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Biomedical subjects

J B King

Publications and source records attributed to J B King.

At least 19 recordsLinked to original sources

Effects of open versus closed kinetic chain training on knee laxity in the early period after anterior cruciate ligament reconstruction.

Knee extensor resistance training using open kinetic chain (OKC) exercise for patients recovering from anterior cruciate ligament reconstruction (ACLR) surgery has lost favour mainly because of research indicating that OKC exercise causes greater ACL strain than closed kinetic chain (CKC) exercise. In this prospective, randomized clinical trial the effects of these two regimes on knee laxity were compared in the early period after ACLR surgery. Thirty-six patients recovering from ACLR surgery (29 males, 7 females; age mean = 30) were tested at 2 and 6 weeks after ACLR with knee laxity measured using the Knee Signature System arthrometer. Between tests subjects trained using either OKC or CKC resistance of their knee and hip extensors in formal physical therapy sessions three times per week. Following adjustment for site of treatment, pretraining injured knee laxity, and untreated knee laxity at post-training, the use of OKC exercise, when compared to CKC exercise, was found to lead to a 9% increase in looseness with a 95% confidence interval of -8% to +29%. These results indicate that the great concern about the safety of OKC knee extensor training in the early period after ACLR surgery may not be well founded.

Adult↗

Correlates of knee laxity change in early rehabilitation after anterior cruciate ligament reconstruction.

Factors other than ligament graft length (knee ROM, knee swelling, initial knee laxity) may need to be accounted for in interpreting changes in knee laxity during rehabilitation following anterior cruciate ligament reconstruction (ACLR) surgery. Twenty-three patients recovering from ACLR surgery (16 M, 7 F, age mean = 30) were tested at 2 and 6 weeks after ACLR with knee laxity measured using th Knee Signature System arthrometer, passive ROM with a standard goniometer and swelling by measuring knee circumference at the mid-patella level using a cloth measuring tape. Spearman correlation coefficients (in parentheses) were calculated using rankings of the change in the injured minus uninjured knee laxity as the dependent variable and the following independent variables: pre-test injured minus uninjured knee laxity (ranked; -0.457; statistically significant two-tailed P < 0.05); change in injured knee maximum extension relative to the uninjured side (ranked; 0.127); change in injured knee maximum flexion relative to the uninjured side (unranked; -0.073); and change in the injured minus uninjured knee girth (unranked; -0.159). These results indicate that consideration should be given to the patient's knee laxity at the start of intervention when using changes in laxity to guide rehabilitation after ACLR.

Adult↗

Arthroscopy in sporting and sedentary children and adolescents.

We performed arthroscopic procedures on 97 knees in 91 patients younger than 16 years of age. Sixty arthroscopic procedures in 58 patients were for sports-related injuries or symptoms. The most common diagnosis was maltracking of the patella. In 78 cases, an operative procedure was performed at the time of diagnostic arthroscopy. No complications were experienced. The accuracy of diagnosis for suspected meniscal tears was poor. Further pathologies, especially meniscal tears, were commonly associated with anterior cruciate ligament tears. Arthroscopy of the knee in children is safe, has a high diagnostic accuracy, and, in a significant proportion of patients, it can have not only a diagnostic role but allows the management of a wide variety of intra-articular conditions.

Adolescent↗

Surgical management of tendinopathy of the main body of the patellar tendon in athletes.

OBJECTIVE: To report the results of surgery for tendinopathy of the main body of the patellar tendon. DESIGN: Retrospective study. SETTING: A teaching hospital of the University of London. PATIENTS: Twenty-eight patients reviewed at an average follow-up of 42 months from surgery for tendinopathy of the main body of the patellar tendon after failed conservative treatment. INTERVENTION: Exploration of the affected patellar tendon, stripping of the paratenon, excision of pathological areas, and multiple longitudinal tenotomies. MAIN OUTCOME MEASURES: Postoperative complications, ability to return to sport, and subjective satisfaction, as measured by formal clinical assessment or telephone questionnaire. RESULTS: At follow-up, 23 patients were completely free of pain and had resumed full sporting activity at the same preoperative level. Three patients were improved enough to have returned to their preoperative sporting level or just below it. In two patients, the initial operation failed. In the patients who resumed sport, the average time from surgery to resuming full sporting activity was 7 months (range 6 weeks to 12 months). The most common early postoperative complications were wound hematoma and superficial infection. The most common late complications were related to the incision, with anterior knee pain on kneeling and skin dysesthesia. CONCLUSION: Surgical decompression of the patellar tendon with multiple longitudinal tenotomies is an effective treatment for patellar tendinopathy. In the middle term, patients do not seem to relapse once they have recovered, whereas those who do not respond to surgery do not recover at all and may need a new operation.

