Orthopedics Commons^™

Herniated Nucleus Pulposus Radiculopathy In Athletes, Elizabeth G. Massel

Capstone Showcase

Herniated nucleus pulposus (HNP), commonly referred to as intervertebral disc (IVD) herniation, is the second most common cause of neck and back pain, and most common cause of radiculopathy. The purpose of this CME article is to provide guidance on the medical management and secondary prevention of HNP in athletic populations, and highlight the pathophysiological process of mechanical overload putting athletes at a proportionately higher risk of the disease. It will address the unique pathophysiology of overuse-related HNP, as opposed to underuse, with the mechanical overload on vertebral discs associated with many sports. It will also review, with more emphasis …

Biomechanical Outcomes Of Distinct Tka Surgical Alignments And Implant Designs, Alexis Kathleen Nelson-Tranum

Theses and Dissertations (ETD)

Introduction. Total knee arthroplasty (TKA) has advanced over the past two decades from traditional post-operative neutral alignment methods with an overall goal of implant longevity to ones that are more personalized to better replicate individual native knee kinematics. Personalizing TKA knee kinematics to better replicate a patient’s native knee kinematics has evolved in response to a reported 20% dissatisfaction by patients with their TKA. These personalization advancements include innovations in surgical alignment techniques include the kinematic alignment (KA) and joint line obliquity (JLO) restoration, in contrast to the mechanical alignment (MA) technique that places everyone into the same mold. Additionally, …

Acute Postoperative Pain And Dorsal Root Ganglia Transcriptomic Signatures Following Total Knee Arthroplasty (Tka) In Rats: An Experimental Study, Justice Achonu, David E. Komatsu, Sardar Mz Uddin, Chris Gordob, Martha Kanjiya, Diane Bogdan, Adriana Dibua, Hira Iftikhar, Amanda Ackermann, Rohan J. Shah, Jason Shieh, Agnieszka B. Bialkowska, Martin Kaczocha

Stony Brook Orthopaedic and Musculoskeletal Journal

Total knee arthroplasty (TKA) is the final treatment option for patients with advanced knee osteoarthritis (OA). Unfortunately, TKA surgery is accompanied by acute postoperative pain that is more severe than arthroplasty performed in other joints. Elucidating the molecular mechanisms specific to post-TKA pain necessitates an animal model that replicates clinical TKA procedures, induces acute postoperative pain, and leads to complete functional recovery. Here, we present a new preclinical TKA model in rats and report on functional and behavioral outcomes indicative of pain, analgesic efficacy, serum cytokine levels, and dorsal root ganglia (DRG) transcriptomes during the acute postoperative period. Following TKA, …

Demographic And Diagnostic Factors In Physical Therapy Attendance, William Leatherwood, Adrian Torres, Sofia Hidalgo Perea, Megan Paulus

Stony Brook Orthopaedic and Musculoskeletal Journal

Introduction: Previous studies have demonstrated physical therapy (PT) to be an effective nonoperative treatment for various orthopedic diagnoses. However, patients may dismiss PT in favor of another intervention for their injury. While there are many studies on PT, there is little data on patient compliance. This study aimed to elucidate patient compliance with a basic PT prescription and whether PT led to subjective injury improvement.

Methods: This is a retrospective study of patients seen in Stony Brook Orthopedic clinics from 08/01/2022 – 12/23/2022. Patients prescribed PT received a phone call six weeks after the PT prescription. The primary …

Intraoperative Nerve Stimulation As A Functional Assessment Of Acute Stretch Injury In The Rat Median Nerve, Matthew Gluck, Pierce J. Ferriter Jr., Christoph A. Schroen, Christina M. Beck, Zachary L. Bernstein, Todd A. Rubin, Michael R. Hausman, Paul J. Cagle

Stony Brook Orthopaedic and Musculoskeletal Journal

Introduction: Peripheral nerve injuries (PNIs) are common complications of upper extremity injuries, yet few clinical options exist to quickly and accurately assess motor nerve function intraoperatively. PNIs are a significant source of not only disability to the patient, but also cost. This study’s purpose was to evaluate the utility of intraoperative nerve stimulation in an
animal model.

