Third-Generation Medium Cross-Linked Polyethylene Demonstrates Very Low Wear In Total Hip Arthroplasty., 2020 Hoag Orthopaedic Institute, Irvine, CA
Third-Generation Medium Cross-Linked Polyethylene Demonstrates Very Low Wear In Total Hip Arthroplasty., Omid Jalali, Travis S Scudday, Marie-Claire Fickenscher, Steven L Barnett, Robert S Gorab
Articles, Abstracts, and Reports
Background: Cross-linked polyethylene (XLPE) liners have shown lower wear rates than conventional polyethylene liners in total hip arthroplasty. The primary aim of our study was to report our most recent analysis of wear rates and clinical outcomes of a third-generation XLPE liner. Secondary aims were to investigate the rate of adverse events related to mechanical failure or oxidation of this liner.
Methods: A series of 266 total hip arthroplasties using a specific XLPE liner were retrospectively reviewed. Radiographs were examined to determine linear and volumetric wear rates and presence of osteolysis. Clinical outcomes, revision rates, mechanical failures, and risk factors ...
Effects Of Coronavirus (Covid-19) Pandemic On Orthopedic Residency Program In The Seventh Largest City Of The World: Recommendations From A Resource-Constrained Setting, Marij Zahid, Syed Arif Ali, Naveed Baloch, Shahryar Noordin
Section of Orthopaedic Surgery
The coronavirus (COVID-19) pandemic has hit the entire world hard. Since its inception from Wuhan China the whole world is affected now. Health care facilities and workers are overwhelmed and the situation is changing on daily basis. With the changes in the dynamics of the hospitals, residency and fellowships training programs have also suffered undoubtedly. Due to decreased elective cases and outpatient clinics surgical training gets compromised, however on the other side this physical distancing and isolation have proven to be effective measures in controlling the disease. In this article we share our experience of effect of COVID-19 pandemic on ...
Combined Open Calcaneocuboid, Naviculocuneiform And Subtalar Dislocation: A Case Report And Literature Review, 2020 Khoo Teck Puat Hospital, Singapore
Combined Open Calcaneocuboid, Naviculocuneiform And Subtalar Dislocation: A Case Report And Literature Review, Khai Phang Wong, Zhi Hao Tang, Gek Meng Tan
Open dislocations of the midfoot and subtalar joints are extremely rare injuries. Understanding the anatomy of these joints and the various injury patterns is imperative to obtain stable concentric reduction and provide good functional outcome. We present a report of a 26- year old male who was involved in a road traffic accident and sustained open dislocations of the calcaneocuboid, naviculocuneiform and subtalar joints. He initially underwent external fixation in view of the severe soft tissue injury. After improvement of the soft tissue condition, he underwent K-wiring of the calcaneocuboid joint, buttress plating of the talonaviculocuneiform joint, peroneal tendon reconstruction ...
Acute Opioid Withdrawal Mimicking Postoperative Joint Infection Following Anterior Cruciate Ligament (Acl) Reconstruction: A Case Report., 2020 Department of Orthopedic Surgery, Albert Einstein Medical Center, Philadelphia, PA, United States; Department of Orthopedic Surgery, Drexel University College of Medicine, Hahnemann University Hospital, Philadelphia, PA, United States
Acute Opioid Withdrawal Mimicking Postoperative Joint Infection Following Anterior Cruciate Ligament (Acl) Reconstruction: A Case Report., Qingwu Kong, Martin Griffis, Brandon J Shallop, Amrit S Khalsa, Kyle Brougham, Paul A Marchetto
Department of Orthopaedic Surgery Faculty Papers
BACKGROUND A short course of opioid narcotics is often prescribed for postoperative anterior cruciate ligament (ACL) reconstruction pain management. Unfortunately, there is a well-documented incidence of opioid withdrawal syndrome (OWS) following short-term use of these medications. OWS can present with symptoms such as influenza-like illness. It is important to differentiate OWS from infectious illnesses, especially after surgery. CASE REPORT We present a case of OWS in a patient who underwent ACL reconstruction 7 days prior. The patient's OWS symptoms were similar to symptoms of a postoperative infection. The knee was aspirated, and the analysis of the aspirate was not ...
