Orthopedics Commons^™

Lipoma Of The Index Finger In A 64-Year-Old Man: A Case Report, Norfleet B. Thompson, Moheb S. Moneim

UNM Orthopaedic Research Journal

Lipomas are benign tumors composed of adipose tissue and typically encountered in middle-aged patients. Although the etiology remains unknown, this lesion can occur throughout the body. However, it is rarely seen in the finger. Typical treatment has often involved observation, but excision techniques have also reported successful outcomes. We describe a 64-year-old male patient who reported to our clinic with a painless soft-tissue mass in the index finger of his left hand, and we performed operative excision for treatment. The findings of physical examinations, radiographs, and magnetic resonance imaging tests had indicated the presence of lipoma, and results of pathological …

Cell Stimulation And Calcium Mobilization By Picosecond Electric Pulses, Iurii Semenov, Shu Xiao, Dongkoo Kang, Karl H. Schoenbach, Andrei G. Pakhomov

Bioelectrics Publications

We tested if picosecond electric pulses (psEP; 190 kV/cm, 500 ps at 50% height), which are much shorter than channel activation time, can activate voltage-gated (VG) channels. Cytosolic Ca²⁺ was monitored by Fura-2 ratiometric imaging in GH3 and NG108 cells (which express multiple types of VG calcium channels, VGCC), and in CHO cells (which express no VGCC). Trains of up to 100 psEP at 1 kHz elicited no response in CHO cells. However, even a single psEP significantly increased Ca²⁺ in both GH3 (by 114 +/- 48 nM) and NG108 cells (by 6 +/- 1.1 nM). Trains of …

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 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 …

Bioactive Lipid Coating Of Bone Allografts Direct Engraftment And Fate Determination Of Bone Marrow-Derived Cells In Rat Gfp Chimeras, Anusuya Das, Claire E. Segar, Yihsuan Chu, Tiffany W. Wang, Yon Lin, Chunxi Yang, Roy C. Ogle

Medical Diagnostics & Translational Sciences Faculty Publications

Bone grafting procedures are performed to treat wounds incurred during wartime trauma, accidents, and tumor resections. Endogenous mechanisms of repair are often insufficient to ensure integration between host and donor bone and subsequent restoration of function. We investigated the role that bone marrow-derived cells play in bone regeneration and sought to increase their contributions by functionalizing bone allografts with bioactive lipid coatings. Polymer-coated allografts were used to locally deliver the immunomodulatory small molecule FTY720 in tibial defects created in rat bone marrow chimeras containing genetically-labeled bone marrow for monitoring cell origin and fate. Donor bone marrow contributed significantly to both …

Nonthermal Atmospheric Pressure Plasma Enhances Mouse Limb Bud Survival, Growth, And Elongation., Natalie Chernets, Jun Zhang, Marla J Steinbeck, Deepa S Kurpad, Eiki Koyama, Gary Friedman, Theresa A. Freeman

Department of Orthopaedic Surgery Faculty Papers

The enhanced differentiation of mesenchymal cells into chondrocytes or osteoblasts is of paramount importance in tissue engineering and regenerative therapies. A newly emerging body of evidence demonstrates that appendage regeneration is dependent on reactive oxygen species (ROS) production and signaling. Thus, we hypothesized that mesenchymal cell stimulation by nonthermal (NT)-plasma, which produces and induces ROS, would (1) promote skeletal cell differentiation and (2) limb autopod development. Stimulation with a single treatment of NT-plasma enhanced survival, growth, and elongation of mouse limb autopods in an in vitro organ culture system. Noticeable changes included enhanced development of digit length and definition of …

Adolescent Idiopathic Scoliosis: Comparing And Contrasting Operative Versus Non-Operative Treatment Abstract, Ethan Morris

