Orthopedics Commons^™

Defining Outcome Measures For Psoriatic Arthritis: A Report From The Grappa-Omeract Working Group., Alexis Ogdie, Maarten De Wit, Kristina Callis Duffin, Willemina Campbell, Jeffrey Chau, Laura C Coates, Lihi Eder, Musaab Elmamoun, Oliver Fitzgerald, Dafna D Gladman, Niti Goel, Jana James, Umut Kalyoncu, John Latella, Chris Lindsay, Philip Mease, Denis O'Sullivan, Ingrid Steinkoenig, Vibeke Strand, William Tillett, Ana-Maria Orbai

Articles, Abstracts, and Reports

The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)-Outcome Measures in Rheumatology (OMERACT) Psoriatic Arthritis (PsA) Core Set working group recently published the updated 2016 psoriatic arthritis (PsA) core domain set, a set of disease features that should be measured in all clinical trials. At the GRAPPA annual meeting in July 2016, the PsA working group presented the updated PsA core domain set endorsed by 90% of participants at OMERACT in May 2016 and drafted a roadmap for the development of the PsA core outcome measurement set. In this manuscript, we review the development process of the …

The Effect Of Three Different Ankle Braces On Vertical Jump Performance In Female College Volleyball Players, Ashley M. Jefferson

Undergraduate Theses

Background/Purpose: Ankle braces are often used to stabilize the ankle joint of an athlete to reduce the risk of initial injury while participating in athletic activity or to protect the joint from re-injury when returning to play. The purpose of this study was to examine the effects of application of three different braces on vertical jump performance in collegiate female volleyball players. A secondary aim was to compare participant preference and satisfaction on selected characteristics of each of the three different braces.

Subjects: 31 female varsity/club college volleyball players >18 years of age.

Materials/Methods: Health History Assessment and a dynamic …

Posterior Interosseous Nerve Localization Within The Proximal Forearm - A Patient Normalized Parameter, Srinath Kamineni, Crystal R. Norgren, Evan M. Davidson, Ellora P. Kamineni, Andrew S. Deane

Orthopaedic Surgery and Sports Medicine Faculty Publications

AIM

To provide a "patient-normalized" parameter in the proximal forearm.

METHODS

Sixty-three cadaveric upper extremities from thirty-five cadavers were studied. A muscle splitting approach was utilized to locate the posterior interosseous nerve (PIN) at the point where it emerges from beneath the supinator. The supinator was carefully incised to expose the midpoint length of the nerve as it passes into the forearm while preserving the associated fascial connections, thereby preserving the relationship of the nerve with the muscle. We measured the transepicondylar distance (TED), PIN distance in the forearm's neutral rotation position, pronation position, supination position, and the nerve width. …

Anatomic Femoral And Tibial Tunnel Placement During Anterior Cruciate Ligament Reconstruction: Anteromedial Portal All-Inside And Outside-In Techniques, Jeremy M. Burnham, Chaitu S. Malempati, Aaron Carpiaux, Mary Lloyd Ireland, Darren L. Johnson

Orthopaedic Surgery and Sports Medicine Faculty Publications

Tunnel malposition is one of the most common technical reasons for anterior cruciate ligament reconstruction failure. Small changes in tunnel placement can result in significant differences in outcome. More anatomic placement of the tunnels can lead to greater knee stability and a more accurate reproduction of native knee kinematics. This Technical Note describes 2 tibial tunnel–independent methods to obtain anatomic femoral tunnel placement. The all-inside anteromedial portal technique requires only minimal surgical incisions but allows precise femoral tunnel placement. However, hyperflexion of the knee is required, adequate surgical assistance is necessary, and this technique may be susceptible to graft-tunnel mismatch. …

Rare Complications Of Cervical Spine Surgery: Pseudomeningocoele., Tamir Ailon, Justin S. Smith, Ahmad Nassr, Zachary A. Smith, Wellington K. Hsu, Michael G. Fehlings, David E. Fish, Jeffrey C. Wang, Alan S. Hilibrand, Praveen V. Mummaneni, Dean Chou, Rick C. Sasso, Vincent C. Traynelis, Paul M. Arnold, Thomas E. Mroz, Zorica Buser, Elizabeth L L. Lord, Eric M. Massicotte, Arjun S. Sebastian, Khoi D. Than, Michael P. Steinmetz, Gabriel A. Smith, Jonathan Pace, Mark Corriveau, Sungho Lee, K. Daniel Riew, Christopher Shaffrey

Rothman Institute Papers

STUDY DESIGN: This study was a retrospective, multicenter cohort study.

