Musculoskeletal Diseases Commons^™

Sexually Dimorphic Effects Of Gpnmb Modulation On Vertebral Bone Mass Regulation And Intravertebral Disc Health, Hakem Altawil, Fayez Safadi

Williams Honors College, Honors Research Projects

Osteoporosis and vertebral degeneration are major contributors to musculoskeletal morbidity, yet the molecular mechanisms regulating vertebral bone and intervertebral disc (IVD) homeostasis remain incompletely understood. GPNMB (osteoactivin) has been identified as a regulator of bone remodeling, though its role in spine health is unclear. This study evaluated the effects of GPNMB deficiency on lumbar vertebral bone microarchitecture and IVD integrity in a sex-dependent context.

Six-month-old male and female wild-type (WT) and GPNMB knockout (KO) mice were analyzed using micro–computed tomography (µCT) of lumbar vertebrae (L4–L6) and histological assessment of the L5–L6 IVD. KO males exhibited increased bone volume fraction, bone …

Magnesium-Based Metal Matrix Nanocomposite Implants And Nanobubble-Based Delivery Systems: Integrated Strategies For Bone Loss Treatment With Cytocompatibility Evaluation, Lucas José Martinho Bizuti

Honors Undergraduate Theses

This thesis intends to investigate the development of different multimodal therapeutic strategies for combating bone loss. Most specifically, this paper will emphasize the utilization of Magnesium-Based Metal Matrix Nanocomposite Implants (MMNC) and Nanobubble-Based Delivery Systems as options for future treatment focus. The effects of biodegradable magnesium implants were evaluated for cytotoxicity and cytocompatibility via Hematoxylin and Eosin, and Masson’s Trichrome staining, as well as radiological images. The Nanobubble-Based Delivery System is being developed and optimized as a delivery system to target osteoclast activity. This paper focused on optimizing experimental parameters, which include Rotational speeds for nanobubble stimulation under microgravity conditions …

The Associations Between Meniscus Tear Location And The Prevalence And Severity Of Cartilage Wear In Different Knee Compartments Using An Arthroscopic Grading System, Tara Korbal, Claudia Leonardi, Amy Bronstone, Vinod Dasa

School of Medicine Faculty Publications

Introduction: Meniscus tears are associated with progressive cartilage degeneration and worsening osteoarthritis. Although several previous studies have explored the relationship between meniscus tears and cartilage damage, few have examined the relationship between tear location and cartilage wear in all knee compartments using an arthroscopic grading system. Objectives: Evaluate the association between meniscus tear location and the prevalence and severity of high-grade cartilage wear in knee compartments. Methods: A total of 210 patients were categorized into groups based on meniscus tear location: medial meniscus tear (MMT, n = 106), lateral meniscus tear (LMT, n = 41), and medial-lateral meniscus tear (MLMT, …

The Articularis Genu As A Surrogate For Structural Determinants Of Peri-Articular Myopenia In Osteoarthritis, Davis Martin, José A.Cruz Ayala, Mary C. Gatterer, Tara Soria, Ryan Schroeder, Vinod Dasa, Luis Marrero

School of Medicine Faculty Publications

The functional limitations associated with the painful stiffness of knee osteoarthritis (kOA) can affect the muscles of the knee, such as the quadriceps femoris (QF) and articularis genu (AG). The vastus medialis oblique (VMO) of the QF complex is particularly sensitive to kOA. The AG, which can be sampled during total knee arthroplasty (TKA) for kOA, can provide information about the condition of the QF when affected by patient-reported disuse, helping to identify indicators of muscle weakness in the synovial fluid. This study compares the structural and gene expression changes between the VMO and the AG collected from patients with …

The Use Of Intramedullary Screw For Fixation Of Distal Ulnar Fractures, Adam Lencer, John Pignataro, Justin Le, Joyce Daniel Suarez, Michael Rivlin

Rowan-Virtua Research Day

Background

Distal ulna fractures frequently accompany distal radius fractures but are often underappreciated in both clinical and research contexts. While conservative management is frequently employed, particularly following volar locking plate (VLP) fixation of the radius, certain indications, such as distal radioulnar joint (DRUJ) instability, comminution, or high-energy trauma, may necessitate surgical fixation. This study evaluates patient-reported outcomes among patients with distal radius fractures treated operatively, comparing those with and without concomitant distal ulna fractures, and further stratifying based on the method of ulna fixation.

