Orthopedics Commons^™

Effect Of Hemiepiphysiodesis On The Growth Plate: The Histopathological Changes And Mechanism Exploration Of Recurrence In Mini Pig Model., Jing Ding, Jin He, Zhi-Qiang Zhang, Zhen-Kai Wu, Fang-Chun Jin

Manuscripts, Articles, Book Chapters and Other Papers

Purpose: Hemiepiphysiodesis has been widely used to correct angular deformity of long bone in immature patients. However, there is a limited knowledge about the biomechanical effect of this technique on the histopathological changes of the growth plate and the mechanism of recurrence of malformation after implant removal. We aimed to evaluate the biomechanical effect of hemiepiphysiodesis on the histopathological changes of the growth plate and the mechanism of recurrence of malformation after implant removal in Bama miniature pigs, and to explore the role of asymmetric stress during this procedure.

Methods: Eight 3-month-old male Bama miniature pigs sustained surgeries on the …

An Inpatient Rehabilitation Interprofessional Care Pathway For Traumatic Hip Fracture: A Pilot Quality Improvement Project, Sarah Plante

DNP Scholarly Projects

Background: Each year over 300,000 older adults are hospitalized for hip fracture. The impact of the cost of hip fracture on the US health care system is estimated to be as high as $9 billion, with the typical cost of a hip fracture episode around $30,000. Formalized pathways have been developed and successfully utilized for many patient presentations, including hip fracture, in the acute setting. Although this research is important to the comprehensive care of the elderly hip fracture patient, very little research exists that outlines evidence-based best-practice for patients in the post-acute recovery period.

Purpose: The primary aim of …

Superior Capsular Reconstruction In The Active Population With A Massive Irreparable Rotator Cuff Tear, Hernandez Emmanuel

Physician Assistant Scholarly Project Papers

The prevalence of rotator cuff tears is a leading cause of upper extremity functional disability and affects people across the lifespan. The primary age groups that are diagnosed include young adults as well as the elderly population. Early diagnosis and identification of rotator cuff injuries are paramount for the appropriate treatment to be facilitated. Approximately one-fifth of rotator cuff tears (RCT) are diagnosed as “massive” and prove to be difficult for orthopedic surgeons to repair. If the massive RCT is also diagnosed as “irreparable”, surgical intervention is technically difficult and is a challenging procedure. Historically, treatment options have been limited …

The Effectiveness Of Oral Non-Steroidal Anti-Inflammatories Versus Steroid Injections In Patients With Shoulder Pain, Darren Scott Pledger

Physician Assistant Scholarly Project Papers

Shoulder pain is the third most common musculoskeletal complaint in primary care. Therefore, it is important that we have quality evidenced based treatments to guide clinicians in treating shoulder pain. I examined in this review whether corticosteroid injection into the glenohumeral joint or oral NSAIDs was more effective in reducing shoulder pain as well as the side effects associated with each treatment modality. Search methods included the PubMed and Cochrane databases. Only studies comparing corticosteroid injection and oral NSAIDs were included and not each treatment individually. In conclusion, corticosteroid injections into the glenohumeral joint accelerate pain relief but have equal …

The Effectiveness Of Oral Non-Steroidal Anti-Inflammatories Versus Steroid Injections In Patients With Shoulder Pain, Darren Scott Pledger

Physician Assistant Scholarly Project Posters

- The fact that shoulder pain is the most common musculoskeletal complaint in primary care shows that clinicians must have an arsenal of quality interventions to treat this problem.

- The need for quality research and evidenced based guidelines are necessary to educate clinicians on their treatment options, the efficacy of those treatments, and their safety profiles.

