ABSTRACT
Arthritis remains a widespread and yet unsolved therapeutic dilemma. Cartilage grafting has proven to be difficult and satisfactory results are often elusive. There are several inherent difficulties. These include both chondrocyte migration and the lack of sufficient uptake of nutrients to allow for graft survival. With autografts, there is also the paucity of symptom-free donor sites. Accordingly, multiple alternative therapies for cartilage regeneration and/or substitution have been developed over time. In this article, the authors shall discuss the options for the treatment of damaged cartilage with a focus on the cartilage grafting techniques.
ABSTRACT
The methods used to treat intrasynovial flexor tendon injuries are the result of decades of clinical experience coupled with advances in understanding the biomechanical, physiologic, and cellular milieu of the repair. Successful treatment requires optimizing the factors that can be controlled and ameliorating those that cannot be controlled.
Subject(s)
Orthopedic Procedures/methods , Tendon Injuries/surgery , Biomechanical Phenomena , Humans , Range of Motion, Articular , Tendon Injuries/physiopathology , Tendon Injuries/rehabilitationABSTRACT
Basic science and clinical investigation have advanced significantly the treatment and the outcome following intrasynovial flexor tendon repair and rehabilitation and reconstruction over the past 30 years. The application of modern multistrand suture repair techniques as well as postoperative rehabilitation protocols emphasizing the application of intrasynovial repair site excursion has led to a protocol for treatment of intrasynovial flexor tendon lacerations emphasizing a strong initial repair followed by the application of postoperative passive motion rehabilitation. Protocols for the reconstruction of failed initial treatment have likewise undergone modification given new findings on the biologic and clinical behavior of flexor tendon grafts. Currently accepted treatment protocols following flexor tendon repair and reconstruction are based on current clinical and scientific data.
Subject(s)
Hand Injuries/rehabilitation , Hand Injuries/surgery , Orthopedic Procedures/methods , Tendon Injuries , Tendons/surgery , Humans , Orthopedic Procedures/rehabilitation , Postoperative Care , Postoperative Complications/prevention & control , Prostheses and Implants , Tendons/transplantationABSTRACT
Resistance to activated protein C is a newly described genetic coagulation disorder previously only reported in patients with venous thromboembolism or central arterial embolism (cerebral or coronary). We report this defect in association with digital artery thrombosis and describe the pathophysiology of this disorder.
