Orthopedics Commons^™

Comparison Of Sports Medicine Questions On The Orthopaedic In-Training Examination Between 2009 And 2012 And 2017 And 2020 Reveals An Increasing Number Of References, Brandon Klein, Mark Lagreca, Peter B. White, Robert Trasolini, Randy M. Cohn

Orthopedic Surgery Resident Research

Purpose

To provide an updated analysis of the sports medicine section of the Orthopedic In-Training Examination (OITE).

Methods

A cross-sectional review of OITE sports medicine questions from 2009 to 2012 and 2017-2020 was performed. Subtopics, taxonomy, references, and use of imaging modalities were recorded and changes between the time periods were analyzed.

Results

The most tested sports medicine subtopics included ACL (12.6%), rotator cuff (10.5%), and throwing injuries to the shoulder (7.4%) in the early subset, while ACL (10%), rotator cuff (6.25%), shoulder instability (6.25%), and throwing injuries to the elbow (6.25%) were the most common in the later subset. …

Effect Of Drain Duration And Output On Perioperative Outcomes And Readmissions After Lumbar Spine Surgery, Brian A. Karamian, Parth Kothari, Gregory R. Toci, Mark J. Lambrechts, Jose A. Canseco, Jennifer Mao, Raj Narayan, Sammy Alfonsi, Francis Sirch, Nadim Kheir, Nicholas Semenza, Barrett I. Woods, Jeffrey A. Rihn, Mark Kurd, Kris Radcliff, I David Kaye, Alan S. Hilibrand, Christopher K. Kepler, Alex R. Vaccaro, Gregory D. Schroeder

Rothman Institute Papers

Study design: Single-center retrospective cohort.

Purpose: To compare surgical outcomes of patients based on lumbar drain variables relating to output and duration.

Overview of literature: The use of drains following lumbar spine surgery, specifically with respect to hospital readmission, postoperative hematoma, postoperative anemia, and surgical site infections, has been controversial.

Methods: Patients aged ≥18 years who underwent lumbar fusion with a postoperative drain between 2017 and 2020 were included and grouped based on hospital readmission status, last 8-hour drain output (<40 mL cutoff), or drain duration (2 days cutoff). Total output of all drains, total output of the primary drain, drain duration in days, drain output per day, last 8-hour output, penultimate 8-hour output, and last 8-hour delta (last 8-hour output subtracted by penultimate 8-hour output) were collected. Continuous and categorical data were compared between groups. Multivariate logistic regression analysis and receiver operating characteristic (ROC) analysis were performed to determine whether drain variables can predict hospital readmission, postoperative blood transfusions, and postoperative anemia. Alpha was 0.05.

Results: Our cohort consisted of 1,166 patients with 111 (9.5%) hospital readmissions. Results of regression analysis did not identify …

Serotonin Reuptake Inhibitor Increases Pseudarthrosis Rates In Anterior Cervical Discectomy And Fusions, Mark J. Lambrechts, Nicholas D. D'Antonio, Gregory R R. Toci, Brian A. Karamian, Josuhu Pezzulo, Dominic Farronato, Jose Canseco, Ian David Kaye, Barrett Woods, Jeffrey A. Rihn, Mark Kurd, Joseph K. Lee, Md, Alan S. Hilibrand, Christopher K. Kepler, Alexander R. Vaccaro, Gregory D. Schroeder

Rothman Institute Papers

STUDY DESIGN: Retrospective cohort.

PURPOSE: To determine (1) the effects of serotonin reuptake inhibitors in pseudarthrosis rates after anterior cervical decompression and fusion (ACDF) and (2) to identify patient-reported outcome measures in patients taking serotonin reuptake inhibitors.

OVERVIEW OF LITERATURE: Recent literature suggests that selective serotonin reuptake inhibitors (SSRIs) may inhibit fracture healing via downregulation of osteoblast differentiation. Spinal fusion supplementation with osteoblast-rich substances enhances spinal fusion, thus SSRIs may be detrimental.

