PubMed Health⌕ Search

Biomedical subjects

Nikhil N Verma

Publications and source records attributed to Nikhil N Verma.

8 recordsLinked to original sources
PubMed2006

Prospective evaluation of allograft meniscus transplantation: a minimum 2-year follow-up.

BACKGROUND: Clinical and biomechanical studies have demonstrated the increase in contact pressure and progressive deterioration of the tibiofemoral compartments that occur after partial or complete meniscectomy. Meniscus transplantation has been indicated for the symptomatic postmeniscectomy patient to alleviate symptoms and potentially prevent the progression of articular degeneration. PURPOSE: To report the early-term results after allograft meniscus transplantations from a single institution performed by a single surgeon. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Forty-four meniscus transplants in 39 patients were evaluated at minimum 2-year follow-up using the Lysholm, Tegner, International Knee Documentation Committee, Knee Injury and Osteoarthritis Outcome Score, Noyes symptom rating and sports activity, and SF-12 scoring systems; visual analog pain scales; patient satisfaction; and physical examination. Four transplants failed early, leaving 40 transplants in 36 patients for review. Patients were grouped into medial and lateral transplant groups as well as those with isolated and combined procedures. Twenty-one menisci were transplanted in isolation (52.5%), and 19 were combined with other procedures (47.5%) to address concomitant articular cartilage injury. RESULTS: Patients demonstrated statistically significant improvements in standardized outcomes surveys and visual analog pain and satisfaction scales. In 7 patients, treatment had failed at final follow-up. Overall, 77.5% of patients reported they were completely or mostly satisfied with the procedure, and 90% of patients were classified as normal or nearly normal using the International Knee Documentation Committee knee examination score at final follow-up. There were no significant differences in the medial and lateral subgroups, although the lateral subgroup did demonstrate a trend toward greater improvement. No significant differences were noted in the isolated and combined subgroups. CONCLUSION: Meniscus transplantation alone or in combination with other reconstructive procedures results in reliable improvements in knee pain and function at minimum 2-year follow-up. Longer term studies are necessary to determine if transplantation can prevent the articular degeneration associated with meniscectomy.

Adolescent↗
PubMed2006

All-arthroscopic versus mini-open rotator cuff repair: a retrospective review with minimum 2-year follow-up.

PURPOSE: To compare the clinical outcomes of patients undergoing all-arthroscopic versus mini-open rotator cuff repair. In addition, ultrasound was used to assess the integrity of the repair. METHODS: A total of 38 patients who had undergone all-arthroscopic repair and 33 patients who had undergone mini-open repair with minimum 2-year follow-up were evaluated. All patients completed the American Shoulder and Elbow Surgeons' Scoring Survey (ASES), the Simple Shoulder Test, the L'Insalata Scoring Survey, and visual analog scales for pain. Physical examination, including strength testing and ultrasound evaluation to determine the integrity of the rotator cuff, was performed. RESULTS: No statistical difference in ASES scores was noted between patients who had all-arthroscopic repair versus mini-open repair, and 24% of all-arthroscopic repairs and 27% of mini-open repairs showed recurrent defects on ultrasound at follow-up. This difference was not statistically significant. Patients with an original tear larger than 3 cm were 7 times more likely to have a recurrent defect at follow-up. Patients with persistent defects had statistically significant deficits in strength on forward elevation and external rotation when compared with those with a normal shoulder. However, no difference was observed with regard to pain or outcome scores between patients with intact repairs and those with persistent defects. CONCLUSIONS: No difference in clinical outcomes was found between patients with rotator cuffs repaired arthroscopically and those repaired with use of a mini-open technique. LEVEL OF EVIDENCE: Level III, retrospective comparative study.

Aged↗
PubMed2005

The docking technique for posterolateral corner reconstruction.

