Orthopedics Commons^™

Hip Fractures Before And During The Covid-19 Pandemic: Comparative Demographics And Outcomes, Alireza K. Nazemi, Samer M. Al-Humadi, Ryan Tantone, Thomas R. Hays, Stephen N. Bowen, David E. Komatsu, Nicholas Divaris

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: During the height of the COVID-19 pandemic in NY, hip fractures requiring operative management continued to present to Stony Brook University Hospital. Given the novelty of SARS-CoV-2, there is recent interest in the pandemic and its relationship to orthopaedic operative outcomes.

Purpose: This retrospective cohort study compared outcomes for operative hip fractures in patients prior to and during the COVID-19 pandemic at a Level 1 academic center.

Methods: Data were collected from patients age18 years or older who underwent operative management for hip fractures performed from January 21, 2019 to July 1, 2019 (pre-pandemic) and from January 21, 2020 …

Is There A Role For Ct Pan-Scans In The Initial Work-Up Of Fragility Fracture Patients?, Eric Lepkowsky, Trevor Simcox, Hunter Rogoff, Shahidul Islam, Omid Barzideh

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: CT pan-scans have become increasingly commonplace as part of the initial diagnostic work-up for patients sustaining traumatic injuries. They have proven effective in improving diagnostic accuracy in those with high energy mechanisms of injury. However, the utility of pan-scans in the geriatric population sustaining low energy traumatic injuries remains unproven. There is no study that assesses the usefulness of CT pan-scans in patients who sustain injuries related to osteoporosis, also known as fragility fractures.

Methods: A retrospective review was conducted of patients who sustained a fragility fracture at a Level 1 trauma center over a 15-month period. Patients underwent …

Effects Of Alcohol Use On Total Knee Arthroplasty Patient Osteoarthritis Severity, Preoperative Pain Scores, And Postoperative Range Of Motion: A Retrospective Study, Christopher Ruland, Samir Baig, Zach Warheit, David E. Komatsu, James Nicholson

Stony Brook Orthopaedic and Musculoskeletal Journal

Introduction: Despite the prevalence of significant alcohol use, the effect of alcohol consumption on patients undergoing total knee arthroplasty (TKA) is poorly understood. Other forms of substance abuse, such as narcotic dependence, decrease patient pain tolerance and increase self-reported pain scores, while excessive alcohol consumption has been associated with adverse outcomes following other elective surgical procedures. In the context of TKA, perception of pain is also likely linked to the ability to achieve functional postoperative range of motion (ROM), one of the most important predictive indicators of patient satisfaction. It is not well understood whether heavy alcohol users who are …

Biomechanical Comparison Of Krackow Open Repair And Percutaneous Achilles Repair System For Achilles Tendon Rupture: A Cadaveric And Finite Element Model Study, David R. Swanson, Alireza Nazemi, Bonnie Macaluso, Chaudhry R. Hassan, Megan Paulus, Yi-Xian Qin, David E. Komatsu

Stony Brook Orthopaedic and Musculoskeletal Journal

Achilles tendon ruptures are one of the most common tendon injuries. Numerous surgical procedures have been developed to repair these injuries, but there is no consensus as to which technique is superior. This combined cadaveric and finite element model study was performed to compare directly initial biomechanical integrity between two operative techniques and use these resulting data to validate a finite element model.

Multicenter Studies In Orthopaedic Trauma: Importance, Challenges, And Stony Brook’S Contributions, Amanda C. Pawlak, Nathan Olszewski, Maxwell Alley, Thomas Seaver, Diana Lee, Michael Doany, Paul Tornetta Iii, Stephen A. Kottmeier, Orthopaedic Trauma Research Consortium

Stony Brook Orthopaedic and Musculoskeletal Journal

Historically, research within the field of orthopaedic surgery has largely consisted of small cohort studies or case series, typically produced out of one single center.1 Multicenter studies, however, allow for larger sample sizes and analyses with greater power and improved generalizability.2 Though these collaborative studies present challenges, including time, cost, communication and authorship issues, the value of these types of studies cannot be overstated.2,3 The Orthopaedic Trauma Research Consortium (OTRC) is one of several multi-institution research groups dedicated to furthering the field of orthopaedic trauma research. This manuscript reviews four recent OTRC studies that Stony Brook provided significant contributions to: …

