Orthopedics Commons^™

The Effect Of Covid-19 On Total Joint Arthroplasty, Hailey Worstman, James E. Feng, Alex Miller, Drew Moore

Posters

• Arthritis is debilitating disease that is common throughout the U.S. For patients with refractory disease, total hip and knee arthroplasty, collectively known as total joint arthroplasty, are used for definitive management.1 •

Total joint arthroplasty, TJA, is one of the most common procedures in the U.S. and is typically inpatient in order to start physical therapy and promote joint mobility as soon as possible.

• Elective procedures, including total joint arthroplasties, were halted in March 2020 due to the pandemic.2,3

• When TJAs resumed they shifted towards outpatient procedures and at home physical therapy.4

• The impact of the …

Second-Site Periprosthetic Joint Infection After Subsequent Primary Hip Or Knee Arthroplasty, Daniel Nikolaidis, Devin Young, Andrew Steffensmeier, Robert Runner, Mark Karadsheh

Posters

Periprosthetic joint infections (PJI) can arise anytime in the lifetime of a patient. Therefore, patients who have multiple prosthetic joints are at risk for developing multiple PJIs. Polyarticular PJI can be classified as either synchronous or metachronous. Synchronous PJIs present simultaneously in two or more joints. Metachronous PJIs (MPJI) occur in two or more joints after a disease-free period. Incidence of MPJI varies in the literature from 8-20%.1

Known risk factors associated with MPJI include Rheumatoid Arthritis, sepsis or SIRS, infection with MRSA, ≥3 revision arthroplasties, longer length of stay in the hospital, and an index TKA PJI.2

Only a …

A Review Of Risk Factors For Postoperative Failure After Isolated Primary Medial Patellofemoral Ligament Reconstruction, Bilal Tarar, Ameen Suhrawardy, Clark Yin, Leonardo Cavinatto, Elizabeth Dennis, Jeffrey Fischgrund, Betina B. Hinckel

Posters

• Medial patellofemoral ligament reconstruction (MPFL-R) is a surgical treatment for patellar instability [1].

• Cases of post-operative recurrent dislocation and persistent instability may occur due to preexisting anatomic risk factors and technical errors in the procedure.

• Current rates of recurrent dislocation are reported to be up to 20% [2].

• Research Question: What anatomic and technical risk factors are associated with increased rates of recurrent dislocation after primary MPFL-R?

Metachronous Periprosthetic Joint Infection In Patients With Multiple Arthroplasties At Index Infection, Devin Young, Daniel Nikolaidis, Andrew Steffensmeier, Robert Runner, Mark Karadsheh

Posters

Periprosthetic joint infection (PJI) is a devastating complication of one of the most successful surgeries in medicine. About 1% to 2% of patients will develop PJI after primary total hip arthroplasty (THA) or primary total knee arthroplasty (TKA) [1]. The 5-year patient survival rate of THA PJI is estimated to be worse than that of common cancers, such as breast cancer [2]. The burden of this disease is likely to increase exponentially as the population ages and the number of patients undergoing total joint arthroplasties increases in the future [3].

Most devastating is what Murray et al deem as metachronous …

Gender And Racial Disparities In Pediatric Orthopaedic Surgery Fellows: A Decade-Long Analysis, Naomi Haque, Mazen Zamzam, Imran Bitar, Ehab Saleh

Posters

• The Association of American Medical Colleges (AAMC) has highlighted the increasing gender, racial, and ethnic diversity among medical student applicants, noting a significant rise in the number of underrepresented students.
• In the 2021-2022 academic year, there was an 18% increase in total applicants. The number of Black or African American applicants rose by 21%, with Black or African American students comprising 11.3% of matriculants in 2021, up from 9.5% the previous year. First-year students of Hispanic, Latino, or Spanish origin saw a 7.1% increase, making up 12.7% of matriculants. Additionally, women constituted 56.8% of applicants, 55.5% of matriculants, and 52.7% …

Influence Of Medicaid And Medicare On Total Joint Arthroplasty Outcomes: 10-Year Report Of Michigan Hospitals, Madeleine Declercq, Jacob Keeley, Robert Runner, Kevin Weisz, Leonardo Cavinatto, Drew Moore

Posters

Access to healthcare significantly varies by medical insurance type, particularly for individuals for low socioeconomic status.

• Medicaid often covers these individuals (a government-funded program for low-income adults and children).

• Only 45% of primary care providers accept new Medicaid patients, versus 94% for private insurance.1

• Large non-profit medical centers accept Medicaid but still present considerable access challenges for patients.

• Lower reimbursement rates, complex medical needs, and extensive administrative requirements are key barriers for providers accepting Medicaid.

