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Academic Center Tiered Operating Room Strategy (Action): Comparing A High Efficiency Or To The Conventional Or, Moaz Bin Yunus Chohan 2019 The University of Western Ontario

Academic Center Tiered Operating Room Strategy (Action): Comparing A High Efficiency Or To The Conventional Or, Moaz Bin Yunus Chohan

Electronic Thesis and Dissertation Repository

Canadian healthcare system is under immense economic pressure. In an attempt to resolve the problem, outpatient surgical services were offered to patients presenting with orthopaedic surgical complaints. An observational cohort study was carried out, comparing the conventional surgical setup to the newly designed high-efficiency setup that provided similar care, with a significantly lower operating cost. A total of 200 patients were enrolled in the study. Standardized and unstandardized questionnaires were used to evaluate pre-operative and post-operative patient data that reflected quality of life outcomes. Data was collected at enrolment and during post-operative follow-ups of up to 6 months. Results indicate ...


Adopting The Direct Anterior Approach: Experience And Learning Curve In A Chinese Patient Population., Xiangpeng Kong, Luis Grau, Alvin Ong, Charlie Yang, Wei Chai 2019 Chinese PLA General Hospital

Adopting The Direct Anterior Approach: Experience And Learning Curve In A Chinese Patient Population., Xiangpeng Kong, Luis Grau, Alvin Ong, Charlie Yang, Wei Chai

Rothman Institute Faculty Papers

BACKGROUND: There are concerns regarding the complications encountered during the learning curve when switching to a direct anterior approach (DAA) for total hip arthroplasty (THA). The purpose of our study is to report our outcomes and complications after adopting a new approach in a Chinese patient population.

METHODS: From 2016 to 2018, a single surgeon's first 100 cases with unilateral DAA for THA were reviewed. The patients were divided into 2 groups, the first 50 cases were designated as group A and the second 50 cases were designated as group B. The preoperative, intraoperative, and postoperative clinical data were ...


Malignant Distal Femur Tumors Management In Children, Low Cost Innovations With Affordable Care In A Tertiary Care Hospital, A Cross Sectional Study, Masood Umer, Javeria Saeed, Obada Hussein Hasan 2019 Aga Khan University

Malignant Distal Femur Tumors Management In Children, Low Cost Innovations With Affordable Care In A Tertiary Care Hospital, A Cross Sectional Study, Masood Umer, Javeria Saeed, Obada Hussein Hasan

Section of Orthopaedic Surgery

Introduction: Malignant musculoskeletal tumors in children are mostly comprised of Osteosarcoma and Ewing's sarcoma and distal femur is the most common site for primary bone tumors. This study examined the surgical management outcomes of pediatric patients (<18 years) presented in our setup with malignant distal femur tumors.
Methodology: We retrospectively reviewed the medical records of patients diagnosed with malignant sarcomas of distal femur and younger than 18 years of age who underwent limb salvage surgery during June 2009-June2017.
Results: There were 31 pediatric patients who had distal femur malignant tumors and out of them 20 patients were selected who underwent limb salvage as a primary surgery. The mean age (range ...


Pelvic Prehabilitation: Pelvic Exercises Assist In Minimizing Inter-Fraction Sacral Slope Variability During Radiation Therapy, Jennifer Baima, Lauren O'Loughlin, Alexander Lukez, Yunsheng Ma, Janaki Moni 2019 University of Massachusetts Medical School

Pelvic Prehabilitation: Pelvic Exercises Assist In Minimizing Inter-Fraction Sacral Slope Variability During Radiation Therapy, Jennifer Baima, Lauren O'Loughlin, Alexander Lukez, Yunsheng Ma, Janaki Moni

Orthopedics and Physical Rehabilitation Publications

Introduction: Prehabilitation for radiation therapy is not well studied. Retrospective data shows variability in set-up positioning of patients during daily pelvic RT. We hypothesize that a brief structured daily exercise regimen is feasible for subjects to perform before RT and may minimize variability in positioning as measured by sacral slope angles (SSA) on lateral views. Determining feasibility and effectiveness of these exercises in decreasing set-up variability has clinical implications, both for targeting treatment sites and preventing adverse effects.

Methods: Subjects in the exercise intervention condition (n=8, 8 F) performed a structured daily hip exercise regimen throughout the duration of ...


