Orthopedics Commons^™

Two-Stage Total Knee Arthroplasty (Tka) For A Rigid And Infected Knee: A Rare Case Report Of Aspergillosis, Túlio Vinícius De Oliveira Campos, David G. Kasuya Barbosa, Victor A. Kasuya Barbosa, Santiago Enrique Sarmiento Molina, Guilherme Moreira De Abreu Silva, Marco Antônio Percope De Andrade

Western Journal of Orthopaedics

Knee infection caused by Aspergillus is a rare condition that presents a diagnostic challenge for orthopaedic surgeons and musculoskeletal specialists. This case report aims to describe the treatment of a patient with active articular Aspergillus infection and knee arthrofibrosis through a two-stage total knee arthroplasty (TKA). A 37-year old woman presented with knee arthrofibrosis, which was complicated by an Aspergillus infection. The treatment involved a two-stage procedure: 1) bone cuts for TKA and systemic antibiotic therapy; and 2) TKA with the use of specific antibiotic-loaded cement. The patient has been followed for 30 months, showing no signs of failure.

Proximal Tibia Biplanar Anterior And Lateral Closing Wedge Osteotomy With Concomitant Revision Anterior Cruciate Ligament Reconstruction: A Case Report, Shane H. Johns, Lisandro Nardin, Jessica A. Nelson, Robert Schenck

Western Journal of Orthopaedics

This report documents a unique, successful strategy to manage a failed anterior cruciate ligament reconstruction (ACLR) in the setting of coronal and sagittal plane malalignment. The patient is a 38-year-old man with a history of a failed ACLR who presented with recurrent knee instability. Imaging revealed a posterior tibial slope (PTS) of 17° complicated by a varus malalignment of 10°. A single-stage anterior and lateral closing wedge tibial osteotomy (biplanar) with simultaneous revision anterior cruciate ligament reconstruction was performed. Final radiographic evaluation revealed that the tibial osteotomy healed with correction of coronal alignment to a physiologic 3° varus and a …

Recurrent Baker’S Cyst In A Pediatric Athlete: A Case Report, Gaurav Singh, Rebecca Peebles, Justin Bartley

Western Journal of Orthopaedics

Also known as popliteal cysts, Baker’s cysts are fluid-filled lesions found in the popliteal fossa, typically originating from the gastrocnemius-semimembranosus bursa. While these cysts are relatively common in adults, with a prevalence ranging from 5.0% to 41.0%, they are extremely rare in children, showing an incidence of just 2.4%. In most cases, Baker’s cysts result from intra-articular knee pathologies that lead to an increased production and sequestration of synovial fluid. The authors present the case of an athletic 16-year-old adolescent boy with a recurrent left-knee Baker’s cyst with magnetic resonance imaging showing no intra-articular pathology. Despite conservative treatment, including non-steroidal …

Treatment Of Congenital Cruciate Ligament Absence In A Teenager Knee-Ding Stability, Gaurav Singh, Anna Bergquist, Rebecca Peebles, Justin Bartley

Western Journal of Orthopaedics

The congenital absence of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) is an extremely rare condition, with an estimated prevalence of 0.017 per 1,000 live births for ACL agenesis. The authors present the case of a 15-year-old adolescent girl with autosomal dominant multiple synostosis, who developed progressive bilateral knee pain and functional limitations. Bilateral knee x-rays revealed trochlear dysplasia and an absent tibial eminence, suggesting a congenital ligamentous abnormality. Magnetic resonance imaging confirmed the bilateral absence of both the ACL and PCL. Surgical reconstruction of both ligaments was performed, with the first procedure taking place in October …

High-Throughput Drug Screening For Disease-Modifying Arthritis Therapy, Janapriya Vijayakumar