Adipose Tissue As Pain Generator In The Lower Back And Lower Extremity: Application In Musculoskeletal Medicine, Se Won Lee, Craig Van Dien, Sun Jae Won

HCA Healthcare Journal of Medicine

Adipose tissue (AT) has diverse and important functions in body insulation, mechanical protection, energy metabolism and the endocrine system. Despite its relative abundance in the human body, the clinical significance of AT in musculoskeletal (MSK) medicine, particularly its role in painful MSK conditions, is under-recognized. Pain associated with AT can be divided into intrinsic (AT as a primary pain generator), extrinsic (AT as a secondary pain generator) or mixed origin. Understanding AT as an MSK pain generator, both by mechanism and its specific role in pain generation by body region, enhances the clinical decision-making process and guides therapeutic strategies in …

Right Arm Pain, Color Change And Swelling In A 17-Year-Old Male Baseball Pitcher, Alvin Chi

Research Days

No abstract provided.

Balance Of Adults With Chronic Ankle Instability Following A 6-Week Core Stability Program, Natalie Dickol

Theses and Dissertations

Ankle injuries are one of the most common injuries in the athletic population because of the anatomy of the ankle in conjunction with dynamic activity. During injury, mechanoreceptors are damaged, effecting neuromuscular control. Lack of neuromuscular control puts patients at risk for re-injury. Chronic ankle instability (CAI) has been defined as a condition associated with recurrent sprains and persistent symptoms, including feelings of "giving way," loss of function and limited movement and continuous ankle pain. Patients with CAI are commonly shown to have functional deficits in postural control, such as overcompensating on the uninvolved limb or unable to maintain proper …

Return To Sport And Athletic Function In An Active Population After Primary Arthroscopic Labral Reconstruction Of The Hip, David R. Maldonado, Sarah L. Chen, Mitchell J. Yelton, Philip J. Rosinsky, Rafael Walker-Santiago, Jacob Shapira, Ajay C. Lall, Benjamin G. Domb

Student Papers, Posters & Projects

Background: Labral reconstruction has been advocated as an alternative to debridement for the treatment of irreparable labral tears, showing favorable short-term results. However, literature is scarce regarding outcomes and return to sport in the nonelite athletic population.

Purpose: To report minimum 1-year clinical outcomes and the rate of return to sport in athletic patients who underwent primary hip arthroscopy with labral reconstruction in the setting of femoroacetabular impingement syndrome and irreparable labral tears.

Study Design: Case series; Level of evidence, 4.

Methods: Data were prospectively collected and retrospectively analyzed for patients who underwent an arthroscopic labral reconstruction between August 2012 …

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. …

Anterior Cruciate Ligament Injury-Induced Alterations In Inflammation And Muscle Physiology, Emily R. Hunt

Theses and Dissertations--Rehabilitation Sciences

Long term weakness and atrophy of the quadriceps muscle are a direct result of anterior cruciate ligament (ACL) injuries and persist for up to 10 years post injury. Muscle atrophy ensues regardless of ligamentous reconstruction surgery, indicating that muscle atrophy following injury is a function of the ligament rupture and not reconstruction surgery. Elucidating the mechanisms underlying quadriceps atrophy following ACL rupture is crucial for developing interventions to restore proper quadriceps size and mitigate weakness thereby allowing for improved patient function. In addition to understanding the specific mechanisms that contribute to quadriceps atrophy following ACL rupture, the timing of atrophic …

Oral Contraceptives As Possible Acl Injury Prevention Method, Haley Schweizer

Capstone Showcase

ABSTRACT

Introduction: Anterior Cruciate Ligament (ACL) injuries are an upsetting setback for many athletes that require a long and costly recovery process. The injury rates are four times greater in women than men. Preventative measures that help to prevent ACL injuries are limited to stretching and strengthening. Therefore, this review aims to investigate if oral contraceptive [I] usage provides a possible new avenue for prevention of ACL injury [O] in young female athletes (ages 18-30) [P] compared to those that do not take oral contraceptives [C].

