Medicine and Health Sciences Commons^™

Return To Recreational Sports Participation Following Rotator Cuff Repair In Adults Over 40 Years Of Age: Outcomes And Return To Play Analysis, John Hayden Sonnier, Gregory Connors, Michael P. Campbell, Matthew Sabitsky, Ryan W. Paul, Hayden E. Sando, William D. Emper, Steven B. Cohen, Michael G. Ciccotti, Fotios P. Tjoumakaris, Kevin B. Freedman

Rothman Institute Faculty Papers

Background: Despite the high prevalence of rotator cuff (RTC) tears in older adults, there is limited literature evaluating the return to recreational sport after repair. The purpose of this study was (1) to assess the patient-reported outcomes and return to sport rates following rotator cuff repair in patients aged more than 40 years with minimum 2-year follow-up; (2) to compare baseline, preoperative and postoperative outcomes, and level of play following repair of self-reported athletes with nonathletes; and (3) to compare return to sport rates in overhead athletes compared to nonoverhead athletes. Methods: Patients undergoing arthroscopic rotator cuff repair between January …

Effect Of Mesenchymal Stem Cells On Osteoarthritis Of The Knee, Brendan Avery, Jessica Gray

Physician Assistant Capstones, 2020-current

Osteoarthritis of the knee is one the most common sources of chronic pain due to altered joint function.¹ Current treatment modalities offer short term relief of symptoms but lack long term aid and regenerative properties.¹ Mesenchymal stem cells (MSC) offer regenerative and anti-inflammatory properties and can be collected from umbilical cord blood, adipose tissue, or bone marrow.⁴ The three studies included were all randomized controlled trials within the past 10 years that each utilized more than 30 participants who had a diagnosis of osteoarthritis and a mean age above 50 years old. MSCs were compared to corticosteroid …

Total Hip Arthroplasty In Patients With Neurological Conditions: A Systematic Review, Conor S O'Driscoll, Andrew J Hughes, Martin S Davey, Joseph M Queally, Brendan J O'Daly

Rothman Institute Faculty Papers

Background: As operative techniques and implant design have evolved over time, total hip arthroplasty (THA) is increasingly being carried out for patients with neurological impairment. This patient group places unique surgical challenges to the arthroplasty surgeon, which may include contractures, instability, and altered muscular tone. The purpose of this systematic review is to report the patient outcomes, complications, and implant survival following THA for patients with neurological conditions affecting the hip. Thus, we aim to support orthopaedic surgeon decision-making when considering and planning THA for these patients.

Methods: A systematic review was performed as per Preferred Reporting Items for Systematic …

Sagittal Alignment Differences On The Operating Room Table Compared To Preoperative And Postoperative Imaging In Anterior Cervical Discectomy And Fusion, Mark J. Lambrechts, Gregory R. Toci, Brian A. Karamian, Zachary Kozick, John Prodoeh, David Reiter, Rahul Muchintala, Eric Tecce, Alexander Vaccaro Jr., Patrick O’Connor, Amit Syal, Dominic Lambo, Jose A. Canseco, I. David Kay, Barrett I. Woods, Alan S. Hilibrand, Christopher K. Kepler, Alexander R. Vaccaro, Gregory D. Schroeder

Rothman Institute Faculty Papers

Study Design: The study design used was a retrospective cohort. Objective: The objective of this study is to determine if intraoperative improvements in sagittal alignment on the operating table persisted on postoperative standing radiographs. Summary of Background Data: Cervical sagittal alignment may be correlated to postoperative outcomes. Since anterior cervical discectomy and fusions (ACDFs) can restore some cervical lordosis through intervertebral grafts/cages, it is important to understand if intraoperative radiographic measurements correlate with persistent postoperative radiographic changes. Materials and Methods: Patients undergoing elective primary ACDF were screened for the presence of lateral cervical radiographs preoperatively, intraoperatively, and postoperatively. Patients were …

