Hollis G Potter

Hospital for Special Surgery, New York, New York, United States

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Publications (242)583.11 Total impact

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    ABSTRACT: The enhanced posterior soft tissue repair has reduced the frequency of dislocation after primary THA performed through the posterolateral approach. However, the long-term integrity of the repair is unknown and could influence surgeon choice regarding surgical technique and THA approach. We asked: (1) What is the durability of the enhanced posterior soft tissue repair at a minimum of 49 months using MRI to evaluate soft tissue to bone integrity? (2) How does the appearance of the posterior soft tissues change during this time? (3) Are there patient characteristics associated with the long-term imaging appearance of the posterior repair? All patients without a contraindication for MRI who were undergoing unilateral primary uncemented THA through a posterior approach between February and May 2005 were eligible for inclusion. Ninety percent consented to participate (36 of 40 patients), and 30 patients were followed prospectively with MRI postoperatively and again at 3 months; of those, 22 (73%; 12 men, 10 women) completed the study by having another MRI study at a minimum of 49 months (mean, 51 months; range, 49-59 months). Each patient underwent metal-artifact-reduction sequence MRI to evaluate the integrity of the posterior soft tissues, which had been repaired anatomically during primary THA at a minimum of 4 years earlier. The results were compared with those of prior MR images obtained immediately after surgery and at 3 months postoperatively. All patients were given a self-reported modified Harris hip score at the time of the most recent MRI study (maximum score = 81). At latest followup, 21 of 22 (96%) patients had a posterior capsule in contact with bone, and 21 of 22 (96%) had an intact quadratus femoris. Twenty-one patients (96%) had soft tissue or a scar from the piriformis and conjoined tendons in continuity with bone. In these cases, the interface between the piriformis and conjoined tendons and the greater trochanter observed immediately postoperatively and at 3 months postoperatively became filled with hypointense tissue, with signal characteristics similar to tendon. Time from surgery was most associated with changes in native tendon-to-bone distances (p < 0.001) and MRI signal intensity of the repair (p < 0.001). At followup of just more than 4 years, the posterior capsule and quadratus femoris most often were healed to bone. In the majority of patients, scar tissue between the piriformis and conjoined tendons and bone matured to achieve orientation and signal intensity resembling native tendon. We believe the enhanced posterior soft tissue repair facilitates this process. Our results provide a plausible explanation for improved postoperative stability observed in patients receiving an enhanced soft tissue repair compared with those in whom a repair is not performed. Level IV, therapeutic study.
    Clinical Orthopaedics and Related Research 06/2015; DOI:10.1007/s11999-015-4380-0 · 2.88 Impact Factor
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    ABSTRACT: Purpose To describe the magnetic resonance (MR) imaging characteristics associated with adverse local tissue reactions and tissue damage around hip arthroplasties in which the recalled Rejuvenate modular dual-taper stem was used. Materials and Methods The institutional review board of the Hospital for Special Surgery approved the study. All study patients provided informed consent. MR imaging studies were retrospectively reviewed in a cohort of 58 patients with 66 hip arthroplasties with Rejuvenate stems who had presented for imaging evaluation because of recall of the implant. Multiple regression analysis was used to examine MR imaging features, biomechanical factors, and metal ion levels as predictors of aseptic lymphocytic vasculitis-associated lesion (ALVAL) score at histologic assessment while adjusting for age and sex for 54 revised hips. Results Revision surgery was performed in 54 hips on the basis of clinical or imaging findings (24% of hips were completely asymptomatic). The median ALVAL score among the revised hips was 9 (range, 1-10). Imaging characteristics observed with high frequency in patients with ALVAL included synovitis, mixed- or solid-type synovitis, synovial thickening, and capsular dehiscence. Conclusion MR imaging provides an effective noninvasive method for assessing the presence and severity of adverse local tissue reaction, as well as the degree of pre-existing tissue damage, thereby facilitating early and accurate identification of candidates for revision surgery. (©) RSNA, 2015.