• Studies, such as those by Deans et al., highlight greater travel burdens for Medicaid patients needing revision hip or knee …

Polymicrobial Prosthetic Joint Infection Including Mycobacterium Tuberculosis: A Case Report, Hernan Andres Yunis, Zachary J. Walker, Matthew E. Charlick, Daniel P. Mccall

Posters

• Usual culprits of PJI affecting total hip and knee arthroplasty are Staphylococcus aureus and streptococcus epidermidis in the acute phase.

• During the chronic presentation, microbes become much more diverse as they may seed due to hematogenous spread from other body sites.

• The purpose of this case study was to illustrate an instance when polymicrobial total hip arthroplasty PJI included Mycobacterium Tuberculosis.

Subclinical Presentation Of Cutibacterium Acnesinfection Following Revision Rotator Cuff Repair: A Case Report, Zachary Walker, David Shuster, David Sosnoski, Ali Hamade, Hussein Saad, Marc Milia

Posters

Cutibacterium acnesis a gram-positive anaerobic bacillus which is commonly found in the sebaceous glands of the skin generally in the axilla, chest and back regions1,2.

Shoulder infections have been reported to occur at 3.4% following arthroscopic or open shoulder surgeries, where they are most commonly due to C. acnes3,4.

This case report demonstrates a unique case and management of a subclinical presentation of confirmed C. acnes infection.

Laryngeal Tuberculosis Mimicking Laryngeal Candidiasis, Claire Walters, Maranda Saigh, Eytan Keidar

Posters

Tuberculosis (TB) from the bacterium Mycobacterium tuberculosisand candidiasis from the fungus Candida albicansare both opportunistic pathogens with the ability to instigate infections within the larynx with similar clinical features, yet vastly different diagnostic parameters and treatment regimens.

Here, we highlight a case of an Indian woman on immune-modulating drugs who presented with severe laryngeal symptoms initially presumed to be laryngeal candidiasis but was later discovered to be laryngeal tuberculosis.

Ocd Lesions Of The Lateral Femoral Condyle And The Impact Of The Location On Recovery, Catharine Kral, Joshua Cummings, Ellie Helton, Shannon Margherio, Brian S. Harvey, Kevin Latz

Posters

Descriptive study based on Zhou, Liang, et al. we categorized the LFC OCD lesions into weight bearing and non-weight bearing lesions to assess clinical and radiographic variables and evaluate the need for progression to operative management.

Subclinical Presentation Of Cutibacterium Acnes Infection Following Revision Rotator Cuff Repair: A Case Report, Zachary Walker, David Shuster, David Sosnoski, Ali Hamade, Hussein Saad, Marc Milia

Posters

Cutibacterium acnes is a gram-positive anaerobic bacillus which is commonly found in the sebaceous glands of the skin generally in the axilla, chest and back regions 1,2.

Shoulder infections have been reported to occur at 3.4% following arthroscopic or open shoulder surgeries, where they are most commonly due to C. acnes3,4.

This case report demonstrates a unique case and management of a subclinical presentation of confirmed C. acnes infection.

Pseudoaneurysm Development After Short Cephalomedullary Femoral Nailing, Nicholas E. Runge, Daniel P. Mccall

Posters

Hip fractures are amongst the most treated conditions by orthopaedic surgeons1 and are routinely treated with cephalomedullary nails (CMN)s.

Pseudoaneurysm formation is a rare complication after femoral CMN. The primary cause of pseudoaneurysm formation in previous studies has been found to be related to overpenetration of the far cortex with a drill or screw.

Patients with neuromuscular diseases may have aberrant anatomy potentially leading to increased risk of pseudoaneurysm formation

This the first case report of a patient with post-polio syndrome who developed a symptomatic deep femoral artery pseudoaneurysm status post short CMN fixation for a basicervical femoral neck fracture …

Remove The Ring: A Quality Improvement Initiative For Upper Extremity Trauma, Brandon Wallace, Matthew Charlick, Josiah Valk, Aaron Seidman

Posters

Upper extremity trauma is a common injury and post traumatic edema is an expected sequela. Retained rings on the digits prohibit circumferential swelling and may lead to tourniquet syndrome if left in place leading to a devastating and avoidable consequence.

Expeditious ring removal in upper extremity trauma is prudent for patient safety.

Radiographs are typically obtained early in the triage and treatment of patients suffering from upper extremity trauma. This presented itself as as reliable efficient target to have rings removed prior to this treatment step.

An opportunity to make a systemic change to maximize patient safety and care was …

Two For One – Simultaneous Bilateral Shoulder Injuries In Gym Teacher: A Case Report, Zachary Walker, Josiah Valk, David Sosnoski, Kelley Brossy, Mohamed Saad

Posters

28M gym teacher history of T1DM, seizure d/o, and alcohol use disorder presents with bilateral shoulder pain after an inebriated fall, two nights prior. Not on antiepileptics at baseline. C/o bilateral shoulder pain and mid-thoracic spine pain.

