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Intraoperative Hypothermia In Patients Undergoing Total Knee Arthroplasty: A Cross-Sectional Study From A Developing Country, Ronika Devi Ukrani, Aiman Arif, Anum Sadruddin Pidani, Obada Hussein Hasan, Shahryar Noordin 2021 Aga Khan University

Intraoperative Hypothermia In Patients Undergoing Total Knee Arthroplasty: A Cross-Sectional Study From A Developing Country, Ronika Devi Ukrani, Aiman Arif, Anum Sadruddin Pidani, Obada Hussein Hasan, Shahryar Noordin

Medical College Documents

Background: Intraoperative hypothermia is associated with various risk factors, morbidity, and mortality in patients undergoing total knee arthroplasty (TKA), increasing the emotional and financial burden on patients. This study aimed to identify risk factors of intraoperative hypothermia in patients undergoing TKA.
Materials and methods: All adult patients (⩾18 years) who underwent TKA from January 2016 to December 2017 at a tertiary-care hospital in Pakistan were included in this retrospective, cross-sectional study. Temperature < 36 °C was defined as hypothermia.
Results: The study included 286 patients (77.6% female) with a mean age of 61.4 ± 10.4 years. The overall proportion of intraoperative hypothermia was 26.6 ...


Weight Reduction Motivation In Osteoarthritis Patients Through Nurse Practitioner Driven Education And Follow-Up: A Pilot Project, Caoilfhionn Mulvey, Martha Fuller PhD 2021 University of San Diego

Weight Reduction Motivation In Osteoarthritis Patients Through Nurse Practitioner Driven Education And Follow-Up: A Pilot Project, Caoilfhionn Mulvey, Martha Fuller Phd

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: The ultimate goal of this short-term pilot project is for

overweight or obese osteoarthritis patients to increase their knowledge on the benefits of

weight loss and physical activity. Research shows that for every kilogram of weight lost,

2.2–4.0 kilograms of weight is taken off of the joint and could reduce joint pain up to

thirty to fifty percent and improve quality of life. Following education from the provider,

patients will understand the correlation of osteoarthritis symptom management with

weight loss.

EBP Model/Frameworks: This project utilizes the Iowa Model of Evidence-Based

Practice to Promote ...


Radiologic Measurements In The Assessment Of Patellar Instability: A Systematic Review And Meta-Analysis., Alex E White, Peters T Otlans, Dylan P. Horan, Daniel Calem, William Emper, Kevin Freedman, Fotios Tjoumakaris, MD 2021 Hospital for Special Surgery, New York, New York, USA

Radiologic Measurements In The Assessment Of Patellar Instability: A Systematic Review And Meta-Analysis., Alex E White, Peters T Otlans, Dylan P. Horan, Daniel Calem, William Emper, Kevin Freedman, Fotios Tjoumakaris, Md

Rothman Institute Faculty Papers

Background: Numerous diagnostic imaging measurements related to patellar instability have been evaluated in the literature; however, little has been done to compare these findings across multiple studies.

Purpose: To review the different imaging measurements used to evaluate patellar instability and to assess the prevalence of each measure and its utility in predicting instability. We focused on reliability across imaging modalities and between patients with and without patellar instability.

Study Design: Systematic review; Level of evidence, 4.

Methods: We performed a systematic review of the literature using the PubMed, SCOPUS, and Cochrane databases. Each database was searched for variations of the ...


Reducing Unnecessary Crossmatching For Hip Fracture Patients By Accounting For Preoperative Hemoglobin Concentration, Raj M Amin, Varun Puvanesarajah, Yash P Chaudhry, Matthew J Best, Sandesh S Rao, Steven M Frank, Erik A Hasenboehler 2021 Philadelphia College of Osteopathic Medicine

Reducing Unnecessary Crossmatching For Hip Fracture Patients By Accounting For Preoperative Hemoglobin Concentration, Raj M Amin, Varun Puvanesarajah, Yash P Chaudhry, Matthew J Best, Sandesh S Rao, Steven M Frank, Erik A Hasenboehler

Orthopedic Surgery Resident Research

BACKGROUND: Maximum surgical blood order schedules were designed to eliminate unnecessary preoperative crossmatching prior to surgery in order to conserve blood bank resources. Most protocols recommend type and cross of 2 red blood cell (RBC) units for patients undergoing surgery for treatment of hip fracture. Preoperative hemoglobin has been identified as the strongest predictor of inpatient transfusion, but current maximum surgical blood order schedules do not consider preoperative hemoglobin values to determine the number of RBC units to prepare prior to surgery.

