Bradley Lambert

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Verified

Bradley verified their affiliation via an institutional email.

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• Doctor of Philosophy
• Assistant Research Professor of Orthopedic Surgery at Houston Methodist Hospital

Background: Although blood flow restriction (BFR) is becoming increasingly popular in physical therapy and athletic training settings, little is known about the effects of BFR combined with low-intensity exercise (LIX) on muscles proximal to the site of occlusion. Hypothesis/Purpose: Determine whether LIX combined with BFR applied distally to the...

BACKGROUND: Lower limb bone stress injury (BSI) of the pelvis, femur, and tibia is prevalent in collegiate track and field distance runners. Bone mineral density (BMD), body composition (BComp), and anthropometric parameters before initial collegiate injury have not been compared between runners with BSI and their noninjured counterparts. PURPOSE:...

Background Muscle atrophy is common after an injury to the knee and anterior cruciate ligament reconstruction (ACLR). Blood flow restriction therapy (BFR) combined with low-load resistance exercise may help mitigate muscle loss and improve the overall condition of the lower extremity (LE). Purpose To determine whether BFR decreases the loss of LE...

Background: Recent evidence indicates that combined upper extremity blood flow restriction (BFR, applied distally to the shoulder) and low-load resistance exercise (LIX) augments clinically meaningful responses in shoulder region tissues proximal to the occlusion site. The purpose of this investigation was to determine the efficacy of BFR-LIX for...

Background: As blood flow restriction (BFR) utilization continues to rise, it is crucial to define optimal parameters for use. Currently unknown are the effects of occlusion level during BFR on muscle activity in the proximal shoulder. Purpose/Hypothesis: The purpose of this study was to compare electromyographic amplitude (EMGa) of shoulder muscul...

Background: Total hip arthroplasty (THA) is a successful surgical treatment for end-stage hip arthritis. There is controversy over whether the surgical approach leads to any differences in implant sizing, implant positioning, and clinical outcomes. This study sought to compare radiographic and clinical outcomes when performing primary THA through t...

Objectives Female professional ballet performers are a unique population that undergo substantial physiologic stresses related to training, performance, and, at times, reduced energy availability that can result in elevated incidences of injury relative to their male counterparts and, even more so, the general population. However, there are current...

Objectives Osteoarthritis (OA) is a joint disease characterized by degradation of articular cartilage and subchondral bone. Cartilage injury plays an important role in the pathogenesis of osteoarthritis, and disease modifying treatments aiming to preserve and possibly regenerate cartilage are an area of active interest. Early diagnosis is crucial,...

OBJECTIVES: Patients often experience a significant amount of muscle and bone atrophy following Achilles tendon rupture and surgical repair due to mechanical unloading and an inability to safely perform resistance training at intensities sufficient to preserve mass in the early postoperative period. This potentially increases the risk of reinjury,...

BACKGROUND: Ideal target limb alignment remains a debated topic in total knee arthroplasty (TKA). We aimed to determine the effect of limb alignment correction on patient-reported outcomes and knee range-of-motion (ROM) following TKA. METHODS: In this retrospective analysis, patients (N = 409) undergoing primary TKA at a single institution were st...

BACKGROUND: Transcranial Motor Evoked Potentials (TcMEPs) can improve intraoperative detection of femoral plexus and nerve root injury during lumbosacral spine surgery. However, even under ideal conditions, TcMEPs are not completely free of false-positive alerts due to the immobilizing effect of general anesthetics, especially in the proximal muscu...

Background In the COVID-19 era, there has been increasing interest in same-day discharge (SDD) after total joint arthroplasty (TJA). However, patient perception of SDD is not well reported. Purpose We sought to understand patients’ perceptions and preferences of postoperative care by surveying patients who have completed both an overnight stay (ON...

Background: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are no longer considered inpatient-only procedures. Qualifying for inpatient status reimbursement requires additional, unreimbursed administrative effort, and may limit care to these patients. Purpose: We sought to evaluate and compare the overall health status of patients r...

