Sports Medicine Specialist, Orthopedic Surgeons, Neurologist (brain, nervous system), Surgical Specialist
10 years of experience
Video profile
Accepting new patients
Woods Corner
Lahey Clinic
41 Mall Rd
Burlington, MA 01803
978-538-4270
Locations and availability (1)

Education ?

Medical School Score Rankings
Northwestern University (2000)
  • Currently 3 of 4 apples
Top 50%

Awards & Distinctions ?

Appointments
Boston University School of Medicine
Assistant Professor of Orthopaedic Surgery
Associations
American Orthopaedic Society for Sports Medicine
American Board of Orthopaedic Surgery

Affiliations ?

Dr. Baumfeld is affiliated with 4 hospitals.

Hospital Affilations

Score

Rankings

  • Lahey Clinic
    Orthopaedic Surgery
    41 Mall Rd, Burlington, MA 01803
    • Currently 4 of 4 crosses
    Top 25%
  • Virginia Ambulatory Surgery, Inc.
  • Lahey Clinic Hospital
  • Lahey Clinic North Shore
    1 Essex Center Dr, Peabody, MA 01960
  • Publications & Research

    Dr. Baumfeld has contributed to 8 publications.
    Title Joint Infection Unique to Hamstring Tendon Harvester Used During Anterior Cruciate Ligament Reconstruction Surgery.
    Date June 2008
    Journal Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
    Excerpt

    Joint infection after anterior cruciate ligament (ACL) reconstruction is a rare but important clinical issue that must be resolved quickly to prevent secondary joint damage and preserve the graft. After careful analysis, we observed 3 infection cases within a 12-month period after ACL reconstruction, which represented an abnormally elevated risk. All reconstructions were performed by the same surgeon and used hamstring tendon allograft. For each surgery, the Target Tendon Harvester (DePuy Mitek, Raynham, MA) was used to harvest hamstring tendons. Through our review, we learned that this instrument was sterilized while assembled. It is our belief that ineffective sterilization of this hamstring graft harvester served as the origin for these infections. We have determined that appropriate sterilization technique involves disassembly of this particular hamstring tendon harvester before sterilization because of the tube-within-a-tube configuration. We have since continued to use the Target Tendon Harvester, disassembling it before sterilization. There have been no infections in the ensuing 12 months during which the surgeon performed over 40 primary ACL reconstructions via hamstring autograft. The information from this report is intended to provide arthroscopists with information about potential sources of infection after ACL reconstruction surgery.

    Title The Effect of Femoral Tunnel Starting Position on Tunnel Length in Anterior Cruciate Ligament Reconstruction: a Cadaveric Study.
    Date December 2007
    Journal Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
    Excerpt

    PURPOSE: The purpose of this cadaveric study was to evaluate the effect of femoral tunnel starting position on femoral tunnel length and to evaluate the effect of tibial tunnel starting position on femoral tunnel starting position in anterior cruciate ligament (ACL) reconstruction. METHODS: Seven fresh-frozen cadaver knees were studied. Tibial tunnels were placed at each of 3 different locations: anterior placement, far medial placement, and midway between the anterior and far medial placements. Femoral guidewires were placed using a 5-mm offset guide at each of 4 different locations: 1 from each of the 3 tibial tunnels and 1 from the anteromedial arthroscopic portal. The depth of the resultant femoral tunnels and the clock face location of each tunnel were measured. RESULTS: The mean clock position (o'clock) and length (mm) of the femoral tunnel versus tibial starting position were as follows. Anterior tibia: 11:30 o'clock and 61 mm. Midpoint tibia: 10:50 o'clock and 44 mm. Far medial tibia: 10:17 o'clock and 37 mm. Medial arthroscopy portal: 9:35 o'clock and 23 mm. The differences in tunnel length between starting positions were statistically significant, and the differences in femoral starting position between tibial starting positions were statistically significant. CONCLUSIONS: Tunnel length greater than 2 cm and 10:30 o'clock starting position can be achieved by medial placement of the tibial tunnel. Placement from the medial arthroscopy portal can result in femoral tunnels more lateral than 10 o'clock, but they may be shorter than 2 cm. CLINICAL RELEVANCE: Tibial starting position affects femoral starting position in the intercondylar notch. Femoral starting position affects femoral tunnel length. Femoral starting position and tunnel length are important considerations in clinical ACL reconstruction.

