Orthopedics Commons^™

Letter From The Chair, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Letter From The Co-Editors, 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.

Unmorj Short Instructions For Authors, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Wjo.Unmorj Full Instructions For Authors, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Wjo.Unmorj Short Instructions For Authors, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Instructions For Peer Reviewers, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Cost-Effectiveness Analysis Of Needle Arthroscopy Versus Magnetic Resonance Imaging In The Diagnosis And Treatment Of Meniscal Tears Of The Knee, N. Amin, L. Mcintyre, T. Carter, J. Xerogeanes, J. Voigt

Journal Articles

© 2019 The Authors Purpose: To determine whether needle arthroscopy (NA) compared with magnetic resonance imaging (MRI) in the diagnosis and treatment of meniscal tears is cost-effective when evaluated over a 2-year period via patient-reported outcomes. The hypothesis is that improved diagnostic accuracy with NA would lead to less costly care and similar outcomes. Methods: A Markov model/decision tree analysis was performed using TreeAge Pro 2017 software. Patients were evaluated for degenerative and traumatic damage to the lateral/medial meniscus. Assumed sensitivities and specificities were derived from the medical literature. The direct costs for care were derived from the 2017 Medicare …

Quantifying The Impact Of Patient-Specific Factors And Disease Severity On Clinical Decision Making In Cuff Tear Arthropathy: A Case-Based Survey, A. P. Schumaier, Y. H. Bedeir, J. S. Dines, K. Kenter, L. V. Gulotta, D. M. Dines, B. M. Grawe

Journal Articles

© 2019, The Author(s). Background: Rotator cuff tears are a common cause of disability. Some patients with massive and irreparable tears can develop cuff tear arthropathy (CTA), which makes management more challenging. Questions/Purposes: We sought to examine how orthopedists determine treatment for patients with CTA. Specifically, we investigated (1) the effect of patient age, symptoms, activity level, range of motion, and radiographic findings on the decision making of shoulder specialists and (2) the observer reliability of the Seebauer and Hamada grading systems. Methods: Five shoulder surgeons were each sent 108 simulated patient cases. Each simulated patient had a different combination …

Full-Body Radiographic Analysis Of Postoperative Deviations From Age-Adjusted Alignment Goals In Adult Spinal Deformity Correction And Related Compensatory Recruitment., P. G. Passias, C. M. Jalai, B. G. Diebo, D. L. Cruz, G. W. Poorman, A. J. Buckland, L. M. Day, J. H. Oren, T. J. Errico, V. Lafage, +8 Additional Authors

Journal Articles

Background: Full-body stereographs for adult spinal deformity (ASD) have enhanced global deformity and lower-limb compensation associations. The advent of age-adjusted goals for classic ASD parameters (sagittal vertical axis, pelvic tilt, spino-pelvic mismatch [PI-LL]) has enabled individualized evaluation of successful versus failed realignment, though these remain to be radiographically assessed postoperatively. This study analyzes pre- and postoperative sagittal alignment to quantify patient-specific correction against age-adjusted goals, and presents differences in compensation in patients whose postoperative profile deviates from targets.

Methods: Single-center retrospective review of ASD patients ≥ 18 years with biplanar full-body stereographic x-rays. Inclusion: ≥ 4 levels fused, complete baseline …

Melatonin Prevents Osteoarthritis-Induced Cartilage Degradation Via Targeting Microrna-140, Yijian Zhang, Jun Lin, Xinfeng Zhou, Xi Chen, Angela Carley Chen, Bin Pi, Guoquing Pan, Ming Pei, Huilin Yang, Tao Liu, Fan He

Faculty & Staff Scholarship

Abstract

Osteoarthritis (OA) is characterized by the progressive destruction of articular cartilage, which is involved in the imbalance between extracellular matrix (ECM) synthesis and degradation. MicroRNA-140-5p (miR-140) is specifically expressed in cartilage and plays an important role in OA-induced matrix degradation. The aim of this study was to investigate (1) whether intra-articular injection of melatonin could ameliorate surgically induced OA in mice and (2) whether melatonin could regulate matrix-degrading enzymes at the posttranscriptional level by targeting miR-140. In an in vitro OA environment induced by interleukin-1 beta (IL-1β), melatonin treatment improved cell proliferation of human chondrocytes, promoted the …

Impact Of Fibronectin Knockout On Proliferation And Differentiation Of Human Infrapatellar Fat Pad-Derived Stem Cells, Yiming Wang, Yawen Fu, Zuoqin Yan, Xiao-Bing Zhang, Ming Pei

