Orthopedics Commons^™

Missed Early Glenohumeral Septic Arthritis During Emergency Department Visit Owing To Low Virulence Streptococcus Mitis: A Case Report, Ashley A. Crum, Christopher A. Mcgrew, Matthew A. Tennison

UNM Orthopaedic Research Journal

Glenohumeral joint septic arthritis in a native joint is uncommon but can be debilitating if not treated early. Septic arthritis does not always present with the typical clinical findings, especially in immunocompromised patients. We report a rare case of glenohumeral septic arthritis from Streptococcus mitis infection in a diabetic woman that was initially missed on first presentation in the emergency department (ED). The exact cause of infection in this case remains unclear but is likely due to poor dentition and possible transient bacteremia in the setting of large rotator cuff tear in an immunocompromised patient (diabetes). The patient had a …

Posttraumatic Attenuation Of The Lisfranc Ligament In A 14-Year-Old Athlete: A Case Report, Paul J. Johnson, David M. Bennett

UNM Orthopaedic Research Journal

Lisfranc injuries in children are rare and range from mild midfoot sprains to severe traumatic fracture-dislocations. Management of sprains is nonoperative, whereas treatment of fracture-dislocations often requires internal fixation. We present a unique case of a midfoot sprain in a 14-year-old adolescent boy, with gradual increased instability at the joint owing to attenuation of the Lisfranc ligament. Closed reduction and percutaneous pinning resulted in successful treatment at 3 weeks postoperatively. Midfoot sprains may lead to further ligamentous attenuation and widening as seen on radiographs and thus should be monitored for signs of persistent pain and instability. Because midfoot instability contributes …

Capitate Stress Injuries Of Both Wrists In An Adolescent Female Gymnast: A Case Report, Brynne R.W Latterell, Deana M. Mercer, Shane P. Cass, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

Gymnastic activities expose the wrist to a wide variety of overuse and acute stresses. Injuries to the distal radius are the most commonly reported gymnastic wrist condition; however, many other structures are at risk of injury from the sport’s high acute and overuse demands, including the carpal bones, most commonly the scaphoid. We describe a 17-year-old female, high-level gymnast in whom stress injuries to both capitate bones were ultimately diagnosed after initial symptoms of pain. This case demonstrated the need for prompt recognition, without which much chronic and debilitating injury would develop. For successful diagnosis, healthcare providers should carefully examine …

Carpal Tunnel Release During Pregnancy: Report Of Two Cases, Erica J. Gauger, Deana M. Mercer, Moheb S. Moneim

UNM Orthopaedic Research Journal

Symptoms of carpal tunnel syndrome are common occurrences during pregnancy, particularly in the third trimester. Most patients undergo successful nonoperative treatment shortly after birth or the cessation of breast feeding. However, symptoms noted earlier during pregnancy are more likely to be severe and persistent. We present the cases of two women who developed symptoms of severe carpal tunnel syndrome during the second trimester and did not improve with nonoperative measures. Both underwent carpal tunnel release during pregnancy, with excellent postoperative result. Obstetric providers and surgeons alike should consider surgical treatment for patients with carpal tunnel syndrome who do not improve …

Lipoma Of The Tendon Sheath Causing Symptoms Of De Quervain’S Tenosynovitis: A Case Report, James Rose, Moheb S. Moneim

UNM Orthopaedic Research Journal

Deep lipomas arising from the extensor compartments of the wrist are extremely rare. Owing to infrequent presentation and mass effect on nearby structures, lipomas can be mistaken for other clinical entities. We describe a 70-year-old woman who presented to our clinic with symptoms initially suggestive of de Quervain’s tenosynovitis of the left wrist. However, findings of physical examinations and imaging techniques revealed a lipoma of the tendon sheath of the second dorsal compartment. The patient was successfully treated operatively, with excision and release of the first dorsal compartment. To help accurately diagnosis and treat lipomas of the wrist in deep-tissue …

Diagnosing An Acute Quadratus Plantae Tear In A 37-Year-Old Athlete: A Case Report, James P. Toldi, Shane P. Cass, Richard A. Miller, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

