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1,481 full-text articles. Page 47 of 68.

Surgical Treatment Of Calcaneal Fracture Malunions And Posttraumatic Deformities., John Stapleton, Ronald Belczyk, Thomas Zgonis 2015 Lehigh Valley Health Network

Surgical Treatment Of Calcaneal Fracture Malunions And Posttraumatic Deformities., John Stapleton, Ronald Belczyk, Thomas Zgonis

John J Stapleton DPM, FACFAS

The surgical management of calcaneal fractures presents with several obstacles to the treating physician. Many experienced surgeons acknowledge a steep and significant learning curve in the operative management of calcaneal fractures. Nonoperative management of displaced intra-articular calcaneal fractures may result in malunion, thereby affecting the function of the ankle and subtalar joint. Although some calcaneal fractures can be treated conservatively, a majority of them require operative intervention. The goal of this article is to bring some insight into the realm of revisional surgery on residual deformity of the calcaneus after operative intervention and also provide a rationale approach to successfully ...


Surgical Reconstruction Of The Diabetic Charcot Foot: Internal, External Or Combined Fixation?, John Stapleton, Thomas Zgonis 2015 Lehigh Valley Health Network

Surgical Reconstruction Of The Diabetic Charcot Foot: Internal, External Or Combined Fixation?, John Stapleton, Thomas Zgonis

John J Stapleton DPM, FACFAS

Charcot neuroarthropathy of the foot and ankle is a devastating neuropathic complication that can eventually lead to a lower extremity amputation in the presence of an ulceration or infection. Current surgical approaches for the management of the diabetic Charcot foot and ankle deformities are largely based on expert opinions in various fixation methods attempting to avoid major postoperative complications. The goal of this article is to discuss the advantages and disadvantages of various internal, external, or combined fixation methods as they relate to the inherent challenges in the management of the diabetic Charcot foot.


Complications And Revisional Hallux Valgus Surgery., Ronald Belczyk, John Stapleton, Jordan P Grossman, Thomas Zgonis 2015 Lehigh Valley Health Network

Complications And Revisional Hallux Valgus Surgery., Ronald Belczyk, John Stapleton, Jordan P Grossman, Thomas Zgonis

John J Stapleton DPM, FACFAS

Complications with hallux valgus surgery can manifest in a variety of ways, but ultimately preventing them depends on the surgeon's expertise in patient and procedural selection, ability to perform the surgery selected, and knowledge in dealing with postoperative care and complications if present. In this article, the authors discuss common diagnostic and treatment dilemmas when dealing with recurrent hallux valgus, hallux varus, malunion, and avascular necrosis following bunion surgery.


Diabetic Charcot Neuroarthropathy Of The Foot And Ankle With Osteomyelitis., Crystal L Ramanujam, John Stapleton, Thomas Zgonis 2015 University of Texas Health Science Center

Diabetic Charcot Neuroarthropathy Of The Foot And Ankle With Osteomyelitis., Crystal L Ramanujam, John Stapleton, Thomas Zgonis

John J Stapleton DPM, FACFAS

One of the most devastating foot and/or ankle complications in the diabetic population with peripheral neuropathy is the presence of Charcot neuroarthropathy (CN). In recent years, diabetic limb salvage has been attempted more frequently as opposed to major lower extremity amputation for CN of the foot and ankle with ulceration and/or deep infection. Treatment strategies for osteomyelitis in the diabetic population have evolved. This article reviews some of the most common surgical strategies recommended for the diabetic patient with CN of the foot and/or ankle and concomitant osteomyelitis.


Management Of Diabetic Neuropathic Foot And Ankle Malunions And Nonunions., John Stapleton 2015 Lehigh Valley Health Network

Management Of Diabetic Neuropathic Foot And Ankle Malunions And Nonunions., John Stapleton

John J Stapleton DPM, FACFAS

The management of diabetic neuropathic foot and ankle malunions and/or nonunions is often complicated by the presence of broken or loosened hardware, Charcot joints, infection, osteomyelitis, avascular bone necrosis, unstable deformities, bone loss, disuse and pathologic osteopenia, and ulcerations. The author discusses a rational approach to functional limb salvage with various surgical techniques that are aimed at achieving anatomic alignment, long-term osseous stability, and adequate soft tissue coverage. Emphasis is placed on techniques to overcome the inherent challenges that are encountered when surgically managing a diabetic nonunion and/or malunion. Particular attention is directed to the management of deep ...