OBJECTIVES: Rare complications of cervical spine surgery are inherently difficult to investigate. Pseudomeningocoele (PMC), an abnormal collection of cerebrospinal fluid that communicates with the subarachnoid space, is one such complication. In order to evaluate and better understand the incidence, presentation, treatment, and outcome of PMC following cervical spine surgery, we conducted a multicenter study to pool our collective experience.

METHODS: This study was a retrospective, multicenter cohort study of patients who underwent cervical spine surgery at any level(s) from C2 to C7, inclusive; were over 18 years of age; and …

Iatrogenic Spinal Cord Injury Resulting From Cervical Spine Surgery., Alan H. Daniels, Robert A. Hart, Alan S. Hilibrand, David E. Fish, Jeffrey C. Wang, Elizabeth L. Lord, Zorica Buser, P. Justin Tortolani, D. Alex Stroh, Ahmad Nassr, Bradford L. Currier, Arjun S. Sebastian, Paul M. Arnold, Michael G. Fehlings, Thomas E. Mroz, K. Daniel Riew

Rothman Institute Papers

STUDY DESIGN: Retrospective cohort study of prospectively collected data.

OBJECTIVE: To examine the incidence of iatrogenic spinal cord injury following elective cervical spine surgery.

METHODS: A retrospective multicenter case series study involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network was conducted. Medical records for 17 625 patients who received cervical spine surgery (levels from C2 to C7) between January 1, 2005, and December 31, 2011, were reviewed to identify occurrence of iatrogenic spinal cord injury.

RESULTS: In total, 3 cases of iatrogenic spinal cord injury following cervical spine surgery were identified. Institutional incidence rates ranged …

Epidemiology And Outcomes Of Vertebral Artery Injury In 16 582 Cervical Spine Surgery Patients: An Aospine North America Multicenter Study., Wellington K. Hsu, Abhishek Kannan, Harry T. Mai, Michael G. Fehlings, Zachary A. Smith, Vincent C. Traynelis, Ziya L. Gokaslan, Alan S. Hilibrand, Ahmad Nassr, Paul M. Arnold, Thomas E. Mroz, Mohamad Bydon, Eric M. Massicotte, Wilson Z. Ray, Michael P. Steinmetz, Gabriel A. Smith, Jonathan Pace, Mark Corriveau, Sungho Lee, Robert E Isaacs, Jeffrey C. Wang, Elizabeth L. Lord, Zorica Buser, K. Daniel Riew

Rothman Institute Papers

STUDY DESIGN: A multicenter retrospective case series was compiled involving 21 medical institutions. Inclusion criteria included patients who underwent cervical spine surgery between 2005 and 2011 and who sustained a vertebral artery injury (VAI).

OBJECTIVE: To report the frequency, risk factors, outcomes, and management goals of VAI in patients who have undergone cervical spine surgery.

METHODS: Patients were evaluated on the basis of condition-specific functional status using the Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA) score, the Nurick scale, and the 36-Item Short-Form Health Survey (SF-36).