AIM: To determine the preoperative hemoglobin level resulting in the optimal 2:1 crossmatch-to-transfusion (C:T) ratio in ...


The Effect Of Covid-19 On Pediatric Orthopaedic Trauma Volume At A Level 1 Pediatric Trauma Center In The Midwestern United States, Kirsten Norrell 2021 Children's Mercy Kansas City

The Effect Of Covid-19 On Pediatric Orthopaedic Trauma Volume At A Level 1 Pediatric Trauma Center In The Midwestern United States, Kirsten Norrell

Research Days

Background: School and playground closures and the cancellation of extracurricular activities in the Kansas City region on March 17, 2020 due to the COVID-19 pandemic created an unprecedented situation for children and parents. Early reports in the literature on adult and pediatric trauma volume suggested a decrease in orthopaedic injuries during the pandemic. This is the first study to report how the pandemic affected orthopaedic trauma volume at a Level 1 pediatric trauma center during the entire five months since school and activity closures went into effect.

Objectives/Goal: The aim of this study was to compare the volume and ...


Effect Of Change In Usmle Step 1 Grading On Orthopaedic Surgery Applicants: A Survey Of Orthopaedic Surgery Residency Program Directors., Alex Gu, Jacob Farrar, Safa C. Fassihi, Seth Stake, Pradip Ramamurti, Chapman Wei, Lauren E Wessel, Duretti T Fufa, Raj D. Rao 2021 George Washington University

Effect Of Change In Usmle Step 1 Grading On Orthopaedic Surgery Applicants: A Survey Of Orthopaedic Surgery Residency Program Directors., Alex Gu, Jacob Farrar, Safa C. Fassihi, Seth Stake, Pradip Ramamurti, Chapman Wei, Lauren E Wessel, Duretti T Fufa, Raj D. Rao

Orthopaedic Surgery Faculty Publications

No abstract provided.


Risk Scores And Machine Learning To Identify Patients With Acute Periprosthetic Joints Infections That Will Likely Fail Classical Irrigation And Debridement., Marjan Wouthuyzen-Bakker, Noam Shohat, Javad Parvizi MD, Alex Soriano 2021 Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, Netherlands

Risk Scores And Machine Learning To Identify Patients With Acute Periprosthetic Joints Infections That Will Likely Fail Classical Irrigation And Debridement., Marjan Wouthuyzen-Bakker, Noam Shohat, Javad Parvizi Md, Alex Soriano

Rothman Institute Faculty Papers

The most preferred treatment for acute periprosthetic joint infection (PJI) is surgical debridement, antibiotics and retention of the implant (DAIR). The reported success of DAIR varies greatly and depends on a complex interplay of several host-related factors, duration of symptoms, the microorganism(s) causing the infection, its susceptibility to antibiotics and many others. Thus, there is a great clinical need to predict failure of the "classical" DAIR procedure so that this surgical option is offered to those most likely to succeed, but also to identify those patients who may benefit from more intensified antibiotic treatment regimens or new and innovative ...


The Effect Of Chronic Alcohol Consumption On Exercise-Induced Muscle Damage In Young Men, Emma Hamilton, Grant Hilliard 2021 University of Mississippi

The Effect Of Chronic Alcohol Consumption On Exercise-Induced Muscle Damage In Young Men, Emma Hamilton, Grant Hilliard

Honors Theses

PURPOSE: To investigate the effects of chronic alcohol consumption on exercise-induced muscle damage of the knee extensors in young men. METHODS: Twenty-one males (age 21.9 ± 1.1 yr; weight 183.4 ± 27.6 lbs; height 174.0 ± 13.1 cm) performed 100 maximal eccentric contractions at 30°/sec of the knee extensors using their non-dominant leg. The isometric and isokinetic muscle strengths (60°/sec and 180°/sec) were measured pre-exercise and immediately, 24 h, 48 h, 72 h, 96 h, and 120 h post-exercise. Muscle soreness and plasma creatine kinase (CK) activity were measured pre-exercise and 24 h, 48 ...


