Orrin H Sherman, M.D.

MR Imaging Assessment of Articular Cartilage Repair Procedures
Chang, Gregory; Sherman, Orrin; Madelin, Guillaume; Recht, Michael; Regatte, Ravinder
2011 May;19(2):323-337, Magnetic resonance imaging clinics of North America
Because articular cartilage is avascular and has no intrinsic capacity to heal itself, physical damage to cartilage poses a serious clinical problem for orthopedic surgeons and rheumatologists. No medication exists to treat or reconstitute physical defects in articular cartilage, and pharmacotherapy is limited to pain control. Developments in the field of articular cartilage repair include microfracture, osteochondral autografting, osteochondral allografting, repair with synthetic resorbable plugs, and autologous chondrocyte implantation. MR imaging techniques have the potential to allow in vivo monitoring of the collagen and proteoglycan content of cartilage repair tissue and may provide useful additional metrics of cartilage repair tissue quality
— id: 134459, year: 2011, vol: 19, page: 323, stat: Journal Article,

Meniscal allograft transplantation
Hergan, David; Thut, David; Sherman, Orrin; Day, Michael S
2011 Jan;27(1):101-112, Arthroscopy
PURPOSE: Meniscal allograft transplantation (MAT) has become an accepted treatment option for patients undergoing meniscectomy with recalcitrant pain in the corresponding compartment. Whether MAT can oppose cartilage degeneration is unclear. Our purpose was to perform a systematic review of available literature to answer the following: (1) Does MAT prevent advancing chondrosis? (2) Who is the ideal candidate for MAT? (3) What is the survival time for allograft in a stable knee? (4) Can MAT be successful when performed with concomitant procedures? (5) Is there an outcome difference between medial and lateral meniscal allograft transplants? (6) What is the expected function of a knee that has undergone MAT? METHODS: Two authors performed a systematic review of the literature pertaining to MAT. Included in the review are studies with at least 2 years' follow-up, studies with validated outcome measures, and studies in which the allograft meniscal horns were secured with bony fixation. RESULTS: We identified 14 clinical articles that satisfied our inclusion and exclusion criteria. Thirteen of the articles provided Level IV evidence, and one article provided Level III evidence. CONCLUSIONS: MAT can result in alleviation of knee pain, improvement in knee function, and good patient satisfaction if performed in the optimal candidate. Improvements in both objective and subjective outcome measures were shown in relatively young patients without significant chondromalacia who underwent concomitant procedures for cartilage defects, limb malalignment, and/or knee instability. We detected no significant difference in outcomes when comparing medial and lateral meniscal allograft transplants. We detected no significant difference when comparing isolated MAT with MAT performed with concomitant procedures. LEVEL OF EVIDENCE: Level IV, systematic review of Level III and IV studies
— id: 116220, year: 2011, vol: 27, page: 101, stat: Journal Article,

Sternoclavicular joint reconstruction - a systematic review
Thut, David; Hergan, David; Dukas, Alex; Day, Michael; Sherman, Orrin H
2011 ;69(2):128-135, Bulletin of the NYU Hospital for Joint Diseases
Background: Dislocation of the sternoclavicular joint is a rare injury that has a low incidence of signifcant long-term symptoms. Surgical reconstruction of the joint is indicated in patients with symptomatic, chronic anterior instability or with irreducible or recurrent posterior instability. There have been many reported techniques for stabilization of the joint, but few investigators have reported more than several cases. The ideal reconstruction has not been identifed. Purpose: The purpose of this investigation was to perform a systematic review of the available literature with the objective of identifying one technique of sternoclavicular reconstruction that could be recommended. Methods: A systematic review of literature pertaining to treatment of sternoclavicular joint injuries was performed, focusing on clinical reports with at least six patients and 1 year of follow-up. We also reviewed biomechanical reports pertaining to sternoclavicular reconstruction. Results: Six clinical reports and two biomechanical studies were identifed that met our inclusion criteria. Treatments described in the clinical reports included conservative treatment with a sling, repair of the joint capsule with provisional stabilization, and joint reconstruction with local tissue or graft tissue. One biomechanical study compared the strength of three reconstruction techniques. Conclusion: Reconstruction with tendon tissue woven in a figure-of-eight pattern through drill holes in the manubrium and clavicle is stronger than reconstructions with local tissue. The review of clinical reports suggests excellent outcomes with this technique, and it is recommended in cases of chronic instability. In cases of acute instability requiring open reduction or inability to maintain a reduction in a posterior dislocation, there is evidence that repair of the joint capsule is suffcient surgical treatment
— id: 139914, year: 2011, vol: 69, page: 128, stat: Journal Article,

Distal biceps tendon injuries--current treatment options
Quach, Tony; Jazayeri, Reza; Sherman, Orrin H; Rosen, Jeffrey E
2010 ;68(2):103-111, Bulletin of the NYU Hospital for Joint Diseases
Three percent of all biceps tendon ruptures occur at the distal aspect, where the tendon inserts into the radial tuberosity. Distal bicep tendon ruptures typically occur in middle-aged males after an eccentric extension load is applied to the elbow. Patients usually complain of a sudden, sharp, and painful tearing sensation in the antecubital region, with a palpable defect. The biceps squeeze and hook tests are specific maneuvers by which to diagnose distal biceps ruptures on physical examination. Magnetic resonance imaging (MRI) or ultrasound maybe be helpful to distinguish between partial and complete tears. Anatomic studies suggest there are two distinct insertions for the short and long heads of the distal biceps. The short head may be a more powerful flexor, and the long head may be a more powerful supinator. Nonoperative treatment typically results in loss of flexion and supination strength and endurance. Early anatomic re-attachment is the goal. Surgical approaches include one- or two-incision techniques, and tendon fixation methods include the use of suture anchors, bone tunnels, an endobutton, or biotenodesis screws. Biomechanical studies have shown that endobuttons have higher load-to-failure strengths, compared to the other fixation methods. However, clinical studies have demonstrated that patients do well regardless of surgical approach or fixation method. Possible complications include nerve injuries, heterotopic ossification, postoperative fracture, tendon rerupture, complex regional pain syndrome, and wound infection. Partial ruptures are significantly less common and initially can be treated conservatively. Chronic tears are more difficult to treat because of possible tendon retraction and poor tissue quality. Tendon grafts using semitendinosus, fascia lata, hamstring, Achilles (calcaneal), or flexor carpi radialis have been successfully used for length restoration in these cases
— id: 111381, year: 2010, vol: 68, page: 103, stat: Journal Article,