RESULTS: VAIs were identified in a total of 14 of 16 582 …

C5 Palsy After Cervical Spine Surgery: A Multicenter Retrospective Review Of 59 Cases., Sara E. Thompson, Zachary A. Smith, Wellington K. Hsu, Ahmad Nassr, Thomas E. Mroz, David E. Fish, Jeffrey C. Wang, Michael G. Fehlings, Chadi A. Tannoury, Tony Tannoury, P. Justin Tortolani, Vincent C. Traynelis, Ziya Gokaslan, Alan S. Hilibrand, Robert E. Isaacs, Praveen V. Mummaneni, Dean Chou, Sheeraz A. Qureshi, Samuel K. Cho, Evan O. Baird, Rick C. Sasso, Paul M. Arnold, Zorica Buser, Mohamad Bydon, Michelle J Clarke, Anthony F. De Giacomo, Adeeb Derakhshan, Bruce Jobse, Elizabeth L. Lord, Daniel Lubelski, Eric M. Massicotte, Michael P. Steinmetz, Gabriel A. Smith, Jonathan Pace, Mark Corriveau, Sungho Lee, Peter I. Cha, Dhananjay Chatterjee, Erica L. Gee, Erik N. Mayer, Owen J. Mcbride, Allison K. Roe, Marisa Y. Yanez, D. Alex Stroh, Khoi D. Than, K. Daniel Riew

Rothman Institute Papers

STUDY DESIGN: A multicenter, retrospective review of C5 palsy after cervical spine surgery.

OBJECTIVE: Postoperative C5 palsy is a known complication of cervical decompressive spinal surgery. The goal of this study was to review the incidence, patient characteristics, and outcome of C5 palsy in patients undergoing cervical spine surgery.

METHODS: We conducted a multicenter, retrospective review of 13 946 patients across 21 centers who received cervical spine surgery (levels C2 to C7) between January 1, 2005, and December 31, 2011, inclusive. P values were calculated using 2-sample t test for continuous variables and χ(2) tests or Fisher exact tests for …

Epidural Hematoma Following Cervical Spine Surgery., Gregory D. Schroeder, Alan S. Hilibrand, Paul M. Arnold, David E. Fish, Jeffrey C. Wang, Jeffrey L. Gum, Zachary A. Smith, Wellington K. Hsu, Ziya L. Gokaslan, Robert E. Isaacs, Adam S. Kanter, Thomas E. Mroz, Ahmad Nassr, Rick C. Sasso, Michael G. Fehlings, Zorica Buser, Mohamad Bydon, Peter I. Cha, Dhananjay Chatterjee, Erica L. Gee, Elizabeth L. Lord, Erik N. Mayer, Owen J. Mcbride, Emily C. Nguyen, Allison K. Roe, P. Justin Tortolani, D. Alex Stroh, Marisa Y. Yanez, K. Daniel Riew

Rothman Institute Papers

STUDY DESIGN: A multicentered retrospective case series.

OBJECTIVE: To determine the incidence and circumstances surrounding the development of a symptomatic postoperative epidural hematoma in the cervical spine.

METHODS: Patients who underwent cervical spine surgery between January 1, 2005, and December 31, 2011, at 23 institutions were reviewed, and all patients who developed an epidural hematoma were identified.

RESULTS: A total of 16 582 cervical spine surgeries were identified, and 15 patients developed a postoperative epidural hematoma, for a total incidence of 0.090%. Substantial variation between institutions was noted, with 11 sites reporting no epidural hematomas, and 1 site reporting an …

Misplaced Cervical Screws Requiring Reoperation., Jeremy C. Peterson, Paul M. Arnold, Zachary A. Smith, Wellington K. Hsu, Michael G. Fehlings, Robert A. Hart, Alan S. Hilibrand, Ahmad Nassr, Ra'kerry K. Rahman, Chadi A. Tannoury, Tony Tannoury, Thomas E. Mroz, Bradford L. Currier, Anthony F. De Giacomo, Jeremy L. Fogelson, Bruce C. Jobse, Eric M. Massicotte, K. Daniel Riew

Rothman Institute Papers

STUDY DESIGN: A multicenter, retrospective case series.

OBJECTIVE: In the past several years, screw fixation of the cervical spine has become commonplace. For the most part, this is a safe, low-risk procedure. While rare, screw backout or misplaced screws can lead to morbidity and increased costs. We report our experiences with this uncommon complication.

