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Surgical Procedures, Operative Commons™

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Full-Text Articles in Surgical Procedures, Operative

Preoperative Computed Tomography Scan In Distal Radius Fractures And The Effect On Preoperative Planning, Adam L. Haydel, Ryan C. Roubion, Cristina T. Graphia, Corinne E. Cloud, Claudia Leonardi, Christopher E. Marrero Dec 2023

Preoperative Computed Tomography Scan In Distal Radius Fractures And The Effect On Preoperative Planning, Adam L. Haydel, Ryan C. Roubion, Cristina T. Graphia, Corinne E. Cloud, Claudia Leonardi, Christopher E. Marrero

School of Medicine Faculty Publications

Purpose: It is unclear whether computed tomography (CT) scans alter the surgical plan when ordered before surgery for fixation of intra-articular distal radius fractures (DRFs). The purpose of this study was to determine whether a preoperative CT scan alters the planned approach (PA) or planned fixation strategy (PFS) for open reduction internal fixation of intra-articular DRFs. Methods: Radiology records were retrospectively reviewed by one trauma surgeon and two hand surgeons for 33 intra-articular DRFs that met the inclusion criteria and previously underwent open reduction internal fixation. Surgeons were initially provided only preoperative radiographs; they were asked for their PA and …

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Alt Free Flap Coverage After Carotid Endarterectomy In The Setting Of Severe Radiation Changes, Richard F. Guidry, Hannah E. Doran, Mark W. Stalder Dec 2023

Alt Free Flap Coverage After Carotid Endarterectomy In The Setting Of Severe Radiation Changes, Richard F. Guidry, Hannah E. Doran, Mark W. Stalder

School of Medicine Faculty Publications

Carotid endarterectomy with patch angioplasty is commonly performed for severe atherosclerotic disease to reduce stroke risk. After neck radiation, loss of tissue planes; reactive fibrosis of skin; contraction; and rarely, necrosis of skin may occur, leading to severe wound complications and possible exposure of carotid artery reconstruction. Historically, local myocutaneous flaps have been performed to provide soft tissue coverage; however, these procedures may be associated with increased donor site morbidity and can be affected by radiation changes. This report describes the novel use of a fasciocutaneous free flap for durable vascularized soft tissue, and the associated secondary benefit of improved …

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Surgical Stabilization Of Multiple Rib Fractures In An Asian Population: A Systematic Review And Meta-Analysis, Weiwei He, Yi Yang, Raymark Salonga, Ledford Powell, Patrick Greiffenstein, Jonne T.H. Prins, Stephen Patrick Abella Sep 2023

Surgical Stabilization Of Multiple Rib Fractures In An Asian Population: A Systematic Review And Meta-Analysis, Weiwei He, Yi Yang, Raymark Salonga, Ledford Powell, Patrick Greiffenstein, Jonne T.H. Prins, Stephen Patrick Abella

School of Medicine Faculty Publications

Background: There is no consensus on the effectiveness of surgical stabilization in multiple rib fractures in Asia, especially among patients with a non-flail rib fracture pattern. We aim to synthesize the evidence on the effectiveness of surgical stabilization of rib fractures (SSRF) in an Asian population with multiple nonflail rib fractures. Methods: The MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Cochrane Database of Systematic Reviews were searched in this systematic literature review and meta-analysis to identify studies conducted in Asia that included patients with multiple non-flail rib fractures in at least one of their treatment groups. The …

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Peripheral Arterial Disease And Complications Of Total Knee Arthroplasty: Indications For Advanced Vascular Imaging And Minimally Invasive Soft Tissue Coverage Procedures, Kristopher Katira, Antony Martin, Anna Garbuzov, James Ferrer, Brian Chuong, Ross Parkerson, George Chimento Sep 2023

Peripheral Arterial Disease And Complications Of Total Knee Arthroplasty: Indications For Advanced Vascular Imaging And Minimally Invasive Soft Tissue Coverage Procedures, Kristopher Katira, Antony Martin, Anna Garbuzov, James Ferrer, Brian Chuong, Ross Parkerson, George Chimento

School of Medicine Faculty Publications

Soft tissue coverage of knee wounds can be challenging, in particular in the setting of peripheral arterial disease and knee arthroplasty complications. Options for soft-tissue coverage range from conservative wound care to invasive pedicled and free flaps. Unlike traditional wound coverage problems in plastic surgery patients, arthroplasty coverage decisions oblige surgeons to take into account the possibility of secondary orthopedic procedures. The two cases presented in this manuscript demonstrate the importance of vascular imaging, in particular angiography. In both cases, the workhorse medial gastrocnemius flap harvest could have resulted in critical limb ischemia. When secondary orthopedic revision is required at …

