Medical Specialties Commons^™

Incidence And Outcomes Of Acute Implant Extrusion Following Anterior Cervical Spine Surgery., Gabriel A. Smith, Jonathan Pace, Mark Corriveau, Sungho Lee, Thomas E. Mroz, Ahmad Nassr, Michael G. Fehlings, Robert A. Hart, Alan S. Hilibrand, Paul M. Arnold, David B. Bumpass, Ziya Gokaslan, Mohamad Bydon, Jeremy L. Fogelson, Eric M. Massicotte, K. Daniel Riew, Michael P. Steinmetz

Rothman Institute Papers

STUDY DESIGN: Multi-institutional retrospective case series of 8887 patients who underwent anterior cervical spine surgery.

OBJECTIVE: Anterior decompression from discectomy or corpectomy is not without risk. Surgical morbidity ranges from 9% to 20% and is likely underreported. Little is known of the incidence and effects of rare complications on functional outcomes following anterior spinal surgery. In this retrospective review, we examined implant extrusions (IEs) following anterior cervical fusion.

METHODS: A retrospective multicenter case series study involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network. Medical records for 17 625 patients who received cervical spine surgery (levels …

Outcomes Of Internal Hemipelvectomy For Pelvic Tumors: A Developing Country’S Prospective, Masood Umer, Rizwan Haroon Rashid, Yasir Mohib, Haroon Rashid

Department of Surgery Docs

Introduction: Previously, external hemipelvectomy was the mainstay of treatment for pelvic tumors. However, with technological advancements, limb salvage procedures such as internal hemipelvectomy have emerged as a viable alternative. However, there is limited literature available on long-term outcomes and complications of internal hemipelvectomy, especially from developing countries. Therefore, the objective of this study was to share our experience of internal hemipelvectomy at a tertiary care center in a developing country. Materials and methods: A retrospective review was conducted in which all 24 patients undergoing internal hemipelvectomy from January 1, 2005 to December 31, 2015 at our institution were included. Medical …

A Case Series On Nutrition In Hip Fracture Patients: A Mismatch Between Needs And Dietary Intake, Njalalle Baraza, Eamon Ramhamadany, Thomas Laios

General Surgery, East Africa

Hip fractures are common in the United Kingdom with an overall estimated annual incidence of 100 fractures per 10,000 of the population for males and 81 per 10,000 for females [1], and with an ageing population this figure is set to rise [2]. From recent estimates, this costs the British tax payer over £750,000,000 a year, with over half this amount spent in social care of the patients recovering from the fracture [3]. Elderly hip fracture patients often have co-morbidities and mortality in the first year can be as high as 33% [4].

Outpatient Percutaneous Release Of Trigger Finger: A Cost Effective And Safe Procedure, Marij Zahid, Aurangzeb Qureshi, Rizwan H. R, Haroon Rashid, Pervaiz M. Hashmi

Section of Orthopaedic Surgery

Introduction: Trigger finger is a common cause of pain and disability of the hand. Percutaneous release results in earlier functional recovery and patient satisfaction. This is a rapid and cost-effective method which saves a surgical procedure and results in better functional outcome.
Materials and Methods: This is a prospective observational study conducted on fifty-two fingers and thumbs in 52 patients treated from 1st July 2014 till 31st December 2014, in the Orthopaedic Section, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan. All the baseline characteristics of the patients, like demographics, symptoms, Quinell's criteria and functional outcome were recorded. The …

Osteoporosis Treatment Efficacy For Men: A Systematic Review And Meta-Analysis., Smita Nayak, Susan L Greenspan

Articles, Abstracts, and Reports

OBJECTIVES: To evaluate the efficacy of treatment options to reduce osteoporotic fracture risk in men.

DESIGN: Systematic review and meta-analysis.

SETTING: Randomized clinical trials that evaluated the efficacy of a treatment for osteoporosis or low bone mineral density for adult men and reported fracture outcomes.

PARTICIPANTS: Men.

MEASUREMENTS: PubMed, Embase, and the Cochrane Library databases were searched for relevant studies. Information was extracted from included studies on participant sociodemographic characteristics, number of male participants, treatment evaluated, comparator for evaluated treatment, study duration, and fracture outcomes. Risk of bias of individual studies was assessed using measures recommended by the Cochrane Collaboration. …

Surgical Site Infection And Transfusion Rates Are Higher In Underweight Total Knee Arthroplasty Patients., Jorge Manrique, Antonia F. Chen, Md, Mba, Miguel M. Gomez, Mitchell Maltenfort, Phd, William J. Hozack Md

Rothman Institute Papers

BACKGROUND: Underweight (UW) patients undergoing total hip arthroplasty have exhibited higher complication rates, including infection and transfusion. No study to our knowledge has evaluated UW total knee arthroplasty (TKA) patients. We, therefore, conducted a study to investigate if these patients are at increased risk for complications, including infection and transfusion.

