Musculoskeletal Diseases Commons^™

A Comprehensive Basic Understanding Of Pelvis And Acetabular Fractures After High-Energy Trauma With Associated Injuries: Narrative Review Of Targeted Literature, Muhammad Atif, Obada Hussein Hasan, Naveed Baloch, Masood Umer

Section of Orthopaedic Surgery

Acetabular fractures are caused by energy trauma which is high enough to cause such a fracture with incidence of 3 patients / 100000. In older individuals, most commonmechanism of injury is fall and, in younger individuals, road traffic accidents. Acetabular fractures are usually associated with visceral injuries and other musculoskeletal injuries (about 50% of patient). In this narrative review of targeted English literature from all level of evidences, which is written and supervised by experienced specialized orthopedic and trauma surgeons who were among the pioneers of conducting pelvis fracture management workshops in the country, we aim to describe the mechanism …

Anterior Cruciate Ligament Injury-Induced Alterations In Inflammation And Muscle Physiology, Emily R. Hunt

Theses and Dissertations--Rehabilitation Sciences

Long term weakness and atrophy of the quadriceps muscle are a direct result of anterior cruciate ligament (ACL) injuries and persist for up to 10 years post injury. Muscle atrophy ensues regardless of ligamentous reconstruction surgery, indicating that muscle atrophy following injury is a function of the ligament rupture and not reconstruction surgery. Elucidating the mechanisms underlying quadriceps atrophy following ACL rupture is crucial for developing interventions to restore proper quadriceps size and mitigate weakness thereby allowing for improved patient function. In addition to understanding the specific mechanisms that contribute to quadriceps atrophy following ACL rupture, the timing of atrophic …

Donor Age Effects On The Proliferative And Chondrogenic/Osteogenic Differentiation Performance Of Equine Bone Marrow- And Adipose Tissue Derived Mesenchymal Stem Cells In Culture, Jasmin Bagge

Theses and Dissertations--Veterinary Science

Orthopedic injuries are a major cause of lameness and morbidity in horses. Bone marrow (BM)- and adipose tissue (AT) derived mesenchymal stem cells (MSCs) have shown potential to facilitate the repair of orthopedic injuries and are being used increasingly in veterinary clinics. Presently, the use of MSCs as a therapy for equine patients is most commonly applied as autologous transplants, using BM- and AT-MSCs harvested from the patient shortly after the time of injury. Cell-based therapies are therefore delayed to enable primary cell numbers to be expanded in culture. Of concern, however, are human and rodent studies that have shown …

Comparative Chondrogenesis Of Interzone And Anlagen Cells In Equine Skeletal Development, Chanhee Mok

Theses and Dissertations--Veterinary Science

At the presumptive sites of future synovial joints during mammalian skeletogenesis, articular cartilage develops from interzone located between the cartilaginous anlagen of bones. Thus, two types of cartilaginous tissues differentiate in close proximity. While anlagen cartilage is transient, progressing through endochondral ossification to form bones, articular cartilage is stable and functions throughout life to facilitate both low friction movement and load distribution. Despite important life-long functional properties, articular cartilage has a very limited intrinsic ability to repair structural defects. On the other hand, structural lesions in bones generally heal well by forming a cartilaginous callus and recapitulating endochondral ossification to …

Oral Contraceptives As Possible Acl Injury Prevention Method, Haley Schweizer

Capstone Showcase

ABSTRACT

Introduction: Anterior Cruciate Ligament (ACL) injuries are an upsetting setback for many athletes that require a long and costly recovery process. The injury rates are four times greater in women than men. Preventative measures that help to prevent ACL injuries are limited to stretching and strengthening. Therefore, this review aims to investigate if oral contraceptive [I] usage provides a possible new avenue for prevention of ACL injury [O] in young female athletes (ages 18-30) [P] compared to those that do not take oral contraceptives [C].