Foot injuries occur frequently in distance runners and can notably impact training performance. Common diagnoses include plantar fasciitis, tendinopathies of the forefoot or midfoot, and stress fractures of the metatarsals. Occasionally, more obscure structures may be involved. We describe a 37-year-old male distance runner who presented with symptoms of heel pain and ecchymosis, suggesting an acute plantar fascia injury. However, findings of magnetic resonance imaging revealed a tear to the quadratus plantae (QP). The patient gradually returned to normal levels of physical activity, with complete resolution of symptoms by 4 months after the initial injury. Healthcare providers should be aware …

Unsuccessful Metatarsophalangeal Joint Replacement For Treating Arthritis Of The Great Toe: Report Of Three Cases, Jory Wasserburger, Paul J. Johnson, Katherine J. Gavin, Richard A. Miller

UNM Orthopaedic Research Journal

Metatarsophalangeal (MTP) joint fusion or replacement are commonly performed for treating advanced arthritis of the MTP joint of the great toe. However, results of MTP joint arthroplasty have shown no clear advantages compared to those of fusion. We present a 72-year old woman (case 1), 66-year-old woman (case 2), and 64-yearold man (case 3) who underwent unsuccessful MTP joint replacement of the great toe and presented to our clinic with pain at 15, 1, and 20 years postoperatively, respectively. Operative resection has been scheduled for case 1, whereas symptoms were managed nonoperatively in case 2. In case 3, operative removal …

Rare Tumors Adjacent To The Achilles Tendon: Report Of Two Cases, Jay J. Wojcik, Aditi S. Majumdar, Kathleen M. Madden, Richard A. Miller

UNM Orthopaedic Research Journal

Benign masses are not uncommon near the Achilles tendon of the ankle. However, the occurrence of angiomyomas or glomus tumors in the region has rarely been reported. We describe two patients, a 44-year-old woman and 44-yearold man, who presented with a tender mass posterior to the Achilles tendon. Excision led to successful removal of the lesion in both cases. Results of histological examinations revealed an angiomyoma and glomus tumor in the woman and man, respectively. Although rare, the presence of these tumors should be considered in the differential diagnosis of masses near the Achilles tendon.

Preparing Resident Physicians For Healthcare Reform, Michael M. Decker

UNM Orthopaedic Research Journal

No abstract provided.

Hosting The Perry Outreach Program And Medical Student Outreach Program In Albuquerque: Promoting Women Leaders In Engineering And Orthopaedic Surgery, Lauren Long, Sahar Freedman, Jodi Gomez, Deana M. Mercer, Christina Salas

UNM Orthopaedic Research Journal

No abstract provided.

The Albuquerque Community Sports Medicine Experience: Four Decades And Counting, Christopher A. Mcgrew, Thomas A. Decoster, Shane P. Cass, Richard Gerrells, Edward R. Sweetser

UNM Orthopaedic Research Journal

No abstract provided.

Novel Strategies For Time Efficiency In An Orthopaedic Clinic: A Satire, Christopher L. Shultz, Richard A. Miller

UNM Orthopaedic Research Journal

No abstract provided.

Remembrances: Orthopaedics Throughout The Years (1980s−Present), Richard A. Miller

UNM Orthopaedic Research Journal

No abstract provided.

Intradepartmental System Of Allocating Operating Room Block Time And Its Financial Impact At The University Of New Mexico Department Of Orthopaedics & Rehabilitation: A Preliminary Report, Dustin L. Richter, Gail Case, Nicholas White, Mary A. Jacintha, Robert C. Schenck Jr

UNM Orthopaedic Research Journal

Background: Within a hospital, the operating room (OR) is one of the most critical and expensive resources. Labor productivity is maximized by filling allocated surgical block time with as many hours of cases as possible. We have found that the intradepartmental block time release system at our institution has improved access to operating time, resulting in a substantial financial advantage within the department.

Methods: The annual charges and collections produced by the pick-up of intradepartmental released block time during the past 4 fiscal years (July 1-June 30) was assessed at both the main hospital and an outpatient surgical center.