Sarcopenia In Lung Cancer: Could Chest Imaging Help?, Jennifer Baima, Elke Sarah Schipani, Wasih Kamran, John M. Varlotto, Lacey J. McIntosh, Karl Uy, Isabel Emmerick, Mathew J. Most 2019 University of Massachusetts Medical School

Sarcopenia In Lung Cancer: Could Chest Imaging Help?, Jennifer Baima, Elke Sarah Schipani, Wasih Kamran, John M. Varlotto, Lacey J. Mcintosh, Karl Uy, Isabel Emmerick, Mathew J. Most

Orthopedics and Physical Rehabilitation Publications

Introduction: Fifteen to seventy percent of cancer patients demonstrate sarcopenia.1-6,[i],[ii],[iii],[iv],[v],[vi],[vii],[viii],[ix],[x],[xi],[xii],[xiii] Analysis of iliopsoas cross-sectional area, a non-invasive surrogate measure for sarcopenia in patients with cancer has been associated with survival.[xiv],[xv],[xvi],[xvii] The pectoralis muscle may be a more accessible target for measuring sarcopenia in lung cancer patients,[xviii] but it is not known if it this correlates with iliopsoas cross-sectional area. Since measurements vary, it is most accurate to use internal controls. We attempted to examine the cross-sectional area of the two muscles ...


Does Prior Anterior Cruciate Ligament Reconstruction Affect Outcomes Of Subsequent Total Knee Arthroplasty? A Systematic Review., Zaira S. Chaudhry, Hytham S. Salem, James J. Purtill, Sommer Hammoud 2019 Thomas Jefferson University

Does Prior Anterior Cruciate Ligament Reconstruction Affect Outcomes Of Subsequent Total Knee Arthroplasty? A Systematic Review., Zaira S. Chaudhry, Hytham S. Salem, James J. Purtill, Sommer Hammoud

Rothman Institute Faculty Papers

Background: Anterior cruciate ligament injury may accelerate knee osteoarthritis, and patients with a history of anterior cruciate ligament reconstruction (ACLR) tend to undergo total knee arthroplasty (TKA) at a greater rate than patients without a history of ACLR.

Purpose: To compare clinical outcomes of TKA in patients with and without a history of ACLR through a systematic review.

Study Design: Systematic review; Level of evidence, 3.

Methods: A comprehensive search of the PubMed (MEDLINE), Cochrane Central, and SPORTDiscus databases from inception through November 2018 was performed to identify studies directly comparing outcomes of TKA between patients with and without a ...


Effective Recruitment Strategies To Attract Orthopaedic Surgeons To Rural Nebraska, Carmen A. M. Pavlik 2019 University of Nebraska at Kearney

Effective Recruitment Strategies To Attract Orthopaedic Surgeons To Rural Nebraska, Carmen A. M. Pavlik

Undergraduate Research Journal

Rural communities have difficulty establishing and maintaining a quality healthcare workforce. Twenty percent of Americans compose the rural populations in this country, but only nine percent of physicians practice in these rural areas. From 2000 to 2020, the demand for orthopaedic physicians is expected to increase by 23%, mainly due to the aging population of the United States. Although the demand for orthopaedic surgeons to these underserved, aging rural populations is increasing, there is a shortage which continues to grow in rural areas. One possible driving force of this shortage could be the recruitment strategies exercised by the healthcare managers ...


Comparison Of Asymmetric Reaming Versus A Posteriorly Augmented Component For Posterior Glenoid Wear And Retroversion: A Radiographic Study., Jia-Wei Kevin Ko, Usman Ali Syed, Jonathan D Barlow, Scott Paxton, Bryan J Loeffler, Ocean Thakar, Grant Jamgochian, Joseph A Abboud, Charles L Getz, Gerald R Williams 2019 Orthopedic Physician Associates at Swedish Orthopedic Institute Seattle, WA, USA

Comparison Of Asymmetric Reaming Versus A Posteriorly Augmented Component For Posterior Glenoid Wear And Retroversion: A Radiographic Study., Jia-Wei Kevin Ko, Usman Ali Syed, Jonathan D Barlow, Scott Paxton, Bryan J Loeffler, Ocean Thakar, Grant Jamgochian, Joseph A Abboud, Charles L Getz, Gerald R Williams

Articles, Abstracts, and Reports

Background: Managing posterior glenoid wear and retroversion remains a challenge in shoulder arthroplasty. Correcting glenoid version through asymmetric reaming (AR) with placement of a standard glenoid component and the use of posteriorly augmented glenoid (PAG) components are two methods used to address this problem. Our objective is to report the radiographic outcomes of patients with posterior glenoid wear and/or retroversion treated with either approach.