Background Robotic-assisted total knee arthroplasty (rTKA) has been shown to reduce the number of alignment outliers and to improve component positioning compared to manual TKA (mTKA). The primary purpose of this investigation was to compare the frequency of achieving target postoperative limb alignment and component positioning for rTKA vs mTKA....

Fractures are costly to treat and can significantly increase morbidity. Although dual-energy x-ray absorptiometry (DEXA) is used to screen at risk people with low bone mineral density (BMD), not all areas have access to one. We sought to create a readily accessible, inexpensive, high-throughput prediction tool for BMD that may identify people at ri...

Decreased mechanical loading after orthopaedic surgery predisposes patients to develop muscle atrophy. The purpose of this review was to assess whether the evidence supports oral protein supplementation can help decrease postoperative muscle atrophy and/or improve patient outcomes following orthopaedic surgery. A systematic review was conducted acc...

Purpose: To assess the utility of a validated wearable device (VWD) in examining preoperative and postoperative sleep patterns and how these data compare to patient-reported outcomes (PROs) after rotator cuff repair (RCR) or total shoulder arthroplasty (TSA). Methods: Male and female adult patients undergoing either RCR or TSA were followed up f...

Sidelying hip abduction (SHA) is a common exercise utilized in rehabilitation to strengthen the gluteus medius (GMed). Alterations in the exercise can produce different patterns of muscular activity. No studies have examined the effect of mechanical pelvic stabilization during SHA. This study enrolled 19 participants (male = 11, female = 8) who per...

Objectives Blood Flow Restriction (BFR) training provides partial occlusion at the proximal upper and lower extremities and has been shown to improve muscular strength and hypertrophy following an injury or surgery. By eliciting hypoxic intramuscular conditions, we can stimulate adaptive processes in skeletal muscle in a similar manner to high inte...

Objectives Decreased mechanical loading after orthopaedic surgery predisposes patients to develop muscle atrophy. The purpose of the study was to assess whether oral protein supplementation can help decrease postoperative muscle atrophy and/or improve patient outcomes following orthopaedic surgery. Methods A systematic review of the literature was...

Background: Multimodal pain management regimens and intraosseous infusion of morphine are two novel techniques that show promise in decreasing postoperative pain and opioid consumption following total knee arthroplasty. However, no study has analyzed the intraosseous infusion of a multimodal pain management regimen in this patient population. The...

Purpose: Several factors affect muscle protein synthesis (MPS) in the post-absorptive state. Extreme physical inactivity (e.g., bedrest) may reduce basal MPS, whereas walking may augment basal MPS. We hypothesized that Outpatients would have a higher postabsorptive MPS than Inpatients. Methods: To test this hypothesis, we conducted a retrospecti...

Patient-reported vaccine reactivity (PRVR) is a major contributor to COVID-19 vaccine hesitancy. PRVR responses to the COVID-19 vaccine may be affected by several modifiable and non-modifiable factors that influence immune function. Understanding the effects of these factors on PRVR can aid in better educating patients on expectations, as well as f...

Background: The ulnar collateral ligament (UCL) is a commonly injured elbow stabilizer during throwing. Shear wave elastography (SWE) is a technique that may reveal structural changes in the UCL that are indicative of ligament health and injury risk. The purpose of this study was to assess preseason and inseason shear wave velocity (SWV) in the UC...

Background: Successful fixation of the greater trochanter (GT) in total hip arthroplasty (THA) is a challenging task. A wide range of clinical results are reported in the literature despite advancements in fixation technology. Previous studies may have lacked adequate sample sizes to detect differences. This study evaluates nonunion and reoperatio...

Background Since posterior cervical fixation with lateral mass screws was introduced in 1979, multiple techniques have been described in the literature. However, no study to date has determined whether pre-drilling all lateral masses prior to screw insertion has a benefit over the traditional sequential drilling and screw insertion on the alignment...

