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Biomedical subjects

P Kinnard

Publications and source records attributed to P Kinnard.

At least 19 recordsLinked to original sources
PubMed1996

Comparison between open and arthroscopic acromioplasties: evaluation of absenteeism.

OBJECTIVE: To evaluate the rate of absenteeism from work in patients who had undergone open or arthroscopic acromioplasty. DESIGN: A retrospective case series. SETTING: A university hospital. PATIENTS: Eighteen patients with excellent results after open acromioplasty performed by one orthopedic surgeon and 20 patients with excellent results after arthroscopic acromioplasty performed by another orthopedic surgeon. MAIN OUTCOME MEASURE: The time between operation and return to work. RESULTS: There were no statistical differences between the two techniques with respect to the return to work, age, sex and type of work. The overall time off work averaged 203 days (range from 42 to 840 days) for the arthroscopic group compared with 144 days (range from 60 to 540 days) for the open group. CONCLUSIONS: Open acromioplasty, a safe and reliable procedure for the general orthopedic surgeon, is associated with a shorter, thought not significant, delay in return to work than the arthroscopic technique.

Absenteeism↗
PubMed1995

Biaxial total wrist arthroplasty in rheumatoid arthritis.

OBJECTIVE: To judge the outcome of total wrist arthroplasty. DESIGN: A retrospective study of 13 patients. SETTING: A university hospital. PATIENTS: Seventeen patients with stage III or IV rheumatoid arthritis of the wrist. Only 13 patients were studied because 3 died and 1 was lost to follow-up. INTERVENTION: Biaxial total wrist arthroplasty (15 procedures). MAIN OUTCOME MEASURES: Clinical assessment and the Hospital for Special Surgery scoring system and radiologic review. RESULTS: Good or excellent results were achieved in all patients after an average follow-up of 54 months. CONCLUSION: Biaxial total wrist arthroplasty is a reasonable treatment in rheumatoid patients when preservation of wrist motion is critical.

Adult↗
PubMed1994

[Butel's isoelastic hip prosthesis. A limited prospective study].

INTRODUCTION: A limited prospective study was undertaken at the Centre Hospitalier de l'Université Laval to assess the outcome of 21 isoelastic prostheses described by Butel. MATERIAL AND METHODS: The femoral component consisted of a one-piece forged stainless steel stem with four metallic rods ranging in diameter from 11 to 18 mm, in 1 mm increments. The two lateral and medial rods, 20 cm in length, were linked distally. The 2 mm gap between the medial and lateral rods was obliterated at insertion, allowing the component to be firmly seated in the femoral canal. Twenty-one Butel isoelastic prostheses were inserted in 20 patients (14 men and 6 women with an average age of 51 years). The preoperative diagnosis was aseptic total hip prosthetic loosening in three cases, rheumatoid arthritis in five cases, avascular necrosis in six cases and degenerative arthritis in six cases. A standard postero-lateral approach was used in all cases. Postoperatively, the patients were mobilized immediately, with partial weight bearing on the affected side for six weeks. RESULTS: Follow-up ranged from 24 to 34 months with an average of 28 months. One patient, who developed a late infection, was excluded from the study. Nineteen patients with 20 prostheses were reviewed clinically and roentgenographically by independent observers in the absence of the senior author. Clinically, the patients rated 11 to 58 on the preoperative Harris scale with an average of 34 while they rated 39 to 96 postoperatively with an average of 67. Eight patients were below 70 on the Harris scale postoperatively and were rated unsatisfactory. Eleven patients complained of postoperative thigh pain which was still present in three patients after two years. None complained of pain related to the acetabular component. On roentgenograms, prosthetic seating seemed to be inadequate in 14 cases but with good clinical results in 9 cases. Seating seemed to be adequate in six cases but with an unsatisfactory outcome in three cases. DISCUSSION: The concept of isoelasticity is that the implant and bone should deform as one unit. However, clinical results of an implant must be validated by investigators who are not developers of their own implant. The results in this series do not corroborate with those reported by Butel. A number of technical problems occurring at or after surgery precluded the safety, efficacy and durability of the surgical procedure and its successful outcome. A substantial incidence of thigh pain was found in this series. This has also been noted by a variety of authors using femoral designs with a large intramedullary rod which has less torsional stability than a flat wedge shaped femoral implant. CONCLUSION: The isoelastic prosthesis used in this series did not fulfill the expectations and was considered marginal in regards to quality and efficiency.