    Radiology 06/2015; DOI:10.1148/radiol.2015141967 · 6.21 Impact Factor
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    ABSTRACT: Analysis of fresh specimens in research studies is ideal; however, it is often necessary to freeze samples for evaluation at a later time. Limited evaluation of the effect of freeze-thawing of tendon tissue samples on inherent magnetic resonance imaging (MRI) parameters, such as ultrashort echo time (UTE) T2* values, have been performed to date. This study performed UTE MRI on 14 bovine patellar tendons at harvest and after four consecutive freeze-thaw cycles. Results demonstrated a small but significant reduction (12%) in tendon T2* values after the first freeze thaw cycle, but not after successive cycles. Tendons from juvenile animals with open physis had a significant reduction of T2* following a single freeze thaw cycle, P<0.0001. The results of this study emphasize the importance of using uniform tendon storage protocols when using UTE MRI in preclinical models.
    06/2015; 5(3):368-73. DOI:10.3978/j.issn.2223-4292.2015.03.14
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    ABSTRACT: Imaging of hip in osteoarthritis (OA) has seen considerable progress in the past decade, with the introduction of new techniques that may be more sensitive to structural disease changes. The purpose of this expert opinion, consensus driven recommendation is to provide detail on how to apply hip imaging in disease modifying clinical trials. It includes information on acquisition methods/techniques (including guidance on positioning for radiography, sequence/protocol recommendations/hardware for magnetic resonance imaging (MRI)); commonly encountered problems (including positioning, hardware and coil failures, artifacts associated with various MRI sequences); quality assurance/control procedures; measurement methods; measurement performance (reliability, responsiveness, and validity); recommendations for trials; and research recommendations. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
    Osteoarthritis and Cartilage 05/2015; 23(5):716-731. DOI:10.1016/j.joca.2015.03.004 · 4.66 Impact Factor
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    ABSTRACT: Tunnel widening after anterior cruciate ligament reconstruction (ACL-R) is a well-accepted and frequent phenomenon, yet little is known regarding its origin or natural history. To prospectively evaluate the cross-sectional area (CSA) changes in tibial and femoral bone tunnels after ACL-R with serial MRI. Case series; Level of evidence, 4. Patients underwent arthroscopic ACL-R with the same surgeon, surgical technique, and rehabilitation protocol. Each patient underwent preoperative dual-energy x-ray absorptiometry and clinical evaluation, as well as postoperative time zero MRI followed by subsequent MRI and clinical examination, including functional and subjective outcome tests, at 6, 12, 24, 52, and 104 weeks. Tibial and femoral tunnel CSA was measured on each MRI at tunnel aperture (ttA and ftA), midsection (ttM and ftM), and exit (ttE and ftE). Logistic regression modeling was used to examine the predictive value of demographic data and preoperative bone quality (as measured by dual-energy x-ray absorptiometry) on functional outcome scores, manual and instrumented laxity measurements, and changes in tunnel area over time. Eighteen patients (including 12 men), mean age 35.5 ± 8.7 years, underwent ACL-R. There was significant tunnel expansion at ttA and ftA sites 6 weeks postoperatively (P = .024 and .0045, respectively). Expansion continued for 24 weeks, with progressive tunnel narrowing thereafter. Average ttA CSA was significantly larger than ftA CSA at all times. The ttM significantly expanded after 6 weeks (P = .06); continued expansion to week 12 was followed by 21 months of reduction in tunnel diameter. The ftM and both ttE and ftE sites decreased in CSA over the 2 years. Median Lysholm and International Knee Documentation Committee scores significantly improved at final follow-up (P = .0083 and <.0001, respectively), and patients returned to preoperative activity levels. Pivot shift significantly decreased (P < .0001). Younger age (<30 years), male sex, and delayed ACL-R (>1 year from time of injury) predicted increased tunnel widening and accelerated expansion in CSA (P < .005). Tunnel expansion after ACL-R occurs early and primarily at the tunnel apertures. Expansion may not affect clinical outcome. Younger age, male sex, and delay from injury to ACL-R may be potential risks for enlargement. © 2015 The Author(s).
