Search PubMed⌕ Search

Biomedical subjects

M J Cross

Publications and source records attributed to M J Cross.

66 records · Page 4Linked to original sources
PubMedDate not supplied

Anterior cruciate ligament: functional anatomy of its bundles in rotatory instabilities.

The functional anatomy of tha anterior cruciate ligament was studied in 18 freshly amputated specimens. The cruciates were observed in the extremes of flexion and extension, and in midposition in simulated weight-bearing and nonweight-bearing conditions. Five femoral shafts were split longitudinally so that the femoral and tibial attachments of the ligament could be inspected. The findings indicated that (1) the anterior cruciate ligament is a secondary static stabilizer against rotatory instabilities of the knee; (2) the anteromedial bundle contributes to anterolateral stability; (3) the intermediate bundle adds to straight and anteromedial stability; and (4) the posterolateral bundle assists in posterolateral stability. Specific bundles and functions of bundles must be considered in reconstruction, substitution, or replacement of the anterior cruciate ligament.

Animals↗
PubMedDate not supplied

Long-term followup of posterior cruciate ligament rupture: a study of 116 cases.

With adequate quadriceps exercises, the prognosis of a ruptured posterior cruciate ligament can be greatly improved. Of the 116 cases followed in this report, 55 were sports injuries while most of the remainder were traffic accidents. An excellent or good result was obtained in 47 sports-injured patients, while only 5 involved in road trauma obtained this result. Surgery was used to improve the eventual result and this was successful in nine cases. Early repair is still the treatment of choice. Eighty percent of ruptures can have a good or excellent result with effective management.

Accidents, Traffic↗
PubMedDate not supplied

Femoral nerve block in knee joint surgery.

Assessment is made of the effectiveness of femoral nerve block, administered either before or after surgery, in supplementing postoperative analgesia for knee joint (anterior cruciate) reconstruction surgery. Femoral nerve block, performed before surgery, with Bupivacaine 0.5%, reduced intramuscular opiate administration by 80% in the recovery room and 40% in the first 24 postoperative hours. An effective and rapidly performed technique for femoral nerve block is described.

Adult↗
PubMedDate not supplied

Acute repair of the anterior cruciate ligament with lateral capsular augmentation.

Forty-seven patients had primary repair and extraarticular augmentation with a lateral loop of the iliotibial tract for acute rupture of the ACL. (All of these patients had anterolateral rotatory instability (ALRI) preoperatively as diagnosed by a positive jerk test.) Of these 47 patients, 36 were available for follow-up evaluation. Followup ranged from 6 to 68 months (average, 21.6 months). Twenty-three of the patients (64%) were rated as excellent or good. Ten of the patients (27.8%) were rated as fair, and three patients (8%) were rated as poor. Thirty-three of the 36 patients (91%) were objectively free of ALRI as tested by the jerk test and had 1+ or less result in a Lachman test, with a firm end point. Only one patient felt his knee to be unstable (he had a positive pivot jerk). More than 90% of the patients returned to sport, and 72% returned at their preinjury level.

Acute Disease↗
PubMedDate not supplied

An analysis of the sidestep cutting manoeuvre.

The sidestep cutting manoeuvre is a common mechanism of noncontact or isolated ACL ruptures in athletes. We analyzed the amount and direction of tibial rotation that occurred at the knee joint with a triaxial electrogoniometer on 11 male subjects who performed the sidestep cutting manoeuvre. The mean total tibial rotation was 19.84 +/- 5.63 degrees and the mean maximum point of internal tibial rotation occurred at 34.77 +/- 5.30% of the stance phase. However, greater values for internal tibial rotation occurred in the swing phase in association with a greater angle of knee flexion. Therefore, in our subjects, during the sidestep cutting manoeuvre, internal tibial rotation did occur at the knee but was not maximal. Under normal circumstances when performing the sidestep cutting manoeuvre, maximum internal tibial rotation does not occur and so the ACL is not placed under excessive strain in such a manoeuvre. If the ACL ruptures during a sidestep cutting manoeuvre then a possible cause may be the athlete's loss of the ability to control internal tibial rotation of the knee.

Adolescent↗
PubMedDate not supplied

Regeneration of the semitendinosus and gracilis tendons following their transection for repair of the anterior cruciate ligament.

Apparent regeneration of the tendons of the semitendinosus and gracilis muscles after their use for anterior cruciate ligament reconstruction was noted during routine follow-up of 225 patients. From this group, four patients were selected for thorough examination, including magnetic resonance imaging, electromyographic studies, strength testing, and clinical examination. The results demonstrate that these tendons appear to regrow and are probably functional.

Anterior Cruciate Ligament↗
PubMedDate not supplied

Acute repair of injury to the anterior cruciate ligament. A long-term followup.

We reviewed 30 patients at an average of 7.4 years after acute repair of the anterior cruciate ligament augmented with a loop of iliotibial tract. A noncontact twisting had been the mechanism of injury in 18 of these patients, with 28 having been injured in sports. At followup, 25 patients had not experienced symptoms of instability and 23 were able to return to unrestricted athletic activity; only 5 had been unable or unwilling to return to sporting activity at all. There had been no swelling in 23 patients; however, 17 suffered from pain on exertion. The average Lysholm score was 93.2. Joint laxity was assessed and anteroposterior tibial translation quantified with a KT-1000 arthrometer. Eighteen patients had a normal or 1+ Lachman test and 27 had an absent or 1+ pivot shift. When compared with the results of a similar study performed on this group of patients at 2 years after surgery, there had been little subjective change in knee function. However, objectively there had been significant deterioration of the anteroposterior stability of the knees at 7 years, suggesting failure of the integrity of the repaired ligament with time. An associated medial collateral ligament injury had a significant adverse effect both on the integrity of the anterior cruciate ligament repair and the incidence of postoperative stiffness.

Adult↗
PubMedDate not supplied

Participation in sports after total knee replacement.

Return to regular sports activity was evaluated in a retrospective review of 160 patients who had undergone total knee replacement surgery by a single surgeon (208 knee replacements). Mean age of the patients was 68 years (range, 27 to 87) at surgery and 73 years (range, 33 to 91) at review at a mean follow-up of 5 years (range, 3 to 7). Seventy-nine patients regularly participated in sports, at least once per week, before surgery, and 51 patients regularly participated in sports after surgery. Only eight patients took up sports after surgery who were not regularly involved in sports in the year before surgery. Patients were more likely to return to low-impact activities such as bowls (29 of 32, or 91%) than to high-impact activities such as tennis (6 of 30, or 20% returned). Forty-three of 56 patients (77%) who had participated in regular exercise in the year before surgery returned to sports. Eighty patients did not participate in sports before surgery and 54 of these had coexisting disease that prevented sports. None of these patients returned to sports.

Adult↗
PubMedDate not supplied

Surgical repair of chronic complete hamstring tendon rupture in the adult patient.

Complete rupture of the hamstring tendons in the adult is a rare injury. This report discusses complete rupture of the hamstring tendons in nine patients treated by late operative repair. All patients were referred from outside centers for a second opinion after failed nonoperative treatment. The diagnosis was made quite easily on clinical grounds and was confirmed at surgery. Surgical treatment in all cases consisted of reattachment of the hamstring tendons to the origin on the ischium, and in all cases it was necessary to perform neurolysis of the sciatic nerve. Good results were achieved in all cases, at follow-up all patients were satisfied with the surgery.

Adult↗