Orthopedics Commons^™

A Novel High Tibial Biplanar Osteotomy Technique For Simultaneous Coronal And Sagittal Correction: A Case Example, Ryan C. Price, Kathryn C. Helmig, Dustin L. Richter, Robert C. Schenck Jr

Western Journal of Orthopaedics

Medial opening wedge high tibial osteotomy (HTO) can provide symptom relief, improved ligamentous stability, and lower failure rates in patients with symptomatic medial knee osteoarthritis, ligament instability, and varus alignment after ligament reconstruction. It has been reported that correcting coronal plane abnormalities with a medial opening wedge HTO has resulted in altered posterior tibial slope angle (PTSA). We describe a 38-year-old woman with a history of severe polytrauma who presented with an anterior cruciate ligament tear in the setting of increased PTSA and a posterolateral corner injury with varus deformity of the knee. A medial biplanar HTO was performed using …

Cartilage Restoration Of The Patella Using Prochondrix® Osteochondral Allograft: A Case Report, Evan D. Boyd, Michael S. Barnum, James R. Slauterbeck

Western Journal of Orthopaedics

Articular cartilage injuries are challenging to treat because of the limited healing potential of articular cartilage. Various cartilage restoration procedures have been developed to restore the protective role of articular cartilage and to delay or prevent additional damage to the articular surface. ProChondrix® Cartilage Restoration Matrix is a cryopreserved hyaline cartilage allograft with viable chondrocytes and growth factors necessary to promote its incorporation and viability. We describe a 19-year-old man with a well-contained, full-thickness cartilage defect on his patella. He subsequently underwent cartilage restoration with a ProChondrix® osteochondral allograft. At 1-year postoperatively, the patient had both clinical and radiographic evidence …

Orthopaedic Residency And The Covid Kid, Finley Kemp, Deana Mercer

Western Journal of Orthopaedics

N/A

Excessive Tibial Overgrowth Associated Ankle Valgus Deformity After Pediatric Open Mid-Shaft Tibial Fracture: A Case Report, Ahmed M. Thabet, Rami Khalifa, Rasheed Alnajjar, Amr Abdelgawad

Western Journal of Orthopaedics

Tibial overgrowth after pediatric tibial fractures has been reported in the literature. Multiple factors can affect the amount of overgrowth, including age and gender of patients, type of fracture (open vs closed), degree of communion, reduction techniques, and fixation method. We describe a 10-year-old boy with a 2-cm overgrowth after sustaining an isolated open tibia fracture with an intact fibula, which is more than what has been previously described in the literature for tibia fractures. This overgrowth was associated with asymmetrical growth of the distal tibial physis, asymmetrical growth between tibia and fibula, and ankle valgus deformity.

The University Of New Mexico Orthopaedics Research Journal 2021, Unm Department Of Orthopaedic Surgery

Western Journal of Orthopaedics

No abstract provided.

The Utility Of Continuous Passive Motion After Anterior Cruciate Ligament Reconstruction: A Systematic Review Of Comparative Studies, Taylor D'Amore, Somnath Rao, John Corvi, Robert Jack Ii, Fotios Tjoumakaris, Michael G. Ciccotti, Kevin Freedman

Department of Orthopaedic Surgery Faculty Papers

Background: The application of continuous passive motion (CPM) after anterior cruciate ligament reconstruction (ACLR) was popularized in the 1990s, but advancements in the understanding of ACLR rehabilitation have made the application of CPM controversial. Many sports medicine fellowship–trained surgeons report using CPM machines postoperatively. Purpose: To determine the efficacy of CPM use for recovery after ACLR with respect to knee range of motion (ROM), knee swelling, postoperative pain, and postoperative complications. Study Design: Systematic review; Level of evidence, 3. Methods: The PubMed (MEDLINE), EMBASE, Cochrane, Cumulative Index of Nursing, and Allied Health Literature databases were searched from inception to January …

Trends In Leadership At Orthopaedic Surgery Sports Medicine Fellowships, Nicholas C. Schiller, Andrew J. Sama, Amanda F. Spielman, Chester J. Donnally, Benjamin I. Schachner, Dhanur M. Damodar, Christopher C. Dodson, Michael G. Ciccotti

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Fellowship directors (FDs) in sports medicine influence the future of trainees in the field of orthopaedics. Understanding the characteristics these leaders share must be brought into focus. For all current sports medicine FDs, our group analyzed their demographic background, institutional training, and academic experience.

