Medicine and Health Sciences Commons^™

More Elevated Fastballs Associated With Placement On The Injured List Due To Shoulder Injury, Austin V. Stone, Brooks N. Platt, Brandon S. Collofello, Aaron D. Sciascia, Timothy L. Uhl, William B. Kibler

Orthopaedic Surgery and Sports Medicine Faculty Publications

Purpose

To evaluate whether impending shoulder injury was associated with changes in pitch location or velocity immediately preceding injury.

Methods

Pitchers placed on the injured list (IL) due to a shoulder injury between 2015 and 2020 were identified in the Major League Baseball transactions database. Four-seam fastball velocity and frequency of pitch location for each pitch type was collected for each player in the season before placement on the IL and within 1 month of placement on the IL with a minimum of 55 pitches thrown of 1 type. Pitch locations were collected as identified by Baseball Savant’s Game-Day Zones. …

Blood Flow Restriction Training After Patellar Instability (Brains Trial), Benjamin D. Brightwell, Austin V. Stone, Xiaojuan Li, Peter A. Hardy, Katherine L. Thompson, Brian W. Noehren, Cale A. Jacobs

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background

Patellar instability is a common and understudied condition that disproportionally affects athletes and military personnel. The rate of post-traumatic osteoarthritis that develops following a patellar dislocation can be up to 50% of individuals 5–15 years after injury. Conservative treatment is the standard of care for patellar instability however, there are no evidence-informed rehabilitation guidelines in the scientific literature. The purpose of this study is to assess the effectiveness of blood-flow restriction training (BFRT) for patellar instability. Our hypotheses are that this strategy will improve patient-reported outcomes and accelerate restoration of symmetric strength and knee biomechanics necessary to safely return …

Association Between Pitch Break On The 4-Seam Fastball And Slider And Shoulder Injury In Major League Baseball Pitchers: A Case-Control Study, Brooks N. Platt, Anthony J. Zacharias, Caitlin Conley, Lindsay Hockensmith, Nicholas Stockwell, Aaron Sciascia, Austin V. Stone

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: Few specific risk factors are known for shoulder injury in professional pitchers. New pitch-tracking data allow for risk stratification based on advanced metrics.

Purpose/Hypothesis: The purpose of this study was to determine the association between shoulder injury, pitch frequency, and pitch metrics (velocity, total break, break angle, and spin rate) for the 4-seam fastball, curveball, and slider. We hypothesized that more frequent use of the 4-seam fastball would be associated with shoulder injury.

Study Design: Case-control study; Level of evidence, 3.

Methods: The Major League Baseball (MLB) database was queried for pitchers who had been placed on the injury …

Understanding Barriers And Facilitators To Implementation Of Psychosocial Care Within Orthopedic Trauma Centers: A Qualitative Study With Multidisciplinary Stakeholders From Geographically Diverse Settings, Ana-Maria Vranceanu, Jafar Bakhshaie, Mira Reichman, James Doorley, Ryan A. Mace, Cale A. Jacobs, Mitchel Harris, Kristin R. Archer, David Ring, A. Rani Elwy

Orthopaedic Surgery and Sports Medicine Faculty Publications

BACKGROUND: Psychosocial factors are pivotal in recovery after acute orthopedic traumatic injuries. Addressing psychosocial factors is an important opportunity for preventing persistent pain and disability. We aim to identify barriers and facilitators to the implementation of psychosocial care within outpatient orthopedic trauma settings using the Consolidated Framework for Implementation Research (CFIR) and Proctor's taxonomy of implementation outcomes, and to provide implementation strategies derived from qualitative data and supplemented by the Expert Recommendations for Implementing Change.

METHODS: We conducted live video qualitative focus groups, exit interviews and individual interviews with stakeholders within 3 geographically diverse level 1 trauma settings (N …

Novel Cemented Technique For Trochanteric Fixation And Reconstruction Of The Abductor Mechanism In Proximal And Total Femoral Arthroplasty: An Observational Study, Brian T. Muffly, Kyle T. Boden, Cale A. Jacobs, Patrick W. O’Donnell, Stephen T. Duncan

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: Little evidence exists regarding the clinical outcomes of cemented trochanteric fixation for abductor mechanism reconstruction in proximal or total femoral replacements. Clinical outcomes were assessed for a novel cemented technique for trochanteric fixation in femoral megaprostheses.