Holding Traction During Ct: Simple Tricks To Maintain Reduction In The Lower Extremity, Garrhett G. Via, David A. Brueggeman, Alexander Chase, Jennifer L. Jerele, Kyle S. Mobley 2021 Wright State University

Holding Traction During Ct: Simple Tricks To Maintain Reduction In The Lower Extremity, Garrhett G. Via, David A. Brueggeman, Alexander Chase, Jennifer L. Jerele, Kyle S. Mobley

Medical Student Research Symposium Abstracts and Posters

Traction is one of the pillars of orthopaedic injury management, as it can provide both temporizing and definitive treatment for anatomic malalignment associated with joint dislocations and fractures. In the realm of modern orthopaedic care, post-traction imaging provides the surgeon with information about resting fracture position and the overall effects of traction that are critical to preoperative planning. However, there are often circumstances in which an orthopaedic surgery provider is faced with the discrepancy between the proper sequence of orthopaedic care and the need for emergent, advanced imaging to evaluate other organ systems. In other words, they are often forced ...


Fluorescence-Guided Surgical Debridement Of Chronic Osteomyelitis Utilizing Doxycycline Bone Labeling: A Technical Trick Revived, Garrhett G. Via, David A. Brueggeman, Grant M. Slack, James M. Danias, Jennifer L. Jerele 2021 Wright State University

Fluorescence-Guided Surgical Debridement Of Chronic Osteomyelitis Utilizing Doxycycline Bone Labeling: A Technical Trick Revived, Garrhett G. Via, David A. Brueggeman, Grant M. Slack, James M. Danias, Jennifer L. Jerele

Medical Student Research Symposium Abstracts and Posters

The present manuscript discusses the concept of fluorescence-guided surgical debridement of chronic osteomyelitis in the orthopaedic patient based upon a two-fold mechanism, natural fluorescence of healthy bone combined with bone labeling by tetracyclines. The senior author prefers preoperative administration of oral doxycycline 100 mg twice daily for at least 1 month. The excitation source of choice is an ordinary blacklight, as this is both cost-effective and readily attainable. Intraoperatively, viable bone is noted to fluoresce a greenish hue which is then used to guide the debridement. Previous studies have demonstrated that bleeding bone is not a reliable indicator of a ...


Reconstructionof Congenital Arhinia With Stereolithography, Kelly Spiller, Kaitlynne Pak, Lucas M. Harrison, Spencer Anderson, Steven Schmidt, Salim Mancho 2021 Wright State University - Main Campus

Reconstructionof Congenital Arhinia With Stereolithography, Kelly Spiller, Kaitlynne Pak, Lucas M. Harrison, Spencer Anderson, Steven Schmidt, Salim Mancho

Medical Student Research Symposium Abstracts and Posters

Complete congenital arhinia is a rare defect of embryogenesis leading to the absence of the external nose and nasopharyngeal airway. In this study, we report our novel multi-staged reconstructive approach of congenital arhinia in addition to literature review. Reconstruction was achieved via several spaced operations. A nasal methyl methacrylate prosthesis was first created from a stereolithographic model for use as a temporary prosthesis and tissue expander. Lefort 1 osteotomy with cannulization was then utilized for midface advancement and nasopharyngeal airway formation. External nasal framework was constructed with bilateral conchal bowl cartilage and rib osteocartilagenous grafts. The patient was overall pleased ...


Staphylococcus Aureus Floating Biofilm Formation And Phenotype In Synovial Fluid Depends On Albumin, Fibrinogen, And Hyaluronic Acid, Samantha Knott, Dylan Curry, Neil Zhao, Pallavi Metgud, Sana Dastgheyb, Caroline Purtill, Marc I. Harwood, MD, Antonia F Chen, Thomas P Schaer, Michael Otto, Noreen J. Hickok 2021 Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, United States

Staphylococcus Aureus Floating Biofilm Formation And Phenotype In Synovial Fluid Depends On Albumin, Fibrinogen, And Hyaluronic Acid, Samantha Knott, Dylan Curry, Neil Zhao, Pallavi Metgud, Sana Dastgheyb, Caroline Purtill, Marc I. Harwood, Md, Antonia F Chen, Thomas P Schaer, Michael Otto, Noreen J. Hickok

Department of Orthopaedic Surgery Faculty Papers

Biofilms are typically studied in bacterial media that allow the study of important properties such as bacterial growth. However, the results obtained in such media cannot take into account the bacterial localization/clustering caused by bacteria–protein interactions in vivo and the accompanying alterations in phenotype, virulence factor production, and ultimately antibiotic tolerance. We and others have reported that methicillin-resistant or methicillin-susceptible Staphylococcus aureus (MRSA or MSSA, respectively) and other pathogens assemble a proteinaceous matrix in synovial fluid. This proteinaceous bacterial aggregate is coated by a polysaccharide matrix as is characteristic of biofilms. In this study, we identify proteins important ...


