Orthopedics Commons^™

Acute Correction Of Acquired Genu Valgum Secondary To Post-Traumatic Growth Arrest At The Time Of Distal Femur Fracture., Josiah Wolf, Nicholas Pelz, Adam Mansour, Christopher Iobst, Allen Kadado

Surgery Articles

A 14-year-old male patient sustained a distal femur fracture after a ground-level fall. His history was notable for severe acquired genu valgum secondary to a childhood lawnmower accident, which had required multiple limb salvage procedures including a Syme amputation and soft-tissue skin grafting. Acute correction of the limb deformity was performed concurrently with fracture fixation using a retrograde intramedullary nail and poller blocking screws. Retrograde intramedullary nailing represents a viable treatment option for simultaneous acute correction of acquired genu valgum and stabilization of distal femur fractures.

A Comprehensive Review Of Bone Remodeling After Trauma And Operative Treatment In Orthopedic Surgery, Sarah E. Rabin, Ian P. Marshall, Benjamin A. Nelson, Justine N. Li, Madison M. Baldauf, Ashley B. Bozzay, Benjamin W. Hoyt

Department of Medicine Faculty Publications

Bone remodeling is a dynamic process involving bone resorption and formation that is regulated on a cellular level and impacted by mechanical stress. A variety of Orthopedic surgery treatment strategies can affect bone remodeling, which can in turn may have long-term impacts on skeletal stress tolerance and function. This review provides a comprehensive overview of bone remodeling involved in Orthopedic surgery. Materials related to bone remodeling principles across Orthopedic surgery domains were selected and compiled using databases including PubMed, MEDLINE, AccessMedicine, and CINAHL; case studies were not included. Relevant literature was summarized for a general review of bone remodeling and …

Failure Rates And Patient-Reported Outcomes Are Similar Across 5 Arthroscopic, Suprapectoral Biceps Tenodesis Fixation Techniques, Senah E. Stephens, Samantha M. Strohm, Rachael M. Shaughnessy, Katherine S. Worcester, Kevin F. Bonner

Department Surgery Faculty Publications

Purpose

To compare failure rates and patient-reported outcome measures (PROMs) across 5 arthroscopic, suprapectoral biceps tenodesis fixation techniques: tenodesis screw, tenodesis anchor, expanding tenodesis anchor, onlay with single all-suture anchor, and soft tissue tenodesis in the bicipital groove with suture.

Methods

This was a retrospective cohort study approved by the Institutional Review Board, including patients age 18 years or older who underwent arthroscopic, suprapectoral biceps tenodesis between 2014 and 2024 with a minimum of 6 months of clinical follow-up. Exclusion criteria included cervical pathology, chronic pain syndromes, revisions, and workers' compensation cases. Patients completed PROMs including pain Visual Analog Scale …

Epidemiology Of Closed Ruptured Tendoachilles, Hesham Mousad Alsakaan, Wael Mansour Wafa, Mohieb Sayed Ahmed, Ahmed El Sayed Magdy Elhawary

Mansoura Medical Journal

Background: To restore tendon function and avoid long-term impairment, early diagnosis and adequate treatment are crucial. The purpose of this study was to ascertain the incidence pattern of ATR and to pinpoint possible variables related to presentation and management approach.

Aim  identifying potential risk factors either patient or environmental related and to assess the incidence rate of ATR

Patients and Methods: This retrospective cross-sectional study was performed on 87 achilles tendon rupture patients. All the patients were subjected to full medical history taking. Clinical examination was performed including thompson test and Matles test and radiological investigations.

Results: The median age …

A Chicken Model For Non-Invasive Diagnosis Of Infant Developmental Dysplasia Of The Hip (Ddh) Using Acoustic Transmission Measurements, Aliza Shah

Honors Undergraduate Theses

Developmental dysplasia of the hip (DDH) is a condition characterized by abnormal development and stability of the hip joint. In a healthy infant, the femoral head (ball) fits securely within the acetabulum (socket of the pelvis), allowing for proper joint function. In DDH, the relationship is disrupted, ranging from mild acetabular dysplasia to partial (subluxation) or complete dislocation of the femoral head. This condition represents a range of structural abnormalities that develop during early growth. The integrity of the hip joint is essential for physical mobility, and disruption of this structure can lead to significant functional impairment. DDH may result …

Family Mental Health – A Case Report, Vikrant Arora, Medha Kosireddy, Mathumitha Ananth, Kishor M. Manohar Rao

Digital Journal of Clinical Medicine

Psychiatric illness in India is estimated to be 15% as per National Mental Health Survey 2015-16.  Mental health challenges within families, especially depression, anxiety disorders that are not common and when unaddressed exert cascading effects on all members, disrupting emotional cohesion, relational functioning, and socioeconomic stability. There are few case reports on entire family presenting to psychiatry department.

