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Biomedical subjects

C A Hager

Publications and source records attributed to C A Hager.

7 recordsLinked to original sources
PubMed1996

Clinical and functional outcome of anterior cruciate ligament reconstruction in the recreational athlete over the age of 35.

This study examined the functional, objective, and subjective outcome of anterior cruciate ligament (ACL) reconstruction in recreational athletes > or = 35 years after a minimum of 2 years of follow-up. Patients > or = 35 years who underwent ACL reconstruction by a single surgeon were identified from our surgical database. Nineteen knees in 18 (62% follow-up) patients were available for review by an independent examiner. The patients underwent physical examination, radiographs, functional testing, isokinetic strength testing, and instrumented ligament arthrometer testing. All were seen at a minimum of 2 years of follow-up. The average age was 40 years. Five of 19 underwent reconstruction less than 1 month after injury, and the remainder underwent reconstruction for chronic injuries. All patients preoperatively had at least a grade 2 Lachman and a positive pivot shift noted on physical examination. After a minimum of 2 years of follow-up, 17 of 18 patients had a stable knee on objective testing, including a negative Lachman and pivot shift. Seventeen patients (94%) had < 3 mm side-to-side difference on maximum manual arthrometric testing. Only one patient had > 3 cm prone heel height difference, and all patients had > 125 degrees of flexion. Mean thigh circumference difference was 0.5 cm. Isokinetic testing demonstrated a mean 11%, 7%, and 4% quadriceps asymmetry at 60 degrees, 180 degrees, and 240 degrees/second, respectively. However, functional testing revealed only a mean 6% asymmetry on vertical jump, single leg hop, and timed 6 meter hop. Seventeen of 18 patients were satisfied with their results. The mean postoperative Lysholm Rating Scale score was 93. The mean Noyes Sports Activity Scale score was 86, improved from 31 preoperatively. Thirteen of 18 returned to their preinjury level of sports performance. These results indicate that ACL reconstruction in patients over the age of 35 has functional, objective, and subjective results comparable to those of a younger patient population.

Adult↗
PubMedDate not supplied

Surgical resection of the distal clavicle.

Distal clavicle resection is frequently performed for persistent acromioclavicular pain. However, patient outcome after this procedure has not been well described. The results of subjective and objective retrospective analysis of 23 open distal clavicle resections in 21 patients are reported. Patients were evaluated with a questionnaire, roentgenographs, physical examination, and isokinetic muscle strength testing at an average of 30 months after surgery. Eighteen of 23 shoulders had good or excellent postoperative ratings. All patients had normal motion. No significant weakness of the operated shoulder was seen on objective muscle testing when compared with the unoperated shoulder. The average preoperative Hospital for Special Surgery score was 34, and the average postoperative score was 84. Age and hand dominance were unrelated to postoperative outcomes. Less predictable results were obtained in patients with workmen's compensation and in those patients involved in litigation. Open distal clavicle resection yields good to excellent results in properly selected patients and does not create significant subjective or objective weakness.

Acromioclavicular Joint↗
PubMedDate not supplied

Aerobic dance injuries.

Aerobic dance has taken the spotlight as one of the most popular forms of exercise in America. The benefits of a well developed, comprehensive program include an increase in strength, flexibility, and endurance while promoting a healthy cardiovascular system. Orthopaedic nurse clinicians frequently come in contact with aerobic dance participants before and after injury occurs. This article discusses the occurrence of aerobic dance injuries, treatment, and prevention.

Dancing↗
PubMedDate not supplied

Arthroscopy-assisted anterior cruciate ligament reconstruction using patellar tendon substitution. Two- to four-year follow-up results.

The purpose of this retrospective study was to evaluate clinically, functionally, and objectively our initial experience using free, autogenous middle third patellar tendon for anterior cruciate ligament reconstruction without extraarticular augmentation in 62 of 75 patients (80% followup) who were available for clinical review at a minimum 2-year followup. Subjective, clinical, functional, Cybex dynamometer, and KT-1000 arthrometer tests were performed along with modified tests of the Hospital for Special Surgery, Noyes Cincinnati, Tegner, and Lysholm knee rating scales. Ninety-two percent had a negative pivot shift at followup. The mean Cybex dynamometer extension deficits postoperatively were 9% and 7% at 180 and 240 deg/sec. Mild patellar pain symptoms were noted in 18%. The reoperation rate was 10% with a mild flexion contracture as the most common reason. The Hospital for Special Surgery scoring scale postoperatively was 88; Noyes, 86; Lysholm, 88; and Tegner, 6. Mean postoperative single-legged and vertical jump indices were 88% and 87%, respectively. The KT-1000 arthrometric evaluation postoperatively revealed a mean maximum manual difference of 0.3 mm; 92% of the patients had a maximum manual difference of < or = 3 mm. Subjectively, 95% indicated that they would undergo the procedure again. Early results demonstrate excellent stability, preservation of motion, and encouraging evaluations by scoring scales and arthrometric evaluation.

Adolescent↗
PubMedDate not supplied

Arthrometric results of arthroscopically assisted anterior cruciate ligament reconstruction using autograft patellar tendon substitution.

Sixty-two patients who underwent arthroscopically assisted anterior cruciate ligament reconstruction with the middle-third patellar tendon autograft without extraarticular augmentation were retrospectively reviewed at a minimum 2-year (mean, 37-month) followup. A postoperative KT-1000 arthrometric evaluation revealed a mean maximum manual difference of 0.3 mm (range, -6 to +16). Ninety percent of the patients had a mean maximum difference of < or = 3 mm. Three patients had a > or = 5 mm mean maximum difference; positive pivot shifts were noted in two of these patients. Despite an early range of motion, early weightbearing protocol without an extraarticular backup, the pivot shift (92% negative) was reliably eliminated at postoperative followup. Arthrometric parameters were statistically reduced (P < 0.0001) from preoperative status and were consistent with the diagnostic criteria established for normal knees. There was no relationship established in the "tighter" knees (those with negative side-to-side arthrometric differences) and the incidence of knee flexion contractures, patellar pain symptoms, Cybex extension deficit (> 20%), functional indices, or postoperative rating scales.

Adolescent↗
PubMedDate not supplied

Fat embolism syndrome: a complication of orthopaedic trauma.

Fat embolism syndrome is a potentially serious, life-threatening complication of long bone fractures, blunt trauma, and intramedullary manipulation. The orthopaedic nurse needs to have an understanding of fat embolism syndrome (FES), its pathophysiology, the varied aspects of its clinical presentation, and an understanding of treatment protocols and rationale.

Adult↗