Season Of The Year Influences Infection Rates Following Total Hip Arthroplasty, Samuel Rosas, Alvin C. Ong, Leonard T. Buller, Karim G. Sabeh, Tsun Yee Law, Martin W. Roche, Victor H. Hernandez

Department of Orthopaedic Surgery Faculty Papers

To research the influence of season of the year on periprosthetic joint infections. METHODS We conducted a retrospective review of the entire Medicare files from 2005 to 2014. Seasons were classified as spring, summer, fall or winter. Regional variations were accounted for by dividing patients into four geographic regions as per the United States Census Bureau (Northeast, Midwest, West and South). Acute postoperative infection and deep periprosthetic infections within 90 d after surgery were tracked. RESULTS In all regions, winter had the highest incidence of periprosthetic infections (mean 0.98%, SD 0.1%) and was significantly higher than other seasons in the …

System For Powered Ankle-Foot Prosthesis With Active Control Of Dorsiflexion-Plantarflexion And Inversion-Eversion, Mo Rastgaar, Evandro Ficanha, Kenton Kaufman

Michigan Tech Patents

A system and method for operating a prosthesis is provided. The system includes a socket configured to engage a residual limb of a subject and a shaft having a first end connected to the socket and an opposing second end. The system also includes a foot piece connected to the second end of the shaft. The foot piece includes an ankle plate and a sole piece configured to contact a surface. The system also includes at least one computer configured to detect a state of the foot piece and to transmit an indication of the state of the foot. The …

Venous Thromboembolism Within Professional American Sport Leagues., Meghan Bishop, Matthew Astolfi, Eric M. Padegimas, Peter F. Deluca, Sommer Hammoud

Department of Orthopaedic Surgery Faculty Papers

Background: Numerous reports have described players in professional American sports leagues who have been sidelined with a deep vein thrombosis (DVT) or a pulmonary embolism (PE), but little is known about the clinical implications of these events in professional athletes.

Purpose: To conduct a retrospective review of injury reports from the National Hockey League (NHL), Major League Baseball (MLB), the National Basketball Association (NBA), and the National Football League (NFL) to take a closer look at the incidence of DVT/PE, current treatment approaches, and estimated time to return to play in professional athletes.

Study Design: Descriptive epidemiology study.

Methods: An …

Multimodality Minimally Invasive Treatment Of Large Joint Osteoarthritis: A Pilot Trial Of Stromal Vascular Fraction From Autologous Fat Combined With Platelet-Rich Plasma, Phil Giddings, Insiyah Campwala, Subhas Gupta

Loma Linda University Student Journal

Osteoarthritis (OA) is a degenerative joint disease that can cause severe pain in those affected. Currently, there are no therapeutic drugs available to treat osteoarthritis. While total joint arthroplasties (TJA) allow for improved function, there are no less invasive, yet effective procedures that can be done for patients unwilling or unable to undergo major surgery.

Platelet-rich plasma (PRP) has been shown to reduce the symptoms of OA when injected into the affected joint. Patients treated by this method alone have improved self-reported pain (at least a 50% reduction from original value) as well as lower extremity function. While the effects …

Optimal Management Of Post-Traumatic Radioulnar Synostosis, Arthur Lee Osterman, Melissa S. Arief

Department of Orthopaedic Surgery Faculty Papers

Post-traumatic radioulnar synostosis is a rare complication after forearm or elbow injury that can result in loss of motion and significant disability. Risk factors include aspects of the initial trauma and of the surgical treatment of that trauma. Surgical intervention for synostosis is the standard of care and is determined based on the location of the bony bridge. Surgical timing is recommended between 6 months and 2 years with recent advocacy for the 6- to 12-month period after radiographs demonstrate bony maturation but early enough to prevent further stiffness and contractures. For most types of synostosis, surgical resection with interposition …

Retrieval Analysis Of Necropsy Total Hip Replacements: Considerations Beyond The Implant, Julie Alyse Lowell

Theses and Dissertations (ETD)

Introduction. Total hip arthroplasty (THA) surgery is one of the most commonly performed and successful orthopedic procedures in the United States. More than 300,000 primary THAs and 40,000 revision THAs performed in the United States every year. While the need for revision surgeries can stem from a variety of causes, there have been, to the author’s knowledge, no studies attempting to correlate the concentrations of certain inflammatory cytokines to metal ion concentrations found in the tissue surrounding the implant, amount of polyethylene wear, or strength of the interface of the modular taper. The purpose of this study was to begin …

