Orthopedics Commons^™

Analysis Of Patients Who Undergo Index Arthroscopy With Biopsy But Not Implantation For Staged Chondrocyte Cell Transplantation, Bryson R. Kemler, Emma E. Johnson, Brad M. Evert, Azra N. Dees, Alec M. Giakas, Adeeb Jacob Hanna, Taylor D'Amore, Kevin B. Freedman, Sommer Hammoud

Rothman Institute Papers

BACKGROUND: Autologous chondrocyte implantation (ACI) and matrix-induced autologous chondrocyte implantation (MACI) are 2-stage procedures requiring an index full-thickness cartilage biopsy. Only a portion of patients ultimately undergo second-stage ACI/MACI.

PURPOSE: To identify patients with articular cartilage defects who underwent arthroscopic debridement with biopsy for ACI/MACI and compare those who did with those who did not proceed with implantation within 2 years after biopsy. Additionally, the authors sought to identify why patients did not proceed with implantation.

STUDY DESIGN: Case-control study; Level of evidence, 3.

METHODS: Patients who underwent arthroscopy and autologous chondrocyte biopsy from January 1, 2015, to December 31, …

Lower Extremity Injury Rates On Artificial Turf Versus Natural Grass Surfaces In The National Football League During The 2021 And 2022 Seasons, Nikit Venishetty, Angel X Xiao, Ramesh Ghanta, Rohit Reddy, Nirav Kiritkumar Pandya, Brian T Feeley

SKMC Student Presentations and Publications

BACKGROUND: It has been argued that the use of artificial turf football fields in the National Football League (NFL) increases player injury risk compared with natural grass surfaces.

PURPOSE/HYPOTHESIS: The purpose of this study was to quantify the rate of lower extremity injuries occurring in NFL players on artificial turf compared with natural grass surfaces and characterize the time missed due to injury and proportion of injuries requiring surgery. It was hypothesized that lower extremity injuries requiring surgical intervention would occur at a higher rate on artificial turf than on natural grass.

STUDY DESIGN: Descriptive epidemiology study.

METHODS: Lower extremity …

Srebp2 Restricts Osteoclast Differentiation And Activity By Regulating Irf7 And Limits Inflammatory Bone Erosion, Haemin Kim, In Ah Choi, Akio Umemoto, Seyeon Bae, Kaichi Kaneko, Masataka Mizuno, Eugenia Giannopoulou, Tania Pannellini, Liang Deng, Kyung-Hyun Park-Min

Publications and Research

Osteoclasts are multinucleated bone-resorbing cells, and their formation is tightly regulated to prevent excessive bone loss. However, the mechanisms by which osteoclast formation is restricted remain incompletely determined. Here, we found that sterol regulatory element binding protein 2 (SREBP2) functions as a negative regulator of osteoclast formation and inflammatory bone loss. Cholesterols and SREBP2, a key transcription factor for cholesterol biosynthesis, increased in the late phase of osteoclastogenesis. The ablation of SREBP2 in myeloid cells resulted in increased in vivo and in vitro osteoclastogenesis, leading to low bone mass. Moreover, deletion of SREBP2 accelerated inflammatory bone destruction in murine inflammatory …

Challenges In Traumatic Spinal Cord Injury Care In Developing Countries - A Scoping Review, Mohammad Hosein Ranjbar Hameghavandi, Elaheh Khodadoust, Mahgol Sadat Hassan Zadeh Tabatabaei, Farzin Farahbakhsh, Zahra Ghodsi, Sabra Rostamkhani, Shahryar Ghashghaie, Mahkame Abbaszade, Arash Arbabi, Seyedeh Maede Hossieni, Mohsen Sadeghi-Naini, Rasha Atlasi, Samuel Berchi Kankam, Alexander Vaccaro, James Guest, Michael Fehlings, Vafa Rahimi-Movaghar

Department of Neurosurgery Faculty Papers

OBJECTIVE: To evaluate the leading challenges in developing countries' traumatic spinal cord injury (TSCI) care.

METHODS: We conducted a systematic search in electronic databases of PubMed, SCOPUS, Web of Science, EMBASE, and Cochrane Library on 16 April 2023. Studies that investigated challenges associated with the management of TSCI in developing countries were eligible for review. We extracted related outcomes and categorized them into four distinct parts: injury prevention, pre-hospital care, in-hospital care, and post-hospital care.

