Orthopedics Commons^™

Fabricating Silver-Ceria Polymer Nanocomposite Scaffolds For Biomedical Therapeutic Applications, Shreya S. Pawar

Honors Undergraduate Theses

Improper healing of bone fractures and limited regeneration of bone following bone tumor resection remain a prevalent complication worldwide. Long-term effects of this include joint instability, limited movement, and arthritis. Bone infections (osteomyelitis), reactive oxygen species (ROS) generation via excessive inflammation, and underlying conditions such as osteoporosis can contribute to suboptimal bone tissue regeneration. ROS accumulation stimulates osteoblast apoptosis, while promoting osteoclast differentiation. These processes inhibit mineralization and osteogenesis. Conventional therapeutics involve the utilization of drugs and bone grafts. However, these approaches pose limitations and can result in subsequent complications. Microbial infections, ROS accumulation, and excessive inflammations are factors that …

A Spine-Specific Lexicon For The Sentiment Analysis Of Interviews With Adult Spinal Deformity Patients Correlate With Sf-36, Sf-36, And Odi Scores: A Pilot Study Of 25 Patients, Ross Gore, Michael M. Safaee, Christopher J. Lynch, Christopher P. Ames

VMASC Publications

Classic health-related quality of life (HRQOL) metrics are cumbersome, time-intensive, and subject to biases based on the patient’s native language, educational level, and cultural values. Natural language processing (NLP) converts text into quantitative metrics. Sentiment analysis enables subject matter experts to construct domain-specific lexicons that assign a value of either negative (−1) or positive (1) to certain words. The growth of telehealth provides opportunities to apply sentiment analysis to transcripts of adult spinal deformity patients’ visits to derive a novel and less biased HRQOL metric. In this study, we demonstrate the feasibility of constructing a spine-specific lexicon for sentiment analysis …

Back Matter, Arianna Medina

Western Journal of Orthopaedics

No abstract provided.

A Brief History Of Opioid-Use Disorder In The United States, Effect On Orthopaedics, And Current Management Options, William Curtis, Nicholas Newcomb, Eric S. Kruger, Christopher L. Shultz

Western Journal of Orthopaedics

Declared a public health emergency in 2017 and leading to 11 million years of life lost worldwide, the American opioid crisis has impacted millions of people, with up to 7 million experiencing opioid use disorder. In orthopaedic surgery, opioid analgesia has been associated with various complications, including infections, deep vein thrombosis, prolonged hospital stays, and overall inferior outcomes after surgical procedures. Orthopaedic surgeons commonly rely on opioids to provide postoperative analgesia and may frequently encounter patients with opioid use disorder. It is therefore essential that orthopaedic surgeons understand opioid use disorder, its effect on orthopaedic outcomes, and management of opioid …

Scar Tissue Adhesions, Neuromuscular Guarding, And Functional Recovery: A Case Report Of Physical Therapy Post-Cholecystectomy, Raeisa Griñe, Adam Walsh

Western Journal of Orthopaedics

Scar tissue from abdominal surgeries, such as cholecystectomy, can lead to long-term issues such as restricted movement, painful spasms, and impaired function. Laparoscopic adhesiolysis is a common surgical treatment for pathological scar tissue impairments. Conservative care, such as physical therapy, is a commonly used approach for managing pathological scar tissue. In this case, manual therapy techniques and targeted exercises successfully reduced the intensity and frequency of abdominal spasms, improved core strength and endurance, and enhanced overall functional mobility. These improvements were reflected in enhanced scores on the Lower Extremity Functional Scale and the Vancouver Scar Scale in a 59-year-old woman …

Introducing The University Of New Mexico 12-Level Functional Scale: A Novel Approach For Assessing Functional Recovery In Orthopaedic Trauma Patients, Devin A. Maez, Rick J. Gehlert, Thomas A. Decoster

Western Journal of Orthopaedics

The University of California at Los Angeles (UCLA) Activity Scale and other common activity scales are primarily used for patients undergoing joint reconstructive surgery. However, no such scale exists for musculoskeletal trauma patients. The authors propose The University of New Mexico (UNM) 12-Level Functional Activity Scale to address this gap in assessing functional activity and managing postoperative care for orthopaedic trauma patients. A comprehensive review of existing scales led to the development of the UNM Scale, emphasizing simplicity, objectivity, and potential benefits in patient education and interdisciplinary collaboration. The UNM Scale provides a structured approach to assess and monitor functional …

Fluoroscopy-Guided Versus 3d Navigated Percutaneous Sacroiliac Screw Fixation: A Comparison Of Radiation Exposure And Surgical Duration, Tyler J. Chavez, Jeremiah M. Langsfeld, Solomon Oloyede, Gordon H. Lee, Urvij Modhia