METHODS: Patients with 1-year postoperative dynamic cervical spine radiographs following ACDF were grouped into serotonin reuptake inhibitor prescriptions (SSRI, serotonin-norepinephrine reuptake inhibitor [SNRI], or tricyclic antidepressant [TCA]) and …

Innovative Management Of Posterior Upper Thigh Pain In Two Adolescent Athletes, Thomas Munro, Brian Harvey

Posters

Case history: Two 16-year-old males with posterior upper leg pain. Athlete A reports he had been exploding up to dunk a basketball when he felt a pop with immediate pain in his posterior LLE. He was treated conservatively with activity modification and PT resulting in improvement of symptoms and return to full activity. He returned 15-months after the initial injury due to recurrence of pain. Athlete B stated he had tweaked his hamstring multiple times over the summer and had been working with a physical therapist for rehabilitation. He had attempted full rest for a couple weeks with graded return …

Insidious Ankle Swelling, Catharine Kral, Brian Harvey

Posters

10-year-old female presented to clinic for left heel pain and swelling. She participates in dance for an estimated 8-9 hours a week. Symptoms started four weeks prior to presentation. She does not remember any inciting event, fall, trauma, or other mechanism of injury prior to onset. She says the pain is localized to the lateral aspect of her calcaneus and extending up to her Achilles. She has never seen any bruising, erythema, or skin changes overlaying the swollen region. Family reports she intermittently has a limp. It is most tender to touch or when she bumps her foot on something. …

Colonization Of Patients Hospitalized At Orthopedic Department Of Tertiary Hospital In Uganda With Extended-Spectrum Beta-Lactamase-Producing Enterobacterales, Jules Bizimana, Jerome Ndayisenga, Henry Kajumbura, Phillip Mulepo, Najjuka Florence Christine

Faculty, Staff and Students Publications

BACKGROUND: Beta-lactamase production remains the most contributing factor to beta-lactam resistance. Extended-Spectrum Beta-Lactamase-Producing Enterobacterales (ESBL-PE) are associated with risk factors both in hospital and community settings.

OBJECTIVES: To assess the incidence and risk factors for intestinal carriage of ESBL-PE among patients admitted to orthopedic ward of Mulago National Referral Hospital, and to analyze the acquisition of ESBL-PE during hospital stay and associated factors.

METHODS: We screened 172 patients aged 18 years old and above who got admitted to the orthopedic ward of Mulago National Referral Hospital between May to July 2017. Stool samples or rectal swabs were collected at admission, …

Berberine Disrupts Staphylococcal Proton Motive Force To Cause Potent Anti-Staphylococcal Effects, Neil Zhao, Selin Isguven, Rachel Evans, Thomas P Schaer, Noreen J. Hickok

Department of Orthopaedic Surgery Faculty Papers

The presence of antibiotic resistance has increased the urgency for more effective treatments of bacterial infections. Biofilm formation has complicated this issue as biofilm bacteria become tolerant to antibiotics due to environmental factors such as nutrient deprivation and adhesion. In septic arthritis, a disease with an 11% mortality rate, bacteria in synovial fluid organize into floating, protein-rich, bacterial aggregates (mm-cm) that display depressed metabolism and antibiotic tolerance. In this study, Staphylococcus aureus (S. aureus), which is the most common pathogen in septic arthritis, was tested against different inhibitors that modulate bacterial surface protein availability and that should decrease bacterial aggregation. …

Augmentation Of Bmp Signaling In Cranial Neural Crest Cells Leads To Premature Cranial Sutures Fusion Through Endochondral Ossification In Mice, Hiroki Ueharu, Haichun Pan, Xia Liu, Mamoru Ishii, Jessica Pongetti, Anshul K Kulkarni, Folasade E Adegbenro, Jaden Wurn, Robert E Maxson, Hongchen Sun, Yoshihiro Komatsu, Honghao Zhang, Jingwen Yang, Yuji Mishina

Faculty, Staff and Student Publications

Craniosynostosis is a congenital anomaly characterized by the premature fusion of cranial sutures. Sutures are a critical connective tissue that regulates bone growth; their aberrant fusion results in abnormal shapes of the head and face. The molecular and cellular mechanisms have been investigated for a long time, but knowledge gaps remain between genetic mutations and mechanisms of pathogenesis for craniosynostosis. We previously demonstrated that the augmentation of bone morphogenetic protein (BMP) signaling through constitutively active BMP type 1A receptor (caBmpr1a) in neural crest cells (NCCs) caused the development of premature fusion of the anterior frontal suture, leading to craniosynostosis in …

