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Validity Of The Body Scan Scanner® And Structure Sensor To Measure Limb Volume In Healthy Adults, Mary Insana Fisher, Michaela Claire Viola, Noah James Brueckner, Madison Elizabeth Wolfe, Rachel Lynn Kremer 2020 University of Dayton

Validity Of The Body Scan Scanner® And Structure Sensor To Measure Limb Volume In Healthy Adults, Mary Insana Fisher, Michaela Claire Viola, Noah James Brueckner, Madison Elizabeth Wolfe, Rachel Lynn Kremer

Physical Therapy Faculty Publications

Purpose/Hypothesis: Secondary lymphedema is a chronic condition that can develop in approximately 30 percent of women treated for breast cancer. It is important to measure limb volume changes for early detection of lymphedema, when it is possible to reverse the swelling (stage 1). Common clinical measures carry concerns of infection control (water displacement), are time consuming (truncated cone calculation using circumferential measures), or expensive (perometry). Use of a portable 3D scanner addresses these concerns, but the validity is unknown. The purpose of this phase I study is to investigate the validity of the Body Scan Scanner to measure limb ...


Prehabilitation To Improve Positioning Reproducibility In Patients Undergoing Pelvic Radiation Therapy, Alexander Lukez, Lauren O'Loughlin 2020 University of Massachusetts Medical School

Prehabilitation To Improve Positioning Reproducibility In Patients Undergoing Pelvic Radiation Therapy, Alexander Lukez, Lauren O'Loughlin

Capstone Presentations

Prehabilitation to improve patient positioning: pelvic exercises assist in reducing sacral slope variability during radiation therapy

Purpose/Objective(s):

Reproducible patient positioning is essential for precision in radiation therapy (RT) delivery. However, a retrospective review of pre-treatment imaging demonstrated variability in daily patient set-up. We tested the hypothesis that a structured daily pre-treatment stretching regimen is both feasible and effective for minimizing variability in positioning, as measured by sacral slope angles (SSA).

Materials/Methods:

After obtaining IRB approval, we had 8 female patients undergoing pelvic radiotherapy perform a structured daily hip exercise regimen (extension and external rotation) immediately prior to ...


Evaluating The Performance Of The Who International Reference Standard For Osteoporosis Diagnosis In Postmenopausal Women Of Varied Polygenic Score And Race, Qing Wu, Xiangxue Xiao, Yingke Xu 2020 University of Nevada, Las Vegas

Evaluating The Performance Of The Who International Reference Standard For Osteoporosis Diagnosis In Postmenopausal Women Of Varied Polygenic Score And Race, Qing Wu, Xiangxue Xiao, Yingke Xu

School of Medicine Faculty Publications

Background: Whether the bone mineral density (BMD) T-score performs differently in osteoporosis classification in women of different genetic profiling and race background remains unclear. Methods: The genomic data in the Women’s Health Initiative study was analyzed (n = 2417). The polygenic score (PGS) was calculated from 63 BMD-associated single nucleotide polymorphisms (SNPs) for each participant. The World Health Organization′s (WHO) definition of osteoporosis (BMD T-score ≤ −2.5) was used to estimate the cumulative incidence of fracture. Results: T-score classification significantly underestimated the risk of major osteoporotic fracture (MOF) in the WHI study. An enormous underestimation was observed in African ...


Return To Sport And Athletic Function In An Active Population After Primary Arthroscopic Labral Reconstruction Of The Hip, David R. Maldonado, Sarah L. Chen, Mitchell J. Yelton, Philip J. Rosinsky, Rafael Walker-Santiago, Jacob Shapira, Ajay C. Lall, Benjamin G. Domb 2020 American Hip Institute Research Foundation

Return To Sport And Athletic Function In An Active Population After Primary Arthroscopic Labral Reconstruction Of The Hip, David R. Maldonado, Sarah L. Chen, Mitchell J. Yelton, Philip J. Rosinsky, Rafael Walker-Santiago, Jacob Shapira, Ajay C. Lall, Benjamin G. Domb

Student Papers & Posters

Background: Labral reconstruction has been advocated as an alternative to debridement for the treatment of irreparable labral tears, showing favorable short-term results. However, literature is scarce regarding outcomes and return to sport in the nonelite athletic population.