Can the Bio-Transfx pin fail during initial ACL graft insertion?
Golant, Alexander; Strauss, Eric J; Khajavi, Kevin; Sherman, Orrin H; Rosen, Jeffrey E
2009 ;67(4):334-336, Bulletin of the NYU Hospital for Joint Diseases
BACKGROUND: The Bio-Transfix pin is a biodegradable device used for femoral tunnel anterior cruciate ligament (ACL) graft fixation. Recent clinical studies have suggested the possibility of the pin's postoperative failure. METHODS: This investigation evaluates the initial strength of several Bio-Transfix pin ACL fixations in a simulated femoral tunnel model. The forces generated by five surgeons during simulated ACL graft tensioning were also measured. RESULTS: Average strengths of the pins ranged from 1075 to 2160 N for 10 and 8 mm tunnels, respectively, whereas the maximum surgeon-generated forces were 535 N. CONCLUSIONS: These results imply that initial fracture of the pin itself is unlikely; however, failure of the supporting bone or a decrease in pin strength due to biodegradation could account for early loss of the fixation
— id: 105971, year: 2009, vol: 67, page: 334, stat: Journal Article,

Early fracture of a bioabsorbable tibial interference screw after ACL reconstruction with subsequent chondral injury
Hall, Michael P; Hergan, David M; Sherman, Orrin H
2009 Mar;32(3):208-208, Orthopedics (Thorofare NJ)
Graft fixation in anterior cruciate ligament (ACL) reconstruction is commonly performed with bioabsorbable devices. This article presents a case of a broken bioabsorbable tibial interference screw (Gentle Threads; Biomet, Warsaw, Indiana) that presented as an intra-articular loose body 4 months after ACL reconstruction with posterior tibialis tendon allograft. A 19-year-old man presented with symptoms of pain and catching for 1 week but reported no history of trauma. The broken screw tip was identified on magnetic resonance imaging examination, and the remaining screw appeared to be overinserted into the tibia. During arthroscopic removal, a 10-mm screw tip was found in the lateral gutter. The ACL graft was found to be well fixed, but small areas of chondral damage were found in the patellofemoral and medial compartment. The patient's symptoms resolved postoperatively. To our knowledge, this is the earliest report of a broken bioabsorbable interference screw and only the second report of subsequent chondral injury due to intra-articular migration. Although rare, late breakage and intra-articular migration of bioabsorbable interference screws should be considered during the postoperative evaluation of any patient with pain or mechanical symptoms, regardless of trauma. This case also supports the importance of both measurement of tibial tunnel length and inspection of the intercondylar notch following interference screw insertion. Orthopedic surgeons performing ACL reconstruction must be aware of this possible complication and its potential for devastating chondral injury
— id: 99138, year: 2009, vol: 32, page: 208, stat: Journal Article,

Risk of iatrogenic injury to the peroneal nerve during posterolateral femoral tunnel placement in double-bundle anterior cruciate ligament reconstruction
Hall, Michael P; Ryzewicz, Mark; Walsh, Pamela J; Sherman, Orrin H
2009 Jan;37(1):109-113, American journal of sports medicine
BACKGROUND: There has been concern for iatrogenic injury to the peroneal nerve with posterolateral femoral tunnel placement in double-bundle anterior cruciate ligament reconstruction. HYPOTHESIS: The common peroneal nerve and biceps tendon are at increased risk for injury by the guide wire as the knee is brought into increased extension. STUDY DESIGN: Controlled laboratory study. METHODS: An anatomical descriptive study was performed on 10 cadaveric knees (ages 49-67 years). After the native anterior cruciate ligament was removed arthroscopically, the posterolateral femoral tunnel starting point was identified using standardized measurements from the articular cartilage rim. With the use of a low-medial accessory portal and one cortical entry point, guide pins were inserted at 120 degrees, 90 degrees, and 70 degrees of knee flexion. The guide pins were kept in situ, and the lateral structures of the knee were dissected. The distance between guide pins and the common peroneal nerve, as well as the relationship to the biceps tendon, were analyzed. RESULTS: The common peroneal nerve was not directly injured during any guide pin insertion. The mean distance from the guide pin at 120 degrees of flexion was 44.3 mm (range, 36-53 mm), compared with 28.6 mm (range, 25-32 mm) at 90 degrees of flexion and 22.8 mm (range, 20-28 mm) at 70 degrees of flexion. The differences between all 3 groups were statistically significant (P<.0001). Guide pins inserted at 70 degrees of flexion were also noted to pierce the biceps femoris tendon in all cases. CONCLUSION AND CLINICAL RELEVANCE: During posterolateral femoral tunnel placement, the risk of injury to the common peroneal nerve is minimal but is increased as the knee is placed in less flexion. Guide pin placement at knee flexion of 120 degrees is recommended to ensure safety of the peroneal nerve and the biceps tendon
— id: 94696, year: 2009, vol: 37, page: 109, stat: Journal Article,

Treatment of medial collateral ligament injuries
Miyamoto, Ryan G; Bosco, Joseph A; Sherman, Orrin H
2009 Mar;17(3):152-161, Journal of the American Academy of Orthopaedic Surgeons
The medial collateral ligament is the most frequently injured ligament of the knee. The anatomy and biomechanical role of this ligament and the associated posteromedial structures of the knee continue to be explored. Prophylactic knee bracing has shown promise in preventing injury to the medial collateral ligament, although perhaps at the cost of functional performance. Most isolated injuries are treated nonsurgically. Recent studies have investigated ligament-healing variables, including modalities such as ultrasound and nonsteroidal anti-inflammatory drugs. Concomitant damage to the anterior or posterior cruciate ligaments is a common indication to surgically address the high-grade medial collateral ligament injury. The optimal treatment of multiligamentous knee injuries continues to evolve, and controversy exists surrounding the role of medial collateral ligament repair/reconstruction, with data supporting both conservative and surgical management
— id: 94694, year: 2009, vol: 17, page: 152, stat: Journal Article,

Patellofemoral instability
White, Brian J; Sherman, Orrin H
2009 ;67(1):22-29, Bulletin of the NYU Hospital for Joint Diseases
This review describes the normal patellofemoral joint and detail the mechanism and anatomic elements that predispose patients to patellar instability. The treatment options for both acute and chronic injuries are described and the rationale behind their approach to this problem is explained. In general, most acute dislocations should be treated nonoperatively unless the instability is associated with an osteochondral injury. Chronic dislocators should be treated based on an understanding of the patient's individual reason for recurrent instability. This is achieved with a thorough history, physical examination, and imaging studies. This information can help the clinician select the most appropriate proximal and or distal procedure
— id: 99282, year: 2009, vol: 67, page: 22, stat: Journal Article,