Results: …

Total Ankle Replacement, Then And Now: A Review, Katherine J. Gavin

UNM Orthopaedic Research Journal

Total ankle replacement (TAR) for treating end-stage osteoarthritis of the ankle joint has been evolving since the early 1960s. Increased understanding of the biomechanics and kinematics of the foot and ankle, postoperative results of implant use, and advances in technology have led to improved implant designs and treatment outcomes. The current study reviews associated historical perspectives, kinematics, biomechanics, patient selection, imaging procedures, modern surgical techniques, postoperative complications, and comparison studies with arthrodesis to help evaluate TAR in successfully treating osteoarthritis of the ankle joint. Although arthrodesis remains the gold standard for treatment, findings of new studies have suggested that TAR …

Antegrade Endosteal Fibular Strut Augmentation For Periprosthetic Femur Fracture Above Stemmed Total Knee Arthroplasty, Tyler Snoap, Jason Roberts, Matthew Jaykel

Research Day

Abstract Title: ANTEGRADE ENDOSTEAL FIBULAR STRUT AUGMENTATION FOR PERIPROSTHETIC FEMUR FRACTURE ABOVE STEMMED TOTAL KNEE ARTHROPLASTY Abstract ID: 245 Abstract Category: Clinical Research Introduction: 
The management of peri-prosthetics fracture around total knee replacements is technically challenging. The options for operative fixation become more limited if the femoral component is stemmed, which often is the case after revision arthroplasty procedures. The goals of surgery for peri-prosthetic fractures above knee replacements are to provide a rigid construct to promote healing, allow immediate knee range of motion, and allow weight bearing during the healing process. 
Purpose: 
The purpose of this study is to …

Systemic Sclerosis: Clinical Manifestations, Anesthetic And Orthopedic Considerations In A Patient, Obada Hasan, Muneeba Jessar, Muhammad Ashar, Shahryar Noordin, Tashfeen Ahmad

Section of Orthopaedic Surgery

Introduction: Systemic sclerosis is a rare and progressive multisystem autoimmune disorder that is characterized pathologically by vascular abnormalities, connective tissue sclerosis and atrophy of skin and various internal organs (e.g., alimentary tract, lungs, heart, kidney, CNS), and autoantibodies. With an unknown etiology, Scleroderma is a complex polygenetic disease. A recent Genome Wide Association Study (GWAS) confirmed a strong association with the Major Histocompatibility Complex (MHC) and autoimmunity. We provide a case scenario along with a review of the systems involved and challenges physicians can face in dealing with this rare disease.
Case Presentation: Our patient, a known case of systemic …

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. …

The Feasibility Of Implementing The Ichom Standard Set For Hip And Knee Osteoarthritis: A Mixed-Methods Evaluation In Public And Private Hospital Settings., Ilana N Ackerman, Bernarda Cavka, Jacob Lippa, Andrew Bucknill

Articles, Abstracts, and Reports

Background: There is growing international momentum for standardising patient outcome assessment and using patient-reported outcome measures (PROMs) to capture outcomes that matter to patients. The International Consortium for Health Outcomes Measurement (ICHOM) Standard Sets were developed to capture the outcomes of care for costly conditions including osteoarthritis. This study evaluated the feasibility of implementing the ICHOM Standard Set for Hip and Knee Osteoarthritis in 'real world' public and private hospital settings.

Methods: A mixed-methods design was used to capture comprehensive data on patient outcomes, implementation costs, and the implementation experiences of patients, clinicians and administrative staff. The ICHOM Standard Set …

Understanding Preferences For Treatment After Hypothetical First-Time Anterior Shoulder Dislocation: Surveying An Online Panel Utilizing A Novel Shared Decision-Making Tool, Ben Streufert, Shelby D. Reed, Lori A. Orlando, Dean C. Taylor, Joel C. Huber, Richard C. Mather Iii

Orthopaedics and Sports Medicine Faculty Publications

Background: Although surgical management of a first-time anterior shoulder dislocation (FTASD) can reduce the risk of recurrent dislocation, other treatment characteristics, costs, and outcomes are important to patients considering treatment options. While patient preferences, such as those elicited by conjoint analysis, have been shown to be important in medical decision-making, the magnitudes or effects of patient preferences in treating an FTASD are unknown.