Honors Undergraduate Theses

Current therapy for arthritis predominantly focuses on the symptoms rather than the underlying causes of disease progression. Thus, it is necessary to identify novel drugs which target the underlying molecular basis of such diseases. Using high-throughput cell-based drug screening, we screened 458 different compounds, narrowed down from 811 starting compounds from the NIH Mechanistic Set. We selected drugs from the Mechanistic Set following Lipinski's Rule of 5 to ensure optimal pharmacokinetic properties. The study used modified primary human chondrocytes (IIAM-PRG4Luc), which secrete a lubricin promoter-driven luciferase reporter. We use this luciferase expression as a proxy to measure lubricin, a compound …

Investigation Of Lubricin-Stimulating Fda-Approved Compounds For A Disease-Modifying Osteoarthritic Drug, Swathi S. Menon

Honors Undergraduate Theses

Osteoarthritis (OA) is a degenerative disease that affects many people worldwide. Current methods of treatment are palliative, and no treatment exists to fully reverse or cure OA once it begins to progress. The discovery of a disease-modifying osteoarthritic drug (DMOAD) would increase the quality of life for millions and reduce the need for invasive procedures. Screening FDA-approved drugs ensures more promise due to their known safety profile and potential for faster translation to the clinic. The goal of this project was to conduct dose-response assays with FDA-approved drugs that have been shown to stimulate lubricin production in cells that mimic …

Ocd Lesions Of The Lateral Femoral Condyle And The Impact Of The Location On Recovery, Catharine Kral, Joshua Cummings, Ellie Helton, Shannon Margherio, Brian S. Harvey, Kevin Latz

Posters

Descriptive study based on Zhou, Liang, et al. we categorized the LFC OCD lesions into weight bearing and non-weight bearing lesions to assess clinical and radiographic variables and evaluate the need for progression to operative management.

Trends And Outcomes In Fixation Of Distal Radius Fractures In Elderly Patients: Should Gender Play A Role In Surgical Decision Making?, Rabia Qureshi, Kenny Ling, Sydney Laramie

Stony Brook Orthopaedic and Musculoskeletal Journal

See article.

Impact Of Teriparatide On Surgical And Medical Outcomes In Osteoporotic Patients Undergoing Multilevel Anterior Cervical Discectomy And Fusion, Samuel Akhnoukh, Uttsav Patel, Kenny Ling, Ivan Zapolsky

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: Osteoporotic patients undergoing multi-level anterior cervical discectomy and fusion (ACDF) are at increased risk of pseudarthrosis and perioperative complications, including higher rates of reoperation compared to non-osteoporotic individuals. Teriparatide, an anabolic agent used in osteoporosis treatment, has shown promise in enhancing fusion and reducing complications in lumbar spine procedures, but its role in multi-level ACDF remains unclear.

Purpose: The purpose of this study was to evaluate the impact of postoperative teriparatide use on outcomes in osteoporotic patients undergoing multi-level anterior cervical discectomy and fusion (ACDF). Specifically, the study aimed to determine whether teriparatide could reduce long-term complications such as …

Identifying Authenticity In Orthopaedic Residency Applications: Can Selection Committees Detect Ai-Written Personal Statements, Samir Baig, Lekha Yaramada, David E. Komatsu, James Barsi

Stony Brook Orthopaedic and Musculoskeletal Journal

See article.

Hypertensive Status Predicts 30-Day Postoperative Complications Following Open Reduction Internal Fixation Of Distal Radius Fractures, Nishank Mehta, Emma Smolev, Dorian Cohen, Kenny Ling, Becka Konnayil, Samantha Muhlrad, Edward D. Wang

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: The primary objective of this study was to investigate the association between preoperative hypertension and postoperative complications following open reduction internal fixation of distal radius fractures.

