Kenneth L Cameron

Publications (37) View all

• Article: Surgical treatment of chronic exertional compartment syndrome of the leg: failure rates and postoperative disability in an active patient population.

  Cpt Brian R Waterman, Cpt Matthew Laughlin, Cpt Kelly Kilcoyne, Kenneth L Cameron, Ltc Brett D Owens
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  ABSTRACT: Chronic exertional compartment syndrome of the leg is a frequent source of lower-extremity pain in military personnel, competitive athletes, and runners. We are not aware of any previous study in which the authors rigorously evaluated the rates of return to full activity, persistent disability, and surgical revision after operative management of chronic exertional compartment syndrome of the leg in a large, physically active population. Individuals who had undergone surgical fasciotomy of the anterior, lateral, and/or posterior compartments (Current Procedural Terminology [CPT] codes 27600, 27601, and 27602) for nontraumatic compartment syndrome of the lower extremity (International Classification of Diseases, Ninth Revision [ICD-9] code 729.72) between 2003 and 2010 were identified from the Military Health System Management Analysis and Reporting Tool (M2). Demographic variables including age, sex, and rank were extracted, and rates of postoperative complications, activity limitations, and revision surgery or medical discharge were obtained from the electronic medical record and U.S. Army Physical Disability Agency database. A total of 611 patients underwent 754 surgical procedures. The average patient age was 28.0 years, and 91.8% of the patients were male. Of the surgical procedures, 77.4% involved only anterior and lateral compartment releases; 19.4% addressed the anterior, lateral, and posterior compartments; and 2.2% addressed the posterior compartments alone. Symptom recurrence was reported by 44.7% of the patients, and 27.7% were unable to return to full activity. Surgical complications were documented for 15.7% of the patients, 5.9% underwent surgical revision, and 17.3% were referred for medical discharge because of chronic exertional compartment syndrome. Univariate analysis of prognostic factors revealed that surgical failure was associated with bilateral involvement (odds ratio [OR], 1.64), perioperative complications (OR, 2.12), activity limitations (OR, 4.41), and persistence of preoperative symptoms (OR, 8.46). Multivariable analysis confirmed significant associations between surgical failure and perioperative complications (OR, 1.72), activity limitations (OR, 2.23), and persistence of preoperative symptoms (OR, 5.47), whereas other factors were not significantly associated with surgical failure. Chronic exertional compartment syndrome is a substantial contributor to lower-extremity disability in the military population. Nearly half of all service members undergoing fasciotomy reported persistent symptoms, and one in five individuals had unsuccessful surgical treatment. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
  The Journal of Bone and Joint Surgery 04/2013; 95(7):592-6. · 3.27 Impact Factor
• Article: History of Shoulder Instability and Subsequent Injury During Four Years of Follow-up: A Survival Analysis.

  Kenneth L Cameron, Sally B Mountcastle, Bradley J Nelson, Colonel Ret Thomas M Deberardino, Michele L Duffey, Lieutenant Colonel Steven J Svoboda, Lieutenant Colonel Brett D Owens
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  ABSTRACT: Little is known about the risk factors for glenohumeral joint instability. We hypothesized that a prior history of instability would be a significant risk factor for subsequent injury. We conducted a prospective cohort study over a four-year period within a high-risk group of young athletes to address the research hypothesis. Subjects were freshmen entering the U.S. Military Academy in June of 2006. Part of the baseline assessment included documenting a prior history of glenohumeral instability on entry into the study. All subjects were followed for subsequent glenohumeral joint instability events until graduation in May of 2010. The primary outcome of interest in this study was time to glenohumeral instability event during the follow-up period. We examined injury outcomes, looking for any instability, anterior instability, and posterior instability events. Cox proportional-hazards regression models were used to analyze the data. Among the 714 subjects, eight shoulders were excluded from the analyses due to prior surgical stabilization, leaving 1420 shoulders, of which 126 had a self-reported prior history of instability. There were forty-six (thirty-nine anterior and seven posterior) acute instability events documented in the cohort during the follow-up period. Subjects with a prior history of instability were over five times (p < 0.001) more likely to sustain an acute (anterior or posterior) instability event during the follow-up period. Subjects with a history of instability were also 5.6 times (p < 0.001) more likely to experience a subsequent anterior instability event and 4.6 times (p = 0.068) more likely to experience a posterior instability event during follow-up. Similar results were observed in multivariable models after controlling for the influence of demographic and baseline physical examination findings. Despite meeting the rigorous physical induction standards for military service, subjects with a prior history of glenohumeral joint instability were approximately five times more likely to experience a subsequent instability event, regardless of direction, within this high-risk athletic population. Prognostic Level I. See Instructions for Authors for a complete description of levels of evidence.
  The Journal of Bone and Joint Surgery 03/2013; 95(5):439-45. · 3.27 Impact Factor
• Article: Serum relaxin levels in young athletic men are comparable with those in women.