Methods: A 20% stretch injury was induced in right median nerves using a custom-made stretch applicator, while left median nerves served as a control. A Checkpoint surgical nerve stimulator (Checkpoint Surgical, Cleveland, OH) was used to assess baseline nerve function in …

An Updated Ligament Evaluation Of Perilunate Instability, Emil S. Vutescu, Cris Min, Elias Georgas, Paul G. Arauz, Yi-Qian Qin, David E. Komatsu, Edward D. Wang

Stony Brook Orthopaedic and Musculoskeletal Journal

Introduction: Perilunate dislocations are rare and high-energy proximal carpal row injuries that are associated with long-term disability. The current accepted pathomechanism of this injury is progressive radial to ulnar intrinsic ligament tearing, as described by Mayfield in 1980. Since his description several other ligaments have been described as critical stabilizers of the proximal carpal row.

Purpose: To achieve perilunate instability in a biomechanical model and evaluate integrity of recently described carpal ligamentous stabilizers.

Methods: We tested six fresh-frozen cadaveric upper extremities and loaded them to failure in extension, ulnar deviation and carpal supination using a previously validated three-point …

Can Artificial Intelligence Create Research Hypotheses For Patellofemoral Instability?, Claire Parker, Sofia Hidalgo Perea, James Barsi

Stony Brook Orthopaedic and Musculoskeletal Journal

Introduction: The purpose of this study was to elucidate if artificial intelligence (AI) can generate novel research hypotheses regarding patellofemoral instability (PFI) in the pediatric population that have not previously been investigated. We hypothesized that AI would be able to generate new hypotheses that have not yet been presented or published.

Methods: In December of 2023, Chat Generative Pre-trained Transformer-3.5 (ChatGPT) was used to create a list of 25 research hypotheses about PFI in both the adult and pediatric population. The prompt used to generate the list of hypotheses was: “List 25 detailed and reproducible research ideas regarding …

Age-Related Differences In 30-Day Postoperative Complications Following Aseptic Revision Total Shoulder Arthroplasty: A Comparison Of Patients Under And Over 80 Years Old, Rachel A. Loyst, Patricia Cerri-Droz, Stephen H. Liu, Kenny Ling, Dorian Cohen, David E. Komatsu, Edward D. Wang

Stony Brook Orthopaedic and Musculoskeletal Journal

Introduction: This study investigates the association between patients < 80 years old and patients 80 years old and 30-day postoperative complications following aseptic revision total shoulder arthroplasty (TSA).

Materials and methods: All patients who underwent revision TSA between 2015 and 2022 from the American College of Surgeons National Surgical Quality Improvement (NSQIP) database were surveyed for this study. Patient demographics, comorbidities, and 30-day postoperative complication data were analyzed. Logistic regression was used to analyze the postoperative complications associated in patients greater than or equal to 80 years old.

Results: Compared to patients < 80 years old, patients 80 years old were independently associated with a significantly greater likelihood of experiencing any complication (odds ratio [OR] 1.61, 95% confidence interval [CI] 1.23-2.11; P < .001), non-home discharge (OR 3.68, 95% CI 2.58-5.25; P < .001), and length of stay (LOS) > 2 days (OR 1.57, 95% CI 1.18-2.10; P = 0.002).

Conclusions: Compared to patients < 80 years old, patients 80 years old were independently associated with a significantly greater likelihood of experiencing any complication, non-home discharge, and LOS > 2 days. A better understanding of the age as a risk factor …

Bridging Biomedical Research With Aerospace Engineering In The Lab Of Tomorrow, Christine Walck

Publications

“My goal with this lab is to take biomedical research and tie it into a school that is grounded in aerospace and aeronautical engineering,” says Assistant Professor of Mechanical Engineering at Embry-Riddle Aeronautical University’s Daytona Beach Campus, Christine Walck. “How do I make that connection? That’s the question I’ve been working on for the past couple of years with Vicon.”