Methods: A literature review was performed though PubMed, Google Scholar, SCOPUS Database, and ClinicalKey …

The Effectiveness Of Cannabidiol In Rheumatic Disease Pain: A Systematic Review, Mary C. Wiczek

All Graduate Theses, Dissertations, and Other Capstone Projects

Cannabinoids have long been a part of human culture and medicine, and more recently have been rediscovered for their potential use in the management of rheumatic disease pain. The objective of this review was to evaluate the known clinical effectiveness of cannabidiol treatment for rheumatic disease related pain. The legality and current regulation of these products was also reviewed to establish the current status of federal and state rules regarding their clinical use. Basic definitions of the terms used to differentiate cannabidiol from other cannabinoid products was also outlined. A systematic literature search was then conducted to explore the current …

Prevalence And Predictors Of Chronic Pain Intensity And Disability Among Adults With Sickle Cell Disease, Nadine Matthie, Coretta Jenerette, Ashley Gibson, Sudeshna Paul, Melinda Higgins, Lakshmanan Krishnamurti

Faculty, Staff and Student Publications

Among 170 adults with sickle cell disease, we evaluated chronic pain impact and disability prevalence, assessed age and gender differences, and identified psychosocial predictors of chronic pain intensity and disability. Most participants had a high level of disability. Chronic pain intensity and disability were significantly associated with pain catastrophizing and chronic pain self-efficacy, and worsened with age. Further research is needed to confirm study findings and develop interventions, including palliative care approaches that address catastrophizing and disability, particularly for young women and middle-aged adults with sickle cell disease. Moreover, consistent clinical assessment of chronic pain and psychosocial health should be …

Utilization Of A Continuous Pericapsular Nerve Group (Peng) Block With An Opioid-Sparing Repair Of A Femoral Neck Fracture In A Pediatric Patient, Karla Wyatt, Moustafa Zidane, Chyong-Jy Joyce Liu

Faculty, Staff and Students Publications

In the pediatric population, femoral neck fractures are usually associated with high-impact trauma and often present with pain in the groin area. Regional anesthesia can offer adjunctive therapy for acute pain management. Various techniques have been employed to circumvent pain related to hip fractures and resultant hip surgery. Neuraxial, lumbar plexus, caudal, epidural, fascia iliaca, and femoral continuous nerve block techniques are advantageous in mitigating hip pain. However, these approaches require patient repositioning during placement and carry the potential for motor blockade with resultant weakness. A newly described method, the Pericapsular Nerve Group (PENG) block, allows for analgesia of the …

Pain, Functional Disability, And Their Association In Juvenile Fibromyalgia Compared To Other Pediatric Rheumatic Diseases., Mark Connelly, Jennifer E Weiss, Carra Registry Investigators

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Severe pain and impairments in functioning are commonly reported for youth with juvenile fibromyalgia. The prevalence and impact of pain in other diseases commonly managed in pediatric rheumatology comparatively have been rarely systematically studied. The objective of the current study was to determine the extent to which high levels of pain and functional limitations, and the strength of their association, are unique to youth with juvenile primary fibromyalgia syndrome/JPFS) relative to other pediatric rheumatic diseases.

METHODS: Using data from 7753 patients enrolled in the multinational Childhood Arthritis and Rheumatology Research Alliance (CARRA) Legacy Registry, we compared the levels and …

Burden Of Disease In Pediatric Patients With Hypophosphatasia: Results From The Hpp Impact Patient Survey And The Hpp Outcomes Study Telephone Interview., Eric T. Rush, Scott Moseley, Anna Petryk

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Hypophosphatasia (HPP) is a rare, inherited, metabolic bone disease caused by deficient tissue-non-specific isoenzyme of alkaline phosphatase activity that manifests as a broad range of signs/symptoms, including bone mineralization defects and systemic complications. The burden of disease is poorly characterized, particularly in children. This study aimed to characterize the patient-reported burden of disease among children with HPP using two survey instruments: the HPP Impact Patient Survey (HIPS) and the HPP Outcomes Study Telephone interview (HOST).