    The American Journal of Sports Medicine 02/2015; 43(5). DOI:10.1177/0363546515570461 · 4.70 Impact Factor
  • Darryl B Sneag, Eric A Bogner, Hollis G Potter
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    ABSTRACT: Optimization of metal artifact reduction pulse sequences over the past decade has rendered MRI valuable in knee arthroplasty assessment. MRI can reliably predict the presence and extent of infection, component loosening and polyethylene wear, and component malrotation, and it can evaluate the integrity of surrounding soft tissue structures. Using dynamic contrast-enhanced angiographic techniques, vascular pathology such as pseudoaneurysm formation and recurrent hemarthrosis can also be assessed. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
    Seminars in musculoskeletal radiology 02/2015; 19(1):40-8. DOI:10.1055/s-0034-1396766 · 0.95 Impact Factor
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    ABSTRACT: Reason for performing studyPostoperative imaging in subjects with orthopaedic implants is challenging across all modalities. Magnetic resonance imaging (MRI) is preferred to assess human postoperative musculoskeletal complications, as soft tissue and bones are evaluated without using ionising radiation. However, with conventional MRI pulse sequences, metal creates susceptibility artifact that distorts anatomy. Assessment of the postoperative equine patient is arguably more challenging due to the volume of metal present, and MRI is often not performed in horses with implants. Novel pulse sequences such as multi-acquisition variable resonance image combination (MAVRIC) now provide improved visibility in the vicinity of surgical-grade implants and offer an option for imaging horses with metal implants.Objectives To compare conspicuity of regional anatomy in an equine fracture-repair model using MAVRIC, narrow receiver bandwidth fast spin echo (NBW FSE), and wide receiver bandwidth (WBW) FSE sequences.Study DesignNon-randomised in vitro experiment.MethodsMAVRIC, NBW FSE and WBW FSE were performed on 9 cadaveric distal limbs with fractures and stainless steel implants in the 3rd metacarpal bone and proximal phalanx. Objective measures of artifact reduction were performed by calculating the total artifact area in each transverse image as a percentage of the total anatomic area. The number of transverse images in which fracture lines were visible was tabulated for each sequence. Regional soft tissue conspicuity was assessed subjectively.ResultsOverall anatomic delineation was improved using MAVRIC compared to NBW FSE; delineation of structures closest to the metal implants was improved using MAVRIC compared to WBW FSE and NBW FSE. Total artifact area was the highest for NBW FSE and lowest for MAVRIC; the total number of transverse slices with a visible fracture line was highest in MAVRIC and lowest in NBW FSE.ConclusionMAVRIC and WBW FSE are feasible additions to minimise artifact around implants.
    Equine Veterinary Journal 01/2015; DOI:10.1111/evj.12424 · 2.37 Impact Factor
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    ABSTRACT: Anterior cruciate ligament (ACL) reconstruction in skeletally immature patients can result in growth disturbance due to iatrogenic physeal injury. Multiple physeal-sparing ACL reconstruction techniques have been described; however, few combine the benefits of anatomic reconstruction using sockets without violation of the femoral or tibial physis.
    The American Journal of Sports Medicine 10/2014; DOI:10.1177/0363546514552994 · 4.70 Impact Factor
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    ABSTRACT: Magnetic resonance (MR) imaging evaluation of the painful failed shoulder arthroplasty is a useful imaging modality due to advancements in metal artifact reduction techniques, which allow assessment of the integrity of the supporting soft-tissue envelope and the implant.
