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Luxenburg D, Patel N, Narasimman M, Weinerman J, Russo JP, Martin A, Minaie A, Dodds S. Return to Play After Hook of Hamate Fracture: A Systematic Review and Meta-Analysis. Hand (N Y) 2024:15589447241231303. [PMID: 38419427 DOI: 10.1177/15589447241231303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
In athletes, a hook of hamate fracture is concerning in terms of time to return to sport and effect on performance upon return. This study aims to analyze the treatment of hook of hamate fractures in athletes to determine their rates of return to play, timelines of recovery, and performance level upon return to play. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to perform this analysis. The PubMed database was queried to perform the literature search. Data were pooled and analyzed. P values <.05 were considered significant. Data were analyzed using the Comprehensive Meta-Analysis software to determine heterogeneity. Twenty studies with 823 patients sustaining hook of hamate fractures that reported any competitive level of play were included in the analysis. Of the 823 patients, 778 (94.5%) were able to return to play with 91.2% (506/555) of patients demonstrating similar or improved performance. The mean time to return to play was 45 days (range: 21-168 days). Treatment included surgical excision for 787 patients (95.6%), open reduction and internal fixation for 18 patients (2.2%), stress reduction/casting for 13 patients (1.6%), and loss to follow-up or surgery refusal for 5 patients (0.6%). A very high number of athletes return to play following a hook of hamate fracture at the same or improved level of performance. In our study, the majority of injuries were treated with surgical excision of the fractured hook of hamate fragment. Most athletes returned to their sport at an average of 45 days.
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Affiliation(s)
- Dylan Luxenburg
- Department of Orthopaedic Surgery, University of Miami, Miami, FL, USA
| | - Nikhil Patel
- Department of Orthopaedic Surgery, University of Miami, Miami, FL, USA
| | - Manish Narasimman
- Department of Orthopaedic Surgery, University of Miami, Miami, FL, USA
| | | | - Jean-Paul Russo
- Department of Orthopaedic Surgery, University of Miami, Miami, FL, USA
| | - Anthony Martin
- Department of Orthopaedic Surgery, University of Miami, Miami, FL, USA
| | - Arya Minaie
- Department of Orthopaedic Surgery, University of Miami, Miami, FL, USA
| | - Seth Dodds
- Department of Orthopaedic Surgery, University of Miami, Miami, FL, USA
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Parrino RL, Adams W, Letter MI, Ripic Z, Baraga MG, Kaplan LD, Harrah T, Tremblay J, Luxenburg D, Conti J, Best TM, Signorile JF. Impact of Quadriceps Tendon Graft Thickness on Electromechanical Delay and Neuromuscular Performance After ACL Reconstruction. Orthop J Sports Med 2023; 11:23259671231201832. [PMID: 37846315 PMCID: PMC10576934 DOI: 10.1177/23259671231201832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 05/19/2023] [Indexed: 10/18/2023] Open
Abstract
Background Both partial- and full-thickness quadriceps tendon (QT) graft harvests are used for anterior cruciate ligament reconstruction (ACLR). Purpose To evaluate the impact of QT graft harvest depth (full or partial thickness) on electromechanical delay (EMD), peak torque (PT), and rate of torque development (RTD) after ACLR. Study Design Controlled laboratory study. Methods A total of 26 patients who underwent either partial-thickness (n = 14) or full-thickness (n = 12) autograft QT ACLR were recruited between June and November 2021 (>1 year before participation). Patients performed isokinetic knee extension testing with surface electromyography of the quadriceps muscles. Mixed repeated-measures analysis of variance with least significant difference post hoc testing was used to determine significant differences (mean difference [MD] ± SE) or interactions for all variables. Results A significant speed×depth interaction was seen for the vastus medialis (P = .005). Pairwise analyses showed significantly longer EMD for the partial-thickness graft than the full-thickness graft (MD ± SE, 19.92 ± 6.33 ms; P = .006). In the partial-thickness graft, the EMD was significantly longer at 90 deg/s versus 180 deg/s (MD ± SE, 19.11 ± 3.95 ms; P < .001) and 300 deg/s (MD ± SE, 16.43 ± 5.30 ms; P = .006). For PT, the full-thickness graft had a significantly lower PT on the operated versus nonoperated side at all speeds (MD ± SE: 90 deg/s, -57.0 ± 10.5 N·m, P < .001; 180 deg/s, -26.0 ± 10.2 N·m, P = .020; 300 deg/s, -20.3 ± 8.9 N·m, P = .034). For RTD, the full-thickness graft showed significantly Slower RTD for the operated versus nonoperated side at all time points (MD ± SD: RTD0-25 (0-25% of the range of motion), -131.3 ± 50.9 N·m/s, P = .018; RTD25-50, -197.0 ± 72.5 N·m/s, P = .014; RTD50-75, -113.3 ± 39.8 N·m/s, P = .013; RTD75-100, -149.4 ± 35.9 N·m/s, P < .001). Conclusion Compared with partial-thickness QT, full-thickness QT showed a shorter vastus medialis EMD at higher loading, and therefore greater stiffness, as well as slower RTD and lower PT across all testing speeds. Clinical Relevance The impact of full-thickness QT autograft on EMD and neuromuscular performance should be considered for ACLR.