METHODS: Between September 2009 and June 2011, pediatric patients (aged younger than 18 years) with HPP were recruited to participate in the study via …

Pediatric Ppi Use And Fractures, Nathan R. Fleishman Md, Thomas M. Attard, Troy E. Richardson

Research Days

No abstract provided.

Development Of A Sonically Powered Biodegradable Nanogenerator For Bone Regeneration, Avi Patel

Honors Scholar Theses

Background: Reconstruction of bone fractures and defects remains a big challenge in orthopedic surgery. While regenerative engineering has advanced the field greatly using a combination of biomaterial scaffolds and stem cells, one matter of difficulty is inducing osteogenesis in these cells. Recent works have shown electricity’s ability to promote osteogenesis in stem cell lines when seeded in bone scaffolds; however, typical electrical stimulators are either (a) externally housed and require overcomplex percutaneous wires be connected to the implanted scaffold or (b) implanted non-degradable devices which contain toxic batteries and require invasive removal surgeries.

Objective: Here, we establish a biodegradable, piezoelectric …

Painful Proximal Oriented Large Heterotopic Spur Formation In An Active Adult Non-Traumatic Amputee, Jack Annunziato, Daniel Shor, Shailesh Parikh

Rowan-Virtua Research Day

Heterotopic ossification (HO) is excess bone growth in soft tissues, typically juxta-articular and interfascicular, with varying incidence. HO has been well documented in traumatic amputees but less frequently observed in the non-traumatic amputee population. Symptomatic HO usually includes pain during prosthetic use, with management involving prosthetic adjustments for comfort. This atypical case highlights a non-traumatic amputee developing proximal oriented large spur formation that was painful not with ambulation but with doffing of his prosthesis.

Arthroscopic Medial Meniscus Transplant Utilizing A Multi-Technique Fixation, Elizabeth Ford, Michael Defrance, Sean Mcmillan

Rowan-Virtua Research Day

Arthroscopic medial meniscus transplantation can be a daunting procedure for even the most skilled surgeon. While all-inside suture fixation devices have improved, the ability to successfully perform this procedure via arthroscopy is reliant upon the surgeon's ability to utilize a variety of fixation techniques. Based upon the review of the literature, this paper is the first of it's kind describing the methodology and algorithm for completing an arthroscopic medial meniscus transplant using four techniques.

Mri Findings After A Subchondroplasty Procedure Of The Ankle: A Case Report, Michael E. Calderone, Mansi Patel, Matthew K. Brant

Rowan-Virtua Research Day

Osteoarthritis (OA) of the ankle is a common disease and it is estimated that almost 1% of the world’s adult population have a painful ankle. Often in patients who fail conservative treatment, the use of an MRI is deemed necessary to identify pathologies. Bone marrow lesions (BMLs) seen on MRI have been recognized as a source of the ankle pain. Majority of the BMLs fluctuate in size over time and are seen as hyperintense lesions on MRI.We present MRI findings of a patient following arthroscopy with subchondroplasty.

Rare Case Of Hip Pain: Transiliac Lumbar Hernia, Daniel Tran, James Lee, Alan Lucerna, James Espinosa

Rowan-Virtua Research Day

Bone grafts are essential to achieving a solid spinal fusion by encouraging osteoblastic activity and providing a scaffold to guide bone remodeling. The iliac crest, in particular, is a common site for autologous bone grafting and is still considered the gold standard due to its ease of access to cortical and cancellous bone.[1] However, autologous iliac crest bone grafting can be associated with significant morbidity especially when full thickness tricortical grafts are harvested. Common complications include donor site pain, hematoma, thigh dyesthesias, pelvic instability or fracture.[2] Gastrointestinal herniation on the other hand is a much rarer complication with an incidence …

Platelets To The Rescue? A Literature Review Of The Safety And Efficacy Of Platelet-Rich Plasma For Symptomatic Osteoarthritis Of The Knee, Timothy Simonich

Physician Assistant Scholarly Project Posters

Osteoarthritis of the knee is one of the most common joint disorders in the United States with rising prevalence due to obesity and an aging population. Regarding non-surgical approaches to management, there has been growing interest in the use of intra-articular injections with Platelet Rich Plasma (PRP).

