Medicine and Health Sciences Commons^™

The Impact Of Confirmed Coronavirus Disease 2019 (Covid-19) Infection On Ambulatory Procedures And Associated Delays In Care For Asymptomatic Patients, C. G. Larsen, C. D. Bub, B. C. Schaffler, T. Walden, J. M. Intravia

Journal Articles

© 2021 Elsevier Inc. Background: Since the reopening of ambulatory centers, minimal data has been reported regarding positive tests among patients undergoing ambulatory procedures, associated delays in care, and outcomes of patients previously positive for coronavirus disease 2019. Methods: A retrospective observational case series of ambulatory procedures was performed. Records since the reopening of ambulatory centers in New York were searched for patients with positive coronavirus disease 2019 nasal swab results who underwent ambulatory procedures. Chart reviews were conducted to determine coronavirus disease history and hospitalizations, demographic information, procedure details, and 30-day admissions. Results: A total of 3,762 patients underwent …

Educating Surgeons To Educate Patients About The Covid-19 Pandemic, A Saxena, M Bullock, Jr Danoff, Ds Rodd, Sj Fischer, Bm Stronach, Br Levine

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No abstract provided.

Arthroplasty During The Covid-19 Pandemic, T North, Mw Bullock, Jr Danoff, A Saxena, Sj Fischer, Bm Stronach, Br Levine

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No abstract provided.

Impact Of Covid - 19 Pandemic On Orthopaedics At Northwell Health, New York., B. Petrone, C. Iturriaga, T. Mauri, N. Sgaglione

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The Novel Coronavirus (COVID-19) pandemicplaced an immense strain on healthcare systems and orthopedic surgeons across the world. To limit the spread, federal and state governments mandated the cancellation of all non-urgent surgical cases to address surging hospital admissions and manage workforce and resource reallocation. During the pandemic surge, thousands of surgical cancellations have been required. We outline our experience through the onset and advance of the surge, detail our incident response, and discuss the transition toward recovery.

The Ethics Of Treating Acute Achilles Tendon Ruptures During The Covid-19 Pandemic: A Case Report, P. B. White, M. J. Partan, R. M. Cohn, C. J. Humbyrd, G. Katsigiorgis, A. Bitterman

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No abstract provided.

Covid-19 And Orthopaedics: Recovery After The Pandemic Surge., B. Petrone, C. R. Iturriaga, T. Mauri, N. Sgaglione

Journal Articles

The novel Coronavirus (COVID-19) pandemic has placed an immense strain on health care systems and orthopedic surgeons across the world. To limit the spread, federal and state governments mandated the cancellation of all nonurgent surgical cases to address surging hospital admissions and manage workforce and resource reallocation. During the pandemic surge, thousands of surgical cancellations have been required. We outline our experience through the onset and advance of the surge, detail our incident response and discuss the transition toward recovery. Level of Evidence: Level V.

Resumption Of Elective Orthopaedic Surgery In The Us Epicenter Of Covid-19, E. S. Krauss, A. Segal, D. Schulman, N. Dengler, T. Bily, M. Cronin, K. Altner

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© 2020 Krauss et al. On March 1, 2020, New York State confirmed its first case of COVID-19. This state has had the largest initial mortality in the United States with more than 479,000 confirmed cases and over 25,000 deaths as of October 10, 2020. All elective surgeries in New York State were suspended on March 23, 2020, due to the national state of emergency. Syosset Hospital is a 75-bed community hospital dedicated primarily to elective surgery. During the COVID-19 surge, the hospital was converted to provide needed beds for the treatment of COVID-19 illness. In anticipation of the resumption …

Association Of Disposable Perioperative Jackets With Surgical Site Infections In A Large Multicenter Health Care Organization, E. J. Stapleton, N. Frane, J. M. Lentz, D. Armellino, N. Kohn, R. Linton, A. D. Bitterman

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No abstract provided.

Interaction Between Low-Dose Aspirin And Nonsteroidal Anti-Inflammatory Drugs Can Compromise Aspirin's Efficacy In Preventing Venous Thrombosis Following Total Joint Arthroplasty, E. Krauss, M. Cronin, N. Dengler, A. Segal

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No abstract provided.