Western Journal of Orthopaedics

Background: Pelvic ring injuries are complex surgical challenges requiring significant radiation exposure for safe placement of sacroiliac (SI) screw fixation. Traditionally, SI fixation has been performed with conventional C-arm fluoroscopy to guide screw placement. 3D navigated imaging is a technique that uses fluoroscopic scans and a navigation tracker to guide screws in space. The purpose of this study is to characterize a single institution’s experience with navigated SI fixation and the resulting radiation exposure to patient and staff. Methods: Records of 60 patients who underwent SI fixation using either conventional fluoroscopy (43) or 3D navigation (17) were reviewed. Exposure data …

Fishtail Deformity Complication Of Distal Humeral Fractures In Children, Jorge E. Licano, Ryan Price, Devin A. Maez, Selina A. Silva

Western Journal of Orthopaedics

Background: Pelvic ring injuries are complex surgical challenges requiring significant radiation exposure for safe placement of sacroiliac (SI) screw fixation. Traditionally, SI fixation has been performed with conventional C-arm fluoroscopy to guide screw placement. 3D navigated imaging is a technique that uses fluoroscopic scans and a navigation tracker to guide screws in space. The purpose of this study is to characterize a single institution’s experience with navigated SI fixation and the resulting radiation exposure to patient and staff. Methods: Records of 60 patients who underwent SI fixation using either conventional fluoroscopy (43) or 3D navigation (17) were reviewed. Exposure data …

Rare Case Of Fungal Osteomyelitis Affecting An Intramedullary Lag Screw, Matthew C. Watterson, Robert T. Rella, Timothy K. Summers, David Michaeli, Jess Mullens

Western Journal of Orthopaedics

Osteomyelitis is an infection of the bone that is most commonly of bacterial origin. Cases of fungal osteomyelitis are rare, and treatment often requires a prolonged course of antimicrobials. The authors report a case of a 72-year old man with fungal osteomyelitis affecting an intracortical lag screw, which was discovered during fixation of the left femoral shaft following an injury that occurred 68 years after placement of the affected lag screw. Chronic osteomyelitis can be indolent and subclinical, with the patient experiencing no signs or symptoms of the disease despite having bone infection for decades. This condition may become clinically …

Closed Treatment Of Displaced Radial Neck Fracture In An Adult, Nicholas Newcomb, Tomas Holy, Naomi Kelley, Nathan T. Morrell

Western Journal of Orthopaedics

Making up 1.5% to 4.0% of all fractures, radial head and neck fractures are typically treated based on the severity of angulation at the radial neck or if range of motion (ROM) is blocked. In this study, we present a case of a 43-year old woman with a Mason Type 2 radial neck fracture, successfully treated with closed reduction and one week of immobilization, resulting in near anatomic radial neck angulation without the need for operative intervention. The patient returned to work within two weeks and regained full ROM by six months, maintaining near anatomic reduction throughout. Keywords: Elbow Injury; …

Two-Stage Total Knee Arthroplasty (Tka) For A Rigid And Infected Knee: A Rare Case Report Of Aspergillosis, Túlio Vinícius De Oliveira Campos, David G. Kasuya Barbosa, Victor A. Kasuya Barbosa, Santiago Enrique Sarmiento Molina, Guilherme Moreira De Abreu Silva, Marco Antônio Percope De Andrade

Western Journal of Orthopaedics

Knee infection caused by Aspergillus is a rare condition that presents a diagnostic challenge for orthopaedic surgeons and musculoskeletal specialists. This case report aims to describe the treatment of a patient with active articular Aspergillus infection and knee arthrofibrosis through a two-stage total knee arthroplasty (TKA). A 37-year old woman presented with knee arthrofibrosis, which was complicated by an Aspergillus infection. The treatment involved a two-stage procedure: 1) bone cuts for TKA and systemic antibiotic therapy; and 2) TKA with the use of specific antibiotic-loaded cement. The patient has been followed for 30 months, showing no signs of failure.

Proximal Tibia Biplanar Anterior And Lateral Closing Wedge Osteotomy With Concomitant Revision Anterior Cruciate Ligament Reconstruction: A Case Report, Shane H. Johns, Lisandro Nardin, Jessica A. Nelson, Robert Schenck

Western Journal of Orthopaedics

This report documents a unique, successful strategy to manage a failed anterior cruciate ligament reconstruction (ACLR) in the setting of coronal and sagittal plane malalignment. The patient is a 38-year-old man with a history of a failed ACLR who presented with recurrent knee instability. Imaging revealed a posterior tibial slope (PTS) of 17° complicated by a varus malalignment of 10°. A single-stage anterior and lateral closing wedge tibial osteotomy (biplanar) with simultaneous revision anterior cruciate ligament reconstruction was performed. Final radiographic evaluation revealed that the tibial osteotomy healed with correction of coronal alignment to a physiologic 3° varus and a …

Recurrent Baker’S Cyst In A Pediatric Athlete: A Case Report, Gaurav Singh, Rebecca Peebles, Justin Bartley

