Musculoskeletal Diseases Commons^™

Socioeconomic Disparities Exist In Access To Rotator Cuff Repair Surgery, Justin Solarczyk, Heather Roberts Md, Stephanie Wong Md, Derek Ward Md

Journal of Health Disparities Research and Practice

Background: The relationship of socioeconomic disparity in access to rotator cuff repair (RCR) has not been well studied. Socioeconomic, racial, and ethnic disparities in access to surgical management of rotator cuff tears have previously been described in patients with commercial insurance. This study is a population-level analysis which investigates racial and ethnic disparities in access to surgical rotator cuff repair across multiple health insurance statuses.

Purpose: (1) Is non-white race and ethnicity associated with lower rates of RCR? (2) Do these associations change throughout different insurance statuses?

Methods: We used the Healthcare Cost and Utilization Project (HCUP) database to identify …

Proteoglycan 4 (Prg4)/Lubricin And The Extracellular Matrix In Gout, Khaled A. Elsaid, Gregory D. Jay, Ru Liu-Bryan, Robert Terkeltaub

Pharmacy Faculty Articles and Research

Proteoglycan 4 (PRG4) is a mucinous glycoprotein secreted by synovial fibroblasts and superficial zone chondrocytes, released into synovial fluid, and adsorbed on cartilage and synovial surfaces. PRG4′s roles include cartilage boundary lubrication, synovial homeostasis, immunomodulation, and suppression of inflammation. Gouty arthritis is mediated by monosodium urate (MSU) crystal phagocytosis by synovial macrophages, with NLRP3 inflammasome activation and IL-1β release. The phagocytic receptor CD44 mediates MSU crystal uptake by macrophages. By binding CD44, PRG4 limits MSU crystal uptake and downstream inflammation. PRG4/CD44 signaling is transduced by protein phosphatase 2A, which inhibits NF-κB, decreases xanthine oxidoreductase (XOR), urate production, and ROS-mediated IL-1β …

Stellate Ganglion Block For Refractory Raynaud’S Phenomenon- A Case Report, William J. Naber Ii, Derik J. Scribner, Gabriel Howard

Graduate Medical Education Research Journal

Introduction: Raynaud’s phenomenon (RP) is predominately a sympathetically mediated ischemic vasospastic disease involving the distal limbs and is associated with sharp pains, numbness, and dermatological color changes. The symptoms are commonly induced by cold weather, stress, and trauma and it is known to affect 4.85% of the population. There are few well-defined treatments for patients with RP that are refractory to 1st-line therapies. We present a case of intractable RP with corresponding response to stellate ganglion block (SGB) which demonstrates the efficacy profile and safety of SNS blocks in treatment of resistant RP.

Methods: Per Bon Secours Mercy Health …

Posttreatment Lyme Disease Syndrome And Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Systematic Review And Comparison Of Pathogenesis, Natalie Bai, Christie Richardson

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Lyme disease is the most common vector-borne illness in the United States and has been causing significant morbidity since its discovery in 1977. It is well-documented that about 10% of patients properly treated with antibiotics never fully recover, but instead go on to develop a chronic illness dubbed, posttreatment Lyme disease syndrome (PTLDS) characterized by severe fatigue, cognitive slowing, chronic pain, and sleep difficulties. This review includes 18 studies that detail the symptoms of patients with PTLDS and uses qualitative analysis to compare them to myalgic encephalitis/chronic fatigue syndrome (ME/CFS), a strikingly similar syndrome. In the majority of the PTLDS …

Development And Validation Of An Ultrahigh-Performance Liquid Chromatography–Tandem Mass Spectrometry Method To Investigate The Plasma Pharmacokinetics Of A KCa2.2/KCa2.3 Positive Allosteric Modulator In Mice, Mohammad Asikur Rahman, Devaraj Venkatapura Chandrashekar, Young-Woo Nam, Basir Syed, David Salehi, Hamidreza Montazeri Aliabadi, Miao Zhang, Reza Mehvar

Pharmacy Faculty Articles and Research

Rationale

There is currently no treatment for spinocerebellar ataxias (SCAs), which are a group of genetic disorders that often cause a lack of coordination, difficulty walking, slurred speech, tremors, and eventually death. Activation of K_Ca2.2/K_Ca2.3 channels reportedly exerts beneficial effects in SCAs. Here, we report the development and validation of an analytical method for quantitating a recently developed positive allosteric modulator of K_Ca2.2/K_Ca2.3 channels (compound 2q) in mouse plasma.

