Orthopedics Commons^™

Opioid Use After In Situ Fixation Of Slipped Capital Femoral Epiphysis, Stephanie Coupal, Colleen Moreland, Jonathan R. Warren, Mckenna C. Noe, Lisa Berglund, Caleb Grote

Research Days

Preliminary results of a prospective single-institution study evaluating opioid use following in situ screw fixation of Slipped Capital Femoral Epiphysis (SCFE) in pediatric patients.

Postoperative Opioid Usage And Disposal Strategies After Arthroscopic Procedures In A Young Cohort: A Prospective Observational Study, William Johns, Emma Johnson, Joseph Brutico, Matthew Sherman, Kevin Freedman, William Emper, John Salvo, Sommer Hammoud

Rothman Institute Papers

BACKGROUND: Although several studies have noted that patients are routinely overprescribed opioids, few have reported usage after arthroscopic surgery.

PURPOSE: To determine opioid consumption and allocation for unused opioids after common arthroscopic surgeries.

STUDY DESIGN: Case series; Level of evidence, 4.

METHODS: Patients between the ages of 15 and 40 years who were scheduled to undergo anterior cruciate ligament reconstruction (ACLR), labral repair of the hip or shoulder, meniscectomy, or meniscal repair were prospectively enrolled. Patients were prescribed either 5 mg hydrocodone-325 mg acetaminophen or 5 mg oxycodone-325 mg acetaminophen based on surgeon preference. Patients completed a daily opioid usage …

Outcomes Of Toddler’S Fractures After Implementation Of Comprehensive Care Management Protocol With Controlled Ankle (Cam) Boots, Sheena J. Amin Md, Janet K. O'Rear Bsn, Julia Leamon Msn, Olivia R. Pruss Bs, Mckenna C. Noe Bs, Micah K. Sinclair Md, Caleb W. Grote Md, Phd

Research Days

A study comparing skin breakdown complications in patients being treated for toddler's fractures at a single academic medical center before and after implementation of a new management and immobilization protocol involving the use of CAM boots.

Conservative Management Of Medial Femoral Condyle Osteochondritis Dissecans In The Pediatric Knee, Kennedy J. Morey, Brian Harvey, Kennison Adams, El Domingo-Johnson, Angie Vanderpool, Natalie Stork, Donna Pacicca, Brian Lee, Kevin Latz

Research Days

This study investigates the effectiveness of various non-operative treatments for osteochondritis dissecans (OCD) lesions in the medial femoral condyle (MFC) of the knee, a condition commonly affecting pediatric populations. Our project aims to evaluate outcomes such as symptom resolution, return to activity, and the potential for avoiding surgical intervention among patients undergoing different methods of conservative management. Through a retrospective analysis of patients, the study identifies trends in the effectiveness of different conservative treatment methods.

Health Disparities In Slipped Capital Femoral Epiphysis (Scfe) Presentation, Rithika Ginjupalli, George Thomas, Rohit Siddabattula, Richard M. Schwend, Caleb Grote

Research Days

This study identifies various health disparities in SCFE presentations using neighborhood-level determinants COI and ICE in addition to sociodemographic determinants such as race and gender.

Improving Awareness And Utilization Of Safety Net Resources After Extremity Firearm Injury, Colleen M. Moreland, Caleb W. Grote, Richard M. Schwend, Julia G. Harris

Research Days

The orthopaedic surgery department can improve follow-on care for pediatric survivors of extremity firearm injuries by creating and implementing a checklist of defined safety net resources.

Electrical Stimulation Of The Medial Pin After Insertion Is Safe And Effective In Preventing Iatrogenic Ulnar Nerve Neuropraxias In Type Iii Supracondylar Fractures. A Case Series Of 128 Consecutive Patients., Lucas Georger B.A., Mckenna Noe B.S., Richard M. Schwend M.D.

Research Days

This case series explores the safety and efficacy of using a disposable nerve stimulator for intraoperative stimulation of both medial and lateral pins in Gartland type III supracondylar humerus fractures, revealing no instances of ulnar nerve stimulation response or postoperative iatrogenic ulnar nerve injury, thereby highlighting the potential for this cost-effective approach to ensure stable medial column pin fixation without ulnar nerve complications.

Safety And Efficacy Of Intraoperative Vectored Traction With Gardner-Wells (Gw) Tongs For Pediatric Spine Deformity Surgery - A Series Of 1000 Cases, Lucas Georger B.A., Krish Sardesai B.A., Andrew Dumas B.S., Mckenna Noe B.S., Richard M. Schwend M.D.

