Biomedical subjects
Publications and source records attributed to A E Ellison.
Our basic science knowledge predicates all enlightened discussions of anterior cruciate ligament morbidity and the principles of its reconstruction. To provide a framework for this symposium, the salient anatomy, embryology, and biomechanical functions of this complex structure are presented.
An operative procedure has been developed to prevent anterior subluxation of the proximal end of the tibia in patients with anterolateral rotatory instability of the knee. The results of this procedure in eighteen consecutive patients are reported. Ten (55.6 per cent) had had prior surgery on the involved knee. All patients had an additional pathological lesion and all were incapacitated for their sports prior to reconstruction. The shortest follow-up in this series was thirty-one months and the longest, forty-four months. Forty-four per cent had an excellent result, participating in sports without signs or symptoms, and 39 per cent had a good result, participating but with some modest problem. In 17 per cent the results were unsatisfactory.
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The Inman ankle machine was modified to determine plantarflexion, dorsiflexion, inversion neutral, eversion neutral, plantarflexion inversion, and plantarflexion eversion before taping, immediately after taping, and with tape after a 2.5- to 3-hour football practice. The previously uninjured feet and ankles of 16 college-age football players were used. All were tape by the same method. A single-tailed paired-sample t-test was done to determine the minimun amount of restriction that could be expected for each motion after the exercise period. Ninety percent confidence intervals between untaped versus taped preexercise, untaped versus taped postexercise for all motions were determined. Inversion neutral, plantarflexion inversion, and eversion neutral had an average residual restriction after exercise of 50%, or greater than the initial restriction prior to exercise. plantarflexion, dorsiflexion, and plantarflexion eversion loosened significantly greater than 50%.
Bankart capsulorraphy for recurrent shoulder instability produces predictable results. Time-consuming, technically demanding details of the procedure, however, discourage its use. A simplified technique and new instrumentation solving these limitations was used in 69 procedures, all performed by the same surgeon. Seventy-eight percent of these procedures were reviewed independently at a minimum of 2 years followup: 77% were asymptomatic, 12% had minimal symptoms, and 11% had residual problems. Instability recurred in six patients and was associated with a significant traumatic event in five. Thus, the inside-out Bankart modifications were effective.
This is a report of a surgical technique to secure improved posterior restraining power and to tighten the fibular collateral ligament to a greater degree than the iliotibial band transfer alone. The early results from this lateral repair are superior to those previously reported utilizing the iliotibial band transfer alone. This corroborates Kennedy's observation that the iliotibial band transfer alone may not possess adequate strength for severe forms of lateral tibial plateau subluxation. Reinsertion of the biceps as described above appears to provide requisite additional strength without jeopardizing the iliotibial tract.