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Lamina Spreader Technique Improves Debridement Of Loose Bone And Cement In Total Knee Arthroplasty, Sinan E. Ozgur, Ali Oliashirazi, Grant S. Buchanan, Franklin D. Shuler 2016 Marshall University

Lamina Spreader Technique Improves Debridement Of Loose Bone And Cement In Total Knee Arthroplasty, Sinan E. Ozgur, Ali Oliashirazi, Grant S. Buchanan, Franklin D. Shuler

Franklin D. Shuler

A lamina spreader was introduced to the non-articulating, posterior aspect of the tibial and femoral components, and gentle distraction was applied to improve the inspection of the posterior compartment


Lamina Spreader Technique Improves Debridement Of Loose Bone And Cement In Total Knee Arthroplasty, Sinan E. Ozgur, Ali Oliashirazi, Grant S. Buchanan, Franklin D. Shuler 2016 Marshall University

Lamina Spreader Technique Improves Debridement Of Loose Bone And Cement In Total Knee Arthroplasty, Sinan E. Ozgur, Ali Oliashirazi, Grant S. Buchanan, Franklin D. Shuler

Franklin D. Shuler

Abstract

Loose bone and cement can promote polyethylene wear that may lead to failure in total knee arthroplasty. The authors propose a technique to enhance the debridement of loose bodies by distracting the cemented components with a lamina spreader following standard debridement with pulsatile lavage. Cement and bone/soft tissue debris was recovered from 51 consecutive primary total knee arthroplasty patients. This technique facilitated the removal of hidden debris in 80% of patients (41/51). On average, 2.6 fragments measuring 158 mm3 were removed per patient. The authors advocate that distraction with a lamina spreader be used to ...


A Comparison Of Imaging Modalities For The Diagnosis Of Osteomyelitis, Brandon J. Smith, MD, Grant S. Buchanan, MD, Franklin D. Shuler, MD, PhD 2016 Marshall University, Joan C. Edwards School of Medicine

A Comparison Of Imaging Modalities For The Diagnosis Of Osteomyelitis, Brandon J. Smith, Md, Grant S. Buchanan, Md, Franklin D. Shuler, Md, Phd

Franklin D. Shuler

Osteomyelitis is an increasingly common pathology that often poses a diagnostic challenge to clinicians. Accurate and timely diagnosis is critical to preventing complications that can result in the loss of life or limb. In addition to history, physical exam, and laboratory studies, diagnostic imaging plays an essential role in the diagnostic process. This narrative review article discusses various imaging modalities employed to diagnose osteomyelitis: plain films, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, bone scintigraphy, and positron emission tomography (PET). Articles were obtained from Pubmed and screened for relevance to the topic of diagnostic imaging for osteomyelitis. The authors ...


Technique To Improve Cement Penetration In Total Knee Arthroplasty, Richard Boe, Ali Oliashirazi 2016 Marshall University Joan C. Edwards School of Medicine

Technique To Improve Cement Penetration In Total Knee Arthroplasty, Richard Boe, Ali Oliashirazi

Ali Oliashirazi

Pre-operative and post-operative AP radiographs of initial patient using described technique with the evacuated cyst filled with cement highlighted


Lamina Spreader Technique Improves Debridement Of Loose Bone And Cement In Total Knee Arthroplasty, Sinan E. Ozgur, Ali Oliashirazi, Grant S. Buchanan, Franklin D. Shuler 2016 Marshall University

Lamina Spreader Technique Improves Debridement Of Loose Bone And Cement In Total Knee Arthroplasty, Sinan E. Ozgur, Ali Oliashirazi, Grant S. Buchanan, Franklin D. Shuler

Ali Oliashirazi

Abstract

Loose bone and cement can promote polyethylene wear that may lead to failure in total knee arthroplasty. The authors propose a technique to enhance the debridement of loose bodies by distracting the cemented components with a lamina spreader following standard debridement with pulsatile lavage. Cement and bone/soft tissue debris was recovered from 51 consecutive primary total knee arthroplasty patients. This technique facilitated the removal of hidden debris in 80% of patients (41/51). On average, 2.6 fragments measuring 158 mm3 were removed per patient. The authors advocate that distraction with a lamina spreader be used to ...