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Affiliation(s)
| | - Will Adams
- Max Orovitz Laboratory, University of Miami, Coral Gables, Florida, USA
| | - Michael I. Letter
- Max Orovitz Laboratory, University of Miami, Coral Gables, Florida, USA
- University of Miami Health System Sports Medicine Institute, Coral Gables, Florida, USA
| | - Zachary Ripic
- Max Orovitz Laboratory, University of Miami, Coral Gables, Florida, USA
| | - Michael G. Baraga
- University of Miami Health System Sports Medicine Institute, Coral Gables, Florida, USA
| | - Lee D. Kaplan
- University of Miami Health System Sports Medicine Institute, Coral Gables, Florida, USA
| | - Tanner Harrah
- Valley Orthopedic Associates, San Dimas, California, USA
| | - Julien Tremblay
- Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Dylan Luxenburg
- Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Joseph Conti
- Max Orovitz Laboratory, University of Miami, Coral Gables, Florida, USA
| | - Thomas M. Best
- University of Miami Health System Sports Medicine Institute, Coral Gables, Florida, USA
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Rizzo MG, Costello JP, Luxenburg D, Cohen JL, Alberti N, Kaplan LD. Augmented Reality for Perioperative Anxiety in Patients Undergoing Surgery: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2329310. [PMID: 37589975 PMCID: PMC10436133 DOI: 10.1001/jamanetworkopen.2023.29310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 07/10/2023] [Indexed: 08/18/2023] Open
Abstract
Importance Both augmented reality (AR) and virtual reality (VR) have had increasing applications in medicine, including medical training, psychology, physical medicine, rehabilitation, and surgical specialties, such as neurosurgery and orthopedic surgery. There are little data on AR's effect on patients' anxiety and experiences. Objective To determine whether the use of an AR walkthrough effects patient perioperative anxiety. Design, Setting, and Participants This randomized clinical trial was conducted at an outpatient surgery center in 2021 to 2022. All patients undergoing elective orthopedic surgery with the senior author were randomized to the treatment or control group. Analyses were conducted per protocol. Data analysis was performed in November 2022. Intervention AR experience explaining to patients what to expect on their day of surgery and walking them through the surgery space. The control group received the standard educational packet. Main Outcomes and Measures The main outcome was change in State-Trait Anxiety Inventory (STAI) from the screening survey to the preoperative survey. Results A total of 140 patients were eligible, and 45 patients either declined or were excluded. Therefore, 95 patients (63 [66.3%] male; mean [SD] age, 38 [16] years) were recruited for the study and included in the final analysis; 46 patients received the AR intervention, and 49 patients received standard instructions. The AR group experienced a decrease in anxiety from the screening to preoperative survey (mean score change, -2.4 [95% CI, -4.6 to -0.3]), while the standard care group experienced an increase (mean score change, 2.6 [95% CI, 0.2 to 4.9]; P = .01). All patients postoperatively experienced a mean decrease in anxiety score compared with both the screening survey (mean change: AR, -5.4 [95% CI, -7.9 to -2.9]; standard care, -6.9 [95% CI, -11.5 to -2.2]; P = .32) and preoperative survey (mean change: AR, -8.0 [95% CI, -10.3 to -5.7]; standard care, -4.2 [95% CI, -8.6 to 0.2]; P = .19). Of 42 patients in the AR group who completed the postoperative follow-up survey, 30 (71.4%) agreed or strongly agreed that they enjoyed the experience, 29 (69.0%) agreed or strongly agreed that they would recommend the experience, and 28 (66.7%) agreed or strongly agreed that they would use the experience again. No differences were observed in postoperative pain levels or narcotic use. Conclusions and Relevance In this randomized clinical trial, the use of AR decreased preoperative anxiety compared with traditional perioperative education and handouts, but there was no significant effect on postoperative anxiety, pain levels, or narcotic use. These findings suggest that AR may serve as an effective means of decreasing preoperative patient anxiety. Trial Registration ClinicalTrials.gov Identifier: NCT04727697.