Methods: A literature review was performed though PubMed, Google Scholar, SCOPUS Database, and ClinicalKey …

Humeral Retroversion, Range Of Motion, And Strength Adaptations In Tennis Players, Daniel Hannah

Electronic Theses and Dissertations

Purpose: This study aimed to develop an understanding of humeral retroversion (HRV) asymmetries in tennis players and its impact on physical and performance characteristics of the shoulder.Participants: Healthy tennis players were categorized into 3 groups: younger juniors (n=11, age=14.5±0.5 years), older juniors (n=12, age=17.1±0.9 years), and collegiate (n=16, age=19.6±1.2 years). Methods: HRV, internal rotation (IR), and external rotation (ER), total arc of motion (TAM), HRV-corrected IR (HRVcIR), and HRV-corrected ER (HRVcER) were measured and calculated bilaterally using a digital inclinometer and ultrasonography. Bilateral differences (Δ) were calculated (dominant minus nondominant) for HRV and ROM variables. Isometric ER:IR strength ratios …

Interpreting Patient Reported Outcomes In Orthopaedic Surgery: A Systematic Review, Shgufta Docter, Zina Fathalla, Michael Lukacs, Michaela Khan, Morgan Jennings, Shu-Hsuan Liu, Dong Zi, Dianne Bryant

Western Research Forum

Background: Reporting methods of patient reported outcome measures (PROMs) vary in orthopaedic surgery literature. While most studies report statistical significance, the interpretation of results would be improved if authors reported confidence intervals (CIs), the minimally clinically important difference (MCID), and number needed to treat (NNT).

Objective: To assess the quality and interpretability of reporting the results of PROMs. To evaluate reporting, we will assess the proportion of studies that reported (1) 95% CIs, (2) MCID, and (3) NNT. To evaluate interpretation, we will assess the proportion of studies that discussed results using the MCID or the effect sizes and how …

Sport Participation And Specialization Characteristics Among Pediatric Soccer Athletes, Tamara Valovich Mcleod, Michael Israel, Melissa A. Christino, Jane S. Chung, Scott D. Mckay, Pamela J. Lang, David R. Bell, Charles M. Chan, Allison Crepeau, Elizabeth Davis, Amanda L. Fletcher, Jessica Laniak, Kelsie Mccaffrey, Donna M. Pacicca, Mark Riederer, Katherine Rizzone, Jeremy K. Rush, Tracy Zaslow

Manuscripts, Articles, Book Chapters and Other Papers

© The Author(s) 2019.

Background: Soccer is an increasingly popular sport for children and adolescents in the United States. Little is known about participation patterns related to sport specialization.

Purpose: To investigate soccer participation levels and sport specialization characteristics among youth soccer athletes.

Study Design: Cross-sectional study. Methods: Adolescent athletes aged between 12 and 18 years completed an online survey addressing participant demographics, sports and soccer participation history, and level of specialization. Descriptive analyses characterized participation, while chi-square and Kruskal-Wallis tests assessed the influence of specialization, sex, and grade on survey variables.

Results: Overall, 83.7% of 746 respondents participated in …

Temporary Fracture Stabilization Device, Steven J. Lawrence

Orthopaedic Surgery and Sports Medicine Faculty Patents

A temporary fracture stabilization device includes a first intramedullary fixation rod, a second intramedullary fixation rod, a first extramedullary connector, a second extramedullary connector and a fastener. A field kit for temporary fracture stabilization is also disclosed.

Physicians’ Knowledge And Beliefs Regarding Athletic Trainers, Joseph H. Vogler, Lindsey E. Eberman, Zachary K. Winkelmann, M. Seth Smith, James L. Turner, Kenneth E. Games