Lamina Spreader Technique Improves Debridement Of Loose Bone And Cement In Total Knee Arthroplasty, Sinan E. Ozgur, Ali Oliashirazi, Grant S. Buchanan, Franklin D. Shuler 2016 Marshall University

Lamina Spreader Technique Improves Debridement Of Loose Bone And Cement In Total Knee Arthroplasty, Sinan E. Ozgur, Ali Oliashirazi, Grant S. Buchanan, Franklin D. Shuler

Ali Oliashirazi

A lamina spreader was introduced to the non-articulating, posterior aspect of the tibial and femoral components, and gentle distraction was applied to improve the inspection of the posterior compartment


Technique To Improve Cement Penetration In Total Knee Arthroplasty, Richard Boe Jr, Ali Oliashirazi 2016 Marshall University

Technique To Improve Cement Penetration In Total Knee Arthroplasty, Richard Boe Jr, Ali Oliashirazi

Ali Oliashirazi

In total knee arthroplasty, infection has always been cited as being the number one cause of failure. However, more recent studies have shown aseptic loosening as the top reason for failure now. Proper cement technique is an important factor in reducing the occurrence of aseptic loosening. Clean and dried bone are important in achieving rigid cement fixation. Subchondral cysts may be hidden below the cut bone surface and may interfere with cement interdigitation. During a recent total knee arthroplasty case, a simple technique was developed for identifying and clearing out these cysts. By only using the suction tip, the gentle ...


Lamina Spreader Technique Improves Debridement Of Loose Bone And Cement In Total Knee Arthroplasty, Sinan E. Ozgur, Ali Oliashirazi, Grant S. Buchanan, Franklin D. Shuler 2016 Marshall University

Lamina Spreader Technique Improves Debridement Of Loose Bone And Cement In Total Knee Arthroplasty, Sinan E. Ozgur, Ali Oliashirazi, Grant S. Buchanan, Franklin D. Shuler

Marshall Journal of Medicine

Abstract

Loose bone and cement can promote polyethylene wear that may lead to failure in total knee arthroplasty. The authors propose a technique to enhance the debridement of loose bodies by distracting the cemented components with a lamina spreader following standard debridement with pulsatile lavage. Cement and bone/soft tissue debris was recovered from 51 consecutive primary total knee arthroplasty patients. This technique facilitated the removal of hidden debris in 80% of patients (41/51). On average, 2.6 fragments measuring 158 mm3 were removed per patient. The authors advocate that distraction with a lamina spreader be used to ...


Technique To Improve Cement Penetration In Total Knee Arthroplasty, Richard Boe Jr, Ali Oliashirazi 2016 Marshall University

Technique To Improve Cement Penetration In Total Knee Arthroplasty, Richard Boe Jr, Ali Oliashirazi

Marshall Journal of Medicine

In total knee arthroplasty, infection has always been cited as being the number one cause of failure. However, more recent studies have shown aseptic loosening as the top reason for failure now. Proper cement technique is an important factor in reducing the occurrence of aseptic loosening. Clean and dried bone are important in achieving rigid cement fixation. Subchondral cysts may be hidden below the cut bone surface and may interfere with cement interdigitation. During a recent total knee arthroplasty case, a simple technique was developed for identifying and clearing out these cysts. By only using the suction tip, the gentle ...


Pain Management After Outpatient Anterior Cruciate Ligament Reconstruction: A Systematic Review Of Randomized Controlled Trials., Eric S. Secrist, Kevin B. Freedman, Michael G. Ciccotti, Donald W. Mazur, Sommer Hammoud 2016 Thomas Jefferson University

Pain Management After Outpatient Anterior Cruciate Ligament Reconstruction: A Systematic Review Of Randomized Controlled Trials., Eric S. Secrist, Kevin B. Freedman, Michael G. Ciccotti, Donald W. Mazur, Sommer Hammoud

Rothman Institute

BACKGROUND: Effective pain management after anterior cruciate ligament (ACL) reconstruction improves patient satisfaction and function.

PURPOSE: To collect and evaluate the available evidence from randomized controlled trials (RCTs) on pain control after ACL reconstruction.

STUDY DESIGN: Systematic review.

METHODS: A systematic literature review was performed using PubMed, Medline, Google Scholar, UpToDate, Cochrane Reviews, CINAHL, and Scopus following PRISMA guidelines (July 2014). Only RCTs comparing a method of postoperative pain control to another method or placebo were included.

RESULTS: A total of 77 RCTs met inclusion criteria: 14 on regional nerve blocks, 21 on intra-articular injections, 4 on intramuscular/intravenous injections ...


The Role Of Postural Stability And Other Factors In Distal Radius Fracture, Sheena Saju Philip 2016 The University of Western Ontario

The Role Of Postural Stability And Other Factors In Distal Radius Fracture, Sheena Saju Philip

Electronic Thesis and Dissertation Repository

The objective of the thesis was to describe the factors leading to falls in distal radius fracture (DRF) events, explore patient perceived risk of falls, and postural stability. A mixed method study described the type of fall in DRF patients (n= 1454) and patient perceived contributing factors (n=29). A prospective cohort study examined the postural stability and related fall risk of DRF participants (n=137) in Biodex Balance System (BBS) and compared to normative values. Environmental factors were a major contributor to DRF events. Older adults (44 to 65 years) had the highest rate of DRF (female: male ratio ...


