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Biomedical subjects

J H Henry

Publications and source records attributed to J H Henry.

25 records · Page 2Linked to original sources
PubMedDate not supplied

Patellofemoral stresses during open and closed kinetic chain exercises. An analysis using computer simulation.

Rehabilitation of the symptomatic patellofemoral joint aims to strengthen the quadriceps muscles while limiting stresses on the articular cartilage. Some investigators have advocated closed kinetic chain exercises, such as squats, because open kinetic chain exercises, such as leg extensions, have been suspected of placing supraphysiologic stresses on patellofemoral cartilage. We performed computer simulations on geometric data from five cadaveric knees to compare three types of open kinetic chain leg extension exercises (no external load on the ankle, 25-N ankle load, and 100-N ankle load) with closed kinetic chain knee-bend exercises in the range of 20 degrees to 90 degrees of flexion. The exercises were compared in terms of the quadriceps muscle forces, patellofemoral joint contact forces and stresses, and "benefit indices" (the ratio of the quadriceps muscle force to the contact stress). The study revealed that, throughout the entire flexion range, the open kinetic chain stresses were not supraphysiologic nor significantly higher than the closed kinetic chain exercise stresses. These findings are important for patients who have undergone an operation and may feel too unstable on their feet to do closed chain kinetic chain exercises. Open kinetic chain exercises at low flexion angles are also recommended for patients whose proximal patellar lesions preclude loading the patellofemoral joint in deeper flexion.

Computer Simulation↗
PubMedDate not supplied

Surgical treatment of patellar instability: indications and results.

The purpose of this study was to evaluate a consecutive series of 465 patients with patellar subluxation. Both knees were involved in some patients. Therefore, 557 knees were studied. The average age was 24 years. Specific symptoms and signs were reviewed. Instability, swelling, and patella alta were more common in the group requiring surgery. All patients were treated conservatively with specific exercises initially. Failure of this conservative treatment to significantly improve the symptoms, inability to do the activities of daily living, or expected associated pathology were indications for surgery. Surgery was required in 139 patients (27%). Some patients had surgery on both knees. Therefore 149 knees were repaired. The surgical technique consisted of an extensor mechanism realignment. This consisted of release of the lateral patellofemoral ligaments, advancement of the vastus medialis obliquus muscle and, in some cases, transfer of the tibial tubercle. Arthrotomy was done in all cases. Results were evaluated in terms of pain, function, and patellar instability. Signs evaluated preoperatively and postoperatively were tenderness of the retinaculum or bone, patellar mobility, effusion, muscle atrophy, and tone. Range of motion was also evaluated. The average followup lasted three years.

Athletic Injuries↗
PubMedDate not supplied

The injury rate in professional basketball.

The purpose of this study is to review seven years of medical experience with injuries to players of a professional basketball club. One of the authors was involved with all injuries occurring during this period of time. All 71 athletes participating with this club were evaluated, and their specific injuries were studied with regard to incidence, time loss due to injury, and treatment. Foot, ankle, knee, back, and hand injuries were found to occur most often. The most common as well as the most severe injuries were those of the ankle and knee. The average time loss from play due to injury was amazingly consistent for each specific injury. Rehabilitation of injuries varied from no playing time loss to two years. Even though knee injuries carry a poor prognosis, the authors conclude that the incidence of severe injury in professional basketball is low. This study will hopefully serve as useful information for those involved with the care of basketball players.

Adult↗
PubMedDate not supplied

Natural history of glenohumeral dislocation--revisited.

The purpose of this study was to evaluate the natural history of glenohumeral dislocation in young athletes. A review of the literature revealed a consensus of opinion that the dislocated shoulder should be immobilized from 3-6 weeks. However, a high recurrence rate could be expected. One hundred twenty-one patients with acute traumatic anterior dislocations were evaluated (average age-19 years). Methods of immobilization were shoulder immobilizers and slings and swaths. Sixty-two patients were immobilized and 56 (90%) of these suffered recurrent dislocation. Fifty-nine patients were not immobilized and 50 (85%) re-dislocated their shoulders. The length of immobilization had no effect on the recurrence rate. All re-dislocations occurred within 18 months of the initial injury. Seventy-nine patients were operated on for recurrent dislocation. With such a high recurrence rate in the athletic age group, the authors question if immobilization affects the prognosis.

Adolescent↗
PubMedDate not supplied

Lateral retinacular release in patellofemoral subluxation. Indications, results, and comparison to open patellofemoral reconstruction.

A consecutive series of patients who have undergone arthroscopy and lateral retinacular release for patellofemoral subluxation was evaluated so that the results could be compared to an earlier series of open patellofemoral reconstructions. Of 96 patients, 4 had bilateral releases; therefore, 100 knees were evaluated. The average age was 28 years. Specific symptoms and signs were reviewed. All patients were initially treated conservatively with specific exercises. Failure of the exercise program to improve symptoms significantly, the patient's inability to perform normal daily activities, or expected associated pathology were indications for surgery. The surgical technique consisted of arthroscopy with treatment of associated pathology and lateral retinacular release using the Smillie meniscotome through the inferior lateral portal. The patella could be tilted approximately 90 degrees medially when the release was accomplished. Pain, function, and patellar instability were evaluated preoperatively and postoperatively by signs of tenderness on the retinaculum or bone, patellar mobility, effusion, muscle atrophy, and tone. Range of motion was also evaluated. Average followup was 36 months. When evaluated subjectively by the patients, pain improved from a mean preoperative grade of 3.4 to 1.7 postoperatively, function improved from 3.4 to 1.7, and instability from 3.4 to 1.6. Objective evaluation found that tenderness on the patella improved from a mean preoperative grade of 3.3 to 1.7 postoperatively. Tenderness on the retinaculum improved from 3.2 to 1.7. Patellar mobility improved from 3.3 to 1.7. Effusion dropped from 3.2 preoperatively to 1.5 postoperatively; quadriceps atrophy from a mean preoperative grade of 3.2 to 1.5, and quadriceps tone from 3.2 to 1.6.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