Adult↗
PubMed1994

Interscalene block for pain relief after shoulder surgery. A prospective randomized study.

A prospective randomized study undertaken in 30 patients who underwent outpatient decompressive acromioplasty demonstrated the efficacy and safety of interscalene block post-operatively. Interscalene block improved the postoperative condition and well being of these patients. Their use decreased the hospitalization rate. There were no complications or side effects.

Acromion↗
PubMed1992

The accuracy of the Cartier tibial guide in knee arthroplasty.

The authors reviewed, radiologically, the postoperative position of tibial component in 51 knee arthroplasties performed between 1987 and 1989 with Cartier's extramedullary tibial guide. The results compared favourably with those of other studies. A variation of 1.9 degrees on anteroposterior roentgenograms and 2.4 degrees on lateral roentgenograms was obtained by five orthopedic surgeons, suggesting that, for knee arthroplasties, the guide of Cartier is a useful tool and produces reliable results.

Female↗
PubMed1992

The difficulties in assessment of results of anterior acromioplasty.

A retrospective study of 59 decompressive anterior acromioplasties for chronic impingement of the shoulder in 54 patients compared the results of four different shoulder rating systems. The systems used by Neer, Hawkins, and Post include pain, range of motion, function, and strength, whereas the University of California at Los Angeles (UCLA) scale evaluates the same criteria but on a system of points. After a careful clinical evaluation, satisfactory results ranged from 37% to 80%, using the postoperative evaluation criteria chosen. The criteria defined by Neer, and based on patient satisfaction, minimal pain, full use of the shoulder, less than 20 degrees of limitation of overhead extension, and at least 75% of normal strength, provided the most accurate assessments for this series and resulted in a satisfactory outcome for 60% of the patients.

Acromion↗
PubMed1992

[Ambulatory orthopedic surgery. A retrospective study apropos of 2338 cases].

A retrospective study of 2,338 outpatient surgical procedures performed at the Centre Hospitalier de l'Université Laval was undertaken. There were 1,308 men and 1,030 women, with a mean age of 40.7 years. General anaesthesia was used in 91.5 per cent of the cases. After surgery, the patients were discharged according to the criteria described by Wetchler and Kortilla. The unanticipated hospital admission rate was 6.1 per cent and the complication rate was 1.3 per cent with no life threatening conditions. Proper selection and preparation of the patient, severe criteria for safe discharge after Day Surgery are mandatory for the patient's safety and satisfaction.

Adult↗
PubMed1991

Outpatient orthopedic surgery: a retrospective study of 1996 patients.

Outpatient surgical procedures performed at the Centre Hospitalier de l'Université Laval on 1996 patients (1091 men, 905 women) were studied retrospectively. Lower-limb surgery accounted for 66.5% of the procedures. The mean age of the 1996 patients was 40.7 years. General anesthesia was used in 91.5% of the cases. After surgery, the patients were discharged according to the criteria described by Wetchler and Kortilla. The unanticipated hospital admission rate was 6.3% and the complication rate was 1.3% with no life-threatening conditions. Proper selection and preparation of the patient and strict criteria for safe discharge after day surgery are mandatory for the patient's safety and satisfaction.

Adolescent↗
PubMed1991

The Akin procedure in hallux valgus.