Purpose: To test a novel shared decision-making tool after sustained FTASD. Specifically measured were the following: (1) importance of aspects of operative versus nonoperative treatment, (2) respondents’ agreement with results generated by the tool, (3) willingness to …

Traumatic Laceration Of The Posterior Tibial Tendon Treated With Novel Technique, Nicholas Miladore, Robert Gorman

Research Day

Abstract Title: TRAUMATIC LACERATION OF THE POSTERIOR TIBIAL TENDON TREATED WITH NOVEL TECHNIQUE Abstract ID: 249 Abstract Category: Clinical Research INTRODUCTION: Posterior tibial tendon (PTT) insufficiency is a common entity, and can result in chronic tendon disruption. Acute disruption is a rare occurrence, but has been described in the literature. Most reported cases are associated with ipsilateral ankle fractures. Laceration of the posterior tibial tendon has also been described, typically in the operative setting as a result of iatrogenic injury. 
CASE REPORT: A 15 year old male presented to the clinic with complaints of right ankle pain and weakness. 2.5 …

Effect Of Exercise Position On Percent Changes In Serratus Anterior Muscle Thickness, Joseph M. Day

Physical Therapy Faculty Publications

Objective: A reliable method for measuring SA thickness with ultrasound imaging has been reported, yet the ability to detect differences in levels of contractility has yet to be established. The purpose of this study was to determine if there are differences in the percent change in thickness of the SA during four different exercise positions performed by healthy individuals.

Design: Observational study

Setting: Laboratory

Participants: Twenty-eight healthy participants, mean age 26 (SD 4, 57% female, 100% right handed)

Methods: Volunteers were positioned in a standardized sitting posture and anatomical landmarks were marked for ultrasound probe positioning. Two resting and two …

Use Of Mesenchymal Stem Cells For The Treatment Of Osteoarthritis, Dennis W. Stewart

Physician Assistant Scholarly Project Posters

• Healthy articular cartilage protects and provides smooth functioning of the joint. The deterioration of the articular cartilage leads to the crippling disease known as osteoarthritis (OA).

• OA is a leading cause of disability in the United States. Although some of the current treatment modalities, along with pharmacological treatment, may offer short term improvement with pain and function, they do not offer long term relief, and are ineffective in preventing the progression of OA.

• In advanced stages, surgery in the form of total knee arthroplasty (TKA), is sometimes needed. This is an invasive procedure and typically requires hospitalization. …

Distal Interphalangeal Joint Arthrodesis Complicated By Postoperative Infection: A Rare Presentation Of Disseminated Herpes Simplex Virus., Meredith N. Osterman, Michael P. Gaspar

Department of Orthopaedic Surgery Faculty Papers

Postoperative infection after elective arthrodesis of the interphalangeal joint is an uncommon complication often necessitating urgent debridement. We present the rare case of a female patient with a history of oral herpetic lesions, who underwent elective arthrodesis of the middle and index fingers for treatment of erosive osteoarthritis and subsequently developed a postoperative herpetic infection at the surgical site.

Fellows And Chiefs, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Residents, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Physical Therapy Faculty, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Letter From The Chief Of The Division Of Physical Therapy, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Elbow Injuries In The Throwing Athlete: A Review, Drew K. Newhoff

UNM Orthopaedic Research Journal

Overhand-throwing motions can create supraphysiologic stresses on the elbow. Repeated stresses often result in overuse injuries affecting the elbow, which are commonly seen in throwing athletes. Noted problems include medial epicondylitis, valgus extension overload, olecranon stress fractures, ulnar neuritis, and damage to the ulnar collateral ligament. Symptoms of pain or numbness at presentation vary in location depending on the injury. Successful diagnosis is typically made using results of physical examinations of elbow, wrist, and arm extensions; results of tests for valgus instability; and findings radiographs can all help indicate the problem. However, pathological features of these injuries are not always …

Current Issues In Treatment Of Anterior Shoulder Instability: A Review, Ian Power

UNM Orthopaedic Research Journal

Anterior shoulder instability can be problematic in the young, active population, particularly in athletes and military personnel. The shoulder joint is the most frequently dislocated joint, and there is a high rate of dislocation recurrence in younger patients. The stability of the glenohumeral joint is conferred through the bony anatomy and the static and dynamic stabilizers. Recognizing pathological features, identifying glenoid bone loss, and detecting Bankart and Hill-Sachs lesions are key to formulating an appropriate treatment strategy and improving surgical outcomes. Furthermore, the concept of critical bone loss has been refined by looking at subcritical loss. Recent evidence has shown …