Effect of specialty and experience on the interpretation of knee MRI scans
Kim, Allis; Khoury, Lisa; Schweitzer, Mark; Jazrawi, Laith; Ishak, Charbel; Meislin, Robert; Kummer, Fred; Sherman, Orrin H
2008 ;66(4):272-275, Bulletin of the NYU Hospital for Joint Diseases
The purpose of this study was to evaluate any differences in the accuracy of knee MRI interpretation between radiology and orthopaedic surgery residents as well as to evaluate differences in quality of interpretation relative to resident training level. In this study, 20 MRI scans demonstrating specific pathology of the knee were identified. From one institution, two radiology residents and two orthopaedic surgery residents of each postgraduate year (PGY) of training (2 to 5) were recruited. Each resident was asked to interpret all the studies and choose up to 16 diagnoses for each scan from the list provided. Orthopaedic surgery residents showed improvement in overall accuracy and specificity with each year of additional training. Level of training did not correspond with increased sensitivity in the orthopaedic residents tested. Radiology residents did not demonstrate a consistent trend toward improved accuracy, sensitivity, or specificity with additional years of training. The only statistically significant differences in specificity observed between the two groups were seen in the readings of ACL tears, lateral femoral condyle chondromalacia, and chondromalacia patella. This study found that the accuracy of knee MRI interpretations between radiology and orthopaedic surgery residents did not demonstrate any differences. Level of training had no effect on the interpretation of the MRIs by radiology residents. Orthopaedic surgery residents did show an improvement with each year of additional training
— id: 94695, year: 2008, vol: 66, page: 272, stat: Journal Article,

Knee MR images: what the orthopaedic surgeon needs to know
Khoury, Lisa; Schweitzer, Mark; Sherman, Orrin
2007 Mar;11(1):73-82, Seminars in musculoskeletal radiology
Ideally, the orthopaedic surgeon works together with the radiologist in order to understand and contextualize the data obtained from a knee magnetic resonance imaging study. In this article we review the information most useful to the practice of orthopaedic surgery obtained from these MRI scans, including sections on ligaments, menisci, articular cartilage, limb alignment, bone, and surrounding soft tissues. We place special emphasis on evaluating the postoperative knee, ligament grafts, cartilage integrity, and other conditions that present challenges to both orthopaedic surgeons and radiologists
— id: 74302, year: 2007, vol: 11, page: 73, stat: Journal Article,

Patella instability
Minkowitz, Reuven; Inzerillo, Chris; Sherman, Orrin H
2007 ;65(4):280-293, Bulletin of the NYU Hospital for Joint Diseases
— id: 76147, year: 2007, vol: 65, page: 280, stat: Journal Article,

Operative treatment of acute Achilles tendon ruptures: an institutional review of clinical outcomes
Strauss, Eric J; Ishak, Charbel; Jazrawi, Laith; Sherman, Orrin; Rosen, Jeffrey
2007 Jul;38(7):832-838, Injury
PURPOSE: To retrospectively review the clinical outcome and incidence of post-operative complications after open end-to-end repair of acute Achilles tendon ruptures. METHODS: Seventy consecutive patients (74 open Achilles tendon repairs) operated on between 1989 and 2002 were identified for inclusion in this investigation. The medical records were reviewed and patients were contacted for a follow up interview in order to survey their post-operative function. Outcome scores were calculated based on the Boyden outcome and AOFAS ankle-hindfoot scoring systems. Post-operative complications were documented during the chart review and follow up interview, including an additional nine patients (nine repairs), who were not included in the clinical evaluation portion of the study. RESULTS: Fifty-two patients (54 repairs) were successfully contacted and completed the follow up interview. Within this cohort there were 44 males and 8 females with a mean age of 41 years. Achilles tendon rupture in this population was attributable to participation in athletic activity in 87% of cases. At a mean post-operative follow up of 45 months, 96% of cases achieved an overall Boyden outcome score of good to excellent. The mean AOFAS ankle-hindfoot score was 96, with 74% of cases scoring greater than 90. Forty-two cases (78%) reported no pain and 40 cases (74%) reported no activity limitations. Fourteen post-operative complications were identified after 83 open Achilles tendon repairs, resulting in an institutional complication rate of 16.8%. The complications included four superficial wound infections, five deep wound infections requiring irrigation and debridement, one heel ulcer secondary to post-operative boot wear, three partial Achilles tendon re-ruptures, and one complete Achilles tendon re-rupture. CONCLUSION: Our results demonstrate that open end-to-end repair of acute Achilles tendon ruptures provides long-term functional outcomes with consistent good to excellent results. However, this high clinical success rate was associated with a relatively high incidence of post-operative complications. With careful attention to the surgical wound and patient adherence to post-operative rehabilitation protocols, operative repair of acute Achilles tendon ruptures is a reliable treatment for active patients
— id: 74164, year: 2007, vol: 38, page: 832, stat: Journal Article,

Revision reconstruction of a pectoralis major tendon rupture using hamstring autograft: a case report
Schachter, Aaron K; White, Brian J; Namkoong, Suk; Sherman, Orrin
2006 Feb;34(2):295-298, American journal of sports medicine
— id: 63799, year: 2006, vol: 34, page: 295, stat: Journal Article,

Outcomes of meniscal repair: minimum of 2-year follow-up
Tuckman, David V; Bravman, Jonathan T; Lee, Susan S; Rosen, Jeffrey E; Sherman, Orrin H
2006 ;63(3-4):100-104, Bulletin (Hospital for Joint Diseases)
PURPOSE: The purpose of this study was to determine the success rate of meniscal repair achieved in our sports medicine practice, particularly with interest in characterizing the outcomes observed with the newer all-inside repair devices. TYPE OF STUDY: Retrospective chart review with telephone follow-up. METHODS: 157 patients that had undergone a meniscal repair procedure between 1996 and 2001 were identified. Twenty-four of these patients were lost to follow-up. Thus, the study group consisted of 133 patients providing a follow-up rate of 85%. All patients included had a minimum of two years of follow up. Failure was defined as the need for meniscectomy in the area of the meniscus that was initially repaired. The time interval from injury to surgery was divided into less than six weeks (acute) and greater than six weeks (chronic). The etiology of the meniscal tear was broken down into three categories; sports related trauma, non-sports trauma, and atraumatic. The repair techniques used in these patients included outside-in sutures, inside-out sutures, darts, arrows, meniscal screws, T-fix, FasT-fix, and the RapidLoc. RESULTS: The failure rate was 36%. No association was found between failure and the length of preoperative symptoms, rim width, etiology, concomitant meniscectomy, chondroplasty or anterior cruciate ligament (ACL) reconstruction. There was a higher rate of failure of tears in the medial versus lateral meniscus (20.3% vs. 44.8%). No statistical comparisons could be made between devices due to small sample sizes. CONCLUSIONS: The all-inside meniscal repair devices have simplified the meniscal repair procedure. This may have lead to a broadening of the indications for repair CLINICAL RELEVANCE: The newer generation meniscal repair devices, while simplifying the procedure, do not appear to lead to an increased clinical success rate
— id: 69064, year: 2006, vol: 63, page: 100, stat: Journal Article,

