Orthopedics Commons^™

Impact Of Obesity On Complication Rates After Treatment Of Slipped Capital Femoral Epiphysis: A Retrospective Cohort Database Study, Holden Archer, Scott B Rosenfeld, Pablo Castañeda, Jessica A Mcgraw-Heinrich, Simon P Kelley

Faculty, Staff and Students Publications

Background: While obesity is a well-established risk factor for slipped capital femoral epiphysis (SCFE), limited data exist regarding its impact on postoperative complication rates. This study aimed to evaluate the association between obesity and complications following SCFE treatment.

Methods: We queried a large national database for pediatric patients who underwent treatment for SCFE between June 2005 and June 2025. We divided this cohort into patients with obesity and patients without obesity. We matched the cohorts with a propensity scoring algorithm on a one-to-one basis, resulting in 1,175 patients in each group. We tracked outcomes including infection, pulmonary embolism (PE), chondrolysis, …

Utility Of Diagnostic Arthroscopy Before Medial Patellofemoral Ligament Reconstruction In Pediatric And Adolescent Patients Without Articular Findings On Magnetic Resonance Imaging, Holden Archer, Kaleb Patterson, Jonathan D Schwartzman, Scott D Mckay, Indranil Kushare

Faculty, Staff and Students Publications

BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is frequently used to manage recurrent patellar instability. Diagnostic arthroscopy is commonly performed before MPFL reconstruction to identify, confirm, and address intra-articular pathology. However, when preoperative magnetic resonance imaging (MRI) does not demonstrate intra-articular lesions, it is unclear how often diagnostic arthroscopy in pediatric patients alters surgical management.

PURPOSE: To determine the utility of diagnostic arthroscopy in young patients undergoing MPFL reconstruction who had no intra-articular chondral or osteochondral pathology, meniscal tears, or loose bodies identified on preoperative MRI, and to characterize intra-articular pathology detected on arthroscopy but not identified on MRI.

STUDY DESIGN: …

Variability In The Orthopaedic Residency Trainee Trauma Surgical Experience, Todd Phillips, Benjamin Fiedler, Joshua T Morrow, Zbigniew Gugala, Melvyn Harrington, Douglas R Dirschl

Faculty, Staff and Students Publications

Background: The aim of this study was to analyze fracture fixation case logs from residents training at a level 1 trauma center to assess variability across residents' surgical experiences within a single residency program. The authors hypothesize that notable variability exists between residents' surgical experiences in fracture care.

Methods: A retrospective case series was conducted at a single, urban residency program with a level 1 trauma center. Completed case logs were collected from program graduates from 2022 to 2024. All surgical cases involving fracture fixation at the level 1 trauma center were included for analysis. The anatomic region of the …

Influenza Infection Has Higher Risk Of Postoperative Complications Than Covid-19 In Shoulder Arthroplasty Patients, Jad J Lawand, Umar Ghilzai, Caleb Witsken, Dion Birhiray, Abdullah Ghali, Youssef M Khalafallah, Rohan G Reddy, Sameer R Khawaja, Adil Shahzad Ahmed

Faculty, Staff and Students Publications

INTRODUCTION: The COVID-19 pandemic has captured the attention of healthcare systems worldwide, and testing remains a mainstay of preoperative testing before all surgical procedures, including shoulder arthroplasty. Other viral illnesses, specifically influenza, while still having severe complications, are either overshadowed by testing for COVID-19 or not tested at all.

METHODS: A multi-institutional cohort study using the TriNetX network examined patients undergoing total or hemi shoulder arthroplasty from January 2020 to March 2024. Matched cohorts were created: one with influenza and one with COVID-19 infection, 14 days before surgery.

RESULTS: A total of 3233 and 18,209 patients were included in the …

Association Between Bmi Z-Score And Postoperative Complications In Pediatric Neuromuscular Scoliosis Surgery, Alexander K Mihas, Dion Birhiray, Chun Wai Hung, Lorenzo R Deveza, Dallas Vanorny, Frank Gerow, Darrell Hanson, Benny Dahl

Faculty, Staff and Students Publications

Study Design

Single-center retrospective review.

