Using a rabbit model, we assessed the postoperative status and histopathologic findings of superior oblique tenotomy with silicone expander procedure. In the control group we marked and cut the superior oblique, and in the experimental group we inserted a silicone 240 retinal band 4 mm in length along the edges of incision. At the postoperative weeks 1,3,5 and 7, we randomly chose five rabbits and made a histopathologic examination after hematoxylin-eosin and Masson's trichrome stain. The distance between the incised edges was various in the control group, but constant in the experimental group. With time inflammation decreased and fibrosis of the superior oblique increased. Foreign body reaction occurred around the suture material in both groups., but not around the silicone expander. At 5 weeks atrophy of the superior oblique was observed in both groups.From the above results, we concluded that the superior oblique lengthening procedure using silicone expander is a useful surgical method for weakening the superior oblique muscle.
Animals ; Female ; Fibrosis ; Male ; Oculomotor Muscles/pathology/*surgery ; Rabbits ; *Silicone Elastomers ; Tendons/pathology/*surgery

OBJECTIVETo investigate surgical methods and therapeutic effects of giant cell tumor of tendon sheath in finger.

METHODSFrom July 2002 to December 2010,70 patients with giant cell tumor of tendon sheath in finger which confirmed by operation and pathology,were retrospectively analyzed. There were 29 males,41 females with an average of 42 years (ranged, 16 to 61), and the course of disease ranged form 4 months to 6 years (mean 11 months). The method of surgery and anesthesia were observed.

RESULTSAll wounds were got stage I healing,no necrosis occurred. Vascular crisis occurred in 6 cases (8.6%), inconformity of diagnosis in 18 cases (25.7%), changing of anesthesia due to situation of tumor in operation in 17 cases (24.3%). The patients were followed up from 2.2 to 10.5 years. Among them, 8 cases (11.4%) recurred, and diagnosied by the second operation without malignant change.

CONCLUSIONThe best anesthesia for giant cell tumor in finger should choose brachial plexus to fully expose,complete resection and less harmful damage; while the operation should complete resection at the stage I, and followed up actively, the second operation can be carried out for recorrenced.

Adolescent ; Adult ; Female ; Fingers ; surgery ; Giant Cell Tumors ; diagnosis ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Tendons ; pathology ; surgery ; Young Adult

Adult ; Elbow ; Giant Cell Tumors ; diagnosis ; pathology ; physiopathology ; surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Tendons

OBJECTIVETo study the effects of continuous passive motion on the tendon-bone healing of the semi-tendinous tendon autograft used for anterior cruciate ligament (ACL) reconstruction in rabbits.

METHODSIn 12 healthy 8-month-old male rabbits, an ACL reconstruction was performed by using double semi-tendinous tendon autograft. Postoperatively these animals were treated by either continuous passive motion (CPM) or cage activity. Specimens of the grafts were collected at 6, 12, 24 weeks postoperatively. Histological change in the tendon-bone healing was studied by haematoxylin-eosin and toluidine blue.

RESULTSThere was more new fiber tissue in the anterior half of the interface. Osteoclasts were most numerous at the tunnel aperture and in the anterior half of the interface. Cartilage in the tendon-bone interface was localized to the posterior aspect of tunnels, the area where compressive stress would be predicted. CPM group developed a denser connective tissue with less vascularity and cellularity. The bone tunnel had more areas with ingrowing denser connective tissue compared with cage activity specimens. With the growth of Sharpery's fibers and fibrocartilage into the interface, a direct ligament insertion was found. In the CPM specimens, the interface tissue was more mature and the direct insertion was broader and more structured.

CONCLUSIONSCompressive stress promotes chondroid formation, and the tension promotes fiber formation. Tendon-bone healing may be optimized by CPM after tendon transplantation into a bone tunnel.

Animals ; Anterior Cruciate Ligament ; surgery ; Femur ; pathology ; surgery ; Male ; Motion Therapy, Continuous Passive ; Rabbits ; Random Allocation ; Tendons ; pathology ; transplantation ; Tibia ; pathology ; surgery ; Transplantation, Autologous ; Wound Healing

This investigation was to study the effects of cage-squeezing screw on tendon-bone healing in rabbits. The tendons of Twenty four rabbits were severed and fixed with cage-squeezing screw or ordinary squeezing screw on its tibia, and the interface of tendon-bone was tested at the ends of 3, 6 and 12 weeks after operations, respectively. The cage-squeezing screw can accelerate bone tunel healing and strengthen the graft intension. The experiments proved that the cage-squeezing screw could help the restructuring process of the graft after the beginning of reconstruction.
Animals ; Bone Screws ; Female ; Knee Joint ; surgery ; Male ; Periosteum ; transplantation ; Rabbits ; Tendons ; transplantation ; Tibia ; pathology ; surgery ; Wound Healing

OBJECTIVETo investigate diagnostic methods and surgical effect for the treatment of giant cell tumor of tendinous sheath in wrist.

METHODSFrom September 2002 to October 2009, 8 patients with preoperative diagnosis as giant cell tumor of tendinous sheath based on MRI were treated surgically. There were 5 males and 3 females, ranging in age from 16 to 65 years, with an average of 41 years. The disease course ranged from 10 to 72 months with an average of 31 months.

