Medical Specialties Commons^™

Forty Years, Mary I. Fisher

Physical Therapy Faculty Publications

No abstract provided.

The Role Of Electrical Stimulation For Rehabilitation And Regeneration After Spinal Cord Injury, Brian A Karamian, Nicholas Siegel, Blake Nourie, Mijail Serruya, Robert F Heary, James Harrop, Alex R. Vaccaro

Rothman Institute Papers

Electrical stimulation is used to elicit muscle contraction and can be utilized for neurorehabilitation following spinal cord injury when paired with voluntary motor training. This technology is now an important therapeutic intervention that results in improvement in motor function in patients with spinal cord injuries. The purpose of this review is to summarize the various forms of electrical stimulation technology that exist and their applications. Furthermore, this paper addresses the potential future of the technology.

Enhancing Precision In Bioprinting Utilizing Fuzzy Systems, Ashkan Sedigh, Dayna Dipiero, Kristy M. Shine, Ryan E. Tomlinson

Department of Orthopaedic Surgery Faculty Papers

Bioprinting facilitates the generation of complex, three-dimensional (3D), cell-based constructs for a variety of applications. Although multiple bioprinting technologies have been developed, extrusion-based systems have become the dominant technology due to the diversity of substrate materials (i.e. bioinks) that can be accommodated, either individually or in combination. Each bioink has unique material properties and extrusion characteristics that limit bioprinting precision, particularly when generating identically shaped constructs from different bioinks. Here, we aimed to achieve high precision (i.e. repeatability) across samples by generating bioink-specific printing parameters using a systematic approach. We hypothesized that a Fuzzy system could be used as a …

Tailoring In-Clinic Patient Education To Target Outcome Improvement In Acute Low Back Pain, Trevor Mordhorst, Jake Gooing

View All Washington/Montana GME

Presented at the 2022 Virtual Northwest Medical Research Symposium

Handedness And Specimen Chirality Affect Resident Upper Extremity Motion Patterns During Arthroscopic Simulation, Joseph O'Sullivan, Adam Rosencrans, Taylor Kong, Alexandra Bray, Carolin Curtze, Andrea Herzka, Dennis Crawford, Jacqueline Brady

View All Washington/Montana GME

Presented at the 2022 Virtual Northwest Medical Research Symposium

Validation Of Consumer Activity Monitors In Postoperative Total Arthroplasty Patients, Joshuel A. Pahang, David B. Auyong

View All Washington/Montana GME

Presented at the 2022 Virtual Northwest Medical Research Symposium

Malignant Myopericytoma Of The Right Foot: A Case Report, Ryan Glendenning

View All Washington/Montana GME

Presented at the 2022 Virtual Northwest Medical Research Symposium

Missing The Forest For The Bamboo: Three Decades Of Back Pain In An African American Man, Riyad N H Seervai, Md, Phd, Meera Jain, Md

Poster Presentations

No abstract provided.

Comparison Of Landing Biomechanics Between Different Competitive Levels Of Irish Dance, Jade Shields

West Chester University Master’s Theses

Abstract

Objectives: To determine differences in lower limb landing biomechanics and lower extremity function scale scores between champion levels, in young female Irish dancers.

Design: Cross-sectional.

Setting: McDade-Cara School of Irish Dance

Participants: 12 Open Champion (OC) level female Irish dancers (11.9 ± 3.37 years) and 9 Preliminary Champion (PC) Irish dancers (13.5 ± 3.37 years) performed the landing error scoring system test (LESS), and completed the lower extremity functional scale (LEFS) and a descriptive data questionnaire

Main outcome measures: LESS scoring sheet and LEFS PRO

Results: No significant differences found between OC and PC levels on …

Reporter Chondrocyte Optimization Of Bioinks For Zonal 3d Bioprinting Of Cartilage, Kari Martyniak

Electronic Theses and Dissertations, 2020-2023

Osteoarthritis (OA) is the most common form of arthritis, often thought of as a disease of the elderly, but post traumatic OA predominantly impacts younger individuals. Articular cartilage is the tissue that coats the end of your bones in synovial joints. Since cartilage has limited healing capacity, defects, or injuries to it progressively erodes down to the subchondral bone. Unfortunately, current treatment options all have limitations, particularly for younger patients. Cartilage has a specific zonal architecture that is distinguished by the different cell morphologies and arrangements, biochemical composition, and mechanical properties. 3D bioprinting is a tissue engineering technique that involves …