Successful Brace Treatment Of Pectus Carinatum In Osteogenesis Imperfecta Using The Dynamic Compression System., Beth A. Orrick, Amy L. Pierce, Charles L. Snyder, Uri S. Alon

Manuscripts, Articles, Book Chapters and Other Papers

Osteogenesis imperfecta (OI) is a genetic disorder of collagen resulting in a "fragile" skeleton with increased fracture risk and other complications, dependent on the specific variant. Pectus deformities of the chest wall, while not common, can be associated with OI. The use of a pectus carinatum brace in a patient with OI poses unknown risks for fractures and adverse treatment outcomes. We successfully applied external compression bracing using the dynamic compression system to one such patient. This case illustrates the ability to treat an OI patient with pectus carinatum using a nonsurgical brace, without complications, resulting in an excellent cosmetic …

Longitudinal Screening Detects Cognitive Stability And Behavioral Deterioration In Als Patients, Susan Woolley, Ray Goetz, Pam Factor-Litvak, Jennifer Murphy, Jonathan Hupf, Catherine Lomen-Hoerth, Howard Andrews, Daragh Heitzman, Richard Bedlack, Jonathan Katz, Richard Barohn, Eric Sorenson, Bjorn Oskarsson, Americo Fernandes Filho, Edward J. Kasarskis, Tahseen Mozaffar, Sharon Nations, Andrea Swenson, Agnes Koczon-Jaremko, Georgia Christodoulou, Hiroshi Mitsumoto

Neurology Faculty Publications

Objective. To evaluate longitudinal cognitive/behavioral change over 12 months in participants enrolled in the ALS Multicenter Cohort Study of Oxidative Stress (ALS COSMOS). Methods. We analyzed data from 294 ALS participants, 134 of whom were studied serially. Change over time was evaluated controlling for age, sex, symptom duration, education, race, and ethnicity. Using multiple regression, we evaluated associations among decline in ALS Functional Rating Scale-Revised (ALSFRS-R) scores, forced vital capacity (FVC), and cognitive/behavioral changes. Change in cognitive/behavioral subgroups was assessed using one-way analyses of covariance. Results. Participants with follow-up data had fewer baseline behavior problems compared to patients …

Melatonin-Micronutrients Osteopenia Treatment Study (Mots): A Translational Study Assessing The Effects Of Melatonin, Strontium Citrate, Vitamin D3 And Vitamin K2 On Bone Density, Bone Turnover Markers And Health-Related Quality Of Life In Postmenopausal Osteopenic Women Following A One-Year Double-Blind Randomized Placebo-Controlled Trial And On Osteoblast-Osteoclast Co-Cultures, Sifat Maria

Electronic Theses and Dissertations

Objective: The purpose of this study was to assess if a novel combination of melatonin and three other natural bone-aiding micronutrients: strontium citrate, vitamins D₃ and K₂ (MSDK) could improve bone health by modulating the activity of osteoblasts and osteoclasts in favor of balanced bone remodeling and by improving the overall health-related quality of life in postmenopausal osteopenic women.

