Orthopedics Commons^™

Discontinuation And Switching Patterns Of Tumour Necrosis Factor Inhibitors (Tnfis) In Tnfi-Naive And Tnfi-Experienced Patients With Psoriatic Arthritis: An Observational Study From The Us-Based Corrona Registry., Philip Mease, Chitra Karki, Mei Liu, Youfu Li, Bernice Gershenson, Hua Feng, Peter Hur, Jeffrey D Greenberg

Articles, Abstracts, and Reports

Objective: To examine patterns of tumour necrosis factor inhibitor (TNFi) use in TNFi-naive and TNFi-experienced patients with psoriatic arthritis (PsA) in the USA.

Methods: All patients aged ≥18 years with PsA enrolled in the Corrona Psoriatic Arthritis/Spondyloarthritis Registry who initiated a TNFi (index therapy) between March 2013 and January 2017 and had ≥1 follow-up visit were included. Times to and rates of discontinuation/switch of the index TNFi were compared between TNFi-naive and TNFi-experienced cohorts. Patient demographics and disease characteristics at the time of TNFi initiation (baseline) were compared between cohorts and between patients who continued versus discontinued their index TNFi …

Is Botulinum Toxin Injection Effective In Reducing Pain In Patients Diagnosed With Plantar Fasciitis?, David A. Fry

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not botulinum toxin injection is effective in reducing pain in patients diagnosed with plantar fasciitis.

STUDY DESIGN: Review of three randomized controlled trials (RCTs) comparing the efficacy of botulinum toxin injections versus corticosteroid injections for improving pain and dysfunction in those diagnosed with plantar fasciitis.

DATA SOURCES: All articles were presented in English and were taken from peer reviewed sources using PubMed. All articles were published from 2012-2017.

OUTCOMES: Outcomes of investigation measured are pain score measured using the VASvisual analog scale and Foot Health Status Questionnaire. …

Oral Contraceptive Pills Are Not A Risk Factor For Deep Vein Thrombosis Or Pulmonary Embolism After Arthroscopic Shoulder Surgery, Austin V. Stone, Avinesh Agarwalla, Anirudh K. Gowd, Cale A. Jacobs, Jeffrey A Macalena, Bryson P. Lesniak, Nikhil N. Verma, Anthony A. Romeo, Brian Forsythe

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: Worldwide, more than 100 million women between the ages of 15 and 49 years take oral contraceptive pills (OCPs). OCP use increases the risk of venous thromboembolism (VTE) through its primary drug, ethinylestradiol, which slows liver metabolism, promotes tissue retention, and ultimately favors fibrinolysis inhibition and thrombosis.

Purpose: To evaluate the effects of OCP use on VTE after arthroscopic shoulder surgery.

Study Design: Cohort study; Level of evidence, 3.

Methods: A large national payer database (PearlDiver) was queried for patients undergoing arthroscopic shoulder surgery. The incidence of VTE was evaluated in female patients taking OCPs and those not taking …

Traumatic Neuroma Of The Median Nerve: A Case Report, Keir Johnson, Amber West, Brooke Baker

UNM Orthopaedic Research Journal

Peripheral nerve neuromas are growths that develop after nerve trauma, which can result in enlarged and painful nerve ends when severed. Treatment of neuromas that form within a continuous nerve is controversial; however, success has been reported after general neurolysis with decompression of the nerve after its isolation from the surrounding scar bed. We describe a 21-year-old man who presented with symptoms of pain and intermittent numbness in his left elbow. Findings of high-resolution magnetic resonance imaging and ultrasound confirmed the diagnosis of median nerve neuroma at the level of the forearm. He subsequently underwent neurolysis with protective nerve wrap, …

Fracture Of The Ulnar Sesamoid Bone In The Thumb Of A Collegiate Basketball Player: A Case Report, Andrew M. Hyden, Christopher A. Mcgrew, Deana Mercer

UNM Orthopaedic Research Journal

Sesamoid fractures of the hand are uncommon occurrences that can lead to prolonged pain and swelling if delayed in diagnosis. This is particularly problematic in competitive athletes. We describe an ulnar sesamoid fracture of the thumb due to a blunt traumatic injury in a Division I collegiate basketball player. The 22-year-old woman injured her left thumb when kicked during a game. The patient was treated nonoperatively with promising outcomes. Sesamoid fractures of the hand can be difficult to diagnose, and any delay can lengthen the amount of time before the athlete returns to play. Radiographic findings may help healthcare providers …

Open Lumbosacral Dislocation: A Case Report, Travis M. Hughes, Tony G. Pedri, Antony Kallur