Perioperative Chanage In Cervical Lordosis And Health-Related Quality-Of-Life Outcomes, Jose A Canseco, Brian A Karamian, Parthik D Patel, Michael Markowitz, Joseph K Lee, Mark F Kurd, D Greg Anderson, Jeffrey A Rihn, Alan S Hilibrand, Christopher K Kepler, Alexander R Vaccaro, Gregory D Schroeder

Rothman Institute Faculty Papers

BACKGROUND: Surgeons have scrutinized spinal alignment and its impact on improving clinical outcomes following anterior cervical discectomy and fusion (ACDF). The primary analysis of this study examines the relationship between change in perioperative cervical lordosis (CL) and health-related quality-of-life (HRQOL) outcomes after ACDF. Secondary analysis evaluates the effects of fusion construct length on outcomes in patients grouped by preoperative cervical alignment.

METHODS: A retrospective cohort study was performed on an institutional database including patients who underwent 1- to 3-level ACDF. C2-C7 CL was measured preoperatively and at final follow-up. For primary analysis, patients were classified based on their perioperative cervical …

Perceived Efficacy, Reduced Prescription Drug Use, And Minimal Side Effects Of Cannabis In Patients With Chronic Orthopedic Pain, Ari Greis, Eric Larsen, Conan Liu, Bryan Renslo, Anjithaa Radakrishnan, Adrianne R Wilson-Poe

Rothman Institute Faculty Papers

Introduction: Although cannabis is widely used for the treatment of chronic pain, most research relies on patient self-report and few studies have objectively quantified its efficacy and side effects. Extant inventories for measuring cannabis use were not designed to capture the medically relevant features of cannabis use, but rather were designed to detect problematic use or cannabis use disorder. Thus, we sought to capture the medically relevant features of cannabis use in a population of patients with orthopedic pain and pair these data with objective measures of pain and prescription drug use. Materials and Methods: In this prospective observational study, …

Perceptions Of Orthopaedic Medicine Students And Their Supervisors About Practice-Based Learning: An Exploratory Qualitative Study, Muhamed Nsubuga, Robert Opoka, Moses Galukande, Ian G. Munabi, Aloysius . Mubuuke, Sarah Kiguli

Paediatrics and Child Health, East Africa

Background: Practice-based learning is crucial in forming appropriate strategies for improving learning among the medical students that support the country’s understaffed health sector. Unsatisfactory learning consequently results in poor performance of students and poor quality of health care workforce in the long run. Exploring the perceptions about the current practice-based learning system and how to improve is thus vital. This study set out to explore the perceptions of Orthopaedic medicine students and their supervisors about practice-based learning at a tertiary training hospital.

Methods: This was an exploratory phenomenological qualitative study that involved in-depth interviews among 10 Orthopedic students during their …

Cross-Sectional Area Of The Longus Colli And Cervical Degenerative Spondylolisthesis: A Retrospective Review Evaluating This Anatomic Consideration, Khoa Tran, Aditya Mazmudar, Taylor Paziuk, Mark J. Lambrechts, Eric Tecce, Olivia Blaber, Kamil Okroj, Brian A Karamian, Jose A Canseco, Jeffrey A Rihn, Alan Hilibrand, Christopher Kepler, Alexander R. Vaccaro, Gregory D. Schroeder

Department of Orthopaedic Surgery Faculty Papers

Background: Limited literature is available to define the impact of the longus colli muscle, a deep flexor of the spine, on cervical spine stability despite its close proximity to the vertebrae. Aims and Objectives: The purpose of this study was to determine if longus colli cross-sectional area (CSA) is associated with the severity preoperative cervical degenerative spondylolisthesis. Materials and Methods: Patients undergoing elective anterior cervical discectomy and fusion (ACDF) for cervical spondylolisthesis between 2010-2021 were retrospectively identified. Longus colli cross-sectional areas (CSA) were measured from preoperative MRI images at the C5 level. Preoperative spondylolisthesis measurements were recorded with cervical radiographs. …