The Use Of Two Types Of Suture And Stainless-Steel Wire Tension Banding For The Fixation Of Olecranon Fractures: A Biomechanical Comparison, Stuart Drew, Samer Al-Humadi, David Komatsu, Ann M. Meo

Stony Brook Orthopaedic and Musculoskeletal Journal

Purpose: Tension band constructs are commonly used for olecranon fracture fixation. The purpose of this study was to determine if a tension band constructed of No. 2 Dynacord suture, a silicone and salt-filled core within a UHMWPE sheath that expands radially and shortens axially when exposed to saline aqueous environment will provide constant initial static ompression forces compared to No. 2 FiberWire and stainless 18-gauge metal wire tension band.

Methods: A transverse osteotomy was placed in two sawbones models. Two 1.6 K-wires were placed across the osteotomy site and a Tekscan pressure sensor placed into the osteotomy site. The figure …

Relation Of Neurovascular Structures Of The Elbow To An Accessory Anterolateral Approach To The Capitellum: A Cadaveric Study, Michael Okoli, Ryan Tantone, Chidi Okolo, Samantha Muhlrad, Edward D. Wang

Stony Brook Orthopaedic and Musculoskeletal Journal

Purpose: The purpose of this study is to describe an anterolateral portal technique to the capitellum and to investigate its anatomic relationship nearby neurovascular structures in the elbow.

Methods: The study included 6 arm-to-fingertip adult cadavers. The demographic information of the cadavers was recorded. We initially dissected the elbows using a lateral approach to the capitellum. Next, a 1.5-cm anterolateral portal to the radiocapitellar joint was made and tagged with heavy suture and passed through the lateral elbow wound, with the elbow and forearm in an extended, supinated position. We then dissected out neurovascular structures around the elbow and measuring …

Non-Weightbearing In Cam Boots After Foot/Ankle Fracture Fixation: Are Patients Compliant?, Amos Z. Dai, Michelle Regan, Megan Paulus

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: The controlled ankle motion (CAM) boot has become an integral part of the management of both operative and nonoperative foot and ankle conditions. Similar to casts, CAM boots are used to immobilize the foot and ankle after injury or surgery. However, unlike casts, CAM boots can be readily removed for showering and range of motion (ROM) exercises. While CAM boots are well-designed for ambulation and are frequently utilized in early weightbearing (WB) and early ROM protocols, their usage in non-weightbearing (NWB) protocols is less clear.

Purpose: The purpose of the current study is to determine the patient compliance rate …

Comparison Of Early Active Range Of Motion In Primary Reverse Shoulder Arthroplasty Based On Indication: A Single Center Retrospective Review, Michael E. Doany, Kenny Ling, Rosen Jeong, Alireza K. Nazemi, David E. Komatsu, Edward D. Wang

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: Reverse shoulder arthroplasty (RSA) is commonly used in the treatment of rotator cuff arthropathy.  Indications for RSA have expanded to include complex proximal humerus fractures. Studies directly comparing outcomes between traumatic and traditional elective indications are limited. The purpose of this study was to compare early active range of motion (aROM) within the first two years postoperatively between traumatic and non-traumatic primary RSA, as well as compare ASES scores, and patient satisfaction at final follow-up.

Methods: A retrospective analysis was conducted of all RSA performed by a single surgeon between January 2000 and December 2018. Patients were grouped by …

Multidirectional Instability In Female Athletes, Meghan E. Bishop, Heli Patel, Brandon J. Erickson, Christopher C. Dodson

Rothman Institute Papers

Multidirectional instability (MDI) of the shoulder is characterized by generalized shoulder capsular laxity and symptomatic shoulder instability in more than one direction with one direction of instability as inferior. Generalized ligamentous laxity and specifically shoulder laxity, has been associated with female athletes. While males are at a higher risk of shoulder instability due to a number of extrinsic risk factors including participation in higher risk contact/collision activities, females are particularly susceptible to MDI due to their association with increased joint laxity. Patients with MDI often have a loose patulous capsule and display altered glenohumeral and scapulothoracic mechanics. The mainstay of …

Preventive Training Program Feedback Complexity, Movement Control, And Performance In Youth Athletes, Hayley J. Root, Eleanor M. Beltz, Julie P. Burland, Jessica C. Martinez, R. Curt Bay, Lindsay J. Distefano

Rehabilitation Sciences Faculty Publications

Context: Preventive training programs (PTPs) reduce injury risk by improving movement control. Corrective feedback is important; however, many cues at once may be too complicated for athletes.