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Affiliation(s)
- Michael G. Rizzo
- UHealth Sports Medicine Institute, Department of Orthopaedics, University of Miami, Miami, Florida
| | | | - Dylan Luxenburg
- Miller School of Medicine, University of Miami, Miami, Florida
| | - Jacob L. Cohen
- UHealth Sports Medicine Institute, Department of Orthopaedics, University of Miami, Miami, Florida
| | - Nicolas Alberti
- Center for Computational Science, University of Miami, Miami, Florida
| | - Lee D. Kaplan
- UHealth Sports Medicine Institute, Department of Orthopaedics, University of Miami, Miami, Florida
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Letter MI, Parrino RL, Adams W, Ripic Z, Baraga MG, Kaplan LD, Harrah T, Tremblay J, Luxenburg D, Conti J, Signorile JF. The Associations Between Quadriceps Tendon Graft Thickness and Isokinetic Performance. Am J Sports Med 2023; 51:942-948. [PMID: 36790220 DOI: 10.1177/03635465231152899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
BACKGROUND Anterior cruciate ligament reconstruction (ACLR) using the quadriceps tendon is an increasingly popular technique. Both partial-thickness quadriceps tendon (PT-Q) and full-thickness quadriceps tendon (FT-Q) graft depths are employed. HYPOTHESIS/PURPOSE This study was designed to assess isokinetic peak torque, average power, and total work during knee extension in patients with FT-Q or PT-Q grafts for ACLR. We hypothesized that both groups would show lower isokinetic values for the operated side, with greater deficits in the FT-Q group than in the PT-Q group. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS A total of 26 patients who underwent ACLR with either an FT-Q or PT-Q graft were recruited between June 2021 and November 2021. Patients underwent isokinetic knee extension testing at > 1 year after surgery. Mixed repeated-measures analysis of covariance with least square difference post hoc testing was used to determine significant differences or interactions for all variables. RESULTS Peak torque was significantly lower for the operated limb than the nonoperated limb in the FT-Q group (mean difference [MD] ± standard error [SE], -38.6 ± 8.3 Nċm [95% CI, -55.7 to -21.5 Nċm]; P < .001; d = 0.90) but not in the PT-Q group (MD ± SE, -7.3 ± 7.7 Nċm [95% CI, -23.2 to 8.5 Nċm]; P = .348; d = 0.20). Similarly, average power for the operated limb was lower than that for the nonoperated limb in the FT-Q group (MD ± SE, -53.6 ± 13.4 W [95% CI, -81.3 to -26.9 W]; P < .001; d = 0.88) but not in the PT-Q group (MD ± SE, -4.1 ± 12.4 W [95% CI, -29.8 to 21.5 W]; P = .742; d = 0.07), and total work was lower for the operated limb compared with the nonoperated limb in the FT-Q group (MD ± SE, -118.2 ± 27.1 J [95% CI, -174.3 to -62.2 J]; P < .001; d = 0.96) but not in the PT-Q group (MD ± SE, -18.3 ± 25.1 J [95% CI, -70.2 to 33.6 J]; P = .472; d = 0.15). CONCLUSION The FT-Q group showed significant deficits in the operated limb compared with the nonoperated limb for all isokinetic variables. In contrast, no significant differences were found between the nonoperated and operated limbs for the PT-Q group.
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Affiliation(s)
- Michael I Letter
- University of Miami Sports Medicine Institute, Coral Gables, Florida, USA
- Max Orovitz Laboratory, University of Miami, Coral Gables, Florida, USA
| | - Rosalia L Parrino
- Max Orovitz Laboratory, University of Miami, Coral Gables, Florida, USA
| | - Will Adams
- Max Orovitz Laboratory, University of Miami, Coral Gables, Florida, USA
| | - Zachary Ripic
- Max Orovitz Laboratory, University of Miami, Coral Gables, Florida, USA
| | - Michael G Baraga
- University of Miami Sports Medicine Institute, Coral Gables, Florida, USA
| | - Lee D Kaplan
- University of Miami Sports Medicine Institute, Coral Gables, Florida, USA
| | - Tanner Harrah
- Valley Orthopedic Associates, San Dimas, California, USA
| | - Julien Tremblay
- Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Dylan Luxenburg
- Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Joseph Conti
- Max Orovitz Laboratory, University of Miami, Coral Gables, Florida, USA
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Syros A, Donato Z, Luxenburg D, Landau R, Pandya S, Tandron M, Hernandez G. Supplemental musculoskeletal anatomy education in a shortened medical school curriculum. Clin Anat 2023; 36:291-296. [PMID: 36482009 DOI: 10.1002/ca.23987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/24/2022] [Accepted: 11/27/2022] [Indexed: 12/13/2022]
Abstract
To address anatomy knowledge gaps exacerbated by the education constraints of a new shortened medical school curriculum and the COVID-19 pandemic, the Orthopedic Surgery Interest Group (OSIG) created a novel hybrid anatomy curriculum for students interested in orthopedic surgery. The main objectives were to determine (1) Does this elective supplement to the curriculum improve students' perceived confidence with regard to orthopedic anatomy? (2) What are the students' preferred formats for receiving this elective supplement to the curriculum? To determine this, we used a prospective study design to determine the impact of the OSIG's student-led hybrid anatomy sessions. A survey with a five-point Likert scale (1) Strongly disagree; (2) Disagree; (3) Neither agree nor disagree; (4) Agree; (5) Strongly agree; was used to quantify responses. Chi-squared tests, Fisher's exact tests and T-tests were used when appropriate. Our results show that participants without prior anatomy experience rated the course higher on average when compared with those with prior anatomy experience (4.27 vs. 3.67, respectively; p = 0.168). Most students (88.2%) prefer for anatomy sessions to be held more frequently and 76.4% enjoyed having virtual components. 82.4% of participants reported that this course improved their self-confidence regarding orthopedic anatomy, and 100% would recommend it to other students. Most students enjoyed the course and reported improved self-perceived anatomy knowledge after participating. Medical schools that have a shortened anatomy curriculum can consider using the present study as a model for an optional musculoskeletal anatomy supplement at their institution.
