Publications by authors named "Asif Ilyas"

Purpose: Thumb basal joint arthroplasty (BJA) performed for thumb basal joint arthritis is associated with high patient satisfaction. However, complications requiring reoperation occur, with a previously reported early reoperation rate (within 2 years) of 1.5%.

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The opioid crisis has been an issue in the United States since the mid-1990s, claiming numerous lives and presenting a significant challenge to health care clinicians. Various preoperative, intraoperative, and postoperative strategies aimed at reducing opioid consumption can be used by orthopaedic surgeons to help minimize this crisis. Preoperative screening tools can help identify patients at risk for prolonged opioid use, allowing for tailored interventions and counseling.

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Purpose: The purpose of this study was to identify and characterize factors that may contribute to revision surgery following primary cubital tunnel release (CuTR) surgery.

Methods: A retrospective study was performed by reviewing all patients who underwent CuTR at a single institution between 2014 and 2021. Only primary CuTR surgeries were included.

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Background: Cold intolerance following digital nerve injury burdens patients significantly. To better understand how cold intolerance evolves in the setting of digital nerve injuries, a sub-analysis of a trial comparing conduit-based (CONDUIT) and processed nerve allograft (PNA) repairs was conducted. It was hypothesized that PNA repairs would alleviate cold intolerance more effectively, especially for longer nerve gaps.

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Article Synopsis
  • The combination of xylazine and illicit fentanyl leads to serious soft tissue injuries, including deep tissue necrosis, due to its impact on tissue toxicity.
  • Xylazine, although a non-opioid tranquilizer, enhances the euphoric effects of fentanyl, increasing the risk of abuse and dependence.
  • The rise in xylazine-adulterated opioids, particularly in cities like Philadelphia, necessitates a multidisciplinary approach in managing the resulting wounds, emphasizing the roles of hand and reconstructive surgeons.
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  • This study investigates the effectiveness of the suture suspensionplasty technique for treating thumb carpometacarpal joint arthritis following trapeziectomy in 42 patients over an average follow-up period of 2.1 years.
  • Outcomes measured included pain levels, disability scored via QuickDASH, and the maintenance of trapezial space through radiographic analysis.
  • Results indicated that suture suspensionplasty maintained 42% of trapezial space and showed positive functional outcomes, similar to other surgical techniques for this condition.
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  • A study investigates the occurrence of asymptomatic triangular fibrocartilage complex (TFCC) changes in patients who underwent wrist MRIs for reasons other than ulnar-sided wrist pain.
  • Of the 132 patients reviewed, 44% showed TFCC abnormalities on MRI, while 80% of those with ulnar-sided pain had similar findings.
  • The results emphasize the need to consider a patient's symptoms alongside MRI findings, as many with non-painful TFCC changes might be identified in routine scans.
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  • Time-driven activity-based costing (TDABC) offers a more precise estimation of direct variable costs for carpal tunnel release surgeries compared to traditional methods, examining costs between monitored anesthesia care (MAC) and wide awake local anesthesia no tourniquet (WALANT).
  • A study analyzed 474 surgeries (182 MAC vs. 292 WALANT) to determine facility costs, revealing MAC-CTR was $170 more expensive overall due to higher personnel and supply costs.
  • The findings indicate MAC-CTR is 35% costlier to facilities than WALANT-CTR, emphasizing the need to minimize intraoperative personnel to reduce costs in carpal tunnel releases.
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Purpose: Distal radius fractures (DRF) are among the most commonly encountered fractures. The population of the United States is rapidly growing, aging, and diversifying. This study was undertaken to better understand current incidences and treatment trends across all ages, gender, and races to inform resource allocation and to potentially address treatment inequities.

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Purpose: The purpose of the study was to determine if perioperative prescription anticoagulant (AC) or antiplatelet (AP) medication use increases the rate of revision surgeries or complications following wide-awake hand surgery performed under local anesthesia.

Methods: All patients who underwent outpatient wide-awake hand surgery under local anesthesia without a tourniquet by two fellowship-trained orthopedic hand surgeons at a single academic practice over a 3-year period were included. Prescription history was reviewed to determine if any prescriptions were filled for an AC/AP drug within 90 days of surgery.

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Purpose: Injury to the scapholunate (SL) interosseous ligament (SLIL) is a common cause of carpal instability. Internal brace augmentation has been used in various ligament repair procedures; however, further investigation of its outcomes in hand surgery is needed. This study aimed to examine outcomes for patients who underwent SLIL repair with internal brace augmentation.

