Musculoskeletal Diseases Commons^™

Tat-Beclin 1 And Exercise: Investigating Their Potential Synergy In Improving Sarcopenia-Related Muscle Changes In A Mouse Model, Shreya Krishnan, Thuan Thien Tchen, Kleiton Silva, Gabryel Sales Nascimento

Rowan-Virtua Research Day

No abstract provided.

Understanding The Immune Responses Of Macrophages And Neutrophils In Synovial Fluid And Post-Operative Joint Environments, Allison Noelle Snyder

Rowan-Virtua Research Day

Periprosthetic joint infections (PJI) are devastating complications of total joint replacement (TJA). Even with aggressive antibiotic treatments, PJI recurrence rates are >17%, and 5-year survival is only 87.3%. Understanding the levels of inflammatory markers and cell types present at different timepoints is crucial in maximizing antimicrobial therapy and preventing adverse outcomes following TJA. This study tests the hypothesis that the synovial fluid environment of PJI induces immunosuppression in human macrophages, thereby hindering their ability to kill bacteria.

Brief Review: Quantifying The Risks Of Snow Shoveling: Cardiac, Musculoskeletal, And Environmental Hazards, James Espinosa, Swet A. Patel, James Lee, Alan Lucerna

Rowan-Virtua Research Day

Snow shoveling is a common winter activity in cold-weather regions, yet it uniquely combines intense physical exertion, cold exposure, and environmental hazards. Emergency Departments routinely observe seasonal increases in snow-shoveling–related musculoskeletal injuries, falls, and acute cardiovascular events. Despite this, the cardiovascular risk of snow shoveling is not well emphasized in medical education or patient counseling. Snow shoveling is associated with quantifiable and clinically significant risks, including musculoskeletal injury, falls, and acute cardiovascular events, which are reviewed here.

Glp-1 Receptor Agonists In Obstructive Sleep Apnea: Association With Fractures, Bone Health, And Clinical Outcomes In A Propensity-Matched Cohort, Shefali Waghray, Om Patel, Jashanveer Singh Johal, Jason Hyman

Rowan-Virtua Research Day

Title: “GLP-1 Receptor Agonists in Obstructive Sleep Apnea: Association with Fractures, Bone Health, and Clinical Outcomes in a Propensity-Matched Cohort”

Background: GLP-1 receptor agonists have demonstrated benefits beyond glycemic control, but their impact on musculoskeletal and clinical outcomes in obstructive sleep apnea (OSA) remains poorly defined. We evaluated the association between GLP-1 agonist use and fractures, osteoporosis, vitamin D deficiency, falls, hospitalizations, and mortality in OSA patients without baseline fractures, osteoporosis, vitamin D deficiency, or alcohol use disorder.

Methods: A retrospective cohort study was conducted using the TriNetX Global Collaborative Network. Adults (≥50 years) with OSA and BMI ≥18.5 kg/m² …

Delay In Care Due To High Number Of Provider Evaluations In Hip Arthroscopy, Kaylin Knapsack, Wynn Bastianelli, Alexander Cabrera, Stewart Meridian, Sean Mcmillan

Rowan-Virtua Research Day

Background: Diagnosing hip pain in young and middle-aged adults remains challenging due to overlapping intra- and extra-articular pathology. Femoroacetabular impingement syndrome (FAIS) and acetabular labral tears are increasingly recognized as major contributors to pain, mechanical symptoms, and functional limitation. Despite growing awareness of hip preservation surgery, delays in referral to arthroscopy-trained specialists persist and may contribute to disease progression and inferior outcomes.

Purpose: To evaluate delays in surgical management among patients undergoing hip arthroscopy for labral pathology and identify factors contributing to delayed referral to hip preservation specialists.

