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Hanna AJ, Johns WL, Perez AR, Kemler B, Onor GI, Freedman KB, Dodson CC, Ciccotti MG. Patients' under 25 subjective readiness to return to sport after ACL reconstruction with bone-patellar-bone grafts: Autograft vs. allograft. J Orthop 2024; 55:149-156. [PMID: 38694957 PMCID: PMC11059441 DOI: 10.1016/j.jor.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 04/14/2024] [Indexed: 05/04/2024] Open
Abstract
Purpose To assess the difference in perceived readiness to return to sport (RTS) within the first year postoperative period between individuals undergoing anterior cruciate ligament (ACL) reconstruction with bone-patellar tendon-bone (BTB) autografts or allografts. Methods This was a prospective cohort study of patients undergoing primary ACL reconstruction done either with BTB autograft or allograft from 2010 to 2018. Skeletally mature patients aged 14 to 25 were eligible for inclusion. Patients completed the Marx Activity Rating Scale (MARS) questionnaire postoperatively evaluating perceived ability to perform various activities to compare subjective ability to RTS. Those patients who were outside outlined cohort age, failed to complete a single post-operative survey, underwent revision procedures, or underwent simultaneous or staged additional ligament surgery were excluded. Results Fifty-nine patients (20.1 ± 3.19 years, 57.6 % Male) were included in the study. Sixteen patients underwent ACL reconstruction with allograft (19.8 ± 3.43 years) while 43 patients received autograft (20.2 ± 3.13). At 3 months autograft recipients reported higher perceived ability to cut (P = .003). At 6-months, allograft recipients reported higher perceived ability to run (P = .033), cut (P = .048), and decelerate (P = .008) as well as a higher overall perceived ability to RTS (P = .032). At all other times, there was no significant difference between cohorts' subjective readiness to perform activities. Conclusion The results of this study indicate that at times within the first year of recovery following ACL reconstruction, patients who receive allografts and autografts may have significantly different perceived ability to perform activities or RTS. However, while present at various times throughout the first year of recovery, any difference in perceived ability to perform activities or in overall RTS is no longer present at 12 months. Level of evidence Level II, Prospective cohort study.
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Affiliation(s)
- Adeeb J Hanna
- Rothman Orthopaedics Institute, Philadelphia, PA, USA
| | | | | | - Bryson Kemler
- Rothman Orthopaedics Institute, Philadelphia, PA, USA
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Onor GI, Thome AP, Lemme NJ, Brown KE, Daniels AH. Epidemiology of Ankle Dislocations in the United States: 2009 to 2018. R I Med J (2013) 2023; 106:26-30. [PMID: 37494624] [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] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
BACKGROUND Injuries to the ankle joint are common and often sustained during participation in athletic activities. There is little information regarding the overall epidemiology of ankle dislocation, both with and without associated fracture. DESIGN AND METHODS The National Electronic Injury Surveillance System (NEISS) database was queried to characterize ankle dislocation presentations to U.S. Emergency Departments (ED) from 2009-2018. Ankle dislocations were analyzed by age, sex, mechanism, and race. RESULTS From 2009-2018, 30,477 patients with ankle dislocations presented to U.S. EDs with a majority (59.8%) occurring in male patients. The overall incidence of ankle dislocations increased by 54% from 2009-2018 (p = 0.017). Over half (53%) of ankle dislocations occurred in association with sports. Ankle dislocations peaked in the third decade of life at 16.94 per million person-years. For male, the age at which ankle dislocation peaked was 33.33, whereas for females, ankle dislocations peaked at 39.27. CONCLUSION Preventive strategies are necessary to decrease the risk of sustaining ankle dislocations in the adult population participating in jumping sports.
