Musculoskeletal Diseases Commons^™

Intraoperative Hypothermia In Patients Undergoing Total Knee Arthroplasty: A Cross-Sectional Study From A Developing Country, Ronika Devi Ukrani, Aiman Arif, Anum Sadruddin Pidani, Obada Hussein Hasan, Shahryar Noordin

Medical College Documents

Background: Intraoperative hypothermia is associated with various risk factors, morbidity, and mortality in patients undergoing total knee arthroplasty (TKA), increasing the emotional and financial burden on patients. This study aimed to identify risk factors of intraoperative hypothermia in patients undergoing TKA.
Materials and methods: All adult patients (⩾18 years) who underwent TKA from January 2016 to December 2017 at a tertiary-care hospital in Pakistan were included in this retrospective, cross-sectional study. Temperature < 36 °C was defined as hypothermia.
Results: The study included 286 patients (77.6% female) with a mean age of 61.4 ± 10.4 years. The overall proportion of intraoperative hypothermia was 26.6%. Of the total …

Weight Reduction Motivation In Osteoarthritis Patients Through Nurse Practitioner Driven Education And Follow-Up: A Pilot Project, Caoilfhionn Mulvey, Martha Fuller Phd

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: The ultimate goal of this short-term pilot project is for

overweight or obese osteoarthritis patients to increase their knowledge on the benefits of

weight loss and physical activity. Research shows that for every kilogram of weight lost,

2.2–4.0 kilograms of weight is taken off of the joint and could reduce joint pain up to

thirty to fifty percent and improve quality of life. Following education from the provider,

patients will understand the correlation of osteoarthritis symptom management with

weight loss.

EBP Model/Frameworks: This project utilizes the Iowa Model of Evidence-Based

Practice to Promote Quality Care. This addresses …

Use Of Artificial Intelligence To Identify Predictors Of Functional Outcomes In Patients With Facioscapulohumeral Muscular Dystrophy, Natalie K. Katz

Research Days

Background: Facioscapulohumeral muscular dystrophy (FSHD) is one of the most common forms of muscular dystrophy characterized by slowly progressive muscle weakness. Symptoms initially involve the facial and shoulder girdle muscles, with later involvement of the distal lower extremities, pelvic girdle and proximal lower extremities. FSHD type 1 (FHSD1) is the most common form (~95% of individuals) and is caused by deletion of microsatellite repeats in the D4Z4 region on chromosome 4 (4q35). Normal individuals have >10 repeats whereas individuals with FSHD1 have 1-10 repeats. There is significant variability in regards to disease severity, rates of progression and functional outcomes, but …

Minimally Invasive Surgery For Septic Arthritis Of The First Metatarsophalangeal Joint: An Uncommon Approach Utilizing Small Joint Arthroscopy, Michael Thomas, Hinal Patel, Jeffrey Belancio

Rowan-Virtua Research Day

Small joint arthroscopy can be utilized for septic arthritis, synovitis, osteochondral lesions, arthritis, and various other pathologies. However, information regarding arthroscopy of the first metatarsophalangeal joint (MTPJ) is limited in the literature. This case report discusses the use of arthroscopy for septic arthritis of the 1st MTPJ.

Flexor Tenosynovitis After Bite By Sugar Glider, Dominick Siconolfi, James Espinosa, Alan Lucerna, Russell Mordecai

Rowan-Virtua Research Day

Flexor tenosynovitis is one of the few orthopedic emergencies, often first identified in the emergency department. Pyogenic flexor tenosynovitis is an infection of the flexor tendon sheath of a finger causing local inflammation and tissue destruction. The pathognomonic symptoms of flexor tenosynovitis are known as Kanavel’s signs, a constellation of symptoms that include: pain with passive extension of the finger, tenderness over the flexor tendon sheath, fusiform swelling of the affected finger, and the finger held in passive flexion. The most common cause of flexor tenosynovitis is penetrating trauma into the flexion tendon sheath. Our case involves a 59-year-old male …

Septic Arthritis With Concomitant Pseudogout, Ravin Patel, James Schuck, Nicole Zucconi, David Aderholdt

Rowan-Virtua Research Day

Monoarticular joint pain is a common complaint, however it demands a broad differential diagnosis. These differentials include fracture, dislocation, septic arthritis, gout, pseudogout and several others. The diagnosis of septic arthritis requires a high index of suspicion as early diagnosis is a vital part of initial treatment.