Methods: A retrospective cohort study was conducted on patients undergoing hip arthroscopy …

Case Report: Bilateral Pneumothorax Following T2–T5 Medial Branch Nerve Block, Jenna Rapone Md

Rowan-Virtua Research Day

Bilateral pneumothorax is an uncommon but clinically significant complication of thoracic spinal interventions. We report the case of a 20-year-old female with underlying scoliosis who developed acute pleuritic chest pain, dyspnea, and persistent cough immediately following bilateral T2–T5 medial branch nerve block injections performed in an outpatient pain management setting.  Thoracic medial branch blocks are generally considered low-risk procedures; however, the proximity of the pleura to posterior thoracic elements places patients at risk for iatrogenic pleural injury, particularly in individuals with altered spinal anatomy such as scoliosis. This case underscores the importance of maintaining a high index of suspicion for …

Case Report: Vertebral Artery Dissection After Cervical Manipulation, Devin Hoover, Emily Bolinger, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report the case of a 22-year-old female who presented with dizziness and vomiting after recent cervical manipulation who was diagnosed with a dissection of the vertebral artery. Dizziness can have a variety of causes including vascular etiologies, cerebellar and brainstem lesions, ocular problems, trauma, and others. In the setting of a known trauma and acute vestibular symptoms, it is prudent to consider vascular injuries.

Rethinking Gout Through An Inflammatory Lens, James Espinosa, Alan A. Lucerna

Rowan-Virtua Research Day

This review reframes gout not as a static disease of urate deposition, but as a dynamic inflammatory phenomenon. The emphasis is on immune activation, threshold behavior, and systemic inflammatory context rather than isolated joint pathology.

Efficacy Of Platelet Rich Plasma On Thumb Basal Joint Osteoarthritis: A Narrative Review, Vrushank Shah, Alexander King

Rowan-Virtua Research Day

Platelet-rich plasma (PRP) has emerged as a potential treatment for carpometacarpal (CMC) joint osteoarthritis, with studies suggesting it may offer more durable symptom relief compared to corticosteroids. A comprehensive review of four studies, including two randomized controlled trials (RCTs), a retrospective study, and a pilot study, revealed that both PRP and corticosteroid injections led to short-term improvements in pain and function. However, PRP demonstrated significantly better long-term outcomes, with VAS scores decreasing from 75 to 20 in the PRP group at 12 months, compared to a modest reduction from 70 to 65 in the corticosteroid group. Additionally, PRP showed a …

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 …

A Twist Of Fate: A Case Of Spiral Humerus Fracture After Arm Wrestling, Alec Mirchandani, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Fractures of the humerus are relatively uncommon, with spiral fractures typically resulting from rotational forces. This case report describes a 25-year-old male who sustained a right-sided spiral humerus fracture during an arm-wrestling match. The diagnosis was confirmed through radiographic imaging, and the fracture was successfully managed with closed reduction and posterior long arm splinting. This case highlights the importance of recognizing less common mechanisms of injury, like arm wrestling, in the context of humeral fractures. It also emphasizes the effective non-operative treatment of such fractures in young, healthy individuals.

Radiofrequency Ablation Versus Naproxen For The Management Of Ankylosing Spondylitis: A Comparative Analysis, Akash Manish Patel, Alec Birnbaum, Yashas Sattur

Rowan-Virtua Research Day

Ankylosing spondylitis (AS) is a chronic inflammatory disease characterized by inflammation primarily affecting the spinal vertebrae and sacroiliac joints, leading to pain, stiffness, and progressive loss of spinal mobility.

Management typically focuses on alleviating symptoms and controlling inflammation to improve patient quality of life. In this study, we compared the efficacy of two common treatment modalities: radiofrequency ablation (RFA) and naproxen. RFA is a minimally invasive procedure that targets specific nerve endings to interrupt pain signals, whereas naproxen is a non-steroidal anti-inflammatory drug (NSAID) used to reduce inflammation and provide symptomatic relief. Our systematic review involved a cohort of AS …

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 …

Efficacy Of Platelet-Rich Plasma In The Management And Treatment Of Achilles Tendon Ruptures: A Literature Review, Justin Le, Savana Coraggio, Emir Shahin, Valentin Nicholas Kotlyar, Joshua Sassaman, Christopher Cherfane, Gilbert Siu

Rowan-Virtua Research Day

Background

In the world of regenerative medicine, platelet-rich plasma (PRP) has gained much attention as a potential enhancer of musculoskeletal healing. However, despite promising results in many applications, the use of PRP in Achilles tendon ruptures (ATR) remains a topic of debate. While some studies suggest potential benefits in terms of pain reduction and early-phase healing, others report no significant difference in clinical or functional outcomes compared to standard treatment. This inconsistency underscores the need for further investigation into PRP’s role in tendon repair, particularly in high-stress, load-bearing structures such as the Achilles tendon.