Low-Dose Aspirin For Venous Thromboembolism Prophylaxis Is Associated With Lower Rates Of Periprosthetic Joint Infection After Total Joint Arthroplasty, Farideh Najafi, Joseph K. Kendal, Nicholas V. Peterson, Kerri-Anne Ciesielka, Camilo Restrepo, Javad Parvizi, Nicholas M. Bernthal

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Aspirin as a venous thromboembolism (VTE) prophylactic agent has been shown to have antistaphylococcal and antibiofilm roles. Optimal acetylsalicylic acid (ASA) dosage would facilitate antimicrobial effects while avoiding over-aggressive inhibition of platelet antimicrobial function. Our purpose was to determine the periprosthetic joint infection (PJI) rate after total joint arthroplasty in patients receiving low-dose ASA (81 mg twice a day), in comparison to high-dose ASA (325 mg twice a day).

METHODS: We conducted a retrospective cohort study between 2008 and 2020. Eligible patients were older than 18 years, underwent primary total joint arthroplasty, both total knee arthroplasty and total hip …

Irreparable Massive Rotator Cuff Tears: Subacromial Balloon Surgical Technique, Alexander J. Rondon, Dominic M. Farronato, Joshua D. Pezzulo, Joseph A. Abboud

Rothman Institute Faculty Papers

Massive irreparable rotator cuff tears pose a significant challenge for both the treating orthopedic surgeon and patient. Surgical treatment options for massive rotator cuff tears include arthroscopic debridement, biceps tenotomy or tenodesis, arthroscopic rotator cuff repair, partial rotator cuff repair, cuff augmentation, tendon transfers, superior capsular reconstruction, subacromial balloon spacer, and ultimately reverse shoulder arthroplasty. The present study will provide a brief overview of these treatment options along with a description of the surgical technique for subacromial balloon spacer placement.

Keeping The Lights On: The Impact Of The Covid-19 Pandemic On Elective Total Joint Arthroplasty Utilization In The United States, Matthew W. Cole, Lacee K. Collins, Garrett H. Williams, Olivia C. Lee, William F. Sherman

School of Medicine Faculty Publications

Background: It was estimated that up to 30,000 primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) procedures would be cancelled each week during the moratorium on elective surgeries in the United States. The purpose of this study was to analyze the impact of the COVID-19 pandemic on elective total joint arthroplasty utilization in the United States. Methods: A retrospective study was conducted using the PearlDiver database. Patients who underwent primary elective THAs and TKAs were identified and filtered by state and month from January through September of both 2019 and 2020. The volume of these procedures immediately following …

Injury To The Posterior Horn Of The Lateral Meniscus From A Misplaced Tibial Tunnel For Anterior Cruciate Ligament Reconstruction: A Case Report, Amar S Vadhera, Jonathan S Lee, Harsh Singh, Safa Gursoy, Kyle N Kunze, Nikhil N Verma, Jorge Chahla

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND Posterior meniscal root avulsions can cause meniscal extrusion, joint space narrowing, and progressive knee arthritis. Iatrogenic posterior meniscal root avulsions after malpositioning of the transtibial tunnels during anterior cruciate ligament (ACL) reconstruction can account for poor long-term outcomes seen in some patients following ACL reconstruction. Therefore, correct transtibial tunnel placement during ACL reconstruction is essential to avoid iatrogenic meniscal damage. CASE REPORT A 32-year-old man presented with 1 year of right knee pain and instability following a non-contact twisting injury sustained while playing soccer. An ACL tear with no meniscal involvement was diagnosed at an outside institution. A double-bundle …

Membership And Feedback On The American Academy Of Orthopaedic Surgeons And Other Subspecialty Societies: A Survey Study Of Orthopaedic Surgeons., Arjun Saxena, Gregory R Toci, Parker L Brush, Alexis Reinhardt, Pedro K Beredjiklian, Alan S. Hilibrand, Alex R. Vaccaro, Daniel Fletcher

Rothman Institute Faculty Papers

Introduction: Orthopaedic surgeons face decreased reimbursement, lower income, and increased rates of burnout. As subspecializing through fellowship training in orthopaedics becomes more and more prevalent, the value of membership to a general orthopaedic society (American Academy of Orthopaedic Surgeons [AAOS]) warrants investigation.

