Orthopedics Commons^™

Front Matter, Arianna Medina

Western Journal of Orthopaedics

No abstract provided.

Back Matter, Arianna Medina

Western Journal of Orthopaedics

No abstract provided.

21st Century Perspective On The Changing Pattern Of Nerve Injuries From Gunshot Wounds In The U.S., Thomas A. Decoster

Western Journal of Orthopaedics

Gunshot wounds (GSWs) with nerve injuries in the 21st century differ significantly from those reported in the 20th century. The vast majority are now low-velocity civilian injuries, in contrast to high-velocity military injuries previously reported. The rate of nerve injury in civilian GSWs is approximately 5%, compared with the 30% reported in military cohorts. However, the most common pattern of nerve injury in the current civilian population is neurotmesis and partial neurotmesis, in contrast to the majority axonotmesis of the military cohorts. In the 20th century, treatment generally consisted of watchful waiting for signs of spontaneous recovery over three months …

Full Issue, Arianna Medina

Western Journal of Orthopaedics

No abstract provided.

Peripheral Nerve Repair And Reconstruction: Current Techniques, Adjuncts, And Emerging Therapies, Niklaus Skipp, Lana Dokic, Christina Wassef, Jazzlyn Gonzalez, Ana Love, Heather Mercer, Deana Mercer

Western Journal of Orthopaedics

Peripheral nerve injuries require reconstruction when direct, tension-free repair is not possible. A range of reconstructive strategies are used to restore continuity and promote axonal regeneration, including graft-based reconstruction, nerve transfers, conduit-based repair, supercharged end-to-side augmentation, and emerging regenerative therapies. Autologous interfascicular nerve grafts and vascularized grafts remain established techniques, whereas processed nerve allografts provide a donor-sparing alternative. Nerve transfers are increasingly used for proximal injuries with long regeneration distances, and conduits are an option for gaps shorter than 5 mm. Nerve-wrapping techniques are used to reduce perineural scarring and preserve gliding in complex or revision cases. Emerging adjunctive therapies, …

The Effect Of Institutional Reputation On Clerkship Grades, Jerry Speight Grimes

Western Journal of Orthopaedics

Background: Clinical rotation scores have been reported to predict resident performance. However, the reporting of clerkship grades varies widely across institutions. The authors explored the correlation of an institution’s reputation and the percentage of students receiving honors. Methods: During the review of applicants for orthopaedic residency, the percentage of students receiving the highest grade in the surgery and internal medicine clerkships was recorded for each institution. The authors then compared published institutional rankings with the proportion of students awarded honors in these clerkships. Results: One hundred nineteen institutions were reviewed. There was poor correlation between the institutional rankings by U.S. …

Analysis Of Patient Factors That Predict Early Restoration Of Neutral Dorsiflexion After Achilles Tendon Rupture, W. Chad Elliott, Alvin Ouseph, Alexander Abraham, Jerry Speight Grimes

Western Journal of Orthopaedics

Background: Achilles Tendon Rupture (ATR) is a common musculoskeletal injury with an increasing incidence in the United States. Early functional rehabilitation is a key component of improving patient outcomes, and restoration of range of motion is a common threshold for progression to strengthening. Neutral ankle dorsiflexion represents an important early milestone in ATR recovery. This study aimed to assess which patient factors were associated with achieving this early rehabilitation milestone. Methods: A retrospective review was performed on 70 patients who sustained ATR and were treated at an academic center. Demographics, baseline characteristics, and common ATR risk factors were collected. The …

Insertion Of An Internal Joint Stabilizer Through A Posterolateral Approach For The Management Of Complex Elbow Instability, Miguel A. Pirela-Cruz, Nikalus Skipp, Ana Love, Deana Mercer, Jazzlyn Gonzalez

Western Journal of Orthopaedics

Background: Complex elbow fracture-dislocations represent a substantial surgical challenge. Achieving adequate stability while permitting early postoperative motion is essential to prevent stiffness. The internal joint stabilizer (IJS) has emerged as an alternative to hinged external fixation, providing internal dynamic stabilization with improved patient tolerance and reduced risk of soft-tissue complications. Although the IJS is commonly inserted through a lateral approach, injuries involving multiple anatomical structures may necessitate broader exposure. Purpose: To describe the surgical technique for IJS insertion through a posterolateral approach (PLA) for complex elbow injuries involving multiple anatomical structures. Methods: The PLA provides extensile exposure to the posterior, …

Exploring The Interaction Between Cranial Nerves V And Vii In Chronic Eyelid Myokymia: A Case Report, Karina Miramontes, Adam Walsh, Tomas Tafoya