Methods: A descriptive series of 13 patients who underwent proximal or total femoral arthroplasty from 2016 to 2019 were reviewed. Radiographic trochanteric displacement > 1 cm defined construct failure. A Kaplan-Meier survival analysis was performed to determine survival rates for these cemented constructs. Demographic information was obtained to better characterize the patient population in whom this technique was used.

Results: Eleven patients were …

Unicompartmental Knee Arthroplasty Is Associated With A Lower Rate Of Periprosthetic Joint Infection Compared To Total Knee Arthroplasty, Cody S. Lee, Edwin P. Su, Michael B. Cross, Alberto V. Carli, David C. Landy, Brian P. Chalmers

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: Several studies have reported lower perioperative complications with unicompartmental knee arthroplasty (UKA) than with total knee arthroplasty (TKA). However, there is a paucity of data analyzing the incidence of periprosthetic joint infection (PJI) in similar patients undergoing UKA and TKA. As such, we sought to analyze the incidence of UKA and TKA PJI in a large matched population.

Material and Methods: The Mariner data set of the PearlDiver database was queried for all patients undergoing UKA or TKA during 2010-2017. Included patients were required to have at least 2 years of database inclusion after surgery. Patients were then matched …

Making Sense Of Hip Preservation Procedural Coding--Getting Paid For Your Work!, Stephen T. Duncan, Brian T. Muffly, Anthony J. Zacharias, Cale A. Jacobs, Austin V. Stone

Orthopaedic Surgery and Sports Medicine Faculty Publications

Hip preservation and peri-trochanteric procedures are becoming more commonplace for the arthroplasty surgeon. Understanding the reimbursement for these procedures remains a challenge for those looking to expand this portion of their practice. In order to financially maximize the surgeon’s efforts, we present recommendations for hip preservation procedural coding.

Is Cooled Radiofrequency Genicular Nerve Block And Ablation A Viable Option For The Treatment Of Knee Osteoarthritis?, Andrew G. Carlone, Olivia F. Grothaus, Cale A. Jacobs, Stephen T. Duncan

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background

The purpose of this study was to determine demographic and psychosocial factors that influence the effectiveness of cooled radiofrequency genicular nerve ablation (C-RFA) and block in patients with chronic knee pain secondary to osteoarthritis (OA).

Methods

A retrospective review was completed including patients with knee OA who underwent genicular nerve ablation or block or both. Patient information collected included opioid use, psychological comorbidities, smoking history, body mass index, and medical comorbidities. Success was defined using the Osteoarthritis Research Society International criterion of greater than or equal to 50% reported pain relief from the procedure. Patients without a diagnosis of …

Development Of A Mind Body Program For Obese Knee Osteoarthritis Patients With Comorbid Depression, Cale A. Jacobs, Ryan A. Mace, Jonathan Greenberg, Paula J. Popok, Mira Reichman, Christian Lattermann, Jessica L. Burris, Eric A. Macklin, Ana-Maria Vranceanu

Orthopaedic Surgery and Sports Medicine Faculty Publications

Knee osteoarthritis (OA) is the most common joint disorder in the U.S. and a leading cause of disability. Depression and obesity are highly comorbid among knee OA patients, and the combination of obesity and depression is associated with decreased physical activity, higher pain and disability, and more rapid cartilage degradation. Depression, obesity and OA exacerbate one another and share a common pathophysiology involving systemic inflammation and pro-inflammatory cytokines, reflecting a complex mind-body interaction. Current treatments for knee OA offer little to no benefit over placebo, and do not emphasize mind-body practices or physical activity to target the underlying pathophysiology. Mind-body …

Thrower's Exostosis Of The Shoulder: A Systematic Review With A Novel Classification, Michael T. Freehill, Sandeep Mannava, Laurence D. Higgins, Alexandre Lädermann, Austin V. Stone

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: A variety of thrower's exostoses are grouped under the term Bennett lesion, which makes understanding diagnosis and treatment difficult.

Purpose: To identify all types of reported thrower's and overhead athlete's exostoses and categorize them into a classification system to allow a morphology-based classification.

Study Design: Systematic review; Level of evidence, 4.

Methods: A systematic review of all articles pertaining to Bennett lesions and thrower's exostosis was performed. The classification and treatments were evaluated to describe the types, proposed causes, diagnosis, and treatment options.

