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N L Harris

Publications and source records attributed to N L Harris.

204 records · Page 12Linked to original sources
PubMedDate not supplied

Osteogenic sarcoma arising from bony regenerate following Ilizarov femoral lengthening through fibrous dysplasia.

Sarcomatous degeneration of fibrous dysplasia has been previously documented in rare cases, often in association with prior radiation therapy. This case report describes the occurrence of osteosarcoma arising in the distal femur of a 15-year-old male with previous biopsy-proven fibrous dysplasia, who had undergone limb lengthening through a distal femoral corticotomy using the technique described by Ilizarov. In addition, distraction osteogenesis through an area of fibrous dysplasia in the proximal tibia produced a new area of fibrous dysplasia in the regenerate tissue as shown by histopathologic examination. This case raises two questions: (a) whether the biologic stimulus of distraction osteogenesis through abnormal metaplastic bone increases the risk of malignant neoplasia, and (b) whether distraction osteogenesis through dysplastic bone is contraindicated, since the regenerate tissue does not form normal bone.

Bone Lengthening↗
PubMedDate not supplied

Comparison of an optical catheter office arthroscope with a standard rigid rod-lens arthroscope in the evaluation of the knee.

In a prospective, randomized study, 47 patients underwent arthroscopic evaluation of the knee in an operating room setting with both a standard rod-lens arthroscope and a newer flexible optical catheter fiberoptic system. The goal of the study was to assess the diagnostic accuracy of the newer catheter system, which is recommended for use in the office setting. Forty-four patients were included in the data analysis, three were eliminated because we were unable to perform an adequate examination with the catheter scope secondary to intraarticular adhesions or excessive bleeding. A comparison of the two systems revealed an overall underestimation and underrecognition of intraarticular knee pathologic changes. Anterior cruciate ligament tears were missed in 3 of 21 knees; no posterior cruciate ligament tears were detected by the rod-lens arthroscope in 44 knees, but one false-positive result was "seen" using the optical catheter device. Similar trends in diagnosis (sensitivity, 25% to 67%; specificity, 96% to 99%) were seen for tears of the medial and lateral menisci, chondral lesions, and the identification of loose bodies. We conclude from the results of this study that the use of the optical catheter system for arthroscopic evaluation and treatment of the knee in the office setting may result in a significant compromise in visual acuity, resulting in missed and incorrect diagnoses.

Anterior Cruciate Ligament Injuries↗
PubMedDate not supplied

Central quadriceps tendon for anterior cruciate ligament reconstruction. Part I: Morphometric and biomechanical evaluation.

We examined the anatomic and biomechanical adequacy of the central quadriceps tendon as an alternative graft source for anterior cruciate ligament reconstruction. Morphometry was performed on 15 preserved and 6 fresh-frozen specimens. Biomechanical testing was performed on the six fresh-frozen specimens. We initially used a triple suture through the tendon construction, and then clamping directly on the tendon. Morphometry yielded the following measurements: length, 6.1 +/- 1.0 cm; width, 2.7 cm (range, 2.1 to 3.7); and thickness, 7 mm (range, 6.4 to 7.8). The thickness was 1.8 times that of the patellar tendon. Biomechanical testing showed that suture failure occurred at 692 +/- 181 N, and tendon failure occurred at 1075 +/- 449 N. The load to tendon failure was 1.36 times that of a comparable-width patellar tendon graft, although the difference was not statistically significant. The failure mode was primarily through partial or complete tendinous avulsion, with only one specimen failing at midsubstance. These findings show the central quadriceps graft is of sufficient size and strength to be used for anterior cruciate ligament reconstruction.

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