Methods: One hundred thirty orthopaedic surgeons were surveyed by e-mail through a 14-item anonymous survey administered through SurveyMonkey. The survey inquired about surgeon experience, practice type, fellowship training, and details regarding AAOS and subspecialty society membership.

Results: The response rate was 67%, with 94% of respondents indicating that they were members of AAOS and a subspecialty society. The …

Traumatic Anterior Shoulder Dislocation With Concomitant Pectoralis Rupture And Bankart Lesion, Alayna Vaughan, Tyler Luthringer, Joseph Abboud

Rothman Institute Faculty Papers

Traumatic anterior shoulder dislocation is frequently associated with injury to the static soft tissue stabilizers of the glenohumeral joint, with the most common injury being an anterior inferior labral avulsion (Bankart lesion) in 73% of patients after a first time dislocation1. Bony injury can also occur from a single episode of instability. Glenoid rim fractures occur in 5.4%-11% of patients. Greater tuberosity fractures occur in 12%-15% in primary anterior shoulder dislocations. Hill-Sachs lesions occur in 38%-90% of primary anterior shoulder dislocations. Less commonly there can be vascular and nerve injury. Additionally, in patients over the age of 40, rotator cuff …

Effects Of Ohio Opioid Prescribing Policy On Postsurgical Prescriptions Following Sports Procedures, Joseph D. Henningsen, Scott Huff, Andrew D. Schneider, Fady Y. Hijji, Andrew W. Froehle, Anil Krishnamurthy

Orthopaedic Surgery Faculty Publications

Background: Prescribed opioid medication after orthopedic sports surgery has been shown to exceed patient requirements. In 2017, as a response to the opioid epidemic, Ohio passed Opioid Prescribing Guidelines (OPG) limiting narcotic prescriptions for acute pain. This study sought to evaluate the effects of the OPG on prescribing behavior of orthopedists following knee arthroscopy (KA), shoulder arthroscopy (SA), and anterior cruciate ligament reconstruction (ACLR).

Methods: An institutional database was queried to calculate morphine equivalent dose (MED) prescribed at discharge, acute follow-up (<90 days), and chronic follow-up (>90 days) and compare MED pre- and post-OPG. Cases were identified over a 2-year period starting 1 year …

Clinical Practice Guidelines: The Road Map To Better Care, Mary I. Fisher

Physical Therapy Faculty Publications

Systematic reviews and meta-analyses are important tools in translating research evidence into clinical practice as they critically evaluate and summarize the body of evidence on clinical topics. Clinicians can use these studies to quickly survey the current literature base to increase understanding of a clinical diagnosis they make, with the intent of using this information to improve their clinical practice. A well-written systematic review or meta-analysis, with critical evaluation of study quality, is then that Cliffs Note version of what to know and what to do. Therefore, with the proliferation of systematic reviews and meta-analyses, we should see a corresponding …

Larger Perioperative Opioid Prescriptions Lead To Prolonged Opioid Use After Hand And Upper Extremity Surgery: A Multicenter Analysis, Clay B Townsend, Justin A Ly, Ryan Judy, Matthew Sherman, Nick Elmer, Christine Conroy, Hesham M Abdelfattah, Mark K Solarz, Katharine Woozley, Asif M Ilyas

Rothman Institute Faculty Papers

Introduction: The opioid epidemic remains an ongoing public health crisis. The purpose of this study was to investigate whether surgeons' prescribing patterns of the initial postoperative opioid prescription predispose patients to prolonged opioid use after upper extremity surgery.

