Medical Specialties Commons^™

Assessment Of Landing Biomechanics And Rehabilitation After Anterior Cruciate Ligament Reconstruction, Sheila S. Gagnon

Electronic Thesis and Dissertation Repository

Aberrant landing biomechanics increase the risk of anterior cruciate ligament (ACL) injury and are a focus of rehabilitation after ACL reconstruction. The purpose of the present thesis was to develop and evaluate methods of assessing landing mechanics and investigate the effects of different rehabilitation strategies after ACL reconstruction. Three studies were conducted. The first study used a Delphi process to develop the content of a Clinician-Rated Drop Vertical Jump Scale to evaluate jump landing mechanics during rehabilitation after ACL reconstruction. Twenty experts participated in four rounds of questioning, resulting in 92% agreement for knee valgus collapse, lateral trunk lean, insufficient …

The Examination Of Expectations In Day-Surgery Patients And The Development Of A Patient Satisfaction Questionnaire For Day-Surgery Patients, Tishara M. Wijayanayaka

Electronic Thesis and Dissertation Repository

Patient satisfaction has become a growing area of study within health care. Existing hospital- wide satisfaction tools don’t provide the specificity that various departments require to truly get a sense of where they stand in terms of patient satisfaction. Further, many of these tools fail to consider an important component associated with satisfaction, patient expectations. Currently, there is no patient satisfaction tool specific to adult day-surgery patients that has been developed through a careful exploration of patient expectations. In this qualitative study, we conducted a series of semi-structured interviews on patients undergoing outpatient surgery to explore expectations. We performed a …

Ultrasound-Guided Resuscitation In Open Aortic Surgery - The Aortus Trial, John H. Landau

Electronic Thesis and Dissertation Repository

Introduction: Major abdominal aortic surgery requires significant fluid resuscitation in the post-operative phase. Patients are at significant risk of perioperative morbidity and mortality which can be affected by the approach to post-operative fluid resuscitation. Point of care ultrasonography (POCUS) has evolved as a tool to perform whole-body assessments at the bedside to augment the physical exam and guide the resuscitation of the critically ill. This study will aim to explore the value of rigorous goal-directed resuscitation in aortic surgery using point of care ultrasonography (POCUS).

Methods: In an open-label, randomized, feasibility trial we enrolled 17 patients to receive resuscitation guided …

Navigation And Patient Specific Instrumentation In Shoulder Arthroplasty, Joseph Cavanagh

Electronic Thesis and Dissertation Repository

The humeral head osteotomy influences shoulder arthroplasty component height, version and neck shaft angle and therefore outcomes. The purpose of this study is to develop and utilize navigation to execute the osteotomy.

3D printed models were used to develop a navigation technique, and then to execute planned osteotomies. Free hand, fixed angle guide, patient specific guides, and real time navigation osteotomies were completed. The height, neck shaft angle and version were recorded. Also collected, were the planes of the guides once they were placed.

Navigation had significantly less error from the planned osteotomy in neck shaft angle versus all other …

Quadriceps Muscle Layer Thickness In Kidney Transplant Recipients: A Potential Measure Of Frailty And Sarcopenia, Max A. Levine

Electronic Thesis and Dissertation Repository

Introduction: Frailty and sarcopenia are related concepts that can impact outcomes after kidney transplantation. Measures of these two entities and new/emerging metrics of sarcopenia remain to be validated.

Methods: In a prospective cohort study, kidney and kidney-pancreas transplant recipients were assessed at the time of transplant with the Physical Frailty Phenotype, bioimpedance analysis, quadriceps muscle layer thickness (QMLT), and CT. The impact on length of stay (LOS), prediction of frailty/sarcopenia, and relative concordance of metrics were analyzed.

Results: Low QMLT, a putative surrogate of sarcopenia/frailty, was more frequently associated with longer LOS (>14 days) after transplant. Additionally, QMLT was …

The Of Application Of 3d-Printing To Lumbar Spine Surgery, Andrew J. Kanawati

Electronic Thesis and Dissertation Repository

Rapid prototyping refers to the manufacturing process in which a three-dimensional (3D) digital model can be transformed into a physical model by layering material in the shape of successive cross sections atop of previously layers. Rapid prototyping has been increasing in popularity in the field of medicine and surgery due to the ability to personalize various aspects of patient care. The thesis will explore the use of rapid prototyping in lumbar spine surgery, aim to quantify the accuracy of medical imaging when relating to imaged structures and their corresponding models produced by rapid prototyping, and determine if complex patient-specific guides …

Feasibility Of Post-Operative Mobile Health Monitoring Among Colorectal Surgery Patients, Tanya Kuper

Electronic Thesis and Dissertation Repository

Post-operative readmission following colorectal surgery is a common and costly occurrence. Remote health monitoring via mobile applications has the potential to reduce post-operative readmissions by early identification of complications. This intervention depends on patient acceptance and compliance with available technology. The feasibility of home monitoring using automated daily surveys and wound photo uploads, delivered via a mobile health application, was tested in the immediate post-operative period after colorectal surgery. Patient compliance, the association between generated alerts and readmissions, and patient satisfaction were measured. Patient satisfaction was high; 80.5% of patients reported that they felt safer going home knowing that they …