Supramalleolar Osteotomy And Ankle Arthrodiastasis For Juvenile Posttraumatic Ankle Arthritis., John Stapleton, Thomas Zgonis 2015 Lehigh Valley Health Network

Supramalleolar Osteotomy And Ankle Arthrodiastasis For Juvenile Posttraumatic Ankle Arthritis., John Stapleton, Thomas Zgonis

John J Stapleton DPM, FACFAS

Numerous techniques have been described for posttraumatic ankle arthritis with or without an associated lower extremity deformity in the adult population. These surgical procedures may include, but are not limited to, ankle exostectomy with joint resurfacing, ankle arthrodiastasis, ankle arthroplasty, and ankle arthrodesis. Associated deformities may also be addressed with supramalleolar osteotomies, tibia or fibular lengthening, and calcaneal osteotomies. In juvenile patients, surgical treatment options for posttraumatic ankle arthritis can be challenging, especially when an associated deformity is present. This article describes a combined supramalleolar osteotomy and ankle arthrodiastasis for a juvenile patient with posttraumatic ankle arthritis and valgus deformity.


Concomitant Osteomyelitis And Avascular Necrosis Of The Talus Treated With Talectomy And Tibiocalcaneal Arthrodesis, John Stapleton, Thomas Zgonis 2015 Lehigh Valley Health Network

Concomitant Osteomyelitis And Avascular Necrosis Of The Talus Treated With Talectomy And Tibiocalcaneal Arthrodesis, John Stapleton, Thomas Zgonis

John J Stapleton DPM, FACFAS

The goal with Lisfranc fracture-dislocations is to regain joint congruity and reestablish midfoot stability to avoid debilitating posttraumatic arthrosis and chronic pain in the sensate patient. In the diabetic population, dense peripheral neuropathy and/or vascular disease are equally important and may alter the surgical approach to traumatic tarsometatarsal injuries. The initial diagnosis in the diabetic population may be delayed due to subtle radiographic findings and/or patient unawareness of trauma in the insensate foot. Failure to initiate treatment in the early stages of acute diabetic neuropathic Lisfranc injuries can predispose the patient to midfoot instability, potential ulceration, infection, and ...


Plantar Foot Donor Site As A Harvest Of A Split-Thickness Skin Graft., Ronald Belczyk, John Stapleton, Peter A Blume, Thomas Zgonis 2015 University of Texas Health Science - San Antonio

Plantar Foot Donor Site As A Harvest Of A Split-Thickness Skin Graft., Ronald Belczyk, John Stapleton, Peter A Blume, Thomas Zgonis

John J Stapleton DPM, FACFAS

The authors present a minimally invasive procedure for harvesting a split thickness skin graft (STSG) from the plantar surface of the foot. This is another option to consider for soft tissue reconstruction of diabetic foot wounds to help restore form and function and to prevent amputation. The authors do not recommend this technique for all soft tissue wounds of the toes and plantar aspect of the foot but believe it is a viable option for selected small diabetic foot wounds that may benefit from a STSG.


Advanced Foot And Ankle Fixation Techniques In Patients With Diabetes., Nicholas J Bevilacqua, John Stapleton 2015 North Jersey Orthopaedic Specialists

Advanced Foot And Ankle Fixation Techniques In Patients With Diabetes., Nicholas J Bevilacqua, John Stapleton

John J Stapleton DPM, FACFAS

This article presents advanced techniques and current fixation constructs that are advantageous for the management of diabetic foot and ankle trauma and Charcot neuroarthropathy. Both these pathologies are often intimately related, and the fixation constructs that are required often require sound biomechanical concepts coupled with innovative approaches to achieve bone healing and limb salvage.


