Medicine and Health Sciences Commons^™

Osteoarthritis Disease Severity In The Temporomandibular Joint And The Knee Joint: A Comparative Cadaveric Study, Jessica A Immonen, Jason Ciccotelli, Linh M Nguyen, Lesley Gilmer, Landen Broadhead, Mackenzie Kitchen, Conner Paul, Jeremy James

Journal Articles

OBJECTIVE: The objective of this study was to determine the level of disease severity in a pilot cohort of temporomandibular joints (TMJs) and compare them to the pathology findings previously characterized in cadaveric knee joints.

DESIGN: Thirty-one intact TMJs from 17 cadaveric donors were harvested and arthritic lesioning seen in the knee joint was investigated on the condyle and the fossa of the TMJ. Prevalence of gross alterations was equated and disease severity was determined for sex- and age-based donor pools using a validated, osteoarthritis (OA) disease severity scale (DSS). Knee joint DSS scores were also compared to the TMJ …

Current Relevance Of Biomarkers In Diagnosis Of Periprosthetic Joint Infection: An Update., Saksham Tripathi, Saad Tarabichi, Javad Parvizi, Ashok Rajgopal

Rothman Institute Faculty Papers

With a significant rise in the number of arthroplasty procedures performed worldwide, the increasing revision burden posed by periprosthetic joint infection (PJI) is a matter of growing concern. In spite of various attempts to diagnose PJI, there are no defined tests that can be called a gold standard. Given the importance of early diagnosis in PJI, newer tests and biomarkers have been introduced to improve cumulative diagnostic accuracy. Novel biomarkers like calprotectin, lipocalcin, monocyte-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and platelet-to-mean platelet volume ratio have demonstrated a potential as diagnostic biomarkers for PJI. This article discusses the relevance of available …

Diagnostic Dilemma: Schwannoma Or Ganglion Cyst, Karthik Ks, Prakash M, Gurumurthy B, Sujanatheja Js, Pramod Bm, Punith N

Digital Journal of Clinical Medicine

Schwannomas are rare, slow growing benign tumors of peripheral nerve sheath originating from Schwann cells surrounding the nerve associated with delayed presentation of pain and paresthesia. Their incidence being 5% of all upper extremity tumors. They may be a part of neurofibromatosis called schwannomatosis with multiple peripheral schwannomas. We present a case of solitary schwannomas from the peripheral nerves probably superficial branch of median nerve mistaken initially for ganglion cyst.

Laboratory-Reported Normal Value Ranges Should Not Be Used To Diagnose Periprosthetic Joint Infection., Salvador A. Forte, Joseph A. D'Alonzo, Zachary Wells, Brett Levine, Stephen Sizer, Carl Deirmengian

Orthopedic Surgery Resident Research

INTRODUCTION: Clinical laboratories offer several multipurpose tests, such as the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), which are not intended to diagnose any specific disease but are used by clinicians in multiple fields. The results and laboratory interpretation (normal/abnormal) of these multipurpose tests are based on laboratory-reported normal thresholds, which vary across clinical laboratories. In 2018, the International Consensus Meeting on Musculoskeletal Infection (2018 ICM) provided a gold-standard definition to diagnose periprosthetic joint infection (PJI) which included many multipurpose laboratory tests, along with thresholds optimized to diagnose PJI. The discrepancy between laboratory-reported normal thresholds and 2018 ICM-recommended PJI-optimized …

Sacral Fractures And Associated Injuries., Ricardo Rodrigues-Pinto, Mark F. Kurd, Gregory D. Schroeder, Christopher K. Kepler, James C. Krieg, Jörg H. Holstein, Carlo Bellabarba, Reza Firoozabadi, F Cumhur Oner, Frank Kandziora, Marcel F. Dvorak, Conor P. Kleweno, Luiz R. Vialle, S. Rajasekaran, Klause J. Schnake, Alexander R. Vaccaro

Rothman Institute Faculty Papers

STUDY DESIGN: Literature review.

OBJECTIVE: The aim of this review is to describe the injuries associated with sacral fractures and to analyze their impact on patient outcome.

METHODS: A comprehensive narrative review of the literature was performed to identify the injuries associated with sacral fractures.

RESULTS: Sacral fractures are uncommon injuries that result from high-energy trauma, and that, due to their rarity, are frequently underdiagnosed and mistreated. Only 5% of sacral fractures occur in isolation. Injuries most often associated with sacral fractures include neurologic injuries (present in up to 50% of sacral fractures), pelvic ring disruptions, hip and lumbar spine …

A New Diagnosis Of Multiple Sclerosis In A 29-Year-Old Former Collegiate Basketball Player With Initial Symptoms Of Recurrent Bell’S Palsy: A Case Report, Eric R. Reynolds, Andrew D. Ashbaugh, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

