Orthopedics Commons^™

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 …

Recurrence Of Ganglion Cysts Following Re-Excision, Lindsay S. Mcalpine, Msiii, Juana Medina, Md, Nayoung Kim, Bs, Michael Rivlin, Md

CwiC Posters

Previous studies have examined the recurrence of ganglion cysts after surgical excision at a rate of 4 to 40%. However, recurrence after revision surgical excision is unknown. The purpose of this study was to define the incidence of recurrent ganglion cysts in patients who underwent a 2nd excisional procedure.

Causes, Evaluation, And Treatment Of Instability Of The Patellofemoral Joint Of The Knee: A Review, Michael J. Hopson

UNM Orthopaedic Research Journal

Instability of the patellofemoral (PF) joint of the knee is typically caused by chronic atraumatic injuries and inciting traumatic events. Anatomically, bony and softtissue structures surrounding the PF joint and extensor mechanism contribute to overall stability of the area, which results in efficient kinematic function at the PF articulation. Furthermore, physiological, genetic, anatomical, and demographical factors may affect the development and progression of PF joint instability. Treatment techniques have varied owing to individual factors that may have influence on pathological features of the injury. Nonoperative treatment has predominantly focused on strengthening of the quadriceps and vastus medialis by coordinated, closed …

Ruptures Of The Quadriceps And Patellar Tendons Of The Extensor Mechanism: A Review, Judd R. Fitzgerald

UNM Orthopaedic Research Journal

Damage to the quadriceps and patellar tendons of the extensor mechanism can be devastating and often life-changing injuries that require prompt diagnosis and treatment. A sound understanding of anatomy, biomechanics, and degenerative changes of both tendons and the extensor mechanism of the knee can help guide surgical repair and postoperative rehabilitation of patients. Immediate primary repair has often resulted in improved postoperative results compared with delayed reconstruction, and the avoidance of gap formation by use of careful techniques and augmentation has been critical for successful treatment. Additionally, patients with extensor mechanism injuries frequently have medical comorbidities or notable tendon degeneration; …

Alumni Map, 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.

Fellows And Chiefs, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Diagnosis Of Wolff-Parkinson-White Syndrome In A 19-Year-Old Collegiate Football Player Owing To A Routine Clinical Visit: A Case Report, Andrew D. Ashbaugh, Fernando J. Tondato, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

Wolff-Parkinson-White (WPW) syndrome is a heart disorder characterized by an additional electrical pathway from the atria to ventricular chambers and episodes of tachycardia. Although the incidence of WPW is relatively low, the pre-excitation syndrome can result in sudden cardiac death, with a higher prevalence noted in younger patient populations. We present a 19-year-old male collegiate football player in whom WPW syndrome was diagnosed during a checkup at a sports-medicine clinic for a rash on his back. Radiofrequency ablation resulted in successful treatment of WPW syndrome, and the patient gradually returned to increasing levels of sports-related activity. Orthopaedic physicians should be …

Hosting The Fourth Annual Perry Outreach Program In Albuquerque, New Mexico, Christina Salas, Sahar Freedman, Deana M. Mercer

UNM Orthopaedic Research Journal

No abstract provided.

My Tenure As Department Chair, 1990-2006, Moheb S. Moneim

UNM Orthopaedic Research Journal

No abstract provided.

In Vitro Inflammatory Effects Of Hard Metal (Wc-Co) Nanoparticle Exposure, Andrea L. Armstead, Bingyun Li

Faculty & Staff Scholarship

Identifying the toxicity of nanoparticles (NPs) is an important area of research as the number of nanomaterial-based consumer and industrial products continually rises. In addition, the potential inflammatory effects resulting from pulmonary NP exposure are emerging as an important aspect of nanotoxicity. In this study, the toxicity and inflammatory state resulting from tungsten carbide–cobalt (WC–Co) NP exposure in macrophages and a coculture (CC) of lung epithelial cells (BEAS-2B) and macrophages (THP-1) at a 3:1 ratio were examined. It was found that the toxicity of nano-WC–Co was cell dependent; significantly less toxicity was observed in THP-1 cells compared to BEAS-2B cells. …

Artificial Disc Replacement As An Alternative To Lumbar Spinal Function In The Treatment Of Chronic Low Back Pain, Jennifer Polniak