Seasonal Influence On Postoperative Hip Fracture Complications: Retrospective Cohort Of More Than 1000 Patients From A Tertiary-Care University Hospital, Obada Hasan, Mashal Amin, Fatima Mahmood, Amna Rabbani, Umar Rabbani, Shahryar Noordin
Department of Paediatrics and Child Health
Background: Hip fractures account for one of the most debilitating conditions affecting the general population amongst the developed and developing nations. Investigators aimed to study the influence of the ongoing season i.e. whether patients operated upon in summer or winter, on post-operative complications occurring within 30 days of surgical procedure for hip fractures at a tertiary care hospital and level 1 trauma center.
Materials and methods: Investigators conducted a non-funded, non-commercialized retrospective cohort of 1045 patients with hip fractures managed surgically. Primary exposure was surgical procedures undertaken during the summer months (April-September). Our primary outcome was determining post-operative complication ...
Do New Trainees Pose A Threat To Postoperative Complications After Hip Fracture Surgeries? Retrospective Cohort Of 1045 Patients Over A Decade At A University Hospital, 2020 University of Iowa, United States
Do New Trainees Pose A Threat To Postoperative Complications After Hip Fracture Surgeries? Retrospective Cohort Of 1045 Patients Over A Decade At A University Hospital, Obada Hasan, Mashal Amin, Umar Rabbani, Amna Rabbani, Fatima Mahmood, Shahryar Noordin
Department of Paediatrics and Child Health
Introduction: Induction of new residents and surgical trainees in most institutes occurs once a year. Fresh residents with no experience, may pose a threat to the surgical procedure outcome and there can be a potential increase in patients' morbidity and mortality as a result of this turnover. Literature is inconclusive about this effect. Our aim was to study the "new residents' induction effect" on postoperative complications after hip fracture surgeries.
Methodology: This is non funded non commercialized study from a university hospital. Investigators studied a retrospective cohort of 1045 adult hip fracture patients who were operated at our tertiary care ...
Quantitation Of Gait And Stance Alterations Due To Monosodium Iodoacetate–Induced Knee Osteoarthritis In Yucatan Swine, Katherine T. Lavallee, Timothy P. Maus, Joseph D. Stock, Kenneth J. Stalder, Locke A. Karriker, Naveen S. Murthy, Rahul Kanwar, Andreas S. Beutler, Mark D. Unger
Veterinary Diagnostic and Production Animal Medicine Publications
Knee osteoarthritis is one of the most common causes of chronic pain worldwide, and several animal models have been developed to investigate disease mechanisms and treatments to combat associated morbidities. Here we describe a novel method for assessment of locomotor pain behavior in Yucatan swine. We used monosodium iodoacetate (MIA) to induce osteoarthritis in the hindlimb knee, and then conducted live observation, quantitative gait analysis, and quantitative weight-bearing stance analysis. We used these methods to test the hypothesis that locomotor pain behaviors after osteoarthritis induction would be detected by multiparameter quantitation for at least 12 wk in a novel large ...
Risk Factors And The Natural History Of Accelerated Knee Osteoarthritis: A Narrative Review, 2020 Tufts Medical Center
Risk Factors And The Natural History Of Accelerated Knee Osteoarthritis: A Narrative Review, Jeffrey B. Driban, Matthew S. Harkey, Mary F. Barbe, Robert J. Ward, James W. Mackay, Julie E. Davis, Bing Lu, Lori Lyn Price, Charles B. Eaton, Grace H. Lo, Timothy E. Mcalindon
Open Access Articles
BACKGROUND: Osteoarthritis is generally a slowly progressive disorder. However, at least 1 in 7 people with incident knee osteoarthritis develop an abrupt progression to advanced-stage radiographic disease, many within 12 months. We summarize what is known - primarily based on findings from the Osteoarthritis Initiative - about the risk factors and natural history of accelerated knee osteoarthritis (AKOA) - defined as a transition from no radiographic knee osteoarthritis to advanced-stage disease < 4 years - and put these findings in context with typical osteoarthritis (slowly progressing disease), aging, prior case reports/series, and relevant animal models. Risk factors in the 2 to 4 years before radiographic manifestation of AKOA (onset) include older age, higher body mass index, altered joint alignment, contralateral osteoarthritis, greater pre-radiographic disease burden (structural, symptoms, and function), or low fasting glucose. One to 2 years before AKOA onset people often exhibit rapid articular cartilage loss, larger bone marrow lesions and effusion-synovitis, more meniscal pathology, slower chair-stand or walking pace, and increased global impact of arthritis than adults with typical knee osteoarthritis. Increased joint symptoms predispose a person to new joint trauma, which for someone who develops AKOA is often characterized by a destabilizing meniscal tear (e.g., radial or root tear). One in 7 people with AKOA onset subsequently receive a knee replacement during a 9-year period. The median time from any increase in radiographic severity to knee replacement is only 2.3 years. Despite some similarities, AKOA is different than other rapidly progressive arthropathies and collapsing these phenomena together or extracting results from one type of osteoarthritis to another should be avoided until further research comparing these types of osteoarthritis is conducted. Animal models that induce meniscal damage in the presence of other risk factors or create an incongruent distribution of loading on joints create an accelerated form of osteoarthritis compared to other models and may offer insights into AKOA.