Methods: All patients who underwent open reduction internal fixation (ORIF) for distal radius fractures (DRF) between 2015 to 2021 were queried from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Postoperative complications were reported within 30 days of procedure. We identified a total of 26,138 patients and 31.5% (n=8,225) of patients had hypertension. Hypertension was defined as blood pressure greater than 140/90 as documented in the medical record, requiring …

Femoral Avascular Necrosis And Triptan Therapy: A Multicenter Retrospective Study, Joseph Bisiani, Francisco Martos Jr., Brian Lynch

Stony Brook Orthopaedic and Musculoskeletal Journal

Aims: Migraines are one of the most common neurological disorders that patients typically suffer from. One of the more common prescription medications for migraines are triptans, which can lead to vasoconstriction throughout the peripheral vasculature as a potential side effect. However, a possible risk of femoral avascular necrosis may arise from these treatments, as it has been well known that a lack of blood flow to the femur can arise due to this peripheral vasoconstriction. Therefore, research is warranted for whether taking anti-migraine medications is associated with a higher risk of developing avascular necrosis within the femur, an area highly …

Extensor Tendon Injuries: Does Repair Technique Influence Re- Rupture Rate?, Rahul Rai, Joseph Bisiani, Athikur Rahman, David Komatsu, Lawrence Hurst

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: Extensor tendon injuries are common injuries to the hand. When poorly managed, these injuries can have significant long-term effects on a patient’s hand function. There are multiple described repair techniques to repair an injured extensor tendon. The aim of this study was to determine if there was a correlation between extensor tendon repair technique and subsequent re-rupture rate.

Methods: A retrospective analysis was conducted on patients who underwent extensor tendon repair at our institution, utilizing the electronic medical record database of patients with extensor tendon injuries from 2015 to 2024. Data were collected on patient demographics, injury mechanisms, tendon …

Biomechanical Comparison Of Posterolateral Fibula Plating With Independent Syndesmotic Screw Fixation Versus Direct Lateral Plating With Syndesmotic Screw Fixation Through Plate, Dmitriy Butsenko, Zack Bonick, J Gary Bledsoe, Michael E. Doany

Stony Brook Orthopaedic and Musculoskeletal Journal

Syndesmotic fixation has been extensively investigated. Screw size, number, position, orientation, and flexible fixation options have all been investigated at length. There is however a lack of knowledge of any difference between an independent syndesmotic screw versus onethrough a lateral plate. The purpose therefore is to perform a biomechanical assessment of syndesmotic fixation comparing independent screw vs screw through plate combination, analyzing torsional strength of both constructs. To perform this, seven matched cadaveric through tibia-fibula lower leg specimens were prepared by creating an oblique fracture performing surgical syndesmotic disruption. The specimens were then randomized into the direct lateral through plate …

Association Between Glp-1 Agonist Use And Site-Specific Fracture Risk: A Retrospective Cohort Analysis, Nathan Zou, Joseph Bisiani, Brian Lynch

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: Type 2 diabetes and obesity rates are expected to rise, possibly increasing the usage of Glucagon-like peptide-1 (GLP-1) agonists. Use of these agents for nondiabetic patients for weight loss I s approaching the number prescribed for diabetes. GLP-1 agonists may influence bone metabolism by promoting formation and reducing resorption, but their impact on fracture risk remains unclear. While some studies show no association, others suggest increased vulnerability. Most prior research has examined overall fracture risk without considering specific skeletal sites. This study aimed to compare site-specific fracture rates in adults with T2DM or obesity receiving GLP-1 therapy with those …

All Inside Meniscus Repair - How Close Is Too Close?, Frederick Hance, Kenny Ling, Liam Edwards-Gaherty, Diana Patterson

Stony Brook Orthopaedic and Musculoskeletal Journal

Although rare, neurovascular injuries are major complications. The purpose of this study was to use cadaveric dissection to determine the proximity of medial and lateral meniscus repair to major neurovascular structures in the posterior knee. We hypothesized that repair of the posterior horn of the medial and lateral menisci would be within 1 centimeter proximity of a key neurovascular structure.

The study was performed on 4 fresh-frozen cadaveric specimens that included the full knee joint spanning from the distal femur to proximal tibia and fibula. Following identification and tagging of the key structures, arthroscopic meniscus repair was simulated using Arthrex …

Immersive Medical Practice And Clinical Training: Virtual And Mixed Reality In Pharmacy And Orthopedic Surgery, Silas Semprini De Toledo Contaifer

Theses and Dissertations

Extended‑reality (XR) technologies including virtual reality (VR) and mixed reality (MR) offer new ways to improve training and surgical precision. This thesis evaluates their educational and clinical impact through two complementary studies.

