Orthopedics Commons^™

Is Your Cyst Really A Ganglion Cyst? A Case Report Of Angioleiomyoma Mimicking A Plantar Fascia Cystic Lesion, Christopher Anjorin Ms Dpmc, Joseph Bender Dpm

School of Podiatric Medicine - Student Research

Ganglion cysts are among the most common benign soft tissue masses encountered in podiatric clinical practice, and their diagnosis is often presumed based on location, clinical observation, and transillumination. However, this case highlights a diagnostic idiosyncrasy: a lesion clinically presumed to be a ganglion cyst within the plantar fascia was ultimately identified as an angioleiomyoma following surgical excision and histopathological evaluation. This finding underscores the importance of maintaining a broad differential diagnosis when assessing cystic lesions, particularly those that transilluminate, as benign vascular tumors may closely mimic more common entities in both clinical presentation and imaging. More importantly, what if …

Joint Disease And Demographic Factors In Clinical Populations Of Medically Underserved Communities, Blake C. Martin, Juan Lopez-Alvarenga, Michael Sander

School of Medicine Publications

Background: The Rio Grande Valley is a medically underserved, demographically unique population that warrants the exploration of various conditions.

Objectives: We sought to analyze the demographic disparities between the different types of common joint conditions in this community. We hypothesized that osteoarthritis would be the most common joint condition and that the demographics between the various joint conditions would vary depending on age, sex, BMI, and ethnicity.

Methods: This was a retrospective cohort, from January 1, 2018, to September 4, 2024. Patients’ charts were obtained using the ICD-10 diagnosis codes M15-M19 for osteoarthritis, M05-M06 for rheumatoid arthritis, M10 or M1A …

Platelet Rich Plasma Injection Treatment Outcomes In Patellar Tendinopathy, Hunter M. Butler, Aamir Ahmad

School of Medicine Publications

Background: Platelet rich plasma (PRP) refers to the processed product of autologous peripheral blood with a concentration of platelets higher than baseline. This product has garnered interest for 30 years as a potential method of regenerative medicine. PRP injections have shown to be an effective treatment for patellar tendinopathy. However, some concerns remain with regards to empiric treatment of tendinopathy with PRP injections.

Objective: This article aims to investigate the outcomes of platelet rich plasma injections in patients with patellar tendonitis.

Methods: A systematic literature search was conducted using the University of Texas Rio Grande Valley (UTRGV) online database. The …

Symptomatic Manifestations Of Hip Dysplasia In Young Adults: How Do Patients Present Before Or After Surgery? Results From A Social Media Cohort, John M. Gaddis, Amanda J. Wheeler, Erika Shults, Charles South, Stephen T. Duncan, Joel Wells

School of Medicine Publications

This study aimed to analyse the symptomatic differences of hip dysplasia before or after separate surgical interventions, including pain location and characteristics, severity, patient-reported outcomes, and a body pain diagram. A REDCap-based survey was distributed through social media from October 2023 to May 2024 and targeted individuals with current or past hip pain. The survey gathered data on demographics, comprehensive hip-specific history, and various patient-reported outcome measures. Of 509 completed surveys, 287 respondents reported a diagnosis of hip dysplasia and were divided into cohorts based on treatment history: no surgery (n = 65), post-periacetabular osteotomy (PAO) (n = 162), post-THA …

Foot And Ankle Biomaterials: A Comprehensive Review Of Current Applications, Challenges, And Future Directions, Peter Elvin, Amayrani Sanchez, Anthony Allen Reyes, Hagner L. Andrade, Meelad Karami, Hooman Mir, Javier La Fontaine, Danieli Rodrigues, Claudia Biguetti

School of Podiatric Medicine Publications

Metallic biomaterials enable successful reconstruction and fixation of skeletal tissues by supporting repair, load-bearing function, and anatomical alignment in foot and ankle surgery. However, the unique anatomic and biomechanical demands of this region, combined with challenging pathologies such as flatfoot and Charcot neuroarthropathy, present distinct challenges, with effective intervention requiring targeted biomaterial solutions and precise indications. Furthermore, metallic biomaterials currently represent the most predominant and clinically validated fixation systems in foot and ankle surgical reconstructions, while also generating the largest body of outcome-based evidence. This review summarizes and discusses their contemporary applications, outcomes, limitations, unmeet needs, and future directions based …

