Orthopedics Commons^™

Liv Selection In ‘Tweener’ Patients Treated With Magnetically Controlled Growing Rods Vs. Posterior Spinal Fusion, Brandon Yoshida, Claudia Leonardi, Jacquelyn Valenzuela-Moss, Lindsay M. Andras, Tyler A. Tetreault, John B. Emans, John T. Smith, Joshua M. Pahys, G. Ying Li, Michael J. Heffernan

School of Public Health Faculty Publications

Purpose: The purpose of this study was to compare the LIV selection in ‘tweener’ patients treated with MCGR or PSF. Methods: A multicenter pediatric spine database was queried for ambulatory patients ages 8–11 years treated by MCGR or PSF with at least 2-year follow-up. The relationship between the LIV and preoperative spinal height, curve magnitude, and implant type were assessed. The relationship between the touched vertebrae (TV), the last substantially touched vertebrae (LSTV), the stable vertebrae (SV), and the LIV were evaluated. Results: One hundred and fifty-nine patients met inclusion criteria. Preoperative curve magnitude was similar between groups (MCGR 68 …

Venous Thromboembolism Prophylaxis In Orthopedic Surgery: A Narrative Review, Jacob Lahti, Sarah Gallitto, Thomas C. Varkey

Annual Research Symposium

This poster highlights current and updated guidelines for chemical and mechanical prophylaxis for venous thromboembolism in patients undergoing major and minor orthopedic surgery. Existing and new potential therapies were reviewed, as well as an analysis into the lack of high-quality risk-prediction score calculators to improve personalization of prophylaxis regimens. Alongside a summary of existing and potential new prophylaxis protocols, a call to action to improve validity of said risk score calculators so as to improve patient outcomes and personalized medicine is made.

A New Treatment For Knee Osteoarthritis: Microfragmented Adipose Tissue Injections, Anne Bernot, Elizabeth Colantonio

Physician Assistant Capstones, 2020-current

Objective: Assess the effectiveness of microfragmented adipose tissue injections at lowering knee injury and osteoarthritis outcome scores (KOOS) 6 months post treatment in patients aged 18-75 with symptomatic knee osteoarthritis compared to platelet rich plasma injections. Design: systematic literature review. Methods: A search of PubMed and Google Scholar was performed using the terms “Lipogems”, “adipose tissue injection”, “Micro Fragmented adipose tissue injections”, “Micro Fragmented adipose tissue and PRP”, and “MFAT vs. PRP knee”. The search was limited to randomized controlled trials (RCTs) published in the past ten years. Results: Three randomized control trials (RCTs) met inclusion …

Advancements And Emerging Insights In Thoracolumbar Spine Trauma, Jonathan Neuhoff, Alex R. Vaccaro, Cumhur Oner, Klaus Schnake, Frank Kandziora

Department of Orthopaedic Surgery Faculty Papers

Thoracolumbar spine trauma represents a complex and evolving field within spinal surgery, with a continuous shift in treatment paradigms as research refines optimal approaches for specific patient populations. This special issue, with contributions from 20 peer-reviewed articles, brings together recent advancements in thoracolumbar trauma care, offering insight into improved diagnostic protocols, emerging surgical techniques, patient-centred outcomes, and the integration of new technologies.

Concomitant Epidural And Longitudinal Anterior Spinal Artery Contrast Spread In A Lumbar Transforaminal Epidural Steroid Injection (Tfesi), Philip J. Koehler Iii, Paul M. Kitei, David S. Stolzenberg, Elaine H. Hatch

Rothman Institute Papers

A 78-year-old female with a remote history of L3-4 decompression and fusion presented with several months of low back and radicular leg pain. MRI revealed moderate L2-L3 spinal canal stenosis, ligamentum flavum infolding, moderate bilateral foraminal stenosis, and a grade I retrolisthesis. A right sided L2-L3 TFESI was performed using multiplanar fluoroscopic imaging with a subpedicular supraneural approach. During live iodinated contrast injection, imaging revealed concomitant epidural and central arterial contrast spread. The needle was retracted and repeat live fluoroscopic imaging demonstrated no vascular uptake. Desired epidural and nerve root contrast spread remained in place with repeat still imaging. Dexamethasone …

Re: Proteomic Exploration Of Potential Blood Biomarkers In Haemophilic Arthropathy, Quang D La, David F Lo, Don D Shamilov

Rowan-Virtua School of Osteopathic Medicine Departmental Research

We wish to convey our reflections on the scholarly article titled “Proteomic exploration of potential blood biomarkers in haemophilic arthropathy” [1]. This investigation elucidates significant results concerning the plasma proteome of individuals afflicted with hemophilic arthropathy (HA) across a spectrum of severities, accentuating pivotal variations in protein expression correlated with disease severity and emphasizing the intricate nature of HA pathophysiology.