Specific Aim 1 compared an immersive 360° video VR module with conventional training for teaching USP < 797> sterile‑compounding skills to second‑year PharmD students (N = 36). VR trainees raised their knowledge from 6.14 ± 1.55 to 8.69 ± 1.07, yet the overall post‑test advantage versus control was not statistically significant (U = 71.50, p = 0.21). Item‑level McNemar testing showed significant VR‑exclusive gains on three critical questions (K5, K6, …

Meniscal Allograft Transplantation Provides Long-Term Chondroprotection After Meniscectomy, Melanie Valencia

South Atlantic Division GME Research Day 2025

No abstract provided.

Functional Outcome Of Radial Head Replacement And Lateral Ulnar Collateral Ligament (Lucl) Repair In Terrible Triad Injuries Of The Elbow: Can Associated Type I Coronoid Fractures Be Neglected?, Ansarul Haq Lone, Azad Ahmad Shah, Nadeem Ali, Imtiyaz Hussain Dar

Digital Journal of Clinical Medicine

Introduction: Type III coronoid fractures associated with terrible triad injuries of the elbow joint should always be stabilized. However, management of type I and type II fractures is debatable. In this study, we evaluate the functional outcome of neglecting type I coronoid fractures associated with terrible triad injury.

Methods: This prospective study was conducted on 20 patients with a type I coronoid fracture in terrible triad fracture dislocations of the elbow. All the patients were managed by radial head replacement and repair of the lateral collateral ligament without any fixation of the coronoid fracture. All the patients were evaluated clinically …

Comparison Of Baumgaertner Reduction Quality Criteria , Chang Criteria And Ap3×Ml3 Classification And Their Ability To Predict Mechanical Complications Of Trochanteric Fractures Fixed With Proximal Femoral Nail, Amr Elhadidy Elhadidy, Ahmed Abdelbadie Ibrahim, Sallam Ibrahim Fawzy, Ehab Youssef Hassanin

Mansoura Medical Journal

Background Trochanteric fractures are common injuries among the elderly. Despite advances in fixation with proximal femoral nails (PFN), Mechanical complication remain significant. Several reduction quality systems have been proposed, but their predictive value and reproducibility remain debated. Aim To evaluate and compare the predictive value and reproducibility of Baumgaertner Reduction Quality Criteria (BRQC), Chang Reduction Quality Criteria (CRQC), and AP3×ML3 classification in patients with AO Foundation/Orthopaedic Trauma Association (AO/OTA) 31-A1 and 31-A2 trochanteric fractures fixed with PFN. Methods A prospective observational study was conducted on 146 patients with 31-A1 and A2 trochanteric fractures treated by PFN. Postoperative radiographs were assessed …

Effectiveness Of Fu's Subcutaneous Needling In Pain Management And Rehabilitation: A Narrative Review, Po-En Chiu, Chun-Chang Wu, De-Jian Lu, Zhonghua Fu, Li-Wei Chou

Rehabilitation Practice and Science

Fu’s Subcutaneous Needling (FSN) is a modern needling technique distinct from traditional acupuncture, primarily used for musculoskeletal pain, neuropathic conditions, and emerging applications in rehabilitation. FSN is also designated as a kind of dry needling focusing on deactivating myofascial trigger points. This review categorizes FSN-related studies into case reports, clinical trials, and animal studies, evaluating its therapeutic efficacy, safety, and mechanisms. Case reports suggest that FSN provides rapid pain relief and functional improvement, while clinical trials, including randomized controlled trials (RCTs), support its role in reducing pain and enhancing neuromuscular function despite limitations in sample size and protocol consistency. Animal …