Western Journal of Orthopaedics

Also known as popliteal cysts, Baker’s cysts are fluid-filled lesions found in the popliteal fossa, typically originating from the gastrocnemius-semimembranosus bursa. While these cysts are relatively common in adults, with a prevalence ranging from 5.0% to 41.0%, they are extremely rare in children, showing an incidence of just 2.4%. In most cases, Baker’s cysts result from intra-articular knee pathologies that lead to an increased production and sequestration of synovial fluid. The authors present the case of an athletic 16-year-old adolescent boy with a recurrent left-knee Baker’s cyst with magnetic resonance imaging showing no intra-articular pathology. Despite conservative treatment, including non-steroidal …

Treatment Of Congenital Cruciate Ligament Absence In A Teenager Knee-Ding Stability, Gaurav Singh, Anna Bergquist, Rebecca Peebles, Justin Bartley

Western Journal of Orthopaedics

The congenital absence of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) is an extremely rare condition, with an estimated prevalence of 0.017 per 1,000 live births for ACL agenesis. The authors present the case of a 15-year-old adolescent girl with autosomal dominant multiple synostosis, who developed progressive bilateral knee pain and functional limitations. Bilateral knee x-rays revealed trochlear dysplasia and an absent tibial eminence, suggesting a congenital ligamentous abnormality. Magnetic resonance imaging confirmed the bilateral absence of both the ACL and PCL. Surgical reconstruction of both ligaments was performed, with the first procedure taking place in October …

High-Throughput Drug Screening For Disease-Modifying Arthritis Therapy, Janapriya Vijayakumar

Honors Undergraduate Theses

Current therapy for arthritis predominantly focuses on the symptoms rather than the underlying causes of disease progression. Thus, it is necessary to identify novel drugs which target the underlying molecular basis of such diseases. Using high-throughput cell-based drug screening, we screened 458 different compounds, narrowed down from 811 starting compounds from the NIH Mechanistic Set. We selected drugs from the Mechanistic Set following Lipinski's Rule of 5 to ensure optimal pharmacokinetic properties. The study used modified primary human chondrocytes (IIAM-PRG4Luc), which secrete a lubricin promoter-driven luciferase reporter. We use this luciferase expression as a proxy to measure lubricin, a compound …

Investigation Of Lubricin-Stimulating Fda-Approved Compounds For A Disease-Modifying Osteoarthritic Drug, Swathi S. Menon

Honors Undergraduate Theses

Osteoarthritis (OA) is a degenerative disease that affects many people worldwide. Current methods of treatment are palliative, and no treatment exists to fully reverse or cure OA once it begins to progress. The discovery of a disease-modifying osteoarthritic drug (DMOAD) would increase the quality of life for millions and reduce the need for invasive procedures. Screening FDA-approved drugs ensures more promise due to their known safety profile and potential for faster translation to the clinic. The goal of this project was to conduct dose-response assays with FDA-approved drugs that have been shown to stimulate lubricin production in cells that mimic …

Ocd Lesions Of The Lateral Femoral Condyle And The Impact Of The Location On Recovery, Catharine Kral, Joshua Cummings, Ellie Helton, Shannon Margherio, Brian S. Harvey, Kevin Latz

Posters

Descriptive study based on Zhou, Liang, et al. we categorized the LFC OCD lesions into weight bearing and non-weight bearing lesions to assess clinical and radiographic variables and evaluate the need for progression to operative management.

Trends And Outcomes In Fixation Of Distal Radius Fractures In Elderly Patients: Should Gender Play A Role In Surgical Decision Making?, Rabia Qureshi, Kenny Ling, Sydney Laramie

Stony Brook Orthopaedic and Musculoskeletal Journal

See article.

Impact Of Teriparatide On Surgical And Medical Outcomes In Osteoporotic Patients Undergoing Multilevel Anterior Cervical Discectomy And Fusion, Samuel Akhnoukh, Uttsav Patel, Kenny Ling, Ivan Zapolsky

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: Osteoporotic patients undergoing multi-level anterior cervical discectomy and fusion (ACDF) are at increased risk of pseudarthrosis and perioperative complications, including higher rates of reoperation compared to non-osteoporotic individuals. Teriparatide, an anabolic agent used in osteoporosis treatment, has shown promise in enhancing fusion and reducing complications in lumbar spine procedures, but its role in multi-level ACDF remains unclear.

Purpose: The purpose of this study was to evaluate the impact of postoperative teriparatide use on outcomes in osteoporotic patients undergoing multi-level anterior cervical discectomy and fusion (ACDF). Specifically, the study aimed to determine whether teriparatide could reduce long-term complications such as …

Identifying Authenticity In Orthopaedic Residency Applications: Can Selection Committees Detect Ai-Written Personal Statements, Samir Baig, Lekha Yaramada, David E. Komatsu, James Barsi

Stony Brook Orthopaedic and Musculoskeletal Journal

See article.