Methods: The Melatonin-micronutrients Osteopenia Treatment Study (MOTS) is a translational research study that used both clinical and in vitro approaches to assess the efficacy of MSDK on bone health in women and to identify potential mechanisms for its effects. …

Urinary Tract Infection In Children With Spina Bifida And Spinal Cord Injury., Obumneke Amadi, Harolyn Belcher

GW Research Days 2016 - 2020

Introduction: Urinary tract infections (UTI) are one of the most common bacterial infections (Schappert & Rechtsteiner, 2008; Litwin et al., 2005). Data from the National Ambulatory Medical Care Survey estimated that UTI caused 8.1 million physicians visits (Schappert & Rechtsteiner, 2008). Children with spina bifida (SB) and spinal cord injury (SCI) are at high risk for UTI (Ouyang et al., 2010; Nair et al., 2005). The purpose of this study was to examine the organisms associated with UTI in the population of children with SB and SCI who were treated in out-patient and in-patient settings at the Kennedy Krieger …

Effects Of Revision Surgery On Grade Of Adverse Local Tissue Reaction Following Recall Of A Modular Hip Implant, Joseph F. Davies, Danielle M. Greer, Susan Truchan

Journal of Patient-Centered Research and Reviews

Background: The Stryker Rejuvenate modular hip implant device allows for greater versatility in matching a patient’s anatomy than conventional implants. Device recalls and in vivo metal hypersensitivity after total hip arthroplasty (THA) are common. However, recall of the Rejuvenate implant represents one of the largest recall volumes to date, highlighting our uncertainty regarding causes of device metal fretting/corrosion and adverse local tissue reaction (ALTR). While devices with metal-on-metal bearings historically were culprits for release of metal debris, more recently developed modular-neck devices add opportunity for adjacent metal components to rub together. With the Rejuvenate device, corrosion or fretting likely occurs …

Alternative Interventions For Children Coping With Chronic Conditions: A Critical Review Of The Literature, Nina M. Pelsi, Kim S. Amer

DePaul Discoveries

Reduction of stressors and anxiety levels in adolescents with chronic illnesses is a critical concept in pediatric health care in America today. The many stressors associated with chronic illness include displaying physical and mental differences, social stigma, financial difficulty, and family stress. These stressors may affect the adolescent’s ability to learn and cope in everyday life. The current research was a critical review of the literature examining studies done with adolescents coping with chronic diseases and illnesses. The aim was to analyze the most efficacious non-pharmacological methods for reducing stressors in adolescents with chronic illness. A critical review of the …

Motor Learning And Adaptation In People With Knee Osteoarthritis And Chronic Pain, Heather Turcotte, Katherine S. Rudolph

Osteopathic Medicine Student Research Posters

Osteoarthritis (OA) affects an estimated 50 million people in the US, and approximately 43% have limitations in daily function due to arthritis pain.3 Individuals with knee osteoarthritis (OA) have heightened sensitization to pain2,5 as well as reduced strength, diminished function and quality of life1 that prompts them to seek care from health care providers. Physical therapists commonly work with patients to improve function and quality of life by helping them learn to move without pain. Unfortunately, chronic pain causes changes to the nervous system that may impact the ability to learn new ways but the extent to which chronic pain …

Effects Of Glucosamine Versus Chondroitin Sulfate In Reducing Joint Space Narrowing In Knee Osteoarthritis, Caroline Horton, Ashani Andrews

Physician Assistant Capstones, 2016 to 2019

Objective: To determine if over the counter supplements, chondroitin sulfate and glucosamine, in combination or alone, are effective in the treatment of joint space narrowing (JSN) in knee osteoarthritis.

Design: Systematic Literature Review

Methods: Database search of PubMed and MEDLINE using the search terms “glucosamine”, “chondroitin sulfate”, “osteoarthritis”, and joint space narrowing. Filters were implemented to include articles that only dealt with human subjects, that were published in 2000 or later, and were full-text. Articles were excluded if they were cohort studies, reviews, non-English papers, or had pain as the only outcome.

Results: Sawitzke et al.primary outcomes revealed no …

Factors In Patient Responsiveness To Directional Preference-Matched Treatment Of Neck Pain With Or Without Upper Extremity Radiation, Benjamin Holmes, Ruta Brazauskas, Laura D. Cassidy, Rachel A. Wiegand

Journal of Patient-Centered Research and Reviews

Purpose

Patient-related predictive factors in responsiveness to directional preference therapy for neck pain with or without upper extremity radiation (NP/R) have not been reported. A directional preference is any neck movement that, when performed repeatedly to end range, results in centralization and/or alleviation of NP/R. It was hypothesized that patient compliance with a prescribed, directional preference-matched home exercise program would improve positive responsiveness to NP/R treatment.

