Biomedical subjects

Champ L Baker

Publications and source records attributed to Champ L Baker.

8 recordsLinked to original sources

PubMed2007

Assessment of normal ACL double bundle anatomy in standard viewing planes by magnetic resonance imaging.

Anatomical studies show that the native ACL consists of two distinct functional bundles, termed the anteromedial (AM) and posterolateral (PL) bundles. The utility of using routine magnetic resonance imaging (MRI) to distinguish the individual bundles of the ACL has not been evaluated. The purpose of this study was to evaluate the intra- and inter-observer agreement for assessment of the AM and PL bundles using MRI in the axial, coronal, and sagittal viewing planes. We identified a series of patients seen in the senior author's clinic during a 16-month period. Images were independently evaluated in blinded fashion at two separate time points by a musculoskeletal radiologist and two orthopaedic residents. The AM bundle was detected in most planes of view with high frequency and reliability, while detection of the PL bundle was less frequent and had a lower associated reliability. Our results indicate that it is difficult to reliably detect both the AM and PL bundles using a low-field strength magnet with standard planes of view. It has been demonstrated that the ACL may be imaged effectively in planes that are based on the natural course of the ligament, and it is likely that this will also facilitate visualization of the individual AM and PL bundles. The use of additional oblique planes of view offers a potential approach for improved evaluation of the ACL, even with low field strength magnets. Future work in this area may assist in the pre-operative assessment of isolated AM or PL bundle injuries, facilitating a more anatomic approach to ACL reconstruction.

Adult↗

PubMed2006

Arthroscopic capsulolabral reconstruction for posterior instability of the shoulder: a prospective study of 100 shoulders.

BACKGROUND: There are few reports in the literature detailing arthroscopic treatment of unidirectional posterior shoulder instability. HYPOTHESIS: Arthroscopic capsulolabral reconstruction is effective in restoring stability and function and alleviating pain in athletes with symptomatic unidirectional posterior instability. This population has significant differences in glenoid and chondrolabral versions when compared with controls. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Ninety-one athletes (100 shoulders) with unidirectional recurrent posterior shoulder instability were treated with an arthroscopic posterior capsulolabral reconstruction and evaluated at a mean of 27 months postoperatively. A subset of 51 shoulders in contact athletes were compared with the entire group of 100 shoulders. Patients were evaluated prospectively with the American Shoulder and Elbow Surgeons scoring system. Stability, strength, and range of motion were evaluated preoperatively and postoperatively with standardized subjective scales. Forty-eight shoulders had magnetic resonance arthrograms performed and were available for review. The posterior inferior chondrolabral and bony glenoid versions were measured and compared with controls. RESULTS: At a mean of 27 months postoperatively, the mean American Shoulder and Elbow Surgeons score improved from 50.36 to 85.66 (P < .001). There were significant improvements in stability, pain, and function based on standardized subjective scales (P < .001). The contact athletes did not demonstrate any significant differences when compared with the entire cohort for any outcome measure. The results in the 71 shoulders followed for at least 2 years were similar to the overall group. On magnetic resonance arthrography, the shoulders with posterior instability were found to have significantly greater chondrolabral and osseous retroversion in comparison with controls (P < .001 and P = .008, respectively). CONCLUSION: Arthroscopic capsulolabral reconstruction is an effective, reliable treatment for symptomatic unidirectional recurrent posterior glenohumeral instability in an athletic population. Overall, 89% of patients were able to return to sport, with 67% of patients able to return to the same level postoperatively.

Adolescent↗

PubMed2006

Elbow arthroscopy.

Many surgeons avoid performing elbow arthroscopy because the elbow's unique anatomy and proximity to multiple neurovascular structures make it a technically demanding procedure with the potential for complications. However, recent advances in surgical technique and equipment have made arthroscopy easier and safer to perform and have expanded the indications for arthroscopic evaluation and treatment of elbow disorders. Careful patient selection, examination, and portal placement are critical to minimizing the potential for complications. Other techniques to decrease the incidence of complications from elbow arthroscopy include accurate preoperative outlining of anatomic landmarks, appropriate joint distention achieved by placing the patient's elbow in 90 degrees of flexion before portal placement, and the use of retractors to protect nerves and to maintain visualization and control of instruments during the procedure.