We present a case with multifactorial joint pathology contributing to a patient’s presentation, specifically septic joint and pseudogout. The incidence of these entities being present in the same patient, let alone the same joint, is not well documented in the literature.

The presentation of these diseases have a multitude of similarities and differences, …

Sarcopenia Screening By Registered Dietitian Nutritionists (Rdns) In The United States (U.S.), Madison Marcom

Electronic Theses and Dissertations

Sarcopenia is a disease of muscle wasting primarily seen in older adults. Although this term was first coined over three decades ago, there is a lack of consensus on a definition, screening criteria, and treatment protocol for sarcopenia. The primary purpose of this study is to determine whether registered dietitian nutritionists (RDNs) in the United States (U.S.) screen for sarcopenia. Study participants were recruited through a randomized email list and included RDNs throughout the U.S. Respondents completed a survey questioning knowledge of sarcopenia, screening tools and company protocols in place, and the need and desire for sarcopenia education. Data revealed …

In Men With Obesity, T2dm Is Associated With Poor Trabecular Microarchitecture And Bone Strength And Low Bone Turnover, Francesca Vigevano, Giulia Gregori, Georgia Colleluori, Rui Chen, Vimlin Autemrongsawat, Nicola Napoli, Clifford Qualls, Dennis T Villareal, Reina Armamento-Villareal

Faculty, Staff and Students Publications

INTRODUCTION: Obesity and type 2 Diabetes (T2D) are both associated with greater bone mineral density (BMD) but increased risk of fractures. The effect of the combination of both conditions on bone metabolism, microarchitecture, and strength in the obese population remains unknown.

METHODS: Data from 112 obese men were collected. Bone turnover and biochemical markers were measured by enzyme-linked immunosorbent assay, body composition and BMD at all sites were assessed by dual energy X-ray absorptiometry, whereas bone microarchitecture and strength (stiffness and failure load) were measured by high-resolution peripheral computed tomography. Data were compared among metabolically healthy obese (MHO) and metabolically …

Assessing The Patient-Perceived Monetary Value Of Patient-Reported Outcome Improvement For Patients With Chronic Knee Conditions, Sarah B. Floyd, Alicia Oostdyk, Melanie Cozad, John M. Brooks, Paul Siffri, Brian Burnikel

Journal of Patient-Centered Research and Reviews

Purpose: The high cost of orthopaedic care has attracted criticism in the current value-based health care environment. The objective of this work was to assess the properties of a willingness to pay (WTP)-based approach to estimate the monetary value that patients place on health improvements in chronic knee conditions following orthopaedic treatment.

Methods: A sample of patients with a chronic knee condition were surveyed between January and May of 2018 at a large orthopaedic practice. Each patient provided their WTP for restoration to ideal knee health and completed the Single Assessment Numerical Evaluation (SANE) to describe their baseline knee state. …

Osteogenesis Imperfecta, Dustin Kim

Campus Research Month

Osteogenesis Imperfecta is an inherited disease that has varying stages of severity. The effects of this disease results in a person's bones becoming brittle and weak to where it can easily fracture or completely break. Though this disease is similar to other bone-deteriorating diseases, like osteoporosis, osteogenesis imperfecta begins with a person having abnormalities in the genes that produce collagen in bones. Collagen is an important component of bone, keeping it strong and resilient against injuries. Yet, those genes end up shutting off, and the victim begins to lack collagen in their bones, making their bones susceptible to breaking.