Enthesopathy on shoulder MRI: A potential secondary marker for rotator cuff disorders
Coen, AR; Schweitzer, ME; Rafii, M; Sherman, OH; Rokito, AS
2005 JUN 21 ;184(4):103-104, American journal of roentgenology
— id: 56260, year: 2005, vol: 184, page: 103, stat: Journal Article,

Anterior cruciate ligament radiofrequency thermal shrinkage: a short-term follow-up
Farng, Eugene; Hunt, Stephen A; Rose, Donald J; Sherman, Orrin H
2005 Sep;21(9):1027-1033, Arthroscopy
PURPOSE: To review the results of 34 patients who underwent radiofrequency thermal shrinkage (RFTS) for treatment of anterior cruciate ligament (ACL) laxity in the attenuated and partially torn ACL. TYPE OF STUDY: Retrospective cross-sectional survey performed at least 6 months after treatment. METHODS: Patients with recurrent instability after attenuation of ACL autografts and partially torn ACLs were treated with RFTS. Follow-up included subjective questionnaires (International Knee Documentation Committee [IKDC], Tegner, and Lysholm) and objective clinical tests (IKDC, KT-1000, pivot-shift, Lachman, single-leg hop). RESULTS: Mean follow-up was 21.4 months. Based on IKDC and subjective evaluation, 18 of 20 (90%) partially torn ACLs and 10 of 14 reconstructed ACLs (71%) treated with RTFS were judged to have good or excellent knee function (overall 82%). ACL laxity based on KT-1000 was less successful, with 15 of 20 (75%) partially torn ACLs and 8 of 12 (66%) reconstructed ACLs considered successful. CONCLUSIONS: With no major complications in this study, we conclude that RFTS for treatment of ACL laxity is a well-tolerated procedure with success rates around 71% to 90% in selected patients. RFTS may be offered as a less-extensive alternative to patients being considered for ACL reconstruction who have either attenuated or partially torn ligaments, especially in the athletically low-demand population. LEVEL OF EVIDENCE: Level IV, case series
— id: 63816, year: 2005, vol: 21, page: 1027, stat: Journal Article,

A double-blind prospective comparison of rofecoxib vs ketorolac in reducing postoperative pain after arthroscopic knee surgery
Kim, Jung T; Sherman, Orrin; Cuff, Germaine; Leibovits, Allen; Wajda, Michael; Bekker, Alex Y
2005 Sep;17(6):439-443, Journal of clinical anesthesia
STUDY OBJECTIVE: The aim of this study was to compare the analgesic efficacy of premedication with rofecoxib vs intravenous (IV) ketorolac in reducing postoperative pain after arthroscopic knee surgery. STUDY DESIGN: This is a prospective, randomized, double-blinded study. SETTING: This study was set at a university hospital. SUBJECTS: The subjects include 54 patients with American Society of Anesthesiologists physical statuses I, II, and III undergoing knee arthroscopy. INTERVENTIONS: Group 1 received 50 mg oral rofecoxib preoperatively with IV placebo injection, which was administered 20 minutes before the end of the operation. Group 2 received a preoperative placebo and 30 mg IV ketorolac 20 minutes before the end of surgery. MEASUREMENTS: The primary outcome measure was the proportion of patients reporting pain in the postoperative anesthesia care unit, 6 hours and 24 hours after discharge. Additional end points included the use of 5:325 mg oxycodone-acetaminophen (O/A) tablets, pain scores, patient's satisfaction survey, and comparison of side effects. Data were analyzed using independent samples t tests for continuous variables or chi2 tests for categorical variables. P < .05 was considered significant. RESULTS: The 2 groups were comparable with regard to patient characteristics, intraoperative medication use, and duration of surgery. There was no difference either in pain scores or O/A use in the postoperative anesthesia care unit. At 24 hours after discharge, significantly more patients in the ketorolac group (91%) reported pain than the rofecoxib group (63%) (P = .02). Sixty-one percent of patients in the ketorolac group used O/A during the first 24 hours vs 38% in the rofecoxib group. The difference, however, was not statistically significant. CONCLUSION: Preoperative rofecoxib is as effective as ketorolac for the treatment of pain after knee arthroscopy. Higher frequency of pain reporting at 24 hours by patients in ketorolac group is explained by the longer analgesic effect of rofecoxib. Future studies should directly compare gastrointestinal injury of these drugs, as well as cost-effectiveness of rofecoxib vs ketorolac
— id: 58974, year: 2005, vol: 17, page: 439, stat: Journal Article,

Diffuse FDG shoulder uptake on PET is associated with clinical findings of osteoarthritis
Wandler, Eric; Kramer, Elissa L; Sherman, Orrin; Babb, James; Scarola, Jean; Rafii, Mahvash
2005 Sep;185(3):797-803, American journal of roentgenology
OBJECTIVE: Our objective was to examine the degree and pattern of (18)F-FDG uptake within the shoulder as a potential marker of joint inflammation or injury. SUBJECTS AND METHODS: Twenty-four patients undergoing (18)F-FDG PET for clinical oncologic assessment completed questionnaires regarding history of shoulder disease, trauma, pain, and/or functional impairment. Thorough physical examination of the shoulder was performed. A clinical diagnosis of specific shoulder derangement or normal was established for each patient. PET scans were evaluated blindly by a nuclear medicine physician and a musculoskeletal radiologist qualitatively for location, distribution, and intensity of shoulder uptake. Standardized uptake values (SUV) were measured. RESULTS: Twenty-one patients had shoulder PET findings. Fourteen had clinical findings consistent with a specific diagnosis in the PET-positive shoulder. The remaining seven PET-positive patients were clinically normal. Three recognizable patterns of uptake were appreciable. Eight of 10 patients with diffuse uptake had findings of osteoarthritis (n = 7) or bursitis (n = 1). Two of four patients with focal greater tuberosity uptake had findings of rotator cuff injury. Two of four patients with focal glenoid uptake had findings of frozen shoulder. SUV showed a positive correlation with subject age (p < 0.01), but no association with clinical findings was identified. CONCLUSION: The pattern of FDG uptake within the shoulder may point to specific clinical entities. While focal uptake is less reliably related to clinical findings, diffuse uptake is associated with signs and symptoms of osteoarthritis or bursitis
— id: 58893, year: 2005, vol: 185, page: 797, stat: Journal Article,