CONCLUSION: Accelerated knee osteoarthritis is unique from typical knee osteoarthritis. The incidence of AKOA in the Osteoarthritis Initiative and Chingford Study is substantial. AKOA needs to be taken into account and studied ...
The Impact Of Covid-19 On The Orthopaedic Surgery Residency Application Process., 2020 Orthopaedic Specialty Institute / Hoag Orthopedic Institute, Orange, CA
The Impact Of Covid-19 On The Orthopaedic Surgery Residency Application Process., Amiethab A Aiyer, Caroline J Granger, Kyle L Mccormick, Cara A Cipriano, Jonathan R Kaplan, Matthew A Varacallo, Seth D Dodds, William N Levine
Articles, Abstracts, and Reports
Over recent months, coronavirus disease 2019 (COVID-19) has swept the world as a global pandemic, largely changing the practice of medicine as it was previously known. Physician trainees have not been immune to these changes - uncertainty during this time is undeniable for medical students at all levels of training. Of particular importance is the potential impact of COVID-19 on the upcoming residency application process for rising fourth year students; a further source of added complexity in light of the newly integrated allopathic and osteopathic match in the 2020-2021 cycle. Due to the impact COVID-19 could have on the residency match ...
Composite Quantitative Knee Structure Metrics Predict The Development Of Accelerated Knee Osteoarthritis: Data From The Osteoarthritis Initiative, 2020 University of Massachusetts Medical School
Composite Quantitative Knee Structure Metrics Predict The Development Of Accelerated Knee Osteoarthritis: Data From The Osteoarthritis Initiative, Matthew S. Harkey, Julie E. Davis, Lori Lyn Price, Robert J. Ward, James W. Mackay, Charles B. Eaton, Grace H. Lo, Mary F. Barbe, Ming Zhang, Jincheng Pang, Alina C. Stout, Bing Lu, Timothy E. Mcalindon, Jeffrey B. Driban
UMass Center for Clinical and Translational Science Supported Publications
BACKGROUND: We aimed to determine if composite structural measures of knee osteoarthritis (KOA) progression on magnetic resonance (MR) imaging can predict the radiographic onset of accelerated knee osteoarthritis.
METHODS: We used data from a nested case-control study among participants from the Osteoarthritis Initiative without radiographic KOA at baseline. Participants were separated into three groups based on radiographic disease progression over 4 years: 1) accelerated (Kellgren-Lawrence grades [KL] 0/1 to 3/4), 2) typical (increase in KL, excluding accelerated osteoarthritis), or 3) no KOA (no change in KL). We assessed tibiofemoral cartilage damage (four regions: medial/lateral tibia/femur), bone ...
Computer Based Learning Module: Neuraxial And Peripheral Nerve Blocks, 2020 Southern Illinois University Edwardsville
Computer Based Learning Module: Neuraxial And Peripheral Nerve Blocks, Altan Halici
Doctor of Nursing Practice Projects
Neuraxial and peripheral nerve blocks (PNB) have been present for many years, but recently these pain management techniques are gaining popularity as an alternative to the use of opioids. Neuraxial and PNB reduce the opioid usage during and after the surgery and improve postoperative recovery in terms of pain relief, pain-related sleep disruption, and reduction of side effects, such as nausea and vomiting. Conversely, inadequate pain management after surgery may delay surgical recovery, decreased patient satisfaction, increased length of hospital stay, increased readmissions and healthcare costs (Patacsil, McAuliffe, Feyh, & Sigmon, 2016).