Sex-Differences In Psychological Readiness For Return-To-Sport Following Anterior Cruciate Ligament Reconstruction., Turk Robby, Nadim Hussein, Arakua Welbeck, Mallory Faherty, Carolyn Killelea, Lee Diehl, Jocelyn Wittstein, Jonathan Riboh, Alison Toth, Ned Amendola, Timothy C Sell

Surgery Articles

Females are at greatest risk for reinjury after return to sport (RTS) following anterior cruciate ligament (ACL) reconstruction (ACLR). The reasons for these sex differences, however, remain unclear. Psychological factors such as kinesiophobia have been identified as a potential predictor for reinjury following RTS. Studies investigating kinesiophobia have identified sex differences, yet whether this holds in the ACLR population remains unknown. The purpose of this study was to examine whether there are sex differences in kinesiophobia and other psychological factors, such as readiness to RTS and self-reported pain in the ACLR population. A total of 20 participants, eleven males (23.0 …

Outcomes Of Simultaneous Lengthening And Acl Reconstruction In Fibular Hemimelia: A Retrospective Case Series, Bradley Reeves, Brennan Roper, Reba Salton, Ava Baumann, Radomir Dimovski, Nancy Hadley-Miller, Jay Albright

Faculty, Staff and Student Publications

BACKGROUND: Fibular hemimelia is the most common congenital long bone deficiency. It is often associated with femoral and tibial deficiencies which result in a clinically evident leg length discrepancy. The primary soft tissue concern is ACL/PCL deficiency. If treatment includes bony lengthening, joint stability is imperative to avoid complications. In this study, we detail a novel technique for long bone lengthening and ACL reconstruction in a single, cohesive surgery. This consolidates the need for multiple procedures and offers improved limb length symmetry and knee stability for this patient population. Clinical outcomes of pediatric patients with hemimelia who underwent either femoral …

Treatment Of Lateral Epicondylitis: Is Surgery Still An Option?, Samuel G Ruiz, Marijke J Devos, Ryan J Warth, Dean W Smith

Faculty, Staff and Student Publications

Background

The prevailing trend for the treatment of lateral epicondylitis (LE) is nonsurgical. Although many providers consider LE surgery controversial, others consider surgical intervention in patients with recalcitrant symptoms. The purpose of this study is to analyze epidemiological changes in LE surgery over a 9-year period prior to the coronavirus pandemic in 2019.

Methods

A cross-sectional analysis of the Texas health care database from 2010 to 2018 was performed. We analyzed all procedures performed for LE during the set time period using Current Procedure Terminology (CPT) codes. Statistical analyses included procedures performed, patient demographics, zone of residence, and insurance designation. …

Peripheral Nerve Stimulation After Total Knee Arthroplasty And Non-Operable Patella Fracture, Peter D Vu, Farah Gul, Christopher L Robinson, Grant H Chen, Jamal Hasoon

Faculty, Staff and Student Publications

Chronic knee pain, affecting over 25% of adults in the United States, has surged by 65% over the past two decades leading to rising functional deficits, mobility problems, and a diminished quality of life. While conservative management with pharmacologic and minimally invasive injections are pursued early in the disease process, total knee arthroplasty for refractory osteoarthritis of the knee is often considered. This procedure usually improves pain and functionality within the first three months. However, a significant portion of patients often suffer from postoperative pain that can become chronic and debilitating. We detail the case of a patient with a …

Evaluating Outcomes Post-Adoption Of Reck Solution For Total Shoulder Arthroplasties: A Retrospective Quality Analysis, Benjamin Levi Tillis

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Evaluating Outcomes Post-adoption of RECK Solution for Total Shoulder Arthroplasties: A Retrospective Quality Analysis