Delivery Of Patient Education And Support Using An Online Digital Platform For Patients Undergoing Primary Hip And Knee Replacement: The Patient’S Perspectives, Paul N. Baker, Natalie L. Clark 2021 South Tees Hospitals NHS Foundation Trust

Delivery Of Patient Education And Support Using An Online Digital Platform For Patients Undergoing Primary Hip And Knee Replacement: The Patient’S Perspectives, Paul N. Baker, Natalie L. Clark

Patient Experience Journal

The aim of the present evaluation was to evaluate the use of an online digital platform (ODP) to deliver patient education and support (PES) to patients undergoing total hip replacement (THR) and total knee replacement (TKR) surgery. Six objectives were outlined to assess the following areas: patient engagement; ease of use; understanding of information; quantity of information; aid of recovery; suggestions for improvements. A qualitative service evaluation of the ODP. Participants included patients who were registered to the platform for THR or TKR, were at least 90 days post-surgery and had accessed at least one carepac. Interviews followed a semi-structured ...


Assessing The Patient-Perceived Monetary Value Of Patient-Reported Outcome Improvement For Patients With Chronic Knee Conditions, Sarah B. Floyd, Alicia Oostdyk, Melanie Cozad, John M. Brooks, Paul Siffri, Brian Burnikel 2021 Clemson University

Assessing The Patient-Perceived Monetary Value Of Patient-Reported Outcome Improvement For Patients With Chronic Knee Conditions, Sarah B. Floyd, Alicia Oostdyk, Melanie Cozad, John M. Brooks, Paul Siffri, Brian Burnikel

Journal of Patient-Centered Research and Reviews

Purpose: The high cost of orthopaedic care has attracted criticism in the current value-based health care environment. The objective of this work was to assess the properties of a willingness to pay (WTP)-based approach to estimate the monetary value that patients place on health improvements in chronic knee conditions following orthopaedic treatment.

Methods: A sample of patients with a chronic knee condition were surveyed between January and May of 2018 at a large orthopaedic practice. Each patient provided their WTP for restoration to ideal knee health and completed the Single Assessment Numerical Evaluation (SANE) to describe their baseline knee ...


Perioperative Family Updates Reduce Anxiety And Improve Satisfaction: A Randomized Controlled Trial, Lindsay S. Howe, Daniel Wigmore, Nathaniel Nelms, Patrick Schottel, Craig Bartlett, David Halsey, Martin Krag, David Lunardini, Robert Monsey, Bruce Beynnon, Michael Blankstein 2021 Larner College of Medicine at the University of Vermont

Perioperative Family Updates Reduce Anxiety And Improve Satisfaction: A Randomized Controlled Trial, Lindsay S. Howe, Daniel Wigmore, Nathaniel Nelms, Patrick Schottel, Craig Bartlett, David Halsey, Martin Krag, David Lunardini, Robert Monsey, Bruce Beynnon, Michael Blankstein

Journal of Patient-Centered Research and Reviews

Purpose: This study aimed to determine if standardized updates at specific perioperative events affect anxiety and satisfaction of the family members and if the length of surgical procedure affects the satisfaction with updates.

Methods: This study was a randomized control trial. In the control group, surgeons communicated with the family only once near the completion of the procedure. In the intervention group, families received electronic updates at 3 significant perioperative events during the procedure. A postoperative survey rating family member satisfaction and anxiety levels, using a Likert scale of 0–5, was administered.

Results: Mean level of overall satisfaction did ...


Patellofemoral Disfunction, Chris Mulholland, MD 2021 Thomas Jefferson University

Patellofemoral Disfunction, Chris Mulholland, Md

Department of Family & Community Medicine Presentations and Grand Rounds

No abstract provided.


