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Advances In Bone And Orthopedics 2024 Edition, Jean-Philippe Berteau, Laurent Pujo-Menjouet

Publications and Research

We are delighted to present the latest edition of ”Advances in Bone and Orthopedics,” a comprehensive compilation of pioneering research and innovative developments in the field. This volume brings together a selection of peer-reviewed abstracts from BONITOS 2024, the Fourth Season of the Bone and Orthopedics Interdisciplinary Symposium, held on May 31st, 2024, at the College of Staten Island in New York. This symposium, a hallmark event in the calendar of professionals dedicated to bone health and orthopedic excellence. The contributions within this volume reflect the breadth and depth of research presented at BONITOS 2024. These abstracts represent cutting-edge studies …

A Multimodal Approach: Implementing Omm For Spinal Surgery Patients' Pain And Anxiety, Summer Barnes

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to encourage thorough assessment of pain and anxiety prior to spinal surgery in order to identify the need for implementation of additional modalities, such as osteopathic interventions for pain and anxiety management. It is pertinent that as holistic providers we address this populations often missed psychological distress and ineffective pharmacological pain regimens to promote better patient outcomes.

Background: Research says there are approximately 1.62 million instrumented spinal procedures performed annually in the United States. Spinal surgery is not uncommon, and neither is the chronic pain and …

The Ins And Outs Of Wide-Awake Hand Surgery, Molly Milano

Bone Bulletin

Introduction

As the name might imply, “wide awake local anesthesia no tourniquet” (WALANT) is a surgical method to perform hand surgery using only a local anesthetic without the use of a tourniquet or any sedation and general anesthetics. The WALANT technique takes advantage of the vasoconstrictive effects of epinephrine combined with the local anesthetic effects of lidocaine to create a surgical field that does not require a tourniquet or general anesthesia.¹ The main contributor is epinephrine, which decreases bleeding in the surgical field while also lengthening lidocaine’s absorption and effect.² When first introduced to the surgical world, the …

Standardizing Care For Zone 1 Fifth Metatarsal Base Fractures At The University Of Wisconsin Department Of Orthopedics, Mallory Rongstad, Richard Behlmer, Kevin Condit, Jarod Moyer, Kurt Rongstad

Tower Health Research Day

No abstract provided.

Evaluation Of Modern Splinting Materials For Use In Low To Middle Income Countries; A Cost-Benefit Analysis, Brianne M. Giuffrida Bs, Andrew B. Harris Md, Julius Oni Md

Tower Health Research Day

No abstract provided.

Parosteal Lipoma Of The Left Femur: A Case Report., James P Waters, Sydney Horenstein, Austin Egger, Parker Johnsen, Tae Won Kim

Orthopedic Surgery Resident Research

Multidisciplinary team collaboration in the diagnosis of rare tumors such as parosteal lipoma is highly important, especially when suspicious of malignancy. The use of radiological and physical examinations is imperative to monitor recurrence and quality of life.

A Systematic Review Of The Social Determinants Of Health In Shoulder Arthroplasty Outcomes, Allison Boland, John Pum, Michael Gaudiani, Matthew A. Gasparro

Medical Student Research Symposium

This systematic review investigates the impact of social determinants of health (SDOH) on outcomes in shoulder arthroplasty (SA). SA, a common orthopedic procedure, has seen an increasing focus on SDOH influencing postoperative results. The study aims to comprehensively assess this impact on both surgical and patient-reported outcomes.

Through a systematic search of databases, 34 studies (2011-2021) met the inclusion criteria, involving 4,825,547 patients. Explored SDOH included insurance status, race/ethnicity, age, sex, income, social support, and veteran status. Outcomes considered were length of stay, American Shoulder and Elbow Surgeons scores, total SA rates, revision rates, complication rates, and discharge status.

