Robert J Meislin, M.D.

Right hip pain in a 20-year-old epee fencer
Petchprapa CN; Bencardino JT; Meislin RJ
2011 Mar;41(3):361-362, Skeletal radiology
— id: 141655, year: 2011, vol: 41, page: 361, stat: Journal Article,

Double-bundle versus single-bundle ACL reconstruction
Boyer, Jason; Meislin, Robert J
2010 ;68(2):119-126, Bulletin of the NYU Hospital for Joint Diseases
Surgical repair of the anterior cruciate ligament is a fairly common necessity in knee injuries, usually with good to excellent outcomes. However a successful repair and return to activities for a subpopulation of patients, 10% to 30%, remain elusive. Additionally, some athletes have arthritic changes, even with ligament repair. These issues are likely multi-factorial in nature but the debate continues even over which primary operative technique will produce the most favorable outcome. This review examines and discusses the anatomic and historical rationale of double-bundle ACL reconstruction techniques, the published kinematics of double-bundle reconstructions, and the clinical literature comparing double-bundle outcomes to those of the more traditional single-bundle constructs. Conclusions regarding surgical care include a need for more standardization of measuring parameters and the future application of advanced technologies that would inform more correct models of knee kinematics for comparison to various ACL construction approaches, potentially allowing improvement in the techniques of ACL reconstruction
— id: 111383, year: 2010, vol: 68, page: 119, stat: Journal Article,

Hip arthroscopy in adults
Nord, Russell M; Meislin, Robert J
2010 ;68(2):97-102, Bulletin of the NYU Hospital for Joint Diseases
The acceptance and rates of hip arthroscopy are increasing in the United States and abroad and the literature describing it is expanding. Indications for hip arthroscopy include labral tears, loose bodies, femoroacetabular impingement, ruptured ligamentum teres, chondral injuries, adhesive capsulitis, instability, synovial disease, disorders of the iliopsoas tendon, external coxa saltans, tears of the hip abductors, and diagnosis of unresolved intra-articular hip pain. Current techniques in the central and peripheral compartments include, but are not limited to, labral debridement, labral repair, chondroplasty, microfracture, synovectomy, loose body removal, acetabuloplasty, proximal femoral osteoplasty, and iliopsoas release, with other procedures possible in the peritrochanteric space. Long-term outcomes are limited, but early data shows good results for many arthroscopic procedures in the hip when they are performed in the absence of degenerative disease. Improved techniques and technology are allowing for more advanced procedures to become popularized, but long-term outcome data about hip arthroscopy is still relatively sparse
— id: 111380, year: 2010, vol: 68, page: 97, stat: Journal Article,

Posterior cruciate ligament injuries in the athlete: diagnosis and treatment
Colvin, Alexis Chiang; Meislin, Robert J
2009 ;67(1):45-51, Bulletin of the NYU Hospital for Joint Diseases
Posterior cruciate ligament injuries occur much less frequently than anterior cruciate ligament injuries. We review the important physical examination and radiographic findings, as well as provide the indications for nonoperative and operative treatment
— id: 99285, year: 2009, vol: 67, page: 45, stat: Journal Article,

Platelet-rich plasma: current concepts and application in sports medicine
Hall, Michael P; Band, Phillip A; Meislin, Robert J; Jazrawi, Laith M; Cardone, Dennis A
2009 Oct;17(10):602-608, Journal of the American Academy of Orthopaedic Surgeons
Platelet-rich plasma is defined as autologous blood with a concentration of platelets above baseline values. Platelet-rich plasma has been used in maxillofacial and plastic surgery since the 1990s; its use in sports medicine is growing given its potential to enhance muscle and tendon healing. In vitro studies suggest that growth factors released by platelets recruit reparative cells and may augment soft-tissue repair. Although minimal clinical evidence is currently available, the use of platelet-rich plasma has increased, given its safety as well as the availability of new devices for outpatient preparation and delivery. Its use in surgery to augment rotator cuff and Achilles tendon repair has also been reported. As the marketing of platelet-rich plasma increases, orthopaedic surgeons must be informed regarding the available preparation devices and their differences. Many controlled clinical trials are under way, but clinical use should be approached cautiously until high-level clinical evidence supporting platelet-rich plasma efficacy is available
— id: 104722, year: 2009, vol: 17, page: 602, stat: Journal Article,

