Orthopedics Commons^™

Biportal Endoscopic Spine Surgery For Lumbar Laminectomy And Discectomy: Post-Operative Outcomes And Surgical Learning Curve, Matthew Lipphardt, Philip Zakko, Ali Jawad, Daniel Park, Maximillian Lee

Conference Presentation Abstracts

Background/Introduction

Biportal endoscopic spine surgery (BESS) is a minimally invasive spinal surgery which has gained increased traction for lumbar laminectomy and discectomy. To justify the transition from tubular or open surgery to BESS, BESS outcomes and surgical learning curve should be known. The primary goal of this study is to evaluate rates of complications with BESS as well as how these rates change with increased surgeon experience, especially in the US environment.

Materials/Methods

A United States Fellowship trained orthopaedic surgeon's clinical practice database was interrogated for consecutive patients who underwent BESS at a single institution. Patients aged greater than 18 …

Osteoporosis Is Underdiagnosed And Undertreated In Patients With Fragility Femoral Neck And Vertebral Compression Fractures, Philip Zakko, Lauren Eberhardt, Madeline Declercq, Ahyoung Park, Megan Audet, Daniel Park

Conference Presentation Abstracts

Background/Introduction

Femoral neck (FNF) and vertebral compression fractures (VCF) are common fragility fractures (FF) in the elderly population. Defined as fractures from low-energy trauma, FF are diagnostic of osteoporosis and require treatment. The purpose of this study was to assess whether patients were appropriately diagnosed and treated for osteoporosis following fragility FNF and VCF.

Materials/Methods

A retrospective chart review was performed at a single-institution from 1/1/2017 to 12/31/2020 on consecutive patients who sustained fragility FNF treated with closed reduction percutaneous pinning, hemiarthroplasty, or total hip arthroplasty or VCF treated with kyphoplasty. Patients <50 years of age, who sustained a high-energy or a non-osteoporotic pathologic fracture, were treated non-operatively, or deceased within one-year post-op were excluded. Preoperative demographics, ASA, CCI, smoking, alcohol, and glucocorticoid use were obtained. Diagnosis and treatment of osteoporosis, including dual-energy X-ray absorptiometry (DEXA) scans, calcium, vitamin D, bisphosphonates, denosumab, and alternative treatments (teriparatide, calcitonin, raloxifene, estrogen) were assessed pre-op and within one-year post-op. Subsequent FF were recorded.

Results

Of 593 patients, 276 FNF and 94 …

Microbial Colonization Of Capsular Traction Sutures In Hip Arthroscopic Surgery, Ian S Patten, Yuhang Sun, David R Maldonado, Michael S Lee, Michael B Banffy

Faculty, Staff and Student Publications

BACKGROUND: A common practice in hip arthroscopic surgery is the utilization of capsular traction sutures that can be incorporated into the capsular repair site at the end of the procedure, potentially seeding the hip joint with colonized suture material.

PURPOSE: To investigate the rate of the microbial colonization of capsular traction sutures used during hip arthroscopic surgery and to identify patient-associated risk factors for this microbial colonization.

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

METHODS: A total of 50 consecutive patients who underwent hip arthroscopic surgery with a single surgeon were enrolled. There were 4 braided nonabsorbable sutures utilized …

Exploring 5-Minute Heart Rate Variability In Spinal Cord Injury During Acute Inpatient Rehabilitation, Argyrios Stampas, Colton Malesovas, Michael Burke, Sahira Farooq, Mani Singh, Radha Korupolu, Sheng Li

Faculty, Staff and Student Publications

To explore the use of 5-minute heart rate variability (HRV) during inpatient rehabilitation in the acute phase of traumatic spinal cord injury (SCI). Longitudinal observational study. Acute inpatient rehabilitation (AIR). 10 patients with acute traumatic SCI. 5-minute HRV supine recordings twice daily on three different days per patient. HRV values were evaluated (1) within a single day (Early versus Late); (2) across the inpatient admission (initial, mid, and discharge); (3) by SCI phenotypes and by clinical outcomes (ex. pressure injuries (PI)). Patients had an average age of 38 years, 80% male, and 40% with tetraplegia. There were no HRV differences …

Critical Review Of Oncologic Medical Malpractice Claims Against Orthopaedic Surgeons, William Davis, Shravya Kichena, Michael D Eckhoff, Benjamin R Childs, Rajiv Rajani, Matthew E Wells, Sean P Kelly

Faculty, Staff and Student Publications

INTRODUCTION: The purpose of this study was to determine the most common allegations for malpractice litigation brought against orthopaedic surgeons for oncologic matters and the resulting verdicts.