METHODS: A case-control study was conducted using a prospectively collected institutional database. Twenty-seven TKA patients were identified as UW (body mass index [BMI] < 18.5 kg/m

RESULTS: The average BMI was 17.1 kg/m

CONCLUSIONS: Our study demonstrates that UW TKA patients have a higher likelihood of developing SSI and requiring blood transfusions. The …

Epidemiology And Impact Of Abdominal Oblique Injuries In Major And Minor League Baseball., Christopher L Camp, Stan Conte, Steven B. Cohen, Matthew Thompson, John D' Angelo, Joseph T Nguyen, Joshua S Dines

Rothman Institute Papers

BACKGROUND: Oblique injuries are known to be a common cause of time out of play for professional baseball players, and prior work has suggested that injury rates may be on the rise in Major League Baseball (MLB).

PURPOSE: To better understand the current incidence of oblique injuries, determine their impact based on time out of play, and to identify common injury patterns that may guide future injury prevention programs.

STUDY DESIGN: Descriptive epidemiological study.

METHODS: Using the MLB Health and Injury Tracking System, all oblique injuries that resulted in time out of play in MLB and Minor League Baseball (MiLB) …

Technical Considerations In Revision Anterior Cruciate Ligament Reconstruction For Operative Techniques In Orthopaedics, Jeremy M. Burnham, Elmar Herbst, Thierry Pauyo, Thomas Pfeiffer, Darren L. Johnson, Freddie H. Fu, Volker Musahl

Orthopaedic Surgery and Sports Medicine Faculty Publications

As the incidence of anterior cruciate ligament (ACL) reconstruction continues to increase, the rate of revision surgery continues to climb. Revision surgery has inherent challenges that must be addressed to achieve successful results. The cause of the primary ACL reconstruction failure should be determined and careful preoperative planning should be performed to address the cause(s) of failure. Each patient undergoing revision surgery should undergo a thorough history and physical examination, receive full-length alignment radiographs, lateral radiographs, 45° flexion weight-bearing posteroanterior radiographs, and patellofemoral radiographs. The 3-dimensional computed tomography scan should be performed to assess tunnel position and widening. Magnetic resonance …

High-Speed Video Capture Of Anterior Cruciate Ligament Tear, Steven L. Cook, Devon T. Smith

Biomedical Engineering Western Regional Conference

High-speed Video Capture of Anterior Cruciate Ligament Tear

Enhancement Of Fracture Healing In The Rat, Modulated By Compounds That Stimulate Inducible Nitric Oxide Synthase: Acceleration Of Fracture Healing Via Inducible Nitric Oxide Synthase., R A Rajfer, A Kilic, Andrew S Neviaser, L M Schulte, S M Hlaing, J Landeros, M G Ferrini, E Ebramzadeh, S-H Park

Orthopaedic Surgery Faculty Publications

OBJECTIVES: We investigated the effects on fracture healing of two up-regulators of inducible nitric oxide synthase (iNOS) in a rat model of an open femoral osteotomy: tadalafil, a phosphodiesterase inhibitor, and the recently reported nutraceutical, COMB-4 (consisting of L-citrulline, Paullinia cupana, ginger and muira puama), given orally for either 14 or 42 days.

MATERIALS AND METHODS: Unilateral femoral osteotomies were created in 58 male rats and fixed with an intramedullary compression nail. Rats were treated daily either with vehicle, tadalafil or COMB-4. Biomechanical testing of the healed fracture was performed on day 42. The volume, mineral content and bone density …

Prospects And Limitations Of Improving Skeletal Growth In A Mouse Model Of Spondyloepiphyseal Dysplasia Caused By R992c (P.R1192c) Substitution In Collagen Ii., Machiko Arita, Jolanta Fertala, Cheryl Hou, James Kostas, Andrzej Steplewski, Andrzej Fertala