Effectiveness Of Surgery For Lumbar Stenosis And Degenerative Spondylolisthesis In The Octogenarian Population: Analysis Of The Spine Patient Outcomes Research Trial (Sport) Data., Jeffrey A Rihn, Alan S Hilibrand, Wenyan Zhao, Jon D Lurie, Alexander Vaccaro, MD, PhD, Todd Albert, James Weinstein 2015 Rothman Institute, Thomas Jefferson University Hospital

Effectiveness Of Surgery For Lumbar Stenosis And Degenerative Spondylolisthesis In The Octogenarian Population: Analysis Of The Spine Patient Outcomes Research Trial (Sport) Data., Jeffrey A Rihn, Alan S Hilibrand, Wenyan Zhao, Jon D Lurie, Alexander Vaccaro, Md, Phd, Todd Albert, James Weinstein

Rothman Institute Faculty Papers

BACKGROUND: The purpose of this study was to determine whether surgery is an effective option for the treatment of stenosis of the lumbar spine and degenerative spondylolisthesis in the octogenarian population.

METHODS: An as-treated analysis of patients with lumbar stenosis and degenerative spondylolisthesis enrolled in the Spine Patient Outcomes Research Trial (SPORT) was performed. Patients who were at least eighty years of age (n = 105) were compared with those younger than eighty years (n = 1130). Baseline patient and clinical characteristics were noted, and the difference in improvement from baseline between operative and nonoperative treatment was determined for each group at ...


Distal Humerus Hemiarthroplasty: Joint Kinematics, Stability, Congruency And Implant Design, Sagar J. Desai 2015 The University of Western Ontario

Distal Humerus Hemiarthroplasty: Joint Kinematics, Stability, Congruency And Implant Design, Sagar J. Desai

Electronic Thesis and Dissertation Repository

Distal humeral hemiarthroplasty is a treatment option for fractures, non-unions and avascular necrosis of the distal humerus. Commercially available distal humeral implants are available; however, many unanswered questions remain regarding their role in treatment of distal humeral pathology. The optimal articular shape of the implant has not been defined, the biomechanical effects have not been reported, and contact stresses on native articular cartilage are unknown.

This work has defined the osseous anatomy and anatomic variability of the distal humeral articulation using accurate 3D reconstruction methods. A data bank of distal humeral dimensions has been created and may be effective in ...


Contributions Of Body Fat And Effort In The 5k Run: Age And Body Weight Handicap, Anne R. Crecelius, Paul M. Vanderburgh, Lloyd L. Laubach 2015 University of Dayton

Contributions Of Body Fat And Effort In The 5k Run: Age And Body Weight Handicap, Anne R. Crecelius, Paul M. Vanderburgh, Lloyd L. Laubach

Anne R. Crecelius

The 5K handicap (5KH), designed to eliminate the body weight (BW) and age biases inherent in the 5K run time (RT), yields an adjusted RT (RTadj) that can be compared between runners of different BW and age. As hypothesized in a validation study, however, not all BW bias may be removed, because of the influences of body fatness (BF) and effort (run speed; essentially the inverse as measured by rating of perceived exertion (RPE)). This study's purpose was to determine the effects of BF and RPE on BW bias in the 5KH. For 99 male runners in a regional ...


Muscle Contraction Duration And Fibre Recruitment Influence Blood Flow And Vo2 Independent Of Contractile Work During Steady-State Exercise In Humans, Jennifer C. Richards, Anne R. Crecelius, Brett S. Kirby, Dennis G. Larson, Frank A. Dinenno 2015 Colorado State University - Fort Collins

Muscle Contraction Duration And Fibre Recruitment Influence Blood Flow And Vo2 Independent Of Contractile Work During Steady-State Exercise In Humans, Jennifer C. Richards, Anne R. Crecelius, Brett S. Kirby, Dennis G. Larson, Frank A. Dinenno

Anne R. Crecelius

We tested the hypothesis that, among conditions of matched contractile work, shorter contraction durations and greater muscle fibre recruitment result in augmented skeletal muscle blood flow and oxygen consumption (O2) during steady-state exercise in humans. To do so, we measured forearm blood flow (FBF; Doppler ultrasound) during 4 minutes of rhythmic handgrip exercise in 24 healthy young adults and calculated forearm O2 via blood samples obtained from a catheter placed in retrograde fashion into a deep vein draining the forearm muscle. In Protocol 1 (n = 11), subjects performed rhythmic isometric handgrip exercise at mild and moderate intensities under conditions in ...


