Lenox Hill Hospital

About: Lenox Hill Hospital is a healthcare organization based out in New York, New York, United States. It is known for research contribution in the topics: Population & Medicine. The organization has 2569 authors who have published 3561 publications receiving 114326 citations.

Arthroscopic surgery of the knee in the geriatric patient.

Abstract: There remains some controversy and confusion regarding arthroscopic surgery of the knee in the elderly population, particularly for patients with osteoarthritis. A retrospective review was undertaken of 105 knees in patients 60 years or older who had arthroscopy during a 4-year period. The surgical outcomes were evaluated using a postoperative knee scoring system at a mean followup period of 11.7 months. Good and excellent results were obtained in 65% of knees. The most significant predictors of good outcome were preoperative mechanical symptoms, such as those resulting from loose bodies or flap tears of the meniscus, and only mild articular degeneration seen at arthroscopy. A review of the literature reflects similar success rates. Although the results are equivocal by orthopaedic standards, in selected patients arthroscopic surgery can offer significant relief of acute symptoms and defer more extensive surgical procedures with minimal risk.

Boxer's knuckle—dorsal capsular rupture of the metacarpophalangeal joint of a finger

Abstract: An injury to the dorsal aspect of the metacarpophalangeal joint of a finger usually damages the sagittal fibers of the extensor tendon mechanism. Rupture of the underlying joint capsule, a far more serious injury, has received scant attention in the medical literature. The problem is often unrecognized because the extensor tendon may remain in its normal midline position. Eight dorsal capsular ruptures are described in six patients who had closed direct trauma to either the knuckle of their index or long fingers. Most of the injuries occurred in professional boxers.

High-Speed Rotational Atherectomy of Human Coronary Stenoses: Acute and One-Year Outcomes From the New Approaches to Coronary Intervention (NACI) Registry

Abstract: High-speed rotational atherectomy (RA) is a new percutaneous procedure for treatment of coronary stenoses that operates by the unique mechanism of plaque abrasion. This article reports acute (in-hospital) outcomes and 1-year follow-up in a large cohort of patients treated with this device by NACI investigators. A total of 525 patients with 670 lesions treated with RA form the substrate of this report. Patients tended to be older (mean age 64.8 years) than those in previously reported series of percutaneous transluminal coronary angioplasty (PTCA), with more extensive disease and more complex lesions. Calcification was present in 54% of lesions, and eccentricity in 41%. Balloon angioplasty postdilation was performed after RA in 88% of cases. Angiographic and procedural success (angiographic success without death, Q-wave myocardial infarction [MI] or emergency coronary artery bypass graft [CABG] surgery) rates were 89% and 88%, respectively. Acute in-hospital events included 4 deaths (1%) and 1 emergency CABG surgery (0.4%). MI occurred in 6% of patients, consisting predominantly of non-Q-wave MI (5%). After RA, angiographic complications included coronary dissection (12%), abrupt closure (5%), side branch occlusion (3%), and distal embolization (3%). Most of these were resolved after postdilation except for coronary dissection, which was present in 15% of lesions treated. Mean length of stay was 3 days. At 1-year follow-up, 27% of patients required target lesion revascularization and 30% had experienced death, Q-wave MI, or target lesion revascularization. Preprocedural characteristics that independently predicted 1-year death, Q-wave MI, or target lesion revascularization were male gender, high risk for surgery, target lesions that were proximal to or in bifurcations, eccentric, long, or highly stenosed. RA, even when applied to lesions of traditionally unfavorable morphology, appears to provide reasonable procedural and angiographic success rates. Restenosis and progression of disease contribute to subsequent clinical and procedural events.