Accuracy of non-contrast MRI for diagnosis of SLAP lesions
Bhandarkar, P; Rafii, M; Moore, S; Sherman, O; Rokito, A
2004 APR ;182(4):57-57, American journal of roentgenology
— id: 46654, year: 2004, vol: 182, page: 57, stat: Journal Article,

Meniscal repair devices: a clinical and biomechanical literature review
Farng, Eugene; Sherman, Orrin
2004 Apr;20(3):273-286, Arthroscopy
PURPOSE: The development of new approaches to arthroscopic meniscal repair has spurred the concomitant publication of studies reviewing their use and biomechanical properties. The purpose of this article is to review both the devices and the literature surrounding their clinical and biomechanical properties. TYPE OF STUDY: Literature review. METHODS: Studies were initially gathered using a MEDLINE search, and additional information was found through cross references. We evaluate a series of studies comparing sutures, suture anchors, screws, staples, and a variety of other devices in terms of initial fixation strength, degradation profile, performance under cyclical loading, and clinical success. RESULTS: In the traditional suture studies, vertical sutures are clearly superior to both horizontal sutures and knot-end techniques in terms of initial fixation strength and performance under cyclical loading. Unfortunately, multidevice studies have been less consistent and less conclusive. the Linvatec Biostinger, Smith & Nephew T-fix, and Bionx Meniscus Arrow have separately been shown to have superior initial fixation strength on par with suture techniques. After cyclical loading, horizontal sutures, vertical sutures, 16-mm Arrows, 13-mm Arrows, and the Smith & Nephew T-fix generally show higher fixation strengths. Only the Bionx Arrow, Linvatec Biostinger, and Clearfix Screw have been shown to retain their initial fixation strengths through four months of hydrolysis time. CONCLUSIONS: Data suggest that the biomechanical performance of some devices is nearly equivalent to current suture techniques. Ultimately, the combination of a simplified surgical technique, high clinical healing rates (75%-92%), and relatively minor complications makes these devices attractive for properly indicated meniscal tears
— id: 46177, year: 2004, vol: 20, page: 273, stat: Journal Article,

Anterior cruciate ligament reconstruction: which graft is best?
Sherman, Orrin H; Banffy, Michael B
2004 Nov;20(9):974-980, Arthroscopy
Abstract For the last 4 decades, since the initial use of the patellar tendon for anterior cruciate ligament (ACL) reconstruction, there has been controversy regarding the ideal graft choice for this procedure. Beside bone-patellar tendon-bone autografts, several other graft choices have become popular, including hamstring tendon and a variety of allografts. Within the past 5 years, several randomized and nonrandomized studies have compared the graft choices in ACL reconstruction. However, the question still remains: Is there an ideal graft for ACL reconstruction? The purpose of this review is to assess the most recent data, identifying if there truly is an ideal graft choice
— id: 56158, year: 2004, vol: 20, page: 974, stat: Journal Article,

Arthroscopic treatment of osteochondral lesions of the talus with correlation of outcome scoring systems
Hunt, Stephen A; Sherman, Orrin
2003 Apr;19(4):360-367, Arthroscopy
PURPOSE: The goal of this study was to perform a retrospective review of arthroscopically treated osteochondral lesions of the talus (OCLTs) to determine their outcome and to analyze the correlation of 3 subjective outcome scoring systems for the ankle. METHODS: Between 1985 and 1999, 37 arthroscopic debridement or subchondral drilling procedures were performed on 33 ankles to treat OCLTs. The charts of these patients were reviewed for general demographic, preoperative, surgical, and postoperative information. Patients were sent a questionnaire that included 3 subjective outcome scoring systems: the Martin Score questionnaire; the Berndt and Harty scale; and the Single Assessment Numeric Evaluation (SANE) question. Twenty-eight people responded to the questionnaire. Twenty-four patients reported a history of trauma. There were 17 lesions on the medial aspect of the talus, 10 laterally, and 1 centrally. The lesions were classified according to their arthroscopic appearance. There were 7 stage I, 2 stage II, 10 stage III, and 9 stage IV lesions. After all data were analyzed, the Pearson product-moment correlation coefficient (r) and correlation of determination (r2) were performed among the 3 outcome scales. RESULTS: The mean follow-up time was 66 months (range, 6-169 months). Outcome results varied according to the scoring system. Using the Berndt and Harty scale, 13 (46%) patients had good, 13 (46%) fair, and 2 (8%) poor results. According to the Martin Score, 1 patient (4%) had excellent, 10 (35%) good, 9 (32%) fair, and 8 (29%) had poor results. According to the SANE score, 5 patients (18%) had excellent, 8 (29%) good, 9 (32%) fair, and 6 (21%) had poor results. Seventeen patients reported some form of pain at follow-up examination. Analysis of variables, including age at operation, stage of the lesion, length of follow-up, and previous surgery revealed no statistical significance. All 3 scales showed positive correlations. Based on these outcome data, the Berndt and Harty scale showed good correlation with both the SANE and the Martin outcome systems (r =.81 and r =.69, respectively). The Martin Score showed moderate correlation with the SANE outcome system (r =.57). CONCLUSIONS: The outcome results for our patient population were not as successful as has been previously reported. Our analysis showed positive correlation among the 3 subjective outcome systems. However, it remains difficult to compare these data with previous results secondary to the variety of outcome measures employed by previous reports in the literature
— id: 42669, year: 2003, vol: 19, page: 360, stat: Journal Article,

Arthroscopic management of osteoarthritis of the knee
Jazrawi, Laith; Sherman, Orrin; Hunt, Steve
2003 Jul-Aug;11(4):290-290, Journal of the American Academy of Orthopaedic Surgeons
— id: 63817, year: 2003, vol: 11, page: 290, stat: Journal Article,