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Affiliation(s)
- Alina Syros
- University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Zachary Donato
- University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Dylan Luxenburg
- University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Rebecca Landau
- University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Shivani Pandya
- University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Marissa Tandron
- Department of Orthopaedic Surgery, University of Miami/Jackson Health Systems, Miami, Florida, USA
| | - Giselle Hernandez
- Department of Orthopaedic Surgery, University of Miami/Jackson Health Systems, Miami, Florida, USA
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Luxenburg D, Bondar K, Syros A, Mohile N, Lee D, Rasoulinejad P, Saifi C, Donnally C. Clinical Outcomes of Bariatric Surgery Before Spinal Fusion: A Systematic Review. World Neurosurg 2023; 170:107-113.e1. [PMID: 36396053 DOI: 10.1016/j.wneu.2022.11.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Morbidly obese patients are at increased risk for intraoperative and postoperative complications following spinal fusion. Preoperative weight loss can improve clinical outcomes. The present systematic literature review is aimed to evaluate the hypothesis that bariatric surgery before spinal fusion surgery is associated with higher rates of complications and revisions. METHODS Three databases were queried for literature pertaining to bariatric surgery prior to spinal fusion. A 2-author screening process was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Methodologic index for non-randomized studies criteria was used to objectively assess the methodologic quality of the studies reviewed. Retrospective cohort studies in which the patients underwent bariatric surgery were included. RESULTS Four retrospective cohort studies consisting of a total of 180,090 patients were included. Length of stay was significantly shorter for the bariatric surgery (BS) group patients than the control (C) groups patients (P = 0.009). There were no significant differences in 1-year mortality rate (P = 1.0), readmission rate (P = 0.86), overall postoperative complications (P = 0.83), and postoperative infections (P = 0.97) between the BS and C groups. CONCLUSIONS There were no consistent differences in rates of postoperative complications, infections, hospital readmission, and mortality between obese patients with bariatric surgery prior to spinal fusion and control group patients. The present study does not support the hypothesis that bariatric surgery before spinal fusion contributes to a higher rate of postoperative complications in patients undergoing spinal fusion.
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Affiliation(s)
- Dylan Luxenburg
- Department of Orthopaedic Surgery and Department of Education, University of Miami, Miami, Florida, USA
| | - Kevin Bondar
- Department of Orthopedic Surgery and Sports Medicine, Houston Methodist Hospital, Houston, Texas, USA.
| | - Alina Syros
- Department of Orthopaedic Surgery and Department of Education, University of Miami, Miami, Florida, USA
| | - Neil Mohile
- Department of Orthopaedic Surgery and Department of Education, University of Miami, Miami, Florida, USA
| | - Danny Lee
- Department of Orthopaedic Surgery and Department of Education, University of Miami, Miami, Florida, USA
| | - Parham Rasoulinejad
- London Health Sciences Centre, London, Ontario, Canada; Schulich School of Medicine, Western University, London, Ontario, Canada
| | - Comron Saifi
- Department of Orthopedic Surgery and Sports Medicine, Houston Methodist Hospital, Houston, Texas, USA
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Luxenburg D, Wasserman NA, Geller JS, Perez JR, Burke J, Kaplan LD. Hamstring injuries in the national football league: An epidemiological study. J Orthop 2023; 35:111-114. [PMID: 36467428 PMCID: PMC9708442 DOI: 10.1016/j.jor.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 11/16/2022] [Accepted: 11/16/2022] [Indexed: 11/23/2022] Open
Abstract
Background While numerous studies have evaluated National Football League injuries, there is limited literature evaluating hamstring injuries sustained in games. Our primary aim is to analyze the effect of player position on the relative incidence of hamstring injuries in the National Football League. Our secondary aims are to analyze the effects of field surface, week of the season, and short rest weeks. Methods Official National Football League game books containing injury data from the 2013-2016 regular seasons were used. Data were analyzed to determine the incidence of hamstring injuries by field surface, rest, and week of the season. Field surface was considered either turf or grass. Short rest was considered four days. Relative incidence of hamstring injuries by position was performed with standardized incidence ratios. P values < 0.05 were considered statistically significant. Results Seventy-eight qualifying hamstring injuries were identified and included in our analysis. Linebackers had the highest relative incidence per play with a standardized incidence ratio of 2.02 (CI: 1.14-2.91), followed by Defensive Backs (1.62; 95% CI: 1.14-1.62). Offensive linemen and defensive linemen had standardized incidence ratios significantly less than 1. Fifty-seven percent of hamstring injuries occurred on turf fields (p = 0.082). There was no significant difference between the proportion of hamstring injuries that occurred on short rest and the proportion of games played on short rest (p = 0.959). Hamstring injuries were not more likely to occur than the pooled group of all other types of injuries on short rest (p = 0.861). With a 17-week season, the mean week of hamstring injury was 8.05 (95% CI: 7.06-9.04), while the median week was 7.5. Conclusions Linebackers and Defensive Backs have the highest relative incidence of hamstring injuries compared to other position groups, while offensive and defensive linemen have the lowest. Field surface and a short rest period did not show significance.
