Medicine and Health Sciences Commons^™

Orthopass: Long-Term Outcomes Following Implementation Of An Orthopaedic Patient Handoff Template., Harry Lightsey, Caleb Yeung, Laura Rossi, Antonia Chen, Mitchel Harris, Derek Stenquist

Rothman Institute Faculty Papers

Standardized handoff tools improve communication and patient care; however, their widespread use in surgical fields is lacking. OrthoPass, an orthopaedic adaptation of I-PASS, was developed in 2019 to address handoff concerns and demonstrated sustained improvements across multiple handoff domains over an 18-month period. We sought to characterize the longitudinal effect and sustainability of OrthoPass within a single large residency program 3.5 years after its implementation. This mixed methods study involved electronic handoff review for quality domains in addition to survey distribution and evaluation. We conducted comparative analyses of handoff adherence and survey questions as well as a thematic analysis of …

Venous Thromboembolism In Orthopedic Surgery: Global Guidelines, Kadir Uzel, İbrahim Azboy, Javad Parvizi

Rothman Institute Faculty Papers

Venous thromboembolism (VTE) is a severe complication that can occur after major orthopedic procedures. As VTE-related morbidity and mortality are a significant concern for both medical professionals and patients, and preventative measures are typically employed. Multiple organizations, including the American College of Chest Physicians (ACCP) and the American Academy of Orthopedic Surgeons (AAOS), have developed guidelines for VTE prophylaxis specifically in patients undergoing joint replacement procedures. However, recently, the International Consensus Meeting (ICM) was convened, which brought together over 600 experts from 68 countries and 135 international societies. These experts, spanning a range of medical disciplines including orthopedic surgery, anesthesia, …

The Diagnostic Process Of Spinal Post-Traumatic Deformity: An Expert Survey Of 7 Cases, Consensus On Clinical Relevance Does Exist, Erin E.A. De Gendt, Lori M. Benneker, Andrei F. Joaquim, Mohammad El-Sharkawi, Gaurav R. Dhakal, Frank Kandziora, Jin Tee, Richard J. Bransford, Emiliano N. Vialle, Alexander R. Vaccaro, Eugen C. Popescu, Rishi M. Kanna, David W. Polly, Klaus J. Schnake, Pedro Berjano, Sergey Ryabykh, Marko Neva, Claudio Lamartina, Dominique A Rothenfluh, Stephan J. Lewis, Sander. P.J Muijs, F. Cumhur Oner

Rothman Institute Faculty Papers

STUDY DESIGN: Survey of cases.

OBJECTIVE: To evaluate the opinion of experts in the diagnostic process of clinically relevant Spinal Post-traumatic Deformity (SPTD).

SUMMARY OF BACKGROUND DATA: SPTD is a potential complication of spine trauma that can cause decreased function and quality of life impairment. The question of when SPTD becomes clinically relevant is yet to be resolved.

METHODS: The survey of 7 cases was sent to 31 experts. The case presentation was medical history, diagnostic assessment, evaluation of diagnostic assessment, diagnosis, and treatment options. Means, ranges, percentages of participants, and descriptive statistics were calculated.

RESULTS: Seventeen spinal surgeons reviewed …

Anterior Shoulder Instability And Open Procedures: History, Indications, And Clinical Outcomes, Mohamad Y. Fares, Peter Boufadel, Mohammad Daher, Jonathan Koa, Akshay Khanna, Joseph A. Abboud

Rothman Institute Faculty Papers

The shoulder, being the most mobile joint in the human body, is often susceptible to dislocations and subluxations more so than other joints. As such, shoulder instability constitutes a common complaint among patients worldwide, especially those who are young, participate in contact sports, and have increased innate flexibility in their joints. Management options in the setting of instability vary between conservative and surgical options that aim to mitigate symptoms and allow return of function. Surgical options can be arthroscopic and open, with a general shift among surgeons towards utilizing arthroscopic surgery in the past several decades. Nevertheless, open procedures still …

Validation Of The Hierarchical Nature Of The Ao Spine Sacral Classification And The Development Of The Sacral Ao Spine Injury Score, Brian A. Karamian, Gregory D. Schroeder, Mark J. Lambrechts, Jose A. Canseco, Emiliano N. Vialle, Frank Kandziora, Lorin M. Benneker, Rajasekaran Shanmuganathan, F. Cumhur Öner, Klaus J. Schnake, Christopher K. Kepler, Alexander R. Vaccaro

Rothman Institute Faculty Papers

STUDY DESIGN: Global cross-sectional survey.

OBJECTIVE: The objective of this study was to validate the hierarchical nature of the AO Spine Sacral Classification System and develop an injury scoring system.

SUMMARY OF BACKGROUND DATA: Although substantial interobserver and intraobserver reliability of the AO Spine Sacral Classification System has been established, the hierarchical nature of the classification has yet to be validated.

METHODS: Respondents numerically graded each variable within the classification system for severity. Based on the results, a Sacral AO Spine Injury Score (AOSIS) was developed.