METHODS: The Westlaw Legal research database was queried for malpractice cases filed against orthopaedic surgeons for oncologic matters in the United States after 1980. Plaintiff demographics, state of filing, allegations, and outcomes of lawsuits were recorded and reported accordingly.

RESULTS: A total of 36 cases met the inclusion and exclusion criteria and were subsequently included in the final analysis. The overall rate of cases filed remained consistent through the past four decades and …

Publication Rates Of Abstracts Presented Across 6 Major Spine Specialty Conferences, Tariq Z. Issa, Yunsoo Lee, Mark J. Lambrechts, Christopher Reynolds, Ryan Cha, James Kim, Jose A. Canseco, Alex R. Vaccaro, Christopher K. Kepler, Gregory D. Schroeder, Alan S. Hilibrand

Rothman Institute Papers

Background: Although scientific researchers aim to present their projects at academic conferences as a step toward publication, not all projects mature to become a peer-reviewed manuscript. The publication rate of meetings can be utilized to assess the quality of presented research. Our objective was to evaluate the contemporary publication rate of abstracts presented at spine conferences.

Methods: We reviewed annual meeting programs of North American Spine Society (NASS), Scoliosis Research Society (SRS), International Meeting on Advanced Spine Techniques (IMAST), Spine Global Spine Congress (GSC), Lumbar Spine Research Society (LSRS), and Cervical Spine Research Society (CSRS) from 2017 to 2019. Abstracts …

Does Prehabilitation Before Surgery Affect Return To Sport In Baseball Pitchers With Partial Ulnar Collateral Ligament Tears?, Kourtney Snigar, Ryan W. Paul, Joshua M. Spada, Usman Zareef, Anya Hall, Brandon J. Erickson, Michael G. Ciccotti, Stephen J. Thomas

Rothman Institute Papers

BACKGROUND: Purposeful rehabilitation before surgery (prehabilitation) has been researched and implemented in the treatment of anterior cruciate ligament tears. However, it is unclear whether prehabilitation would affect outcomes for baseball pitchers with partial ulnar collateral ligament (UCL) tears.

PURPOSE/HYPOTHESIS: The purpose of this study was to determine whether baseball pitchers with partial UCL tears who completed ≥4 weeks of prehabilitation (prehab group) have different return to play (RTP) outcomes than pitchers with 0 to 3 weeks of preoperative physical therapy (no prehab group). We hypothesized that pitchers in the prehab group would have similar RTP rates compared with pitchers in …

Regenerative Medicine For Tendon/Ligament Injuries: De Novo Equine Tendon/Ligament Neotissue Generation And Application, Takashi Taguchi

LSU Doctoral Dissertations

Tendon and ligament injuries are debilitating conditions across species. Poor regenerative capacities of these tissues limit restoration of original functions. The first study evaluated the effect of cellular administration on tendon/ligament injuries in horses using meta-analysis. The cellular administration was effective in restoring ultrasonographic echogenicity and increasing vascularity during early phase of healing. Additionally, it improved microstructural organization of healed tissue in terms of cellularity and fiber alignment. However, the study did not support its use for increasing rate of return to performance, expression/deposition of tendon-specific genes/proteins, or mechanical properties.

The findings led to the second study that engineered implantable …

Extracellular Targets To Reduce Excessive Scarring In Response To Tissue Injury, Jolanta Fertala, Mark L. Wang, Michael Rivlin, Pedro K. Beredjiklian, Joseph Abboud, William V. Arnold, Andrzej Fertala

Department of Orthopaedic Surgery Faculty Papers

Excessive scar formation is a hallmark of localized and systemic fibrotic disorders. Despite extensive studies to define valid anti-fibrotic targets and develop effective therapeutics, progressive fibrosis remains a significant medical problem. Regardless of the injury type or location of wounded tissue, excessive production and accumulation of collagen-rich extracellular matrix is the common denominator of all fibrotic disorders. A long-standing dogma was that anti-fibrotic approaches should focus on overall intracellular processes that drive fibrotic scarring. Because of the poor outcomes of these approaches, scientific efforts now focus on regulating the extracellular components of fibrotic tissues. Crucial extracellular players include cellular receptors …

Opportunistic Retrospective Assessment Of Huac, Bone Density, Sft And Breast Density On Ct Images And Relationship With Severity Of Covid-19, Mahmut Subasi, Mustafa Duger, Cengiz Erol, Irmak Durur-Subasi