A Ring-Like Accretion Structure In M87 Connecting Its Black Hole And Jet, Ru-Sen Lu, Keiichi Asada, Thomas P Krichbaum, Jongho Park, Fumie Tazaki, Hung-Yi Pu, Masanori Nakamura, Andrei Lobanov, Kazuhiro Hada, Kazunori Akiyama, Jae-Young Kim, Ivan Marti-Vidal, José L Gómez, Tomohisa Kawashima, Feng Yuan, Eduardo Ros, Walter Alef, Silke Britzen, Michael Bremer, Avery E Broderick, Akihiro Doi, Gabriele Giovannini, Marcello Giroletti, Paul T P Ho, Mareki Honma, David H Hughes, Makoto Inoue, Wu Jiang, Motoki Kino, Shoko Koyama, Michael Lindqvist, Jun Liu, Alan P Marscher, Satoki Matsushita, Hiroshi Nagai, Helge Rottmann, Tuomas Savolainen, Karl-Friedrich Schuster, Zhi-Qiang Shen, Pablo De Vicente, R Craig Walker, Hai Yang, J Anton Zensus, Juan Carlos Algaba, Alexander Allardi, Uwe Bach, Ryan Berthold, Dan Bintley, Do-Young Byun, Carolina Casadio, Shu-Hao Chang, Chih-Cheng Chang, Song-Chu Chang, Chung-Chen Chen, Ming-Tang Chen, Ryan Chilson, Tim C Chuter, John Conway, Geoffrey B Crew, Jessica T Dempsey, Sven Dornbusch, Aaron Faber, Per Friberg, Javier González García, Miguel Gómez Garrido, Chih-Chiang Han, Kuo-Chang Han, Yutaka Hasegawa, Ruben Herrero-Illana, Yau-De Huang, Chih-Wei L Huang, Violette Impellizzeri, Homin Jiang, Hao Jinchi, Taehyun Jung, Juha Kallunki, Petri Kirves, Kimihiro Kimura, Jun Yi Koay, Patrick M Koch, Carsten Kramer, Alex Kraus, Derek Kubo, Cheng-Yu Kuo, Chao-Te Li, Lupin Chun-Che Lin, Ching-Tang Liu, Kuan-Yu Liu, Wen-Ping Lo, Li-Ming Lu, Nicholas Macdonald, Pierre Martin-Cocher, Hugo Messias, Zheng Meyer-Zhao, Anthony Minter, Dhanya G Nair, Hiroaki Nishioka, Timothy J Norton, George Nystrom, Hideo Ogawa, Peter Oshiro, Nimesh A Patel, Ue-Li Pen, Yurii Pidopryhora, Nicolas Pradel, Philippe A Raffin, Ramprasad Rao, Ignacio Ruiz, Salvador Sanchez, Paul Shaw, William Snow, T K Sridharan, Ranjani Srinivasan, Belén Tercero, Pablo Torne, Efthalia Traianou, Jan Wagner, Craig Walther, Ta-Shun Wei, Jun Yang, Chen-Yu Yu

Faculty, Staff and Student Publications

The nearby radio galaxy M87 is a prime target for studying black hole accretion and jet formation1,2. Event Horizon Telescope observations of M87 in 2017, at a wavelength of 1.3 mm, revealed a ring-like structure, which was interpreted as gravitationally lensed emission around a central black hole3. Here we report images of M87 obtained in 2018, at a wavelength of 3.5 mm, showing that the compact radio core is spatially resolved. High-resolution imaging shows a ring-like structure of 8.4+0.5−1.1 Schwarzschild radii in diameter, approximately 50% larger than that seen at 1.3 mm. The outer …

Sustainable Development Goal For Quality Education (Sdg 4): A Study On Sdg 4 To Extract The Pattern Of Association Among The Indicators Of Sdg 4 Employing A Genetic Algorithm, David R Maldonado, Michael S Lee, Cynthia Kyin, Andrew E Jimenez, Jade S Owens, Paulo A Perez-Padilla, Benjamin G Domb

Faculty, Staff and Student Publications

BACKGROUND: There is a paucity of literature reporting outcomes after revision hip arthroscopic surgery in obese patients.

PURPOSE: To report the minimum 5-year survivorship, patient-reported outcomes (PROs), clinical benefit, and risk factors for conversion to total hip arthroplasty (THA) in obese patients after revision hip arthroscopic surgery.