Multiple sclerosis (MS) is a demyelinating disorder of the central nervous system, characterized by immunemediated destruction of myelinated axons, which leads to notable physical disability. Although presence among active athletes is extremely low, it can cause considerable lifestyle changes for those athletes affected as they transition into life after competitive athletics. We describe a 29-year-old former collegiate women’s basketball player in whom MS was diagnosed during a visit for recurrent evaluation of Bell palsy. Subsequent neurology consult and magnetic resonance imaging led to the confirmation of the diagnosis of MS, and the patient began treatment for relapsing-remitting MS. During visits …

Diagnosing An Acute Quadratus Plantae Tear In A 37-Year-Old Athlete: A Case Report, James P. Toldi, Shane P. Cass, Richard A. Miller, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

Foot injuries occur frequently in distance runners and can notably impact training performance. Common diagnoses include plantar fasciitis, tendinopathies of the forefoot or midfoot, and stress fractures of the metatarsals. Occasionally, more obscure structures may be involved. We describe a 37-year-old male distance runner who presented with symptoms of heel pain and ecchymosis, suggesting an acute plantar fascia injury. However, findings of magnetic resonance imaging revealed a tear to the quadratus plantae (QP). The patient gradually returned to normal levels of physical activity, with complete resolution of symptoms by 4 months after the initial injury. Healthcare providers should be aware …

Development And Validation Of A Direct Tibial Loading Device For Mice, Sylvie Kalikoff

Honors Theses

Of the six million bones fractured each year in the United States, 5 to 10% do not heal properly. Fractures range in severity and classification, and are therefore treated differently depending on the type of bone that was broken, the location of the break, and the way in which the specific bone regrows. It is crucial that the appropriate treatment be carried out in order to properly heal the broken bone.

Improving Rural Bone Health And Minimizing Fracture Risk In West Virginia: Validation Of The World Health Organization Frax® Assessment Tool As A Phone Survey For Osteoporosis Detection, Franklin D. Shuler Md, Phd, Kelly Scott Md, Mph, Timothy Wilson-Byrne Md, Miranda R. Morgan, Linda Morgan

Timothy Wilson-Byrne MD

West Virginia ranks second nationally in population ≥ 65 years old placing our state at greater risk for osteoporosis and fracture. The gold standard for detecting osteoporosis is dual X-ray absorptiometry (DXA), yet over half of West Virginia’s counties do not have this machine. Due to access barriers, a validated phone-administered fracture prediction tool would be beneficial for osteoporosis screening. The World Health Organization’s FRAX® fracture prediction tool was administered as a phone survey to 45 patients; these results were compared to DXA bone mineral density determination. Results confirmed that the FRAX® phone survey is as reliable as DXA in …

Improving Rural Bone Health And Minimizing Fracture Risk In West Virginia: Validation Of The World Health Organization Frax® Assessment Tool As A Phone Survey For Osteoporosis Detection, Franklin D. Shuler Md, Phd, Kelly Scott Md, Mph, Timothy Wilson-Byrne Md, Miranda R. Morgan, Linda Morgan

Franklin D. Shuler

West Virginia ranks second nationally in population ≥ 65 years old placing our state at greater risk for osteoporosis and fracture. The gold standard for detecting osteoporosis is dual X-ray absorptiometry (DXA), yet over half of West Virginia’s counties do not have this machine. Due to access barriers, a validated phone-administered fracture prediction tool would be beneficial for osteoporosis screening. The World Health Organization’s FRAX® fracture prediction tool was administered as a phone survey to 45 patients; these results were compared to DXA bone mineral density determination. Results confirmed that the FRAX® phone survey is as reliable as DXA in …

Improving Rural Bone Health And Minimizing Fracture Risk In West Virginia: Validation Of The World Health Organization Frax® Assessment Tool As A Phone Survey For Osteoporosis Detection, Franklin D. Shuler Md, Phd, Kelly Scott Md, Mph, Timothy Wilson-Byrne Md, Miranda R. Morgan, Linda Morgan

Orthopaedics

West Virginia ranks second nationally in population ≥ 65 years old placing our state at greater risk for osteoporosis and fracture. The gold standard for detecting osteoporosis is dual X-ray absorptiometry (DXA), yet over half of West Virginia’s counties do not have this machine. Due to access barriers, a validated phone-administered fracture prediction tool would be beneficial for osteoporosis screening. The World Health Organization’s FRAX® fracture prediction tool was administered as a phone survey to 45 patients; these results were compared to DXA bone mineral density determination. Results confirmed that the FRAX® phone survey is as reliable as DXA in …

Surgical Treatment Of Chronic Dislocation Of A Posterior Tibial Tendon In A Collegiate Athlete: A Case Report, Tony G. Pedri, Richard A. Miller

UNM Orthopaedic Research Journal

Traumatic dislocation of the posterior tibial tendon (PTT) is a rare and often misdiagnosed injury. The limited number of cases, ambiguous results of initial imaging studies, and presence of symptoms similar to medial ankle sprains can contribute to unsuccessful long-term treatment. Current studies, although limited, report high rates of failure in nonoperative compared with operative treatment. We describe a 21-year-old male baseball player who experienced pain and mild swelling in his ankle after falling while running at full speed. After 5 months of continuous pain in the medial ankle, the patient was referred to our clinic and underwent suture anchor …

