Orthopedics Commons^™

Weight Reduction Motivation In Osteoarthritis Patients Through Nurse Practitioner Driven Education And Follow-Up: A Pilot Project, Caoilfhionn Mulvey, Martha Fuller Phd

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: The ultimate goal of this short-term pilot project is for

overweight or obese osteoarthritis patients to increase their knowledge on the benefits of

weight loss and physical activity. Research shows that for every kilogram of weight lost,

2.2–4.0 kilograms of weight is taken off of the joint and could reduce joint pain up to

thirty to fifty percent and improve quality of life. Following education from the provider,

patients will understand the correlation of osteoarthritis symptom management with

weight loss.

EBP Model/Frameworks: This project utilizes the Iowa Model of Evidence-Based

Practice to Promote Quality Care. This addresses …

Development Of A Mind Body Program For Obese Knee Osteoarthritis Patients With Comorbid Depression, Cale A. Jacobs, Ryan A. Mace, Jonathan Greenberg, Paula J. Popok, Mira Reichman, Christian Lattermann, Jessica L. Burris, Eric A. Macklin, Ana-Maria Vranceanu

Orthopaedic Surgery and Sports Medicine Faculty Publications

Knee osteoarthritis (OA) is the most common joint disorder in the U.S. and a leading cause of disability. Depression and obesity are highly comorbid among knee OA patients, and the combination of obesity and depression is associated with decreased physical activity, higher pain and disability, and more rapid cartilage degradation. Depression, obesity and OA exacerbate one another and share a common pathophysiology involving systemic inflammation and pro-inflammatory cytokines, reflecting a complex mind-body interaction. Current treatments for knee OA offer little to no benefit over placebo, and do not emphasize mind-body practices or physical activity to target the underlying pathophysiology. Mind-body …

Acupuncture Therapy In The Treatment Of Osteoarthritis Of The Knee, Reece Bartell

Capstone Showcase

Abstract

Introduction: Osteoarthritis (OA) is a chronic condition that affects the joints of the body, most commonly the knees; it has the potential to cause debilitating pain, and stiffness and decrease quality of life. The current management involves lifestyle modifications of a healthy diet and exercise as well as analgesics like NSAIDs or acetaminophen to manage symptoms. Long-term use of these medications has been associated with many side effects affecting the GI and CV system. This review analyzes the use of acupuncture therapy (I) for symptom management (O) in patients aged 60-80 years old suffering from mild to moderate …

Effects Of Alcohol Use On Total Knee Arthroplasty Patient Osteoarthritis Severity, Preoperative Pain Scores, And Postoperative Range Of Motion: A Retrospective Study, Christopher Ruland, Samir Baig, Zach Warheit, David E. Komatsu, James Nicholson

Stony Brook Orthopaedic and Musculoskeletal Journal

Introduction: Despite the prevalence of significant alcohol use, the effect of alcohol consumption on patients undergoing total knee arthroplasty (TKA) is poorly understood. Other forms of substance abuse, such as narcotic dependence, decrease patient pain tolerance and increase self-reported pain scores, while excessive alcohol consumption has been associated with adverse outcomes following other elective surgical procedures. In the context of TKA, perception of pain is also likely linked to the ability to achieve functional postoperative range of motion (ROM), one of the most important predictive indicators of patient satisfaction. It is not well understood whether heavy alcohol users who are …

A Comparison Of 4-Year Total Medical Care Costs, Adverse Outcomes, And Opioid/Prescription Analgesic Use For 3 Knee Osteoarthritis Pain Treatments: Intra-Articular Hyaluronic Acid, Intra-Articular Corticosteroids, And Knee Arthroplasty., John Mackowiak, John T Jones, Vinod Dasa

School of Medicine Faculty Publications

To compare the medical costs associated with treatments for knee osteoarthritis (OA): intra-articular corticosteroids (ICS) and intra-articular hyaluronic acid (IHA) primarily, and ICS/IHA vs knee arthroplasty (TKA) secondarily. This was a retrospective analysis of an insurance claims database. Eligible members had diagnosed OA and no claims for ICS, IHA, or TKA during the 6–18-month look-back period. Cohorts of interest over the 4-year observation period were: patients who received ICS only, those who received IHA only, and those who received TKA only. Outcomes assessed included: (1) total allowed medical costs, (2) claims for pre-specified, treatment-related adverse outcomes and costs, and (3) …

Comparison Of Non-Nsaid Pain Management In The Treatment Of Patients With Symptomatic Knee Osteoarthritis, Nicholas Schmitz

Theses and Graduate Projects

Objective: To compare the efficacy of other modalities and interventions versus standard first-line therapy of nonsteroidal anti-inflammatory drugs for pain management in patients with symptomatic knee osteoarthritis

Methods: Perform literature reviews outlining patients suffering from Grade II or higher KOA using the Kellgren-Lawrence classification system and currently experiencing symptoms of pain, stiffness, and impaired physical functioning. Use data and results from various studies to compare improvement of symptoms from these modalities versus improvement of NSAIDs alone.