Methods: Patients with posterior glenoid wear and a minimum of 15 degrees of retroversion, treated with AR and standard glenoid component or with a PAG component (3 mm, 5 mm, or 7 mm posterior augmentation ...


Global Spinal Deformity From The Upper Cervical Perspective. What Is "Abnormal" In The Upper Cervical Spine?, Peter G Passias, Haddy Alas, Renaud Lafage, Bassel G Diebo, Irene Chern, Christopher P Ames, Paul Park, Khoi D Than, Alan H Daniels, D Kojo Hamilton, Douglas C Burton, Robert A Hart, Shay Bess, Breton G Line, Eric O Klineberg, Christopher I Shaffrey, Justin S Smith, Frank J Schwab, Virginie Lafage 2019 Swedish Neuroscience Institute, Seattle, WA

Global Spinal Deformity From The Upper Cervical Perspective. What Is "Abnormal" In The Upper Cervical Spine?, Peter G Passias, Haddy Alas, Renaud Lafage, Bassel G Diebo, Irene Chern, Christopher P Ames, Paul Park, Khoi D Than, Alan H Daniels, D Kojo Hamilton, Douglas C Burton, Robert A Hart, Shay Bess, Breton G Line, Eric O Klineberg, Christopher I Shaffrey, Justin S Smith, Frank J Schwab, Virginie Lafage

Articles, Abstracts, and Reports

Hypothesis: Reciprocal changes in the upper cervical spine correlate with adult TL deformity modifiers.

Design: This was a retrospective review.

Introduction: The upper cervical spine has remarkable adaptability to wide ranges of thoracolumbar (TL) deformity.

Methods: Patients >18 years with adult spinal deformity (ASD) and complete radiographic data at baseline (BL) and 1 year were identified. Patients were grouped into component types of the Roussouly classification system (Type 1: Pelvic incidence [PI]

Results: A total of 343 ASD patients were analyzed. When grouped by BL Schwab and Roussouly, Group

Conclusions: Our study suggests that upper cervical alignment remains relatively stable ...


Can Alternate-Day Statin Regimen Minimize Its Adverse Effects On Muscle And Tendon?: A Systematic Review, Zehra Abdul Muhammad, Tashfeen Ahmad, Naveed Baloch 2019 Aga Khan University

Can Alternate-Day Statin Regimen Minimize Its Adverse Effects On Muscle And Tendon?: A Systematic Review, Zehra Abdul Muhammad, Tashfeen Ahmad, Naveed Baloch

Section of Orthopaedic Surgery

Objective: To review evidence-based data with respect to safety and efficacy of alternate-day statin therapy in dyslipidaemia compared to the standard daily dose.
Methods: The literature review was conducted at Aga Khan University Hospital, Karachi from July, 2016 to August, 2017. Electronic database search was carried out to compile available literature using PubMed, Excerpta Medica database and Google Scholar. The most relevant evidence-based research articles published over 10 years were selected. The latest search was dated August 03, 2017.
Results: A total of 2,074 articles were initially located. Alternate day statin regimen was reported in 53% of articles. Adverse ...


Consumer Prices For Surgical Management Of Ankle Arthritis: Limited Availability And Wide Variability., Niall A Smyth, Brody J Dawkins, Joshua P Goldstein, Jonathan R Kaplan, Lew C Schon, Amiethab A Aiyer 2019 Orthopaedic Specialty Institute / Hoag Orthopedic Institute, Orange, CA

Consumer Prices For Surgical Management Of Ankle Arthritis: Limited Availability And Wide Variability., Niall A Smyth, Brody J Dawkins, Joshua P Goldstein, Jonathan R Kaplan, Lew C Schon, Amiethab A Aiyer

Articles, Abstracts, and Reports

Background: Healthcare costs for the surgical management of ankle arthritis continue to rise. Patients are generally unaware of the prices of the services they use. Understanding the costs associated with surgical management of ankle arthritis is an important facet of patient care. The purposes of this study were to (1) determine the access to the surgical cost of total ankle arthroplasty (TAAs) and ankle arthrodesis and (2) the variability of the price between the two procedures.