Perceived Patient-Centered Care In Marching Band Artists, A L. Merrill, Z K. Winkelmann, N A. Uriegas

Bakerman Student Research Awards

Objective: Approximately 27,000 college marching band (MB) artists in the United States could benefit from access to healthcare services and patient-centered clinicians. The purpose of this study was to explore HCPs MB artists have access to and their perceptions of patient-centered care (PCC). Methods: We used a cross-sectional web-based survey of MB artists (n=751, age=20±8 years). MB directors from 242 colleges were emailed a survey link to forward to MB artists. Participants indicated which HCPs they could access. Those who reported no access or unsure were prompted to describe what they would do if an injury or illness occurred. Participants …

Conservative Management Of A Rare Clinical Phenomenon: Paraspinal Compartment Syndrome - A Review Of Existing Literature., Mark Lagreca, Arash Badragheh, Nathan Jones, Thomas Falconiero, Brian Danshaw

Orthopedic Surgery Resident Research

INTRODUCTION: This review of case series and case reports explores conservative management strategies for paraspinal compartment syndrome (PCS), a rare clinical condition. Extremity compartment syndrome has been shown to be managed most effectively with emergent surgical release of the fascial compartment. Given the rarity of PCS and the paucity of research in the literature, some authors have suggested the possibility of conservative treatment. There has been no study to date that has specifically investigated the cases of non-operative management of PCS.

MATERIALS AND METHODS: There are 16 case reports in the literature with 22 cases of PCS treated conservatively. The …

How Does 2 Level Cervical Disc Replacement Compare To Single Level?, Pierce Nunley, Brian Perry, Celeste Abjornson, Ashvin Patel, Faheem Sandhu, Armen Khachatryan, Jad Khalil

Conference Presentation Abstracts

Introduction: Anterior Cervical Discectomy and Fusion (ACDF) is highly successful at a single level with greater than 90% fusion rates and high patient satisfaction. However, multi-level ACDF surgery, though still successful, has diminishing results with increasing levels. With many Investigational Device Exemption (IDE) clinical trials for the treatment of Symptomatic Cervical Disc Disease (SCDD) at a single level and recent IDE clinical trials for two contiguous levels, these trials offer the opportunity to compare clinical outcomes utilizing the same motion sparing technology mechanisms of action (MOA). The hypothesis is that cervical total disc replacement (cTDR) maintains its clinical benefits from …

Forty-Eight-Month Clinical Outcomes Of Patients Over 60 Years Old In A Prospective, Controlled, Multicenter Study Evaluating Two-Level Cervical Disc Arthroplasty With A Peek-On-Ceramic Artificial Disc, Andrew Park, Richard Guyer, Pierce Nunley, Ashvin Patel, Jad Khalil, James Yue, Arman Khachatryan, K Brandon Strenge, Hyun Bae, Christopher Good, Rick Sasso