Faculty & Staff Scholarship

Fibronectin plays an essential role in tissue development and regeneration. However, the effects of fibronectin knockout (FN1-KO) on stem cells’ proliferation and differentiation remain unknown. In this study, CRISPR/Cas9 generated FN1-KO in human infrapatellar fat pad-derived stem cells (IPFSCs) was evaluated for proliferation ability including cell cycle and surface markers as well as stemness gene expression and for differentiation capacity including chondrogenic and adipogenic differentiation. High passage IPFSCs were also evaluated for proliferation and differentiation capacity after expansion on decellularized ECM (dECM) deposited by FN1-KO cells. Successful FN1-KO in IPFSCs was confirmed by Sanger sequencing and Inference of CRISPR Edits …

Meniscal Repair In Pediatric Populations: A Systematic Review Of Outcomes, Daniel J. Liechti, David S. Constantinescu, Taylor J. Ridley, Jorge Chahla, Justin J. Mitchell, Alexander R. Vap

Faculty & Staff Scholarship

Background: Loss of meniscal tissue in the pediatric population can have long-term consequences on joint health, highlighting the importance of meniscal preservation in this group. Purpose: To systematically review reported knee outcome measures and complication rates after repair of meniscal tears in children and adolescents. Study Design: Systematic review; Level of evidence, 4. Methods: A review of the literature regarding the existing evidence for pediatric meniscal tear outcomes was performed through use of the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, PubMed (1980-present), and MEDLINE (1980-present). Included were articles in English that reported the outcomes …

A Nationwide Comparative Analysis Of Medical Complications In Fibromyalgia Patients Following Total Knee Arthroplasty, T. Moore, N. Sodhi, A. Kalsi, R. M. Vakharia, J. O. Ehiorobo, H. K. Anis, K. Dushaj, V. Papas, G. Scuderi, M. A. Mont, +2 Additional Authors

Journal Articles

No abstract provided.

A 6-Year Trends Analysis Of Infections After Revision Total Hip Arthroplasty, P. A. Gold, L. J. Garbarino, N. Sodhi, H. K. Anis, J. O. Ehiorobo, S. M. Kurtz, J. R. Danoff, V. J. Rasquinha, C. A. Higuera, M. A. Mont

Journal Articles

No abstract provided.

The Effect Of Operative Time On In-Hospital Length Of Stay In Revision Total Knee Arthroplasty, L. J. Garbarino, P. A. Gold, N. Sodhi, H. K. Anis, J. O. Ehiorobo, S. Boraiah, J. R. Danoff, V. J. Rasquinha, C. A. Higuera-Rueda, M. A. Mont

Journal Articles

No abstract provided.

Impact Of A Resident-Guided Rounding Initiative On The Hospital Consumer Assessment Of Healthcare Providers And Systems Survey Scores In Orthopaedic Surgery Inpatients., E. Stapleton, N. Frane, J. Lentz, K. Yngstrom, C. Healy, R. Cohn, G. Katsigiorgis

Journal Articles

No abstract provided.

Implementation And Validation Of The 2013 Caprini Score For Risk Stratification Of Arthroplasty Patients In The Prevention Of Venous Thrombosis, E. S. Krauss, A. Segal, M. A. Cronin, N. Dengler, M. L. Lesser, S. Ahn, J. A. Caprini

Journal Articles

© The Author(s) 2019. Appropriate chemoprophylaxis choice following arthroplasty requires accurate patient risk assessment. We compared the results of our prospective department protocol to the Caprini risk assessment model (RAM) retrospectively in this study group. Our goal was to determine whether the department protocol or the Caprini score would identify venous thromboembolism (VTE) events after total joint replacement. A secondary purpose was to validate the 2013 Caprini RAM in joint arthroplasty and determine whether patients with VTE would be accurately identified using the Caprini score. A total of 1078 patients met inclusion criteria. A Caprini score of 10 or greater …

Periarticular Injection And Continuous Femoral Nerve Block Versus Continuous Femoral Nerve Block Alone On Postoperative Opioid Consumption And Pain Control Following Total Knee Arthroplasty: Randomized Controlled Trial, D. Dimaculangan, J. F. Chen, R. B. Borzio, J. J. Jauregui, V. J. Rasquinha, A. V. Maheshwari

Journal Articles

© 2017 Continuous femoral nerve block (CFNB) has been used to prevent the breakthrough pain after total knee arthroplasty (TKA). Multimodal drug injection (PMDI) has also been shown to decrease opioid consumption and pain. We investigated whether the use of PMDI further improves analgesic and rehabilitation outcomes when used in conjunction with CFNB. This is a prospective randomized controlled study of 44 patients undergoing primary TKA. The treatment group (n = 23) received a PMDI of combined ropivacaine, epinephrine, ketorolac and morphine, and the controlled group (n = 21) received saline at wound closure. Total opioid consumption, pain scores, knee …