BACKGROUND CONTEXT Ergometer rowing has gained popularity as a “low-impact” form of exercise. Lumbar spine injuries are the most common injury in rowers. Previous studies have shown ergometer training to be associated with an increased risk of injury. Muscular fatigue and spine range of motion may correlate to pain or injury in ergometer rowing. P...

INTRODUCTION: Tracking of patient reported outcome measures (PROMs) is common following total joint replacement via various self-reported survey formats. However, such measures are highly subjective and limited. The purpose of this study was to (1) develop a simple mobility outcomes testing battery (MOTB) incorporating movements of daily living as...

Objectives Lower limb bone stress injuries (BSI) of the pelvis, femur, and tibia are prevalent in collegiate track & field distance runners. However, it is not known the population’s bone, body composition (BComp), and anthropometric parameters prior to first respective collegiate injury compared to non-injured counterpart. This respective injury h...

Patient reported reactivity (PRVR) to COVID-19 vaccines are common within 24-72h of injection. PURPOSE: To identify and characterize demographic and lifestyle factors that may influence acute PRVR in adults following vaccination. METHODS: Following consent, an electronic survey (RedCap) was completed by 5,831 adults[62±15yr (18-98),♂2564♀3267] wh...

# Background The functional movement screen (FMS™) and Y-balance test (YBT) are commonly used to evaluate mobility in athletes. # Purpose The primary aim of this investigation was to determine the relationship between demographic and anthropometric factors such as sex, body composition, and skeletal dimension and scoring on YBT and FMS™ in male...

Background: Intraosseous (IO) infusion of medication is a novel technique for total knee arthroplasty (TKA) antibiotic prophylaxis. To decrease postoperative pain in TKA patients, we investigated addition of morphine to a standard IO antibiotic injection. Methods: A double-blind, randomized controlled trial was performed on 48 (24 each) consecutive...

BACKGROUND: Pain management after TKA is an important consideration to improve patient outcomes and reduce length of stay. This has led to the development of multi-modal pain management protocols. Currently, many institutions have incorporated cycylooxygnase-2-specific (COX-2) anti-inflammatory agents, neurogenic agents, intra-articular injections,...

Background Hip abductor complex tears remain an injury without clear consensus on management. Surgical treatment has been recommended after unsuccessful non-operative management. This study evaluates both tenodesis and bone trough techniques, with treatment choices guided by previously described tear classification. Methods This is a retrospective...

Objective Lumbar spondylolysis (SPONDY) and lumbar disc herniation (DISC) are common lumbar spine injuries that occur in baseball athletes. The purpose of this study was to determine whether Major League Baseball (MLB) draftees with a history of SPONDY or DISC have shorter career length, lower level of professional advancement, and longer cumulativ...

The use of blood flow restriction (BFR) within rehabilitation is rapidly increasing as further research is performed elucidating purported benefits such as improved muscular strength and size, neuromuscular control, decreased pain, and increased bone mineral density. Interestingly, these benefits are not isolated to structures distal to the occlusi...

Introduction: Pneumatic tourniquets are used extensively in orthopedic hand/wrist surgery. Complications, while rare, are associated with elevated pressure and duration of tourniquet use. Limb occlusion pressure (LOP) is the minimum tourniquet pressure at which arterial blood flow is restricted. Therefore, we performed a cross-sectional double-blin...

Background: The relationship between pitch volume and injury is well-represented within baseball literature. However, the impact of softball pitch volume on injury epidemiology is limited. Hypothesis: The purpose was to determine if increased pitch volumes in high school–aged softball pitchers are related to increased rates of subjectively reported...

Introduction to Blood Flow Restriction: Blood flow restriction (BFR) therapy utilizes a specialized cuff that is applied proximally around an injured limb, and restricts blood flow (50-80% arterial limb occlusion pressure, LOP) via compression. When combined with low-intensity exercise (LIX; <30% 1-repetition maximum), BFR-LIX has been shown to mim...