Automatic Generation And Novel Validation Of Patient-Specific, Anatomically Inclusive Scoliosis Models For Biomechanics-Informed Surgical Planning, Austin Tapp, Michel Audette, James Bennett

College of Engineering & Technology (Batten) Posters

Scoliosis is an abnormal spinal curvature of greater than 10 degrees. Severe scoliotic deformities are addressed with highly invasive procedures: anterior or posterior spinal fusion approaches. This invasiveness is due, in part, to the constraints of current surgical planning, which utilizes computed tomography (CT) scans unable to discern spinal ligaments that are dissected to make the spine sufficiently compliant for correction. If localization of ligaments and soft tissues were achieved pre-operatively, corrective procedures could become safer and more efficient by using finite element (FE) biomechanical simulations to determine decreased incidences of ligament releases. This research aims to achieve ligament localization …

Trunk Kinematics Using Musculoskeletal Modeling During Range Of Motion Tasks, Maryam Moeini, Ruth M. Higgins, Hunter Bennett, Stacie Ringleb

College of Health Sciences Posters

A spine model can be used to predict post-spinal fusion motion needed to perform physical activities in individuals with scoliosis. Full body lumbar spine (FBLS) model (Raabi et al., 2016) allows for modeling lumbar spine and pelvis movement and was validated for jogging. However, like other existing adult spine models, FBLS model does not allow for a motion providing thoracic and spine. Purpose: To adapt the FBLS model for simulating thoracic, lumbar and pelvis motion during trunk rotation in all 3 planes of motion. Methods: Since T12-L1 in FBLS model is designed as a dependent joint (axial rotation analogous to …

Sustainable Return To Work Following A Musculoskeletal Disorder: Courses Of Action For Supervisors, Iuliana Nastasia, Marie-France Coutu, Romain Rives, Jessica Dubé, Sarah Gaspard, Audrey Quilicot

Rapports de recherche scientifique

Les troubles musculosquelettiques (TMS) demeurent un problème majeur de santé au travail dans les pays industrialisés. Les conséquences de l’incapacité au travail représentent un fardeau important pour les travailleurs et leurs familles, mais aussi pour les organisations. Même si plusieurs études sur l’incapacité au travail soulignent le rôle important du superviseur dans le contexte de différents programmes de retour au travail, peu se sont intéressées spécifiquement au rôle de celui-ci, à ses responsabilités ainsi qu’à ses actions pour faciliter la réintégration des travailleurs qui ont eu une blessure musculosquelettique reliée au travail.

L’objectif général de cette étude est de proposer …

A Bisphosphonate With A Low Hydroxyapatite Binding Affinity Prevents Bone Loss In Mice After Ovariectomy And Reverses Rapidly With Treatment Cessation, Abigail A. Coffman, Jelena Basta-Pljakic, Rosa M. Guerra, Frank H. Ebetino, Mark W. Lundy, Robert J. Majeska, Mitchell B. Schaffler

Publications and Research

Bisphosphonates (BPs) are a mainstay of osteoporosis treatment; however, concerns about bone health based on oversuppression of remodeling remain. Long-term bone remodeling suppression adversely affects bone material properties with microdamage accumulation and reduced fracture toughness in animals and increases in matrix mineralization and atypical femur fractures in patients. Although a “drug holiday” from BPs to restore remodeling and improve bone quality seems reasonable, clinical BPs have long functional half-lives because of their high hydroxyapatite (HAP) binding affinities. This places a practical limit on the reversibility and effectiveness of a drug holiday. BPs with low HAP affinity and strong osteoclast inhibition …

Développement D’Un Outil Personnalisé D’Aide À La Décision En Vue De Minimiser Les Risques En Manutention Impliquant Des Postures Symétriques Et Asymétriques, Aboulfazl Shirazi-Adl, Navid Arjmand, André Plamondon

Rapports de recherche scientifique

Les charges excessives imposées sur la colonne vertébrale lombaire constituent un facteur de risques important pour les maux de dos. La modélisation biomécanique de la colonne vertébrale est la seule approche non invasive permettant d’estimer ces charges, mais la complexité de ces modèles limite leur utilisation par des ergonomes. Pour aider ces derniers à identifier des situations à risque de blessures au dos afin de limiter le chargement aux structures lombaires, il existe des outils d’aide à la décision comme l’équation de levage du NIOSH (Revised NIOSH Lifting Equation, Waters et al., 1993) ainsi que les tables …