Results: A total of 27 studies were included in the systematic review. The anatomic locations …

Optimizing The Double-Row Construct: An Untied Medial Row Demonstrates Equivalent Mean Contact Pressures In A Rotator Cuff Model, Austin V. Stone, T. David Luo, Aman Sharma, Kerry A. Danelson, Michael De Gregorio, Michael T. Freehill

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: The merits of a double-row rotator cuff repair (RCR) construct are well-established for restoration of the footprint and lateral-row security. The theoretical benefit of leaving the medial row untied is to prevent damage to the rotator cuff by tissue strangulation, and the benefit of suture tape is a more even distribution of force across the repair site. These benefits, to our knowledge, have not been evaluated in the laboratory.

Hypothesis: Leaving the medial row untied and using a suture bridge technique with suture tape will offer more even pressure distribution across the repair site without compromising total contact force. …

The Antibacterial Effect Of Sonication And Its Potential Medical Application, Srinath Kamineni, Chifu B. Huang

Orthopaedic Surgery and Sports Medicine Faculty Publications

Introduction: Recent applications of ultrasonic probes include cataract removal and tennis elbow treatment. Early data support the use of ultrasonic probe debridement in the treatment of recalcitrant diabetic foot ulcers. No data are available concerning the potential antibacterial properties of the clinical grade, lower energy ultrasound probes. We investigated the effect of a clinically available ultrasonic debridement probe with respect to bacterial viability.

Methods: A commercially available Tenex sonication machine with a Tx1 probe was used for this study. Three bacterial strains, aerobic and anaerobic, were investigated, G-negative (Porphyromonas gingivalis) and G-positive bacteria (Staphylococcus aureus …

Aseptic Loosening Of An Aptis Distal Radioulnar Joint Arthroplasty – Case Report, Karis Bennett, Srinath Kamineni

Orthopaedic Surgery and Sports Medicine Faculty Publications

Dysfunction of the distal radioulnar joint can cause significant pain and instability. The self-stabilizing APTIS distal radioulnar joint prosthesis is used as a solution for severe distal radioulnar joint pathologies. We present a case of a 60-year-old male, who received an APTIS distal radioulnar joint prosthesis which resulted in aseptic loosening within five years of the initial implantation. Infection, incorrect implantation, demographic differences and over-activity were all excluded as the source; therefore, mechanical aseptic loosening was concluded. Ultimately, two surgeries were required to resolve the patient's pain, which resulted in a one-bone forearm once the implant was extracted. The solution …

Performance Of The Promis In Patients Undergoing 3 Common Elbow Procedures, Edward O. Rojas, Natalie Glass, Jessell Owens, Chris A. Anthony, Matthew Bollier, Brian R. Wolf, Carolyn Hettrich

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: Ulnar collateral ligament (UCL) reconstruction, distal biceps tendon repair, and elbow arthroscopic surgery are common elbow procedures performed in active patients.

Hypothesis: We hypothesized (1) good to excellent correlation between Patient-Reported Outcomes Measurement Information System (PROMIS) instruments and traditional orthopaedic upper extremity patient-reported outcome (PRO) measures; (2) that PROMIS instruments would demonstrate ceiling effects; and (3) that the PROMIS physical function computer adaptive test (PF CAT) would demonstrate a low question burden compared with other PRO instruments.

Study Design: Cohort study (diagnosis); Level of evidence, 2.

Methods: A total of 76 patients undergoing UCL repair/reconstruction, distal biceps tendon repair, …

Performance Of The Promis After Operative Interventions For Shoulder Instability, Christina J. Hajewski, Natalie A. Glass, Robert W. Westermann, Matthew Bollier, Brian R. Wolf, Carolyn Hettrich

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) was developed to capture patient-reported outcomes (PROs) in an efficient manner. Few studies have assessed this instrument postoperatively.

Purpose: To compare the PROMIS Physical Function computer adaptive test (PROMIS PF CAT) and Upper Extremity (PROMIS UE) item bank to other previously validated PRO instruments and to evaluate ceiling and floor effects and construct validity responsiveness in patients who underwent operative interventions for shoulder instability.

Study Design: Cohort study (diagnosis); Level of evidence, 2.

Methods: A total of 72 patients who underwent operative interventions for shoulder instability completed the American Shoulder and Elbow …

Extremely Low Testosterone Due To Relative Energy Deficiency In Sport: A Case Report, Ana Narla, Kimberly Kaiser, Lisa R. Tannock

Orthopaedic Surgery and Sports Medicine Faculty Publications

Objective: Recognize extremely low testosterone due to hypothalamic dysfunction from overtraining syndrome in a male athlete with relative energy deficiency in sport (RED-S).