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Affiliation(s)
- Gabriel I Onor
- Department of Orthopaedics, Thomas Jefferson University Philadelphia, PA
| | - Andrew P Thome
- Department of Orthopaedics, Washington University School of Medicine, Saint Louis, MO
| | - Nicholas J Lemme
- Department of Orthopaedics, Warren Alpert Medical School of Brown University Providence, RI
| | - Kelsey E Brown
- Warren Alpert Medical School of Brown University Providence, RI
| | - Alan H Daniels
- Department of Orthopaedics, Warren Alpert Medical School of Brown University Providence, RI
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Aguwa UT, Aguwa CJ, Onor GI, Srikumaran D, Canner J, Knight OJ, Green LK, Woreta F. Racial and Ethnic Diversity Within U.S. Residencies: Trends from 2011 to 2019. J Surg Educ 2022; 79:587-594. [PMID: 35153146 DOI: 10.1016/j.jsurg.2022.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 12/15/2021] [Accepted: 01/08/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Examine trends in the proportion of underrepresented minority (URM) residents from 2011 to 2019 across all specialties and investigate differences between surgical and non-surgical specialties. DESIGN Cross-sectional study. SETTING N/A. PARTICIPANTS The authors extracted data on the proportion of URM residents in all specialties from the Accreditation Council for Graduate Medical Education yearly reports. RESULTS There was a statistically significant decline in the proportion of URM residents in surgical specialties (p < 0.01) from 2011 (9.9%) to 2019 (9.1%) and a significant increase in the proportion of URM residents in non-surgical specialties (p < 0.01) from 2011 (9.6%) to 2019 (10.2%). CONCLUSIONS This study emphasizes the need to increase recruitment of URMs in medicine, especially in surgical specialties. Findings from this study can inform much-needed initiatives to address barriers to entry for diverse applicants within specialties that lack diversity and have shown minimal improvement over time.
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Affiliation(s)
- Ugochi T Aguwa
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Chibuzo J Aguwa
- Meharry Medical College School of Medicine, Nashville, Tennessee
| | - Gabriel I Onor
- Department of Orthopedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Divya Srikumaran
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
| | - Joseph Canner
- Johns Hopkins Surgery Center for Outcomes Research, Johns Hopkins University, Baltimore, Maryland
| | - O'Rese J Knight
- Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Laura K Green
- Department of Ophthalmology, Krieger Eye Institute, Sinai Hospital, Baltimore, Maryland
| | - Fasika Woreta
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
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Abstract
OBJECTIVE To assess rates of peripheral nerve injuries (PNI) in sport, exercise, and recreational activities. METHODS The National Electronic Injury Surveillance System (NEISS) was used to query nerve injuries presenting to emergency departments across the United States. Identified injuries were stratified to those with product codes associated with exercise, sports, or recreation. Injuries only to the upper and lower extremities were included as cranial and spinal cord injuries were excluded. PNI was analyzed by age, sex, sport/recreational activity, race, and evaluated for incidence rates by year and activity. Statistical significance was considered to be P < 0.05. RESULTS Between 2009-2018, 551,612 patients presented with PNI from which 120,675 (21.9%) were associated with exercise, sports, or recreation. PNI significantly increased between 2009-2018 (p = 0.002) with an overall incidence rate of 36.9 (95% confidence interval: 28.6, 45.2) per 1,000,000 person-years. A majority of PNI occurred through exercise (n = 56,328, 46.7%). PNI peaked in the fourth and fifth decades in males and females, respectively, with males accounting for significantly more than females (incidence rate ratio: 1.52, 95% confidence interval: 1.18, 1.86; p < 0.0001). White patients had a majority of PNI at 49.3% though African-Americans carried the highest incidence rate at 30.4 (95% confidence interval: 23.8, 36.9) per 1,000,000 person-years. Football had the highest proportion of PNI until age 19 (17.3%) as exercise carried the highest proportion for those 20 and older ranging from 27.9% to 53.8% of PNI. CONCLUSION PNIs are rising with participation in exercise, sports, and recreation over this 10-year study period. Injuries predominantly occurred in football for those under 20 and exercise for those 20 and older. Precautions and appropriate training are necessary for individuals participating in high-intensity exercise, sports, or recreation to limit the risk of a devastating neurological injury.