Comorbidity Profiles Associated With Total Knee Arthroplasty In A Medically Underserved Population, Blake C. Martin, Manoj Peiris

School of Medicine Publications

Introduction: Total knee arthroplasty (TKA) is a common orthopedic procedure that is increasing in incidence and prevalence and is rising in younger populations. The Rio Grande Valley (RGV) represents a medically underserved region in the southern United States characterized by high rates of chronic conditions such as obesity, diabetes, and arthritis. The purpose of this study is to investigate the relationship between pre-existing chronic medical conditions and TKA within this medically underserved and at-risk population.

Methods: This retrospective chart review was conducted using data obtained from University of Texas Rio Grande Valley medical records spanning January 1, 2018, through January …

Assessing The Accuracy And Readability Of Chatgpt 4.0'S Original And Simplified Responses To Common Patient Questions Regarding Periacetabular Osteotomy, John M. Gaddis, Elias Arellano, Blake Martin, Yossef Alsabawi, Martin Salgado-Flores, Charles South, Pablo Castaneda, Joel Wells

School of Medicine Publications

Purpose: The study aimed to evaluate the accuracy, comprehensiveness, and readability of responses generated by ChatGPT 4.0 to 30 common patient questions about the Bernese periacetabular osteotomy (PAO).

Methods: Two fellowship-trained orthopaedic surgeons specializing in hip preservation selected thirty questions from a prior study identifying common PAO questions on social media. Each question was entered into ChatGPT 4.0, and the surgeons independently graded responses. Responses were evaluated using an established grading system. Accuracy and comprehensiveness were assessed based on the concordance of response content with current literature. Readability was analysed by calculating the Flesch-Kincaid Grade Level and Flesch-Kincaid Reading Ease. …

The Association Between Pre-Existing Medical Conditions And Trigger Finger Release In A Medically Underserved Region, Blake C. Martin, Manoj Peiris, Michael D. Sander

Research Colloquium

Background: Trigger finger is a relatively common condition that may affect daily activities. The Rio Grande Valley (RGV) is a health professional shortage area with a unique patient population. Our primary objective in this study was to analyze patients with various pre-existing medical conditions and determine if there was an association with the risk of trigger finger release surgery.

Methods: We conducted a retrospective chart review using the University of Texas Rio Grande Valley (UTRGV) UTHealth electronic database utilizing medical charts from January 1, 2018, to January 1, 2025. We collected and analyzed medical charts of patients who were diagnosed …

Chronic Conditions And Osteoporosis Risk: Insights From Penalized Logistic Modeling, Blake C. Martin, Juan Lopez Alvarenga

Research Colloquium

Background: The Rio Grande Valley (RGV) is a rural area with underserved, unique communities that may influence the health of the population. The primary objective of this study was to analyze factors associated with osteoporosis in individuals in the RGV to determine if the number of pre-existing medical conditions had an association with the frequency of osteoporosis. We hypothesized that individuals with more pre-existing medical conditions would be associated with an increased frequency of osteoporosis.

Methods: This study was a retrospective chart review from January 1, 2018, to January 1, 2025, using the University of Texas Rio Grande Valley (UTRGV) …

Demographic And Clinical Characteristics Of Patients With Benign Bone Tumors: Evidence Of Bimodal Age Distribution In A Hispanic Population, Blake Martin, Mohammad Khalil, Juan Lopez-Alvarenga, Michael Sander

School of Medicine Publications

Background

As far as researchers know, there's no way to prevent BBTs from forming. Although these tumors generally do not metastasize, they can still be dangerous as they may grow and compress healthy tissues and lead to poor outcomes. The principal objective was to evaluate the demographic and clinical characteristics linked to BBTs in individuals from the Rio Grande Valley. We hypothesized that older age and males would have greater frequency of BBTs.