Objective

This review aims to evaluate …

The Ancient Remedy For Modern Ailments: Analysis Of Manual, Laser, And Electro-Acupuncture Therapy Usage On Carpal Tunnel Syndrome, Yue Chen, Austin J. Wong, Alexander King

Rowan-Virtua Research Day

In the United States, while acupuncture is still primarily used as a complementary therapy, consumer interest and usage are steadily increasing. Carpal tunnel syndrome (CTS), a condition where the median nerve is compressed in the wrist, can lead to numbness, tingling, weakness in fingers, and thus impaired hand function, possessing significant burdens to patients suffering from this chronic disease. Multiple acupuncture applications exist such as electroacupuncture, auricular acupuncture, laser acupuncture, moxibustion, and acupressure; very few comprehensive studies have been done in comparing their effectiveness in treating CTS.

In this study, we aim to conduct a literature review with the primary …

Ultrasound-Guided Vs. Fluoroscopy Guided Steroid Injection For Lumbar Spine Pain On Functional And Pain Outcomes: A Systematic Review, Yashas Sattur, Akash Patel, Alec Birnbaum, Athena Nomula

Rowan-Virtua Research Day

Fluoroscopy-guided steroid injections are standard for lumbar spine pain but involve radiation. Ultrasound offers a safer, radiation-free alternative. Ultrasound-guided injections are non-inferior in improving pain and function. A systematic review of PubMed, Embase, Cochrane, Scopus, and Web of Science was conducted. Studies in adults comparing ultrasound and fluoroscopy-guided injections reporting VAS, NRS, or ODI were included. Fifteen studies showed both techniques significantly improved pain and function, with no consistent superiority. Ultrasound-guided injections are effective and safe, providing comparable outcomes to fluoroscopy while eliminating radiation exposure.

Case Report: Dysphagia In Inclusion Body Myositis Leading To Respiratory And Gastrointestinal Complications, Veroneka Mikhail, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Inclusion body Myositis (IBM) stands as a rare and complex neuromuscular disorder (NMD) characterized by progressive muscle weakness and atrophy. Among its cardinal symptoms are dysphagia and respiratory distress, which are the most common cause of death in this disease. While the differential diagnosis of respiratory distress is vast and includes aspiration, pneumonia, acute coronary syndrome, emphysema, and congestive heart failure, a clinician should recognize that respiratory distress can also be secondary to dysphagia in NMDs like IBM and can quickly become life threating. Here we present the case of a 68-year-old female with a history of IBM who presented …

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 …

Resection And Reconstruction Of Ewing Sarcoma Of The Cuboid Utilizing Vascularized Fibular Autograft: A Case Report, Brandon Cunha, Alexandre Arkader

Rowan-Virtua Research Day

Ewing Sarcoma (EWS) rarely presents in the bones of the foot, and particularly in the cuboid, making it an exceedingly rare occurrence. We present the case of a 7-year-old female diagnosed with EWS of the right cuboid, detailing the management and outcomes of this rare presentation. The patient, now almost 5 years post-initial local control, exhibits restored foot function, a normalized gait, and no evidence of disease recurrence. This case underscores the potential for preserving lower extremity function and improving postoperative quality of life in rare presentations of EWS through innovative reconstruction strategies.

Lower Extremity Weakness In The Setting Of Covid Myositis, Christopher Dellmyer, Frank Wheeler

Rowan-Virtua Research Day

Bilateral lower extremity weakness has numerable causes including stroke, peripheral neuropathy, deconditioning, Guillain-Barre, Multiple Sclerosis, anterior cord syndrome, trauma, spinal epidural abscess and many more. It is imperative however, that we investigate and understand more rare causes of lower extremity weakness. Here we present the case of a 74-year-old female presented to the ED with a complaint of lower extremity weakness due to Covid myositis causing significant bilateral lower extremity weakness.