Conference Presentation Abstracts

Introduction: Cervical total disc replacement (cTDR) has gained acceptance as a treatment for symptomatic disc degeneration with symptoms of radiculopathy with/without myelopathy. While clinical outcomes of cTDR have consistently been reported to be similar or superior to those of cervical discectomy and fusion, there are limited reports addressing differences related to patient age. The purpose of this study was to compare the 4-year results of two-level PEEKon-ceramic cervical TDR for patients ≥60 years old to those < 60. Materials and Methods: Data were from the prospective Food and Drug Administration (FDA) Investigational Device Exemption (IDE) trial for the Simplify cervical disc. The study included 145 patients who completed 4-year follow-up, of which 124 were < 60 years old at the time of surgery and 21 were ≥60 years. All patients were treated for two-level cervical disc degeneration with radiculopathy and/or myelopathy. Clinical outcome was based on the Neck Disability Index (NDI), neck pain and arm pain intensity scores (10-point scale), and neurologic status. Radiographic measures included flexion/extension (F/E) range of motion (ROM), disc space height, heterotopic ossification, and adjacent-level degeneration based on Kellgren-Lawrence grading. Mean 48-month outcomes for patients ≥60 years old were compared to those of patients < 60. Radiographs were evaluated by an independent lab specializing in image assessment. Results: Of the outcomes reviewed, only one statistically significant difference was detected based on age group. The mean change in F/E ROM from baseline to 48 months at the inferior index level was 3.33° (< 60) and -0.19° (≥60) (p=0.01). At the superior index level, the difference was not significant (1.80° (< 60) vs. 0.12° (≥60); p=0.20). The difference in change in global ROM was also not significant (5.67° (< 60) vs. 0.77° (≥60); p=0.07). Statistically significant differences were not seen for the other outcomes assessed: mean change in NDI, mean change in neck pain, mean change in arm pain. Neurologic status was normal in 93.6% of the < 60 age group and 100.0% of the ≥60 group (p=0.24). The mean change in average disc height from baseline to 48 months was similar in both groups. The distribution of Kellgren-Lawrence grades (none, doubtful, minimal, moderate, and severe) was also similar for each age group for the level above and below the surgical levels (p=0.88 above, p=0.49 below) and the rate of radiographically relevant HO (grade 3 or 4) was comparable between age groups (superior level (p=0.49); inferior level (p=0.20)). Through latest follow-up, there were zero secondary surgical interventions in the ≥60 cohort and 9 in the < 60 cohort. Conclusion: This study found that patients ≥60 years of age who were treated with PEEK-on-ceramic TDR at two levels had comparable clinical and radiographic outcomes to patients < 60 years of age through 4-year follow-up. These results affirm that cervical TDR performs similarly in patients ≥60 versus those < 60, although the small sample size of patients ≥60 years of age is a limitation.

What Is The Difference Of A Decade Of Experience? Comparing Two Multi-Center, Prospective, Randomized Clinical Investigational Device Exemption Trials Of An Approved Tdr At Two Contiguous Levels Of The Cervical Spine, Ashvin Patel, Jad Khalil, Brian Perri, Celeste Abjornson, Feheem Sandhu, Armen Khachatryan, Pierce Nunley

Conference Presentation Abstracts

Introduction: In 2013, the first Investigational Device Exemption (IDE) clinical trial for the treatment of Symptomatic Cervical Disc Disease (SCDD) at two contiguous levels was approved for an unconstrained Total Disc Replacement (cTDR). A decade later, this same device was the control arm of a new IDE trial at 2 levels. Although different investigators, the objective of this analysis was to explore if a decade of knowledge demonstrated a significant improvement in patient outcomes compared to the original trial. Materials and Methods: Both studies were prospective, randomized, multi-center, controlled IDE clinical trials with similar inclusion/exclusion criteria and study designs. The …

Characteristics Of High-Risk Bipolar Bone Loss Lesions Using 3-Dimensional Imaging, Petar Golijanin, Justin Arner, Claire Ryan, Qais Zai, Liam Peebles, Annalise Peebles, Phob Ganokroj, Ryan Whalen, Stephanie Eble, Danielle Rider, Srdjan Ninković, Matthew Provencher

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: The concept of on-track versus off-track bone lesions in glenohumeral instability continues to evolve. Although much has been ascertained from an original biomechanical model, bony pathological changes, especially on 3-dimensional (3D) imaging, have not been fully evaluated.

PURPOSE: To compare the differences in on-track versus off-track lesions to characterize glenoid and humeral head bone defects using 3D modeling software.

STUDY DESIGN: Cross-sectional study; Level of evidence, 3.