Methods

This retrospective review included 477 patients treated operatively for distal radius fractures by a single …

Does Sports-Specialization Increase The Risk Of Injury In Youth Athletes?, Kinjal Shah

Rowan-Virtua Research Day

Sports specialization, defined as intensive, year-round training in a single sport for more than eight months per year, has become increasingly prevalent among youth athletes. While it is often pursued with the goal of elite performance, early specialization may increase the risk of both physical injuries and psychological strain. This risk is especially pronounced in individual sports such as swimming and tennis, where early and focused training is frequently encouraged. This study explores the association between early sports specialization and injury risk in young athletes, with the goal of identifying contributing factors and informing prevention strategies. Evidence suggests that while …

The Gut Microbiome And Knee Osteoarthritis: A Review Of Emerging Pathophysiologic Links, Krisha S. Patel, Maduka Gunasinghe, Umer Shah, Kushkumar K. Patel, Zarif Ladak

Rowan-Virtua Research Day

Background

Knee osteoarthritis (OA), a multifactorial degenerative joint disease with growing prevalence in aging and obese populations, leads to disabling pain. Traditionally viewed as mechanically driven, increasing research implicates systemic inflammation and metabolic and neuroimmune modulation. The gut microbiome—an ecosystem of commensal organisms regulating host immune, metabolic, and inflammatory regulation—has emerged as a potential contributor to OA pathogenesis and symptom severity. This review aims to synthesize literature evaluating associations between gut microbiota composition and knee OA, focusing on inflammatory pathways, pain modulation, and emerging therapies.

Methods

A literature search was conducted using PubMed, Embase, Scopus, and Web of Science. Inclusion …

Exploring Microrna Pathways And Metformin's Anti-Inflammatory Potential In Osteoarthritis, Quang D La, Benjamin Tangkamolsuk, David F Lo

Rowan-Virtua School of Osteopathic Medicine Departmental Research

No abstract provided.

Bilateral Popliteal Entrapment Syndrome: A Rare And Challenging Case Report, Jose Burgos, Gabriela Llerena, Spencer Rheingold, Jorge De La Portilla

HCA-NSU MD Research Day

Bilateral Popliteal Entrapment Syndrome: A Rare and Challenging Case Report Burgos, Jose Julian, MD, MDIV, HCA Florida Kendall Department of Vascular Surgery Miami, Florida. Llerena, Gabriela2, OMSIV, Nova Southeastern University Dr. Kiran Patel College of Osteopathic Medicine. Rheingold, Spencer, MSIV, Nova Southeastern University Dr. Kiran Patel College of Allopathic Medicine. De La Portilla, Jorge MD, assistant professor, HCA Florida Kendall Department of Vascular Surgery Miami, Florida1 Objective: This case describes an atypical presentation of PES in an older male patient who presented with a sudden onset of symptoms without a history of claudication. Background: Popliteal entrapment syndrome (PES) is a …

Use Of Electrical Bone Growth Stimulators In High-Risk Patients Following Spinal Fusion, Soumya Malhotra, Khavir Sharieff

HCA-NSU MD Research Day

Title: Use of Electrical Bone Growth Stimulators in High-Risk Patients Following Spinal Fusion Authors: Soumya Malhotra, BA., MS1 & Khavir Sharieff, DO, MBA2 1Class of 2027, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL 2Assistant Professor of Surgery, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Tampa Bay, FLNova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine Objective: This study aimed to elucidate the advantages of EBGSs following high-risk spinal fusions. Background: Pseudarthrosis is a condition where bones fail to fuse after an injury or surgery. It causes significant …