Platelet-Rich Plasma Injection With Percutaneous Needling For Recalcitrant Lateral Epicondylitis: Comparison Of Tenotomy And Fenestration Techniques., Michael P. Gaspar, Michael A. Motto, Sarah Lewis, Sidney M. Jacoby, Randall W. Culp, A. Lee Osterman, Patrick M. Kane

Department of Orthopaedic Surgery Faculty Papers

Background: Recalcitrant lateral epicondylitis (LE) is a common debilitating condition, with numerous treatment options of varying success. An injection of platelet-rich plasma (PRP) has been shown to improve LE, although it is unclear whether the method of needling used in conjunction with a PRP injection is of clinical importance.

Purpose: To determine whether percutaneous needle tenotomy is superior to percutaneous needle fenestration when each is combined with a PRP injection for the treatment of recalcitrant LE.

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

Methods: A total of 93 patients with recalcitrant LE were treated with a PRP injection and …

Antibiotic Spacers In Shoulder Arthroplasty: Comparison Of Stemmed And Stemless Implants., Eric M. Padegimas, Alexia Narzikul, Cassandra Lawrence, Benjamin A. Hendy, Joseph A. Abboud, Matthew L. Ramsey, Gerald R R. Williams, Surena Namdari

Department of Orthopaedic Surgery Faculty Papers

Background: Antibiotic spacers in shoulder periprosthetic joint infection deliver antibiotics locally and provide temporary stability. The purpose of this study was to evaluate differences between stemmed and stemless spacers.

Methods: All spacers placed from 2011 to 2013 were identified. Stemless spacers were made by creating a spherical ball of cement placed in the joint space. Stemmed spacers had some portion in the humeral canal. Operative time, complications, reimplantation, reinfection, and range of motion were analyzed.

Results: There were 37 spacers placed: 22 were stemless and 15 were stemmed. The stemless spacer population was older (70.9 ± 7.8 years vs. 62.8 …

Psoas Abscess Masquerading As A Prosthetic Hip Infection: A Case Report, Muhammad Atif, Azeem Tariq Malik, Shahryar Noordin

Section of Orthopaedic Surgery

Introduction: Psoas abscess is an unusual condition and is defined as a collection of pus in the iliopsoas compartment. Due to the unique anatomy of psoas muscle it forms a conduit for spread of infection from upper part of body to hip joint in neglected cases.
Case Presentation: A 67year old lady presented with left groin pain for three weeks. She underwent an uncemented unipolar hemiarthoplasty eight years back. Currently, she developed fever and was unable to do any active left hip range of motion. Passive motion of the left hip was restricted to 30° flexion, no internal rotation, 5° …

A Murine Model For Developmental Dysplasia Of The Hip: Ablation Of Cx3cr1 Affects Acetabular Morphology And Gait., George J. Feldman, Arlene Offemaria, Hind Sawan, Javad Parvizi, Theresa A. Freeman

Rothman Institute Papers

BACKGROUND: Developmental dysplasia of the hip (DDH) is a debilitating condition whose distinguishing signs include incomplete formation of the acetabulum leading to dislocation of the femur, accelerated wear of the articular cartilage and joint laxity resulting in osteoarthritis. It is a complex disorder having environmental and genetic causes. Existing techniques fail to detect milder forms of DDH in newborns leading to hip osteoarthritis in young adults. A sensitive, specific and cost effective test would allow identification of newborns that could be non-invasively corrected by the use of a Pavlik harness. Previously, we identified a 2.5 MB candidate region on human …

Conference Proceedings: Aurora Scientific Day 2017

Journal of Patient-Centered Research and Reviews

This supplement includes select abstracts presented at the 43rd Annual Aurora Scientific Day research symposium on May 24, 2017. Aurora Scientific Day hosts a forum for original research conducted by faculty, fellows, residents, and other allied health professionals affiliated with Aurora Health Care, an integrated health system headquartered in Milwaukee, Wisconsin.