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Purpose: The relationship between athletic trainers (ATs) and physicians is a legal obligation and collaboration to improve patient outcomes. The objective of this study was to examine the knowledge of physicians regarding the educational preparation, legal obligations, and scope of practice for ATs and how it relates to previous experiences with ATs. Additionally physicians’ perceptions of Interprofessional Collaboration (IPC) were studied. Methods: 169 physicians medical doctors (MD)=133/169, 78.7%, doctor of osteopathy (DO)=36/169, 21%) completed a 36-question web-based survey, which included a validated IPC scale. Results: Respondents with experience working with an AT scored significantly higher (P < 0.01) on the knowledge assessment, where physicians currently working with an AT scored higher (5.4/8) than those who previously worked with an AT (4.2/8) and those who had never worked with an AT (3.3/8). Additionally, physicians with previous exposure to an AT as an athlete had significantly higher knowledge scores than those without exposure (P < 0.01). Two areas of weakness in IPC from the physician’s perspective included sharing of important information (2.48/4) and importance of work as compared to others on the team (2.38/4). Conclusions: Physicians who have a current working relationship with an AT and those that had access to an AT as an athlete demonstrated significantly higher knowledge about an AT’s academic preparation, legal obligations, and scope of practice. Moreover, physicians currently working with an AT report positive interprofessional collaborations.

A Traumatic Three-Level Brachial Plexus Palsy With Upper Trunk Avulsion, Andre Anderson, Michael Swartzon, Gautam Yagnik, John Uribe

All Publications

No abstract provided.

Long-Term Clinical Results Of Intra-Articular Injections For Osteoarthritis Of The Knee, Michael Swartzon, Andre Anderson, Luis Rodriguez

All Publications

No abstract provided.

Rotator Cuff Tear Progression In Professional Contact Athletes, Gautam Yagnik, William Davis, Michael Swartzon, John Uribe

All Publications

No abstract provided.

Femoroacetabular Impingement As A Complication Of Acetabular Fracture Fixation, David A. Zuelzer, Christopher B. Hayes, Raymond D. Wright, Stephen T. Duncan

Orthopaedic Surgery and Sports Medicine Faculty Publications

Case

We present the case of a thirteen-year-old female who sustained a posterior wall acetabular fracture dislocation. She underwent urgent closed reduction and subsequent uncomplicated open reduction and internal fixation. Post reduction computed tomography demonstrated a concentrically reduced hip joint with no evidence of femoroacetabular impingement (FAI). She subsequently healed her fracture and returned to running activities; however, one year later presented with aching pain in her thigh. Radiographs demonstrated the development of a large osseous prominence on her anterolateral femoral neck consistent with femoroacetabular impingement. Based on these findings she was evaluated by a hip preservation specialist. She subsequently …

Injuries In The Chinese Arena Football League: American Versus Chinese Players., Tianwu Chen, Austin Wetzler, Scott Singer, Michael Feldman, David Rubenstein, Gunnar Gillespie, Shiyi Chen, Merrick Wetzler

Rothman Institute Papers

Background: Arena football is an indoor version of American football played in indoor arenas on a smaller field with 8 players per team. Only 1 study has evaluated injury rates in arena football, and no study had compared 2 distinct cohorts of players.

Purpose/Hypothesis: The purpose of this study was to evaluate and compare injury rates in American versus Chinese athletes in the Chinese Arena Football League. Our hypothesis was that the rate of significant injuries (≥7 days of time lost from play) would be statistically significantly higher in Chinese athletes.

Study Design: Cohort study; Level of evidence, 2.

Methods: …

Spinal Cord Trauma: An Overview Of Normal Structure And Function, Primary And Secondary Mechanisms Of Injury, And Emerging Treatment Modalities, Daniel Morin

Senior Honors Theses

The structures of the spinal cord and vertebral column are designed to provide flexibility, while still providing ample protection for the spinal cord deep within. While it does offer remarkable protection against most routine trauma, the spinal cord is still vulnerable to high-force etiologies of trauma and may become damaged as a result. These events are referred to as primary injury. Following the initial injury, the body’s own physiological responses cause a cascade of deleterious effects, known as secondary injury. Secondary injury is a major therapeutic target in mitigating the effects of spinal cord injury (SCI), and much research is …

Active And Inactive Leg Hemodynamics During Sequential Single-Leg Interval Cycling, Nicole Gordon, Chris R. Abbiss, Mohammed Ihsan, Andrew J. Maiorana, Jeremiah J. Peiffer