Spinal Compression Fractures: No Additional Pain Relief With Use Of Back Braces, Kayla A. Berigan, Brandon Baker, Zakaria Ahmad, Aaron Simpson 2016 Wayne State University School of Medicine

Spinal Compression Fractures: No Additional Pain Relief With Use Of Back Braces, Kayla A. Berigan, Brandon Baker, Zakaria Ahmad, Aaron Simpson

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Li M, Law SW, Cheng J, Kee HM, Wong MS. A comparison study on the efficacy of SpinoMed® and soft lumbar orthosis for osteoporotic vertebral fracture. J. Prosthet. Orthot. Int. 2015;39(4):270-276. doi: 10.1177/0309364614528204


Drop Vertical Jump Landing Mechanics Following Anterior Cruciate Ligament Reconstruction With And Without Lateral Extra-Articular Tenodesis, Michal Daniluk 2016 The University of Western Ontario

Drop Vertical Jump Landing Mechanics Following Anterior Cruciate Ligament Reconstruction With And Without Lateral Extra-Articular Tenodesis, Michal Daniluk

Electronic Thesis and Dissertation Repository

The use of combined anterior cruciate ligament (ACL) plus lateral extra-articular tenodesis (LET) reconstruction has shown promising results during clinical testing, however, no studies have examined its effectiveness during a dynamic functional task. We used the drop vertical jump (DVJ) to compare in vivo biomechanics of ACL reconstructed patients with and without LET.

Our primary outcome was peak knee abduction moment during stance phase. Secondary kinetic and kinematic outcomes included peak initial contact and stance values for knee abduction angle, knee flexion moment and angle, knee internal rotation moment and angle, and vertical ground reaction force. We also assessed fear ...


Evaluating The Effects Of Patellofemoral Offset Changes And Trochlear Design In Total Knee Arthroplasty: A Radiographic, Visual, And Topographical Analysis, Jacob Matz 2016 The University of Western Ontario

Evaluating The Effects Of Patellofemoral Offset Changes And Trochlear Design In Total Knee Arthroplasty: A Radiographic, Visual, And Topographical Analysis, Jacob Matz

Electronic Thesis and Dissertation Repository

Total knee arthroplasty (TKA) is a common procedure for the treatment of advanced knee osteoarthritis. Complications involving the patellofemoral joint (PFJ) are common following TKA, and the etiology is controversial. The purpose of this thesis was to evaluate two potentially modifiable factors affecting the PFJ: (i) changes in patellofemoral offset (PFO) and (ii) trochlear design.

Through a retrospective radiographic review, we demonstrated that PFO changes occur frequently post-TKA, and that the PFJ can tolerate these changes without adverse clinical outcomes. Retrieval analysis provided additional evidence that PFO changes are not associated with femoral component surface damage or wear.

In order ...


Diagnostic Utility Of Anti-Citrullinated Protein Antibody And Its Comparison With Rheumatoid Factor In Rheumatoid Arthritis, Aysha Habib Khan, Lena Jafri, M Ahraz Hussain, Saliha Ishaq 2016 Aga Khan University

Diagnostic Utility Of Anti-Citrullinated Protein Antibody And Its Comparison With Rheumatoid Factor In Rheumatoid Arthritis, Aysha Habib Khan, Lena Jafri, M Ahraz Hussain, Saliha Ishaq

Aysha Habib

Objective:

To assess the diagnostic utility of anti-citrullinated protein antibody (anti-CCP) in rheumatoid arthritis (RA) and compare it with rheumatoid factor (RF).

Study Design:

Analytical study.

Place and Duration of Study:

Section of Chemical Pathology, Department of Pathology and Microbiology and Medicine, the Aga Khan University, Karachi, from January to May 2010.

Methodology:

A review of medical records of patients presenting to the clinics with complaints of muscular or joint pains and who were tested for their serum anti-CCP was done. Inclusion criteria were presence of clinical synovitis in at least one joint and an absence of alternative diagnosis. Patients ...


Catastrophic Femoral Head-Stem Trunnion Dissociation Secondary To Corrosion., Laura Matsen Ko, Antonia F. Chen, MD, MBA, Gregory K Deirmengian, William J. Hozack MD, Peter F. Sharkey 2016 Orthopedic Physician Associates, Seattle, WA

Catastrophic Femoral Head-Stem Trunnion Dissociation Secondary To Corrosion., Laura Matsen Ko, Antonia F. Chen, Md, Mba, Gregory K Deirmengian, William J. Hozack Md, Peter F. Sharkey

Rothman Institute

BACKGROUND: Modular femoral heads provide procedural enhancement by allowing accurate restoration of hip offset and limb-length equalization. However, corrosion may lead to adverse local tissue reactions. Severe trunnion corrosion can also lead to femoral head dissociation and catastrophic implant failure following primary total hip arthroplasty.

