacchelli B Marcacci M 《The Knee》2007,14(2):87-93
Following anterior cruciate ligament (ACL) reconstruction with the middle third part patellar tendon, the graft undergoes histological rearrangement due to biomechanical action, which transforms it into a structure similar to the normal ACL. The purpose of our study was to make a qualitative and quantitative histological evaluation, by transmission electron microscopy (TEM), of the neoligamentization process of a bone-patellar tendon-bone (BTPB) graft used as pro-ACL at different follow-up times. We analysed the ultrastructure of collagen fibrils by focusing on their size and distribution with respect to a normal patellar tendon and a normal ACL used as controls. Our results showed that up to 24 months follow-up, progressive ultrastructural changes towards the normal ACL were observed. At longer times after surgery (48 and 120 months) no further changes were evident and the ultrastructure showed a marked reduction in large fibrils, which was typical of the control patellar tendon, and a significant increase in small fibrils. The ultrastructure seemed to combine fibrils from two different morphological units. The BPTB graft used as ACL underwent a transformation process for up to two years. After that period the transformation ceased and for ten years failed to reach the ultrastructural aspect of a normal ACL. However, from an architectural point of view the graft was slowly transformed into a structure similar to ACL with respect to the different mechanical stresses the ligament has to sustain. 相似文献
27.
F.?ColleEmail author S.?Bignozzi N.?Lopomo S.?Zaffagnini L.?Sun M.?Marcacci 《Knee surgery, sports traumatology, arthroscopy》2012,20(3):552-558
Purpose
No study, up to now, has examined the effect of arthritis on pathologic subjects using functional flexion axis (FFA). The purpose of this study is to understand whether arthritis affects somehow the FFA evaluation and to assess whether the FFA could be considered a usable reference for implant positioning for osteoarthritic knees. 相似文献28.
Marcacci M Zaffagnini S Bonanzinga T Marcheggiani Muccioli GM Bruni D Iacono F 《Knee surgery, sports traumatology, arthroscopy》2012,20(7):1404-1408
Revision ACL presents many technical issues that are not seen in the primary ACL reconstruction. A variety of surgical techniques for revising ACL reconstruction have been described in the literature to address these concerns. The purpose of this article is to present a novel technique consisting in a non-anatomic double-bundle ACL revision reconstruction, using a fresh-frozen Achilles tendon allograft with soft tissue fixation. This technique is a valid treatment option when faced with a complex scenario such as ACL revision surgery. 相似文献
29.
Filardo G Kon E Di Martino A Patella S Altadonna G Balboni F Bragonzoni L Visani A Marcacci M 《Knee surgery, sports traumatology, arthroscopy》2012,20(9):1704-1713
Purpose
Degenerative cartilage lesions present a negative joint environment, which may have a negative effect on the process of cartilage regeneration. The aim of this study is to analyze the clinical outcome obtained with the treatment for isolated degenerative knee cartilage lesions by second-generation arthroscopic autologous chondrocyte implantation (ACI).Methods
Fifty-eight consecutive patients affected by focal degenerative chondral lesions of the femoral condyles and trochlea were treated by second-generation arthroscopic ACI. The mean age at surgery was 34.7?±?9.1?years and the average defect size was 2.3?±?0.9?cm2. The patients were prospectively evaluated with IKDC, EQ-VAS, and Tegner scores preoperatively, at 2 and 6?years.Results
A statistically significant improvement was observed in all scores from the basal evaluation to the final follow-up. The IKDC subjective score improved from 39.3?±?13.6 to 68.8?±?22.7 and 68.5?±?23.9 at the 2- and 6-year follow-ups, respectively, with a significant improvement (P?0.0005) and stable results over time; the same trend was confirmed by the EQ-VAS and Tegner scores. The worst results were found in patients with a low physical activity level, women, and those having undergone previous surgery, whereas the symptom duration before surgery did not influence the final outcome. The failure rate was 18.5%.Conclusions
Despite a significant improvement, the results were lower with respect to the outcome reported in different study populations, and the number of failures was markedly higher, too. Tissue-engineered cartilage implantation is a promising approach for the treatment of degenerative chondral lesions, but graft properties, besides mechanical and biochemical joint environment, have to be improved.Level of evidence
Case series, Level IV. 相似文献30.
Gomoll AH Filardo G Almqvist FK Bugbee WD Jelic M Monllau JC Puddu G Rodkey WG Verdonk P Verdonk R Zaffagnini S Marcacci M 《Knee surgery, sports traumatology, arthroscopy》2012,20(3):468-486
Young patients with early osteoarthritis (OA) represent a challenging population due to a combination of high functional demands and limited treatment options. Conservative measures such as injection and physical therapy can provide short-term pain relief but are only palliative in nature. Joint replacement, a successful procedure in the older population, is controversial in younger patients, who are less satisfied and experience higher failure rates. Therefore, while traditionally not indicated for the treatment of OA, cartilage repair has become a focus of increased interest due to its potential to provide pain relief and alter the progression of degenerative disease, with the hope of delaying or obviating the need for joint replacement. The field of cartilage repair is seeing the rapid development of new technologies that promise greater ease of application, less demanding rehabilitation and better outcomes. Concurrent procedures such as meniscal transplantation and osteotomy, however, remain of crucial importance to provide a normalized biomechanical environment for these new technologies. LEVEL OF EVIDENCE: Systematic review, Level II. 相似文献