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In recent years, new orthopaedic surgical simulation and virtual reality (VR) training models have emerged to provide unlimited education medium to an unlimited number of trainees with no time limit, especially in response to trainee work-hour restrictions. Surgical simulators range from simple wooden boxes to animal and cadaver models to three-dimensional-printed and VR simulators. The coronavirus disease 2019 pandemic further highlighted the need for at-home learning tools for orthopaedic surgical trainees.

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Fractures involving the lunate facet of the distal radius (commonly called the volar ulnar corner or "critical corner") are often difficult to recognize radiographically. "Lunate facet escape" refers to the displacement of this fragment after attempted distal radius fracture closed or open reduction methods. Lunate facet escape can have severe consequences including carpal collapse with pain, instability, and arthritis.

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Purpose: Forearm shaft fractures of the radius and/or ulna are typically repaired with plates and screws, with 3.5 mm nonlocking screws being generally recommended. However, smaller plates and screws, either nonlocking or locking, can also be applied.

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Purpose: Distal radius fractures (DRFs) are among the most common fractures and occur among all age groups. Carpal tunnel syndrome (CTS) is a known sequela of DRFs, but its incidence is poorly understood. This study was undertaken to determine the incidence of CTS following a DRF, with the hypothesis being that CTS occurs more commonly after nonsurgical treatment of a DRF.

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Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most widely used and prescribed medications because of their important role in reducing inflammation and pain, in addition to their non-addictive properties and safety profiles. However, some studies have documented an association between NSAIDs and delayed union or nonunion of joint arthrodesis procedures due to a potential inhibition of the bone's inflammatory healing response. As a result, some orthopedic surgeons hesitate to prescribe NSAIDs after an arthrodesis procedure.

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Background: Amid the ongoing national crisis of opioid misuse in the United States, medical cannabis (MC) has emerged as a potential alternative for chronic pain conditions. This study was performed to understand which orthopedic conditions patients are seeking MC certification for.

Methods: This prospective study was conducted at the Department of Medical Cannabis, Rothman Orthopaedic Institute, Philadelphia, PA, USA.

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Background: There are myriad strategies to reduce opioid consumption after total knee arthroplasty (TKA). Recent studies have suggested that preoperative counseling may reduce opioid use after a variety of orthopedic procedures. The purpose of this study was to investigate whether preoperative video-based patient education regarding opioid use and abuse reduces opioid consumption after TKA.

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Purpose: Metacarpal fractures are common injuries of the hand that often require operative repair. However, there is a paucity of data regarding the rate of reoperation and circumstances following metacarpal repair.

Methods: A retrospective review of all metacarpal fracture cases performed at a single academic institution between 2017 and 2021 was performed.

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Purpose: Intramedullary screw fixation has emerged as a popular approach for the treatment of displaced metacarpal fractures. The purpose of this study was to investigate the functional and radiographic outcomes of a newly designed, headless noncompressive fully threaded intramedullary nail (TIMN) for the treatment of metacarpal fractures.

Methods: A retrospective chart review was performed on patients who were treated with the INnate TIMN (ExsoMed) at a single academic institution with a minimum of 1-year follow-up.

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Purpose: Opioid stewardship ensures effective pain management while avoiding overprescribing of opioids after surgery. This prospective randomized study investigates the efficacy of a multimodal postoperative pain regimen compared to a traditional opioid-only pain regimen following elective outpatient orthopedic hand surgery. We hypothesized that patients receiving multimodal pain management would consume fewer opioids and report greater satisfaction than patients receiving only opioids.

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Purpose: There is no consensus regarding optimal closure for trigger finger release (TFR) surgery. The purpose of this study was to compare the number of postoperative visits and complications following TFR closure with nonabsorbable sutures versus those following TFR closure with absorbable sutures and skin glue. The hypothesis was that wound closure with absorbable sutures and glue will result in fewer postoperative visits, while having similar complication rates as that with nonabsorbable sutures.

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Purpose: This systematic review aimed to determine the incidence of complications following surgical fixation of an acute capitellum fracture. We secondarily aimed to compare the complication rate between anterior-to-posterior (A-P) versus posterior-to-anterior (P-A) screw insertion.

Methods: PubMed, EMBASE, and Scopus were searched to identify studies on surgical fixation of capitellum fractures in skeletally mature patients.

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Objectives: Intramedullary (IM) screw fixation of metacarpal fractures is a technique, which has gained in popularity owing to its simplicity, speedy rehabilitation, and good functional outcomes. A new, larger diameter, non-compression screw designed specifically for IM metacarpal fixation was recently introduced which could provide better fracture stability and reduce the risk of hardware failure. Our goal was to evaluate the strength of this screw compared to a first-generation screw.

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