Lipoma Of The Index Finger In A 64-Year-Old Man: A Case Report, Norfleet B. Thompson, Moheb S. Moneim

UNM Orthopaedic Research Journal

Lipomas are benign tumors composed of adipose tissue and typically encountered in middle-aged patients. Although the etiology remains unknown, this lesion can occur throughout the body. However, it is rarely seen in the finger. Typical treatment has often involved observation, but excision techniques have also reported successful outcomes. We describe a 64-year-old male patient who reported to our clinic with a painless soft-tissue mass in the index finger of his left hand, and we performed operative excision for treatment. The findings of physical examinations, radiographs, and magnetic resonance imaging tests had indicated the presence of lipoma, and results of pathological …

Efficacy Of A Novel Examination Maneuver In Diagnosing Meniscal Pathology, Eric J. Freeh, Ryan Lurtsema

UNM Orthopaedic Research Journal

In this retrospective study we examine the effectiveness of the here named “Twist test” in diagnosing meniscal pathology. In preparation for this study, a literature review was conducted to look at commonly used “gold standard” exam maneuvers utilized in the diagnosis of meniscal lesions. The data from these studies was used as comparisons against the twist test. Medical records of patients who underwent knee arthroscopy from the 2013 calendar year were pulled and assessed for positive or negative Twist test results. These results were then correlated with Magnetic Resonance Imaging (MRI), and more definitively, arthroscopic findings. With this data, we …

Tuberculosis Of The Ankle: A Case Report, Drew Newhoff, Richard A. Miller

UNM Orthopaedic Research Journal

No abstract provided.

Spinal Tuberculosis: Diagnosis And Management., Mohammad R Rasouli, Maryam Mirkoohi, Alexander R Vaccaro, Kourosh Karimi Yarandi, Vafa Rahimi-Movaghar

Department of Neurosurgery Faculty Papers

The spinal column is involved in less than 1% of all cases of tuberculosis (TB). Spinal TB is a very dangerous type of skeletal TB as it can be associated with neurologic deficit due to compression of adjacent neural structures and significant spinal deformity. Therefore, early diagnosis and management of spinal TB has special importance in preventing these serious complications. In order to extract current trends in diagnosis and medical or surgical treatment of spinal TB we performed a narrative review with analysis of all the articles available for us which were published between 1990 and 2011. Althoug h the …

Revision Total Knee Arthroplasty: Infection Should Be Ruled Out In All Cases, Mohammad R. Rasouli, Armin Aalami Harandi, Bahar Adeli, James J. Purtill, Javad Parvizi

Rothman Institute Faculty Papers

We hypothesized that some aseptic revision total knee arthroplasty failures are indeed caused by occult infection. This prospective study recruited 65 patients undergoing revision total knee arthroplasty. The mean follow-up period was 19 months. Collected synovial fluid was analyzed by Ibis T5000 biosensor (Abbott Molecular Inc, Ill; a multiplex polymerase chain reaction technology). Cases were considered as infected or aseptic based on the surgeon's judgment and Ibis findings. Based on Ibis biosensor, 17 aseptic cases were indeed infected that had been missed. Of these 17 cases, 2 developed infection after the index revision. A considerable number of so-called aseptic failures …

Management Of Morel-Lavallee Lesion Of The Knee: Twenty-Seven Cases In The National Football League, Samir G. Tejwani, Steven B. Cohen, James P. Bradley

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: The Morel-Lavallee lesion is a closed degloving injury most commonly described in the region of the hip joint after blunt trauma. It also occurs in the knee as a result of shearing trauma during football and is a distinct lesion from prepatellar bursitis and quadriceps contusion.

PURPOSE: To review the authors' experience with Morel-Lavallee lesion of the knee in the elite contact athlete to construct a diagnostic and treatment algorithm.

STUDY DESIGN: Case series; Level of evidence, 4.

METHODS: Twenty-seven knees in 24 players were identified from 1 National Football League team's annual injury database as having sustained a …

Rotator Cuff Contusions Of The Shoulder In Professional Football Players: Epidemiology And Magnetic Resonance Imaging Findings, Steven B. Cohen, Jeffrey D. Towers, James P. Bradley

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: No published reports have studied the epidemiology and magnetic resonance imaging findings associated with rotator cuff contusions of the shoulder in professional football players.

PURPOSE: To determine a single professional football team's incidence, treatment, and magnetic resonance imaging appearance of players sustaining rotator cuff contusions of the shoulder.

STUDY DESIGN: Case series; Level of evidence, 4.

METHODS: From 1999 to 2005, a North American professional football team's injury records were retrospectively reviewed for athletes who had sustained a rotator cuff contusion of the shoulder during in-season participation. Those patients who had magnetic resonance imaging of the shoulder with a …