With informed consent a city-based middle-class family of non-consanguineous origin, where the 40-year-old female, presented with intractable limb pains and health anxiety, she had multiple consultation in last few months and her 48-year-old husband also had with episodic pains, irritability and her …

Assessing Access To Orthopaedic Care For Patients With Osteogenesis Imperfecta, Annemarie K. Leonard, Kara Ayers, Lauren Faokunla, Kaeli Samson, Erika Carter, Tracy Hart, Maegen Wallace

Graduate Medical Education Research Journal

Background. Osteogenesis Imperfecta (OI) is a rare disorder caused by variations in collagen. Clinical manifestations include multiple fractures, short stature, scoliosis, blue sclera, hearing loss, and opalescent teeth. Patients often need many different medical providers frequently, which may place financial burdens on families. This study sought to identify and understand barriers to care for children with OI.

Methods. We utilized an Institutional Review Board (IRB)-approved survey for primary caregivers of children with OI. Questions included demographic data, type of health insurance, history of and reasons for insurance denials, access to multidisciplinary OI care, and travel to receive OI care. The …

Research Productivity Variation In Applicants Who Matched Into Home Orthopaedic Surgery Programs, Frances Akwuole, Cole Christenson, Freddy Jacome, James Macleod, Omar Shaikh, Michael W. Pullen, Avani Chopra, Owen Lema, Justin Lee, Sia Cho, Annemarie K. Leonard, Alfonso Mejia

Graduate Medical Education Research Journal

Background. Research output among orthopaedic surgery applicants remains an important factor in the orthopaedic surgery residency selection process. However, there is limited literature comparing objective measures such as research productivity across different types of orthopaedic surgery applicants. We aim to determine if students who match at their home programs have significantly different research productivity and, secondarily, Alpha Omega Alpha (AOA) membership rates, compared to those who match at external programs.

Methods. This study was conducted in April 2024. A list of orthopaedic surgery residents was acquired from publicly available websites using a Python script. Programs were stratified into four geographic …

Synergizing Digital And Print: Leveraging Spine Surgeons' Social Media To Transform Publishing And Society Interaction, Benedikt W. Burkhardt, Kai-Uwe Lewandrowski, Choll W. Kim, Morgan P Lorio, Oscar L. Alves, Rossano Kepler Alvim Fiorelli, Sergio Luis Schmidt, Hansen A. Yuan, Alex R. Vaccaro

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Social media has fundamentally altered how information is created, disseminated, and consumed, with growing impact on spine surgeons and professional societies. Traditional academic publishing remains the standard for research validation, but digital platforms now shape much of the real-time dialogue in spine care.

OBJECTIVE: To explore strategies for integrating spine surgeons' social media presence with traditional publishing channels to enhance knowledge dissemination, support clinical innovation, and improve member engagement within spine societies.

METHODS: This perspective reviews current patterns of social media use among spine surgeons, focusing on platforms such as X (formerly Twitter), Instagram, and LinkedIn. It analyzes benefits …

Regenerative And Wellness Medicine: A Boon Or Barrier To Surgical Innovation In Degenerative Spine Care?, Álvaro Dowling, Kai-Uwe Lewandrowski, Morgan P. Lorio, Óscar L. Alves, Rossano Kepler Alvim Fiorelli, Sergio Luis Schmidt, Hansen A. Yuan, Alexander R. Vaccaro

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Regenerative and wellness medicine is rapidly reshaping health care, particularly in the management of degenerative spine conditions. Noninvasive or minimally invasive options such as stem cell therapy, platelet-rich plasma (PRP) injections, and holistic wellness programs are increasingly selected by patients who wish to avoid the risks, costs, and prolonged recovery associated with elective spine surgery.

PURPOSE: This perspective article examines whether regenerative and wellness approaches function primarily as a boon or a barrier to innovation in spine surgery and explores their impact on traditional, insurance-based surgical care models.

METHODS: Using a narrative, opinion-based framework, this article synthesizes current trends …

Surgical Treatment Of Post-Traumatic Elbow Stiffness In Pediatric Patients: A Systematic Review And Meta-Analysis, Roya Khorram, Areeb Ahmad, Reza Vafadar, Ronald Joseph Shamus, Surena Namdari, G. Russell Huffman, Amir R. Kachooei

Rothman Institute Papers

BACKGROUND: Post-traumatic elbow stiffness (PTES) has been reported in up to 21% of pediatric patients following elbow fractures and can profoundly compromise a child's function, and independence. The primary surgical approaches include open and arthroscopic arthrolysis, both of which have demonstrated improvements in range of motion (ROM) and functional scores. This systematic review and meta-analysis aims to compare the effectiveness, ROM, and complication rates between open and arthroscopic release in pediatric patients with PTES.

METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were utilized to conduct a systematic review and meta-analysis on surgical treatment for PTES. Comprehensive …

Osteoprogenitor Cells From Non-Regenerative Bone Show Greater Resistance To Cellular Stress Than Those From Regenerative Bone, Joshua Broussard, Sylvia Culpepper, Tyrel Long, Alexander J. Trostle, Robert J. Tower, Mimi C. Sammarco, Jennifer Simkin

School of Medicine Faculty Publications

INTRODUCTION: Bone regeneration following injury depends on osteoprogenitor cells derived predominantly from the periosteum. Incomplete regeneration has been attributed to both cell-extrinsic factors (e.g., environment, inflammation, mechanical instability) and cell-intrinsic factors (e.g., impaired proliferation or differentiation of stem cells). In the digit amputation mouse model, amputation through the third phalanx (P3) supports complete regeneration, while amputation through the second phalanx (P2) results in callus formation and scarring. Periosteal cells are known to be the major contributing cell source for repair and regeneration. Yet the healing outcomes of P2 and P3 amputations are significantly different. This study tests whether P2 and …

Surgical Revision In The Presence Of An S. Aureus Infection Increases Virulence Factor Expression And Activates A Multi-Tissue Inflammatory Response, Carly J. Smith, Arianna J. Moniodes, Amanda R. Watkins, Autumn G. Melvage, Thomas P. Thompson, Eirene Choi, Abigail A. Lucas, Brendan F. Gilmore, Thomas P. Schaer, Noreen J. Hickok, Theresa A. Freeman

Department of Orthopaedic Surgery Faculty Papers

Replacing implanted medical hardware due to infection often requires one or more revision surgeries. Each surgery triggers a tissue injury response and disrupts the established bacterial biofilm. However, the complex tissue response to reinjury and biofilm disturbance is not well understood. Our results show that with an existing infection, immunological niches such as the bone marrow, lymph nodes, and circulating blood further upregulate pro-inflammatory programs in response to revision. Rather than reducing bacterial burden, this heightened inflammation provokes virulence factor expression and tissue damage, including bone osteolysis and muscle fibrosis. While muscle fibrosis appears transient and begins resolving by 14 …

Transient Neuromonitoring Changes And Delayed Vertebrobasilar Infarction Following Anterior Cervical Discectomy And Fusion: Illustrative Case, Jacob M. Chaisson, Jack A. Leoni, Ellery A. Hayden, Gabriel C. Tender, Amit K. Bhandutia

School of Medicine Faculty Publications

BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is a common spinal procedure with a well-established safety profile. While direct vertebral artery injury is rare and typically recognized intraoperatively, delayed posterior circulation stroke is an even less common but major complication. In patients with risk factors for vascular disease, vascular stress from surgical manipulation may predispose them to thromboembolic events that are not immediately apparent. Transient intraoperative neuromonitoring (IONM) changes may represent early, underrecognized indicators of such vascular compromise. OBSERVATIONS: The authors present the case of a 61-year-old male who underwent elective three-level ACDF for degenerative cervical myelopathy. During cage placement, …

The Effect Of Platelet Rich Plasma Injection Vs. Steroid Injection On Plantar Fasciitis, Brian Nangle, Lasya Ampaty

Physician Assistant Capstones, 2020-current

Objective: Assess the ability of platelet-rich plasma (PRP) injections to perform better than steroid injections in a population refractory to conservative treatment. Design: Systematic literature review. Methods: Searches were done in PubMed and Scopus, utilizing the terms platelet-rich plasma, steroid injection, and plantar fasciitis. The following limits and terms were used: published in the last 5 years, randomized control trial, used both VAS scale and AOFAS scale. Results: All 3 studies demonstrated that PRP injections allowed more pain reduction and improved stability when compared to steroid injections. Conclusion: PRP injections offer a well-tolerated, minimally invasive procedure for patients refractory to …

Recreating Fiber Recruitment With Fiber Recruitment Using Additive Manufacturing, Natalia D. Mciver

Biomedical Engineering ETDs

Injured ligaments are often repaired with tendon grafts which may over or under constrain the joint; there is a need for an artificial graft option with the mechanical properties of a native ligament. Crimped fibers within ligaments allow for recruitment which means the viscoelastic properties of stress relaxation and creep are not inversely related. A feasibility study using ACLs and large-scale crimp models to study viscoelasticity, led to an in-depth analysis of the scapholunate interosseous ligament. Using the Modified Kelvin spring-dashpot model, for describing viscoelasticity with a variable stiffness property (time dependent fiber recruitment), we defined the relationship between creep …