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

METHODS: Data were prospectively collected and retrospectively reviewed for patients who underwent revision hip arthroscopic surgery by a single surgeon between April 2010 and August 2016. Inclusion criteria were a body mass index ≥30 and baseline and minimum 5-year postoperative values for the modified Harris …

Evaluation And Treatment Of Postoperative Periprosthetic Humeral Fragility Fractures, Evangeline F. Kobayashi, Surena Namdari, Mara Schenker, George S. Athwal, Jaimo Ahn

Rothman Institute Papers

Postoperative periprosthetic humeral shaft fractures represent a growing and difficult complication to treat given the aging patient population and associated bone loss. Determining the best treatment option is multifactorial, including patient characteristics, fracture pattern, remaining bone stock, and implant stability. Possible treatment options include nonoperative management with bracing or surgical intervention. Nonoperative treatment has been shown to have higher nonunion rates, thus should only be selected for a specific patient population with minimally displaced fractures or those that are unfit for surgery. Surgical management is recommended with prosthetic loosening, fracture nonunion, or failure of nonoperative treatment. Surgical options include open …

Worse Postoperative Outcomes And Higher Reoperation In Smokers Compared To Nonsmokers For Arthroscopic Rotator Cuff Repair, Susan G. Wager, Spencer Brown, Michael Gaudiani, Joshua P. Castle, Eric Jiang, Vasilios Moutzouros, Eric Makhni, Stephanie J. Muh

Medical Student Research Symposium

Introduction: Smoking impairs healing potential and is a significant risk factor for complications following orthopaedic surgeries. The purpose of this study was to determine if a cohort of former or current smokers at time of surgery met the minimally clinical important difference (MCID) for Patient-Reported Outcomes Measurement Information System Upper Extremity (PROMIS-UE), Depression (PROMIS-D), and Pain Interference (PROMIS-PI) scores in comparison to nonsmokers.

Methods: A retrospective review of patients who underwent rotator cuff repair was performed. Patients who completed preoperative and 6-month postoperative PROMIS scores were included. The MCID was calculated using a distribution technique with a threshold of 0.5 …

The Top 50 Most Cited Articles On The Medial Patellofemoral Ligament (Mpfl): A Bibliometric Analysis, Varag Abed, Alex Duvall, Jonathan D. Rexroth, Alyssa Goodwin, Joseph Liu, Austin Stone

Medical Student Research Symposium

Objectives: To determine which original articles on the topic of the medial patellofemoral ligament (MPFL) have been cited the most in the literature utilizing a bibliometric approach. Secondarily, to determine temporal trends between article types.

Methods: Articles on the topic of the MPFL were identified by utilizing the Web of Science Database. The search yielded 1,596 results and the top 50 cited original articles were collected for further analysis. The following information was gathered for all included articles: title, first author's name, journal name, year of publication, impact factor of the journal in 2021, total number of citations of the …

Preoperative Promis Depression Scores Can Predict Failure To Improve After Trapeziectomy And Lrti, Shreya Balusu, Hardy Evans Md, Eric Jiang Md, Matthew Myhand, Noopur Ranganathan, Charles Day Md

Medical Student Research Symposium

INTRODUCTION: Patient-Reported Outcomes Measurement Information System (PROMIS) scores have been utilized in setting realistic post-intervention expectations. Having a model to stratify likelihood of improvement based on pre-operative variables may allow for better decision making and patient counseling. We hypothesized that preoperative PROMIS scores correlate with patients’ subjective level of improvement after trapeziectomy and ligament reconstruction with tendon interposition (LRTI)

METHODS: Retrospective chart review was performed to identify patients who underwent trapeziectomy and LRTI. Demographic data along with preoperative PROMIS Upper Extremity (UE), Pain Interference (PI), Depression (DP), and QuickDASH (QD) scores were collected. At their follow-up appointment, patients were asked …

Preoperative Promis Depression Scores Can Predict Failure To Improve After Trapeziectomy And Lrti, Shreya Balusu, Hardy Evans Md, Eric Jiang Md, Matthew Myhand, Noopur Ranganathan, Charles Day Md

Medical Student Research Symposium

Introduction

Patient-Reported Outcomes Measurement Information System (PROMIS) scores have been utilized in setting realistic post-intervention expectations. Predicting likelihood of improvement based on pre-operative variables may allow for better decision-making and patient counseling. We hypothesized that preoperative PROMIS scores correlate with patients’ subjective level of improvement after trapeziectomy and ligament reconstruction with tendon interposition (LRTI)

