Orthopedics Commons^™

A Longer Duration Of Intravenous Antibiotic Treatment For Patients With Early Periprosthetic Joint Infections Is Not Associated With A Lower Failure Rate, Janneke Meijer, Alex Soriano, Wierd Zijlstra, Bas Ten Have, Saad Tarabichi, Paul Jutte, Javad Parvizi, Marjan Wouthuyzen-Bakker

Rothman Institute Papers

BACKGROUND: In recent years, many studies have demonstrated the efficacy of an early switch to oral antibiotics after surgical treatment in orthopedic-related infections. However, large analyses on periprosthetic joint infections (PJIs) are lacking.

MATERIAL AND METHODS: We conducted a retrospective observational multicenter study in patients diagnosed with an early post-operative PJI, defined as one occurringdebridement, antibiotics, and implant retention (DAIR). Patients from Europe and the USA were included. We took advantage of the fact that an early oral antibiotic switch is routine practice in Europe as opposed to a long duration of intravenous (IV) antibiotic treatment in the USA. Failure …

Skeletal And Dental Tissue Mineralization: The Potential Role Of The Endoplasmic Reticulum/Golgi Complex And The Endolysosomal And Autophagic Transport Systems, Irving M. Shapiro, Makarand V. Risbud, Tengteng Tang, William J. Landis

Department of Orthopaedic Surgery Faculty Papers

This paper presents a review of the potential role of the endoplasmic reticulum/Golgi complex and intracellular vesicles in mediating events leading to or associated with vertebrate tissue mineralization. The possible importance of these organelles in this process is suggested by observations that calcium ions accumulate in the tubules and lacunae of the endoplasmic reticulum and Golgi. Similar levels of calcium ions (approaching millimolar) are present in vesicles derived from endosomes, lysosomes and autophagosomes. The cellular level of phosphate ions in these organelles is also high (millimolar). While the source of these ions for mineral formation has not been identified, there …

Risk-Stratified Venous Thromboembolism Chemoprophylaxis After Total Joint Arthroplasty: Evaluation Of An Institutional Approach., Sara J Hyland, Maria J Fada, Michelle Secic, Robert A Fada, Marie M Lockhart, Richard H Parrish

OhioHealth Research Institute Articles

No abstract provided.

The Impact Of Fibular Fixation Method On Pilon Fracture Healing., Anthony Perugini, Scott Hyland, James Iandoli, Zachary Hill, John Peabody, Daniel Degenova, Mallory Faherty, Benjamin Taylor

OhioHealth Research Institute Articles

No abstract provided.

Robotic-Assistance Is Associated With Better Joint Outcomes Compared To Conventional Techniques In Surgically Routine Total Hip Arthroplasty: A Propensity-Matched Large Database Study Of 3948 Patients, Aakash K. Shah, Monish S. Lavu, Christian J. Hecht

Student Scholarship

Introduction: The outcomes of total hip arthroplasty (THA) are highly dependent upon the restoration of native hip biomechanics and optimal component positioning. Robotic technologies for THA have rapidly improved the accuracy of component positioning and maintaining the planned center of rotation. While robotic-assisted THA (RA-THA) has primarily been employed in surgically intricate cases, its potential benefits in scenarios of diminished surgical complexity remain less explored. Therefore, the purpose of this study was to assess the odds of developing systemic and joint complications following RA-THA in cases of reduced surgical complexity. Methods: A retrospective cohort study was conducted using the TriNetX …

Use Of Intraoperative Vancomycin Powder And Its Effects On The Incidence Of Surgical Site Infection In Orthopaedic Trauma: A Systematic Review And Meta-Analysis, Troy Puga, Mckenna Box, Alan Lam, Claire Ferguson, Mason Poffenbarger, Cornelis Potgieter, John Riel

North Texas Research Forum 2025

Introduction Surgical site infection (SSI) in orthopaedic trauma can have devastating consequences for patients. Many risk factors for SSI exist and many strategies are employed to prevent SSI. The use of intraoperative powdered vancomycin is one such strategy used in orthopaedic trauma surgery, however, evidence and guidelines remain unclear. The aim of this systematic review is to evaluate the evidence for the use of powdered vancomycin in orthopaedic trauma surgery for the prevention of SSI. Methods A search was conducted across Pubmed/Medline, Cochrane, and Embase databases to evaluate for the use of powdered vancomycin in orthopaedic trauma surgery for the …