We recently observed a high prevalence of low pelvic bone mineral density (BMD) in female professional ballet performers. Because this population is susceptible to musculoskeletal overuse injuries, we aimed to determine which regions of the pelvis may be at greatest risk compared to general population females (GENPOP) as well as professional female...

# Background Fatigue may play a role in anterior cruciate ligament (ACL) injury, but has not been incorporated into objective test batteries for return to sport decisions following ACL reconstruction (ACLR) surgery. The effect of fatigue on muscle function and performance following surgery and rehabilitation has been poorly studied. # Purpose/Hyp...

Background Studies of cement use in total knee arthroplasty (TKA) have historically addressed mechanical properties and application strategies. Recently, cement technique has been studied as a means to reduce cost. We transitioned from opening two bags (80 grams) of cement to one bag (40 grams) of cement for primary TKA to improve cost efficacy. Th...

INTRODUCTION: Little data exists on the difference between various progressive hitting phases that may be involved with return to baseball after elbow injury. The purpose of this study was to critically analyze and report the kinetic force of the medial elbow during various phases and intensities of hitting in Division I collegiate baseball athlete...

BACKGROUND & PURPOSE: We recently observed a high prevalence of low pelvic bone mineral density (BMD) in elite female professional ballet performers (Lambert et al., PMID:32079918). Because this population is susceptible to stress and impact-based fractures, we aimed to determine which regions of the pelvis may be at greatest risk compared to gener...

Recently, the risk of hip injury during row exercise training has been illuminated by advances in diagnostic and imaging technology. PURPOSE: (1) To determine if a maximal effort 2000m row test commonly performed as a fitness assessment in rowers places participants in ranges of motion (ROM) associated with increased risk of hip injury (RISK THRESH...

EC Orthopaedics 12(4): 87-98, 2021. Background: Computer-assisted-navigated-surgery (CANS) has recently been utilized to improve implant positioning. The purpose of this study was to compare acetabular cup positioning between conventional (CON) surgery and CANS in primary total-hip arthroplasty (THA). Methods: A review of 176 (86 CANS/90 CON) prima...

The purpose of this study was to develop an equation to predict strength for seven common resistance training exercises using anthropometric and demographic measures. One-hundred forty-seven healthy adults (74 males, 73 females, 35±12yr, 174±10cm, 88±19kg) volunteered to participate. Body composition values (regional/total) and body dimensions were...

Background Revision total knee arthroplasty commonly involves stemmed components. If the diaphysis is engaged, this technique may be problematic for mechanical alignment (MA) in cases of tibial bowing, which are not infrequent (up to 30%). The aim of this study is to compare an intra-medullary(IM) and extra-medullary(EM) alignment method. We hypoth...

Context: Shoulder rehabilitation can be a difficult task due to the dynamic nature of the joint complex. Various weight training implements, including kettlebells (KB), have been utilized for therapeutic exercise in the rehabilitation setting to improve shoulder girdle strength and motor control. The KBs are unique in that they provide an unstable...

Background: Knee periarticular bone mineral density (BMD) is influenced by limb malalignment. The purpose of this study was to determine if the nature and magnitude of alignment correction (ΔAlign°) performed during primary total knee arthroplasty (TKA) had an impact on BMD at the metaphysis of the distal femur (DFmr) and proximal tibia (PTb). Meth...

Background: Eccentric exercise has demonstrated great utility in the rehabilitation of various shoulder pathologies. Research on the electromyographic (EMG) activity of the shoulder musculature during these activities is limited, however. Furthermore, no studies have observed how forearm positioning during exercise affects EMG output. Purpose/Hypot...

We examined bone mineral density (BMD) measurements made by dual-energy-xray-absorptiometry (DEXA) taken from 100 patients (♂46/♀54, 66±6yr) who previously underwent single total-knee arthroplasty (TKA) to determine if automated software-based artifact detection (ASAD) adequately removes implant artifact from the DXA image before analysis and if po...