Association Between Mri Findings Of Facet Arthropathy And Synovitis With Health-Related Outcome And Pain Scores Following Therapeutic Lumbar Facet Injections., Michael S Green, Michele Van Hal, Matthew Onimus, Christopher R Hoffman, Dhruv K C Goyal, Valeria Potigailo, Khuram S Kazmi

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Low back pain is a common complaint among adults. The facet joint is a major source of lumbar pain, and therapeutic facet injections have gained popularity as a minimally invasive treatment option. In addition, magnetic resonance imaging (MRI) utilization for diagnosing low back pain has increased significantly over the past few decades. Facet synovitis is an entity characterized by edema and inflammatory changes affecting the facet joints, adjacent bone marrow, and surrounding soft tissues. Although its underlying etiology remains poorly understood, recent reports suggest a high incidence in patients with arthropathy and arthritis. It is essential to explore potential correlations …

A Review Of The Literature On The Utilization Of Stem Cells In Knee Osteoarthritis, Katrina Krist

Theses and Graduate Projects

Background: This literature review evaluates the utilization of various types of stem cells in the treatment of osteoarthritis.

Purpose: To assess the different types of stem cell therapy available in an attempt to determine its effectiveness and viability as a long term therapy option.

Methods: Articles were found by searching Augsburg Library Services, Google Scholar, and PubMed for recent, original studies using both allogeneic or autologous stem cells from a variety of cell lines including bone marrow and adipose tissue.

Conclusions: The utilization of stem cells as a viable treatment option for osteoarthritis shows improvement in pain management and return …

Comparing Bilateral And Unilateral Metal Stabilizers: Incision Complications In Pectus Repair, Seth Saylors, Shawn D. St Peter, Tolulope A. Oyetunji Md Mph, Nelimar Cruz-Centeno, Nitin Nadella

Research Days

Introduction: The use of metal stabilizers in minimally invasive pectus excavatum repair (MIPER) has been previously associated with multiple postoperative complications. We aimed to identify if bilateral metal stabilizers increase the risk of incision complications when compared to unilateral stabilizers.

Methods: Institutional Review Board approval was obtained. Patients that underwent MIPER with metal stabilizers from 2019 to 2022 and currently had the bar in place, at a single tertiary care pediatric center, were included. A telephone survey evaluated if they had incision-associated symptoms, and if the location was congruent with the stabilizer site. A retrospective chart review was performed to …

A Literature Review Of Pain Control In Osteoarthritis Patients Using Blood Flow Restriction Training, John Gericke, Dakota Pastore, Tyler Pigott

Rowan-Virtua Research Day

Background: Osteoarthritis (OA) is a degenerative disease that mainly affects articular cartilage of joints. OA most commonly affects the knees and causes pain and reduces quality of life in older adults. Blood flow restriction (BFR) occludes arterial and venous flow during exercise using a blood pressure cuff placed on the proximal lower limb. This creates an intramuscular hypoxic environment which promotes muscle hypertrophy. High load training can cause pain and inflammation in knee OA patients due to increased stress. BFR can allow patients with knee OA to use lower loads to achieve beneficial effects of rehabilitation.

Methods: Data was ascertained …

Utilizing Microwave Ablation In Combination With Vertebroplasty Is An Effective Method In Reducing Cancer Related Back Pain, Disability, And Opioid Use: A Systematic Review And Meta-Analysis, Jonathan Elias, Lothar Vidal, Richard Jermyn

Rowan-Virtua Research Day

Background: It is estimated that metastases from primary malignant neoplasms affect the spine around 30%-70% of the time. Many times, these osteolytic tumors will cause the degradation of the vertebrae, leaving patients in a tremendous amount of pain, disability, and dependence on opioids as analgesics. Microwave ablation (MWA) followed by vertebroplasties (VP) has been a developing treatment for such a condition; however, there are no systematic reviews or meta-analyses examining the method’s effectiveness thus far.

