Orthopedics Commons^™

Effects Of Yoga On Arm Volume Among Women With Breast Cancer Related Lymphedema: A Pilot Study, Mary Insana Fisher, Betsy Donahoe-Fillmore, Laura Leach, Colleen O'Malley, Cheryl Paeplow, Tess Prescott, Harold L. Merriman

Physical Therapy Faculty Publications

Lymphedema affects 3–58% of survivors of breast cancer and can result in upper extremity impairments. Exercise can be beneficial in managing lymphedema. Yoga practice has been minimally studied for its effects on breast cancer related lymphedema (BCRL). The purpose of this study was to determine the effect of yoga on arm volume, quality of life (QOL), self-reported arm function, and hand grip strength in women with BCRL. Six women with BCRL participated in modified Hatha yoga 3×/week for 8 weeks. Compression sleeves were worn during yoga sessions. Arm volume, QOL, self-reported arm function, and hand grip strength were measured at …

The Effect Of Fixation Plate Length On Spinal Instability Following Anterior Cervical Plate Fixation For The Repair Of In Vitro Flexion-Distraction Injuries, Abdulaziz J. Al-Kuwari

Electronic Thesis and Dissertation Repository

Abstract:

The Effect of Fixation Plate Length on Spinal Instability Following Anterior Cervical Plate Fixation for the Repair of in Vitro Flexion-Distraction Injuries

Introduction: Anterior cervical decompression and fusion with a plate (ACDFP) is a commonly performed treatment following a traumatic injury to the subaxial cervical spine. The purpose of the presented work was to determine the biomechanical effect of plate length on cervical spine kinematic stability following ACDFP stabilization for a simulated traumatic injury.

Methods: Eleven fresh-frozen cadaveric C5-C6 and C6-C7 motion segments were examined in this study. To assess kinematics, flexibility testing was performed on each specimen …

Risk Factors For Surgical Site Infection Following Total Joint Arthroplasty., Mohammad R Rasouli, Camilo Restrepo, Mitchell Maltenfort, Phd, James J Purtill, Javad Parvizi

Rothman Institute Faculty Papers

BACKGROUND: Currently, most hospitals in the United States are obliged to report infections that occur following total joint arthroplasty to the Centers for Disease Control and Prevention through the National Healthcare Safety Network surveillance. The objective of this study was to identify the risk factors of surgical site infections that were reported to the Centers for Disease Control and Prevention from a single institution.

METHODS: For this study, 6111 primary and revision total joint arthroplasties performed from April 2010 to June 2012 were identified. Surgical site infection cases captured by infection surveillance staff on the basis of the Centers for …

Blood Conservation In Total Hip Arthroplasty: Interim Analysis Of The Tranexamic Acid Comparison In Hip Replacement (Teach-R) Trial, Richard P. Nadeau

Electronic Thesis and Dissertation Repository

Intravenous tranexamic acid (TEA) is used in total hip arthroplasty (THA) to reduce blood loss. Concern of increased thromboembolic risk has prompted the search for treatment alternatives. The Tranexamic Acid Comparison in Hip Replacement (TeACH-R) trial is a prospective randomized controlled trial comparing the efficacy of intravenous and topical TEA in reducing perioperative blood loss. For interim data analysis, 52 of the planned 144 participants had completed the initial phase of the TeACH-R trial. No significant differences were identified between the intravenous and topical TEA treatment arms for delta-hemoglobin (ΔHgb; 34.81±13.78 vs. 35.65±15.54 mg/dL; p=0.840), calculated blood loss (1548±509 …

The Effect Of Tooth Presence On Identification Of Tooth Socket Lamina Dura Surface: A Cbct Study, Morse Stonecypher

Loma Linda University Electronic Theses, Dissertations & Projects

Aim: The accuracy in identifying anatomical landmarks on CBCT images can be affected by the presence of surrounding anatomical structures with similar radiodensity. The purpose of this study was to evaluate the effect of the presence of tooth structure on the accuracy in identifying the lamina dura surface, facial bone surface, facial and lingual bone margins, socket apex, as well as in facial bone thickness measurement. Materials & Methods: Three fresh cadaver heads were scanned using a NewTom 5G CBCT at 0.100 mm voxel size at three time-points: before extraction (T1), after extraction and reinsertion (T2), and after tooth removal …