RESULTS: We identified 82 articles that met the eligibility criteria including 13 studies on injury prevention, 25 on pre-hospital care, 32 on in-hospital care, and …

Local Antibiotic Infusion In Periprosthetic Joint Infection Following Total Hip Arthroplasty, Atthakorn Jarusriwanna, Wenbo Mu, Javad Parvizi

Rothman Institute Papers

Local antibiotic infusion has emerged as a promising adjunctive therapy, delivering high concentrations of antibiotics directly to the infection site. This approach aims to enhance eradication of pathogens while minimizing systemic side effects associated with prolonged antibiotic use. This narrative review encompassed 10 articles focused on all three procedures of surgical intervention for periprosthetic joint injection (PJI) following total hip arthroplasty (THA): debridement, antibiotics, and implant retention (DAIR), single-stage revision arthroplasty, and two-stage revision arthroplasty. Recent studies report success rates ranging from 90 to 100% in patients undergoing DAIR, 82 to 100% in single-stage revision arthroplasty, and 80% in two-stage …

Fragility Analysis And Systematic Review Of Patellar Resurfacing Versus Non-Patellar Resurfacing In Total Knee Arthroplasty, Teja Polisetty, Alexandra L. Hohmann, Eric Didomenico, Jess H. Lonner

Rothman Institute Papers

INTRODUCTION: Fragility analysis is a method of further characterising the robustness of statistical outcomes. This study evaluates the statistical fragility of randomised controlled trials (RCTs) comparing patellar resurfacing versus non-patellar surfacing in total knee arthroplasty (TKA).

METHODS: PubMed, MEDLINE and EMBASE were searched for RCTs comparing outcomes in TKA based on patellar resurfacing. Fragility index (FI) and reverse FI (collectively, "FI") were calculated for dichotomous outcomes as the number of outcome reversals needed to change statistical significance. Fragility quotient (FQ) was calculated by dividing the FI by the sample size for that outcome. Median FI and FQ were calculated for …

Risk Factors For Malalignment After Intramedullary Nail Treatment Of Distal Tibia Fractures With Associated Fibula Fractures., Yash P Chaudhry, Jose M Gutierrez-Naranjo, Micheal Raad, Diane Ghanem, Luis M Salazar, Jason T Goodrum, Kitchai Luksameearunothai, Boris A Zelle, Erik A Hasenboehler

Orthopedic Surgery Resident Research

PURPOSE: Malalignment of distal tibia fractures can lead to malunion/nonunion or alter the limb mechanical axis which may cause arthritis. Proposed methods to decrease malalignment include fibular fixation or multiplanar interlocking screws, however these remain controversial. This study aimed to identify factors associated with malalignment in distal tibial fractures with associated fibular shaft fractures.

METHODS: A retrospective review was performed of distal tibia fractures with associated fibular shaft fractures treated with intramedullary nailing at two level one trauma centers between 2015 and 2019. Cases involving malalignment (> 5° of deviation from anatomic axis on either coronal/sagittal axis) on final follow-up …

Advanced Visualization In Minimally Invasive Spine Surgery: The Ergonomics, Economics, And Evolution Of Camera-Based Tubes And Retractors, Advith Sarikonda, Ahilan Sivaganesan, Sheeraz Qureshi

SKMC Student Presentations and Publications

BACKGROUND: Tubular spine surgery has emerged as a hallmark of minimally invasive spine (MIS) procedures. In recent years, thanks to technological advances, tubular dilators and retractors have been integrated with digital cameras to allow for ergonomic, high-definition visualization of the surgical field.

OBJECTIVE: To detail the evolution, ergonomics, economics, and outcomes of camera-based tubular spine surgery, spanning the origins of MIS tubular techniques to the current use of operative microscopes and tube-mounted digital cameras (TMDCs).

METHODS: This is a narrative review of studies examining the evolution of tubular spine surgery as well as its most recent advances, with a particular …

Structure And Function Are Not The Same: The Case For Restoring Mechanoreceptor Continuity Following Anterior Cruciate Ligament Injury, Jillian E Beveridge, Payam Zandiyeh, Brett D Owens, Ata M Kiapour, Braden C Fleming

Faculty, Staff and Student Publications

Anterior cruciate ligament (ACL) injury, particularly in increasingly young and active adolescents, continues to pose a clinical challenge with re-injury rates reported as high as 30%. Evidence also suggests that current standard-of-care ACL reconstruction (ACLR) does not mitigate post-traumatic osteoarthritis (PTOA) risk. Bridge- enhanced ACL restoration (BEAR) is a recently developed and tested ACL surgery that promotes primary healing of the native ACL with excellent early results. BEAR has shown to reduce signs of early PTOA compared to ACLR in an animal model. Here, we describe a theoretical framework related to re-innervation that can clarify why the outcomes of ACLR …

Chronic Recurrent Shoulder Instability Treated With A Hemiarthroplasty, Glenojet Allograft Glenoid Reconstruction, And Anterior Capsular Reconstruction: A Case Report., Matthew Glazier, Morgan Turnow, Peter Spencer, Vishvam Metha, Hunter Pharis, Nathaniel Long, Stephen Wiseman

Surgery Articles

No abstract provided.