Pyogenic Tenosynovitis Of Tibialis Anterior Tendon After Cat Bite, Daniel Blascak, David Sosnoski, Aaron Seidman

Posters

Pyogenic tenosynovitis is a bacterial infection of the synovial sheath that surrounds a tendon.

Commonly occurs within flexor tendons of the hand; theoretically can occur within any sheathed tendon.

Delayed diagnosis may lead to spread of infection to surrounding tissues and tendon rupture.

Tibialis anterior tendon is encased in a synovial sheath that runs from above the superior extensor retinaculum to the talonavicular joint.

Only five cases of pyogenic tenosynovitis of the tibialis anterior tendon have been reported in the literature.

None of the reported cases were due to animal bite injury.

Comparing The Outcomes Of Titanium And Stainless Steel Flexible Nails In Repairing Pediatric Long Bone Fractures, Novelpreet Boparai, Suzan Kamel-Elsayed, Ehab Saleh

Posters

• Traditionally, pediatric femoral fracture treatment favored conservative methods.
• Surgical intervention was deferred until age 6, as non-operative approaches often resulted in complications.
• Titanium elastic nailing (TENS) emerged as an effective treatment for diaphyseal femoral fractures in ages 6 to 16. However, the choice between TENS and stainless steel elastic nailing (SSENS) remains debated due to inconsistent findings.

Public Perception Of Robotic Assisted Total Hip Replacement Surgery, Marvee Espiritu, James E. Feng, Phillip Vartanyan, Drew Moore, Robert Moore, Mark Karadsheh

Posters

• Robotic or technology assisted THA has received significant attention recently due to its precision in acetabular cup placement within the Lewinnek safe zone.1
• Few studies have assessed the public’s perception of robotic-assisted THA.3,4 Insight into patients’ perception of robotic-assisted THA may yield valuable information that may impact further integration of the technology within hospitals and surgeon training.

Morbidity Of Tendon Harvest Site For Acl Autograft; A Systematic Review, Jessi Fore, Betina Hinckel, Elijah Auch

Posters

Primary anterior cruciate ligament (ACL) ruptures are highly common and lead to a significant number of primary ACL reconstruction surgeries in the U.S.1. When choosing a graft, surgeons can pick between auto- and allografts2. An autograft can include a bone-patellar tendon-bone (BPTB) graft, a hamstrings tendon (HT) graft, or a quadriceps tendon (QT) graft2. Currently, there is a wide range of research on graft types, but no paper compares all threes graft types directly. This review will compare literature to determine the morbidity associated with each graft type and determine which autograft is best for primary reconstruction.

Metastatic Osteosarcoma Involving The Skin: A Systematic Review Of Patient Demographics, Clinical Characteristics, And Treatment Outcomes, Sarah Fried, Ameen Suhrawardy, Rafey Rehman, Malik Al-Jamal, Drew Moore, Darius Mehregan

Posters

Skeletal osteosarcomas - most common primary malignant bone tumor1 and commonly metastasize to:

• Lungs (95%)2 •

Other bones (50%)2 •

Kidneys (12%)2 •

Rarely to the skin3

Extraskeletal osteosarcomas (ESOS) – soft tissue tumors that may also metastasize to the skin4,5,6

Value in gathering data on this rare phenomenon:

• Informs biology and dermatologic care of patients suffering from this cancer.

This systematic review characterizes metastatic osteosarcomas involving the skin.

Assessing Patient Preferences For Technology-Assisted Versus Traditional Total Knee Arthroplasty Using A Validated Online Survey Marketplace: Before And After Patient Education, Tanner J. Hafen, James E. Feng, Phillip Vartanyan, Drew Moore, Robert Runner

Posters

• Computer (CA) and robotic (RA) assisted TKA has becoming increasingly prevalent in orthopaedic surgery1,2.
• There is limited insight into the public perception of CA and RA3.

Outcomes Of Primary Acl Repair For Proximal Tears: A Systematic Review And Meta Analysis, Collin Braithwaite, Tanner Hafen, Robert Dean, Joseph Guettler, James Bicos

Posters

The purpose of this study was to determine which primary ACL repair technique resulted in the lowest failure rates postoperatively.

Pediatric Upper Cervical Spine Trauma: A 10-Year Single Center Retrospective Study, Sazid Hasan, Muhammad Waheed, Shahrukh Naseer, Jad G. Khalil, Ehab S. Saleh

Posters

This study seeks to answer whether or not there is a significant association between mechanism of injury and patient age, and to elucidate any notable differences in overall outcomes based on various treatment modalities.

Quantifying The Importance Of Orthopaedic Surgeon Attributes By The Public, Rasheed Abdullah, James E. Feng, Phillip Vartanyan, Hassan Alosh, Drew Moore, Leonardo M. Cavinatto, Betina Hinckel

Posters

Evaluate what surgeon attributes are currently important to our patients, and what modalities may be most effective in finding orthopaedic surgeons, using online crowdsourcing.