Objective

To investigate the association between BMI Z-scores and postoperative complications in pediatric patients with neuromuscular scoliosis undergoing spinal instrumentation.

Methods

Pediatric patients who underwent spinal instrumentation for neuromuscular scoliosis from July 2012 to June 2016 with a minimum 2-year follow-up were included. BMI and BMI Z-scores were calculated, and patients were stratified into CDC-defined BMI-for-age percentiles: underweight (< 5th percentile), normal (5th to < 85th percentile), overweight (85th to < 95th percentile), and obese (≥95th percentile). Logistic regression assessed associations of BMI, BMI Z-score, and BMI groups with postoperative complications.

Results

In total, 147 patients were included. Average follow-up was 3.2 ± 1.4 years. The most common diagnosis was cerebral palsy (39.5%). Complications occurred in 65 (44.2%) patients: 32 (21.8%) had a surgical site infection (SSI), …

Preoperative Malnutrition Is Associated With Increased Postoperative Complications Following Lumbar Fusion: A Propensity-Matched Analysis, Ali Mehaidli, Muaaz Wajahath, Jad Lawand, Omar Abdalla, Lorenzo Deveza, Noah Hodson, Ryan J Berger, Kevin Taliaferro

Faculty, Staff and Students Publications

Background: Lumbar fusion (LF) is a common surgical intervention for degenerative spinal conditions but carries significant short- and long-term risks. Preoperative malnutrition, characterized by low serum albumin or leukocyte counts, impairs wound healing and increases susceptibility to infection, yet its influence on LF outcomes remains underexplored. This study evaluates the association between preoperative malnutrition and long-term postoperative outcomes following LF.

Methods: Adult patients undergoing LF between 2003 and 2023 were identified in the TriNetX US Collaborative Network. Malnutrition was defined as serum albumin < 3.5 g/dL or leukocyte count < 1,500/mm3 within 1 year preoperatively. A 1:1 propensity score match was performed for demographics, comorbidities, surgical approach, and body mass index (BMI), yielding two cohorts (n=20,693 each). Ninety-day and 5‑year postoperative outcomes were compared using hazard ratios (HRs) with 95% confidence intervals (CIs).

Results: Malnourished patients experienced significantly higher 90‑day rates of transfusion (8.4% vs. 4.5%; HR 1.87, 95% CI: …

3d Geometric Modelling And Clinical Validation Of Lower Limb And Preliminary 2-Year Post-Operative Clinical Outcomes Of Neutral Boundary Alignment In Total Knee Arthroplasty, Bruno Violante, Lorenzo Deveza, Francesco Pollara, Giovanni Rusconi, Gianroberto Ferreri, Alessandro Annibaldi, Ilwhan Park

Faculty, Staff and Students Publications

Purpose: To introduce a novel three-dimensional (3D) modelling concept for lower limb alignment in total knee arthroplasty (TKA), termed neutral boundary alignment (NBA) and to present preliminary clinical data supporting this physics-based custom alignment strategy.

Methods: NBA is defined as the alignment at which the knee joint line is parallel to the ground during the mid-stance phase of gait, achieving static equilibrium with the NBA axis aligned to gravity. A theoretical geometric model of the lower limb was developed, integrating principles of physics to describe this condition. Preliminary clinical validation was performed using radiographic data from an initial cohort of …

A Comparative Analysis Of The Sport Mental Health Assessment Tool (Smhat-1) Between Paediatric And Adult Olympic And Paralympic Athletes, Ashley N Triplett, Travis Anderson, Eric G Post, Jessica Bartley, Jeffrey S Shilt, Eric L Dugan, Amber Donaldson, Jonathan Finnoff, William M Adams

Faculty, Staff and Students Publications

Objective: To determine if paediatric athletes exhibit differences in positive screenings on the Sport Mental Health Assessment Tool (SMHAT-1) compared with adults.