Methods

Mouse plasma samples (10 μL) containing various concentrations of 2q were subjected to protein precipitation in the presence of a structurally similar …

Identifying The Neural Correlates Of Anticipatory Postural Control: A Novel Fmri Paradigm, Jo Armour Smith, Rongwen Tain, Kelli G. Sharp, Laura M. Glynn, Linda R. Van Dillen, Korinne Henslee, Jesse V. Jacobs, Steven C. Cramer

Physical Therapy Faculty Articles and Research

Altered postural control in the trunk/hip musculature is a characteristic of multiple neurological and musculoskeletal conditions. Previously it was not possible to determine if altered cortical and subcortical sensorimotor brain activation underlies impairments in postural control. This study used a novel fMRI-compatible paradigm to identify the brain activation associated with postural control in the trunk and hip musculature. BOLD fMRI imaging was conducted as participants performed two versions of a lower limb task involving lifting the left leg to touch the foot to a target. For the supported leg raise (SLR) the leg is raised from the knee while the …

Impact Of Osteopathic Manipulative Therapy (Omt) On Morbidity In Pregnant Persons Aged 18-39, Jessica-Sophie Chang Horoschak

Stratford Campus Research Day

Background: Rates of maternal morbidity and mortality in the United States continue to rise.1 Pregnant persons are more vulnerable to stress and morbidities associated with the physiological changes of pregnancy. Low back pain and posterior pelvic pain are of high incidence experienced in pregnant persons.2 Prevention strategies are necessary to improve maternal health outcomes in the United States. Some studies have shown that Osteopathic Manipulative Therapy (OMT) can be an effective treatment modality for pregnant patients experiencing somatic pain. These studies, however, are limited and of small sample size.

Purpose: To examine the current literature on the impact of OMT …

The Effect Of Graft Selection On Patients’ Subjective Readiness To Return To Sport After Acl Reconstruction, Adeeb Hanna, William Johns, Emma Johnson, Bryson Kelmer, Gabriel Onor, Kevin Freedman, Christopher Dodson, Michael Ciccotti

Stratford Campus Research Day

Background: Patients who undergo ACL reconstruction with allografts may have an easier functional recovery compared to autograft patients. This is due to decreased donor site morbidity and less muscle atrophy compared to autograft patients. This “easier” recovery may be perceived by patients and may result in a subjective earlier readiness for return to sports.

Hypothesis/Purpose: To determine if there is a difference in perceived readiness to return to sport (RTS) in the first year postoperative period between individuals who undergo ACL reconstruction utilizing bone-patellar tendon-bone (BTB) autografts or allografts.

Study Design: Prospective Cohort Study, Level II Methods: This was a …

Determining Accuracy Of Chondral Lesion Sizing Methods Prior To Surgery, Adeeb Hanna, Henson Destine, Emma Johnson, Michael Campbell, Austin Looney, Dominic Farronato, Joshua Pezzulo, Bradford S. Tucker, Kevin Freedman

Stratford Campus Research Day

Background: Osteochondral lesions of the knee may require cartilage restoration such as osteochondral allograft (OCA) transplantation or autologous chondrocyte implantation (ACI). Although MRI and arthroscopy can offer valuable information regarding lesion characteristics prior to these procedures, no study has compared the use of each in estimating the sizes of grafts used at the time of surgical correction.