Auricular Point Acupressure Smartphone Application To Manage Chronic Musculoskeletal Pain: A Longitudinal, One-Group, Open Pilot Trial, Jennifer Kawi, Chao Hsing Yeh, Mengchi Li, Keenan Caswell, Maurice Mazraani, Nada Lukkahatai, Sylvanus Mensah, Janiece Taylor, Chakra Budhathoki, Paul Christo

Nursing Faculty Research

Background: Chronic musculoskeletal pain (CMP) is the most common self-reported chronic pain condition. Current treatment for CMP is limited. Methods: This was a two-phase study. In Phase 1, three auricular point acupressure (APA)-naïve participants were recruited to explore their experiences of APA and a smartphone app was developed based on their feedback. In Phase 2, a prospective longitudinal study was used to examine the effectiveness of the smartphone app to self-manage CMP. Results: Phase 1 resulted in the successful development of the APA smartphone app. In Phase 2, after four weeks of APA, participants reported reduced pain intensity (30%), pain …

Developing A Targeted Ultrasound-Responsive Nanobubble-Based Gene Delivery System For Osteoporosis Treatment, Angela Shar

Honors Undergraduate Theses

The overall goal of this project was to develop, optimize, and test an ultrasound-responsive targeted nanobubble for delivering osteoporosis-related silencing genes such as Cathepsin K small interfering RNA (CTSK siRNA) for osteoporosis treatment. The nanobubbles were synthesized using an in situ sonochemical method. The nanobubble (NB) is composed of a gas core made from perfluorocarbon, stabilized with albumin, encapsulated with CTSK siRNA, and embedded with alendronate (AL) for bone targeting (CTSK siRNA-NB-AL). Following its development, the responsiveness of CTSK siRNA-NB-AL to a therapeutic ultrasound probe was examined. The results of biocompatibility tests with human bone marrow-derived mesenchymal stem cells proved …

Contribution Of The Human Microbiome And Proteus Mirabilis To Onset And Progression Of Rheumatoid Arthritis: Potential For Targeted Therapy, Jessica Kerpez, Marc Kesselman, Michelle Demory Beckler

Internet Journal of Allied Health Sciences and Practice

The human microbiome has been shown to play a role in the regulation of human health, behavior, and disease. Data suggests that microorganisms that co-evolved within humans have an enhanced ability to prevent the development of a large spectrum of immune-related disorders but may also lead to the onset of conditions when homeostasis is disrupted. In many conditions, a link between dysbiosis (microbial imbalance or microbiome upset) has been identified and associated with immune conditions such as rheumatoid arthritis (RA). This review provides insight into how an individual’s unique microbiome, combined with a genetic predisposition and environmental factors may lead …

Using A Lubricin Reporter Cell To Test Current Vs. Optimized Media Compositions, Sean M. Kennedy

Honors Undergraduate Theses

Osteoarthritis is a joint disease characterized by the breakdown of articular cartilage. The field of tissue engineering is interested in developing methods to produce biological alternatives to current orthopedic procedures. Lubricin is a molecule which is important in the proper lubrication of articular cartilage. It is a challenge in the field of tissue engineering to produce cartilage with sufficient lubricin expression. Developing a reporter cell for lubricin allowed for a more efficient investigation of the conditions wh­­­ich may influence its expression. By comparing "optimized" and traditional media solutions, it was determined that the use of a previously reported type II …

Acoustic Detection Of Developmental Dysplasia Of The Hip In Models Representing Neonates, Pinak Raodeo

Honors Undergraduate Theses

Developmental dysplasia of the hip (DDH) is a condition that involves the dislocation of the head of the femur in the acetabulum of the pelvic bone. Although it may not interfere with a child's range of motion during infancy, DDH can cause various effects over time such as joint pain, abnormal gait, and even paralysis. It is crucial to catch this phenomenon early on so that permanent disability is not introduced to the patient. In this study, an excitation device was used to send a broadband frequency signal through a hip joint simulated by a 3D printed bone apparatus consisting …

The Effects Of The Traditional Scaling Technique Versus A Modified Scaling Technique On Muscle Activity And Pinch Force Generation: A Pilot Study, Jessica R. Suedbeck, Cortney Armitano-Lago

Dental Hygiene Faculty Publications

Purpose: Dental hygienists perform precision instrumentation tasks repetitively throughout the workday, placing them at increased risk for developing a musculoskeletal disorder. The purpose of this pilot study was to determine differences in muscle activity and pinch force generation between the traditional scaling technique and a modified scaling technique.