Osteopathic Representation In Orthopedic Literature: A 25-Year Analysis Of Publication Trends Of Former Aoa Residency Programs And Osteopathic Medical Schools, Troy Puga, Ibraheem Qureshi, Hans Drawbert, Michael Muncy, John T. Riehl

North Texas Research Forum 2025

Background Orthopedic surgery remains one of the most competitive specialties. Osteopathic candidates have recently matched at lower rates than allopathic students. One disparity that may exist is research, which has become a critical component of candidate applications. This study aimed to examine the representation of osteopathic-affiliated first authors, senior authors, and overall osteopathic-affiliated authors, in the top 25 leading U.S. orthopedic journals published between 2000 and 2024. Methods A retrospective bibliometric review was conducted on articles published from 2000 to 2024 in orthopedic journals. Journals were selected based on their h-index score. Institutional affiliations were used to identify osteopathic authors. …

Bucks Traction In The Emergency Departments (Ed) In North Texas Division (Ntxd), Mason Poffenbarger, Neil Werthmann, Cody Beltran, Hannah Affleck, Kristen Payne, Caleb Shin, Hans Drawbert, Hayley Buehler, James Drinan, Sanjay Sharma, Diona Johnson, John T. Riehl, Adam Green

North Texas Research Forum 2025

Implementing Buck’s traction for elderly hip fracture patients in the emergency department (ED) is often inefficient, leading to prolonged setup times, increased staff workload, and delays in patient care, ultimately impacting ED length of stay (LOS). This quality improvement project aims to streamline the process by establishing a standardized storage system for traction equipment, optimizing bed compatibility, developing a clear workflow flowchart, and providing targeted staff training. By improving organization and efficiency, we anticipate a reduction in setup time, enhanced workflow, and decreased ED LOS for hip fracture patients. Measuring pre- and post-intervention times will ensure continuous refinement, ultimately leading …

Incidence Of Allergic Reactions To Cefazolin In Patients With Penicillin Allergy Undergoing Operative Repair Of Pelvis Or Extremity Fracture, Hans Drawbert, Laclan Anderson, Marisa Fat, John Riehl

North Texas Research Forum 2025

Introduction Surgical site infections (SSI) account for 20% of all healthcare associated infections with an estimated yearly cost of $3.3 billion in the US alone (1). Cefazolin (Ancef) is a commonly used prophylactic antibiotic in orthopaedic surgery and has been shown to reduce SSI compared to other antibiotics, but potential cross-reactivity in patients with a penicillin allergy (PA) leads to concerns regarding the safety of cefazolin administration. This study evaluates the incidence of allergic reactions to cefazolin in patients undergoing orthopaedic surgery with a PA. Methods A retrospective cross-sectional database review study was conducted. Patients aged 18 or over who …

​Comparison Of Diagnostic Accuracy Of Ct And Spect-Ct In Pseudarthrosis Detection: A Systematic Review And Meta-Analysis​, Nicholas Schiller, Miguel Cartagena-Reyes, Elyette Lugo, Diego Lopes De Lima, Brett Schlifka, Milad Alam

East Florida Division GME Research Day 2025

No abstract provided.

Heterotopic Ossification (Ho) Prophylaxis In Total Hip Arthroplasty (Tha): A Systematic Review Of Level I And Level Ii Evidence Since 2000, Troy Puga, Mckenna Box, Vincent Dieu, Charles Marchese, John T. Riehl

North Texas Research Forum 2025

Introduction: Heterotopic ossification (HO) is a somewhat common occurrence after total hip arthroplasty (THA), particularly with certain approaches. This complication can be detrimental to the success of the surgical outcome. Indomethacin and radiotherapy remain common treatment modalities; however, no true gold-standard treatment is universally agreed upon. This study aims to evaluate Level I and Level II evidence for treatment practices of HO prophylaxis since 2000. Methods: To evaluate HO prophylaxis in total hip arthroplasty, a search was conducted across MEDLINE/Pubmed, Cochrane, and Embase databases using keywords and Medical Subject Heading (MeSH) terms. Titles and abstracts were screened for eligibility for …

Facial Hair And Infection: A Beardly Question With A Bald Spot In The Literature, Kyle O'Connor, Samuel Stegelmann, Hans Drawbert, Edwin Dudoussat, John T. Riehl

