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Biomedical subjects

J C Hughston

Publications and source records attributed to J C Hughston.

At least 19 recordsLinked to original sources
PubMed1991

Popliteal cyst: a surgical approach.

Twenty-nine adult patients (30 knees) who failed conservative treatment had surgical excision of a non-rheumatoid cyst. To determine the effectiveness of this surgical procedure, we reviewed the cases of 24 patients (25 knees) who were available for subjective and objective follow up. Twenty of the 25 knees (80%) were rated excellent or good. Three knees had fair results. Two knees continued to have problems and ultimately underwent total knee replacement for degenerative arthritis.

Adolescent↗
PubMed1989

Patellar subluxation. A recent history.

For 15 years (1955 to 1970), I was plowing "new ground" pretty much by myself. When you plow behind an old mule and hit a stump hole full of cottonmouth moccasins, you have to get on the move in a hurry and figure out some solution to the predicament or you won't get your corn planted. So, I was not treating the overweight, knock-kneed, loose-jointed, teenaged girl, but the young boy or girl who thought that he or she was an athlete and had dreams of being a star. If rehabilitation did not work, then I thought a lateral release, an Elmslie, and nothing short of a full reconstruction would solve the problem. One had to develop as much vastus medialis obliquus power as this dysplastic muscle could generate, had to transfer the strong vastus lateralis to a more central pull, and, with the distal reconstruction, correct any patella alta and Q-angle abnormality. One had to give the knee every possible advantage in order to serve an athlete. As Hippocrates so wisely noted, one needed to study the athlete to know, with appropriate modifications, what is best for every patient, young or old. In the late 1960s and early 1970s, many fine young orthopedists were stimulated by the information of the AAOS postgraduate courses in sports medicine. They, after having gained further through their own experiences, have become the major contributors to our increasing knowledge of the patellofemoral joint, especially in athletes, and many of these fine "young" (now a little older) orthopedists are now the contributors to this issue. They are giving you their experiences, knowledge, and lessons. A close and repeated study of their information must be combined with compassion for your patient. Then, only experience will develop the desired fine tuning.

Humans↗
PubMed1989

Roentgenographic findings in pigmented villonodular synovitis of the knee.

Twenty-nine cases of pigmented villonodular synovitis (PVS) of the knee in 27 patients were reviewed to determine characteristic roentgenographic findings. All cases met strict histologic criteria for diagnosis. Four cases were localized PVS (LPVS), and 25 cases were diffuse PVS (DPVS). Roentgenographic findings were largely in the soft tissues. Cystic invasion of bone or degenerative changes were rare, although present in some cases. When present in DPVS, these changes were most pronounced in the patellofemoral articular surface. In the cases of DPVS, large posterior tumefactions did not correlate with extraarticular extension. Clinical behavior of PVS was governed more by anatomic site and form of disease than by the severity of histologic or roentgenographic findings.

Adolescent↗
PubMed1988

Miyakawa patellectomy.

A Miyakawa patellectomy was done in seventeen patients (twenty knees) for either osteoarthritis or chondromalacia of the patella, or both, secondary to malfunction of the extensor mechanism. Patients who had had a patellar fracture were not included in the series. The Miyakawa patellectomy realigns the extensor mechanism, with the proper tension, and centers the functional pull of the quadriceps tendon and patellar ligament. A superficial strip of the quadriceps tendon is pulled distally to fill the void that was left by removal of the patella and to maintain proper length. The musculotendinous portions of the vastus lateralis and vastus medialis are advanced over this defect in the midline and are sutured to the quadriceps tendon. The average length of follow-up was 13.8 years (range, 3.6 to 31.7 years). Nineteen of the twenty knees had a good or excellent subjective result and eighteen had a good or excellent objective result. No subsequent surgical treatment was needed for problems that were caused by malfunction of the extensor mechanism of the knee.

Adult↗
PubMed1985

Associated joint pathology in the anterior cruciate ligament-deficient knee with emphasis on a classification system and injuries to the meniscocapsular ligament-musculotendinous unit complex.