Purpose: To report minimum 1-year clinical outcomes and the rate of return to sport in athletic patients who underwent primary hip arthroscopy with labral reconstruction in the setting of femoroacetabular impingement syndrome and irreparable labral tears.

Study Design: Case series; Level of evidence, 4.

Methods: Data were prospectively collected and retrospectively analyzed for patients who underwent an arthroscopic labral reconstruction between August 2012 ...


Assessing Structural Damage Progression In Psoriatic Arthritis And Its Role As An Outcome In Research., Désirée van der Heijde, Dafna D Gladman, Arthur Kavanaugh, Philip Mease 2020 Swedish Medical Center/Providence St. Joseph Health

Assessing Structural Damage Progression In Psoriatic Arthritis And Its Role As An Outcome In Research., Désirée Van Der Heijde, Dafna D Gladman, Arthur Kavanaugh, Philip Mease

Articles, Abstracts, and Reports

Psoriatic arthritis (PsA) is an immune-mediated, clinically heterogeneous disease characterized by arthritis, enthesitis, dactylitis, spondylitis, and psoriasis of the skin and nails. Persistent articular inflammation in patients with PsA can lead to structural damage, which can result in reduced physical function and quality of life. Structural damage can occur rapidly, and irreversible joint damage may be observed if patients are not treated promptly and appropriately. Therefore, evaluating therapeutic agents for their ability to inhibit structural progression has become increasingly important, with radiographic progression becoming a key efficacy outcome in clinical trials in PsA. Here, we review how structural damage and ...


Proton Pump Inhibitor Use Affects Pseudarthrosis Rates And Influences Patient-Reported Outcomes., John J. Mangan, Srikanth N. Divi, James McKenzie, Justin D. Stull, William Conaway, David S. Casper, Dhruv K.C. Goyal, Kristen J. Nicholson, Matthew S. Galetta, Scott C. Wagner, I. David Kaye, Mark Kurd, Barrett I. Woods, Kristen E. Radcliff, Jeffrey A. Rihn, D. Greg Anderson, Alan S. Hilibrand, Alex R. Vaccaro, Gregory D. Schroeder, Christopher K. Kepler 2020 Thomas Jefferson University

Proton Pump Inhibitor Use Affects Pseudarthrosis Rates And Influences Patient-Reported Outcomes., John J. Mangan, Srikanth N. Divi, James Mckenzie, Justin D. Stull, William Conaway, David S. Casper, Dhruv K.C. Goyal, Kristen J. Nicholson, Matthew S. Galetta, Scott C. Wagner, I. David Kaye, Mark Kurd, Barrett I. Woods, Kristen E. Radcliff, Jeffrey A. Rihn, D. Greg Anderson, Alan S. Hilibrand, Alex R. Vaccaro, Gregory D. Schroeder, Christopher K. Kepler

Department of Orthopaedic Surgery Faculty Papers

Study Design: Retrospective cohort review.

Objectives: Cervical pseudarthrosis is a frequent cause of need for revision anterior cervical discectomy and fusion (ACDF) and may lead to worse patient-reported outcomes. The effect of proton pump inhibitors on cervical fusion rates are unknown. The purpose of this study was to determine if patients taking PPIs have higher rates of nonunion after ACDF.

Methods: A retrospective cohort review was performed to compare patients who were taking PPIs preoperatively with those not taking PPIs prior to ACDF. Patients younger than 18 years of age, those with less than 1-year follow-up, and those undergoing surgery ...