EC Orthopaedics 11(10): 83-93, 2020. Background: Pain assessment using the visual analog scale (VAS) is common during patient evaluation in orthopedic settings. However, several factors contribute to variability in patient pain scoring when only assessed in clinic. As a subjective psychological measure, we hypothesized that patient VAS scores woul...

We tested a PEEP (4.2 cmH2O) mouthpiece (PMP) on maximal cycling performance in healthy adults. Experiment-1, PMP vs. non-PMP mouthpiece (CON) [N=9 (5♂), Age=30±2 yr]; Experiment-2, PMP vs. no mouthpiece (NMP) [N=10 (7♂), Age=27±1 yr]. At timepoint 1 in both experiments (mouthpiece condition randomized) subjects performed graded cycling testing (GX...

International Journal of Exercise Science 13(3): 802-817, 2020. Performing yoga in a heated environment (HY) is a popular exercise mode purported to improve range of motion (ROM), body composition, and aerobic fitness. The purpose of this investigation was to compare a session of HY to room temperature yoga (RTY) with regards to ROM, oxygen consum...

Background Vancomycin is a commonly used prophylactic antibiotic for total joint replacement surgery to protect against methicillin-resistant Staphylococcus aureus. Studies have suggested intraosseous (IO) infusions provide superior local tissue antibiotic concentration compared with intravenous (IV) access in total knee arthroplasty (TKA). We revi...

Previously, our laboratory introduced a regression equation for predicting net kcal consumption of a resistance exercise (RE) bout: Total net kcal = 0.874(height, cm)-0.596(age, years)-1.016(fat mass, kg) + 1.638(lean mass, kg) + 2.461(total volume x 10-3)-110.742 (R 2 = 0.773, SEE=28.5 kcal). PURPOSE: The purpose of this study was to validate this...

INTRODUCTION: Osteopenia and osteoporosis are modifiable health factors, particularly for the population group who are most likely to receive a total joint replacement. The World Health Organization has established dual-energy x-ray absorptiometry (DEXA) as the standard assessing bone mineral density (BMD). The purpose of this study is to determine...

INTRODUCTION: Pneumatic tourniquets are used extensively in orthopedic surgery. These are typically set to a standard tourniquet pressure (STP), traditionally 250 mm Hg in upper extremity surgery. Limb occlusion pressure (LOP) is the pressure at which arterial blood flow is restricted. This is believed to cause less tourniquet site pain without com...

Importance: Following recent updated guidelines by the Center for Medicare Services (CMS), total knee athroplasty (TKA) is no longer considered an inpatient only (IPO) procedure unless patients posses a number of criteria (BMI, HbA1c, co-morbidities) to qualify for inpatient status. On the contrary, total hip arthroplasty (THA) remains an IPO proce...

INTRODUCTION: The assessment of bone mineral density(BMD) using dual-energy-xray-absorptiometry (DEXA) is common in clinical settings for the assessment of bone health and fracture risk. Based on an individual’s age, sex, and race, regional BMD measures are scored against population norms using either age-matched Z-scores or young-adult (30 year ol...

INTRODUCTION: Total-knee-arthroplasty (TKA) is a corrective procedure whereby portions of the knee are replaced by prostheses (TKA). While several factors ultimately determine the success of the procedures, mechanical loading patterns and the integrity of the surrounding bone have been shown to play a role in the lifespan of the prostheses and long...

INTRODUCTION: Implant positioning in total hip arthroplasty (THA) directly correlates with improved postoperative outcome especially influencing the rates of dislocation and leg length discrepancy (LLD). With respect to spinopelvic relationship as it relates to functional acetabular component placement, there is increased requirement for precise an...

Stress fractures are common among elite ballet dancers whereby musculoskeletal health may be affected by energy balance and overtraining. Purpose: To characterize bone health in relation to stress fracture history, body composition, eating disorder risk, and blood biomarkers in professional male and female ballet dancers. Methods: A single coho...