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Minoxidil Weakens Newly Synthesized Collagen In Fibrotic Synoviocytes From Osteoarthritis Patients, Stefan Sarkovich, Peter P. Issa, Andrew Longanecker, Davis Martin, Kaitlyn Redondo, Patrick Mcternan, Jennifer Simkin, Luis Marrero Aug 2023

Minoxidil Weakens Newly Synthesized Collagen In Fibrotic Synoviocytes From Osteoarthritis Patients, Stefan Sarkovich, Peter P. Issa, Andrew Longanecker, Davis Martin, Kaitlyn Redondo, Patrick Mcternan, Jennifer Simkin, Luis Marrero

School of Medicine Faculty Publications

Purpose: Synovial fibrosis (SFb) formation and turnover attributable to knee osteoarthritis (KOA) can impart painful stiffness and persist following arthroplasty. To supplement joint conditioning aimed at maximizing peri-operative function, we evaluated the antifibrotic effect of Minoxidil (MXD) on formation of pyridinoline (Pyd) cross-links catalyzed by Plod2-encoded lysyl hydroxylase (LH)2b that strengthen newly synthesized type-I collagen (COL1) in fibroblastic synovial cells (FSCs) from KOA patients. MXD was predicted to decrease Pyd without significant alterations to Col1a1 transcription by FSCs stimulated with transforming growth factor (TGF)β1. Methods: Synovium from 10 KOA patients grouped by SFb severity was preserved for picrosirius and LH2b …

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Targeted Muscle Reinnervation To Reduce Postoperative Pain In Patients Undergoing Hindquarter Resections, Mikaela H. Sullivan, Gavin L. Mills, Hiba Saifuddin, Elyse J. Brinkman, Brian T. Carlsen, Steven L. Moran, Matthew T. Houdek Jul 2023

Targeted Muscle Reinnervation To Reduce Postoperative Pain In Patients Undergoing Hindquarter Resections, Mikaela H. Sullivan, Gavin L. Mills, Hiba Saifuddin, Elyse J. Brinkman, Brian T. Carlsen, Steven L. Moran, Matthew T. Houdek

School of Medicine Faculty Publications

Background/Aim: Pre-emptive targeted muscle reinnervation (TMR) at the time of amputation results in less phantom limb pain (PLP) compared with untreated amputee controls. There is limited literature describing the technique in patients undergoing hindquarter amputation despite up to 90% of these patients reporting PLP and 50% presenting with painful neuroma. The purpose of the current study was to describe the motor nerves accessible through a primary hind-quarter amputation to be used for TMR and review pain outcomes in clinical case correlates of patients with TMR. Patients and Methods: Six limbs were obtained from three fresh adult cadavers and proximal sensory …

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Incidence Of Total Blindness After Central Retinal Artery Occlusion With Ocular Neovascularization, Harshvardhan Chawla, Hayley J. Redrick, Joshua T. Pannell, D. Anthony Mazzulla, Joseph D. Benevento, Sidharth Puri Jun 2023

Incidence Of Total Blindness After Central Retinal Artery Occlusion With Ocular Neovascularization, Harshvardhan Chawla, Hayley J. Redrick, Joshua T. Pannell, D. Anthony Mazzulla, Joseph D. Benevento, Sidharth Puri

School of Medicine Faculty Publications

Annual Meeting Association for Research in Vision and Ophthalmology, ARVO 2023, April 24 - 27, 2023, New Orleans, LA

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A Modified Bicanalicular Crawford Placement Method For Congenital Nasolacrimal Duct Obstruction: Reducing Need For Operative Room Removal, Ellen E. Ingram, John P. Thompson, Elizabeth M. Bozner, Armin Avdic, Charles Reeder, George S. Ellis, Austin M. Pharo Jun 2023

A Modified Bicanalicular Crawford Placement Method For Congenital Nasolacrimal Duct Obstruction: Reducing Need For Operative Room Removal, Ellen E. Ingram, John P. Thompson, Elizabeth M. Bozner, Armin Avdic, Charles Reeder, George S. Ellis, Austin M. Pharo

School of Medicine Faculty Publications

Annual Meeting Association for Research in Vision and Ophthalmology, ARVO 2023, April 24 - 27, 2023, New Orleans, LA

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Minimalistic Approach To Enhanced Recovery After Pediatric Scoliosis Surgery, Scott A. Barnett, Bryant M. Song, Matthew Bauer, Matthew E. Nungesser, Claudia Leonardi, Michael J. Heffernan Mar 2023

Minimalistic Approach To Enhanced Recovery After Pediatric Scoliosis Surgery, Scott A. Barnett, Bryant M. Song, Matthew Bauer, Matthew E. Nungesser, Claudia Leonardi, Michael J. Heffernan