Methods

This was a retrospective chart review and IRB approval was obtained prior to starting this study. We obtained medical charts for individuals who had been diagnosed …

Who Leaves Orthopedics? Analyzing Attrition Among Texas Orthopedic Surgeons, Sean Corcoran, Anesu Karen Murambadoro, Paul Bonilla, Victoria Elizondo, Tori Sayers, Daniela Ramos, Mark Manickath

Research Symposium

Background: Nationally, attrition rates in surgical specialties have been reported to be as high as 20-26%. As of 2019, women comprised only 6.5% of the 29,613 orthopedic surgeons. Female residents showed significantly higher overall attrition rates compared to males (5.96% vs. 2.79%, p < 0.001), with unintended attrition nearly twice as high (2.09% vs. 1.01%, p < 0.001). Attrition can result from a wide array of variables, including sex, ethnicity, education, and background. The aim of this study was to evaluate the demographic and educational factors associated with career longevity beyond training among orthopedic surgeons, with a focus on identifying patterns of attrition in underrepresented groups.

Methods: Data from the Texas Medical Board Physician Database as of September 2024 was evaluated using Microsoft Excel. To determine length of practice, the date of license issuance was subtracted from the date of license expiration. Surgeons with license expirations after 2024 were excluded to maintain a focus on physicians that are no longer practicing. Entries …

Evaluating The Effectiveness Of Cryoneurolysis As A Preoperative Intervention In Total Knee Arthroplasty: A Literature Review, Paul Bonilla, Anesu K. Murambadoro, Juan Pablo Flanagan, Victoria Elizondo, Aamir Ahmad

Research Symposium

Background: Total knee arthroplasty (TKA) is a highly effective treatment for knee osteoarthritis, but significant postoperative pain often necessitates opioid use. Over 70% of patients use opioid drugs 3 weeks after TKA and up to 15% of TKA patients develop opioid dependence, increasing the risk of adverse effects, infections, and contributes to costly revision surgeries. Cryoneurolysis, a minimally invasive technique involving freezing peripheral nerves, has gained attention as a promising preoperative intervention. This study explores the potential of cryoneurolysis as a preoperative intervention to alleviate pain, reduce opioid dependence, and improve functionality.

Methods: A literature search was conducted using the …

Dual-Modality Nerve Ablation: Preoperative Radiofrequency And Cryoneurolysis For Enhanced Pain Relief In Total Knee Arthroplasty, Paul Bonilla, Juan Pablo Flanagan, Anesu Karen Murambadoro, Victoria Elizondo, Aamir Ahmad, Devin Peck

Research Symposium

Background: Total knee arthroplasty (TKA) relieves debilitating knee osteoarthritis but is associated with significant postoperative pain managed by many modalities including opioid treatment. Current pain management strategies rarely address both deep and superficial pain sources effectively. This study aims to introduce a novel dual-modality preoperative pain management technique combining radiofrequency (RF) ablation and cryoneurolysis to improve patient outcomes and reduce opioid dependence postoperatively.

Methods: A literature search was conducted using the University of Texas Rio Grande Valley (UTRGV) online database and PubMed with keywords including “cryoneurolysis” , “TKA” , “radiofrequency ablation”. Additionally, a semi-structured interview was conducted with a recognized …

The Effect Of Artificial Intelligence On High Tibial Osteotomies, Mohammad Khalil, David Rakay, Mohammad Y. Karkoutly, Zayd Ayas, Omar Karkoutly

Research Symposium

Background: High tibial osteotomy (HTO) is a surgical procedure which helps in managing lower limb deformities, provides pain relief, and arrests the progression of osteoarthritis of the knee joint. This surgical method involves cutting and realignment of the tibia and this is only as effective as the accuracy with which the tibia is cut and realigned and this success is based on the understanding of the biomechanics and the anatomical characteristics of the patient. Artificial Intelligence (AI) is becoming more widespread in the field of orthopaedic surgery, with applications in diagnostics, pre-operative planning, and predictive models of outcomes following procedures. …

Return To Sport After Anterior Shoulder Stabilization Of Ncaa Football And Nfl Athletes – A Systematic Review, Yolanda V. Gutierrez, Mohammad Khalil, Aasim Ahmad, Aamir Ahmad

Research Symposium

Background: Anterior shoulder instability is an injury prevalent in contact and non-contact athletes and can result in limited movement, increased recurrence of dislocation, and decreased quality of sports activity. Notable sports that present with frequent anterior shoulder instability include wrestling, hockey, basketball, baseball, and most commonly, football. Athletes may undergo surgical management of anterior shoulder instability via arthroscopic repair, remplissage, Laterjet, or glenoid bone grafting procedures. This review aims to evaluate the return-to-sport rates among elite football athletes in the NCAA and NFL following surgical stabilization, assess post-surgical performance, and analyze the recurrence of instability or complications.