Joint-Preserving Procedures For Osteonecrosis Of The Femoral Head., Bülent Atilla, Sancar Bakırcıoğlu, Alexander J. Shope, Javad Parvizi 2020 Hacettepe University

Joint-Preserving Procedures For Osteonecrosis Of The Femoral Head., Bülent Atilla, Sancar Bakırcıoğlu, Alexander J. Shope, Javad Parvizi

Rothman Institute Faculty Papers

Osteonecrosis of the femoral head is a poorly understood condition that may lead to progressive destruction of the hip joint. Its incidence is common between the third and fifth decades of life and it is the diagnosis behind 5-18% of annually performed total hip arthroplasties (THAs) in the USA.Regarding the high rate of complications of THA in that age group, authors have agreed on the importance of joint-preservation techniques for this disease but techniques vary to establish a generally accepted algorithmic approach.Surgical head-preserving procedures, core decompression with or without graft, stem cell augmentation, or biologic adjuncts, vascularized bone ...


Patient-Reported Outcomes Feedback Report For Knee Arthroplasty Patients Should Present Selective Information In A Simple Design - Findings Of A Qualitative Study, Kathrin I. Fischer, Diarmuid De Faoite, Matthias S. F. Rose 2020 Charité – Universitätsmedizin Berlin

Patient-Reported Outcomes Feedback Report For Knee Arthroplasty Patients Should Present Selective Information In A Simple Design - Findings Of A Qualitative Study, Kathrin I. Fischer, Diarmuid De Faoite, Matthias S. F. Rose

Open Access Articles

BACKGROUND: Technical innovation to assess patient-reported outcomes (PROs) facilitates their implementation in clinical practice. In particular, mobile applications (apps) allow PROs to be assessed outside of the clinical setting. A patient's health status can be remotely monitored and evaluated after discharge, and their recovery process tracked. This is of particular interest for patients after knee arthroplasty, as the recovery phase after surgery usually takes place in an outpatient setting and requires a high level of patient engagement. Providing results of PRO assessments to patients in the form of a feedback report could increase patient engagement and may improve communication ...


National Trends In Total Hip Arthroplasty For Traumatic Hip Fractures: An Analysis Of A Nationwide All-Payer Database., Anthony J Boniello, Alexander M Lieber, Kevin Denehy, Priscilla Cavanaugh, Yehuda E Kerbel, Andrew Star 2020 Thomas Jefferson University

National Trends In Total Hip Arthroplasty For Traumatic Hip Fractures: An Analysis Of A Nationwide All-Payer Database., Anthony J Boniello, Alexander M Lieber, Kevin Denehy, Priscilla Cavanaugh, Yehuda E Kerbel, Andrew Star

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Hemiarthroplasty (HA) has traditionally been the treatment of choice for elderly patients with displaced femoral neck fractures. Ideal treatment for younger, ambulatory patients is not as clear. Total hip arthroplasty (THA) has been increasingly utilized in this population however the factors associated with undergoing HA or THA have not been fully elucidated.

AIM: To examine what patient characteristics are associated with undergoing THA or HA. To determine if outcomes differ between the groups.

METHODS: We queried the Nationwide Inpatient Sample (NIS) for patients that underwent HA or THA for a femoral neck fracture between 2005 and 2014. The NIS ...


Health Literacy And Patient Reported Outcomes In Orthopaedic Surgery Patients, Thiran Udawatta, Lance Flesch, Michael Eng, Jane E. Oliphant, Scott G. Kaar 2020 Saint Louis University School of Medicine

Health Literacy And Patient Reported Outcomes In Orthopaedic Surgery Patients, Thiran Udawatta, Lance Flesch, Michael Eng, Jane E. Oliphant, Scott G. Kaar

Journal of Health Disparities Research and Practice

Background: Health literacy may be an important factor in patient health outcomes, however, prior research has primarily focused on primary care patients with research in orthopaedic specific populations lacking.

Questions/purposes: The purpose of this study was to examine the relationship between health literacy and patient reported outcomes in an orthopaedic patient population.

Patients and Methods: 183 patients >18 years of age who presented to our institution’s sports orthopaedic surgery clinic with shoulder or knee complaints were analyzed. The primary outcomes were physical function recorded using Patient-Reported Outcomes Measurement Information System (PROMIS) physical function and Single Assessment Numerical Evaluation ...