    HSS Journal 10/2014; 10(3):213-24. DOI:10.1007/s11420-014-9399-3
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    ABSTRACT: PurposeIt has previously been demonstrated that increased overlap of spectral bins in three-dimensional multispectral imaging techniques (3D-MSI) can aid in reducing residual artifacts near metal implants. However, increasing spectral overlap also necessitates consideration of saturation effects for species with long T1 values. Here, an interleaved spectral bin acquisition strategy is presented for overlapping 3D-MSI that allows for flexible choice of repetition times while simultaneously addressing these cross talk concerns.MethodsA phantom imaging experiment is used to illustrate the amplified effect of cross talk on 3D-MSI acquisitions. A methodological approach to address cross talk across a variety of prescribed repetition times is then described. Using the presented principles, a clinical subject with a total hip replacement was imaged to generate T1, proton density, and short-tau inversion recovery contrasts. In addition, a fracture instrumentation case was imaged pre- and postcontrast using T1-weighted spectrally overlapped 3D-MSI.ResultsPhantom results demonstrate that conventional spectral interleaving approaches can generate unwanted signal characteristics in heavily overlapped 3D-MSI. Clinical images using the presented methods successfully demonstrate T1, proton density, and inversion recovery image contrasts using heavily overlapped 3D-MSI.Conclusions Through automated management of spectral bin distributions across multiple interleaves, a variety of longitudinal magnetization contrasts can efficiently be acquired without any clinically relevant cross-talk impact using heavily overlapped 3D-MSI. Magn Reson Med, 2014. © 2014 Wiley Periodicals, Inc.
    Magnetic Resonance in Medicine 10/2014; DOI:10.1002/mrm.25518 · 3.40 Impact Factor
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    ABSTRACT: Tendinopathy affects individuals who perform repetitive joint motion. Magnetic resonance imaging (MRI) is frequently used to qualitatively assess tendon health, but quantitative evaluation of inherent MRI properties of loaded tendon has been limited. This study evaluated the effect of cyclic loading on [Formula: see text] values of fresh and frozen rabbit patellar tendons using ultra short echo (UTE) MRI. Eight fresh and 8 frozen rabbit lower extremities had MR scans acquired for tendon [Formula: see text] evaluation. The tendons were then manually cyclically loaded for 100 cycles to 45N at approximately 1Hz. The MR scanning was repeated to reassess the [Formula: see text] values. Analyses were performed to detect differences of tendon [Formula: see text] values between fresh and frozen samples prior to and after loading, and to detect changes of tendon [Formula: see text] values between the unloaded and loaded configurations. No difference of [Formula: see text] was found between the fresh and frozen samples prior to or after loading, p=0.8 and p=0.1, respectively. The tendons had significantly shorter [Formula: see text] values, p=0.023, and reduced [Formula: see text] variability, p=0.04, after cyclic loading. Histologic evaluation confirmed no induced tendon damage from loading. Shorter [Formula: see text] , from stronger spin-spin interactions, may be attributed to greater tissue organization from uncrimping of collagen fibrils and lateral contraction of the tendon during loading. Cyclic tensile loading of tissue reduces patellar tendon [Formula: see text] values and may provide a quantitative metric to assess tissue organization.
    Journal of Biomechanics 09/2014; 47(13). DOI:10.1016/j.jbiomech.2014.08.018 · 2.50 Impact Factor
  • Matthew F Koff, Parina Shah, Hollis G Potter
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    ABSTRACT: OBJECTIVE. The purpose of this article is to explain the basic physics of imaging patients with metal implants, explain conflicting information regarding MRI scanning of "MR Conditional" devices, and relate our experience of scanning total joint arthroplasty (TJA) at our institution. CONCLUSION. MRI near TJA is effective with appropriate imaging protocols and standardized safety precautions. Strict adherence to MR Conditional labeling may preclude broad use of MRI for TJA assessment.
