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Biomedical subjects

I M Levy

Publications and source records attributed to I M Levy.

16 recordsLinked to original sources
PubMed1995

"Press test" for office diagnosis of triangular fibrocartilage complex tears of the wrist.

We present a simple provocative diagnostic office test for detection of triangular fibrocartilage complex tears of the wrist. Twenty-seven patients with a working diagnosis of a triangular fibrocartilage complex tear complained of wrist pain caused by forceful use; 18 had a history of trauma. A "press test" was performed in each, requiring the seated patient to push the body weight up off a chair using the affected wrist, creating an axial ulnar load. A positive test provoked focal ulnar wrist pain replicating the discomfort that had prompted the patient to seek medical attention. Thirteen patients improved with conservative treatment. Seventeen underwent magnetic resonance imaging (showing 13 tears and 4 normal results) and two patients had arthrograms (both had tears). Fourteen patients had wrist arthroscopy; all had triangular fibrocartilage complex tears, which were debrided, with postoperative clinical improvement. As verified by arthroscopy, the press test had 100% sensitivity in preoperative tear detection compared with 79% for magnetic resonance imaging. The press test is recommended as a useful, free, noninvasive clinical test for triangular fibrocartilage complex tears of the wrist.

Adult↗
PubMed1993

Fluoroscopic assist in anterior cruciate ligament reconstruction.

When creating the femoral tunnel during endoscopic anterior cruciate ligament reconstruction, the potential exists for penetration of the posterior femoral cortex. In addition, during placement of the proximal fixation screw, the screw can deviate from its intended path. We have used an image intensifier intraoperatively to obtain a lateral view of the knee to enable the assessment of tunnel placement and screw alignment. This technique assures the accurate placement of the tibial and femoral tunnels and helps avoid screw divergence from the graft.

Anterior Cruciate Ligament↗
PubMed1991

Sagittal MR images of the knee: a low-signal band parallel to the posterior cruciate ligament caused by a displaced bucket-handle tear.

A low-signal band parallel and anterior to the posterior cruciate ligament has been noted on sagittal MR images of the knee in some patients with other evidence for medial meniscal tears. It was hypothesized that this low-signal band represented the mesially displaced fragment of a bucket-handle tear. To verify this, we retrospectively reviewed MR and arthroscopic findings in 54 consecutive patients. Arthroscopy showed a bucket-handle tear of the medial meniscus in seven patients and was considered diagnostic. Sagittal MR images were reviewed without knowledge of the arthroscopic results. The presence of a curvilinear low-signal band above the tibial cortex anterior, inferior, and parallel to the posterior cruciate ligament was identified on MR images in all seven of the patients in whom the presence of a bucket-handle medial meniscal tear was confirmed by arthroscopy. Our findings suggest that a low-signal band anterior and parallel to the posterior cruciate ligament on sagittal MR images of the knee is caused by a mesially displaced bucket-handle tear of the medial meniscus.

Adult↗
PubMed1989

The effect of lateral meniscectomy on motion of the knee.

With the use of a five-degrees-of-freedom testing apparatus, we studied changes in the motion of the knees of cadavera after isolated resection of the lateral meniscus, with section of the anterior cruciate ligament and resection of the medial meniscus. Primary anterior and posterior translations were not affected by lateral meniscectomy. When lateral meniscectomy was done in addition to resection of the anterior cruciate ligament, anterior translation did not increase compared with that measured after isolated section of the anterior cruciate ligament. However, when the means of the paired differences in anterior translation were compared, a significant increase was found. This differed from the results after excision of the medial meniscus and section of the anterior cruciate ligament; in that situation, medial meniscectomy resulted in significantly more anterior translation.

Aged↗
PubMed1987

Arthroscopic removal of entrapped debris following dislocation of a total hip arthroplasty.

The entrapment of a foreign body within a dislocated hip prosthesis is an unusual occurrence. Dislodgement of the fragments by closed reduction should be attempted to try to extricate the fragment from the femoral head and acetabular cup interface. If closed techniques prove unsuccessful, arthroscopy can be used to guide instrumented removal of the interposed fragments.

Aged↗
PubMed1986

Multiple joint sepsis by Hemophilus influenza in an adult.

The bacterium Hemophilus influenza, also known as the Pfeiffer bacillus, is generally regarded as a disease of infancy and early childhood. An occurrence in adulthood is rare. A 43-year-old woman developed septic arthritis of more than one joint caused by Hemophilus influenza. The infrequency of this infection and the degree of difficulty in diagnosis is confirmed by a review of the literature.

Adult↗
PubMed1984

Medial restraints to anterior-posterior motion of the knee.