Preoperative Maximization To Reduce Complications In Spinal Surgery, Sukanta Maitra, Christopher Mikhail, Samuel K. Cho, Michael D. Daubs 2020 University of Nevada, Las Vegas

Preoperative Maximization To Reduce Complications In Spinal Surgery, Sukanta Maitra, Christopher Mikhail, Samuel K. Cho, Michael D. Daubs

School of Medicine Faculty Publications

Study design: Invited narrative review. Objectives: The aim of this review was to summarize current literature regarding risk factors that surgeons can optimize in the preoperative setting in the spinal surgery patient, in order to reduce complications and improve patient-reported outcomes. Methods: Review of the relevant literature by the authors. Results: Modifiable risk factors identified relative to the patient include obesity, malnutrition/nutrient deficiency, diabetes/hyperglycemia, preoperative anemia, vitamin D/DEXA (dual-energy radiograph absorptiometry), nicotine use/smoking, and opioid use/psychosocial factors. Conclusion: By maximizing a patient's physiological and psychological status prior to elective spine surgery, we may move ...


Endoscopic Rhizotomy For Chronic Lumbar Zygapophysial Joint Pain., Yuntao Xue, Tao Ding, Dajie Wang, Jianli Zhao, Huilin Yang, Xiaofeng Gu, Dehong Feng, Yafeng Zhang, Hao Liu, Fenglin Tang, Wanyi Wang, Miao Lu, Chao Wu 2020 Affiliated Wuxi People's Hospital of Nanjing Medical University

Endoscopic Rhizotomy For Chronic Lumbar Zygapophysial Joint Pain., Yuntao Xue, Tao Ding, Dajie Wang, Jianli Zhao, Huilin Yang, Xiaofeng Gu, Dehong Feng, Yafeng Zhang, Hao Liu, Fenglin Tang, Wanyi Wang, Miao Lu, Chao Wu

Department of Anesthesiology Faculty Papers

BACKGROUND: Chronic lumbar zygapophysial joint pain is a common cause of chronic low back pain. Percutaneous radiofrequency ablation (RFA) is one of the effective management options; however, the results from the traditional RFA need to be improved in certain cases. The aim of this study is to investigate the effect of percutaneous radiofrequency ablation under endoscopic guidance (ERFA) for chronic low back pain secondary to facet joint arthritis.

METHODS: This is a prospective study enrolled 60 patients. The cases were randomized into two groups: 30 patients in the control group underwent traditional percutaneous radiofrequency ablation, others underwent ERFA. The lumbar ...


Risk Factors For Liposomal Bupivacaine Resistance After Total Hip Or Knee Arthroplasties: A Retrospective Observational Cohort In 237 Patients, Scott Buzin, Arianna L. Gianakos, Deborah Li, Anthony Viola, Sherif Elkattawy, David M. Keller, Richard S. Yoon, Frank A. Liporace 2020 Philadelphia College of Osteopathic Medicine

Risk Factors For Liposomal Bupivacaine Resistance After Total Hip Or Knee Arthroplasties: A Retrospective Observational Cohort In 237 Patients, Scott Buzin, Arianna L. Gianakos, Deborah Li, Anthony Viola, Sherif Elkattawy, David M. Keller, Richard S. Yoon, Frank A. Liporace

Orthopedic Surgery Resident Research

Purpose: Liposomal bupivacaine demonstrated promise decreasing postoperative pain in total hip and total knee arthroplasty (THA/TKA). Some randomized trials have shown non-superior results; however, confounding variables were not accounted for in such analyses. This study attempts to determine risk factors associated with failure of pain management in patients receiving liposomal bupivacaine.

Methods: Postoperative pain scores were collected following primary or revision arthroplasties between January 2016 and December 2017. Retrospective analysis of institutional total joint quality and outcomes registry was screened and patients undergoing primary or revision arthroplasties who completed a multi-modal pain management including liposomal bupivacaine were included in ...