Physician Assistant Scholarly Project Posters

• Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis. It affects 2-4 percent of adolescents aged 10-16 years. Although most adolescents diagnosed with scoliosis will not develop clinical symptoms, ten percent will progress and require medical intervention due to the potential for rib deformity and respiratory compromise as well as significant emotional distress due to aesthetic changes in appearance. Primary care providers should be prepared to evaluate and recommend treatment when idiopathic scoliosis is discovered or addressed by the patient. Three major factors that determine whether scoliosis will progress are patient gender, magnitude of curve on presentation, …

Unilateral Heat Accelerates Bone Elongation And Lengthens Extremities Of Growing Mice, Maria A. Serrat, Thomas J. Schlierf, Morgan L. Efaw, Franklin D. Shuler, Justin Godby, Laura M. Stanko

Orthopaedics

Linear growth failure results from a broad spectrum of systemic and local disorders that can generate chronic musculoskeletal disability. Current bone lengthening protocols involve invasive surgeries or drug regimens, which are only partially effective. Exposure to warm ambient temperature during growth increases limb length, suggesting that targeted heat could noninvasively enhance bone elongation. We tested the hypothesis that daily heat exposure on one side of the body unilaterally increases femoral and tibial lengths. Mice (N = 20) were treated with 40 °C unilateral heat for 40 min/day for 14 days post-weaning. Non-treated mice (N = 6) served as controls. Unilateral …

Hip Fracture Evaluation With Alternatives Of Total Hip Arthroplasty Versus Hemiarthroplasty (Health): Protocol For A Multicentre Randomised Trial, Mohit Bhandari, P. J. Devereaux, Thomas A. Einhorn, Lehana Thabane, Emil H. Schemitsch, Kenneth J. Koval, Frede Frihagen, Rudolf W. Poolman, Kevin Tetsworth, Ernesto Guerra-Farfán, Kim Madden, Sheila Sprague, Gordon Guyatt, Ali Oliasharazi, Franklin D. Shuler, Jonathon Salva, James Day, Tigran Garabekyan, Felix Cheung, Linda Morgan, Timothy Wilson-Byrne Md, Mary Beth Cordle

Orthopaedics

Introduction: Hip fractures are a leading cause of mortality and disability worldwide, and the number of hip fractures is expected to rise to over 6 million per year by 2050. The optimal approach for the surgical management of displaced femoral neck fractures remains unknown. Current evidence suggests the use of arthroplasty; however, there is lack of evidence regarding whether patients with displaced femoral neck fractures experience better outcomes with total hip arthroplasty (THA) or hemiarthroplasty (HA). The HEALTH trial compares outcomes following THA versus HA in patients 50 years of age or older with displaced femoral neck fractures.

Methods and …

The Effect Of Spinal Cord Injury On Vagal Afferents., April N. Herrity

Electronic Theses and Dissertations

Spinal cord injury (SCI) is a significant public health concern that leaves patients with a multitude of life-long disabilities. Major complications of SCI apart from paralysis, include deficits in bladder and bowel function. Lower urinary tract dysfunction continues to remain a top priority issue affecting quality of life for this population. The majority of visceral organs receive a dual sensory innervation from both spinal nerves as well as the vagus nerve. Following SCI, the vagus nerve is a potential pathway through which information from regions below the level of a spinal injury can travel directly to the brainstem, bypassing the …

Transfusion Practice In Orthopedic Patients: Do We Really Need It?, Kashif Abbas, Raza Askari, Masood Umer, Kamran Hafeez

Department of Surgery

Abstract

OBJECTIVE:

To determine the proportion of inappropriate transfusions in patients undergoing orthopaedic surgery at a tertiary care university hospital, and factors associated with inappropriate transfusions.

METHODS:

The prospective study was conducted at Aga Khan University Hospital, Karachi, from December 2008 to September 2009, and comprised patients admitted to the Orthopaedic Department and received transfusion of at least one packed cell. Patients were divided into four groups: A, those with haemoglobin < 7, B, haemoglobin 7.1-10 without ischemic heart disease, C, haemoglobin 7.1-10 with ischemic heart disease, and D, haemoglobin >10. Variables recorded were, pre-transfusion haemoglobin level, co-morbids, symptoms of hypovolemia, pre-transfusion volume replacement with fluids, transfusion reactions, and haemoglobin after 48 hours. Indications of transfusion were assessed in …

Asymptomatic Urinary Tract Infection: Cause Of Postoperative Wound Infection, Irfan A. Khan, Masood Umer

Department of Surgery

bstract

OBJECTIVE:

To determine the rate of urinary tract infection in patients given incomplete treatment before undergoing hip fracture surgery.

