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Biomedical subjects

D D Buss

Publications and source records attributed to D D Buss.

At least 19 recordsLinked to original sources
PubMed2001

Arthroscopic stabilization of type II SLAP lesions using an absorbable tack.

PURPOSE: To document the outcomes of arthroscopic stabilization of Snyder type II SLAP (superior labrum, anterior and posterior) lesions, using a bioabsorbable tack. TYPE OF STUDY: A case series. METHODS: Twenty-five SLAP lesions were repaired arthroscopically using a bioabsorbable tack. There were 22 recreational, 2 high school, and 1 professional athlete in this group. Shoulder function was surveyed at a mean follow-up of 35 months (range, 24 to 51 months) using the UCLA and ASES shoulder scoring algorithms. RESULTS: Shoulder function improved in 24 of the 25 cases. Follow-up UCLA scores averaged 32 points with 9 patients scoring as excellent, 13 good, 2 fair, and 1 poor, for an overall success rate of 88%. ASES shoulder scores similarly improved from a preoperative average of 45 points to a postoperative average of 92. All but 2 of the athletes had returned to their preinjury level of sports participation. CONCLUSIONS: Detachment of the superior labrum from the glenoid is recognized as a problematic injury in throwing athletes and others who engage in repetitive overhead activities. We conclude from our experience that using an absorbable tack to repair type II SLAP lesions is an effective treatment, even in athletes with high demands and expectations for shoulder function.

Absorbable Implants↗
PubMed2001

Outpatient shoulder surgery: a prospective analysis of a perioperative protocol.

During a 10-month period, 106 consecutive outpatient shoulder procedures were done in 102 patients who were followed up prospectively for a minimum of 6 months. The procedures included arthroscopic surgery alone (60%) and open surgeries with or without associated arthroscopy (40%). The anesthetic protocol included propofol and nitrous oxide, without scalene block augmentation, and local 0.5% bupivacaine. Patients were discharged with oral analgesics. Ninety-five percent of the patients successfully underwent their procedure as an outpatient; only 5% required admission on the day of surgery, and none required readmission. There were no short- or long-term postoperative complications attributable to the protocol. Ninety-six percent of the patients were satisfied with their pain management, and all patients were satisfied with their overall experience.

Ambulatory Surgical Procedures↗
PubMed2000

Arthroscopic decompression for impingement syndrome secondary to an unstable os acromiale.

PURPOSE: The purpose of this study was to examine cases of patients with impingement syndrome secondary to an unfused, unstable, os acromiale. TYPE OF STUDY: Retrospective case series. MATERIALS AND METHODS: Twelve consecutive patients (13 shoulders) presented with impingement symptoms in the presence of an os acromiale. The os acromiale, at the meso-acromion level, was seen on standard radiographs. The patients were all treated conservatively with rotator cuff strengthening, stretching, anti-inflammatory medications, and steroid injections. All patients underwent an impingement test with lidocaine, resulting in complete relief of their pain. After failure of the conservative management, the 12 patients (13 shoulders) underwent an extended arthroscopic subacromial decompression. The goal of the modified arthroscopic acromioplasty was resection of adequate bone to remove the mobile anterior acromial tip. In general, this consisted of more bony resection than the typical arthroscopic acromioplasty. Postoperatively, the patients began a rehabilitation program emphasizing early range of motion followed by isolated free-weight rotator cuff strengthening exercises. Five shoulders had a partial-thickness tear of the rotator cuff. Four involved less than 50% of the thickness of the rotator cuff. These 4 partial-thickness tears underwent arthroscopic rotator cuff debridement. One partial-thickness tear was greater than 50% and repair was performed with a mini-open deltoid-splitting technique. RESULTS: Results were evaluated using UCLA shoulder scoring. Preoperatively, the score averaged 17. The 3-month postoperative score was 27, and at 6 and 12 months, averaged 28. The final follow-up score averaged 31. There were 11 satisfactory results with UCLA scores >/=28. Two unsatisfactory results showed UCLA scores in the fair category. Full strength of the anterior deltoid and rotator cuff muscles was achieved in all patients by 6 months postoperatively as evaluated by manual muscle testing. Twelve of the 13 shoulders were rated by the patients as having a satisfactory result. All of the patients rated their cosmetic results as acceptable. There was no evidence of postoperative deltoid detachment. No patient developed pain at the pseudarthrosis point. CONCLUSIONS: Given the previously reported poor results with attempts at fusion of an unstable os acromiale and open complete excision of meso-acromial fragments, the authors conclude that an extended arthroscopic subacromial decompression results in a reasonable outcome for patients with impingement syndromes secondary to an unstable os acromiale.