Department of Orthopaedic Surgery Faculty Papers

Skeletal dysplasias form a group of skeletal disorders caused by mutations in macromolecules of cartilage and bone. The severity of skeletal dysplasias ranges from precocious arthropathy to perinatal lethality. Although the pathomechanisms of these disorders are generally well defined, the feasibility of repairing established aberrant skeletal tissues that developed in the presence of mutant molecules is currently unknown. Here, we employed a validated mouse model of spondyloepiphyseal dysplasia (SED) that enables temporal control of the production of the R992C (p.R1192C) collagen II mutant that causes this disease. Although in our earlier studies we determined that blocking the expression of this …

Orthopaedic Surgeon Density In West Virginia, Franklin D. Shuler, Grant S. Buchanan, Zachary Sanford, Milad Modarresi, James Timothy Reagan, Kelly Scott, Chad Fisher, Ali Oliashirazi

Marshall Journal of Medicine

Abstract

West Virginia (WV) has many healthcare disparities and access barriers. For bone and joint disorders, WV has some of the highest rates of musculoskeletal problems, including the highest reported rate of adult arthritis in the nation (36.2%). We hypothesized that WV has one of the lowest Orthopaedic surgeon densities in the country, which can negatively impact the delivery of musculoskeletal care. Using the WV Board of Medicine practitioner databank, the Veterans Administration practitioner data, and national Orthopaedic surgeon census data, we demonstrated a considerably low Orthopaedic surgeon density in WV (7.71/100,000 population versus the national average of 8.51/100,000 population) …

Sports Medicine Potpourri, Marc I. Harwood, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives:

At the conclusion of this talk, the learner will be:

• Thoroughly confused by the whirlwind of information presented
• But...able to delve into any of the topics at greater length when time permits.

Presentation: 52:03

Audio for PowerPoint slides.

Faculty, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Front Matter, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Mid-Level Providers, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Division Of Research, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Letter From The Chair, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Letter From The Co-Editors, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Letter From The Residency Director, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Value-Based Bundled Repayment In Total Joint Arthroplasty, Michael M. Decker

UNM Orthopaedic Research Journal

The United States continues to spend an unprecedented amount of annual money on healthcare. However, the costs of providing care may not appropriately reflect the quality of care patients are receiving. This is particularly concerning when examining the projected increase in total joint arthroplasty (TJA) procedures over the next few decades, which are expected to increase to nearly 4 million procedures annually. The Center for Medicare and Medicaid Services (CMS) has responded by increasingly shifting reimbursements from the less efficient fee-forservice repayment model to value-based repayment. The Comprehensive Care for Joint Replacement (CJR) bundle payment model has recently been implemented …

Alumni Map, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Performance-Enhancing Drugs: A Review, G Keith Gill

UNM Orthopaedic Research Journal

Performance-enhancing drugs and substances have been an integral part of athletics and society. The immense popularity and financial compensation associated with success in sports often results in a desire to win at all costs, which stimulates a never-ending appetite for use of ergogenic aids. Athletes have experimented with these substances (ranging from over-the-counter supplements to anabolic-androgenic steroids and beyond) if a possibility of advantage exists, whether scientifically or theoretically supported. As the technology to create new designer drugs becomes more available, the ability to test for the presence of these substances lags slightly behind. The knowledge base of sports-medicine physicians …

Antegrade Nailing Of Femur Shaft Fractures: A Review, Thomas A. Decoster, Shahram Bozorgnia, Samer Kakish

UNM Orthopaedic Research Journal

Rigid intramedullary (IM) nailing is an effective procedure for treating fractures of the femoral shaft. Despite the existence of alternative devices and techniques (eg, unreamed nails, flexible nails, plates, external fixation, and traction), the use of rigid reamed nails has shown excellent healing rates, return of function, alignment, and low complications. This type of nail has been used in an antegrade approach to the entry site of the fracture, resulting in successful treatment. We describe indications, contraindications, and surgical techniques of antegrade IM nailing associated with our personal experience and published results. We provide pearls and pitfalls to assist orthopaedic …

Radiographic And Clinical Evaluation Of Syndesmotic Screws In Treating Injuries Of The Distal Aspect Of The Tibiofibular Syndesmosis, James A. Dollahite, Paul J. Goodwyn, Katherine J. Gavin, Richard A. Miller

UNM Orthopaedic Research Journal

Background: Several factors can affect the success of surgical treatment of injuries to the distal aspect of the tibiofibular syndesmosis, including the bony articulation between the distal aspect of the fibula, tibia, and the supporting ligamentous structures; number and size of screws; number of cortices penetrated; and planned routine removal of screws.