Results: Weight loss and physical activity should remain the mainstay of early osteoarthritis treatment to help slow disease progression and symptoms of KOA. Duloxetine …

Assessment Of The Composition And Biologic Activity Of Platelet Rich Plasma And Its Relationship To Clinical Outcomes In Patients With Knee Osteoarthritis, Daniel Nemirov, Bijan Dehghani, Habib Zahir, Xiaoning Yuan, Christine Kim, Reyna Bhandhari, Patrick Fava, Yurii Chinenov, Joseph Nguyen, Laura Donlin, Brian Halpern, Scott Rodeo, Miguel Otero

Phase 1

Recent studies suggest positive clinical outcomes associated with platelet-rich-plasma (PRP) administration to treat knee osteoarthritis (OA). However, the results remain inconclusive in part because of the high variability in PRP preparations and the limited information regarding the relevant biologically active components of PRP. We hypothesize that the variability in clinical response is driven by the heterogeneous composition of PRP. In this study we evaluated the composition and biological activity of PRP and further correlated our findings to clinical outcomes in patients receiving intra-articular injections for knee OA. After IRB approval and patient consent, we enrolled 51 patients (mean age: 57.9 …

Outcomes Of Bilateral Shoulder Arthroplasties: A Comparison Of Bilateral Total Shoulder Arthroplasties And Bilateral Reverse Shoulder Arthroplasties., Ryan Matthew Cox, Tyler James Brolin, Eric Michael Padegimas, Mark D. Lazarus, Charles Lonnie Getz, Matthew Lee Ramsey, Gerald Ross Williams, Joseph Albert Abboud

Rothman Institute Papers

Background: The purpose of this study was to compare outcomes of patients who underwent bilateral total shoulder arthroplasties (TSAs) for osteoarthritis (OA) versus bilateral reverse shoulder arthroplasties (RSAs) for cuff tear arthropathy (CTA).

Methods: Inclusion criteria were patients who underwent bilateral TSAs for OA or bilateral RSAs for CTA with at least 2 years of follow-up. Twenty-six TSA patients (52 shoulders) were matched 2 to 1 with 13 RSA patients (26 shoulders) by sex, age at first surgery, and time between surgeries. Outcomes measured were shoulder range of motion (ROM), complications, and patient-reported scores.

Results: Preoperatively, TSA patients had significantly …

A Review Of Mesenchymal Stem Cell Injections For Osteoarthritis, Ammar Qureshi, Jill Goodwin, Franklin D. Shuler, Timothy Wilson-Byrne, John J. Jasko, Charles Giangarra

Marshall Journal of Medicine

Mesenchymal stem cell (MSC) injections for osteoarthritis is reviewed.

Methods- PubMed search identifying articles in English from 2003-2018 that used intra- articular injection (IA), cartilage repair, cartilage regeneration, chondral injury, adipose stem cells, bone marrow stem cells, mesenchymal stem cells, or autologous stem cells.

Results – 388 patients receiving IA MSC injections are discussed with data obtained from 10 case reports or case series, 4 randomized clinical trials (RCT), 1 cohort study, and 3 case controlled therapeutic studies.

Conclusions – MSC injections may be an effective adjunct in the management of osteoarthritis and a variety of cartilage related pathologies.

Multimodality Minimally Invasive Treatment Of Large Joint Osteoarthritis: A Pilot Trial Of Stromal Vascular Fraction From Autologous Fat Combined With Platelet-Rich Plasma, Phil Giddings, Insiyah Campwala, Subhas Gupta

Loma Linda University Student Journal

Osteoarthritis (OA) is a degenerative joint disease that can cause severe pain in those affected. Currently, there are no therapeutic drugs available to treat osteoarthritis. While total joint arthroplasties (TJA) allow for improved function, there are no less invasive, yet effective procedures that can be done for patients unwilling or unable to undergo major surgery.

