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Biomedical subjects

Yegappan Kalairajah

Publications and source records attributed to Yegappan Kalairajah.

4 recordsLinked to original sources
PubMed2006

Magnetic resonance imaging evaluation of biodegradable transfemoral fixation used in anterior cruciate ligament reconstruction.

PURPOSE: The study was designed to evaluate bioabsorbable transfemoral fixation in anterior cruciate ligament (ACL) reconstruction using hamstring tendon as graft. Magnetic resonance imaging (MRI) was used to assess the continuity of the bioabsorbable implant at different stages of the patients' rehabilitation. TYPE OF STUDY: Retrospective case series. METHODS: Forty-nine patients underwent ACL reconstruction performed by a single surgeon. The graft, a tensioned quadrupled semitendinosus tendon, was fixed proximally using a bioabsorbable TransFix implant (Arthrex, Naples, FL). The patients underwent an accelerated rehabilitation program and were assessed clinically at regular intervals postoperatively using MRI, with specific attention focused on the implant. RESULTS: The average time from surgery to MRI was 28 weeks (range, 4 to 54 weeks). All implants were fully visible with no evidence of resorption. Five implants were fractured at an average of 20 weeks postoperatively (range, 9 to 47 weeks). Three implants showed deformation but no definite fracture at an average of 14 weeks (range, 12 to 17 weeks). This amounts to 16% of implants with fractures or deformation, many close to the period of theoretical graft incorporation. All patients were clinically stable with no symptoms or signs or instability on clinical review and all had returned to preinjury sporting activities. CONCLUSIONS: Transfemoral biodegradable implants have the potential to fracture or deform during their postoperative course in tensioned hamstring tendon ACL reconstruction. Although no apparent detrimental effect was found in our series, further research is needed on this device before it can be recommended for ACL reconstruction. We also question the idea that rigid fixation for the ACL graft for the entire healing process is required. LEVEL OF EVIDENCE: Level IV, retrospective case series.

Absorbable Implants↗
PubMed2005

Health outcome measures in the evaluation of total hip arthroplasties--a comparison between the Harris hip score and the Oxford hip score.

There has been an increasing need for the sensitive and reproducible measurement of the outcome after hip surgery. Numerous hip scoring systems, varying in their complexity and disease specificity, have been designed to achieve a measure of outcome-some rely ultimately on the judgement of the surgeon, whereas others rely on the patients' perceptions. The Oxford hip score (OHS) has been found to be easier to administer and achieves a much higher follow-up rate than that of the Harris hip score (HHS). Unfortunately, with the availability of numerous scoring systems and the publication of data in these systems, it has been difficult to compare results. Our aim was to compare the more widely used HHS to the shorter OHS. We followed 200 consecutive primary total hip arthroplasties (196 patients between January 1994 and May 1995) for an average of 5 years. All patients had a preoperative HHS recorded. At the 5-year review, assessment was made using OHS and the HHS. There were 115 hips that had full OHS and HHS available. The mean OHS was 19.1 (range 12-52, SD 9.5), and HHS was 89.4 (range 47-100, SD 13.3) at follow-up. The Spearman correlation showed good negative correlation between the 2 results (Spearman rank -0.712, P < .0001). The HHS vs OHS shows good correlation at 5 years. This is the first study to confirm that correlation persists for the OHS in the medium term. We include a classification of OHS of excellent (<19), good (19-26), fair (27-33), and poor (>33) outcomes which correlate well with the HHS. This study enables the case for the Oxford data with its easier analysis and higher compliance rate to be used more directly to compare studies that use the HHS.

Adult↗
PubMed2004

Is the Charnley evolution working? A five-year outcome study.

Two hundred consecutive primary total hip arthroplasties (196 patients) carried out between January 1994 and May 1995 using the Elite Plus cemented femoral components (DePuy International, Leeds, UK) were enrolled in a prospective study. Fifteen patients were lost to follow-up. The patients were evaluated clinically using the Harris Hip Score (HHS) and radiographically. The mean HHS was raised from 39.3 preoperatively to 89.6 at 5 years. Radiologically the mean femoral subsidence was 1.40 mm at 5 years. The mean annual rate of re-operation was 0.2%. There were no revisions for aseptic loosening. In the present series, the Elite Plus hip arthroplasty has produced clinical and radiological results, which are comparable with the Charnley hip at five years.

Adult↗