PubMed Health⌕ Search

Biomedical subjects

J F Redden

Publications and source records attributed to J F Redden.

16 recordsLinked to original sources
PubMed2003

The St. Leger total knee replacement--a 7-year clinical assessment and survivorship analysis.

The St. Leger total knee replacement was developed with the aim of producing an affordable prosthesis which contained the best known features of current designs and also allowed ease of instrumentation. We present the medium term clinical and radiographic outcome and survivorship of the prosthesis. From 1992 to August 1994, 150 St. Leger total knee replacements were performed on 53 male and 72 female patients. Mean age was 67 (Range: 40-86). Sixty-nine percent of operations were for osteoarthritis and 30% for rheumatoid arthritis. Patients were reviewed at 1, 4 and 7 years postoperatively by an independent assessor. One hundred and twenty-three patients were assessed at 4 years and 83 patients at 7 years. The American Knee Association Scores revealed 84% excellent or good, 9% fair, and 7% poor results at 7 years. No patients complained of severe pain, 90% had mild or no pain, 10% had moderate pain. Eighty nine percent of patients were satisfied with their outcome. There were five complications requiring revision: infection (2), loosening (1), valgus instability (1) and knee stiffness (1). Survivorship analysis revealed 95% (95% CI +/-7.2%) survival at 7 years. Total knee replacement using the St. Leger knee prosthesis has comparable results to other condylar knee systems that cost almost twice the price.

Adult↗
PubMed2000

A new technique for delayed primary closure of fasciotomy wounds.

Fasciotomy for compartment syndrome in the lower limb is a surgical emergency to preserve future limb function. The advised standard procedure involves both medial and lateral dermotomy in addition to the fasciotomy. There is often concern before and after performing fasciotomy about the cosmetic appearance and prolonged hospital stay if split skin grafting is required to cover the resultant skin defect. This is the case in over 50% of lower limb fasciotomies. We have used a technique of subcuticular prolene suture, first described for the delayed primary closure of contaminated abdominal wounds, in six patients who had undergone lower limb fasciotomies. In all of these cases delayed primary closure was easily achieved without the need for skin grafting. Experiments using a synthetic skin model have shown a 60% reduction in suture tension when compared with interrupted vertical mattress suturing. The subcutaneous prolene suture has the advantage of being both the method of approximation and final closure whilst spreading tension evenly across the wound edges without causing skin edge necrosis. It appears to be simpler and more economical than any technique so far described for the successful delayed primary closure of fasciotomy wounds.

Compartment Syndromes↗
PubMed2000

Treatment of osteoarthritis of the elbow: a comparison of open and arthroscopic debridement.

PURPOSE: To assess the effectiveness of open and minimally invasive techniques in the debridement of osteoarthritis of the elbow, we compared the Outerbridge-Kashiwagi (O-K) procedure with an arthroscopic modification in which arthroscopic debridement and fenestration of the olecranon fossa was performed. TYPE OF STUDY: The study took the form of a nonrandomized control trial in which subjects were allocated to a treatment depending on the hospital of presentation. MATERIALS AND METHODS: Assessment using the Mayo Clinic elbow function chart enabled comparison of the outcome in 18 cases treated by the O-K procedure and 26 patients treated by arthroscopic debridement and fenestration of the olecranon fossa. Mean follow-up was 35.3 months (minimum 12 months). Of the patients treated by the O-K procedure, 14 were men and 4 were women with a mean age of 55 years. In 83% of patients, the diagnosis was primary osteoarthritis, with the remainder post-traumatic arthritis. The patients treated by arthroscopic debridement and fenestration of the olecranon fossa included 24 men and 2 women with a mean age of 46 years, and a diagnosis of primary osteoarthritis in 91% and post-traumatic arthritis in the remainder. No patients were excluded from the study or refused to be included. RESULTS: Both procedures were shown to be effective, with no major complications. Patients treated by arthroscopic debridement and fenestration of the olecranon fossa achieved better relief of pain (P <.10), whereas those patients undergoing the O-K procedure achieved significantly greater improvement in range of flexion (P <.05). No difference between the procedures in terms of patient-perceived overall effectiveness of the surgery was found. CONCLUSIONS: In conclusion, in the treatment of osteoarthritis of the elbow, arthroscopic debridement and fenestration of the olecranon fossa may be a more suitable procedure when painful symptoms predominate. In contrast, the O-K procedure is a significantly better procedure for improving the range of flexion where this is a particular problem.

Adult↗
PubMed1997

Deliberate self-harm as a cause of persistent discharge from arthroscopic portals.