North Texas Research Forum 2025

Background: Upholding a sterile environment in orthopedic surgery is vital to minimize surgical site infections (SSIs). Among personal protective equipment, beard covers for surgical staff with facial hair have been recommended as a measure to prevent contamination. However, their effectiveness in reducing SSIs remains uncertain, especially in orthopedic procedures that often involve high-risk implants and extended exposure of surgical fields. This systematic review assesses the current evidence on the role of beard covers in infection prevention during surgery. Methods: Using PRISMA guidelines, databases were searched for studies investigating facial hair, beard covers, and infection risk. Eligible studies included comparative studies, …

Nfl Kick-Off Rule Change: A Comparative Analysis Of Injury Incidence, Troy Puga, Tanner Haechten, Coleman Cush, Mckenna Box, Hans Drawbert, John Riehl

North Texas Research Forum 2025

Introduction: Kickoffs in the National Football League (NFL) remain one of the most dangerous plays during an NFL game, with high levels of injuries. In 2024, the NFL implemented kickoff rules intended to reduce the number of injuries during this play, and improve player safety. The purpose of this study is to evaluate the effect of the 2024 NFL kickoff rules on the incidence of injuries during the kickoff. Methods Injuries on kickoffs were identified for the 2024, 2023, and 2022 NFL seasons using the transcribed game book for each game on the official NFL website. Injury type was confirmed …

A Retrospective Cross-Sectional Study Of Glp-1 Agonist Effects On Outcomes After Total Knee Arthroplasty, Mckenna Box, Troy B. Puga, Neil J. Werthmann, Andrew M. Jen, Yingxian Liu, John T. Riehl

North Texas Research Forum 2025

Objective: Total knee arthroplasty (TKA) is one of the most common elective orthopaedic surgeries. In addition, there are rising rates of obesity and diabetes and, with it, medications to treat them. This retrospective cross-sectional analysis aims to examine the outcomes of patients who underwent TKA and were on a Glucagon-like peptide-1 agonist (GLP-1a) at the time of surgery Methods: This study analyzes a database using CPT and ICD-10 codes to identify patients having primary TKA for knee osteoarthritis. Patients were divided into two groups based on GLP-1a use at TKA. Control variables included sex, age, BMI, smoking status, ECI, and …

Advantages Of Humeral Stem Retention In Revision Shoulder Arthroplasty: A Retrospective Study, Matthew Mccrosson, Leon Liu, Daniel Deshetler, John Grossi, Devin John, Diego Lima, Howard Routman

East Florida Division GME Research Day 2025

No abstract provided.

The Major League Baseball Pitch Clock: One Year Position Player Injury Analysis, Troy Puga, Nicholas Scigliano, Mckenna Box, John T. Riehl

North Texas Research Forum 2025

Background In 2023, Major League Baseball (MLB) implemented the pitch clock. The effects of the pitch clock on player injury rates is largely unknown, and some, including the major league baseball players association, have suggested that pitchers may be at an increased risk of injury with its implementation. Position players have received little attention in these discussions, even though they may be at the same theorized risk of injuries. The aim of this study is to determine if implementation of the 2023 MLB pitch clock influenced the incidence of injuries in position players. It is hypothesized that implementation of the …

Retrospective Cross-Sectional Analysis Of Glp-1 Receptor Agonist Effects On Outcomes Of Hemiarthroplasty For Femoral Neck Fractures In Diabetics, Mckenna W. Box, Troy Puga, Neil Werthmann, Yingxian Liu, John T. Riehl

North Texas Research Forum 2025

Introduction: To determine if the use of glucagon-like peptide-1 receptor agonists (GLP-1RA) in type 2 diabetic mellitus (T2DM) patients affects outcomes after hemiarthroplasty for femoral neck fractures (FNFs). Methods: A retrospective cross-sectional analysis of a local hospital system database was performed using Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-10) codes to identify T2DM patients who were at least 18 years of age who underwent hemiarthroplasty (HA) for FNFs and were on a GLP-1RA at the time of injury. A random patient sample of those who underwent HA and were not on a GLP-1RA was used as a …

Comparison Of Fibula Plating Versus Fibula Nailing: A Systematic Review With Meta-Analysis Of All Current Comparative Literature, Troy Puga, Mckenna Box, Charles Marchese, Alan Lam, Sam Stegelmann, John Riehl