Functional Assessment And Potential Therapeutic Role Of Carbon Monoxide Releasing Molecule-­‐3 In A Rodent Model Of Compartment Syndrome, Al Walid Hamam

Electronic Thesis and Dissertation Repository

Compartment syndrome (CS) is a life and limb threatening condition resulting in long term morbidity. Gold standard treatment of CS is surgical fasciotomy. Long-term morbidity is common post fasciotomy. We tested a gait analysis system (CatWalk™) to see if we could detect functional effects of CS in our rodent model. We also investigated the effects of carbon monoxide releasing molecule-3 (CORM-3) on the function of gait in rodents post CS.

The CatWalkTM system was able to detect abnormalities in a rodent’s gait post CS. CORM-3 was also found to alleviate the functional deficits following CS. Multiple dose but not single …

A Survey Of Expert Opinion Regarding Rotator Cuff Repair., Daniel C Acevedo, E Scott Paxton, Gerald R Williams, Joseph A Abboud

Rothman Institute Faculty Papers

Many patients with rotator cuff tears have questions for their surgeons regarding the surgical procedure, perioperative management, restrictions, therapy, and ability to work after a rotator cuff repair. The purpose of our study was to determine common clinical practices among experts regarding rotator cuff repair and to assist them in counseling patients. We surveyed 372 members of the American Shoulder and Elbow Surgeons (ASES) and the Association of Clinical Elbow and Shoulder Surgeons (ACESS); 111 members (29.8%) completed all or part of the survey, and 92.8% of the respondents answered every question. A consensus response (>50% agreement) was achieved …

Definition Of Periprosthetic Joint Infection, Javad Parvizi, Md, Frcs, Thorsten Gehrke, Md

Rothman Institute Faculty Papers

Diagnosis of periprosthetic joint infection (PJI) remains challenging as no “gold standard” for diagnosis exists [3]. The challenge is then what test(s) or criterion (ia) can be used to define PJI. In an effort to standardize the definition of PJI, Musculoskeletal Infection Society (MSIS) convened a workgroup in 2011 to issue diagnostic criteria for PJI [1]. The MSIS definition of PJI consists of two major criteria, when the presence of either criterion would indicate PJI, and six minor criteria, when the presence of four or more would indicate PJI.

The Repair, Reconstruction And Replacement Of The Coronoid Process, Bashar Alolabi

Electronic Thesis and Dissertation Repository

The coronoid process is the most important articular stabilizer of the elbow. While most large coronoid fractures are treated surgically with open reduction and internal fixation, there is limited data on the most effective fixation method. The strengths of five different coronoid fixation methods were assessed using a materials testing machine. Plate fixation proved to be stronger than screw fixation; two screws, regardless of the orientation, were stronger than one; and suture fixation was unreliable. In the setting of an unfixable coronoid fracture, reconstruction of the coronoid using the tip of the olecranon has been described. However, this technique has …

What's New In Spine Surgery., Keith H Bridwell, Paul A Anderson, Scott D Boden, Han Jo Kim, Alexander Vaccaro, Md, Phd, Jeffrey C Wang

Rothman Institute Faculty Papers

No abstract provided.

Aquacel Surgical Dressing Reduces The Rate Of Acute Pji Following Total Joint Arthroplasty: A Case-Control Study., Jenny Cai, Joseph A Karam, Javad Parvizi, Eric B Smith, Peter F. Sharkey

Rothman Institute Faculty Papers

An effort to prevent PJI has led to the development of antimicrobial dressings that support wound healing. We sought to determine whether Aquacel Surgical dressing independently reduces the rate of acute PJI following TJA. A single institution retrospective chart review of 903 consecutive cases who received the Aquacel Surgical dressing and 875 consecutive cases who received standard gauze dressing was conducted to determine the incidence of acute PJI (within 3months). The incidence of acute PJI is 0.44% in the Aquacel dressing group compared to 1.7% in the standard gauze dressing group (P=0.005). Multivariate analysis revealed that use of Aquacel dressing …