Physician Assistant Scholarly Project Posters

Chronic low back pain leads to activity limitations for the patient and widespread burdens on health care systems. Lumbar fusion has been the “gold standard” surgery for severe chronic low back pain non-responsive to conservative treatment, however it has been associated with continued limitations in spinal mobility. This study was executed in order to compare an alternative surgical intervention, artificial disc replacement, with lumbar spinal fusion in the treatment of chronic low back pain in terms of long term spinal function. Literature searches of trials, guidelines and systematic reviews within the past 5 years were completed exploring surgical procedures, associated …

Comparing Biocompatibility Of Ibad-Produced Nano-Films Of Titanium Oxide With Orthopaedic Grade Titanium, Raheleh Miralami

Posters and Presentations: Orthopaedic Surgery & Rehab

Titanium (Ti) is the material of choice for orthopaedic applications because it is biocompatible and encourages osteoblast growth. The present study was devised to compare the osteoblast functions on nano-crystalline titanium oxide films produced by an ion beam assisted deposition (IBAD) technique with the osteoblast functions on micro-crystalline orthopaedic-grade titanium. To characterize the biocompatibility of these surfaces, we have studied cell adhesion, growth, and differentiation on different samples. Cell responses to surfaces were examined using the human osteosarcoma cell line (SAOS-2) with osteoblastic properties. To compare cell adhesion and growth, DAPI-stained nuclei were counted using ImageJ and Metamorph software. Immunofluorescence …

Trigger Point Dry Needling For Musculoskeletal Pain And Disability: A Systematic Review Of Comparative Effectiveness Research, Megan D. Jackson, Kylie Rowe, Todd E. Davenport

School of Pharmacy Faculty Articles

Background: Dry needling (DN) has been proposed to reduce pain and improve function related to myofascial trigger points (MTrPs). Several primary studies and systematic reviews have been conducted to examine the effect of DN versus placebo. However the comparative effectiveness of DN and established interventions has yet to be established.

Purpose: The purpose of this systematic review was to determine whether DN was more effective than other established therapies to treat MTrPs.

Data Sources: MEDLINE Complete, EBSCO, CINAHL, Sport Discus and Cochrane library databases were searched.

Study Selection: Randomized controlled trials that used DN directed to MTrPs and used at …

The Effect Of Scoliotic Deformity On Spine Kinematics In Adolescents., Sarah Galvis, Douglas Burton, Brandon Barnds, John Anderson, Richard M. Schwend, Nigel Price, Sara Wilson, Elizabeth Friis

Manuscripts, Articles, Book Chapters and Other Papers

Background: While adolescent idiopathic scoliosis (AIS) produces well characterized deformation in spinal form, the effect on spinal function, namely mobility, is not well known. Better understanding of scoliotic spinal mobility could yield better treatment targets and diagnoses. The purpose of this study was to characterize the spinal mobility differences due to AIS. It was hypothesized that the AIS group would exhibit reduced mobility compared to the typical adolescent (TA) group.

Methods: Eleven adolescents with right thoracic AIS, apices T6-T10, and eleven age- and gender-matched TAs moved to their maximum bent position in sagittal and coronal plane bending tasks. A Trakstar …

Does The Use Of A Regional Nerve Block Decrease The Incidence Of Post Operative Nausea And Vomiting, Decrease Pain Scores, Or Decrease Discharge Time Compared To General Anesthesia Alone?, Donald Lane Whitney

Doctoral Projects

Problem Statement: The use of regional anesthesia in orthopedic surgeries has been shown to decrease the rate of postoperative nausea and vomiting (PONV), postoperative pain, and decrease postoperative discharge time. However, some healthcare facilities continue to provide anesthesia for these procedures without the use of regional anesthesia techniques.

Purpose: The purpose of this capstone project was to determine if the addition of a regional anesthetic technique would be beneficial to the patient and cost efficient to the healthcare facility.

Methods: A retrospective chart review was conducted and data collected on the population of interest. Inclusion criteria were patients undergoing orthopedic …

An Intra-Bone Axial Load Transducer: Development And Validation In An In-Vitro Radius Model, Nikolas K. Knowles, Michael Gladwell, Louis M. Ferreira

Surgery Publications

Background

Accurate measurement of forces through the proximal radius can assess the effects of some surgical procedures on radioulnar load sharing, but is difficult to achieve given the redundant loading nature of the musculoskeletal system. Previously reported devices have relied on indirect measurements that may alter articular joint location and function. An axial load transducer interposed in the diaphysis of the radius may accurately quantify unknown axial loads of the proximal radius, and maintain articular location.