Western Journal of Orthopaedics

Eyelid myokymia involves involuntary contractions of the orbicularis oculi muscle and is commonly associated with stress, fatigue, and craniocervical factors. Emerging evidence suggests that altered trigeminocervical interactions and craniomandibular muscle tension may contribute to symptom persistence; however, the condition remains underrecognized in physical therapy. This report describes a 65-year-old woman with chronic benign eyelid myokymia and cervical pain who completed 12 physical therapy sessions that included suboccipital functional dry needling, temporomandibular soft-tissue mobilization (STM), and cervical stabilization exercises. A reduction in eyelid myokymia was first observed at the fifth visit, coinciding with the initiation of temporomandibular STM. These findings suggest …

Prosthetic Knee Joint Infection Caused By Gemella Morbillorum, Nataly Echevarria-Castro, Shaleen Duhra, Leonor Echevarria

Western Journal of Orthopaedics

Gemella morbillorum is a gram-positive coccus found in the gastrointestinal tract, and is an uncommon cause of human infections, including prosthetic joint infections (PJI). Reported risk factors include immunosuppression, recent gastrointestinal procedures, and poor dental hygiene. This report describes a case of knee PJI caused by G. morbillorum, likely due to hematogenous seeding following a colonoscopy three months earlier. The patient is a 70-year-old man with well-controlled diabetes mellitus who had undergone total knee arthroplasty three years prior. He presented with three weeks of left knee swelling. Synovial fluid culture revealed G. morbillorum. The patient was treated with debridement, antibiotics, …

Arthroscopic Management Of A Loose Body In The Pisotriquetral Joint: A Case Report, Giovanni Chioda, Tomas Holy, Nicholas Newcomb, Nathan Morrell

Western Journal of Orthopaedics

The pisotriquetral joint is the smallest of the four joints comprising the wrist and is a source of ulnar-sided wrist pain. This condyloid joint connects the pisiform to the triquetrum and is supported by several surrounding ligaments. A variety of pathologies may affect the pisotriquetral joint, including the presence of loose bodies. Because of its small size and the inherent difficulty of visualization, the pisotriquetral joint is often overlooked as an independent joint. Techniques for arthroscopic visualization and loose-body removal have previously been described using the 6R and 4-5 portals. In the following case report, the authors describe successful visualization …

Current Concepts In Hip And Core Assessment To Reduce The Risk Of Acl Injury, Jeremy M. Burnham, Anthony T. Drazick, Ghislain Aminake, Darren L. Johnson, Mary Lloyd Ireland, Brian W. Noehren

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: Hip and trunk (“core”) muscle dysfunction has emerged as a modifiable contributor to lower-limb biomechanics linked with non-contact anterior cruciate ligament (ACL) injuries. Clinicians increasingly target core stability and control during injury-prevention screening and post-operative rehabilitation programs; however, the literature lacks a focused synthesis of core-directed strategies for ACL injury mitigation. The purpose of this current concepts review is to synthesize current evidence on hip- and core-focused assessment and rehabilitation strategies that may mitigate ACL injury risk.

Design: Current Concepts Review.

Methods: A narrative search of PubMed and Google Scholar (January 2000 – April 2025) identified biomechanical, prospective, interventional, …

Decoding A Decade: Evolution In Distal Radius Fracture Techniques From Past To Present, Embracing The Efcr Method, Natasha G. Dark, Ahmed S. Raihane, Laurie G. Wells, Deana Mercer

Western Journal of Orthopaedics

No abstract provided.

Extradigital Glomus Tumor Mimicking Incisional Neuroma After Total Knee Arthroplasty: A Case Report, James W. Li, Michael J. Sayegh, Heng Hong, Zhongyu Li

Stony Brook Orthopaedic and Musculoskeletal Journal

This case report describes a patient who was presented with severe incisional pain following an uncomplicated total knee arthroplasty. There was suspicion for an incisional neuroma; however, excisional biopsy revealed an extradigital glomus tumor. The patient had immediate symptom resolution post-operatively. Clinicians should maintain a suspicion for the possibility of extra-digital glomus tumors at sites of prior extremity surgery, causing exquisite tenderness and pain.

3d Geometric Modelling And Clinical Validation Of Lower Limb And Preliminary 2-Year Post-Operative Clinical Outcomes Of Neutral Boundary Alignment In Total Knee Arthroplasty, Bruno Violante, Lorenzo Deveza, Francesco Pollara, Giovanni Rusconi, Gianroberto Ferreri, Alessandro Annibaldi, Ilwhan Park

Faculty, Staff and Students Publications

Purpose: To introduce a novel three-dimensional (3D) modelling concept for lower limb alignment in total knee arthroplasty (TKA), termed neutral boundary alignment (NBA) and to present preliminary clinical data supporting this physics-based custom alignment strategy.