Methods: This systematic …

Incidence Of Diabetes And Obesity In Adhesive Capsulitis Cases In The Rio Grande Valley, Mohammad Khalil, Blake Martin

Research Symposium

Background: Adhesive capsulitis, or frozen shoulder, is a condition characterized by pain and restricted motion in the shoulder joint. Previous studies implicate diabetes as one of the core risk factors for the condition, along with thyroid disease, female sex, and prolonged immobilization. This study aims to investigate the incidence of diabetes and obesity in patients diagnosed with adhesive capsulitis in the Rio Grande Valley, a region with a high prevalence of metabolic disorders.

Methods: A retrospective analysis (IRB-24-0306) was conducted on 836 patients diagnosed with adhesive capsulitis. Demographic variables, including age, sex, and ethnicity, were collected. Clinical data regarding shoulder …

Symptomatic Manifestations Of Hip Dysplasia In Young Adults: How Do Patients Present Before And After Surgery?, John M. Gaddis, Amanda Wheeler, Yossef Alsabawi, Erika Shults, Charles South, Joel E. Wells

Research Symposium

Background: Hip dysplasia is a common source of hip pain in young adults that can lead to early-onset osteoarthritis. The Bernese periacetabular osteotomy (PAO) and total hip arthroplasty (THA) have shown good results as surgical treatment options for this disorder, yet pain may persist after surgery. A previous study described the clinical features of pre-treated hip dysplasia in a traditional clinical cohort; however, to our knowledge, no previous studies have examined the symptomatic manifestations of hip dysplasia in young adults before and after various surgical treatments including the analysis of pain locations in numerous anatomical areas through a body pain …

Metallosis And An Adverse Reaction To Metal Debris Following Dislocation Of A Metal-On-Metal Hip Arthroplasty: A Case Report, John M. Gaddis, Amanda Wheeler, Bretton Laboret, Joel Wells

Research Symposium

Background: Primary total hip arthroplasties have a reported survivorship exceeding 95% at 10-year data. Metal-on-metal bearing surfaces were introduced to minimize wear rate for patients undergoing THA, however, long-term data has shown an unacceptably high failure rate requiring THA revision. The metal-on-metal implants can lead to failure with the generation of the metal ions, specifically cobalt and chromium. The rise in levels of these metal ions can result in adverse reaction to metal debris (ARMD) which can consist of macroscopic necrosis, corrosive osteolysis, sterile hip effusions, and pseudotumor. There are no specific clinical signs or symptoms indicating metallosis, rather, diagnosis …

Assessing The Accuracy And Readability Of Chatgpt 4.0’S Responses To Common Patient Questions Regarding Periacetabular Osteotomy (Pao), John M. Gaddis, Elias Arellano, Yossef Alsabawi, Pablo Castaneda, Joel Wells

Research Symposium

Aims: The study aimed to evaluate the accuracy, comprehensiveness, and readability of responses generated by ChatGPT 4.0 to 30 common patient questions about the Bernese Periacetabular Osteotomy (PAO).

Methods: Two fellowship-trained orthopaedic surgeons specializing in hip preservation selected thirty questions from a prior study identifying common PAO questions on social media. Each question was entered into ChatGPT 4.0, and the surgeons independently graded responses. Responses were evaluated using an established grading system: “excellent,” “satisfactory requiring minimal clarification,” “satisfactory requiring moderate clarification,” or “unsatisfactory.” Accuracy and comprehensiveness were assessed based on the concordance of response content with current literature. Readability was …

Staged Reconstruction And Salvage Of 5th Finger With Corticocancellous Distal Radius Autograft: A Case Report, Emmanuel Franco, Zayd Ayas, Frank Gerold

Research Symposium

Background: Finger reconstruction in the aftermath of severe trauma poses significant challenges in restorative surgery, particularly when addressing extensive soft tissue damage, comminuted fractures, and simultaneous neurovascular complications. This study presents a case of a patient with a complicated distal phalangeal fracture that pursued digit salvage.