  Jennifer Moriatis Wolf, Kenneth L Cameron, Kari B Clifton, Brett D Owens
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  ABSTRACT: Relaxin was originally described as a reproductive hormone that mediated joint laxity in pregnant women and has been minimally studied in men. The purpose of this descriptive laboratory and clinical study was to evaluate serum relaxin in a young, primarily male population and compare levels between the sexes. In addition, the authors evaluated the relationship between relaxin and generalized laxity.
  Orthopedics 02/2013; 36(2):128-31. · 2.66 Impact Factor
• Article: Simple Method of Glenoid Bone Loss Calculation Using Ipsilateral Magnetic Resonance Imaging.

  Brett D Owens, Travis C Burns, Scot E Campbell, Steven J Svoboda, Kenneth L Cameron
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  ABSTRACT: BACKGROUND:Current methods for estimating glenoid bone loss in patients with chronic shoulder instability include computed tomography imaging with 3-dimensional reconstruction, specialized computer software, and imaging of the contralateral shoulder. An ideal method of glenoid measurement would require only magnetic resonance imaging (MRI) of the injured shoulder. PURPOSE:To determine whether MRI measurement of glenoid height, as well as sex, could be used to estimate glenoid width in healthy subjects with no history of shoulder instability. STUDY DESIGN:Cross-sectional study; Level of evidence, 3. METHODS:Bilateral shoulder MRIs were obtained in a healthy cohort of young athletes as part of the baseline assessment in a prospective cohort study. A musculoskeletal radiologist measured glenoid height and width using the sagittal MRI cuts. Univariate and multivariate regression analyses were performed to determine whether demographic and MRI measurements of the glenoid could be used to estimate glenoid width. RESULTS:Of the 1264 shoulder MRIs evaluated, the mean glenoid width was 26.67 mm (±2.49 mm), and the mean glenoid height was 42.15 mm (±3.00 mm). There were significant differences between the 129 female glenoids and the 1035 male glenoids for both width (23.1 mm, 27.1 mm, respectively, P < .0001) and height (37.9 mm, 42.7 mm, respectively, P < .0001); however, the relationship between glenoid height and width was similar for both men and women. The glenoid width was found to correlate with the height measurement (r = 0.56) for the entire cohort. Based on the results of linear regression analysis, controlling for the influence of sex, a formula was created that represents the relationship between these variables for male subjects: Glenoid Width = (1/3 Height) + 15 mm. Female patients are estimated with a formula that represents the same slope but a different intercept: W = 1/3 H + 13 mm. CONCLUSION:Significant differences in glenoid height and width were found by sex; however, the relationship between height and width was similar. These variables are correlated, and the resultant formula can be used to estimate the expected glenoid width in a patient with bone loss. This formula allows for easy calculation of the amount of glenoid bone loss with only a ruler and an MRI of the injured shoulder.
  The American journal of sports medicine 01/2013; · 3.61 Impact Factor
• Article: Military movement training program improves jump-landing mechanics associated with anterior cruciate ligament injury risk.

  Brett D Owens, Kenneth L Cameron, Michele L Duffey, Donna Vargas, Michael J Duffey, Sally B Mountcastle, Darin Padua, Bradley J Nelson
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  ABSTRACT: As part of the physical education program at the United States Military Academy, all cadets complete a movement training course designed to develop skills and improve performance in military-related physical tasks as well as obstacle navigation. The purpose of this study was to determine if completion of this course would also result in changes in jump-landing technique that reduce the risk of anterior cruciate ligament (ACL) injury. Analysis of landing mechanics on a two-footed jump landing from a height of 30 cm with a three-dimensional motion capture system synchronized with two force plates revealed both positive and negative changes. Video assessment using the Landing Error Scoring System (LESS) revealed an overall improved landing technique (p=.001) when compared to baseline assessments. The studied military movement course appears to elicit mixed but overall improved lower extremity jump-landing mechanics associated with risk for ACL injury.
  Journal of surgical orthopaedic advances 01/2013; 22(1):66-70.