Orthopedics Commons^™

Predictive Algorithm For Surgery Recommendation In Thoracolumbar Burst Fractures Without Neurological Deficits, Charlotte Dandurand, Nader Fallah, Cumhur F. Öner, Richard J. Bransford, Klaus Schnake, Alex R. Vaccaro, Lorin M. Benneker, Emiliano Vialle, Gregory D. Schroeder, Shanmuganathan Rajasekaran, Mohammad El-Skarkawi, Rishi M. Kanna, Mohamed Aly, Martin Holas, Jose A. Canseco, Sander Muijs, Eugen Cezar Popescu, Jin Wee Tee, Gaston Camino-Willhuber, Andrei Fernandes Joaquim, Ory Keynan, Harvinder Singh Chhabra, Sebastian Bigdon, Ulrich Spiegel, Marcel F. Dvorak

Department of Orthopaedic Surgery Faculty Papers

STUDY DESIGN: Predictive algorithm via decision tree.

OBJECTIVES: Artificial intelligence (AI) remain an emerging field and have not previously been used to guide therapeutic decision making in thoracolumbar burst fractures. Building such models may reduce the variability in treatment recommendations. The goal of this study was to build a mathematical prediction rule based upon radiographic variables to guide treatment decisions.

METHODS: Twenty-two surgeons from the AO Knowledge Forum Trauma reviewed 183 cases from the Spine TL A3/A4 prospective study (classification, degree of certainty of posterior ligamentous complex (PLC) injury, use of M1 modifier, degree of comminution, treatment recommendation). Reviewers' regions …

Patient Perception Of Allograft Versus Autograft In Anterior Cruciate Ligament Reconstruction Using A Valaidated Online Survey Marketplace, Tanner J. Hafen, Robert Dean, Collin Braithwaite, Joseph Guettler, Robert F. Laprade, James Bicos

Conference Presentation Abstracts

INTRODUCTION: Anterior cruciate ligament (ACL) reconstruction is the gold standard treatment for ACL tears. Reconstruction is accomplished through the use of an allograft or autograft. This study sought to evaluate the general population’s perception of the use of allografts and autografts in ACL reconstruction. METHODS: A prospective cohort study was performed utilizing a 35-question survey. Participants were paid, and the survey was distributed via a clinically validated, public, online marketplace in June 2023. After collecting baseline demographics, participants were queried on whether they held a preference for ACL reconstruction with an allograft or an autograft. All respondents then sequentially completed …

The Effect Of Marijuana On Postoperative Spine Patients' Emergency Room Visits, Readmission Rates, And Opioid Consumption, Vincent Buddle, James Feng, Maximillian Young-Kyu Lee, Ahyoung L. Park, Daniel K. Park

Conference Presentation Abstracts

INTRODUCTION: The social, political, and legal natural of marijuana has recently seen significant changes, particularly in favor of both medical and recreational use. Since being classified as a Schedule I substance in 1970 by the United States federal government, all but four states have legalized some form of its use. These changes have and will continue to lead to a significant number of orthopaedic patients using marijuana in the perioperative surgical setting. The objectives of this study are to 1) compare the 90-day rates of postoperative emergency department (ED) visits and 90-day readmission rates with patients whom tested positive for …

Effect Of Vitamin E Enhanced Highly Cross-Linked Polyethylene On Wear Rate And Particle Debris In Anatomic Total Shoulder Arthroplasty: A Biomechanical Comparison To Ultrahigh-Molecular-Weight Polyethylene, Adam Khan, Andrew Jawa, Matthew J. Smith, J Michael Wiater, Derek J. Cuff, Anand M. Murthi, Luke Stanford Austin

Conference Presentation Abstracts

INTRODUCTION: Particle-induced osteolysis resulting from polyethylene wear remains a source of implant failure in anatomic total shoulder designs. Modern polyethylene components are irradiated in an oxygen-free environment to induce polyethylene cross-linking, but an unfortunate byproduct of this process is free radical production. Melting or heat annealing is one method of reducing free radicals but can compromise the component’s mechanical properties. The antioxidant, Vitamin E, has been introduced as an alternative adjuvant to neutralize free radicals. Specifically, in anatomic shoulder arthroplasty with a ceramic head component, the vitamin E-enhanced polyethylene showed improved wear compared to the conventional highly-cross linked polyethylene. This …