Methods: Team USA Olympic and Paralympic paediatric athletes ≤21 years (n=589; 58.8% female; age=19.5±1.7 years) completed the SMHAT-1 between January 2021 and September 2024. A comparative sample of Team USA adult athletes (n=493, 54.2% female; age=27.3±4.9 years) matched for sex and sport was randomly sampled, and the percentage of athletes with a positive screening on each questionnaire was calculated. χ2 analysis compared the proportion of positive screenings between paediatric and adult samples. Piecewise linear regression assessed the association …

A Computer Vision And Machine Learning Approach To Classify Views In Distal Radius Radiographs, Rohan Vemu, Dion Birhiray, Bassem Darwish, Raven Hollis, Sai Unnam, Srikhar Chilukuri, Lorenzo Deveza

Faculty, Staff and Students Publications

Advances in computer vision and machine learning have augmented the ability to analyze orthopedic radiographs. A critical but underexplored component of this process is the accurate classification of radiographic views and localization of relevant anatomical regions, both of which can impact the performance of downstream diagnostic models. This study presents a deep learning object detection model and mobile application designed to classify distal radius radiographs into standard views-anterior-posterior (AP), lateral (LAT), and oblique (OB)- while localizing the anatomical region most relevant to distal radius fractures. A total of 1593 deidentified radiographs were collected from a single institution between 2021 and …

A Supplement, Not A Substitute: Accuracy And Completeness Of Chatgpt Responses For Common Elbow Pathology, Benjamin Fiedler, Umar Ghilzai, Abdullah Ghali, Phillip Goldman, Pablo Coello, Michael B Gottschalk, Eric R Wagner, Adil Shahzad Ahmed

Faculty, Staff and Students Publications

Hypothesis: Large language models (LLMs) like ChatGPT have increasingly been used as online resources for patients with orthopedic conditions. Yet there is a paucity of information assessing the ability of LLMs to accurately and completely answer patient questions. The present study comparatively assessed both ChatGPT 3.5 and GPT-4 responses to frequently asked questions on common elbow pathologies, scoring for accuracy and completeness. It was hypothesized that ChatGPT 3.5 and GPT-4 would demonstrate high levels of accuracy for the specific query asked, but some responses would lack completeness, and GPT-4 would yield more accurate and complete responses than ChatGPT 3.5.

Methods: …

Common Cast Complications, Jessica A Mcgraw-Heinrich, Jon C Wall, Scott B Rosenfeld

Faculty, Staff and Students Publications

Complications can arise from the application, wear, and removal of casts and splints. This text reviews common complications, risk factors, and prevention strategies while exploring the medical-legal implications of these complications. Being aware of common pitfalls can help reduce risk and promote optimal patient outcomes.

Key concepts: (1)Proper and judicious casting and splinting techniques are critical to prevent complications.(2)Thermal injuries can occur due to excessive curing heat and cast saw burns.(3)Poor cast molding can lead to skin sores and loss of fracture reduction.(4)Patients should be comfortable in their cast, and uncontrolled pain warrants investigation.

Outcomes Of Suprapatellar Intramedullary Nail Fixation Of Tibial Shaft Fractures In Skeletally Immature Patients, Carlos D Pargas-Colina, Tori J Coble, Sara E Davis, David D Spence, Jonathan K Rowland, Derek M Kelly, Benjamin W Sheffer

Faculty, Staff and Students Publications

Background: Tibial shaft fractures in children require individualized treatment approaches, including elastic nails, plates and screws, intramedullary rigid nails (IMN), and external fixators, with selection based on fracture characteristics and patient factors. IMN risks damaging the physis, but can provide enhanced stability and immediate weight bearing. While both infrapatellar and suprapatellar approaches exist for IMN placement, studies in adults have demonstrated that the suprapatellar approach offers higher patient satisfaction, less anterior knee pain, and lower radiation exposure. However, there is a lack of data on IMN for pediatric tibial fractures.

Methods: This single-center, retrospective cohort study analyzed patients aged 11-16 …

Injury And Illness: An Analysis Of Team Usa Athletes At The 2024 Winter Youth Olympic Games, Ashley N Triplett, Eric G Post, Travis Anderson, Olivia Samson, Alexis D Gidley, Francisco Silva, Lea Thomann, Amber T Donaldson, Jonathan T Finnoff, Eric L Dugan, Jeffrey S Shilt, William M Adams

Faculty, Staff and Students Publications

Background: Injury and illness surveillance is essential for understanding the relative risks of sports participation to develop effective strategies to optimize athlete health, wellness, and performance. Epidemiological studies examining injuries and illnesses among Team USA youth athletes are limited, particularly among athletes competing in Winter sports. The purpose of this study was to characterize the injury and illness incidence rate among Team USA athletes participating in the 2024 Winter Youth Olympic Games (YOG).

