PubMed Health⌕ Search

Biomedical subjects

C A Iobst

Publications and source records attributed to C A Iobst.

4 recordsLinked to original sources
PubMed2000

Acute knee injuries.

Skeletally immature athletes do get major knee injuries. Hemarthrosis is associated with peripheral meniscal tears, anterior cruciate ligament ruptures, tibial tubercle avulsion injuries, and patellar/femoral osteochondral fractures and cannot be ignored. The primary diagnostic tool for patients with a knee injury is a clinical examination by a physician well trained in knee evaluation. MR imaging has significant limitations in this age group. The algorithm for anterior cruciate ligament injury treatment must take into account the patient's physiologic maturity, not chronological age.

Acute Disease↗
PubMed1999

The role of low molecular weight heparin in total knee arthroplasty.

Low-molecular-weight heparin prophylaxis is an acceptable, if not superior, alternative to heparin and warfarin prophylaxis in TKA. Considering the current popularity of pharmacologic prophylaxis after total hip and total knee arthroplasty and the advantages of low-molecular-weight heparins over traditional pharmacologic agents, these agents have the potential to become the prophylactic agent of choice against DVT in TKA. There are several practical differences between low molecular weight heparins and warfarin. Low molecular weight heparins are administered by subcutaneous injection and do not require drug-level or blood monitoring. Warfarin, although administered orally, must be maintained within an appropriate international normalized ratio (INR=2-3) with daily dose adjustments and takes 36 hours to produce a measurable effect, which may leave patients relatively unprotected during the early postoperative period. Comparative trials have demonstrated that low molecular weight heparins are more efficacious than warfarin in producing a greater overall reduction in the incidence and risk of DVT, but show similar rates of PE. Some studies suggest that bleeding may be a greater problem with low molecular weight heparin. Despite the superior efficacy of low molecular weight heparin, the prevalence of venous thromboembolism after TKA continues to be substantial compared with total hip arthroplasty, with at least a quarter of patients still affected. Additional prophylaxis strategies for this indication are needed and could include combining mechanical prophylaxis (eg, external pneumatic compression) with low molecular weight heparin. An appropriate management strategy should be established for all patients undergoing TKA. This should include identification of high-risk patients, cautious transfusion of blood products, pharmacologic prophylaxis with an acceptable agent for TKA, early mobilization, postoperative screening in high-risk patients, and continuing pharmacologic prophylaxis for an appropriate period postoperatively.

Anticoagulants↗
PubMedDate not supplied

The role of glenohumeral capsular ligaments in internal and external rotation of the humerus.

The purpose of this study was to define the relationship between internal and external rotation of the humerus and the lengths of the anterior and posterior components of the glenohumeral capsuloligamentous complex. Six cadaveric shoulders (with intact ligaments and humeri) were stripped of all muscles. Each shoulder was mounted in its correct anatomic position. The extent of internal and external rotation of the humerus was then measured 36 times (at 10 degrees intervals in a 360 degrees humeral cone of motion). One component of the glenohumeral capsuloligamentous complex was lengthened, and the humeral rotation was again measured 36 times. The process of lengthening was done by cutting the ligament and replacing it with a beaded chain and catches sutured across the joint. The process of lengthening each component was repeated in 12 combinations, each with a different anterior and posterior component length. Humeral rotation was measured 36 times using a specially designed goniometer. The length of the anterior component of the glenohumeral capsuloligamentous complex most affected external humeral rotation, and the length of the posterior component most affected internal humeral rotation. However, the lengths of both the anterior and posterior components shared in limiting rotation at a number of positions.

Aged↗