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Biomedical subjects

Paul A Martineau

Publications and source records attributed to Paul A Martineau.

4 recordsLinked to original sources
PubMed2005

Reconstructive procedure for unstable radial-sided triangular fibrocartilage complex avulsions.

PURPOSE: Radial-sided avulsions of the triangular fibrocartilage complex (TFCC) (Palmer 1D) with distal radioulnar joint (DRUJ) instability remain a challenging pathology to treat. We tested an intra-articular reconstruction that addresses unstable radial-sided TFCC avulsions. METHODS: Ten preserved, dissected, cadaveric forearm specimens with intact TFCC and without ulnar-positive variance had biomechanical testing using a hydraulic testing device. The measurement of total displacement of the ulna relative to the radius was performed with an applied load ranging from 20 N in a volar direction to 20 N in a dorsal direction. Specimens were tested sequentially with intact TFCC, with surgically induced Palmer 1D lesions, and after reconstruction of the TFCC. All tests were performed at neutral, maximal pronation, and maximal supination. RESULTS: The mean total displacements of the DRUJ of the specimens at neutral rotation were as follows: 4.1 +/- 0.4 mm for the intact specimens compared with 11.8 +/- 0.8 mm after creation of the tear and 3.9 +/- 0.7 mm for the reconstructed specimens. In maximal pronation the mean total displacements were as follows: 2.4 +/- 0.3 mm intact versus 4.9 +/- 0.7 mm for torn and 2.1 +/- 0.3 mm after reconstruction. In maximal supination the mean total displacements were as follows: 1.4 +/- 0.2 mm intact versus 5.7 +/- 1.3 mm for torn and 1.0 +/- 0.1 mm after reconstruction. All specimens obtained the preoperative pronation and supination motion after the reconstruction. CONCLUSIONS: Current procedures are unable to restore DRUJ stability without a significant limitation of pronation and supination. This intra-articular reconstruction of radial-sided TFCC avulsions succeeded in restoring baseline stability to the DRUJ without interfering with pronation/supination.

Biomechanical Phenomena↗
PubMed2004

Effect of the oral contraceptive pill on ligamentous laxity.

OBJECTIVE: Women are 4 to 8 times more likely to sustain a serious knee injury than their male counterparts. Previous studies have found that female sex steroids affect ligamentous tissue properties. The hypothesis is that there exists a difference in ligamentous laxity between oral contraceptive pill (OCP) users and nonusers. DESIGN: Blinded, single-factor, posttest-only control group design. SETTING: McGill University Sport Medicine Clinic, Montreal, Que-bec, Canada. PARTICIPANTS: One hundred twenty-seven female McGill University varsity athletes. INTERVENTIONS: Participants filled out a screening questionnaire and underwent KT-1000 measurements by 1 blinded examiner. Exclusion criteria related to underlying knee pathology, and hormonal factors were identified with the questionnaire. MAIN OUTCOME MEASUREMENTS: Independent sample, 2-tailed t tests were performed on the nondominant knee data of the OCP users and nonusers. RESULTS: Mean anterior translations at 67 N were 3.00 +/- 1.04 mm for the OCP users and 3.86 +/- 1.72 mm for the nonusers (P = 0.011); at 89 N, 3.98 +/- 1.13 mm vs. 4.83 +/- 1.82 mm, respectively (P = 0.018). Mean anterior translations at 67 N were 2.95 +/- 0.93 mm for the non-menstruating OCP users and 3.86 +/- 1.72 mm for the nonusers (P = 0.008); at 89 N, 3.88 +/- 1.06 mm vs. 4.83 +/- 1.82 mm, respectively (P = 0.011). CONCLUSIONS: Oral contraceptive pill use yielded statistically significant decreases in anterior translation of the tibia as compared with nonusers. The OCP may have a role to play in the prevention of ACL injuries by prophylactically targeting 1 of the variables responsible for the increased ACL injury rates in women.

Adolescent↗
PubMed2004

In-hospital cost of total hip arthroplasty in Canada and the United States.

BACKGROUND: There is little information comparing the costs of specific surgical procedures performed in Canada and those done in the United States. The objective of this study was to compare the in-hospital costs associated with primary total hip arthroplasty performed in the two countries. METHODS: In-hospital costs of 1679 consecutive patients (940 Canadian and 739 American patients) who underwent total hip arthroplasty were extracted from three Canadian and three United States teaching hospitals between 1997 and 2001. Participating hospitals used the same cost accounting system to provide per-patient demographic, clinical, and cost data. Canadian dollar costs were converted to United States dollar costs with use of purchasing power parities. RESULTS: The baseline clinical characteristics of patients undergoing total hip arthroplasty in Canada and the United States were similar. The American patients were a mean of 4.6 years older than the Canadian patients (mean [and standard deviation], 67.8 +/- 12.4 years compared with 63.2 +/- 14.9 years). The median cost for the primary arthroplasty was $6080 (mean [and standard error of the mean], $6766 +/-$119) at the three Canadian hospitals and $12,846 (mean, $13,339 +/-$131) at the United States hospitals (p < 0.0001). The mean length of stay (and standard deviation) was 7.2 +/- 4.7 days for the Canadian patients and 4.2 +/- 2.0 days for the American patients. Implants at one hospital in the United States were found to be four times more costly than those in a Canadian hospital. CONCLUSIONS: Higher in-hospital costs were found for the American hospitals despite the fact that they had a significantly shorter patient length of stay compared with Canadian centers (p < 0.0001). Canadian hospitals should follow the lead of their counterparts in the United States and implement strategies to decrease the length of stay in the hospital, while institutions in the United States should revisit their ability to better manage the costs related to a primary total hip arthroplasty, particularly by controlling unit costs.

Aged↗