Cardiac Risk Factors Predicting 30/90-Day Readmission Rates In Lumbar Decompression Surgeries, Kevin Xiao, Blake Nourie, Joseph Bechay, Dhruv K.C. Goyal 2020 Thomas Jefferson University

Cardiac Risk Factors Predicting 30/90-Day Readmission Rates In Lumbar Decompression Surgeries, Kevin Xiao, Blake Nourie, Joseph Bechay, Dhruv K.C. Goyal

Phase 1

Preoperative cardiopulmonary disease is known to be a risk factor for perioperative complications in deformity surgery and lumbar fusion procedures, however there is a lack of literature evaluating cardiac risk factors and their influence on readmission rates following lumbar decompression surgery. We want to determine whether preoperative cardiac risk factors influenced the 30 and 90-day readmission rates in patients undergoing lumbar decompression surgery. Patient charts from Rothman Institute between were reviewed for history of preoperative cardiac risk factors such as coronary artery disease, congestive heart failure, myocardial infarction, stroke, cardiac catheterization, stent placement, coronary artery bypass graft, aspirin and/or ...


3d Printing Of Bone Spurs Before Surgical Removal During Total Knee Arthroplasty, Chris Li, Jeffrey Henstenburg, MD, Katelyn Koons, John Paul Prodoehl, Matthew Chadwick, Lauren Schlegel 2020 Thomas Jefferson University

3d Printing Of Bone Spurs Before Surgical Removal During Total Knee Arthroplasty, Chris Li, Jeffrey Henstenburg, Md, Katelyn Koons, John Paul Prodoehl, Matthew Chadwick, Lauren Schlegel

Phase 1

Background: In the United States, total knee arthroplasty (TKA) is the most common performed orthopedic surgery, with over 700,000 cases per year. Overall, 21-25% underwent revision due to instability. Incorrect soft tissue balancing during the procedure can lead to improper alignment, flexion, and extension. Visualization of osteophytes in a 3D manner prior to removal is difficult and poses significant risks for improper balancing on TKA. The purpose of the study is to determine whether the utilization of 3D osteophyte models is beneficial to Orthopaedic surgeons in the course of care, specifically with regard to improving outcomes, decreasing complication rates ...


Selective Serotonin Reuptake Inhibitors Are Associated With Increased Bleeding Related Complications Following Primary Total Hip And Total Knee Arthroplasty, Kyle Plusch, John Stammers, MBBS, FRCS, Alexus M. Cooper, Chi Xu, MD, Paul Kitei, MD, Javad Parvizi, MD, FRCS, Jess H. Lonner, MD 2020 Thomas Jefferson University

Selective Serotonin Reuptake Inhibitors Are Associated With Increased Bleeding Related Complications Following Primary Total Hip And Total Knee Arthroplasty, Kyle Plusch, John Stammers, Mbbs, Frcs, Alexus M. Cooper, Chi Xu, Md, Paul Kitei, Md, Javad Parvizi, Md, Frcs, Jess H. Lonner, Md

Phase 1

Introduction: Approximately 10-22% of patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA) are diagnosed with depression. Pre-operative depression is associated with poorer patient reported outcomes, costs and increased complications. Selective serotonin-reuptake inhibitors (SSRIs) are first-line treatment for depression due to their efficacy and low side effect profile. There are conflicting studies regarding SSRI-related bleeding complications. This study compares the rate of bleeding-related complications in THA and TKA patients taking SSRI’s to a control group of non-SSRI users.

Methods: A retrospective single institution study of 16,407 primary THA and TKA’s from 2008 to 2018 was ...


Assessment Of The Composition And Biologic Activity Of Platelet Rich Plasma And Its Relationship To Clinical Outcomes In Patients With Knee Osteoarthritis, Daniel Nemirov, Bijan Dehghani, Habib Zahir, Xiaoning Yuan, Christine Kim, Reyna Bhandhari, Patrick Fava, Yurii Chinenov, Joseph Nguyen, Laura Donlin, Brian Halpern, Scott Rodeo, Miguel Otero 2020 Thomas Jefferson University; Hospital for Special Surgery