Case Presentation: Patient is a 31-year-old woman who sustained a severe injury to her right 5th digit during an ATV rollover. The trauma resulted in an exposed and comminuted fracture of the proximal phalanx with associated loss of soft tissues, flexor tendon, radial nerve injury, and vascular compromise. She elected to pursue digit salvage …

Intraoperative Imaging In Orthopedic Settings: An Assessment Of Changes In Adherence To Imaging Guidelines, Emmanuel Franco, Tabitha Abraham, Zayd Ayas, Frank Gerold

Research Symposium

Background: High-quality intraoperative photography is vital for treatment planning, patient counseling, and surgical education. Inconsistencies in image quality are prevalent in orthopedic literature due to the absence of formalized criteria specific to orthopedic settings. In 2014, "Medical Photography: Principles for Orthopedics" introduced guidelines intending to standardize protocols for capturing clinical images. By comparing the quality of images taken both before and after these proposed guidelines, this project aims to evaluate whether this has influenced a trend toward standardization and consistency in intraoperative orthopedic photography.

Methods: To assess quality differences in orthopedic images before and after the 2014 guidelines, 60 intraoperative …

Impact Of Diabetes On Fall Related Lower Limb Fractures, Bryce M. Bellon, Daniel Salinas, Patrick De La Torre Shutz, Hunter Butler, Sean Corcoran, Kelsey Baker

Research Symposium

Background: Diabetes is a disorder that affects many Americans, characterized primarily by hyperglycemia due to either insulin resistance or lack of insulin secretion. This condition not only impacts blood sugar levels but also has significant effects on bone health. In diabetes, bone density is often decreased due to reduced osteoblast activity, which is responsible for bone formation, and increased osteoclast activity, which leads to bone resorption. This imbalance accelerates the breakdown of bone. Additionally, diabetics frequently suffer from lower extremity arterial disease (LEAD), which results in poor vascularization of the lower limbs. These factors contribute to an increased risk of …

Various Bone Disorders Affecting The Rio Grande Valley, Blake C. Martin, Justin Z. Heckman, Manoj Peiris

Research Symposium

Background: The underserved community that is the Rio Grande Valley (RGV), has a distinct demographic profile, with a high prevalence of chronic conditions such as diabetes and obesity, that warrants investigation of various health issues. The main objective of our study was to analyze the demographic disparities between osteoporosis, osteomalacia, rickets, Paget bone disease, and osteonecrosis in the RGV. We hypothesized that the frequency of osteoporosis would be the most common bone condition (of those analyzed) in the Rio Grande Valley and that the demographics between the various bone conditions would vary depending on age, sex, BMI, and ethnicity …

Joint Involvement In A Psoriasis Affected Population In A Medically Underrepresented Region, Blake C. Martin, Jared Hensley, Manoj Peiris

Research Symposium

Background: Psoriatic arthritis is an aggressive condition that may be characterized by compromised quality of life and significant morbidity. The prevalence of psoriatic arthritis in patients with psoriasis is around 1.7% at 5 years, 3.1% at 10 years, 5.1% at 20 years, and 20.5% at 30 years which shows an increase in joint involvement with increasing age, at least until the age of 30. The objective of this study was to explore joint involvement in psoriatic patients in this region and determine what are the demographic disparities in Psoriatic patients regarding joint involvement. We hypothesized that individuals with psoriasis between …

Gout Versus Pseudogout In The Medically Underserved Rio Grande Valley, Blake C. Martin, Fernando Cisneros, Kristina Vatcheva