Methods: Injuries and illnesses among 101 Team USA youth athletes (40.6% female; age, 17 ± 1 years) were prospectively documented. Injury and illness prevalence, and incidence rate …

Space Flight Missions Over 6 Months Significantly Increase The Risk Of Shoulder Pathology And Rotator Cuff Tears, Benjamin Fiedler, Meghana Jami, Srikhar V Chilukuri, Abdullah Ghali, Todd Phillips, Adil Shahzad Ahmed

Faculty, Staff and Students Publications

Background: The purpose of this study was to determine risk of shoulder injury in astronauts returning from space flight and highlight the need for further exploration of risk factors and preventative strategies.

Methods: Using The Lifetime Surveillance of Astronaut Health epidemiology database at National Aeronautics and Space Administration, a retrospective cohort study was conducted to assess the effect of space flight mission duration on rate of shoulder injury among astronauts. Inclusion criteria were all astronauts who participated in space flight regardless of age or space flight mission time. Exclusion criteria were all injuries occurring greater than 5 years following return …

Which Systemic Responses Should We Evolve To Help Surgeons Navigate Their Regret Experiences?, Ryan X Lam, Ruhi Thapar, Eric J Silberfein, Lorenzo R Deveza

Faculty, Staff and Students Publications

Regret in surgical practice is typically construed as resulting from the commission or the omission of a specific action at a specific decision point, which leads to a deleterious outcome. This article suggests a need to expand this conception of surgical regret to better account for surgeons' regret experiences arising from factors beyond their control. The commentary accompanying the case investigates these external sources of regret, such as resource limitations or professional interpersonal dynamics that prevent a desired outcome from being realized. It also discusses the normative value of addressing surgeons' experiences of regret, especially as a catalyst to facilitate …

Hispanic Patients Undergoing Spinal Fusion For Neuromuscular Scoliosis Sustain Health Inequalities, Armando S Martinez, David Momtaz, Travis Kotzur, Alexandra Mclennan, Abdullah Ghali, Farhan Ahmad, Ebubechi Adindu, Alan C Santiago-Rodriquez, Ali Seifi, Brian Smith

Faculty, Staff and Students Publications

INTRODUCTION: Pre- and postoperative optimization remains a complex process impacted by various demographic factors. Our study aims to identify and describe those demographic factors associated with poor outcomes after spinal fusion with instrumentation in neuromuscular scoliosis to reduce health disparities and improve postoperative outcomes.

METHODS: A retrospective analysis was conducted using Healthcare Cost and Utilization Project data from 2016 to 2020, encompassing a random sample of 20% of procedures in the United States. Data included demographic and hospital variables, including days from admission to the procedure, length of stay, recovery time, total charge, discharge disposition, and mortality rates. In addition …

To Manipulate Or Not? Management Of Pediatric Knee Arthrofibrosis Following Operative Fixation Of Tibial Spine Fractures, Matthew J Folkman, Neeraj M Patel, Alexandra C Stevens, Aristides I Cruz, R Jay Lee, Indranil Kushare, Theodore J Ganley, Henry Ellis, Peter Fabricant, Daniel Green, Benjamin Johnson, Scott Mckay, Gregory Schmale, Yi-Meng Yen, R Justin Mistovich

Faculty, Staff and Students Publications

Background: Knee arthrofibrosis is a common complication after surgical fixation of tibial spine fractures. However, there is no standardized treatment modality for resultant arthrofibrosis, with some surgeons electing for nonoperative management, while others prefer manipulation under anesthesia with a possible arthroscopic lysis of adhesions, if indicated. To better understand indications and outcomes from these treatment modalities for arthrofibrosis, we examined patients treated by both approaches.