Shoulder Arthroplasty Evolution: Comparing Reverse, Anatomic, And Hemiarthroplasty Trends And Outcomes In Key Demographics At A High-Volume Institution, James Fuchs Gannon, Mitchell Thomas Pfennig, Anthony Arveschoug, Betina Bremer Hinckel, J Michael Wiater, Leonardo M. Cavinatto

Conference Presentation Abstracts

The field of shoulder arthroplasty has changed markedly since the inception of the reverse total shoulder arthroplasty (RTSA) in 2004. With yearly gains of 32%, the RTSA now encompasses the largest portion of shoulder arthroplasty procedures. In contrast, the anatomic total shoulder arthroplasty (ATSA) and hemiarthroplasty (HA) have steadied or decreased in usage. Some have offered several explanations for these trends, such as expanding indications for the RTSA, in particular for pathologies traditionally treated with ATSA such as glenohumeral arthritis with an intact rotator cuff and no major bone loss/deformity. Others have cited superior postoperative outcomes of the RTSA over …

Patient Perception Of Different Autografts In Anterior Cruciate Ligament Reconstruction Using A Validated Online Survey Marketplace, Robert Dean, Tanner J. Hafen, Collin Braithwaite, Kevin Xavier Farley, Robert F. Laprade, Joseph Guettler, James Bicos

Conference Presentation Abstracts

INTRODUCTION: Anterior cruciate ligament (ACL) reconstruction is the gold standard treatment for ACL tears. ACL graft reconstruction is commonly performed with an autograft. Common autograft modalities include bone-patellar tendon-bone (BPTB), quadriceps tendon (QT), and hamstring tendon (HT) grafts. This study sought to evaluate the general population’s perception of the use of BPTB, QT, and HT autografts in ACL reconstruction. METHODS: A prospective cohort study was performed utilizing a 35-question survey. Participants were paid, and the survey was distributed via a clinically, validated, public, online marketplace in June 2023. After collecting baseline demographics, participants were queried on whether they held a …

Biomechanical Comparison Of A Novel Circular Glenoid With Peripheral Ring Fixation To A Standard Anchor Pegged Glenoid In Total Shoulder Arthroplasty, Adam Khan, Andrew Jawa, J Michael Wiater, Derek J. Cuff, Anand M. Murthi, Matthew J. Smith, Luke Stanford Austin

Conference Presentation Abstracts

INTRODUCTION: Current standard total shoulder pegged glenoid component designs have a high rate of loosening, which accounts for the most common long term reason for surgical failure. Glenoid design, method of fixation, and implantation version all play a role in component stability. With current designs, 51% of standard glenoid components shift at 2 years. This study aimed to compare the biomechanical stability of a novel circular glenoid with peripheral ring fixation to a standard anchor pegged glenoid. Additionally, we compared the estimated bone removal for the glenoid design types. METHODS: Biomechanical testing [Figure 1] was performed to assess the glenoid …

The Safety And Efficacy Of Posterior Lumbar Interbody Fusions In The Outpatient Setting., Hunter F Pharis, Daniel T Degenova, Braden J Passias, Taylor J Manes, Grace Parizek, Daryl Sybert

Surgery Articles

Introduction Outpatient surgical procedures have shown reduced costs, improved patient outcomes, and decreased postoperative complications. Interest in moving orthopedic and neurosurgical spine procedures to the outpatient setting has grown in recent years because of these factors. Studies investigating open posterior lumbar interbody fusions (PLIFs) in the outpatient setting are sparse. Methods The patients who underwent an open PLIF with pedicle screw and rod construct from 2014 to 2018 were retrospectively reviewed. Outpatient procedures were defined by patient discharge being on the same day of the procedure, without admittance to an inpatient ward. Pertinent demographic, clinical, radiographic, and surgical data were …

