Orthopedics Commons^™

Musculoskeletal Injuries And Conditions In The Orthopaedic Surgeon: A Survey, Katherine Swank, Jamie Furness, Erin A. Baker, Corinn Gehrke, Rachel S. Rohde

Conference Presentation Abstracts

Musculoskeletal conditions are common in orthopaedic surgeons and may lead to morbidity and missed work.

Unicompartmental Knee Arthroplasty Is Associated With A Lower Rate Of Periprosthetic Joint Infection Compared To Total Knee Arthroplasty, Cody S. Lee, Edwin P. Su, Michael B. Cross, Alberto V. Carli, David C. Landy, Brian P. Chalmers

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: Several studies have reported lower perioperative complications with unicompartmental knee arthroplasty (UKA) than with total knee arthroplasty (TKA). However, there is a paucity of data analyzing the incidence of periprosthetic joint infection (PJI) in similar patients undergoing UKA and TKA. As such, we sought to analyze the incidence of UKA and TKA PJI in a large matched population.

Material and Methods: The Mariner data set of the PearlDiver database was queried for all patients undergoing UKA or TKA during 2010-2017. Included patients were required to have at least 2 years of database inclusion after surgery. Patients were then matched …

Dysphagia Should Be Reported As A Separate Legacy Outcome Measure After Anterior Cervical Discectomy And Fusion, Philip Zakko, Rafid Kasir, Nai-Wei Chen, Daniel K. Park

Conference Presentation Abstracts

INTRODUCTION: Dysphagia is a common complication after anterior cervical discectomy and fusion (ACDF) but is not a routinely asked question in legacy patient-reported outcome measures. This study looks to see whether there are associations between dysphagia and legacy outcome measures. METHODS: We retrospectively reviewed 168 patients who underwent ACDF surgery from 2017 to 2019 at a single institution. Demographics, anthropometric data, Neck disability index (NDI), visual analog scale (VAS) pain scores, PROMIS-Health and -Mental scores, Charlson Comorbidities Index (CCI), and Eating Assessment Tool (EAT-10) were obtained for each patient preop and 1, 3, 6, and 12 months postop. Repeated measure …

Surgeon Decision-Making For Individuals With Obesity When Indicating Total Joint Arthroplasty, William F. Sherman, Akshar H. Patel, Nisha N. Kale, Christina M. Freiberger, C. Lowry Barnes, Olivia C. Lee

School of Medicine Faculty Publications

Background: Obesity is a risk factor for complications after total joint arthroplasty (TJA). This study analyzed the impact of individual surgeon demographics, financial concerns, and other factors in determining patient candidacy for TJA based on body mass index (BMI). Methods: A 21-question survey was approved by the American Association of Hip and Knee Surgeons Research Committee for distribution to its membership. Objective questions asked about surgeon or hospital BMI thresholds for offering TJA. Subjective questions asked about physician comfort discussing topics including obesity, bariatric surgery, and weight loss before TJA, as well as insurance and age considerations. Results: For TJA …

The Routine Use And Cost Analysis Of Acid-Fast Bacilli And Fungal Cultures In Foot And Ankle Surgery: A Retrospective Study, Zein S. El-Zein, Scott Diamond, Margaret C. Bohr, Erin A. Baker, Mackenzie M. Fleischer, Corinn Gehrke, Paul T. Fortin, Zachary Vaupel

Conference Presentation Abstracts

This study highlighted low rates of positive AFB/fungal cultures in our foot and ankle surgery department and demonstrated that routine use of such cultures poses substantial costs to the hospital.

Modulation Of The Acute Post-Anterior Cruciate Ligament Rupture Intra-Articular Environment Via Recruitment Of Marrow-Derived Stem Cells To Promote Bone Tunnel Healing In Acl Reconstruction, Kevin C. Baker, Samantha Hartner, Mackenzie M. Fleischer, Michael D. Newton, William B. Acker, Perry Altman, Christopher Bush, Tristan Maerz, Asheesh Bedi

Conference Presentation Abstracts

Acute, post-injury peripheral blood mobilization therapy with a CXCR4 antagonist improved bone tunnel healing and graft integration following ACL reconstruction surgery in a rat model.

Diagnosing Total Joint Arthroplasty-Associated Periprosthetic Joint Infections In Immunocompromised Patient Populations, Philip Zakko, Erin A. Baker, Christian M. Huber, Corinn Gehrke, Brett J. Friedman, Michael A. Flierl

Conference Presentation Abstracts

The 2018 ICM/MSIS classification system was used to assess PJI diagnosis in immunocompromised vs. non-immunocompromised patient populations to determine applicability of the scoring criteria.