Research Days

Conducting an ongoing exploration, this study delves into the safety and efficacy of Gardner-Wells Tongs in pediatric spinal deformity surgery, involving a series of 418 cases, revealing a 5.5% complication rate primarily associated with facial swelling and abrasions, emphasizing the need for further investigation to validate the safety and effectiveness of this intervention.

Peripheral Nerve Stimulation Of The Shoulder: A Technical Primer, Sailesh Arulkumar, Elisa E. Neuchat, Eric Ly, Austin Ingwei Ly, Kiana Fahimipour, Mehul J. Desai

School of Medicine Faculty Publications

Scapulalgia or shoulder pain accounts for 16% of all musculoskeletal complaints in the healthy adult population and becomes more common as we age. When this pain exceeds 3 months in duration, it is deemed to be chronic, and typically treated in an escalating manner. Spanning a continuum of conservative and non-conservative measures, chronic shoulder pain treatments range from rest and physical therapy to surgery. Since each patient presents with a unique spectrum of symptoms a customized treatment plan is often required. Over the lifetime of many of these patients, a variety of treatment options are required. One of these treatment …

Subclinical Presentation Of Cutibacterium Acnes Infection Following Revision Rotator Cuff Repair: A Case Report, Zachary Walker, David Shuster, David Sosnoski, Ali Hamade, Hussein Saad, Marc Milia

Posters

Cutibacterium acnes is a gram-positive anaerobic bacillus which is commonly found in the sebaceous glands of the skin generally in the axilla, chest and back regions 1,2.

Shoulder infections have been reported to occur at 3.4% following arthroscopic or open shoulder surgeries, where they are most commonly due to C. acnes3,4.

This case report demonstrates a unique case and management of a subclinical presentation of confirmed C. acnes infection.

Pseudoaneurysm Development After Short Cephalomedullary Femoral Nailing, Nicholas E. Runge, Daniel P. Mccall

Posters

Hip fractures are amongst the most treated conditions by orthopaedic surgeons1 and are routinely treated with cephalomedullary nails (CMN)s.

Pseudoaneurysm formation is a rare complication after femoral CMN. The primary cause of pseudoaneurysm formation in previous studies has been found to be related to overpenetration of the far cortex with a drill or screw.

Patients with neuromuscular diseases may have aberrant anatomy potentially leading to increased risk of pseudoaneurysm formation

This the first case report of a patient with post-polio syndrome who developed a symptomatic deep femoral artery pseudoaneurysm status post short CMN fixation for a basicervical femoral neck fracture …

Remove The Ring: A Quality Improvement Initiative For Upper Extremity Trauma, Brandon Wallace, Matthew Charlick, Josiah Valk, Aaron Seidman

Posters

Upper extremity trauma is a common injury and post traumatic edema is an expected sequela. Retained rings on the digits prohibit circumferential swelling and may lead to tourniquet syndrome if left in place leading to a devastating and avoidable consequence.

Expeditious ring removal in upper extremity trauma is prudent for patient safety.

Radiographs are typically obtained early in the triage and treatment of patients suffering from upper extremity trauma. This presented itself as as reliable efficient target to have rings removed prior to this treatment step.

An opportunity to make a systemic change to maximize patient safety and care was …

Two For One – Simultaneous Bilateral Shoulder Injuries In Gym Teacher: A Case Report, Zachary Walker, Josiah Valk, David Sosnoski, Kelley Brossy, Mohamed Saad

Posters

28M gym teacher history of T1DM, seizure d/o, and alcohol use disorder presents with bilateral shoulder pain after an inebriated fall, two nights prior. Not on antiepileptics at baseline. C/o bilateral shoulder pain and mid-thoracic spine pain.

Pyogenic Tenosynovitis Of Tibialis Anterior Tendon After Cat Bite, Daniel Blascak, David Sosnoski, Aaron Seidman

Posters

Pyogenic tenosynovitis is a bacterial infection of the synovial sheath that surrounds a tendon.

Commonly occurs within flexor tendons of the hand; theoretically can occur within any sheathed tendon.

Delayed diagnosis may lead to spread of infection to surrounding tissues and tendon rupture.

Tibialis anterior tendon is encased in a synovial sheath that runs from above the superior extensor retinaculum to the talonavicular joint.

Only five cases of pyogenic tenosynovitis of the tibialis anterior tendon have been reported in the literature.