The effect of repair of the lacertus fibrosus on distal biceps tendon repairs: a biomechanical, functional, and anatomic study
Landa, Joshua; Bhandari, Sachin; Strauss, Eric J; Walker, Peter S; Meislin, Robert J
2009 Jan;37(1):120-123, American journal of sports medicine
BACKGROUND: To date, repair of the lacertus in distal biceps tendon ruptures, recommended by some, has not been evaluated. The goal of these biomechanical experiments was to evaluate the degree to which its repair increases the strength of a distal biceps tendon repair. HYPOTHESIS: An intact or repaired lacertus fibrosus will increase the strength of a distal biceps tendon repair. STUDY DESIGN: Controlled laboratory study. METHODS: Four matched pairs of fresh-frozen human cadaveric upper extremities were prepared by isolating the lacertus fibrosus and the distal biceps tendon. The extremity was placed in a custom-built rig with the distal biceps brachii clamped and affixed to a stepper motor assembly. The distal biceps tendon was sharply removed directly from the radial tuberosity and repaired through a bony tunnel in all specimens. One side of each pair was randomized to also receive repair of the lacertus. The specimens were pulled at a constant rate until failure. RESULTS: The mean failure strength, defined as maximal strength to 15 mm of displacement, was higher in specimens with a repaired lacertus (250.2 N vs 158.2 N; P =.012), as was mean maximum strength (256.8 N v. 164.5 N; P =.0058). Mean stiffness was not significantly different (16.36 N/mm vs 13.8 N/mm; P =.58). All specimens failed due to fracture at the bony bridge. CONCLUSION: Repair of the lacertus strengthened distal biceps tendon repair in a controlled laboratory setting. CLINICAL RELEVANCE: Repair of the lacertus fibrosus as an adjunct to distal biceps tendon repair strengthens the repair in the laboratory setting. Clinical testing is needed to verify that this increased strength improves clinical results. Surgeons should be cautioned to protect the underlying neurovascular structures during repair of the lacertus fibrosus and to avoid an overly tight repair
— id: 94181, year: 2009, vol: 37, page: 120, stat: Journal Article,

Bone plug versus suture fixation of the posterior horn in medial meniscalallograft transplantation: a biomechanical study
Hunt, Stephen; Kaplan, Kevin; Ishak, Charbel; Kummer, Frederick J; Meislin, Robert
2008 ;66(1):22-26, Bulletin of the NYU Hospital for Joint Diseases
This study was performed to determine if a meniscal al- lograft with attached bone plug and suture offers superior ixation when compared to allograft afixed with suture alone through a bony tunnel. Seven pairs of human cadaver proximal tibia specimens were obtained. The specimens were then randomly assigned to either Group 1 (suture alone) or Group 2 (bone plug plus suture). All Group 1 specimens had the meniscus detached at the bony insertion of the anterior and posterior horns, with two No. 2 Ethibond sutures placed at the posterior root insertion. All Group 2 specimens had a posterior horn with a bone plug and two No. 2 Ethibond sutures. Both groups had their respective sutures passed through a 7 mm tibial tunnel and secured over a screw and post on the proximal tibia. The specimens were then loaded to failure. The mean failure load for Group 1 was 111.8 N (SD: 21 N) and for Group 2 was 112 N (SD: 32 N). Based on the Wilcoxon Rank-Sum analysis, the two groups were not signiicantly different. This study demonstrated no difference in the mean pullout strength of medial meniscal allograft posterior horn ixation between the two groups. This biome- chanical cadaveric study demonstrated that it may not be necessary to use an attached bone plug for medial meniscal transplant ixation, as using suture alone will sufice. The choice of using suture alone for the posterior horn meniscal attachment eases the technique of surgery when compared to using a bone plug plus suture
— id: 79554, year: 2008, vol: 66, page: 22, stat: Journal Article,