Reliability Of The Cutting Alignment Scoring Tool (Cast) To Assess Trunk And Limb Alignment During A 45-Degree Side-Step Cut., Lauren S. Butler, Eryn K. Milian, Amie DeVerna, Kevin Latz, Henry B. Ellis, Alexa R. Martinez, Kristin Hayden, Christian Gerstenkorn, Sara C. Carpenito, Charles W. Wyatt, Dai Sugimoto 2021 Children's Mercy Hospital

Reliability Of The Cutting Alignment Scoring Tool (Cast) To Assess Trunk And Limb Alignment During A 45-Degree Side-Step Cut., Lauren S. Butler, Eryn K. Milian, Amie Deverna, Kevin Latz, Henry B. Ellis, Alexa R. Martinez, Kristin Hayden, Christian Gerstenkorn, Sara C. Carpenito, Charles W. Wyatt, Dai Sugimoto

Manuscripts, Articles, Book Chapters and Other Papers

Background: Three-dimensional (3D) motion analysis is considered the gold standard for evaluating human movement. However, its clinical utility is limited due to cost, operating expertise, and lengthy data processing time. Numerous qualitative scoring systems have been introduced to assess trunk and lower extremity biomechanics during functional tasks. However, the reliability of qualitative scoring systems to evaluate cutting movements is understudied. Purpose/Hypotheses: To assess the inter-rater and intra-rater reliability of the Cutting Alignment Scoring Tool (CAST) among sports medicine providers and to evaluate rater agreement of each component of the CAST. The hypotheses were: 1) there would be good-to-excellent inter-rater ...


A Clinical Review Of Robotic Navigation In Total Knee Arthroplasty: Historical Systems To Modern Design., Ahmed Siddiqi, Timothy Horan, Robert M Molloy, Michael R Bloomfield, Preetesh D Patel, Nicolas S Piuzzi 2021 Philadelphia College of Osteopathic Medicine

A Clinical Review Of Robotic Navigation In Total Knee Arthroplasty: Historical Systems To Modern Design., Ahmed Siddiqi, Timothy Horan, Robert M Molloy, Michael R Bloomfield, Preetesh D Patel, Nicolas S Piuzzi

Orthopedic Surgery Resident Research

Robotic-assisted total knee arthroplasty (RA-TKA) has shown improved reproducibility and precision in mechanical alignment restoration, with improvement in early functional outcomes and 90-day episode of care cost savings compared to conventional TKA in some studies. However, its value is still to be determined.Current studies of RA-TKA systems are limited by short-term follow-up and significant heterogeneity of the available systems.In today's paradigm shift towards an increased emphasis on quality of care while curtailing costs, providing value-based care is the primary goal for healthcare systems and clinicians. As robotic technology continues to develop, longer-term studies evaluating implant survivorship and ...


Early Mobilization Following Elbow Dislocation And Immobilization, Grant Pheil 2021 Georgia College & State University

Early Mobilization Following Elbow Dislocation And Immobilization, Grant Pheil

Graduate Research Posters

Early Mobilization following Elbow Dislocation and Immobilization; Pheil G, Georgia College & State University: Milledgeville, GA.

Background: This case presents a 16-year-old male junior high school soccer athlete. His injury occurred during a homecoming kickball game in which he hyperextended his elbow. The hyperextension resulted in an audible popping sound. Differential Diagnosis: There was an obvious deformity and swelling seen at the athlete’s olecranon process and cubital fossa. The athletic trainer identified a dislocation and reduced the humeroulnar joint on the first attempt. The athletes’ parents were immediately contacted, and he was transported to the orthopedist in town. Neurovascular assessments were WNL; X-ray confirmed proper reduction of dislocation. Treatment: The patient was prescribed a brace and a sling to be worn as immobilization for two weeks. After two weeks, the sling was discontinued, and the arm could be removed from the brace during rehabilitation. From weeks 2-4, thermotherapy and ROM began at the effected and surrounding joints. Around week 3, UBE was introduced. At week 5, full AROM and PROM were achieved as the foundation for strengthening and neuromuscular exercise progression. Progression was followed till week 8, when the athlete stopped ...


Commentary On "A Prospective, Single-Blinded, Bicentric Study, And Literature Review To Assess The Need Of C2-Ganglion Preservation - Saviour's Criteria"., James Harrop 2021 Department of Neurological and Orthopedic Surgery, Thomas Jefferson University, Philadelphia, PA, USA

Commentary On "A Prospective, Single-Blinded, Bicentric Study, And Literature Review To Assess The Need Of C2-Ganglion Preservation - Saviour's Criteria"., James Harrop

Department of Orthopaedic Surgery Faculty Papers

No abstract provided.


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