Purpose: This systematic review and meta-analysis analyzes the 4-week and 12-week outcomes of patients with metastatic spinal cancer treated with the combinatorial treatment …

Complications Following Hemivertebrectomy For Congenital Scoliosis, Sanjana Davuluri, Taemin Oh, Kyrillos Akhnoukh, Zachary Weingrad, Michael Lesgart, Terrence Ishmael, Joshua Pahys, Amer Samdani, Steven Hwang

Rowan-Virtua Research Day

Introduction:

Hemivertebrae are rare congenital anomalies that can cause severe scoliosis requiring surgical correction. We aimed to determine whether severity of deformities is associated with more long-term surgical complications following surgical correction.

Methods:

We performed a retrospective, single-institution review on patients who underwent hemivertebrectomy and spinal fusion for congenital scoliosis between 2008-2020. We extracted pertinent data on demographics, radiographic parameters, operative details, and complication rates. Subgroup analyses were also done by complication severity, deformity complexity, and construct length.

Results:

In our series, 30 patients underwent hemivertebrectomy and fusion. Mean age was 9±4.2 years and there was 2:1 male preponderance, with …

Effect Of Exercise Intervention On Facioscapulohumeral Muscular Dystrophy (Fshd), John Desrochers

Rowan-Virtua Research Day

Facioscapulohumeral Muscular Dystrophy (FSHD) is a common muscular dystrophy. The facial muscles, shoulder girdles, and upper arms are notably affected.¹ A common presenting symptom is asymmetrical scapular winging and further symptoms may include but are not limited to: loss of pectoral muscles, fatigue, severe pain, pathologic spinal curvatures, and foot drop.² It is a particularly debilitating muscular dystrophy, with 20% of people >50 y.o. requiring a wheelchair.³ With no approved therapeutics, patients are managed symptomatically.³ This review sought to determine the effect of different exercise interventions on patients with FSHD. It is hypothesized that exercise may …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Is There Room For Individual Patient-Specified Preferences In The Patient-Reported Outcome Measurement Revolution?, Leif I. Solberg, Jeanette Y. Ziegenfuss, Rachael L. Rivard, Christine K. Norton, Robin R. Whitebird, Glyn Elwyn, Mark Swiontkowski

Journal of Patient-Centered Research and Reviews

Purpose: The study aim was to test the feasibility of collecting qualitative patient-preferred outcomes or goals and the degree of their attainment as an addition to a standardized process for collecting quantitative composite patient-reported outcome measures (PROMs) from patients undergoing knee joint replacement..

Methods: Patients of a large Midwestern medical group scheduled to have total replacement of their knee joint have been asked to complete a PROMs survey preoperatively and at 3 and 12 months after surgery since 2014. In March 2020, an open-ended question about their most important preferred outcome was added to the existing questionnaire. The responses for …

Characterization Of Epithelial Growth Factor Transcripts Identified In Crotalus Atrox Venom, Ivan Lopez, Ying Jia

Research Symposium

Epithelial Growth Factor (EGF) is the primary source in regeneration and stimulation of essential fibroblasts cells commonly found in epithelium. Studies have shown that snake venom components are becoming a growing factor in treating illnesses such as cancer, muscular dystrophy, chronic pain, blood pressure, blood clotting, etc. EGF in human cells contains a promising quaternary structure that can bind to snake venom metalloproteinases, proposing a means of activating biochemical responses through protein-protein interactions to regulate unwanted cellular functions. This supports promising research in achieving a greater understanding of regulation along cellular pathways through ligands, increasing the likelihood of targeting unwanted …

Minoxidil Weakens Newly Synthesized Collagen In Fibrotic Synoviocytes From Osteoarthritis Patients, Stefan Sarkovich, Peter P. Issa, Andrew Longanecker, Davis Martin, Kaitlyn Redondo, Patrick Mcternan, Jennifer Simkin, Luis Marrero