5-Aminolevulinic Acid Tumor Paint And Photodynamic Therapy For Myxofibrosarcoma: An In Vitro Study, S. Kenan, H. Liang, H. J. Goodman, A. J. Jacobs, A. Chan, D. A. Grande, A. S. Levin

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No abstract provided.

Lessons Learned: Using The Caprini Risk Assessment Model To Provide Safe And Efficacious Thromboprophylaxis Following Hip And Knee Arthroplasty, E. S. Krauss, M. A. Cronin, N. Dengler, B. G. Simonson, P. Enker, A. Segal

Journal Articles

© The Author(s) 2020. Two of the more common potential complications after arthroplasty are venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolus (PE), and excess bleeding. Appropriate chemoprophylaxis choices are essential to prevent some of these adverse events and from exacerbating others. Risk stratification to prescribe safe and effective medications in the prevention of postoperative VTE has shown benefit in this regard. The Department of Orthopaedic Surgery at Syosset Hospital/Northwell Health, which performs over 1200 arthroplasties annually, has validated and is using the 2013 version of the Caprini Risk Assessment Model (RAM) to stratify each patient …

Predicting Elective Orthopaedic Sports Medicine Surgical Cancellations Based On Patient Demographics., B. Petrone, J. Fakhoury, P. Matai, A. Bitterman, R. M. Cohn, L. Lutsky

Journal Articles

Purpose:To evaluate whether patient demographics are associated with cancellation of elective orthopaedic sports medicine surgical procedures. Methods:We retrospectively reviewed the electronic medical records of 761 patients who were scheduled to undergo an elective sports medicine orthopaedic operation from January 1, 2015, to December 31, 2017. The patients were divided into 2 groups: those who underwent the scheduled procedure (group A) and those in whom the operation was canceled for any reason prior to the surgical date and not rescheduled (group B). Univariate analysis assessed patient factors consisting of age, sex, race, language, marital status, occupation status, type of insurance (Medicaid …

A 6-Year Trends Analysis Of Infections After Revision Total Hip Arthroplasty, P. A. Gold, L. J. Garbarino, N. Sodhi, H. K. Anis, J. O. Ehiorobo, S. M. Kurtz, J. R. Danoff, V. J. Rasquinha, C. A. Higuera, M. A. Mont

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No abstract provided.

A Nationwide Comparative Analysis Of Medical Complications In Fibromyalgia Patients Following Total Knee Arthroplasty, T. Moore, N. Sodhi, A. Kalsi, R. M. Vakharia, J. O. Ehiorobo, H. K. Anis, K. Dushaj, V. Papas, G. Scuderi, M. A. Mont, +2 Additional Authors

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No abstract provided.

The Effect Of Operative Time On In-Hospital Length Of Stay In Revision Total Knee Arthroplasty, L. J. Garbarino, P. A. Gold, N. Sodhi, H. K. Anis, J. O. Ehiorobo, S. Boraiah, J. R. Danoff, V. J. Rasquinha, C. A. Higuera-Rueda, M. A. Mont

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No abstract provided.

Impact Of A Resident-Guided Rounding Initiative On The Hospital Consumer Assessment Of Healthcare Providers And Systems Survey Scores In Orthopaedic Surgery Inpatients., E. Stapleton, N. Frane, J. Lentz, K. Yngstrom, C. Healy, R. Cohn, G. Katsigiorgis

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No abstract provided.