RESULTS: A total of 142 responses were received. The classification exhibited a hierarchical Injury …

Bibliometric Analysis Of Spinopelvic Alignment In Total Hip Arthroplasty, Samantha Harrer, Justin A. Magnuson, Gregory R. Toci, Andrew M. Star, Arjun Saxena

Rothman Institute Faculty Papers

INTRODUCTION: Postoperative dislocation of unclear etiology remains a concern after total hip arthroplasty (THA). Interest is growing in the importance of spinopelvic alignment on stability in THA. The purpose of this study was to analyze publication trends, areas of interest, and future research direction of spinopelvic alignment in THA.

METHODS: Articles on the topic of spinopelvic alignment in THA published between 1990 and 2022 were obtained through Web of Science Core Collection of Clarivate Analytics (WSCCA). Results were screened by title, abstract, and full text. The inclusion criterion was English-language peer-reviewed journal publications on the clinical topic of spinopelvic alignment …

Treatment Of Angular Deformity And Limb Length Discrepancy With A Retrograde Femur Magnetic Intramedullary Nail: A Fixator-Assisted, Blocking Screw Technique, Erik J. Geiger, Adam D Geffner, S Robert Rozbruch, Austin T Fragomen

Rothman Institute Faculty Papers

Background: Fixator-assisted nailing techniques that incorporate magnetic internal lengthening nails (MILNs) permit acute deformity correction and then gradual limb lengthening without needing postoperative external fixators.

Purposes: We sought to investigate the safety and accuracy of a fixator-assisted, blocking screw technique using retrograde MILNs for the correction of LLD and limb malalignment.

Methods: Forty-one patients (13 patients with genu varum and 28 patients with genu valgum) with LLD treated with fixator-assisted, blocking screw retrograde MILN reconstruction were included. Preoperative LLD, mechanical axis deviation, and joint orientation angles were compared with values at the end of treatment, and bone healing indices were …

Direct Anterior Versus Direct Lateral Hip Approach In Total Hip Arthroplasty With The Same Perioperative Protocols One Year Post Fellowship Training, Asim M. Makhdom, William J. Hozack

Rothman Institute Faculty Papers

BACKGROUND: Variable results have been reported regarding the clinical outcomes in Total hip arthroplasty (THA) based on the surgical approach. The aim of this study is to compare the clinical outcomes between Direct anterior (DA) and direct lateral (DL) approaches in THA when performed immediately after fellowship training.

METHODS: During the 1st year of practice, all consecutive patients who underwent THA via DA and DL hip approaches were retrospectively investigated. Patients' demographics, diagnosis, American society of Anesthesiology (ASA) score, route of anesthesia, length of hospital stay (LOS), leg length discrepancy (LLD), radiographic parameters, operative time, number of opioids refills postoperatively, …

Nationwide Results Of Microorganism Antigen Testing As A Component Of Preoperative Synovial Fluid Analysis., Krista O'Shaughnessey Toler, Pearl Ravindra Paranjape, Alex Mclaren, Brett Levine, Alvin Ong, Carl Deirmengian

Rothman Institute Faculty Papers

BACKGROUND: Antigen immunoassays to detect synovial fluid (SF) microorganisms have recently been made available for clinical use. The purpose of this study was to determine the sensitivity and specificity of an SF microorganism antigen immunoassay detection (MID) panel, evaluate the panel's capability to detect microorganisms in the setting of culture-negative periprosthetic joint infection (PJI), and determine diagnostic predictive values of the MID panel for PJI.

METHODS: This study included 67,441 SF samples obtained from a hip or knee arthroplasty, from 2,365 institutions across the United States, submitted to 1 laboratory for diagnostic testing. All data were prospectively compiled and then …

Surgeon Estimations Of Acetabular Cup Orientation Using Intraoperative Fluoroscopic Imagining Are Unreliable., Parker L Brush, Adrian Santana, Gregory R Toci, Eric Slotkin, Michael Solomon, Tristan Jones, Arjun Saxena

Rothman Institute Faculty Papers

BACKGROUND: Accurate acetabular cup orientation is associated with decreased revision rates and improved outcomes of primary total hip arthroplasty. This study assesses surgeon's ability to estimate both the acetabular component inclination and anteversion angles via intraoperative fluoroscopy (IF) images.

METHODS: We surveyed orthopedic surgeons to estimate acetabular component inclination and anteversion based on 20 IF images of total hip arthroplasty through a direct anterior approach. Postoperative computed-tomography scans were used to calculate the true inclination and anteversion component angles. The absolute difference between the true and estimated values was calculated to determine the mean and standard deviation of the survey …

Open Posterior Reduction And Stabilization Of Ao Spine C3 Sacral Fractures, Philipp Kobbe, Gregory D. Schroeder, Klaus J. Schnake, Lorin M. Benneker, Mark Lambrechts, Frank Hildebrand, Richard M. Sellei

Rothman Institute Faculty Papers

AO Spine C3 sacral fractures are defined by separation of the spine including S1 from the pelvic ring and are usually result of a high-energy injury. Besides their high biomechanical instability and high rate of associated neurological impairment, these fractures are often extremely difficult to reduce due to severe bony impaction and dislocation. Additional difficulties in management of these fractures arise from only a thin-layer of soft-tissue coverage overlying the injured area.