Methods: NBA is defined as the alignment at which the knee joint line is parallel to the ground during the mid-stance phase of gait, achieving static equilibrium with the NBA axis aligned to gravity. A theoretical geometric model of the lower limb was developed, integrating principles of physics to describe this condition. Preliminary clinical validation was performed using radiographic data from an initial cohort of …

A Comparative Analysis Of The Sport Mental Health Assessment Tool (Smhat-1) Between Paediatric And Adult Olympic And Paralympic Athletes, Ashley N Triplett, Travis Anderson, Eric G Post, Jessica Bartley, Jeffrey S Shilt, Eric L Dugan, Amber Donaldson, Jonathan Finnoff, William M Adams

Faculty, Staff and Students Publications

Objective: To determine if paediatric athletes exhibit differences in positive screenings on the Sport Mental Health Assessment Tool (SMHAT-1) compared with adults.

Methods: Team USA Olympic and Paralympic paediatric athletes ≤21 years (n=589; 58.8% female; age=19.5±1.7 years) completed the SMHAT-1 between January 2021 and September 2024. A comparative sample of Team USA adult athletes (n=493, 54.2% female; age=27.3±4.9 years) matched for sex and sport was randomly sampled, and the percentage of athletes with a positive screening on each questionnaire was calculated. χ2 analysis compared the proportion of positive screenings between paediatric and adult samples. Piecewise linear regression assessed the association …

Histopathological Effects Of The Intrathecal Chondroitinase Abc Administration In Spinal Cord Injured Rats: A Systematic Review, Mohammad Amin Habibi, Ali Anjomshoa, Mohsen Sadeghi-Naini, Zahra Ghodsi, Samuel Berchi Kankam, Erfan Razavi, Armin Aryannejad, Seyed Mohammad Piri, Akam Ramezani, Rasha Atlasi, Kawthar Mohamed, Sina Shoo, Meysam Kaveh, Akbar Fotouhi, Arman Zeinaddini, James S. Harrop, Alex R. Vaccaro, Michael G. Fehlings, Vafa Rahimi-Movaghar

Department of Orthopaedic Surgery Faculty Papers

Introduction: Chondroitinase ABC (ChABC) has been considered a potential treatment for spinal cord injury (SCI). We aim to identify and evaluate the histopathological effects of intrathecal ChABC administration in SCI rat models.

Methods: We searched PubMed/MEDLINE, Scopus, Web of Science, Embase, and Cochrane Library for studies published from the inception of each database until November 22, 2022.

Results: Of 3857 screened citations, 17 studies met eligibility criteria and were entered into the qualitative analysis. Sixteen studies were of high quality, and one study was of medium quality. The four main rat strains used in studies were Sprague-Dawley, Wistar, Lister hooded, …

Synthesis And Characterization Of Glass-Ceramic Nanoparticles And Nanobubbles For Integration Into Bone Regenerative Biomaterials, Sun Latt

Honors Undergraduate Theses

Osteoporosis affects over 200 million individuals worldwide and is characterized by an imbalance between osteoclastic bone resorption and osteoblastic bone formation, leading to fragility fractures that significantly diminish quality of life. Current clinical bone cements, such as poly(methyl methacrylate), are limited by poor osseointegration, toxic monomers, and an inability to address the underlying pathophysiology of osteoporosis. This work presents the synthesis, characterization, and systematic in vitro evaluation of a sol-gel-derived, magnesium-incorporated glass-ceramic (GC) nanoparticle within the CaO-MgO-SiO₂ system for incorporation into a novel hydrogel bone cement and bioresorbable magnesium implants. XRD confirmed a biphasic amorphous-crystalline diopside composition, and TEM …

Relationships Between Quadriceps Neuromuscular Function And Time From Surgery Following Acl Reconstruction Are Sex-Specific, Tatiana Restrepo

Honors Undergraduate Theses

Anterior cruciate ligament reconstruction (ACLR) is associated with persistent quadriceps dysfunction, including muscular weakness and altered spinal and cortical excitability. While recovery has been widely studied, most investigations focus on isolated domains and fixed postoperative time points. Emerging evidence suggests females often experience slower or less complete quadriceps recovery compared to males, yet the time-dependent nature of these sex-specific outcomes remains unclear. The purpose of this study is to examine whether relationships between time since ACLR and quadriceps neuromuscular outcomes differ by sex across muscular, spinal, and cortical domains. Adults aged 18–35 with a history of primary, unilateral ACLR were …

Proceeding Of The 31st Annual Orthopaedic Symposium June 19, 2026, David Komatsu

Stony Brook Orthopaedic and Musculoskeletal Journal

Proceeding of the 31st Annual

Orthopaedic Symposium

June 19, 2026