AIM: To serve as a framework for those aspiring to achieve this position in orthopaedics and also identify opportunities to improve the position.

METHODS: Fellowship programs were identified using both the American Orthopaedic Society for Sports Medicine and the Arthroscopy Association of North America Sports Medicine Fellowship Directories. The demographic and educational background data for …

Leveraging Advancements In Tissue Engineering For Bioprinting Dental Tissues, Devin Grace Morrison, Ryan E. Tomlinson

Department of Orthopaedic Surgery Faculty Papers

3D bioprinting allows biocompatible materials and cells to be deposited in precise locations in three-dimensional space, enabling researchers to surpass the limitations of traditional 2D cell culture and to create innovative therapies. 3D bioprinting is one of the newest tools developed in the field of tissue engineering, which has traditionally utilized a paradigm revolving around scaffolds, cells, and signals. In this review, we discuss how new developments in each of these three research areas relates to bioprinting dental tissues – specifically teeth, periodontal ligament, and alveolar bone. Important considerations include how scaffold materials and geometry affect regeneration of dental tissues, …

Low Intensity Pulsed Ultrasound (Lipus) Use For The Management Of Instrumented, Infected, And Fragility Non-Unions: A Systematic Review And Meta-Analysis Of Healing Proportions, Ross Leighton, Mark Phillips, Mohit Bhandari, Robert Zura

School of Medicine Faculty Publications

Background: Non-union occurs in approximately 5 to 10% of fracture patients, with certain bones at greater risk of failing to heal. Non-unions have a significant impact on socioeconomic costs and the patients short and long-term quality of life. Low intensity pulsed ultrasound (LIPUS) is a non-invasive therapy for non-union treatment that can improve the long-term outcome. The purpose of this study is to summarize the available literature assessing LIPUS potential to improve the union rate in instrumented, infected, and fragility non-unions. Methods: A literature search was conducted in the MEDLINE, EMBASE, and CINAHL databases for all relevant literature on the …

Iatrogenic Electrocautery Damage And Cellular-Based Corrosion Of Total Joint Arthroplasty Biomaterials, Kirsten Carol Miller

Theses and Dissertations (ETD)

Introduction. The number of patients undergoing a Primary Total Knee Arthroplasty (PTKA) has been increasing steadily each year. Of those PTKA patients, 20% report long-term pain and/or some functional deficit. Cobalt-Chromium-Molybdenum (CoCrMo) alloy is one of the most used materials in Total Joint Arthroplasty (TJA) implants due the material’s high strength, high corrosion resistance, and biocompatibility. The release of metal ions and potential occurrence of metallosis in TJA has been shown to be detrimental to the longevity of the implant. The mechanisms leading to this increase in metal ion concentrations have been up for debate, with some believing it is …

Development Of A Standardized Histopathology Scoring System Using Machine Learning Algorithms For Intervertebral Disc Degeneration In The Mouse Model-An Ors Spine Section Initiative., Itzel Paola Melgoza, Srish S Chenna, Steven Tessier, Yejia Zhang, Simon Y Tang, Takashi Ohnishi, Emanuel José Novais, Geoffrey J Kerr, Sarthak Mohanty, Vivian Tam, Wilson C W Chan, Chao-Ming Zhou, Ying Zhang, Victor Y Leung, Angela K Brice, Cheryle A Séguin, Danny Chan, Nam Vo, Makarand V Risbud, Chitra L Dahia