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Affiliation(s)
- Dylan Luxenburg
- University of Miami Department of Orthopaedics, United States
| | | | | | - Jose R. Perez
- University of Miami Department of Orthopaedics, United States
| | - Jonathan Burke
- University of Miami Department of Orthopaedics, United States
| | - Lee D. Kaplan
- University of Miami Department of Orthopaedics, United States
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Costello JP, Markowitz MI, Luxenburg D, Rizzo MG, Mahmoud RH, Barnhill SW, Vilella-Hernandez FE. Effects of immunocompromised status on diagnostic criteria in septic arthritis. J Orthop 2022; 34:80-83. [PMID: 36035198 PMCID: PMC9411066 DOI: 10.1016/j.jor.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/06/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Septic arthritis is an orthopaedic emergency, with permanent cartilage damage possible within hours of the onset of symptoms. Diagnostic criteria for septic arthritis in immunocompetent patients are well established, however, there is a paucity of literature evaluating diagnostic criteria in immunocompromised patients. The purpose of this retrospective case-control study was to evaluate the laboratory and clinical information of immunocompromised patients with septic arthritis and compare them to immunocompetent patients with septic arthritis to enable physicians to diagnose septic arthritis more accurately in this population. Methods All patients at our institution, a level I trauma center, with a clinical diagnosis of septic arthritis between January 1, 2006 and November 1, 2021 were identified and reviewed retrospectively. Patients 18 years old or older were screened for immunocompromised status and those meeting criteria were included for review. The control cohort was matched by the joint affected and age. Data were analyzed using the Shapiro-Wilk test, Turkey's test, Mann-Whitney U test, independent sample t-test, and chi-square analysis. A p-value of <0.05 was considered significant. Results A total of 36 patients with positive joint aspirate cultures were compared (18 immunocompetent and 18 immunocompromised). The immunocompromised group had a significantly longer length of hospital stay than the immunocompetent group (p = 0.044). There was no significant difference in erythrocyte sedimentation rate (ESR) (p = 0.852), peripheral white blood cell count (pWBC) (p = 0.696), joint aspirate white blood cell count (aWBC) (p = 0.901), polymorphonuclear cell percentage (PMN%) (p = 0.325), or total operations performed per patient (p = 0.365). Conclusion At our institution, immunocompromised patients with septic arthritis did not have significantly different diagnostic laboratory values when compared to immunocompetent patients. This suggests that immunocompromised patients with suspicion of septic arthritis can be assessed with similar diagnostic criteria as immunocompetent individuals; however, a larger cohort study is needed to assess the difference more precisely in laboratory values.
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Affiliation(s)
- Joseph P. Costello
- University of Miami Miller School of Medicine, 1600 NW 10th Ave, Miami, FL 33136, USA
| | - Moses I. Markowitz
- University of Miami Miller School of Medicine, 1600 NW 10th Ave, Miami, FL 33136, USA
| | - Dylan Luxenburg
- University of Miami Miller School of Medicine, 1600 NW 10th Ave, Miami, FL 33136, USA
| | - Michael G. Rizzo
- University of Miami Department of Orthopaedic Surgery, 1611 NW 12th Ave, Miami, FL 33136, USA
| | - Rami H. Mahmoud
- University of Miami Miller School of Medicine, 1600 NW 10th Ave, Miami, FL 33136, USA
| | - Spencer W. Barnhill
- University of Miami Department of Orthopaedic Surgery, 1611 NW 12th Ave, Miami, FL 33136, USA
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9
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Syros A, Perez OF, Luxenburg D, Cohen JL, Swonger R, Huntley S. The most influential studies concerning revision shoulder arthroplasty research. J Orthop 2022; 34:349-356. [PMID: 36238961 PMCID: PMC9550591 DOI: 10.1016/j.jor.2022.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 09/25/2022] [Indexed: 11/16/2022] Open
Abstract
Background Bibliometric analysis is a unique tool that can be used to study the characteristics and trends of a given topic. This study aimed to report on the most influential studies concerning revision shoulder arthroplasty research. Methods On July 4th, 2022, the Institute of Scientific Information (ISI) Web of Knowledge Database was used to identify articles concerning revision shoulder arthroplasty research. The top 50 most cited articles were selected and analyzed. Results The mean number of citations was 142 (median: 97; range 599-70). Most articles were published in the 2010s (56%), followed by the 2000s (38%), and 1990s (6%). The most common level of evidence (LOE) was LOE II (42%) followed by LOE IV (38%), LOE I and III each had 10%. The greatest number of papers were published in the Journal of Shoulder and Elbow Surgery (46%), followed by the Journal of Bone and Joint Surgery- American Version (14%). Conclusion This review can serve as a useful tool to study the most influential articles concerning revision shoulder arthroplasty research. Most of the articles were classified as clinical outcomes (62%), followed by natural history/epidemiology (12%), and surgical technique (10%). Our findings suggest that high-quality studies (LOE I) are lacking and other areas of research besides clinical outcomes are not as well studied.