Implementation And Validation Of The 2013 Caprini Score For Risk Stratification Of Arthroplasty Patients In The Prevention Of Venous Thrombosis, E. S. Krauss, A. Segal, M. A. Cronin, N. Dengler, M. L. Lesser, S. Ahn, J. A. Caprini

Journal Articles

© The Author(s) 2019. Appropriate chemoprophylaxis choice following arthroplasty requires accurate patient risk assessment. We compared the results of our prospective department protocol to the Caprini risk assessment model (RAM) retrospectively in this study group. Our goal was to determine whether the department protocol or the Caprini score would identify venous thromboembolism (VTE) events after total joint replacement. A secondary purpose was to validate the 2013 Caprini RAM in joint arthroplasty and determine whether patients with VTE would be accurately identified using the Caprini score. A total of 1078 patients met inclusion criteria. A Caprini score of 10 or greater …

Cost-Effectiveness Analysis Of Needle Arthroscopy Versus Magnetic Resonance Imaging In The Diagnosis And Treatment Of Meniscal Tears Of The Knee, N. Amin, L. Mcintyre, T. Carter, J. Xerogeanes, J. Voigt

Journal Articles

© 2019 The Authors Purpose: To determine whether needle arthroscopy (NA) compared with magnetic resonance imaging (MRI) in the diagnosis and treatment of meniscal tears is cost-effective when evaluated over a 2-year period via patient-reported outcomes. The hypothesis is that improved diagnostic accuracy with NA would lead to less costly care and similar outcomes. Methods: A Markov model/decision tree analysis was performed using TreeAge Pro 2017 software. Patients were evaluated for degenerative and traumatic damage to the lateral/medial meniscus. Assumed sensitivities and specificities were derived from the medical literature. The direct costs for care were derived from the 2017 Medicare …

Optimum Anatomic Socket Position And Sizing For The Direct Anterior Approach: Impingement And Instability, N. Mercer, E. Hawkins, L. Menken, A. Deshmukh, P. Rathod, J. A. Rodriguez

Journal Articles

© 2019 A comprehensive strategy is important for ensuring reproducible and safe acetabular component sizing and positioning. Presented here is our approach for anatomic acetabular component positioning in direct anterior total hip arthroplasty. This strategy has evolved with our understanding of the ramifications of socket sizing and positioning on instability and impingement. Data collected by a single surgeon (J.A.R.) between 2009 and 2011 influenced our current paradigm. We compare the sizing and positioning parameters of the anterior and posterior approach, thus demonstrating how the 2 are different. By highlighting these differences, we hope to provide a clear, defined approach to …

Quantifying The Impact Of Patient-Specific Factors And Disease Severity On Clinical Decision Making In Cuff Tear Arthropathy: A Case-Based Survey, A. P. Schumaier, Y. H. Bedeir, J. S. Dines, K. Kenter, L. V. Gulotta, D. M. Dines, B. M. Grawe

Journal Articles

© 2019, The Author(s). Background: Rotator cuff tears are a common cause of disability. Some patients with massive and irreparable tears can develop cuff tear arthropathy (CTA), which makes management more challenging. Questions/Purposes: We sought to examine how orthopedists determine treatment for patients with CTA. Specifically, we investigated (1) the effect of patient age, symptoms, activity level, range of motion, and radiographic findings on the decision making of shoulder specialists and (2) the observer reliability of the Seebauer and Hamada grading systems. Methods: Five shoulder surgeons were each sent 108 simulated patient cases. Each simulated patient had a different combination …

Full-Body Radiographic Analysis Of Postoperative Deviations From Age-Adjusted Alignment Goals In Adult Spinal Deformity Correction And Related Compensatory Recruitment., P. G. Passias, C. M. Jalai, B. G. Diebo, D. L. Cruz, G. W. Poorman, A. J. Buckland, L. M. Day, J. H. Oren, T. J. Errico, V. Lafage, +8 Additional Authors

Journal Articles

Background: Full-body stereographs for adult spinal deformity (ASD) have enhanced global deformity and lower-limb compensation associations. The advent of age-adjusted goals for classic ASD parameters (sagittal vertical axis, pelvic tilt, spino-pelvic mismatch [PI-LL]) has enabled individualized evaluation of successful versus failed realignment, though these remain to be radiographically assessed postoperatively. This study analyzes pre- and postoperative sagittal alignment to quantify patient-specific correction against age-adjusted goals, and presents differences in compensation in patients whose postoperative profile deviates from targets.

