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Biomedical subjects

J I Bayley

Publications and source records attributed to J I Bayley.

12 recordsLinked to original sources
PubMed1993

Cell and matrix changes associated with pathological calcification of the human rotator cuff tendons.

The causative mechanism of tendon calcification ('calcifying tendinitis') is unknown. In this report, pathological human tendon samples were examined to give morphological and ultrastructural detail of the calcified regions and these findings were compared with those from normal tendon. Selected specimens were cryosectioned to enable histochemical and immunohistochemical comparison of the occurrence and distribution of specific matrix molecules in diseased and normal tendon tissues. The lack of collagen type II and alkaline phosphatase in the pathological regions suggests that the calcification process is not mediated through an endochondral transition. In contrast, the pathological areas were characterised by widespread labelling for chondroitin-4-sulphate/dermatan sulphate and intense pericellular localisation of chondroitin-6-sulphate.

Adult↗
PubMed1990

The diagnostic value of arthroscopy in glenohumeral instability.

Over a six-year period, 166 shoulder arthroscopies were performed in 153 patients with symptoms of subluxation, but no firm evidence of dislocation and no clear-cut clinical diagnosis. Arthroscopy confirmed the working diagnosis in 133 shoulders (80%), but changed it in 33 (20%). In 26 shoulders the presumed direction of instability was changed and in seven a different diagnosis was made. Arthroscopy was particularly helpful for patients with shoulder instability of uncertain type or direction.

Adolescent↗
PubMed1988

Movement of the shoulder after resection of a tumor of the scapula.

Forty-seven patients who had a tumor of the scapula were seen by the Bone Tumour Panel at the Royal National Orthopaedic Hospital, Stanmore, Middlesex, England. Sixteen resections were performed in fourteen patients. Although other authors have discussed the length of survival of one or a few such patients, none, to our knowledge, has reported on postoperative movement of the shoulder. We correlated the type of resection of bone and muscle with the restrictions of postoperative movement. Our patients had an excellent range of postoperative movement, even after subradical resection. The study enabled us to make recommendations for reconstruction of muscle after resection and to determine the functional prognosis.

Adolescent↗
PubMed1986

Arthrography of the shoulder after operative repair of the torn rotator cuff.

Double-contrast shoulder arthrograms were performed in 20 patients at an average of 30 months after operative repair of a torn rotator cuff. In 18 out of 20 shoulders the contrast medium leaked into the subacromial bursa indicating a defect in the rotator cuff. Despite this, 17 patients had complete relief of pain and 15 had a full range of shoulder elevation. The results suggest that a completely watertight closure is not essential for a good functional result, and that arthrography may not be helpful in the investigation of failure of repair.

Adult↗
PubMed1983

Operative treatment of chronic ruptures of the rotator cuff of the shoulder.

The results of 63 operative repairs of chronic tears of the rotator cuff in 61 patients are reviewed retrospectively; the mean follow-up was 32.7 months. Fifty-four patients presented with symptoms of persistent pain and seven patients with gross loss of movement. All the patients had failed to respond to conservative treatment. Results were assessed in terms of relief of pain, restoration of movement, the patients' ability to return to work and whether they were satisfied with the results. Overall, a good result in terms of relief of pain was achieved in 40 shoulders. In 31 shoulders (30 with pain and one without pain) the operation included particular measures to decompress the subacromial space; 26 of the patients achieved relief of pain which was significantly better than in those patients whose operation did not include a decompression. The complications and failures are discussed. It is suggested that operative repair of the chronically torn rotator cuff of the shoulder is a worthwhile operation and that the operation should include an adequate decompression of the subacromial space.

Adult↗
PubMed1982

Early complications of acute anterior dislocation of the shoulder in the middle-aged and elderly patient.

Shoulder function following acute anterior dislocation may be impaired by rotator cuff rupture, fracture of the greater tuberosity and/or nerve injury. Twelve such cases seen at a referral shoulder clinic are described. The most common symptoms were loss of movement (100 per cent of patients) and pain (66 per cent). Some loss of active abduction was present in all cases and muscle wasting in 33 per cent. Operation was indicated in 9 patients. There were 2 good, 3 fair and 4 poor results following "late' operation performed as a salvage procedure. Rotator cuff rupture may be obscured by a circumflex nerve palsy. If suspected, diagnosis can be confirmed by careful clinical evaluation, together with arthrography and electromyographic studies. Functional improvement and pain relief were obtained in 4 of the 5 patients who underwent late surgical repair for this complication.

Adult↗
PubMed1978

Nerve repair.

Explore the source record for details and available documents.

Humans↗
PubMedDate not supplied

Arthroscopic partial resection of the scapula for snapping scapula: a new technique.

We describe a new method of arthroscopic bony surgery to the superomedial corner of the scapula in patients with painful snapping caused by bony impingement. Seven patients who had failed conservative treatment were monitored prospectively. In 5 patients we used 3-dimensional computed tomography as a diagnostic aid. The condition was successfully managed in 6 cases. One procedure was abandoned because of intraoperative swelling; there was 1 minor wound infection. In all cases the operation relieved symptoms. Two of the 5 patients scanned had narrowing of the superomedial interval. The advantages of this technique are in cosmesis and early rehabilitation, and the early results are good. Provided due care is taken in portal placement, complications should be minimal. Three-dimensional reconstruction computed tomography scanning may be useful in some patients to show narrowing between the superomedial corner and the chest wall, but we cannot at present recommend its routine use.

Adult↗
PubMedDate not supplied

Arthroscopic subacromial decompression: results and factors affecting outcome.

Arthroscopic subacromial decompression was performed on 114 patients with rotator cuff impingement who had not responded to nonoperative measures. None of the patients had a full-thickness cuff tear. Patients with associated instability, symptomatic acromioclavicular joint disease, or ruptures of the long head of biceps were not included. Results were determined by questioning patients about their satisfaction with the outcome of surgery and by functional assessment of the shoulder with the parameters of pain, ability to perform daily activities, and range of motion according to the Constant scoring system. When reviewed at a mean interval of 19 months after surgery, 85 patients (75%) were satisfied with the outcome. Pain scores improved by an average of 8.6 points; "activities of daily living" scores improved by an average of 5.8 points; range-of-motion scores improved by an average of 3.6 points. The improvements in all 3 parameters scored were significant (P < .05). The following variables were statistically analyzed to assess their influence on final outcome: age, sex, occupation, duration of symptoms before surgery, dominance of the affected shoulder, outcome of the impingement test, state of the cuff, and experience of the surgeon performing the operation. The duration of symptoms before surgery was the most significant predictor of outcome. Symptoms of prolonged duration were associated with an unsatisfactory subjective results (P < .01) and with smaller improvements in the parameters of the Constant score (P < .001). Recovery after arthroscopic subacromial decompression and eventual outcome were related to the extent of cuff damage. Patients with partial thickness tears or fraying of the cuff had a delayed return to work (P < .001) and were found to have smaller increases in the pain and range-of-motion scores (P < .05). A satisfactory subjective result was most often associated with a positive impingement test (P < .05). Unsatisfactory outcomes were associated with a questionable diagnosis and lack of clear evidence of impingement at arthroscopy, inadequate decompression of the subacromial space, or the presence of calcium deposits in the rotator cuff.

Adult↗