Methods: We performed a multicenter retrospective case series of patients with arthrofibrosis after tibial spine fracture surgery. Arthrofibrosis was defined as loss of knee extension ≥10.0° and/or knee flexion ≥25.0° compared to the contralateral, uninjured …

Chatgpt Provides Acceptable Responses To Patient Questions Regarding Common Shoulder Pathology, Umar Ghilzai, Benjamin Fiedler, Abdullah Ghali, Aaron Singh, Benjamin Cass, Allan Young, Adil Shahzad Ahmed

Faculty, Staff and Students Publications

BACKGROUND: ChatGPT is rapidly becoming a source of medical knowledge for patients. This study aims to assess the completeness and accuracy of ChatGPT's answers to the most frequently asked patients' questions about shoulder pathology.

METHODS: ChatGPT (version 3.5) was queried to produce the five most common shoulder pathologies: biceps tendonitis, rotator cuff tears, shoulder arthritis, shoulder dislocation and adhesive capsulitis. Subsequently, it generated the five most common patient questions regarding these pathologies and was queried to respond. Responses were evaluated by three shoulder and elbow fellowship-trained orthopedic surgeons with a mean of 9 years of independent practice, on Likert scales …

Editorial Comment: Diversity And Disparities In Orthopaedic Surgery: Update 2024, Kimberly J Templeton, Melvyn A Harrington

Faculty, Staff and Students Publications

No abstract provided.

Factors Associated With Failed Closed Reduction In Flexion And Gartland Type Iii Pediatric Supracondylar Humerus Fractures, Pablo Coello, Nathaniel Grey Loyd, David A Hsiou, Rachel S Silverstein, Scott B Rosenfeld

Faculty, Staff and Students Publications

Background: Most displaced supracondylar humerus fractures (SCHFs) are treated with closed reduction and percutaneous pinning. While there are only a few possible indications for converting to an open reduction, a failed closed reduction is a common cause. This study aims to elucidate possible risk factors for failed closed reductions of SCHF.

Methods: A retrospective review of SCHF from 2010 to 2020 at a pediatric tertiary medical center, which underwent operative fixation, was conducted. Exclusion criteria were open fractures and reasons for open reduction other than failed closed reduction. Rates of open reduction were assessed by preoperative fracture classification and assessed …

Risk Factors For Loss To Follow Up In Pediatric Supracondylar Humerus Fractures, Nathaniel Grey Loyd, David Hsiou, Armando Martinez, Pablo Coello, Lon Kai Pang, Muhammad Hamza Shamim, Jessica Mcgraw-Heinrich, Scott B Rosenfeld

Faculty, Staff and Students Publications

Background: This study seeks to analyze risk factors associated with loss to follow up (LTF) after pin pull in pediatric patients with operatively treated supracondylar humerus fractures (SCHF).

Methods: A retrospective cohort study of patients under 18 years with operative SCHF from 2010 to 2020 was conducted. Factors of interest included LTF, age, race, language, distance to the hospital, Gartland fracture type, and Social Deprivation Index (SDI) by ZIP code. Univariate logistic regression was performed for each independent variable and significant variables were additionally analyzed with multivariate logistic regression analysis.

Results: Six hundred ninety-eight patients were included in the study. …

Evaluation Of Tibial Slope On Radiographs In Pediatric Patients With Tibial Spine Fractures: An Age- And Sex-Matched Study, Chang Ho Shin, Akbar N Syed, Morgan E Swanson, Indranil V Kushare, Kevin G Shea, Asteroid, Theodore J Ganley, Soroush Baghdadi, Aristides I Cruz, Henry B Ellis, Peter D Fabricant, Theodore J Ganley, Daniel W Green, Alicia Kerrigan, Julia Kirby, Mininder Kocher, Indranil V Kushare, R Jay Lee, James P Macdonald, Scott D Mckay, Shital N Parikh, Neeraj M Patel, Yi-Meng Yen, Gregory A Schmale, Kevin G Shea, R Justin Mistovich

Faculty, Staff and Students Publications

BACKGROUND: A recent study has reported that the radiographic measurement of posterior tibial slope (PTS) is larger in male pediatric patients with tibial spine fractures (TSF) than in controls. However, they found no difference in PTS between female patients and controls.

PURPOSE: (1) To identify whether PTS is larger in female pediatric patients with TSF than in female controls and (2) to validate the relationship between PTS and pediatric TSF in male patients.