Findings …

P2y2 Inhibition Modifies The Anabolic Response To Exercise In Adult Mice, Nickolas Vinokurov, Devin Mendez, Amit Chougule Dr, Chunbin Zhang, Joseph Gardinier Dr

Medical Student Research Symposium

Osteocytes serve as a sensory network that responds to dynamic loading of the skeleton and play a crucial role in regulating bone mass while maintaining bone quality [1]. Osteocytes’ induction of bone formation in response to loading is extremely age dependent, such that clinical studies have shown exercise to be less and less effective as we age [2,3]. As a result, modifying osteocytes’ mechanosensitivity may enable older adults to better capitalize on the anabolic nature of exercise to increase bone mass and reduce fracture risk. Based on our previous work, P2Y2 activation down-regulates the mechanosensitivity of bone cells by increasing …

Maximizing Value In Total Knee Arthroplasty: Ambulatory Surgical Center Or Hospital Outpatient Department?, Megan Carulla, Meet Patel, Emily Mazier, Alex Lindahl, Trae Hill, Charles S. Day

Medical Student Research Symposium

Introduction:

In the United States, healthcare costs have consistently ranked the highest among developed countries, leading to an urgent push towards decreasing spending. This study compared the cost of robot-assisted total knee arthroplasty (TKA) performed in a hospital outpatient department (HOPD) to an Ambulatory Surgical Center (ASC).

Methods and Materials:

Costs were determined using Time-Driven Activity-Based Costing (TDABC) methodology. All steps of a patient care pathway for robotic TKA performed in ASC and HOPD were organized into one process map. All personnel involved in patient care were included and the average time each allocated to patients was multiplied by their …

Proximal Femoral Plate Versus Proximal Femoral Nailing Fixation For Treatment Of Unstable Intertrochanteric Femoral Fractures, Ibrahim Ahmed Mostafa, Sameh Anwer Elsayed Abdel-Aal, Mahmoud Elsayed Omar Yassin

Al-Azhar International Medical Journal

Background: The rising prevalence of osteoporosis among the elderly has been associated with an increase in trochanteric fractures. Intramedullary devices like proximal femoral nail and proximal anatomic femur plates are used for the management of Intertrochanteric femur fractures. However, there is still a lot of research to be done to determine which implant is best for treating these fractures with the fewest possible side effects. Aim and objectives: with the purpose of evaluating the efficacy of different therapies for fractures of the trochanteric region of the femur by proximal femoral nail versus proximal Trochantric femur plate. Subjects and methods: This …

Using Of Fragment Specific Plate 2.5 Millimetre In Cases Of Distal Radius Fracture, Ibrahim Ahmed Hussien, Amro Ahmed Fouaad, Ahmed Samy Al-Noamany

Al-Azhar International Medical Journal

Background: Fractures of the distal radius inside the joint are a common injury. Whether caused by high-energy trauma or, more commonly among the elderly and those with osteoporosis, low-energy trauma, these fractures tend to be unstable and require immediate medical attention. The use of external fixators for intra-articular distal radius fractures has been supplanted by the use of internal fixators. Aim and objectives: to examine the radiological and clinical results of treating distal radius fractures that occurred on the dorsum of the individual's right and left arms (dorsal or dorso-radial) using a fragment-specific plate (2.5 mm). Subjects and methods: Hospitals …

Open Wedge High Tibial Osteotomy For Treatment Of Varus Knee In Adults Combined With Arthroscopic Evaluation, Mohamad Shaaban El Eryan, Mahmoud Seddik Hassan, Faisal Hasan Zayed

Al-Azhar International Medical Journal

Background: Varus knee in adults is fairly common and considered the most predisposing factor for early medial compartment osteoarthritis of the knee joint. Patients and Methods: Fifteen patients underwent a medial open wedge high tibial osteotomy (MOWHTO) combined with arthroscopic evaluation for medial compartment osteoarthritis or intra articular pathology lesions. Measurements included mechanical axis of lower limb, hip knee ankle angle (HKA), posterior tibial slope angle, and medial proximal tibial angle (MPTA). Clinical evaluation was applied with Lysholm knee scoring scale and Knee Injury and Osteoarthritis Outcome Score (KOOS). Results: There were remarkable differences between the mean of pre and …

Endoscopic Assisted Management Of Benign Osteolytic Bone Lesions, Ahmed Mohamed Shawky, Mahmoud Seddik Hassan, Amro Ahmed Fouaad Attia, Ahmed Ismail Hammouda