Research outputs 2014 to 2021

Introduction Leg order during sequential single-leg cycling (i.e., exercising both legs independently within a single session) may affect local muscular responses potentially influencing adaptations. This study examined the cardiovascular and skeletal muscle hemodynamic responses during double-leg and sequential single-leg cycling. Methods Ten young healthy adults (28 ± 6 yr) completed six 1-min double-leg intervals interspersed with 1 min of passive recovery and, on a separate occasion, 12 (six with one leg followed by six with the other leg) 1-min single-leg intervals interspersed with 1 min of passive recovery. Oxygen consumption, heart rate, blood pressure, muscle oxygenation, muscle blood volume, and …

Incidence, Positional Distribution, Severity, And Time Missed In Medial Collateral Ligament Injuries Of The Knee In Ncaa Division I Football Athletes., Ali R Motamedi, Anirudh K Gowd, Alireza K Nazemi, Stephen T Gardner, Caleb J Behrend

Articles, Abstracts, and Reports

Introduction: We studied injury to the medial collateral ligament (MCL) in National Collegiate Athletic Association (NCAA) Division I football players, their incidence, magnitude of injury, distribution by position, and missed time, which has not previously been described in a consecutive series.

Methods: The knee injuries sustained in 163 consecutive NCAA Division I collegiate football players at our institution were evaluated over a span of 6 years.

Results: The incidence of MCL injuries with any knee injury was 29% (47 of 163). Of 47 MCL injuries, 34% occurred in defensive linemen and 29% in offensive linemen. The average days missed by …

Biomechanical Testing Of An Exercise For Strengthening The Proximal Femur., Alyssa Osbourne

Electronic Theses and Dissertations

Based on the principles of cutting edge bone remodeling research, a unique therapeutic exercise device was designed specifically to improve bone quality at the most critical location of the proximal femur prone to fracture: the superior-lateral femoral neck where the fracture first initiates during a fall. The exercise/device is intended to work by inducing enough strain in the bone to stimulate the body’s natural bone remodeling mechanisms to increase bone density in the proximal femur and consequently prevent a fracture from arising if a fall to the side does occur.

In order to test the proposed exercise, experiments simulating the …

Early Versus Delayed Rehabilitation After Arthroscopic Rotator Cuff Repair, Abigail Chang, Jessica Dennis

Physician Assistant Capstones, 2016 to 2019

Objective: To determine how the timing of rehabilitation, early versus delayed, affects clinical results and tendon healing rates after arthroscopic rotator cuff repair. Design: Systematic literature review. Methods: Searches were done in PubMed, utilizing the terms arthroscopic rotator cuff repair, rehabilitation, early, and delayed. In PubMed the following filters and terms were used: published in the last 10 years, humans, randomized controlled trial, free full-text articles, and English. Results: The Keener et al study was included because it evaluated clinical results and tendon healing rates after arthroscopic repair using two distinct rehabilitation protocols, early versus delayed …

The Effect Of Three Different Ankle Braces On Vertical Jump Performance In Female College Volleyball Players, Ashley M. Jefferson

Undergraduate Theses

Background/Purpose: Ankle braces are often used to stabilize the ankle joint of an athlete to reduce the risk of initial injury while participating in athletic activity or to protect the joint from re-injury when returning to play. The purpose of this study was to examine the effects of application of three different braces on vertical jump performance in collegiate female volleyball players. A secondary aim was to compare participant preference and satisfaction on selected characteristics of each of the three different braces.

Subjects: 31 female varsity/club college volleyball players >18 years of age.

Materials/Methods: Health History Assessment and a dynamic …

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.

The Reliability Of The Navicular Drop Test And Its Transferability To Dynamic Movement, Joshua Krispin

College of Graduate Studies: Theses & Dissertations

Background: Navicular drop can be defined as the distance the navicular tuberosity moves from a standing weight bearing to a standing neutral position, as the subtalar joint moves from a relaxed position to a neutral position. Navicular drop is an important measurement for clinicians used to describe foot function, pronation, and excessive movement seen in several pathologies. Objective: The purpose of this study is to see if navicular drop is influenced by mode or speed of locomotion, if it is will there be other influences such as the forefoot and heel soft tissue, and will those factors influence those measures. …