Background: Limited data exist delineating the reasons women choose subspecialties within orthopaedics. Purpose:(1) To perform a survey that determines subspecialties female orthopaedic surgeons select and (2) to analyze the motivations behind their choices.Methods:A 10-question survey was distributed via e-mail to theRuth Jackson Orthopaedic Socie...

Background: Comprehensive systematic reviews of results from homogenous or heterogeneous clinical trials, meta-analyses are used to summarize and to interpret studies. Proponents believe that their use can increase study power and improve precision results. Critics emphasize that heterogeneity between studies and bias of individual studies comprom...

INTRODUCTION: Hip abductor tendon tears have been referred to as “rotator cuff tears of the hip,” and are a recognized etiology for persistent, often progressive, lateral hip pain, weakness, and limp. Multiple repair techniques and salvage procedures for abductor tendon tears have been reported in the literature; however, re-tear remains a frequent...

Blood flow restriction (BFR) therapy has been observed to improve post-operative recovery in the limbs when combined with low intensity resistance exercise (LIX). Little data exists regarding use of BFR for proximal benefit of the upper limbs (shoulders). PURPOSE: (1) Determine if rotator cuff (RC) exercises combined with BFR (BFR-Rx) promote great...

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PURPOSE: We report testing results of wearing a positive end-expiratory pressure (PEEP) valve mouthpiece during exercise on VO2max and cycling time to exhaustion. METHODS: 4 women & 5 men (Age 31±2 yrs, Ht 172.2±3.8 cm, WT 72.1±3.7 kg) were assigned at random on two separate occasions (time of day controlled, at least 48 hr between each test) to we...

Introduction: Perioperative hypothermia (PH) is common in patients undergoing total joint arthroplasty (TJA). A previous study at our institution identified the largest drop in core body temperature between preoperative holding and induction of anesthesia. This study evaluates the effect of preoperative warming measures on PH in TJA patients. Met...

Introduction: Total knee arthroplasty (TKA) is a common procedure practiced in both the community and academic setting and one that all orthopaedic surgery residents are expected to become competent in. The aim of this study is to determine the most common technical obstacles encountered during TKA learning. Methods: This is a prospective, cohort...

max from treadmill performance in American-style football athletes. J Strength Cond Res 33(4): 1028-1034, 2019-Prediction equations are often used to estimate V _ O 2 max in the general population but are lacking for American-style football (ASF) athletes. We sought to develop a regression model to estimate V _ O 2 max from treadmill exercise time...

Objectives: Patients often experience atrophy and bone loss immediately following anterior cruciate ligament (ACL) reconstruction. Rehabilitation (rehab) combined with blood flow restriction (BFR) therapy have been shown to mitigate muscle atrophy and reduce timelines for earlier return to function. Little is known about how BFR may impact bone los...

Objectives Patients often experience atrophy and bone loss immediately following anterior cruciate ligament (ACL) reconstruction. Rehabilitation (rehab) combined with blood flow restriction (BFR) therapy have been shown to mitigate muscle atrophy and reduce timelines for earlier return to function. Little is known about how BFR may impact bone loss...

CITATION INFORMATION Chaliki, Kalyan; Delgado, Domenica; Dong, David; Moreno, Michael; Lee, Joshua; McCulloch, Patrick; Harris, Joshua; and Lambert, Bradley (2019) "Acute Effects of a Single Session of Hot Yoga on Caloric Expenditure, Range of Motion, and Metabolism," International Journal of Exercise Science: Conference Proceedings: Vol. 2 : Iss....

The energy expenditure of resistance exercise (RE) is an important consideration for exercise prescription and weight management, yet prediction models are lacking. Purpose: This study aimed to develop regression equations to predict energy expenditure (kcal) for RE involving each major muscle group using commonly measured demographic and exercis...