The Morbidity Of Greater Trochanteric Pain Syndrome Versus That Of Patients Awaiting Total Hip Replacement, Sonia Wadekar, John M. Gaddis, Emily Middleton, Yin Xi, Ed Mulligan, Ryan P. Bialaszewski, Bretton Laboret, Joel Wells

School of Medicine Publications

Background: Greater trochanteric pain syndrome (GTPS) is a commonly diagnosed medical issue, yet there are little data assessing the relative morbidity of GTPS. We sought to characterize the morbidity on presentation of GTPS and compare it to that of patients with end-stage hip osteoarthritis awaiting total hip arthroplasty. We hypothesized that patients with GTPS would have morbidity similar to or worse than that of patients with osteoarthritis.

Materials and methods: This retrospective case-control study examined patient-reported outcome measures of 156 patients with GTPS (193 hips) and 300 patients with hip osteoarthritis before total hip arthroplasty (326 hips). Patients with secondary …

Editorial Comment: Diversity And Disparities In Orthopaedic Surgery: Update 2024, Kimberly J Templeton, Melvyn A Harrington

Faculty, Staff and Students Publications

No abstract provided.

Factors Associated With Failed Closed Reduction In Flexion And Gartland Type Iii Pediatric Supracondylar Humerus Fractures, Pablo Coello, Nathaniel Grey Loyd, David A Hsiou, Rachel S Silverstein, Scott B Rosenfeld

Faculty, Staff and Students Publications

Background: Most displaced supracondylar humerus fractures (SCHFs) are treated with closed reduction and percutaneous pinning. While there are only a few possible indications for converting to an open reduction, a failed closed reduction is a common cause. This study aims to elucidate possible risk factors for failed closed reductions of SCHF.

Methods: A retrospective review of SCHF from 2010 to 2020 at a pediatric tertiary medical center, which underwent operative fixation, was conducted. Exclusion criteria were open fractures and reasons for open reduction other than failed closed reduction. Rates of open reduction were assessed by preoperative fracture classification and assessed …

Risk Factors For Loss To Follow Up In Pediatric Supracondylar Humerus Fractures, Nathaniel Grey Loyd, David Hsiou, Armando Martinez, Pablo Coello, Lon Kai Pang, Muhammad Hamza Shamim, Jessica Mcgraw-Heinrich, Scott B Rosenfeld

Faculty, Staff and Students Publications

Background: This study seeks to analyze risk factors associated with loss to follow up (LTF) after pin pull in pediatric patients with operatively treated supracondylar humerus fractures (SCHF).

Methods: A retrospective cohort study of patients under 18 years with operative SCHF from 2010 to 2020 was conducted. Factors of interest included LTF, age, race, language, distance to the hospital, Gartland fracture type, and Social Deprivation Index (SDI) by ZIP code. Univariate logistic regression was performed for each independent variable and significant variables were additionally analyzed with multivariate logistic regression analysis.

Results: Six hundred ninety-eight patients were included in the study. …

Anterior Solid Dual-Rod Instrumentation And Fusion For Flexible Thoracolumbar Or Lumbar Spinal Deformities In Adolescent Idiopathic Scoliosis., Mckenna C. Noe, Kenneth A. Furlough, Richard M. Schwend

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Anterior spinal instrumentation and fusion (ASIF) via a thoracolumbar approach has been used to treat Lenke 5 adolescent idiopathic scoliosis for decades. Advances in ASIF technique and instrumentation have yielded significant improvements in rates of instrumentation failure, need for reoperation, instrumented and adjacent segment kyphosis, and pseudarthrosis. Despite reports of ASIF's success using these strategies, a detailed technical description with illustrations of this procedure in the literature is lacking.

METHODS: We present a detailed illustrated surgical technique guide for anterior solid-rod instrumentation via a thoracoabdominal approach in the correction of a Lenke 5 adolescent idiopathic scoliosis deformity.

RESULTS: ASIF …

The Role Of Humeral Torsion On Glenohumeral Rotation In Injured Baseball Players, Kalie Entler, J Kaylin Kruseman, Sean M Kennedy, John E Conway, Griffin J Reyes, J Craig Garrison, Lane B Bailey, Natalie L Myers

Faculty, Staff and Student Publications

Background: Differences in rotational range of motion (ROM) compared to humeral retrotorsion (HRT)-corrected rotational ROM exist in healthy baseball athletes, but it is unclear whether these differences exist in a pathological population.

