Medical Specialties Commons^™

Comparison Of Intraarticular Distal Humerus Fracture Outcomes Treated With Or Without Olecranon Osteotomy - A Case Series, Naveed Baloch, Tashfeen Ahmad, Zehra Abdul Muhammad

Section of Orthopaedic Surgery

A case series was extracted from the trauma registry at Aga Khan University Hospital from the period June 2015 to June 2019. Included were 16 adult patients who presented with intra-articular distal humerus fracture type C2. The functional, clinical and radiological outcomes of fractures treated with or without olecranon osteotomy up to 12 months follow-up were compared. Outcomes were assessed at 6 weeks, 3, 6 and 12 months re-visits. Among the 16 studied patients, 9 (56%) were males and 7 (44%) were females. In the group without osteotomy, there was a good functional and clinical outcome with a mean Quick …

Patient Outcomes Association With Patient Factors And Care Provided: Trauma Registry Derived Cohort Study, Tashfeen Ahmad, Zehra Abdul Muhammad

Section of Orthopaedic Surgery

Objective: To determine the association of delay in treatment with injury-specific patient outcomes.
Methods: This was a single-center, longitudinal cohort study on orthopaedic trauma registry. Data on patients enrolled between June 2015 and June 2018 were analyzed. Data was collected from admitted consenting patients' medical records. Definitive surgical care provided after 24 hours was considered as 'delayed surgical treatment'. Outcomes of patients were serially assessed on follow-up visits up to 12 months using injury-specific scoring system.
Results: A total of 789 patients, were enrolled with 856 upper or lower extremity injuries altogether; in 67 cases both extremities were involved. Surgery …

Iatrogenic Trauma Following Percutaneous And Minimally Invasive Surgical Interventions, M Hammad Ather, Tashfeen Ahmad, Shabbir Akhtar, Tabish Chawla, Aneela Darbar, Wardah Rafaqat, Syed Shahabuddin, Noman Shahzad, Shahid Ahmed Sami

Section of Urology

Technological progress has changed the landscape of surgical practice. Minimally invasive surgery (MIS) and percutaneous interventions (PC) are constantly replacing open procedures. This reduces hospital stay and allows quicker recovery. The application of MIS should follow the good medical practice dictum by Hippocrates i.e. "First do no harm". To remain abreast with new procedures, the medical personnel are required to update and enhance their knowledge and skill. To ensure safety, the innovations are rigorously tested and tried. The learning curve of MIS is shortened by simulator training and proctorship. Credentialing processes are in place to enhance safe delivery of care. …

Proton Pump Inhibitor Use Affects Pseudarthrosis Rates And Influences Patient-Reported Outcomes., John J. Mangan, Srikanth N. Divi, James Mckenzie, Justin D. Stull, William Conaway, David S. Casper, Dhruv K.C. Goyal, Kristen J. Nicholson, Matthew S. Galetta, Scott C. Wagner, I. David Kaye, Mark Kurd, Barrett I. Woods, Kristen E. Radcliff, Jeffrey A. Rihn, D. Greg Anderson, Alan S. Hilibrand, Alex R. Vaccaro, Gregory D. Schroeder, Christopher K. Kepler

Department of Orthopaedic Surgery Faculty Papers

Study Design: Retrospective cohort review.

Objectives: Cervical pseudarthrosis is a frequent cause of need for revision anterior cervical discectomy and fusion (ACDF) and may lead to worse patient-reported outcomes. The effect of proton pump inhibitors on cervical fusion rates are unknown. The purpose of this study was to determine if patients taking PPIs have higher rates of nonunion after ACDF.

Methods: A retrospective cohort review was performed to compare patients who were taking PPIs preoperatively with those not taking PPIs prior to ACDF. Patients younger than 18 years of age, those with less than 1-year follow-up, and those undergoing surgery …

Sexual Dysfunction In Men After High Energy Pelvic Fractures: Narrative Review Of Targeted Literature, Obada Hussein Hasan, Muhammad Atif, Naveed Baloch, Imran K. Jalbani, Masood Umer