Methods: This multicenter retrospective study was done at three academic institutions. Patients who underwent carpal tunnel release, basal joint arthroplasty, and distal radius fracture open reduction and internal fixation over a 1.5-year period were included. Opioid prescription data were obtained from the Pennsylvania Prescription Drug Monitoring Program website.

Results: Postoperatively, 30.1% of the patients (191/634) filled ≥1 additional opioid prescription, and 14.0% …

Venous Thromboembolism In Musculoskeletal Oncology Surgery, Ahna Donahue, Keenan Sobol, John A. Abraham

Rothman Institute Faculty Papers

Abstract

Venous thromboembolism (VTE), including both deep venous thrombosis (DVT) and pulmonary embolism (PE), is a major complication of musculoskeletal surgery in general, and the risk is heightened in musculoskeletal oncology surgery. Despite the well-known association between cancer and VTE, the mechanism promoting this pathology is not entirely well understood. It is estimated that nearly all cancer patients will experience from some form of VTE, whether or not clinically relevant, during the course of their disease. Nonetheless, numerous studies have analyzed the occurrence and prevention of VTE in patients with cardiovascular disease or suffering trauma, but very few have specifically …

Routine Use Of Closed Suction Drains Following Revision Arthroplasty May Not Be Necessary, Farideh Najafi, Jonah M. Stein, Nicholas V. Peterson, Michael Meghpara, Matthew B. Sherman, Camilo Restrepo, Javad Parvizi

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: There are numerous studies demonstrating that closed suction drainage (CSD) usage after primary total joint arthroplasty (TJA) has little to no benefit. There are little data on the role of CSDs after revision TJA. The purpose of our study was to evaluate whether there is any clinical advantage to CSD usage after revision TJA.

METHODS: This retrospective study evaluated the clinical records of 2,030 patients undergoing revision TJA between 2007 and 2021. CSD was used in 472 patients and not used in 1,558 patients. Primary outcome was blood transfusion rate and secondary outcomes included total blood loss (TBL), as …

Sterile Setup Table In The Operating Room Is Not So Sterile, Farideh Najafi, Diana Fernández-Rodríguez, Javad Parvizi

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: One of the important factors for surgical site infection prevention is the implementation of an ultraclean operating room. This study was designed to evaluate back-table sterility during total joint arthroplasty.

METHODS: This prospective study includes 52 patients undergoing primary total joint arthroplasty between November 2021 and January 2022. A total of 4 swabs (2 air swabs and 2 table swabs) were obtained for each case, at the conclusion of surgery and prior to the takedown of drapes. One swab from each set was sent for culture, and the other was sent for next-generation sequencing (NGS) analysis.

RESULTS: Among 104 …

Failure Factors For Carpal Tunnel Syndrome Surgical Treatment: When And How To Perform A Revision Carpal Tunnel Decompression Surgery, Carlos Henrique Fernandes, João Baptista Gomes Santos, Francisco Schwartz-Fernandes, A. Lee Ostermann, Flávio Faloppa

Department of Surgery Faculty Papers

Despite being a procedure widely used all over the world with high rates of symptom remission, surgical treatment of carpal tunnel syndrome may present unsatisfactory outcomes. Such outcomes may be manifested clinically by non-remission of symptoms, remission of symptoms with recurrence a time after surgery or appearance of different symptoms after surgery. Different factors are related to this unsuccessful surgical treatment of carpal tunnel syndrome. Prevention can be achieved through a thorough preoperative clinical evaluation of the patient. As such, the surgeon will be able to make differential or concomitant diagnoses, as well as determine factors related to patient dissatisfaction. …

How Does Spinopelvic Alignment Influence Short-Term Clinical Outcomes After Lumbar Fusion In Patients With Single-Level Degenerative Spondylolisthesis?, Stephen Dimaria, Brian A. Karamian, Mark J. Lambrechts, Arun P. Kanhere, John J. Mangan, Winston W. Yen, Arlene Maheu, Mahir A. Qureshi, Jose A. Canseco, David L. Kaye, Barrett I. Woods, Mark F. Kurd

Rothman Institute Faculty Papers

Context: Studies on adult spinal deformity have shown spinopelvic malalignment results in worse outcomes. However, it is unclear if this relationship exists in patients with single‑level degenerative spondylolisthesis (DS) receiving short‑segment fusions.

