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Biomedical subjects

J L Goldner

Publications and source records attributed to J L Goldner.

At least 73 records · Page 4Linked to original sources
PubMed1978

Simultaneous and staged bilateral total knee arthroplasty.

Bilateral total knee arthroplasties were performed in twenty-six patients with severe rheumatoid arthritis and osteoarthritis. Twelve had simultaneous operations bilaterally and fourteen had separate, staged procedures. The improvement in the two groups of patients was statistically comparable to the relief of pain and the over-all restoration of function. There were no intraoperative complications. The postoperative morbidity was minimum and was not predominant in either group. Costs were greatly increased with the staged procedure.

Arthritis, Rheumatoid↗
PubMed1977

Metacarpophalangeal joint arthroplasty with silicone-Dacron prostheses (Niebauer type): six and a half years' experience.

Four hundred and forty-one silicone-Dacron arthroplasties done since 1968 were reviewed. Results were influenced by both durability and immediate fixation of the prosthesis, disease characteristics, speed of progression, the amount of hand stress, the extent of soft tissue release, and postoperative dynamic and protective splinting. Dislocations were eliminated by a woven tie-in holding the prosthesis to bone; prosthetic buckling was eliminated by soft tissue release, sufficient bone removal, and suture of the dorsal capsule to the extensor mechanism. Early prosthetic models fractured easier than did current ones. Seventeen percent of the combined 4, 5, and 6 year follow-up prostheses fractured, and 30% of the 6 year prostheses have fractured. Function was not affected, however, and protheses have not been replaced. We continue to use silicone-Dacron protheses with immediate tie-in to bone.

Arthroplasty↗
PubMed1977

Arthroscopy: its role in treating nontraumatic and traumatic lesions of the knee.

Arthroscopy of the knee is a useful adjunct in the diagnosis and treatment of intra-articular disease. We reviewed 178 patients who had arthroscopy at Duke from November 1972 to May 1975. Anesthesia was either general or local with a block of the infrapatellar fat pad and the infrapatellar branch of the saphenous nerve. This experience demonstrated that arthroscopy was relatively rapid, increased the accuracy of diagnosis from 70% by clinical assessment alone to 96%, and influenced the management of the knee in 55% of the cases. In many instances, arthroscopy demonstrated major pathologic conditions not readily noted by prior arthrography, multiple roentgenograms, or physical examination. Arthroscopy does not eliminate the need for arthrography, although frequency of arthrography diminished as arthroscopic technics were mastered and equipment improved. Arthroscopy is valuable in the management of most knee problems. The surgeon undertaking the procedure must have adequate instruction and a wide and continued usage in order to become and remain adept.

Adolescent↗
PubMed1975

Restoration of strong opposition after median-nerve or brachial plexus paralysis.

In hands in which the superficial flexors of the fingers and thenar muscles of opposition are denervated, usually as the result of high median-nerve or brachial plexus injury, thumb opposition can be restored by transfer of the superficial flexor of the ring finger to the thumb through a dynamic pulley made from the distal segment of flexor carpi ulnaris which is attached to the proximal segment of flexor carpi ulnaris to the transferred paralyzed superficial ring-finger flexor tendon. Of sixteen patients treated by this method, twelve had good or satisfactory results; one had a poor result; and three were lost to follow-up.

Adolescent↗
PubMed1975

Effects and distribution of acute fat embolism in spontaneously breathing dogs using radioactive carbon triolein.

The acute effects of a triolein infusion in dogs were secondary to the mechanical effects of this neutral fat which was distributed in the pulmonary and systemic vascular tree of all organs without inflammatory change. Hypoxia developed immediately and became progressively worse as the infusion was continued. Pulmonary hypertension developed during the fat infusion without pneumonia, congestive heart failure or pulmonary edema. There was a slow leak of 14C triolein into the systemic circulation rather than a rapid shower, and this radioactive fat was recirculated between the pulmonary and systemic vasculature. Seventy-six per cent of the 14C triolein was retained in the lungs. Terminally, the dogs had a respiratory arrest without cardiac decompensation, cardiac arrest or pulmonary edema; cerebral fat embolism in addition to severe hypoxia appears to be the cause.

Acute Disease↗