Platelet-rich plasma (PRP) has been shown to reduce the symptoms of OA when injected into the affected joint. Patients treated by this method alone have improved self-reported pain (at least a 50% reduction from original value) as well as lower extremity function. While the effects …

Motor Learning And Adaptation In People With Knee Osteoarthritis And Chronic Pain, Heather Turcotte, Katherine S. Rudolph

Osteopathic Medicine Student Research Posters

Osteoarthritis (OA) affects an estimated 50 million people in the US, and approximately 43% have limitations in daily function due to arthritis pain.3 Individuals with knee osteoarthritis (OA) have heightened sensitization to pain2,5 as well as reduced strength, diminished function and quality of life1 that prompts them to seek care from health care providers. Physical therapists commonly work with patients to improve function and quality of life by helping them learn to move without pain. Unfortunately, chronic pain causes changes to the nervous system that may impact the ability to learn new ways but the extent to which chronic pain …

Long-Term Outcomes In Anterior Cruciate Ligament Reconstruction: A Systematic Review Of Patellar Tendon Versus Hamstring Autografts., Kirsten L. Poehling-Monaghan, Hytham Salem, Kirsten E. Ross, Eric S Secrist, Michael C. Ciccotti, Fotios Tjoumakaris, Michael G. Ciccotti, Kevin B. Freedman

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Much controversy still exists surrounding graft choice in anterior cruciate ligament (ACL) reconstruction. Over the past decade, an increase in comparative studies with longer follow-up has enhanced our understanding of current graft options and outcomes.

PURPOSE: To describe the long-term comparative outcomes of ACL reconstruction with autograft bone-patellar tendon-bone (BPTB) versus autograft hamstring (HS) ACL reconstruction with regard to clinical and radiographic outcomes.

STUDY DESIGN: Systematic review; Level of evidence, 2.

METHODS: A search of the PubMed, MEDLINE, Cochrane, and Scopus databases was performed to identify studies in the English language with outcome data comparing ACL reconstruction utilizing autograft …

Effects Of Glucosamine Versus Chondroitin Sulfate In Reducing Joint Space Narrowing In Knee Osteoarthritis, Caroline Horton, Ashani Andrews

Physician Assistant Capstones, 2016 to 2019

Objective: To determine if over the counter supplements, chondroitin sulfate and glucosamine, in combination or alone, are effective in the treatment of joint space narrowing (JSN) in knee osteoarthritis.

Design: Systematic Literature Review

Methods: Database search of PubMed and MEDLINE using the search terms “glucosamine”, “chondroitin sulfate”, “osteoarthritis”, and joint space narrowing. Filters were implemented to include articles that only dealt with human subjects, that were published in 2000 or later, and were full-text. Articles were excluded if they were cohort studies, reviews, non-English papers, or had pain as the only outcome.

Results: Sawitzke et al.primary outcomes revealed no …

Radiographic Prevalence Of Osteoarthritis Of The Scaphotrapeziotrapezoid Joint In Patients With Carpometacarpal Osteoarthritis Of The Thumb: A Retrospective Case Series, Charlotte E. Orr, Robert Mercer, Deana M. Mercer, Drew K. Newhoff, Matthew D. Martin, Moheb S. Moneim

UNM Orthopaedic Research Journal

Background: In planning operative treatment of thumb carpometacarpal (CMC) joint osteoarthritis, surgeons should consider the presence of an arthritic scaphotrapeziotrapezoid (STT) joint. We aimed to determine the radiographic prevalence of concomitant (STT) osteoarthritis with thumb CMC osteoarthritis in patients who underwent surgical treatment at our institution. We hypothesized that the prevalence of concomitant arthritis at these 2 joints (STT and CMC) would be lower than previously reported.

Methods: Between September 2005 and July 2012, a total of 417 patients were identified from our institution using the Current Procedural Terminology code for thumb CMC joint arthroplasty (25447). After applying exclusion criteria …

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 …

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 …

Synovial Neuronal Changes In Knee Joint Osteoarthritis, Haq Nawaz, Masood Umer, Shahryar Noordin, Bo Christer Bertilson, Jian Li, Aisha Siddiqah Ahmed, Mahmood Ahmed