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Affiliation(s)
- Neill Y Li
- Department of Orthopaedics, Warren Alpert Medical School of Brown University, RI
| | - Gabriel I Onor
- Warren Alpert Medical School of Brown University, Providence, RI
| | - Nicholas J Lemme
- Department of Orthopaedics, Warren Alpert Medical School of Brown University, RI
| | - Joseph A Gil
- Department of Orthopaedics, Warren Alpert Medical School of Brown University, RI
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Onor IO, Duchane RM, Payne CJ, Lambert HN, Mitchner DM, Beyl RA, Nguyen AT, Bilbe SE, White AA, Johnson MW, Faciane AI, Kouagou E, Hymel SA, Wates BM, Sanders AD, Vo PCB, Bates JD, Spooner RJ, Gillard CJ, Okogbaa JI, Sarpong DF, Hadgu RM, Okpechi SC, Onor GI, Okoronkwo MC, Naljayan MV, Guillory SG, Sanne SE. Evaluation of serum calcium differences in hypertensive crises and control patients: A randomly matched case-control study. J Clin Hypertens (Greenwich) 2021; 23:1767-1775. [PMID: 34291559 PMCID: PMC8635273 DOI: 10.1111/jch.14268] [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] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/02/2021] [Accepted: 05/04/2021] [Indexed: 11/28/2022]
Abstract
The role of calcium in blood pressure has been widely studied among hypertensive patients; however, no study has explored the role of calcium in hypertensive crises. The primary objective of this study is to evaluate the differences in serum calcium levels between hypertensive crises patients and a 1:1 random matched controls (age‐, sex‐, race‐, diabetes, and body mass index matched). This study is a single‐center, retrospective, chart review, case‐control study of patients with hypertensive crises (case group) and patients without hypertensive crises (control group). Patients were included in the case group if they were 18 years of age or older with hypertensive crises and have a documented calcium level. The control group patients were required to be 18 years of age or older, have a documented calcium level, and have no diagnosis of hypertensive crises. The primary outcome of the study was to compare the mean serum calcium in patients with hypertensive crises vs patients without hypertensive crises. Five hundred and sixty‐six patients were included in the study: 283 patients in both the case group and control group. The primary outcome results showed that serum calcium concentration was not significantly different between the case group (8.99 ± 0.78 mg/dL) and control group (8.96 ± 0.75 mg/dL) (P = .606). This study found no significant difference in serum calcium levels in patients with hypertensive crises compared to a random matched control group. Larger observational or experimental studies may be useful to evaluate the effect of calcium on blood pressure in hypertensive crises.
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Affiliation(s)
- IfeanyiChukwu O Onor
- CardioRenal Research Group (CRRG), College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA.,Department of Medicine, Louisiana State University Health Sciences Center School of Medicine, New Orleans, LA, USA.,Department of Pharmacy, University Medical Center New Orleans, New Orleans, LA, USA
| | - Rose M Duchane
- CardioRenal Research Group (CRRG), College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
| | - Casey J Payne
- CardioRenal Research Group (CRRG), College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
| | - Hannah Naquin Lambert
- CardioRenal Research Group (CRRG), College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
| | - DeMaurian M Mitchner
- CardioRenal Research Group (CRRG), College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA.,Department of Pharmacy, University Medical Center New Orleans, New Orleans, LA, USA
| | - Robbie A Beyl
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Anh T Nguyen
- CardioRenal Research Group (CRRG), College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
| | - Sarah E Bilbe
- CardioRenal Research Group (CRRG), College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
| | - Andrea Arriaga White
- CardioRenal Research Group (CRRG), College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
| | - Mariah W Johnson
- CardioRenal Research Group (CRRG), College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
| | - Amber I Faciane
- CardioRenal Research Group (CRRG), College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
| | - Emmanuel Kouagou
- CardioRenal Research Group (CRRG), College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
| | - Stephanie A Hymel
- CardioRenal Research Group (CRRG), College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
| | - Bria M Wates
- CardioRenal Research Group (CRRG), College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
| | - Asia D Sanders
- CardioRenal Research Group (CRRG), College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
| | - Phillip C B Vo