Methods

An in-vitro radius model was developed by interposing an axial load transducer in the diaphysis of the proximal radius. Static loads of 20, …

Primary Care Management Of Plantar Fasciitis, Thomas J. Melvin Pharmd, Zach J. Tankersly Dpm, Zain N. Quazi, John J. Jasko, Russell Odono Md, Franklin D. Shuler Md, Phd

Orthopaedics

Plantar fasciitis (PF) is present in 10% of the population and is the most common cause of plantar heel pain. PF is painful, can alter daily activities and presents as a sharp pain localized to the plantar foot and medial heel. The underlying etiology involves microtrauma to the plantar fascia, specifically at its insertion point on the calcaneus. Successful management of plantar fasciitis is typically achieved with the conservative therapy approaches discussed.

Toe-Tourniquet Syndrome: A Rare Potentially Devastating Entity, Naveed Baloch, M Atif, Rizwan Hussain Rashid, Pervaiz Mahmood Hashmi

Section of Orthopaedic Surgery

Toe-tourniquet syndrome is a rare and commonly misdiagnosed condition caused by a hair or a fiber wrapped around digits (fingers and toes). A four months baby girl who was crying and presented with redness and swelling at her 2nd and 3rd toes of right foot. Child had red and swollen 2nd and 3rd toes of right foot with hair end protruding through wounds. Constricting hairs were cut and removed. Toetourniquet syndrome is a rare entity which is caused by hair wrapped around a toe or a digit. Diagnosis is mostly clinical. In order to prevent this condition to happen, education …

Hip Fragility Fractures: Anaemia, Calcium And Vitamin D Supplementation, Iqra Khan, Ambreen Jawaid, Khabir Ahmad, Shahryar Noordin

Department of Family Medicine

Objective: To assess the burden of anaemia and osteoporosis in hip fracture patients, to determine the rate of blood transfusion per-operatively, to assess the use of calcium and vitamin D supplements and the use of anti-osteoporotic medications postoperatively.
Methods: A retrospective study was conducted at Aga Khan University and Hospital (AKUH) between June 2009 and May 2011, and comprised record of patients treated for intertrochanteric and femur neck fractures. Patients with associated pathological, open or long bone fractures were excluded. The main study outcome measures were the use of pre-operative and post-operative calcium, vitamin D, bisphosphonates and management of anaemia …

Clinic-Based Biopsy With A Small Curette: Is It A Reliable And Safe Option In Extremity Tumours?, Waseem Ahmed, Masood Umer, Yasir Mohib, Rizwan Haroon Rashid

Department of Surgery Docs

Objective: To establish the diagnostic accuracy and safety of clinic-based biopsy done with a small curette.
Methods: The retrospective study was conducted at Aga Khan University Hospital Karachi and comprised data of patients who underwent biopsy procedure of extremity tumours in clinic under local anaesthesia from July 2009 to June 2012. Patients who underwent the procedure in operating room under general anaesthesia were excluded and so were those with insufficient or missing information, or those who had the final procedure done elsewhere. Clinical parameters were evaluated and histo-pathology was compared with the final resected specimen.
Results: The mean age of …

Trends In Management Of Neck Of Femur Fracture, Tashfeen Ahmad, Umair Ashraf, Omar Irfan, Zehra Abdul Muhammad

Department of Surgery Docs

Abstract

OBJECTIVE:

To identify trends related to surgical procedure for the management of neck of femur fracture to see how the choice is changing over time in relation to different age groups.

METHODS:

The retrospective audit was conducted at Aga Khan University Hospital, Karachi, and comprised data of all patients who presented with neck of femur fracture from 1995 to 2014. Patients with open fractures and those having external fixators were excluded. Data was retrieved from the hospital database, and analysed using SPSS 17.

RESULTS:

Records of 1039 patients were reviewed. The proportion of patients in the 70+ years age …

Prophylaxis Against Heterotopic Ossification After Elbow And Acetabular Fractures — Do We Really Need It, Rizwan Haroon Rashid, Irfan Qadir, Waseem Ahmed, Masood Umer

Department of Surgery Docs

Abstract

OBJECTIVE:

To compare the efficacy and safety of prophylactic modalities for heterotopic ossification prevention after elbow and acetabular surgeries.

METHODS:

The retrospective chart review was conducted at the Aga Khan University Hospital and comprised record of patients who underwent open reduction and internal fixation for elbow and acetabular fractures between 2010 and 2013. Data was classified into three groups: Group A patients had received single dose of radiotherapy; Group B patients had received indomethacin, and Group C patients had not received any prophylaxis. Outcome variables included time-to-fracture healing, heterotopic ossification, non-union and wound infection.