STUDY DESIGN: Cross-sectional study; Level of evidence, 3.

METHODS: After an a priori power analysis, 84 pediatric patients with TSF (50 female patients and 34 male patients) …

Retrospective Review Of 181 Patients With Pathologic Vertebral Compression Fractures, Tristen N Taylor, Callie S Bridges, Lauren E Pupa, Beatrice A Morrow, Brian G Smith, Nicole I Montgomery

Faculty, Staff and Students Publications

Background: Compression fractures are often associated with lower energy trauma and may occur in the setting of abnormal bone health associated with genetic disorders and endocrine disorders, neoplastic disease, infection, and inflammatory disorders. There is no significant series in the literature describing the prevalence or etiology of pathologic pediatric compression fractures.

Methods: IRB-approved retrospective study was performed at a tertiary children's hospital from 2012-2022. Patients < 18 years old diagnosed with atraumatic vertebral compression fractures were included and reviewed for demographics, underlying diagnosis/comorbidity, presentation, mobility, deformities, imaging data, treatments, and outcomes.

Results: 181 patients (54% Male) were included with mean age 14.17 years and follow-up of 20 months. A compression fracture was the presenting symptom of an underlying diagnosis in 32% of patients, and 21% of …

Assessing The Contributions Of Modifiable Risk Factors To Serious Falls And Fragility Fractures Among Older Persons Living With Hiv, Julie A Womack, Terrence E Murphy, Linda Leo-Summers, Jonathan Bates, Samah Jarad, Thomas M Gill, Evelyn Hsieh, Maria C Rodriguez-Barradas, Phyllis C Tien, Michael T Yin, Cynthia A Brandt, Amy C Justice

Faculty, Staff and Students Publications

BACKGROUND: Although 50 years represents middle age among uninfected individuals, studies have shown that persons living with HIV (PWH) begin to demonstrate elevated risk for serious falls and fragility fractures in the sixth decade; the proportions of these outcomes attributable to modifiable factors are unknown.

METHODS: We analyzed 21,041 older PWH on antiretroviral therapy (ART) from the Veterans Aging Cohort Study from 01/01/2010 through 09/30/2015. Serious falls were identified by Ecodes and a machine-learning algorithm applied to radiology reports. Fragility fractures (hip, vertebral, and upper arm) were identified using ICD9 codes. Predictors for both models included a serious fall within …

Colonization Of Patients Hospitalized At Orthopedic Department Of Tertiary Hospital In Uganda With Extended-Spectrum Beta-Lactamase-Producing Enterobacterales, Jules Bizimana, Jerome Ndayisenga, Henry Kajumbura, Phillip Mulepo, Najjuka Florence Christine

Faculty, Staff and Students Publications

BACKGROUND: Beta-lactamase production remains the most contributing factor to beta-lactam resistance. Extended-Spectrum Beta-Lactamase-Producing Enterobacterales (ESBL-PE) are associated with risk factors both in hospital and community settings.

OBJECTIVES: To assess the incidence and risk factors for intestinal carriage of ESBL-PE among patients admitted to orthopedic ward of Mulago National Referral Hospital, and to analyze the acquisition of ESBL-PE during hospital stay and associated factors.

METHODS: We screened 172 patients aged 18 years old and above who got admitted to the orthopedic ward of Mulago National Referral Hospital between May to July 2017. Stool samples or rectal swabs were collected at admission, …

Retrospective Review Of 80 Patients With Chronic Recurrent Multifocal Osteomyelitis Evaluated By Pediatric Orthopaedic Surgeons, Tristen Noble Taylor, Callie Shawhan Bridges, Ekene Uchenna Ezeokoli, Tyler Scott Smith, Nicole Irene Montgomery

Faculty, Staff and Students Publications

Background: Chronic Recurrent Multifocal Osteomyelitis (CRMO) is a rare aseptic autoinflammatory disease with a wide and vague clinical presentation that often mimics infection, malignancy, or benign conditions, leading to a delayed diagnosis. We aimed to evaluate the clinical characteristics, differential diagnoses from evaluating pediatric orthopaedic surgeons, and compared the number of patients that could have avoided a biopsy in 80 patients with CRMO.