Assessment Of The Composition And Biologic Activity Of Platelet Rich Plasma And Its Relationship To Clinical Outcomes In Patients With Knee Osteoarthritis, Daniel Nemirov, Bijan Dehghani, Habib Zahir, Xiaoning Yuan, Christine Kim, Reyna Bhandhari, Patrick Fava, Yurii Chinenov, Joseph Nguyen, Laura Donlin, Brian Halpern, Scott Rodeo, Miguel Otero

Phase 1

Recent studies suggest positive clinical outcomes associated with platelet-rich-plasma (PRP) administration to treat knee osteoarthritis (OA). However, the results remain inconclusive in part because of the high variability in PRP preparations and the limited information regarding the relevant biologically active components of PRP. We hypothesize that the variability in clinical response is driven by the heterogeneous composition of PRP. In this study we evaluated the composition and biological activity of PRP and further correlated our findings to clinical outcomes in patients receiving intra-articular injections for knee OA. After IRB approval and patient consent, we enrolled 51 patients (mean age: 57 ...


Meta-Analysis Of Repair Techniques For Mixed Nerve Damage, Grant Jones, Zachary J. Herman, Asif Ilyas 2020 Thomas Jefferson University

Meta-Analysis Of Repair Techniques For Mixed Nerve Damage, Grant Jones, Zachary J. Herman, Asif Ilyas

Phase 1

BACKGROUND: Injuries to the upper extremity are common and can occur with trauma, surgery, or compression. Particularly, injuries that result in complete transection often require surgical intervention in attempt to restore function and quality of life. Classically, nerve autografts have been used as the gold standard to repair these peripheral lesions. An alternative to the autologous nerve graft is the use of the processed nerve allograft. limited research exists in comparing sensory and motor outcomes of allograft nerve repair in the upper extremity with data for autograft repair. In this systematic review and meta-analysis, we set out to cumulate results ...


Dual Mobility Bearing Articulations Result In Lower Rates Of Dislocation After Revision Total Hip Arthroplasty., Zachary Kozick, William Li, Matthew Sherman, Camilo Restrepo, MD, Eric B. Smith, MD, P. Maxwell Courtney, MD 2020 Thomas Jefferson University

Dual Mobility Bearing Articulations Result In Lower Rates Of Dislocation After Revision Total Hip Arthroplasty., Zachary Kozick, William Li, Matthew Sherman, Camilo Restrepo, Md, Eric B. Smith, Md, P. Maxwell Courtney, Md

Phase 1

Introduction: The purpose of our study is to directly compare the rates of instability after revision total hip arthroplasty (THA) between a modular dual mobility (DM) and a conventional polyethylene single-bearing surface.

Methods: We retrospectively reviewed a consecutive series of patients who underwent revision THA from 2012 to 2016 at a single institution with a minimum of 2 years of follow-up. Rates of re-revision, dislocation, complications, and short-form (SF-12) scores were compared between the DM and single-bearing groups. To control for confounding variables, a multivariate logistic regression analysis was performed.

Results: Of the 267 revision THA patients, 94 patients had ...


Opioid Tolerance Influences Outcomes After Lumbar Fusion In Patients With Degenerative Pathology, Noah Levy, Max Detweiler, Dhruv K.C. Goyal, Ariana Reyes, Alexander R. Vaccaro 2020 Thomas Jefferson University

Opioid Tolerance Influences Outcomes After Lumbar Fusion In Patients With Degenerative Pathology, Noah Levy, Max Detweiler, Dhruv K.C. Goyal, Ariana Reyes, Alexander R. Vaccaro

Phase 1

Introduction: Extended opioid use prior to surgery has been implicated in poorer postoperative outcomes. However, it remains unclear if there is a significant difference in postoperative outcomes among preoperative opioid-naïve and opioid-tolerant patients who undergo lumbar spinal fusion. The purpose of this study was to determine the effect of preoperative opioid use on patient-reported outcome measures in patients undergoing lumbar spinal fusion.

Methods: This retrospective cohort analysis identified 260 patients who underwent lumbar spinal fusion at a high-volume, single institution. There were two cohorts: patients who were opioid-naïve (defined as total opioid consumption of ≤ 7 days in the two months ...


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