METHODS:A consecutive cohort of 75 patients with recurrent anterior instability, with evidence of Hill-Sachs lesions (HSLs) and
glenoid bone loss (GBL) and a mean age of 27.1 years (range, 18-48 years), were …

Evaluating The Superiority Of Multimodal Analgesia Over Opioid-Based Analgesia In Postoperative Pain Management For Total Knee Arthroplasty: A Comprehensive Integrative Review, Janna Smith, Mahdi Mofazali, Nya-Qien Smith

Master's Projects

With total knee arthroplasty (TKA), postoperative pain management is so important for optimal recovery and patient outcomes. This integrative review evaluates the effectiveness of multimodal analgesia (MMA) compared to traditional opioid-based analgesia in reducing pain and opioid consumption post-TKA. Research shows that MMA is very effective at providing adequate pain relief, reducing side effects, and also decreasing opioid use. MMA also addresses both the specific needs of individual patients and the broader public health issue of opioid dependence. However, a significant barrier to widespread adoption is the absence of standardized protocols. This review sets forth the importance of coming up …

Current State Of Frailty In Revision Arthroplasty., Brendan Kelly, Nicholas Stratigakis, Arsalaan Sayyed, Tyler K Williamson, Cameron Atkison, Taylor Manes, Nithin Gupta, Morgan Turnow, Frank A Buttacavoli

Surgery Articles

No abstract provided.

Effect Of Patient Resilience On Functional Outcomes After Meniscectomy, Adeeb Hanna, Andres Perez, Alice He, John Sonnier, Henson Destine, Rahul Muchintala, Ralph Cook, Sean Bryan, Fotios Tjoumakaris, Kevin Freedman

Rothman Institute Papers

BACKGROUND: Recent literature has identified that patient resilience may affect outcomes after meniscectomy. Research into psychological risk factors for poor surgical outcomes has been a focus in orthopaedic surgery.

PURPOSE/HYPOTHESIS: The purpose of this study was to examine the relationship between preoperative patient resilience and 2-year postoperative outcomes after arthroscopic meniscectomy. It was hypothesized that there would be no relationship between resilience and patient-reported outcomes after meniscectomy.

STUDY DESIGN: Cohort study; Level of evidence, 2.

METHODS: Patients who underwent meniscectomy between January and June 2020 at a single multicenter institution were identified, and those aged ≥18 years without evidence of …

Applications Of Computer Vision In Biomechanics And Orthopaedics, William Stewart Burton Ii

Electronic Theses and Dissertations

Machine learning has emerged as a key technology for enabling advanced computer vision systems. These systems now permeate many industries, and have enhanced traditional processes through autonomous interpretation of visual data. In the field of orthopaedics, the increasing prevalence of imaging highlights a need for similar tools. In many cases, however, direct translation of available frameworks fails to resolve the complex problems currently facing this field. Stringent performance requirements, complex visual environments, data scarcity, and implications for patient safety represent domain-specific factors which pose unique challenges to proven techniques. Novel approaches are needed to realize the full benefits of visual …

A Novel Machine Learning Model To Predict Revision Acl Reconstruction Failure In The Mars Cohort, Kinjal Vasavada, Vrinda Vasavada, Jay Moran, Sai Devana, Changhee Lee, Sharon L. Hame, Laith M. Jazrawi, Orrin H. Sherman, Laura J. Huston, Amanda K. Haas, Christina R. Allen, Daniel E. Cooper, Thomas M. Deberardino, Kurt P. Spindler, Michael J. Stuart, Annunziato Ned Amendola, Christopher C. Annunziata, Robert A. Arciero, Bernard R. Bach, Champ L. Baker, Arthur R. Bartolozzi, Keith M. Baumgarten, Jeffrey H. Berg, Geoffrey A. Bernas, Stephen F. Brockmeier, Robert H. Brophy, Charles A. Bush-Joseph, J. Brad Butler V, James L. Carey, James E. Carpenter, Brian J. Cole, Jonathan M. Cooper, Charles L. Cox, R. Alexander Creighton, Tal S. David, Warren R. Dunn, David C. Flanigan, Robert W. Frederick, Theodore J. Ganley, Charles J. Gatt, Steven R. Gecha, James Robert Giffin, Jo A. Hannafin, Norman Lindsay Harris, Keith S. Hechtman, Elliott B. Hershman, Rudolf G. Hoellrich, David C. Johnson, Timothy S. Johnson, Morgan H. Jones, Christopher C. Kaeding, Ganesh V. Kamath, Thomas E. Klootwyk, Bruce A. Levy, C. Benjamin Ma, G. Peter Maiers, Robert G. Marx, Matthew J. Matava, Gregory M. Mathien, David R. Mcallister, Eric C. Mccarty, Robert G. Mccormack, Bruce S. Miller, Carl W. Nissen, Daniel F. O'Neill, Brett D. Owens, Richard D. Parker, Mark L. Purnell, Arun J. Ramappa, Michael A. Rauh, Arthur C. Rettig, Jon K. Sekiya, Kevin G. Shea, James R. Slauterbeck, Matthew V. Smith, Jeffrey T. Spang, Steven J. Svoboda, Timothy N. Taft, Joachim J. Tenuta, Edwin M. Tingstad, Armando F. Vidal, Darius G. Viskontas, Richard A. White, James S. Williams, Michelle L. Wolcott, Brian R. Wolf, Rick W. Wright, James J. York

