The use of magnetic resonance arthrography to detect partial-thickness rotator cuff tears.
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Adult↗
Biomedical subjects
William B Stetson
Publications and source records attributed to William B Stetson.
Two-versus three-portal technique for routine knee arthroscopy.
The purpose of this study was to compare the results of a two-portal versus a three-portal technique for knee arthroscopy and to determine differences in patient and muscle recovery time and postoperative pain. We prospectively evaluated 16 patients undergoing routine knee arthroscopy in a randomized, double-blinded study. Six patients underwent arthroscopy with the standard three-portal technique, with the superomedial portal established through the vastus medialis obliquus muscle. Ten patients underwent the procedure with only two portals, the anteromedial and anterolateral. A third incision was created in the area of the vastus medialis obliquus muscle, but a portal was not created and the muscle was not violated. The same surgeon performed all procedures. Quadriceps muscle strength, total strength, and Lysholm scores were consistently greater for patients in the two-portal group than for patients in the three-portal group. Patients in the three-portal group returned to work and normal activities at a mean of 19 days after surgery, compared with 9 days for patients in the two-portal group. Standard knee arthroscopy with a two-portal technique does not violate the vastus medialis obliquus muscle and allows an earlier return of quadriceps muscle function and strength, earlier rehabilitation, and a faster return to activity.
Adolescent↗
The crank test, the O'Brien test, and routine magnetic resonance imaging scans in the diagnosis of labral tears.
BACKGROUND: Tears of the superior labrum of the shoulder, anterior to posterior, are difficult to diagnose clinically. PURPOSE: We examined whether the crank or O'Brien tests were reliable tools for detecting glenoid labral tears. STUDY DESIGN: Nonrandomized prospective study. METHODS: Results of diagnostic shoulder arthroscopy were compared with those of the preoperative tests and magnetic resonance imaging for 65 patients who had symptoms of shoulder pain. RESULTS: The crank test result was positive in 29 patients (45%), and the O'Brien test was positive in 41 patients (63%). The crank test had a positive predictive value of 41%, was 56% specific, 46% sensitive, and had a negative predictive value of 61%. The O'Brien test had a positive predictive value of 34%, was 31% specific, 54% sensitive, and had a negative predictive value of 50%. Magnetic resonance imaging had a positive predictive value of 63%, was 92% specific, 42% sensitive, and had a negative predictive value of 83%. CONCLUSIONS: The O'Brien and crank tests were not sensitive clinical indicators for detecting glenoid labral tears and other tears of the anterior and posterior labrum. Results were often falsely positive for patients with other shoulder conditions, including impingement or rotator cuff tears.
Adolescent↗