School of Medicine Faculty Publications

Purpose: Prior studies of enhanced recovery protocols (ERP) have been conducted at large institutions with abundant resources. These results may not apply at institutions with less resources directed to quality improvement efforts. The purpose of this study was to assess the value of a minimalistic enhanced recovery protocol in reducing length of stay (LOS) following PSF for adolescent idiopathic scoliosis. We hypothesized that accelerated transition to oral pain medications and mobilization alone could shorten hospital length of stay in the absence of a formal multimodal pain regimen. Methods: AIS patients aged 10–18 who underwent PSF at a tertiary pediatric hospital …

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Delayed Thoracodorsal Artery Perforator Free Flap For Calcaneal Degloving Injury Reconstruction, Mallorie L. Huff, Ahmed M. Mansour, Mamtha S. Raj, Robert J. Allen, Sean J. Wallace Mar 2023

Delayed Thoracodorsal Artery Perforator Free Flap For Calcaneal Degloving Injury Reconstruction, Mallorie L. Huff, Ahmed M. Mansour, Mamtha S. Raj, Robert J. Allen, Sean J. Wallace

School of Medicine Faculty Publications

The thoracodorsal artery perforator (TDAP) flap has a long vascular pedicle that is ideal for lower extremity reconstruction, but it generally relies on the presence of a dominant septocutaneous perforator vessel. Surgical delay optimizes flap survival by creating relative ischemia to augment perforator vessels. In this report, we describe the use of a delayed free TDAP flap in the setting of an absent dominant perforator vessel for the reconstruction of a calcaneal degloving injury. A 22-year-old actively smoking patient with a body mass index of 33.5 presented with a nonhealing left heel wound with overlying necrotic changes after traumatic degloving …

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A Modern Multimodal Pain Protocol Eliminates The Need For Opioids For Most Patients Following Total Knee Arthroplasty: Results From A Retrospective Comparative Cohort Study, Leland Van Deventer, Amy Bronstone, Claudia Leonardi, Matthew Bennett, Peter Yager, Vinod Dasa Feb 2023

A Modern Multimodal Pain Protocol Eliminates The Need For Opioids For Most Patients Following Total Knee Arthroplasty: Results From A Retrospective Comparative Cohort Study, Leland Van Deventer, Amy Bronstone, Claudia Leonardi, Matthew Bennett, Peter Yager, Vinod Dasa

School of Medicine Faculty Publications

Purpose: Modern multimodal analgesia has been shown to significantly reduce opioid use following total knee arthroplasty (TKA). This study was conducted to determine if changing TKA discharge opioid prescriptions from automatic to upon request resulted in more opioid free recoveries without compromising pain control. Methods: Between December 2019 and August 2021, an orthopedic surgeon performed 144 primary unilateral TKAs; patients received the same multimodal analgesia protocol except for postoperative opioid prescribing. The first consecutively-treated cohort automatically received an opioid prescription following discharge (automatic group) and the second cohort received opioid prescriptions only upon request (upon request group). Opioid prescription data …

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Hemoglobinopathy Is Associated With Total Hip Arthroplasty Indication Even Beyond Sickle Cell Anemia, Maxwell J. Rakutt, Daniel N. Bracey, Anna Cohen-Rosenblum, Peter K. Sculco, Franco M. Sabatini, Cale A. Jacobs, Stephen T. Duncan, David C. Landy Feb 2023

Hemoglobinopathy Is Associated With Total Hip Arthroplasty Indication Even Beyond Sickle Cell Anemia, Maxwell J. Rakutt, Daniel N. Bracey, Anna Cohen-Rosenblum, Peter K. Sculco, Franco M. Sabatini, Cale A. Jacobs, Stephen T. Duncan, David C. Landy

School of Medicine Faculty Publications

Background: The extent to which hemoglobinopathies other than sickle anemia (HbSS) are associated with hip osteonecrosis is unknown. Sickle cell trait (HbS), hemoglobin SC (HbSC), and sickle/β-thalassemia (HbSβTh) may also predispose to osteonecrosis of the femoral head (ONFH). We sought to compare the distributions of indications for a total hip arthroplasty (THA) in patients with and without specific hemoglobinopathies. Methods: PearlDiver, an administrative claims database, was used to identify 384,401 patients aged 18 years or older undergoing a THA not for fracture from 2010 to 2020, with patients grouped by diagnosis code (HbSS N = 210, HbSC N = 196, …

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Keeping The Lights On: The Impact Of The Covid-19 Pandemic On Elective Total Joint Arthroplasty Utilization In The United States, Matthew W. Cole, Lacee K. Collins, Garrett H. Williams, Olivia C. Lee, William F. Sherman Nov 2022

