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Vipool K Goradia

Publications and source records attributed to Vipool K Goradia.

10 recordsLinked to original sources
PubMed2006

Factors associated with decreased muscle strength after anterior cruciate ligament reconstruction with hamstring tendon grafts.

PURPOSE: To identify factors associated with decreased muscle strength and activity after anterior cruciate ligament (ACL) reconstruction with semitendinosus-gracilis tendon (ST-G) grafts. TYPE OF STUDY: Retrospective review. METHODS: Eighty-five patients who underwent ACL reconstruction with ST-G grafts were evaluated at a mean of 44.4 months after surgery. Patients underwent isokinetic testing, physical examination, radiographs, instrumented laxity testing, and Lysholm, Cincinnati, and International Knee Documentation Committee (IKDC) ratings. Cartilage and meniscal pathology at surgery was reviewed. Strength group 1 (n = 30) showed greater than 20% deficits in strength; strength group 2 (n = 55) had less than 20% strength deficits. Activity group 1 (n = 60) maintained their IKDC activity level at final follow-up relative to preinjury level; activity group 2 (n = 25) decreased activity by 1 or more levels. RESULTS: With all patients combined, there was less than a 4% difference in mean hamstring and quadriceps strength between the reconstructed and contralateral legs at follow-up. Knee flexion deficits were associated with decreased hamstring strength. Subjective giving way and squatting/kneeling discomfort were associated with decreased quadriceps strength. Patients in strength group 1 were more likely to have squatting/kneeling discomfort and lower Cincinnati Function scores. Activity group 2 had a longer interval from injury to surgery and more chondromalacia at surgery. At follow-up, activity group 2 had lower subjective scores and was more likely to have pain, swelling, giving way, and flexion deficits. Activity group 2 also had greater deficits in quadriceps strength. CONCLUSIONS: Articular cartilage injury and meniscal pathology were not associated with decreased muscle strength. ACL reconstruction with ST-G grafts has a 38% incidence of squatting/kneeling pain that occurs secondary to patellofemoral crepitus, harvest site symptoms, and tibial hardware sensitivity. LEVEL OF EVIDENCE: Level IV, therapeutic, case series, no control group.

Anterior Cruciate Ligament↗
PubMed2006

Electronic medical records for the arthroscopic surgeon.

Electronic medical records (EMR) are being used increasingly in health care. Many of these have been developed for large hospitals and primary care physicians. As physicians recognize the potential benefits of increased office efficiency and improved patient care, smaller practices and specialist are beginning to evaluate EMRs. The purpose of this review is to discuss the various aspects of an EMR for the arthroscopic surgeon. Surgeons should carefully understand their specific needs and how various EMRs can meet those needs.

Arthroscopy↗
PubMed2005

Arthroscopic capsular plication-shift.

We describe a technique of arthroscopic capsular plication and shift used to address both anterior and posterior capsular laxity. This technique is used when the labrum is intact or if laxity persists after labral repair.

Arthroscopy↗
PubMed2005

In vitro analysis of rotator cuff repairs: a comparison of arthroscopically inserted tacks or anchors with open transosseous repairs.

PURPOSE: The purpose of this study was to employ a cyclic loading protocol to compare rotator cuff repair strengths of arthroscopically inserted cuff tacks and suture anchors with the traditional open transosseous suture repair. TYPE OF STUDY: In vitro cadaveric analysis. METHODS: Full-thickness 1 x 3-cm rotator cuff defects were created in 25 fresh-frozen cadaveric shoulders, and were randomized to 1 of 4 repair groups: (1) open repair with transosseous sutures, (2) arthroscopic repair with 2 singly loaded suture anchors, (3) arthroscopic repair with 2 doubly loaded suture anchors, and (4) arthroscopic repair with cuff tacks. All repairs were cyclically loaded from 10 to 180 N, and the numbers of cycles to 50% (5-mm gap) and 100% (10-mm gap) failure were recorded. RESULTS: The number of cycles to 100% failure was significantly higher for the arthroscopic doubly loaded suture anchor repairs when compared with the (1) open transosseous suture repair (P = .009), (2) arthroscopic cuff tack repair (P = .003), and (3) arthroscopic singly loaded suture anchor repair (P = .02). Additionally, the number of cycles to 50% failure was significantly higher for all anchors versus open or tack repair (P = .03 for both). CONCLUSIONS: Immediate postoperative fixation of rotator cuff repairs with doubly loaded suture anchors was more stable than that provided by the open transosseous suture repairs, arthroscopic singly loaded suture anchors, or cuff tacks. However, additional evaluation is needed to examine the effects on the sustained strength of the repair throughout the healing process. CLINICAL RELEVANCE: These in vitro results indicate that superior immediate postoperative fixation of rotator cuff repairs may be achieved with the doubly loaded suture anchors. However, additional evaluation is needed to examine the effects on the sustained strength of the repair throughout the healing process.