The Role Of Rotator Interval Closure In Bankart Lesion Repair, Lauren L. Rainsford

Electronic Thesis and Dissertation Repository

Twenty-nine patients who had sustained an anterior shoulder dislocation were randomly assigned to receive Bankart lesion repair, or Bankart lesion repair with rotator interval closure. External rotation range of motion with 90° of abduction external rotation range of motion with no abduction, and forward flexion range of motion were measured preoperatively, and at three and six months postoperatively. Quality of life, function, and pain were measured preoperatively, and at three, six, 12 and 24 weeks postoperatively. We found no significant differences between groups for any outcome but the confidence intervals were wide and definitive conclusions could not be made. This …

The Relative Efficacy Of Antifibrinolytics In Adolescent Idiopathic Scoliosis: A Prospective Randomized Trial., Kushagra Verma, Md, Thomas Errico, Chris Diefenbach, Christian Hoelscher, Austin Peters, Joseph Dryer, Tessa Huncke, Kirstin Boenigk, Baron S Lonner

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Antifibrinolytics can reduce intraoperative blood loss. The primary aim of this study was to determine the efficacy of intraoperative tranexamic acid, epsilon-aminocaproic acid, and placebo at reducing perioperative blood loss and the transfusion rate in patients with adolescent idiopathic scoliosis undergoing posterior spinal arthrodesis.

METHODS: This is a prospective, randomized, double-blind comparison of tranexamic acid, epsilon-aminocaproic acid, and placebo used intraoperatively in patients with adolescent idiopathic scoliosis. One hundred and twenty-five patients with adolescent idiopathic scoliosis were randomly assigned to the tranexamic acid, epsilon-aminocaproic acid, or control groups. Parameters recorded included estimated blood loss, hematocrit, blood product usage, drain …

Effects Of Music Intervention On The Patient’S Perception Of Pain After Knee Replacement Surgery, Heather E. Hooks

Electronic Theses and Dissertations

The purpose of this study was to determine whether therapeutic music affects the patient’s perception of pain, postoperative day 1 after knee replacement surgery in an inpatient hospital. In addition to the patient’s pain levels, the study was an analysis of the quantity of opioids the patient was requested, the length of stay, and the physiological parameters, which included blood pressure, heart rate, respiratory rate, and oxygen saturation. Sixty knee replacement patients were randomly placed in the music group or the quiet group. The Faces Pain Scale Revised with Numeric Rating Scale was used to measure pain levels. Statistical analysis …

Preventing Falls With Vitamin D, Franklin D. Shuler Md, Phd, Thomas Schlierf, Matthew Wingate

Orthopaedics

Falls are the number one cause for injury-related morbidity and mortality in West Virginia’s seniors. Multiple independent variables contribute to the risk of a fall: previous falls, alterations in balance and vision, impairments in gait and strength, and medications most highly correlate with the risk for a fall. Vitamin D supplementation is emerging as an easy, safe and well-tolerated fall reduction/prevention strategy due to the beneficial effects on the musculoskeletal system with improvements in strength, function and navigational abilities. From meta-analysis data, maximal fall reduction benefit in seniors is achieved when correcting vitamin D deficiency and when using adjunctive calcium …

Assessing Function And Endurance In Adults With Spinal And Bulbar Muscular Atrophy: Validity Of The Adult Myopathy Assessment Tool, Michael O. Harris-Love, Lindsey E. Rhodes, Galen Joe, Joseph A. Shrader, Sungyoung Auh, Cheunju Chen, Li Li, Ellen Levy, Todd E. Davenport, Nicholas Diprospero, Kenneth H. Fischbeck

School of Pharmacy Faculty Articles

Purpose. The adult myopathy assessment tool (AMAT) is a performance-based battery comprised of functional and endurance subscales that can be completed in approximately 30 minutes without the use of specialized equipment. The purpose of this study was to determine the construct validity and internal consistency of the AMAT with a sample of adults with spinal and bulbar muscular atrophy (SBMA). Methods. AMAT validity was assessed in 56-male participants with genetically confirmed SBMA (mean age, 53 ± 10 years). The participants completed the AMAT and assessments for disease status, strength, and functional status. Results. Lower AMAT scores were associated with longer …