METHODS: We describe 5 cases, from our institution, in which the femoral head became dissociated from the femoral stem trunnion secondary to severe corrosion. Possible causes are evaluated.

RESULTS: Demographic commonalities among the 5 patients included a body mass index (BMI) of ≥30 kg/m(2) and male sex. All femoral heads were made of ...


Using Interviews To Understand Patients’ Post-Operative Pain Management Educational Needs Before And After Elective Total Joint Replacement Surgery, Celeste A. Lemay, Patricia D. Franklin 2016 University of Massachusetts Medical School

Using Interviews To Understand Patients’ Post-Operative Pain Management Educational Needs Before And After Elective Total Joint Replacement Surgery, Celeste A. Lemay, Patricia D. Franklin

Celeste A. Lemay

Objective: To better understand the education needs of patients electing to have TJR in managing their pain in the post-operative period after discharge from the hospital.

Methods: An exploratory, descriptive, qualitative design. Convenience sample of people who reported that they had not received information about pain management prior to TJR surgery were recruited from 9 surgeon practices in 8 states to participate in telephone interviews, utilizing open-ended questions. Questions included: recollection of pre-op class attended and content; experiences with surgical pain after surgery and how it was managed; experiences with pain medicine; experience using non-medicine related pain reduction methods; suggestions ...


Effective Pain Information Pre-Operatively Is Associated With Improved Functional Gain After Total Joint Replacement, Celeste A. Lemay, David Ayers, Patricia D. Franklin 2016 University of Massachusetts Medical School

Effective Pain Information Pre-Operatively Is Associated With Improved Functional Gain After Total Joint Replacement, Celeste A. Lemay, David Ayers, Patricia D. Franklin

Celeste A. Lemay

Objective: We evaluated receipt of pre-operative pain management education in a national prospective cohort on post-operative pain and function.

Methods: Preoperative, 2 week and 6 month postoperative data from a nationally representative cohort of 1404 primary unilateral TJR patients with a date of surgery between May 2011 and December 2014. Data included demographics, comorbid conditions, operative joint pain severity (HOOS/KOOS), musculoskeletal disease burden, physical function (SF36 PCS), and mental health (SF36 MCS). At 2 weeks post-op, patients were asked if they had received information prior to surgery about pain management options and if so, how helpful the information was ...


6-Month Change In Pain And Function By Pre-Operative Pain And Function Among Patients Selected For Total Knee Replacement In The United States, Uyen-Sa D.T. Nguyen, David Ayers, Wenjun Li, Leslie R. Harrold, Patricia D. Franklin 2016 University of Massachusettts Medical School

6-Month Change In Pain And Function By Pre-Operative Pain And Function Among Patients Selected For Total Knee Replacement In The United States, Uyen-Sa D.T. Nguyen, David Ayers, Wenjun Li, Leslie R. Harrold, Patricia D. Franklin

Leslie R. Harrold

Background/Purpose: The increase in total knee replacements (TKRs) between 1979 and 2006 is staggering. Debate is growing regarding the appropriate utilization of TKRs. We examined pain, function, quality of life (QOL), and satisfaction at 6-month post-surgery by pain and function at time of surgery. Methods: Data came from the nationally representative FORCE-TJR cohort of patients from 150 surgeons. Participants had primary, unilateral TKRs due to osteoarthritis between 2011 and 2014. Their knee pain (KOOS), physical functions (SF36), and QOL were measured at pre- and 6 months post-surgery. We classified patients as having high or low pre-operative pain (KOOS Pain ...


Vitamin D Supplementation: Preventing Fractures, Courtney L. Carn, Michael S. Doherty 2016 James Madison University

Vitamin D Supplementation: Preventing Fractures, Courtney L. Carn, Michael S. Doherty

Physician Assistant Capstones

Objective: To assess the ability of vitamin D supplementation in preventing musculoskeletal fractures. Methods: Systematic literature review using Google Scholar search terms “vitamin D supplementation” and “preventing hip fractures” from 2006-2015. Only RCTs, meta-analysis, and clinical guidelines were included. Results: Our search resulted in one meta-analysis and two randomized controlled trials. Conclusion: The summation of our investigation into vitamin D deficiency and the presence of musculoskeletal fractures has proven to be relatively inconclusive. The resulting data from our three studies did not provide any definitive proof that improved vitamin D levels correlates with better bone health.


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