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Biomedical subjects

D R Gore

Publications and source records attributed to D R Gore.

At least 19 recordsLinked to original sources
PubMed1987

Function following partial fibulectomy.

The fibula is a valuable source of a bone graft, but because the fibula has a role in lower extremity function, it is important to determine whether partial removal results in dysfunction or other problems. Forty-one patients (48 +/- 10 years of age) had a portion of their fibula removed for a bone graft. At evaluation 27 +/- 8 months later, 24 had no pain, 11 mild pain, and six moderate or severe pain. Sixteen had no complaints of any kind, but four without pain had minor difficulties with vigorous activities, and three complained of ankle swelling. There were no differences in range of motion between the operated and nonoperated side. Average muscle torque was lower on the operated than on the nonoperated side, but this difference was statistically significant only for ankle evertors in men. This study demonstrates that most patients will have subjective complaints and mild muscular weakness after removal of a portion of the fibula.

Adult↗
PubMed1986

Roentgenographic findings following anterior cervical fusion.

We reviewed the pre- and postoperative lateral cervical roentgenograms in 90 patients who had anterior fusions and compared their findings with age and sex-matched people without neck problems. The average interval from surgery to review was 5 years. Preoperatively, all patients had a higher incidence of degenerative spondylosis at the levels to be fused than their asymptomatic counterparts. Postoperatively, there was no difference in the incidence of degenerative change between the operated and the control group at the levels above and below the fusion with the exception of anterior osteophyte formation which was more frequent in those with fusions.

Cervical Vertebrae↗
PubMed1986

Correlations between objective measures of function and a clinical knee rating scale following total knee replacement.

Few objective measurements of function, other than range of motion, have been reported for patients with total condylar knee replacement. Moreover, to our knowledge, no studies have been reported which assess the degree of relationship between clinical ratings and measurements of function in these patients. Kinesiologic tests of function and the Hospital for Special Surgery (HSS) Knee Rating Form were used to evaluate 34 patients before and 2 years after 39 total condylar knee replacements. Prosthetic alignment was also evaluated postoperatively. The kinesiologic studies showed postoperative improvement in muscle strength, weight-bearing ability, and use of assistive devices, and in velocity, knee flexion-extension, and lateral head motion during walking. A moderate but significant degree of improvement was measured by the HSS score. Correlation coefficients showed that the postoperative knee rating score was significantly related to almost all of the postoperative objective measurements of function. Correlation coefficients between the prosthetic alignment scores and measurements of function were not statistically significant. The study strengthens the validity of use of the HSS Knee Rating Form as a tool for evaluating functional performance, particularly during the postoperative period.

Aged↗
PubMed1986

Comparison of function two years after revision of failed total hip arthroplasty and primary hip arthroplasty.

Because of the known high complication rate, it is important for both the patient and physician to know as much as possible about the outcome of revision operations for loosened total hip arthroplasties. This study evaluates the changes in subjective ratings and objective kinesiologic measurements from before revision operations through two years after revision operations. The object is to compare these measurements with the measurements of a group of patients with primary replacements. Both groups of patients showed significant improvement in most parameters from before to after surgery. These parameters included walking performance, hip muscle strength, range of motion, forces applied to canes, and the amount of weight borne on the operated limb during quiet standing. Compared to the control group with primary replacements, the group with revision used more assistive devices, had less pain relief, walked slower, had less hip motion, and had more lateral lurch. While results after revision surgery were not as gratifying as those after primary hip replacement, patients requiring revision can still anticipate substantial improvement.

Adult↗
PubMed1986

Shoulder-muscle strength and range of motion following surgical repair of full-thickness rotator-cuff tears.

Postoperative measurements of the range of motion and muscle strength of the shoulder and ratings of pain and the ability to perform daily activities were made in fifty-eight patients (sixty-three shoulders) who had a repair of a full-thickness rotator-cuff tear. Postoperatively, the patients had an average of 126 degrees of active flexion of the shoulder and an average of 130 degrees of active abduction. Passive motion averaged 21 degrees more than active motion. The strength of the abductor muscles of the shoulder averaged approximately 86 per cent of normal. Most patients reported marked relief of pain and rated themselves as having mild or no deficits in their ability to perform daily activities. The length of the cuff tear significantly affected the functional results. Short tears (less than 2.5 centimeters) were associated with greater strength and range of motion than were long tears. Fifteen of the nineteen patients who were unable to work preoperatively because of the shoulder returned to work after surgery, but not necessarily to the same type of work that they had done before the onset of the problem with the shoulder.

Acromion↗
PubMed1985

Hip function after total vs. surface replacement.

Kinesiologic measurements were made in two groups of 20 men before and 6 and 24 months after resurfacing or conventional replacement. Before surgery the group to have resurfacing was younger, had less pain, slightly more hip motion, greater muscle strength, walked faster, and used fewer assistive devices during walking than the group to have the conventional replacement. After surgery, the group with resurfacing maintained its advantage in muscle strength and walking velocity.

Age Factors↗
PubMed1985

Functional performance after tibial rotationplasty.

We measured muscle strength, joint motion, and gait parameters and determined the electromyographic activities of the ankle and knee during walking, running, and stair-climbing in two children who had had a tibial rotationplasty for osteosarcoma of the distal end of the femur. Both had marked loss of strength in the plantar flexors on the side of the prosthesis compared with the sound side, although electromyographic recordings showed that the rotated calf muscles, to a substantial degree, had assumed the function of extensors of the prosthetic knee. Despite some abnormalities in gait, both children walked at speeds that were comparable to those of normal children. They could also run, climb stairs by stepping up with both limbs, and participate in many recreational activities. The functional abilities of these children suggested that rotationplasty, in patients with a similar lesion, is a worth-while alternative to above-the-knee amputation.