Effect of specialty and experience on the interpretation of knee MRI scans
Kim, Allis; Khoury, Lisa; Schweitzer, Mark; Jazrawi, Laith; Ishak, Charbel; Meislin, Robert; Kummer, Fred; Sherman, Orrin H
2008 ;66(4):272-275, Bulletin of the NYU Hospital for Joint Diseases
The purpose of this study was to evaluate any differences in the accuracy of knee MRI interpretation between radiology and orthopaedic surgery residents as well as to evaluate differences in quality of interpretation relative to resident training level. In this study, 20 MRI scans demonstrating specific pathology of the knee were identified. From one institution, two radiology residents and two orthopaedic surgery residents of each postgraduate year (PGY) of training (2 to 5) were recruited. Each resident was asked to interpret all the studies and choose up to 16 diagnoses for each scan from the list provided. Orthopaedic surgery residents showed improvement in overall accuracy and specificity with each year of additional training. Level of training did not correspond with increased sensitivity in the orthopaedic residents tested. Radiology residents did not demonstrate a consistent trend toward improved accuracy, sensitivity, or specificity with additional years of training. The only statistically significant differences in specificity observed between the two groups were seen in the readings of ACL tears, lateral femoral condyle chondromalacia, and chondromalacia patella. This study found that the accuracy of knee MRI interpretations between radiology and orthopaedic surgery residents did not demonstrate any differences. Level of training had no effect on the interpretation of the MRIs by radiology residents. Orthopaedic surgery residents did show an improvement with each year of additional training
— id: 94695, year: 2008, vol: 66, page: 272, stat: Journal Article,

Posterolateral corner injuries of the knee
Frank, Joshua B; Youm, Thomas; Meislin, Robert J; Rokito, Andrew S
2007 ;65(2):106-114, Bulletin of the NYU Hospital for Joint Diseases
The posterolateral region of the knee is an anatomically complex area that plays an important role in the stabilization of the knee relative to specific force vectors at low angles of knee flexion. A renewed interest in this region and advanced biomechanical studies have brought additional understanding of both the anatomy and the function of posterolateral structures in knee stabilization and kinematics. Through sectioning and loading studies, the posterolateral corner has been shown to play a role in the prevention of varus angulation, external rotation, and posterior translation. The potential for long-term disability from these injuries may be related to increased articular pressure and chondral degeneration. The failure of the reconstruction of cruciate ligaments may be due to unrecognized or untreated posterolateral corner injuries. Various methods of repair and reconstruction have been described and new research is yielding superior results from reconstruction of this region
— id: 73804, year: 2007, vol: 65, page: 106, stat: Journal Article,

Articular cartilage restoration of the knee
Shah, Mehul R; Kaplan, Kevin M; Meislin, Robert J; Bosco, Joseph A 3rd
2007 ;65(1):51-60, Bulletin of the NYU Hospital for Joint Diseases
Articular cartilage defects are common and play a significant role in degenerative joint disease. Cartilage is unable to regenerate, secondary to an inherent lack of vascular supply, thus, various techniques have been described in an attempt to treat and potentially restore these defects. Treatment decisions should be based on appropriate evaluation and classification of the pathology. Only then can the surgeon choose to perform a repair or a restoration of the articular surface. Current literature and techniques for the treatment of articular cartilage defects are reviewed, with an algorithm developed for the management of articular cartilage defects by orthopaedic surgeons.
— id: 73027, year: 2007, vol: 65, page: 51, stat: Journal Article,

MR imaging features of radial tunnel syndrome: initial experience
Ferdinand, Brett D; Rosenberg, Zehava Sadka; Schweitzer, Mark E; Stuchin, Steven A; Jazrawi, Laith M; Lenzo, Salvatore R; Meislin, Robert J; Kiprovski, Kiril
2006 Jul;240(1):161-168, Radiology
PURPOSE: To retrospectively assess magnetic resonance (MR) imaging features of radial tunnel syndrome. MATERIALS AND METHODS: Institutional review board approval was obtained, and informed consent was waived for the retrospective HIPAA-compliant study. MR images of 10 asymptomatic volunteers (six men, four women; mean age, 30 years) and 25 patients (11 men, 14 women; mean age, 49 years) clinically suspected of having radial tunnel syndrome were reviewed for morphologic and signal intensity alterations of the posterior interosseous nerve and adjacent soft-tissue structures. MR images of the asymptomatic volunteers were reviewed to establish the normal appearance of the radial tunnel. MR images of the symptomatic patients were evaluated for the following: signal intensity alteration and morphologic alteration of the posterior interosseous nerve; the presence of mass effect on the posterior interosseous nerve such as the presence of bursae, a thickened leading edge of the extensor carpi radialis brevis, or prominent radial recurrent vessels; signal intensity alteration within the depicted forearm musculature such as edema or atrophy; and signal intensity changes at the origin of the common extensor and common flexor tendons, which would suggest a diagnosis of epicondylitis. RESULTS: All images of volunteers demonstrated normal morphology and signal intensity within the posterior interosseous nerve and adjacent soft tissues. Two volunteers had borderline thickening of the leading edge of the extensor carpi radialis brevis. Thirteen patients (52%) had denervation edema or atrophy within muscles (supinator and extensors) innervated by the posterior interosseous nerve. One patient had isolated pronator teres edema. Seven (28%) patients had the following mass effects along the posterior interosseous nerve: thickened leading edge of the extensor carpi radialis brevis (n = 4), prominent radial recurrent vessels (n = 1), schwannoma (n = 1), or bicipitoradial bursa (n = 1). The rest of the patients had either normal MR imaging findings (n = 4) or lateral epicondylitis (n = 2). CONCLUSION: Muscle denervation edema or atrophy along the distribution of the posterior interosseous nerve is the most common MR finding in radial tunnel syndrome
— id: 66465, year: 2006, vol: 240, page: 161, stat: Journal Article,

