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Biomedical subjects

W F Donaldson

Publications and source records attributed to W F Donaldson.

28 records · Page 2Linked to original sources
PubMed1988

Total condylar III knee prosthesis. Long-term follow-up study.

The total condylar III knee prosthesis (TCP III) is a constrained, unlinked knee that provides medial and lateral stability through a rectangular tibial post and a high femoral box. Thirty-one knees were implanted in 25 patients. There were 17 primary arthroplasties and 14 revisions. The average follow-up period was 3.8 years. The average arc of motion was improved from 63 degrees to 97 degrees. This resulted in 77% good and excellent results. There were five failures (16%), all of which occurred in the revision group. These results compare favorably with results of constrained prostheses; however, the deformity in this group was quite severe. The major indications for use of TCP III would be medial ligament loss, severe valgus or combined deformities, or cases of unstable revision in which a surface arthroplasty will not suffice. The prosthesis should not be used in cases that demonstrate massive bone loss. In those cases, the prosthesis should have a weight-bearing intramedullary stem to transfer stress lines to cortical bone.

Adult↗
PubMed1975

Preliminary experience with a method of quadricepsplasty in recurrent subluxation of the patella.

Nineteen knees were treated for recurrent subluxation or dislocation of the patella by lateral and distal transfer of the vastus medialis with or without release of the lateral retinaculum. Fifty-eight per cent has good or excellent and 42 per cent had poor results after a mean follow-up of twenty-nine months. The factors that predisposed to failure were genu valgum greater than 15 degrees and, to a lesser extent, palpable synovitis associated with symptomatic chondromalacia patellae.

Adolescent↗
PubMedDate not supplied

A comparison of acute anterior cruciate ligament examinations. Initial versus examination under anesthesia.

The preoperative examination, the examination under anesthesia, and the findings at surgery were compared for acutely injured knees that were found at surgery to have anterior cruciate ligament (ACL) tears. The pivot shift was initially positive in only 35% of the knees; however, under anesthesia 98% were positive. The Lachman test was initially positive in 99% of the knees, and under anesthesia, 100%. The anterior drawer sign was present initially in 70% of the knees, and under anesthesia this increased to 91%. Of the 37 patients with isolated ACL tears, only 20 (54%) had initially positive anterior drawer signs. In the knees in which secondary restraints to anterior-posterior motion were injured, this percentage increased to 69% in medial meniscus injury, 82% in lateral meniscus injury and 89.5% in rupture of the medial collateral ligament (MCL). The Lachman test seems relatively unaffected by associated ligamentous or meniscal injuries, but the end point in the Lachman test is absent in all complete ACL tears. The pivot shift phenomenon, which was demonstrable in 98% of patients when tested under anesthesia, may be diminished when there is a MCL injury or absent in partial ACL tears. Experience in performing the Lachman test and in appreciating the quality of the end point will give the examiner a high degree of accuracy in making the diagnosis of an ACL tear without resorting to anesthesia, arthroscopy, or arthrography in most patients.

Adolescent↗
PubMedDate not supplied

Cervical spine alignment in the immobilized football player. Radiographic analysis before and after helmet removal.

We investigated the effect of football helmet removal on the sagittal alignment of the cervical spine. A quantitative radiographic assessment of relative cervical spine position in subjects immobilized to a standard backboard wearing shoulder pads either with or without a helmet was performed. Comparison was made to a control situation with subjects on a backboard wearing no equipment. Ten subjects were studied using lateral computed tomographic scout films; each subject served as his own control. Radiographs were measured for overall sagittal cervical alignment and the amount of lordosis or kyphosis present within specific segments of the cervical spine. Mean values for each of the three defined situations (no equipment, shoulder pads and helmet, shoulder pads alone after helmet removal) were calculated and subjected to statistical analysis. No statistically significant difference in cervical sagittal alignment was noted when either no equipment or both shoulder pads and helmet were worn. In contrast, a statistically significant increase in cervical lordosis (extension) was found when comparing the control situation to that when only shoulder pads were worn after the helmet had been removed. The majority of this increase occurred in the subaxial spine. Therefore, the authors recommend that football players with a potential cervical spine injury be immobilized for transport with both their helmet and shoulder pads left in place, thereby maintaining the neck in a position most closely approximating "normal."

Adult↗