Ultrasound-Guided Percutaneous Needle Barbotage And Ultrasonic Tenotomy For Rotator Cuff Calcific Tendinopathy, Toru Omodani

Rehabilitation Practice and Science

Rotator cuff calcific tendinopathy (RCCT) is a common source of shoulder pain caused by calcium deposits within the rotator cuff tendons. Ultrasound-guided interventions have emerged as effective, minimally invasive alternatives to surgery for symptomatic cases unresponsive to conservative treatments. This review summarizes two primary techniques: percutaneous needle barbotage and percutaneous ultrasonic tenotomy. In needle barbotage, one or two needles are inserted under ultrasound guidance to inject and aspirate saline, thereby fragmenting and removing the calcific deposit. This method yields rapid pain relief and improved shoulder function, with follow-up imaging often demonstrating near-complete deposit resolution. For particularly hard or recalcitrant deposits, …

Psychometric Validation Of Eq-5d-5l In Individuals With Chronic Spinal Cord Injury In China, Haixia Xie, Qi Zhang, Rong Jin, Jianhui He, Xinxing Hu, Yixuan Zhang, Xiaoping Shao, Xiaohong Li, Hua Zhai, Fengshui Chang

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objectives

The EQ-5D is a brief measure for assessing health-related quality of life (HRQoL), but chronic spinal cord injury (CSCI) related psychometric evaluation of the EQ-5D-5L has not been explored. We conducted a validation study on the Chinese version of the EQ-5D-5L for individuals with CSCI in China.

Methods

A cross-sectional study was conducted in the Shanghai Sunshine Rehabilitation Center. The floor and ceiling effects, internal consistency, test and retest reliability, discriminatory power (only for EQ-5D-5L), convergent validity (using Spearman correlation coefficients), and known-group validity of the EQ-5D-5L and visual analog scale (VAS) were analyzed.

Results

A total of 271 …

Arthroscopic Inlay Biceps Tenodesis Using A Tendon-Docking Anchor, Mark G. Soliman, Katherine S. Worcester M.S., Thomas E. Herron, Kevin F. Bonner

Department of Medicine Faculty Publications

Pathology of the long head of the biceps tendon can be treated surgically with a multitude of tenodesis techniques; however, there is a lack of consensus on which technique provides the most optimal outcomes. Commonly used methods include inlay tenodesis with a bone tunnel and interference screw construct and onlay tenodesis with anchors or unicortical buttons. Although current methods typically provide satisfactory outcomes, many surgeons believe complications and failure rates remain suboptimal across techniques. In this article, we present an arthroscopic suprapectoral biceps tenodesis technique using an anchor device that was developed to address the shortcomings of current techniques, optimize …

Is Fixation Of A Single End Of Flail Segment Rib Fractures Enough?, Anthony Perugini, James Iandoli, Nicholas Pelz, Daniel Degenova, Anthony Melaragno, Mallory Faherty, Benjamin C Taylor

OhioHealth Research Institute Articles

BACKGROUND: Segmental rib fractures in blunt thoracic trauma present with increased morbidity and mortality with an association of increased pulmonary insult and concomitant injuries. There is a paucity within the literature regarding the necessity of fixation of one or both segments of rib fractures in a flail chest. This study aimed to analyze surgical rib fixation and assess outcomes for non-fixed fractured rib ends in segmental rib fractures.

METHODS: This is a retrospective review of 125 patients who underwent open reduction internal fixation of flail segmental rib fractures at our urban Level 1 trauma center. Initial plain films and CT …

Innovative Biomechanical And Engineering-Based Assessments Of Hip Mechanics In Individuals With Hip-Related Pain, Holly M. Stanze

Theses and Dissertations--Kinesiology and Health Promotion

Individuals with hip-related pain exhibit altered movement patterns, and worse fear of movement (kinesiophobia), compared to asymptomatic controls. Exacerbation of hip pain during movement and the role of hip symptom duration may help further our understanding of specific movement patterns that are associated with hip-related pain. A better understanding of the potential connections between hip-related symptom duration, kinesiophobia, hip pain during movement, and lower limb mechanics in those with hip-related pain may allow for more efficient referrals to clinicians and lead to more effective rehabilitation. In addition, the impact of hip-related pain on intra-articular hip loading patterns is not well …