Methods: Fifty foot and ankle centers (25 academic, 25 private) that perform TAAs and ankle arthrodeses were contacted using a standardized patient script. The ...


The Impact Of Osteotomy Grade And Location On Regional And Global Alignment Following Cervical Deformity Surgery., Peter G Passias, Samantha R Horn, Tina Raman, Avery E Brown, Virginie Lafage, Renaud Lafage, Justin S Smith, Cole A Bortz, Frank A Segreto, Katherine E Pierce, Haddy Alas, Breton G Line, Bassel G Diebo, Alan H Daniels, Han Jo Kim, Alex Soroceanu, Gregory M Mundis, Themistocles S Protopsaltis, Eric O Klineberg, Douglas C Burton, Robert A Hart, Frank J Schwab, Shay Bess, Christopher I Shaffrey, Christopher P Ames 2019 Swedish Neuroscience Institute, Seattle, WA

The Impact Of Osteotomy Grade And Location On Regional And Global Alignment Following Cervical Deformity Surgery., Peter G Passias, Samantha R Horn, Tina Raman, Avery E Brown, Virginie Lafage, Renaud Lafage, Justin S Smith, Cole A Bortz, Frank A Segreto, Katherine E Pierce, Haddy Alas, Breton G Line, Bassel G Diebo, Alan H Daniels, Han Jo Kim, Alex Soroceanu, Gregory M Mundis, Themistocles S Protopsaltis, Eric O Klineberg, Douglas C Burton, Robert A Hart, Frank J Schwab, Shay Bess, Christopher I Shaffrey, Christopher P Ames

Articles, Abstracts, and Reports

Introduction: Correction of cervical deformity (CD) often involves different types of osteotomies to address sagittal malalignment. This study assessed the relationship between osteotomy grade and vertebral level on alignment and clinical outcomes.

Methods: Retrospective review of a multi-center prospectively collected CD database. CD was defined as at least one of the following: C2-C7 Cobb >10°, cervical lordosis (CL) >10°, C2-C7 sagittal vertical axis (cSVA) >4 cm, and chin-brow vertical angle > 25°. Patients were evaluated for level and type of cervical osteotomy.

Results: 86 CD patients were included (61.4 ± 10.6 years, 66.3% female, body mass index 29.1 ...


Improvement In Mental Health Following Total Hip Arthroplasty: The Role Of Pain And Function, Uyen-Sa D. T. Nguyen, Thomas Perneger, Patricia D. Franklin, Christophe Barea, Pierre Hoffmeyer, Anne Lubbeke 2019 University of Massachusetts Medical School

Improvement In Mental Health Following Total Hip Arthroplasty: The Role Of Pain And Function, Uyen-Sa D. T. Nguyen, Thomas Perneger, Patricia D. Franklin, Christophe Barea, Pierre Hoffmeyer, Anne Lubbeke

Open Access Articles

BACKGROUND: Mental health has been shown to improve after total hip arthroplasty (THA). Little is known about the role of pain and function in this context. We assessed whether change in mental health was associated with improvement in pain and function 1 year post-surgery.

METHODS: This prospective study included patients enrolled in a THA registry from 2010 to 2014. We examined the mental component score (MCS) before and 1 year post-surgery, and 1-year change, in association with Western Ontario McMaster Universities (WOMAC) pain and function scores. All scores were normalized, ranging from 0 to 100 (larger score indicating better outcome ...


Interpreting Patient Reported Outcomes In Orthopaedic Surgery: A Systematic Review, Shgufta Docter, Zina Fathalla, Michael Lukacs, Michaela Khan, Morgan Jennings, Shu-Hsuan Liu, Dong Zi, Dianne Bryant 2019 Western University

Interpreting Patient Reported Outcomes In Orthopaedic Surgery: A Systematic Review, Shgufta Docter, Zina Fathalla, Michael Lukacs, Michaela Khan, Morgan Jennings, Shu-Hsuan Liu, Dong Zi, Dianne Bryant

Western Research Forum

Background: Reporting methods of patient reported outcome measures (PROMs) vary in orthopaedic surgery literature. While most studies report statistical significance, the interpretation of results would be improved if authors reported confidence intervals (CIs), the minimally clinically important difference (MCID), and number needed to treat (NNT).

