Vol 3-2 Mini Review

Sex-specific Considerations for Shoulder Instability and Adhesive Capsulitis in Females

Kathryn A. Barth, Claire D. Eliasberg, Karen M. Sutton*

Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA

There has been an increasing focus on sex-specific differences within the context of sports medicine. Differences exist between the sexes leading to disparities in the types of injuries female athletes sustain and the rates at which they experience them. Recognition and awareness of subtle differences between the sexes can lead to a more nuanced diagnosis and treatment of such injuries. The purpose of this study is to review shoulder pathologies that are relevant to the female athlete, specifically adhesive capsulitis, multidirectional instability, and traumatic unidirectional shoulder instability, and highlight the differences in diagnosis, treatment, and outcomes between the sexes. Women suffer from adhesive capsulitis at a greater rate than men and there are risk factors such as breast cancer surgery that are unique to women. Females are much more likely to experience atraumatic shoulder instability than their male counterparts. While females represent a minority of patients who suffer traumatic unidirectional shoulder instability, they should not be overlooked with regards to this condition. There are challenges related to the diagnosis and treatment of these pathologies that are distinctive to female athletes.

DOI: 10.29245/2767-5130/2022/2.1130 View / Download Pdf
Vol 3-2 Commentary

Commentary: “The Impact of Surgical Trainee Involvement in Total Knee Arthroplasty: A Systematic Review of Surgical Efficacy, Patient Safety, and Outcomes”

Ryan S. Marder, Neil V. Shah, Aditya V. Maheshwari*

Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, Brooklyn, New York, USA

DOI: 10.29245/2767-5130/2022/2.1159 View / Download Pdf
Vol 3-2 Review Article

Combining All Available Clinical Outcomes on Cervical Disc Arthroplasty: A Systematic Review and Meta-Analysis

Jenna M. Wahbeh1,2, Claire J. Bogosian1,3, Natalie M. Kistler1,4, Sang-Hyun Park1,5, Edward Ebramzadeh1,4,5, Sophia N. Sangiorgio1,2,5*

1The J. Vernon Luck, Sr., M.D. Orthopaedic Research Center, Orthopaedic Institute for Children in Alliance with UCLA, Los Angeles, CA, USA

2Department of Bioengineering, University of California, Los Angeles, CA, USA

3Department of Bioengineering, University of California, Berkeley, CA, USA

4Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA

5Department of Orthopaedic Surgery, University of California, Los Angeles, CA, USA

Background: Reviews of total disc arthroplasty (TDA) performance have focused on prospective randomized controlled trials (RCTs), excluding potentially important clinical information reported by others. The goal of the present study was to perform a comprehensive review, including both RCTs and non-randomized cohorts with more than five years of clinical outcome. We further explored the differences in outcome between prospective RCT and non-randomized, including retrospective studies.

Methods: A systematic literature review was performed following PRISMA guidelines. Inclusion criteria were: clinical follow-up ≥ 5 years with quantitative clinical and radiographic outcome. All studies that met these criteria, including retrospective and non-randomized studies, were included, for a total of 62 studies. As anterior cervical discectomies and fusion (ACDF) was included as a control group in the majority of the studies, comparisons between TDA and ACDF were conducted.

Results: Overall, there was a statistically significant difference between the rates of secondary surgeries reported for prospective RCTs and all other studies, with reoperation rates of 5.4% for prospective RCT studies v. 7.5% in all others (P<0.01). Including all studies, the reoperation rate for TDA patients was 5.6% and for fusion patients (included as control groups), 7.8%, (P=0.06). Overall, the reported incidence of adjacent segment degeneration was 26.2% in TDA patients and 43.9% in fusion patients (P<0.001).

Conclusions: These findings demonstrated the need for including all available data to assess the current outcomes of cervical disc arthroplasty and account for potential biases.

DOI: 10.29245/2767-5130/2022/2.1158 View / Download Pdf
Vol 3-1 Commentary

Commentary: Preventing the Triad/RED-S by Educating on Variables Affecting Development in Female Adolescent Athletes

Ann Spence1*, Carrie Gilligan, Janine Bartholomew2

1Department of Nursing, Carlow University, Pittsburgh, PA, USA

2Department of Biology, Portage Learning, Beaver Falls, PA, USA

DOI: 10.29245/2767-5130/2022/1.1155 View / Download Pdf
Vol 3-1 Commentary

Commentary: Cell-free Stem Cell-Derived Extract Formulation for Treatment of Knee Osteoarthritis

Ashim Gupta

General Therapeutics, Cleveland Heights, OH, USA

Future Biologics, Lawrenceville, GA, USA

South Texas Orthopaedic Research Institute(STORI Inc.), Laredo, TX, USA

DOI: 10.29245/2767-5130/2022/1.1157 View / Download Pdf
Vol 3-1 Research Article

No-touch smartphone technique to confirm acetabular cup position in Total Hip Replacement

Adeel Hamid*, Usman Gill, Mian Hanif

Department of Orthopaedic Surgery, Lahore General Hospital and Post Graduate Medical Institute, Lahore, Pakistan

In order to achieve good results following Total hip replacement , proper and reproducible acetabular cup placement is of paramount importance. The safe zone described by Lewwinick is still considered to be the target cup position. Various techniques have been used to improve the precision and accuracy of cup placement including the use of computer navigation which is often prohibitively expensive for developing countries. We present a ‘No touch smartphone technique’ to check positioning of acetabular cup intra operatively, without compromising the sterility of the operative field which we have found to be simple, quick, inexpensive and reproducible.