Modified Himawari Technique For Comminuted Patella Fractures: A Case Report - An Economically Yet Rigidly Efficient Option, Leong Li Theng Dr, Eyrique Goh Boay Heong Dr

Manipal Journal of Nursing and Health Sciences

Comminuted patella fracture is a tricky and complicated case to manage and yet a common fracture. It’s often complicated with post operative pseudoarthrosis, malunion, poor rehabilitation and reduced knee range of motion. Tension band wiring, Cerclarge wiring and screw fixation are the common surgical modalities however it’s unable to hold peripherally scattered fragments in place rigidly. It is often associated with failure osteosynthesis, fracture displacement, resulting in post op osteoarthritis. Here we demonstrate a case of a modification of the original Himawari Technique as a much cost-effective method compared to the original, while being a superior treatment option with good …

Tetravalent Sars-Cov-2 S1 Subunit Protein Vaccination Elicits Robust Humoral And Cellular Immune Responses In Siv-Infected Rhesus Macaque Controllers, Rachel C Vanderkruik, Craig Ferguson, Lauren A Kobylski, Joseph J Locascio, Gabriella E Hamlett, Parker C Killenberg, Robert Lewis, Noah Jones, Ella T Rossa, Hannah Dineen, Rosalind Picard, Lee S Cohen

Faculty, Staff and Student Publications

BACKGROUND: Depression during pregnancy is increasingly recognized as a worldwide public health problem. If untreated, there can be detrimental outcomes for the mother and child. Anxiety is also often comorbid with depression. Although effective treatments exist, most women do not receive treatment. Technology is a mechanism to increase access to and engagement in mental health services.

OBJECTIVE: The Guardians is a mobile app, grounded in behavioral activation principles, which seeks to leverage mobile game mechanics and in-game rewards to encourage user engagement. This study seeks to assess app satisfaction and engagement and to explore changes in clinical symptoms of depression …

A New Perspective On Intervertebral Disc Calcification-From Bench To Bedside, Emanuel Novais, Rajkishen Narayanan, Jose Canseco, Koen Van De Wetering, Christopher Kepler, Alan Hilibrand, Alex Vaccaro, Makarand Risbud

Department of Orthopaedic Surgery Faculty Papers

Disc degeneration primarily contributes to chronic low back and neck pain. Consequently, there is an urgent need to understand the spectrum of disc degeneration phenotypes such as fibrosis, ectopic calcification, herniation, or mixed phenotypes. Amongst these phenotypes, disc calcification is the least studied. Ectopic calcification, by definition, is the pathological mineralization of soft tissues, widely studied in the context of conditions that afflict vasculature, skin, and cartilage. Clinically, disc calcification is associated with poor surgical outcomes and back pain refractory to conservative treatment. It is frequently seen as a consequence of disc aging and progressive degeneration but exhibits unique molecular …