    American Journal of Roentgenology 07/2014; 203(1):154-61. DOI:10.2214/AJR.13.11991 · 2.74 Impact Factor
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    ABSTRACT: Hip arthroplasty has become the standard treatment for end-stage hip disease, allowing pain relief and restoration of mobility in large numbers of patients; however, pain after hip arthroplasty occurs in as many as 40% of cases, and despite improved longevity, all implants eventually fail with time. Owing to the increasing numbers of hip arthroplasty procedures performed, the demographic factors, and the metal-on-metal arthroplasty systems with their associated risk for the development of adverse local tissue reactions to metal products, there is a growing demand for an accurate diagnosis of symptoms related to hip arthroplasty implants and for a way to monitor patients at risk. Magnetic resonance (MR) imaging has evolved into a powerful diagnostic tool for the evaluation of hip arthroplasty implants. Optimized conventional pulse sequences and metal artifact reduction techniques afford improved depiction of bone, implant-tissue interfaces, and periprosthetic soft tissue for the diagnosis of arthroplasty-related complications. Strategies for MR imaging of hip arthroplasty implants are presented, as well as the imaging appearances of common causes of painful and dysfunctional hip arthroplasty systems, including stress reactions and fractures; bone resorption and aseptic loosening; polyethylene wear-induced synovitis and osteolysis; adverse local tissue reactions to metal products; infection; heterotopic ossification; tendinopathy; neuropathy; and periprosthetic neoplasms. A checklist is provided for systematic evaluation of MR images of hip arthroplasty implants. MR imaging with optimized conventional pulse sequences and metal artifact reduction techniques is a comprehensive imaging modality for the evaluation of the hip after arthroplasty, contributing important information for diagnosis, prognosis, risk stratification, and surgical planning. ©RSNA, 2014.
    Radiographics 07/2014; 34(4):E106-E132. DOI:10.1148/rg.344140010 · 2.73 Impact Factor
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    Arthroscopy The Journal of Arthroscopic and Related Surgery 06/2014; 30(6):e1–e2. DOI:10.1016/j.arthro.2014.04.010 · 3.19 Impact Factor
  • Denis Nam, Robert L Barrack, Hollis G Potter
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    ABSTRACT: Adverse tissue reactions are known to occur after total hip arthroplasty using both conventional and metal-on-metal (MoM) bearings and after MoM hip resurfacing arthroplasty (SRA). A variety of imaging tools, including ultrasound (US), CT, and MRI, have been used to diagnose problems associated with wear after MoM hip arthroplasty and corrosion at the head-trunnion junction; however, the relative advantages and disadvantages of each remain a source of controversy. The purposes of this review were to evaluate the advantages and disadvantages of (1) US; (2) CT; and (3) MRI as diagnostic tools in the assessment of wear-related corrosion problems after hip arthroplasty. A systematic literature review was performed through Medline, EMBASE, Scopus CINAHL, and the Cochrane Library without time restriction using search terms related to THA, SRA, US, CT, MRI, adverse tissue reactions, and corrosion. Inclusion criteria were Level I through IV studies in the English language, whereas expert opinions and case reports were excluded. The quality of included studies was judged by their level of evidence, method of intervention allocation, outcome assessments, and followup of patients. Four hundred ninety unique results were returned and 40 articles were reviewed. The prevalence of adverse local tissue reactions in both asymptomatic and symptomatic patients varies based on the method of evaluation (US, CT, MRI) and imaging protocols. US is accessible and relatively inexpensive, yet has not been used to report synovial thicknesses in the setting of wear-related corrosion. CT scans are highly sensitive and provide information regarding component positioning but are limited in providing enhanced soft tissue contrast and require ionizing radiation. MRI has shown promise in predicting both the presence and severity of adverse local tissue reactions but is more expensive. All three imaging modalities have a role in the assessment of adverse local tissue reactions and tribocorrosion after total hip arthroplasty. Although US may serve as a screening technique for the detection of larger periprosthetic collections, only MRI has been shown to predict the severity of tissue destruction found at revision and correlate to the degree of tissue necrosis at histologic evaluation.