School of Medicine Faculty Publications

Purpose: Synovial fibrosis (SFb) formation and turnover attributable to knee osteoarthritis (KOA) can impart painful stiffness and persist following arthroplasty. To supplement joint conditioning aimed at maximizing peri-operative function, we evaluated the antifibrotic effect of Minoxidil (MXD) on formation of pyridinoline (Pyd) cross-links catalyzed by Plod2-encoded lysyl hydroxylase (LH)2b that strengthen newly synthesized type-I collagen (COL1) in fibroblastic synovial cells (FSCs) from KOA patients. MXD was predicted to decrease Pyd without significant alterations to Col1a1 transcription by FSCs stimulated with transforming growth factor (TGF)β1. Methods: Synovium from 10 KOA patients grouped by SFb severity was preserved for picrosirius and LH2b …

Impact Of Draft Order On Stress Sonography Of The Ulnar Collateral Ligament Of The Elbow In Professional Baseball Pitchers: An 18-Year Study, Adeeb Hanna, John Sonnier, Brian Fliegel, Matthew Sherman, Michael Ciccotti, Robert Jack, Steven Cohen

Rowan-Virtua Research Day

Background: The MLB draft is a common route for players to enter professional baseball in the United States. Individuals taken in earlier rounds are typically higher-performing players. When looking at pitchers specifically, higher performance at the amateur level may be associated with increased frequency of adaptive change in the throwing elbow.

Purpose/Hypothesis: To determine if players taken in earlier rounds of the MLB draft have a greater frequency or extent of pathological change in the elbow, as measured by dynamic stress ultrasound.

Study Design: Retrospective Cohort Study Methods: Dynamic stress ultrasounds (SUS) were performed over an 18-year period on the …

Adaptive Changes Of The Ulnar Collateral Ligament Of Professional Baseball From Different Climates Over Multiple Seasons: An 18-Year Study, Adeeb Hanna, Brian Fliegel, John Sonnier, Matthew Sherman, Michael Ciccotti, Robert Jack, Steven Cohen

Rowan-Virtua Research Day

Background: The ulnar collateral ligament (UCL) is put under high levels of stress through the overhead throwing motion typical of professional baseball pitchers. In response to repetitive stress the UCL undergoes adaptive changes including thickening of the ligament and increased joint laxity under valgus stress. Studies examining the adaptive changes in the elbows of professional pitchers over multiple seasons are limited. Investigations such as this one offer insight into the changes in the UCL of professional pitchers over multiple years of professional play as well as the risk for injuries that may be associated with these changes.

Purpose/Hypothesis: The purpose …

Mesenchymal Stem Cell Use In The Treatment Of Osteoarthritis: A Literature Review, Samantha Arrizon, Nolan Barnes, Teresa Del Toro, Lei Wena Herme, Vanessa Mendoza, Thi Tran, Reeta Zamro

Physician Assistant Studies | Student Literature Reviews

Mesenchymal stem cell (MSC) therapies have been growing in popularity in research due to their anti-inflammatory, immunomodulatory, and regenerative properties. Many ongoing clinical trials are investigating the safety and efficacy of MSC therapies to treat osteoarthritis, also known as “wear and tear” arthritis. As the average life expectancy increases, with age people are more prone to developing this disease, therefore, increasing its prevalence. This condition is progressive and will lead to functional decline, decreased quality of life, and increased medical costs. Our focus is to discuss the efficacy of mesenchymal stem cell injections in alleviating pain, improving functionality, and slowing …

Use Of Osteopathic Manipulative Treatment In Alleviating Hypertonic Chest Wall Pain, David Ho, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We present the case of a 20-year-old male patient with no cardiac history coming in for left sided chest pain described as “burning” sensation. On physical exam, it was noted that patient had hypertonic chest wall muscles that were tight and spastic when palpated on the left chest wall. We used Osteopathic Manipulative Treatment (OMT) to help patient relieve hypertonic muscle. We chose to use muscle energy technique (MET) since this relies on reciprocal inhibition with the end result being relaxation of the target muscle.