Objective: To compare movement control and long-jump (LJ) changes in youth athletes participating in a season-long PTP, with simplified feedback, traditional feedback, or a warmup of the coaches' choosing.

Design: Cluster-randomized controlled trial.

Setting: Soccer fields.

Patients or Other Participants: A total of 420 athletes (simplified feedback = 173, traditional feedback = 118, and control = 129; age = 11 ± 3 years).

Intervention(s): Teams were randomized into the simplified PTP, traditional PTP, …

A Plague Of Their Own: Injury Incidence Remains Elevated In The 2021 Major League Baseball Season Compared To Pre-Covid-19 Seasons, Brooks N. Platt, Breanna Sullivan, Shawn Dripchak, Timothy L. Uhl, Aaron Sciascia, William B. Kibler, Austin V. Stone

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background Significant increases in injuries were observed in the 2020 Major League Baseball (MLB) season; these were attributed to an increased acute to chronic workload due to the interrupted preseason and compressed season during the coronavirus disease of 2019 (COVID-19) pandemic. In 2021, the MLB resumed its regular schedule.

Hypothesis/Purpose The purpose of this study was to determine the injury incidence and epidemiology of the 2021 MLB season compared to the injury incidence in the 2020 season and pre-COVID-19 seasons. The hypothesis was that, with the return to normal preseason training, injury incidence in 2021 would return to pre-COVID-19 rates. …

The Outcomes Of Cemented Versus Cementless Total Knee Arthroplasty In Modern Day Patients With Osteoarthritis, Jordan Powelson

Capstone Showcase

Osteoarthritis (OA), the degeneration of cartilage and bone, is the most progressive musculoskeletal disease and a leading cause of disability in the United States, affecting over 27 million adults. Although conservative treatments for knee OA are available, total knee arthroplasty (TKA) is the only definitive treatment for end-stage knee OA. For the past several decades, the use of bone cement has been the gold standard for total knee arthroplasty, but the cementless TKA is being revisited as an option as the age of patients seeking TKA decreases and the average BMI increases. This review analyzes and compares the outcomes of …

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 …

Thirty Day Low-Dose Versus Regular-Dose Aspirin For Venous Thromboembolism Prophylaxis In Primary Total Joint Arthroplasty, Alexander Duke, Stephen Bowen, Samir Baig, David E. Komatsu, James Nicholson

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: Aspirin (ASA) is an effective chemical prophylaxis for venous thromboembolism (VTE) after total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, the optimal dosage and duration of therapy remains debatable. The main objective of this study was to compare two ASA regimens with regard to the incidence of symptomatic deep venous thrombosis (DVT), pulmonary embolism (PE), bleeding (based on patient’s dressing), and infection within 90 days after primary THA and TKA.

Methods: We retrospectively identified 625 primary THA and TKA surgeries among 483 patients who received aspirin for four weeks post operatively. A total of 301 patients received …

Current Concepts Review: Postoperative Analgesia After Posterior Spinal Fusion For Adolescent Idiopathic Scoliosis, Aadit Shah, Eduard P. Pey, Stephen Bowen, James Barsi

Stony Brook Orthopaedic and Musculoskeletal Journal

Many post-operative analgesic options exist after a posterior spinal fusion for adolescent idiopathic scoliosis, with newer interventions gaining attention. It is unclear which provide the most benefit. The aim of this current concept review is to document efficacy, safety and quality of evidence of analgesic interventions after posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS). Potent analgesia with IV opioids or epidural anesthesia remains the cornerstone of postoperative analgesia following PSF for AIS. A diverse set of analgesic adjuvants are under investigation with promising results, including GABA-analogues, intrathecal anesthesia, nonsteroidal anti-inflammatory drugs and acetaminophen, ketamine, spinal nerve block, alpha …

Level Of Obesity Is Directly Associated With Complications Following Arthroscopic Rotator Cuff Repair, Alireza K. Nazemi, Kevin I. Kashanchi, David E. Komatsu, Edward D. Wang

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: The purpose of this study was to investigate the association between increasing levels of obesity and post-operative complications within 30 days of arthroscopic rotator cuff repair (ARCR).