Al-Azhar International Medical Journal

Background: Benign lytic bone lesions have various clinical and histopathological forms, the most frequent lytic lesions are unicameral bone cyst, giant cell tumor, aneurysmal bone cyst, fibrous dysplasia, osteoblastoma and enchondroma, and they are rarely to be symptomatic and usually diagnosed accidentally on imaging. Treatment has wide range from conservative treatment with regular follow up to many surgical interventions without significant established consensus to support any of them. Aim of the work: this study evaluates the outcome of endoscopic assisted management of benign osteolytic bone lesions for 2 year of follow up. Patients and methods: In this prospective, 20 patients …

Philos Plating Versus Percutaneous K-Wire Fixation In Proximal Humerus Fractures In The Elderly, Aly Mohammed El-Geoshy, Usama Gaber Abdalla, Ehab Khaled Gaafar

Al-Azhar International Medical Journal

Objectives: To compare the results of Percutaneous K-Wires versus PHILOS plate in terms of activity, shoulder function, radiological assessment and complications. Methods: Thirty patients randomly divided into two groups with closed envelop method between July 2021 to July 2022, Group (A), The K-Wires group, 7 males and 8 females, with mean age 68 years, and Group (B), The PHILOS group, 9 males and 6 females, with mean age 66 years. Included patients were elderly with recent, closed, two, three and four parts fracture. Excluded patients were open fractures, old, nonunited, malunited or patients with contraindications of general anesthesia. Results: Both …

Idiopathic Acute On Chronic Osteomyelitis Mimicking Metastatic Lesion In Humeral Head: A Case Report, Lucas Marks, Gavin Cobb, Nick Duff, Holli Barber

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.

Safety Of Tourniquet Use In Difficult Primary Total Knee Arthroplasty: A Retrospective Comparative Study, Ahmed Mohamed El-Behiry, Ahmed Abdel-Monem Dewidar

Menoufia Medical Journal

Objectives: To examine the outcomes of performing difficult primary TKA with and without tourniquet. Background: Tourniquet use has been widely employed in total knee arthroplasty (TKA), yet its outcomes are a subject of debate. Methods: Patients with difficult primary TKA without tourniquet (NT group) and with tourniquet (T group). A review of patients' records was conducted to collect demographic data, hemoglobin (Hb) levels, range of motion (ROM), operating room time, operative time, drain output, need for blood transfusion, hospital stay, and postoperative complications. Functional results were evaluated with the Oxford Knee Score (OKS) and the Knee Society Score (KSS). Results: …

Treatment Of Transverse Patellar Fractures By Tension Band Wiring Versus Tension Band Using Cannulated Screws, Ahmed Abdel-Monem Dewidar

Menoufia Medical Journal

Objectives: To compare the results of fixation of patellar fractures by tension band fixation using Kirschner wires versus figure of eight wiring through cannulated screws. Background: Patellar fractures are relatively uncommon injuries which need to be fixed if displacement occurs more than 2 mm. Methods: This was a prospective study compared the results of treatment of 30 patients with transverse patellar fractures by two methods; Group I: including 15 patients treated with tension band wiring by the kirshner wires. Group II: including 15 patients treated by tension band wiring with cannulated screws. The final results were evaluated after 6 months …

Bridging Bone Health: Osteoporosis Disparities In The Rio Grande Valley, Ryan P. Bialaszewski, John M. Gaddis, Blake Martin, Philippe J. Dentino, John Ronnau

School of Medicine Publications and Presentations

Introduction: Osteoporosis is characterized by decreased bone mass and decreased bone quality, leading to increased bone fragility and risk of fractures. The number of fractures due to osteoporosis is projected to increase to over three million by the year 2025 and cost $25.3 billion annually. It ranks highly among diseases that cause patients to become bedridden with serious complications and reduced quality of life. Additionally, osteoporosis disproportionately affects Hispanics, which comprise most of the Rio Grande Valley (RGV) population. Therefore, our primary objective was to determine the prevalence of osteoporosis within the RGV. Additionally, we had secondary objectives to determine …

Improving Access To Care For Specialty Pediatric Orthopedic Patients: Maximizing Telehealth To Achieve Outcomes, Tammy Keesey

Student Scholarly Projects

Practice Problem: The lack of resources such as transportation, insurance, and finances can negatively impact a patient’s access to much-needed specialty care. Providing education, assessing telehealth literacy, and creating a specific process for identifying appropriate telehealth visits can improve pediatric specialty access to care.