The patient had resolution of chest pain after applying the technique. Although we did not …

Does Prehabilitation Prior To Ulnar Collateral Ligament Surgery Affect Return To Sport Rate Or Time In Baseball Players With Partial Ucl Tears?, Joshua Spada, Kourtney Snigar, Ryan W. Paul, Usman Zareef, Anya Hall, Brandon J. Erickson, Michael G. Ciccotti, Stephen J. Thomas

Rowan-Virtua Research Day

Those who suffer a partial thickness ulnar collateral ligament (UCL) tear often undergo a period of nonoperative management including physical therapy rehabilitation. This treatment is aimed at optimizing range of motion (ROM) and strengthening the supporting structures around the elbow to help offload the UCL.

Unfortunately, some of these patients fail nonoperative management and require surgical intervention. This creates a unique set of patients who essentially underwent “prehabilitation” prior to their UCL surgery. Prehabilitation is considered a period of structured physical therapy rehabilitation aimed at strengthening structures surrounding an injured tendon or ligament, to allow for dissipation of stress away …

Development And Implementation Of A Protocol For Denosumab Administration In An Outpatient Infusion Clinic, Erin Stavrakas

The Eleanor Mann School of Nursing DNP Capstone Projects

Denosumab, or Prolia, is a medication given to increase bone mineral density (BMD) and prevent fracture risk in patients with osteoporosis. Guidelines for monitoring of side effects, data on long-term effects, and appropriate precautions are still being researched and developed. Healthcare teams are often unaware of preventative care measures to guide informed clinical decision making and patient care management. The recognized gap in care also reduces the standardization of health care delivery in clinics administering Prolia; this gap can lead to errors and miscommunication between patients and healthcare teams an increased risk for side effects. The aim of this translation …

The Morbidity Of Greater Trochanteric Pain Syndrome Is Similar To That Of Pre-Tha Hip Osteoarthritis, Sonia Wadekar, Avneesh Chhabra, Emily Middleton, Yin Xi, Joel Wells

MEDI 9331 Scholarly Activities Clinical Years

Aims: We sought to characterize the morbidity upon presentation of GTPS and compared it to patients with end-stage, hip osteoarthritis (OA) awaiting total hip arthroplasty (THA). We hypothesize that patients with GTPS will have similar or worse morbidity than hip OA patients.

Methods: This retrospective case-control study examined patient reported outcomes measures (PROMs) on activity limitations, quality of life, pain, and level of disability, in 156 GTPS patients (193 hips) and 300 pre-THA hip OA patients (326 hips). All patients presented at a single academic medical center. Patients with secondary hip conditions or previous hip surgeries were excluded from the …

Minimizing Musculoskeletal Injury Risk In Health Care Professionals With Education On Safe Patient Handling, Aubrey Graves

Honors College Theses

Introduction: Nursing is a high-risk occupation for musculoskeletal injuries due to the strenuous activity of patient handling. These tasks include, assisting a patient in bed, moving a patient from the bed to a wheelchair, and assisting with walking. These work-related tasks can create a large amount of stress on the body, especially the back if proper technique is not utilized and/or if excessive loads are applied. The purpose of this study is to examine if teaching proper body mechanics and the dangers of not performing the tasks properly is an effective way of reducing musculoskeletal injuries.

Methods: The NUR 202 …

Investigating The Role Of The Skeletal Muscle In Amyotrophic Lateral Sclerosis Neuromuscular Junction Dysfunction, Agnes Badu-Mensah

Electronic Theses and Dissertations, 2020-2023

Neuromuscular junction (NMJ) dysfunction has been identified as one of the earliest events in Amyotrophic Lateral Sclerosis (ALS) pathology. However, which tissue type induces NMJ disruption; be it the motoneurons (hMN), Schwann cells or skeletal muscle (hSKM) remains unresolved. While mechanisms by which ALS hMN contribute to NMJ dysfunction are well-described in literature, limited information exist on how the other tissue types in the tripartite synapse (hSKM and Schwann cells) induce and/or contribute to ALS NMJ disruption. A fair understanding of the role of each tissue type in NMJ dysfunction would help shape the trajectory of future ALS research and …