Treatment And Outcomes Of Soft Tissue Sarcoma Of Groin, Hip And Thigh: A Retrospective Review From A Tertiary Care Hospital, Masood Umer, Javeria Saeed, Zaid Ahmed Shamsi, Muhammad Usman Tariq

Section of Orthopaedic Surgery

Objective: To study the frequency of the thigh, hip and groin soft tissue sarcomas and retrospectively analyse the management, treatment results, and outcomes of these uncommon malignant tumours, in a tertiary care hospital of the city of Karachi.
Methodology: Data of soft tissue tumours registered from 2017-2018 was retrieved during January 2019 to March 2019 from Aga Khan University Hospital, Karachi bone and soft tissue tumour registry. A retrospective review was performed and all soft tissue tumour cases treated with surgical intervention (with adjuvant /neoadjuvant therapy) or palliative intention were included.
Results: Total 119 cases of soft tissue tumours (STS) …

Prevention Of Falls In Hospital: Audit Report From A Tertiary Care Hospital Of Pakistan, Anum Sadruddin Pidani, Tashfeen Ahmad, Nasreen Panjwani, Shahryar Noordin

Department of Surgery Docs

Objective: The study aims to assess the fall incidents in past 5 years and fall assessment practices at the Aga Khan University Hospital, Karachi.
Methods: We performed a single-center retrospective audit at Aga Khan University Hospital from October 2019 to December 2019. A list of all patients admitted to Aga Khan University Hospital under the Musculoskeletal and Sports Medicine Service Line was obtained using the Hospital Information Management System (HIMS) from Jan 2017 to June 2018. Data including fall assessment scores was collected retrospectively from medical record files.
Results: A total of 1499 patients were admitted during this time period, …

Long-Term Clinical And Functional Outcomes Of Distally Based Sural Artery Flap: A Retrospective Case Series, Pervaiz Hashmi, Abeer Musaddiq, Muhammad Ali, Alizah Hashmi, Marij Zahid, Zohaib Nawaz

Section of Orthopaedic Surgery

Background: Reconstruction of soft tissue defects around the lower leg, foot and ankle is a challenge for orthopedic surgeons. These defects commonly occur as a result of trauma, infection and tumor excision. Sural artery neurovascular island flap is a relatively thin, pliable and insensate flap with minimum donor-site morbidity and acceptable aesthetic outcome.
Methods: A retrospective analysis of a case series was conducted, all operated by a single surgeon over a period of 25 years from July 1996 to February 2020. Data were collected through a structured proforma; the variables included were as follows: demographic data, mechanism of injury, defect …

Rehabilitation And Return-To-Play Criteria After Fresh Osteochondral Allograft Transplantation: A Systematic Review., Michael Stark, Somnath Rao, Brendan Gleason, Robert A. Jack, Bradford Tucker, Sommer Hammoud, Kevin B. Freedman

Rothman Institute Papers

Background: Fresh osteochondral allograft (OCA) is a treatment option that allows for the transfer of size-matched allograft cartilage and subchondral bone into articular defects of the knee. Although long-term studies show good functional improvement with OCA, there continues to be wide variability and a lack of consensus in terms of postoperative rehabilitation protocols and return to sport.

Purpose: To systematically review the literature and evaluate the reported rehabilitation protocols after OCA of the knee, including weightbearing and range of motion (ROM) restrictions as well as return-to-play criteria.

Study Design: Systematic review; Level of evidence, 4.

Methods: PubMed, EMBASE, Cumulative Index …

Prevalence Trend And Disparities In Rheumatoid Arthritis Among Us Adults, 2005–2018, Yingke Xu, Qing Wu

School of Public Health Faculty Research

Rheumatoid arthritis (RA) trends among US adults and disparities in RA patients in recent years have not been well described. We aimed to examine the trend of RA prevalence and disparities among US adults. Data from the National Health and Nutrition Examination Survey (NHANES) of the years 2005–2018 were analyzed to examine the self-reported RA prevalence trend. Age-adjusted RA prevalence stratified by race/ethnicity and socioeconomic status (SES), as well as associated linear trends, were calculated for both genders. The multivariable adjustment was used to evaluate the association between race, SES, and RA. During 2005–2018, there was no significant linear trend …

Patient Resilience Has Moderate Correlation With Functional Outcomes, But Not Satisfaction, After Primary Unilateral Total Knee Arthroplasty., Amer Haffar, Sean Bryan, Marc Harwood, Jess H. Lonner

Rothman Institute Papers

Background: As many as 20% of patients who undergo total knee arthroplasty (TKA) are dissatisfied. Psychological factors have been shown to play a role in outcomes after TKA. The purpose of this study was to investigate the impact of patient resilience on functional outcomes and satisfaction after primary unilateral TKA.