Benjamin Tillis

Introduction: Local infiltration analgesia (LIA) has become an integral part of postoperative pain relief for West Virginia University (WVU) Medicine’s total joint arthroplasty procedures. However, not all LIAs are the same. Liposomal bupivacaine has a unique mechanism of delivery which could potentially lead to longer lasting effects. Ropivacaine, epinephrine, clonidine, and ketorolac (RECK) solution offers a multimodal approach to enhancing the duration of effect for the LIA. In 2022, WVU Medicine switched from liposomal bupivacaine to the RECK solution for total joint …

Pilot Quality Improvement Project To Update Surgeon Preference Cards Of A Community Hospital's Orthopedic Service, Jessica R. Mitchell

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Implementation of a Pilot Quality Improvement Project to Update Surgeon Preference Cards

of a Community Hospital’s Orthopedic Service

Jessica R. Mitchell

Problem Statement: Over time, surgeons change preferences for surgical equipment, and their preference cards need updating. Failure to update preference cards leads to impaired staff communication, opening of unnecessary equipment, excess waste, increased cost to patients and facilities, and potential threats to patient safety.

Background: Members of the orthopedic surgical team in a community hospital in suburban West Virginia wanted to establish a process to regularly update outdated surgeon preference cards (SPC) for several common orthopedic procedures. The …

Far Posterior Approach For Rib Fracture Fixation: Surgical Technique And Tips., Taylor J Manes, Daniel T Degenova, Benjamin C Taylor, Jignesh N Patel

Surgery Articles

BACKGROUND: The present video article describes the far posterior or paraspinal approach to posterior rib fractures. This approach is utilized to optimize visualization intraoperatively in cases of far-posterior rib fractures. This technique is also muscle-sparing, and muscle-sparing posterolateral, axillary, and anterior approaches have been shown to return up to 95% of periscapular strength by 6 months postoperatively

DESCRIPTION: Like most fractures, the skin incision depends on the fracture position. The vertical incision is made either just medial to a line equidistant between the palpable spinous processes and medial scapular border or directly centered over the fracture line in this region. …

Biomechanics, Strength, And Physical Function After Surgical Repair Of Rotational Ankle Fractures, Benjamin Brightwell

Theses and Dissertations--Kinesiology and Health Promotion

Ankle Fractures account for approximately 9% of all lower extremity fractures and incidence continues to rise. Up to 53% of ankle fractures require surgical intervention. Impaired physical function is one of the most reported and observed lasting effects of surgically repaired ankle fractures. Additionally, limited physical capacity and function have been identified as the primary threats to health-related quality of life after surgical repair of ankle fractures. These impairments to physical capacity and functionality can last longer than 5 years after surgery. Since surgery typically successfully restores stability and congruency of the talocrural joint, these poor long-term outcomes are an …

Konsep Diagnosis Dan Penatalaksanaan Fraktur Osteoporosis Terkini, I Gusti Ngurah Wien Aryana, Febyan Febyan

Jurnal Penyakit Dalam Indonesia

Osteoporosis is a metabolic bone disease that is caused by a decreased amount of bone mass, and microarchitectural damage to bone tissue that affects the bone to break easily. Osteoporosis can be divided into primary and secondary etiologies. Vertebral, hip, distal radius, and proximal humerus are the most common predilection of fracture complication due to osteoporosis. The diagnosis of osteoporotic fractures is established based on the identification of risk factors, general clinical manifestations, specific manifestation from each fracture predilection, and advanced examinations, including radiology imaging and dual-energy x-ray absorptiometry. The purpose of osteoporotic fractures management in elderly is a stable …

A Novel Multimodal Postoperative Pain Protocol For 1- To 2-Level Open Lumbar Fusions: A Retrospective Cohort Study, Michael Markowitz, Barrett I. Woods, Gregory D. Schroeder, Christopher K Kepler, David Kaye, Mark Kurd, Joshua Armstrong, Alex R. Vaccaro, Kris Radcliff

Rothman Institute Papers

BACKGROUND: There has been increased interest in exploring methods to reduce postoperative pain without opioid medications. In 2015, a multimodal analgesia protocol was used involving the perioperative use of celecoxib, gabapentin, intravenous acetaminophen, lidocaine, and liposomal bupivacaine. Overall, the goal was to reduce the utilization of scheduled opioids in favor of nonopioid pain management.