Rothman Institute Papers

BACKGROUND: As machine learning becomes increasingly utilized in orthopaedic clinical research, the application of machine learning methodology to cohort data from the Multicenter ACL Revision Study (MARS) presents a valuable opportunity to translate data into patient-specific insights.

PURPOSE: To apply novel machine learning methodology to MARS cohort data to determine a predictive model of revision anterior cruciate ligament reconstruction (rACLR) graft failure and features most predictive of failure.

STUDY DESIGN: Cohort study; Level of evidence, 3.

METHODS: The authors prospectively recruited patients undergoing rACLR from the MARS cohort and obtained preoperative radiographs, surgeon-reported intraoperative findings, and 2- and 6-year follow-up …

Assessing Musculoskeletal Pathologies In American Sign Language Users: Incidence And Development Of Preventative Strategies, Melissa Jomsky, Tali Shir, Amanda Garcia, David Feldman Phd, Gary B. Schwartz Md

HCA-NSU MD Research Day

INTRODUCTION: American Sign Language (ASL) is the fourth most common language in the United States, primarily used by the Deaf community and ASL interpreters. Prolonged and repetitive stress on the upper extremities during daily ASL communication can lead to various musculoskeletal pathologies. This study aims to identify the incidence of common conditions such as arthritis, medial and lateral epicondylosis, biceps tendinosis, rotator cuff tendinosis, De Quervain’s tenosynovitis, trigger finger, and carpal tunnel syndrome, and their association with the regular ASL use. METHODS: A one-time survey was designed for certified Deaf interpreters (CDI), Deaf individuals, and ASL interpreters to collect data …

Flexor Tenosynovitis Of The Wrist And Hand Due To Non-Tuberculous Mycobacteria, Mariafe Reyes, Tatevik Malisetyan, Skylar Harmon, Mohammadali M. Shoja Md, Gary B. Schwartz Md

HCA-NSU MD Research Day

Title: Flexor Tenosynovitis of the Wrist and Hand Due to Non-tuberculous Mycobacteria Authors: Mariafe Reyes1,Tatevik Malisetyan1, Skylar Harmon1, Mohammadali M. Shoja, MD1 Gary B. Schwartz, MD1 1Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA INTRODUCTION: Non-tuberculous mycobacteria (NTM) are a group of bacteria, including Mycobacterium marinum, Mycobacterium kansasii, and Mycobacterium avium intracellulare (MAI), that usually exist in the soil and water sources. The most common site of infection is the lungs, but extra-pulmonary involvement of the skin and rarely the musculoskeletal (MSK) system does occur, especially the hands and wrists. CASE PRESENTATION: A 45-year-old, …

Determinants Of Salary Variation And The Gender Pay Gap: A Survey Of The American Association Of Hip And Knee Surgeons (Aahks) Surgeon Member Workforce, Prem N. Ramkumar, Jenna A. Bernstein, David C. Landy, David E. Demik, Justin T. Deen, Reena J. Olsen, Anna Cohen-Rosenblum

School of Medicine Faculty Publications

Background: The increased emphasis on reimbursement, diversity, and burnout in hip and knee arthroplasty necessitates a foundational understanding of the surgeon workforce. The purpose of the study was to cross sectionally survey a representative sample of the AAHKS surgeon membership on the subject of salary, practice patterns, and demographic factors to establish a baseline framework for future advocacy efforts and initiatives. Methods: An online survey was sent to AAHKS members between December 20, 2022 and January 19, 2023. Surgeon demographic data, experience, practice geography and type, and annual case volume were solicited. Univariate and multivariate analyses were performed to describe …