Optimum Anatomic Socket Position And Sizing For The Direct Anterior Approach: Impingement And Instability, N. Mercer, E. Hawkins, L. Menken, A. Deshmukh, P. Rathod, J. A. Rodriguez

Journal Articles

© 2019 A comprehensive strategy is important for ensuring reproducible and safe acetabular component sizing and positioning. Presented here is our approach for anatomic acetabular component positioning in direct anterior total hip arthroplasty. This strategy has evolved with our understanding of the ramifications of socket sizing and positioning on instability and impingement. Data collected by a single surgeon (J.A.R.) between 2009 and 2011 influenced our current paradigm. We compare the sizing and positioning parameters of the anterior and posterior approach, thus demonstrating how the 2 are different. By highlighting these differences, we hope to provide a clear, defined approach to …

Rigid Nail Fixation For Treatment Of Femur Fractures In Children Aged 6 To 12 Years: A Review, Brielle Payne Plost, David M. Bennett, Andrew W. Parsons, Matthew G. Wharton

UNM Orthopaedic Research Journal

Although femoral shaft fractures are common in children, treatment using rigid intramedullary nail fixation remains controversial owing to concerns of avascular necrosis (AVN) and disruption of growth of the proximal femur. We examined studies on AVN complications and proximal femur deformity after rigid nail fixation in children aged 6 to 12 years. Of the 13 studies included, nine had no incidents of AVN or clinically significant proximal femur deformity using a greater trochanter entry point. Four studies showed cases of AVN or proximal femoral deformity in patients treated with intramedullary nails through a starting point at or near the piriformis …

Multimodal Analgesia In Orthopaedic Surgery And Presentation Of A Comprehensive Postoperative Pain Protocol: A Review, Christopher L. Shultz, Benjamin D. Packard, Kathryn C. Helmig, Christopher Kurnik, Benjamin S. Albertson, Nathan E. Huff, Gehron P. Treme

UNM Orthopaedic Research Journal

Rising opioid use in the United States has now been termed an epidemic. Opioid use is associated with considerable morbidity, mortality, and cost to the healthcare system. Orthopaedic surgeons play a key role in the opioid epidemic by prescribing postoperative narcotics. Although our understanding of the quantity of narcotics to prescribe postoperatively for analgesia is progressing, there is still a paucity of data focused on routine postoperative pain protocols. The purpose of this article is to review the current options for both opioid and non-opioid analgesia and put forth a multisubspecialty orthopaedic protocol of postoperative pain. On the basis of …

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

UNM Orthopaedic Research Journal

No abstract provided.

Use Of Intraarticular Injections Of Platelet-Rich Plasma In The Treatment Of Knee Osteoarthritis: A Review Article, Naveed Baloch, Obada Hasan, Zain Baig, Umme-E-Hani Abdullah, Mohammad Atif, Hiroshi Ohuchi

Section of Orthopaedic Surgery

Osteoarthritis is one of the most common degenerative conditions affecting knee joint. As our understanding in the disease pathogenesis is evolving, so do the treatment modalities. One of the postulated mechanisms suggests the production of inflammatory cytokines secondary to repeated micro trauma than in turn lead to cartilage damage overtime. Cartilage being avascular structure has limited potential for repair. Based on this, recent studies have been focusing on stimulating cartilage-healing process by growth factors. This is where platelet-rich plasma comes in to light. Literature is showing promising results of platelet-rich plasma in treating knee osteoarthritis. In this review we have …

Does Surgical Approach Affect Outcome After Fixation Of Intra-Articular Fractures Of Distal Humerus?: Retrospective Cohort Study From A Level-1 Trauma Centre In A Metropolitan City, Muhammad Atif, Obada Hasan, Yasir Mohib, Rizwan Haroon Rashid, Pervaiz Hashmi

Section of Orthopaedic Surgery

Introduction: Fractures around the distal humerus fractures make up to 2% of all fractures. Complex intra-articular distal humerus fractures present as challenge to restore of painless, stable and mobile elbow joint. Surgical exposure to all critical structures is of paramount importance to achieve anatomic reduction. Conflict still persists regarding the choice of ideal approach. In this study we compare the effect of surgical approach triceps lifting vs olecranon osteotomy on the functional outcome after fixation of distal humerus fractures.
Methods: Non-funded, non-commercial, retrospective cohort study was conducted on patients with closed distal humerus intra-articular fractures between 2010 and 2015 at …

Arthroscopic Removal Of Loose Bodies In Synovial Chondromatosis Of Shoulder Joint, Unusual Location Of Rare Disease: A Case Report And Literature Review, Hussain Wahab, Obada Hasan, Ahmed Habib, Naveed Baloch

