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Combined Open Calcaneocuboid, Naviculocuneiform And Subtalar Dislocation: A Case Report And Literature Review, Khai Phang Wong, Zhi Hao Tang, Gek Meng Tan 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

BioMedicine

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 ...


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 2020 Mayo Clinic

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, 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 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., Amiethab A Aiyer, Caroline J Granger, Kyle L McCormick, Cara A Cipriano, Jonathan R Kaplan, Matthew A Varacallo, Seth D Dodds, William N Levine 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, 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 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, ALTAN HALICI 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, Nili S. Amir 2020 University of Massachusetts Medical School

Frequency Of Complications Following Spinal Fusion In Children With Cerebral Palsy, Nili S. Amir

GSBS Dissertations and Theses

Background:

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.

Methods:

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 ...


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 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 ...


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 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.


Bilateral Posterior Fracture-Dislocation Of The Proximal Humerus After First-Time Seizure, John D. Murphy DO, MBA, Phillip Braunlich DO, Mohit Bansal MD 2020 HCA Healthcare

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 [1]. 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 [4]. 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 [5]. In this case report, we present a previously undescribed case presentation and treatment for bilateral posterior fracture-dislocations of the ...


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 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 ...


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 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, Cameron Adams 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, Andrew J. Kanawati 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, Natalie Dickol 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 ...


Sustaining The National Spinal Cord Injury Registry Of Iran (Nscir-Ir) In A Regional Center: Challenges And Solutions, Zahra Azadmanjir, Zahra Mohtasham-Amiri, Seyed-Mahdi Ziabari, Leila Kochakinejad, Hamid Haidari, Guilan University of Medical Sciences, Hadis Sabour, Zahra Khazaeipour, Mahdi Sharif-Alhoseini, Zahra Ghodsi, Abbas Amirjamshidi, Farshad Akbarzadeh, Kazem Zendehdel, Amir Azarhomayouon, Khatereh Naghdi, Gerard Oreilly, Ellen Merete, Alexander Vaccaro, Edward C. Benzel, Seyed Behzad Jazayeri, Vafa Rahimi-Movaghar 2020 Tehran University of Medical Sciences, National Inistitue for Medical Research Development

Sustaining The National Spinal Cord Injury Registry Of Iran (Nscir-Ir) In A Regional Center: Challenges And Solutions, Zahra Azadmanjir, Zahra Mohtasham-Amiri, Seyed-Mahdi Ziabari, Leila Kochakinejad, Hamid Haidari, Guilan University Of Medical Sciences, Hadis Sabour, Zahra Khazaeipour, Mahdi Sharif-Alhoseini, Zahra Ghodsi, Abbas Amirjamshidi, Farshad Akbarzadeh, Kazem Zendehdel, Amir Azarhomayouon, Khatereh Naghdi, Gerard Oreilly, Ellen Merete, Alexander Vaccaro, Edward C. Benzel, Seyed Behzad Jazayeri, Vafa Rahimi-Movaghar

Department of Orthopaedic Surgery Faculty Papers

Background: The National Traumatic Spinal Cord Injury Registry in Iran (NSCIR-IR), was implemented initially in three hospitals as a pilot phase from 11 Oct 2015 to 19 Jun 2016 and has been active in eight centers from 19 Jun 2016. Poursina Hospital, a trauma care referral center in Rasht, Guilan Province of Iran is one of the registry sites, and has been involved in registering eligible patients since 1 Jan 2016. This study aimed to identify the challenges and solutions for sustaining the NSCIR-IR in a regional center.

Methods: This was a mixed-methods study. For the quantitative analysis, a retrospective ...