An Experience With A Concurrent Bilateral Tibia Interlocking Nailing: Its About Dancing With The Rhythm, Hoh Wee Liam Dr, Eyrique Goh Boay Heong, Hanif Azman

Manipal Journal of Nursing and Health Sciences

Tibial shaft fractures are the most common injuries resulting from high energy trauma such as motor vehicle accident or fall from height. Operative management options of tibia shaft fractures include intramedullary nailing, plating or external fixation or conservative by casting. Interlocking nail of tibia remains favorite among other type of surgical fixation as patient can rehabilitate post op earlier.

Interlocking nail of bilateral tibia are usually performed sequentially in view of patient needing to be properly positioned to allow easy entry and reaming of interlocking nail. Hence, this will prolong operative time, thus increasing risk of general anaethesia and surgical …

Evaluasi Ekonomi Total Hip Arthroplasty Protokol Enhance Recovery After Surgery Dibandingkan Konvensional Di Rsup Fatmawati Jakarta, Hanna Elisabet Lumbangaol, Mardiati Nadjib

Jurnal Ekonomi Kesehatan Indonesia

Total hip arthroplasty (THA) is a common orthopedic procedure performed to replace damaged hip joints with prostheses. The demand for this procedure is expected to rise in the future. Enhanced Recovery After Surgery (ERAS) has been introduced as an evidence-based, multidisciplinary approach aimed at optimizing postoperative recovery and reducing hospital length of stay. This study aims to evaluate the costs and effectiveness, including hospital stay duration and surgical success rates, of THA using the ERAS protocol compared to conventional approaches. This cross-sectional study involved data collection from healthcare providers between January 2020 and May 2023. The analysis showed that both …

Comparing Functional Outcomes Between 3d Printed Acetabular Cups And Traditional Prosthetic Implants In Hip Arthroplasty: A Systematic Review And Meta Analysis, Ryan St. John, Seth Spicer, Mo Hadaya, Hanna Brancaccio, Seungkyu Park, Sean Mcmillan

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVE: The primary research aim was to determine if the use of traditional or 3D printed prosthesis resulted in better functional outcome scores in hip arthroplasty.

METHODS: A systematic review and meta-analysis was conducted utilizing the PRISMA 2020 guidelines. Six databases (PubMed, Embase, Scopus, WebOfScience, and Cochrane Library, Google Scholar) were searched yielding 1117 article titles and abstracts. Rayyan.ai was used to detect duplicates (n = 246) and for manual screening for inclusion and exclusion criteria. Included were controlled studies of any publication time that assessed Harris Hip Score (HHS) at baseline and twelve months. Six papers were sought for …

Liv Selection In ‘Tweener’ Patients Treated With Magnetically Controlled Growing Rods Vs. Posterior Spinal Fusion, Brandon Yoshida, Claudia Leonardi, Jacquelyn Valenzuela-Moss, Lindsay M. Andras, Tyler A. Tetreault, John B. Emans, John T. Smith, Joshua M. Pahys, G. Ying Li, Michael J. Heffernan

School of Public Health Faculty Publications

Purpose: The purpose of this study was to compare the LIV selection in ‘tweener’ patients treated with MCGR or PSF. Methods: A multicenter pediatric spine database was queried for ambulatory patients ages 8–11 years treated by MCGR or PSF with at least 2-year follow-up. The relationship between the LIV and preoperative spinal height, curve magnitude, and implant type were assessed. The relationship between the touched vertebrae (TV), the last substantially touched vertebrae (LSTV), the stable vertebrae (SV), and the LIV were evaluated. Results: One hundred and fifty-nine patients met inclusion criteria. Preoperative curve magnitude was similar between groups (MCGR 68 …