Early Management Of Adult Traumatic Spinal Cord Injury In Patients With Polytrauma: A Consensus And Clinical Recommendations Jointly Developed By The World Society Of Emergency Surgery (Wses) & The European Association Of Neurosurgical Societies (Eans), Edoardo Picetti, Andreas Demetriades, Fausto Catena, Bizhan Aarabi, Fikri Abu-Zidan, Oscar Alves, Luca Ansaloni, Rocco Armonda, Rafael Badenes, Miklosh Bala, Zsolt J Balogh, Andrea Barbanera, Alessandro Bertuccio, Walter Biffl, Pierre Bouzat, Andras Buki, Ana Maria Castano-Leon, Davide Cerasti, Giuseppe Citerio, Federico Coccolini, Raul Coimbra, Carlo Coniglio, Francesco Costa, Federico De Iure, Bart Depreitere, Enrico Fainardi, Michael Fehlings, Nikolay Gabrovsky, Daniel Agustin Godoy, Peter Gruen, Deepak Gupta, Gregory Hawryluk, Raimund Helbok, Iftakher Hossain, Peter Hutchinson, Corrado Iaccarino, Kenji Inaba, Marcel Ivanov, Stanislav Kaprovoy, Andrew Kirkpatrick, Sam Klein, Angelos Kolias, Nikolay Konovalov, Alfonso Lagares, Laura Lippa, Angelica Loza-Gomez, Teemu Luoto, Andrew Maas, Andrzej Maciejczak, Ronald Maier, Niklas Marklund, Matthew Martin, Ilaria Melloni, Sergio Mendoza-Lattes, Geert Meyfroidt, Marina Munari, Lena Napolitano, David Okonkwo, Yasuhiro Otomo, Marios Papadopoulos, Ondra Petr, Wilco Peul, Aichholz K Pudkrong, Zaffer Qasim, Frank Rasulo, Carla Reizinho, Florian Ringel, Sandro Rizoli, Elham Rostami, Andres Rubiano, Emanuele Russo, Aarti Sarwal, Jan Schwab, Franco Servadei, Deepak Sharma, Salman Sharif, Ehab Shiban, Lori Shutter, Philip Stahel, Fabio Taccone, Nicole Terpolilli, Claudius Thomé, Peter Toth, Parmenion Tsitsopoulos, Andrew Udy, Alex Vaccaro, Albert Varon, Monica Vavilala, Alexander Younsi, Monika Zackova, Tommaso Zoerle, Chiara Robba

Rothman Institute Papers

BACKGROUND: The early management of polytrauma patients with traumatic spinal cord injury (tSCI) is a major challenge. Sparse data is available to provide optimal care in this scenario and worldwide variability in clinical practice has been documented in recent studies.

METHODS: A multidisciplinary consensus panel of physicians selected for their established clinical and scientific expertise in the acute management of tSCI polytrauma patients with different specializations was established. The World Society of Emergency Surgery (WSES) and the European Association of Neurosurgical Societies (EANS) endorsed the consensus, and a modified Delphi approach was adopted.

RESULTS: A total of 17 statements were …

The Challenges Of Implementing And Documenting Ottawa Ankle Rules In The Pediatric Emergency Department: A Retrospective Study, Emmalee M. Kugler, Michael Gillman, Olivia Toner

Cooper Rowan Medical Journal

INTRODUCTION
Acute ankle sprains account for nearly 2% of visits to the pediatric emergency department (PED). The Ottawa Ankle Rules (OAR) were developed as a safe and effective clinical decision-making tool for detecting the need for radiographs in adults with acute ankle pain. OAR state radiographs are required with at least one of the following:

1. Inability to bear weight immediately following the injury and for four steps in the ED 2. Bony tenderness at the posterior edge of the lateral or medial malleolus

OBJECTIVE
Few prospective cohort studies have attempted to assess OAR pediatric populations. This study investigates the …

Supraventricular Tachycardia Associated With Repeat Cesarean Section Under Spinal Anesthesia, Malik A Althobiani, Rebecca Shuttleworth, John Conway, Jonathan Dainton, Anna Duckworth, Ana Jorge Da Ponte, Jessica Mandizha, Joseph W Lanario, Michael A Gibbons, Sarah Lines, Chris J Scotton, John R Hurst, Joanna C Porter, Anne-Marie Russell

Faculty, Staff and Student Publications

INTRODUCTION: Patients diagnosed with Interstitial Lung Diseases (ILD) use devices to self-monitor their health and well-being. Little is known about the range of devices, selection, frequency and terms of use and overall utility. We sought to quantify patients' usage and experiences with home digital devices, and further evaluate their perceived utility and barriers to adaptation.

METHODS: A team of expert clinicians and patient partners interested in self-management approaches designed a 48-question cross-sectional electronic survey; specifically targeted at individuals diagnosed with ILD. The survey was critically appraised by the interdisciplinary self-management group at Royal Devon University Hospitals NHS Foundation Trust during …

A Data-Driven Methodology To Comprehensively Assess Bone Drilling Using Radar Plots, Aman Nigam, James F Kellam, Catherine G Ambrose, Bruce L Tai

Faculty, Staff and Student Publications

BACKGROUND: The study aims to develop a data-driven methodology to assess bone drilling in preparation for future clinical trials in residency training. The existing assessment methods are either subjective or do not consider the interdependence among individual skill factors, such as time and accuracy. This study uses quantitative data and radar plots to visualize the balance of the selected skill factors.