    Title Predictors for Hamstring Graft Diameter in Anterior Cruciate Ligament Reconstruction.
    Date November 2007
    Journal The American Journal of Sports Medicine
    Excerpt

    BACKGROUND: The ability to accurately predict the diameter of autograft hamstring tendons has implications for graft choice and fixation devices used in anterior cruciate ligament (ACL) reconstruction. PURPOSE: To determine whether simple anthropometric measurements such as height, mass, body mass index (BMI), age, and gender can be used to accurately predict the diameter of hamstring tendons for ACL reconstruction surgery. STUDY DESIGN: Cohort study (prevalence); Level of evidence, 2. METHODS: The authors conducted medical record reviews and telephone interviews of 106 consecutive patients with ACL reconstruction using quadrupled semitendinosus-gracilis autograft from 2004 to 2006. Data included anthropometric measurements (height, mass, gender, and age at the time of surgery). Hamstring diameter was obtained using cylindrical sizers in 0.5-mm increments and recorded in the patient's surgical record. Correlation coefficients (Pearson r) and stepwise, multiple linear regression were used to determine the relationship between the outcome variable (hamstring graft diameter) and the predictor variables (age, gender, height, mass, and BMI). Independent sample t tests were used to compare hamstring graft diameter between genders. RESULTS: Hamstring graft diameter was related to height (r = .36, P < .001), mass (r = .25, P = .005), age (r = -.16, P = .05), and gender (r = -.24, P = .006) but was not related to BMI (P > .05). Height was a statistically significant prediction variable (R(2) = .13, P < .001). From the current data, a regression equation was calculated that suggested that a patient <147 cm (58 in) tall is likely to have a quadrupled hamstring graft diameter <7 mm in diameter (graft size = 2.4 + 0.03 x height in cm). Women had significantly smaller hamstring graft diameters (7.5 +/- 0.7 mm) than did men (7.9 +/- 0.9 mm, P = .01). CONCLUSIONS: Of the parameters studied, height was the best predictor of hamstring tendon diameter, particularly in women.

    Title The Effect of the Orientation of the Radial Head on the Kinematics of the Ulnohumeral Joint and Force Transmission Through the Radiocapitellar Joint.
    Date August 2006
    Journal Clinical Biomechanics (bristol, Avon)
    Excerpt

    Background. The treatment of radial head fractures that are not amenable to an open reduction and internal fixation, remains to be a difficult issue. A potential problem with prosthetic replacement of the radial head is the shape of current radial head prostheses. The purpose of this study was to determine the effect of the shape of the radial head on kinematics and load transfer of the elbow. Methods. Kinematics of the elbow and radiocapitellar force transmission were measured in 6 fresh frozen upper extremities. The effect of radial head shape was tested by rotating the head 90 degrees , with a custom-made 'native' radial head prosthesis. 3-D spatial orientation of the ulna showed an average difference in ulnohumeral laxity, between the nominal and 90 degrees conditions, of 0.1 degrees throughout the arc of motion with neutral forearm rotation (maximum: 2 degrees ). Findings. We found an average difference in ulnar axial rotation, of 0.1 degrees (maximum: 1.9 degrees ). No differences showed statistical significance. Radiohumeral joint force was measured and maximally showed a 32 times increase of force in the altered shape conditions. Interpretation. Our results show that the kinematics of the elbow was not affected by altering the shape of the radial head, but it did adversely affect the forces in the radiohumeral joint. This could possibly generate degenerative changes in the elbow.

    Title The Kinematic Importance of Radial Neck Length in Radial Head Replacement.
    Date July 2005
    Journal Medical Engineering & Physics
    Excerpt

    Comminuted radial head fractures can be treated with a radial head implant. The effects of lengthening (2.5 mm, 5 mm) and shortening (2.5 mm, 5 mm) of the radial neck, were compared to the nominal length in six human upper extremity cadavers. Total varus-valgus laxity and ulnar rotation were recorded. We hypothesized that restoring the exact length of the radius is important to maintain normal kinematics in the elbow joint. Lengthening or shortening of more than 2.5 mm significantly changed elbow kinematics. Lengthening caused a significant decrease (p < 0.001) in varus-valgus laxity, with the ulna tracking in varus and external rotation. Shortening caused a significant increase in varus-valgus laxity (p < 0.001) and ulnar rotation (p < 0.001), with the ulna tracking in valgus and internal rotation. Our study suggests that a restoration of radial length is important and that axial understuffing or overstuffing the radiohumeral joint by 2.5 mm or more, will alter elbow kinematics.

