Orthopedics Commons^™

Doha Agreement Meeting On Terminology And Definitions In Groin Pain In Athletes, A. Weir, P. Brukner, E. Delahunt, J. Ekstrand, G. Lovell, T. Tyler, G. Verrall, R. J. De Vos, Z. Vuckovic, P. Holmich, +14 Additional Authors

Journal Articles

Background Heterogeneous taxonomy of groin injuries in athletes adds confusion to this complicated area. Aim The 'Doha agreement meeting on terminology and definitions in groin pain in athletes' was convened to attempt to resolve this problem. Our aim was to agree on a standard terminology, along with accompanying definitions. Methods A one-day agreement meeting was held on 4 November 2014. Twenty-four international experts from 14 different countries participated. Systematic reviews were performed to give an up-to-date synthesis of the current evidence on major topics concerning groin pain in athletes. All members participated in a Delphi questionnaire prior to the meeting. …

Platelet-Rich Plasma And Other Cellular Strategies In Orthopedic Surgery, P. N. Williams, G. Moran, J. P. Bradley, N. S. Elattrache, J. S. Dines

Journal Articles

The use of biologics in the treatment of musculoskeletal disease has become increasingly more common as research studies continue to provide further elucidation of their mechanisms in healing. Platelet-rich plasma, patches, growth factors, and stem cells are among the many biologics under active investigation and have varying levels of success in augmenting surgical or nonoperative interventions. However, the limitations of these treatments exist, and clear guidelines for their indications and application have yet to be established. Well-designed clinical trials will help determine the appropriate future use of biologics to ensure consistent outcomes.

Pregabalin And Pain After Total Knee Arthroplasty: A Double-Blind, Randomized, Placebo-Controlled, Multidose Trial, J. T. Yadeau, Y. Lin, D. J. Mayman, E. A. Goytizolo, M. M. Alexiades, D. E. Padgett, K. G. Fields, A. K. Goon, J. Curren, G. H. Westrich, +4 Additional Authors

Journal Articles

BACKGROUND: Pregabalin may reduce postoperative pain and opioid use. Higher doses may be more effective, but may cause sedation and confusion. This prospective, randomized, blinded, placebo-controlled study tested the hypothesis that pregabalin reduces pain at 2 weeks after total knee arthroplasty, but increases drowsiness and confusion. METHODS: Patients (30 per group) received capsules containing pregabalin (0, 50, 100, or 150 mg); two capsules before surgery, one capsule twice a day until postoperative day (POD) 14, one on POD15, and one on POD16. Multimodal analgesia included femoral nerve block, epidural analgesia, oxycodone-paracetamol, and meloxicam. The primary outcome was pain with flexion …

Effect Of Bone Loss In Anterior Shoulder Instability, G. H. Garcia, J. N. Liu, D. M. Dines, J. S. Dines

Journal Articles

Anterior shoulder instability with bone loss can be a difficult problem to treat. It usually involves a component of either glenoid deficiency or a Hill-Sachs lesion. Recent data shows that soft tissue procedures alone are typically not adequate to provide stability to the shoulder. As such, numerous surgical procedures have been described to directly address these bony deficits. For glenoid defects, coracoid transfer and iliac crest bone block procedures are popular and effective. For humeral head defects, both remplissage and osteochondral allografts have decreased the rates of recurrent instability. Our review provides an overview of current literature addressing these treatment …

Integrating Biodegradable 3-Dimensional-Printing Into Tracheal Reconstruction, T. Goldstein, L. Smith, B. Smith, D. Grande, D. Zeltsman

Journal Articles

No abstract provided.

Comorbid Profile Rather Than Age Determines Hip Fracture Mortality In A Nonagenarian Population, A. Graver, S. Merwin, L. Collins, N. Kohn, A. Goldman

Journal Articles

BACKGROUND: In light of poor outcomes with nonoperative management of hip fractures, orthopedic surgeons are faced with difficult decisions about which patients are too ill or too old for surgical treatment. QUESTIONS/PURPOSES: This study sought to investigate if patients over 90 years had different preoperative laboratory, clinical, and injury characteristics than younger patients with the same injury. We compared our cohort with previously published data. We wished to identify if there were pre-injury risk factors associated with 30-day mortality, which could be modified to enhance postoperative outcomes. METHODS: This is a retrospective review of 198 operatively managed hip fractures in …