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Affiliation(s)
- Alina Syros
- University of Miami Miller School of Medicine, 1600 NW 10th Ave #1140, Miami, FL, 33136, USA
| | - Olivia F. Perez
- University of Miami Miller School of Medicine, 1600 NW 10th Ave #1140, Miami, FL, 33136, USA
| | - Dylan Luxenburg
- University of Miami Miller School of Medicine, 1600 NW 10th Ave #1140, Miami, FL, 33136, USA
| | - Jacob L. Cohen
- University of Miami/Jackson Health Systems Department of Orthopedic Surgery, 1611 NW 12th Ave #303, Miami, FL, 33136, USA
| | - Ronald Swonger
- University of Miami Miller School of Medicine, 1600 NW 10th Ave #1140, Miami, FL, 33136, USA
| | - Samuel Huntley
- University of Miami/Jackson Health Systems Department of Orthopedic Surgery, 1611 NW 12th Ave #303, Miami, FL, 33136, USA
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Luxenburg D, Destine H, Rizzo MG, Constantinescu D, Ghali M, Kaplan LD, Baraga MG. The 50 Most Cited Articles in Knee Medial Collateral Ligament Injury Research. Orthop J Sports Med 2022; 10:23259671221124575. [PMID: 36199831 PMCID: PMC9528047 DOI: 10.1177/23259671221124575] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/21/2022] [Indexed: 11/27/2022] Open
Abstract
Background: Medial collateral ligament (MCL) injury is a common orthopaedic knee injury with a plethora of published articles regarding evaluation, treatment, and outcome. Purpose: To perform a comprehensive bibliometric analysis of the 50 most cited articles in MCL research. Study Design: Cross-sectional study. Methods: We performed a keyword search of the Institute for Scientific Information’s Web of Knowledge database for the identification of articles published before September 2021 encompassing the MCL. The conducted search yielded 9534 articles. The results were then filtered using predetermined guidelines and criteria, and the 50 most cited articles were selected for analysis. Extracted data included title, authors, citation count, year of publication, topic, journal, article type, country of origin, and level of evidence. Results: The selected 50 articles ranged from 1976 to 2013. The largest proportion was classified as having level 4 evidence (n = 12; 24%). The majority of the articles were published in the decade from 2000 to 2009 (n = 17; 34%), followed by 1990 to 1999 (n = 16; 32%). The mean raw citation score per article was 133 (range, 74-422). The most popular topic discussed was surgical technique and outcome (n = 14; 28%), followed by anatomy and biomechanics (n = 13; 26%). Conclusion: This study provides a comprehensive and objective measure of the most cited articles on MCL research. Knowledge of the characteristics of these most influential articles improves the understanding of MCL injury and can guide discussion for future research.
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Affiliation(s)
- Dylan Luxenburg
- UHealth Sports Medicine Institute, University of Miami Health Systems, Coral Gables, Florida, USA
| | - Henson Destine
- UHealth Sports Medicine Institute, University of Miami Health Systems, Coral Gables, Florida, USA
| | - Michael G. Rizzo
- UHealth Sports Medicine Institute, University of Miami Health Systems, Coral Gables, Florida, USA
| | - David Constantinescu
- UHealth Sports Medicine Institute, University of Miami Health Systems, Coral Gables, Florida, USA
| | - Miriyam Ghali
- UHealth Sports Medicine Institute, University of Miami Health Systems, Coral Gables, Florida, USA
| | - Lee D. Kaplan
- UHealth Sports Medicine Institute, University of Miami Health Systems, Coral Gables, Florida, USA
| | - Michael G. Baraga
- UHealth Sports Medicine Institute, University of Miami Health Systems, Coral Gables, Florida, USA
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Luxenburg D, Constantinescu D, St. Louis G, Bondar KJ, Sudah SY, D’Apuzzo M. Characteristics and Trends of the Most Cited Publications in The Journal of Arthroplasty. Arthroplast Today 2022; 16:211-218. [PMID: 35880227 PMCID: PMC9307491 DOI: 10.1016/j.artd.2022.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/08/2022] [Accepted: 05/20/2022] [Indexed: 11/18/2022] Open
Abstract
Background This study aims to identify the most frequently cited articles published in the Journal of Arthroplasty (JOA) and to analyze the trends in the content and contributors of the literature within the journal. Methods The 100 most cited articles published in the JOA were accessed using the Scopus database. The number of citations, year of publication, level of evidence (LOE), article type, country of origin, and contributing institution were each recorded for each article. Results The United States (63%) was the most prolific publishing nation. The 1990s (30%) and 2000s (47%) were the most productive decades. The most common article category was clinical outcomes (33%), followed by technical note (16%) and biomechanics (14%). The plurality of the top 100 articles were well-designed case-control or cohort studies of LOE II (46%) followed by LOE V (32%) and LOE I (11%). Conclusions Using citation analysis, the most influential articles in the JOA were comprehensively and objectively analyzed. The most popular fields of research involved clinical outcomes (33%) and technical note (16%), both of which increase an article’s likelihood of being highly cited. Knowledge of the most influential articles in the JOA allows for appreciation of current and potential future areas of literature regarding diagnosis, management, and outcome of a patient undergoing arthroplasty.