Perioperative nurses are instrumental during the post-operative period in ...
Frequency Of Complications Following Spinal Fusion In Children With Cerebral Palsy, 2020 University of Massachusetts Medical School
Frequency Of Complications Following Spinal Fusion In Children With Cerebral Palsy, Nili S. Amir
GSBS Dissertations and Theses
Neuromuscular Scoliosis is a frequent complication of Cerebral Palsy that requires surgical management including spinal fusion. The objective of this observational study was to describe differences in the frequency of postoperative complications in children with Cerebral Palsy following spinal fusion surgery compared to children with Idiopathic Scoliosis.
The 2016 Kids’ Inpatient Database was queried to identify pediatric patients (old) with concurrent diagnoses of Cerebral Palsy and Neuromuscular Scoliosis undergoing spinal fusion surgery. Cases were compared to children without Cerebral Palsy and with a diagnosis of Idiopathic Scoliosis undergoing the same procedure. Fitted Poisson regression analysis with robust variance ...
Racial/Ethnic Disparities In Physical Function Before And After Total Knee Arthroplasty Among Women In The United States, 2020 San Diego State University
Racial/Ethnic Disparities In Physical Function Before And After Total Knee Arthroplasty Among Women In The United States, Alyson M. Cavanaugh, Mitchell J. Rauh, Caroline A. Thompson, John Alcaraz, William M. Mihalko, Chloe E. Bird, Giselle Corbie-Smith, Milagros C. Rosal, Wenjun Li, Aladdin H. Shadyab, Todd Gilmer, Andrea Z. Lacroix
Open Access Articles
Importance: Although racial/ethnic differences in functional outcomes after total knee arthroplasty (TKA) exist, whether such differences are associated with differences in presurgical physical function (PF) has not been thoroughly investigated.
Objective: To examine trajectories of PF by race/ethnicity before and after TKA among older women.
Design, Setting, and Participants: This cohort study was conducted among the prospective Women's Health Initiative with linked Medicare claims data. A total of 10325 community-dwelling women throughout the United States with Medicare fee-for-service underwent primary TKA between October 1, 1993, and December 31, 2014, and were followed up through March 31, 2017 ...
Fracture Blisters, 2020 HCA Healthcare
Fracture Blisters, Jessica Khabra Md, Jinal K. Patel Md, Gauthier L. Stepman Md, Kulveer Dabb Md, Kenny Hernandez Md, Debra Angelo Md, Johnathan Frunzi Md
West Florida Division Virtual Research Day
Fracture blisters are tense vesicles or bullae that develop on edematous skin following some acute long bone fractures. Fracture blisters are infrequently seen, as the reported incidence is 2.9% to 6.6%.1 This rare complication, may not regularly be encountered by Physicians in the hospital. Fracture blisters typically occur within 24-48 hours following high energy trauma injuries & may last up to several weeks. Ultimately, this condition can lead to prolonged hospital stay due to an increased risk of infection and delay in surgical intervention.2 Early recognition of this dermatologic complication may be helpful in reducing hospital stays.
Novel Infection Status Post Electrocution Requiring A 4th Ray Amputation, 2020 HCA Healthcare
Novel Infection Status Post Electrocution Requiring A 4th Ray Amputation, William R. Judson Iv, Do, John D. Murphy Do, Mba, Phillip H. Sussman Do, John N. Harker Do
West Florida Division Virtual Research Day
- Prevotella bivia is an anaerobic, non-pigmented, Gram-negative bacillus species that is known to inhabit the human female vaginal tract and oral flora. It is most commonly associated with endometritis and pelvic inflammatory disease.1, 2
- Rarely, P. bivia has been found in the nail bed, chest wall, intervertebral discs, and hip and knee joints.1 The bacteria has been linked to necrotizing fasciitis, osteomyelitis, or septic arthritis.3, 4
- Only 3 other reports have described P. bivia infections in the upper extremity with one patient requiring amputation2, and one with deep soft tissue infection requiring multiple debridements and extensive tenosynovectomy ...