Arthroscopic management of osteoarthritis of the knee
Hunt, Stephen A; Jazrawi, Laith M; Sherman, Orrin H
2002 Sep-Oct;10(5):356-363, Journal of the American Academy of Orthopaedic Surgeons
Recent advances in instrumentation and a growing understanding of the pathophysiology of osteoarthritis have led to increased use of arthroscopy for the management of degenerative arthritis of the knee. Techniques include lavage and debridement, abrasion arthroplasty, subchondral penetration procedures (drilling and microfracture), and laser/thermal chondroplasty. In most patients, short-term symptomatic relief can be expected with arthroscopic lavage and debridement. Greater symptomatic relief and more persistent pain relief can be achieved in patients who have acute onset of pain, mechanical disturbances from cartilage or meniscal fragments, normal lower extremity alignment, and minimal radiographic evidence of degenerative disease. Arthroscopic chondroplasty techniques provide unpredictable results. Concerns include the durability of the fibrocartilage repair tissue in subchondral penetration procedures and thermal damage to subchondral bone and adjacent normal articular cartilage in laser/thermal chondroplasty. Although recent prospective, randomized, double-blinded studies have demonstrated that outcomes after arthroscopic lavage or debridement were no better than placebo procedure for knee osteoarthritis, controversy still exists. With proper selection, patients with early degenerative arthritis and mechanical symptoms of locking or catching can benefit from arthroscopic surgery
— id: 32638, year: 2002, vol: 10, page: 356, stat: Journal Article,

Thermal treatment of anterior cruciate ligament injury and laxity with its imaging characteristics
Khan, A Shabi; Sherman, Orrin H; DeLay, Brian
2002 Oct;21(4):701-11, ix, Clinics in sports medicine
The use of radiofrequency or laser to treat lax anterior cruciate ligaments is at its infancy. The imaging results of such treated ligaments using MRI are undocumented in the literature. This article reviews the basic science behind thermal treatment of ligaments and previously published and unpublished data on this therapy and its imaging implications
— id: 63818, year: 2002, vol: 21, page: 701, stat: Journal Article,

Thermal energy - Preface
Sherman, OH
2002 OCT ;21(4):XV-XV, Clinics in sports medicine
— id: 33284, year: 2002, vol: 21, page: XV, stat: Journal Article,

The incidence and outcome of patella fractures after anterior cruciate ligament reconstruction
Stein, Drew A; Hunt, Stephen A; Rosen, Jeffrey E; Sherman, Orrin H
2002 Jul-Aug;18(6):578-583, Arthroscopy
PURPOSE: The study was performed to determine the incidence and eventual outcome of patella fractures after anterior cruciate ligament (ACL) reconstructions using bone-patella tendon-bone autograft. TYPE OF STUDY: Retrospective review. METHODS: Between 1989 to 1999, 618 consecutive primary, single-incision bone-patella tendon-bone autograft ACL reconstructive procedures were performed by 3 surgeons at our institution. Of this group, 8 (1.3%) had postoperative patella fracture of the donor knee. The charts of these patients were retrospectively reviewed, and patients were followed with physical examination and outcome questionnaires. RESULTS: The patella fractures occurred at a mean of 57 days after the ACL reconstruction (range, 24-121 days). Five patients sustained indirect trauma, whereas 3 experienced direct trauma. Three patients had nondisplaced transverse fractures treated nonoperatively. Five patients had displaced fractures (3 transverse and 2 Y-shaped) requiring surgical intervention. All 8 patients have full flexion when compared with their opposite knee. Two patients did not regain 5 degrees of hyperextension but were not symptomatic. The mean length of follow-up for the questionnaire was 4 years (range, 1.5 to 6.5 years). The mean score on the Lysholm knee questionnaire was 89.6 (range, 77-98). The mean Single Assessment Numeric Evaluation score was 85.8 (range, 50-100). CONCLUSIONS: Most cases of postoperative patella fractures, in our experience, have caused minor changes postoperatively and no differences in the outcome of these patients. Seventy-five percent of our patients had excellent or good Lysholm scores. This study confirms previous reports in the literature that observed minimal residual sequelae from postoperative patella fractures after ACL reconstruction with bone-patella tendon-bone autograft
— id: 32332, year: 2002, vol: 18, page: 578, stat: Journal Article,

Histologic analysis of radiofrequency energy chondroplasty
Yetkinler, Duran N; Greenleaf, John E; Sherman, Orrin H
2002 Oct;21(4):649-61, viii, Clinics in sports medicine
Two types of radiofrequency energy are currently used for chondroplasty: thermal and ablative. The primary mode of operation for monopolar radiofrequency energy is thermal, whereas the primary mode for bipolar radiofrequency energy is ablation. The safety of radiofrequency energy in articular cartilage is investigated because these treatment modalities can result in injury of target and surrounding tissues. Histologic analysis is used to assess this degree of damages and the efficacy of these techniques, but the accuracy and relevance of the results are affected by the design and duration of the analysis. A review of recent studies using different methods of histologic analysis of articular cartilage subject to radiofrequency energy techniques is presented
— id: 63819, year: 2002, vol: 21, page: 649, stat: Journal Article,

Thermal capsular shrinkage: Basic science and clinical applications
Medvecky, MJ; Ong, BC; Rokito, AS; Sherman, OH
2001 JUL-AUG ;17(6):624-635, Arthroscopy
Recently, the use of thermal energy to shrink the redundant glenohumeral joint capsule in patients with instability has generated a great deal of interest. Proponents assert that the procedure avoids the need for an open stabilization and it may be used as an adjunct to an open or arthroscopic capsulolabral repair. The use of nonablative thermal energy to shrink soft-tissue collagen appears to induce ultra-structural and mechanical changes at or above 60 degreesC. The microscopic changes reflect the unwinding of the collagen triple helix and loss of the fiber orientation. The fibrils contract into a shortened state and reactive fibroblasts have been shown to grow into this treated area and synthesize the collagen matrix. The biomechanical properties of the tissue do not appear to be detrimentally altered if shrinkage is limited to less than 15% and if ablation or excess focal treatment is avoided. The endpoint of optimal shrinkage is not known and clinical estimations of tissue changes and volumetric reduction are used as guides to treatment. The first clinical follow-up study was only recently published in the peer-reviewed literature and prior preliminary reports were optimistic regarding the use of thermal energy for the treatment of glenohumeral instability. Thermal capsular shrinkage has been used as an adjunct to a capsulolabral repair, as well as an isolated treatment for the disorders of internal impingement and multidirectional instability. Additional evaluation is necessary to determine the optimal quantity of energy needed for tissue shrinkage without inadvertent tissue destruction. The long-term clinical effect, mechanical propel-ties, and durability of the newly produced collagen need to be analyzed further. The basic science and clinical applications of this newly applied technology are reviewed in this article
— id: 55016, year: 2001, vol: 17, page: 624, stat: Journal Article,