Acromion↗
PubMed1998

Management of shoulder impingement syndrome and rotator cuff tears.

Rotator cuff impingement syndrome and associated rotator cuff tears are commonly encountered shoulder problems. Symptoms include pain, weakness and loss of motion. Causes of impingement include acromioclavicular joint arthritis, calcified coracoacromial ligament, structural abnormalities of the acromion and weakness of the rotator cuff muscles. Conservative treatment (rest, ice packs, nonsteroidal anti-inflammatory drugs and physical therapy) is usually sufficient. Some patients benefit from steroid injection, and a few require surgery.

Diagnosis, Differential↗
PubMed1998

MR imaging of the shoulder after an impingement test: how long to wait.

OBJECTIVE: The purpose of this study was to determine the appropriate minimum waiting time between an impingement test with subacromial injection and subsequent MR imaging to avoid misinterpretation if the injected fluid is still present. CONCLUSION: MR imaging should be delayed a minimum of 24 hr after a subacromial injection. Fluid in the subacromial space 24 hr after subacromial injection is unrelated to an impingement test.

Adult↗
PubMed1997

Chronically injured posterior cruciate ligament: magnetic resonance imaging.

Magnetic resonance imaging has been said to be highly reliable for diagnosis of acute posterior cruciate ligament insufficiency. In the present study, 13 patients whose posterior cruciate ligament insufficiency had been documented by magnetic resonance imaging within 10 weeks of the acute injury were recalled for a followup examination and magnetic resonance imaging. The followup interval ranged from 5 months to 4 years. In only 23% of the cases did the posterior cruciate ligament still appear discontinuous on followup magnetic resonance imaging. In the remaining 77%, the posterior cruciate ligament was continuous from tibia to femur, although it appeared abnormally arcuate or hyperbuckled. Conventional interpretation of these magnetic resonance images would suggest that the posterior cruciate ligament had healed. Nevertheless, by clinical examination results, these same patients all were judged to have posterior cruciate ligament insufficiency. Thus, it was concluded that although magnetic resonance imaging may be reliable for evaluation of acute posterior cruciate ligament injury, magnetic resonance imaging findings should not be used to infer functional status in chronic cases.

Chronic Disease↗
PubMed1996

Evidence for a relation between inspired gas mixture and the left ventricular contrast achieved with Albunex in a canine model.

BACKGROUND: In a previous experiment, a marked reduction in the right- and left-sided contrast effect of Albunex was noted in an intubated animal spontaneously breathing isoflurane in 100% oxygen. The theory suggests that the time course of echogenicity of microbubbles in liquid is dependent on the pressure and the gradients of dissolved gases. The present set of experiments tested whether the loss of contrast occurs at commonly used therapeutic concentrations of inspired oxygen. HYPOTHESIS: This research tested the hypothesis that the left ventricular (LV) contrast effect achieved with intravenous injection of the ultrasound contrast agent Albunex is related to the inspired oxygen content. METHODS: Intubated dogs were maintained in a spontaneously respiring anesthetic state on isoflurane and mixtures of oxygen (12-50%) in nitrogen. FIO2 was held steady for 15 min prior to injection of 0.08 ml/kg of Albunex. The contrast effects were recorded from a transthoracic short-axis view. Left and right ventricular brightness curves were generated from digitized sequences of end-diastolic frames. The minimum and maximum brightness and area under the time-brightness curves were determined. RESULTS: The LV maximum brightness and area under the curve showed significant negative correlations (p = < 0.004) with the FIO2, while the minimum brightness showed a significant positive correlation (p = < 0.002). No significant correlations were found for the right ventricular brightness parameters. CONCLUSIONS: These findings show an important relationship between the FIO2 and loss of the contrast effect of Albunex. This loss occurs at oxygen concentrations in the therapeutic range, but could be overcome by increasing the dose of Albunex. The mechanism is likely related to an outward nitrogen gradient causing a loss of echogenicity. The clinical implication is that patients on supplemental oxygen may require higher doses of Albunex to achieve optimal opacification.

Albumins↗