    Clinical Orthopaedics and Related Research 03/2014; 472(12). DOI:10.1007/s11999-014-3579-9 · 2.88 Impact Factor
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    ABSTRACT: Subclavius posticus is a rare anomalous muscle that traverses from the costal cartilage of the first rib posterolaterally to the superior border of the scapula. We present an athlete who presented with incapacitating suprascapular nerve compression associated with a subclavius posticus diagnosed by MRI. Symptoms were relieved, and function was restored by decompression of the nerve and excision of the anomalous muscle. We present this case to bring awareness of the subclavius posticus as an anatomic variant and a potential additional source for compression in suprascapular neuropathy. We recommend high-resolution magnetic resonance imaging to evaluate cases of isolated suprascapular neuropathy. V.
    Hand 03/2014; 10(1). DOI:10.1007/s11552-014-9652-8
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    ABSTRACT: ➤ Novel (i.e., quantitative and semiquantitative) cartilage imaging techniques can evaluate cartilage composition to augment information obtained from traditional magnetic resonance imaging sequences that detail morphology.➤ A well-defined role for drugs leading to chondroprotection has not yet been determined.➤ Shortcomings of bone marrow stimulation include limited production of hyaline repair tissue, unpredictable repair cartilage volume, and a negative impact on later cellular transplantation if required.➤ The role of biological augments, such as cellular concentrates or platelet-rich plasma, remains undefined. When their use is reported in the literature, it is important that their process of production and characterization be detailed.➤ Rehabilitation programs, incorporating controlled exercise and progressive partial weight-bearing, are an important part of cartilage repair surgery and should be detailed in reports on operative techniques applied.➤ Malalignment, meniscal injury, and ligament deficiency should be corrected in a staged or concomitant fashion to reduce the overall likelihood of mechanical failure in cartilage repair surgery.
    The Journal of Bone and Joint Surgery 02/2014; 96(4):336-344. DOI:10.2106/JBJS.L.01329 · 4.31 Impact Factor
  • Shari T Jawetz, Parina H Shah, Hollis G Potter
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    ABSTRACT: As the intensity of youth participation in athletic activities continues to rise, the number of overuse injuries has also increased. A subset of overuse injuries involves the physis, which is extremely susceptible to injury. This paper aims to review the utility of the various imaging modalities in the diagnosis and management of physeal injuries in the skeletally immature population. A search for the keywords pediatric, physis, growth plate, x-ray, computed tomography, magnetic resonance imaging, and overuse injury was performed using the PubMed database. No limits were set for the years of publication. Articles were reviewed for relevance with an emphasis on the imaging of growth plate injuries. Retrospective literature review. Level 4. Three major imaging modalities (radiographs, computed tomography, and magnetic resonance imaging) complement each other in the evaluation of pediatric patients with overuse injuries. However, magnetic resonance imaging is the only modality that offers direct visualization of the physis, and it also offers the best soft tissue contrast for evaluating the other periarticular structures for concomitant injury. Imaging has an important role in the diagnosis of physeal injuries, and the information it provides has a tremendous impact on the subsequent management of these patients.
    Sports Health A Multidisciplinary Approach 02/2014; 7(2):142-153. DOI:10.1177/1941738114559380
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    ABSTRACT: Object Tissue-engineered intervertebral discs (TE-IVDs) represent a new experimental approach for the treatment of degenerative disc disease. Compared with mechanical implants, TE-IVDs may better mimic the properties of native discs. The authors conducted a study to evaluate the outcome of TE-IVDs implanted into the rat-tail spine using radiological parameters and histology. Methods Tissue-engineered intervertebral discs consist of a distinct nucleus pulposus (NP) and anulus fibrosus (AF) that are engineered in vitro from sheep IVD chondrocytes. In 10 athymic rats a discectomy in the caudal spine was performed. The discs were replaced with TE-IVDs. Animals were kept alive for 8 months and were killed for histological evaluation. At 1, 5, and 8 months, MR images were obtained; T1-weighted sequences were used for disc height measurements, and T2-weighted sequences were used for morphological analysis. Quantitative T2 relaxation time analysis was used to assess the water content and T1ρ-relaxation time to assess the proteoglycan content of TE-IVDs. Results Disc height of the transplanted segments remained constant between 68% and 74% of healthy discs. Examination of TE-IVDs on MR images revealed morphology similar to that of native discs. T2-relaxation time did not differ between implanted and healthy discs, indicating similar water content of the NP tissue. The size of the NP decreased in TE-IVDs. Proteoglycan content in the NP was lower than it was in control discs. Ossification of the implanted segment was not observed. Histological examination revealed an AF consisting of an organized parallel-aligned fiber structure. The NP matrix appeared amorphous and contained cells that resembled chondrocytes. Conclusions The TE-IVDs remained viable over 8 months in vivo and maintained a structure similar to that of native discs. Tissue-engineered intervertebral discs should be explored further as an option for the potential treatment of degenerative disc disease.