METHODS: The results of a consecutive series of 1- to 2-level open primary lumbar fusions were compared to a cohort of patients after the implementation the perioperative multimodal pain management protocol. Primary endpoints included patient-reported pain scores and secondary endpoints included length of stay.

RESULTS: There …

Bridging Bone Health: Osteoporosis Disparities In The Rio Grande Valley, Ryan P. Bialaszewski, John M. Gaddis, Blake Martin, Philippe J. Dentino, John Ronnau

School of Medicine Publications

Introduction: Osteoporosis is characterized by decreased bone mass and decreased bone quality, leading to increased bone fragility and risk of fractures. The number of fractures due to osteoporosis is projected to increase to over three million by the year 2025 and cost $25.3 billion annually. It ranks highly among diseases that cause patients to become bedridden with serious complications and reduced quality of life. Additionally, osteoporosis disproportionately affects Hispanics, which comprise most of the Rio Grande Valley (RGV) population. Therefore, our primary objective was to determine the prevalence of osteoporosis within the RGV. Additionally, we had secondary objectives to determine …

The 2023 Orthopedic Research Society's International Consensus Meeting On Musculoskeletal Infection: Summary From The In Vitro Section, Noreen J. Hickok, Bingyun Li, Ebru Oral, Sebastian A.J. Zaat, David A. Armbruster, Gerald J. Atkins, Antonia F. Chen, Débora C. Coraça-Huber, Tianhong Dai, Edward M. Greenfield, Rajendra Kasinath, Matthew Libera, Cláudia N.H. Marques, T. Fintan Moriarty, K. Scott Phillips, Kapil Raghuraman, Dacheng Ren, Lia Rimondini, Kordo Saeed, Thomas P. Schaer, Edward M. Schwarz, Christopher Spiegel, Paul Stoodley, Vi Khanh Truong, Shao-Ting Jerry Tsang, Britt Wildemann, Anja R. Zelmer, Annelies S. Zinkernagel

Department of Orthopaedic Surgery Faculty Papers

Antimicrobial strategies for musculoskeletal infections are typically first developed with in vitro models. The In Vitro Section of the 2023 Orthopedic Research Society Musculoskeletal Infection international consensus meeting (ICM) probed our state of knowledge of in vitro systems with respect to bacteria and biofilm phenotype, standards, in vitro activity, and the ability to predict in vivo efficacy. A subset of ICM delegates performed systematic reviews on 15 questions and made recommendations and assessment of the level of evidence that were then voted on by 72 ICM delegates. Here, we report recommendations and rationale from the reviews and the results of …

Vascular Injury Risk Stratification For Lateral Lumbar Interbody Fusion (Llif) At L4-L5: A Morphometric Study Using Magnetic Resonance Imaging, Takashi Hirase, Aaron J Greenberg, Catherine G Ambrose, Derek T Bernstein, Jeffrey J Ratusznik, Rex A W Marco

Faculty, Staff and Student Publications

BACKGROUND: Proper vascular injury risk stratification (VIRS) methods for L4-L5 lateral lumbar interbody fusion (LLIF) surgery have not been well-described. The objective of this study was to propose a novel VIRS method for L4-L5 LLIF surgery via the transpsoas approach.

METHODS: Axial magnetic resonance imaging (MRI) of adult patients were obtained and analyzed. The VIRS scores were assessed using anterior disc line to posterior vessel wall distance, the disc vessel angle (DVA), and the disc edge to vessel distance at the level of L4-L5 disc space.