North Texas Research Forum 2025

Introduction Ankle fracture surgeries are common orthopaedic procedures. Fibular fixation is often an important component in restoring ankle stability. Fibular intramedullary nailing (fIMN) has gained recent interest as an alternative technique to fibular plating. This systematic review and meta-analysis was performed to compare the outcomes of fibular nailing versus fibular plating for all current available literature. Methods A PRISMA-compliant systematic review was conducted across MEDLINE/Pubmed, Cochrane, and Embase databases for cohort and clinical trial studies comparing outcomes of fibular nailing and fibular plating of ankle fractures. Demographics and results of the studies were extracted from the articles. Outcomes of interest …

Femoral Neck Allograft For Glenoid Reconstruction During Revision Reverse Total Shoulder Arthroplasty: A Case Report, Devin Q. John, Leon Z. Liu, Diego J L Lima, Howard D. Routman

East Florida Division GME Research Day 2025

No abstract provided.

Surgical Repair Of An Atypical Midsubstance Distal Biceps Tendon Partial Tear: A Case Report, Michael M. Valenzuela, Genoveffa R. Morway, Christopher M. Jones

Orthopedic Surgery Resident Research

[No abstract available]

Fabricating Silver-Ceria Polymer Nanocomposite Scaffolds For Biomedical Therapeutic Applications, Shreya S. Pawar

Honors Undergraduate Theses

Improper healing of bone fractures and limited regeneration of bone following bone tumor resection remain a prevalent complication worldwide. Long-term effects of this include joint instability, limited movement, and arthritis. Bone infections (osteomyelitis), reactive oxygen species (ROS) generation via excessive inflammation, and underlying conditions such as osteoporosis can contribute to suboptimal bone tissue regeneration. ROS accumulation stimulates osteoblast apoptosis, while promoting osteoclast differentiation. These processes inhibit mineralization and osteogenesis. Conventional therapeutics involve the utilization of drugs and bone grafts. However, these approaches pose limitations and can result in subsequent complications. Microbial infections, ROS accumulation, and excessive inflammations are factors that …

A Spine-Specific Lexicon For The Sentiment Analysis Of Interviews With Adult Spinal Deformity Patients Correlate With Sf-36, Sf-36, And Odi Scores: A Pilot Study Of 25 Patients, Ross Gore, Michael M. Safaee, Christopher J. Lynch, Christopher P. Ames

VMASC Publications

Classic health-related quality of life (HRQOL) metrics are cumbersome, time-intensive, and subject to biases based on the patient’s native language, educational level, and cultural values. Natural language processing (NLP) converts text into quantitative metrics. Sentiment analysis enables subject matter experts to construct domain-specific lexicons that assign a value of either negative (−1) or positive (1) to certain words. The growth of telehealth provides opportunities to apply sentiment analysis to transcripts of adult spinal deformity patients’ visits to derive a novel and less biased HRQOL metric. In this study, we demonstrate the feasibility of constructing a spine-specific lexicon for sentiment analysis …

Back Matter, Arianna Medina

Western Journal of Orthopaedics

No abstract provided.

A Brief History Of Opioid-Use Disorder In The United States, Effect On Orthopaedics, And Current Management Options, William Curtis, Nicholas Newcomb, Eric S. Kruger, Christopher L. Shultz

Western Journal of Orthopaedics

Declared a public health emergency in 2017 and leading to 11 million years of life lost worldwide, the American opioid crisis has impacted millions of people, with up to 7 million experiencing opioid use disorder. In orthopaedic surgery, opioid analgesia has been associated with various complications, including infections, deep vein thrombosis, prolonged hospital stays, and overall inferior outcomes after surgical procedures. Orthopaedic surgeons commonly rely on opioids to provide postoperative analgesia and may frequently encounter patients with opioid use disorder. It is therefore essential that orthopaedic surgeons understand opioid use disorder, its effect on orthopaedic outcomes, and management of opioid …

Scar Tissue Adhesions, Neuromuscular Guarding, And Functional Recovery: A Case Report Of Physical Therapy Post-Cholecystectomy, Raeisa Griñe, Adam Walsh

Western Journal of Orthopaedics

Scar tissue from abdominal surgeries, such as cholecystectomy, can lead to long-term issues such as restricted movement, painful spasms, and impaired function. Laparoscopic adhesiolysis is a common surgical treatment for pathological scar tissue impairments. Conservative care, such as physical therapy, is a commonly used approach for managing pathological scar tissue. In this case, manual therapy techniques and targeted exercises successfully reduced the intensity and frequency of abdominal spasms, improved core strength and endurance, and enhanced overall functional mobility. These improvements were reflected in enhanced scores on the Lower Extremity Functional Scale and the Vancouver Scar Scale in a 59-year-old woman …