Purpose/hypothesis: The purpose of this study was to determine if there are disparities between objectively measured differences in ROM and HRT-corrected deficits in injured baseball players. It was hypothesized that disparities would exist between (1) the side-to-side difference in glenohumeral external rotation (GER) and the HRT-corrected glenohumeral external rotation deficit (GERD) and (2) the side-to-side difference in glenohumeral internal rotation (GIR) and the HRT-corrected glenohumeral internal rotation deficit …

The Effect Of Blood Flow Restriction Training On Quadriceps Activity After Anterior Cruciate Ligament Reconstruction: A Preliminary Randomized Controlled Trial, Florian Forelli, Camille Nguyen, Jean Mazeas, Georgios Kakavas, Timothy E. Hewett, Andreas Bjerregaard, Vasileios Korakakis, Alexandre Jm Rambaud

Marshall Journal of Medicine

Background

After anterior cruciate ligament reconstruction, a crucial priority is restoring knee muscle strength, especially the quadriceps, to reach the pre-injury strength levels as fast as possible. A feasible alternative to heavy loading might be blood flow restriction training that may elicit quadriceps muscle strength adaptations using low external loads. This study assessed whether quadriceps strengthening using low load blood flow restriction (LL-BFR) would enhance electromyographic (EMG) activity of the vastus medialis (VMO), vastus lateralis (VLO), and rectus femoris (RF) similar to quadriceps strengthening using heavy loads resistance training (HLRT). The secondary objective was to assess intra-quadriceps regional EMG differences …

Comparison Of Clinical Outcomes After Medial Patellofemoral Ligament Reconstruction With Allograft Versus Autograft: A Matched-Cohort Analysis, Jeffrey Henstenburg, Josuhu Pezzulo, Dominic Farronato, Emma Johnson, John Bodnar, Philip Petrucelli, Christopher Dodson, Kevin Freedman, Steven Cohen, Sommer Hammoud

Rothman Institute Papers

BACKGROUND: Disruption of the medial patellofemoral ligament (MPFL) may lead to recurrent lateral patellar dislocation and patellofemoral chondral injury. Despite significant previous work investigating numerous performance parameters, the optimal graft choice for MPFL reconstruction for patellar instability remains unclear.

PURPOSE: To compare functional outcomes scores, subjective recurrent instability, and revision rates between autograft and allograft in MPFL reconstruction.

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

METHODS: Patients who underwent MPFL reconstruction with autograft between 2013 and 2018 were identified. A 2:1 comparison group of patients who underwent MPFL reconstruction with allograft was matched by sex, age (±3 years), and …

Risk Factors Associated With Pyogenic Spinal Infections Among Intravenous Drug Users And Nonusers, Vivek Biololikar, Brendan Gleason, Lee Kripke, Robert Merrill, Colin Whitaker, Jon Handal

Einstein Health Papers

PURPOSE: To identify the differences in patient factors, presentation, treatment course, and outcomes of intravenous drug users (IVDA) vs. nonusers (non-IVDA) presenting with pyogenic spinal infections.

METHODS: We identified all cases involving spinal infections at our institution between May 2017 and January 2023. Postsurgical infections were excluded, and patients were separated into IVDA and non-IVDA groups. The patient charts were reviewed and analyzed for statistical or clinically significant differences using RStudio (2019 version 3.6.2). Our institutional review board approved this study, IRB# 2020-277, iRISID-2023-1384.

RESULTS: Fifty patients (29 males and 21 females) with primary pyogenic spinal infections were included in …

Low Skeletal Muscle Mass Is Associated With Inferior Preoperative And Postoperative Shoulder Function In Elderly Rotator Cuff Tear Patients, Yang Yang, Binbin Zheng, Xiaofang Lin, Mengqin Zhang, Yongzhi Ye, Haixiao Chen, Xiaobo Zhou

Faculty, Staff and Student Publications

BACKGROUND: The age-related loss of skeletal muscle mass is an important characteristic of sarcopenia, an increasingly recognized condition with systemic implications. However, its association with shoulder function in elderly patients with rotator cuff tears (RCT) remains unknown. This study aimed to investigate the relationship between low skeletal muscle mass and shoulder function in elderly RCT patients.

METHODS: A retrospective analysis was conducted on RCT patients who underwent chest computed tomography (CT) scans for clinical evaluation. Preoperative CT scan images of the chest were used to calculate the cross-sectional area (CSA) of thoracic muscle at the T4 level. The medical records …