RESULTS: Ninety-one consecutive adult patients were included in the study. The right common iliac …

Reducing Adverse Event With Single And Double Bundle Acl Reconstruction Techniques, Alicia Hudalla, Caroline Casey

Physician Assistant Capstones, 2020-current

Objective: Assess whether athletes or individuals who live an active lifestyle or occupation between the ages of 18-40, who have had an ACL reconstruction done by either single bundle or double bundle repair to compare whether or not double-bundle ACL reconstructive surgery reduce rates of adverse events (re-tear rates, graft failure and laxity) post ACL reconstruction as compared to single-bundle ACL reconstruction. Design: Systemic literature review. Methods: Searches were done in PubMed, utilizing the terms “single bundle vs. double bundle ACL reconstruction.” The following limits and terms were used wrong ligament discussed, systematic reviews or review, not enough participants, 10+ …

Evaluating The Efficacy Of A Thermoresponsive Hydrogel For Delivering Anti-Collagen Antibodies To Reduce Posttraumatic Scarring In Orthopedic Tissues., Andrzej Steplewski, Jolanta Fertala, Lan Cheng, Mark Wang, Michael Rivlin, Pedro K Beredjiklian, Andrzej Fertala

Department of Orthopaedic Surgery Faculty Papers

Excessive posttraumatic scarring in orthopedic tissues, such as joint capsules, ligaments, tendons, muscles, and peripheral nerves, presents a significant medical problem, resulting in pain, restricted joint mobility, and impaired musculoskeletal function. Current treatments for excessive scarring are often ineffective and require the surgical removal of fibrotic tissue, which can aggravate the problem. The primary component of orthopedic scars is collagen I-rich fibrils. Our research team has developed a monoclonal anti-collagen antibody (ACA) that alleviates posttraumatic scarring by inhibiting collagen fibril formation. We previously established the safety and efficacy of ACA in a rabbit-based arthrofibrosis model. In this study, we evaluate …

Sirtuin 6 Activation Rescues The Age-Related Decline In Dna Damage Repair In Primary Human Chondrocytes, Michaela E. Copp, Jacqueline Shine, Hannon L. Brown, Kirti R. Nimmala, Oliver B. Hansen, Susan Chubinskaya, John A. Collins, Richard F. Loeser, Brian O. Diekman

Department of Orthopaedic Surgery Faculty Papers

While advanced age is widely recognized as the greatest risk factor for osteoarthritis (OA), the biological mechanisms behind this connection remain unclear. Previous work has demonstrated that chondrocytes from older cadaveric donors have elevated levels of DNA damage as compared to chondrocytes from younger donors. The purpose of this study was to determine whether a decline in DNA repair efficiency is one explanation for the accumulation of DNA damage with age, and to quantify the improvement in repair with activation of Sirtuin 6 (SIRT6). After acute damage with irradiation, DNA repair was shown to be more efficient in chondrocytes from …

Preoperative Computed Tomography Scan In Distal Radius Fractures And The Effect On Preoperative Planning, Adam L. Haydel, Ryan C. Roubion, Cristina T. Graphia, Corinne E. Cloud, Claudia Leonardi, Christopher E. Marrero

School of Medicine Faculty Publications

Purpose: It is unclear whether computed tomography (CT) scans alter the surgical plan when ordered before surgery for fixation of intra-articular distal radius fractures (DRFs). The purpose of this study was to determine whether a preoperative CT scan alters the planned approach (PA) or planned fixation strategy (PFS) for open reduction internal fixation of intra-articular DRFs. Methods: Radiology records were retrospectively reviewed by one trauma surgeon and two hand surgeons for 33 intra-articular DRFs that met the inclusion criteria and previously underwent open reduction internal fixation. Surgeons were initially provided only preoperative radiographs; they were asked for their PA and …

Pediatric Parosteal Osteosarcoma Of The Distal Radius Causing Extensive Erosive Mass Effect Of The Adjacent Ulna: A Case Report, Andrea Perloff, Sehoon Park, Robert Panganiban, John Devries