Methods: Clinical and laboratory information are described.

Results: A 20-year-old male division I collegiate swimmer was found to have strikingly low total, free, and bioavailable testosterone levels with normal sex hormone–binding globulin and inappropriately normal follicle-stimulating hormone and luteinizing hormone. Lab testing ruled out hyperprolactinemia and hypothyroidism as etiologies, and pituitary imaging was normal. A diagnosis of RED-S was made, and the patient worked with the sports medicine team to increase nutrition and modify physical activity. His …

Results Of A Feasibility Randomized Controlled Trial (Rct) Of The Toolkit For Optimal Recovery (Tor): A Live Video Program To Prevent Chronic Pain In At-Risk Adults With Orthopedic Injuries, Ana-Maria Vranceanu, Cale A. Jacobs, Ann Lin, Jonathan Greenberg, Christopher J. Funes, Mitchel B. Harris, Marilyn M. Heng, Eric A. Macklin, David Ring

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: Orthopedic injuries are the leading cause of hospital admissions in the USA, and many of these patients transition into chronic pain. Currently, there are no evidence-based interventions targeting prevention of chronic pain in patients with orthopedic injuries. We iteratively developed a four-session intervention “The Toolkit for Optimal Recovery” (TOR) which we plan to subsequently test for efficacy in a phase III hybrid efficacy-effectiveness multi-site clinical trial. In order to prevent methodological weaknesses in the subsequent trial, we conducted a feasibility pilot to evaluate the TOR delivered via secure live video versus usual care (UC) in patients with orthopedic injuries …

Oral Contraceptive Pills Are Not A Risk Factor For Deep Vein Thrombosis Or Pulmonary Embolism After Arthroscopic Shoulder Surgery, Austin V. Stone, Avinesh Agarwalla, Anirudh K. Gowd, Cale A. Jacobs, Jeffrey A Macalena, Bryson P. Lesniak, Nikhil N. Verma, Anthony A. Romeo, Brian Forsythe

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: Worldwide, more than 100 million women between the ages of 15 and 49 years take oral contraceptive pills (OCPs). OCP use increases the risk of venous thromboembolism (VTE) through its primary drug, ethinylestradiol, which slows liver metabolism, promotes tissue retention, and ultimately favors fibrinolysis inhibition and thrombosis.

Purpose: To evaluate the effects of OCP use on VTE after arthroscopic shoulder surgery.

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

Methods: A large national payer database (PearlDiver) was queried for patients undergoing arthroscopic shoulder surgery. The incidence of VTE was evaluated in female patients taking OCPs and those not taking …

Femoroacetabular Impingement As A Complication Of Acetabular Fracture Fixation, David A. Zuelzer, Christopher B. Hayes, Raymond D. Wright, Stephen T. Duncan

Orthopaedic Surgery and Sports Medicine Faculty Publications

Case

We present the case of a thirteen-year-old female who sustained a posterior wall acetabular fracture dislocation. She underwent urgent closed reduction and subsequent uncomplicated open reduction and internal fixation. Post reduction computed tomography demonstrated a concentrically reduced hip joint with no evidence of femoroacetabular impingement (FAI). She subsequently healed her fracture and returned to running activities; however, one year later presented with aching pain in her thigh. Radiographs demonstrated the development of a large osseous prominence on her anterolateral femoral neck consistent with femoroacetabular impingement. Based on these findings she was evaluated by a hip preservation specialist. She subsequently …

Select Biomarkers On The Day Of Anterior Cruciate Ligament Reconstruction Predict Poor Patient-Reported Outcomes At 2-Year Follow-Up: A Pilot Study, Christian Lattermann, Caitlin E. -W. Conley, Darren L. Johnson, Emily K. Reinke, Laura J. Huston, Janet L. Huebner, Ching-Heng Chou, Virginia B. Kraus, Kurt P. Spindler, Cale A. Jacobs

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background. The majority of patients develop posttraumatic osteoarthritis within 15 years of anterior cruciate ligament (ACL) injury. Inflammatory and chondrodegenerative biomarkers have been associated with both pain and the progression of osteoarthritis; however, it remains unclear if preoperative biomarkers differ for patients with inferior postoperative outcomes. Hypothesis/Purpose. The purpose of this pilot study was to compare biomarkers collected on the day of ACL reconstruction between patients with "good" or "poor" 2-year postoperative outcomes. We hypothesized that inflammatory cytokines and chondrodegenerative biomarker concentrations would be significantly greater in patients with poorer outcomes. Study Design. Prospective cohort design. Methods. 22 …

