Dr. Jason  Zemanovic  Md image

Dr. Jason Zemanovic Md

1600 Eureka Rd
Roseville CA 95661
916 844-4000
Medical School: University Of California, Ucla School Of Medicine - 1998
Accepts Medicare: Yes
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: A70828
NPI: 1629156393
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The resisted supination external rotation test: a new test for the diagnosis of superior labral anterior posterior lesions. - The American journal of sports medicine
To evaluate a new clinical test, the resisted supination external rotation test, for the diagnosis of superior labral anterior posterior lesions of the shoulder.Cohort study (diagnosis); Level of evidence, 2.Forty athletes (average age, 23.9 years) with activity-related shoulder pain were enrolled in the study. The patients underwent 3 different tests designed specifically to detect superior labral anterior posterior lesions (the resisted supination external rotation test, the crank test, and the active compression test); the tests were performed in a random order on the affected shoulder. The results of the tests were compared with arthroscopic findings.Out of 40 athletes, 29 (72.5%) had superior labral anterior posterior tears. The resisted supination external rotation test had the highest sensitivity (82.8%), specificity (81.8%), positive predictive value (92.3%), negative predictive value (64.3%), and diagnostic accuracy (82.5%) of all tests performed.By re-creating the peel-back mechanism, the resisted supination external rotation test is more accurate than 2 other commonly used physical examination tests designed to diagnose superior labral anterior posterior tears in overhead-throwing athletes. By using this test in the context of a thorough clinical history and physical examination, lesions of the superior labrum can be more reliably diagnosed.
Nonoperative treatment of partial-thickness meniscal tears identified during anterior cruciate ligament reconstruction. - Orthopedics
The reported incidence and treatment of partial-thickness meniscal tears seen at anterior cruciate ligament (ACL) reconstruction varies widely. The success of nonoperative treatment of partial meniscal tears identified during ACL reconstruction at our institution was reviewed. All incomplete meniscal tears were treated with observation, all full-thickness tears were treated with repair or partial meniscectomy. Partial tears of the lateral meniscus were noted three times more commonly than in the medial meniscus and were seen more acutely after ACL injury than full-thickness tears. At 2-year follow-up, excellent knee function was noted when these tears were treated nonoperatively.
Cyclic loading of posterior cruciate ligament replacements fixed with tibial tunnel and tibial inlay methods. - The Journal of bone and joint surgery. American volume
The optimal method of replacement of the posterior cruciate ligament with a bone-patellar tendon-bone graft is not known. The purpose of this study was to compare the mechanical responses to cyclic loading tests of bone-patellar tendon-bone allograft replacements fixed to the tibia with one of two methods: a tibial tunnel or a tibial inlay technique.The proximal ends of sixty-two posterior cruciate graft replacements, thirty-one fixed with the tibial tunnel technique and thirty-one fixed with the tibial inlay technique in cadaver knees, were subjected to 2000 cycles of tensile force of 50 to 300 N with the angle of pull at 45 to the tibial plateau. The central 10 mm of the medial and lateral halves of previously fresh-frozen bone-patellar tendon-bone preparations from cadaver knees were used as the grafts. Two pairs of tibiae were used for testing; the two types of fixation and the medial and lateral halves of the patellar tendons were distributed between the tibial pairs. Graft thickness was measured at the point of highest anticipated tissue deformation and at two additional locations at distances from these points. The total change in graft length after cyclic loading at an applied force level of 200 N was recorded. Elongation of the graft during loading cycles between 20 and 200 N of applied tensile force was also measured. A repeated-measures analysis of variance was used to compare all measurements between the inlay and tunnel techniques, and between the medial and lateral halves of the graft used for the inlay method.Ten of the thirty-one grafts that had been passed through a tibial tunnel failed at the acute angle before 2000 cycles of testing could be completed; all thirty-one grafts that had been fixed to the tibia with use of the inlay method survived the testing intact. Evaluation of the twenty-one graft pairs that survived testing after both fixation techniques revealed that the grafts that had been fixed with the inlay method had significantly less thinning at all three measurement sites at the completion of testing; the mean reduction of thickness was 40.6% (at the acute angle) in the grafts fixed with the tunnel method and 12.5% (adjacent to the bone block) in those fixed with the inlay method. After 2000 cycles, the mean lengths of the grafts fixed with the inlay and tunnel methods increased 5.9 and 9.8 mm, respectively; 38% of this increase occurred during the first six loading cycles. After both methods of fixation, the mean graft elongation during a loading cycle decreased approximately 50% from cycle 1 to cycle 2000, resulting in an effectively stiffer graft construct. There was no significant difference in any measured parameter between medial and lateral graft halves.These tests showed that the inlay technique of posterior cruciate ligament replacement was superior to the tunnel technique with respect to graft failure, graft thinning, and permanent increase in graft length.

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