Aims: To determine if spinopelvic alignment affects patient‑reported outcome measures (PROMs) after posterior lumbar decompression and fusion (PLDF) with or without a transforaminal lumbar interbody fusion in patients with L4‑5 DS.

Settings and Design: A retrospective cohort analysis was conducted on patients who underwent PLDF for L4‑5 DS at a single tertiary referral academic medical center.

Materials and Methods:Patients were divided into groups based on preoperative cutoff …

Next-Generation Sequencing Supports Targeted Antibiotic Treatment For Culture Negative Orthopedic Infections, Ravina Kullar, Emanuele Chisari, James Snyder, Christopher Cooper, Javad Parvizi, Jason Sniffen

Rothman Institute Faculty Papers

The isolation of an infective pathogen can be challenging in some patients with active, clinically apparent infectious diseases. Despite efforts in the microbiology lab to improve the sensitivity of culture in orthopedic implant-associated infections, the clinically relevant information often falls short of expectations. The management of peri-prosthetic joint infections (PJI) provides an excellent example of the use and benefits of newer diagnostic technologies to supplement the often-inadequate yield of traditional culture methods as a substantial percentage of orthopedic infections are culture-negative. Next-generation sequencing (NGS) has the potential to improve upon this yield. Bringing molecular diagnostics into practice can provide critical …

Review: Management Of Midshaft Clavicle Fractures In Adolescents , Matthew B. Holloway

Longitudinal Scholar's Project

Clavicle fractures are common injuries that occur across all age ranges, but are largely seen in young, active males. The majority of these fractures (70-80%) occur in the midshaft of the clavicle. The purpose of this review was to compare non-operative treatment to operative treatment of midclavicular fractures and determine whether treatment for adolescent clavicle fractures more closely aligns with pediatric or adult management. Adolescent clavicle fractures are increasingly treated with open reduction and internal fixation, especially in the 15 to 19 age group. Nevertheless, there remains a lack of high-level studies comparing outcomes of operative and conservative treatment specifically …

Gut Permeability May Be Associated With Periprosthetic Joint Infection After Total Hip And Knee Arthroplasty, Emanuele Chisari, Jeongeun Cho, Marjan Wouthuyzen-Bakker, Javad Parvizi

Rothman Institute Faculty Papers

A growing number of recent investigations on the human genome, gut microbiome, and proteomics suggests that the loss of mucosal barrier function, particularly in the gastrointestinal tract, may substantially affect antigen trafficking, ultimately influencing the close bidirectional interaction between the gut microbiome and the immune system. This cross-talk is highly influential in shaping the host immune system function and ultimately affecting the outcome of interventions. We hypothesized that the loss of mucosal barrier in the gut may be associatedto acute and chronic periprosthetic joint infections (PJI). Zonulin, soluble CD14 (sCD14), and lipopolysaccharide (LPS) were tested in plasma as part of …

Arthroscopic Suprapectoral Biceps Tenodesis: The Best Of Both Worlds, Tyler Pratte, Tyler Smith, Alfonso Arevalo, Joseph Wazen, David Rubenstein

Orthopedic Surgery Resident Research

Biceps tendinopathy and superior labrum anterior posterior lesions are a common source of shoulder pain and disability and can be effectively treated with biceps tenodesis. There are a variety of open and arthroscopic tenodesis techniques, but no one technique has demonstrated superiority. Arthroscopic techniques often disregard the extra-articular portions of the biceps tendon as a potential source of pain. Open techniques address this concern; however, they can be associated with wound complications, increased blood loss, nerve injury, and disruptions to surgical workflow. Here, we describe an all arthroscopic tenodesis technique at the suprapectoral zone of the tendon. This method addresses …