Reliability Of Posterolateral Acromion Process To Examination Table Measurement To Estimate Shoulder Protraction Contracture, Bart D. Taylor, Antonia M. Norris, Zachary J. Mertz, Todd E. Davenport 2015 Matt Smith Physical Therapy

Reliability Of Posterolateral Acromion Process To Examination Table Measurement To Estimate Shoulder Protraction Contracture, Bart D. Taylor, Antonia M. Norris, Zachary J. Mertz, Todd E. Davenport

School of Pharmacy and Health Sciences Faculty Articles

Study Design: Retrospective study. Objectives: To determine the reliability of measuring the perpendicular distance between the posterolateral acromion process and examination table to estimate passive shoulder protraction in student physical therapists.

Background: Previous research has identified scapular dyskinesis to be associated with musculoskeletal shoulder pain, and commonly addressed by physical therapists. Tightness of the anterior shoulder muscles may be associated with scapular movement abnormality. Thus, reliable clinical measurements for anterior shoulder muscle length are imporrant for physical therapy care.

Methods: After a 1 0-minute review session, two measurements of the distance between the posterior acromion process and examination table were ...


Biocompatibility Of Nano-Crystalline Coatings Produced By Ion Beam Assisted Deposition (Ibad), Raheleh Miralami, Geoffrey M. Thiele, J. Graham Sharp, Fereydoon Namavar, Kevin L. Garvin 2015 University of Nebraska Medical Center

Biocompatibility Of Nano-Crystalline Coatings Produced By Ion Beam Assisted Deposition (Ibad), Raheleh Miralami, Geoffrey M. Thiele, J. Graham Sharp, Fereydoon Namavar, Kevin L. Garvin

Posters and Presentations: Orthopaedic Surgery & Rehab

No abstract provided.


A New Method For Calculating Femoral Anterior Cortex Point Location And Its Effect On Component Sizing And Placement, M. R. Mahfouz, E. E. A. Fatah, L. Bowers, G. Scuderi 2015 Hofstra Northwell School of Medicine

A New Method For Calculating Femoral Anterior Cortex Point Location And Its Effect On Component Sizing And Placement, M. R. Mahfouz, E. E. A. Fatah, L. Bowers, G. Scuderi

Journal Articles

Variation in anterior femoral cortex morphology can cause improper component placement and alignment. When surgical inaccuracies occur, the mechanical properties of the distal femur may be altered, which could result in lower surgical success rates and an increased chance of postoperative complications. The purpose of the study is to come up with a reproducible computational algorithm to simulate what the surgeon does in the operating room. This method could help in surgical preplanning, patient-specific instruments, and implant design. From there, we evaluated (1) the angular difference between reference alignment axes; and (2) whether the location of the anterior cortex point ...


Multirater Agreement Of The Causes Of Anterior Cruciate Ligament Reconstruction Failure: A Radiographic And Video Analysis Of The Mars Cohort, M. J. Matava, R. A. Arciero, K. M. Baumgarten, J. A. Hannafin, B. S. Miller, C. W. Nissen, T. N. Taft, B. R. Wolf, E. B. Hershman, R. W. Wright, +3 additional authors 2015 Hofstra Northwell School of Medicine

Multirater Agreement Of The Causes Of Anterior Cruciate Ligament Reconstruction Failure: A Radiographic And Video Analysis Of The Mars Cohort, M. J. Matava, R. A. Arciero, K. M. Baumgarten, J. A. Hannafin, B. S. Miller, C. W. Nissen, T. N. Taft, B. R. Wolf, E. B. Hershman, R. W. Wright, +3 Additional Authors