Methods: We queried the American College of Surgeons National Surgical Quality Improvement Program database for all patients who underwent ARCR from 2015 to 2017. Patients were stratified into 3 cohorts according to their body mass index (BMI). Patients with a BMI < 30 kg/m2 were placed in the non-obese cohort, patients with a BMI between 30 and 40 kg/m2 were placed in the obese cohort, and patients with a BMI > 40 kg/m2 were placed in the morbidly obese cohort. Postoperative complications within 30 days of the procedure were collected. Multivariate logistic regression was used to investigate the relationship between increasing levels …

Severity Assessment Of Impairment In Spinal Cord Injury; A Systematic Review On Challenging Points About International Standards For Neurological Classification Of Spinal Cord Injury, Mahmoud Yousefifard, Mostafa Hosseini, Alireza Oraii, Alex R. Vaccaro, Vafa Rahimi-Movaghar

Department of Orthopaedic Surgery Faculty Papers

Objective: Assessment of spinal cord injuries (SCI) severity is usually done according to the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). However, a limitation of ISNCSCI has not been thoroughly evaluate; therefore, a systematic review was performed to gather current evidence on the limitations of the ISNCSCI for assessing SCI. Methods: An extensive literature search was performed using Medline, Embase, Web of Science, Cochrane library, and Scopus for all articles up until the end of 2017 and then was updated to the end of 2020. Data was summarized by two independent reviewers and limitations of the ISNCSCI …

The Impact Of Preoperative Neurological Symptom Severity On Postoperative Outcomes In Cervical Spondylotic Myelopathy, Gregory R Toci, Jose A Canseco, Brian A Karamian, Michael Chang, Giovanni Grasso, Kristen Nicholson, Emily M Pflug, Glenn S Russo, Daniel Tarazona, I David Kaye, Mark Kurd, Alan S. Hilibrand, Barrett I. Woods, Jeffrey A Rihn, D Greg Anderson, Kris E Radcliff, Christopher K Kepler, Alex R. Vaccaro, Gregory D. Schroeder

Department of Orthopaedic Surgery Faculty Papers

Study design: The study design is a retrospective cohort study.

Objective: To compare patient-reported outcomes between patients with mild versus moderate-to-severe myelopathy following surgery for cervical spondylotic myelopathy (CSM).

Summary of background data: Recent studies have demonstrated that decompression for CSM leads to improved quality of life when measured by patient-reported outcomes. However, it is unknown if preoperative myelopathy classification is predictive of superior postoperative improvements.

Materials and methods: A retrospective review of patients treated surgically for CSM at a single institution from 2014 to 2015 was performed. Preoperative myelopathy severity was classified according to the modified Japanese Orthopaedic Association …

"Everybody Wants To Be Included": Experiences With 'Inclusive' Strategies In Physical Education, Katherine Holland, Justin A. Haegele, Xihe Zhu, Jonna Bobzien

Human Movement Studies & Special Education Faculty Publications

This study examined how students with orthopedic impairments experienced strategies identified in the literature to support ‘inclusion’. An interpretative phenomenological analysis research approach was used, and six students with orthopedic impairments (age 10–14 years) served as participants. Data sources were written prompts, semi-structured, audiotaped interviews, and reflective interview notes. Based on thematic data analysis, four themes were constructed: “It’s kind of embarrassing”: experiences with support; “I don’t want to be different”: equipment, activity, and rule modifications; “I like to be a part of the conversation”: autonomy and choice in PE; and “I would rather be like the other students”: discussing …

Patient-Reported Outcomes Of Primary Total Ankle Arthroplasty In Patients Aged <50 Years, M Pierce Ebaugh, Travis Alford, Kamen Kutzarov, Elizabeth Davis, Michael Greaser, William C Mcgarvey

Faculty, Staff and Student Publications

Background:

Compared to more prevalent arthritic conditions, ankle arthritis is complicated by an earlier age of onset. Recently published data demonstrates excellent survivorship and complication rates in short-/midterm follow-up of younger patients who received a primary total ankle arthroplasty (TAA). Additionally, older TAA patients display comparable reported outcomes relative to hip/knee arthroplasty. However, there remains a paucity of literature surrounding the reported outcomes of younger patients undergoing TAA. Thus, our aim was to assess the reported outcomes of individuals aged <50 years receiving a primary TAA.