Department of Surgery Docs

Abstract Purpose: The purpose is to study whether pain and inflammation in knee joint osteoarthritis (OA) are associated with local synovial neuronal changes. Methods: Synovial biopsies were harvested from the medial and lateral knee compartments from OA patients undergoing total joint replacement surgery. All patients had predominant pain at the medial joint compartment. Pain and knee joint function were evaluated by knee society score (KSS). Synovial inflammation was analyzed by histopathological analysis and expression of growth associated protein-43 (GAP-43), sensory (SP, CGRP) and autonomic (NPY, VIP, TH) neuropeptides was studied by single and double immunohistochemistry techniques. Results: We observed reduced …

Psychosocial And Demographic Factors Influencing Pain Scores Of Patients With Knee Osteoarthritis, Lauren A. Eberly, Dustin L. Richter, George D. Comerci, Deana M. Mercer, Gary W. Mlady, Daniel C. Wascher, Robert C. Schenck Jr

UNM Orthopaedic Research Journal

Background: Noted levels of pain in patients with diagnosed osteoarthritis (OA) of the knee are commonly assessed by using a numeric scoring system. However, the results of pain levels in patients with knee OA may be influenced by factors other than the patient’s actual physical discomfort or disease severity, including demographic and psychosocial variables. We retrospectively examined 355 patients with knee OA who had reported associated pain levels using a 0- to 10-point rating scale.

Methods: Data obtained from the medical records of patients were Kellgren-Lawrence (KL) grade, demographic characteristics, body mass index (BMI), concomitant disorders, drug use, alcohol use, …

How To Manage Knee Arthritis: Best Practices For Treatment Prior To Orthopaedic Referral, Ali Oliashirazi Md, Alex Caughran Md, Zain Quazi Md, Grant Buchanan Md, Akash Sharma, Franklin D. Shuler Md, Phd

Orthopaedics

Osteoarthritis (OA) of the knee is a debilitating disease in which degeneration of the joint space cartilage can lead to life-altering pain and stiffness. The prevalence of OA has a strong correlation with age, with evidence of radiographic knee OA found in 37.4% of persons older than 60 years of age. According to the Agency for Healthcare Research and Quality’s (AHRQ) 2013 report, osteoarthritis was ranked the second most expensive condition for Medicare and private insurers, with over 90% of the hospitalizations for OA involving a knee or hip replacement. It is projected that by 2030 the number of primary …

Effect Of Continuous Passive Motion On Knee Flexion Range Of Motion After Total Knee Arthroplasty, Naveed Baloch, Akbar Jaleel Zubairi, Rizwan Haroon Rashid, Pervaiz Hashmi, Riaz Hussain Lakdawala

Department of Surgery Docs

Abstract

OBJECTIVE:

To compare mean knee flexion in patients on continuous passive motion and those without it after total knee arthroplasty.

METHODS:

The randomised controlled study was conducted at Aga Khan University Hospital, from July 2013 to June 2014, and comprised patients who underwent total knee arthroplasty. Patients were randomly assigned to either group, with Group A receiving standardised physiotherapy from 1st postoperative day, and Group B receiving physiotherapy and one hour of continuous passive motion twice a day from 1st postoperative day until discharge. Outcome assessment was done on the day of discharge.

RESULTS:

Of the 76 patients, there …

First Carpometacarpal Arthroplasty With Ligamentous Reconstruction: A Long-Term Follow-Up, Mark A Yaffe, Bennet Butler, James M Saucedo, Daniel J Nagle

Faculty, Staff and Student Publications

BACKGROUND: The purpose of the present study is to evaluate a single surgeon's short, intermediate, and long-term clinical, functional, and radiographic outcomes with a trapeziectomy with flexor carpi radialis (FCR) suspension arthroplasty without tendon interposition (LRSA).

METHODS: Twenty-one patients underwent 26 FCR suspension arthroplasties without tendon interposition by a single senior surgeon. All patients had Eaton stage III and IV carpometacarpal (CMC) osteoarthritis. The Patient-Rated Wrist and Hand Evaluation (PRWHE) and Quick Disabilities of Arm, Shoulder, and Hand (QuickDASH) were used to evaluate functional outcomes. A comprehensive strength and range of motion evaluation was performed to evaluate clinical outcomes. Plain …

The Aging Athlete, Taylor Jobe

UNM Orthopaedic Research Journal

No abstract provided.

Osteoarthritis Of The Knee: Does Physical Therapy Intervention Alone Improve Functional Outcome Scores Of The Timed Up And Go More Than Total Knee Arthroplasty?, Alyson N. Wilson, Beth Moody Jones

UNM Orthopaedic Research Journal

No abstract provided.