Methods: A convenience sample of dental hygienists (n=12) acted as their own controls in this counterbalance-designed pilot study. Muscle activity and pinch forces were assessed while participants performed traditional and modified scaling techniques with designated instruments on artificial calculus applied to the lower left quadrant of a typodont, for a period of …

Regulation Of Osseous Healing By Macrophage-Derived Wnt Ligands, Jefferson Overlin Abaricia

Theses and Dissertations

Osseous healing is regulated by various classes of cells and signaling mechanisms. Of these, Wnt signaling has long been known to be critically important in directing the differentiation of mesenchymal stem cells (MSCs) into osteoblasts during bone healing. However, the source of these Wnt ligands is not known. Recently, a body of literature has arisen finding both beneficial and detrimental effects of macrophage-derived Wnt ligands on the regeneration of other tissues (liver, kidney, heart, and intestine), often by regulating inflammatory activation and stem cell behavior. As macrophages have been well-characterized as orchestrators of healing, their use of Wnt signaling to …

Self-Reported Diet And Health Outcomes Of Participants Of The Ccsvi-Tracking Survey Study, Patricia Grace-Farfaglia

Health Science Faculty Publications

Of the 1575 participants of the CCSVI-Tracking Survey, 475 patients recorded their quality of life and EDSS outcomes for at least 2 months. Self-reported use of complementary and conventional therapies included diet, use of drug therapy, symptoms, quality of life, and mobility. Analysis included comparing outcomes related to different diets within and between groups. Adherence to the MS diet was not associated with a greater quality of life, less disability, a lower Symptom Score, or faster walking speed compared to other diets. Alternately, the participants from the Mediterranean diet region as a whole (µ = 32.65 (SD = 11.37, SE …

Restoration Of Bone Material And Microstructural Properties After Long-Term Remodeling Suppression, Abigail A. Coffman

Dissertations and Theses

Anti-resorptive drugs, principally bisphosphonates (BPs), are the mainstay of osteoporosis treatment. They work by inhibiting bone resorption/remodeling, thus preventing bone loss. However, long-term suppression of bone resorption adversely affects bone tissue mechanical properties, even while conserving bone mass. Lack of remodeling leads to accumulation of fatigue-induced microdamage, altered matrix mineralization and reduction in normal bone tissue heterogeneity, causing impaired strength and fracture toughness. The most severe consequence to patients, while rare, is Atypical Femur Fractures (i.e., complete fatigue fractures of the femoral shaft). To counteract the effects of long-term remodeling suppression, a temporary break in BP treatment (a "drug holiday) …

Structural Remodeling Of The Lumbar Multifidus, Thoracolumbar Fascia And Lateral Abdominal Wall Perimuscular Connective Tissues: A Search For Its Potential Determinants, Christian Larivière, Sharon M. Henry, Richard Preuss

Études primaires

Recently remodeling of lumbar soft tissues has received increased research attention. However, the major determinants that influence remodeling need to be elucidated in order to understand the impact of different rehabilitation modalities on tissue remodeling. The main aim of this study was to explore the between-subject variance of different measures of lumbar soft tissues quantified with rehabilitative ultrasound imaging (RUSI). RUSI measures (n = 8) were collected from 30 subjects without and 34 patients with LBP: (1) lumbar multifidus (LM) echogenicity (fatty infiltration/fibrosis) at three vertebral levels (L3/L4, L4/L5 and L5/S1) (n = 3); (2) posterior layer thickness …

The Effect Of Extensible And Non-Extensible Lumbosacral Orthoses On Anticipatory Postural Adjustments In Participants With Low Back Pain And Healthy Controls, Christian Larivière, Richard Preuss

Études primaires

Background

Wearing a lumbosacral orthosis (LSO) is known to influence spine mechanics, but less is known about how LSOs affect motor control. Whether the use of a LSO can negatively affect motor control of the lumbar spine is still under debate.

