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Biomedical subjects

J Insall

Publications and source records attributed to J Insall.

At least 19 recordsLinked to original sources
PubMed1979

The total condylar knee prosthesis. A report of two hundred and twenty cases.

The total condylar knee prosthesis is a non-hinged surface replacement which can be used for almost all knee deformities. This report discusses the first consecutive 220 arthroplasties in 183 patients. Follow-up time was three to five years. Before operation eighty-six knees had more than 10 degrees of fixed varus deformity and thirty-one knees had more than 10 degrees of fixed valgus deformity. All patients were assessed using The Hospital for Special Surgery scoring system. Of the total of 220 knees, 137 (62%) were rated excellent; sixty-one (28%), good; ten (4.5%), fair; and twelve (5.5%), poor. Of 139 osteoarthritic knees, 93% were rated excellent or good. Complications included three deep infections and four cases of posterior subluxation. The over-all reoperation rate was 3.6%.

Arthritis, Rheumatoid↗
PubMed1979

Proximal "tube" realignment of the patella for chondromalacia patellae.

In young people complaining of patellar pain there is often an anatomic basis (an increased quadriceps angle or a high-riding patella). Forty-eight knees with one or other of these abnormalities underwent proximal quadriceps realignment. The results were excellent or good in 94%. Shaving of chondromalacic cartilage was also done in 11 knees but did not seem to improve the results, and is not now recommended except for "blister" lesions. Extensor mechanism dysplasia is an etiologically correct name for the disorder and therefore preferable to "chondromalacia patellae."

Cartilage Diseases↗
PubMed1976

Chondromalacia Patellae. A prospective study.

In a prospective study of 105 arthrotomies for chondromalacia patellae, patella alta or an increased Q angle was found in most of the knees and was considered to be the usual cause of chondromalacia. The chondromalacia on the patella was usually centrally located with extension equally onto the medial and lateral facets. Femoral changes were uncommon. Patellar realignment together with excision of chondromalacic cartilage gave a satisfactory result in 79 per cent of the eighty-seven knees that could be followed.

Adolescent↗
PubMed1976

Recurrent dislocation of the patella. Relation of treatment to osteoarthritis.

Eighty-one knees surgically treated and twenty-six conservatively treated for recurrent dislocation of the patella in seventy-eight patients were studied. The average follow-up on the surgically treated knees was eight years and on the conservatively treated knees, sixteen years. In the non-surgical group dislocations tended to become less frequent with advancing age and there was very little evidence of osteoarthritis. After the sixty-nine tibial tubercle transfers there was a 20 per cent recurrence rate; further procedures were often needed, and the incidence of late osteoarthritis was disturbingly high. After the twelve soft-tissue corrections without movement of the tibial tubercle, dislocation recurred in three, but late osteoarthritis was not seen.

Female↗
PubMed1976

High tibial osteotomy for osteoarthritis of the knee: a changing concept.

High tibial osteotomy is most successful in patients with osteoarthritis with mild varus deformity which is not associated with subluxation of flexion contracture. Success in the valgus knee is limited. If tibial osteotomy is indicated, undercorrection is undesirable in the varus knee while overcorrection is undesirable in the valgus knee.

Contracture↗
PubMed1976

Total condylar knee replacment: preliminary report.

The Total Condylar Prosthesis is a non-hinged unit designed to: replace the patellofemoral articulation; improve fixation of the tibial component by means of a stout central peg; permit accurate and reproducible insertion. The cruciate ligaments are excised to obtain better tibial fixation. Instability has not been a problem except in a few cases of a technical error (removal of excessive bone from the tibia creates instability in flexion). The prosthesis cannot be positioned by "eye" and the instrumentation must be applied exactly.

Humans↗
PubMed1976

Duo-condylar knee arthroplasty: hospital for special surgery design.

This is a report of 94 knees in 88 patients with the duo-condylar type of knee arthroplasty. The follow-up period of time was between 2 to 4 years with an average of 3 years. The rheumatoid to osteoarthritic patient ratio was 3 to 1. The overall results were excellent in 37.5 per cent, good in 37.5 per cent, fair in 16 per cent, and poor in 9 per cent. The main causes of failure and poor results were: (1) under or over correction of deformity leading to subluxation and/or instability of the knee; (2) loosening of the tibial component, and (3) symptoms arising from the patellofemoral joint. The revision rate is 5.5 per cent. The progressive radiolucency at the cement bone bond is 26 per cent of which 16 per cent is up to 1 mm and 10 per cent is between 1.5 to 3 mm. To further improve the results of arthroplasty, one should take into consideration (1) replacement of the patellofemoral joint, (2) insertion of the prosthesis in the proper anatomical location under correct tension of the ligaments and capsule with the help of proper instrumentation and (3) improvement in fixation of the tibial component.

Adult↗
PubMed1976

Unicondylar knee replacement.

Unicompartmental knee arthroplasty was conceived for the treatment of osteoarthritic knees with deterioration of either the medial or lateral compartment of the knee. The Unicondylar prosthesis was used in 19 medial and 5 lateral compartment arthroplasties. A two to 4 year follow-up evaluation of these patients was somewhat disappointing as only 5 knees could be rated excellent and 6 rated a good result. The best results were seen in the lateral compartment arthroplasties. Such deformities may be the only future indication for the use of this operation as these knees do not do well when treated by tibial osteotomy. However, when only the medial compartment is involved, osteotomy may still remain the treatment of choice.

Female↗