Shoulder Arthroplasty: Return To Sport, M. M. Khair, J. S. Dines, D. M. Dines

Journal Articles

CONTEXT: Increasingly, total shoulder arthroplasty is being performed not only to treat the pain associated with glenohumeral arthritis but also to return patients to the level of activity and function they enjoyed prior to the development of arthritis. While return to sport and activity have been studied in the total knee and total hip replacement literature, it is only relatively recently that the same focus has been placed on total shoulder replacements. EVIDENCE ACQUISITION: PubMed database from the years 2000 to 2014. All studies relevant to shoulder arthroplasty and return to sport were included in the review. STUDY DESIGN: Clinical …

Coping With Congenital Hand Differences, L. E. Franzblau, K. C. Chung, N. Carlozzi, A. Y. T. Chin, K. W. Nellans, J. F. Waljee

Journal Articles

Background: Although functional outcomes following reconstruction for congenital hand differences are frequently described, much less is known regarding children's ability to cope with the psychosocial effects of these conditions. The authors qualitatively explored stress and coping mechanisms among children following reconstructive surgery for congenital hand differences. Methods: Forty patients and their parents participated in semistructured interviews examining children's stress related to hand functioning and appearance, emotional responses to stress, and coping strategies. Interviews were audiotaped, transcribed, and analyzed thematically. A consensus taxonomy for classifying content evolved from comparisons of coding by two reviewers. Themes expressed by participants were studied for …

A New Method For Calculating Femoral Anterior Cortex Point Location And Its Effect On Component Sizing And Placement, M. R. Mahfouz, E. E. A. Fatah, L. Bowers, G. Scuderi

Journal Articles

Variation in anterior femoral cortex morphology can cause improper component placement and alignment. When surgical inaccuracies occur, the mechanical properties of the distal femur may be altered, which could result in lower surgical success rates and an increased chance of postoperative complications. The purpose of the study is to come up with a reproducible computational algorithm to simulate what the surgeon does in the operating room. This method could help in surgical preplanning, patient-specific instruments, and implant design. From there, we evaluated (1) the angular difference between reference alignment axes; and (2) whether the location of the anterior cortex point …

Minimally Invasive Knee Arthroplasty: An Overview, A. J. Tria, G. R. Scuderi

Journal Articles

Minimally invasive surgery (MIS) for arthroplasty of the knee began with surgery for unicondylar knee arthroplasty (UKA). Partial knee replacements were designed in the 1970s and were amenable to a more limited exposure. In the 1990s Repicci popularized the MIS for UKA. Surgeons began to apply his concepts to total knee arthroplasty. Four MIS surgical techniques were developed: quadriceps sparing, mini-mid vastus, mini-subvastus, and mini-medial parapatellar. The quadriceps sparing technique is the most limited one and is also the most difficult. However, it is the least invasive and allows rapid recovery. The mini-midvastus is the most common technique because it …

Biologics In Achilles Tendon Healing And Repair: A Review, E. Shapiro, D. Grande, M. Drakos

Journal Articles

Injuries of the Achilles tendon are relatively common with potentially devastating outcomes. Healing Achilles tendons form a fibrovascular scar resulting in a tendon which may be mechanically weaker than the native tendon. The resulting strength deficit causes a high risk for reinjury and other complications. Treatments using biologics aim to restore the normal properties of the native tendon and reduce the risk of rerupture and maximize tendon function. The purpose of this review was to summarize the current findings of various therapies using biologics in an attempt to improve the prognosis of Achilles tendon ruptures and tendinopathies. A PubMed search …

Research Round-Up: Manual Muscle Testing, Mary Insana Fisher, Shana Harrington

Physical Therapy Faculty Publications

Manual muscle testing was developed in response to the need to assess muscle strength losses during the polio outbreak in early part of the 20th century. The development of this original method is credited to Wilhelmine Wright and Robert W. Lovett, MD. Wright presented this method in 1912 in the Boston Medical Surgical Journal, and Lovett expanded the description of the testing method in 1916 in the Journal of the American Medical Association. The development of quantifying muscle strength by rating force generated against external resistance was an important development in objectifying assessment methods of the time.