Persistent discharge and bleeding from arthroscopy portals are rare complications. We report three cases which occurred as a result of deliberate self-harm. To our knowledge the occurrence of self-inflicted injury following arthroscopy has not been reported. Although suspicion of such activity may be delayed we consider it important to be aware of the possibility of this behaviour and to seek specialist help early in order to reduce the likelihood of further permanent physical damage.

Adolescent↗
PubMed1994

Neglected bilateral congenital recurvatum of the knee.

The authors report two cases of neglected bilateral congenital recurvatum of the knee, one in a ten-year-old girl and the other in a 23-year-old man. The treatment of this rare deformity in infancy and childhood is described. A surgical approach to the deformity, which is not known to have been reported, is also presented.

Adult↗
PubMed1993

Arthroscopic fenestration of the olecranon fossa in the treatment of osteoarthritis of the elbow.

A new arthroscopic approach to the treatment of elbow osteoarthritis that permits debridement of the elbow joint together with the removal of intraarticular loose bodies is described. Twelve patients (11 male, one female) with an age range of 29-64 (mean 47.5 years) underwent the procedure. Post-surgery all patients had relief of elbow-locking and experienced a reduction in elbow pain (follow-up 3-30 months, mean 16 months). The technique is offered as a treatment option for patients with elbow osteoarthritis.

Adult↗
PubMed1992

Management of hip posture in cerebral palsy.

Seating arrangements for cerebral palsy children with total body involvement are often unsatisfactory and can pose considerable problems for the multi-disciplinary team. Hip joints at risk of dislocation must be kept in an abducted position in order to minimize pain. A new wheelchair with a barrel-shaped cylindrical seat has been developed which improves the femoral head location and alleviates pain.

Cerebral Palsy↗
PubMed1991

Improving care: a study of orthopaedic outpatient referrals.

OBJECTIVE: To identify aspects of outpatient referral in which general practitioners', consultants', and patients' satisfaction could be improved. DESIGN: Questionnaire survey of general practitioners, consultant orthopaedic surgeons, and patients referred to an orthopaedic clinic. SETTING: Orthopaedic clinic, Doncaster Royal Infirmary. SUBJECTS: 628 consecutive patients booked into the orthopaedic clinic. MAIN OUTCOME MEASURES: Views of the general practitioners as recorded both when the referral letter was received and again after the patient had been seen, views of the consultants as recorded at the time of the clinic attendance, and views of the patients as recorded immediately after the clinic visit and some time later. RESULTS: Consultants rated 213 of 449 referrals (42.7%) as possibly or definitely inappropriate, though 373 of 451 patients (82.7%) reported that they were helped by seeing the consultant. Targets for possible improvement included information to general practitioners about available services, communication between general practitioners and consultants, and administrative arrangements in clinics. Long waiting times were a problem, and it seemed that these might be reduced if general practitioners could provide more advice on non-surgical management. Some general practitioners stated that they would value easier telephone access to consultants for management advice. It was considered that an alternative source of management advice on musculoskeletal problems might enable more effective use to be made of specialist orthopaedic resources. Conclusion--A survey of patients' and doctors' views of referrals may be used to identify aspects in which the delivery of care could be made more efficient. Developing agreed referral guidelines might help general practitioners to make more effective use of hospital services.

Attitude of Health Personnel↗
PubMed1988

Profile of half-day arthroscopic surgery in a district general hospital.

The first 50 patients who underwent arthroscopic surgery as a half-day procedure in Doncaster Royal Infirmary were studied: 22 patients underwent an arthroscopic meniscectomy and 6 patients had other procedures. The mean return-to-work time for meniscectomy patients was 23.9 days. The cost improvement per patient, when compared with a two-night stay in hospital, was pounds 432.84 per patient. Not only is this a comparatively comfortable operation for the patient, but a rapid return to work is possible. The saving to the Department of Health and Social Security, when assessed on a national scale, could be very considerable.

Adolescent↗
PubMed1981

Management of fissure fractures in Paget's disease.

Forty-five patients with Paget's disease were studied, of whom 25 had fissure fractures affecting the bones of the lower limb. Ten patients treated with salmon calcitonin showed no improvement in their fissure fractures despite reduction in bone turnover. Treatment was effective where bone deformity was improved by traction or intra-medullary nail fixation combined with osteotomy. Surgical treatment should be undertaken in those patients who complain of acute pain at the site of a fissure fracture and who risk completing the fracture. Fissure fractures involving the femoral neck should be fixed even when asymptomatic because of the risk of non-union if they become complete.

Aged↗