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Biomedical subjects

Christopher A Kurtz

Publications and source records attributed to Christopher A Kurtz.

8 recordsLinked to original sources
PubMed2006

Meniscus transplantation using the femoral distractor.

Accurate tunnel placement, graft passage, and secure suture fixation are key elements in meniscus allograft transplantation. We describe the use of a femoral distractor in meniscus transplantation. Joint distraction on the side of the transplantation by the femoral distractor can dramatically improve visibility and joint access. The distractor is applied after all necessary preparatory work. The distal femoral pin is placed in the supracondylar region on the side corresponding to the side to be transplanted. To avoid injury to the peroneal nerve, the proximal tibial pin is placed medial to lateral for both medial and lateral transplantations. The tibial pin is placed at a level approximately 1 to 2 cm below the tibial tubercle. The knee is then held in the flexion angle that affords the best visualization arthroscopically (typically between 60 degrees and 90 degrees of flexion). Gradual distraction is then applied with the distraction rod until adequate visualization is obtained. The case then proceeds with tunnel or trough creation, graft delivery, and peripheral repair. The improved visualization and access provided by the femoral distractor markedly simplifies the more challenging aspects of meniscus transplantation, helping to ensure precise tunnel placement, facilitate graft passage, and aid in accurate suturing.

Femur↗
PubMed2006

Nonsurgical management of lateral side injuries of the knee.

Non-surgical management of posterolateral corner (PLC) knee injuries is reserved for specific isolated mild to moderate injuries. There has been a relative scarcity of studies discussing non-surgical management existing secondary to the relative rarity of isolated PCL injuries. In these specific cases, a few studies have shown non-surgical management to result in satisfactory outcomes. This review of the literature outlines the outcomes and treatment options for posterolateral corner (PLC) knee injuries, which is based on the grade of the injury. However, no matter what the grade of injury, it is crucial to rule out other associated deficiencies before undertaking a nonoperative approach in the management of the posterolateral corner of the knee.

Humans↗
PubMed2006

Symptomatic os acromiale.

Os acromiale, the joining of the acromion to the scapular spine by fibrocartilaginous tissue rather than bone, is an anatomic variant that has been reported in approximately 8% of the population worldwide. It is more common in blacks and males than in whites and females. Although it is often an incidental finding, os acromiale has been identified as a contributor to shoulder impingement symptoms and rotator cuff tears. When nonsurgical management of a symptomatic os acromiale fails to relieve symptoms, surgical intervention is considered. Options include os acromiale excision, open reduction and internal fixation, and arthroscopic decompression. Excision usually is reserved for small to midsized fragments (preacromion) or after failed open reduction and internal fixation. Persistent deltoid dysfunction may result from excision of a large os acromiale. Open reduction and internal fixation preserves large fragments while maintaining deltoid function. Cannulated screw fixation has been shown to result in good union rates. Arthroscopic techniques have shown mixed results when used for treating impingement secondary to an unstable os acromiale. Associated rotator cuff tears may be addressed arthroscopically or through an open transacromial approach, followed by open reduction and internal fixation of the os acromiale.

Acromion↗
PubMed2005

Posterolateral corner reconstruction of the knee: surgical technique utilizing a bifid Achilles tendon allograft and a double femoral tunnel.

Reconstruction of the posterolateral corner of the knee has received increased attention in the recent literature. Basic science studies have helped us determine the 3 critical structures of the posterolateral corner: the lateral collateral ligament (LCL), the popliteus tendon, and the popliteofibular ligament. We have developed an anatomic posterolateral corner reconstruction that most closely resembles these 3 key structures and is based on the work of previous authors. Our technique is performed using a single Achilles allograft. The bone plug is secured in a femoral tunnel at the anatomic attachment of the popliteus tendon with an interference screw. The Achilles tendon is then split approximately 1 to 2 cm distal to the bone plug into 2 segments: (1) the popliteofibular ligament portion that is passed through a fibular tunnel starting at the anatomic attachment of popliteofibular ligament and fixed with a biointerference screw and (2) the static portion of the popliteus tendon securing this through a tibial tunnel passed from posterior to anterior right at the musculotendinous junction of the popliteus. The anterior limb of the Achilles tendon exiting the fibula is then brought back around, secured to the fibular attachment of the LCL with a suture anchor, and is then passed through a separate femoral tunnel placed at the anatomic attachment of the LCL.

Achilles Tendon↗
PubMed2005

Treatment of acute and chronic anterior cruciate ligament-posterior cruciate ligament-lateral side knee injuries.

Knee dislocations are rare but devastating injuries. The ACL-PCL-lateral side injury combination is representative of the challenges these injuries present. Early management is focused on vascular integrity. When possible, acute repair and reconstruction within 3 weeks from injury is preferred. Chronically deficient knees generally will require lateral side reconstruction rather than repair and may require limb realignment. Addressing all injured structures is imperative to afford the best chance at a reasonable outcome. Good results with surgery are possible, but some degree of persistent disability is to be expected.

Anterior Cruciate Ligament↗
PubMed2004

Transtibial and tibial inlay double-bundle posterior cruciate ligament reconstruction: Surgical technique using a bifid bone-patellar tendon-bone allograft.

Abstract The treatment of posterior cruciate ligament injuries is difficult and controversial. Reconstructive technique and graft design are 2 of the unsolved issues in posterior cruciate ligament reconstruction. We present a technique using a bifid bone-patellar tendon-bone allograft for reconstruction of the posterior cruciate ligament. This graft more closely mimics normal anatomy and may be used in both transtibial and tibial inlay reconstructions.

Humans↗