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Affiliation(s)
- Dylan Luxenburg
- University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
- Corresponding author. University of Miami Leonard M. Miller School of Medicine, 1600 NW 10th Ave #1140, Miami, FL 33136, USA. Tel.: +1 954 873 0647.
| | | | - Gemma St. Louis
- University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Kevin J. Bondar
- University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Suleiman Y. Sudah
- Department of Orthopedic Surgery, Monmouth Medical Center, Long Branch, NJ, USA
| | - Michele D’Apuzzo
- Department of Orthopaedic Surgery, University of Miami Hospital, Miami, FL, USA
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Greif DN, Shah HA, Luxenburg D, Hodgens BH, Epstein AL, Kaplan LD, Munoz J, Letter M, Baraga MG. Word of Mouth and Online Reviews Are More Influential Than Social Media for Patients When Selecting a Sports Medicine Physician. Arthrosc Sports Med Rehabil 2022; 4:e1185-e1191. [PMID: 35747660 PMCID: PMC9210471 DOI: 10.1016/j.asmr.2022.04.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 04/19/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose To (1) identify the percentage of patients seen in an orthopaedic sports medicine practice who use social media and (2) identify the role that social media has in physician selection as compared with other factors. Methods After institutional review board approval was received, new patients aged 18 years or older who attended a single orthopaedic sports medicine office from February 2020 to May 2021 were identified for inclusion. Sociodemographic information was recorded, and each patient was asked to fill out a questionnaire that assessed social media usage and online resources used to choose and formulate opinions regarding the patient’s provider. Results Two hundred patients met the inclusion criteria and completed the questionnaire. Of these, 96.5% reported social media use. The most common online method of searching for and identifying a physician was Google (50.5%). Social media outlets such as Facebook, Instagram, or LinkedIn were only used 15.5% of the time to search for and select a physician. Older patients were more likely to use recommendations from friends and family in their consideration when selecting a physician. Conclusions Despite almost all participants stating that they use social media, only 15.5% of patients reported that they used social media to search for and potentially select their physician. Our study suggests that although social media can be a helpful tool for patient education, other factors such as physician education and physician reputation through word-of-mouth referrals, online reviews, and online ratings seem to play a larger role in the patient’s selection of his or her physician. Clinical Relevance This information may be of value to orthopaedic surgeons looking for ways to build their patient base, online reputation, or other aspects of their practice on the Internet.
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Rizzo MG, Allegra PR, Yakkanti R, Luxenburg D, Dodds SD. Electric scooters as a source of orthopedic injuries at a Level-I trauma center. J Orthop 2022; 31:86-91. [PMID: 35496354 PMCID: PMC9048081 DOI: 10.1016/j.jor.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/04/2022] [Accepted: 04/09/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Electric scooter rentals are offered by major ridesharing companies as a new and alternative method for urban travel in major metropolitan areas. The correlation between motorized electric scooter rental services and orthopedic injuries has not been well scrutinized. The purpose of our study is to evaluate orthopedic injuries sustained by motorized scooter riders and their potential correlation with patient demographics and associated injuries. Methods We retrospectively reviewed level 1 trauma center patients with orthopedic injuries sustained while riding motorized electric scooters from 4/2019-11/2019. Demographics, fracture characteristics, and patient management were examined. Results Sixty-two patients sustained 86 orthopedic injuries. There were 56 (65.1%) upper extremity and 29 (33.7%) lower extremity injuries. Six patients (9.7%) suffered open injuries and 30 (48.4%) sustained injuries that required surgery. Anatomic location of the injury was associated with both the presence of open fracture and needing surgery (P = 0.016 and P less than 0.001, respectively). Also, the presence of multiple orthopedic injuries was associated with the need for surgery (P less than 0.001). Scooter collision events were significantly associated with multiple orthopedic and the presence of non-orthopedic injuries (P less than 0.01 and P less than 0.01). Conclusion Electric scooter accidents can result in orthopedic injuries, many of which require surgery. Caution should be exercised when riding electric scooters, and special attention should be given by trauma centers and emergency departments to patients who present after electric scooter injury as the potential for orthopedic injury is high with this mechanism of injury.
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Affiliation(s)
| | | | | | - Dylan Luxenburg
- Corresponding author. , Department of Orthopaedic Surgery University of Miami / Jackson Memorial Hospital, 1611 NW 12th Ave, Miami, FL, 33136, USA.