METHODS: A multicenter, retrospective case series was undertaken at 23 institutions in the United States. Patients were included who underwent cervical spine surgery from January 1, 2005, to December 31, 2011, and had misplacement of screws requiring reoperation. Institutional review board approval was obtained at all …

Incidence And Outcomes Of Acute Implant Extrusion Following Anterior Cervical Spine Surgery., Gabriel A. Smith, Jonathan Pace, Mark Corriveau, Sungho Lee, Thomas E. Mroz, Ahmad Nassr, Michael G. Fehlings, Robert A. Hart, Alan S. Hilibrand, Paul M. Arnold, David B. Bumpass, Ziya Gokaslan, Mohamad Bydon, Jeremy L. Fogelson, Eric M. Massicotte, K. Daniel Riew, Michael P. Steinmetz

Rothman Institute Papers

STUDY DESIGN: Multi-institutional retrospective case series of 8887 patients who underwent anterior cervical spine surgery.

OBJECTIVE: Anterior decompression from discectomy or corpectomy is not without risk. Surgical morbidity ranges from 9% to 20% and is likely underreported. Little is known of the incidence and effects of rare complications on functional outcomes following anterior spinal surgery. In this retrospective review, we examined implant extrusions (IEs) following anterior cervical fusion.

METHODS: A retrospective multicenter case series study involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network. Medical records for 17 625 patients who received cervical spine surgery (levels …

Outcomes Of Internal Hemipelvectomy For Pelvic Tumors: A Developing Country’S Prospective, Masood Umer, Rizwan Haroon Rashid, Yasir Mohib, Haroon Rashid

Department of Surgery Docs

Introduction: Previously, external hemipelvectomy was the mainstay of treatment for pelvic tumors. However, with technological advancements, limb salvage procedures such as internal hemipelvectomy have emerged as a viable alternative. However, there is limited literature available on long-term outcomes and complications of internal hemipelvectomy, especially from developing countries. Therefore, the objective of this study was to share our experience of internal hemipelvectomy at a tertiary care center in a developing country. Materials and methods: A retrospective review was conducted in which all 24 patients undergoing internal hemipelvectomy from January 1, 2005 to December 31, 2015 at our institution were included. Medical …

A Case Series On Nutrition In Hip Fracture Patients: A Mismatch Between Needs And Dietary Intake, Njalalle Baraza, Eamon Ramhamadany, Thomas Laios

General Surgery, East Africa

Hip fractures are common in the United Kingdom with an overall estimated annual incidence of 100 fractures per 10,000 of the population for males and 81 per 10,000 for females [1], and with an ageing population this figure is set to rise [2]. From recent estimates, this costs the British tax payer over £750,000,000 a year, with over half this amount spent in social care of the patients recovering from the fracture [3]. Elderly hip fracture patients often have co-morbidities and mortality in the first year can be as high as 33% [4].

Outpatient Percutaneous Release Of Trigger Finger: A Cost Effective And Safe Procedure, Marij Zahid, Aurangzeb Qureshi, Rizwan H. R, Haroon Rashid, Pervaiz M. Hashmi

Section of Orthopaedic Surgery

Introduction: Trigger finger is a common cause of pain and disability of the hand. Percutaneous release results in earlier functional recovery and patient satisfaction. This is a rapid and cost-effective method which saves a surgical procedure and results in better functional outcome.
Materials and Methods: This is a prospective observational study conducted on fifty-two fingers and thumbs in 52 patients treated from 1st July 2014 till 31st December 2014, in the Orthopaedic Section, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan. All the baseline characteristics of the patients, like demographics, symptoms, Quinell's criteria and functional outcome were recorded. The …

Osteoporosis Treatment Efficacy For Men: A Systematic Review And Meta-Analysis., Smita Nayak, Susan L Greenspan

Articles, Abstracts, and Reports

OBJECTIVES: To evaluate the efficacy of treatment options to reduce osteoporotic fracture risk in men.

DESIGN: Systematic review and meta-analysis.

SETTING: Randomized clinical trials that evaluated the efficacy of a treatment for osteoporosis or low bone mineral density for adult men and reported fracture outcomes.

PARTICIPANTS: Men.

