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Biomedical subjects

T N Lindenfeld

Publications and source records attributed to T N Lindenfeld.

17 recordsLinked to original sources
PubMed1998

Early rehabilitation after a modified inferior capsular shift procedure for multidirectional instability of the shoulder.

Sixteen patients with multidirectional instability of the shoulder underwent an inferior capsular shift procedure with suture anchor augmentation and participated in an early motion and strengthening program. Postoperative rehabilitation included use of a sling with 0 degree to 90 degrees elevation allowed during the first 3 weeks. All patients began isometric shoulder exercise by 3 weeks and initiated progressive resistance exercises by 6 weeks postsurgery. After an average 20 months of follow-up, 14 patients were evaluated for pain, function, range of motion, stability, and activity level. Pain and function improved significantly. No patient reported postoperative subluxation or dislocation, and 11 of 14 patients had returned to their premorbid activity level.

Adolescent↗
PubMed1997

Joint loading with valgus bracing in patients with varus gonarthrosis.

The purpose of this study was to determine whether a brace designed to unload varus degenerative knees actually alters medial compartment loads by decreasing the adduction moment. Eleven patients who had arthrosis confined to the medial compartment were fitted with a valgus brace and tested before and after brace wear with pain and function scoring instruments and by automated gait analysis. The biomechanical data from these patients were compared with those from 11 healthy control subjects. Scores from an analog pain scale decreased 48% with brace wear, and function with activities of daily living increased 79%. Mean adduction moment without the brace measured 4.0 +/- 0.8% body weight times height versus 3.6 +/- 0.8% body weight times height when wearing the brace (10% decrease). The mean adduction moment for control subjects was 3.5 +/- 0.6% body weight times height. Thus, the mean adduction moment decreased from approximately one standard deviation from the normal mean to a value that is similar to the control value. Nine of 11 patients had a decrease in the adduction moment with the brace, five of 11 patients had a reduction higher than 10%, and decreases in this moment were as high as 32%. This study shows that pain, function, and biomechanical knee loading can be altered by a brace designed to unload the medial compartment of the knee.

Arthritis↗
PubMed1988

The stabilized Lachman test.

While the Lachman test is the clinical standard for assessing increased anterior tibial translation, it has some drawbacks. Problems remain with quantitation, reproducibility, and execution. The authors report on modifications designed to solve these problems. The modifications are comfortable for patients, reliable, and can be performed on limbs of all sizes.

Humans↗
PubMedDate not supplied

Medial approach in elbow arthroscopy.

The author undertook a cadaveric dissection study to confirm the hypothesis that starting with the anterior medial portal in elbow arthroscopy is safer than starting with the anterior radial portal. In six cadaveric elbows, the capsule was distended with saline. Both anterior medial and anterior radial approaches were made with the elbow flexed to 90 degrees. Four and one-half millimeter arthroscopic sheaths were inserted and obturators were then left in place while the saline was drained; expanding polyurethane foam was used to distend the capsule. We allowed the polyurethane foam to harden and then dissected all elbows, with special attention given to exposure of the radial and medial nerve and the brachial artery. The hardened foam allowed for continued capsular distension during these dissections and recreated normal distances from instrument portals to neurovascular bundles. The minimum distance from the path of the arthroscopic sheath to the large neurovascular structures was then measured. The distance from the medial portal to the nearest neurovascular structure (median nerve, brachial artery) averaged 23 mm. The distance from the radial portal to the nearest neurovascular structure (radial nerve) averaged 3 mm. The ulnar nerve averaged a 25 mm clearance from the medial portal. Even when the medial portal was made by an incorrect method, the minimum clearance to the median nerve averaged 11 mm. The most frequently recommended current standard technique for elbow arthroscopy involves beginning with an anterior radial portal. However, the findings in this study suggest that an anterior medial portal is a superior starting point.(ABSTRACT TRUNCATED AT 250 WORDS)

Arthroscopy↗
PubMedDate not supplied

Incidence of injury in indoor soccer.