Objective

The current study examined the immediate effects of two flexible LSOs (extensible and non-extensible) on the anticipatory postural adjustments that prepare the spine for a predictable perturbation.

Design

A comparative study using a repeated measures design in a laboratory setting.

Methods

Healthy controls (n = 20) and participants with low back pain (n = 40) performed a rapid …

Structural Remodeling Of The Lumbar Multifidus, Thoracolumbar Fascia And Lateral Abdominal Wall Perimuscular Connective Tissues: Medium-Term Test-Retest Reliability Of Ultrasound Measures, Christian Larivière, Dany H. Gagnon, Richard Preuss

Études primaires

Abstract

Introduction

Growing interest is being paid to the lumbar multifidus (LM) intramuscular fatty infiltrations and fibrosis that are secondary to low back pain as well to the remodeling of perimuscular connective tissues (fasciae) such as the thoracolumbar fascia and fascia sheets separating the abdominalwall muscles. Magnetic resonanceimaging and computed tomography have traditionally been used but rehabilitative ultrasound imaging (RUSI) is much more affordable and practical, which can accelerate research and clinical applications on this topic. The aim of this study was to test the medium-term (8 weeks) test-retest reliability of the corresponding RUSI measures.

Methods

Thirty-four participants …

Recurrent Nontuberculous Mycobacterial Tenosynovitis, Melissa Kwan, Richard Tupler

Faculty, Staff and Student Publications

Background: Nontuberculous mycobacteria are an uncommon pathogen for musculoskeletal infection and are difficult to treat because of delays in diagnosis, prolonged treatment requiring both antimycobacterial therapy and surgical debridement, and high rates of resistance to antimycobacterial therapy.

Case Report: We report the case of an 88-year-old male with recurrent Mycobacterium avium complex tenosynovitis despite receiving multiple courses of pharmacologic therapy and surgical debridement.

Conclusion: Nontuberculous mycobacterial musculoskeletal infections can be difficult to diagnose and equally difficult to treat. A combination of antimycobacterial therapy and surgical debridement is often required; however, the rate of treatment failure remains high, particularly with rapidly …

Multi-Digit Auto-Amputation In Setting Of Mixed Connective Tissue Disease, Kishan P. Patel, Jennifer L. Medlin, Michelene Hearth-Holmes

Graduate Medical Education Research Journal

Raynaud’s disease is a cutaneous manifestation often present in various connective tissue and vascular diseases. Depending on the age of onset and acuity of symptoms, the phenomenon can provide clinicians with some insight as to the severity of underlying disease, including the distinction between primary and secondary Raynaud’s. However, this diagnostic approach seems to have its limitations regarding efficacy and timing of treatment. Traditionally, treatment of Raynaud’s has focused on reestablishing blood perfusion to affected tissue, which has previously been achieved with vasodilatory medications and site-specific surgical intervention. In lieu of the severe sequelae of Raynaud’s in the setting of …

The Physiological Interaction Of Sleep Deprivation And Zoledronate On Distal Femur Trabecular Thickness Of Ovariectomized Rats, Erin Nolte, Frank Frisch, Oliver Lopez

Health Sciences and Kinesiology Faculty Articles

Osteoporosis, a disease resulting in an increased risk of fracture due to compromised bone, affects 1 in 3 postmenopausal women. Discontinuities in the microarchitecture of bone, such as trabeculae, are seen in postmenopausal osteoporosis. This study aimed to evaluate how sleep deprivation affects the distal femur trabecular thickness of estrogen-deficient rats treated with Zoledronate. 29 ovariectomized Wistar female rats were separated into 4 groups. The control group (C) was housed in standard housing with a 12-hour light/dark cycle and was given an intravenous injection of 0.45 mL of 0.9% saline. The Zoledronate group (Z) were also housed in standard conditions …