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Greif DN, Shallop BJ, Allegra PR, Cade WH, Minesinger KE, Luxenburg D, Kaplan LD, Baraga MG. A Comparison of Two-Year Anterior Cruciate Ligament Reconstruction Clinical Outcomes Using All-Soft Tissue Quadriceps Tendon Autograft With Femoral/Tibial Cortical Suspensory Fixation Versus Tibial Interference Screw Fixation. Arthroscopy 2022; 38:881-891. [PMID: 34252561 DOI: 10.1016/j.arthro.2021.06.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 06/04/2021] [Accepted: 06/28/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE To contribute to future quadriceps tendon harvest and fixation guidelines in the setting of anterior cruciate ligament reconstruction by comparing 2-year patient-reported subjective knee outcome scores and incidence of graft-related complications between the shorter harvest all-inside tibial-femoral suspensory fixation (TFSF) approach versus the longer harvest standard tibial interference screw fixation technique. METHODS Patients who underwent primary anterior cruciate ligament reconstruction with all soft tissue quadriceps tendon autograft from January 2017 to May 2019 were identified for inclusion. Patients were matched into 2 cohorts of 62 based on reconstruction technique. All patients completed baseline and minimum 2-year International Knee Documentation Committee, Tegner Activity Level, and Lysholm questionnaires and were queried regarding subsequent procedures and complications to the operative knee. RESULTS Average graft length for the all-inside TFSF was 69.55 (95% confidence interval 68.99-70.19) mm versus 79.27 (95% confidence interval 77.21-81.34) mm in the tibial screw fixation cohort (P = .00001). Two-year Lysholm scores were greater in the TFSF cohort (P = .04) but were not clinically significant. There was no difference in 2-year International Knee Documentation Committee (P = .09) or Tegner (P = .69) scores between cohorts, but more patients in the TFSF cohort returned to or exceeded their baseline activity level compared with the tibial screw fixation cohort (73% vs 61%, P = .25). Seven patients in the TFSF cohort versus 13 in the tibial screw fixation cohort reported anterior knee pain or kneeling difficulty (P = .22). There were no differences in reported complications. CONCLUSIONS All-inside soft-tissue quadriceps tendon autograft with TFSF resulted in clinically comparable subjective outcome scores at 2 years to tibial screw fixation. There were also no differences in complications or reports of anterior knee pain or kneeling difficulty. All-inside TFSF can be a viable alternative to tibial screw fixation for all-soft tissue quadriceps autograft. LEVEL OF EVIDENCE III, comparative therapeutic trial.
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Affiliation(s)
- Dylan N Greif
- University of Miami Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, Florida, U.S.A..
| | - Brandon J Shallop
- University of Miami Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, Florida, U.S.A
| | - Paul R Allegra
- University of Miami Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, Florida, U.S.A
| | - William H Cade
- University of Miami Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, Florida, U.S.A
| | - Kayla E Minesinger
- University of Miami Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, Florida, U.S.A
| | - Dylan Luxenburg
- University of Miami Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, Florida, U.S.A
| | - Lee D Kaplan
- University of Miami Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, Florida, U.S.A
| | - Michael G Baraga
- University of Miami Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, Florida, U.S.A
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Luxenburg D, Bondar KJ, Cohen LL, Constantinescu D, Barnhill S, Donnally CJ. Return to Golf Following Cervical and Lumbar Spinal Fusion: A Systematic Review. World Neurosurg 2021; 156:4-10. [PMID: 34438101 DOI: 10.1016/j.wneu.2021.08.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/14/2021] [Accepted: 08/16/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is a paucity of literature about return to play (RTP) for golf protocols following cervical and lumbar fusions. The timing of return to this sport is a common question among patients. The aim of this review was to analyze and report the current protocols for RTP following cervical and lumbar spinal fusion. METHODS A systematic search was conducted using the following databases: MEDLINE, PubMed, Web of Science, Scopus, and Google Scholar. A 3-step, multiauthor screening process was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria included peer-reviewed and published prospective, case-control, cohort, case series, or review articles. Studies had to pertain to RTP for golf following instrumented cervical or lumbar spinal fusion to be included. RESULTS Three articles met inclusion criteria: 2 retrospective survey-based cohort studies and 1 survey-based case series study. All studies included a minimum of 1 year of follow-up. Of patients, 71.6% (n = 51) were able to RTP following surgery; 54.3%-80% were able to RTP at a similar or improved level of play as preoperatively. Postoperative pain reduction was noted in 2 articles. CONCLUSIONS Most golfers are able to RTP within 12 months following cervical or lumbar spinal fusion. Patients generally reported decreased lower back pain and leg pain postoperatively. Following cervical or lumbar fusion, many golfers are able to RTP at the same or an increased frequency compared with preoperatively.
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Affiliation(s)
- Dylan Luxenburg
- Department of Medical Education, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA
| | - Kevin J Bondar
- Department of Medical Education, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
| | - Lara L Cohen
- Department of Medical Education, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA
| | - David Constantinescu
- Department of Orthopaedic Surgery, University of Miami Hospital, Miami, Florida, USA
| | - Spencer Barnhill
- Department of Orthopaedic Surgery, University of Miami Hospital, Miami, Florida, USA
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