Artificial Limbs↗
PubMed1985

Antalgic maneuvers during walking in men with unilateral knee disability.

The gait of men with unilateral knee disability has not been quantified previously. Interrupted-light photography was used to quantify the gait abnormalities of 35 men whose major disability was unilateral knee pain. The following antalgic maneuvers were found to be common to the gait of these patients: slow and uneven forward progression with lateral lurching toward the painful side, asymmetry in stride and temporal components, and abnormalities in the displacement patterns of most body segments. Subnormal knee motion was found during the stance and swing phases. Because treatment of patients with knee problems is usually directed toward pain relief, an understanding of how pain affects walking performance is important to the clinician when assessing a patient's problem.

Adult↗
PubMed1979

A comparison of the funtional performance of patients with Charnley and Müller total hip replacement. A two-year follow-up of eighty-nine cases.

Measurements of functional performance in 35 cases with Charnley total hip replacement were compared with those of 54 cases with Müller replacement before surgery and at 6- and 24-month follow-up intervals. The measurements included strength of the hip abductor and adductor muscles, hip motion, the amount of weight borne on the involved limb during standing posture, multiple components of free-speed and fast walking, and force applied to canes and crutches. Both replacement groups improved significantly in most components of function. In fact, both groups reached or nearly reached the lower limits of normal variability in weight-bearing ability, cadence, and some components which relate to smoothness of walking performance. The groups with Müller and Charnley replacement differed most in some components of range of hip motion, hip muscle strength, and lateral lurching during walking.

Adult↗
PubMed1977

Roentgenographic measurements after Müller total hip replacement. Correlations among roentgenographic measurements and hip strength and mobility.

In fifty-two patients with Müller total hip replacement, roentgenographic measurements of prosthetic component positioning were correlated with hip-muscle strength and mobility measurements. Compared with the normal side, the average position of the center of the prosthetic head was more medial and superior in the pelvis, and the greater trochanter was more distal and lateral. Increasing neck length (distance from the center of the prosthetic head to the lesser trochanter) and a more distal position of the greater trochanter were among the measurements that related favorably to measurements of patient function. More superior placement of the center of the prosthetic head in the pelvis was associated with a more superior position of the lesser trochanter, which related adversely to function.

Aged↗
PubMed1975

Kinesiology after McKee-Farrar total hip replacement. A two-year follow-up of one hundred cases.

Measurements of functional performance were made before and at six and twenty-four months after 100 McKee-Farrar total hip replacements in eighty-three patients. The measurements included: range of motion of the hip, hip-muscle torque, weight-bearing activity during standing, forces applied to canes or crutches, and multiple components of walking performance. In the absence of serious complications, most patients had improvement in most components of function, with greater gains occurring during the first six months and lesser but continued gains between the sixth and twenty-fourth postoperative months. Patients with serious operative complications, postoperative infections, or component loosening showed declines in almost every component of function tested.

Biomechanical Phenomena↗
PubMed1975

Walking patterns of men with unilateral surgical hip fusion.

The gait of men with unilateral hip fusion is somewhat slow, asymmetrical, and arrhythmic as compared with that of normal men. Compensation for absent hip motion is accomplished by increased transverse and sagittal rotation of the pelvis, increased motion in the sound hip, and increased flexion of the knee throughout the stance phase on the fused side. Relationships between the fusion position, certain physical traits, and walking performance suggest that the best gait can be expected in young patients who have free motion of the lumbar spine, the sound hip, and the knee on the side of fusion, and who have equal limb lengths and a hip fused in a position that does not include excessive adduction.

Adolescent↗
PubMedDate not supplied

Osteoid-osteoma of the spine with localization aided by 99 mTc-polyphosphate bone scan. Case report.

This is a case report of a 13-year-old boy with an osteoid-osteoma located in the pedicle of the third lumbar vertebra. The lesion could not be visualized on routine roentgenograms but with the use of technetium polyphosphate bone scan as a guide a suggestive bone lesion was found with tomograms. Histologic examination confirmed the diagnosis of osteoid-osteoma. This case illustrates the value of skeletal scanning in occult bone lesions.

Adolescent↗
PubMedDate not supplied

Roentgenographic findings of the cervical spine in asymptomatic people.

The purpose of this study was to determine the incidence and severity of degenerative changes seen on lateral roentgenograms in 200 asymptomatic men and women in five age groups with an age range of 20-65 years and to determine the normal values of cervical lordosis and spinal canal sagittal diameters and their relationship to degenerative changes. It was found that by age 60-65, 95% of the men and 70% of the women had at least one degenerative change on their roentgenograms. A small sagittal diameter correlated with the presence of degenerative changes at the same disc level, and the strongest correlation was with the size of the posterior osteophytes at C5-6 (r = 0.52). Cervical lordosis measurements did not relate to degenerative changes except for subjects over age 50 with moderate or severe intervertebral narrowing. It is important to realize that although roentgenographic abnormalities represent structural changes in the spine, they do not necessarily cause symptoms.

Adult↗
PubMedDate not supplied

Neck pain: a long-term follow-up of 205 patients.

Two hundred five patients with neck pain were evaluated clinically and roentgenographically for a minimum of 10 years after onset of symptoms. Seventy-nine percent had a decrease in pain, and 43% were free of pain; however, 32% had moderate or severe residual pain. Patients who had been injured and initially had severe pain were the most likely to have an unsatisfactory outcome; however, no other clinical features were of value in predicting the final result. The presence or severity of pain was not related to the presence of degenerative changes, the sagittal diameter of the spinal canal, the degree of cervical lordosis, or to any changes in these measurements over the evaluation period.

Adult↗