All injuries occurring over a 7-week period at a local indoor soccer arena were documented for analysis of incidence rates. All injury rates were calculated per 100 player-hours. The overall injury rates for male and female players were similar, 5.04 and 5.03, respectively. The lowest injury rate was found among the 19- to 24-year-old athletes and the highest injury rate was found among the oldest age group (> or = 25 years). Collision with another player was the most common activity at the time of injury, accounting for 31% of all injuries. The most common injury types were sprains and muscle contusions, both occurring at a rate of 1.1 injuries per 100 player-hours. Male players suffered a significantly higher rate of ankle ligament injuries compared with female players (1.24 versus 0.43, P < 0.05), while female players suffered a significantly higher rate of knee ligament injuries (0.87 versus 0.29, P < 0.01). Goalkeepers had injury rates (4.2) similar to players in nongoalkeeper positions (4.5).

Adolescent↗
PubMedDate not supplied

Association between the menstrual cycle and anterior cruciate ligament injuries in female athletes.

Anterior cruciate ligament injury rates are four to eight times higher in women than in men. Because of estrogen's direct effect on collagen metabolism and behavior and because neuromuscular performance varies during the menstrual cycle, it is logical to question the menstrual cycle's effect on knee injury rates. Of 40 consecutive female athletes with acute anterior cruciate ligament injuries (less than 3 months), 28 (average age, 23 +/- 11 years) met the study criteria of regular menstrual periods and noncontact injury. Details concerning mechanism of injury, menstrual cycle, contraceptive use, and previous injury history were collected. A chi-square test was used to compute observed and expected frequencies of anterior cruciate ligament injury based on three different phases of the menstrual cycle: follicular (days 1 to 9), ovulatory (days 10 to 14), and luteal (day 15 to end of cycle). A significant statistical association was found between the stage of the menstrual cycle and the likelihood for an anterior cruciate ligament injury (P = 0.03). In particular, there were more injuries than expected in the ovulatory phase of the cycle. In contrast, significantly fewer injuries occurred in the follicular phase. These hormones may be a factor in the knee ligament injury dilemma in women.

Acute Disease↗
PubMedDate not supplied

The effect of neuromuscular training on the incidence of knee injury in female athletes. A prospective study.

To prospectively evaluate the effect of neuromuscular training on the incidence of knee injury in female athletes, we monitored two groups of female athletes, one trained before sports participation and the other not trained, and a group of untrained male athletes throughout the high school soccer, volleyball, and basketball seasons. Weekly reports included the number of practice and competition exposures and mechanism of injury. There were 14 serious knee injuries in the 1263 athletes tracked through the study. Ten of 463 untrained female athletes sustained serious knee injuries (8 noncontact), 2 of 366 trained female athletes sustained serious knee injuries (0 noncontact), and 2 of 434 male athletes sustained serious knee injuries (1 noncontact). The knee injury incidence per 1000 athlete-exposures was 0.43 in untrained female athletes, 0.12 in trained female athletes, and 0.09 in male athletes (P = 0.02, chi-square analysis). Untrained female athletes had a 3.6 times higher incidence of knee injury than trained female athletes (P = 0.05) and 4.8 times higher than male athletes (P = 0.03). The incidence of knee injury in trained female athletes was not significantly different from that in untrained male athletes (P = 0.86). The difference in the incidence of noncontact injuries between the female groups was also significant (P = 0.01). This prospective study demonstrated a decreased incidence of knee injury in female athletes after a specific plyometric training program.

Adolescent↗
PubMedDate not supplied

Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies.

An estimated 80,000 anterior cruciate ligament (ACL) tears occur annually in the United States. The highest incidence is in individuals 15 to 25 years old who participate in pivoting sports. With an estimated cost for these injuries of almost a billion dollars per year, the ability to identify risk factors and develop prevention strategies has widespread health and fiscal importance. Seventy percent of ACL injuries occur in noncontact situations. The risk factors for non-contact ACL injuries fall into four distinct categories: environmental, anatomic, hormonal, and biomechanical. Early data on existing neuromuscular training programs suggest that enhancing body control may decrease ACL injuries in women. Further investigation is needed prior to instituting prevention programs related to the other risk factors.

Adult↗