Hypothesis/Purpose: To compare osteochondral defect size measurements and characteristics across MRI, arthroscopy, and at the time of implantation with OCA or ACI. Study Design: Retrospective Cohort Study (Level III)

Methods: Patients who underwent ACI and OCA transplantation at a single institution between 2015 …

Adaptive Changes Of The Ulnar Collateral Ligament Of Professional Baseball From Different Climates Over Multiple Seasons: An 18-Year Study, Adeeb Hanna, Brian Fliegel, John Sonnier, Matthew Sherman, Michael Ciccotti, Robert Jack, Steven Cohen

Stratford Campus Research Day

Background: The ulnar collateral ligament (UCL) is put under high levels of stress through the overhead throwing motion typical of professional baseball pitchers. In response to repetitive stress the UCL undergoes adaptive changes including thickening of the ligament and increased joint laxity under valgus stress. Studies examining the adaptive changes in the elbows of professional pitchers over multiple seasons are limited. Investigations such as this one offer insight into the changes in the UCL of professional pitchers over multiple years of professional play as well as the risk for injuries that may be associated with these changes.

Purpose/Hypothesis: The purpose …

Case Report: Use Of Bedside Handheld Ultrasound To Diagnose Finger Dislocation, Frank Wheeler, Philip Carhart, James Espinosa, Alan Lucerna, Henry Schuitema

Stratford Campus Research Day

Here we present the case of a 37-year-old male with a finger injury in which finger dislocation was suspected clinically. A bedside pocket ultrasound was performed using a water submersion technique, which identified a posterior dislocated right 2nd digit at the PIP joint. This finding was confirmed with an x-ray. This case report demonstrates that ultrasonography can be utilized to correctly identify finger dislocation. Although larger studies need to be performed to validate the accuracy of this imaging technique, the implications may improve care of the patient. It would also be particularly beneficial for this technique to be applied to …

Impact Of Draft Order On Stress Sonography Of The Ulnar Collateral Ligament Of The Elbow In Professional Baseball Pitchers: An 18-Year Study, Adeeb Hanna, John Sonnier, Brian Fliegel, Matthew Sherman, Michael Ciccotti, Robert Jack, Steven Cohen

Stratford Campus Research Day

Background: The MLB draft is a common route for players to enter professional baseball in the United States. Individuals taken in earlier rounds are typically higher-performing players. When looking at pitchers specifically, higher performance at the amateur level may be associated with increased frequency of adaptive change in the throwing elbow.

Purpose/Hypothesis: To determine if players taken in earlier rounds of the MLB draft have a greater frequency or extent of pathological change in the elbow, as measured by dynamic stress ultrasound.

Study Design: Retrospective Cohort Study Methods: Dynamic stress ultrasounds (SUS) were performed over an 18-year period on the …

Outcomes Of Arthroscopic Vs. Open Biceps Tenodesis For Treatment Of Slap Lesion In Female Patients, Adeeb Hanna, Matthew Wallingford, William Johns, John Sonner, Emma Johnson, Sommer Hammoud, Brandon Erickson, Steven Cohen, Michael Ciccotti, Meghan Bishop

Stratford Campus Research Day

Background: Biceps tenodesis (BT) is one alternative treatment to repair of superior labrum anterior to posterior (SLAP) tears. It can be performed as an arthroscopy or open procedure. While there have been studies comparing the outcomes of SLAP repair procedures with BT for the treatment of SLAP tears, literature comparing arthroscopic and open BT for the treatment of SLAP tears is limited. Additionally, no previous study has specifically examined the outcomes of these procedures in female patients.

Hypothesis/Purpose: The purpose of this study was to compare outcomes following Arthroscopic BT and Open BT for SLAP tears in females. The authors …

Case Report And Review: Hawthorne Root Toxicity, James Espinosa, Darren Finn, Alan Lucerna

Stratford Campus Research Day

Here we present the case of a patient who purchased a hawthorn root product, Raiz de Tejocote, for weight loss purposes. The side effect profile seen, including a positive digoxin level, are consistent with hawthorn root. This case reinforces the importance of asking a patient about all medications, including over the internet medications.