Section of Orthopaedic Surgery

Pelvic fractures represents high energy trauma with associated other organ injuries including intra-abdominal injuries, haemorrhage and extremity injuries. Anatomical location of genitourinary structures makes them vulnerable to injury with pelvic fracture. Incidence of sexual dysfunction varies in literature with 5% incidence of dysfunction in patients without urethral injury and 42% with urethral injuries. Hence in pelvic fracture, erectile dysfunction may be due to neurogenic, vascular, corporal and psychogenic injury. In this narrative review of targeted English literature from all level of evidences, which is written and supervised by experienced specialized orthopaedic, trauma and urology surgeons who were among the pioneers …

Joint-Preserving Procedures For Osteonecrosis Of The Femoral Head., Bülent Atilla, Sancar Bakırcıoğlu, Alexander J. Shope, Javad Parvizi

Rothman Institute Papers

Osteonecrosis of the femoral head is a poorly understood condition that may lead to progressive destruction of the hip joint. Its incidence is common between the third and fifth decades of life and it is the diagnosis behind 5-18% of annually performed total hip arthroplasties (THAs) in the USA.Regarding the high rate of complications of THA in that age group, authors have agreed on the importance of joint-preservation techniques for this disease but techniques vary to establish a generally accepted algorithmic approach.Surgical head-preserving procedures, core decompression with or without graft, stem cell augmentation, or biologic adjuncts, vascularized bone grafting, and …

National Trends In Total Hip Arthroplasty For Traumatic Hip Fractures: An Analysis Of A Nationwide All-Payer Database., Anthony J Boniello, Alexander M Lieber, Kevin Denehy, Priscilla Cavanaugh, Yehuda E Kerbel, Andrew Star

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Hemiarthroplasty (HA) has traditionally been the treatment of choice for elderly patients with displaced femoral neck fractures. Ideal treatment for younger, ambulatory patients is not as clear. Total hip arthroplasty (THA) has been increasingly utilized in this population however the factors associated with undergoing HA or THA have not been fully elucidated.

AIM: To examine what patient characteristics are associated with undergoing THA or HA. To determine if outcomes differ between the groups.

METHODS: We queried the Nationwide Inpatient Sample (NIS) for patients that underwent HA or THA for a femoral neck fracture between 2005 and 2014. The NIS …

Health Literacy And Patient Reported Outcomes In Orthopaedic Surgery Patients, Thiran Udawatta, Lance Flesch, Michael Eng, Jane E. Oliphant, Scott G. Kaar

Journal of Health Disparities Research and Practice

Background: Health literacy may be an important factor in patient health outcomes, however, prior research has primarily focused on primary care patients with research in orthopaedic specific populations lacking.

Questions/purposes: The purpose of this study was to examine the relationship between health literacy and patient reported outcomes in an orthopaedic patient population.

Patients and Methods: 183 patients >18 years of age who presented to our institution’s sports orthopaedic surgery clinic with shoulder or knee complaints were analyzed. The primary outcomes were physical function recorded using Patient-Reported Outcomes Measurement Information System (PROMIS) physical function and Single Assessment Numerical Evaluation (SANE) scores. …

Us Trends Of Opioid-Use Disorders And Associated Factors Among Hospitalized Patients With Spinal Conditions And Treatment From 2005 To 2014, Se Won Lee, Jay Shen, Sun Jung Kim, Sung-Youn Chun, Pearl Kim, Jahan Riaz, Ji Won Yoo, Jinwook Hwang

School of Public Health Faculty Research

Study Design: Serial cross-sectional study utilizing the National Inpatient Sample (NIS) 2005 to 2014. Objective: The aim of this study was to examine the trends of opioid-use disorders among hospitalized patients with spinal conditions and treatment and to identify its contributing factors. Summary of Background Data: The opioid is widely used in chronic spinal conditions, and misuse of prescriptions is the main culprit of the opioid crisis. Cannabis, the most commonly utilized illicit drug, has recently been substituted for opioid despite increasing cannabis-use emergency room visits. There is limited information on opioid-use disorders, the association with cannabis, and other contributing …

You Say “Goodbye,” And I Say, “Hello, Hello, Hello.”, Mary I. Fisher

Physical Therapy Faculty Publications

No abstract provided.