Methods: Children diagnosed with CRMO at a single tertiary pediatric hospital in the United States between 2012 and 2022 who were evaluated by a pediatric orthopaedic surgeon were retrospectively reviewed. The differential diagnoses from the surgeons were …

Incidence Of Injury And Illness Among Paediatric Team Usa Athletes Competing In The 2020 Tokyo And 2022 Beijing Olympic And Paralympic Games, Eric G Post, Travis Anderson, Jeffrey S Shilt, Eric L Dugan, Stephanie C Clark, Emily G Larson, Kayle E Noble-Taylor, David M Robinson, Amber T Donaldson, Jonathan T Finnoff, William M Adams

Faculty, Staff and Students Publications

OBJECTIVE: To describe the incidence of injuries and illnesses among paediatric Team USA athletes competing in the Tokyo 2020 Olympic and Paralympic Games, and the 2022 Beijing Olympic and Paralympic Games.

METHODS: An electronic medical record system documented all injuries and illnesses that occurred while competing in the four Games periods. Incidence (IR) with 95% CI per 1000 athlete days were calculated for both injuries and illnesses. Incidence rate ratios (IRR) were calculated to compare injury and illness rates based on age (paediatric vs non-paediatric) sex, Games period and sport type.

RESULTS: Two hundred paediatric athletes (age range, 15-21 years) …

Native Bk Polyomavirus Nephropathy In An Orthotopic Heart Transplant Patient, Zachary M Thompson, George Ajene, Prathit A Kulkarni, Nidhi Aggarwal, Savitri Fedson, Maulin K Shah

Faculty, Staff and Students Publications

BK polyomavirus nephropathy (BKVN) is a common cause of nephropathy in kidney transplant patients and is typically seen within the first year after transplantation. BK polyomavirus nephropathy can occur in the native kidneys of patients with nonrenal solid-organ transplants (NRSOT). However, this is rare, especially outside the early post-transplant period, and BKVN is not usually considered in the differential diagnosis for acute kidney injury in NRSOT patients. We present a case of a 75-year-old man who had undergone orthotopic heart transplant 13 years prior with stable allograft function who developed progressive renal dysfunction in the setting of recent unilateral obstructive …

In Vivo Measurement Of Intradiscal Pressure Changes Related To Thrust And Non-Thrust Spinal Manipulation In An Animal Model: A Pilot Study, William R Reed, Michael A K Liebschner, Carla R Lima, Harshvardhan Singh, Christopher P Hurt, Daniel F Martins, James M Cox, Maruti R Gudavalli

Faculty, Staff and Students Publications

BACKGROUND: The intervertebral disc is a known back pain generator and is frequently the focus of spinal manipulative therapy evaluation and treatment. The majority of our current knowledge regarding intradiscal pressure (IDP) changes related to spinal manual therapy involves cadaveric studies with their inherent limitations. Additional in vivo animal models are needed to investigate intervertebral disc physiological and molecular mechanisms related to spinal manipulation and spinal mobilization treatment for low back disorders.

METHODS: Miniature pressure catheters (Millar SPR-1000) were inserted into either the L4-L5 or L5-L6 intervertebral disc of 3 deeply anesthetized adult cats (Oct 2012-May 2013). Changes in IDP …

Risk Factors For Early Symptomatic Femoroacetabular Impingement Following In Situ Fixation Of Slipped Capital Femoral Epiphysis, Melissa M Allen, Ramesh B Ghanta, Matthew Lahey, Scott B Rosenfeld

Faculty, Staff and Students Publications

In situ fixation of slipped capital femoral epiphysis (SCFE) results in residual deformity that can cause femoroacetabular impingement (FAI). It is unknown what factors could help differentiate patients who are more likely to become symptomatic. We performed a retrospective review of 55 hips treated with in situ pinning for SCFE and subsequent secondary deformity correction procedure for symptomatic FAI and compared them to 39 asymptomatic hips with SCFE deformity using multivariable analysis. Case patients were slightly older than controls (12.6 vs 11.3 years, p = 0.0002) but had similar BMI. The mean epiphyseal-diaphyseal angle was 56° in cases versus 44° …