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Biomedical subjects

M McShane

Publications and source records attributed to M McShane.

7 recordsLinked to original sources
PubMed1996

Range of motion in total knee replacement.

This is a multicenter prospective clinical study using a modified Knee Society scoring system which evaluated the effect of age, gender, weight, preoperative range of motion and knee score, previous surgery, and modification of the posterior femoral condyle geometry on postoperative range of motion. The primary outcome variable was change in flexion. The data were collected from 5 surgeons using a single total knee system. The current study has 621 patients enrolled, of which 282 total knee replacements have followup of 12 months and 86 have followup of 24 months. Multivariate analysis was used to evaluate the data. The variables listed were examined as to their relationship to changes in flexion. Patients were divided into 3 groups: preoperative flexion less than 90 degrees, 91 degrees to 105 degrees, and greater than 105 degrees. When comparing the patients with preoperative motion less than 90 degrees to those with motion greater than 105 degrees, the first group improved 26 degrees more than the latter. They also improved 12 degrees more than the midrange group. The midrange group improved 14 degrees more than the upper range group. These values are all adjusted to eliminate differences due to the other variables. None of the other variables showed a significant correlation with the flexion outcome. To analyze the knee score, the group was also divided into 3 groups: preoperative score less than 27, 28 to 40, and greater than 40. The preoperative knee score was the best predictor of the postoperative knee score. The patients with preoperative knee scores below 27 improved 16 points more than those in the 27 to 40 range and 33 points greater than the greater than 40 group. To analyze functional evaluation, the patients were divided into 3 groups based on preoperative score: less than 40, 41 to 50, and greater than 50. Those in the less than 40 group improved 14 points more than the midrange group and 35 points more than the greater than 50 group. Analysis of delta range of motion and delta pain showed similar results. Age, weight, previous open surgical procedure, and altered femoral component contour, did not seem significantly correlated with changes in postoperative flexion. The best predictors of postoperative clinical results are the preoperative scores.

Aged↗
PubMed1988

Does oedema following lower limb revascularisation cause compartment syndromes?

Oedema of the leg, particularly the calf, is a well-recognised complication following lower limb reconstructive vascular surgery, but its effect on the limb is unknown. In this study, anterior compartment pressures and calf circumference were measured in both the operated and non-operated limbs following femoropopliteal bypass in 15 patients. All the patients developed lower limb swelling, which was significantly greater than the non-operated limb, P less than 0.05 paired t test (day 2-5). There was a significant difference in the mean anterior compartment pressures between the operated and non-operated limbs on the third and fourth postoperative days for the overall and below knee group, P less than 0.05 (paired t test). However, none of the patients developed signs, symptoms or pressures indicative of a compartment syndrome. These results suggest that the oedema following reconstructive vascular surgery is subcutaneous rather than compartmental in origin and that compartment pressure measurements should only be undertaken if a fasciotomy is being contemplated.

Adult↗
PubMed1984

The prevalence of child sexual abuse victimization in an adult sample of Texas residents.

Attempts to identify characteristics of children who have been sexually abused have generally been based on cases reported to clinics, hospitals, law enforcement and social service agencies. In this study a questionnaire was mailed to a representative sample of the adult population in Texas. Child sexual abuse was defined as sexual interaction between a child and an adult or between two minors when the perpetrator is significantly older than the victim or is in a position of power over the victim. A return rate of 53% was obtained. The surveys returned varied from previous studies of the same population in that the respondents were slightly older, more often married and from a slightly higher socioeconomic level. They were, however, closely matched on the variables of sex, race and educational level. Childhood sexual victimization was reported by 7.4% of the respondents. Female victims comprised 82% of this group. The racial/ethnic distribution of victims paralleled that of the Texas census with 77% white, 5% black, and 16% Hispanic. Victimization rates were highest for Hispanic females followed by black and white females in that order. Hispanic and black males reported the lowest victimization rates. Based on these findings, it was estimated that 821,359 adult Texas residents were sexually abused as children. These results were compared with those of other studies along with their implications for policy-making.

Adolescent↗