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Biomedical subjects

J J Callaghan

Publications and source records attributed to J J Callaghan.

150 records · Page 9Linked to original sources
PubMed1985

Results of revision for mechanical failure after cemented total hip replacement, 1979 to 1982. A two to five-year follow-up.

From January 1979 to February 1982, 143 patients (seventy-nine women and sixty-four men) with 146 uninfected cemented total hip arthroplasties had revision cemented hip arthroplasty at The Hospital for Special Surgery for what was considered to be mechanical failure. The average age of the patients at primary arthroplasty was 56.1 years and at revision, 62.1 years. Loosening of the femoral component before revision correlated with varus positioning in 50 per cent of the hips, inadequate cement in 34 per cent, and a relatively young age in 16 per cent. The average age of the patients (fifteen hips) with a loose femoral component that had been placed in a neutral or valgus position with good cementing technique was 48.2 years at the time of primary arthroplasty. Loosening of the acetabular component was attributed to high placement of the cup in 41 per cent, inadequate bone in 18 per cent, a vertical orientation of the opening of the cup in 7 per cent, and poor cementing technique in 3 per cent. Complications associated with revision included perforation of the femoral cortex in 13 per cent, postoperative deep infection in 3.4 per cent, postoperative dislocation in 8.2 per cent, trochanteric complications in 6.2 per cent, and sciatic palsy in 0.7 per cent. Of the 139 hips that were followed for an average of 3.6 years (range, two to five years) after revision, the results were excellent in 59 per cent, good in 7 per cent, fair in 16 per cent, and poor in 18 per cent. After revision of the 139 hips, 29 per cent showed progressive radiolucencies; 18 per cent, femoral subsidence; and 9 per cent, acetabular migration. Definite mechanical failure after revision was identified in 15.8 per cent of the hips. These failures were due to loosening in 12.2 per cent of the hips, femoral fracture in 2.2 per cent, and disabling dislocation in 1.4 per cent. At the time of follow-up, twelve hips (8.6 per cent) had been revised a second time: six (4.3 per cent) for loosening of one or both components, three (2.2 per cent) for femoral fracture, and three (2.2 per cent) for infection. Mechanical failure and progressive radiolucencies were associated with poor quality of bone (p less than 0.001) and inadequate anatomical reconstruction (p less than 0.03).

Adult↗
PubMed1985

Hip arthrodesis. A long-term follow-up.

In a retrospective study, we examined twenty-eight patients who had had an arthrodesis seventeen to fifty years previously (average, thirty-five years). Hip and knee ratings were obtained, as well as anteroposterior and flexion-extension radiographs of the lumbar spine and standing anteroposterior radiographs of the knees and hips. About 60 per cent of the patients had pain in the ipsilateral knee (average time to onset, twenty-three years after arthrodesis), and a similar percentage had back pain (average time to onset, twenty-five years after the operation). Pain in the contralateral hip occurred in approximately 25 per cent of the patients (average time to onset, twenty years after arthrodesis). Only one patient was unemployed due to disabling pain in the back or knee. Seventy per cent of the patients could walk more than one mile (1.6 kilometers), and a similar percentage could sit comfortably for at least two hours. Seventy-five per cent of the patients had anteroposterior laxity of the ipsilateral knee, and 80 per cent had mediolateral laxity. The patients whose hip was fused in some abduction more frequently had pain in the ipsilateral knee and the back, and they had greater degenerative changes in the ipsilateral knee than the patients whose hip was fused in adduction or in the neutral position. Six patients had undergone total hip arthroplasty for pain in the back or the ipsilateral knee, or both, and all had marked relief of back pain, while two of four had relief of pain in the knee. Two patients had a total knee arthroplasty for relief of pain in the ipsilateral knee.

Activities of Daily Living↗
PubMedDate not supplied

A prospective comparison study of double contrast computed tomography (CT) arthrography and arthroscopy of the shoulder.

Thirty consecutive patients who underwent double contrast CT arthrography prior to shoulder arthroscopy were prospectively studied. Results from both studies were recorded with the radiologist blinded to the arthroscopic findings when making the final CT reading. The sensitivity, specificity, and accuracy, respectively, of CT arthrography findings compared to arthroscopy were 50%, 100%, 96% for rotator cuff; 66%, 100% 96% for bicipital labral complex; 100%, 100%, 100% for loose bodies; 50%, 100% 93% for Hill-Sachs lesions; 90%, 73%, 83% for anterior labral defects; and 100%, 100%, 100% for posterior labral defects. We conclude that shoulder arthroscopy accurately delineates abnormalities of the anterior and posterior labrum, bicipital labral complex, rotator cuff, joint synovium, and humeral head. CT arthrography accurately delineates capsular redundancy, loose bodies, hardware around joints, and bony glenoid rim abnormalities.

Adolescent↗
PubMedDate not supplied

Cervical spinal stenosis and stingers in collegiate football players.

We evaluated the relationship of cervical spinal stenosis with the occurrence of "stingers" in collegiate football players who participated at our institution from 1987 through 1991. Preparticipation cervical spine radiographs of 266 players were used to measure Torg ratio. Forty players with stingers were identified: 34 had an extension-compression mechanism; 6 had a brachial plexus stretch mechanism. Time-loss neck injuries occurred in 31 players; the remaining 195 players were asymptomatic. The mean Torg ratio was significantly smaller for the stinger group (P = 0.02). The Torg ratio was less than 0.8 at 1 or more levels in 47.5% of the stinger group, 32.3% of the time-loss neck pain group, and 25.1% of the asymptomatic group. No player with a brachial plexus stretch mechanism had a mean Torg ratio less than 0.8, but 20.6% of the players with an extension-compression mechanism had a mean Torg ratio less than 0.8. Players with a Torg ratio less than 0.8 had 3 times the risk of incurring stingers. We conclude that cervical spinal stenosis increases the risk for having stingers with complicated clinical courses.

Adult↗
PubMedDate not supplied

Midfoot sprains in collegiate football players.

We studied midfoot sprains in collegiate football players to define and document incidence, mechanisms, injury patterns, and disabilities. Twenty-three athletes with 24 injuries from 1987 through 1991, with a mean followup of 30.8 months, were identified for the study. The injuries occurred in 4% of the football players per year with offensive linemen incurring 29.2% of the injuries. The location of maximal tenderness on physical examination was an important prognostic indicator such that injuries with medial and global midfoot tenderness to palpation had the longest time loss from participation and time until full healing. Lateral midfoot sprains required short periods of disability, and players were able to return to participation with the use of an orthosis. Nineteen athletes with 20 injuries responded to a questionnaire. Four players reported residual functional problems. Only 1 of these players had to modify his recreational activities because of pain. The other players remained very active with only mild complaints of pain after high-demand activities. Midfoot sprains were associated with acute disability that required prolonged restriction from competition, but for most players the long-term residual problems were minor.

Absenteeism↗