Biomedical subjects

R J Devilee

Publications and source records attributed to R J Devilee.

4 recordsLinked to original sources

PubMed1999

Patellar tendon graft position after anterior cruciate ligament reconstruction. Interobserver variability on lateral radiographs.

We compared the reliability and validity of graft position measurements made by 4 orthopedic surgeons on intraoperative radiographs obtained using fluoroscopic control and postoperative radiographs obtained from the same 17 patients 6 weeks after ACL reconstruction. Measurements from postoperative radiographs varied significantly more than those from intraoperative radiographs. There was little agreement between the postoperative and intraoperative measurements of the tibial and femoral graft position. We conclude that postoperative radiographs are not a sufficient tool for assessing graft placement after ACL reconstruction using patellar tendon autografts. In order to consider graft position in follow-up studies and to compare results from various surgeons, we suggest intraoperative fluoroscopy to produce radiographs for accurate and reliable measurements.

Adolescent↗

PubMed1998

Computer assistance in arthroscopic anterior cruciate ligament reconstruction.

Accurate placement of the graft is considered one of the most important factors in anterior cruciate ligament surgery. However, reconstruction with contemporary guiding systems still can result in unacceptable graft placement variability. To improve the reproducibility of graft placement, intraoperative visual feedback was added to the arthroscopic technique. First, fluoroscopic visualization was added to evaluate guidewire placement before tunnel drilling. Second, computer graphic overlays were added to the fluoroscopic view. Three groups of patients were treated: 29 patients with arthroscopy, 53 patients with fluoroscopy added, and 50 patients with computer overlays added. Graft placement variability was reduced significantly with fluoroscopic visualization. Computer overlays resulted in additional significant reductions in graft placement variability. Simple visual enhancements seem to be useful in improving the accuracy of arthroscopic anterior cruciate ligament reconstruction.

Anterior Cruciate Ligament↗

PubMed1990

[Appendectomy à froid; a superfluous operation?].

A retrospective study was made of the course of the disease of 69 patients who during an uninterrupted period had been admitted with the diagnosis of acute appendicitis with infiltrate. After the usual conservative treatment, elective appendectomy à froid was scheduled for a few months later. On completion of the study, 61 of the 69 patients had been operated. Three patients had been operated on earlier than planned, because of recurrent abdominal complaints, while two patients had developed acute appendicitis. Two patients proved to have a carcinoma of the colon, one a carcinoid and three, an encapsulated abscess. Of the 61 patients operated on, 43 had no symptoms at the time of the appendectomy à froid. The authors advise no longer to perform appendectomy à froid; however, in patients over 40 years of age the possibility that a malignancy is causing the abdominal symptoms should be excluded.

Appendectomy↗

PubMedDate not supplied

Locating femoral graft placement from lateral radiographs in anterior cruciate ligament reconstruction: a comparison of 3 methods of measuring radiographic images.

Graft positioning in anterior cruciate ligament (ACL) reconstruction is usually documented from lateral postoperative radiographs. The purpose of this study was to compare 3 measurement methods for femoral graft placement in 50 patients with ACL reconstruction. Intraoperative radiographic images were obtained and divided into 2 groups. The first group showed suboptimal projections, with out-of-plane rotations causing the femoral condyles to not be perfectly overlapped. The second group showed good projection, with optimal rotation and fully overlapped femoral condyles. In our study, only the measurement technique described by Amis produced data with the least measurement error when multiple observers assessed both groups. It is recommended that Amis' method be used to measure femoral ACL graft position so that reliable data are available for comparison between medical centers.

Adult↗