Osteonecrosis of the distal femur
Gorczynski, Christopher; Meislin, Robert
2006 ;63(3-4):145-152, Bulletin (Hospital for Joint Diseases)
— id: 69069, year: 2006, vol: 63, page: 145, stat: Journal Article,

The effect of interference screw diameter on soft tissue graft fixation
Namkoong, Suk; Heywood, Christian S; Bravman, Jonathan T; Ieyasa, Kazuho; Kummer, Frederick J; Meislin, Robert J
2006 ;63(3-4):153-155, Bulletin (Hospital for Joint Diseases)
Tibial fixation of soft-tissue grafts is a weak link in anterior cruciate ligament reconstruction. Previous studies have examined varying interference screw lengths, screw types and tunnel sizes as means to improve graft fixation. We hypothesized that increasing interference screw diameter would significantly increase the maximum load to failure of the graft and decrease the graft's initial slippage. Seventy tibialis anterior and tibialis posterior tendons were divided, looped, trimmed, and sutured to simulate 4-strand hamstring grafts. These grafts were then inserted into composite bone blocks having pre-drilled 8 mm holes and fixed with 8 mm, 9 mm, 10 mm, 11 mm, or 12 mm interference screws. Fourteen grafts were tested for each screw size. The graft was first cyclically loaded from 50 N to 250 N at 0.3 Hz for 100 cycles to measure graft slippage. The graft was then tested to failure at 0.5 mm/sec to determine the maximum load to failure and mode of failure. Graft slippage was not affected by screw diameter. Maximum load to failure increased with increasing screw diameter up to 11 mm; 11 mm screw fixation was 20% stronger than 8 mm screw fixation. In this model, no increase in graft fixation was seen in by increasing interference screw diameter beyond 3 mm of the tunnel diameter
— id: 69070, year: 2006, vol: 63, page: 153, stat: Journal Article,

Persistent shoulder pain: epidemiology, pathophysiology, and diagnosis
Meislin, Robert J; Sperling, John W; Stitik, Todd P
2005 Dec;34(12 Suppl):5-9, American journal of orthopedics (Belle Mead, NJ)
Persistent shoulder pain is a very common condition that often has a multifactorial underlying pathology and is associated with high societal cost and patient burden. In 2000, the direct costs for the treatment of shoulder dysfunction in the United States totaled $7 billion. Persistent shoulder pain can result from bursitis, tendinitis, rotator cuff tear, adhesive capsulitis, impingement syndrome, avascular necrosis, glenohumeral osteoarthritis (OA), and other causes of degenerative joint disease or from traumatic injury, either in combination or as a separate entity. Rotator cuff disorders, adhesive capsulitis, and glenohumeral OA are all common causes of persistent shoulder pain, accounting for about 10%, 6%, and 2% to 5%, respectively, of all shoulder pain. All 3 conditions have complex etiologies, but they can be diagnosed in the majority of patients on the basis of medical history, focused physical examination, and plain film radiographs. This brief review and the following articles in this supplement focus on persistent shoulder pain associated with rotator cuff disorders, adhesive capsulitis, and glenohumeral OA
— id: 63738, year: 2005, vol: 34, page: 5, stat: Journal Article,