Methods: Eighty-six patients who underwent primary unilateral TKA by a single surgeon were studied. Primary outcomes were the Brief Resilience Scale (BRS), mental health component of the Veterans Rand 12-Item Health Survey (VR-12 MCS), Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, and New Knee Society Score. Correlations between …

Robotic Assistance In Unicompartmental Knee Arthroplasty Results In Superior Early Functional Recovery And Is More Likely To Meet Patient Expectations., Meredith P. Crizer, Amer Haffar, Andrew Battenberg, Mikayla Mcgrath, Ryan Sutton, Jess H Lonner

Rothman Institute Papers

Robotic technology has reduced the errors of implant alignment in unicompartmental knee arthroplasty (UKA), but its impact on functional recovery after UKA is poorly defined. The purpose of this study was to compare early functional recovery, pain levels, and satisfaction in UKA performed with either robotic assistance or conventional methods. A retrospective analysis was performed on 89 matched consecutive patients who underwent outpatient UKA by a single physician using either conventional instruments (n = 39) or robotic methods (n = 50), with otherwise identical perioperative protocols. Outcomes studied included Lower Extremity Functional Score (LEFS), new Knee Society Score …

Endoscopic Proximal Median Nerve Decompression: An Alternative Treatment For Pronator Syndrome, Scott A. Barnett, Sagar A. Shah, Rasheed I. Ahmad

School of Medicine Faculty Publications

Proximal forearm median nerve compressive neuropathy, termed as pronator syndrome, is difficult to diagnose and often overlooked. Its symptoms include vague proximal volar forearm pain that may be associated with paresthesia and numbness in the median nerve distribution. Weakness is typically not present. The treatment of pronator syndrome is largely nonsurgical, consisting of activity modification, anti-inflammatory medication, corticosteroid injections, stretching, and periods of splinting. Surgery is indicated when conservative therapy fails; however, there is no consensus on the treatment approach or technique. Most decompressions are performed using an open technique through a variety of incisions. Recently, endoscopic approaches have drawn …

Why We Can’T Wait, Mary I. Fisher

Physical Therapy Faculty Publications

No abstract provided.

Improving Patient Outcomes With Post-Op Education For Nurses Caring For Patients Undergoing Total Joint Replacement, Amanda Collier

Doctor of Nursing Practice Projects

Background: Surgical site infections (SSI) are the third most reported nosocomial infection causing an increased length of stay, increased healthcare cost, and a substantial increase in morbidity. A SSI is an infection developing within 30 days of surgery without using an implant and within one year of surgery utilizing any form of implant. Typically SSI occurs at the time of incision. However, poor postoperative wound care can lead to an SSI.

Purpose: This project aims to educate nursing staff on care of the total joint replacement (TJR) patient to reduce readmission rates for postoperative SSI.

Design Methods: This …

Publisher Correction To: Development Of The Asia Pacific Consortium On Osteoporosis (Apco) Framework: Clinical Standards Of Care For The Screening, Diagnosis, And Management Of Osteoporosis In The Asia-Pacific Region, M Chandran, P J. Mitchell, T Amphansap, S K. Bhadada, M Chadha, D-C Chan, Y-S Chung, P Ebeling, N Gilchrist, Aysha Habib Khan

Department of Pathology and Laboratory Medicine

No abstract provided.

Microfracture For Cartilage Defects In Today’S Orthopaedics: Pearls And Pitfalls, Himanshu Yn, Sufyan Ibrahim

Manipal Journal of Medical Sciences

Microfracture technique has vacillating clinical outcomes, limited demographic applicability, high failure rate, and variable patient satisfaction. Although it does not deserve to be a gold standard technique, there has not been a technique that could overcome all possible disadvantages associated with the technique and at the same time give a favourable result/be suitable for widespread use/not have its own disadvantages. Microfracture, integrated with biomaterial/stem cell transfer has shown promise over the past decade but studies evaluating the long-term efficacy of the tests and standardization are lacking. Besides, cost and operative difficulties limit widespread use. Twenty-five years into the field, microfracture …

Solitary Plasmacytoma Of Manubrium Sterni - A Case Report, Shyamasunder N. Bhat, Sp Mohanty

Manipal Journal of Medical Sciences

Solitary plasmacytoma is a tumour consisting of neoplastic monoclonal plasma cells without systemic involvement. It constitutes about 5% of all plasma cell dyscrasias and is mainly detected in the spine, pelvis and ribs and rarely in the sternum.

Here we report a case of a 45-year-old man presenting with pain and swelling in the midline of the chest over manubrium sterni. Plain radiograph and CT scan revealed an expansile, osteolytic lesion in the manubrium sterni. There was no M Band in protein electrophoresis, and the iliac bone marrow aspirate did not show plasmacytoma. However, histopathology of the lesion was suggestive …