Absorbable Implants↗
PubMed2005

Anterior capsulorrhaphy: an in vitro comparison of volume reduction--arthroscopic plication versus open capsular shift.

PURPOSE: The purpose of this study was to objectively compare volume reduction after arthroscopic plication and open lateral capsular shift. TYPE OF STUDY: Experimental cadaver study. METHODS: Fifteen fresh-frozen human cadaver shoulders were assigned to 1 of 2 groups: arthroscopic plication (n = 7) or open lateral capsular shift (n = 8). Initial capsular volume was measured by repeated injection of a viscous fatty acid sulfate solution and recorded for each specimen. Repeated measurements were taken after the procedure to determine volume reduction. RESULTS: Both procedures resulted in reduction of capsular volume. The arthroscopic plication resulted in a 22.8% volume reduction and the open lateral capsular shift resulted in a 49.9% volume reduction. Comparison of the 2 procedures revealed significant volume reduction after open lateral capsular shift compared with arthroscopic plication (P = .00001). Repeated measurements confirmed that the injection technique was valid and reproducible. CONCLUSIONS: The lateral capsular shift resulted in significantly greater volume reduction compared with arthroscopic plication. Based on these results, we recommend an open lateral-based capsular shift for patients with multidirectional instability in which a larger capsular shift is required. However, additional plication sutures may allow for an even further reduction in volume. The amount of volume reduction required to eliminate instability still remains unknown for patients with shoulder instability caused by capsular laxity. LEVEL OF EVIDENCE: Level IV Case Series, in vitro anatomic comparison of 2 surgical procedures.

Adult↗
PubMed2004

The Tuckahoe knot: a secure locking slip knot.

We describe a simple and easy-to-tie knot that can slide and lock. The benefit of these characteristics is that when the knot is seated and locked, it is secure in that it will not slip before the 3 reversed half-hitches with alternating posts are placed.

Arthroscopy↗
PubMed2003

Arthroscopic management of calcific tendinitis of the popliteus tendon.

Calcific tendinitis is seen most commonly affecting the rotator cuff but has not been previously reported affecting the popliteus tendon. Symptoms mimic a tear of the posterior horn of the lateral meniscus. Arthroscopic debridement of the calcific deposit results in resolution of symptoms.

Arthroscopy↗
PubMed2002

Chronic lateral knee instability treated with a high tibial osteotomy.

Published studies have recommended correction of osseous alignment in patients with chronic deficiencies of multiple knee ligaments and varus angulation. However, similar treatment for isolated chronic lateral collateral ligament deficiency has not been reported. We report such a case treated successfully with a medial high tibial osteotomy using a dynamic external fixator.

Adult↗
PubMedDate not supplied

A biomechanical study of stability of the elbow to valgus stress before and after reconstruction of the medial collateral ligament.

The purpose of this study was to assess the stability of the elbow to valgus loads after reconstruction of the anterior bundle of the medial collateral ligament (MCL). The MCL in 14 human cadaveric elbows was exposed with a muscle-splitting approach. Each sample was secured in a materials test frame,5 N-m valgus moments were applied in 30 degrees, 60 degrees, 90 degrees, and 120 degrees of flexion, and baseline stability was measured. This sequence was performed after the anterior bundle was sectioned and again after ligamentous reconstruction was done with the Jobe technique. At 30 degrees, 60 degrees, 90 degrees, and 120 degrees of flexion, reconstruction reproduced an average of 99%, 102%, 97%, and 89%, respectively, of the stability of the intact ligament. The only significant difference between intact and reconstructed samples was at 120 degrees of flexion (P <.05). We concluded that this procedure reliably restores stability to a ruptured MCL throughout the flexion arc in the immediate postoperative period.

Aged↗