METHODS:

The descriptive case series was conducted at Aga Khan University Hospital, Karachi, From October 25, 2012 to April 24, 2013. 84 postmenopausal women having hip fracture along with asymptomatic urinary tract infection. The infection was treated incompletely and postoperatively wound infection rate was determined. The SPSS version 17 was used to analyze the data.

RESULTS:

The overall mean age of the 84 patients in the study was 63.57+10.34 years. Overall, 14(16.7%) patients had wound infection after orthopaedic implant surgery …

Our Experience With Van Nes Rotationplasty For Locally Advanced Lower Extremity Tumours, Raza Askari, Masood Umer, Mohsin-E-Azam, Haroon Rashid

Department of Surgery

Abstract

OBJECTIVE:

To present an early experience with the time-tested technique of Van Ness Rotationplasty to save distal lmbs.

METHODS:

Van Nes Rotationplasty for locally advanced lower extremity tumours. A reterorespective audit was conducted at Aga Khan University Hospital, Karachi, and comprised cases of bone and soft tissue sarcoma who underwent Van Ness Rotationplasty over seven years from January 2005 to December 2011. Demographic data, family history, past history, co-morbids, date since diagnosis, duration of symptoms, type of tumour, metastasis, pre-op and post-op functional status, recurrence and survival were collected.

RESULTS:

Of the 351 cases of bone and soft tissue …

Effect Of Teriparatide On Bone Regenerate After Distraction Osteogenesis, Masood Umer, Tashfeen Ahmad, Sadia Habib, Rasham Rehman, Mahmood Ahmed, Irfan Qadir

Department of Surgery

Abstract

OBJECTIVE:

To determine the effect of teriparatide on new bone formation in a rat model of distraction osteogenesis.

METHODS:

The experimental study was conducted at the Aga Khan University Hospital, Karachi, in November-December 2010, and comprised male Sprague-Dawley rats weighing 250gm each who were allocated to two treatment groups, teriparatide and saline, both given subcutaneously for 7 weeks. Femoral distraction was done for 3 weeks at the rate of 0.4mm/day, followed by a further 4 weeks for consolidation. New bone formation was assessed using X-ray scoring system, bone densitometry and histology.

RESULTS:

The 12 rats in the study were …

Competing Interests Of Undergraduate Medical Education And Industry: Integration Into Longitudinal Curricular Themes., Shahryar Noordin, Sheilla Pinjani

Department of Surgery

Abstract

Recent changes in curricula around the globe with emphasis on teaching/learning and assessing professionalism in medical schools has been the priority. With the changing public expectations and professional demands, it has become imperative to develop clear guidelines and policies for students and faculty to better understand and meet the expectations of them as part of professionalism. In order to analyse this problem and highlight potential solutions, a literature search was conducted using Eric, Medline, Google Scholar and CINAHL Plus databases from 1985 to February 2013. We reviewed publications regarding the relationship between the pharmaceutical and device industry and medical …

Operative Management Of Patients With Non-Spinal Metastatic Bone Disease. Does It Actually Improve Quality Of Life?, Masood Umer, Yasir Mohib, Hafiz Muhammad Umer

Department of Surgery

Abstract

OBJECTIVE:

To determine the survival rate and functional outcome of skeletal stabilisation in patients with metastatic bone disease.

METHODS:

The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised data of patients with non-spinalmetastatic bone disease managed surgically from January 2002 to December 2010. All patients had been managed by experienced orthopaedic, oncology and multidisciplinary teams. Patients managed by non-oncologic orthopaedic surgeons were excluded. The prognostic influence of clinical, pathological and treatment variables on Musculoskeletal Tumour Society score, range of motion, local complications and death rate were measured. SPSS 19 was used for statistical analysis.