Posterolateral corner injuries of the knee are an uncommon but potentially debilitating injury. They are easily missed on physical examination and are often associated with alternate ligament pathology. When identified early, these injuries are best managed by primary repair with or without augmentation of the involved structures. However, chronic injuries are generally not amenable to primary repair and often require reconstruction. Experimental data suggest that the lateral collateral ligament and popliteofibular ligament present critical biomechanical restraints of the posterolateral aspect of the knee and should be incorporated into contemporary reconstruction techniques. We describe a novel method of reconstructing these critical components of the posterolateral corner using a new docking technique for fixation on the femur with a graft placed through a fibular head tunnel.

Humans↗
PubMed2005

The arthroscopic active compression test.

Pathology of the biceps tendon is often a factor in the pathogenesis of shoulder pain. However, diagnosis and management of such pathology remains controversial. Multiple tests have been described to identify pathology related to the biceps tendon and biceps anchor. The active compression test is one such test that has been used clinically to identify patients with superior labral/biceps anchor pathology. An arthroscopic version of this test is described to identify biceps pathology intraoperatively and to aid the surgeon in making diagnostic and treatment decisions.

Arthroscopy↗
PubMed2005

Arthroscopic transfer of the long head biceps to the conjoint tendon.

Pathology of the biceps tendon is often a factor in the etiology of shoulder pain. However, diagnosis and treatment of such pathology remains controversial. When conservative management fails to relieve symptoms, surgical options include tenotomy or tenodesis. Tenotomy has provided excellent results with regard to local pain relief, but a potential cosmetic deformity and occasional painful cramping are common in younger patients. Tenodesis has also had high failure rates resulting from persistent local pain. We have used an all-arthroscopic technique for transfer of the long-head biceps to the conjoint tendon instead of traditional tenodesis. We believe that this transfer more closely recreates the normal axis of the biceps muscle and may offer improved results over conventional tenodesis.

Arthroscopy↗
PubMed2005

Preliminary clinical results of two techniques for addressing graft tunnel mismatch in endoscopic anterior cruciate ligament reconstruction.

This study reports the initial clinical results of 540 degrees of graft rotation or free tibial bone block to address graft tunnel mismatch in endoscopic anterior cruciate ligament (ACL) reconstruction. The operative reports of patients who underwent endoscopic ACL reconstruction between 1999 and 2001 were reviewed. Nine of 11 patients treated with a free tibial bone block and 14 of 17 patients treated with 540 degrees of graft rotation were evaluated. Mean follow-up was 20 months (range: 13-40 months) for the bone block group and 34 months (range: 18-48 months) for the 540 degrees group. There were statistically significant improvements in physical examination test results postoperatively, and only one patient in the 540 degrees group had a grade one positive pivot shift test. KT-1000 arthrometer testing demonstrated a statistically significant decrease in manual maximum and side-to-side differences at final follow-up. Mean Lysholm and Noyes sports function scores were excellent or good for all patients. One patient required reoperation for flexion contracture, one patient required an arthroscopic irrigation and debridement for a minor infection, and one patient required arthroscopic subtotal medial meniscectomy for failed meniscal repair. No difference was noted between these results and previous results of patients undergoing conventional endoscopic ACL reconstruction. These results demonstrate graft rotation and free bone block techniques are effective in addressing graft tunnel mismatch in endoscopic ACL reconstruction.

Adolescent↗
PubMedDate not supplied

Normalization of the Constant score.

The strength of the normal shoulder may differ by gender and deteriorate with age. Thus, the Constant score may also decrease in absolute value while still reflecting a normal score. To account for age- and gender-related differences, normal results for this scale must be determined across a population of patients without shoulder disease. Patients presenting for evaluation of nonshoulder conditions participated. A subjective questionnaire was completed. Range of motion and strength were measured. This analysis includes the data of 441 patients. The mean Constant score for men was significantly greater than that for women in each age group ( P < .05). Significant age-related differences were noted in each group ( P < .05). Normative values for the Constant score based on age and gender were determined. The adjusted score represents the gender- and age-matched function of the shoulder and is useful in the evaluation of shoulder outcomes.

Adolescent↗