Research Symposium

Background: Gout and pseudogout are inflammatory joint conditions, with gout being one of the most prevalent etiologies of chronic inflammatory arthritis in the United States. The patient population in the Rio Grande Valley (RGV) has a distinct demographic profile that warrants exploration of various health conditions. The primary objective of this study is to compare the frequencies of gout and pseudogout in the Rio Grande Valley to national frequencies and determine if there were demographic disparities between Gout and Pseudogout in this community. We hypothesized that the frequency gout and pseudogout would be higher in the RGV compared to the …

Demographic And Clinical Characterization Of Bone Metastases And Primary Malignant Bone Neoplasia In The Rio Grande Valley, Blake C. Martin, Neharika Penmetcha, Aun Bangash, Juan Lopez Alvarenga

Research Symposium

Background: The Rio Grande Valley (RGV) is a developing clinical research region characterized by its distinctive demographic profile that offers an opportunity to investigate diverse health issues. This pilot investigation seeks to identify the characteristics of patients diagnosed with bone metastasis and primary malignant bone neoplasia (PMBN) in the RGV. The main objective was to evaluate the demographic and clinical characteristics linked to bone metastases and PMBN in patients from the Rio Grande Valley. We hypothesized that older age and higher BMI individuals would have greater frequency of metastatic lesions compared to PMBN.

Methods: Data was gathered from the …

Demographic And Clinical Characteristics Of Patients With Benign Bone Tumors: Evidence Of Bimodal Age Distribution In A Hispanic Population, Blake C. Martin, Mohammad Khalil, Juan Lopez Alvarenga

Research Symposium

Background: As far as researchers know, there’s no way to prevent BBTs from forming. Although these tumors generally do not metastasize, they can still be dangerous as they may grow and compress healthy tissues and lead to poor outcomes. The principal objective was to evaluate the demographic and clinical characteristics linked to BBTs in individuals from the Rio Grande Valley. We hypothesized that older age, males, and higher BMI individuals would have greater frequency of BBTs.

Methods: This was a retrospective chart review and IRB approval was obtained prior to starting this study. We obtained medical charts for individuals who …

Characterizing Fracture Distribution By Sex, Age, And Body Region: Insights From A Regional Population Study, Blake C. Martin, Jared Hensley, Juan Lopez Alvarenga

Research Symposium

Background: This Rio Grande Valley (RGV) region of South Texas is a unique region that is impoverished and medically underserved. We conducted this study in order to further the knowledge of orthopedics in this unique, medically underserved community. We sought to determine if certain body regions, based on sex and age, were at increased risk for fracture in this population. We hypothesized that females would have increased fracture frequency at older ages while males would have increased fracture frequency at all other ages. We also hypothesized that femur and forearm fractures would be increased in females compared to males.

Methods …

Bone And Joint Infections: A Retrospective Chart Review Of The Medically Underserved Rio Grande Valley, Blake C. Martin, Chloe Harris, Manoj Peiris

Research Symposium

Background: The Rio Grande Valley (RGV) is a demographically unique region that is impoverished and medically underserved. Because of its unique patient population, this community may be at increased risk for bone and joint infections and the morbidity and mortality that follows. The goal of this study was to analyze individuals with osteomyelitis, septic arthritis, and periprosthetic joint infections and determine which infectious bone or joint conditions are most prevalent in the Rio Grande Valley and determine if there were any demographic disparities between the various types of bone and joint infections and healthy individuals. We hypothesized that age and …

Association Of Joint Disease With Demographic Factors In Clinical Populations Of The Rio Grande Valley, Blake C. Martin, Devian D. Baez, Juan C. Lopez-Alvarenga

Research Symposium

Background: The Rio Grande Valley (RGV) is a medically underserved, demographically unique population that warrants the exploration of various conditions, including joint conditions, such as osteoarthritis (OA), rheumatoid arthritis (RA), gout, ankylosing spondylitis (AS), psoriatic arthritis (PA), juvenile idiopathic arthritis (JIA), and septic arthritis (SA). We sought to determine the demographic disparities between the different types of common joint conditions in this community. We hypothesized that OA would follow national trends and be the most common joint condition in the Rio Grande Valley. We hypothesized that the demographics between the various joint conditions would vary depending on age, sex, BMI, …