Journal of Mind and Medical Sciences

Aim. To evaluate mean Hounsfield unit calculation (HUAC), bone density, subcutaneous fat thickness (SFT), breast density (constitutional imaging biomarkers) and age in symptomatic patients with COVID-19, to assess their correlation with pneumonia severity. Materials and Methods. Between 11 March and 30 May 2020, 272 consecutive symptomatic female patients with COVID-19 who underwent chest CT imaging at baseline were reviewed. HUAC, bone density, SFT and breast density were evaluated retrospectively and statistically compared in cases with negative/positive PCR test results, with/without pneumonia and with mild/moderate-severe pneumonia. Univariate/multivariate logistic regression analyses were applied for estimation of moderate/severe pneumonia. Results. The parameters of …

A Retrospective Evaluation Of External Rotation At 0 Degree And 90 Degrees Of Abduction After Atrhoscopic Latarjet Procedure, Michael E. Bodine, Shariff K. Bishai, Guy Ball, Cameron King, Lydia Wait, Grace Brannan

Conference Presentation Abstracts

BACKGROUND: Several papers have shown that shoulder stabilizing procedures, including the Latarjet procedure, lead to postoperative external rotation (ER) deficits. However, no study on arthroscopic Latarjet procedures has investigated the effect on ER when the arm is abducted at 0° and 90°. This study examined the relationship between the arthroscopic Latarjet procedure and the subsequent effect on external rotation at both 0° and 90° of abduction compared to the contralateral extremity. METHODS: Records of patients who underwent an arthroscopic Latarjet Procedure from December 2015 to April 2021 were retrospectively evaluated for this study. Requirements included both a three- and six-month …

Public Perception Of Robotic-Assisted Total Hip Replacement Surgery, James E. Feng, Marvee Espiritu, Phillip Vartanyan, Drew Moore, Robert Runner, Mark Karadsheh

Conference Presentation Abstracts

PURPOSE: Computer-assisted and robotic (CA/R) total hip arthroplasty (THA) has gained considerable attention due to its superior accuracy and precision. However, few studies have evaluated the public’s understanding and appraisal of this technology. Here, we evaluate the public’s initial perception of technology-assisted compared to traditional THA, and if interactive education may alter an individual’s preferences. MATERIALS & METHODS: A prospective cohort study was developed utilizing a 48-question, paid survey distributed via a clinically validated, public, online marketplace in April 2022. After collecting baseline demographics and knowledge regarding THA, participants were queried whether they would prefer a CA/R THA or traditional …

Preoperative Mri Delays Surgery In Pediatric Patients With Infectious Atraumatic Extremity Pain, Ethan Englert, Collin Braithwaite, Aaron Lam, Mohamed Sarraj, Maria Aguirre-Flores, Abigail Kumagai, Amr Abdelgawad, Ahmed Thabet Hagag, Waleed Kishta, Ehab Saleh

Conference Presentation Abstracts

INTRODUCTION: Management of atraumatic extremity pain in a pediatric patient often poses a dilemma to the treating orthopedic surgeon. The benefits of timely intervention must often be weighed against the utility of preoperative MRI to better characterize the responsible infection or other pathology. To determine if outcomes were superior for patients who underwent preoperative vs. postoperative MRI, this multicenter study reviewed the hospital courses of pediatric patients who presented with atraumatic extremity pain, underwent irrigation and debridement, and received at least one preoperative or postoperative MRI during their admission. METHODS: This study is a multi-institution retrospective review from four pediatric …

Bridge Plating In The Setting Of Radiocarpal Instability: Does Distal Fixation To The Second Or Third Metacarpal Matter? A Cadaveric Study, Eloy Tabeayo, James M Saucedo, Ramesh C Srinivasan, Amita R Shah, Efstathios Karamanos, Jason Rockwood, E Carlos Rodriguez-Merchan

Faculty, Staff and Student Publications

BACKGROUND: Radiocarpal dislocations are rare but potentially devastating injuries. Poorer outcomes are associated with inadequate or lost reduction, such as ulnar translocation, but no consensus exists on the ideal fixation technique. Dorsal bridge plate fixation has been described for various settings in the treatment of complex distal radius fractures and can be fixed distally to the second or third metacarpal, but its application for radiocarpal dislocations has not been established.

AIM: To determine whether distal fixation to the second or third metacarpal matters.