None of the reported cases were due to animal bite injury.

Accuracy Of Machine Learning To Predict The Outcomes Of Shoulder Arthroplasty: A Systematic Review, Amir H. Karimi, Joshua Langberg, Ajith Malige, Omar Rahman, Joseph A. Abboud, Michael A. Stone

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Artificial intelligence (AI) uses computer systems to simulate cognitive capacities to accomplish goals like problem-solving and decision-making. Machine learning (ML), a branch of AI, makes algorithms find connections between preset variables, thereby producing prediction models. ML can aid shoulder surgeons in determining which patients may be susceptible to worse outcomes and complications following shoulder arthroplasty (SA) and align patient expectations following SA. However, limited literature is available on ML utilization in total shoulder arthroplasty (TSA) and reverse TSA.

METHODS: A systematic literature review in accordance with PRISMA guidelines was performed to identify primary research articles evaluating ML's ability to …

The Impact Of External Beam Radiation Therapy (Xrt) On Shoulder Surgical Outcomes, Rami Beydoun

Conference Presentation Abstracts

Purpose: To assess whether prior history of breast cancer treated with XRT has an impact on outcomes following shoulder surgery Significance: Long-term effects of XRT on complications and outcomes following shoulder surgery are largely unknown. Methods: 20-year single institution retrospective chart review. Inclusion criteria: patients with history of breast cancer treated with XRT and a subsequent ipsilateral shoulder surgical procedure. Demographics, comorbidities, and postoperative outcomes including ROM and VAS pain scores were collected. Results: 18 female patients (average age 66.3 years) were identified. 10 underwent rotator cuff repair, 7 shoulder arthroplasty (3 reverse), and 1 arthroscopic labral repair. Four patients …

A Literature Review Of Pain Control In Osteoarthritis Patients Using Blood Flow Restriction Training, John Gericke, Dakota Pastore, Tyler Pigott

Rowan-Virtua Research Day

Background: Osteoarthritis (OA) is a degenerative disease that mainly affects articular cartilage of joints. OA most commonly affects the knees and causes pain and reduces quality of life in older adults. Blood flow restriction (BFR) occludes arterial and venous flow during exercise using a blood pressure cuff placed on the proximal lower limb. This creates an intramuscular hypoxic environment which promotes muscle hypertrophy. High load training can cause pain and inflammation in knee OA patients due to increased stress. BFR can allow patients with knee OA to use lower loads to achieve beneficial effects of rehabilitation.

Methods: Data was ascertained …

Resection And Reconstruction Of Ewing Sarcoma Of The Cuboid Utilizing Vascularized Fibular Autograft: A Case Report, Brandon Cunha, Alexandre Arkader

Rowan-Virtua Research Day

Ewing Sarcoma (EWS) rarely presents in the bones of the foot, and particularly in the cuboid, making it an exceedingly rare occurrence. We present the case of a 7-year-old female diagnosed with EWS of the right cuboid, detailing the management and outcomes of this rare presentation. The patient, now almost 5 years post-initial local control, exhibits restored foot function, a normalized gait, and no evidence of disease recurrence. This case underscores the potential for preserving lower extremity function and improving postoperative quality of life in rare presentations of EWS through innovative reconstruction strategies.

Investigating The Factors That Lead To Sports Related Injuries In Children, Kinjal Shah, Shawna Rotoli

Rowan-Virtua Research Day

This project’s focus is to investigate if playing contact versus non-contact sports at a young age leads to more sports related injuries and to identify which factors correlate with increased injury rate in order to develop the most effective prevention and treatment methods. Data was collected through a survey including questions that delve deeper to quantify the amount of strain being put on the youth athlete’s body such as hours played a week, level of competitiveness, weeks played in a year, contact versus non-contact sport, and number of sports played. The following set of questions then addressed the actual injury …

Case Report: Hidden Posterior Dislocation Of The Clavicular Head, David F. Koziel

Rowan-Virtua Research Day

Reported is a case of a 24-year-old male who presented with left shoulder pain and decreased range of motion of the same shoulder upon awakening, diagnosed with a posterior dislocation of the proximal clavicle, with the clavicular head residing in the mediastinum. In the conscious, ambulatory, young adult it is arguably much more common for major bony trauma involving the upper extremity and shoulder to present with pain, deformity, and a known mechanism. This is an example that lacks all three of these characteristics and highlights the importance of details in the physical examination as well as clinical gestalt.