Introducing The University Of New Mexico 12-Level Functional Scale: A Novel Approach For Assessing Functional Recovery In Orthopaedic Trauma Patients, Devin A. Maez, Rick J. Gehlert, Thomas A. Decoster

Western Journal of Orthopaedics

The University of California at Los Angeles (UCLA) Activity Scale and other common activity scales are primarily used for patients undergoing joint reconstructive surgery. However, no such scale exists for musculoskeletal trauma patients. The authors propose The University of New Mexico (UNM) 12-Level Functional Activity Scale to address this gap in assessing functional activity and managing postoperative care for orthopaedic trauma patients. A comprehensive review of existing scales led to the development of the UNM Scale, emphasizing simplicity, objectivity, and potential benefits in patient education and interdisciplinary collaboration. The UNM Scale provides a structured approach to assess and monitor functional …

Fluoroscopy-Guided Versus 3d Navigated Percutaneous Sacroiliac Screw Fixation: A Comparison Of Radiation Exposure And Surgical Duration, Tyler J. Chavez, Jeremiah M. Langsfeld, Solomon Oloyede, Gordon H. Lee, Urvij Modhia

Western Journal of Orthopaedics

Background: Pelvic ring injuries are complex surgical challenges requiring significant radiation exposure for safe placement of sacroiliac (SI) screw fixation. Traditionally, SI fixation has been performed with conventional C-arm fluoroscopy to guide screw placement. 3D navigated imaging is a technique that uses fluoroscopic scans and a navigation tracker to guide screws in space. The purpose of this study is to characterize a single institution’s experience with navigated SI fixation and the resulting radiation exposure to patient and staff. Methods: Records of 60 patients who underwent SI fixation using either conventional fluoroscopy (43) or 3D navigation (17) were reviewed. Exposure data …

Fishtail Deformity Complication Of Distal Humeral Fractures In Children, Jorge E. Licano, Ryan Price, Devin A. Maez, Selina A. Silva

Western Journal of Orthopaedics

Background: Pelvic ring injuries are complex surgical challenges requiring significant radiation exposure for safe placement of sacroiliac (SI) screw fixation. Traditionally, SI fixation has been performed with conventional C-arm fluoroscopy to guide screw placement. 3D navigated imaging is a technique that uses fluoroscopic scans and a navigation tracker to guide screws in space. The purpose of this study is to characterize a single institution’s experience with navigated SI fixation and the resulting radiation exposure to patient and staff. Methods: Records of 60 patients who underwent SI fixation using either conventional fluoroscopy (43) or 3D navigation (17) were reviewed. Exposure data …

Rare Case Of Fungal Osteomyelitis Affecting An Intramedullary Lag Screw, Matthew C. Watterson, Robert T. Rella, Timothy K. Summers, David Michaeli, Jess Mullens

Western Journal of Orthopaedics

Osteomyelitis is an infection of the bone that is most commonly of bacterial origin. Cases of fungal osteomyelitis are rare, and treatment often requires a prolonged course of antimicrobials. The authors report a case of a 72-year old man with fungal osteomyelitis affecting an intracortical lag screw, which was discovered during fixation of the left femoral shaft following an injury that occurred 68 years after placement of the affected lag screw. Chronic osteomyelitis can be indolent and subclinical, with the patient experiencing no signs or symptoms of the disease despite having bone infection for decades. This condition may become clinically …

Closed Treatment Of Displaced Radial Neck Fracture In An Adult, Nicholas Newcomb, Tomas Holy, Naomi Kelley, Nathan T. Morrell

Western Journal of Orthopaedics

Making up 1.5% to 4.0% of all fractures, radial head and neck fractures are typically treated based on the severity of angulation at the radial neck or if range of motion (ROM) is blocked. In this study, we present a case of a 43-year old woman with a Mason Type 2 radial neck fracture, successfully treated with closed reduction and one week of immobilization, resulting in near anatomic radial neck angulation without the need for operative intervention. The patient returned to work within two weeks and regained full ROM by six months, maintaining near anatomic reduction throughout. Keywords: Elbow Injury; …