DOI: 10.29245/2767-5130/2022/1.1156 View / Download Pdf
Vol 3-1 Mini Review

The Impact of Lumbar Spine Disease on Hip-Spine Relationship in Total Hip Arthroplasty: A Mini-Review

Jingqiao Chen1,3#, Kaiwei Shen1#, Zhiming Lu1,2, Eryou Feng1*

1Department of Arthrosis Surgery, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, China

2The Third School of Clinical Medicine, Fujian Medical University, Fuzhou Fujian, China

3The Second School of Clinical Medicine, Fujian University of Traditional Chinese Medicine, Fujian, China

#These authors contributed equally to this work

Background: Patients with severe lumbar spine diseases run a high risk of dislocation after total hip arthroplasty. Therefore, it is essential to determine the pathological effect of common lumbar diseases on pelvic motions before the surgery.

Aim: This study reviewed the literature on the hip-spine relationship during total hip arthroplasty and explored the degenerative presentations and management of four common lumbar disorders. The review showed that patients with the spinal deformity in ankylosing spondylitis (AS) were characterized by thoracolumbar kyphosis with corresponding hip extension and pelvic retroversion, prone to anterior hip dislocation; patients with lumbar spinal fusion (LSF) were more susceptible to prosthetic impingement and ultimate dislocation, especially in the limited posterior tilt of the pelvis while sitting; those with degenerative disc disease (DDD) had a greater compensatory pelvic posterior angle while standing and greater hip joint flexion while sitting to compensate for the reduced lumbar flexion; those with degenerative lumbar spondylolisthesis (DSPL) demonstrated a pelvic flexibility with a much wider range and relative acetabular anteversion, especially when standing.

Recommendation: According to the literature, spinal osteotomy and total hip arthroplasty are the most common surgical interventions in AS cases. DSPL is classified into the Flexible & Unbalanced type and should be placed more posteriorly, but the literature suggests that patients with lumbar instability should first be placed in a more predictable position. In contrast, LSF and DDD are categorized as the Rigid & Balanced type. For these two types of disorders, the literature suggests that acetabular prostheses require more anterior tilt at the time of implantation.

Conclusion: These findings indicate that for degenerative lumbar disorders, a balance between stable component implantation and minimal wear should be based on the different changes in spinopelvic mobility.

DOI: 10.29245/2767-5130/2022/1.1151 View / Download Pdf
Vol 3-1 Research Article

Influence of Whole Body Vibration on Drop Jump Landings and Knee Loading Mechanics

Ryan P. Hubble1,2, Henry Wang1,3, Paul Nagelkirk3, Jason M. Avedesian1,4, Robert Wilkinson1,3, D. Clark Dickin1,3*

1Biomechanics Laboratory, Ball State University, Muncie, IN, USA

2Wesley College of Health and Behavioral Sciences, Public and Allied Health, Delaware State University, Dover, DE, USA

3School of Kinesiology, Ball State University, Muncie, IN, USA

4Clemson University, Clemson, SC, USA

Plyometric training is one commonly used method of improving jump performance through improving explosive power generation. Research has also demonstrated that whole body vibration (WBV) can improve jumping and enhance explosive strength especially when supplementing resistance and plyometric training programs. With the drop jump being a common training skill, proper lower extremity landing mechanics are important to consider. Limited evidence suggests that WBV may reduce ground reaction forces and improve knee stability however, its influence on knee loading have not been reported. This study sought to examine the effects of WBV on ground reaction forces and knee valgus during a drop jump. 19 participants (10 female) completed drop jumps pre, immediately post, 10 & 20 minutes post WBV. Results were analyzed by repeated measures ANOVA. Main findings indicated that valgus knee angle increased significantly (p=0.011) post vibration and remained elevated across the 10 & 20 minute post vibration time intervals. Significant differences between sexes revealed that females demonstrated greater internal knee abduction moments (p=0.038). Findings that WBV increases knee valgus angle, a position linked to anterior cruciate ligament injury, suggest further investigation understand the effects of WBV on neuromuscular control and eccentric loading. Strength and conditioning professionals should exercise caution when incorporating WBV into plyometric protocols.

DOI: 10.29245/2767-5130/2021/1.1152 View / Download Pdf
Vol 3-1 Commentary

Commentary on: Middle East Pain Syndrome is A Pollution-Induced New Disease Mimicking Rheumatoid Arthritis

Adel A Elbeialy1*, Abdlnby M Bauomi2, Basma M Elnaggar1, Hala M Elzomor1

1Department of Rheumatology, Al-Azhar faculty of Medicine, Cairo, Egypt

2Department of Radiology, Al-Azhar faculty of Medicine, Cairo, Egypt

DOI: 10.29245/2767-5130/2022/1.1153 View / Download Pdf