MEASUREMENTS: PubMed, Embase, and the Cochrane Library databases were searched for relevant studies. Information was extracted from included studies on participant sociodemographic characteristics, number of male participants, treatment evaluated, comparator for evaluated treatment, study duration, and fracture outcomes. Risk of bias of individual studies was assessed using measures recommended by the Cochrane Collaboration. …

Surgical Site Infection And Transfusion Rates Are Higher In Underweight Total Knee Arthroplasty Patients., Jorge Manrique, Antonia F. Chen, Md, Mba, Miguel M. Gomez, Mitchell Maltenfort, Phd, William J. Hozack Md

Rothman Institute Papers

BACKGROUND: Underweight (UW) patients undergoing total hip arthroplasty have exhibited higher complication rates, including infection and transfusion. No study to our knowledge has evaluated UW total knee arthroplasty (TKA) patients. We, therefore, conducted a study to investigate if these patients are at increased risk for complications, including infection and transfusion.

METHODS: A case-control study was conducted using a prospectively collected institutional database. Twenty-seven TKA patients were identified as UW (body mass index [BMI] < 18.5 kg/m

RESULTS: The average BMI was 17.1 kg/m

CONCLUSIONS: Our study demonstrates that UW TKA patients have a higher likelihood of developing SSI and requiring blood transfusions. The …

Epidemiology And Impact Of Abdominal Oblique Injuries In Major And Minor League Baseball., Christopher L Camp, Stan Conte, Steven B. Cohen, Matthew Thompson, John D' Angelo, Joseph T Nguyen, Joshua S Dines

Rothman Institute Papers

BACKGROUND: Oblique injuries are known to be a common cause of time out of play for professional baseball players, and prior work has suggested that injury rates may be on the rise in Major League Baseball (MLB).

PURPOSE: To better understand the current incidence of oblique injuries, determine their impact based on time out of play, and to identify common injury patterns that may guide future injury prevention programs.

STUDY DESIGN: Descriptive epidemiological study.

METHODS: Using the MLB Health and Injury Tracking System, all oblique injuries that resulted in time out of play in MLB and Minor League Baseball (MiLB) …

Technical Considerations In Revision Anterior Cruciate Ligament Reconstruction For Operative Techniques In Orthopaedics, Jeremy M. Burnham, Elmar Herbst, Thierry Pauyo, Thomas Pfeiffer, Darren L. Johnson, Freddie H. Fu, Volker Musahl

Orthopaedic Surgery and Sports Medicine Faculty Publications

As the incidence of anterior cruciate ligament (ACL) reconstruction continues to increase, the rate of revision surgery continues to climb. Revision surgery has inherent challenges that must be addressed to achieve successful results. The cause of the primary ACL reconstruction failure should be determined and careful preoperative planning should be performed to address the cause(s) of failure. Each patient undergoing revision surgery should undergo a thorough history and physical examination, receive full-length alignment radiographs, lateral radiographs, 45° flexion weight-bearing posteroanterior radiographs, and patellofemoral radiographs. The 3-dimensional computed tomography scan should be performed to assess tunnel position and widening. Magnetic resonance …

High-Speed Video Capture Of Anterior Cruciate Ligament Tear, Steven L. Cook, Devon T. Smith

Biomedical Engineering Western Regional Conference

High-speed Video Capture of Anterior Cruciate Ligament Tear

Enhancement Of Fracture Healing In The Rat, Modulated By Compounds That Stimulate Inducible Nitric Oxide Synthase: Acceleration Of Fracture Healing Via Inducible Nitric Oxide Synthase., R A Rajfer, A Kilic, Andrew S Neviaser, L M Schulte, S M Hlaing, J Landeros, M G Ferrini, E Ebramzadeh, S-H Park

Orthopaedic Surgery Faculty Publications

OBJECTIVES: We investigated the effects on fracture healing of two up-regulators of inducible nitric oxide synthase (iNOS) in a rat model of an open femoral osteotomy: tadalafil, a phosphodiesterase inhibitor, and the recently reported nutraceutical, COMB-4 (consisting of L-citrulline, Paullinia cupana, ginger and muira puama), given orally for either 14 or 42 days.

MATERIALS AND METHODS: Unilateral femoral osteotomies were created in 58 male rats and fixed with an intramedullary compression nail. Rats were treated daily either with vehicle, tadalafil or COMB-4. Biomechanical testing of the healed fracture was performed on day 42. The volume, mineral content and bone density …