Orthopedics Commons^™

A Retrospective Analysis Of Opioid Consumption Among Different Orthopedic Surgeons For Total Joint Replacement, Costas J. Gioules, Hayden B. Rockson, Russell M. Flatto, Arnel J. Almeda, Anthony L. Schwagerl

Senior Scholars Program

Background: Throughout the world, baby boomers reaching their sixth, seventh, and eighth decade of life are requiring a significant number of joint replacements—hips and knees. Due to the increasing number of joint replacements, it is important to find a multi-modal approach (MMA) to control pain, reduce the amount of opioid consumption, and improve patient satisfaction.

Purpose: The purpose of this study was to evaluate the intraoperative, postoperative, and total opioid consumption of patients undergoing total hip and knee replacements in an effort to develop a multi-modal approach to decrease opioid consumption, minimize adverse effects secondary to narcotic administration, and ...

The Association Between Preoperative Spinal Cord Rotation And Postoperative C5 Nerve Palsy, Mark S. Eskander, Steve Balsis, Chris Balinger, Caitlin M. Howard, Nicholas W. Lewing, Jonathan P. Eskander, Michelle E. Aubin, Jeffrey Lange, Jason C. Eck, Patrick J. Connolly, Louis G. Jenis

Orthopedics and Physical Rehabilitation Publications and Presentations

BACKGROUND: C5 nerve palsy is a known complication of cervical spine surgery. The development and etiology of this complication are not completely understood. The purpose of the present study was to determine whether rotation of the cervical spinal cord predicts the development of a C5 palsy.

METHODS: We performed a retrospective review of prospectively collected spine registry data as well as magnetic resonance images. We reviewed the records for 176 patients with degenerative disorders of the cervical spine who underwent anterior cervical decompression or corpectomy within the C4 to C6 levels. Our measurements included area for the spinal cord, space ...

A Variant Of A Type V Lateral Clavicle Fracture Involving A Posteriorly Displaced Medial Segment. A Case Report, Thomas P. Goss, Xinning Li

Orthopedics and Physical Rehabilitation Publications and Presentations

The clavicle connects the shoulder girdle to the axial skeleton, providing support and mobility for optimal upper extremity function. Fractures of the clavicle account for up to 4% of all fractures and comprise up to 44% of all injuries to the shoulder girdle. We present a 63-year-old female patient who suffered what appeared to be a minimally displaced Type V lateral clavicle fracture after a fall as evidenced by an anteroposterior shoulder radiograph. However, an axillary projection demonstrated the proximal segment to be posteriorly displaced and buttonholed through the trapezius musculature with tenting of the skin. The patient underwent an ...

Quality Management Across The Continuum Of Care In Orthopedics, James F. Pelegano Md, Ms

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Ulnar Tunnel Syndrome., Abdo Bachoura, Sidney M Jacoby

Department of Orthopaedic Surgery Faculty Papers

Ulnar tunnel syndrome could be broadly defined as a compressive neuropathy of the ulnar nerve at the level of the wrist. The ulnar tunnel, or Guyon's canal, has a complex and variable anatomy. Various factors may precipitate the onset of ulnar tunnel syndrome. Patient presentation depends on the anatomic zone of ulnar nerve compression: zone I compression, motor and sensory signs and symptoms; zone II compression, isolated motor deficits; and zone III compression; purely sensory deficits. Conservative treatment such as activity modification may be helpful, but often, surgical exploration of the ulnar tunnel with subsequent ulnar nerve decompression is ...

The Impact Of Epidural Steroid Injections On The Outcomes Of Patients Treated For Lumbar Disc Herniation: A Subgroup Analysis Of The Sport Trial., Kristen Radcliff, Alan Hilibrand, Jon D Lurie, Tor D Tosteson, Lawrence Delasotta, Jeffrey Rihn, Wenyan Zhao, Alexander Vaccaro, Todd J Albert, James N Weinstein

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: The Spine Patient Outcomes Research Trial (SPORT) is a prospective, multicenter study of operative versus nonoperative treatment of lumbar intervertebral disc herniation. It has been suggested that epidural steroid injections may help improve patient outcomes and lower the rate of crossover to surgical treatment.

METHODS: One hundred and fifty-four patients included in the intervertebral disc herniation arm of the SPORT who had received an epidural steroid injection during the first three months of the study and no injection prior to the study (the ESI group) were compared with 453 patients who had not received an injection during the first ...

Feasibility, Effectiveness, Costs And Patient Satisfaction Associated With A Web-Based Follow-Up Assessment Following Total Joint Arthroplasty, Jacquelyn Marsh

Electronic Thesis and Dissertation Repository

Objectives: To determine the feasibility, effectiveness, costs and satisfaction involved with a web-based assessment following total joint arthroplasty compared to the usual method of in-person assessment.

Methods: We determined agreement between electronic and paper versions of the WOMAC and SF-12 questionnaires (Chapter 2). We randomized patients who were at least 12 months post-operative to complete a web-based follow-up or to have their appointment at the clinic. We recorded travel distances, costs, and time involved with each appointment. We report the frequency of web-based patients who: 1) indicated they were having problems, 2) had an identified radiographic issue, 3) the surgeon ...

Anatomical Relationships Of The Anterior Blood Vessels To The Lower Lumbar Intervertebral Discs: Analysis Based On Magnetic Resonance Imaging Of Patients In The Prone Position., Alexander R Vaccaro, Christopher K Kepler, Jeffrey A Rihn, Hidekazu Suzuki, John K Ratliff, James S Harrop, William B Morrison, Worawat Limthongkul, Todd J Albert

Rothman Institute

BACKGROUND: Intra-abdominal vascular injuries are rare during posterior lumbar spinal surgery, but they can result in major morbidity or mortality when they do occur. We are aware of no prior studies that have used prone patient positioning during magnetic resonance imaging for the purpose of characterizing the retroperitoneal iliac vasculature with respect to the intervertebral disc. The purpose of this study was to define the vascular anatomy adjacent to the lower lumbar spine with use of supine and prone magnetic resonance imaging.

METHODS: A prospective observational study included thirty patients without spinal abnormality who underwent supine and prone magnetic resonance ...

What's New In Spine Surgery., Keith H Bridwell, Paul A Anderson, Scott D Boden, Alexander R Vaccaro, Jeffrey C Wang

Rothman Institute

No abstract provided.