Department of Orthopaedic Surgery Faculty Papers

Mice have been increasingly used as preclinical model to elucidate mechanisms and test therapeutics for treating intervertebral disc degeneration (IDD). Several intervertebral disc (IVD) histological scoring systems have been proposed, but none exists that reliably quantitate mouse disc pathologies. Here, we report a new robust quantitative mouse IVD histopathological scoring system developed by building consensus from the spine community analyses of previous scoring systems and features noted on different mouse models of IDD. The new scoring system analyzes 14 key histopathological features from nucleus pulposus (NP), annulus fibrosus (AF), endplate (EP), and AF/NP/EP interface regions. Each feature is categorized and …

Isolated Volar Dislocation Of The Distal Radioulnar Joint Treated With Successful Closed Reduction., Matthew T Glazier, Hayden B Schuette, Benjamin A Schnee, Brian Skura, Craig Goubeaux

Surgery Articles

We report the case of A 34-year-old right-hand-dominant male who presented with an isolated left volar dislocation of the distal radioulnar joint (DRUJ) without any associated fractures. The patient had sustained the injury in an altercation in the evening prior to the presentation and had woken up the next morning with left wrist pain and restricted wrist motion. Closed reduction was successful under conscious sedation and the patient was treated conservatively with splint immobilization without needing operative intervention. This report highlights a rare injury pattern - an isolated volar DRUJ dislocation - that was successfully closed reduced, despite reports that …

Intraoperative Hypothermia In Patients Undergoing Total Knee Arthroplasty: A Cross-Sectional Study From A Developing Country, Ronika Devi Ukrani, Aiman Arif, Anum Sadruddin Pidani, Obada Hussein Hasan, Shahryar Noordin

Medical College Documents

Background: Intraoperative hypothermia is associated with various risk factors, morbidity, and mortality in patients undergoing total knee arthroplasty (TKA), increasing the emotional and financial burden on patients. This study aimed to identify risk factors of intraoperative hypothermia in patients undergoing TKA.
Materials and methods: All adult patients (⩾18 years) who underwent TKA from January 2016 to December 2017 at a tertiary-care hospital in Pakistan were included in this retrospective, cross-sectional study. Temperature < 36 °C was defined as hypothermia.
Results: The study included 286 patients (77.6% female) with a mean age of 61.4 ± 10.4 years. The overall proportion of intraoperative hypothermia was 26.6%. Of the total …

Does More Testing In Routine Preoperative Evaluation Benefit The Orthopedic Patient? Case Control Study From A Resource-Constrained Setting, Obada Hasan, Shah Fahad, Mohammad Mustafa, Pervaiz Hashmi, Shahryar Noordin

Section of Orthopaedic Surgery

Background: Routine preoperative tests in healthy patients not only cause extra anxiety, but may delay treatment without influencing surgical plan. This has worse impact in resource-constrained settings where fee for service rather than health insurance is the usual norm. Investigators aim to determine if "routine" pre-operative tests are justified in healthy orthopedic patients.
Methods: We conducted a non-commercialized, non-funded matched case control study in tertiary care university hospital and a level-1 trauma centre for healthy patients (ASA-1&2) admitted from January 2014-December 2016 for elective orthopedic intermediate and major procedures. Cases (patient who had a change in his/her surgical plan after …

Weight Reduction Motivation In Osteoarthritis Patients Through Nurse Practitioner Driven Education And Follow-Up: A Pilot Project, Caoilfhionn Mulvey, Martha Fuller Phd

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: The ultimate goal of this short-term pilot project is for

overweight or obese osteoarthritis patients to increase their knowledge on the benefits of

weight loss and physical activity. Research shows that for every kilogram of weight lost,

2.2–4.0 kilograms of weight is taken off of the joint and could reduce joint pain up to

thirty to fifty percent and improve quality of life. Following education from the provider,

patients will understand the correlation of osteoarthritis symptom management with

weight loss.