A retrospective study of 28 Akin procedures was undertaken to assess their results. Patient satisfaction, clinical findings and roentgenographic measurements were evaluated after follow-up periods of 12 to 42 months. The outcome was excellent in nearly 60% of the patients, especially those whose discomfort was related to the laterally deviated great toe and to the prominence of the first metatarsal head.

Adult↗
PubMed1990

The Borden and Gearen modification of the Sugioka transtrochanteric rotational osteotomy in avascular necrosis. A preliminary report.

Since 1985, ten transtrochanteric rotational osteotomies have been performed following the modification of Borden and Gearen for osteonecrosis of the femoral head. All patients were evaluated functionally and roentgenographically. There were five Ficat Stage II and five Ficat Stage III lesions. The involvement of femoral head necrosis averaged 33%. Good results were obtained in seven patients after an average of 28 months from the surgical procedure. The Borden and Gearen modification requires calibrated guide wires inserted under an image intensifier to obtain precise rotation and rigid internal fixation of the femoral head. This procedure is technically easier to perform than the original Sugioka osteotomy and gives similar results.

Adult↗
PubMed1989

Dorsiflexion osteotomy in Freiberg's disease.

A retrospective study of the postsurgical results of 10 patients who had dorsiflexion osteotomy was undertaken. Patient satisfaction, clinical findings, and roentgenographic measurements were all carefully evaluated after an average duration of follow-up of 36.5 months. The procedure gave excellent results for all patients, with minimal loss of metatarsophalangeal motion and an average radiological metatarsal shortening of 2.3 mm and no postoperative metatarsalgia. The authors believe that the dorsiflexion osteotomy is a reasonable treatment for symptomatic Freiberg's disease. The procedure is reliable and not destructive, should further treatment be necessary.

Adolescent↗
PubMed1986

Roy-Camille plates in unstable spinal conditions. A preliminary report.

From 1979 to 1982, 21 consecutive patients with posttraumatic or pathologic fractures of the spine were treated at the University of Sherbrooke by Roy-Camille plates to provide stabilization. Ten burst fractures and 11 fracture-dislocations were treated in this manner. Nine patients had complete paraplegia, 6 had various neurologic deficits, and 6 had no neurologic problems before operation. Using the technique described by Roy-Camille, the authors stabilized the spine with two plates in 18 patients and one plate plus fusion in 3. No major complications occurred with surgery nor after a follow-up of 1-3 1/2 years. Sixteen patients had no loss of correction, and 5 lost 10 degrees-12 degrees. This technique was safe and effective and thought to be a valid alternative to conventional forms of spinal fixation, particularly in paraplegic patients, in those with spinal metastasses, and in those necessitating extensive laminectomies impairing spinal stability.

Adolescent↗
PubMed1984

The plica syndrome. A syndrome of controversy.

A plica is a synovial fold inside the knee joint that may become symptomatic following trauma. The authors diagnosed and excised 20 symptomatic plicae; after a mean follow-up period of 20 months 13 patients were free of symptoms, while six were unchanged or worse. Plica syndrome is not common, and careful assessment must be made to exclude other causes of pathologic knee conditions. The treatment of choice consists of excision of the entire plica to prevent recurrence of the symptoms.

Adolescent↗
PubMed1984

Hemangiopericytoma: case reports.

The authors' experience with two recent cases and their review of the literature suggest that the behaviour of hemangiopericytoma is unpredictable and that wide surgical excision is the treatment of choice because of the potential for malignant change.

Adolescent↗
PubMed1984

The orthopedic approach in infected median sternotomy.

A retrospective review of 10 infected median sternotomies revealed that the management may be difficult and several procedures may be required to obtain a satisfactory result. Repeated curettage was successful in four patients. The cavity created by d ebridement was treated by the temporary insertion of gentamicin beads in one patient and by the Papineau bone grafting procedure in two. In two patients the thoracic cage became unstable as a result of extensive d ebridement and was stabilized successfully by inserting Harrington compression rods. One patient died of mediastinitis.

Adult↗