Methods

Patient-related factors thought to affect responsiveness to care were collected retrospectively from charts and de-identified for patients with NP/R who underwent chiropractic treatment at a multispecialty spine clinic from January 2014 through June …

Do The Disc Degeneration And Osteophyte Contribute To The Curve Rigidity Of Degenerative Scoliosis?, Feng Zhu, Hongda Bao, Peng Yan, Shunan Liu, Mike Bao

Dartmouth Scholarship

The factors associated with lateral curve flexibility in degenerative scoliosis have not been well documented. Disc degeneration could result in significant change in stiffness and range of motion in lateral bending films. The osteophytes could be commonly observed in degenerative spine but the relationship between osteophyte formation and curve flexibility remains controversial. The aim of the current study is to clarify if the disc degeneration and osteophyte formation were both associated with curve flexibility of degenerative scoliosis.

Parent And Child Report Of Pain And Fatigue In Jia: Does Disagreement Between Parent And Child Predict Functional Outcomes?, Amy C. Gaultney, Maggie H. Bromberg, Mark Connelly, Tracy Spears, Laura E. Schanberg

Manuscripts, Articles, Book Chapters and Other Papers

While previous research in juvenile idiopathic arthritis (JIA) has identified discrepancy between parent and child perception of disease-related symptoms such as pain, the significance and impact of this disagreement has not been characterized. We examined the extent to which parent-child discordance in JIA symptom ratings are associated with child functional outcomes. Linear regression and mixed effects models were used to test the effects of discrepancy in pain and fatigue ratings on functional outcomes in 65 dyads, consisting of youth with JIA and one parent. Results suggested that children reported increased activity limitations and negative mood when parent and child pain …

New Insights Into Post-Sepsis Muscle Weakness Elucidated Using A Novel Animal Model, Allison M. Steele

Theses and Dissertations--Physiology

Sepsis is a severe life-threatening critical illness that damages multiple physiological systems. After hospital discharge, more than 70% of severe sepsis survivors report profound weakness which significantly impacts quality of life. Such weakness gives rise to new limitations of daily living, which ultimately leads to loss of independence in many patients. Despite wide recognition of this serious issue by clinicians and researchers alike, the mechanisms contributing to chronic skeletal muscle dysfunction after sepsis are not well understood. Lack of progress in this field is largely due to the absence of an appropriate animal model; current models are either too mild …

Functional Validation Of Novel Compound Heterozygous Variants In B3gat3 Resulting In Severe Osteopenia And Fractures: Expanding The Disease Phenotype., Florian Job, Shuji Mizumoto, Laurie Smith, Natario Couser, Ashley Brazil, Howard Saal, Melanie Patterson, Margaret Gibson, Sarah E. Soden, Neil A. Miller, Isabelle Thiffault, Carol J. Saunders, Shuhei Yamada, Katrin Hoffmann, Kazuyuki Sugahara, Emily G. Farrow

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: A new disease class of syndromes, described as linkeropathies, which are derived from defects in the glycosaminoglycan-linker region as well as glycosaminoglycan-side chains of proteoglycans is increasingly being recognized as a cause of human disease. Proteoglycans are an essential component of the extracellular matrix. Defects in the enzymatic process of proteoglycan synthesis broadly occur due to the incorrect addition of side chains. Previously, homozygous missense variants within the B3GAT3 gene encoding beta 1,3 glucuronyltransferase 3(GlcAT-I) responsible for the biosynthesis of glycosaminoglycans have been described in 7 individuals.

CASE PRESENTATION: In this study, a 4-year-old patient with a severe phenotype …