Practical considerations in anterior cruciate ligament replacement surgery
Fineberg, MS; Zarins, B; Sherman, OH
2000 OCT ;16(7):715-724, Arthroscopy
The endoscopic method of anterior cruciate ligament (ACL) reconstruction using a patellar tendon graft that is secured with interference screws is a commonly performed procedure. It has many potential pitfalls, the majority of which are secondary to technical errors. Prevention of errors starts with a full knowledge of normal ACL anatomy and any discrepancies with the size and shape of the graft substitute. Accurate tibial and femoral tunnel placement is essential and involves using consistent intra-articular landmarks and achieving specific radiographic criteria. Accurate tunnel placement minimizes graft excursion and impingement against the roof of the intercondylar notch. This will result in maximum knee stability and motion. Much has been written about the principles of graft-tunnel mismatch and interference screw-bone plug divergence. The clinical implications of these potential sources of error remain somewhat controversial and are discussed in this article
— id: 54509, year: 2000, vol: 16, page: 715, stat: Journal Article,

Acute patellar tendon rupture: A new surgical technique
Ong BC; Sherman O
2000 Nov;16(8):869-870, Arthroscopy
The most common method used in the treatment of acute patellar tendon ruptures is primary end-to-end repair. The use of the Acufex ACL guide (Acufex Microsurgical, Mansfield, MA) provides efficient and accurate placement of transosseous drill holes in the patella and minimizes the risk, tourniquet time, and surgical time of acute patellar tendon repairs
— id: 26836, year: 2000, vol: 16, page: 869, stat: Journal Article,

MR imaging of impingement and rotator cuff disorders. A surgical perspective
Sherman OH
1997 Nov;5(4):721-734, Magnetic resonance imaging clinics of North America
The role of MR imaging in the diagnosis of impingement and rotator cuff disorders is expanding greatly. This article discusses the clinically pertinent history, physical examination, and surgical treatment of rotator cuff problems. A rationale for consideration of open, 'mini-open,' and arthroscopic surgical intervention is proposed. The utilization of MR imaging by the orthopedic surgeon for nonoperative, preoperative, and postoperative decision-making are presented. A close working relationship between the radiologist and the orthopedist is emphasized
— id: 56992, year: 1997, vol: 5, page: 721, stat: Journal Article,

Patellar tendon length after anterior cruciate ligament reconstruction.A prospective study
Krosser BI; Bonamo JJ; Sherman OH
1996 Fall;9(4):158-160, American journal of knee surgery
Shortening of the patellar tendon after anterior cruciate ligament (ACL) reconstruction has been implicated as a cause of postoperative complications such as anterior knee pain, patella infera syndrome, and traumatic patellar tendon rupture. This prospective study was designed to asses whether closure of the patellar tendon defect during ACL reconstruction with mid-third bone-patellar tendon-bone autograft leads to radiographic evidence of patellar tendon shortening. One hundred fourteen patients underwent arthroscopically assisted ACL reconstruction using mid-third bone-patellar tendon-bone autograft. Group I (59 patients) had the patellar tendon defect left open. Group II (55 patients) had the defect sutured closed. The paratenon was approximated in all patients. Lateral knee radiographs were taken pre- and post-operatively. The pre- and postoperative patellar tendon lengths were measured and compared. Group I (defect left open) showed virtually no patellar tendon shortening (average 0.3%). Group II (defect closed) showed minimal but slightly more shortening (average: 0.51%). The maximum shortening was 2.3% in Group I and 4.3% in Group II. Therefore, closure of the patellar tendon defect does not significantly alter the length of the patellar tendon after ACL reconstruction
— id: 12672, year: 1996, vol: 9, page: 158, stat: Journal Article,

A historical perspective on meniscal repair
Petrosini AV; Sherman OH
1996 Jul;15(3):445-453, Clinics in sports medicine
The treatment of meniscal injuries has changed drastically over the past 50 years. This evolution has been fueled by research on the natural history, basic science, and biomechanics of meniscal injury and by the advent of arthroscopy. This article presents a brief overview of these developments
— id: 12588, year: 1996, vol: 15, page: 445, stat: Journal Article,

Meniscal repair - Preface
Sherman, OH
1996 JUL ;15(3):R11-R11, Clinics in sports medicine
— id: 52870, year: 1996, vol: 15, page: R11, stat: Journal Article,

Meniscal repair
Sherman, Orrin H
Phildelphia : W.B. Saunders, 1996,
— id: 604, year: 1996, vol: , page: , stat: ,

Complications of arthroscopic meniscal repair
Austin KS; Sherman OH
1993 Nov-Dec;21(6):864-868, American journal of sports medicine
The results of 101 consecutive arthroscopic meniscal repairs were studied to determine the nature and frequency of associated complications. All arthroscopic repairs were done by the senior author (OS) between November 1984 and June 1991. Our data include 65 patients with associated anterior cruciate ligament injuries, of which 49 underwent concurrent arthroscopic anterior cruciate ligament reconstruction. There was an overall complication rate of 18%. There was a 20% risk of complication with meniscal repair when associated with anterior cruciate ligament injury and 14% without anterior cruciate ligament injury. There was a 10% incidence of arthrofibrosis when meniscal repair was performed with anterior cruciate ligament reconstruction and a 6% incidence when performed in an anterior cruciate ligament-deficient, non-reconstructed knee. Overall, there was a 13% risk of complication with lateral repairs compared with 19% with medial repairs. In the subset of patients with intact anterior cruciate ligaments and isolated meniscal lesions, there were no complications associated with lateral repair and an 18% risk of complication with medial repair. Female patients demonstrated a higher likelihood of complication (29%) than male patients (13%). Excluding repair failures, there was an 8% reoperation or rehospitalization rate
— id: 13055, year: 1993, vol: 21, page: 864, stat: Journal Article,

Fracture of the supracondylar femur after anterior cruciate ligament reconstruction using patellar tendon and iliotibial band tenodesis. A case report
Noah J; Sherman OH; Roberts C
1992 Sep-Oct;20(5):615-618, American journal of sports medicine
— id: 13454, year: 1992, vol: 20, page: 615, stat: Journal Article,