Incomplete (A3) Versus Complete (A4) Thoracolumbar Burst Fractures: Results From A Prospective International Multicenter Cohort Study, Jin W. Tee, Barry T. S. Kweh, Alex R. Vaccaro, Klaus J. Schnake, Mohammad El-Sharkawi, Eugen C. Popescu, Shanmuganathan Rajasekaran, Lorin M. Benneker, Sebastian F. Bigdon, John France, Jerome Paquet, R. Todd Allen, William F. Lavelle, Miguel Hirschfeld, Spyridon Pneumaticos, Richard J. Bransford, Andrei F. Joaquim, Harvinder S. Chhabra, Ulrich Spiegl, Hauri Dimitri, F. Cumhur Oner, Marcel Dvorak, Gregory D. Schroeder, Charlotte Dandurand

Department of Orthopaedic Surgery Faculty Papers

OBJECTIVE: The objective was to compare incomplete (A3) versus complete (A4) thoracolumbar burst fractures managed nonoperatively or operatively with respect to reaching minimal clinically important difference (MCID) in Oswestry Disability Index (ODI) score.

METHODS: A prospective observational international multicenter cohort study was conducted. After stratification using the AO Spine Thoracolumbar Injury Classification System, A3 and A4 outcomes were analyzed separately within nonoperative and operative management groups. Outcomes included absolute and relative improvement in ODI scores between discharge and 12-month follow-up. Kaplan-Meier curves were generated and compared with the log-rank test. Multivariable Cox regression models were constructed. The Cox regression models …

Patient Preferences When Selecting Their Total Joint Arthroplasty Surgeon: A Multicenter Survey Study, Jake Laverdiere, Danielle Lonati, Swaroopa Vaidya, Gregory Panza, Antonia Chen, Mary Morcos, Yale Fillingham, Jessica Leipman, Molly Hartzler, Jenna Bernstein

Rothman Institute Papers

BACKGROUND: Surgeon selection can influence patient satisfaction, outcomes, and access in total joint arthroplasty (TJA). Awareness of patient preferences enables practices to enhance trust, optimize communication, and improve adherence. While referrals and word-of-mouth recommendations often outweigh online marketing, prospective multicenter research exploring how patients choose their TJA surgeon is limited. The aim of this study was to identify key decision-making factors and how they vary by demographics.

METHODS: This prospective, multicenter cross-sectional survey study included patients undergoing elective total joint arthroplasty at 4 high-volume institutions from January 2024 to 2025. Participants completed a survey on surgeon selection, including how they …

Outcomes After Ulnar Collateral Ligament Reconstruction And Repair In Nonthrowing Athletes, William L. Johns, Neel K. Patel, Benjamin Miltenberg, Ryan W. Paul, Adeeb J. Hanna, Michael C. Ciccotti, Steven B. Cohen, Michael G. Ciccotti, Christopher C. Dodson

Rothman Institute Papers

BACKGROUND: Surgical management of ulnar collateral ligament (UCL) tears in nonthrowing athletes is less commonly performed, and the outcomes of that management have not been thoroughly described.

PURPOSE: To describe the clinical outcomes of surgical management of UCL injury in nonthrowing athletes.

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

METHODS: A retrospective review was conducted on all patients who underwent UCL reconstruction or repair across a 10-year period (2010-2020), with nonthrowing athletes who had >2-year follow-up being specifically identified. Demographic variables such as age, sport participation, concomitant procedures, and graft type, as well as postoperative outcomes such as complications, …

Radiation-Induced Brachial Plexopathy: Current Understanding, Diagnosis, And Treatment Options, Alex G. Lambi, Tomas Holly, Ryan E. Tomlinson, Mary F. Barbe

Department of Orthopaedic Surgery Faculty Papers

Radiation-induced brachial plexopathy (RIBP) is a gruesome complication of cancers treated with radiation therapy around the lung and chest wall, head and neck, and breast and axilla. It can occur in an early-onset (transient) or a late-onset (chronic) fashion. The diagnosis involves exclusion of a compressive neoplastic process, either new or recurrent, and relies largely on patient symptomatology without well-validated, objective scoring systems. Treatment options remain limited as no major advances have been made to prevent or halt disease progression. This article reviews the background incidence, pathophysiology, and diagnosis of RIBP. In addition to surgical treatment options, nonsurgical modalities, often …