We investigated the motion of cadaver knees before and after section of the medial structures and anterior cruciate ligament. The knees were tested using a 5-degrees-of-freedom in vitro knee-testing apparatus that measured anterior-posterior, medial-hateral, and axial displacement as well as internal-external and valgus-varus rotation. The fiexion angle could be varied but was fixed for each individual test. A 125-newton anterior-posterior force was applied perpendicular to the tibial shaft and the resulting motion of the knee was measured. In five knees the anterior cruciate ligament was cut first, followed by progressive cuts of the structures on the medial side (superficial medial collateral ligament, deep medial ligament, oblique fibers of the superficial medial ligament, and the posteromedial part of the capsule). Conversely, in five knees the medial structures were progressively cut first, followed by section of the anterior cruciate ligament. Tests were performed after each cut. With an intact anterior cruciate ligament, progressive cutting of the medial side had no effect on anterior and posterior displacements. When section of the medial structures followed cutting of the anterior cruciate ligament, anterior displacement exceeded that seen after isolated section of the anterior cruciate ligament. The anterior and posterior load-tests were repeated with the tibia fixed in 5 degrees of internal and 5 degrees of external rotation. Fixed external notation had no effect on anterior and posterior displacements. Fixed internal rotation significantly decreased anterior displacement only when both the anterior cruciate ligament and the medial structures were cut. The amounts of tibial rotation and tibial torque resulting from the applied anterior and posterior forces were low compared with our previous results, and we attributed this to decreased constraints on motion of the knee in the current testing apparatus. CLINICAL RELEVANCE: Athletic injuries of the knee frequently involve both the anterior cruciate ligament and the medial side of the knee. Clinical studies have demonstrated that combined injuries of the anterior cruciate and medial collateral ligaments often cannot be successfully managed conservatively. Our in vitro findings support the clinical data and suggest that injuries to the medial structures further compromise anterior stability when they accompany anterior cruciate injuries.

Adult↗
PubMed1984

An anteromedial approach to the posterior cruciate ligament.

A straight anteromedial incision for the exposure of the medial, posteromedial, and posterior ligaments of the knee provides favorable exposure of the distal attachment site of the posterior cruciate ligament. This approach enables a medial parapatellar arthrotomy to be performed through the same incision. The key elements of the exposure are the reflection of the semimembranosus tendon and detachment of the posterior capsule from the medial meniscus.

Humans↗
PubMed1982

The effect of medial meniscectomy on anterior-posterior motion of the knee.

We used an in vitro knee-testing apparatus to measure anterior-posterior displacement of the tibia on the femur and the accompanying tibial rotation in response to an applied anterior-posterior force. Testing was performed on nine intact knees, on five knees after medial meniscectomy, on three knees after isolated section of the anterior cruciate ligament, and on eight knees after both excision of the medial meniscus and section of the anterior cruciate ligament. The induced anterior-posterior displacement and the coupled rotation were unaffected by meniscectomy. Isolated section of the anterior cruciate ligament allowed a significant (p less than 0.05) increase in anterior displacement but had no effect on posterior displacement. The coupled internal rotation associated with anterior displacement was lost after section of the anterior cruciate ligament. Excision of the medial meniscus and section of the anterior cruciate ligament allowed significantly (p less than 0.05) greater increases in anterior displacement than those already increased by isolated section of the anterior cruciate ligament.

Aged↗
PubMedDate not supplied

Living with artificial grass: a knowledge update. Part 1: Basic science.

Part I of this two part study reviews the development and characteristics of artificial grass, and the influence of this surface on the American football player. Artificial grass was initially developed to provide city children with increased play space and thus enable them to maintain a fitness level equal to their peers in more rural locales. Today, artificial grass fields allow for increased use when field availability is limited, or for a grass substitute where grass will not grow. However, epidemiologic studies suggest that there is an increased risk of lower extremity injury to the football athlete playing on an artificial grass field. By reviewing available studies, a knowledge base can be formed that can serve to direct future investigations concerning the influence of artificial grass surfaces and injury and, ultimately, how that influence can be affected.

Athletic Injuries↗
PubMedDate not supplied

Living with artificial grass: a knowledge update. Part 2: Epidemiology.

Part 2 of our study evaluated the effect of artificial grass on the athletes that play on it. In this section we have reviewed the epidemiological studies that have evaluated the influence that artificial grass has on the frequency and site of injury to American football players. From this review we have concluded that play and practice on an artificial surface is probably responsible for an increase in the relative risk of injury to the lower extremity of the participants. However, it is evident that more well controlled studies are necessary to completely clarify this issue.

Athletic Injuries↗
PubMedDate not supplied

Meniscal lesions associated with anterior cruciate ligament injury.

The menisci frequently are injured during anterior cruciate ligament (ACL) injury or degenerate in a period of several years. The meniscus, in addition to transferring force across the joint, prevents tibial displacement on the femur if the ACL is injured. Ten per cent to 30% of the peripheral meniscus has circulation; healing can occur if a tear communicates with this region. Arthroscopic partial meniscectomy in irreparable tears can be helpful in some patients with meniscus-derived complaints. Total meniscectomy should be avoided in ACL insufficient knees when possible. Accurate meniscal reattachment with ligamentous reconstruction should restore knee stability.

Animals↗