Objective: To assess the quality and interpretability of reporting the results of PROMs. To evaluate reporting, we will assess the proportion of studies that reported (1) 95% CIs, (2) MCID, and (3) NNT. To evaluate interpretation, we will assess the proportion of studies that discussed results using the MCID or the effect sizes and how ...


The Feasibility Of Gathering Patient-Reported Outcome Measures On Individuals With Acute Ankle Sprains In A Busy Clinic Environment, Ryan Reeson 2019 The University of Western Ontario

The Feasibility Of Gathering Patient-Reported Outcome Measures On Individuals With Acute Ankle Sprains In A Busy Clinic Environment, Ryan Reeson

Electronic Thesis and Dissertation Repository

Ankle sprains are the most common sports injury and can lead to long-term deficits. Patient-reported outcome measures (PROMs) may assist clinicians in evaluating the recovery trajectory of patients with ankle sprains. However, before a large-scale study can be performed, it is necessary to determine whether it is feasible to collect PROMs in a busy clinic environment. This study had a narrow recruitment window but the consent rate was 100%. Ten patients at Fowler Kennedy Sport Medicine Clinic were followed for up to six visits. Three PROMs that characterized lower extremity function were measured. The measurement completion rate decreased from 100 ...


A Traumatic Three-Level Brachial Plexus Palsy With Upper Trunk Avulsion, Andre Anderson, Michael Swartzon, Gautam Yagnik, John Uribe 2019 West Kendall Baptist Hospital

A Traumatic Three-Level Brachial Plexus Palsy With Upper Trunk Avulsion, Andre Anderson, Michael Swartzon, Gautam Yagnik, John Uribe

Gautam Yagnik

No abstract provided.


Complications In Brief: Quadriceps And Patellar Tendon Tears, Gautam Yagnik, John Uribe 2019 Baptist Health Medical Group; Miami Orthopedics & Sports Medicine Institute

Complications In Brief: Quadriceps And Patellar Tendon Tears, Gautam Yagnik, John Uribe

Gautam Yagnik

No abstract provided.


A Biomechanical Comparison Of New Techniques For Distal Clavicular Fracture Repair Versus Locked Plating, Gautam Yagnik, Joseph Zimmerman, Charles Jordan, David Porter 2019 Baptist Health Medical Group; Miami Orthopedics & Sports Medicine Institute

A Biomechanical Comparison Of New Techniques For Distal Clavicular Fracture Repair Versus Locked Plating, Gautam Yagnik, Joseph Zimmerman, Charles Jordan, David Porter

Gautam Yagnik

No abstract provided.


Arthroscopic Setup, Instrumentation, Portals, And Operative Pearls, Gautam Yagnik, John Uribe 2019 Baptist Health Medical Group; Miami Orthopedics & Sports Medicine Institute

Arthroscopic Setup, Instrumentation, Portals, And Operative Pearls, Gautam Yagnik, John Uribe

Gautam Yagnik

No abstract provided.


The Impact Of Cholesterol Deposits On The Fibrillar Architecture Of The Achilles Tendon In A Rabbit Model Of Hypercholesterolemia., Andrzej Steplewski, Jolanta Fertala, Ryan Tomlinson, Kevth'er Hoxha, Lin Han, Ocean Thakar, Jason Klein, Joseph A. Abboud, Andrzej Fertala 2019 Thomas Jefferson University

The Impact Of Cholesterol Deposits On The Fibrillar Architecture Of The Achilles Tendon In A Rabbit Model Of Hypercholesterolemia., Andrzej Steplewski, Jolanta Fertala, Ryan Tomlinson, Kevth'er Hoxha, Lin Han, Ocean Thakar, Jason Klein, Joseph A. Abboud, Andrzej Fertala

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Increased tendon pain and tendon damage is a significant complication related to hyperlipidemia. Unlike the well-established pathogenesis associated with increased serum concentrations of total cholesterol, triglycerides, and low-density lipoprotein in atherosclerotic cardiovascular disease, the role of hyperlipidemia in promoting tendon damage remains controversial and requires mechanistic clarity.

METHODS: In this study, we analyzed the consequences of hypercholesterolemia on the integrity of the collagen-based architecture of the Achilles tendon. The Achilles tendons from rabbits fed with normal-cholesterol (nCH) and high-cholesterol (hCH) diets were analyzed. We studied the morphology of tendons, distribution of lipids within their collagen-rich milieu, the relative amounts ...


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