Daniel Charles Wascher

There is no published data regarding the financial impact of training orthopaedic residents in the operating room. No comparisons between orthopaedic faculty and residents in regard to operative time and costs are known. One hundred eleven cases of anterior cruciate ligament reconstruction with or without partial meniscectomy were evaluated from 1996 to 1997. Fifty-three cases met the selection criteria of times, documentation and identification of the surgeon. Twenty-one cases were ...

CONTEXT: Isolated chondral and osteochondral defects of the knee are a difficult clinical challenge, particularly in younger patients for whom alternatives such as partial or total knee arthroplasty are rarely advised. Numerous surgical techniques have been developed to address focal cartilage defects. Cartilage treatment strategies are characterized as palliation (eg, chondroplasty and debridement), repair (eg, drilling and microfracture [MF]), or restoration (eg, autologous chondrocyte ...

PurposeThe need for a period of non-weight bearing after medial opening wedge high tibial osteotomy remains controversial. It is hypothesized that immediate weight bearing after medial opening wedge high tibial osteotomy would have no difference in functional scores at one year compared to delayed weight bearing.MethodsFifty patients, median age 54 years (range 40–65), with medial compartment osteoarthritis, underwent a medial opening wedge high tibial osteotomy utilizing a locking plate ...

OBJECTIVE: To evaluate bicruciate knee injuries and determine whether they should be treated as knee dislocations, especially with regard to vascular injuries.

DESIGN: Retrospective.

SETTING: University hospital, level 1 trauma center.

PATIENTS: Fifty patients admitted between 1987 and 1994 who had sustained knee dislocations or bicruciate ligament injuries.

MAIN OUTCOME MEASURES: Mechanism of injury, direction of dislocation, knee ligament injury pattern, presence or absence of ...

We reviewed the results in 13 patients who underwent simultaneous allograft reconstruction of both the anterior and posterior cruciate ligaments after a knee dislocation (nine acute and four chronic injuries). Seven patients sustained related medial collateral ligament injuries and six patients had posterolateral complex injuries. Ligament reconstructions were performed using fresh-frozen Achilles or patellar tendon allografts. At follow-up evaluation (mean of 38 months), only one ...

BACKGROUND: Iontophoresis ostensibly facilitates the delivery of medications through the skin to underlying tissues using a direct electrical current. Dexamethasone is the most commonly used medication with iontophoresis to treat a variety of connective tissue disorders.

HYPOTHESIS: Iontophoresis will facilitate the absorption of dexamethasone into connective tissue compared with diffusion.

STUDY DESIGN: Controlled laboratory study.

METHODS: Twenty-nine adults undergoing anterior ...

A high-velocity knee dislocation is a true orthopedic emergency. A high index of suspicion is necessary to identify reduced knee dislocations in multiple trauma patients. Coexisting injuries are common in patients with high-velocity knee dislocations. After an initial assessment, the knee joint should be reduced immediately and splinted. Popliteal artery injury is common in high-velocity dislocations. Arteriograms can be helpful but should not delay operative treatment of obvious ...

Background: Many studies have evaluated the management of knee dislocations (KDs) and multiligamentous knee injuries (MLKIs). However, no study to date has analyzed the quality of the most cited articles in this literature.

Hypothesis: There is a positive correlation between the number of article citations in the KD and MLKI literature and their methodologic quality.

Study Design: Systematic review.

Methods: The Web of Science online database was searched to identify the top 50 cited ...

Chronic extensor mechanism ruptures are uncommon but challenging clinical problems. Previously published procedures for treating chronic extensor mechanism ruptures assume an intact patella is available to anchor the repair. A case is presented of a patient who had a previous patellectomy, followed by rupture of the extensor mechanism. After two failed attempts at repair, an Achilles tendon allograft was used successfully to restore function of the extensor mechanism. The described ...

Background: Injury to the posterolateral corner (PLC) of the knee requires reconstruction to restore coronal and rotary stability. Two commonly used procedures are the Arciero reconstruction technique (ART) and the LaPrade reconstruction technique (LRT). To the authors' knowledge, these techniques have not been biomechanically compared against one another.

Purpose: To identify if one of these reconstruction techniques better restores stability to a PLC-deficient knee and if concomitant ...

BACKGROUND: Pain levels in patients with osteoarthritis (OA) of the knee are commonly assessed by using a numeric scoring system, but results may be influenced by factors other than the patient's actual physical discomfort or disease severity, including psychosocial and demographic variables. We examined the possible relation between knee-pain scores and several psychosocial, sociodemographic, disease, and treatment variables in 355 patients with knee OA.

METHODS: The pain-evaluation ...

Three cases of Staphylococcus epidermidis septic arthritis following inside-out arthroscopic meniscus repair within a 4-day period at the same facility are described. All three patients responded to surgical debridement and 4 to 6 weeks of intravenous antibiotics. In each instance, the meniscus and repair sutures were left intact; 12- to 38-month follow-up revealed no evidence of infection or meniscal symptoms. Epidemiological investigation implicated the meniscus repair cannulas as one ...

BACKGROUND: Treatment of traumatic knee dislocations remains controversial and challenging. Current techniques for PCL reconstruction utilize either a transtibial approach with potential risk of vascular injury from drilling toward the popliteal artery or a tibial inlay technique with prone patient positioning, which is cumbersome and adds operative time. We therefore developed a surgical technique using a supine posteromedial approach for PCL tibial inlay reconstruction for the ...

BACKGROUND: Traumatic knee dislocation is becoming more prevalent because of improved recognition and increased exposure to high-energy trauma, but long-term results are lacking.

PURPOSE: To present 2 cases with minimum 20-year follow-up and a review of the literature to illustrate some of the fundamental principles in the management of the dislocated knee.

STUDY DESIGN: Review and case reports.

METHODS: Two patients with knee dislocations who underwent multiligamentous knee ...