Methods:

A retrospective cohort analysis of adult patients <50 years who received a primary total ankle replacement was conducted. Patient demographics, diagnosis, treatment, and outcome characteristics were recorded from a chart review of 41 patients with at least 1 year of postoperative clinical follow-up. Postoperative reported outcomes were obtained via telephone interviews. Primary outcomes that were measured included emotional and physical health, activity limitation, ambulation, and global health. Measures used included the 36-Item Short Form Health Survey (SF-36), Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health, and Sickness Impact Profile Ambulation. The functional outcomes in our study sample were compared with age- and gender-matched norms from a general US population, and 95% CIs were calculated for each functional outcome mean. Student t test was used for continuous variables, and χ2 analysis was used …

Arthroscopic Stabilization Of Posterior Shoulder Instability Without Glenoid Bone Loss, Shawn D Feinstein, James M Gregory

Faculty, Staff and Student Publications

BACKGROUND: Contact athletes who experience posterior shoulder instability have a high likelihood of recurrence necessitating surgery.

INDICATIONS: Patients with posterior shoulder instability without glenoid or humeral head bone loss who have failed activity modification, bracing, and physical therapy may benefit from arthroscopic stabilization surgery.

TECHNIQUE DESCRIPTION: We describe a technique for arthroscopic labral repair with capsular plication through 4 portals in the lateral decubitus position.

RESULTS: Arthroscopic capsulolabral reconstruction is an effective and reliable treatment for posterior shoulder instability with good patient-reported outcomes, low recurrence rates, and high rate of return-to-play.

DISCUSSION/CONCLUSION: Arthroscopic capsulolabral reconstruction in the lateral decubitus position …

Plastic Multilayered Closure Versus Orthopedic Surgeon Closure After Spinal Instrumentation In Pediatric Neuromuscular Scoliosis, Ekene U Ezeokoli, Poornima L Tamma, Neritan Borici, Ifeoma Inneh, Edward P Buchanan, Brian G Smith

Faculty, Staff and Students Publications

OBJECTIVE: To compare wound complication rates between orthopedic closure (OC) and plastic multilayered closure (PMC) in patients undergoing primary posterior spinal fusion for neuromuscular scoliosis (NMS). We hypothesize that multilayered closure will be associated with better postoperative outcomes.

METHODS: We collected data on pediatric patients diagnosed with NMS who underwent first time spinal instrumentation between 1 January 2018 and 31 May 2021. Patient demographics, length of surgery, spinal levels fused and operative variables, wound complication rate, treatments, and need for wound washout were reviewed in depth and recorded.

RESULTS: In total, 86 patients were reviewed: 46 with OC and 40 …

Intraoperative Acoustics: Auditory Cues In Hip Reconstructive Surgery, Jeffrey M. Henstenburg, Walaa Abdelfadeel, Anthony J. Boniello, Joseph Schmitz, Jeffrey J. Vakil, Andrew M. Star

Rothman Institute Papers

Background: Orthopaedic surgeons rely on visual and tactile cues to guide performance in the operating room (OR). However, there is very little data on how sound changes during orthopaedic procedures and how surgeons incorporate audio feedback to guide performance. This study attempts to define meaningful
changes in sound during vital aspects of total hip arthroplasty (THA) within the spectrum of human hearing.

Methods: 84 audio recordings were obtained during primary elective THA procedures during sawing of the femoral neck, reaming of the acetabulum, acetabular cup impaction, polyethylene liner impaction, femoral broaching, planning of the femoral calcar and press-fit of a …

The Relationship Between Discoid Meniscus And Articular Cartilage Thickness: A Quantitative Observational Study With Mri, Joseph Brutico, Margaret Wright, Sarah Kamel, Adam C Zoga, Kirsten Poehling-Monaghan, Sommer Hammoud

Rothman Institute Papers

Background: Several cadaveric imaging studies have demonstrated that the articular cartilage thickness on the tibial plateau varies depending on coverage by native meniscal tissue. These differences are thought to partially contribute to the rates of cartilage degeneration and development of osteoarthritis after meniscectomy. Because there is greater tibial plateau coverage with meniscal tissue in the setting of a discoid meniscus, these findings may also have implications for the long-term health of the knee after saucerization of a torn discoid meniscus.

Purpose: To evaluate the relationship between lateral compartment articular cartilage thickness and the presence or absence of a discoid meniscus. …