Screening And Assessment Of Cancer-Related Fatigue: An Executive Summary And Road Map For Clinical Implementation, Joy C. Cohn, Shana Harrington, Jeannette Lee, Daniel Malone, Mary I. Fisher

Physical Therapy Faculty Publications

Background: Cancer-related fatigue (CRF) prevalence is reported as high as 90%. Cancer-related fatigue is multidimensional and associated with lower health-related quality of life. Effective screening and assessment are dependent upon use of valid, reliable, and clinically feasible measures. This Executive Summary of the Screening and Assessment of Cancer-related Fatigue Clinical Practice Guideline provides recommendations for best measures to screen and assess for CRF based on the quality and level of evidence, psychometric strength of the tools, and clinical utility.

Methods: After a systematic review of the literature, studies evaluating CRF measurement tools were assessed for quality; data extraction included psychometrics …

Unsupervised Home Exercises Versus Formal Physical Therapy After Primary Total Hip Arthroplasty: A Systematic Review, Yash P. Chaudhry, Hunter Hayes, Zachary Wells, Efstratios Papadelis, Alfonso Arevalo, Timothy Horan, Harpal S Khanuja, Carl Deirmengian

Orthopedic Surgery Resident Research

Historically, postoperative exercise and physical therapy (PT) have been viewed as crucial to a successful outcome following primary total hip arthroplasty (THA). This systematic review and meta-analysis aimed to assess differences in both short- and long-term objective and self-reported measures between primary THA patients with formal supervised physical therapy versus unsupervised home exercises after discharge. A search was conducted of six electronic databases from inception to December 14, 2020, for randomized controlled trials (RCTs) comparing changes from baseline in lower extremity strength (LES), aerobic capacity, and self-reported physical function and quality of life (QoL) between supervised and unsupervised physical therapy/exercise …

Periprosthetic Knee Infection After Benign Tumor Excision Complicated By Carbapenem Resistant Enterobacteriaceae: A Case Report, Jennifer Adams, Daniel Habenicht, Duncan C. Ramsey

MEDI 9331 Scholarly Activities Clinical Years

Introduction

Periprosthetic joint infection (PJI) is a major complication after total knee arthroscopy. Enterobacter is a rare cause of PJI.

Case presentation

We present a 65 year old Caucasian man who presented with acute right knee PJI with Carbapenem-resistant Enterobacteriaceae (CRE) two months after undergoing right knee intra-articular mass removal with endoprosthetic reconstruction. The periprosthetic joint infection (PJI) was treated with revision with 1-stage static spacer and IV meropenem.

Discussion

CRE is an uncommon cause of PJI, but when it does occur, it commonly infects patients who are immunosuppressed or have specific risk factors. For an immunocompetent patient with CRE …

Open Repair Of Complete Proximal Hamstring Avulsions In Workers' Compensation Patients, Emma E Johnson, Joseph M Brutico, Lasya Rangavajjula, Yuwei Xia, Ryan W Paul, Peters Otlans, Justin W Arner, Sommer Hammoud, James P Bradley, Steven B Cohen

Rothman Institute Faculty Papers

Background: Several studies have reported excellent results after surgical repair of proximal hamstring avulsions. However, the effect on these patients of receiving workers' compensation has not yet been explored.

Hypothesis: Workers' compensation patients undergoing proximal hamstring repair of complete tears will have similar outcomes when compared with a matched control group of non-workers' compensation patients.

Study Design: Cohort study; Level of evidence, 3.

Methods: Workers' compensation patients who underwent complete proximal hamstring avulsion open repair between 2010 and 2019 were identified (WC group). A control group was matched by age (±3 years), sex, and body mass index (BMI; ±3). Demographics …