PICOT: The PICOT question for this project was: In pediatric orthopedic clinic patients (P), what is the impact of the active introduction of telehealth as a clinic visit option (I) versus the current standard passive process of scheduling telehealth visits (C) on the rates of access to care (O) after nine total weeks of …

Is There Room For Individual Patient-Specified Preferences In The Patient-Reported Outcome Measurement Revolution?, Leif I. Solberg, Jeanette Y. Ziegenfuss, Rachael L. Rivard, Christine K. Norton, Robin R. Whitebird, Glyn Elwyn, Mark Swiontkowski

Journal of Patient-Centered Research and Reviews

Purpose: The study aim was to test the feasibility of collecting qualitative patient-preferred outcomes or goals and the degree of their attainment as an addition to a standardized process for collecting quantitative composite patient-reported outcome measures (PROMs) from patients undergoing knee joint replacement..

Methods: Patients of a large Midwestern medical group scheduled to have total replacement of their knee joint have been asked to complete a PROMs survey preoperatively and at 3 and 12 months after surgery since 2014. In March 2020, an open-ended question about their most important preferred outcome was added to the existing questionnaire. The responses for …

Orthopass: Long-Term Outcomes Following Implementation Of An Orthopaedic Patient Handoff Template., Harry Lightsey, Caleb Yeung, Laura Rossi, Antonia Chen, Mitchel Harris, Derek Stenquist

Rothman Institute Faculty Papers

Standardized handoff tools improve communication and patient care; however, their widespread use in surgical fields is lacking. OrthoPass, an orthopaedic adaptation of I-PASS, was developed in 2019 to address handoff concerns and demonstrated sustained improvements across multiple handoff domains over an 18-month period. We sought to characterize the longitudinal effect and sustainability of OrthoPass within a single large residency program 3.5 years after its implementation. This mixed methods study involved electronic handoff review for quality domains in addition to survey distribution and evaluation. We conducted comparative analyses of handoff adherence and survey questions as well as a thematic analysis of …

Femoral Neck Fracture Management In The Young Patient: A Case Review, Luis Berrios, Kevin J. Orellana, Michael Lago, Frank Gerold

Research Colloquium

Introduction:The optimal management of femoral neck fractures in the young patient remains controversial. Although there are universally accepted principles, there remains some variability in the optimal timing of surgery and method of fixation. In general, surgery should be performed on an urgent or emergent basis when feasible to decrease peri-operative complications, length of stay, and most importantly the ultimate likelihood of avascular necrosis. However, it is important to note that the preference toward a specific method of fixation remains heterogeneous among orthopedic surgeons.(1)

The purpose of this study is to present our preferred technique for treatment of displaced femoral …

Assessing Morbidity In Patients With Greater Trochanteric Pain Syndrome (Gtps), Sonia Wadekar, Joel Wells

Research Colloquium

Introduction: Greater trochanteric pain syndrome (GTPS) continues to be a challenge among orthopedics to rid discomfort for their patients, especially since there are few studies on characterization of GTPS morbidity.

Objective: The purpose of this study is to characterize the morbidity of GTPS in order to aid orthopedics in providing an early diagnosis and better treatment/care options for their patients.

Methods: A total of 156 patients were included from January of 2016 to July of 2020. Refer to Figure 1 for a visual of inclusion criteria. All patient information was taken from first appointment notes, operative notes, chart reviews, and …

Rotator Cuff Injury In The Pediatric Population: A Systematic Review Of Patient Characteristics, Treatment, And Outcomes, Kevin J. Orellana, Kathleen L. Harwood, John G. Horneff 3rd, Joseph J. King, Brendan A. Williams

Research Colloquium

Background: Rotator cuff injuries (RCIs), traditionally thought to be an adult-type pathology, have been reported in the pediatric population, but there remains limited evidence regarding this injury pattern in pediatric patients. The purpose of this study was to systematically review the literature to characterize the epidemiology, injury patterns, treatment modalities, and outcomes for pediatric patients with RCIs.