Methods: We conducted a retrospective review of radiographs and clinic notes for all patients who underwent open reduction and internal fixation of injury to the tibiofibular syndesmosis, which was performed by a single surgeon (RAM), between January 2011 and December 2014. Only screws were used. The screws were …

Lateral Versus Dorsal Plating For Treating Metacarpal And Phalanx Fractures: A Retrospective Cohort Study, Joshua W. Hustedt, Collin C. Barber, Michael Bonnelli, Lloyd P. Champagne

UNM Orthopaedic Research Journal

Background: The purpose of this study was to investigate the differences between the dorsal and lateral plate position for metacarpal and phalanx fractures.

Methods: We conducted a retrospective review of prospectively collected patient data for 186 fractures treated by a single surgeon between 2009 and 2011. Rates of plate removal, total arc of postoperative motion (TAM), and patient and injury demographics were tested for association with plating position.

Results: Increasing age, larger plates, and dorsal plating were found in univariate analysis to be associated with decreased TAM and increased plate removal in phalanx but not in metacarpal fractures.

Conclusions: These …

Determining Frequency And Defining The Patient Profile Of Sacral Insufficiency Fractures, Blake Obrock, Jeremy Wearn, Matthew L. Dehart, Paxton Gehling, Amer M. Mirza

UNM Orthopaedic Research Journal

Background: Insufficiency fractures at the sacrum represent a considerable cause of low back pain and disability within the geriatric population. However, there has never been a large-scale study examining the epidemiologic trends associated with the disease, and thus this condition has been largely under recognized.

Methods: This study analyzed a Nationwide Inpatient Sample (NIS) database to trend frequency and burden of sacral insufficiency fractures (SIF). All inpatient stays from 1998 to 2010 noted on the NIS were included if the case maintained at least one or more diagnostic code. A total of 257,697 unique admissions (63% women, 37% men) met …

Hierarchical Modeling Versus Regression Analysis For Evaluating Results Of Orthopaedic Studies That Use The National Inpatient Sample, Joshua W. Hustedt, Kade Mcquivey, John C. Hustedt

UNM Orthopaedic Research Journal

Background: Owing to its hierarchical sampling structure, the National Inpatient Sample (NIS) often involves clusters of study data. We aimed to (1) understand the statistical methods of currently published orthopaedic studies using NIS and (2) examine the role of hierarchical modeling versus traditional regression analysis in a retrospective cohort of patients from NIS.

Methods: We conducted a systematic review to examine statistical methods of orthopaedic studies (published between 2005 and 2014) using NIS. Ultimately, 132 studies were identified. We noted percentages of studies that used hierarchical modeling versus traditional regression analysis. Using NIS, we identified a retrospective cohort of patients …

Radiographic Prevalence Of Osteoarthritis Of The Scaphotrapeziotrapezoid Joint In Patients With Carpometacarpal Osteoarthritis Of The Thumb: A Retrospective Case Series, Charlotte E. Orr, Robert Mercer, Deana M. Mercer, Drew K. Newhoff, Matthew D. Martin, Moheb S. Moneim

UNM Orthopaedic Research Journal

Background: In planning operative treatment of thumb carpometacarpal (CMC) joint osteoarthritis, surgeons should consider the presence of an arthritic scaphotrapeziotrapezoid (STT) joint. We aimed to determine the radiographic prevalence of concomitant (STT) osteoarthritis with thumb CMC osteoarthritis in patients who underwent surgical treatment at our institution. We hypothesized that the prevalence of concomitant arthritis at these 2 joints (STT and CMC) would be lower than previously reported.

Methods: Between September 2005 and July 2012, a total of 417 patients were identified from our institution using the Current Procedural Terminology code for thumb CMC joint arthroplasty (25447). After applying exclusion criteria …

External Fixation For Treating Tibial Shaft Fractures Using A Triangular Two-Planar Frame: A Computational And Biomechanical Study, Christina Salas, Daniel Hoopes, Mahmoud M. Reda Taha, Thomas A. Decoster

UNM Orthopaedic Research Journal

Background: Construct stability is a necessary characteristic of external fixators. Many commonly used fixators are constructed as symmetric one-plane frames. We postulate that asymmetric two-plane triangular constructs provide enhanced stability with simplicity and freedom in pin placement. We hypothesized that results of finite element analysis would determine optimal geometric configuration, and findings of mechanical testing would confirm the improved stability of two-plane triangular constructs.

Methods: Finite element modeling was used to analyze configurations for 16 triangular designs compared to a single-rod (SR) uniplanar frame. Variables included pin axial angulation (0°, 22.5°, 45°, and 90°), connectivity of the rod-to-pin couplers, and …