Role of hip MR imaging in the management of sports-related injuries
Meislin, Robert; Abeles, Andrew
2005 Nov;13(4):635-640, Magnetic resonance imaging clinics of North America
MR imaging is an invaluable method for the workup of a painful hip. It is showing increased sensitivity and specificity for many of the soft tissue and bony abnormalities of the hip, especially with the addition of intra-articular contrast(MR arthrography). Chondral injuries of the femoral head and acetabulum remain an area in MR imaging that should continue to improve with new gradient protocols
— id: 62367, year: 2005, vol: 13, page: 635, stat: Journal Article,

Osteotomy about the knee: applications, techniques, and results
Preston, Charles F; Fulkerson, Eric W; Meislin, Robert; Di Cesare, Paul E
2005 Oct;18(4):258-272, Journal of knee surgery
Varus or valgus malalignment of the knee may be either a cause or a consequence of unicompartmental knee arthritis in young, active adults. Proximal tibial osteotomy for the varus knee and distal femoral osteotomy for the valgus knee have been used for decades to manage this condition; however, their use has decreased significantly in recent years as the popularity of unicompartmental and total knee arthroplasty has grown. With the advent of biologic resurfacing techniques for focal full-thickness articular cartilage injury, combined or staged high tibial osteotomy is becoming increasingly popular. In addition, in the face of cruciate ligamentous instability with or without posterolateral corner instability coupled with varus malalignment, high tibial osteotomy with and without ligament reconstruction provides a solution to complex orthopedic problems. Recent long-term follow-up studies have concluded osteotomy allows for improved function and pain relief in properly selected young patients
— id: 62366, year: 2005, vol: 18, page: 258, stat: Journal Article,

A new method to utilize a motorized shaver in hip arthroscopy without the use of a cannula
Shen, Michael; Meislin, Robert
2005 Jul;21(7):895-895, Arthroscopy
This article describes an effective and safe method of motorized shaver placement during hip arthroscopy without the use of a conventional cannula. With this technique, the arthroscopist has greater freedom in maneuvering the shaver in and around the hip joint. This method allows for reproducible placement of the shaver in all 3 portals of the hip
— id: 62524, year: 2005, vol: 21, page: 895, stat: Journal Article,

Symptomatic snapping hip: targeted treatment for maximum pain relief
Idjadi, Jeremy; Meislin, Robert
2004 Jan;32(1):25-31, Physician & Sportsmedicine
A painful condition known as snapping hip may prevent athletes from attaining peak performance, and it presents diagnostic and treatment challenges to the sports medicine physician as well. Three types of snapping hip (external, internal, and intra-articular) are known, and each has a distinct pathomechanic cause, specific symptoms, and classic clinical presentation. History and physical exam are coupled with a variety of imaging modalities to help distinguish the three types. Nonoperative approaches are the mainstay of treatment, but, if unsuccessful, operative treatments also achieve good results. Patients may resume their activities when pain subsides
— id: 106287, year: 2004, vol: 32, page: 25, stat: Journal Article,

The acromion-splitting approach for large and massive rotator cuff tears
Paulos LE; Meislin RJ; Drawbert J
1994 May-Jun;22(3):306-312, American journal of sports medicine
A retrospective review of 42 patients in whom a rotator cuff injury was diagnosed and who subsequently underwent surgery with the superior acromion-spitting approach technique was conducted. The average size of the tear was 4.2 cm with an average tear retraction of 4.1 cm. Thirty-seven (38 shoulders) of the 42 patients underwent a physical examination, interview, and radiographs at an average followup of 33.4 months (range, 15 to 66). Using the University of California, Los Angeles Shoulder Rating Scale, 27 shoulders were graded as excellent or good, and 11 shoulders were graded as fair or poor. Radiographic examination demonstrated bony union in 29 shoulders. The remaining 9 shoulders had evidence of fibrous union that could be characterized as clinically asymptomatic. Twenty patients had computed tomography scans that demonstrated decompression where the bony or fibrous union had occurred. In addition, some increased decompression in several patients with fibrous union indicated that the anterior acromion sought its appropriate level. Based on the results of this study, the acromion-splitting approach, used as an extension of the miniapproach for rotator cuff tears, can be successfully used when a large or massive rotator cuff tear is identified
— id: 32684, year: 1994, vol: 22, page: 306, stat: Journal Article,