Methods: Single-center retrospective review of ASD patients ≥ 18 years with biplanar full-body stereographic x-rays. Inclusion: ≥ 4 levels fused, complete baseline …

Periarticular Injection And Continuous Femoral Nerve Block Versus Continuous Femoral Nerve Block Alone On Postoperative Opioid Consumption And Pain Control Following Total Knee Arthroplasty: Randomized Controlled Trial, D. Dimaculangan, J. F. Chen, R. B. Borzio, J. J. Jauregui, V. J. Rasquinha, A. V. Maheshwari

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© 2017 Continuous femoral nerve block (CFNB) has been used to prevent the breakthrough pain after total knee arthroplasty (TKA). Multimodal drug injection (PMDI) has also been shown to decrease opioid consumption and pain. We investigated whether the use of PMDI further improves analgesic and rehabilitation outcomes when used in conjunction with CFNB. This is a prospective randomized controlled study of 44 patients undergoing primary TKA. The treatment group (n = 23) received a PMDI of combined ropivacaine, epinephrine, ketorolac and morphine, and the controlled group (n = 21) received saline at wound closure. Total opioid consumption, pain scores, knee …

Arthroscopic Wrist Debridement And Radial Styloidectomy For Advanced Scapholunate Advanced Collapse Wrist: Long-Term Follow-Up, P. C. Noback, M. Seetharaman, J. R. Danoff, M. Birman, M. P. Rosenwasser

Journal Articles

© The Author(s) 2017. Background: Symptomatic stage 2 or 3 scapholunate advanced collapse (SLAC) wrist is aggressively treated with salvage procedures, such as proximal row carpectomy or partial wrist fusion with resultant pain relief but limited motion. We hypothesize that arthroscopic synovectomy, radial styloidectomy, and neurectomy will preserve wrist motion, relieve pain, and delay or avoid salvage procedures. Methods: We evaluated outcomes in 13 wrists through questionnaires and 11 of these through additional physical examination at a mean follow-up of 5.0 years. Eight wrists were stage 2 and 5 were stage 3. Data at final follow-up included mobility/strength measurements, subjective …

Epidemiology Of Injuries In Tennis Players, M. C. Fu, T. S. Ellenbecker, P. A. Renstrom, G. S. Windler, D. M. Dines

Journal Articles

© 2018, Springer Science+Business Media, LLC, part of Springer Nature. Purpose of review: To review the recent literature regarding the epidemiology of tennis injuries at all levels of play, and to discuss recent findings in injury surveillance by the Association of Tennis Professionals (ATP). Recent findings: Following the release of a consensus statement in 2009 calling for standardized documentation and analysis of tennis-related injuries, multiple studies have been published describing longitudinal injury incidences at Grand Slam tournaments and the Davis Cup. Recent efforts by the ATP have further elucidated injury patterns on tour. There have also been recent high-quality studies …

Revision Total Shoulder Arthroplasty Is Associated With Increased Thirty-Day Postoperative Complications And Wound Infections Relative To Primary Total Shoulder Arthroplasty, V. Boddapati, M. C. Fu, W. W. Schairer, L. V. Gulotta, D. M. Dines, J. S. Dines

Journal Articles

© 2017, Hospital for Special Surgery. Background: With an increasing volume of primary total shoulder arthroplasties (TSA), the number of revision TSA cases is expected to increase as well. However, the postoperative medical morbidity of revision TSA has not been clearly described. Questions/Purposes: The purpose of this study was to determine the rate of postoperative complications following revision TSA, relative to primary TSA. In addition, we sought to identify independent predictors of complications, as well as to compare operative time and postoperative length of stay between primary and revision TSA. Methods: Patients who underwent primary/revision TSA between 2005 and 2015 …

Septic Arthritis After Anterior Cruciate Ligament Reconstruction: Clinical And Functional Outcomes Based On Graft Retention Or Removal, B. R. Waterman, W. Arroyo, E. J. Cotter, M. A. Zacchilli, E. S. Garcia, B. D. Owens

