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Biomedical subjects

Sara E Pearson

Publications and source records attributed to Sara E Pearson.

7 recordsLinked to original sources
PubMed2006

Reverse rotator interval closure.

We describe a technique for reducing capsular volume arthroscopically by shifting the anterior inferior glenohumeral ligament (AIGHL) and capsule up to the top of the subscapularis. This procedure is performed when laxity exists in the absence of a Bankart lesion. The AIGHL is first released from the capsule. This allows sutures to be placed through the capsule inferiorly so that it can be shifted up superiorly during the repair. The AIGHL and capsule are then released from the underlying subscapularis. Sutures are then passed through the capsule and out of the accessory anterior portal, progressing laterally. A BirdBeak suture passer (Arthrex, Naples, FL) is inserted through the superior edge of the subscapularis and is used to grasp each undersurface strand of suture and pull it through and out of the anterior portal. The sutures are then tied sequentially, effectively shifting the capsule and ligament up in a superior direction.

Arthroscopy↗
PubMed2006

Factors associated with decreased muscle strength after anterior cruciate ligament reconstruction with hamstring tendon grafts.

PURPOSE: To identify factors associated with decreased muscle strength and activity after anterior cruciate ligament (ACL) reconstruction with semitendinosus-gracilis tendon (ST-G) grafts. TYPE OF STUDY: Retrospective review. METHODS: Eighty-five patients who underwent ACL reconstruction with ST-G grafts were evaluated at a mean of 44.4 months after surgery. Patients underwent isokinetic testing, physical examination, radiographs, instrumented laxity testing, and Lysholm, Cincinnati, and International Knee Documentation Committee (IKDC) ratings. Cartilage and meniscal pathology at surgery was reviewed. Strength group 1 (n = 30) showed greater than 20% deficits in strength; strength group 2 (n = 55) had less than 20% strength deficits. Activity group 1 (n = 60) maintained their IKDC activity level at final follow-up relative to preinjury level; activity group 2 (n = 25) decreased activity by 1 or more levels. RESULTS: With all patients combined, there was less than a 4% difference in mean hamstring and quadriceps strength between the reconstructed and contralateral legs at follow-up. Knee flexion deficits were associated with decreased hamstring strength. Subjective giving way and squatting/kneeling discomfort were associated with decreased quadriceps strength. Patients in strength group 1 were more likely to have squatting/kneeling discomfort and lower Cincinnati Function scores. Activity group 2 had a longer interval from injury to surgery and more chondromalacia at surgery. At follow-up, activity group 2 had lower subjective scores and was more likely to have pain, swelling, giving way, and flexion deficits. Activity group 2 also had greater deficits in quadriceps strength. CONCLUSIONS: Articular cartilage injury and meniscal pathology were not associated with decreased muscle strength. ACL reconstruction with ST-G grafts has a 38% incidence of squatting/kneeling pain that occurs secondary to patellofemoral crepitus, harvest site symptoms, and tibial hardware sensitivity. LEVEL OF EVIDENCE: Level IV, therapeutic, case series, no control group.

Anterior Cruciate Ligament↗
PubMed2005

Arthroscopic capsular plication-shift.

We describe a technique of arthroscopic capsular plication and shift used to address both anterior and posterior capsular laxity. This technique is used when the labrum is intact or if laxity persists after labral repair.

Arthroscopy↗
PubMed2003

Fracture of Bilok interference screws on insertion during anterior cruciate ligament reconstruction.

New femoral and tibial interference screws for use during anterior cruciate ligament (ACL) reconstruction have been developed using a composite of poly-L-lactic acid (PLLA) and tricalcium phosphate (TCP). The combination is described as having better incorporation than standard bioabsorbable screws with no loss of mass during incorporation and without the brittle nature associated with conventional TCP implants. However, the screw can fracture during insertion, leaving the distal third inside the femoral or tibial tunnel, making extraction and revision difficult. This is a report of 2 cases of PLLA-TCP screw breakage, 1 occurring in the femoral tunnel and 1 occurring in the tibial tunnel.

Absorbable Implants↗
PubMed2003

The long-term outcome of total knee patients with moderate loss of motion.

This study determined the outcome of total knee replacement (TKR) patients with moderate loss of motion who received no particular treatment. Twenty patients with an average arc of motion of 8 degrees-91 degrees of flexion 3 months postoperatively underwent 3-year follow-up. No formal treatment was given. All patients' range of motion and Knee Society scores improved over time. Most of the improvement occurred by 2 years. Patients with moderately stiff TKRs continue to improve over time without vigorous, prolonged physical therapy, manipulation, or bracing.

Aged↗
PubMed2002

Allograft anterior cruciate ligament reconstruction in patients over 40 years of age.

PURPOSE: The study goal was to determine the results of allograft anterior cruciate ligament (ACL) reconstruction in patients over 40 years old at a minimum of 24 months follow-up (mean, 59.7 months; range, 24 to 110 months). TYPE OF STUDY: Retrospective review. METHODS: The records of 57 consecutive patients (mean age at surgery, 45.0 years; range, 40.2 to 60.8 years) were reviewed retrospectively. Nine patients who had undergone either prior ACL reconstruction, extra-articular reinforcement of the intra-articular procedure, or subsequent upper tibial osteotomy were eliminated. One patient was lost to follow-up. Of the remaining 47 patients (48 knees), 29 (62%) were men, and 18 (38%) were women. Twenty-eight of the 47 study patients (60%) were available for clinical interview consisting of physical examination, radiographs, and functional testing. Twenty-seven of these patients also underwent KT-1000 measurement, and 26 underwent Biodex evaluation. The remaining 19 patients were interviewed by telephone. RESULTS: At follow-up, Lachman, anterior drawer, and pivot shift tests were 0 or 1 in 27 (96%) of 28 patients. Differences between the index and contralateral legs as measured by KT-1000 at 20 lb of force were 0 to 2 mm in 22 of 27 patients (81%) and 3 to 5.5 mm in 5 patients (19%). None had a side-to-side difference greater than 5.5 mm. Based on the International Knee Documentation Committee activity classification system, 26 (55%) of 47 patients achieved the same or higher grade of activity postoperatively as they had preinjury. CONCLUSIONS: Results of ACL reconstruction in patients over 40 compare favorably with those observed in younger patients. Age should not be a limiting factor in choosing surgical reconstruction to treat functional instability in the ACL-deficient patient.

Adult↗