Intramedullary nailing of subtrochanteric fractures: a critical review of device failure and case analysis
Meislin R; Frankel VH; Kummer FJ
1993 Winter;52(2):17-20, Bulletin (Hospital for Joint Diseases)
Although device failure in intramedullary (IM) nailing of subtrochanteric fractures is uncommon, breakage of the nail can occur. Following a review of the literature on this subject, a case is reported that illustrates the surgical and biomechanical factors that can lead to nail failure
— id: 65821, year: 1993, vol: 52, page: 17, stat: Journal Article,

Arthroscopic treatment of synovial impingement of the ankle
Meislin RJ; Rose DJ; Parisien JS; Springer S
1993 Mar-Apr;21(2):186-189, American journal of sports medicine
Twenty-nine cases of operative arthroscopy of the ankle were done between 1985 and 1989 for synovial impingement of the ankle. The average age of the patients was 37 years. All patients (17 men, 12 women) reported an earlier history of injury, with 24 of the patients (83%) noting chronic ankle pain after an inversion injury and 5 of the patients (17%) reporting a previous ankle fracture. Physical examination elicited anterolateral tenderness at the ankle in all cases with associated anteromedial pain in 4 patients. A demonstrable 'click' was evident in 6 of the patients (21%) on forced dorsiflexion of the ankle. All patients failed conservative treatment including physical therapy and nonsteroidal antiinflammatory drugs. Surgery was performed at an average of 36 months postinjury. Ankle arthroscopy revealed extensive hypertrophic synovial thickening and scar tissue anterolaterally, indicating synovial impingement in all patients. Associated chondromalacia of the distal tibia was seen in 21% of the patients. Operative arthroscopy included partial synovectomy and debridement of the hypertrophic tissue and partial shaving chondroplasty of the tibia when indicated. Postoperatively, patients were weightbearing as tolerated. Results were assessed subjectively and objectively. At 25-month followup 26 patients had excellent or good results and 3 had fair results; there were no poor results. There were no major complications, including infection or neurovascular compromise. The 3 patients with associated ankle instability comprised the 'fair' result group and eventually required lateral ankle reconstruction. Thus, chronic ankle pain due to synovial impingement can be safely, predictably, and effectively treated by operative ankle arthroscopy
— id: 32685, year: 1993, vol: 21, page: 186, stat: Journal Article,

Type III acromioclavicular joint separation associated with late brachial-plexus neurapraxia
Meislin RJ; Zuckerman JD; Nainzadeh N
1992 ;6(3):370-372, Journal of orthopaedic trauma
We report the case of a 28-year-old woman who developed signs and symptoms of brachial-plexus neurapraxia eight years after a type III acromioclavicular (AC) joint separation. Stabilization of the AC joint resulted in resolution of the symptoms
— id: 32686, year: 1992, vol: 6, page: 370, stat: Journal Article,

Closed treatment of canine nonunions by controlled compression and distraction using an Ilizarov fixator: a preliminary study
Kummer FJ; Meislin RJ; Pankovich A; Frankel VH
1990 Dec;13(12):1379-1381, Orthopedics (Thorofare NJ)
The Ilizarov fixator was used for closed treatment of canine nonunions by controlled compression and distraction. The fibrous matrix and cartilage formed within the nonunion site transformed to osteoid and bone with increased vascularity. Healing was demonstrated by substantial bone bridging the nonunion at 6 weeks. The Ilizarov method appears to be a viable treatment for nonunions
— id: 32687, year: 1990, vol: 13, page: 1379, stat: Journal Article,

Arthroscopic excision of synovial hemangioma of the knee
Meislin RJ; Parisien JS
1990 ;6(1):64-67, Arthroscopy
A synovial hemangioma in the knee joint of a 33-year old woman was diagnosed and removed arthroscopically. Preoperatively, this rare benign soft tissue lesion had caused recurrent swelling of the knee along with persistent pain and occasional buckling. Two years after surgery, the patient has a painless range of motion with no evidence of recurrence
— id: 32690, year: 1990, vol: 6, page: 64, stat: Journal Article,