Methods

Retrospective chart review was performed to identify patients who underwent trapeziectomy and LRTI. Preoperative PROMIS Upper Extremity (UE), Pain Interference (PI), Depression (DP), and QuickDASH (QD) scores were collected. At follow-up appointments, patients were asked an anchor question: “Since your treatment, how would you rate …

High Variability Exists In Reporting Clinical And Patient-Reported Outcome Measures Following Meniscal Surgery, Leah Shephard, Varag Abed, Michael Nichols, Andrew Kennedy, Camille Khalily, Caitlin Conley, Cale Jacobs, Austin V. Stone

Medical Student Research Symposium

Purpose: To evaluate the variability in outcomes following surgical meniscal repair and compare responsiveness between patient reported outcome measures (PROMs).

Methods: A systematic search of the PubMed/MEDLINE and Web of Science databases was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A total of 257 unique studies met inclusion criteria. Patient and study attributes were extracted, including pre- and postoperative means for PROMs. Of the studies that met inclusion criteria for responsiveness analysis (2+ PROMs reported, 1-year minimum follow-up; n=172), we compared the responsiveness between PROM instruments using effect size and relative efficiency (RE) if …

Do Lower Extremity Injuries Of Nfl Players Affect Their Yearly Income?, Abdullah Sahyouni, Robert De La Torre, Gautham Pavar, Kinan Sawar, Yasmeen Alcodray, Bohdan Matsko, Justin Bennie, Nicole Xu, Harika Bollineni

Medical Student Research Symposium

Introduction: Injuries are arguably the most daunting career setbacks professional sports players have to face. To better understand the drawbacks of sports injuries, we decided to examine players’ annual income before and after sports injuries. Income is arguably the most important metric of success for professional athletes. To make the study more relevant for the US, we collected data on one of the most viewed professional sports leagues in the country: the National Football League (NFL).

Methods: We examined the NFL’s weekly injury reports for seasons from 2016 to 2020, and recorded players with lower extremity injuries (LEI) (Hamstring, Calves, …

Towards Standardized, Safe And Efficacious Screening Approaches To Patients With Lower Extremity Peripheral Arterial Disease In The Setting Of Lower Extremity Arthroplasty, Zaina N. Khoury, Adam Pearl, Ahmad Hassan, Mohamed Awad, Khaled Saleh

Medical Student Research Symposium

INTRODUCTION: Peripheral arterial disease (PAD) impedes recovery from lower extremity arthroplasties (LEA) and increases risk of complications/mortality, yet there aren’t standards for screening PAD patients pre-LEA. This review proposes some.

METHODS: This review searched databases for articles containing relevant terms. Non-English articles, those unrelated to LEA, and duplicates were excluded. Articles were cross-referenced to find other relevant papers for a total of 111.

RESULTS: Up to 49.2% of PAD patients have CAD. Wagner grade III/IV ulcers increase amputations and decrease wound closures. The Wound, Ischemia, and Foot Infection (WIfI) system provides more accurate, and therefore actionable, assessment. Overlooking PAD in …

Promis Mcid And Scb Achievement In Rotator Cuff Repair, Nikhil Yedulla, Joseph S. Tramer, Alexander Ziedas, Sreten Franovic, Mit Patel, Stephanie Muh, Eric C. Makhni

Medical Student Research Symposium

The purpose of this study was to establish threshold score changes to determine minimal clinically important difference (MCID) and substantial clinical benefit (SCB) in PROMIS computer adaptive test (CAT) scores following rotator cuff repair (RCR). Patients undergoing arthroscopic RCR were identified over a 24-month period. PROMIS CAT forms for upper extremity physical function (PROMIS-UE), pain interference (PROMIS-PI), and depression (PROMIS-D) were utilized. Analysis of variance testing with post hoc least significant difference pairwise comparisons and Tukey’s B subset analysis were used in determining if anchor question responses showed statistically significant differences between answers. These findings were used to establish two …

Systematic Assessment Of The Quality And Comprehensibility Of Youtube Content On Ulnar Collateral Ligament Injury And Management, Sohil S. Desai, Matthew J. Anderson, Connor R. Crutchfield, Anastasia Gazgalis, Frank J. Alexander, Charles A. Popkin, Christopher S. Ahmad

Department of Orthopaedic Surgery Faculty Papers

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