Percutaneous Heel Cord Release For Clubfoot: A Retrospective, Multicentre Cost Analysis, B. Hedrick, F. K. Gettys, S. Richards, Ryan D. Muchow, C. -H. Jo, M. D. Abbott

Orthopaedic Surgery and Sports Medicine Faculty Publications

Purpose The Ponseti method of treatment is the standard of care for idiopathic clubfoot. Following serial casting, percutaneous tendo-Achilles tenotomy (TAT) is performed to correct residual equinus. This procedure can be performed in either the outpatient clinic or the operating room. The purpose of this study was to evaluate the expense of this procedure by examining hospital charges in both settings.

Methods We retrospectively reviewed charts of 382 idiopathic clubfoot patients with a mean age of 2.4 months (0.6 to 26.6) treated with the Ponseti method at three institutions. Patients were divided into three groups depending on the setting for …

Performance Of The Promis In Patients After Anterior Cruciate Ligament Reconstruction, Elizabeth J. Scott, Robert Westermann, Nathalie A. Glass, Carolyn Hettrich, Brian R. Wolf, Matthew J. Bollier

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) is designed to advance patient-reported outcome (PRO) instruments by utilizing question banks for major health domains.

Purpose: To compare the responsiveness and construct validity of the PROMIS physical function computer adaptive test (PF CAT) with current PRO instruments for patients before and up to 2 years after anterior cruciate ligament (ACL) reconstruction.

Study Design: Cohort study (diagnosis); Level of evidence, 2.

Methods: Initially, 157 patients completed the PROMIS PF CAT, Short Form-36 Health Survey (SF-36 physical function [PF] and general health [GH]), Marx Activity Rating Scale (MARS), Knee injury and Osteoarthritis Outcome …

Posterior Interosseous Nerve Localization Within The Proximal Forearm - A Patient Normalized Parameter, Srinath Kamineni, Crystal R. Norgren, Evan M. Davidson, Ellora P. Kamineni, Andrew S. Deane

Orthopaedic Surgery and Sports Medicine Faculty Publications

AIM

To provide a "patient-normalized" parameter in the proximal forearm.

METHODS

Sixty-three cadaveric upper extremities from thirty-five cadavers were studied. A muscle splitting approach was utilized to locate the posterior interosseous nerve (PIN) at the point where it emerges from beneath the supinator. The supinator was carefully incised to expose the midpoint length of the nerve as it passes into the forearm while preserving the associated fascial connections, thereby preserving the relationship of the nerve with the muscle. We measured the transepicondylar distance (TED), PIN distance in the forearm's neutral rotation position, pronation position, supination position, and the nerve width. …

Anatomic Femoral And Tibial Tunnel Placement During Anterior Cruciate Ligament Reconstruction: Anteromedial Portal All-Inside And Outside-In Techniques, Jeremy M. Burnham, Chaitu S. Malempati, Aaron Carpiaux, Mary Lloyd Ireland, Darren L. Johnson

Orthopaedic Surgery and Sports Medicine Faculty Publications

Tunnel malposition is one of the most common technical reasons for anterior cruciate ligament reconstruction failure. Small changes in tunnel placement can result in significant differences in outcome. More anatomic placement of the tunnels can lead to greater knee stability and a more accurate reproduction of native knee kinematics. This Technical Note describes 2 tibial tunnel–independent methods to obtain anatomic femoral tunnel placement. The all-inside anteromedial portal technique requires only minimal surgical incisions but allows precise femoral tunnel placement. However, hyperflexion of the knee is required, adequate surgical assistance is necessary, and this technique may be susceptible to graft-tunnel mismatch. …

Technical Considerations In Revision Anterior Cruciate Ligament Reconstruction For Operative Techniques In Orthopaedics, Jeremy M. Burnham, Elmar Herbst, Thierry Pauyo, Thomas Pfeiffer, Darren L. Johnson, Freddie H. Fu, Volker Musahl