METHODS: In the experiment, straight vertical drilling was assessed across 3 skill levels: expert surgeons (N = 10), intermediate residents (postgraduate year-2-5, N = 5), and novice residents (postgraduate year-1, N = 10). Motion and force were measured for …

The Impact Of Local Physiology On The Corrosion Of Orthopedic Alloys, Madison Nicole Brown

Theses and Dissertations (ETD)

Introduction. Total knee arthroplasty (TKA) is used in the treatment of end-stage osteoarthritis of the knee. It is one of the most common elective surgeries performed with predictions expecting significant increases in the number of procedures performed over the next decade. However, the patient satisfaction rate after TKA is as low as 80%. Cobalt-chromium-molybdenum (CoCrMo) is regularly used for TKA protheses due to the alloy’s mechanical strength, biocompatibility, and corrosion resistance. The corrosion resistance of this alloy relies on a passive oxide layer. This oxide layer can be impacted by phagocytic cells which can leave pits and craters on implant …

The Pernicious Right Shoulder Pain, Julie Hwang, Md, Weiya Wysham, Md, Qian Leng, Md, Mph

Poster Presentations

No abstract provided.

Comparison Of 3 Treatments For Fractures Of The Humeral Shaft, Neil Werthmann, Mason Poffenbarger, John Riehl

North Texas GME Research Forum 2024

INTRODUCTION: Over the past 40 years, surgical treatment for humeral shaft fractures has become more common. The purpose of the study was to evaluate complication rates seen with different treatments for humeral shaft fractures. Nerve injury (NI), infection, deep vein thrombosis (DVT), and nonunion (NU) were the specific complications investigated. METHODS: A retrospective database review was performed looking at all patients with humeral shaft fractures. Data was analyzed for complication rates for non-surgical (NS) treatment, open reduction internal fixation (ORIF), and intramedullary nailing (IMN). Inclusion criteria were: 1) patients ages of 18 to 89 and 2) those with humeral shaft …

Early Outcomes Of Femoral Neck System Vs. Percutaneous Cannulated Screw Fixation In Non-Displaced Femoral Neck Fractures: A Retrospective Database Study, Satish Chandrasekhar, Harrison Seltzer, Dardiny Saint-Clair, James P. Mcfadden

North Florida Division GME Research Day 2024

No abstract provided.

Serial Irrigation And Debridement And Kerecis For Treatment Of Necrotizing Fasciitis: A Case Report, Katherine Manseau, Jacob Frisbie, Robert Garner, Collin Erickson, Charles Orth

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.

Incidence Of Above Knee Amupations Due To Total Knee Arthroplasty Complications: A Comprehensive Analysis From A Midwest Metropolitan Hospital System, Robert Garner, Collin Erickson, Evan Johnson, Brandalynn Holland, Jacob Frisbie

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.

Masquelet Technique Promotes Osteogenesis In Traumatic Open Tibial Plateau Fracture, Melanie Valencia, Paul C. Baldwin

South Atlantic Division GME Research Day 2024

No abstract provided.

Impact Of Opioid-Free Analgesia On Pain Severity And Patient Satisfaction After Discharge From Surgery: Multispecialty, Prospective Cohort Study In 25 Countries, Tabish Chawla, Aliya Aziz, Anoosha Marium, Ayesha Akbar Waheed, Faiqa Binte Aamir, Faiza Qureshi, Hammad Ather, Iqra Fatima Munawar Ali, Izza Tahir, Maha Ghulam Akbar, Ronika Devi Ukrani, Sajjan Raja, Sehar Salim Virani, Shahryar Noordin, Saif Ur Rehman, Shalni Golani, Syed Roohan Aamir, Syed Musa Mufarrih, Usama Waqar, Maliha Taufiq