Journal Articles

BACKGROUND: Anterior cruciate ligament (ACL) reconstruction failure occurs in up to 10% of cases. Technical errors are considered the most common cause of graft failure despite the absence of validated studies. Limited data are available regarding the agreement among orthopaedic surgeons regarding the causes of primary ACL reconstruction failure and accuracy of graft tunnel placement. HYPOTHESIS: Experienced knee surgeons have a high level of interobserver reliability in the agreement about the causes of primary ACL reconstruction failure, anatomic graft characteristics, and tunnel placement. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 3. METHODS: Twenty cases of revision ACL reconstruction were ...


Research Roundup From The Research Committee, Mary Insana Fisher, Shana Harrington 2015 University of Dayton

Research Roundup From The Research Committee, Mary Insana Fisher, Shana Harrington

Physical Therapy Faculty Publications

With the expectations of accountability by consumers and third party payors for the efficacy of physical therapy practice, there has been a significant increase in the push to develop outcome measures in rehabilitation. One type of these measures, patient-reported outcome measures (PROs), are becoming increasingly more common in clinical practice. The American Physical Therapy Association’s Guide to Physical Therapist Practice 3rd edition includes outcomes assessment as an integral part of the Patient and Client Management model, and delineates that appropriate tests and measures depend upon established psychometric properties of the measurement.1 The Section on Research formed the Evidence ...


Motion-Tracking Drill System Using A Haptic Device For Evaluating And Training Motor Skills Of Orthopaedic Resident Physicians Outside The Operating Room: A Pilot Study, Ashkan Pourkand, Christina Salas, Deana M. Mercer, David I. Grow 2015 University of New Mexico

Motion-Tracking Drill System Using A Haptic Device For Evaluating And Training Motor Skills Of Orthopaedic Resident Physicians Outside The Operating Room: A Pilot Study, Ashkan Pourkand, Christina Salas, Deana M. Mercer, David I. Grow

UNM Orthopaedic Research Journal

Background: Although experience within the operating room can help surgeons learn simple bone-drilling techniques, outside training may be better suited for complex procedures. We adapted a rotary handpiece with dual trigger and drilling attachments to a haptic device to train and evaluate motor skills of orthopaedic resident physicians outside of the operating room.

Methods: A total of 7 participants with varying levels of skill in orthopaedic surgery were asked to perform a task three times: drill a hole (at 45° from the normal angle) through both cortices of a synthetic diaphysis of a distal radius. Acceleration and acoustic data were ...


Patient Expectations And Long-Term Outcomes In Rheumatoid Arthritis Patients: Results From The Sara (Silicone Arthroplasty In Rheumatoid Arthritis) Study, K. C. Chung, K. W. Nellans, P. B. Burns, E. F. S. Wilgis, F. D. Burke, D. A. Fox, H. M. Kim 2015 Hofstra Northwell School of Medicine

Patient Expectations And Long-Term Outcomes In Rheumatoid Arthritis Patients: Results From The Sara (Silicone Arthroplasty In Rheumatoid Arthritis) Study, K. C. Chung, K. W. Nellans, P. B. Burns, E. F. S. Wilgis, F. D. Burke, D. A. Fox, H. M. Kim

Journal Articles

Little evidence exists to understand the influence of patient expectations on outcomes for silicone metacarpophalangeal arthroplasty (SMPA). The purpose of this paper is to compare long-term treatment outcome experiences regarding hand function/appearance for a surgical and nonsurgical cohort of rheumatoid arthritis (RA) patients and contrast them to expectations at baseline. This sample is part of a larger multicenter prospective cohort study of RA patients enrolled from 2004 to 2008. A total of 169 RA patients with severe deformities at the metacarpophalangeal (MCP) joints were recruited in the original study. Expectations for SMPA were collected at enrollment. A follow-up patient-reported ...


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