Case Report: Dysphagia In Inclusion Body Myositis Leading To Respiratory And Gastrointestinal Complications, Veroneka Mikhail, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Inclusion Body Myositis (IBM) stands as a rare and complex neuromuscular disorder (NMD) characterized by progressive muscle weakness and atrophy. Among its cardinal symptoms are dysphagia and respiratory distress, which are the most common cause of death in this disease. While the differential diagnosis of respiratory distress is vast and includes aspiration, pneumonia, acute coronary syndrome, emphysema, and congestive heart failure, a clinician should recognize that respiratory distress can also be secondary to dysphagia in NMDs like IBM and can quickly become life threating. Here we present the case of a 68-year-old female with a history of IBM who presented …

Does Strength Training Decrease The Risk Of Sports Related Knee Injury?, Zachary J. Noll, Quin W. Buob

Rowan-Virtua Research Day

The knee is the most common joint affected by sports-related injuries, with approximately 2.5 million cases treated annually in the US alone, alongside 2 million worldwide ACL repairs. Among athletes engaged in contact sports like football, soccer, basketball, and volleyball, ACL tears are the primary injury concern. In non-contact sports, particularly running, meniscus tears are commonly experienced. A notable 23% of college athletes encounter knee injuries to varying degrees. Many risk factors have been identified including patient sex, activity type, and body composition, justifying the need for individualized preventive measures.

Various strength training protocols have demonstrated efficacy in reducing the …

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 …

Comparing The Effectiveness Of Hyaluronic Acid And Dextrose Prolotherapy Injections In The Treatment Of Lateral Epicondylitis: A Systematic Review And Meta-Analysis, Sara Ragab, Sami Dakhel, Jonathan Elias, Hesham Abdelfattah

Rowan-Virtua Research Day

Background: Lateral epicondylitis (LE), commonly referred to as tennis elbow, is characterized by micro-tears to the tendon origin that attaches to the outer portion of the elbow, with the extensor carpi radialis brevis being the most commonly affected tendon. It presents most often amongst manual workers and athletes that participate in repetitive movements. Patients may experience burning and aching sensations that can potentially radiate down to the wrist. Hyaluronic acid is a primary component of synovial fluid and has anti-inflammatory properties and also provides lubrication to joints. Prolotherapy involves injection of an irritant, most commonly dextrose, into the common extensor …

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 …

Pseudogout, A Case Of Rejection-Associated Pain, Emily Clark, Ziqian Wang

Rowan-Virtua Research Day

Pseudogout, known as calcium pyrophosphate deposition disease (CPPD), is an arthritis caused by the deposition of calcium pyrophosphate dihydrate crystals within the joint space. Certain medications have been implicated in the development of pseudogout. This case report examines a patient who developed pseudogout thought to be caused by the use of the immunosuppressant medication tacrolimus.

How Psychological And Nonpharmacological Treatment Modalities Reduce The Disease Burden Of Amplified Musculoskeletal Pain Syndromes In Pediatrics, Aalia Narvel, Sabrina Gmuca

Rowan-Virtua Research Day

The prevalence of pediatric chronic musculoskeletal pain ranges from 8.5% to 40%.¹ This literature review examined the treatment of amplified musculoskeletal pain syndrome (AMPS), which is a general term that represents a spectrum of pain disorders for patients who may not satisfy specific diagnostic criteria.² Specifically, sources were analyzed to compare the efficacy of individual components in the nonpharmacological, interdisciplinary treatment of AMPS against pain medications. These components included cognitive behavioral psychotherapy (CBT), physical therapy (PT), as well as occupational therapy (OT). There is limited information that assesses these components individually, but there is ample evidence that when …

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 …

Outcomes Of Arthroscopic Vs. Open Biceps Tenodesis For Treatment Of Slap Lesion In Female Patients, Adeeb Hanna, Matthew Wallingford, William Johns, John Sonner, Emma Johnson, Sommer Hammoud, Brandon Erickson, Steven Cohen, Michael Ciccotti, Meghan Bishop

Rowan-Virtua Research Day

Background: Biceps tenodesis (BT) is one alternative treatment to repair of superior labrum anterior to posterior (SLAP) tears. It can be performed as an arthroscopy or open procedure. While there have been studies comparing the outcomes of SLAP repair procedures with BT for the treatment of SLAP tears, literature comparing arthroscopic and open BT for the treatment of SLAP tears is limited. Additionally, no previous study has specifically examined the outcomes of these procedures in female patients.

Hypothesis/Purpose: The purpose of this study was to compare outcomes following Arthroscopic BT and Open BT for SLAP tears in females. The authors …