Adolescent↗

Training in élite young athletes (the Training of Young Athletes (TOYA) Study): injuries, flexibility and isometric strength.

Using a mixed longitudinal design, the incidence of injuries, and the development of flexibility and isometric strength of the upper and lower limbs were studied for 2 years in 453 élite young athletes (aged between 9 and 18 years) practising football, gymnastics, swimming or tennis. The children suffered from a low incidence of injuries. Strength and flexibility did not exert a significant role in determining injuries. The rate of injury was not significantly different between the 2 years of the study. Young swimmers showed a greater generalized flexibility. Girls were more flexible than boys between the ages of 13 to 16 years. Athletic children are able to exert greater isometric strength than normal schoolchildren. Boys diverged from the normal population at 14 years, while athletic girls were stronger at all ages. Girls were stronger than boys up to age 12, who were still increasing their muscle strength at 19 years. The average maximal isometric strength exerted in both upper and lower limbs in the four sports was not significantly different. Male gymnasts over 11 years old were significantly stronger than all other athletes.

Adolescent↗

A prospective, double-blind trial of electrical capacitive coupling in the treatment of non-union of long bones.

Twenty-three patients who had an established non-union of a long bone were entered into a prospective, double-blind trial in which electrical capacitive coupling was used for treatment. Twenty-one patients completed the study: ten who were actively managed and eleven who were managed with a placebo unit. The non-union healed in six of the ten patients who had been managed actively but in none of the patients who had been managed with the placebo unit. This difference in the rates of healing between the actively managed and the placebo groups is highly significant (p = 0.004).

Adolescent↗

Patterns of meniscal tears associated with anterior cruciate ligament lesions in athletes.

In this study, 400 clinically anterior cruciate ligament (ACL) deficient knees were arthroscoped and studied prospectively in the period January 1986 to April 1992. An ACL tear was always confirmed, and 41 per cent of these patients did not have an associated meniscal tear. In 30.25 per cent the lateral meniscus was torn; in 21.25 per cent the ACL tear was associated with a medial meniscus tear, and in the remaining 7 per cent both menisci were torn. The most frequently associated meniscal injury was the bucket handle tear of the medial meniscus (9 per cent), followed by the posterior horn tear of the lateral meniscus, which showed the same frequency as the ragged (or degenerated) tear of the lateral meniscus (6 per cent). The horizontal tear of the posterior part of the lateral meniscus showed a prevalence of 4.3 per cent. This picture is probably dependent on a secondary referral nature of the centre surveyed, in which the average time between injury and arthroscopy was 23.3 months.

Adolescent↗

Blockage of urethral catheters by bacterial biofilms.

We report the case of a 63-year-old woman whose indwelling urethral catheter became blocked regularly at 4-5 day intervals over a period of 10 weeks. 'Worm-like' structures 25-30 cm in length were found either in the catheter, completely occluding the lumen, or in the drainage tube thereby blocking the valve of the drainage bag. Electron microscopy showed that these structures were composed of bacteria, while culture revealed them to be mixed communities of Pseudomonas aeruginosa, Escherichia coli, Enterococcus faecalis and Proteus mirabilis. Following treatment with ciprofloxacin, catheter drainage continued freely for a further period of 10 weeks.

Catheters, Indwelling↗

Accidental injection of white spirit into the hand in golfers.

We report two cases in which white spirit has been injected accidentally into the hand by golfers, while attempting to remove the grip of the golf-club handle in order to replace it. One of our patients has anecdotal evidence of this happening in at least two other cases, one of which resulted in amputation of the index finger, and the other in severe damage to the thumb.

Accidents↗

Vocal matching of frequency modulation in synthesized vowels.

Nine male singers attempted to match rates and extents of synthesized vocal vibrato at low, middle, and high pitch levels. The results showed that on average, the singers were able to match rates of 3, 5, and 7 Hz within 13%. It was difficult for the singers, however, to match extents of 0.5, 1.0, and 1.5 semitones. Thus, the results indicated singers' reasonably good ability to match rates but, contrary to prevalent opinions, not extents of vocal vibrato.

Adult↗