Preoperative Maximization To Reduce Complications In Spinal Surgery, Sukanta Maitra, Christopher Mikhail, Samuel K. Cho, Michael D. Daubs

School of Medicine Faculty Research

Study design: Invited narrative review. Objectives: The aim of this review was to summarize current literature regarding risk factors that surgeons can optimize in the preoperative setting in the spinal surgery patient, in order to reduce complications and improve patient-reported outcomes. Methods: Review of the relevant literature by the authors. Results: Modifiable risk factors identified relative to the patient include obesity, malnutrition/nutrient deficiency, diabetes/hyperglycemia, preoperative anemia, vitamin D/DEXA (dual-energy radiograph absorptiometry), nicotine use/smoking, and opioid use/psychosocial factors. Conclusion: By maximizing a patient's physiological and psychological status prior to elective spine surgery, we may move closer to achieving the goals of …

Endoscopic Rhizotomy For Chronic Lumbar Zygapophysial Joint Pain., Yuntao Xue, Tao Ding, Dajie Wang, Jianli Zhao, Huilin Yang, Xiaofeng Gu, Dehong Feng, Yafeng Zhang, Hao Liu, Fenglin Tang, Wanyi Wang, Miao Lu, Chao Wu

Department of Anesthesiology Faculty Papers

BACKGROUND: Chronic lumbar zygapophysial joint pain is a common cause of chronic low back pain. Percutaneous radiofrequency ablation (RFA) is one of the effective management options; however, the results from the traditional RFA need to be improved in certain cases. The aim of this study is to investigate the effect of percutaneous radiofrequency ablation under endoscopic guidance (ERFA) for chronic low back pain secondary to facet joint arthritis.

METHODS: This is a prospective study enrolled 60 patients. The cases were randomized into two groups: 30 patients in the control group underwent traditional percutaneous radiofrequency ablation, others underwent ERFA. The lumbar …

Arthroplasty During The Covid-19 Pandemic, T North, Mw Bullock, Jr Danoff, A Saxena, Sj Fischer, Bm Stronach, Br Levine

Journal Articles

No abstract provided.

Lessons Learned: Using The Caprini Risk Assessment Model To Provide Safe And Efficacious Thromboprophylaxis Following Hip And Knee Arthroplasty, E. S. Krauss, M. A. Cronin, N. Dengler, B. G. Simonson, P. Enker, A. Segal

Journal Articles

© The Author(s) 2020. Two of the more common potential complications after arthroplasty are venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolus (PE), and excess bleeding. Appropriate chemoprophylaxis choices are essential to prevent some of these adverse events and from exacerbating others. Risk stratification to prescribe safe and effective medications in the prevention of postoperative VTE has shown benefit in this regard. The Department of Orthopaedic Surgery at Syosset Hospital/Northwell Health, which performs over 1200 arthroplasties annually, has validated and is using the 2013 version of the Caprini Risk Assessment Model (RAM) to stratify each patient …

Validity And Reliability Of Three-Dimensional Imaging To Measure Limb Volume: A Systematic Review, Rachel Kremer, Madison Elizabeth Wolfe, Noah James Brueckner, Michaela Claire Viola, Mary Insana Fisher

Physical Therapy Faculty Publications

Introduction: Approximately 30% of women treated for breast cancer will develop lymphedema, yet early identification can prevent this occurrence. It is important to accurately and efficiently measure limb volume to identify pre-clinical lymphedema. Three-dimensional (3 D) imaging is emerging as a potential method to meet the need for accuracy and efficiency. The purpose of this review was to evaluate the psychometrics of 3 D imaging to measure limb volume.

Methods: A systematic search of 4 databases was conducted for articles using 3 D imaging to measure limb volume. Articles were included that compared 3 D imaging to water displacement using …

Impact Of Covid - 19 Pandemic On Orthopaedics At Northwell Health, New York., B. Petrone, C. Iturriaga, T. Mauri, N. Sgaglione

Journal Articles

The Novel Coronavirus (COVID-19) pandemicplaced an immense strain on healthcare systems and orthopedic surgeons across the world. To limit the spread, federal and state governments mandated the cancellation of all non-urgent surgical cases to address surging hospital admissions and manage workforce and resource reallocation. During the pandemic surge, thousands of surgical cancellations have been required. We outline our experience through the onset and advance of the surge, detail our incident response, and discuss the transition toward recovery.

The Ethics Of Treating Acute Achilles Tendon Ruptures During The Covid-19 Pandemic: A Case Report, P. B. White, M. J. Partan, R. M. Cohn, C. J. Humbyrd, G. Katsigiorgis, A. Bitterman

Journal Articles

No abstract provided.