Methods: A systematic review was performed in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines reviewing Pubmed, Embase, Cochrane, and CINAHL databases. Studies reporting imaging confirmed RCIs and treatment outcomes in patientsdemographics, mechanism, injury type and injury location were …

Bad To The Bone. Not All Bone Tumors Are Cancer: Case Of Long Bone Osteomyelitis, Tat W. Yau, Bennet D. Franz, Hanadi A. Osman, Jessica C. Rivera, Ashaur Azhar

School of Medicine Faculty Publications

Long bone osteomyelitis could mimic bony tumor in clinical presentation and imaging studies. We present a case of a 47-year man who presented with leg pain, weight loss and night sweats that initially was thought to be related to osteosarcoma, later suffered a pathologic fracture from Staphylococcus aureus osteomyelitis. This case highlights the importance of source control of infection and careful clinical evaluation including radiographic and pathologic findings that can help physicians to differentiate between competing diagnoses.

Evaluation Of Results Of Percutaneous Acetabular Columns Fixation, Emad E. El Agroudy

Menoufia Medical Journal

Objective: Is to evaluate results of percutaneous screw fixation of acetabular column fractures. Design: This study included 18 patients with acetabular column fractures. They were fixed under fluoroscopy guidance by percutaneous column screws. Background: Acetabular geometry makes percutaneous screw insertion a challenging procedure. An anatomical reduction of acetabular fractures is a good predictor of functional outcome and reduced risk of posttraumatic osteoarthritis. The percutaneous technique allows for earlier return to activity and better pain control when compared with nonsurgical management. Percutaneous technique has been described in the literature as an adjuvant to open reduction and internal fixation. Results: According to …

Combined Knee Arthroscopy With Medial Open Wedge High Tibial Osteotomy In Management Of Medial Knee Joint Disorder Of Adults Varus Knee, Emad Eid Elagroudy

Menoufia Medical Journal

Objectives: To elucidate the outcome of medial opening wedge high tibial osteotomy accompanied with arthroscopic management of medial knee joint mechanical disorders in adult patients with varus knee. Background: Medial open wedge high tibial osteotomy improves alignment and weight distribution in patients with varus knee deformity with intraoperative ability to adjust correction through one bone cut, without disruption of proximal tibio-fibular joint or lateral compartment invasion. Methods: The study included adult patients with symptomizing varus knees. A medial opening wedge was stabilized with osteotomy plate combined with arthroscopic intra articular management of medial knee disorders. Results: The study was conducted …

Lateral Extra-Articular Tenodesis Combined With Intra-Articular Acl Reconstruction In Management Of Anterolateral Knee Instability, Emad E. El Agroudy

Menoufia Medical Journal

Objectives: Was to evaluate the clinical and functional outcomes of combining lateral extra-articular tenodesis with arthroscopic anterior cruciate ligament reconstruction in treatment of high grade anterolateral rotational knee instability. Background: Lateral extra-articular tenodesis with arthroscopic anterior cruciate ligament reconstruction in treatment of high grade anterolateral rotational knee instability grants equivalent isokinetic muscle recovery as does stand-alone anterior cruciate ligament in knees with no rotational instability. Methods: This study was conducted on twenty patients with anterolateral knee instability. Lateral extra articular tenodesis using iliotibial band distally attached and fixed to lateral femoral epicondyle with intra articular arthroscopic anterior cruciate ligament reconstruction …

Corrective Osteotomy Of Dorsal Malunited Fractures Of The Distal End Radius Using Volar Locking Plate And Bone Block Graft Substitute, Mohamed Samy

Menoufia Medical Journal

Objective

To evaluate the results of corrective osteotomy of dorsal malunited fracture lower end radius using volar locking plates and bone block graft substitutes.

Background

Malunion of the distal radius usually occurs following conservative treatment. The indication for corrective osteotomy is symptomatic, rather than radiological malunion.

Patients and methods

All the patients had dorsally malunited (dorsal tilt) extra-articular distal radius fracture following conservative management. The mean time of postfracture intervention was 4 months (range, 3–5 months). All the patients underwent open wedge corrective osteotomy through the volar approach and fixation with volar locking plates and filling the osteotomy gap with …

Pelvic Fractures - An Overview, Shashank Cheemalapati

Digital Journal of Clinical Medicine

Pelvic fractures are injuries commonly caused by high-energy trauma, such as motor vehicle accidents and falls from a height. Understanding the anatomy, mechanisms of injury, classification, diagnosis and the management of these fractures is crucial to improve patient outcomes. This short article aims to provide a comprehensive overview of the current state of knowledge regarding pelvic fractures.