This article defines the anterior cruciate ligament-deficient knee in terms of capsular instabilities. This definition lends itself to a better assessment of the associated pathology consisting of torn capsular ligaments, torn medial and lateral menisci, chondral fractures, subluxation of the patella, and acute contusion of the peroneal nerve. The specific incidence of torn medial meniscus was 70 per cent, with a torn lateral meniscus identified 77 per cent of the time.

Humans↗
PubMed1979

Peroneal nerve paralysis: a complication of extensor reconstruction of the knee.

Adequate hemostasis is extremely important in extensor reconstruction of the knee and possibly all knee injury. Hemarthrosis postoperatively contributes to postoperative discomfort and may increase the risk of infection. Hematoma formation is also responsible for neurovascular complications. Peroneal nerve palsies were associated with hematoma formation in this series and probably represented a pressure palsy. Release of the tourniquet with good hemostasis and a pressure dressing prior to cast application will aid in the prevention of hemarthroses and consequent neurovascular complications. Peroneal nerve palsy is probably more common in reconstruction of the extensor mechanism of the knee than has previously been reported.

Adolescent↗
PubMed1979

Proximal and distal reconstruction of the extensor mechanism for patellar subluxation.

Proximal and distal reconstruction of the leg extensor mechanisms has been developed and performed in 346 cases over a period of 25 years. Proximal extensor mechanism reconstruction produces very satisfactory results in over 70% of cases and continues to be the basic principle of surgical treatment for patellar subluxation. In patients with Q angles (angle between line of the quadriceps force and the direction of the patellar tendon) greater than 10 degrees distal reconstruction (patellar tendon transfer) is done in addition to, not in lieu of, the dynamic proximal reconstruction. Treatment of the chondromalacia developing secondary to altered extensor mechanism mechanics can be by simple chondrectomy provided that the causal mechanical abnormalities are modified.

Humans↗
PubMed1977

Treatment of patellar fractures by partial patellectomy.

Results of treating 238 transverse, longitudinal, and osteochondral fractures of the patella are reviewed. Of these, 89 patients had partial patellectomy and extensor mechanism reconstruction. After an average follow-up of four years, functional results have been excellent; there have been no late patellectomies and traumatic arthritis has not developed. Total patellectomy is recommended only when the entire patella is so severely comminuted that none of it can be used as part of the extensor mechanism of the knee.

Female↗
PubMed1976

Classification of knee ligament instabilities. Part I. The medial compartment and cruciate ligaments.

Based on the clinical and operative findings in sixty-eight knees with acute tears of the medial compartment and cruciate ligaments, a standardized terminology and classification of knee ligament instability is presented. With an intact posterior cruciate ligament, anteromedial, anterolateral, or posterolateral rotatory instability may occur, but not true posteromedial rotatory instability. With the posterior cruciate ligament ruptured, straight anterior, posterior, medial, or lateral instability may be found.

Humans↗
PubMed1976

Classification of knee ligament instabilities. Part II. The lateral compartment.

Lateral instability of the knee is less frequent but more disabling than medial instability of a comparable amount. At the same time the diagnostic tests for lateral instability are more subtle and more frequently misinterpreted. Posterolateral rotatory subluxation is demonstrated by an apparently positive posterior drawer test with the tibia in neutral rotation or by the external rotation-recurvatum test with the knee in extension. Anterolateral rotatory subluxation is present when the anterior drawer test with the tibia in neutral rotation demonstrates that the lateral tibial condyle appears to become more prominent or that both condyles appear to become equally prominent.

Knee Injuries↗
PubMedDate not supplied

Tibial plateau topography.

A logical definition of the anatomy of the tibial surface, based on the shape of the tibial surface as measured in the laboratory, is presented. The relevance of these data to a better understanding of normal and pathological knee joint function is discussed. The thesis that the spine of the tibia is the major weight-bearing portion of the tibial surface can be supported by this contour study. The significance of the lateral plateau contour relative to the static stability of the joint contributed by joint apposition has been indicated. In addition, the path followed by the lateral femoral condyle during the "screw home mechanism" and caused by joint contour has been clearly demonstrated. We hope that this experimental evidence will establish itself as the basis for understanding the anatomy of the proximal tibial surface and that the nomenclature can be accepted to provide a common base for discussion of the tibial surface.

Adult↗