UNM Orthopaedic Research Journal

Open injuries in the lumbar spine are rare. We describe a 20-year-old woman who presented with persistent weaknesses due to an associated lumbar plexus injury. She underwent surgical treatment of lumbosacral dislocation with prompt reduction with debridement and stabilization. At 7 months postoperatively, her symptoms showed signs of recovery. We believe the immediate reduction of the dislocation prevented permanent neurological injury, and stabilization helped healing and early mobilization. In keeping with the classical teaching of open fracture treatment, prioritizing early initiation of intravenous antibiotics and prompt debridement and stabilization may have helped decrease the long-term morbidity and overall sequelae of …

Accuracy And Reliability Of Examiners’ Observations Of Pre-Practice Warm-Up And Fifa 11+ Injury Prevention Program Exercises, James R. Slauterbeck, Pamela M. Vacek, Rebecca Choquette, Tessa Kettelkamp, Autumn Reilly, Brandon Lentine, Bruce D. Beynnon

UNM Orthopaedic Research Journal

Background: The Fédération Internationale de Football Association (FIFA) 11+ is an injury prevention program that decreases the incidence of lower extremity injuries. The purpose of the current study was to understand what specific exercises prevented injury from occurring. We thus developed and tested a form to identify these exercises. We hypothesize that trained examiners could accurately and reliably use this form to identify and record individual exercises performed during preparticipation warm-up.

Methods: A repeated-measures study design was used in this investigation. After observing five prepractice warm-up videos obtained from multiple high schools, 11 examiners observed and recorded performed exercises at …

Training Orthopaedic Residents To Formulate Evidence-Based Questions, Jonathan D. Eldredge

UNM Orthopaedic Research Journal

Background: Formulating questions that are both focused and answerable is an essential clinical skill for evidence-based practice (EBP). Possessing this skill can successfully launch research projects. Yet studies have depicted mixed results pertaining to the teaching of question formulation. This report describes introducing orthopaedic residents to question formulation and showcases an accompanying evaluation rubric originally developed for training second-year medical students.

Methods: In this prospective cohort study, a total of 23 orthopaedic residents at The University of New Mexico Health Sciences Center participated in a 1-hour training. The study included application exercises using an evaluation rubric for learners to assess …

Physical Therapy Faculty, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Letter From The Residency Director, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Unmorj Full Instructions For Authors, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Tofacitinib Or Adalimumab Versus Placebo: Patient-Reported Outcomes From Opal Broaden-A Phase Iii Study Of Active Psoriatic Arthritis In Patients With An Inadequate Response To Conventional Synthetic Disease-Modifying Antirheumatic Drugs., Vibeke Strand, Kurt De Vlam, Jose A Covarrubias-Cobos, Philip Mease, Dafna D Gladman, Daniela Graham, Cunshan Wang, Joseph C Cappelleri, Thijs Hendrikx, Ming-Ann Hsu

Articles, Abstracts, and Reports

Objectives: Tofacitinib is an oral Janus kinase inhibitor for treatment of psoriatic arthritis (PsA). We evaluated patient-reported outcomes (PROs) in patients with PsA refractory to ≥1 conventional synthetic disease-modifying antirheumatic drug (csDMARD-IR) and tumour necrosis factor inhibitor-naïve in a 12-month, phase III randomised controlled trial (OPAL Broaden [NCT01877668]).

Methods: Patients (N=422) received tofacitinib 5 mg or 10 mg twice daily, adalimumab 40 mg subcutaneously every 2 weeks or placebo advancing to tofacitinib 5 mg or 10 mg twice daily at month 3. Least squares mean changes from baseline and percentages of patients reporting improvements ≥minimum clinically important differences (MCID); and …

Measurement Properties Of The Minimal Disease Activity Criteria For Psoriatic Arthritis., Laura C Coates, Vibeke Strand, Hilary Wilson, Dennis Revicki, Brad Stolshek, Ahmed Samad, James B Chung, Dafna Gladman, Philip Mease

Articles, Abstracts, and Reports

Objective: To comprehensively assess evidence on the measurement properties of the minimal disease activity (MDA) criteria, a composite measure of the state of disease activity in psoriatic arthritis (PsA).

Methods: A targeted literature review was conducted to identify studies that informed the validity and/or ability of the MDA to detect change among patients known to have experienced a change in clinical status. The search was conducted using MEDLINE and Embase databases (published as of October 2017). Pertinent articles provided by investigators and identified from select conference proceedings were also evaluated.