    Title Detrimental Effects of Overstuffing or Understuffing with a Radial Head Replacement in the Medial Collateral-ligament Deficient Elbow.
    Date January 2005
    Journal The Journal of Bone and Joint Surgery. American Volume
    Excerpt

    BACKGROUND: Comminuted radial head fractures associated with an injury of the medial collateral ligament can be treated with a radial head implant. We hypothesized that lengthening and shortening of the radial neck would alter the kinematics and the pressure through the radiocapitellar joint in the medial collateral ligament-deficient elbow. METHODS: The effects of lengthening (2.5 and 5 mm) and shortening (2.5 and 5 mm) of the radial neck were assessed in six human cadaveric upper extremities in which the medial collateral ligament had been surgically released. The three-dimensional spatial orientation of the ulna was recorded during simulated active motion from extension to flexion. Total varus-valgus laxity and ulnar rotation were measured. Radiocapitellar joint pressure was assessed with use of pressure-sensitive film. RESULTS: Radial neck lengthening or shortening of >/=2.5 mm significantly changed the kinematics in the medial collateral ligament-deficient elbow. Lengthening caused a significant decrease (p < 0.05) in varus-valgus laxity and ulnar rotation (p < 0.05), with the ulna tracking in varus and external rotation. Shortening caused a significant increase in varus-valgus laxity (p < 0.05) and ulnar rotation (p < 0.05), with the ulna tracking in valgus and internal rotation. The pressure on the radiocapitellar joint was significantly increased after 2.5 mm of lengthening. CONCLUSIONS: This study suggests that accurate restoration of radial length is important and that axial understuffing or overstuffing of the radiohumeral joint by >/=2.5 mm alters both elbow kinematics and radiocapitellar pressure. CLINICAL RELEVANCE: This in vitro cadaver study indicates that a radial head replacement should be performed with the same level of concern for accuracy and reproducibility of component position and orientation as is appropriate with any other prosthesis.

    Title The Effect of the Orientation of the Noncircular Radial Head on Elbow Kinematics.
    Date August 2004
    Journal Clinical Biomechanics (bristol, Avon)
    Excerpt

    OBJECTIVE: The objective of this study was to identify the effect of radial head shape and orientation on elbow kinematics in the otherwise intact elbow. DESIGN: Biomechanical study, analyzing simulated active motion of cadaveric arms. BACKGROUND: A discrepancy exists between the noncircular anatomy of the radial head and radial head prostheses. The effect of radial head shape is unknown. METHODS: Kinematic effects of radial head shape were tested in six fresh-frozen upper extremities. A custom-made native radial head prosthesis was used to simulate altered shape conditions, by rotating the radial head 90 degrees. Three-dimensional spatial orientation of the ulna was recorded, during simulated active motion. A three factor ANOVA was used to compare (a) nominal and 90 degrees oriented conditions, (b) throughout the flexion arc (c) in three forearm positions (P < 0.05). Post-hoc Tukey tests were done to assess significance. RESULTS: No significant effect of altering radial head shape was found on total ulnohumeral laxity and angulation during gravity valgus stress. We did find a significant effect on total ulnar axial rotation and rotation during gravity valgus stress. CONCLUSION: The outer shape of the radial head seems to change rotation of the ulna during flexion-extension in an otherwise intact elbow. RELEVANCE: The shape of the radial head effects intact elbow kinematics. Clinical importance of this finding is clear. If a sub-optimally placed radial head prosthesis were to be used in an otherwise intact elbow, the elbow could be at risk for early ulnohumeral arthritis.

    Title Tunnel Widening Following Anterior Cruciate Ligament Reconstruction Using Hamstring Autograft: a Comparison Between Double Cross-pin and Suspensory Graft Fixation.
    Date
    Journal Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the Esska
    Excerpt

    Femoral and tibial tunnel widening following ACL reconstruction using hamstring autograft has been described. Greater tunnel widening has been reported with suspensory fixation systems. We hypothesized that greater tunnel widening will be observed in patients whose hamstring autograft was fixated using a cortical, suspensory system, compared to double cross-pin fixation on the femur. We performed clinical and radiographic evaluation on 46 patients at minimum 2 years after primary ACL reconstruction. We measured subjective and objective outcomes including KT-1000 and AP, lateral radiographs. A musculoskeletal radiologist, independent of the surgical team, measured tunnel width, while correcting for magnification, at the widest point and at 1 cm away from tibial and femoral tunnel apertures. Patients in the suspensory graft fixation group exhibited significantly greater absolute change and greater percent change in femoral tunnel diameter compared to patients with double cross-pin fixation (P </= 0.05). This difference was noted on both AP and lateral radiographs and at both measurement sites. There was no significant difference between groups for tibial tunnel widening, IKDC subjective scores or KT-1000 side to side differences. There was significantly more femoral tunnel widening associated with the use of the endobutton suspensory fixation system compared to the use of double cross-pins for fixation within the tunnel.


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