RESULTS: …

Malrotation After Reamed Intramedullary Nailing With And Without A Fracture Table For Closed Fractures Of The Femoral Shaft, Rizwan Haroon Rashid, Akbar Jaleel Zubairi, Masood Umer

Department of Surgery

Abstract Introduction: To observe the effect of the choice of surgical table on the incidence of malrotation. Methods: The randomised trial was conducted from July 2012 to January 2013 at the Aga Khan University Hospital, Karachi, during which 74 patients were inducted. Randomisation was done via random allocation software version 1.0.0 and sealed envelopes were used to guide the choice of table. Malrotation was assessed by the operating surgeon using the lesser trochanteric shape signunder intra-operative fluoroscopy. SPSS 19 was used for statistical analysis. Results: The 74 patients in the study were divided into two groups of 37(50%) each using …

Leukocyte Esterase Strip Test: Matched For Musculoskeletal Infection Society Criteria., Eric H Tischler, Priscilla K Cavanaugh, Javad Parvizi Md

Rothman Institute Faculty Papers

BACKGROUND: The presence of leukocyte esterase in the synovial fluid has recently been proposed as a marker for periprosthetic joint infection. However, the sensitivity and specificity of leukocyte esterase has not been determined when matched for the current, most inclusive Musculoskeletal Infection Society (MSIS) criteria for periprosthetic joint infection.

METHODS: The presence of leukocyte esterase was prospectively evaluated in synovial joint aspirates from hips and knees from May 2009 to May 2013. The cohort consisted of 189 hip and knee aspirations (fifty-two positive and 137 negative for infection). If the aspirate was bloody, a centrifuge was used to precipitate red …

What's Good For The Heart Is Good For The Shoulder? Commentary On An Article By Chang-Meen Sung, Md, Et Al.: "Are Serum Lipids Involved In Primary Frozen Shoulder? A Case-Control Study"., Mark D Lazarus

Rothman Institute Faculty Papers

No abstract provided.

Loss Of Hif-1Α In The Notochord Results In Cell Death And Complete Disappearance Of The Nucleus Pulposus., Christophe Merceron, Laura Mangiavini, Alexander Robling, Tremika Leshan Wilson, Amato J Giaccia, Irving Shapiro, Ernestina Schipani, Makarand V Risbud

Department of Orthopaedic Surgery Faculty Papers

The intervertebral disc (IVD) is one of the largest avascular organs in vertebrates. The nucleus pulposus (NP), a highly hydrated and proteoglycan-enriched tissue, forms the inner portion of the IVD. The NP is surrounded by a multi-lamellar fibrocartilaginous structure, the annulus fibrosus (AF). This structure is covered superior and inferior side by cartilaginous endplates (CEP). The NP is a unique tissue within the IVD as it results from the differentiation of notochordal cells, whereas, AF and CEP derive from the sclerotome. The hypoxia inducible factor-1α (HIF-1α) is expressed in NP cells but its function in NP development and homeostasis is …

Does Functional Gain And Pain Relief After Tkr And Thr Differ By Patient Obese Status?, Wenjun Li, Jeffrey Lange, Leslie R. Harrold, Jeroan J. Allison, Courtland Lewis, Thomas Bowen, David C. Ayers, Patricia D. Franklin

Jeroan J. Allison

Introduction: Obesity is an important predictor of functional status and pain after total knee (TKR) and total hip (THR) replacement. However, variations in pre-post TKR and THR changes in function and pain by obesity status remain to be examined.

Material & Methods: Pre- and 6 month post surgery data were collected on 2,964 primary TKR and 2,040 primary THR patients between 5/2011 and 3/2013. Data included demographics, comorbidities, operative joint pain severity based on the Knee Injury or Hip Disability and Osteoarthritis Outcome Score (KOOS/HOOS), WOMAC pain (higher is better), physical function (SF-36 PCS, higher is better), mental health (SF-36 …