RESULTS:

Of the 104patients 70(67.3%) …

Osats For Total Knee Replacement: Assessment Of Surgical Competence In The Operating Room, Shahryar Noordin, Salim Allana

Department of Surgery Docs

No abstract provided.

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 …

Does Tranexamic Acid Reduce Blood Transfusion Following Surgery For Inter-Trochanteric Fracture? A Randomized Control Trial, Yasir Mohib, Rizwan Haroon Rashid, Moiz Ali, Akbar Jaleel Zubairi, Masood Umer

Department of Surgery Docs

Abstract

OBJECTIVE:

To compare the frequency of blood transfusion after surgery for fixation of inter-trochanteric fractures in patients given tranexamic acid versus placebo.

METHODS:

The randomised control trial was conducted at the Aga khan university hospital from May 1 to October 31, 2014, and comprised patients diagnosed with Inter-trochanteric fracture based on X-ray imaging. The patients were randomised into two equal groups based on a computer-generated random number table. The Intervention group received two doses of 10mg/kg body weight of tranexamic acid just before surgery and three hours later intravenously. The Control group received two doses of 10mg/kg body weight …

Bomb Blast Injuries: Tertiary Care Hospital In-Patient Experience Over The Last 20 Years, Naveed A. Pasha, Raja Samir Khan, Shahryar Noordin

Department of Surgery Docs

Abstract

OBJECTIVE:

To examine the distribution and nature of limb injuries in young bomb blast victimsand their management in a tertiary healthcare setting.

METHODS:

The retrospective study was conducted at the Aga Khan University Hospital, Karachi and data was searched using the University Medical Record Database with International Classification of Diseases-Ninth Revision-Clinical Modification codes for injuries and terrorism between 1990 and 2012. Data regarding injuries, including admission time, hospital stay duration, interventions and mortality, was collected and classified as per the New Injury Severity Score.

RESULTS:

There were 22 patients in the study; 19(86.3%) males and 3(13.7%) females. The mean …

Unlocking The Doors To Patient Satisfaction In Pediatric Orthopaedics, Frederick B. Peng, Bs, James F. Burrows, Mba, Eric D. Shirley, Md, Paul Rosen, Md, Mph, Mmm

Department of Pediatrics Posters

Background

• Many hospitals continue to struggle to improve patient satisfaction as the identification of tangible quality improvement areas remains difficult
• Medicare hospital payments are linked to patient satisfaction and hospitals' HCAHPS scores, which has contributed to the growing influence of patient satisfaction measures
• Investigation into the major drivers of patient satisfaction in the pediatric clinical arena has not been thoroughly pursued
• To determine the main drivers of patient experience in pediatric orthopaedics, we performed an analysis of patient satisfaction surveys collected from outpatient pediatric orthopaedic practices at 5 locations in 3 states
• Hypothesis: the patient-physician relationship is the most important …

High Prevalence Of Obesity And Female Gender Among Patients With Concomitant Tibialis Posterior Tendonitis And Plantar Fasciitis., Christopher W. Reb, Faith A. Schick, Homyar N. Karanjia, Joseph N. Daniel

Rothman Institute Papers

UNLABELLED: The link between increased body weight and hindfoot complaints is largely based on correlation to single foot pathology. We retrospectively reviewed 6879 patients with tibialis posterior tendonitis (TPT), plantar fasciitis (PF), or both. Among patients with either TPT or PF, 1 in 11 (9%) had both. We then compared age, gender, and body mass index among these groups. Patients with both diagnoses were neither statistically older nor more obese than patients with single diagnoses. However, they were statistically more female. Given the overall high prevalence of obesity in the study population, we feel these data support the link between …

Distal Insertional Footprint Of The Brachialis Muscle: 3d Morphometric Study, Srinath Kamineni, Abdo Bachoura, William Behrens, Ellora Kamineni, Andrew Deane

Orthopaedic Surgery and Sports Medicine Faculty Publications

Objective. The purpose of this study is to describe the three-dimensional morphometry of the brachialis muscle at its distal attachment to the ulna. Methods. Fifty cadaveric elbows were dissected and the brachialis distal insertion was isolated on the ulna bone and probed with a three-dimensional digitizer, to create a three-dimensional model of the footprint. Measurements and analysis of each footprint shape were recorded and compared based on gender and size. Results. There was significant gender difference in the surface length (P = 0.002) and projected length (P = 0.001) of the brachialis footprint. The shapes …