Biomedical subjects

William R Post

Publications and source records attributed to William R Post.

4 recordsLinked to original sources

PubMed2005

Anterior knee pain: diagnosis and treatment.

Anterior knee pain is a frequent clinical problem. It provides a common challenge to diagnose and manage. Basic science studies have provided insight into the origin of anterior knee pain and refined understanding of the anatomy. Clinical evaluation has progressively focused on the contribution of the entire lower extremity to patellofemoral function. Nonsurgical management has been refined by the concept of the "envelope of function" and by increased understanding of the neuromuscular control of the knee. Indications for lateral release have been clarified and narrowed. Although anteromedial transfer of the tibial tuberosity is helpful in certain circumstances, reports of postoperative fracture have led to less aggressive rehabilitation protocols. Chondral resurfacing of the patellofemoral joint and patellofemoral arthroplasty are evolving. Emphasis should remain on nonsurgical management, which is sufficient in most patients.

Arthralgia↗

PubMed2005

Patellofemoral pain: results of nonoperative treatment.

Nonoperative treatment of patellofemoral pain has a long-standing tradition of success. I will discuss the scientific background and practical application of such treatment. Evaluation and treatment should include lower extremity flexibility, muscular control, and careful evaluation of tender structures. Avoiding pain during rehabilitation is important and suggestions for this are included in this review. Emphasis on accurate diagnosis, careful clinical evaluation, activity modification, flexibility, and strengthening in creating an effective program are discussed and the literature is reviewed. Most patients should go thorough nonoperative treatment before elective surgery for patellofemoral pain is prescribed.

Humans↗

PubMed2004

Lateral retinacular release: a survey of the International Patellofemoral Study Group.

PURPOSE: The purpose of this investigation was to determine current views regarding lateral release among experienced knee surgeons with a specific interest in the patellofemoral joint. TYPE OF STUDY: Scientific survey. METHODS: A questionnaire was developed and mailed to all members of an international group with a specific interest in disorders of the patellofemoral joint. Frequencies and percentages of responses were calculated for each question to determine surgeon consensus. We measured agreement among responses using the kappa statistic. This provided an indication of consistency for each question as well as correlation among the responses to different questions. RESULTS: The survey response rate was 60%. Isolated lateral release was estimated to account for only 1 to 5 surgical cases per respondent per year, or 2% of cases performed annually. In the setting of arthroscopy or exploration, 74% of respondents believed that lateral release calls for specific informed consent. Strong consensus was found that objective evidence is needed to justify lateral release, but agreement was poor as to what clinical evidence provides the most appropriate indication for the procedure. CONCLUSIONS: Even among experienced knee surgeons with a special interest in diseases of the patellofemoral articulation, isolated lateral release is rarely performed. Strong consensus was found that isolated lateral release should not be undertaken without prior planning in the form of objective clinical indications and preoperative informed consent. LEVEL OF EVIDENCE: Level V.

Arthroscopy↗

PubMed2002

Patellofemoral malalignment: looking beyond the viewbox.

A clear understanding of the pathophysiology of anterior knee pain is inhibited by the use of imprecise, poorly defined, and often interchanged words, such as malalignment, patellar alignment, maltracking, subluxation, dislocation, and congruence. The literature is filled with articles regarding the diagnosis, "malalignment of the patella," most of which give no precise diagnosis. This article presents a definition of malalignment and a plea for rational descriptive and scientific analysis. Much of what is described is based on theory, not facts. These ideas are supported by clinical experience and logical analysis, but very little in the way of scientific data. Most of the data involve radiographic images, which present only one piece of the puzzle.

Humans↗