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Biomedical subjects

L P Coughlin

Publications and source records attributed to L P Coughlin.

3 recordsLinked to original sources

Pigmented villonodular synovitis of joints.

In a series of 38 young adults with intra-articular pigmented villonodular synovitis, the joint predominantly affected was the knee. For early diagnosis of intra-articular pigmented villonodular synovitis, a high level of suspicion is necessary for patients with complaints of persistent pain or swelling in the knee, or erosive osteoarthritis of the hip and shoulder of unknown etiology in young individuals. Arthrography of the knee was not found to be a very helpful test in the diagnosis of pigmented villonodular synovitis. Localized intra-articular pigmented villonodular synovitis should be treated by local excision. Diffuse intra-articular pigmented villonodular synovitis of the knee should be treated by extensive synovectomy followed by manipulation under general anesthesia two to three weeks postsurgery. Intra-articular pigmented villonodular synovitis of the shoulder and hip should be treated by extensive synovectomy or by total joint arthroplasty in cases with marked bone destruction and cyst formation.

Adolescent↗

Recurrent subluxation of the glenohumeral joint.

Recurrent subluxation of the shoulder is a common condition. In our hospital, 30% of operations for shoulder instability were performed on patients who never had a frank dislocation but presented with symptoms of instability or, occasionally, simply with pain on throwing. The most common physical finding in this group was apprehension on abduction-external rotation. Thirty-four of the 50 shoulders with subluxation showed radiological changes consisting mainly of infraglenoid new bone formation. Six showed fracture of the anterior glenoid margin. Examination under anaesthesia demonstrated the instability on all cases in which it was tested. Thirty-three of the 50 shoulders had Bankart lesions and six had anterior glenoid margin fractures. Thirty-nine shoulders were treated by Putti-Platt repair and 10 had stapling alone. There was a tendency for loss of external rotation in patients with Putti-Platt reinforcement. We conclude that recurrent subluxation of the shoulder is a common injury that can be confirmed by demonstrating subluxation under anaesthesia, and Bankart repair alone is recommended if the athlete is to return to throwing activities.

Athletic Injuries↗

Objective knee evaluation using the Genucom Knee Analysis System. Clinical implications.

The Genucom Knee Analysis System was used in a clinical setting to study the clinical practicality of the Genucom instrument, and the degree of correlation between Genucom and clinical knee examinations. The Genucom evaluation performed by an experienced examiner required 25 to 30 minutes for a 14 test bilateral examination. The instrument provided detailed graphical and tabular data of the test results. One hundred "normal knees" were examined in a series of seven Genucom tests. Normal "laxity bands" for both males and females were generated for a range of load applications for the seven tests. There was no significant difference observed between the male and female laxity distributions. However, a slightly lesser laxity was observed for the male population in general. A group of 38 subjects with 1 injured knee were assessed concurrently using clinical and instrument techniques. Comparisons were made for the 90 degrees anterior-posterior (AP) drawer, the 30 degrees AP drawer (Lachman), and the varus/valgus stress test. For the 90 degrees AP drawer test, 16 subjects were found clinically to have less than or equal to 5 mm of excess laxity based on comparison with the opposite normal knee. The instrumented measurement concurred in 10 cases. In the other six cases it was noted that laxity on the uninjured knee reached the maximum of the "normal" instrumented population, that is with higher than normal laxities. Fifteen subjects were clinically tested with greater than 5 mm of excess laxity. The instrumented test concurred in all but one.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