Ankle reconstruction for malunion by fibular osteotomy and lengthening with direct control of the distal fragment: a report of three cases and review of the literature
Roberts C; Sherman O; Bauer D; Lusskin R
1992 Jan;13(1):7-13, Foot & ankle
Malunion of ankle fractures will lead to severe osteoarthritis when the architecture and mechanics of the talocrural joint are deranged. When fibular shortening is present, ankle reconstruction can be achieved by fibular lengthening and can provide an alternative to early arthrodesis for deformity and pain. Acceptable clinical and radiographic results can be achieved, provided that accurate reconstruction is achieved and intra-articular osteochondral injury is minimal. Restoration of fibular length, necessary for a good clinical result, can be estimated radiographically by the bimalleolar angle. We report three cases of ankle reconstruction by fibular lengthening with an average follow-up of 33 months
— id: 13748, year: 1992, vol: 13, page: 7, stat: Journal Article,

Arthroscopic surgery
Minkoff, Jeffrey; Sherman, Orrin H
Baltimore : Williams & Wilkins, c1990,
— id: 246, year: 1990, vol: , page: , stat: ,

Rotator cuff lesions: signal patterns at MR imaging
Rafii M; Firooznia H; Sherman O; Minkoff J; Weinreb J; Golimbu C; Gidumal R; Schinella R; Zaslav K
1990 Dec;177(3):817-823, Radiology
The signal intensity patterns of rotator cuff lesions at magnetic resonance (MR) imaging were evaluated in 80 patients who had surgical correlation and in 13 asymptomatic individuals (14 shoulders). Six cadaver shoulders were examined with MR, and histologic correlation was obtained in four. All studies were performed at 1.5 T with a flexible circular surface coil. The accuracy of MR imaging in detection of full-thickness cuff tears (31 patients) was 0.95 and of partial thickness tears (16 patients), 0.84. The most common and accurate pattern for full-thickness cuff tears (22 of 31 tears) was a region of intense signal seen on T2-weighted images. Less often the torn region consisted of an extremely degenerated and attenuated tendon with moderate signal intensity or was obscured by low-signal-intensity scar. The intense signal pattern on T2-weighted images was also accurate, although a less common finding (seven of 16 cases), in the diagnosis of partial tears. Tendinitis was recognized as focal or diffuse regions of increased signal intensity or a nonhomogeneous pattern of increased signal often associated with tendinous enlargement. In some patients, manifestations of subacromial-subdeltoid bursitis was present. Tendon degeneration was also manifested as regions of increased signal intensity. Some similarity and overlap of signal patterns of partial interstitial tears, tendinitis, and tendon degeneration are observed
— id: 14257, year: 1990, vol: 177, page: 817, stat: Journal Article,

Computed tomography (CT) arthrography of shoulder instabilities in athletes
Rafii M; Minkoff J; Bonamo J; Firooznia H; Jaffe L; Golimbu C; Sherman O
1988 Jul-Aug;16(4):352-361, American journal of sports medicine
Sixty professional and recreational athletes underwent CT arthrography of the shoulder for evaluation of suspected shoulder joint derangement. These athletes, 46 males and 14 females ranging in age from 15 to 60 years (mean, 32 years), all had persistent pain that interfered with their sports activity and was resistant to conservative treatment. Seventeen patients had shoulder instability based on clinical manifestations and CT arthrographic findings. An additional five patients, also based on clinical manifestations and CT arthrographic findings, were considered to have an unobtrusive degree of anterior joint laxity. Patients with anterior instability (20 cases) all had an anteroinferior tear or detachment of the glenoid labrum, as well as some violation of the insertion of the joint capsule onto the scapula. Those with posterior instability (two cases) had a combination of labral and capsular tears. Two other major patterns of labral tears, both unaffiliated with shoulder instability, were identified. These included total or partial detachment of superior segments of the labrum, and anterior labral tears at the midglenoid level. Moreover, various degrees of labral attenuation (or, less often, enlargement), osteophyte formation, and alterations in articular cartilage were observed. Surgical correlation was obtained in 25 patients, with 95% accuracy of CT arthrographic findings. CT arthrography is a minimally invasive and highly accurate technique for investigation of glenohumeral derangement. Specifically, the extent of pathologic changes associated with instability can be determined and differentiated from other intraarticular causes of incapacity, such as labral tears caused by throwing, or degenerative changes
— id: 11046, year: 1988, vol: 16, page: 352, stat: Journal Article,

Posterior fracture dislocation of the shoulder with biceps tendon interposition
Goldman A; Sherman O; Price A; Minkoff J
1987 Sep;27(9):1083-1086, Journal of trauma
Posterior dislocation of the shoulder, a rare injury, results from direct trauma, indirect trauma, or via a seizure or electrical shock. We present a case with a posterior fracture dislocation of the shoulder secondary to a seizure in which interposition of the biceps tendon precluded closed reduction. The fractured lesser tuberosity fragment included the bicipital groove, allowing the biceps tendon to sublux posteriorly preventing closed reduction, thus requiring a subsequent open reduction
— id: 11373, year: 1987, vol: 27, page: 1083, stat: Journal Article,

CONSIDERATIONS PURSUANT TO THE REHABILITATION OF THE ANTERIOR CRUCIATE INJURED KNEE
Minkoff, J; Sherman, OH
1987 Jun;15(6):297-349, Exercise & sport sciences reviews
— id: 31169, year: 1987, vol: 15, page: 297, stat: Journal Article,

Arthroscopy
Minkoff, Jeffrey; Sherman, Orrin H.; Kizer, Kenneth W
Philadelphia : Saunders, 1987,
— id: 362, year: 1987, vol: , page: , stat: ,

The perioperative management of the arthroscopic patient
Sherman OH
1987 Jul;6(3):491-502, Clinics in sports medicine
This article has described the perioperative management of the arthroscopic patient. As emphasized, preoperative planning requires a precise diagnosis, patient education, and selective procedures. The operative management is sophisticated, exacting, and challenging, as discussed in other articles of this issue. Finally, the postoperative management is specifically directed toward pathology and procedure. Recovery times are variable, and complications are not insignificant and can lead to prolonged patient morbidity and financial loss. It is important to consider patient goals versus reality, patient willingness to opt for acceptable versus optimal results, and if the procedure is necessary versus justified versus contraindicated. If all of these factors are kept in mind by the surgeon and conveyed to the patient, arthroscopic surgery can be extremely rewarding to both
— id: 11390, year: 1987, vol: 6, page: 491, stat: Journal Article,

PERONEAL NERVE COMPRESSION SECONDARY TO POSTERIOR OSTEOPHYTE
Sherman, O; Testa, NN; Klein, MJ
1983 ;6(10):1317-1319, Orthopedics (Thorofare NJ)
— id: 30614, year: 1983, vol: 6, page: 1317, stat: Journal Article,