Keeping The Lights On: The Impact Of The Covid-19 Pandemic On Elective Total Joint Arthroplasty Utilization In The United States, Matthew W. Cole, Lacee K. Collins, Garrett H. Williams, Olivia C. Lee, William F. Sherman

School of Medicine Faculty Publications

Background: It was estimated that up to 30,000 primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) procedures would be cancelled each week during the moratorium on elective surgeries in the United States. The purpose of this study was to analyze the impact of the COVID-19 pandemic on elective total joint arthroplasty utilization in the United States. Methods: A retrospective study was conducted using the PearlDiver database. Patients who underwent primary elective THAs and TKAs were identified and filtered by state and month from January through September of both 2019 and 2020. The volume of these procedures immediately following …

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Serious Adverse Events And 30-Day Hospital Readmission Rate Following Elective Total Knee Arthroplasty: A Systematic Review And Meta-Analysis., Costas Papakostidis, Peter V Giannoudis, J. Tracy Watson, Robert Zura, R. Grant Steen Mar 2021

Serious Adverse Events And 30-Day Hospital Readmission Rate Following Elective Total Knee Arthroplasty: A Systematic Review And Meta-Analysis., Costas Papakostidis, Peter V Giannoudis, J. Tracy Watson, Robert Zura, R. Grant Steen

School of Medicine Faculty Publications

Background: Elective total knee arthroplasty (TKA) is a common surgery which has evolved rapidly. However, there are no recent large systematic reviews of serious adverse event (SAE) rate and 30-day readmission rate (30-dRR) or an indication of whether surgical methods have improved. Methods: To obtain a pooled estimate of SAE rate and 30-dRR following TKA, we searched Medline, Web of Science, Cochrane Library, and Google Scholar databases. Data were extracted by two authors following PRISMA guidelines. Eligibility criteria were defined prior to a comprehensive search. Studies were eligible if they were published in 2007 or later, described sequelae of TKA …

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The Utility Of Hyperbaric Oxygen Therapy In Post-Transplant Cyclophosphamide-Induced Hemorrhagic Cystitis: A Case Report And Review Of The Literature., Moayed Ibrahim, Kshama Bhyravabhotla, Basil Khalaf, Keith Van Meter, Nakhle S Saba, Hana Safah, Francisco Socola Jan 2021

The Utility Of Hyperbaric Oxygen Therapy In Post-Transplant Cyclophosphamide-Induced Hemorrhagic Cystitis: A Case Report And Review Of The Literature., Moayed Ibrahim, Kshama Bhyravabhotla, Basil Khalaf, Keith Van Meter, Nakhle S Saba, Hana Safah, Francisco Socola

School of Medicine Faculty Publications

Background: To date, there are only a few case reports of cyclophosphamide (Cy)-induced hemorrhagic cystitis (HC) in adult or pediatric allogeneic stem cell transplant (SCT) patients treated successfully with hyperbaric oxygen (HBO). In all the reported cases, Cy was used as a part of the conditioning regimen, rather than post-transplant for graft-versus-host-disease (GVHD) prophylaxis. More recently, the risk of HC in allogeneic SCT is further increased by the widespread use of post-transplantation cyclophosphamide (PTCy) as a highly effective strategy for GVHD prophylaxis. This is the first case reported of PTCy-induced HC successfully treated with HBO to the best of our …

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A Comparison Of 4-Year Total Medical Care Costs, Adverse Outcomes, And Opioid/Prescription Analgesic Use For 3 Knee Osteoarthritis Pain Treatments: Intra-Articular Hyaluronic Acid, Intra-Articular Corticosteroids, And Knee Arthroplasty., John Mackowiak, John T Jones, Vinod Dasa Dec 2020

A Comparison Of 4-Year Total Medical Care Costs, Adverse Outcomes, And Opioid/Prescription Analgesic Use For 3 Knee Osteoarthritis Pain Treatments: Intra-Articular Hyaluronic Acid, Intra-Articular Corticosteroids, And Knee Arthroplasty., John Mackowiak, John T Jones, Vinod Dasa

School of Medicine Faculty Publications

To compare the medical costs associated with treatments for knee osteoarthritis (OA): intra-articular corticosteroids (ICS) and intra-articular hyaluronic acid (IHA) primarily, and ICS/IHA vs knee arthroplasty (TKA) secondarily. This was a retrospective analysis of an insurance claims database. Eligible members had diagnosed OA and no claims for ICS, IHA, or TKA during the 6–18-month look-back period. Cohorts of interest over the 4-year observation period were: patients who received ICS only, those who received IHA only, and those who received TKA only. Outcomes assessed included: (1) total allowed medical costs, (2) claims for pre-specified, treatment-related adverse outcomes and costs, and (3) …

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