Bilateral Posterior Fracture-Dislocation Of The Proximal Humerus After First-Time Seizure, John D. Murphy Do, Mba, Phillip Braunlich Do, Mohit Bansal Md
West Florida Division Virtual Research Day
Fractures of the proximal humerus are commonly associated with osteoporosis and comprise 5.7% of all adult fractures . Posterior dislocations of the shoulder comprise 2-5% of all shoulder dislocations, and when bilateral are even more infrequent, occurring less than 5%. [2,3]. Posterior dislocations are often associated with motor vehicle accidents, seizures, or electrical shock . Fracture-dislocations of the proximal humerus occur in only 1% of all shoulder dislocations, thus making posterior fracture-dislocations off the proximal humerus exceedingly rare . In this case report, we present a previously undescribed case presentation and treatment for bilateral posterior fracture-dislocations of the ...
What Outcomes Matter To Patients After Joint Or Spine Surgery?, 2020 University of St. Thomas
What Outcomes Matter To Patients After Joint Or Spine Surgery?, Robin R. Whitebird, Leif I. Solberg, Christine K. Norton, Jeanette Y. Ziegenfuss, Stephen E. Asche, Elizabeth S. Grossman
Journal of Patient-Centered Research and Reviews
Purpose: Patient-reported outcome measures (PROMs) are increasingly used in clinical care, but there have been few studies of what patients identify as the most important outcomes.
Methods: Semi-structured interviews were conducted with 65 patients undergoing hip or knee replacement, spinal discectomy/laminotomy, or a spinal fusion. Interviews focused on outcomes patients identified as important, perceived usefulness of standardized PROMs measures, and contextual situations important to their care. Data were analyzed using a directed content analysis approach.
Results: Patients identified desired outcomes that were unique and important to them. Their preferred outcomes focused in the areas of freedom from pain, getting ...
Orthopedic Injuries In Athletes, 2020 Winthrop University
Orthopedic Injuries In Athletes, Cameron Adams
Showcase of Undergraduate Research and Creative Endeavors (SOURCE)
When thinking of athletes and orthopedic injuries, we often associate these injuries with more physical sports such as football, basketball, or even soccer. What we don’t realize is that an injury of any degree can occur in any sport, regardless of the level of physicality. An orthopedic injury is any injury to the bones, muscles, or joints of the musculoskeletal system. These injuries include, but are not limited to, ACL tears, meniscus tears, broken bones, muscle tears, sprains, dislocations, or fractures, obtained during a sport. Most injuries of this nature are hard to ignore, but depending on the area ...
The Of Application Of 3d-Printing To Lumbar Spine Surgery, 2020 The University of Western Ontario
The Of Application Of 3d-Printing To Lumbar Spine Surgery, Andrew J. Kanawati
Electronic Thesis and Dissertation Repository
Rapid prototyping refers to the manufacturing process in which a three-dimensional (3D) digital model can be transformed into a physical model by layering material in the shape of successive cross sections atop of previously layers. Rapid prototyping has been increasing in popularity in the field of medicine and surgery due to the ability to personalize various aspects of patient care. The thesis will explore the use of rapid prototyping in lumbar spine surgery, aim to quantify the accuracy of medical imaging when relating to imaged structures and their corresponding models produced by rapid prototyping, and determine if complex patient-specific guides ...
Balance Of Adults With Chronic Ankle Instability Following A 6-Week Core Stability Program, 2020 Rowan University
Balance Of Adults With Chronic Ankle Instability Following A 6-Week Core Stability Program, Natalie Dickol
Theses and Dissertations
Ankle injuries are one of the most common injuries in the athletic population because of the anatomy of the ankle in conjunction with dynamic activity. During injury, mechanoreceptors are damaged, effecting neuromuscular control. Lack of neuromuscular control puts patients at risk for re-injury. Chronic ankle instability (CAI) has been defined as a condition associated with recurrent sprains and persistent symptoms, including feelings of "giving way," loss of function and limited movement and continuous ankle pain. Patients with CAI are commonly shown to have functional deficits in postural control, such as overcompensating on the uninvolved limb or unable to maintain proper ...