Comparative Outcomes Of Autologous Chondrocyte Implantation And Osteochondral Allograft Transplantation With Patellar Realignment For Patellar Instability With Associated Cartilage Defects, Adeeb Hanna, Michael Campbell, John Matthews, Gabriel Onor, Emma Johnson, Bradford Tucker, Kevin Freedman

Stratford Campus Research Day

Abstract Background: Articular cartilage pathology can stem from a spectrum of etiologies including osteochondritis dissecans, avascular necrosis, degenerative joint disease, and injury resulting from recurrent instability of the patella.

Hypothesis/Purpose: The purpose of this study was to identify differences in clinical and functional outcomes in patients treated with either ACI or OCA transplantation for chondral defects with concomitant MPFL reconstruction and tibia tubercle osteotomy.

Study Design: Retrospective Cohort Study

Methods: A retrospective review identified patients who underwent autologous chondrocyte implantation (ACI) or osteochondral allograft (OCA) transplantation with concomitant medial patellofemoral ligament (MPFL) reconstruction and tibia tubercle osteotomy (TTO). Outcome measures …

Under Pressure: A Case Of Acute Compartment Syndrome/Vitt After The Covid-19 Vaccine, Thashali Anthony, Brittany Lyons

South Atlantic Division Research Day 2023

No abstract provided.

Localization Of Ctg-Repeat-Containing Transgenes In Drosophila Melanogaster Myotonic Dystrophy Models, Andrea Waltrip

Student Research Submissions

Myotonic Dystrophy Type 1, DM1, is a multi-systemic muscle wasting disorder that results from expression of expanded CTG repeats in the DMPK gene in humans. Three transgenic Drosophila melanogaster lines have been created containing 60, 250, or 480 CTG repeats to model DM1. The transgenic repeats are expressed using the GAL4/UAS system. Expression of long-repeat transgenes ((CTG)₂₅₀ and i(CTG)₄₈₀) produces phenotypes consistent with DM1, relative to control lines ((CTG)₆₀). The precise chromosomal location of insertion of the transgenes has not been reported. We used classical genetic approaches to localize CTG-repeat transgene insertion to a specific …

Worse Postoperative Outcomes And Higher Reoperation In Smokers Compared To Nonsmokers For Arthroscopic Rotator Cuff Repair, Susan G. Wager, Spencer Brown, Michael Gaudiani, Joshua P. Castle, Eric Jiang, Vasilios Moutzouros, Eric Makhni, Stephanie J. Muh

Medical Student Research Symposium

Introduction: Smoking impairs healing potential and is a significant risk factor for complications following orthopaedic surgeries. The purpose of this study was to determine if a cohort of former or current smokers at time of surgery met the minimally clinical important difference (MCID) for Patient-Reported Outcomes Measurement Information System Upper Extremity (PROMIS-UE), Depression (PROMIS-D), and Pain Interference (PROMIS-PI) scores in comparison to nonsmokers.

Methods: A retrospective review of patients who underwent rotator cuff repair was performed. Patients who completed preoperative and 6-month postoperative PROMIS scores were included. The MCID was calculated using a distribution technique with a threshold of 0.5 …

Minimalistic Approach To Enhanced Recovery After Pediatric Scoliosis Surgery, Scott A. Barnett, Bryant M. Song, Matthew Bauer, Matthew E. Nungesser, Claudia Leonardi, Michael J. Heffernan

School of Medicine Faculty Publications

Purpose: Prior studies of enhanced recovery protocols (ERP) have been conducted at large institutions with abundant resources. These results may not apply at institutions with less resources directed to quality improvement efforts. The purpose of this study was to assess the value of a minimalistic enhanced recovery protocol in reducing length of stay (LOS) following PSF for adolescent idiopathic scoliosis. We hypothesized that accelerated transition to oral pain medications and mobilization alone could shorten hospital length of stay in the absence of a formal multimodal pain regimen. Methods: AIS patients aged 10–18 who underwent PSF at a tertiary pediatric hospital …

Development Of An Affordable, Manual Method Of Dna Extraction From Bones And Teeth ​, Varos Victer Manukyan, Lara Laughrey, Ryan V. Powers, Amar Paul, Davis Johnston, Dashon Eure, Todeh Toomians, John A. Kriak, Kyle B. Bills, David W. Sant

Annual Research Symposium

No abstract provided.