A biomechanical study of tendon adhesion reduction using a biodegradable barrier in a rabbit model
Meislin RJ; Wiseman DM; Alexander H; Cunningham T; Linsky C; Carlstedt C; Pitman M; Casar R
1990 Spring;1(1):13-19, Journal of applied biomaterials (Orlando)
Adhesion formation associated with tendon surgery is a widespread problem in which a healing tendon becomes adherent via scar tissue to surrounding structures such as bone, muscle, skin, tendon sheath, or other tendons. A model is described in which adhesions were generated reproducibly between the plantaris and Achilles tendons of the rabbit using a partial tenotomy, a Bunnel suture, and immobilization. Using this model, the effect of an absorbable barrier, INTERCEED (TC7), on adhesion formation was investigated. This material, which is a fabric comprised of oxidized regenerated cellulose, was found to diminish significantly the extent and severity of intertendinous adhesions, assessed both mechanically and histologically. No evidence of a foreign body reaction was observed
— id: 32683, year: 1990, vol: 1, page: 13, stat: Journal Article,

A biomechanical analysis of the sliding hip screw: the question of plate angle
Meislin RJ; Zuckerman JD; Kummer FJ; Frankel VH
1990 ;4(2):130-136, Journal of orthopaedic trauma
There is general agreement that the implant of choice for intertrochanteric fractures is the sliding hip screw (SHS). However, considerable differences of opinion exist as to which plate angle--varying from 130 to 150 degrees--is preferred. Thus far there has been no cadaver-based biomechanical analysis of this problem. To examine these questions, we determined the effect of plate angle on plate strain and proximal medial femoral strain distribution in cadaver femurs fixed with 130, 135, 140, 145, and 150 degrees SHS after experimentally produced stable and unstable intertrochanteric fractures. Twenty-four fresh adult cadaver femurs were assigned randomly to either the 130, 135, 140, 145, or 150 degrees SHS group. Each femur was radiographed and bone mineral density was determined by dual-photon absorptiometry. Multiple-strain gauges were affixed to the femur, with specific focus on the proximal femur and plate. Femurs were loaded at 25 degrees adduction in increments of 70 N from 0 to 1,800 N in a servohydraulic testing machine. Femurs were tested in a progressive manner: (a) intact femur; (b) intact femur with SHS inserted; (c) a stable two-part intertrochanteric fracture reduced with SHS; (d) a four-part fracture with the posteromedial fragment (PMF) reduced anatomically by a lag screw; (e) the same fracture with the PMF rotated 180 degrees and held in place by a lag screw to approximate a 'near-anatomic' reduction; and (f) the same fracture with the PMF discarded. Screw sliding measurements were determined at regular intervals throughout each test.(ABSTRACT TRUNCATED AT 250 WORDS)
— id: 32689, year: 1990, vol: 4, page: 130, stat: Journal Article,

Injections for joint and soft tissue disorders: when and how to use them
Zuckerman JD; Meislin RJ; Rothberg M
1990 Apr;45(4):45-52, 55, Geriatrics
Joint and soft tissue injections may be the only way to differentiate various arthritic disorders, accurately identify a septic joint, and apply focused treatment. Certain considerations can make these injections safer and more effective. This article reviews the principles of diagnostic and therapeutic use of joint and soft tissue injections and makes specific recommendations for common injection sites. Also described are appropriate aseptic techniques for aspirating and injecting joints, bursae, and soft tissue, as well as the judicious use of corticosteroid injections in this age group
— id: 32688, year: 1990, vol: 45, page: 45, stat: Journal Article,

Management of an infected total knee arthroplasty
Meislin R; Zuckerman JD
1989 Spring;49(1):21-36, Bulletin of the Hospital for Joint Diseases Orthopaedic Institute
Infection following total knee arthroplasty can be one of the most challenging problems in orthopaedic surgery. This article discusses the pertinent clinical factors to be considered and the treatment options in the management of patients with infection following total knee replacement
— id: 44621, year: 1989, vol: 49, page: 21, stat: Journal Article,

Bilateral posterior hip dislocations with femoral head fractures
Meislin RJ; Zuckerman JD
1989 ;3(4):358-361, Journal of orthopaedic trauma
An unusual case of bilateral posterior fracture-dislocation of the hip (Pipkin Type IV) occurred in a 63-year-old man with Paget's disease of the pelvis. Other injuries included a displaced humeral shaft fracture and patellar ligament disruption. Bilateral cemented total hip arthroplasty was performed to avoid the need for prolonged immobilization. Postoperative low-dose irradiation was used because of the risk of heterotopic ossification
— id: 32691, year: 1989, vol: 3, page: 358, stat: Journal Article,