Arthroscopy↗

PubMed2005

Future treatment of osteoarthritis.

Osteoarthritis represents an advanced stage of disease progression caused in part by injury, loss of cartilage structure and function, and an imbalance in inflammatory and noninflammatory pathways. The burden of this disease will increase in direct proportion to the increase in the older adult population. Research on current and experimental treatment protocols are reviewed, including the effect of hyaluronic acid in both in vitro and in vivo studies, autologous chondrocyte and osteochondral plug implantation, and gene therapy. Disease-modifying osteoarthritis drugs and in vivo studies of glucosamine and chondroitin sulfate are reviewed.

Adjuvants, Immunologic↗

PubMed2004

Lateral epicondylitis.

Lateral epicondylitis is a diagnostic term that describes a pattern of pain and localized tenderness at the lateral epicondyle of the distal humerus. In this article, we discuss the pathology, clinical presentation, and treatment of this disorder. After a description of nonoperative treatment, we focus on the operative techniques for treating the disorder, and touch on postoperative care and results of treatment.

Athletic Injuries↗

PubMed2003

Calcific tendinitis of the shoulder.

Calcific tendinitis of the shoulder is a process involving calcium deposition commonly in the rotator cuff tendons. It is a cell-mediated process that is often chronic in nature, but it is usually self-limiting with regard to its acute pain states. Nonoperative management is still the treatment of choice and is successful in up to 90% of patients. When conservative measures fail, a needling technique or surgical removal may be indicated; the trend is toward arthroscopic management. Acromioplasty should not be performed without radiographic signs of impingement. If a resulting large rotator cuff defect is found after removal of the calcific deposit, it may be worthwhile to close the defect arthroscopically with suture to prevent cuff tear progression and to promote healing.

Arthroscopy↗

PubMed2003

Lateral epicondylitis of the elbow.

Lateral epicondylitis is a diagnostic term that describes a pattern of pain and localized tenderness at the lateral epicondyle of the distal humerus. The disorder was originally termed tennis elbow in 1883. This term remains in use despite the fact that most affected people are not tennis players. The incidence of lateral epicondylitis is equal among men and women. The average peak age distribution is 42 years (range, 30-50 years). Acute onset of symptoms is much more common in young athletes, and the chronic, recalcitrant pattern most often occurs in older people.This paper discusses the pathology, clinical presentation, and treatment of lateral epicondylitis. A brief description of nonoperative treatment is followed by an in-depth discussion of operative techniques for treating this disorder and a concise report on postoperative care, results, and failures.

Journal Article↗

PubMed2003

Arthroscopic rotator cuff tear repair.

Rotator cuff injuries or disease can be particularly troubling to patients by causing them pain, weakness, and dysfunction of the shoulder. Surgery of the shoulder and, in particular, of the rotator cuff, has evolved over the years from open surgery to include arthroscopic treatment for many conditions. Although technically demanding, arthroscopic repair of full- and partial-thickness rotator cuff tears has been shown to produce satisfactory results. Along with the advantages of the arthroscopic technique, smaller skin incisions, access to the glenohumeral joint for inspection and treatment of intra-articular lesions, no detachment of the deltoid, and less soft-tissue dissection, patients' results are comparable with those obtained with the open method of repair. The three phases of shoulder rehabilitation for patients who have undergone surgical treatment of rotator cuff disease are described: Phase 1, the immediate postoperative, or protective, phase; phase 2, the progressive strengthening phase; and phase 3, the advanced conditioning and return-to-sport phase. The postoperative rehabilitation programs for the arthroscopic and mini-open rotator cuff repair are essentially the same.

Arthroscopy↗