Department of Orthopaedics Faculty Research

Introduction: Parosteal osteosarcomas are low-grade bony malignancies that are treated primarily with surgical resection and reconstruction. This report discusses a unique case of a pediatric patient who presented with a parosteal osteosarcoma of the distal radius causing extensive erosive mass effect and growth disturbance of the adjacent ulna. Likely due to their slow-growing nonaggressive nature, parosteal osteosarcomas have not been previously described to abut adjacent bony structures through direct contact. The patient presented in a significantly delayed manner due to social circumstances, inadvertently revealing this novel behavior. This report reviews this rare case and describes the current understanding of this …

Correction Of Spinal Sagittal Alignment After Posterior Lumbar Decompression: Does Severity Of Central Canal Stenosis Matter?, Delano Trenchfield, Yunsoo Lee, Mark J. Lambrechts, Nicholas D'Antonio, Jeremy Heard, John Paulik, Sydney Somers, Jeffrey Rihn, Mark Kurd, David Kaye, Jose Canseco, Alan Hilibrand, Alex Vaccaro, Christopher K Kepler, Gregory Schroeder

Rothman Institute Papers

STUDY DESIGN: This study adopted a retrospective study design.

PURPOSE: Our study aimed to investigate the impact of central canal stenosis severity on surgical outcomes and lumbar sagittal correction after lumbar decompression.

OVERVIEW OF LITERATURE: Studies have evaluated sagittal correction in patients with central canal stenosis after lumbar decompression and the association of stenosis severity with worse preoperative sagittal alignment. However, none have evaluated the impact of spinal stenosis severity on sagittal correction.

METHODS: Patients undergoing posterior lumbar decompression (PLD) of ≤4 levels were divided into severe and non-severe central canal stenosis groups based on the Lee magnetic resonance imaging …

Inhibition Of Neurogenic Inflammatory Pathways Associated With The Reduction In Discogenic Back Pain, Jose A. Canseco, Hannah A. Levy, Brian A. Karamian, Olivia Blaber, Michael Chang, Neil Patel, John G. Curran, Alan S. Hilibrand, Gregory D. Schroeder, Alex R. Vaccaro, Dessislava Z. Markova, David E. Surrey, Christopher K. Kepler

Rothman Institute Papers

STUDY DESIGN: Retrospective cohort study.

PURPOSE: This study aimed to determine whether the initiation of anti-calcitonin gene-related peptide (CGRP inhibitor) medication therapy for migraines was also associated with improvements in back/neck pain, mobility, and function in a patient population with comorbid degenerative spinal disease and migraine.

OVERVIEW OF LITERATURE: CGRP upregulates pro-inflammatory cytokines such as tumor necrosis factor-α, interleukin-6, brain-derived neurotrophic factor, and nerve growth factor in spinal spondylotic disease, which results in disc degeneration and sensitization of nociceptive neurons. Although CGRP inhibitors can quell neurogenic inflammation in migraines, their off-site efficacy as a therapeutic target for discogenic back/neck pain …

Osteoarthritis Disease Severity In The Temporomandibular Joint And The Knee Joint: A Comparative Cadaveric Study, Jessica A Immonen, Jason Ciccotelli, Linh M Nguyen, Lesley Gilmer, Landen Broadhead, Mackenzie Kitchen, Conner Paul, Jeremy James

Faculty, Staff and Student Publications

OBJECTIVE: The objective of this study was to determine the level of disease severity in a pilot cohort of temporomandibular joints (TMJs) and compare them to the pathology findings previously characterized in cadaveric knee joints.

DESIGN: Thirty-one intact TMJs from 17 cadaveric donors were harvested and arthritic lesioning seen in the knee joint was investigated on the condyle and the fossa of the TMJ. Prevalence of gross alterations was equated and disease severity was determined for sex- and age-based donor pools using a validated, osteoarthritis (OA) disease severity scale (DSS). Knee joint DSS scores were also compared to the TMJ …