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Biomedical subjects

S W Casscells

Publications and source records attributed to S W Casscells.

14 recordsLinked to original sources
PubMed1986

Arthroscopic meniscus repair: a safe approach to the posterior horns.

Seventy arthroscopic meniscus repairs were performed using a technique that places posterior horn sutures through spinal needles from safe posterior corner punctures, thus avoiding injury to the posterior neurovascular structures. Follow-up averaged 18 months, with a range from 12 to 28 months. Associated anterior cruciate ligament instability (31%) was either stabilized surgically (13%) or braced postoperatively for pivoting activity (18%). Clinical results were excellent in 98.6% of patients, with only one second tear (1.5%) occurring 2 months postoperatively. Complications (2.8%) included one transient saphenous nerve irritation and one case of pyarthrosis. No major neurovascular complications occurred.

Adolescent↗
PubMed1979

The arthroscope in the diagnosis of disorders of the patellofemoral joint.

Despite our current knowledge and accumulated information, orthopedic surgeons often experience difficulties in the diagnosis of internal derangement of the knee. Too often, the admission diagnosis I.D.K. means "I don't know." Disorders of the patellofemoral joint contribute to this difficulty and may simulate torn menisci and loose bodies, as well as the instability which results from rotary displacement. Patients often have difficulty describing and locating their symptoms, and 2 or more pathologic lesions may be present in the same joint. Early lesions involving the articular cartilage are especially difficult to diagnose. Even the most astute clinician cannot rely entirely on his clinical judgement, and, at times, needs the assistance of other diagnostic measures. Arthroscopy is an invaluable aid in the diagnosis of all intra-articular pathology, permitting the proper incision in the proper area, often eliminating the necessity of opening the joint and always avoiding unnecessary meniscectomy.

Adult↗
PubMed1978

The torn or degenerated meniscus and its relationship to degeneration of the weight-bearing areas of the femur and tibia.

Data was collected on 300 cadaver knees dissected for the prime purpose of studying chondromalacia of the patella. Simultaneous observations were also made on the state of the meniscus and the articular cartilage in the tibio-femoral joint. The data did not seem to support the oft-repeated statement that the torn meniscus is the primary cause of unicompartmental osteoarthritis. Investigations were also carried out on 69 additional cadaver knees and 100 consecutive unselected arthroscoped knees in which there was damage either to the meniscus or the adjacent joint surfaces. In 60% of the combined series of cadaver and arthroscoped knees, the meniscal changes could not be correlated with the condition of the articular cartilage. In the remaining 40% in which there was coexisting pathology in the meniscus and the articular cartilage, a cause and effect relationship could not be established, but there was no evidence that a torn meniscus posed a significant threat to the articular cartilage.

Aged↗
PubMed1978

Gross pathological changes in the knee joint of the aged individual: a study of 300 cases.

The incidence of chondromalacia of the pattella and degenerative arthritis of the knee is based on conjectural rather than objective autopsy observations. The notion that chondromalacia is a disabling, troublesome and almost universal disease affecting most older individuals is chiefly derived from clinical impressions of physicians who treat arthritis plus a few reports of European authors published some 50 years ago. The present investigation of 300 cadaver knees, whose average age was 70 years, demonstrates a much lower incidence of degenerative lesions of the articular cartilage than might be expected. There was minimal or no damage to the patella in 62% of the cases and an even lower incidence of 23% in the weight-bearing areas of the joint. Eighty-two per cent of the menisci were essentially normal, as were 96% of the cruciates. In patients in the U.S.A., articular cartilage of the knee resists the wear and tear of a normal lifespan remarkably well and infrequently undergoes progressive degradation.

Aged↗
PubMedDate not supplied

Arthroscopic meniscal repair evaluated by second-look arthroscopy.

Of 353 arthroscopic peripheral meniscal repairs performed using the "outside to inside" suturing technique with rasp preparation of the tear region, 74 repairs (50 medial and 24 lateral) were assessed by second-look arthroscopy and are the basis of this report. Results were graded as either healed, incompletely healed, or failed; these findings were correlated with clinical symptoms and associated ACL deficiency. Overall, asymptomatic healing occurred in 84%, with 65% healed and 19% incompletely healed. The failure rate was 16%. All failures were symptomatic while all healed and incompletely healed menisci were asymptomatic. Failure was associated with ACL deficiency in all cases. No failures occurred in either an ACL uninjured knee or an ACL reconstructed knee. Failure was also associated with tear location in the posterior horn of the medial meniscus. Eleven of 12 failures (92%) involved posterior medial meniscal tears with only 1 failure located posterolaterally. Visual evidence of healing required a 4 month time interval.

Anterior Cruciate Ligament↗