- CardioRenal Research Group (CRRG), College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
| | - Jordan D Bates
- CardioRenal Research Group (CRRG), College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
| | - Raven J Spooner
- CardioRenal Research Group (CRRG), College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
| | - Christopher J Gillard
- CardioRenal Research Group (CRRG), College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA.,Department of Medicine, Louisiana State University Health Sciences Center School of Medicine, New Orleans, LA, USA.,Department of Pharmacy, University Medical Center New Orleans, New Orleans, LA, USA
| | - John I Okogbaa
- CardioRenal Research Group (CRRG), College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA.,Department of Medicine, Louisiana State University Health Sciences Center School of Medicine, New Orleans, LA, USA
| | - Daniel F Sarpong
- CardioRenal Research Group (CRRG), College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA.,Center for Minority Health and Health Disparities Research and Education, College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
| | - Rim M Hadgu
- Midwestern University College of Pharmacy - Glendale, Glendale, AZ, USA
| | - Samuel C Okpechi
- Department of Biochemistry and Molecular Biology, School of Medicine and Health Sciences Center, Louisiana State University, New Orleans, LA, USA
| | - Gabriel I Onor
- Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Michael C Okoronkwo
- Department of Medicine, Louisiana State University Health Sciences Center School of Medicine, New Orleans, LA, USA
| | - Mihran V Naljayan
- Department of Medicine, Louisiana State University Health Sciences Center School of Medicine, New Orleans, LA, USA
| | - Shane G Guillory
- Department of Medicine, Louisiana State University Health Sciences Center School of Medicine, New Orleans, LA, USA
| | - Shane E Sanne
- Department of Medicine, Louisiana State University Health Sciences Center School of Medicine, New Orleans, LA, USA
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Onor GI, Yalcin S, Kaar SG, Pace JL, Ferrua P, Farrow LD. The Evaluation of Trochlear Osseous Morphology: An Epidemiologic Study. Orthop J Sports Med 2021; 9:2325967121994548. [PMID: 33869646 PMCID: PMC8020235 DOI: 10.1177/2325967121994548] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 09/24/2020] [Accepted: 11/18/2020] [Indexed: 01/17/2023] Open
Abstract
Background: The femoral trochlea is considered the most significant osseous factor
affecting stability in the patellofemoral joint. The true prevalence of
trochlear dysplasia in the general population is largely unknown. Purpose/Hypothesis: To investigate the prevalence of trochlear dysplasia in the general
population. Our hypothesis was that, while trochlear dysplasia is not
uncommon, there is a low prevalence of severe dysplasia in the general
population. Study Design: Descriptive epidemiology study. Methods: Five observers were asked to evaluate 692 skeletally mature femoral specimens
from 359 skeletons for trochlear dysplasia at 2 time points. We further
subclassified the dysplastic trochlea in 62 femora with the highest rated
degree of dysplasia. Results: Sex (P = .11) and race (P = .2) had no
effect on the severity of dysplasia. Interobserver reliability was excellent
(0.906 and 0.904), and intraobserver reliability was good to excellent
(0.686 to 0.808). The percentages of trochlea graded as normal, mildly
dysplastic, moderately dysplastic, and severely dysplastic were 61.5%,
21.4%, 12.7%, and 4.4%, respectively, in the first evaluation, and 58.5%,
23.7%, 12.7%, and 5.1% in the second evaluation. Of the 62 trochlea with the
highest scores for dysplasia, 36 had trochlear dysplasia without a
supratrochlear spur, 8 had trochlear dysplasia with medial femoral condyle
hypoplasia, and 18 had trochlear dysplasia with a supratrochlear spur. Conclusion: Observers with differing degrees of clinical experience had similar opinions
on the degree of trochlear dysplasia. Also, our cohort showed that moderate
to severe dysplasia is not uncommon, as it is present in approximately 17%
of knees in our cohort. Our findings also suggest that clinicians are
speaking the same language when identifying and describing trochlear
dysplasia on gross inspection.
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Affiliation(s)
- Gabriel I Onor
- Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Sercan Yalcin
- Cleveland Clinic Orthopaedic and Rheumatologic Institute, Cleveland, Ohio, USA
| | - Scott G Kaar
- Department of Orthopaedic Surgery, St. Louis University, St. Louis, Missouri, USA
| | - J Lee Pace
- Elite Sports Medicine, Connecticut Children's Medical Center, Farmington, Connecticut, USA
| | - Paolo Ferrua
- Gaetano Pini Orthopaedic Institute, University of Milan, Milan, Italy
| | - Lutul D Farrow
- Cleveland Clinic Orthopaedic and Rheumatologic Institute, Cleveland, Ohio, USA
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