    Journal of neurosurgery. Spine 02/2014; 20(4). DOI:10.3171/2013.12.SPINE13112 · 2.36 Impact Factor
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    ABSTRACT: To identify with magnetic resonance imaging the location and severity of ligamentous injury after acute elbow dislocations. Based on observations that many elbow dislocations arise from an initial acute valgus load, we hypothesized that all patients would have a high-grade medial injury but not all would demonstrate injury of the lateral ligaments. The medial collateral ligament was subdivided into anterior bands of the anterior bundle of the medial collateral ligament (MCL) and posterior bands of the anterior bundle of the MCL, whereas the lateral collateral ligament was divided into the lateral ulnar collateral ligament and the radial collateral ligament. Distinction on magnetic resonance imaging was made between normal morphology and low-grade partial tear (< 50% of the ligament fibers), high-grade partial tear (≥ 50%), and full-thickness disruption. The site of disruption was also characterized. Acute magnetic resonance imaging studies for 16 patients were included. No low-grade tears or intact evaluations of either the anterior or posterior bands of the anterior bundle of the MCL were observed; most demonstrated complete tears. The lateral ulnar collateral ligament most frequently showed complete disruption but was occasionally intact. The radial collateral ligament infrequently showed full disruption. Complete tears involving either the anterior or posterior portions of the anterior band of the MCL were significantly more common than complete tears involving the ligaments on the lateral side. After elbow dislocation, complete ligamentous tears were more common on the medial versus the lateral side. Whereas the lateral ligaments were occasionally preserved, this was never observed on the medial side. These data suggest a sequence of failure starting on the medial side with subsequent variable energy dissipation laterally. Diagnostic IV.
    The Journal of hand surgery 02/2014; 39(2):199-205. DOI:10.1016/j.jhsa.2013.11.031 · 1.66 Impact Factor

Publication Stats

5k Citations
583.11 Total Impact Points


  • 1992–2015
    • Hospital for Special Surgery
      • Department of Orthopaedic Surgery
      New York, New York, United States
  • 1989–2015
    • Cornell University
      • • Department of Orthopaedic Surgery
      • • Department of Radiology
      • • Department of Surgery
      Итак, New York, United States
  • 2001–2014
    • Rush University Medical Center
      Chicago, Illinois, United States
  • 2000–2014
    • Weill Cornell Medical College
      • • Department of Radiology
      • • Department of Orthopaedic Surgery
      New York City, New York, United States
  • 2011
    • Advance MRI
      Frisco, Texas, United States
  • 2010
    • Brown University
      Providence, Rhode Island, United States
  • 2009
    • Pennsylvania Medical Society
      Philadelphia, Pennsylvania, United States
  • 2004
    • University of Colorado at Boulder
      Boulder, Colorado, United States
  • 2002
    • Albert Einstein College of Medicine
      New York City, New York, United States
  • 1998
    • New York Medical College
      New York City, New York, United States
  • 1997
    • Brigham and Women's Hospital
      • Department of Orthopaedic Surgery
      Boston, MA, United States
    • Lenox Hill Hospital
      New York City, New York, United States
  • 1995
    • Philadelphia University
      Filadelfia, Pennsylvania, United States