Operative Versus Non-Operative Treatment Of Z-Type Clavicle Shaft Fracture In Adolescents: A Retrospective Study, Sami Azeroual, Colin Van Wagoner, Jeffrey Leider, Ehab Saleh

Posters

• The clavicle is one of the most fractured bones in the human body.
• Traditional treatment involves conservative management with a sling or immobilization but recently the effectiveness of the approach has been questioned.
• Studies done on the adult population have found higher rates of mal or non-union than previously noted, especially in those with displaced or comminuted fractures.
• The noted malunion or non-union was noted to have effects on shoulder mechanics, pain with overhead activity, and loss of strength and endurance.
• Due to differences in physiology the findings in the adult studies do not necessarily translate to the pediatric population. …

Anterior Hip Pain In Adolescent Female Wrestler, Melanie Kennedy

Posters

No abstract provided.

A Mssic Study Reveals Non- Modifiable Risk Factors Were Associated With Post-Operative Hematoma Following Acdf, Richard Easton, Matthew Lipphardt, Matthew Easton, Nicholas Papakonstantinou, Lonni Schultz, Hsueh-Han Yeh, Cecile Pestano

Posters

Introduction

Post-operative hematoma (POH) following anterior cervical discectomy (ACDF) is uncommon . Although rare, POH is recognized as a potentially catastrophic post-operative complication . There is limited information as to who is vulnerable . From a large database, the authors sought to identify common modifiable and non-modifiable risk factors for developing POH and its associated clinical outcomes.

Materials and Methods

The Michigan Spine Surgery Improvement Collaborative (MSSIC) is a statewide quality improvement initiative . ACDF cases in MSSIC registry from 2014-2018 were identified . Patients who developed POH (POH) were compared to those who did not (non-POH) . Chi-square and …

Assessment Of Radiographic Features In Predicting Complete Quadriceps And Complete Patellar Tendon Ruptures In The Pre-Operative Setting, Mitchell Pfennig, Matthew Astolfi, Christopher Vasileff, Betina Hinckel

Posters

Acute patellar tendon or quadriceps tendon rupture is a severely debilitating injury resulting in complete loss of the knee extensor mechanism. Early diagnosis and prompt surgical repair are preferential in order to achieve good functional outcomes. In the setting of trauma and knee pain, plain film radiographs of the knee are obtained to rule out fractures. Patellar and quadriceps tendon rupture is primarily a clinical diagnosis but can benefit from additional imaging to differentiate between a partial and complete tear when there is uncertainty. Our goal is to assess the reliability and reproducibility of radiographic features in a population with …

Surveillance Of Dual-Mobility Hip Systems: Damage Mode And Clinical Data Analysis, Camilla Cascardo, Conner D. Ahlgren, Michael J. Maxwell, Tyler Vovos, Mark Karadsheh, Drew Moore

Posters

Hip instability following total hip arthroplasty (THA) is a prominent indication for revision surgery. Dual mobility (DM) implants are designed to increase stability, and trending use makes characterizing in vivo damage and clinical failure modes important. This study expounds upon micro- and macroscopic damage mode findings of Lombardo et al., including novel screw ring damage using an updated retrieval registry.

The Routine Use And Cost Analysis Of Acid-Fast Bacilli And Fungal Cultures In Foot And Ankle Surgery: A Retrospective Study, Margaret Bohr, Robert Dean, Zein El-Zein, Megan Audet, Paul Fortin, Zachary Vaupel

Posters

Infection is a significant complication seen in orthopaedic surgery. In such cases, samples are sent to be cultured for aerobes, anaerobes, acid-fast bacilli (AFB) and fungi. AFB and fungi are generally slow-growing, difficult to culture, and rarely the pathogen, whereas aerobic and anaerobic cultures are routinely positive and guide antibiotic treatment. The goal of this study is to evaluate the value of routinely ordering AFB and fungal cultures in the setting of foot and ankle surgery.

Phenotype Characterization Of Genetic Murine Mouse Models Of Developmental Dysplasia Of The Hip (Ddh), Stephanie Mrowczynski, Kevin Baker, Michael Newton

Posters

Developmental dysplasia of the hip (DDH) is a congenital hip alteration that changes the “ball in socket” movement of the leg inside the pelvis. Genome-wide association studies have identified CX3CR1 polymorphisms associated with increased risk of Developmental Dysplasia of the Hip. Mouse models of CX3CR1 knock-out (KO) mice show unilateral, bony discrepancies between the femur head and acetabulum in comparison to wild-type (WT) mice, as well as gait impairment similar to that of humans with osteoarthritis (which develops in DDH patients later in life). The primary goal of this project is to assess joint congruity in a CX3CR1 KO model …