Effects Of Revision Surgery On Grade Of Adverse Local Tissue Reaction Following Recall Of A Modular Hip Implant, Joseph F. Davies, Danielle M. Greer, Susan Truchan

Journal of Patient-Centered Research and Reviews

Background: The Stryker Rejuvenate modular hip implant device allows for greater versatility in matching a patient’s anatomy than conventional implants. Device recalls and in vivo metal hypersensitivity after total hip arthroplasty (THA) are common. However, recall of the Rejuvenate implant represents one of the largest recall volumes to date, highlighting our uncertainty regarding causes of device metal fretting/corrosion and adverse local tissue reaction (ALTR). While devices with metal-on-metal bearings historically were culprits for release of metal debris, more recently developed modular-neck devices add opportunity for adjacent metal components to rub together. With the Rejuvenate device, corrosion or fretting likely occurs …

Metastatic Deaths In Retinoblastoma Patients Treated With Intraarterial Chemotherapy (Ophthalmic Artery Chemosurgery) Worldwide., David H. Abramson, Carol L. Shields, Pascal Jabbour, Luiz Fernando Teixeira, José Roberto Falco Fonseca, Marcio Chaves Pedro Marques, Francis L. Munier, Francesco Puccinelli, Theodora Hadjistilianou, Sandra Bracco, Guillermo Chantada, Alejandro Ceciliano, Y. Pierre Gobin

Department of Neurosurgery Faculty Papers

BACKGROUND: Ophthalmic artery chemosurgery [OAC, intra-arterial chemotherapy (IAC)] was introduced in 2006 as treatment modality for intraocular retinoblastoma. The purpose of this commentary is to retrospectively review the incidence of metastatic deaths in retinoblastoma patients treated with OAC worldwide over a 10 year period. Retrospective data regarding metastatic deaths was collected from six international retinoblastoma centers (New York City USA, Philadelphia USA, Sao Paulo Brazil, Siena Italy, Lausanne Switzerland and Buenos Aires Argentina). All retinoblastoma patients from these centers (naive and recurrent, unilateral and bilateral) treated with OAC/IAC since 2006 have been included in this study. Data regarding number of …

Tnf-Α Promotes Nuclear Enrichment Of The Transcription Factor Tonebp/Nfat5 To Selectively Control Inflammatory But Not Osmoregulatory Responses In Nucleus Pulposus Cells., Zariel I. Johnson, Alexandra C. Doolittle, Joseph W. Snuggs, Irving M. Shapiro, Christine L. Le Maitre, Makarand V. Risbud

Department of Orthopaedic Surgery Faculty Papers

Intervertebral disc degeneration (IDD) causes chronic back pain and is linked to production of proinflammatory molecules by nucleus pulposus (NP) and other disc cells. Activation of tonicity-responsive enhancer-binding protein (TonEBP)/NFAT5 by non-osmotic stimuli, including proinflammatory molecules, occurs in cells involved in immune response. However, whether inflammatory stimuli activate TonEBP in NP cells and whether TonEBP controls inflammation during IDD is unknown. We show that TNF-α, but not IL-1β or LPS, promoted nuclear enrichment of TonEBP protein. However, TNF-α-mediated activation of TonEBP did not cause induction of osmoregulatory genes. RNA sequencing showed that 8.5% of TNF-α transcriptional responses were TonEBP-dependent and …

Perceived Stress Levels May Impact Upper Extremity Function Among Women Treated For Breast Cancer, Mary Insana Fisher, Anne Fleischer, Lynn Hendricks, Megan Mcclure, Kim Parent, Renee Roberts

Physical Therapy Faculty Publications

Purpose/Hypothesis: Women treated for breast cancer report ongoing upper extremity disability with functional limitations; however, objective measures do not appear to explain the extent of perceived dysfunction. The purpose of this study was to investigate the relationship between perceived stress level, fear of physical activity, self-reported upper extremity function, and objective measures of upper extremity function including range of motion (ROM), strength, and muscular endurance, among women treated for breast cancer.

Number of Subjects: 25

Materials/Methods: Women diagnosed with stage I-III breast cancer in the past 12-60 months were evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH), …