Journal Articles

© 2018, © The Author(s) 2018. Background: There remains a debate over whether to retain the index anterior cruciate ligament (ACL) graft in the setting of septic arthritis. Purpose: To evaluate and compare clinical outcomes for the treatment of septic arthritis after ACL reconstruction (ACLR) in those with and without early graft retention. Study Design: Case series; Level of evidence, 4. Methods: The Military Health System was queried for all ACLR procedures performed between 2007 and 2013. Inclusion criteria required active military status, primary ACLR with secondary septic arthritis, and minimum 24-month surveillance. Demographic, clinical, and surgical variables were evaluated …

Long Head Of Biceps Tendon Management: A Survey Of The American Shoulder And Elbow Surgeons, K. T. Corpus, G. H. Garcia, J. N. Liu, D. M. Dines, S. J. O’Brien, J. S. Dines, S. A. Taylor

Journal Articles

© 2017, Hospital for Special Surgery. Background:: Management of symptomatic long head of biceps tendon (LHBT) pathology remains a source of debate. Questions/Purposes:: The purpose of this study was to identify consensus trends for the treatment of LHBT pathology among specialists. Methods:: A survey was distributed to members of the American Shoulder and Elbow Society (ASES), consisting of three sections—demographics, case scenarios, and general LHBT pathology management. Cases presented common clinical scenarios, and surgeons reported their management preferences. Consensus responses were defined as > 50% of participants giving a single response. Results:: One hundred and forty-two of 417 (34%) surgeons completed …

Arthroscopic Knotless Rotator Cuff Repair: Factors Associated With Construct Selection And Recent Trends From A Manual Review Of 1617 Cases, S. S. Shah, A. Shah, V. Chadayammuri, M. Mcgill, N. Wei, D. V. Tuckman, N. A. Sgaglione

Journal Articles

© 2018 Prof. PK Surendran Memorial Education Foundation Purpose: Our aim was to identify predictors of construct selection and recent trends for arthroscopic knotless rotator cuff repair (RCR). Methods: A manual review of 1617 operative reports was performed. Results: A medium-sized tear had a threefold increase in odds of single row (SR) knotless repair (OR, 6.91; p = 0.009) versus SR knotted (OR, 3.05; p = 0.003). Generalist orthopaedic surgeons were 79% less likely to perform SR knotless repairs versus sports medicine trained specialists (p < 0.001). Conclusion: There was a significant increase from 2009 to 2016 in SR knotless and double row medial row knotless constructs contrasting the declining use of the SR knotted technique.

Can Weakness In End-Range Plantar Flexion After Achilles Tendon Repair Be Prevented?, K. F. Orishimo, S. Schwartz-Balle, T. F. Tyler, M. P. Mchugh, B. B. Bedford, S. J. Lee, S. J. Nicholas

Journal Articles

Background: Disproportionate end-range plantar flexion weakness, decreased passive stiffness, and inability to perform a heel rise on a decline after Achilles tendon repair are thought to reflect increased tendon compliance or tendon lengthening. Since this was first noted, we have performed stronger repairs and avoided stretching into dorsiflexion for the first 12 weeks after surgery.

Hypothesis: Using stronger repairs and avoiding stretching into dorsiflexion would eliminate end-range plantar flexion weakness and normalize passive stiffness.

Study Design: Case series; Level of evidence, 4.

Methods: Achilles repairs with epitendinous augmentation were performed on 18 patients. Plantar flexion torque, dorsiflexion range of motion …

Tranexamic Acid Increases Early Perioperative Functional Outcomes After Total Knee Arthroplasty., M. J. Grosso, D. P. Trofa, J. R. Danoff, T. R. Hickernell, T. Murtaugh, A. Lakra, J. A. Geller

Journal Articles

Background: The purpose of this study was to investigate the influence of tranexamic acid (TXA) on functional outcomes in the immediate postoperative period after total knee arthroplasty (TKA). We hypothesized that the known benefits of TXA would confer measurable clinical improvements in physical therapy (PT) performance, decrease pain, and decrease hospital length of stay (LOS).

Methods: We retrospectively analyzed 560 TKA patients, including 280 consecutive patients whose surgery was performed before the initiation of a standardized TXA protocol and the first 280 patients who received TXA after protocol initiation. Outcome measurements included postoperative changes in hemoglobin and hematocrit, LOS, pain …