Covid-19 And Orthopaedics: Recovery After The Pandemic Surge., B. Petrone, C. R. Iturriaga, T. Mauri, N. Sgaglione

Journal Articles

The novel Coronavirus (COVID-19) pandemic has placed an immense strain on health care systems and orthopedic surgeons across the world. To limit the spread, federal and state governments mandated the cancellation of all nonurgent surgical cases to address surging hospital admissions and manage workforce and resource reallocation. During the pandemic surge, thousands of surgical cancellations have been required. We outline our experience through the onset and advance of the surge, detail our incident response and discuss the transition toward recovery. Level of Evidence: Level V.

Educating Surgeons To Educate Patients About The Covid-19 Pandemic, A Saxena, M Bullock, Jr Danoff, Ds Rodd, Sj Fischer, Bm Stronach, Br Levine

Journal Articles

No abstract provided.

5-Aminolevulinic Acid Tumor Paint And Photodynamic Therapy For Myxofibrosarcoma: An In Vitro Study, S. Kenan, H. Liang, H. J. Goodman, A. J. Jacobs, A. Chan, D. A. Grande, A. S. Levin

Journal Articles

No abstract provided.

Association Of Disposable Perioperative Jackets With Surgical Site Infections In A Large Multicenter Health Care Organization, E. J. Stapleton, N. Frane, J. M. Lentz, D. Armellino, N. Kohn, R. Linton, A. D. Bitterman

Journal Articles

No abstract provided.

Interaction Between Low-Dose Aspirin And Nonsteroidal Anti-Inflammatory Drugs Can Compromise Aspirin's Efficacy In Preventing Venous Thrombosis Following Total Joint Arthroplasty, E. Krauss, M. Cronin, N. Dengler, A. Segal

Journal Articles

No abstract provided.

Predicting Elective Orthopaedic Sports Medicine Surgical Cancellations Based On Patient Demographics., B. Petrone, J. Fakhoury, P. Matai, A. Bitterman, R. M. Cohn, L. Lutsky

Journal Articles

Purpose:To evaluate whether patient demographics are associated with cancellation of elective orthopaedic sports medicine surgical procedures. Methods:We retrospectively reviewed the electronic medical records of 761 patients who were scheduled to undergo an elective sports medicine orthopaedic operation from January 1, 2015, to December 31, 2017. The patients were divided into 2 groups: those who underwent the scheduled procedure (group A) and those in whom the operation was canceled for any reason prior to the surgical date and not rescheduled (group B). Univariate analysis assessed patient factors consisting of age, sex, race, language, marital status, occupation status, type of insurance (Medicaid …

Resumption Of Elective Orthopaedic Surgery In The Us Epicenter Of Covid-19, E. S. Krauss, A. Segal, D. Schulman, N. Dengler, T. Bily, M. Cronin, K. Altner

Journal Articles

© 2020 Krauss et al. On March 1, 2020, New York State confirmed its first case of COVID-19. This state has had the largest initial mortality in the United States with more than 479,000 confirmed cases and over 25,000 deaths as of October 10, 2020. All elective surgeries in New York State were suspended on March 23, 2020, due to the national state of emergency. Syosset Hospital is a 75-bed community hospital dedicated primarily to elective surgery. During the COVID-19 surge, the hospital was converted to provide needed beds for the treatment of COVID-19 illness. In anticipation of the resumption …

Surgical Gps Proof Of Concept For Scoliosis Surgery, Austin Tapp, Michel Audette

Computational Modeling & Simulation Engineering Faculty Publications

Scoliotic deformities may be addressed with either anterior or posterior approaches for scoliosis correction procedures. While typically quite invasive, the impact of these operations may be reduced through the use of computer-assisted surgery. A combination of physician-designated anatomical landmarks and surgical ontologies allows for real-time intraoperative guidance during computer-assisted surgical interventions. Predetermined landmarks are labeled on an identical patient model, which seeks to encompass vertebrae, intervertebral disks, ligaments, and other soft tissues. The inclusion of this anatomy permits the consideration of hypothetical forces that are previously not well characterized in a patient-specific manner. Updated ontologies then suggest procedural directions throughout …