Hip Reconstruction Osteotomy By Ilizarov Method As A Salvage Option For Abnormal Hip Joints, Masood Umer, Haroon Rashid, Hafiz Muhammad Umer, Hasnain Raza

Department of Radiology

Hip joint instability can be secondary to congenital hip pathologies like developmental dysplasia (DDH) or acquired such as sequel of infective or neoplastic process. An unstable hip is usually associated with loss of bone from the proximal femur, proximal migration of the femur, lower-extremity length discrepancy, abnormal gait, and pain. In this case series of 37 patients coming to our institution between May 2005 and December 2011, we report our results in treatment of unstable hip joint by hip reconstruction osteotomy using the Ilizarov method and apparatus. This includes an acute valgus and extension osteotomy of the proximal femur combined …

Nanotechnology: Current Concepts In Orthopaedic Surgery And Future Directions., M P Sullivan, K J Mchale, Javad Parvizi Md, S Mehta

Rothman Institute Faculty Papers

Nanotechnology is the study, production and controlled manipulation of materials with a grain size < 100 nm. At this level, the laws of classical mechanics fall away and those of quantum mechanics take over, resulting in unique behaviour of matter in terms of melting point, conductivity and reactivity. Additionally, and likely more significant, as grain size decreases, the ratio of surface area to volume drastically increases, allowing for greater interaction between implants and the surrounding cellular environment. This favourable increase in surface area plays an important role in mesenchymal cell differentiation and ultimately bone-implant interactions. Basic science and translational research have revealed important potential applications for nanotechnology in orthopaedic surgery, particularly with regard to improving the interaction between implants and host bone. Nanophase materials more closely match the architecture of native trabecular bone, thereby greatly improving the osseo-integration of orthopaedic implants. Nanophase-coated prostheses can also reduce bacterial adhesion more than conventionally surfaced prostheses. Nanophase selenium has shown great promise when used for tumour reconstructions, as has nanophase silver in the management of traumatic wounds. Nanophase silver may significantly improve healing of peripheral nerve injuries, and nanophase gold has powerful anti-inflammatory effects on tendon inflammation. Considerable advances must be made in our understanding of the potential health risks of production, implantation and wear patterns of nanophase devices before they are approved for clinical use. Their potential, however, is considerable, and is likely to benefit us all in the future. Cite this article: Bone Joint J 2014; 96-B: 569-73.

Performance Evaluation Of Material Decomposition Using Rapid Kvp-Switching Dual-Energy Ct For Assessing Bone Mineral Density, John M. Wait

Dissertations & Theses (Open Access)

Osteoporosis is diagnosed by assessing the bone mineral density (BMD) of the trabecular bone, and has previously been characterized with dual-energy x-ray absorptiometry (DXA) or single-energy computed tomography (SECT). Dual-energy computed tomography (DECT) is able to create two three-dimensional sets of images representing the densities of two materials in a given basis pair. DECT is theoretically capable of providing a true density measurement of trabecular bone material with the proper material basis pair.

Using the rapid kVp-switching GE HD750 scanner, the concentrations of various solutes were assessed in two-material syringe-phantoms in different experimental conditions with DECT material density images, SECT …

Pathophysiology Of Compartment Syndrome, Abdel-Rahman Lawendy

Electronic Thesis and Dissertation Repository

Acute limb compartment syndrome (CS), a potentially devastating complication of musculoskeletal trauma, is characterized by increased pressure within a closed osseofascial compartment, resulting in muscle-threatening and ultimately limb-threatening ischemia. Urgent fasciotomy remains the only effective treatment and a current gold-standard surgical therapy. Despite a large body of literature dedicated to understanding the pathophysiology of CS, the mechanisms of CS-induced tissue damage are rather poorly understood. The established view is that increasing compartmental pressure compromises microcirculatory perfusion, restricting oxygen and nutrient delivery to vital tissues, resulting in cellular anoxia and severe tissue necrosis. However, unlike complete ischemia, CS causes myonecrosis in …