Boning Up On Autophagy: The Role Of Autophagy In Skeletal Biology., Irving Shapiro, Robert Layfield, Martin Lotz, Carmine Settembre, Caroline Whitehouse

Department of Orthopaedic Surgery Faculty Papers

From an evolutionary perspective, the major function of bone is to provide stable sites for muscle attachment and affording protection of vital organs, especially the heart and lungs (ribs) and spinal cord (vertebrae and intervertebral discs). However, bone has a considerable number of other functions: serving as a store for mineral ions, providing a site for blood cell synthesis and participating in a complex system-wide endocrine system. Not surprisingly, bone and cartilage cell homeostasis is tightly controlled, as is the maintenance of tissue structure and mass. While a great deal of new information is accruing concerning skeletal cell homeostasis, one …

Is Valdecoxib An Effective Treatment Option To Improve Pain In Adults With Diagnosed Osteoarthritis Of The Hip Or Knee?, Karen A. Mcsorley

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Valdecoxib is an effective treatment option to improve pain in adults with osteoarthritis of the hip or knee.

STUDY DESIGN: This review consists of three randomized control trials; two were published in 2002 and the third in 2006.

DATA SOURCES: Sources were studies comparing groups taking Valdecoxib 10mg QD to placebo, which were found via Pubmed, MEDLINE, Ovid, and Cochrane databases.

OUTCOMES MEASURED: The three articles measured various outcomes: pain improvement, stiffness, physical improvement, adverse effects, and onset of analgesia during acute pain …

Is Phlogenzym Effective In Reducing Moderate To Severe Osteoarthritis Pain In Adults?, Vanessa K. Wood

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Phlogenzym (or ERC) effective in reducing moderate to severe osteoarthritis pain in adults.

STUDY DESIGN: Review of three randomized controlled trials in the English language from 2001 to 2006.

DATA SOURCES: Two double blind RCTs and one open RCT was found using Cochrane Library EBM Online Database, Ovid Medline, and PubMed Online.

OUTCOMES MEASURED: Each of the three studies measured for pain at rest, pain with motion, and restricted function at baseline assessing efficacy using the Lequesne’s Algofunctional Index, visual analog scales, and …

Medication And Supplement Use For Managing Joint Symptoms Among Patients With Knee And Hip Osteoarthritis: A Cross-Sectional Study, Jeffrey B. Driban, Sara A. Boehret, Easwaran Balasubramanian, Nicole M. Cattano, Joseph Glutting, Michael R. Sitler

Sports Medicine Faculty Publications

No abstract provided.

Biochemical Comparison Of Osteoarthritic Knees With And Without Effusion, Nicole M. Cattano, Jeffrey B. Driban, Easwaran Balasubramanian, Mary F. Barbe, Mamta Amin, Michael R. Sitler

Sports Medicine Faculty Publications

No abstract provided.

Limitations Of The Knee Society Score In Evaluating Outcomes Following Revision Total Knee Arthroplasty., Elie Ghanem, Ian Pawasarat, Adam Lindsay, Lauren May, Khalid Azzam, Ashish Joshi, Javad Parvizi

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Traditionally, the results of revision total knee arthroplasty have been determined with use of surgeon-based measures such as the Knee Society rating system. Recently, outcome and quality-of-life measures have shifted toward a greater emphasis on patient-based evaluation. The aim of our study was to determine the validity and responsiveness of the Knee Society rating system compared with the Short Form-36 health survey (SF-36), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and a four-question 4-point Likert scale satisfaction questionnaire following revision total knee arthroplasty.

METHODS: A total of 152 patients underwent revision total knee arthroplasty at our institution, between …

Isolated Polyethylene Exchange Versus Acetabular Revision For Polyethylene Wear, Camilo Restrepo, Elie Ghanem, Carrie Houssock, Mathew Austin, Javad Parvizi, William J. Hozack

Department of Orthopaedic Surgery Faculty Papers

Polyethylene wear and osteolysis are not uncommon in THA mid- and long-term. In asymptomatic patients the dilemma faced by the orthopaedic surgeon is whether to revise the cup and risk damage to the supporting columns and even pelvic discontinuity or to perform isolated polyethylene exchange and risk a high rate of postoperative recurrent instability and dislocation that will necessitate further surgery. We retrospectively reviewed 62 patients (67 hips) who underwent revision arthroplasty for polywear and osteolysis. Thirty-six hips had isolated polyethylene exchange, while 31 had full acetabular revision. The minimum followup was 2 years (mean, 2.8 years; range, 2-5 years). …