Risk Factors For Liposomal Bupivacaine Resistance After Total Hip Or Knee Arthroplasties: A Retrospective Observational Cohort In 237 Patients, Scott Buzin, Arianna L. Gianakos, Deborah Li, Anthony Viola, Sherif Elkattawy, David M. Keller, Richard S. Yoon, Frank A. Liporace

Orthopedic Surgery Resident Research

Purpose: Liposomal bupivacaine demonstrated promise decreasing postoperative pain in total hip and total knee arthroplasty (THA/TKA). Some randomized trials have shown non-superior results; however, confounding variables were not accounted for in such analyses. This study attempts to determine risk factors associated with failure of pain management in patients receiving liposomal bupivacaine.

Methods: Postoperative pain scores were collected following primary or revision arthroplasties between January 2016 and December 2017. Retrospective analysis of institutional total joint quality and outcomes registry was screened and patients undergoing primary or revision arthroplasties who completed a multi-modal pain management including liposomal bupivacaine were included in the …

Opioid Tolerance Influences Outcomes After Lumbar Fusion In Patients With Degenerative Pathology, Noah Levy, Max Detweiler, Dhruv K.C. Goyal, Ariana Reyes, Alexander R. Vaccaro

Phase 1

Introduction: Extended opioid use prior to surgery has been implicated in poorer postoperative outcomes. However, it remains unclear if there is a significant difference in postoperative outcomes among preoperative opioid-naïve and opioid-tolerant patients who undergo lumbar spinal fusion. The purpose of this study was to determine the effect of preoperative opioid use on patient-reported outcome measures in patients undergoing lumbar spinal fusion.

Methods: This retrospective cohort analysis identified 260 patients who underwent lumbar spinal fusion at a high-volume, single institution. There were two cohorts: patients who were opioid-naïve (defined as total opioid consumption of ≤ 7 days in …

A Medial Congruent Polyethylene Offers Satisfactory Early Outcomes And Patient Satisfaction In Total Knee Arthroplasty, Benjamin M. Frye, Caitlyn Patton, Jason A. Kinney, T. Ryan Murphy, Adam E. Klein, Matthew J. Dietz

Faculty & Staff Scholarship

Background

Although a successful operation, almost 20% of patients are dissatisfied with total knee arthroplasty (TKA). The purpose of this retrospective cohort study was to see if a medial congruent (MC) polyethylene would offer satisfactory early outcomes and patient satisfaction after TKA.

Methods

We reviewed prospectively collected data on 327 TKAs using multiple bearings within the same implant system. Ninety-six received an MC bearing, 70 received a cruciate-retaining (CR) bearing, and 161 received a posterior-stabilized (PS) bearing. We evaluated the visual analog scale pain scores and range of motion (ROM) at 2 weeks, 6 weeks, 3 months, and 1 year; …

Ain To Ulnar Motor Nerve Transfer Meta Analysis, Melanie Luikart, Asif M. Ilyas, Md

Phase 1

Background: There are currently few comprehensive studies of end-to-end and “supercharged” reverse end-to-side (SETS) anterior interosseous nerve (AIN) to ulnar nerve transfers for treatment of ulnar neuropathy. The authors performed a literature review existing published literature to evaluate the indications for, and utility of, AIN-ulnar nerve transfer as a treatment method and to inform future treatment decisions.

Methods: A literature review was performed based on the following inclusion criteria: inclusion of anterior interosseous nerve or AIN, ulnar nerve or ulnar motor nerve, transfer or nerve transfer, and outcome, motor, clinical, ulnar neuropathies, ulnar nerve paralysis, treatment or function. Exclusion criteria …

Meta-Analysis Of Repair Techniques For Mixed Nerve Damage, Grant Jones, Zachary J. Herman, Asif Ilyas

Phase 1

BACKGROUND: Injuries to the upper extremity are common and can occur with trauma, surgery, or compression. Particularly, injuries that result in complete transection often require surgical intervention in attempt to restore function and quality of life. Classically, nerve autografts have been used as the gold standard to repair these peripheral lesions. An alternative to the autologous nerve graft is the use of the processed nerve allograft. limited research exists in comparing sensory and motor outcomes of allograft nerve repair in the upper extremity with data for autograft repair. In this systematic review and meta-analysis, we set out to cumulate results …