METHODS: Using a cadaveric radiocarpal dislocation model, the effect of distal fixation was studied in two stages: …

Microbubble Cavitation Restores Staphylococcus Aureus Antibiotic Susceptibility In Vitro And In A Septic Arthritis Model, Neil Zhao, Dylan Curry, Rachel E Evans, Selin Isguven, Theresa A. Freeman, John R. Eisenbrey, Flemming Forsberg, Jessica M Gilbertie, Sophie Boorman, Rachel Hilliard, Sana S. Dastgheyb, Priscilla Machado, Maria Stanczak, Marc I. Harwood, Antonia F Chen, Javad Parvizi, Irving Shapiro, Noreen J. Hickok, Thomas P Schaer

Department of Orthopaedic Surgery Faculty Papers

Treatment failure in joint infections is associated with fibrinous, antibiotic-resistant, floating and tissue-associated Staphylococcus aureus aggregates formed in synovial fluid (SynF). We explore whether antibiotic activity could be increased against Staphylococcus aureus aggregates using ultrasound-triggered microbubble destruction (UTMD), in vitro and in a porcine model of septic arthritis. In vitro, when bacterially laden SynF is diluted, akin to the dilution achieved clinically with lavage and local injection of antibiotics, amikacin and ultrasound application result in increased bacterial metabolism, aggregate permeabilization, and a 4-5 log decrease in colony forming units, independent of microbubble destruction. Without SynF dilution, amikacin + UTMD does …

Differences In The Academic Attributes Of Matched And Unmatched Orthopaedic Surgery Residency Applicants Are Narrowing, Suleiman Y. Sudah, Nareena Imam, Francis Sirch, Allen D. Nicholson, Surena Namdari, Mariano E. Menendez

Rothman Institute Papers

Background: Orthopaedic surgery remains one of the most competitive residency specialties, with the number of applicants outpacing the availability of residency positions each year. The purpose of this study was to analyze present-day orthopaedic surgery match data, identify differences between matched and unmatched applicants, and compare our findings to previous trends.

Methods: Applicant data from the National Resident Matching Program from 2016 to 2022 were analyzed. The number of matched and unmatched US allopathic senior orthopaedic applicants relative to the number of available positions was used to determine respective match rates. Performance metrics and applicant characteristics were compared by match …

Patellofemoral Disorders, Betina Hinckel

Conference Presentation Abstracts

No abstract provided.

Comparing Pain And Pain Coping Mechanisms In Patients Undergoing Total Joint Arthroplasty As Part Of A Mission Trip To Those In The United States., Yash P. Chaudhry, Kevin L Mekkawy, Alyssa Wenzel, Claudia Campbell, Robert S Sterling, Harpal S Khanuja

Orthopedic Surgery Resident Research

BACKGROUND: Access to total joint arthroplasty can be difficult in low-resource settings. Service trips are conducted to provide arthroplasty care to populations in need around the world. This study aimed to compare the pain, function, surgical expectations, and coping mechanisms of patients from one such service trip to the United States.

METHODS: In 2019, the Operation Walk program conducted a service trip in Guyana during which 50 patients had hip or knee arthroplasties. Patient demographics, patient-reported outcome measures, questionnaires assessing pain attitudes and coping, and pain visual analog scales were collected preoperatively and at 3 months postoperatively. These outcomes were …

Prevention Of Surgical Site Infection: A Ten-Step Approach, Saad Tarabichi, Javad Parvizi

Rothman Institute Papers

Surgical site infection (SSI) is a common cause of morbidity and mortality in patients undergoing surgery. Similarly, periprosthetic joint infection (PJI), is a major cause of failure after total joint arthroplasty (TJA). As the annual volume of TJA procedures is projected to rise, so will the rate of subsequent SSI and PJI. Currently, prevention has been identified as the single most important strategy for combating SSI/PJI. Hence, the present article will serve as a summary of an evidence-based ten-step approach for SSI/PJI prevention that may help orthopedic surgeons with their infection prevention strategies.

Cold Atmospheric Pressure Plasma-Antibiotic Synergy In Pseudomonas Aeruginosa Biofilms Is Mediated Via Oxidative Stress Response, Jordanne-Amee Maybin, Thomas P. Thompson, Padrig B. Flynn, Timofey Skvortsov, Noreen J. Hickok, Theresa A. Freeman, Brendan F. Gilmore

Department of Orthopaedic Surgery Faculty Papers

Cold atmospheric-pressure plasma (CAP) has emerged as a potential alternative or adjuvant to conventional antibiotics for the treatment of bacterial infections, including those caused by antibiotic-resistant pathogens. The potential of sub-lethal CAP exposures to synergise conventional antimicrobials for the eradication of Pseudomonas aeruginosa biofilms is investigated in this study. The efficacy of antimicrobials following or in the absence of sub-lethal CAP pre-treatment in P. aeruginosa biofilms was assessed. CAP pre-treatment resulted in an increase in both planktonic and biofilm antimicrobial sensitivity for all three strains tested (PAO1, PA14, and PA10548), with both minimum inhibitory concentrations (MICs) and minimum biofilm eradication …