Biomedical subjects

K M Singer

Publications and source records attributed to K M Singer.

6 recordsLinked to original sources

PubMed1990

Meniscal cysts.

Meniscal cysts are cysts that occur as a direct extension, or within the substance of the meniscus. The incidence varies in reports from 1% to 20% and are much more common laterally. They usually present as joint-line pain, swelling, or both in young adult men, and are often associated with meniscal tears. The exact etiology of meniscal cysts is unknown. A myxoid degenerative process is identified histologically. There is often a history of precedent trauma. Diagnosis is often suspected clinically and can be confirmed by arthrogram, CT, or MRI when necessary. Conservative treatment in the patient with few symptoms is recommended. Should the cyst become significantly symptomatic, it is necessary to treat the meniscal pathology to prevent a cyst recurrence. At the present time it is our recommendation that this be done by arthroscopically resecting the meniscus back to normal meniscus and either aspirating and injecting the cyst with steroid or local cyst excision if the aspiration and injection fails. If no meniscal tear is documented at arthroscopy, exploration and excision of the cyst are recommended.

Arthrography↗

PubMed1989

Instrumented Lachman tests for the evaluation of anterior laxity after reconstruction of the anterior cruciate ligament.

Using a KT-1000 arthrometer, in fifty subjects were measured the anterior ligamentous laxity in a knee in which the anterior cruciate ligament had been reconstructed and in the normal, contralateral knee. We also determined the anterior tibial displacement and anterior compliance, using the Lachman test. The subjects were divided into groups according to the type of autogenous intra-articular substitute (either the central one-third of the patellar tendon or the semitendinosus tendon) that had been used for the anterior cruciate ligament and according to the duration of follow-up (range, twenty-four to 101 months). Lachman tests were performed, applying sixty-eight and ninety newtons of force, and indices for anterior compliance were calculated. Although significantly more anterior laxity was demonstrated with both sixty-eight and ninety newtons of force in the reconstructed knees than in the contralateral, normal knees (p less than 0.001), thirteen subjects, of whom eight lacked full extension of the reconstructed knee, had more anterior laxity in the normal knee. Analyses of variance showed no significant differences in the results of the Lachman tests as related to either the type of reconstruction or the length of postoperative follow-up. The results suggested that the two types of ligamentous substitute that were used in this study were equally efficient in limiting anterior tibial displacement, as demonstrated by the Lachman test. The study also demonstrated that the substitutes did not elongate significantly during the period of the study.

Adolescent↗

PubMedDate not supplied

Little League survey: the Eugene study.

In a clinical and radiographic survey of the elbows of 120 pitchers ages 11 and 12, 20% were found to have symptoms, 10% flexion contractures, and 23% roentgenographic changes related to traction stresses on the medial side of the elbow. Five per cent had more serious lateral compression findings related to the radial head or capitellum, but none of these had symptoms. Although this represents a definite incidence of abnormal occurrence, there were no statistically significant correlations or interrelations found relating to pitching experience, valgus elbow deformities, symptoms, flexion contractures, or x-ray findings.

Age Factors↗

PubMedDate not supplied

Retrospective direct comparison of three intraarticular anterior cruciate ligament reconstructions.

A long-term retrospective study (minimum 5 years) was done looking at three groups of anterior cruciate deficient knee patients using both subjective and objective anterior cruciate tests. Twenty-seven chronic anterior cruciate ligament deficient knees reconstructed with the middle third of the patellar tendon and 28 chronic anterior cruciate ligament deficient knees reconstructed with the semitendinosus tendon were included in this consecutive group of patients and were felt to be directly comparable. It was found that the chronic anterior cruciate ligament deficient group reconstructed with the semitendinosus tendon had 4 excellent, 10 good, 7 poor, and 7 failures with an objective score averaging 4.5 of a possible 12, while the comparable group reconstructed with the middle third of the patellar tendon had 16 excellent, 7 good, 3 poor, and only 1 failure with a score of 10 of a possible 12 (P less than 0.0032). For completeness sake, 20 anterior cruciate deficient knees from this group of consecutive patients that were reconstructed acutely with the semitendinosus tendon were also examined. This group had 8 excellent results, 9 good, 3 poor, and no failures with a score of 9.8 (P less than 0.03 compared to the other group using the semitendinosus tendon). This comparison between the two groups where the semitendinosus tendon was used in the anterior cruciate ligament reconstruction was made only to show the difference between studies dealing with knee reconstructions. There may be a significant difference between a study dealing with acutely reconstructed knees versus one focusing on chronically reconstructed knees, most likely because of both patient selection and time between injury and reconstruction.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

PubMedDate not supplied

Stress changes of the distal radial growth plate. A radiographic survey and review of the literature.

We conducted a radiographic survey to determine skeletal age and the nature and prevalence of stress-related changes affecting the distal radial growth plate in 60 young competitive gymnasts (39 females, 21 males). Comparison of results for chronological and skeletal age revealed a significant delay in maturation for girls (P less than 0.001). Radiographic evaluation revealed 5 gymnasts (4 girls and 1 boy) with stress-related changes of the left wrist, and four of these were considered to be minimal. These results, in conjunction with our previous findings and the review of related literature, reveal three important observations. First, the widening and irregularities of the distal radial physis that we described previously appear to be the first in a spectrum of abnormal changes secondary to overuse and probably represent a stress fracture of the distal radial growth plate. The radiographic changes associated with this injury are not the normal adaptive changes seen in young, competitive gymnasts. Secondly, more serious long-term abnormality may result even though the injury may initially resemble a Salter-Harris type I or II stress fracture. Long-term complications may include symmetrical or asymmetrical retardation or halted growth at the affected site, positive ulnar variance, and associated pathoanatomic sequelae. Thirdly, the incidence of distal radial growth plate stress injury remains unclear; we recommend a further, large-scale prospective epidemiologic study involving both male and female gymnasts. We urge that physicians and other health professionals associated with gymnastics clubs educate coaches about the possibility of significant injury to the distal radial physis, risk factors, and suggested preventive measures.

Adolescent↗

PubMedDate not supplied

Clinical test for anterolateral rotary instability of the knee.

A simplified test for anterolateral rotary subluxation of the knee is largely based on the concepts described by Galway and McIntosh although performed in a different manner. The examiner places the right hand gently on the lateral side of the knee with the thumb overlying the posterior aspect of the fibula and the index finger palpating the anterolateral aspect of the joint line to determine the the tibiofemoral relationship. The left hand embraces the lateral side of the distal end of the femur with the thumb over the posterior aspect of the lateral femoral condyle. With equal pressure on the lateral femoral condyle and fibular head the knee is pushed gently forward into flexion. When anterointernal tibial luxation is present, a reduction phenomenon is felt as the knee passes into the 25 to 40 degree flexion range. This may occur as a sudden palpable and occasionally audible repositioning which is responsible for such terminology as a "pivot shift" or "jerk sign." We have experienced many instances where the reduction phenomenon is more subtle and is determined by palpation alone. The pathologic mechanics are determined by observations at surgery in 45 patients with a positive test. This test has improved our diagnositc ability and is easly taught to those unfamiliar with knee joint disorders.

Humans↗