Results: A total of 20 publications met the inclusion criteria. …

Are Plasma Rich Platelets More Effective In Decreasing Chronic Lower Back Pain As Compared To Epidural Injections In Young Adults?, Linda M. Leones

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not PRP injections are more effective in decreasing chronic lower back pain as compared to epidural injections in young adults.

Study Design: Systematic review of three English language randomized controlled trials (RCTs), all published after 2012.

Data Sources: Two double-blind RCTs and one randomized open blinded end point (PROBE), which analyzed the effectiveness of PRP and epidural injections in young adults with chronic lower back pain. All studies were found using PubMed.

Outcome(s) Measured: Each of the articles analyzed the pain relief and function ability stated by …

Is Platelet-Rich Plasma (Prp) A More Effective Treatment In Reducing Pain Than Corticosteroid (Cs) Injections In Musculoskeletal Injuries?, Nicole Gazzola

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not, “Is Platelet-Rich Plasma (PRP) a more effective treatment in reducing pain than corticosteroid (CS) injections in musculoskeletal injuries?”

STUDY DESIGN: Review of three, double blind, randomized controlled trials (RCTs), published between 2013 and 2016, all in the English language were included. The articles compared platelet-rich plasma (PRP) and corticosteroid (CS) injections to a visually matched placebo of saline in regard to reduction of pain from baseline in varying different musculoskeletal injuries.

DATA SOURCES: Three RCTs were found using PubMed and Google Scholar. All articles were published …

Optimization Of Primary Cilia Detection In Musculoskeletal Tissue, Ragen Engel

Williams Honors College, Honors Research Projects

The objective of this research project was to optimize a laboratory technique for visualizing primary cilia in musculoskeletal tissue of young swine, specifically the growth plate of long bones. This was accomplished through varying fixation procedures, antigen retrieval methods, antibody concentrations, and incubation times. By varying these parameters, a reproducible procedure was developed to examine the primary cilia in multiple tissues including ligament, fascia, and growth plate. This experiment introduced variances in fixation methods, with methanol or formalin. Paraffin and frozen embedding techniques were also varied for comparison with regards to cilia visualization. Results from the acetylated alpha tubulin (aTUB) …

Post Surgical Outcomes Following Limited-Open Carpal Tunnel Release Or Endoscopic Carpal Tunnel Release, Keeley Shaye Smith

Online Theses and Dissertations

Carpal Tunnel Syndrome is a neurological condition that may contribute to decreased grip strength, sensory function, activities of daily living, and many other negative impacts on an individual’s life. The purpose of this study was to assess whether patients who received endoscopic carpal tunnel release had better patient reported outcomes than patients who received limited-open carpal tunnel release. This study prospectively assessed patient reported outcomes such as pain, Patient-Specific Functional Score, Quick Disabilities of the Arm Shoulder and Hand Score, two-point discrimination, and hand grip-strength. This study demonstrated that there were significant differences within all subjective data measures (p≤0.017) from …

Development And Exploration Of A Z-Shaped Foot And Ankle Internal Fixation Plate, Rhaz Shaghaghi Paul, Ian Hames, Sean Rich

Williams Honors College, Honors Research Projects

This paper will detail the design process of developing a Z-shaped foot and ankle internal fixation plating system. Group 6: Plates for the Sole was made up of 5 team members, who worked together to accommodate their client’s request to complete a biomechanical analysis of a Z-Plate design and a construct a prototype. The Z-Plate’s purpose is to provide podiatrists with a new solution that can fit nicely on the small, irregular bones of the foot, while also remaining strong enough to withstand the forces and torques of the foot.

Marjolin's Tumor Complicating Chronic Periprosthetic Infection Of A Total Knee Arthroplasty, Timothy Horan, Matthew T. Wallace, Albert J. Aboulafia, Janet D. Conway

Orthopedic Surgery Resident Research

Marjolin's tumor is a term used to describe a malignancy developing in the setting of a chronic wound, infection, or other tissue subject to chronic inflammatory changes. These malignancies usually present after many years of chronicity, and can range from lower grade basal cell carcinomas to high-grade sarcomas. We present the case of a squamous cell carcinoma that developed within a chronic periprosthetic infection of a total knee arthroplasty of 7 years duration. The intra-articular location, association with an orthopaedic implant, and brief latency period are all unique features of this case.

A Traumatic Three-Level Brachial Plexus Palsy With Upper Trunk Avulsion, Andre Anderson, Michael Swartzon, Gautam Yagnik, John Uribe

All Publications

No abstract provided.