Section of Orthopaedic Surgery

Introduction: Synovial chondromatosis is a benign mono-articular arthropathy affecting synovial joints. It mostly affects knee joint, followed by hip, elbow and wrist and is rarely reported for shoulder joint. The exact pathogenesis is not known. Usual symptoms are pain, difficulty in movement due to mechanical obstruction. The classic treatment is arthrotomy, removal of chondromatoid loose bodies and synovectomy. With recent advances arthroscopic removal of the chondromatoid loose bodies is a good option with relatively better post op rehabilitation and faster recovery.
Case presentation: 20 years old gentleman presented to clinic with history of pain in right shoulder for 2 years …

Predicting Adherence To Therapy In Rheumatoid Arthritis, Psoriatic Arthritis Or Ankylosing Spondylitis: A Large Cross-Sectional Study., Josef S Smolen, Dafna Gladman, H Patrick Mcneil, Philip J Mease, Joachim Sieper, Maja Hojnik, Pascal Nurwakagari, John Weinman

Articles, Abstracts, and Reports

Objective: This analysis explored the association of treatment adherence with beliefs about medication, patient demographic and disease characteristics and medication types in rheumatoid arthritis (RA), psoriatic arthritis (PsA) or ankylosing spondylitis (AS) to develop adherence prediction models.

Methods: The population was a subset from ALIGN, a multicountry, cross-sectional, self-administered survey study in adult patients (n=7328) with six immune-mediated inflammatory diseases who were routinely receiving systemic therapy. Instruments included Beliefs about Medicines Questionnaire (BMQ) and 4-item Morisky Medication Adherence Scale (MMAS-4

Results: A total of 3390 rheumatological patients were analysed (RA, n=1943; PsA, n=635; AS, n=812). Based on the strongest significant …

Narcotic-Free, Over-The-Counter Pain Management After Wide-Awake Hand Surgery, Sraj Shafic

Faculty & Staff Scholarship

Introduction: Prescribing opioids for postoperative pain has increased steadily, and hand surgery has been no exception. Current hand surgery literature does not describe the efficacy of pain self-management postoperatively. The purpose of this study is to describe our experience with over-the-counter (OTC), narcotic-free, postoperative pain management. Methods: We have done a retrospective chart review at an academic tertiary-care facility. Patients who underwent softtissue hand surgery in an office-based procedure room between January 1, 2018, and March 1, 2019, done using wide-awake local anesthesia only with no tourniquet were included. Results: Eighty-one continuous patients met the inclusion and exclusion criteria. The …

Participation In An Innovative Patient Support Program Reduces Prescription Abandonment For Adalimumab-Treated Patients In A Commercial Population., Diana Brixner, Manish Mittal, David T Rubin, Philip Mease, Harry H Liu, Matthew Davis, Arijit Ganguli, A Mark Fendrick

Articles, Abstracts, and Reports

Purpose: Nonadherence to indicated therapy reduces treatment effectiveness and may increase cost of care. HUMIRA Complete, a Patient Support Program (PSP), aims to reduce nonadherence in patients prescribed adalimumab (ADA). The objective of this study was to assess the relationship between participation in the PSP and prescription abandonment rates among ADA-treated patients.

Patients and methods: This longitudinal study using patient-level data from AbbVie's PSP linked with medical and pharmacy claims data included patients ≥18 years with an ADA-approved indication, ≥1 pharmacy claim for ADA, and available data ≥3 months before and ≥6 months after the index date (defined as the …

Effect Of Tofacitinib On Patient-Reported Outcomes In Patients With Active Psoriatic Arthritis And An Inadequate Response To Tumour Necrosis Factor Inhibitors In The Phase Iii, Randomised Controlled Trial: Opal Beyond., Vibeke Strand, Kurt De Vlam, Jose A Covarrubias-Cobos, Philip Mease, Dafna D Gladman, Linda Chen, Elizabeth Kudlacz, Joseph Wu, Joseph C Cappelleri, Thijs Hendrikx, Ming-Ann Hsu

Articles, Abstracts, and Reports

Objectives: Tofacitinib is an oral Janus kinase inhibitor for treatment of psoriatic arthritis (PsA). Patient-reported outcomes (PROs) were evaluated in patients with PsA with inadequate responses to tumour necrosis factor inhibitors (TNFi-IR) in a 6-month, phase III randomised controlled trial (OPAL Beyond [NCT01882439]).

Methods: Patients (N=394) received tofacitinib 5 or 10 mg twice daily or placebo (advancing to tofacitinib 5 or 10 mg twice daily at month 3). Least squares mean changes from baseline and percentages of patients reporting improvements ≥minimum clinically important differences and scores ≥normative values were determined in Patient Global Assessment of disease activity (PtGA), Pain, Patient …