EBP Model/Frameworks: This project utilizes the Iowa Model of Evidence-Based

Practice to Promote Quality Care. This addresses …

Reporting And Analyzing Race And Ethnicity In Orthopaedic Clinical Trials: A Systematic Review., Ryan W. Paul, Donghoon Lee, Joseph Brutico, Fotios P. Tjoumakaris, Michael G. Ciccotti, Kevin B, Freedman

Rothman Institute Papers

BACKGROUND: The distinction between race and ethnicity should be carefully understood and described for demographic data collection. Racial healthcare differences have been observed across many orthopaedic subspecialties. However, the frequency of reporting and analyzing race and ethnicity in orthopaedic clinical trials has not been determined. Therefore, the primary purpose of this systematic review was to determine how frequently race and ethnicity are reported and analyzed in orthopaedic clinical trials.

METHODS: The top 10 journals by impact factor in the field of orthopaedics were manually screened from 2015 to 2019. All randomized controlled trials related to orthopaedics and assessing clinical outcomes …

Radiologic Measurements In The Assessment Of Patellar Instability: A Systematic Review And Meta-Analysis., Alex E White, Peters T Otlans, Dylan P. Horan, Daniel Calem, William Emper, Kevin Freedman, Fotios Tjoumakaris, Md

Rothman Institute Papers

Background: Numerous diagnostic imaging measurements related to patellar instability have been evaluated in the literature; however, little has been done to compare these findings across multiple studies.

Purpose: To review the different imaging measurements used to evaluate patellar instability and to assess the prevalence of each measure and its utility in predicting instability. We focused on reliability across imaging modalities and between patients with and without patellar instability.

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

Methods: We performed a systematic review of the literature using the PubMed, SCOPUS, and Cochrane databases. Each database was searched for variations of the …

Reducing Unnecessary Crossmatching For Hip Fracture Patients By Accounting For Preoperative Hemoglobin Concentration, Raj M Amin, Varun Puvanesarajah, Yash P Chaudhry, Matthew J Best, Sandesh S Rao, Steven M Frank, Erik A Hasenboehler

Orthopedic Surgery Resident Research

BACKGROUND: Maximum surgical blood order schedules were designed to eliminate unnecessary preoperative crossmatching prior to surgery in order to conserve blood bank resources. Most protocols recommend type and cross of 2 red blood cell (RBC) units for patients undergoing surgery for treatment of hip fracture. Preoperative hemoglobin has been identified as the strongest predictor of inpatient transfusion, but current maximum surgical blood order schedules do not consider preoperative hemoglobin values to determine the number of RBC units to prepare prior to surgery.

AIM: To determine the preoperative hemoglobin level resulting in the optimal 2:1 crossmatch-to-transfusion (C:T) ratio in hip fracture …

When Total Joint Arthroplasty After Septic Arthritis Can Be Safely Performed, Timothy L. Tan, Chi Xu, Feng-Chih Kuo, Elie Ghanem, Jaiben George, Noam Shohat, Ji-Ying Chen, Mel S Lee, Carlos Higuera, Javad Parvizi

Rothman Institute Papers

Background: Patients undergoing total joint arthroplasty (TJA) following septic arthritis are at higher risk for developing periprosthetic joint infection (PJI). Minimal literature is available to guide surgeons on the optimal timing of TJA after completing treatment for prior native joint septic arthritis. This multicenter study aimed to determine the optimal timing of TJA after prior septic arthritis and to examine the role of preoperative serology in predicting patients at risk for developing PJI.

Methods: A total of 207 TJAs were performed after prior septic arthritis from 2000 to 2017 at 5 institutions. Laboratory values, prior treatment, time from the initial …

The Effect Of Covid-19 On Pediatric Orthopaedic Trauma Volume At A Level 1 Pediatric Trauma Center In The Midwestern United States, Kirsten Norrell

Research Days

Background: School and playground closures and the cancellation of extracurricular activities in the Kansas City region on March 17, 2020 due to the COVID-19 pandemic created an unprecedented situation for children and parents. Early reports in the literature on adult and pediatric trauma volume suggested a decrease in orthopaedic injuries during the pandemic. This is the first study to report how the pandemic affected orthopaedic trauma volume at a Level 1 pediatric trauma center during the entire five months since school and activity closures went into effect.

Objectives/Goal: The aim of this study was to compare the volume and type …