Section of General Surgery

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.
Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Bilateral Spontaneous Osteonecrosis Of The Knee (Sponk) In Young Male: A Case Report, Hans Drawbert, Mason Poffenbarger, Joshua Payne

North Texas GME Research Forum 2024

Introduction: Spontaneous osteonecrosis of the knee (SPONK) is a relatively uncommon disease consisting of a focal, subchondral lesion thought to be a subchondral insufficiency fracture that has progressed to collapse and may lead to end-stage osteoarthritis of the knee. There are several treatment options, including nonsurgical and surgical measures but almost 80% of cases end up requiring surgery, usually consisting of unicompartmental or total knee arthroplasty. However, despite these treatment options, there remains no good option for young patients who present with SPONK in large areas of their distal femur or disease in both medial and lateral condyles. Case …

Nail-Plate Fixation Vs Distal Femoral Replacement For Periprosthetic Distal Femur Fractures, Matthew Mccrosson, Mamun Al Rashid

East Florida Division GME Research Day 2024

No abstract provided.

Use Of An Antibiotic Spacer And Pedicled Groin Flap In The Treatment Of Chronic Osteomyelitis Of The Forearm: A Case Study, Nathan Elder, Christopher Morford, Alexander Selsky, William Judson Iv

West Florida Division GME Research Day 2024

No abstract provided.

Robotic-Assistance In Total Hip Arthroplasty Is Associated With Decreased Dislocation Rates, Gabrielle N. Swartz, Sandeep S. Bains, Jeremy A. Dubin, Reza Katanbaf, Hunter Hayes, James Nace, Michael A. Mont, Ronald E. Delanois

Orthopedic Surgery Resident Research

Background

As the use of robotics in total hip arthroplasty (THA) continues to gain popularity, differences in clinical outcomes when compared to manual techniques have remained unclear. This study aimed to compare postoperative complications between patients undergoing robotic-assisted techniques and manual THA for primary osteoarthritis at 90 days, 1 year, and 2 years.

Methods

Using an all-payer national database, we identified 405,048 patients who underwent either robotic-assisted or manual THA for primary osteoarthritis. A propensity match was performed for age, sex, a comorbidity index, chronic kidney disease, obesity, and diabetes, resulting in 7652 patients in each cohort. We assessed postoperative …

Novel Engineering Approaches For Orthopedic Injury Treatment And Infection Diagnosis, Cynthia Co

Bioengineering Dissertations - Archive

Bioengineering has made significant contributions to the treatment of orthopedic injury through interdisciplinary approaches. Central to these advancements are many orthopedic implants, including anchors and joint replacements, which have been designed to restore mobility. Despite their functional efficacy, these products have limited lifespan and are associated with many complications, such as implant-associated infection. The success of implant design and function, both in the short and long term, is paramount for enhancing patient outcomes and overall well-being. Therefore, my thesis work is dedicated to addressing these critical challenges, aiming to maximize their treatment effect while minimizing the implant-associated complications.

Long-term patient …

Biomechanical Evaluation And Intraoperative Strategies For Addressing Suture Anchor Failure In Osteoporotic Bone, Richard Marchese, Samir Baig, Sofia P. Hidalgo, Jaclyn Brunner, David E. Komatsu, Edward D. Wang

Stony Brook Orthopaedic and Musculoskeletal Journal

Purpose: When aiming to enhance the strength of a suture anchor construct, typically in osteoporotic bone, it is often suggested to employ a method referred to as "under-tapping" (UT). A comprehensive assessment of tapping protocols for anchor placement was conducted to ascertain if this contributes to the prevention of anchor failure. Further, supplementary fixation techniques were examined to offer methods for secure fixation in the event of unanticipated failure.

Hypothesis: Under-tapping can increase load to failure compared to standard tapping (ST). If the initial fixation fails, using larger diameter anchors or bioabsorbable Trim-IT pins (TIP) via cross-pinning can provide stable …