Orthopaedic Surgery and Sports Medicine Faculty Publications

As the incidence of anterior cruciate ligament (ACL) reconstruction continues to increase, the rate of revision surgery continues to climb. Revision surgery has inherent challenges that must be addressed to achieve successful results. The cause of the primary ACL reconstruction failure should be determined and careful preoperative planning should be performed to address the cause(s) of failure. Each patient undergoing revision surgery should undergo a thorough history and physical examination, receive full-length alignment radiographs, lateral radiographs, 45° flexion weight-bearing posteroanterior radiographs, and patellofemoral radiographs. The 3-dimensional computed tomography scan should be performed to assess tunnel position and widening. Magnetic resonance …

Youth Football Injuries: A Prospective Cohort, Andrew R. Peterson, Adam J. Kruse, Scott M. Meester, Tyler S. Olson, Benjamin N. Riedle, Tyler G. Slayman, Todd J. Domeyer, Joseph E. Cavanaugh, M. Kyle Smoot

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: There are approximately 2.8 million youth football players between the ages of 7 and 14 years in the United States. Rates of injury in this population are poorly described. Recent studies have reported injury rates between 2.3% and 30.4% per season and between 8.5 and 43 per 1000 exposures.

Hypothesis: Youth flag football has a lower injury rate than youth tackle football. The concussion rates in flag football are lower than in tackle football.

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

Methods: Three large youth (grades 2-7) football leagues with a total of 3794 players were enrolled. Research …

Early Detection Of Idiopathic Scoliosis In Adolescents, M. Timothry Hresko, Vishwas Talwalkar, Richard Schwend

Orthopaedic Surgery and Sports Medicine Faculty Publications

The early detection of idiopathic scoliosis has been advocated since the 1950s and ’60s, concurrent with the development in the modern era of ambulatory spinal orthoses to treat scoliosis in adolescents. This led to the development of screening programs for specific populations, as evidenced by school screening programs in the United States and public health systems in Europe and Asia. Over time, the value of population screening in terms of optimal health care and economics has been debated in the popular press, by the U.S. Preventive Services Task Force, and by professional societies. Recent studies on the effectiveness of bracing …

Distal Insertional Footprint Of The Brachialis Muscle: 3d Morphometric Study, Srinath Kamineni, Abdo Bachoura, William Behrens, Ellora Kamineni, Andrew Deane

Orthopaedic Surgery and Sports Medicine Faculty Publications

Objective. The purpose of this study is to describe the three-dimensional morphometry of the brachialis muscle at its distal attachment to the ulna. Methods. Fifty cadaveric elbows were dissected and the brachialis distal insertion was isolated on the ulna bone and probed with a three-dimensional digitizer, to create a three-dimensional model of the footprint. Measurements and analysis of each footprint shape were recorded and compared based on gender and size. Results. There was significant gender difference in the surface length (P = 0.002) and projected length (P = 0.001) of the brachialis footprint. The shapes …

Inner Synovial Membrane Footprint Of The Anterior Elbow Capsule: An Arthroscopic Boundary, Srinath Kamineni, Abdo Bachoura, Koichi Sasaki, Danielle Reilly, Kate N. Harris, Anthony Sinai, Andrew Deane

Orthopaedic Surgery and Sports Medicine Faculty Publications

Introduction. The purpose of this study is to describe the inner synovial membrane (SM) of the anterior elbow capsule, both qualitatively and quantitatively. Materials and Methods. Twenty-two cadaveric human elbows were dissected and the distal humerus and SM attachments were digitized using a digitizer. The transepicondylar line (TEL) was used as the primary descriptor of various landmarks. The distance between the medial epicondyle and medial SM edge, SM apex overlying the coronoid fossa, the central SM nadir, and the apex of the SM insertion overlying the radial fossa and distance from the lateral epicondyle to lateral SM edge along the …

Percutaneous Ultrasonic Debridement Of Tendinopathy—A Pilot Achilles Rabbit Model, Srinath Kamineni, Timothy Butterfield, Anthony Sinai

Orthopaedic Surgery and Sports Medicine Faculty Publications

BACKGROUND: Tendinopathy is a common clinical pathology, with mixed treatment results, especially when chronic. In this study, we examine the effects of an ultrasonic debridement modality in a rabbit tendinopathy model. We asked four questions: (1) Was it possible to create and visualize with ultrasound a tendinopathy lesion in a rabbit Achilles tendon? (2) Was it possible to guide a 19-gauge ultrasonic probe into the tendinopathy lesion? (3) Following ultrasonic treatment, was tendinopathy debris histologically present? and (4) Was the collagen profile qualitatively and quantitatively normalized following treatment?

METHODS: Skeletally mature female New Zealand white rabbits (n = 12) …