RESULTSThe diagnosis of all the patients was confirmed as giant cell tumor of tendinous sheath by postoperative pathology. All the patients were followed up, and the during ranged from 5 to 48 months (averaged, 34.2 months). One patient recurred and 3 patients got obvious relief of symptoms of median nerve injury. All the patients had significant improvement in wrist function after surgery.

CONCLUSIONPreoperative MRI is helpful for differential diagnosis of giant cell tumor of tendinous sheath. Thorough removal of tumor is very important in prevention of recurrence.

Adolescent ; Adult ; Aged ; Female ; Giant Cell Tumors ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Soft Tissue Neoplasms ; diagnosis ; surgery ; Tendons ; pathology

OBJECTIVETo analyze the histological results and the biological remodeling of ligamentous insertion after the reconstruction of anterior cruciate ligament (ACL) with autograft or allograft tendon.

METHODSExtensor digitorum tendon was harvested from hind limb as graft material and transplanted to reconstruct the resected ACL in 12 mongrel dogs. Each free tendon end was secured by holding sutures and then the sutures were tied to the post screw at the femoral and tibial bony tunnel outlet after transplantation respectively. Autograft was randomly performed on one side of knee while allograft on the other side of knee. After transplantation, the histological analysis was undertaken at the 6th, 12th weeks and the 6th month using hematoxylin-eosin (HE) stain under light microscope.

RESULTSThe insertion structure of normal ACL typically consisted of four layers, i.e., dense connective tissue, fibrocartilage, mineralized fibrocartilage and bone. There was a distinct regular tidemark line between fibrocartilage and mineralized fibrocartilage. At the 6th week postoperatively, loose connective tissue presented in the interspace between graft and bony tunnel wall in both autograft and allograft groups. At the 12th week postoperatively, the collagenous fibers between autograft and tunnel wall became well organized and the four layers of insertion with discontinuous tidemark line were demonstrated indistinctly in autograft group but not in allograft group. At the 6th month postoperatively, both of a clear and continuous tidemark line and distinct four layers could be seen in autograft group. In allograft group, only a waved discontinuous tidemark line was shown and either the anatomic morphology or the maturity of insertion was inferior to that of autograft group.

CONCLUSIONSAt the 6th month postoperatively, although the ligament-cartilage insertion is primarily formed after ACL reconstruction with autograft or allograft tendon, the histological morphology and the maturation of insertion of autograft tendon are better than those of allograft group, which suggests that postoperative rehabilitation should be paid more attention and could be safer if little delayed during ACL reconstruction with allograft tendon.

Animals ; Anterior Cruciate Ligament ; pathology ; surgery ; Dogs ; Reconstructive Surgical Procedures ; rehabilitation ; Tendons ; pathology ; transplantation ; Transplantation, Autologous ; Transplantation, Homologous

The localized type of tenosynovial giant cell tumor usually occurs on the palmar side of fingers and toes. Tenosynovial giant cell tumors of the tendon sheath are rarely intra-articular. We report a giant cell tumor of the tendon sheath arising from femoral attachment of the anterior cruciate ligament and its treatment with arthroscopy in a 28-year-old man.
Adult ; Anterior Cruciate Ligament/pathology/surgery ; Arthroscopy ; Femur ; Giant Cell Tumors/diagnosis/surgery ; Humans ; Knee ; Male ; Synovitis, Pigmented Villonodular/diagnosis/*surgery ; Tendons/*pathology

OBJECTIVETo explore the technique of diagnosis and treatment of intra-articular giant cell tumor of tendon sheath (GCTTS) in knee joint, and to evaluate its clinical results.

METHODSTwelve patients with GCTTS treated during 15 years were reviewed. Nine cases were misdiagnosed with meniscus injury (6 cases) and chronic synovitis (3 cases) before operation, only 3 cases were confirmed the diagnosis of GCTTS by MRI. Complete tumorectomy under arthroscope was performed on all 12 cases.

RESULTSThe results of clinical and radiographic followed-up of 9 patients for 1 to 10 years after operation was satisfactory. Clinical symptoms disappeared, range of motion and X-ray findings were normal. There was no recurrent case found.

CONCLUSIONSArthroscopic removal of GCTTS is an effective treatment. Tumor wide resection and debriding the channel which tumor passed through are the key point to prevent the recurrence after operation.

Adult ; Arthroscopy ; Female ; Follow-Up Studies ; Giant Cell Tumors ; diagnosis ; surgery ; Humans ; Knee Joint ; surgery ; Male ; Muscle Neoplasms ; diagnosis ; surgery ; Retrospective Studies ; Tendons ; pathology

Adult ; Diagnosis, Differential ; Female ; Fibroma ; metabolism ; pathology ; Fingers ; Giant Cell Tumors ; metabolism ; pathology ; Humans ; Mucin-1 ; metabolism ; Nerve Sheath Neoplasms ; metabolism ; pathology ; surgery ; Neurilemmoma ; metabolism ; pathology ; Sclerosis ; metabolism ; pathology ; Soft Tissue Neoplasms ; metabolism ; pathology ; surgery ; Tendons ; Young Adult