Today, manual muscle …

Workup And Treatment Of Acute Peripheral Nerve Injuries: A Review, Scott D. Evans

UNM Orthopaedic Research Journal

Peripheral nerve injury (PNI) can be a devastating and life-changing condition, normally caused from traumatic and iatrogenic events. Proper treatment of PNI remains difficult, with less than half of surgical procedures resulting in good or excellent outcomes. Subsequently, physicians should be aware of important principles that can help with management of acute PNI. I reviewed studies on PNI involving anatomy and classification schemes; workup such as electrodiagnostic tests, imaging procedures, and surgical indications; and operative treatment options (including nerve repair and use of nerve grafts and conduits, and nerve, muscle, and tendon transfers). Although treatment of these injuries continues to …

Screening And Surveillance Ct Abdomen/Pelvis For Metastases In Patients With Soft-Tissue Sarcoma Of The Extremity, M. J. Thompson, J. Ross, G. Domson, W. Foster

Orthopaedic Surgery Publications

Objectives The clinical utility of routine cross sectional imaging of the abdomen and pelvis in the screening and surveillance of patients with primary soft-tissue sarcoma of the extremities for metastatic disease is controversial, based on its questionable yield paired with concerns regarding the risks of radiation exposure, cost, and morbidity resulting from false positive findings.

Methods Through retrospective review of 140 patients of all ages (mean 53 years; 2 to 88) diagnosed with soft-tissue sarcoma of the extremity with a mean follow-up of 33 months (0 to 291), we sought to determine the overall incidence of isolated abdominopelvic metastases, their …

Celebrating The Life, Laughter, And Leadership Of Dr. Dale V. Hoekstra, Robert C. Schenck Jr

UNM Orthopaedic Research Journal

No abstract provided.

Complications And Predictors Of Need For Return To The Operating Room In The Treatment Of Supracondylar Humerus Fractures In Children, Matthew E. Oetgen, Gudrun E. Mirick, Lara Atwater, John F. Lovejoy

Orthopaedic Surgery Faculty Publications

Supracondylar humerus fractures are common pediatric injuries. Little is known about the risk factors for repeat operative procedures. A retrospective chart review of 709 patients treated for a displaced supracondylar humerus fracture was performed to identify risk factors for return to the operating room during the initial post-operative period. Deviations of routine fracture care were recorded and complication rates were compared between Gartland type 2 and 3 fractures using logistic regression. Type 3 fractures were found to have a higher complication rate, and, specifically, more peri-operative nerve palsies, more likely to need to return to the operating room for hardware …

Initial Report Of The Osteogenesis Imperfecta Adult Natural History Initiative., Laura L. Tosi, Matthew E. Oetgen, Marianne K Floor, Mary Beth Huber, Ann M Kennelly, Robert J. Mccarter, +5 Additional Authors

Orthopaedic Surgery Faculty Publications

BACKGROUND: A better understanding of the natural history of osteogenesis imperfecta (OI) in adulthood should improve health care for patients with this rare condition.

METHODS: The Osteogenesis Imperfecta Foundation established the Adult Natural History Initiative (ANHI) in 2010 to give voice to the health concerns of the adult OI community and to begin to address existing knowledge gaps for this condition. Using a web-based platform, 959 adults with self-reported OI, representing a wide range of self-reported disease severity, reported symptoms and health conditions, estimated the impact of these concerns on present and future health-related quality of life (QoL) and completed …

Vacuum Assisted Closure-Utilization As Home Based Therapy In The Management Of Complex Diabetic Extremity Wounds, Kamran Hafeez, Haroon Ur Rashid, Ghulam Mustafa Karim Khani, Darshan Kumar, Sunil Kumar

Section of Orthopaedic Surgery

Objective: Vacuum assisted closure is a reported technique to manage complex wounds. We have utilized this technique by using simple locally available material in the management of our patients on outpatient basis. The objective of this study is to present our experience.
Methods: This study was conducted from June 2011 to June 2013 at Dow University Hospital and Aga Khan University Hospital, Karachi. There were 38 patients managed with vacuum assisted closure. Mean age was 56±7.8 years. Twenty three patients presented with necrotizing fasciitis and 15 patients with gangrene. Lower limbs were involved in majority of the patients. Debridement or …

Biocompatibility Of Nano-Crystalline Coatings Produced By Ion Beam Assisted Deposition (Ibad), Raheleh Miralami, Geoffrey M. Thiele, J. Graham Sharp, Fereydoon Namavar, Kevin L. Garvin

Posters and Presentations: Orthopaedic Surgery & Rehab

No abstract provided.

The Role Of Occupational Therapy In Primary Care, Priti Patel

Occupational Therapy Doctorate Capstone Projects

The Capstone Project is focused on communicating, influencing and educating other health care professionals regarding the role of occupational therapy in the future model of primary care delivery initiated by the adoption of the Affordable Care Act and the Triple Aim Initiative. Currently, primary care, the largest health care platform in United States, is not inclusive of occupational therapy services. Occupational therapists have the scope, knowledge and understanding to be part of the redesigned team model of primary care. Educating those currently working in primary care about adding occupational therapy services can have a significant impact on the profession of …