Comparison Of Pre- And Post-Operative Shoulder Muscle Emg Profiles In Reverse Total Shoulder Arthroplasty Patients, Emily Lau, Sreten Franovic, Noah Kuhlmann, Eric C. Makhni MD, Stephanie Muh MD 2020 Henry Ford Health System

Comparison Of Pre- And Post-Operative Shoulder Muscle Emg Profiles In Reverse Total Shoulder Arthroplasty Patients, Emily Lau, Sreten Franovic, Noah Kuhlmann, Eric C. Makhni Md, Stephanie Muh Md

Medical Student Research Symposium

Background: Deltoid muscle function is central in reverse total shoulder arthroplasty (RTSA) function; however, there is limited information available regarding changes in deltoid activity before and after surgery. Few tests exist to evaluate specific muscle metrics pre and post operatively. Surface Electromyographic (EMG) is non-invasive and allows for observation of motions with multifaceted analysis of movement with minimal patient demand. Understanding the changes in shoulder muscle activation, namely in the deltoid, in patients pre and post-RTSA can further advance understanding of the procedure and rehabilitation efforts.

Methods: Nine individuals were recruited for this study: all patients underwent RTSA by a ...


Application Of Laser Technology In The Non-Surgical Management Of Periprosthetic Joint Infection (Pji); Novel Insights From Peri-Implantitis, Kareem Giovanni Elhage, Mohamed Awad, Ahmad Hasan, Brendan Farley, Khaled Saleh 2020 Wayne State University

Application Of Laser Technology In The Non-Surgical Management Of Periprosthetic Joint Infection (Pji); Novel Insights From Peri-Implantitis, Kareem Giovanni Elhage, Mohamed Awad, Ahmad Hasan, Brendan Farley, Khaled Saleh

Medical Student Research Symposium

Introduction: The management of periprosthetic joint infection (PJI) is challenging, and its socio-economic impact is significant. Moreover, the incidence of MRSA and other resistant organisms are on the rise. Recently, laser technology has been incorporated into treatment protocols of dental peri-implantitis. This review explores the possibility of using laser technology to manage peri-implantitis.

Methods: This article will provide a detailed, comprehensive, and perspective review of the existing evidence of laser technology in management of dental peri-implantitis.

Results: Dental literature investigated the efficacy of several types of lasers. It was shown that diode lasers improved periodontal probing depth (PPD) and bleeding ...


The Use Of Urine Drug Testing For Risk Stratification And Efficacious Drug Monitoring In Pain Management Settings, Ahmad I. Hasan, Kareem Elhage, Brendan Farley, Khaled J. Saleh 2020 Wayne State University

The Use Of Urine Drug Testing For Risk Stratification And Efficacious Drug Monitoring In Pain Management Settings, Ahmad I. Hasan, Kareem Elhage, Brendan Farley, Khaled J. Saleh

Medical Student Research Symposium

Objective: To understand the current landscape of urine drug testing (UDT) guidelines as part of risk assessment for opioid abuse, and to offer recommendations towards adopting universal screening guidelines.

Background: There has been an opioid epidemic within the United States, and the role of prescription opioids has been well established. Despite proposed recommendations, there has yet to be a published universal screening guideline on the use of UDT in the setting of opioid abuse risk stratification as well as postoperative drug monitoring.

Methods: We explored current guidelines for UDT on two levels. First, we explore general indications for UDT within ...


Upper-Extremity Injuries Are The 2nd Most Common Workplace Injuries From 1992 To 2018, Nikhil R. Yedulla, Dylan S. Koolmees, Eric B. Battista, Syed S. Raza, Zachary A. Montgomery, Charles S. Day 2020 Wayne State University School of Medicine

Upper-Extremity Injuries Are The 2nd Most Common Workplace Injuries From 1992 To 2018, Nikhil R. Yedulla, Dylan S. Koolmees, Eric B. Battista, Syed S. Raza, Zachary A. Montgomery, Charles S. Day

Medical Student Research Symposium

Musculoskeletal injuries occur frequently in the workplace, yet it is unclear whether upper-extremity, lower-extremity, or trunk injuries are the most prevalent. We hypothesize that: (1) trunk injuries are the most common in the overall workplace, and (2) upper-extremity injuries are more common in labor-based industries than non-labor industries. Workplace related injury data from 1992 to 2018 was collected from the Bureau of Labor Statistics “Workplace Injuries & Illnesses” database. Occurrence of trunk, upper-extremity, and lower-extremity injuries in major industries (agriculture, construction, manufacturing, and healthcare) were aggregated during this time period and compared. Overall workplace related injury occurrence in major industries from ...


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